4Health Magazine # 205 issue by MOO Publishing

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Editorial Department: Editors Colleen M. Story Nataly Smolyanska Contributing Writers Colleen M. Story Lynn Merrell Gordon Barclay Morgan Rice

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5 REASONS TO AVOID SMOKING MARIJUANA

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WEIGHT LOSS IMPROVES SLEEP AND MOOD

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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. 4HEALTH | 877.807.0989

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Vaccines Aren’t Just for Kids—Are You Up to Date? Seniors Need Vaccines to Protect Their Health

COULD PROBIOTICS HELP TAME PEANUT ALLERGIES?

IT’S ALL ABOUT HELPING PEOPLE LIVE BETTER LIVES

11 8 I’m Not Ready to Have a Family— Should I Freeze My Eggs? Who is a Good Candidate for Oocyte Cryopreservation?

13 Do These Mouth Sores Indicate Oral Cancer?

When You Should be Concerned About Mouth Sores

16 Might the Fasting Diet Work for You? Comparison of Fasting and Restriction Diets

17 Are Sports Too Dangerous for Kids? Doctor Suggests Waiting to Avoid Concussions

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Study Gives Parents Hope

An Interview with Dr. Yan Katsnelson, CEO of USA Fibroid Centers

AM I GAINING TOO MUCH WEIGHT DURING PREGNANCY? Extra Pounds Can Increase Risk of Complications

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

ADVANCES IN PARKINSON’S DISEASE Discoveries May Lead to Early Diagnosis and New Treatment Options

7 TIPS TO KEEP EYES HEALTHY WHILE TRAVELING

GETTING SHORTER? COULD BE OSTEOPOROSIS

ERASE SUN DAMAGE AND SHAVE YEARS OFF YOUR APPEARANCE

SHOULD YOU GET A BUTT LIFT?

MYTHS AND FACTS ABOUT THE SHINGLES DISEASE

Don’t Wait to Check Out Injuries & Problems

Height Analysis Could Identify Patients Who Need Treatment

Dr. Roman Rayham on a New Treatment Provides Dramatic Results with Little Downtime

What’s Involved in Enhancing Your Backside

How to Increase Your Odds of Avoiding Pain

WALKING WITHOUT PAIN

WHY YOU SHOULD SEE A DOCTOR ABOUT THAT NON-HEALING WOUND

SHOULD YOU ASK YOUR FRIEND FOR A DOCTOR RECOMMENDATION?

DON’T LET SWIMMER’S EAR RUIN YOUR FUN

ANTIBIOTICS DON’T HELP THE COMMON COLD OR BRONCHITIS…BUT THIS WILL

INSOMNIA? TURN OFF THE GADGETS!

AFTER A STROKE—HOW TO AVOID GOING THROUGH THAT AGAIN

What Causes Heel Spurs and How Are They Treated?

Leg Ulcers Can Indicate Other Circulatory Issues

How to Determine the Right Doctor for You

Tips for Treatment and Prevention

Have You Tried Acupuncture to Reduce Troublesome Symptoms?

Study Shows Blue Light Affects Sleep Hormone

Tips to Reduce the Risk of the Dreaded Second Stroke 4HEALTH | 877.807.0989

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4HEALTH

VACCINES AREN’T JUST FOR KIDS — ARE YOU UP TO DATE? SENIORS NEED VACCINES TO PROTECT THEIR HEALTH

When you think of keeping up with vaccinations, you probably think of young children. According to the Centers for Disease Control and Prevention (CDC), immunizations not only may save a child’s life, but also help protect future generations. But immunizations aren’t just for children. There are several available for adults, as well, that can help them avoid disease. As we get older, particularly when we enter our senior years (60 and beyond), the immune system declines somewhat, which can leave us more vulnerable to diseases and infections that can seriously affect our health. If you’re not sure where you are on your vaccination schedule, or what vaccines you need in your golden years, I’ve got the answers for you below. Bottom line: It’s your health. Don’t take chances with it.

ic health conditions. No one can afford to be down with the flu, but if you have other health conditions, the flu can develop into a serious illness. Recent studies show the vaccine reduces the risk of flu by 40 to 60 percent among the overall population. That definitely increases your odds of staying well this year. The CDC also recommends that if you didn’t receive the Tdap vaccine as an adolescent (to protect against whooping cough), you should definitely get that, as well as the tetanus and diphtheria (Td) booster shot every 10 years. Pregnant women need the Tdap vaccine for each pregnancy, taken usually between 27 and 36 weeks. Young women up to the age of 26 years should also get the HPV vaccine to protect against the virus that causes most cervical cancers, anal cancer, and genital warts. It’s also recommended for men up to 21 years old, and men aged 22–26 who have sex with men.

RECOMMENDED VACCINATIONS FOR ADULTS

RECOMMENDED VACCINATIONS FOR SENIORS

We’re smack in the middle of flu season, so if you haven’t gotten your flu shot yet, now is the time. The CDC recommends that all adults get a seasonal flu vaccine every year, but add that it is particularly important for pregnant women and for people with chron-

Once you reach the age of 60, you need to be aware of other vaccines that can benefit your health. Remember that age is associated with a decline in the immune system. Researchers reported in a 2013 study that age reduces the production of certain immune cells

