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HOW TO CHOOSE THE BEST ORTHOTIC FOR YOUR FEET

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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

4HEALTH

Women’s Heart Disease from Venus, Men’s from Mars

Many Differences Exist Between the Sexes

11 8 Pros and Cons of Bariatric Surgery for Obese Patients New Study Shows It May Improve Incontinence

24 Want to Avoid Cataracts? Eat This! Study Suggests A Certain Diet Can Protect Vision

28 5 Alternative Treatments for Chronic Pain

Complementary Therapies Offer Relief with Fewer Side Effects

30 How to Choose the Best Orthotic for Your Feet

WRINKLES, HYPERPIGMENTATION, AGE SPOTS—ARE LASERS THE ANSWER?

ADVANCES IN HEARING AIDS MAKE TREATMENT THE BEST CHOICE

DOES ELIMINATING COFFEE AND ALCOHOL HELP WITH ACID REFLUX?

STOMACHACHE? IT COULD BE COLITIS

STUDY SHOWS TREATMENT FOR UTERINE FIBROIDS IMPROVES SEXUAL FUNCTION

CAN HEART RATE FLUCTUATIONS PREDICT EPILEPTIC SEIZURES?

WHAT’S CAUSING YOUR BELLY FAT?

WHY WOMEN RECEIVING A BREAST CANCER DIAGNOSIS SHOULD SEE A THERAPIST

SAVE YOUR CHILD FROM RIDICULE

HOW TO PROTECT YOUR ARTERIES AND VEINS FROM TOO MUCH SITTING

SUMMER SEASON IS KIDNEY STONE SEASON

FEEL BETTER TODAY WITH NEW, NON-INVASIVE DEPRESSION TREATMENT

6 THINGS TO DO IN THE DOCTOR’S WAITING ROOM

Cosmetic Laser Procedures Have Come a Long Way

Untreated Hearing Loss Can Lead to Dementia

What Two Lifestyle Changes Have Proven to Really Work

By Dr. Sam Weissman

UFE Reduces Painful Symptoms and Boosts Quality of Life for Women

New Study Shows Promise for Wearable Device

By Dr. Prab R. Tumpati

Even If It’s a False-Positive, the Trauma is Real

Dr. Roman Rayham Can Fix Protruding Ears

Study Shows Small Bursts of Activity are Helpful

How to Reduce Your Risk of This Painful Condition

TMS Therapy Solution Requires No Drugs or Surgery

How to Use the Time in a Productive Way

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4HEALTH

WOMEN’S HEART DISEASE FROM VENUS, MEN’S FROM MARS MANY DIFFERENCES EXIST BETWEEN THE SEXES

■■■■By Morgan Rice Heart disease remains the number one killer of both men and women in the United States. It causes about one in four deaths each year, affecting about 610,000 people. Cardiovascular diseases, as a whole, regularly claim more lives than all forms of cancer combined. For years, we’ve understood that classic symptoms like chest pain and shortness of breath signaled a potential pending heart attack, but recently we’ve found that other symptoms like fatigue, nausea, and confusion can also signal heart troubles, particularly for women. Today, we also now know that there are other differences between men and women when it comes to heart disease.

DIFFERENCES BETWEEN MEN AND WOMEN WITH SUSPECTED HEART DISEASE In a recent study published in the Journal of American College of Cardiology — Cardiovascular Imaging, researchers from Duke Clinical Research Institute reported on how heart disease may be diagnosed and assessed in women, as opposed to men. For their study, they researched more than 10,000 patients, split evenly between men and women. None of them had a prior history of heart disease, though they had all

recently been suspected of developing the disease. The results of their analysis showed that women actually have more risk factors for heart disease then men, but still, they are more likely to be assessed as having a lower risk by their doctors. In addition, possible predictors of the disease, such as depression, a sedentary lifestyle, and a family history of early heart disease, were excluded in the assessment, and were more frequently reported by women than men. Women were also found to be more frequently referred for imaging for stress tests compared to men, but were less likely to have a positive test. There was also a difference in how women experienced chest pain. Though about the same number of men and women reported chest pain when talking to their doctors about suspected heart disease, women were more likely to say that it felt like a crushing pressure or tightness. Men, on the other hand, described it as a dull ache or burning sensation.

WOMEN AND MEN LIKELY TO BE TAKING DIFFERENCE MEDICATIONS The researchers found other differences as well. These included the following: ■■ Women were more likely than men to

suffer from back, neck, or jaw pain as symptoms of heart problems. ■■ Women were also more likely to suffer from heart palpitations than men.

■■ Men were more likely to suffer from fa-

tigue and weakness, though both sexes reported these substances. ■■ Women were more likely than men to be taking beta-blockers and diuretics. Men were more likely to be taking antiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, statins, and aspirin. The results of the study pointed out, once again, that men and women may have some things in common when it comes to heart disease, but they also have a lot of differences — more than we may have realized. The researchers concluded that these differences need to be taken into account by healthcare providers.

YOU KNOW YOUR BODY BEST Other studies have reported on the differences between men and women when it comes to heart disease. The American Heart Association states that women age 45 and younger are more likely to die within a year of their first heart attack, and that women are less likely to call 9–1–1 when they believe they’re suffering symptoms. «Women need to become fierce advocates for their own health,» the association states. Whatever your gender, you know your body best, so if you feel something is just not right, speak up. It’s always better to be safe than sorry. www.4health.net

4HEALTH

WRINKLES, HYPERPIGMENTATION, AGE SPOTS — ARE LASERS THE ANSWER? COSMETIC LASER PROCEDURES HAVE COME A LONG WAY

■■■■By Morgan Rice We’re all much more aware of the flaws in our skin these days. Our culture’s focus on youth and anti-aging has us all inches from the mirror pointing out hyperpigmentation, scarring, age spots, fine lines and wrinkles, sagging and bagging, and more. Ugh. Is there any way to recover some of that smooth, soft skin that we lost over time? According to the American Academy of Dermatology, laser treatments have come a long way over the past several years, and can now offer patients a number of skin solutions with more effectiveness and less downtime than ever before. Below is a quick review of the treatments available for a variety of skin conditions. If you’re suffering from one of these, you may want to ask your dermatologist or cosmetic surgeon for more information.

WHAT ARE LASER TREATMENTS AND HOW DO THEY WORK? Physicians use actual lasers — machines that produce light energy — to help treat a number of skin conditions. Because of recent advances in laser technology, practitioners now have a number of options that they can use either one at a time or in combination to address a variety of skin problems. They may use one device to treat redness, for instance,

another for brown spots, and another to treat sagging skin. And they can do all of this in one treatment, reducing the patient’s need to be in the office and also reducing recovery time. With demand rising for more anti-aging options, lasers have become increasingly specialized over the years, with each made specifically for the condition it’s designed to treat. Today’s machines also deliver smaller doses, reducing trauma to the skin, decreasing the risk of side effects and complications, and resulting in a safer, more effective treatment. It is important for patients to be careful, however, especially in choosing their doctor. In the wrong hands, a laser device may cause burning, hyperpigmentation, and scarring. Always look for a board-certified physician and make sure the one you choose has experience in the type of treatment you’re looking for.

WHAT TYPES OF SKIN PROBLEMS DO LASERS TREAT? The usefulness of lasers spans a number of different conditions and problems, including the following:

1. Acne scars: Acne scars, particularly as a result of cystic acne, can affect physical appearance and confidence. Laser treatment can help remove scars with little discomfort and very little downtime. Ask your doctor about your options. Surface-level scars will typically require a different treatment than deeper columns or pits in the skin.

