4Health Magazine #186

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SENSITIVE TEETH? CUT BACK ON THIS

SIGNS AND SYMPTOMS

OF OBSESSIVE COMPULSIVE DISORDER

CAN YOU GET TWO EYE DISEASES AT ONCE?

HOW CAN I LOSE WEIGHT WHEN MY FEET HURT?

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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

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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4HEALTH

Sensitive Teeth? Cut Back On This

Study Shows Which Beverages Are Most Damaging to Enamel

11 10 Could You Have OCD?

Signs and Symptoms of Obsessive Compulsive Disorder

16 Can You Get Two Eye Diseases At Once?

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ACNE, OR ROSACEA?

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INTRODUCING MESODERM THERAPY FROM VK SKIN SPA

11

DENTAL PROBLEMS COULD BE CAUSING YOUR HEADACHES SHOULD YOU TAKE A DAILY ASPIRIN TO REDUCE RISK OF BREAST CANCER?

14

TIRED? ACHY? YOU COULD BE GETTING TOO MUCH IRON

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22 How Can I Lose Weight When My Feet Hurt?

Obesity Increases Risk of Foot Pain

32 Are You Delusional?

Five Signs That Someone You Love May Have Delusional Disorder

By Dr. Namik Yusufov, DDS, MDT

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Actress Roseanne Barr Reveals Her Loss of Vision

How to Tell the Difference Between Two Similar Skin Conditions

Studies Continue to Show Positive Results

Hemochromatosis More Common Than People Think

STOMACHACHE? IT COULD BE COLITIS

By Dr. Sam Weissman

WHAT’S CAUSING YOUR BELLY FAT?

By Dr. Prab R. Tumpati

THE PAIN OF TRIGGER POINTS How to Find Relief

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BACK PAIN? IT COULD BE A SPINAL FRACTURE

28

NON-SURGICAL LUNCHTIME FACE AND NECK LIFTING

30

YOUR SUMMER COLD COULD BE ALLERGIES

34

MY DOC RECOMMENDED BUNION SURGERY—SHOULD I DO IT?

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FEEL BETTER TODAY WITH NEW, NON-INVASIVE DEPRESSION TREATMENT

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EXPERIENCE OR BEDSIDE MANNER—WHICH IS MOST IMPORTANT?

Minimally Invasive Treatment Can Have You Feeling Normal Again

By Dr. Roman Rayham MD

Tips on How to Tell the Difference

Examining 3 Myths of Bunion Surgery

TMS Therapy Solution Requires No Drugs or Surgery

What to Look for When Choosing a Doctor

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4HEALTH

ACNE, OR ROSACEA? HOW TO TELL THE DIFFERENCE BETWEEN TWO SIMILAR SKIN CONDITIONS

nnn Lynn Merrell Sherry looked in the mirror and cringed.

Her face was breaking out again, and she’d just gotten it calmed down only four days before. She had a party to attend that night, and she was going to have to pile on the makeup to keep from looking like she’d been attacked by bees. Why was this happening?

Sherry’s problem may not be what she thinks it is. Instead of acne, she may have rosacea. The two skin conditions can look similar, and often confuse many people. How can you tell the difference? And if it is rosacea, what does that mean?

DIFFERENCE BETWEEN ACNE AND ROSACEA These two conditions can look like each other, and may also occur together. Acne is a disease that affects the oil glands and pores of the skin. The pores overproduce cells and become blocked, so the oil that normally drains to the surface is also blocked. As a result, bacteria grow underneath the surface, creating blackheads and whiteheads. Further inflammation can cause papules and pustules, commonly called pimples.

Rosacea, on the other hand, is a chronic skin disorder affecting about one in every 20 adults. The cause is unknown, but for some reason facial blood vessels dilate and the increased blood near the surface of the skin makes the skin look red or flushed around the nose, cheeks, chin, and forehead. Acne-like

bumps may appear, often in the red area of the central face.

How can you tell the difference? The best way is to see your dermatologist. Other clues include: n Blackheads are usually not present with rosacea, so if you have those, you may have acne. n Acne may affect the face, but also the back, shoulders, or chest. Rosacea affects only the face. n Rosacea usually shows up as flushing or redness, whereas acne usually doesn’t include flushing. n If you have rosacea, acne treatments will make it worse. Those with rosacea have extremely sensitive skin, so acne treatments actually aggravate their condition. n Rosacea can also affect the eyes, creating redness, dry eyes, and burning sensations. Acne does not affect the eyes.

RISK FACTORS FOR ROSACEA One of the biggest risk factors for rosacea is family history, so if someone in your family has it, rosacea may affect you as well. Fairskinned people are more at risk, particularly those of English, Scottish, and Swedish descent. Those between the ages of 30 and 60 are also more at risk, especially women going through menopause.

HOW DOES ROSACEA PROGRESS? Most dermatologists note that the signs and symptoms of rosacea can gradually get worse

without treatment. The skin may become more sensitive to previously tolerated cosmetics, cleansers, perfumes, and sunscreens, and the eyes may start to be affected. Later, flare-ups may begin to last longer, with the redness hanging around for days rather than hours. Over time, the redness can become nearly permanent and may be accompanied by larger facial pores. At its severe stage, which is rare, rosacea can cause facial lesions, disfigurements of the nose, and other thickening facial features.

SEE YOUR DERMATOLOGIST FOR TREATMENTS Medical therapy and lifestyle modifications can help reduce rosacea flare-ups and control signs and symptoms on a long-term basis.

Working with your dermatologist, you may try oral antibiotics and topical treatments.

You may change your cleansing routine to incorporate gentler products and become more diligent about avoiding the sun. Most important will be learning to avoid your «triggers»—those factors that cause your face to flush. Triggers may include sun exposure, hot or cold weather, alcohol, spicy foods, intense exercise, some medications, menopausal symptoms, and stress. By keeping track of your flare-ups, what you were doing when they happened, and the environment you were in, you and your doctor can identify your triggers and help you enjoy healthier and calmer skin. www.4health.net

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4HEALTH

SENSITIVE TEETH? CUT BACK ON THIS

STUDY SHOWS WHICH BEVERAGES ARE MOST DAMAGING TO ENAMEL nnn

Colleen M. Story

Have sensitive teeth?

Blame your soda. Or your fruit juice.

According to a recent study, it may be time to think about cutting back, or choosing a different sort of drink, because once that tooth enamel is gone, you can’t get it back.

ONE IN EIGHT PEOPLE SUFFER FROM TOOTH SENSITIVITY The 2013 survey of U.S. dental offices found that one in eight people has oversensitive teeth. They were found to be most common in young adults, women, and people who had receding gums or did at-home tooth whitening.

“The condition is impacting people’s lives,” said lead study author Dr. Joana Cunha-Cruz, “and they may avoid some foods.” If you have sensitive teeth, you know what she means. You eat something hot, cold, or sweet, and you get that jolt of pain in your mouth. Sometimes, it doesn’t go away until you rinse out or brush your teeth.

Why does this happen? A recent study blames it on what we’re choosing to drink.

ENAMEL USUALLY PROTECTS TEETH Teeth can become sensitive when the enamel on the outside of the tooth wears away.

Enamel is a protective coating that forms a hard shell around each of the teeth. It helps shield teeth from hard foods and extreme temperatures. Though considered harder than even human bone, it can dissolve or decay over time when exposed to acid and bacteria. Once it’s gone, it doesn’t grow back, and your teeth become much more vulnerable to whatever goes in your mouth.

Saliva helps support enamel, cancelling out acid and restoring the natural balance in the mouth after we consume something acidic.

It needs adequate time, however, to do its job.

If the teeth are assaulted again within a short time, repairs are halted and more damage is done. Over time, this process can result in damaged enamel that can’t be restored. And that results in sensitive teeth.

HOW TO PROTECT YOUR TEETH FROM ACIDIC BEVERAGES Does this mean you have to give up drinking soda and fruit juice? It would probably make your dentist happy. But if you’re not ready to take that drastic a step, try these tips instead: n Cut back: Are you drinking more soda and

THOSE WHO DRINK MORE SODA AND JUICE SHOW MORE TOOTH DAMAGE According to a recent 2015 study, nearly 80 percent of participants had evidence of dental erosion (damaged enamel). Those with the most severe tooth wear were the ones who consumed more soft drinks and fruit juices every day.

The acids in these drinks attack the enamel on your teeth, gradually wearing it away. Soft drinks contain citric acid, which is highly corrosive. Fruit juices also may contain citric, malic, and tartaric acids. All of these drinks also contain sugar, which feeds bacteria in the mouth. Bacteria also excrete acid, so when you drink these types of beverages — especially if you drink several servings a day — you’re creating dangerous and destructive conditions in your mouth for your teeth.

In 2009, researchers reported that soft drinks have acids and sugars that erode enamel, and can cause harmful effects on the teeth and oral health. In 2013, researchers found something even more alarming: drinking diet soda was found to take a toll on teeth comparable to years of smoking crystal meth or crack cocaine.

In other words, your addition to soda could be as bad for your teeth as an addiction to an illegal drug.

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fruit juice than you are water? If so, you’re consuming way too much. Try to limit your sugary beverage to just once a day.

Choose healthier options: When you’d normally reach for a soda or fruit juice beverage, choose water or milk instead.

Rinse afterwards: When you do indulge, rinse your mouth out with water when you’re done. Don’t brush until at least an hour has passed — brushing when your teeth are weakened by acid can cause more damage to the enamel.

Drink through a straw: This can help keep some of the acidic beverage off your teeth.

Choose root beer: Of all the soda flavors, root beer was found in studies to be slightly less acidic than other options. Diet soda also caused less corrosion than real-sugar versions.

Watch out for energy drinks: These were found in studies to have higher acidity levels than soda, and caused more tooth enamel erosion.

Drink, don’t sip: Sipping on a soda throughout the day bathes your teeth in a continuous sea of acid. Drink the beverage fairly quickly, and then rinse with water.