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By Gordon Barclay

in the bone marrow and thymus and diminishes the function of other cells, resulting in a less robust system that is not able to protect you like it did when you were younger. That means seniors need to take advantage of vaccines that can help them stay well. The recommended schedule is as follows: n Flu shot: Over 60 percent of seasonal flurelated hospitalizations occur in seniors 65 years or older. Get your flu shot every year, preferably in early autumn. Ask your doctor about using the high dose — it’s 25 percent more effective than the standard dose, and is more likely to protect you in your senior years. n Shingles vaccine: About one million Americans get shingles every year. This is a painful rash that develops along the nerve and shows up in the skin. It’s caused by the same virus that causes chickenpox, so if you ever had chickenpox, you’re at risk. The vaccine is recommended for seniors 60 years and older. n Pneumonia vaccine: Pneumonia is a serious infection in the lungs and can cause hospitalization and even death in older individuals. The vaccine is recommended for all adults 65 and older. n Tdap: If you’ve never had a booster, get it. It protects against whooping cough, tetanus, and diphtheria. 4HEALTH | 877.807.0989

4HEALTH

COULD PROBIOTICS HELP TAME PEANUT ALLERGIES? STUDY GIVES PARENTS HOPE

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By Colleen M. Story

Estimates are that about 15 million Americans suffer from food allergies, including about 6 million kids under the age of 18. Between 1997 and 2007, food allergies increased 18 percent among children, and between 2004 and 2006, about 9,500 children were hospitalized each year because of the effects of food allergies. Peanut allergy is the most common among children, and can cause reactions so serious that they are potentially fatal. “I worry every day that my daughter could die from ingesting a peanut product,” says mom Christine O’Brien. “She is not expected to outgrow this allergy, so we will live our lives on high alert.” Scientists are hard at work trying to find a solution. A recent study provided some hope the answer may be a lot simpler than we thought.

DOES IT HELP TO EXPOSE YOUNG CHILDREN A LITTLE AT A TIME? Currently, there is no cure for a peanut allergy, and since peanuts and peanut residue are found in a number of different foods, it can be very difficult to deal with. There is no treatment beyond avoidance — and emergency care if a reaction occurs — which is why many kids carry around epinephrine injectors. 4HEALTH | 877.807.0989

Scientists continue to study desensitization, a treatment in which doctors gradually expose children to small doses of food containing peanuts, increasing the dose over time to allow the body to adjust. The long-term safety of this approach is still uncertain, however, and there is the risk of a reaction at any time, which would understandably make most parents nervous. One study showed good results with the process in children between the ages of 4 and 11 months, but so far the treatment is not FDA-approved.

SCIENTISTS FIND GOOD RESULTS WITH PROBIOTICS Scientists are working on other approaches that may be safer for kids, and recently reported on a couple that look very promising. In the first one, they gave one group of children probiotics — Lactobacillus rhamnosus — combined with gradually increasing amounts of peanut protein, while they gave a second group only a placebo. After 18 months, 82 percent of the children had become tolerant to peanuts. In the placebo group, only 4 percent became tolerant. Scientists instructed the families of the children who were tolerant to allow the kids to consume peanuts as part of their regular diet. In the second study, which occurred four years later, the scientists retested the tolerant children via skin prick-tests and in controlled food challenges. They found that the kids re-

mained tolerant to peanuts four years after stopping the treatment. “These children were able to eat peanut like children who don’t have a peanut allergy and still maintain their tolerant state,” said lead author Professor Mimi Tang of the University of Melbourne’s Department of Pediatrics in Australia. “Over half were consuming moderate to large amounts of peanut on a regular basis, others were only eating peanut infrequently.” She went on to state that the study was a “major step forward” in identifying effective treatments to address food allergies.

PARENTS SHOULD TALK TO THEIR ALLERGY DOCTORS ABOUT DESENSITIZATION If you have a baby that may be at risk for peanut allergies, talk to your allergy doctor about your options. New guidelines from the National Institute for Allergy and Infectious Disease (NIAID) recommend introduction of peanut-containing foods as early as 4–6 months for high-risk infants, after determining that it is safe to do so. Always check with your doctor first to avoid an emergency situation. If your child is older, continue to treat the allergy as you have, but ask your doctor for advice. New treatments are being tried all the time, and there is always hope that something more can be done.

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“IT’S ALL ABOUT HELPING PEOPLE LIVE BETTER LIVES” AN INTERVIEW WITH DR. YAN KATSNELSON, CEO OF USA FIBROID CENTERS

Through affordable, non-invasive therapy, USA Fibroid Centers, USA Vein Clinics, and USA Vascular Centers are changing the lives of thousands of patients around the country. Dr. Yan Katsnelson is the founder of the USA Fibroid Centers, USA Vein Clinics, and USA Vascular Centers. He is a cardiovascular and thoracic surgeon by training, and he has performed complex, livesaving heart surgeries, including valve replacements, repairs, and heart transplants. He started treating patients with uterine fibroids when a minimally invasive treatment called uterine fibroid embolization (UFE) became available. Prior to this non-surgical solution, patients with uterine fibroids almost exclusively underwent hysterectomy, which is highly invasive and leaves women unable to bear any more children. The novel UFE treatment made such a tremendous difference in the patients’ lives that Dr. Katsnelson changed his focus from heart surgery to the treatment of fibroid disease.

“I was immediately amazed by the results of this minimally invasive treatment, how people improved so quickly after this procedure, how well they tolerated the treatment, and how it changed their lives,” he says. “They would come in with heavy bleeding, severe cramps, even back and leg pain that they had been suffering from for years, and, suddenly, a treatment done in under an hour would completely change their way of living.” He and his wife, Dr. Flora Katsnelson, natives of the former Soviet Union, opened their first fibroid clinic in Bensonhurst, New York, in 2015. Due to high demand, in 2017, Dr. Katsnelson launched 13 new clinics under USA Fibroid Centers, which offers treatment for women who suffer from excessive menstrual bleeding and pain from uterine fibroids. USA Fibroid Centers are currently located in Illinois and New York and will be expanding to California and Washington in this year.