2. Lines and wrinkles: Depending on how advanced your wrinkles are, your doctor may use different types of laser treatments. For deeper, more visible wrinkles, downtime may be a bit longer. Recovery is typically a week or less for most treatments. 3. Hyperpigmentation and tattoos: If you suffer from skin blotches, melasma, or even tattoo scars, lasers can help. They help target the melanin inside the cells, resulting in a lighter appearance. 4. Hair removal: Tired of the extra hair on your lip, between your brows, or on your chin? Laser treatments can help remove dark hair quickly, and results usually last from 3–6 months. 5. Psoriasis: Studies have shown that laser treatments can help treat psoriasis lesions. The FDA cleared certain types of lasers to treat mild-to-moderate psoriasis, helping to reduce the appearance of flaky, patchy skin. 6. Sagging skin: Though lasers won’t create the results that a face-lift would for sagging and bagging skin, they can help encourage the production of collagen and create a tightening, toning effect. Check with your doctor on your options. 7. Redness: Redness, rosacea, and so-called «vascular lesions» often respond well to laser treatment. The light energy targets damaged tissues in the lower layers of skin, helping to remove visible blood vessels and resulting in a smoother, more even appearance. www.4health.net

4HEALTH

ADVANCES IN HEARING AIDS MAKE TREATMENT THE BEST CHOICE UNTREATED HEARING LOSS CAN LEAD TO DEMENTIA

■■■■Colleen M. Story According to the National Institute on Deafness and Other Communication Disorders, one-third of Americans between the ages of 65 and 74 suffer from hearing loss. Half of those over the age of 75 can no longer hear as well as they used to. Yet studies show that only about a fifth of these seek help for the condition. That’s unfortunate, as according to a recent study, those who failed to treat their mild hearing loss scored significantly worse in cognitive tests. Meanwhile, the National Council on Aging (NCOA) reports that hearing loss can have a significant negative impact on life, leading to depression, anxiety, and fatigue. If you suffer from hearing loss, there’s hope. Many of the newly designed hearing aids are barely visible and more efficient at picking up specific sounds. Plus, with the popularity of Bluetooth earpieces for cell phones and other gadgets, hearing aids no longer carry the social stigma that they used to.

HEARING AIDS ADVANCED WITH NEW TECHNOLOGY Today’s hearing aids use advanced computer chips to convey sounds into digital code, and adjust based on the patient’s needs. “Microprocessors, noise-reducing software, and digital speech enhancement, means hearing aids are better able to pick up the sounds you want to hear,” says Women’s Health Advisor. New technology has also created improvements in a hearing aids’ ability to separate

background noise from nearby conversations. Today’s hearing aids are mostly digital, with a dramatic improvement in signal processing abilities that help simulate natural sound with a wider frequency response. They also have more features than ever before, including noise reduction and directional microphones, allowing them to work better in a variety of environments. Many can even connect with your cell phone, TV, MP3 player, or landline so you can listen to these devices directly through your hearing aid — wirelessly! What about shape and style? Hearing aid manufacturers have responded to patient requirements, producing new designs that are barely visible, or made to make a fashion statement. Because of these improvements, the Better Hearing Institute reports that the use of hearing aids is on the rise, because patients find them more effective than before. Shapes and styles include: ■■ Those that go behind the ear ■■ Those that go into the ear canal, but re-

main visible ■■ Those that go into the ear canal, and are

barely visible ■■ Implantable hearing aids

WHICH HEARING AID IS RIGHT FOR YOU? The hearing aid that will work the best for you depends on many factors, including your level of hearing loss, your daily activities, whether or not you suffer from arthritis, and your interaction with technology. Your best

bet is to check with your doctor, have your hearing tested, and then do some research and shopping to find the hearing aid that’s right for you. Even if you don’t think you have lost any sense of hearing, it’s best to get tested if you’re over 50 years old. Many people don’t realize they’re losing their hearing in the early stages, because the symptoms can be subtle. A hearing test is easy and painless — you have nothing to lose! If you do purchase a hearing aid and then have trouble with it, or find it doesn’t work as you expected, be sure to go back to your doctor. Sometimes finding the right device takes time, trial, and error. “Your audiologist will review your hearing test results and match you to the right aid with the right features,” says Dr. William Reisacher, an associate professor of otolaryngology at New York Presbyterian Hospital/Weill Cornell Medical College. “Keep in mind that the best hearing aid for a given person is not always the most expensive one. And not every hearing aid is right for every one.” The most important thing is to address your hearing loss. Continuing to go about life without being able to hear as well as you used to has been linked with not only depression and anxiety, but reduced job performance, impaired memory, irritability, and even early dementia and Alzheimer’s disease. On the other hand, a new hearing aid can open up your life in ways you may not have even thought possible. www.4health.net

4HEALTH

DOES ELIMINATING COFFEE AND ALCOHOL HELP WITH ACID REFLUX? WHAT TWO LIFESTYLE CHANGES HAVE PROVEN TO REALLY WORK

■■■■Colleen M. Story If you suffer from acid reflux disease, or GERD, you know how uncomfortable it can be. “I hate the flare ups,” writes one forum member. “Some days I’ll be fine, but then boom, I suffer a raw, burning throat, acid taste in my mouth, hot tongue and lips, and coughing.” Another sufferer relates how just days after changing his diet over the holidays, he suffered bloating and a lot of pain. What can be especially difficult about the condition is that it can pop up unexpectedly, taking patients by surprise. “You don’t know if you’re going to have a good day or a bad day,” says one forum member. We’ve been told that diet plays a huge role in whether acid reflux flares up or not, and two of the offenders often listed are coffee and alcohol. Should you avoid these beverages?

COFFEE MAY TRIGGER ACID REFLUX It can be tough to give up that morning cup of coffee, particularly if you need to be alert right away, but this popular drink is one of the most common triggers for heartburn. According to a study published in Alimentary Pharmacology & Therapeutics, drinking regular caffeinated coffee led to significant reflux effects when compared to tea and water. How might coffee cause these problems? Researchers speculate it may encourage the lower esophageal sphincter (LES)—the tight

ring of muscle that usually closes to prevent stomach acids from rising up into the esophagus—to relax. A loose LES allows small amounts of stomach acids to rise up, creating those burning and burping sensations. The caffeine in coffee also seems to stimulate the stomach to produce more gastric acid. Coffee itself is highly acidic as well, which causes irritation, so caffeinated coffee hits the stomach with two ingredients that can increase stomach acids. (Some studies have shown decaffeinated coffee to produce fewer symptoms.) Caffeine can also exacerbate stress because of its stimulating effects on the brain and gastrointestinal tract. Many studies, however, have not found a link between coffee and acid reflux, leaving scientists confused. The best way to find out if coffee may be contributing to your symptoms is to avoid it for a couple weeks, and see if your symptoms subside. Then you can gradually add it back into your diet to see if you notice a difference.

ALCOHOL TRIGGERS ACID REFLUX Alcohol is one of the other beverages often included on the “avoid” list for those with acid reflux. As with coffee, studies are mixed. Some have linked alcoholic beverages with painful symptoms, but others have not. A study published in BMC Gastroenterology found that the severity of symptoms increased when patients drank more alcohol. Researchers speculate that when patients drink, the alcohol can

cause direct damage to the esophagus, and may also affect the function of the LES. As with coffee, the effects probably depend more on the person. Try eliminating alcohol from your diet for a couple weeks, then gradually add it back in and keep a “food journal” to help you keep track of the effects.