Chew sugarless gum: Pop in a piece after drinking your soda to help clean out your mouth. www.4health.net

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4HEALTH

SHOULD YOU TAKE A DAILY ASPIRIN TO REDUCE RISK OF BREAST CANCER? STUDIES CONTINUE TO SHOW POSITIVE RESULTS

nnn Colleen M. Story If you have a headache or backache, an aspirin can be a lifesaver. Taken every day at a low dose, it can also help reduce the risk of a second heart attack or stroke. Even if you haven’t suffered from one of these yet, if you have been diagnosed with cardiovascular disease, a daily aspirin may help you avoid ending up in the hospital.

The fact that aspirin can do all this — relieve pain and inflammation and reduce the risk of heart attack and stroke — is pretty miraculous. Recent evidence, however, has also suggested that it may help protect you from cancer. In a 2015 study, for example, researchers found it to be effective at blocking the growth of breast tumors.

Should we all be taking a small aspirin a day to keep ourselves healthy?

STUDY SUGGESTS ASPIRIN MAY KILL BREAST CANCER CELLS In a recent 2015 study, researchers placed breast cancer cells in 96 separate plates and then incubated them. Over half were exposed to differing doses of aspirin, while the other half were left untreated. Results showed that those cells that were treated with aspirin had a dramatically increased rate of cell death. Many of the cells that didn’t die off were left unable to grow.

Researchers then conducted a second stage of the study. They gave some mice afflicted with aggressive tumors 75 milligrams of aspirin a day — a low dose — and left the other mice untreated. After 15 days, mice that received the aspirin had tumors that were, on

average, 47 percent smaller than those in the mice that were untreated.

Finally, in a third stage of the study, researchers gave a new group of mice aspirin for 10 days, and then exposed them to cancer cells. Those that received the aspirin had significantly less cancerous growth than the control group.

“We found aspirin caused these residual cancer cells to lose their selfrenewal properties,” said lead researcher Dr. Sushanta Banerjee. “Basically, they couldn’t grow or reproduce.” He went on to say that the study suggested aspirin may be used after chemotherapy to help prevent relapse, and may also be able to be used as a preventative measure against breast cancer. He acknowledges that there are risks to taking a daily aspirin, but noted that in this study, a low dose was all that was required.

OTHER STUDIES SHOW PROMISING RESULTS Other studies have shown similarly positive results when it comes to aspirin’s ability to fight cancer, including colon, esophagus, stomach, rectum, and prostate cancer. But doctors have been hesitant to recommend people take a low-dose every day because of the potential risks. Daily aspirin can increase the risk of bleeding in the stomach, small intestine, and brain. Combining it with other medications that “thin” the blood, like warfarin and dabigatran, for example, can also increase risk of bleeding.

Another study first published online in 2014 concluded that while it’s important

to be aware of the risks and potential side effects, “taking aspirin daily looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity, and will probably be much easier to implement,” according to study author Jack Cuzick, Ph.D. Researchers in that study also found that daily aspirin use for 10 years in people between the ages of 50 and 65 would decrease risk of colon cancer by 30–35 percent, esophageal cancer by 25–30 percent, and stomach cancer by 25–30 percent.

Other studies have reported similar estimates. In 2012, for instance, researchers suggested that taking aspirin daily for about 5 years could decrease digestive cancers by 40 percent. Doses for all studies have been between 75 and 100 mg per day.

On the other hand, daily aspirin use was also linked to an increase in the risk of dying from digestive tract bleeding.

SHOULD YOU TAKE A DAILY ASPIRIN TO PREVENT CANCER? Though the studies look promising, researchers have still resisted recommending that everyone age 50 and older take a daily aspirin. Instead, they advise people to check with their doctors. Some who have a high risk of cancer (because of smoking, genetics, or other issues) may find that the potential benefits outweigh the risks. Others, however, who have a low risk and are living healthy lifestyles may be better off waiting. It’s also important to realize that older people (over age 70) and men are more at risk for gastrointestinal bleeding from aspirin. www.4health.net

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TIRED? ACHY? YOU COULD BE GETTING TOO MUCH IRON HEMOCHROMATOSIS MORE COMMON THAN PEOPLE THINK

n nn Colleen M. Story Darren wasn’t feeling well. His joints were always aching, and he was frequently tired.

Fifty-five years old, he thought maybe he was just feeling his age. But then things began to get worse. He felt weaker and weaker, and it didn’t seem to matter how much sleep he got each night. He went to the doctor, and though he went through a number of diagnostic tests, no one could figure out what was wrong. Darren began to feel it was all in his head, until a friend recommended he get his iron levels checked.

Darren was stumped. Iron levels? But he was at his wit’s end, so he asked his doctor for a blood test. The results came back showing his iron levels were through the roof. The doctor diagnosed Darren with hereditary hemochromatosis.

A genetic disorder, hemochromatosis causes the body to absorb an excessive amount of iron from the diet, and then store that iron in various organs, including the liver, pancreas, heart, tests/ ovaries, skin, and joints. Though more common than other genetic conditions like cystic fibrosis, down syndrome, and sickle cell disease, hemochromatosis remains largely unknown, putting many people at risk of serious symptoms like diabetes, impotence, cancer, and heart failure.

WHAT IS HEMOCHROMATOSIS? Hemochromatosis is the most common single-gene disease in the U.S., affecting one out of every 200-300 people. It’s often caused by the mutation of one gene—called “HFE.” Each child inherits one HFE gene from each parent. If both genes are abnormal or mutated,

the child may then develop hemochromatosis.

About 70 percent of people who inherit the two genes will develop iron overload, and will also pass the mutation onto their children.

Those who inherit only one mutated gene will not develop the disease, but will be a carrier.

The defective gene then decreases the production of “hepcidin,” which is a liver protein that normally prevents the absorption of too much iron from the diet. Without enough of this hepcidin, people with hemochromatosis gradually develop iron overload.

The symptoms of hemochromatosis typically do not appear until adulthood, usually between the ages of 50 and 60 in men, and after age 60 in women. Women are more likely to develop symptoms after menopause, and white people are more likely to be affected than blacks and Asians. Men are 24 times more likely to experience complications of the disease than women.

There are other types of hemochromatosis as well. Juvenile hemochromatosis develops in young people between the ages of 15 and 30, and involves a mutation of a different gene called “HJV.” Neonatal hemochromatosis cause iron to build up in the liver of a developing fetus, and is thought to be an autoimmune disease. Secondary hemochromatosis is not inherited, but develops in response to other disease like anemia, chronic liver disease, or an infection.

WHAT ARE THE SYMPTOMS? The tricky thing about hemochromatosis is that it’s symptoms often mimic those of other

health problems. Joint pain and fatigue, for example, can be caused by a number of disorders, so it can be difficult for doctors to realize that hemochromatosis may be the cause.

Other symptoms may include hair loss or hair thinning, abdominal pain, weight loss, frequent colds and infections, headaches, and hypothyroidism.

Though the disease is treatable, if allowed to continue untreated, it can cause more serious problems such as liver failure, heart failure, diabetes, and even death. If you have symptoms—particularly if you have family members with the disease—ask your doctor for a blood test to measure your iron levels.

If you’re concerned about passing on mutated genes to your children, ask your doctor about genetic testing, which is also available.

HOW IS HEMOCHROMATOSIS TREATED? Standard treatment for hemochromatosis involves the regular removal of blood. As in a blood test or when you donate blood, the nurse simply takes about a pint of blood from a vein in your arm. How many withdrawals are needed depends on the amount of iron buildup in the body. Most patients have them once or twice a week for a year or more.

Once the iron level is lowered to a safe level, patients need fewer withdrawals, usually only a few times a year. Early detection and treatment—before the iron causes too much damage—offers the best outlook for long-term quality of life, so be sure to check with your doctor if you are concerned about any symptoms. www.4health.net

Gastroenterology | 4HEALTH15

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STOMACHACHE? IT COULD BE COLITIS WHY YOU SHOULD SEE YOUR GASTROENTEROLOGIST TODAY Have you ever had a really bad stomachache, accompanied by diarrhea or other intestinal complaints? Most of us have at one time or another.

Usually, it passes and we go on with our lives, but sometimes, it can signal something a little more serious.

Colitis, which is the inflammation of the mucus membrane located in the large intestine, is one of the most common gastroenterological diseases. It may be only a temporary illness, related to an infection or medication, or it may be part of the spectrum of inflammatory bowel disease, which includes ulcerative colitis and Crohn’s disease.

Today, we will discuss with gastrointestinal specialist, Dr. Sam Weissman, how colitis can be dangerous, and why we shouldn’t ignore it.

WHY DO MOST PEOPLE WHO EXPERIENCE THE SYMPTOMS OF COLITIS FAIL TO CALL THEIR DOCTORS? There are many reasons. First, the symptoms — which include flatulence, rumbling in the abdomen, bloating, spastic pain and diarrhea — generally feel quite normal and harmless. One may think that he or she ate something that wasn’t fresh and after several days, everything will go back to normal.

Second, over-the-counter drugs, available to anyone in the pharmacy, quickly eliminate the symptoms of colitis, which can make us think that it’s gone away.

Third, many patients, especially women, simply feel shy and nervous about contacting their doctors about such a delicate, personal problem.

Fourth, people don’t know that neglecting colitis over the long term can actually lead to very serious consequences for health.

WHEN WE FAIL TO TREAT COLITIS, WHAT SORT OF COMPLICATIONS CAN DEVELOP? Many. In serious cases, the inflammation can disrupt the function of the small intestine and colon, creating multiple digestive disorders that impair overall quality of life.

Over time, for example, certain types of colitis can develop into ulcerations, such as inflammatory bowel disease or ischemic colitis, which may require long-term treatment.

In addition, there is always the danger that colitis symptoms may be a sign of something more serious.