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4HEALTH “Our mission is to provide the best fibroid, vein, and vascular care to all patients who need it, giving them excellent state-of-the-art medical treatment that is best for them and affordable,” Katsnelson says. To achieve this, USA Fibroid Centers, USA Vein Clinics, and USA Vascular Centers accept Medicare, most insurances plans, and Medicaid, and its team of doctors are highly specialized in fibroid, vein, and vascular care and communicate in an array of languages, which is not the case in most other clinics. “One thing that is unique about our fibroid centers is our doctors. They are interventional radiologists who specialize in women’s health. Dr. Eli Halpert, our director of interventional radiology, specializes in therapeutic procedures for women, including treatments for pelvic congestion syndrome. Our doctors are extremely talented and, collectively, speak more than 10 languages,” he says. “We provide care to a diverse patient population.” This treatment of fibroid disease is called uterine fibroid embolization (UFE), a minimally invasive office procedure that takes about an hour and is an excellent non-surgical fibroid solution. Patients first complete an initial consultation where the doctor will provide a consultation with an ultrasound evaluation and a full mapping of all the fibroids in the uterus. The doctor will discuss the treatment plan and expected results. “We connect the dots between the symptoms and the ultrasound findings, and then connect them to the fibroids. When you combine those three things and administer proper treatment, the results are amazing,” Dr. Katsnelson says. USA Vein Clinics offer a treatment called endovenous laser therapy (EVLT) to treat venous insufficiency, the underlying cause of varicose veins. This procedure is quick, taking only about 15 minutes. Under ultrasound guidance, a thin, fiber-optic laser is inserted into the diseased vein, and laser energy is delivered while the laser fiber is drawn out of the vein, sealing it. The USA Vascular Centers offer a minimally invasive procedure for peripheral artery disease (PAD). Sometimes heavy smokers or others with high blood pressure get blockages in the leg arteries and might need surgery or even an amputation. In order to not lose the leg, this treatment opens the clogged arteries and restores proper circulation.

(718) 504-6525 www.USAFibroidCenters.com

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What Dr. Yan loves most about his job is helping patients across the country with real medical problems to get the bestfibroid, vein, and vascular care when they need it. “I really enjoy helping people with real problems. Their legs and back hurt, they’re fatigued, their periods are heavy and irregular, and they’re using up their sick days and vacation time due to severe cramps. After the treatment, the patients have a new life,” he says. “We can make people feel 20 years younger, and they tell me that all the time. When they feel better, they have more energy, so they’re happier, which makes them look better, too.” Another way Drs. Yan and Flora Katsnelson help others is through giving back. “We’re part of a diverse community, which we appreciate, so we try to give back. One way is through supporting the Save a Child’s Heart project, which saves the lives of many children around the world by providing heart surgeries in a hospital in Israel,” Katsnelson says. Dr. Yan has a connection to this hospital, because he worked there for nine years. Save a Child’s Heart organization has saved the lives of more than 4500 children from more than 50 countries through heart surgery and rehabilitation, all done in Israel free of charge. The program is expanding, too, opening programs in Tanzania, Ethiopia, China, and other countries. “These kids don’t have alternatives. If they don’t have access to surgery, they will die,” Katsnelson says. Drs. Flora and Yan started a chapter of the Save a Child’s Heart organization in Chicago. Their twin girls, Elise and Beatrice, who are juniors at Glenbrook North, want to follow in their parents’ footsteps and organized the first ever high school chapter of the Save a Child’s Heart organization. Instead of having a party for their Bat Mitzvah, as most North Shore kids do, they donated the money that they would have spent on the party to Save a Child’s Heart and saved the lives of two children: one from Ethiopia and one from Romania. “For me, through this organization and through our clinics, it’s all about helping people live better lives,” Katsnelson says.

(718) 509-0906

(718) 393-5331

www.USAVeinCinics.com

www.USAVascularCenters.com

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AM I GAINING TOO MUCH WEIGHT DURING PREGNANCY? EXTRA POUNDS CAN INCREASE RISK OF COMPLICATIONS nnn Lynn Merrell Kerry was a little concerned. She was five months along in her pregnancy and she had gained quite a bit of weight. She knew that some weight gain was normal, but this much? She was suffering from backaches, leg pains, and achy joints, and had already gained 20 pounds. She decided to call her doctor for an appointment. Kerry was right to take action. Several studies have associated overweight and obesity with a number of complications, including high blood pressure, diabetes, and large babies (which can be difficult to deliver vaginally). Recent research warns that women who are obese during pregnancy face an increased risk of delivering a very premature baby, which can lead to lifelong problems like cerebral palsy, impaired vision, and developmental delays.

STUDY LINKS OBESITY AND PREMATURE BIRTH For the study, researchers from the Stanford University School of Medicine examined data from nearly one million California births between January 2007 and December 2009. They looked specifically for spontaneous preterm births, which reduced the number of participants to nearly 990,000. Results showed the following: n For first-time mothers, obesity was

linked with a substantial increase in risk of delivery before 28 weeks of pregnancy. n Non-Hispanic, white first-time mothers in the most obese category were six times

more likely than normal-weight women to deliver a baby early, between 20 and 23 weeks. n Obese women having their second or third or later child were also more likely to deliver early than normal-weight women. n Researchers concluded that something about obesity itself can trigger early birth. They theorized that it may have something to do with inflammation and how obesity can exacerbate it. The researchers warned that women should talk to their doctors about the possible risks of too much weight gain and premature birth.