OTHER TRICKS THAT MAY HELP According to an expert article published in Gastroenterology & Hepatology, of all potential lifestyle modifications, the two that have repeatedly shown to be effective in studies are losing weight and elevating the head when lying down in bed. “I have found in my clinical practice,” writes Joel E. Richter, M.D., “that although patients try to adhere to all of these modifications, they often become very frustrated because their GERD may not be improving and their quality of life is affected by the significant dietary changes. I strongly encourage patients to lose weight and recommend head-of-bed elevation only if patients are experiencing symptoms at night or after dinner.” Richter no longer recommends eliminating certain items of food. Instead, he suggests patients look for their own triggers. If you get heartburn after eating spicy foods, for example, stop eating them and see if that helps. In the end, it seems that personal trial and error—along with weight loss—are the best approaches to reducing your symptoms and experiencing more comfortable digestion. www.4health.net

Gastroenterology | 4HEALTH15

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.

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4HEALTH

STUDY SHOWS TREATMENT FOR UTERINE FIBROIDS IMPROVES SEXUAL FUNCTION

UTERINE FIBROID EMBOLIZATION (UFE) REDUCES PAINFUL SYMPTOMS AND BOOSTS QUALITY OF LIFE FOR WOMEN ■■■■By Morgan Rice Women who undergo nonsurgical treatment for uterine fibroids may find that they not only feel better, but that their sex lives improve. This, according to a new study published in April 2016. Researchers examined the outcome of a minimally invasive, image-guided treatment for uterine fibroids that requires a much smaller incision and shorter recovery time than traditional surgical treatment. Women reported improvement

in troublesome symptoms caused by the fibroids, increased sexual desire, and an overall increased quality of life.

WHAT ARE UTERINE FIBROIDS? Uterine fibroids are benign (noncancerous) growths in the smooth muscle tissue of the uterus. They usually do not develop into cancer, though in rare cases, they can. Instead, they are simply the result of excessive cell growth that results in a mass that can be as small as a www.4health.net

4HEALTH seedling or many times larger, in some cases becoming bulky and enlarging the uterus. Many women develop fibroids and aren’t even aware of it. They can grow slowly, causing no problems, or they may grow for awhile and then shrink again. Some appear during pregnancy, and then go away after childbirth. The Mayo Clinic estimates that as many as three out of four women have uterine fibroids at some time in their lives, but because they don’t cause symptoms, women aren’t bothered by them. In some cases, though, fibroids can cause trouble. When they do, symptoms may include heavy menstrual bleeding, prolonged menstrual periods, pelvic pressure or pain, constipation, frequent urination, pain during sex, reproductive problems, and backache or leg pains.

HOW ARE UTERINE FIBROIDS TREATED? Women who are diagnosed with uterine fibroids and who are experiencing difficult symptoms usually have several options. If the symptoms are mild, doctors will usually recommend watchful waiting, to see if the fibroids or the symptoms will go away on their own. If symptoms are more serious, there are some medications that may help. Some

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target hormones to help treat heavy menstrual bleeding, for example, and potentially shrink the fibroids. Other medications like birth control pills may do the same, and nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain related to fibroids. If these steps don’t help, doctors usually suggest some type of surgical treatment. It used to be that the only option was a hysterectomy or myomectomy (removes fibroids and leaves uterus intact), but now there is also a minimally invasive treatment called uterine fibroid embolization (UFE) that helps resolve fibroid-related symptoms without the hassle of traditional surgery.

STUDY SHOWS UFE REDUCES SYMPTOMS, IMPROVES QUALITY OF LIFE In a UFE procedure, the doctor uses a small x-ray camera to guide him to where the fibroids are. He makes a tiny incision and inserts a very small tube into the femoral artery on top of the leg. This is the artery that supplies the fibroids with blood. Once the doctor reaches the fibroids with the tube, he injects small plastic or gelatin particles through the catheter into the blood vessels that supply the fibroids, essentially robbing them of blood flow. Eventually, the fibroids shrink and die.

Researchers from the Centre Hospitalier Universitaire in Montpelier, France, researched the effectiveness of UFE in their study. They followed 264 women who went through the procedure, and asked them to fill out a questionnaire before and one year after treatment. At the start of the study, 189 of the women suffered from abnormally heavy bleeding, and 171 experienced pain and other symptoms associated with pelvic pressure. A year later, only 39 still suffered from excessive bleeding, and only 41 still had uncomfortable pelvic pressure. In addition, nearly eight in 10 stated that they experienced improvement in sexual function, including reduced pain during intercourse, and increased desire, arousal, and satisfaction. About nine in 10 reported an overall better quality of life. Researchers concluded that compared to surgeries like hysterectomy, UFE helps women return to their daily routines much more quickly, and still reduces symptoms and improves well being. If you’re suffering from symptoms of uterine fibroids, ask your doctor or interventional radiologist about your options. UFE may be an effective treatment for you.

4HEALTH

CAN HEART RATE FLUCTUATIONS PREDICT EPILEPTIC SEIZURES? NEW STUDY SHOWS PROMISE FOR WEARABLE DEVICE

■■■■By Morgan Rice Those who live with epilepsy know it can be difficult to cope. If your medication helps control your seizures, you may be able to function well,

but you may have to deal with uncomfortable side effects. If you have poorly controlled seizures, it can be even more difficult. You’re not sure how much you have to restrict your activity, and you may worry about how an ill-timed seizure could affect your job, your relationships, or even your vacation. www.4health.net

4HEALTH Scientists are working on new ways to help patients learn of an oncoming seizure before it happens. A recent study suggests that keeping track of the heart rate may be more effective than measuring brain activity, and the findings may help point the way to a warning system that patients could wear to help them predict when seizures may occur.

WHAT IS EPILEPSY? Epilepsy is a neurological disorder—a disease affecting the brain—in which the normal pattern of neurological activity is disturbed, causing convulsions or seizures. It often develops as a result of some abnormality in the way the brain is wired, or an imbalance in neurotransmitters—those chemicals that send messages back and forth in the brain. For about half of patients with the disorder, medication can help control the seizures. Another 30 percent or so may get some benefit from medications, but still have seizures now and then. For some people, medications don’t work at all. For them, other solutions are needed. That’s where devices can come in handy.

DEVICES THAT CAN HELP TAME SEIZURES There are a few devices that may help some patients. Vagus nerve stimulation (VNS), for example, applies short bursts of energy into the brain via the vagus nerve (a large nerve in the neck going to the brain), which helps to control seizures. The device is implanted under the skin, with a magnet that can be worn on the wrist or clipped to a belt. The magnets are used to provide extra stimulation to either shorten a seizure or make it easier to recover afterwards.

Responsive nerve stimulation (RNS) is another type of device treatment. It’s placed under the scalp and monitors brain activity and delivers mild electrical pulses to the brain to help reduce the number of seizures. According to researchers, however, a new method of keeping track of the heart rate may be more effective than these two treatments.

STUDY SHOWS THAT HEART RATE MAY BE USED TO PREDICT SEIZURES For the study, researchers analyzed heart rate fluctuations of 14 epileptic patients who had been hospitalized. They found that the heart rate variability produced accurate predictions for epileptic seizures 91 percent of the time. Further, the predictions could be made an average of eight minutes before the seizure started—giving the patient time to get to a safe place. The differences in heart rate when normal and before a seizure were clear, making the chances of a “false-positive” very low. The researchers concluded that it’s possible to use heart rate to make accurate predictions of epileptic seizures. The next step, they suggested, would be to create a wearable device that would monitor the heart and warn the patient when needed. Such a device would be attached to the chest, would be invisible to the outside world, and would allow patients to go about their normal lives while wearing it.

RESEARCH CONTINUES ON OTHER POSSIBLE SOLUTIONS Scientists are also studying other potential treatments for epilepsy. Genetic research may point to which treatments will be most effective for certain people, and other research is looking into the workability of brain implants. If you have seizures that are not well controlled, talk to your doctor about your other options.