Intestinal inflammation may signal Crohn’s disease, for example — a serious, potentially life-threatening disorder — or other complications like large internal bleeding, peritonitis, ileus, internal and external fistulas, strictures of the colon, and intestinal cancer. www.4health.net

WHEN SHOULD SOMEONE SEE A GASTROENTEROLOGIST? Only extremely alarming signals should make an individual literally run to his or her physician. These include the presence of mucus and/or blood in the stool, defecation more than 10 times a day for 2–3 days, severe weight loss, severe weakness, and fatigue.

WHAT ARE THE POSSIBLE CAUSES OF THESE DANGEROUS SYMPTOMS? There are many causes. Only an experienced, qualified specialist can accurately determine them, and decide an optimal treatment that will quickly and effectively put the patient back on his or her feet.

Colitis can be caused by various kinds of poisoning: food, radiation, toxic, and medication (most often a result of taking antibiotics and/or non-steroidal anti-inflammatory drugs like aspirin and ibuprofen).

There are two other common causes — infectious (viruses, pathogenic bacteria, fungi) and parasitic (worms,amoeba dysentery,Trichomonas) infections of the intestine. Also, colitis may occur because of a food or drug allergy, a fiber deficit in the diet, lesions of intestinal blood vessels, and tuberculosis, as well as chronic diseases of the cardiovascular system, kidney, liver, pancreas, stomach and intestines.

HOW IS YOUR OFFICE UNIQUE IN TREATING COLITIS? It depends on the type of colitis (infectious, ulcerative, parasitic, etc.), its severity, the phase of the disease, and the general state of the patient.

In my office, treatment emphasizes a medical, holistic, and dietary approach. We recommend a bland diet consisting of smaller and more frequent steamed and blended foods (vegetables, meat, fish), as well as the exclusion of milk, beans, alcohol, spicy, smoked, and salted dishes.

Depending on the type of colitis, treatment may include antiparasitic or antibacterial therapy.

Additionally, as a rule, we may also prescribe vitamins, adsorption, enzyme preparations, noncarbonated mineral water, therapeutic enemas, and herbal teas and infusions of herbs (sage, blueberry, oak bark, etc.).

In any case, it should be understood that only early diagnosis and comprehensive optimal therapy can help get rid of the unpleasant symptoms of colitis and reduce the risk of its recurrence, as well as serve as an effective prevention of more serious diseases of the digestive system. Thus one should not ignore colitis, but promptly refer to a gastroenterologist.

NAME:

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

SPECIALTY: gastroenterologist

HOSPITAL AFFILIATIONS: New York Methodist Hospital

PROFESSIONAL MEMBERSHIPS American College of Physicians American Gastroenterological Association

AWARDS AND PUBLICATIONS Roth Scholarship for Biomedical Research

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

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4HEALTH

COULD YOU HAVE OCD? SIGNS AND SYMPTOMS OF OBSESSIVE COMPULSIVE DISORDER

nnn Lynn Merrell Laura and her friend Bobbie were making cookies for their friend’s baby shower. After popping the cookie sheet into the oven, Laura washed her hands again. It was the fourth time in the last five minutes.

“Geesh, Laura,” Bobbie said. “You OCD or what?”

Laura smiled. “No, just don’t like that oily feel on my hands.”

Later that night, though, Laura wondered. Here she was over the sink again. Her hands were dry and cracked from so much washing. Was she going a bit overboard?

It’s common for any of us to repeat our actions now and then. But when does that tendency to “obsess” about cleanliness or other issues cross over into something that’s unhealthy?

OCD (obsessive compulsive disorder) is a serious medical condition that affects about one percent of adults. Here’s how to tell if you or a loved one may be displaying symptoms, and whether or not you need to take action for your health.

WHAT IS OCD? Obsessive compulsive disorder (OCD) is a chronic, long-lasting disorder in the brain that leads to uncontrollable, recurring thoughts (obsessions) and behaviors (compulsions). These thoughts and behaviors get in the way of every day life, and tend to cause the individual anxiety. n Obsessions: Thoughts, images, or impulses that occur over and

over again and seemed to “take control” of a person’s mind. These www.4health.net

4HEALTH are often accompanied by uncomfortable feelings, and a need to get things “just right.” Some examples include: fear of germs or contamination, aggressive thoughts toward oneself or others, having things in perfect order, and unwanted or taboo thoughts. n Compulsions: Repetitive behaviors or thoughts a person uses to try to neutralize their obsessions. These occur as a result of the obsessions. They are often ritualistic, undertaken again and again. So for example, excessive handwashing to get rid of germs, or consistently arranging things in perfect order, or counting to six while removing each article of clothing, or repeatedly checking on things.

OCD can start in childhood, usually between the ages of 7 and 12 years of age, though it can be diagnosed at any time. It’s more common in boys than in girls, but in adulthood, more women than men are affected.

CAUSES AND TREATMENTS FOR OCD Scientists don’t yet know why some people develop OCD, but they have some theories. So far, they believe that it runs in families, that genes play a role, and that problems in the

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n Your obsessive thoughts and compul-

In other words, if you are not allowed to rearrange your things to be in perfect order — or if you feel you shouldn’t because you are in mixed company — and being unable to do so makes you feel unsafe and out of control, you may have OCD. n Your compulsions interfere with your daily life. “Having” to go through your rituals is affecting your other activities.

For example, your routine of checking the locks several times on your doors before leaving for work is either making you chronically late, or requiring you to get up an hour early to accommodate this ritual. n Your behavior doesn’t make sense: You know, yourself, that your behaviors don’t make sense, or others are concerned about you. You know that all the extra thoughts in your head are not normal.

sions seem unreasonable. For example: even after scrubbing your hands well, you are still obsessed with germs and worry you didn’t clean them well enough, leading you to wash yet again. n You feel “unsafe” if you aren’t allowed to follow through on your compulsion.

If you or a loved one has any of these symptoms, or you suspect OCD may be an issue, check with your doctor. The good news is that OCD is treatable, and with medical help, patients can feel much better.

way the front part and deeper structures of the brain communicate are all involved. Children who are abused are also at a higher risk for developing OCD. Treatments usually involve medications, to help stabilize neurotransmitters in the brain, and psychotherapy. The most common medications used are selective reuptake inhibitors (SRIs) that help improve symptoms by 40 to 60 percent. Certain types of therapy have also been found to be just as effective as medication, and sometimes more effective, reducing symptoms by 60 to 80 percent.

DO I HAVE OCD? How can you tell if you may be affected by OCD? Your best bet is to visit with your doctor and/or psychiatrist, but you can also look for the following signs:

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BACK OR NECK PAIN? HEAD TRAUMA? SOPHISTICATED TREATMENT AVAILABLE NEAR YOU! AWARD-WINNING DOCTOR SUNDARESAN OFFERS EXPERIENCED NEUROLOGICAL CARE Did you know that if you’re suffering from back pain, neck pain, head trauma, spinal problems, or other disorders related to the central nervous system, you can find some of the top doctors in the field right in your home town?

We had a chance to speak with Dr. Narayan Sundaresan — one of the top neurosurgeons at Memorial Sloan-Kettering Cancer Center for seven years — about his practice in the New York City area. Dr. Sundaresan has authored over 100 abstracts and peer-reviewed articles in the top oncology and spine journals, and currently works with a team of neurosurgical specialists of NY Neurosurgery, PC and Generations Neurosurgery, PC at the largest medical center.

WHAT DO NEUROSURGEONS TREAT? Neurosurgeons like Dr. Sundaresan specialize in disorders of the central and peripheral nervous system, including the following: n traumatic injuries to the brain, skull, spi-

nal cord, or nerves n tumors in the brain, spinal cord, nerves,

skull, or spine n back pain caused by pinched nerves, in-

fections, fractures, and ruptured or bulging disks n neurovascular disorders such as aneurysms, strokes, and brain hemorrhages n brain disorders like epilepsy and Parkinson’s disease n infections of the brain and/or spinal cord

DOCTOR SPECIALIZES IN TREATING BACK AND NECK PAIN Dr. Sundaresan has managed a level-one trauma center for 25 years, and says he still sees a substantial amount of neurosurgery done for head trauma and spinal trauma from motor vehicle accidents. He also treats a substantial number of gunshot wounds, but says that his actual specialty is in treating patients with degenerative conditions, like back and spine problems.

«I would venture to say that more than 25% of human beings have problems with this,» he says, «and that’s the group I’m focused on right now as they also require surgical treatment.» He notes that back problems often come from workrelated injuries, especially with patients who are in the construction business, or who have been in car accidents.

«The majority of my patients come in because they have a herniated disc or ruptured disk in the neck or back and they’re in excruciating pain from pressure on the nerves. And it’s taking care of them that’s a big part of my practice.»

THE IMPORTANCE OF A GOOD DOCTORPATIENT RELATIONSHIP As one of the youngest neurosurgeons in the nation, Sundaresan was working in the field before technology became so critical in the care of the central nervous system. Prior to the heavy use of CAT scans and MRIs, for instance, it was important for a doctor to be able to make a diagnosis without a lot of special equipment.

«In the early days there was a lot of good judgment involved,» he says. «Surgeons of my generation learned by talking to the patient, listening to their history, being personally involved. The clinical skills were very, very important. The way that we were taught was we had to assume personal responsibility not only in surgery, in their preoperative care, their postoperative care, and ongoing care, so there was a very complete relationship.»

In the NY Neurosurgery PC, the doctors pride themselves on continuing the idea that complete care must involve a solid foundation of communication and trust between doctor and patient.

RUSSIAN-SPEAKING NEUROSURGEON JOINS NY NEUROSURGERY PC With years of experience treating people with all types of backgrounds, Dr. Sundaresan sees a large number of Russian-speaking patients,

particularly at his Coney Island location, where he works with Generations Neurosurgery, PC. «Coney Island Hospital is unique because it is the hospital for a very large group of Russians,» he says. Most of the physician’s assistants at Coney Island Hospital speak Russian, so patients are very comfortable there.

«We have just hired for our group a Russianspeaking neurosurgeon,» he says, «who wants to settle in this community and build a practice and serve the Russian community.