TOO MUCH WEIGHT GAIN LEADS TO OTHER COMPLICATIONS Premature birth isn’t the only concern when mom is carrying a few too many pounds. Research has also shown that overweight and obesity can increase the risk for all of the following: n The pregnancy will be more difficult:

As Kerry was discovering, extra pounds made her pregnancy more difficult. She felt more aches and pains and had more trouble getting around than she would have had she stayed within the weightgain recommendations. n Increased risk for diabetes: Extra weight gain increases the risk of gestational diabetes, a serious condition that can lead to excessive birth weight, preterm birth, high blood pressure, preeclampsia, and type 2 diabetes later in life.

n Increased risk of birth complications:

If mom gains too much weight, baby is likely to gain, too, which can make delivery difficult. Large babies have a hard time getting through the birth canal, which can increase risk for shoulder injuries and Erb’s palsy. Doctors may have to deliver via a C-section. n Can lead to long-term weight problems: Pregnancy weight isn’t easy to lose to begin with. If you gain too much, you can be setting yourself up for a lifetime of weight problems. n That the child will be overweight. A 2014 study reported that among all participants who gained more than the recommended weight during pregnancy, 20.4 percent of their children were overweight or obese compared to 14.5 percent of women who gained weight within the guidelines.

HOW MUCH WEIGHT IS TOO MUCH? This varies with every person, so it’s best to talk to your doctor. Basic recommendations are that normal weight women gain 20-35 pounds, overweight women gain 1525 pounds, and obese women gain 11 to 20 pounds, but each case is different. You can also find “pregnancy weight gain calculators” online that can help give you a good idea. The main thing is to remember that pregnancy isn’t an automatic excuse to forget about the normal standards of eating a healthy diet and exercising every day. Both you and your child’s health depend on you making the smartest choices you can about your diet, exercise routine, and weight gain. 4HEALTH | 877.807.0989

4HEALTH

I’M NOT READY TO HAVE A FAMILY — SHOULD I FREEZE MY EGGS? WHO IS A GOOD CANDIDATE FOR OOCYTE CRYOPRESERVATION?

nnn By Lynn Merrell According to the National Center for Health Statistics, American women are waiting longer to have children. The average age of firsttime moms in 2014 was 26.3, up from 24.9 in the year 2000. In 1970, the mean age of a first-time mom was 21.4. The results also reveal that more women over the age of 30 are starting families. There are a lot of reasons for that. Women want to be more financially established before having kids, and want to feel like they’ve lived life enough to be emotionally stable. Many want to have some time to focus on their careers, and enjoy some freedom before tying themselves down. Some also want to be sure they find the right partner. Whatever the reason, women may find themselves in their 30s or older and still a long way away from being ready to have children, yet they know they want them. For these women, egg freezing or egg storage may be an attractive option.

WHAT IS EGG FREEZING? Egg freezing, medically termed “mature oocyte cryopreservation,” is a method of removing and preserving eggs so that a woman can wait to have children. The procedure allows women who are getting older, but who aren’t ready to get pregnant right away, to secure their ability to have a biological child in the future. It’s a way to stop the biological clock, so to speak. Women usually work with a fertility center to store their eggs. Doctors perform an analysis first, to see if a woman is a good candidate for the procedure. This usually involves blood tests and ultrasounds. If everything looks good, the doctor prescribes hormone injections to simulate the ovaries to produce multiple eggs. This part of the process usually lasts about two weeks, and involves additional ultrasounds and blood tests so the doctor can be sure when the eggs are ready. Finally, when the woman reaches her ovulation period, doctors place her under light sedation and then retrieve the eggs and the sur4HEALTH | 877.807.0989

rounding fluid via the vagina. Mature eggs are preserved with rapid cooling in liquid nitrogen. When the woman is ready to have a child, the egg is thawed and fertilized via injection, then grown until ready to be transferred into the uterus, which usually takes 3–5 days.

WHO IS A CANDIDATE FOR EGG FREEZING? Women may consider egg freezing for a lot of reasons, but some common ones include: n I want time to pursue career or educational goals n I want to find the right partner before starting a family n I won’t be ready for a family until I’m older, and want to act immediately while my eggs are of premium quality n I have a type of cancer that may cause infertility n I’ve been diagnosed with early menopause or another condition that may lead to infertility n I’m going through in vitro fertilization, but I don’t want to freeze my embryo Women who elect to freeze their eggs are usually in their 20s or 30s. As women get older, the quality and quantity of the eggs decreases, and the chances for a successful pregnancy go down.

WHAT CAN WOMEN EXPECT? The procedure of extracting the eggs usually takes only about 15–20 minutes, but women may experience cramping, fullness, and pressure for weeks afterwards until the ovaries return to normal. Doctors usually recommend about a week for recovery, and advise women to watch for severe abdominal pain, difficulty urinating, heavy vaginal bleeding (more than two pads an hour), and a high fever. If any of these are present, women should contact their doctors immediately. The good news is that about 90 percent of eggs survive the process, and about 75 percent result in successful fertilization. A woman’s odds of becoming pregnant after implantation are about 30–60 percent, so it’s important to realize that pregnancy is not guaranteed.

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Obesity Medicine | 4HEALTH15

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. 4HEALTH | 877.807.0989

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.

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4HEALTH

DO THESE MOUTH SORES INDICATE ORAL CANCER? WHEN YOU SHOULD BE CONCERNED ABOUT MOUTH SORES

n Inflammatory bowel disease: Individuals living with Crohn’s dis-

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By Morgan Rice

ease and ulcerative colitis may also suffer from canker sores. n You bit your cheek: Any sort of tissue trauma can open the door

Maddy was a little worried. For the past three days, she’d had sores in her mouth and she didn’t know where they came from. They hurt, though they usually felt better after she brushed and rinsed. She waited another week, thinking maybe they would go away, but when they didn’t, she turned to a friend. What did she think she should do? Maddy’s friend told her to make an appointment with her dentist. It wasn’t something Maddy wanted to do, but the sores weren’t getting better, and she was starting to get worried. Could this be cancer?