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ADVANCED CENTER FOR THE TREATMENT OF: • Headache and atypical facial pain • Neck and back pain • Impinged nerve and neuralgia • Muscle pain, weakness and sensory disturbance • Dizziness and noise in the head or ears • Fainting spells and epilepsy • Alzheimer’s disease and other causes of memory loss • Parkinson’s disease and other causes of tremor • Residual deficit of a stroke and it’s prevention • Depression and anxiety • The effects of work-related injuries and automobile accidents

888-747-8009

WITH THE AID OF THE MOST MODERN TECHNOLOGY WE PERFORM:

• Computer diagnostics of neuromuscular diseases • Ultrasound diagnostics of intracranial and extracranial vasculature • Electroencephalography

TRADITIONAL AND ALTERNATIVE METHODS OF TREATMENT INCLUDE: • Intravenous drips and nerve blocks • Homeopathic treatment • Rehabilitation, massage and traction • Electrotherapy, thermotherapy and ultrasound treatment

WE ACCEPT ALL MAJOR INSURANCE AND PROVIDE TRANSPORTATION www.4health.net

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: ■■ traumatic injuries to the brain, skull, spi-

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

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

fections, fractures, and ruptured or bulging disks ■■ neurovascular disorders such as aneurysms, strokes, and brain hemorrhages ■■ brain disorders like epilepsy and Parkinson’s disease ■■ 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 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)

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 | 4HEALTH23

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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PROS AND CONS OF BARIATRIC SURGERY FOR OBESE PATIENTS NEW STUDY SHOWS IT MAY IMPROVE INCONTINENCE

■■■■By Lynn Merrell If you’ve been thinking about weight-loss surgery, here’s another thing to consider: according to a recent study, it may improve incontinence, as well as help you lose weight. We’re talking about bariatric surgery — like gastric bypass, adjustable gastric band, and sleeve gastrectomy — which is intended to help those who are obese to shed the pounds. We already know that these surgeries produce significant weight loss, but we didn’t know if they could address what is often a serious problem for patients. According to a 2009 study, for example, obesity is a strong risk factor for urinary incontinence. Each 5-unit increase in body mass index (BMI) was associated with a 20 to 70 percent increase in urinary incontinence risk. Researchers noted then that weight loss surgery should be strongly considered as an effective way to improve symptoms. Should obese patients consider surgery not only for weight loss and disease reduction, but to improve urinary incontinence as well?

STUDY SHOWS BARIATRIC SURGERY IMPROVES URINARY INCONTINENCE Researchers wanted to see if bariatric surgery helped patients to reduce urinary incontinence. They studied nearly 2,500 adults between the ages of 18 and 78 undergoing first-time bariatric surgical procedures at 10 hospitals around the country between March 14, 2006 and April 24, 2009. They then followed them for three years, evaluating the frequency and type of urinary incontinence episodes. Prevalence was defined as at least weekly urinary incontinence episodes. Almost half of the women and more than a fifth of the men reported having an episode of incontinence prior to the surgery. Following the surgery, after women lost about a third of their weight, and men about a quarter, researchers observed substantial improvements in incontinence. Most of the women and men achieved

remission three years after surgery. The more weight they loss, the more likely they were to leave incontinence behind. Those that regained weight increased risk of incontinence again, but overall, there was substantial improvement in all participants. Researchers concluded: «Among women and men with severe obesity, bariatric surgery was associated with substantially reduced urinary incontinence over 3 years. Improvement in urinary incontinence may be an important benefit of bariatric surgery.»

PROS AND CONS OF BARIATRIC SURGERY If you or a loved one is considering bariatric surgery, the findings of this study may be important. All surgeries come with risks, however. The good thing is that the procedures usually lead to fast, dramatic weightloss results, which can be extremely important for obese individuals facing a number of health risks or problems, like diabetes, heart disease, stroke, and cancer. As the weight comes off, there are usually other benefits, including reduced blood pressure, improved sleep apnea, and even improved blood sugar control. Now, we know that improved urinary incontinence may also be a benefit. Some of the risks remain, however. Depending on the type of surgery, patients may suffer nutrient deficiencies because of poor food absorption, and need supplements to make sure they’re getting all the nutrients they need. There may be a slight increased risk of gallstones, infections, or complications following surgery. Patients often need to stick to strict diets, and have regular postoperative follow-up visits. Thus it’s important to always discuss everything thoroughly with your doctor, and get a second opinion if necessary. Weight-loss surgery may be just what you need to get your health back on track. Just be sure that you understand the process well, and that for you, any risks are overshadowed by the benefits you are likely to experience. www.4health.net

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WHY WOMEN RECEIVING A BREAST CANCER DIAGNOSIS SHOULD SEE A THERAPIST EVEN IF IT’S A FALSE-POSITIVE, THE TRAUMA IS REAL

■■■■By Colleen M. Story Michelle was reeling. She walked out of the doctor’s office and stopped, unable to remember where she parked her car. The world turned in circles, her vision blurring. Unsure she could remain standing, she sat down on a nearby bench, her heart slamming in her chest. Her five-year-old daughter. It was all she could think about. Michelle was a single mom. If she was gone, her daughter would be left alone. It was more than she could take. She felt like crying but her eyes were dry. She clung to the edge of the bench, her fingers digging into the hard cement.

«ARE YOU ALL RIGHT?» Someone was talking to her, but she didn’t know the person. Michelle stared, unable to focus. Her daughter. What was going to happen to her daughter?

Like many women every day, Michelle had just received a breast cancer diagnosis. She assured the doctor she was fine, but then it hit her as she left the office. Her experience isn’t rare. According to a recent study, being told that you have breast cancer can leave lasting psychological scars. Even if subsequent tests show the initial diagnosis was wrong, women are still affected years later. Here’s more about what the researchers found, and why women would be wise to see a therapist after receiving this difficult news.

WOMEN TRAUMATIZED BY DIAGNOSIS, REGARDLESS OF OUTCOME According to researchers at the University of Copenhagen, no matter what the outcome of a breast cancer diagnosis — even if it proves to be incorrect — the news is traumatic. Scientists analyzed a group of 454 women who received «abnormal» results from their mammograms, compared to 908 controls with normal results. They then assessed the women for psychosocial consequences and www.4health.net

4HEALTH compared the two groups of women with those who received falsepositive results (those that were thought to indicate cancer but were later found to be normal).

HERE’S WHAT THEY FOUND: ■■ Facing a potential breast cancer diagnosis has a negative effect,

regardless of the actual consequences. ■■ Long-term effects of a breast cancer diagnosis, even if it’s a false

alarm, could include depression and stress. ■■ Even women who received false-positive mammograms, and were

later told they were cancer free, still suffered from psychological consequences even several years later. ■■ Though researchers believed that women who had to undergo only a physical exam and an additional mammography would feel better than those who had to undergo biopsy or surgery, results showed that wasn’t true, psychologically. There was no difference in the groups of women as to how the breast cancer diagnosis affected them. «Being told that you may have cancer is what affects, stresses, and worries you,» said senior author Bruno Heleno.

WOMEN NEED TO FOCUS ON TAKING CARE OF THEMSELVES This isn’t the first study to make these findings. In the early 1990s, researchers noted, «the diagnosis of breast cancer creates emotional distress for patients as well as family members.» They added that it’s a time of stress, high anxiety, uncertainty, and difficulty making decisions.