It’s very difficult for us to find someone with that background. But we have now gotten an extremely well trained doctor who wants to join us.»

In fact, the doctor’s practice is well suited to take care of all types of neurosurgical issues in the local community, and encourages patients in the Brooklyn area to visit Coney Island.

«I think for the outsider who looks at Coney Island or looks at another hospital you’re not aware as to how sophisticated the services are,» he says. «But this hospital does have a lot of advanced tech in neurosurgery, and we have a very, very experienced neurosurgical team taking care of this. Patients don’t have to go to Manhattan — they have it right here.»

CONTACT DR. SUNDARESAN TODAY In addition to treating back and neck pain along with other neurosurgical conditions, Dr. Sundaresan is often sought out by patients overseas because of his expertise in dealing with complex tumors. He and his team have offices and treat patients in Manhattan, the Bronx, and Brooklyn. For more information, contact the clinic at 212–846–7575, or visit their website at www.nyneurosurgerypc.com.

Generations Neurosurgery, PC

(212) 876-7575 (844)-95-SPINE (77463) www.4health.net

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GENERATIONS

5 East 84th St, New York, NY 10028

2601 Ocean Parkway, 7th Fl Brooklyn, NY 11235

Bronx-Lebanon Hospital Center 199 Mount Eden Pkwy, 6th Fl Bronx, NY 10457

TOLL FREE 1-844-95-SPINE (77463)

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Obesity Medicine | 4HEALTH21

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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

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CAN YOU GET TWO EYE DISEASES AT ONCE? ACTRESS ROSEANNE BARR REVEALS HER LOSS OF VISION nnn Gordon Barclay In 2015, actress and comedienne Roseanne Barr revealed that she was going blind from macular degeneration and glaucoma. According to ABC News, the star admitted in April that she had been diagnosed with a combination of both eye diseases, and that she expects them to ultimately take her eyesight away.

“My vision is closing in now,” she said. “That one’s harsh, ‘cause I read a lot, and then I thought, ‘Well, I guess I could hire somebody to read for me and read to me.’ I just try and enjoy vision as much as possible…y’know, living it up.”

Do these diseases often occur together? If so, could you be at risk?

WHAT ARE MACULAR DEGENERATION AND GLAUCOMA? Age-related macular degeneration, or AMD, is the leading cause of vision loss in the U.S., affecting more than 10 million Americans. An incurable disease, it causes the deterioration of the “macula,” which is the central portion of the retina — that area in the back of the eye that’s needed for sharp, central vision, and that allows us to see straight ahead.

AMD typically affects people age 50 and older, and often progresses slowly, but in some cases it can proceed faster, causing vision loss in www.4health.net

4HEALTH one or both eyes. Symptoms are rare in the early stages, but may later include reduced central vision, blurred vision, visual disturbances like wavy lines, and difficulty adjusting to low light levels.

Glaucoma is a disease that damages the eye’s optic nerve, and over time, can result in vision loss and blindness. The optic nerve connects the retina to the brain, and in those with glaucoma, the fluid pressure in the eye is usually higher than normal, which gradually damages the nerve.

Glaucoma is the second leading cause of blindness in the U.S., and usually occurs in people over the age of 40. Those who have a family history of the disease are at increased risk. Most cases have few or no symptoms in the early stages. As the disease progresses, symptoms may include reduced peripheral vision, tunnel-vision, sensitivity to light, double vision, excess tearing, seeing spots, and a dark spot at the centre of vision.

DO THESE DISEASES USUALLY OCCUR TOGETHER? Though these are the two most common eye diseases, they kind of have an opposite effect. Whereas AMD affects central vision, glaucoma affects peripheral vision. Even in the later stages of glaucoma, patients may still have 20/20 vision through a tunnel-like area, while the entire side area of the vision is gone.

If both of these diseases occur together, as they have with Roseanne Barr, the area of the vision that is affected can be much larger than in either disease alone. It doesn’t seem that the two occur in the same person very often, but the risk factors associated with each are similar.

For example, the following are risk factors for both diseases: n Genetics — having a family history of either disease increases risk

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n Race — whites are more likely than African-Americans or His-

panics to develop AMD, while glaucoma is more common in African-Americans and Hispanics than in whites. n Age — risk for AMD increases in those 50 years and older; risk for glaucoma increases in those 60 years and older. n High blood pressure — increases risk for glaucoma and AMD. n Smoking — increases risk for both diseases.

TREATMENT OVERVIEW Both diseases remain incurable, but there are treatments that can help slow their progression, so patients can hold onto their vision for a longer period of time. Medicated eye drops, for example, help lower pressure in patients with glaucoma, and there are also surgical options that can help relieve pressure and slow the damage to the optic nerve.

For those with AMD, studies have found that some nutritional supplements can help slow progression of the disease, including a combination of vitamins C and E, beta-carotene, zinc, and copper.

There are also other treatments like injections, laser surgery, and photodynamic therapy, which can help to slow the rate of vision loss.

The best approach is prevention. The steps are similar for both diseases:

Don’t smoke Exercise regularly Maintain a healthy weight Get annual eye exams to detect any changes early Manage diseases like high blood pressure, cardiovascular disease, and diabetes n Eat a healthy diet that’s rich in nutrients n n n n n

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THE PAIN OF TRIGGER POINTS HOW TO FIND RELIEF nnn Lynn Merrell Brittney was experiencing severe pain on the right side of her neck, on top of her shoulder and between her shoulder blades. It was so bad that she found herself taking time on her lunch breaks to rotate ice and heat on the painful areas.

Max was a body builder, but he too was experiencing chronic pain in his shoulders, and was buying bottle after bottle of Lidocaine Gel. Both of these individuals have what is called “trigger points”—a common cause of pain, from chronic back and neck pain to headaches and hip pain. What are these sensitive areas, and is there anything you can do about them?

WHAT ARE TRIGGER POINTS? Trigger points are tiny knots that develop in a muscle when it’s overused, overworked, or injured. If you regularly use your muscles in a certain way over and over again during work or play, you may develop trigger points. Poor posture, regularly carrying a heavy purse, or having weak muscles also puts you more at risk.

These hyperirritable spots are usually located in a taut band of skeletal muscle and are extremely sensitive. They can produce pain when touched, but can also produce so-called “referred” pain in nearby areas. For example, if a friend or massage therapist presses on a trigger point, you may also experience a headache.

WHAT ARE THE COMPLICATIONS OF TRIGGER POINTS? In addition to causing pain, if left untreated, trigger points can lead to you to change how

you usually move, sit, or stand, as you instinctively alter your habits to protect yourself from pain. By limiting the use of the injured muscle, however, you can weaken that muscle, and put additional stress on neighboring muscles, ligaments, and joints. This can create more trigger points, setting you up for a vicious cycle of pain.

HOW ARE TRIGGER POINTS TREATED? The first line of treatment for trigger points is usually trigger point therapy. This treatment method uses applied pressure to the trigger points themselves to relieve muscular aches and pains. Through alternating phases of pressure and release, a massage therapist or physical therapist works to release constricted areas in the muscles, involving the patients in deep breathing and relaxation to gradually alleviate pain.

Patients may also treat trigger points themselves with the use of certain tools. After receiving a diagnosis from a doctor or physical therapist, who can help you determine exactly where the trigger points are, you can use various pieces of equipment to massage them. Some people use a tennis or golf ball, place it on a hard surface, and gently roll the body over it where the trigger point is. Some invest in devices shaped like an “S” (such as the “Body Back Buddy” and “Backnobber”) to press on trigger points in hard-to-reach areas like the back, neck, and shoulders.

TRIGGER POINT INJECTIONS When standard trigger point therapy doesn’t work, trigger point injections performed by a physician may offer more relief. These involve injecting a substance, such as a local anesthetic, into the trigger point to inactivate it. Socalled “dry needling” may also be performed,

in which the doctor inserts an empty needle into the spot to stimulate blood flow and reduce spasms.

A series of different studies have shown that injections can provide temporary relief.

A 2009 study from Oregon Health and Science University School of Medicine found that injections of a local anesthetic into the shoulder muscle provided immediate but temporary improvement in the range of neck motion and pain levels in people with whiplash. Other studies have shown injections to be helpful in plantar heel pain, and in chronic neck, shoulder, and back pain.

FINDING LASTING RELIEF Though injections are considered safe and effective, they may not provide lasting relief.

For that, patients need to determine what is causing the trigger points to develop in the first place, and take steps to address those factors. The following tips may help: n Try to practice good posture when stand-

ing and sitting n Stand with your weight on both feet,

n

n n n

n n

rather than leaning on one or the other, which can strain knee and hip joints If your job requires you to sit for long periods of time, get up at least once every hour to stretch and move around Stay warm—cold is a common trigger point activator Practice deep breathing Ask your physical therapist for preventative stretches, and perform them regularly Consider acupuncture and regular massage treatments Try yoga or tai chi to loosen and stretch tight muscles www.4health.net

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BACK PAIN? IT COULD BE A SPINAL FRACTURE MINIMALLY INVASIVE TREATMENT CAN HAVE YOU FEELING NORMAL AGAIN Dan was out working in the yard when a sharp pain seized his back. He grimaced and dropped his tools. Ouch! This was a bad one.

Eventually, he was able to get back to the house, but the walking was difficult. He figured he would wait it out, but the next day it was still there. That’s when his wife insisted he go to the doctor.

Dan was diagnosed with a spinal fracture — something that more than a million people suffer from every year. Though there are different types, all of them can cause sudden back pain that fails to go away.

Fortunately, there is a minimally invasive treatment that can repair the fracture and ease the pain. USA Vascular Centers offers this treatment in the New York area, and urges anyone experiencing this type of pain to come in for an evaluation.

WHAT IS A SPINAL FRACTURE? Spinal fractures occur when the bones in the spine (vertebrae) weaken, break, and collapse. They may be caused by a trauma or injury, such as a fall, car accident, sports injury, or act of violence. Osteoporosis, cancer, or benign lesions can also cause the vertebrae to become weak and brittle, resulting in fractures.