WHAT ARE MOUTH SORES? Mouth sores are actually quite common, and most people will suffer from them at some point in their lives. They typically show up in the soft tissues — on the gums, cheeks, roof of the mouth, under the tongue, or on the tongue — and look like blisters, often with a white or gray center and a red, inflamed perimeter. They are usually painful, and can make eating, drinking, and brushing rather miserable. Internal mouth sores are often called “canker sores,” and are different from “cold sores,” which typically occur outside the mouth and are caused by the herpes simplex virus. Whereas cold sores are contagious, mouth sores usually aren’t.

WHAT CAUSES MOUTH SORES? There are several possible causes for mouth sores. They include: n Acidic foods: Lemons, pineapples, tomatoes, and other acidic foods can trigger a canker sore. n Lackluster immune system: If your immune system is struggling, you’re more likely to suffer from canker sores. They may show up when you’re battling a cold or flu or other illness. n Nutritional deficiency: If you’re not getting enough vitamin B-12, iron, zinc, or other key ingredients, mouth sores may be a side effect of that.

for mouth sores. So if you bite your cheek, or if a sharp tooth scratches the side of your mouth, you may develop a sore. A mouth burn — such as occurs when you take a bite of something that’s too hot — may also cause them. n Leukoplakia: This is a condition that causes raised, plaque-like white patches on the tongue, gums, and lining of the mouth. Unlike canker sores, these are usually painless, and may go away on their own. If they don’t, however, it’s important to get them checked, as they are believed to be a risk factor for oral cancer. Smoking most often causes leukoplakia. n Lichen Planus: This is a disorder that causes an itchy rash that may occur in the mouth or on the skin. It’s related to an immune system malfunction, but does not post a risk of cancer. n Oral thrush: Also called candidiasis, this is a fungal infection that can cause white and red patches in the mouth. Antifungal medications help treat it.

WHEN IS IT MOUTH CANCER? Most canker sores go away within a week or two, so if yours is lasting longer than that — like Maddy’s was — you may worry that it’s something more serious, like mouth cancer. Oral or mouth cancer is most often caused by cigarette smoking or the use of smokeless tobacco. Other risk factors include: n age (over 40) n gender (men are more at risk) n former radiation treatment in the head and neck area n excessive alcohol use Symptoms vary, but may include patches and mouth sores, along with swelling that lasts for more than three weeks, pain when swallowing, jaw pain and stiffness, or a painful tongue. Early diagnosis is important for successful treatment, so always check with your dentist or oral surgeon if you’re concerned. 4HEALTH | 877.807.0989

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MIGHT THE FASTING DIET WORK FOR YOU? COMPARISON OF FASTING AND RESTRICTION DIETS

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By Lynn Merrell

Let’s say you want to lose weight. Should you follow a typical diet, where you restrict how many calories you consume every day, or is it possible you could just eat whatever you want most of the time, but then on certain “fast days,” cut it way back? For a lot of people, the so-called fasting diet sounds really attractive. Surely it’s a lot easier to go without for one day instead of every day. You could eat your normal diet most of the time, and then exercise your will power just once in awhile. Sounds great, right? The question is, does it work?

days, where you can indulge in your favorite foods.

HOW DO FASTING DIETS WORK? The theory is that when you fast, the body turns to its fat stores for energy, helping you to lose weight. Some studies have suggested that fasting may create other benefits too, such as helping to increase the body’s defenses against certain diseases. We don’t have a lot of tests on these types of diets yet. Many doctors and scientists still recommend the standard approach of restricting calories every day as the most promising for long-term weight maintenance and health. But one very recent study suggested that for some people, intermittent fasting might work just as well as regular diets.

WHAT IS A FASTING DIET? There are different types of fasting diets out there, but the main idea is that you choose to severely restrict your calorie intake on certain days, and the rest of the time you eat like normal. The more general term is “intermittent fasting,” which has actually been used in different cultures for centuries to help promote optimal health. The fasting period can last anywhere from a few hours up to a few days, though most diets require a fasting period of two days or less. You simply refrain from eating completely, or severely restrict your eating, for a certain period of time. Most fasting diets also include “cheat” or “feast” 4HEALTH | 877.807.0989

FASTING DIET COMPARABLE TO RESTRICTED DIET For the study, researchers observed 100 obese adults aged 18 to 64 from October 2011 to January 2015. They assigned them to one of three groups for one year: 1. Alternate-day fasting: Participants followed their regular diet except on alternate fasting days, where they consumed only 25 percent of their normal calories, and on alternating feasting days, where they consumed 125 percent of normal calories. 2. Calorie restriction: Participants restricted their normal calorie intake to 75 percent of normal.

3. Control: No changes. The dropout rate was highest in the alternate-day fasting group vs. the calorie restriction group, but the mean weight loss was similar in both groups at one month, and after 12 months. Researchers found an average weight loss of 6 percent in the fasting group, compared to 5.3 percent in the restriction group.

DIFFERENT TYPES OF FASTING DIETS The study results showed that the fasting diet didn’t create better results than the restricted diet, but neither did it create worse results. In other words, if you’re trying to lose weight, you may have success with either method. While it’s always best to check with your doctor, if you’d like to try fasting, there are a variety of methods to try. Here are three of the most popular: n Daily fast: Eat all your meals within a 6–8 hour period, then fast the rest of the day and night. So you would eat your evening meal at 6:00 p. m., then wait until 12:00 p. m. the following day to break the fast. n Weekly approach: Eat like you normally would for five days a week, then on two consecutive days, reduce your calorie intake to about 25 percent of normal (about 500 calories for women, 600 for men). n 24-hour fast: Eat whatever you want most of the time, and then once a week, go on a 24-hour fast.