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A later 2008 study found that women often suffered depression and stress, and even if they found out later they were cancer-free, they still feared they would get cancer eventually. These findings may lead us to think about three things. First: the need to reduce the number of false-positive mammograms. «For each woman who dies of breast cancer,» said Heleno, «there are 200 women who receive a false positive. We may consider discussing whether the negative effects of mammography outweigh the positive effects, and whether it is time to reassess the mammography screening programme.» Second, women need to be aware that false positives do occur, and to try to keep that in mind if they do get a diagnosis. A second opinion may be wise, and additional screening may prove that it was all a mistake. Third, women who have to go through a cancer diagnosis, regardless of what kind it is, should seriously consider getting some psychological help. This isn’t about being strong, but about employing the resources you need to stay as healthy as you can. If it turns out you received a falsepositive, a therapist can help you overcome the traumatic experience, so that it doesn’t go on to haunt you for years to come. If it turns out that you do have cancer and you require treatment, a therapist can also help you face that difficult journey, and can prove to be a valued partner in your health care team. «Licensed psychologists and other mental health professionals with experience in breast cancer treatment can help a great deal,» says the American Psychological Association. «By teaching patients problem-solving strategies in a supportive environment, psychologists help women work through their grief, fear, and other emotions. For many women, this life-threatening crisis eventually proves to be an opportunity for life-enhancing personal growth.»

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WANT TO AVOID CATARACTS? EAT THIS!

STUDY SUGGESTS A CERTAIN DIET CAN PROTECT VISION ■■■■By Lynn Merrell Want to avoid getting cataracts as you age? It may be as simple as changing your diet. This, according to a recent study that shows if you eat more of one particular nutrient, found in a wide variety of foods, you could cut your risk of cataracts. That’s big news, as according to the National Eye Institute, the risk of cataracts increases with every decade of life, starting around age 40. By the age of 75, half of white Americans have cataracts,

and by age 80, a whopping 70 percent of them do, while over half of blacks and 61 percent of Hispanics do, too. If you can keep your vision clear for longer by eating certain foods, wouldn’t you want to do that?

STUDY SHOWS DIET CAN REDUCE RISK OF CATARACTS The study was published in the scientific journal Opthalmology. It’s pretty fascinating, as researchers compared a set of twins to find out if lifestyle could outweigh genetics when it came to this common eye condition. www.4health.net

We know that there is a genetic component to just about every disease, and cataracts are no exception. If someone in your family was affected, your risk is higher than someone who has no family history of cataracts. Genetics aren’t everything, though, and now we know we can control more of our health outcomes than we may have thought. For the study, researchers examined data from more than 1,000 pairs of female twins from the United Kingdom. The participants answered questions about their eating habits. Their questionnaires contained detailed information tracking a number of nutrients, including vitamins A, B, C, D, and E, as well as minerals like copper, manganese, and zinc. Researchers also checked each participants’ eyes to check for «cloudiness»—a sign of developing cataracts — at around the age of 60, and then again about 10 years later. Results showed that diets high in vitamin C were associated with a 20 percent reduced risk of cataracts at the beginning of the study. After 10 years, things got even better for those people consuming vitamin-C rich foods. They had a 33 percent reduced risk of cataract progression. The researchers concluded that though genetics still played a part — they accounted for 35 percent of the difference in cataract progression — lifestyle played a bigger part. Diet, in particular, accounted for 65 percent difference in the progression of cataracts.

WHY IS VITAMIN C PROTECTIVE AGAINST CATARACTS? Why was vitamin C so protective? Researchers stated that it helps to prevent the oxidation that actually causes the clouding of the lens. Cataracts form when the lens of the eye — positioned behind the iris — becomes «clouded,» which means that the tissues break down

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and clump together, creating a visual barrier or veil. These changes are caused by free radicals and cellular damage, and it’s this type of damage that vitamin C helps prevent. Researchers also suggested that more vitamin C in the diet could help increase the amount of fluid around the lens, which would also help protect it. They did caution that the benefits were found with food that contains vitamin C, not supplements.

WHAT FOODS TO EAT TO HELP PREVENT CATARACTS Since cataracts are so prevalent, it’s important for us all to take steps to protect our vision. The best thing you can do is to wear sunglasses, as UV radiation is a major factor in causing tissue changes that result in clouding. See your eye doctor regularly, as early detection can help you take steps to slow progression, and he or she can also recommend treatments when it’s time. Meanwhile, if you’d like to reduce your risk by eating more vitamin C, make sure these items are on your weekly menu: ■■ Peppers (like yellow bell peppers) ■■ Guava fruit ■■ Dark green leafy veggies (like kale and spinach) ■■ Kiwi fruit ■■ Broccoli ■■ Berries ■■ Citrus fruits ■■ Tomatoes (cooked) ■■ Peas ■■ Papaya

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5 ALTERNATIVE TREATMENTS FOR CHRONIC PAIN COMPLEMENTARY THERAPIES OFFER RELIEF WITH FEWER SIDE EFFECTS

■■■■By Colleen M. Story Nearly 50 million Americans suffer from significant chromic pain or severe pain, according to a study by the National Institutes of Health. It affects more people than diabetes, heart disease, and cancer combined, and is the leading cause of disability. The most common treatment usually comes in a pill, with between 5–8 million sufferers using opioid painkillers. In fact, the Centers for Disease Control and Prevention (CDC) states that the sale of these painkillers has quadrupled since 1999, fueling an epidemic of overdosing. Because opioids come with a risk of addiction, and because they don’t work for everyone, there is a growing interest in alternative treatments for chronic pain. Research has also suggested that pain is a complex condition that involves not only biological processes, but emotions like stress and anxiety, as well. In light of these new developments, the government has launched a new national pain strategy to call attention to the condition’s affect on health, and to create systems of improved care for patients. Part of that strategy is to place more attention to alternative treatments that can be used in conjunction with standard medications and therapies, to improve overall outcome. What are these alternative treatments? We’ve listed the most common ones below. Might they be a part of your chronic pain treatment program?

1. Yoga: A number of studies have indicated that yoga can help relieve chronic pain. According to Harvard Healthbeat, the practice can help people with arthritis, migraines, fibromyalgia, low back pain, and other chronic pain conditions. A 2011 study found that yoga was more effective than usual care in improving low back pain, and a 2013 meta-analysis of 17 studies found that it helped improve daily function, mood, and well-being among people with fibromyalgia. Vinyasa and Iyengar yoga are both slow-paced types of the practice that focus on body alignment and are gentle enough to help ease pain. The deep breathing and relaxation that comes with the practices is also believed to help patients experience relief. 2. Meditation: Brain imaging studies have found that when we experience pain, a number of thoughts and emotions are involved, tapping into different areas of the brain. Perhaps because of this brain-body connection, meditation has been found to be a very effective treatment for chronic pain. Studies have shown that the practice reduces perception of pain — after just 20 minutes in one study — and that it produces analgesic (painrelieving) benefits. A recent study from Wake Forest Baptist Medical Center reported that meditation reduces pain through various unique pathways, and that it worked quickly, providing fast results. 3. Hypnosis: The American Psychological Association notes that hypnosis is likely to be effective for more people suffering from different types of pain, and that it’s effective on even severe pain. Brain imaging research

reveals it can reach all of the brain areas involved in processing pain signals, and that regular practice can actually retrain the brain to respond differently. Patients report experiencing not only pain relief, but improved relaxation and sleep, and a boost in energy. A 2007 study review found that hypnosis consistently produced significant reductions in pain for a variety of chronic pain conditions, and a 2012 study found that it was effective for pain management in cancer patients. 4. Acupuncture: Studies have been mixed on acupuncture and chronic pain, but there have been several that have found positive results. A review of about 29 studies, for example, involving nearly 18,000 patients, showed that acupuncture relieved pain by about 50 percent overall. The side effects are low compared to medications, and the benefits so far have been reported in those with back pain, neck pain, osteoarthritis, headache, and more. 5. Biofeedback: Biofeedback involves the use of sensors on the skin that measure things like heart rate, respiration, blood pressure, muscle tension, and more. Patients can see what their levels are, and work to change them through relaxation techniques, breathing practices, and imaging activities. Being able to see how the brain is affecting the body helps patients to improve their control of these systems, and thus better control their own response to pain. Studies have shown it’s most effective for stress-related pain, like migraines and other headaches, back pain, phantom limb pain, and even pain associated with cancer treatments. www.4health.net

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| Plastic Surgery

SAVE YOUR CHILD FROM RIDICULE WITH A SIMPLE EAR SURGERY NAME:

Have you seen the new TV vampire drama, “Being Human?” If so, you may have noticed that one of the main characters, George, has ears that really stick out. So prominent is this feature that the press, critics, and fans are known to tease him about it, affectionately of course, but the actor seems nonplussed by the attention, especially since the show is doing so well.