If you have only a mild fracture, you may experience only mild pain.

A more severe one, like Dan’s, may force you to walk hunched over to avoid worsening the pain. Usually this means the vertebra has affected the spinal cord or nerves.

Other symptoms of spinal fracture, besides pain and difficulty walking, may include numbness, tingling, weakness, or bowel/bladder dysfunction.

You may be surprised to learn that spinal fractures are quite common — twice as common as hip fractures, and three times more common than breast cancer.

HOW DO I KNOW IF I HAVE A SPINAL FRACTURE? The only way to find out for sure is to see your spinal doctor.

A complete physical examination, along with x-rays and imaging technology, can help determine why you’re experiencing pain.

DO I REALLY NEED TREATMENT? Treatment is important to long-term mobility and comfort. If you leave the fracture without addressing it, it may heal in the “broken” or “caved in” position, which could cause you to walk with a permanent hunched-forward posture.

Untreated fractures can also affect the overall alignment of the spine, which can lead to additional complications down the road, like joint pain, reduced mobility, loss of balance, and a greater difficulty performing daily activities. Untreated spinal fractures also tend to increase the risk that more of your vertebrae will weaken and break.

TREATMENT FOR SPINAL FRACTURE If you and your doctor determine that you have a spinal fracture, you may be scheduled for kyphoplasty surgery. This is a minimally invasive procedure that is designed to stop the pain, stabilize the bone, and restore your normal height and mobility.

Also called “balloon vertebroplasty,” the procedure actually involves an orthopedic balloon that helps gently elevate the fractured vertebra.

This helps to restore it to its original position, and helps you regain the height you lost when the vertebra collapsed.

The incision required is usually only about one-third inch, after which the surgeon typically inserts two balloons into the affected area and gently inflates them to return the bone to its correct place. Once everything looks good, the balloons are removed, and the resulting cavity is filled with thick bone cement to stabilize the fracture. It’s like having a cast in your spine that helps keeps everything in place.

WHAT WILL BE MY EXPECTED RECOVERY? Patients usually experience pain relief within the first week after the procedure, and can return to their regular activities within a few days.

Studies have shown that this type of kyphoplasty is more effective than non-surgical care for this sort of fracture, and usually results in faster improvement in pain, mobility, posture, height, and quality of life.

USA VASCULAR CENTERS OFFERS KYPHOPLASTY USA Vascular Centers, a nationwide network of physicians, nurses and specialists, offers spinal fracture evaluation and treatment with kyphoplasty. They have offices all over the nation, including several in the New York area.

USA VASCULAR CENTERS (718) 504-6064 www.4health.net

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| Plastic Surgery

NON-SURGICAL LUNCHTIME FACE AND NECK LIFTING 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

One of the most frustrating signs of skin aging is the telltale sagging that occurs around the cheeks, brows, and neck. Individuals in their 40s and 50s are most often frustrated by this type of sagging because it can be so difficult to counteract. Creams and topical treatments hardly make a difference, yet for many, going under the knife for an all-out surgical face lift seems too drastic a step.

Fortunately, Dr. Rayham of the RR Plastix/ New York Plastic Surgery Center has a new solution that can make you look younger in a matter of weeks, but can be done in about an hour. «This is a non-invasive alternative to a traditional face lift,» he says. «It’s as close as you can get to surgical results without actually performing cuts or incisions on the face.»

What is this new treatment? Called «ultherapy,» it uses the technology of ultrasound to reach the deepest layers of skin and encourage the skin to tighten itself.

WHAT HAPPENS TO SKIN’S NATURAL SUPPORT? Over time, natural aging, exposure to pollutants, sun damage, and more all contribute to the gradual breakdown of the skin’s internal structure. One of the main problems is that the production of collagen slows down. Collagen is a kind of protein that works with elastin to give skin its strength and firmness. As levels decrease, the skin starts to sag, wrinkle, and look older.

According to Dr. Rayham, ultherapy helps stimulate the production of collagen, which then helps to firm up, tighten, and improve the appearance of skin.

HOW ULTHERAPY WORKS Just as an ultrasound allows a doctor to see through the belly to the fetus, ultherapy allows a plastic surgeon to see past the superficial layers of the skin to the deeper layers. This is where we find the musculature of the face—called the Superficial Muscular Aponeurotic System (SMAS).

During surgery, doctors typically manipulated the SMAS to create a lasting lift. With ultherapy, however, the doctor can stimulate this deeper layer without having to make incisions.

«When the ultrasound device hits the SMAS area,» Dr. Rayham says, «it burns small holes

through it without actually burning the skin. The outer layer of the skin remains unaffected. As a result, the SMAS area contracts and creates new collagen during the healing process to generate tightness. We can create all this in one pass.»

The doctor goes on to explain that with a second pass of the ultrasound device over the face, the surgeon can adjust the system to affect the more superficial level of the skin, where most of the collagen already is, and again stimulate new collagen production.

«The procedure can be done in our office, and takes about 40 minutes to an hour depending on how many zones need to be treated. A patient will see some immediate improvement, then after about three to four months, will see significant improvement.»

The best part? There’s no downtime, no weeks of recovery, and no hiding your face from the world. «There may be the occasional bruise,» the doctor says, «but for the most part people come in, get it done, and get back to their lives.»

CHOOSING THE BEST TECHNOLOGY There are several products available that deliver ultherapy, but after over a year of research, Dr. Rayham decided to purchase the Ulthera system for his office. Combining ultrasound imaging with ultrasound therapy in a single «see and treat» device, Ulthera is considered not only effective, but extremely safe.

«It’s been FDA approved for about a year now,» he said. «I followed it to make sure it actually delivered the results the company promised, and I have seen significant improvement.

It can lift sagging skin on the brows, neck, and cheeks, and helps make wrinkles less noticeable.» He adds that complementing ultherapy with filler injections like Sculptra, Juvederm, and Radiesse—around the mouth, for instance—creates cumulative results and an overall «lift» appearance.

If you’d like to look younger over lunch, 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 1-877-582-0400, or visit the website at www.rrplastix.com. www.4health.net

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YOUR SUMMER COLD COULD BE ALLERGIES TIPS ON HOW TO TELL THE DIFFERENCE

nnn By Colleen M. Story You’ve felt fine all summer, and all of a sudden, you have a runny nose. Is it possible you contracted a cold? You don’t remember being around anyone who was infected, and you don’t feel bad — just stuffed up.

Your friend tells you that you may be suffering from allergies. You scoff. You’ve never had allergies before. Besides, isn’t that a spring and fall thing?

Turns out, your friend could be right. According to allergist Richard Weber, M.D., president of the American College of Allergy, Asthma, and Immunology (ACAAI), seasonal allergies don’t strike only in the spring and fall months — they are also common in the summer, and for some people, they can last all year long.

How can you tell if you should reach for an antihistamine or a decongestant? Here are some tips.

WHAT CAUSES SUMMER ALLERGIES? Though allergies are most common in childhood, they can attack anytime, and can often surprise adults by coming on quickly in the summertime. If you suffer an attack, you may wonder what would cause summer allergies, as surely the pollen has gone with the spring breeze?

On the contrary. No matter what the season, pollen is in the air. Though spring is host

to tree pollen, and late spring blows around grass pollen, weeds release their pollen in late July or August. The most common and widespread weed that causes summer allergies is ragweed.

Mold is another common allergy trigger that’s around in summer. Some outdoor mold spores are at their peak in late summer and fall. One of the most common types of mold, named “Alternaria,” can peak at any time, while indoor mildew and mold can also contribute to allergy symptoms, particularly on humid days.

Other potential causes of summer allergies include insect bites and stings, poison ivy, and some seasonal fruits, such as melons, apples, and celery (for sensitive people).

HOW TO TELL THE DIFFERENCE BETWEEN COLD AND ALLERGY SYMPTOMS If you’re sneezing and suffering from red, itchy eyes, how can you tell whether you’re suffering from a cold or allergy symptoms?

Answer these questions to find out. n Do you suffer the same symptoms at roughly the same time each year? n Do the symptoms last for two weeks or more? n Do your symptoms stay pretty much the same — they don’t get better, but they don’t really get that much worse, either? n Is your mucus clear? n Do you suffer from itching or wheezing?

If you answered “yes” to most of these questions, you are more likely to suffer allergies. If you’re still not sure, try these questions: n Did your symptoms go away after about

2–3 weeks? n Did your symptoms seem to come on

and then gradually get worse? In other words, you started with a stuff nose, then started to sneeze with a runny nose, then had thicker mucus? n Do you start out with clear mucus, but then progress to yellow or green colored mucus? n Did you have a fever or body and muscle aches? n Did you suffer from fatigue in addition to your other symptoms?

If you answered “yes’ to most of these questions, you were likely suffering from a cold rather than allergies.

CHECK WITH YOUR DOCTOR If your cold goes on for longer than 10 days, or if your allergies persist beyond two weeks, check with your doctor. It’s always best to be sure you’re not suffering from an infection, and if you do have allergies, it’s important to get treatment to not only improve your quality of life, but avoid a potentially life-threatening anaphylactic reaction sometime in the future. www.4health.net

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HOW CAN I LOSE WEIGHT WHEN MY FEET HURT? OBESITY INCREASES RISK OF FOOT PAIN nnn By Lynn Merrell According to the National Institutes of Health, more than two-thirds of American adults are considered to be overweight or obese, and more than one-third are obese. Both are measured by determining body mass index (BMI). A BMI of 25 to 29.9 is considered overweight, and a BMI of 30 or more is considered obese.

If you’re overweight or obese, you may already be trying to lose weight. If you start on an exercise program, though, you may notice another change that ends up slowing you down — your feet hurt. Indeed, that extra weight you’re carrying can cause foot pain and swelling, as they must work harder to support your body. Over time, the extra pressure can wear down foot structures, causing a number of painful problems, say nothing of derailing your weight-loss goals.