4HEALTH

ADVANCES IN PARKINSON’S DISEASE DISCOVERIES MAY LEAD TO EARLY DIAGNOSIS AND NEW TREATMENT OPTIONS

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By Lynn Merrell

Currently, Parkinson’s disease (PD) is an incurable disease, though treatments can help delay its progress. But scientists are working to better understand it, and have made several advances that may eventually lead to earlier diagnoses, and even treatments that may halt or reverse symptoms.

things, helps the muscles do what you tell them to do. PD causes these nerve cells to gradually break down or die. The more these nerve cells break down, the less dopamine is available to the brain, and the more the muscles struggle. No one knows exactly why these nerve cells break down, but so far scientists have a few theories. It could be because of abnormal genes in some people, or because of toxins in the environment.

WHAT ARE THE SYMPTOMS OF PARKINSON’S DISEASE? WHAT IS PARKINSON’S DISEASE? PD is a neurological disorder that creates affects nerve cells in the brain, making it more difficult for a person to move. These nerve cells produce “dopamine, which is a neurotransmitter that among other

As the nerve cells produce less dopamine, individuals experience tremors, usually in the hands, and may move more slowly. Their limbs may become stiff, and they may struggle to walk and balance. The tremor is usually the first thing people notice, and it often starts on just 4HEALTH | 877.807.0989

4HEALTH one side of the body. In time, as PD gets worse, it affects more muscles, and may eventually lead to problems with swallowing and digestion.

HOW IS PARKINSON’S DISEASE TREATED? Right now, doctors use a variety of medications to manage the symptoms of PD. These medications help increase or substitute for dopamine, or help prevent its breakdown in the brain. Other medications help control tremors. In some cases, deep brain stimulation — a type of surgery — helps to increase movement control.

WHAT ARE WE LEARNING ABOUT PD? One of the main things that scientists have discovered is that PD rarely occurs on its own. Usually, it is accompanied by other problems including: n n n n

Trouble sleeping Constipation Changes in bladder function Mood changes and panic attacks

One way they’re doing this is by testing for a protein called “alphasynuclein,” which in cases of PD, becomes abnormal in the brain, leading to the nerve damage. Researchers can now look for this protein in the skin or in the colon when looking for PD. When alpha-synuclein shows up in either of those places, a biopsy can detect it. Scientists have reported that both of these types of biopsies show signs of PD changes at very early stages. Observing sleep disturbances may also help doctors identify PD. A high percentage of people suffering from REM sleep disorders (disrupted deep sleep), for example, were shown in one study to develop PD within 15 to 20 years. Skin biopsies of these patients revealed signs of the disease. Could PD be an infection? Scientists are also looking into this question. Some studies have suggested that nerve cells that are “sick” from PD can “infect” other nerve cells, leading to the idea that a vaccine could be developed that would stimulate the immune system to fight off the “infection.”

WHAT YOU CAN DO NOW

These issues often show up even before PD is diagnosed. Scientists are exploring these symptoms to find out if they can use them to develop early-screening tests for the disease. The thing is that by the time a tremor shows up, which is usually the first reliable sign of PD, brain cells have already been dying off for years. Scientists believe that if they could detect changes that indicate the disease is there before it develops into tremors, they may be able to do more to detect it and even stop it.

The future looks bright where PD research and treatments are concerned, but unfortunately, science isn’t fast. In the meantime, patients can improve quality of life by exercising — found essential for maintaining balance and muscle control — eating a healthy diet, and talking to their doctors about helpful supplements like CoQ10 (PD patients are often low in this critical nutrient), fish oil, and vitamin C. Tai chi, in particular, has proven helpful in maintaining strength and balance in those living with PD.

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7 TIPS TO KEEP EYES HEALTHY WHILE TRAVELING DON’T WAIT TO CHECK OUT INJURIES & PROBLEMS

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Colleen M. Story

You know that traveling can be hard on your health. The lines, the stress, the change in times, the lack of sleep, the weird food — it can all leave you more vulnerable to illness and feeling more worn out when you return from vacation than when you left. Precautions like packing healthy snacks, drinking extra water, getting a bit of exercise in the airport, or downing a few immuneboosting supplements can all help keep you feeling well on your trip, but there’s one more thing you may not have thought about: your eyes. Many people experience eye discomfort and blurred vision while traveling. Worse, some go through genuine eye emergencies because of injuries or infections. To help you avoid these types of catastrophes, make sure to take the following precautions to safeguard your peepers until you get back home. Bring an extra pair. If you wear glasses or contacts, bring an extra pair with you. There are countless stories of people losing contacts in the swimming pool or leaving glasses behind in the hotel. Particularly if you need your vision correction to drive, an extra pair can be critical to getting around while you’re away. Keep the second set close — in your purse or briefcase — to be sure it’s there if you need it.

Assume you’ll have dry eyes. Even if you don’t regularly suffer dry eyes, you’re likely to experience them while traveling. Airplanes are notorious for their dry, stale air, and even a short trip can sap your eyes of their normal moisture. Differences in weather patterns, too, can make your eyes dry and teary, obstructing your vision. Bring over-the-counter drops for extra lubrication. If you have prescription drops for dry eyes, be sure to pack those along, too. If you wear contacts, take them out if you’re going to sleep on the plane. Otherwise you could wake up with your eyes stinging and burning. Take contact cleaning solution. It takes up extra room in your suitcase or carry-on, but it’s critical to healthy eyes. If you’re wearing your contacts on the plane, be sure to take a lens case with solution in it with you. It’s dangerous to store contacts in plain water, as it may contain bacteria that you then later transfer to your eyes, where they can cause serious infections. For the same reason, if you’re going to another country or somewhere you’re not sure about the water quality, use bottled water to wash your contacts. Take vision changes seriously. It’s normal to want to wait until you get home to see an ophthalmologist. But if you notice significant eye problems while you’re on the road, don’t wait. If you accidently scratch your eye, for example, leaving it could give it time to cause an