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

Other famous people have had to manage with protruding ears, including Prince Charles—who’s suffered numerous taunts from both sides of the Atlantic—Will Smith, and even President Obama. Some, however, like Clark Gable, who “looked like a taxicab with both doors open” according to Howard Hughes, have had their ears surgically corrected to appear more normal. Protruding ears is one of the most common congenital deformities, and hits children particularly hard. Those born with prominent ears often suffer cruel taunts and heartless teasing that can wreak havoc on their confidence and self esteem. “Wing nut,” “radar,” and “dumbo” are typical nicknames that can scar a child’s psyche. Fortunately, Dr. Rayham at the RR Plastix/New York Plastic Surgery Center can fix the problem, and often performs the procedure on school-age children.

WHAT CAUSES PROTRUDING EARS? Protruding ears can be caused by many things, including genetics, birth defects, or even trauma and nerve damage. Most children who have it are born with it, a result of a glitch in development in the womb where the folds in the cartilage don’t form normally. The defect usually runs in families. Though protruding ears can be a sign of Down syndrome or other chromosomal problems, most of the time babies are perfectly healthy otherwise. Protruding ears usually don’t cause any physical problems, though in rare cases they can affect hearing. However, since the ears are one of the first body parts to reach full size, they can be especially noticeable in children. Some will “grow out” of them as the rest of their growth catches up to the ears, but for

many, the ears remain unnaturally prominent, which can lead to serious emotional setbacks.

EMOTIONAL CONSEQUENCES According to Dr. David Ju, protruding ears can “produce profound psychological effects on children which hinder the normal mental development and personality. This can be carried into adult life and permanently affect the whole outlook of life.”1 Dr. Rayham is particularly fond of “otoplasty,” the procedure that restores a more normal look to protruding ears, because of the profound positive benefits it can have on his patients. “A lot of times a mom will come in with her child who has protruding ears,” he says, “and the child will have suffered from the other kids teasing and making fun of him. I like to fix that situation. I do a very nice operation where we tuck the ears back so they look normal again, and the child feels so much better around his peers. Sometimes we can do the procedure even before the child starts school, to save him the embarrassment.”

PROCEDURE OPTIONS If you’re child has protruding ears—or if you’re an adult and want to improve the appearance of your ears—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 flatten the ears and bring them closer to the head. The surgery typically takes one-two hours and you can go home the same day. An initial consultation can determine your best options. Call 1-877-582-0400, or visit the website at www.rrplastix.com.

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HOW TO CHOOSE THE BEST ORTHOTIC FOR YOUR FEET MULTIPLE OPTIONS CAN MAKE IT CONFUSING

■■■■By Gordon Barclay I’ve bought a lot of shoe inserts over the years. As a guy who pronates a lot, they’re kind of necessary for any exercise I’m going to be doing, even just regular walking. Some of them worked, but a lot of them weren’t helpful, and I ended up having to throw them out.

WASTE OF MONEY, RIGHT? So I wondered — is there any way to tell beforehand if one of these things is going to work for you or not? Here’s what I found. The Difference Between Shoe Inserts and Orthotics Before we get too far into this, it’s best to be sure we’re all on the same page. I thought all things that you put into shoes were the same, but turns out the foot doctors don’t see it that way. Instead, we have a couple different categories:

Shoe inserts: These are the inserts you can find at the store — nonprescription foot supports designed to be worn inside shoes. These in-

clude things like arch supports, insoles, heel liners, and foot cushions. These are also sometimes called «over-the-counter orthotics.» Orthotics: These are custom-made, specially designed devices designed to support and comfort your feet, in particular. They are made to match the contours of your feet. Though either one of these inserts may be able to help you, podiatrists usually recommend custom-made orthotics as the best option for reducing foot-related pain related to conditions like plantar fasciitis, tendinitis, diabetic foot problems, bursitis, and other issues.

SOME GENERAL INSERT GUIDELINES So with all the choices out there, how are you to know exactly what you need? Your best bet is to see your podiatrist. Everyone has different feet, and therefore, different needs for foot support, and it’s hard to tell what that means on your own. There are some basic guidelines, though, that can get you a little closer to the right thing. www.4health.net

4HEALTH Hard or soft? I tried one of those hard inserts one time, and ouch! I couldn’t use them. But that doesn’t mean they wouldn’t be right for you. In general, if you have low-arched or flat feet, try a more rigid insert to help control the motion of the foot. If your arches are high — with a large gap between the floor and the arch when standing — a softer orthotic is better to help absorb shock. Cushioning or supportive? If you’re someone who is on her feet all day and feels the resulting pain at night, you may need simple cushioning inserts that will help increase your comfort while standing. These are simply flat inserts with gel or foam that help cushion the foot. They are often thicker to absorb more shock. Supportive inserts, on the other hand, help provide structural support for feet that are misaligned somehow. If you have high or low arches, as mentioned above, or if you pronate or supinate, or have plantar fasciitis, then you’re more likely to need supportive inserts that help keep the foot in its proper position. Fit problems? If you have trouble getting your shoes to fit, other types of inserts may help. If your heel slips, for example, a supportive, mid- to high-volume insole may help reduce excess volume in the rear of the shoe and stabilize the heel. If your foot lengthens considerably when you stand as opposed to when you sit, look for a supportive insole that helps reduce the elongation and creates a better fit. Custom-made at the store: You’ve likely seen the fairly new «customized» machines at stores that give you information on which insert is right for you. You step on the machine and it takes quick measurements on the shape of your foot, your arch type, foot length, and pres-

www.4health.net

sure points. It then spits out the insert best for you. This may help you get a bit closer to the right insert than you would otherwise, but just be aware that it won’t be perfect. Most podiatrists feel that these machines provide only a slight advantage, if any, over simply going with your best guess. Full-length or three-quarter length? In general, the rule goes that full-length is best for athletic shoes, while three-quarter is best for casual and dress shoes. If you have heel slippage, though, the threequarter may work best for you in both shoes, as it will allow the front of your foot the extra room it needs, while reducing volume at the heel of the shoe.

CHOOSING THE RIGHT OPTION FOR YOU How do you know if your inserts are working? Listen to your feet, legs, knees, and hips. Improper foot positioning can cause pain in any and all of these areas — even your back. If the over-the-counter products don’t do the trick, see your podiatrist for possible custommade orthotics. These can help support your individual foot in a way that may even help prevent pain and arthritis down the road.