4HEALTH If you’ve gained weight and you’re noticing the effects in your feet, talk to your podiatrist. He or she may have some ideas to help reduce pain and support your feet so you can move more comfortably.

FOOT INJURIES THAT ACCOMPANY WEIGHT GAIN As you walk around carrying extra pounds, connective tissues in your feet can stretch out, and the natural fat pads in your soles can compress down. Your muscles must work harder to support you, which can cause muscle strain and pain, and may also put extra stress on your tendons and joints.

According to a 2012 study, for example, increasing body mass index — especially extra weight around the belly area — is “strongly associated with foot pain and disability.” A 2012 report also found that 51 percent of those who said they suffered from fair or poor foot health were obese, compared to only 21 percent of those with a normal BMI. Overweight and obese people are at a higher risk for the following foot problems:

HOW TO MAKE PAINFUL FEET MORE COMFORTABLE The best way to ease any of the above types of foot pain is to lose weight. But if your feet hurt, how are you to do that?

Fortunately, there are a number of treatments that can help support your feet, so you can continue to exercise as you need to. These include the following: n Footwear: Your podiatrist can help you choose supportive foot-

n

n

n Pain: Feet tend to be sore and uncomfortable at the end of the day,

or after a period of activity.

n

n Tendonitis: Tendons within the foot become inflamed and painful

because of increased pressure. Effects are usually most common on the posterior tibial tendon, which is on the inner side of the ankle. n Arthritis: Arthritis in the small joints of the feet and ankles can cause inflammation and pain. There are 28 bones in the foot, and more than 30 joints that allow a wide range of motion. Arthritis can settle into any of these joints, making it more difficult to stay active. n Plantar fasciitis: One of the most common causes of foot pain, plantar fasciitis involves pain and inflammation in the plantar fascia, which is the thick band of tissue that runs from the heel bone to your toes. It causes a stabbing pain that is worst first thing in the morning.

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n

wear that provides adequate cushioning and helps relieve pressure on your feet. These may include more supportive shoes, as well as padded socks.

Custom orthotics: Orthotics made specifically for your feet can help provide support exactly where you need it, relieving pain and helping to keep the foot in its proper place while walking.

Low-impact exercise: Until your feet feel better, you can choose low-impact exercise options, like swimming, bicycling, and rowing. Strength training can also help you reduce body fat and increase lean muscle mass, and is usually easier to do with painful feet.

Specific exercises: Your podiatrist or physical therapist can help you with specific strengthening and stretching exercises that can help your foot muscles cope with their increased work load. These exercises can help decrease pain.

Dietician: Your podiatrist may recommend diet counseling to help you with your weight-loss goals, as well as to help decrease the inflammation in your body. Certain foods, particularly fruits and vegetables, can naturally reduce inflammation, which can help your feet recover.

See the doctor: Experts recommend that overweight and obese people who are experiencing foot pain see their podiatrist more often. If you typically go only once a year, consider going every six months instead, to check on your progress and discuss additional treatment methods if needed.

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MY DOC RECOMMENDED BUNION SURGERY — SHOULD I DO IT? EXAMINING 3 MYTHS OF BUNION SURGERY nnn Colleen M. Story Your doctor has suggested surgery for your bunion, but you’ve heard the horror stories. It’s extremely painful. You’ll have to take a ton of time off work. You’ll have lasting scars, and after all that, the bunion will probably come back anyway.

Should you believe the rumors, and continue to live in pain, or agree to the surgery? We decided to ask Dr. Kordai DeCoteau, DPM, of Weil Podiatry of New York, to find out.

Q: Doctor, what is a Bunion?

A: The American Podiatric Medical Association (APMA) states that a bunion is a bump on the joint at the base of the big toe. You can also think of it as a sort of malformation, where the bone or tissue at the joint actually moves out of place, bending the big toe inwards so the bone pokes out.

Bunions develop over time, as the big toe joint is forced to consistently bear more weight than it’s designed to hold. The pressure wears the joint down, and eventually it becomes unstable, producing the hard knob that juts out.

What causes this instability? It may develop for a number of reasons.

Bunions run in families because of problems in the way the foot is formed.

Foot injuries can cause problems in the joint that lead to instability and the formation of bunions. Other potential causes include low arches and flat feet, arthritis, and excess pressure on the feet, such as that which may occur in dancers and other athletes.

Whatever causes the problem, all sufferers agree they are painful. In addition to the unsightly bump, they can be red and swollen, and may cause difficulty walking.

Q: When is surgery necessary?

A: Identifying bunions in their early stages can result in early treatment that relieves pressure on the joint and halts the formation of the bunion. Medication, physical therapy, and orthotics may all help at this stage.

Once the bunion is fully formed and causing problems, however, the typical treatment is surgery. The goal is to relieve the pain and restore better function to the foot. Depending on the extent of the joint damage, surgeons may simply remove the swollen tissue around it, shave away part of the bone, realign the bone between the back part of the foot and

the big toe, or fuse the bones of the affected joint together to provide more stability.

Q: Isn’t it painful?

Though surgery is usually a last result, if we recommend it, it’s likely to be the best option for you.

“But isn’t it painful?” you may ask.

It’s may be uncomfortable, but not necessarily more so than other surgeries. You may notice it more because you’re typically on your feet a lot, so the recovery may feel inconvenient. The foot is also below the heart, which means that gravity carries the blood down to it, potentially increasing the feeling of “throbbing”. Pain medications usually help a lot, as will time off your feet. Together, you can come up with a plan that should help with your recovery.

Q: Will I have to take a long leave of absence?

A: This depends on your job. If you have a sit-down position that doesn’t include driving, you can likely return within a few days. If you have to be on your feet a lot, however, you may need some more time.

Q: Will the bunion return?

A: Small percentage of people have experienced recurrence, but you can take steps to reduce your risk. First, be sure to go to a doctor who has a lot of experience in bunions. He or she is likely to know which type of surgery will give you the best outcome. Second, find out what you can do after the surgery to reduce your risk of recurrence. Orthotics, for example, can help stabilize your foot so you’re not putting so much pressure on the joint.

Surgery is always a big decision. If your bunion is causing you to drop out of activities you used to enjoy, however, or is otherwise interfering with your life, it may be the best decision. We invite you to call us at Weil Podiatry at 718–504–5877, or come in and talk to us about it at 4159 Broadway, Washington Heights, New York and 59–20 Myrtle Ave., Queens, New York 11385. We can go over all your options with you, so you feel more confident about whatever course of action you choose.

Weil Podiatry of New York (718) 504-5877

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Early detection with HeartScore could save your life.

:KDW LV heartscore FDUGLDF FDOFLXP VFRULQJ" tŚĞŶ LJŽƵ ƚŚŝŶŬ ĂďŽƵƚ ŚĞĂƌƚ ĂƚƚĂĐŬ͕ LJŽƵ ƉƌŽďĂďůLJ ĂƐƐƵŵĞ ŝĨ LJŽƵ ŚĂǀĞ ŶŽƌŵĂů ďůŽŽĚ ƉƌĞƐƐƵƌĞ ĂŶĚ ŶŽ ƉƌŽďůĞŵ ǁŝƚŚ ĐŚŽůĞƐƚĞƌŽů LJŽƵ͛ƌĞ ŝŶ ƚŚĞ ĐůĞĂƌ͘ dŚŝŶŬ ĂŐĂŝŶ͘ /Ŷ ĨĂĐƚ͕ ĞdžƉĞƌƚƐ ƐĂLJ ϴϬ ƉĞƌĐĞŶƚ ŽĨ ƚŚĞ ƉĞŽƉůĞ ǁŚŽ ƐƵĨĨĞƌ ŚĞĂƌƚ ĂƚƚĂĐŬƐ ŚĂǀĞ ŶŽƌŵĂů ĐŚŽůĞƐƚĞƌŽů͘ EĞǁ ƌĞƐĞĂƌĐŚ ƐŚŽǁƐ Ă ƋƵŝĐŬ ƉƌĞǀĞŶƚŝǀĞ ƚĞƐƚ͕ ůŝŬĞ Ă ĐĂƌĚŝĂĐ ĐĂůĐŝƵŵ ƐĐŽƌŝŶŐ͕ ŵĂLJ ŐŝǀĞ ƉĂƚŝĞŶƚƐ ƚŚĞ ďĞƐƚ ŝŶĨŽƌŵĂƚŝŽŶ LJĞƚ͘

HeartScore cardiac calcium scoring is a quick, painless, noninvasive procedure performed with a multislice computed tomography (CT) scanner. During a 30-second test, highly trained experts in Cardiac disease at Sinai diagnostics can accurately determine the degree and severity of hard plaque within the coronary arteries.

Mammogram for the Heart- Coronary Calcium Score Who should get a heartscore? +HDUW6FRUH cardiac calcium scoring is recommended for anyone at risk of coronary artery disease, especially for healthy males over the age of 40 and females over the age of 45. If you have a family history of heart disease, you may want to be tested earlier. Other risk factors of heart disease include high blood pressure or cholesterol (even if managed by medication), smoking, obesity, and inactive or high-stress lifestyles.

Why is cardiac calcium scoring important?

Heart disease is the leading cause of death for both men and women. Often people have no warning signs prior to a cardiac event. +HDUW6FRUH detects this life-threatening build up and gives people the opportunity to change their lifestyles and obtain medication before extensive, irreversible damage occurs.

How can I get my cardiac calcium scoring?

Call 718-615-4100 to Schedule an Appointment at Sinai Diagnostics Cardiovascular Center for your HeartScore test.

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What does my heartscore mean? the lower your heartscore is the better. Scores Can range from zero to thousands. Any person with a score above zero should consider further medical advice for ways to prevent a heart attack through various preventative therapies like lifestyle changes and medications to stress testing.

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4HEALTH

Compression Fracture Vertebral Disc Vertebra

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FEEL BETTER TODAY WITH NEW, NON-INVASIVE DEPRESSION TREATMENT TMS THERAPY SOLUTION REQUIRES NO DRUGS OR SURGERY Tri-State TMS is an outpatient psychiatric service providing psychopharmacology and individual psychotherapy treatment. We launched this new clinical service—known as TMS—in Brooklyn for patients with severe, refractory Major Depression Disorder.