infection. Symptoms like blurred vision could indicate blood pressure or blood sugar problems that are too dangerous to ignore. If you see floaters or flashes, you could be suffering from a detached retina. Other concerning symptoms include eye pain and redness, nausea or headache with eye pain, and bleeding or other discharges. Bottom line: take issues seriously, and get them checked right away to avoid suffering additional problems. If you’re in a location where you don’t know the doctors, ask a friend or family for a recommendation, or check out Eye Smart’s “Find an Eye M. D.” for a list of American Academy of Ophthalmology members. (See http://www. geteyesmart.org/eyesmart/find/) Prepare for allergies. If you have allergies, realize that a new location may spark reactions that affect your eyes. Take along some oral antihistamines and eye drops to deal with any troublesome symptoms. Protect from the sun. The sun can damage your eyes just as much as it can your skin, so a good pair of sunglasses is essential. Again, taking along an extra pair is a good idea. Take your prescription. An updated copy of your prescription can come in really handy if you need to purchase another pair of glasses or contacts for some reason. A simple card with the prescription on it, signed by your doctor, can save you the cost of another exam in another state. 4HEALTH | 877.807.0989

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GETTING SHORTER? COULD BE OSTEOPOROSIS HEIGHT ANALYSIS COULD IDENTIFY PATIENTS WHO NEED TREATMENT

nnn Colleen M. Story Several years after I grew up and left home, I returned to visit and noticed that my father seemed a little shorter than I remembered. I chalked it up to aging, but according to a new study, losing height in your senior years could be a sign of something potentially more serious — osteoporosis. A medical condition that causes bones to become brittle and fragile, osteoporosis can eventually weaken bones and increase the risk of breaks and fractures. Fortunately, there are treatments that can delay bone loss.

STUDY FINDS HEIGHT LOSS LINKED WITH OSTEOPOROSIS According to the Ohio State University, the loss of two inches or more in height during adulthood is a powerful predictor of osteoporosis of the hip. A study from the Ohio State University Medical Center discovered this after conducting an analysis of bone density scans on more than 2,100 women with an average age of 60 years. Other results included: n Height loss between 2–3 inches increased

more than fourfold the chances a woman had osteoporosis of the hip. n Odds of osteoporosis of the hip were nearly 10 times greater in women with 3 or more inches of height loss, compared to women with less than an inch of loss. n Height loss of one inch or less was not associated with any increased risk of osteoporosis of the hip.

The researchers noted that considering the results of this study, a simple evaluation of height could help physicians decide whether a patient should go through a bone density scan.

WHAT IS A BONE DENSITY SCAN? A bone density scan uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The fewer the minerals, the more fragile the bone. The test can help diagnose bone loss and osteoporosis, or tell doctors how bones are recovering after medical treatment for osteoporosis. It can also help predict a person’s risk of potential fractures. Doctors typically recommend that women over the age of 65 and men over the age of 70 get a bone density scan, whether or not they have lost any height. Gauging height loss, however, may help encourage some patients to get the bone scans they need, and may also identify some patients that may be suffering from bone loss before the age of 65. Some people are more at risk for osteoporosis than others, and should keep a closer watch on their bone density. These include those with: n Chronic rheumatoid arthritis or kidney n n n n n

disease Past broken bones Eating disorders Early menopause Height loss Smoking habits

n Strong family history of osteoporosis n History of hormone treatment for pros-

tate or breast cancer n A history of drinking more than three

alcohol beverages a day

TREATMENT FOR OSTEOPOROSIS The results of a bone density test come back as either a T-score or a Z-score. The first compares your bone density to that of healthy young women, and a Z-score compares it to other people of your age, gender, and race. n A T-score of –1.0 or lower is considered

normal. n A T-score between –1.0 and –2.5 indi-

cates the beginning of bone loss. n A T-score below –2.5 indicates osteopo-

rosis. Treatment for osteoporosis includes lifestyle changes and sometimes, medications. Weight-bearing exercises like walking, jogging, yard work, house cleaning, lifting weights, or using exercise bands can all help build bone density. A healthy diet with the proper daily calcium and vitamin D intake can also help. If these changes aren’t enough, your doctor may prescribe medications that help slow down bone loss. Side effects may include stomach upset and heartburn, but taking the drugs on an empty stomach can alleviate these. Talk to your doctor about the best treatment for you, but don’t ignore the signs of weak bones — treatment is important to prevent future fractures and breaks. 4HEALTH | 877.807.0989

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ARE SPORTS TOO DANGEROUS FOR KIDS? DOCTOR SUGGESTS WAITING TO AVOID CONCUSSIONS nnn By Colleen M. Story The word is out about concussions in sports, and parents are concerned. According to a 2016 study, the more impacts to the head, even when a child is wearing a helmet, the more changes in the white matter

of the brain, which could impact function, cognition, and even personality down the road. Head trauma and concussions in kidsâ&#x20AC;&#x2122; sports can create brain damage that gets progressively worse as the years pass. Does that mean parents should pull their kids out of these activities? Dr. Bennet Omalu, 4HEALTH | 877.807.0989

4HEALTH the forensic pathologist featured in the Will Smith film “Concussion,” says parents should strongly consider it.