Weil Podiatry of New York 718.504.5877

4159 Broadway, Washington Heights, NY 10033 59-20 Myrtle Ave, Queens, NY 11385

4HEALTH

HOW TO PROTECT YOUR ARTERIES AND VEINS FROM TOO MUCH SITTING STUDY SHOWS SMALL BURSTS OF ACTIVITY ARE HELPFUL

■■■■By Colleen M. Story You’ve probably heard that sitting is the new smoking. Recent research has discovered that the more we sit, the less healthy we are, and that sitting for more than six hours a day

can significantly affect our health, increasing risk of diabetes, heart disease, and even premature death. The other reason sitting is so bad for us is that it slows our circulation. This can have a negative affect on our vascular health, as a whole. Varicose veins, for example, are

considered to be partially caused by a sedentary lifestyle. The good news is that we can counteract the effects of sitting with just small bursts of activity. A recent study, for example, found that just a ten-minute walk can do wonders for our health. www.4health.net

4HEALTH LACK OF MOVEMENT SLOWS CIRCULATION, CAUSES VASCULAR PROBLEMS When we sit for more than just a few minutes, blood and other fluids tend to pool more readily in our legs and feet. This increases pressure on the blood vessels there, which can increase risk that those vessels will eventually become damaged. That leads to weakened vessel walls, damaged valves in the veins, and eventually, leakage and varicose veins. Prolonged sitting also tends to increase levels of cholesterol in the blood. More cholesterol is bad news for our blood vessels, particularly the arteries. It can collect in the arterial walls, gradually forming a hard plaque that narrows the opening and makes it harder for the heart to pump blood through. Over time, the result can be a higher risk of narrowed arteries and heart disease. The problem isn’t just sitting, however. It’s the overall lack of movement. Though many people are switching to standing desks now, figuring that it’s healthier, a recent study found that standing is not much better than sitting if you’re not moving much. «Any stationary posture where energy expenditure is low may be detrimental to health,» said Melvyn Hillsdon, one of the researchers on the study, «be it sitting or standing.»

of us — the blood flow in one of the arteries in the lower leg was greatly reduced. A short, 10-minute walk, however, restored the impaired vascular function and improved blood flow. In other words, it seemed to offset the harm that the prolonged sitting had caused. «It’s easy for all of us to be consumed by work and lose track of time,» said Jaume Padilla, lead author of the study, «subjecting ourselves to prolonged periods of inactivity. However, our study found that when you sit for six straight hours, or the majority of an eight-hour workday, blood flow to your legs is greatly reduced. We also found that just 10 minutes of walking after sitting for an extended time reversed the detrimental consequences.» Improving vascular function with more short breaks to walk could result in a number of health benefits, including a reduced risk of varicose veins, deep vein thrombosis, and cardiovascular disease.

OTHER OPTIONS FOR TAKING SHORT ACTIVE BREAKS Though walking is the easiest activity for most of us to do when taking a break at work, on the airplane, or on a car trip, there are other ways to break up the sitting to get yourself moving. Here are some options: ■■ Keep a jump rope with you and take a break to jump for 30–60

seconds, pause, and repeat three times.

THE SOLUTION? IT MAY BE AS EASY AS GOING FOR MORE SHORT WALKS.

■■ Turn on the tunes and dance for five minutes. ■■ Drop and do 20 push-ups, followed by 20 jumping jacks. Repeat

A 10-Minute Walk Helps Counteract the Effects of Sitting In a recent study, researchers compared the vascular function of 11 healthy young men both before and after a period of prolonged sitting. They found that after six hours of sitting — a standard workday for most

■■ Alternate between sitting and standing while at your desk. ■■ Strike a few yoga poses to stretch your muscles and move your

if you can.

legs.

You may have a condition called venous insufficiency, which left untreated can lead to serious health complications. Our non-surgical, minimally invasive and painless endovenous procedure only takes 15 minutes.

www.4health.net

4HEALTH

SUMMER SEASON IS KIDNEY STONE SEASON HOW TO REDUCE YOUR RISK OF THIS PAINFUL CONDITION ■■■■Colleen M. Story The temperature is going up, and before long, we’ll be breaking out the flip-flops, sunscreen, and bikinis. Unfortunately, summertime is not only the time for barbeques and beach parties, but for a bevy of kidney stones. According to the Mayo Clinic and other health organizations, the summer season is “kidney stone season.” Why is this, and could you be at risk?

WHAT ARE KIDNEY STONES? Kidney stones are hard deposits of mineral and acid salts that form inside the kidney when the conditions are right. These stones may then remain where they are, or travel down the urinary tract to be expelled from the body. If they’re small, you won’t notice their passage. Larger kidney stones, however, can become stuck in the urinary tract, causing pain, bleeding, and urine blockage.

WHAT CAUSES KIDNEY STONES? It’s not always clear exactly what causes kidney stones, but there are several factors that can increase your risk of having them. These include: Genetics: People with parents who suffered from kidney stones have a higher risk of developing them, and those who’ve had one in the past are more likely to have another in the future. Dehydration: If you’re not getting enough water, you are at an increased risk of kidney stones. Obesity: Those who are extremely overweight or obese are at a higher risk of suffering kidney stones.

Age and gender: Men over the age of 40 are most at risk, though kidney stones can affect men and women at any age. Diet: If you eat an unbalanced diet with foods that are high in sugar, salt, and protein, this can create the conditions suitable for kidney stone formation. A diet high in sodium, in particular, increases the amount of calcium the kidneys have to filter, and most kidney stones are formed with calcium. Medical conditions: Some medical conditions can increase your risk, like hyperparathyroidism, tubular acidosis, and some urinary tract infections.

WHY DOES THE SEASON MATTER? In addition to the risk factors above, summertime presents its own unique challenges for those at risk for kidney stones. Because it’s hot, people are more likely to sweat more and become more easily dehydrated. Without the necessary hydration, the fluids in your body become more concentrated with minerals like calcium. Imagine a flow of water gradually bogged down by dirt. The more dirt you have, the more likely that dirt will be to clump together to form clods—similar to the way minerals like calcium can clog together to form kidney stones. If you add more water, the dirt keeps moving, but slow the water down, and you’re likely to get clumps. Since people aren’t used to drinking more water in the summer, they often don’t drink enough to compensate for the water weather. In addition, they often drink fluids that don’t really help hydration, like beer, colas, and iced coffee.

WHAT ARE THE SYMPTOMS? You’re not likely to feel anything that indicates you may be at risk for kidney stones until one actually starts to make its way between your kidney and bladder. At that point, you may feel symptoms including severe pain in the side, back, lower abdomen and groin. The pain may fluctuate, coming and going, and you may also have pain during urination. Additional symptoms include pink, red, or brown urine, nausea and vomiting and a persistent urge to urinate. If you have pain so severe you can’t get comfortable, see your doctor right away. Other emergency symptoms include blood in the urine, and fever and chills that come with the pain. Treatment may include therapies that use sound waves to break up the stone.

HOW TO PREVENT KIDNEY STONES During the warmer summer months, the most important thing you can do to avoid kidney stones is to drink more water throughout the day. If you live in a hot, dry climate, drink more, particularly during and after strenuous exercise. Oftentimes, you need to double your normal water intake to compensate for the warmer temperatures. Other prevention steps include reducing your sodium intake, limiting caffeine, and cutting back on meat. If you’ve had a kidney stone before, you may want to ask your doctor about calcium supplements. Calcium in food won’t affect your risk, but calcium supplements may. In addition, eat more citrus fruits, particularly lemons, which are high in citrate, a kidney-stone inhibitor. Homemade lemonade might be just the ticket for an enjoyable summer. www.4health.net

4HEALTH

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: ■■ Have you been diagnosed with major de-

pressive disorder? ■■ Have you had trouble finding relief with

antidepressant medications? ■■ 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

4HEALTH

6 THINGS TO DO IN THE DOCTOR’S WAITING ROOM HOW TO USE THE TIME IN A PRODUCTIVE WAY ■■■■Colleen M. Story Most doctors do everything they can to take you in at your appointment time, but sometimes patient emergencies, unplanned complications, insurance demands, or even things like the weather, a flat tire, or the traffic can mean that you’re left waiting a little longer than you’d like. How can you use that time in a way that will reduce your frustration and increase your productivity? Try these ideas on for size. 1. Write down your questions. You may not have remembered to do this before your appointment, or maybe you just didn’t get the time. Now you can. If you don’t have paper and pen, ask the receptionist, then write down all your questions related to your current health concern, and/or any other questions you may have. With some quiet time to sit down and think, most likely you’ll come up with key inquiries that will help you get the most from your appointment. Need some help? Think about the following: ■■ What symptoms are you having? How often do they appear?