The Transcranial Magnetic Stimulation (TMS) device was cleared by the FDA for treating adult patients with major depression who have failed to benefit from antidepressant medications.

WHAT IS TMS? TMS uses electromagnetic induction to induce weak electric currents using a rapidly changing magnetic field. It is treatment for patients who have not responded to conventional pharmacological and cognitive-behavior therapy: Depression, Anxiety, OCD, PTSD, etc.

TMS—repetitive transcranial magnetic stimulation (rTMS)—has been tested as a treatment tool for various neurological and psychiatric disorders including migraine, stroke, Parkinson’s disease, dystonia, tinnitus, bulimia nervosa (BN), fibromyalgia, pain, and many other symptoms.

A non-invasive procedure, TMS is a treatment for depression that uses magnetic fields to stimulate nerve cells in the brain. During the procedure, the patient reclines in a chair while the doctor places an electromagnetic coil around the scalp. Once it’s in place, the physician determines the settings that will create the best outcome for the patient.

Then the magnet sends painless, low-dose pulses that activate areas of the brain that are typically less active in people with depression.

Treatment usually lasts about 40 minutes, after which patients can go back to their normal www.4health.net

activities for the day. A series of treatments is recommended for optimal results, and usually consists of one treatment per day for five days a week over a period of about 4-6 weeks.

WHAT ARE THE ADVANTAGES OF TMS? There are advantages of TMS over other standard treatments for depression. The treatment is safe, requires no anesthesia or sedation, and creates none of the side effects typical to antidepressants. That means no sexual dysfunction, dry mouth, dizziness, insomnia, weight changes, or digestive problems.

Generally, TMS appears to be free from harmful effects. Research using animals and human volunteers has shown none or little adverse effects on the body in general as a result of stimulation, and examination of brain tissue subjected to thousands of TMS pulses has shown no detectable structural changes.

These procedures have shown safety and efficiency in number of studies and are now typically covered by Medicare and some commercial insurance carriers.

Tri-State TMS is excited to offer this drugfree outpatient procedure for the treatment of depression, and can help determine if this treatment may be a good option for you. Doctors Mark Gurtovy and Felix Dron both completed their training in Psychiatry at the Mount Sinai School of Medicine, and they have over 30 years of successful medical experience.

Patients in New York, New Jersey, and Connecticut who have not had good luck with typical treatments for depression are urged to contact Tri-State TMS for more information. Call 718-232-1492, or see website at www.brooklyntms.com.

COULD TMS HELP YOU? How can you tell if you may be a candidate for TMS? Ask yourself these questions: n Have you been diagnosed with major de-

pressive disorder? n Have you had trouble finding relief with

antidepressant medications? n Have you suffered from depression for a

Felix Dron, MD Mark Gurtovy, MD

while with no real relief?

If you answered “yes” to one or more of these questions, you may be a candidate for TMS. Our office provides treatment with FDA-approved systems such as Neurostar TMS and Brainsway Deep TMS. Our clinic is the medical organization in New York, where you will find both of these unique systems available.

7620 Bay Parkway, Suite 1B, Brooklyn, NY, 11214

Tel: 718–232–1492 Fax: 718–232–4505 www.BrooklynTMS.com www.TristateTMS.com

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4HEALTH

ARE YOU DELUSIONAL?

FIVE SIGNS THAT SOMEONE YOU LOVE MAY HAVE DELUSIONAL DISORDER nnn By Colleen M. Story The word “delusional” is sometimes bantered about in fun. If nerdy George, for example, tells his friends about how he’s going to make the gorgeous Stephanie fall in love with him, they may respond by calling him delusional. We may say politicians have “delusions of grandeur,” or that tone-deaf youngsters trying out for American Idol are “selfdeluded.”

A true delusional disorder, however, is no laughing matter. A true psychological condition, it causes a person to be unable to determine what’s real or what’s imagined. Following are some signs that you or someone you love may have this disorder.

WHAT IS DELUSIONAL DISORDER? Delusional disorder is a mental health condition in which the person cannot tell the difference between reality and what he imagines reality to be. He has complex, paranoid, or other untrue perceptions that put him into conflict with others in his life.

These perceptions, or delusions, may be bizarre, or non-bizarre, in that they are either within or without the realm of possibility. A non-bizarre delusion, for example, may be that the person believes his significant other is about to die, even though there is no evidence of that.

That the person could die, however, is within the realm of possibility.

A bizarre delusion might be that the person believes he has been abducted by aliens, or that someone has mysteriously removed some of his internal organs without leaving a trace. These are delusions that have no basis in reality, but the person clings to them nevertheless.

People with delusional disorder may function okay in society, and may not seem out-of-the-ordinary at first, until one comes to know their delusions. Some, however, may seem markedly different, with disorganized speech patterns, strange behaviors, or other symptoms that go with the particular delusions that the person is suffering from.

FIVE SIGNS OF DELUSIONAL BEHAVIOR The following may indicate a delusional disorder, as long as symptoms persist for a month or longer:

1. Something bad is going to happen: If the person is convinced there is a plot afoot, and something bad is about to happen to her, she may be suffering from this disorder. Conspiracy theories involving imminent harm are typical of this type of delusion.

2. The love spell: The person believes that someone else is in love with them, regardless of any lack of evidence to support their belief. He may be so convinced of this that he becomes a stalker.

3. I’m a genius: The person may believe that she has an amazing talent, even if she doesn’t, or that she has made an amazing discovery that will significantly change the world.

4. He’s cheating: The person may be convinced that her lover is cheating on her, regardless of reality, and will point to seemingly harmless actions to support her belief. She will misinterpret most everything in her skewed point of view, and may resort to stalking, persecution of her partner, or even assault.

5. I’m weird: The person believes that something about his body — a physical deformity, odor, internal parasite, medical condition, etc. — makes him different from everyone else. An example may be that the person believes he has bugs under his skin.

TREATMENT FOR DELUSIONAL DISORDER Psychotherapy is considered the best treatment for people suffering from delusions. An experience therapist can help reinforce a patient’s sense of confidence and self-reliance, and gradually help challenge the delusional beliefs, though the process often takes considerable time, from months to years.

Therapy for loved ones is also recommended, so that families can cope more effectively with the disorder and learn how to help the delusional person to improve. www.4health.net

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EXPERIENCE OR BEDSIDE MANNER — WHICH IS MOST IMPORTANT? WHAT TO LOOK FOR WHEN CHOOSING A DOCTOR nnn Gordon Barclay Ask your friends what they like about their doctors, and you’ll probably receive a variety of answers. Some will say their doctors listen to them, and always make them feel comfortable. Others will say that their doctors have a ton of experience, and know what they’re doing.

If you’re looking for a new doctor, or thinking about changing the one you have, you may wonder which qualities matter most. Should you

look for experience, or a doctor you can relate to? Which is likely to lead to your best healthcare outcome?

A GOOD BEDSIDE MANNER MAY IMPROVE HEALTH In a 2014 Robert Wood Johnson Foundation survey, 59 percent of respondents said that a doctor’s personality and the quality of their relationship with him was the most important thing to them. An earlier 2013 Vanguard Communications survey reported that the most www.4health.net

4HEALTH common complaints about online doctors were that they were dismissive of patient concerns and didn’t listen well.

Even if you’re someone who would choose experience first, you may want to examine more closely a doctor’s bedside manner. According to a 2014 study review, patients who had good relationships with their doctors experienced better health outcomes. Things like building empathy, maintaining eye contact, motivating their patients, and helping them set goals were all qualities that helped patients lower their blood pressure, control their weight, and better manage painful symptoms.

An earlier 2011 study found that both hospitalized patients and doctors thought that compassionate care was very important to successful medical treatment. Unfortunately, only about half the patients and 58 percent of doctors said that the healthcare system generally provides such compassionate care. The researchers noted: “Given strong evidence that such care improves health outcomes and patients’ care experiences, we recommend the national quality standards include measures of compassionate care.”

WHAT SHOULD YOU LOOK FOR? Of course, experience matters too, particularly in matters of serious medical procedures, like surgery. Ideally, you’d be able to find physicians that have both, but that’s not always possible. Instead, you can follow these guidelines: n Surgery: If you’re going through a one-time operation, like get-

ting a hip replaced, a broken bone set, a serious brain surgery, etc., experience is your most important quality to look for. You want a physician who has done the surgery many times before, is the best qualified to do a good job, and is prepared to handle any potential complications. Since you’ll likely have little interaction with him or her, bedside manner can come second. n Rare conditions: If you’re struggling with a rare disease, a difficult health condition, or a syndrome that has been tough for

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other doctors to diagnose or treat, you need experience. Likely you’re seeking someone who is on the cutting edge of medical care in this case, and the individual’s personality is likely to be less important. n Regular doctor: Whatever doctor you see regularly — your family doctor, gynecologist, etc. — needs to be able to listen to you and understand your concerns. This is where bedside manner is key. Your relationship with this doctor is critical. A good one will help you to feel comfortable and to open up about any concerns you have. n Chronic illness: If you’re managing something like diabetes, cancer, heart disease, Parkinson’s disease, etc., you need a doctor that you can talk to. A strong relationship in this case may help motivate you to take the right lifestyle steps to improve your condition and quality of life.

WHAT IF YOU CAN’T CHANGE? If you’re not happy with your relationship with your doctor, but you can’t change because of insurance requirements, ask your doctor to help you out. Don’t be afraid to speak up. This is your health we’re talking about. The following questions are perfectly reasonable, and may help your doctor to realize what you need. n “I’m sorry, I didn’t understand what you said — can you explain it

more simply for me?” n “I’m really stressed about this. I’d appreciate it if you could take just

a moment to understand my concerns.” n “I know we’ve talked about this before, but I’m feeling really un-

comfortable about it. Could we take an additional 10 minutes today to discuss it?