■■ What makes your symptoms better or

worse? ■■ What concerns do you have about these symptoms? ■■ What else is going on in your life that may be making the symptoms worse? ■■ What other questions do you have about your health in general? ■■ If you’re on medications, do you feel they’re working? Why or why not? ■■ Is there anything else you want to ask about your health and wellness at your age? 2. Make a list of all medications you’re taking. Though doctors and pharmacists are typically careful, medication errors have been made. Some drugs interact dangerously with others (or with supplements), or can be too strong or too weak for you at certain doses. Think about everything you’re taking right now, including any vitamins, minerals, herbal supplements, daily medications, prescriptions, etc. 3. Check with the receptionist on any outstanding test results. Did you get an X-ray since your last visit? Have a blood test or MRI scan? Ask your receptionist to see if the results are on file. If so, you can look them over before your appointment. If not, the reception-

ist may be able to get them faxed or emailed over before you see the doctor. 4. Make sure the office has your correct insurance information. To save yourself any surprise bills, check to be sure the office has all your information. You may need pre-authorization for diagnostic tests, and you want to be sure that your provider pays for what you expect they’ll pay for. Ask any questions you have. 5. Avoid infection. Remember that people who go to the doctor’s office are usually ill. Magazines and surfaces may be contaminated. Wash your hands when you get to the office and before you leave. Keep your hands away from your face. Bring along your own magazines or books, and keep them either on your lap or in a bag—don’t leave them on the table or elsewhere in the office where they may pick up germs. 6. Try to relax. For some, being in a doctor’s office can be nerve racking. If you know you’re going to be a big uneasy, consider taking along an iPod, electronic game, book, your latest crocheting or knitting project, or other favorite items that will help you relax and take your mind off your worries. www.4health.net

4HEALTH

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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

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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

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

(718) 576-1212

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

(718) 759-6979

(212) 876-7575

(718) 375-4747

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

(718) 283-7219

(718) 627-8300

ORTHOPAEDIC SURGERY

Amit SCHWARTZ, MD

OBESITY MEDICINE

Harout MARGOSSIAN , MD 7206 Narrows Ave Brooklyn, NY 11209

(888) 404-5046

1529 Richmond Rd Staten Island, NY 10304

(888) 538-2717

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

1642 W 9th St Brooklyn, NY 11223

(718) 336-2258

(718) 513-6060

321 Edison St Staten Island, NY 10306

(718) 980-2525 NEUROLOGY

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

(888) 283-0399

Namik YUSUFOV, DDS, MDT

PAIN MANAGEMENT

Anella BAYSHTOK, MD

(718) 512-2160

158-06 Northern Blvd Flushing, NY 11358

(212) 804-0500 (732) 728-7075

(516) 775-0272

2101 Ave X Brooklyn, NY 11235

305 W 28th St New York, NY 10001

170 Morris Ave, Ste A Long Branch, NJ 07740

133-55 Lefferts Blvd South Ozone Park, NY 11420

Prabhakara R. TUMPATI, MD

(718) 445-3700 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 ALTERNATIVE MEDICINE - GENERAL

PODIATRY

Michael RISKEVICH, MD

2736 Ocean Ave, Ste 1A Brooklyn, NY 11229

(718) 934-8484

PHYSICAL THERAPY

Alina VASILYEVA, DPM

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

LSA RECOVERY

1300 Ave P Brooklyn, NY 11229

(888) 983-4055 RADIOLOGY

Ridwan SHABSIGH, MD

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

(718) 283-7746

(718) 646-0131

1901 82nd St Brooklyn, NY 11214

(718) 490-2416 www.magichandspt.com

PLASTIC SURGERY

230 Park Ave, Fl 10 New York, NY 10196

(212) 729-3922 PSYCHIATRY

AESTHETIC CENTERS

Michael PATIN, MD

6417 Bay Pkwy Brooklyn, NY 11204

(718) 234-6767

102-51 Queens Blvd Forest Hills, NY 11375

(718) 896-2333

NUTRITION AND DIETETICS

Sinai DIAGNOSTICS Chloe CARMICHAEL

8635 21st Ave Brooklyn, NY 11214

(888) 410-3442

PSYCHOLOGY

Vladislav RUDNER, PT

Ada KULAGINA, LAC

2560 Ocean Ave Brooklyn, NY 11229

(888) 496-2688

2071 Clove Rd Staten Island, NY 10304

(888) 496-2688 UROLOGY

David SHUSTERMAN, MD

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

VK SKIN SPA

Albert GROSS, CNS, NYS, CDN

1942 E 8th St Brooklyn, NY 11223

(718) 376-8317

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

(646) 200-5856

MEDICAL SUPPLY

www.nylifex.com

MULTI SPECIALTY

Natalie BORODOKER, MD

2792 Ocean Ave, Ste 4 Brooklyn, NY 11229

(718) 517-2555

Felix DRON, MD

7620 Bay Pkwy, Ste 1B Brooklyn, NY 11214

(718) 232-1492

Yuly CHALIK, MD

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

(347) 508-3991 www.nyui.org

USA VEIN CLINICS

Globe SURGICAL SUPPLY

1153 First Ave New York, NY 10065

Multi SPECIALTY CLINIC

2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

(877) 807-0989

2029 Bath Ave Brooklyn, NY 11214

(888) 418-0442

3023-3027 Ave V Brooklyn, NY 11229

2444 86 St, Ste A Brooklyn, NY 11214 Th

116-02 Queens Blvd Forest Hills, NY 11375 1975 Hylan Blvd Staten Island, NY 10306

Roman RAYHAM, MD, BOARD CERTIFIED IN PLASTIC SURGERY

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

Mark GURTOVY, MD

7620 Bay Pkwy, Ste 1B Brooklyn, NY 11214

(718) 232-1492

(877) 582-0400

www.nyplasticsurgerycenter.com

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

Vitaly RAYKHMAN, MD

4159 Broadway Washington Heights, NY 10033

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

59-20 Myrtle Ave Queens, NY 11385

www.nyui.org

(718) 509-0906

(347) 508-3991

USA VASCULAR CENTERS

2444 86th St, Ste A Brooklyn, NY 11214

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

(855) 328-5525

30-33 Steinway St Astoria, NY 11103 www.usaveinclinics.com

Interborough DEVELOPMENTAL & CONSULTATION CENTER 1623 Kings Hwy, Fl 4 Brooklyn, NY 11229

(888) 987-5751

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

Compression Fracture Vertebral Disc Vertebra

Spine Fracture?

A spinal fracture, also known as a vertebral compression fracture (VCF), occurs when one of the bones of the spinal column weakens and collapses. Spinal fractures tend to be painful and if left untreated, can adversely affect overall health and well-being. It is important that spinal fractures are diagnosed and treated by a physician. A physical exam, along with an X-ray, can help determine if a spinal fracture has occurred. Contact USA Vascular Centers to discuss the benefits of Kyphoplasty Treatments and to determine whether you are a suitable candidate for this treatment. Kyphoplasty is minimally invasive treatment that can repair spinal fractures caused by osteoporosis, osteopo cancer or benign lesions.

Am I At Risk For A

Compression Fracture • Do you have sudden onset, sharp back pain that lasts longer than 3 days? • Are you over 50 or post-menopausal? • Have you ever been diagnosed with osteoporosis or low bone mineral density? If one or more of these apply to you , you may benefit from an evaluation. Contact one of our specialists today!

(718) 504-6064 2444 86th St, Ste A, Bensonhurst, NY 11214 260 W Sunrise Hwy, Ste 102, Valley Stream NY 11581 www.USAVascularCenters.com info@usavascularcenters.com www.4health.net

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