Realize that though your doctor may be experienced in medicine, you may actually be the better communicator. Put your skills to work to help improve your relationship, and your health.

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

Medical Office is looking for a FT Front Desk Receptionist and a FT Medical Assistant (experience is a MUST).

718-854-5100

Newly open Medical Office is seeking PT doctors: internal medicine, allergist, pain management, orthopedist.

718-975-3369

Call us if you need Mobile Ultrasound Services: Echo, Vascular and General Ultrasound.

(917) 750-2275

Call Dr. Joseph Juliano 973-752-9559

Nurse Practitioner, Physician Assistant (FT or PT) needed for Medical Office.

Telephone (917) 412-3797

Good reimbursement.

718-954-2202

Medical Office is looking for PA or NP for Internal Medicine Doctor.

(347) 587-3777

For additional information please call Joe 917-208-4291

New multispecialty clinic looking for any specialty doctors.

347-453-0523

available for PT. Own Malpractice Ins.

Ultrasound technologist with five years of experience available for part time.

Medical offices for rent: 1500 sq ft, 2327 83rd St., Brooklyn, NY 1500 sq ft, 7819 18th Ave, Brooklyn, NY

Per Diem Covering CHIROPRACTIC PHYSICIAN (NY/NJ Lic.)

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 — 1.67%.

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Free plug-in to your software (billing).

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Call now (866) 573-0604 ext 706

Medical space for subleasing at 500 Brightwatercourt in Brooklyn (b/n Brighton 4th street and Brighton 5th Street) for any medical specialist (not for internal medicine doctor and podiatrist). The office is located in the building for senior citizens. There is a big potential for new patients referrals.

For details call (646)251-6646.

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.

MEDICAL OFFICE FOR RENT First Floor, 1,500 sq ft. located on New Dorp Ln, Staten Island NY 6 MONTHS FREE For additional information please call 212-945-8550

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MEDICAL OFFICE FOR RENT First Floor plus Legal Basement, total 3,000 sq ft., located on New Dorp Ln, Staten Island NY 6 MONTHS FREE For additional information please call 212-945-8550

MEDICAL OFFICE FOR RENT

First Floor, Second Floor plus Legal Basement, total 4,500 sq ft., located on New Dorp Ln, Staten Island NY 6 MONTHS FREE For additional information please call 212-945-8550 www.4health.net

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4HEALTH

DENTISTRY - GENERAL

Vladimir LEMPERT, DMD

3037 Ave U Brooklyn, NY 11229

(888) 607-9725

DENTISTRY - PEDIATRIC

Marina KREPKH, DDS

7708 4th Ave Brooklyn, NY 11209

(888) 502-6245

INTERNAL MEDICINE

Victoria ALEKSANDROVICH, MD

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

(718) 207-7071

OB/GYN - GENERAL

Sergey ZHIVOTENKO, MD

2797 Ocean Pkwy, Fl 2 Brooklyn, NY 11235 20-04 Seagirt Blvd Far Rockaway, NY 11691

(888) 757-3877

NEUROSURGERY

DERMATOLOGY

Hayama BRILL, MD

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

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

Paul GLIEDMAN, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160 OPTOMETRY

(212) 744-0392 OB/GYN - FERTILITY SPECIALIST

Yekaterina LEVIN, DDS

7000 Bay Pkwy, Ste C Brooklyn, NY 11204

(888) 838-6212

Alexander BEYLINSON, DO Leonard LEVITZ, MD

4434 Amboy Rd Staten Island, NY 10312

(718) 984-9658

Margarita BAUMAN, OD

Narayan SANDARESAN, MD

1749 E 16 St Brooklyn, NY 11229

5 E 84 St New York, NY 10028

321 Edison St Staten Island, NY 10306

2601 Ocean Pkwy, FL 7 Brooklyn, NY 11235 199 Mount Eden Pkwy, Fl 6 Bronx, NY 10457

1910 Ave U Brooklyn, NY 11229

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th

th

(212) 876-7575

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GASTROENTEROLOGY

(844) 957-7463

Hanna JESIONOWSKA, MD

159 E 74th St, Ste C New York, NY 10021

OB/GYN - UROGYNECOLOGY

Nataliya SAFONOVA, DDS

Lilia LEVITZ, MD

2211 Ocean Ave Brooklyn, NY 11229

Aleksandra ZLOTNIK, OD

1749 E 16th St Brooklyn, NY 11229

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

1910 Ave U Brooklyn, NY 11229

(718) 375-4747

(718) 759-6979

321 Edison St Staten Island, NY 10306

Irina BERLIN, MD

NEPHROLOGY

948 48 St, Fl 2 Brooklyn, NY 11219 th

40 West Brighton Ave, Ste 104 Brooklyn, NY 11224

ORTHOPAEDIC SURGERY

Amit SCHWARTZ, MD

(718) 283-7219

(718) 627-8300

OBESITY MEDICINE

Harout MARGOSSIAN , MD 7206 Narrows Ave Brooklyn, NY 11209

(888) 404-5046

1529 Richmond Rd Staten Island, NY 10304

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Stephanie YAMPOLSKY, DDS

ONCOLOGY

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

Victor KATZ, MD

Yana SHTERN, MD

(877) 434-7889

Alexander BRODSKY, MD

8622 Bay Pkwy, Ste 1 Brooklyn, NY 11214

(718) 333-2121

2523 Kings Hwy, Ste 1D Brooklyn, NY 11229

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321 Edison St Staten Island, NY 10306

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2003 Bath Ave Brooklyn, NY 11214 543 45th St Union City, NJ 07087

(888) 283-0399

Namik YUSUFOV, DDS, MDT

(516) 775-0272

PAIN MANAGEMENT

Anella BAYSHTOK, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160

305 W 28th St New York, NY 10001

158-06 Northern Blvd Flushing, NY 11358

(212) 804-0500

(718) 445-3700

170 Morris Ave, Ste A Long Branch, NJ 07740

(732) 728-7075

133-55 Lefferts Blvd South Ozone Park, NY 11420

Prabhakara R. TUMPATI, MD

www.brooklynroc.com

Sam WEISSMAN, MD

202 Foster Ave Brooklyn, NY 11230

(718) 854-5100

Dmitriy GRINSHPUN, MD

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

(888) 747-8009

Mila MOGILEVSKY, DO

1599 E 15th St, Fl 2 Brooklyn, NY 11230 369 Lexington Ave, STE 800 New York, NY 10017

(347) 252-6732

www.4health.net

4HEALTH PSYCHOLOGY

Michael RISKEVICH, MD

2736 Ocean Ave, Ste 1A Brooklyn, NY 11229

(718) 934-8484

PHYSICAL THERAPY

RADIOLOGY

Chloe CARMICHAEL

Sinai DIAGNOSTICS

(212) 729-3922

(888) 496-2688

230 Park Ave, Fl 10 New York, NY 10196

PSYCHIATRY

2560 Ocean Ave Brooklyn, NY 11229

NUTRITION AND DIETETICS

Ridwan SHABSIGH, MD

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

(718) 283-7746

2071 Clove Rd Staten Island, NY 10304

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MEDICAL SUPPLY

Albert GROSS, CNS, NYS, CDN

Globe SURGICAL SUPPLY

(718) 376-8317

(888) 418-0442

1942 E 8th St Brooklyn, NY 11223

2029 Bath Ave Brooklyn, NY 11214

www.nylifex.com

(888) 496-2688

MULTI SPECIALTY

RHEUMATOLOGY

Vladislav RUDNER, PT

1901 82nd St Brooklyn, NY 11214

(718) 490-2416 www.magichandspt.com

David SHUSTERMAN, MD Felix DRON, MD

7620 Bay Pkwy, Ste 1B Brooklyn, NY 11214

(718) 232-1492

PLASTIC SURGERY

Yelena SOKOLOVA, MD

4766-B Bedford Ave, Fl 2 Brooklyn, NY 11235

(718) 648-8877

800 2nd Ave, Fl 9 New York, NY 10017 69-15 Yellowstone Blvd Forest Hills, NY 11375 1013 Ave J Brooklyn, NY 11230

(718) 360-9550 nyurology.com

VASCULAR SURGERY

USA VASCULAR CENTERS

Multi SPECIALTY CLINIC

2444 86th St, Ste A Brooklyn, NY 11214

(855) 328-5525

3023-3027 Ave V Brooklyn, NY 11229

(877) 807-0989 AESTHETIC CENTERS

UROLOGY

Roman RAYHAM, MD, BOARD CERTIFIED IN PLASTIC SURGERY

Mark GURTOVY, MD

7620 Bay Pkwy, Ste 1B Brooklyn, NY 11214

(718) 232-1492

Yuly CHALIK, MD

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

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

(877) 582-0400

www.nyplasticsurgerycenter.com

(347) 508-3991 www.nyui.org

PODIATRY

USA VEIN CLINICS

1153 First Ave New York, NY 10065 2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

Vitaly RAYKHMAN, MD

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

(347) 508-3991 www.nyui.org

1300 Ave P Brooklyn, NY 11229

(888) 983-4055

www.4health.net

(718) 896-2333

2444 86Th St, Ste A Brooklyn, NY 11214

4159 Broadway Washington Heights, NY 10033

LSA RECOVERY

102-51 Queens Blvd Forest Hills, NY 11375

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

(888) 987-5751

(718) 646-0131

(718) 234-6767

1975 Hylan Blvd Staten Island, NY 10306

1623 Kings Hwy, Fl 4 Brooklyn, NY 11229

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

6417 Bay Pkwy Brooklyn, NY 11204

116-02 Queens Blvd Forest Hills, NY 11375

Interborough DEVELOPMENTAL & CONSULTATION CENTER

Alina VASILYEVA, DPM

Michael PATIN, MD

59-20 Myrtle Ave Queens, NY 11385 30-33 Steinway St Astoria, NY 11103

VK SKIN SPA

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

(646) 200-5856

(718) 509-0906 www.usaveinclinics.com

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

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