KIDS SUFFERING HEAD INJURIES IN SPORTS ACTIVITIES Dr. Omalu told the “Today” show that kids who play football, hockey, and lacrosse could face a lifetime of health problems because of brain damage. “Knowing what we know today,” he said, “there is no reason whatsoever that any child under the age of 18 should play the high-impact, high-contact sports. The big six are: American football, ice hockey, mixed martial arts, boxing, wrestling and rugby. Blows to the head are intrinsic to the game.” These may not be the only concerning sports, though. According to a 2017 study, girls’ soccer and basketball players have higher concussion rates than their male counterparts. In fact, between 2005 and 2015, the number of diagnosed concussions in high school sports increased 2.2-fold, with the concussion rate higher in girls’ soccer than in boys’ football. (The authors theorized that lack of protective gear and “head-butting” could play a part in the results.) Children and adolescents have less cognitive reserve or resistance to brain damage than adults, which means those concussions can create greater risks of more severe symptoms. The concern is real, and it extends younger than high-school age. Research has found that football, in particular, can alter the brains of kids as young as 8 years old.

STUDIES SHOW HEAD TRAUMA VERY DANGEROUS IN YOUNG KIDS Scientists performing imaging scans on the brains of young football players aged 8 to 13 who had no symptoms of concussions found that the scans still showed changes associated with traumatic brain injury. This is even more concerning for parents, at it suggests that the sport itself could cause brain damage, even if kids don’t suffer from fullblown concussions. The researchers tested the kids before and after the football season, and found tiny changes in the neurons in the brain, with boys who had experienced more head impact showing more changes. The changes were similar to those seen in cases of mild traumatic brain injury. “It’s difficult to say what the changes mean,” study author Joel Stitzel told The Atlantic, “but they do seem to be directly correlated with the impact that kids are sustaining.” He went on to note that while fewer than 2,000 people play in the NFL, there are about 3.5 million kids playing youth football in the U.S., with little information on how the game may be affecting their brain development.

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According to a 2015 study, NFL players who started playing football before the age of 12 had the highest risk of altered brain development, when compared to players who started later in life. Ann McKee, director of the Boston University Chronic Traumatic Encephalopathy Center, told The Washington Post that kids under 14 shouldn’t be playing football, as they were at a greater risk for brain and head injuries than adults.

SHOULD PARENTS KEEP KIDS FROM DANGEROUS SPORTS? Does this mean you should stop your child from playing these sports? It’s always up to you and your kids, but experts are suggesting that the way these games are played today, they are just too dangerous. With increased protection or different rules, it could be different, but for now, the danger is real. Dr. Omalu suggests, for example, that heading should not be allowed in soccer games played by kids under the age of 18, and that even then, the game should be played only by teens aged 12–14. As for kids’ football, he compares it to smoking, and says that according to modern-day research, it takes only one concussion for a child to suffer brain damage, and that even sub-concussions (more mild head impacts) can create permanent changes. In a 2014 study, for example, researchers found that if a child suffers just one concussions that results in hospitalization, the child is more likely to die before the age of 42, has 2–4 times increased risk of committing suicide, and is about 2–4 times more likely to suffer a major psychiatric illness as an adult. SOURCES Alice Park, “How One Season of Football Affects a Child’s Brain,” Time, October 24, 2016, http://time. com/4539398/football-concussion-brain-trauma/. A. Pawlowski, “‘Concussion’ doctor says kids shouldn’t play these sports until their 18,” Today, https://www. today.com/health/concussion-doctor-warns-against-contact-sports-kids-t115938. “Female soccer players suffer the most concussions in high school sports,” AAOS, [Press Release], March 14, 2017, http://aaos-annualmeeting-presskit.org/2017/research-news/concussions_hsu/. James Hamblin, “Football Alters the Brains of Kids as Young as 8,” The Atlantic, October 24, 2016, https://www. theatlantic.com/health/archive/2016/10/football-kids-heads/504863/. Stamm Julie M., et al., “Age at First Exposure to Football is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players,” Journal of Neurotrauma, November 10, 2015; 32(22): http://online.liebertpub.com/doi/10.1089/neu.2014.3822.

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| Plastic Surgery

ERASE SUN DAMAGE AND SHAVE YEARS OFF YOUR APPEARANCE NEW TREATMENT PROVIDES DRAMATIC RESULTS WITH LITTLE DOWNTIME

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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.

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What do you see when you look in the mirror lately? Are you noticing dryness, hyperpigmentation, age spots, or wrinkling? Do your pores seem to be getting larger? Are you noticing, in essence, the effects of aging? According to the Skin Cancer Foundation, more than 90 percent of the visible changes we see and call “aging” are caused by the sun. Harsh weather conditions, heating systems, dry air, pollution, stress, poor diet, and more can also cause lasting damage that makes it difficult for skin to recover. Fortunately, Dr. Rayham of the RR Plastix/New York Plastic Surgery Center has a solution. There’s a brand new way to erase sun damage, fade dark spots, and get your youthful glow back with minimal downtime. It’s called “Halo Laser Skin Rejuvenation,” but this isn’t the laser you’re used to hearing about. Forget the weeks of downtime. Now, you can come in Thursday, get one treatment, and go back to work Monday looking fabulous!

WHAT IS HALO LASER SKIN REJUVENATION? Dr. Rayham’s office is one of the first in the area to have the new Sciton Halo laser, a breakthrough new technology that combines the effectiveness of laser treatments with the accelerated healing experience customers love. Laser resurfacing is a treatment that uses a laser to treat facial flaws and improve the appearance of skin. An ablative laser removes thin layers of skin, allowing new and improved skin to form in its place. A non-ablative laser is less invasive, and stimulates collagen growth while helping to tighten and firm skin. In the past, patients had only two options: 1) get ablative, or “fractional” laser treatments, and spend weeks to heal, but enjoy dramatic results, or 2) get non-ablative, or “non-fractional” laser treatments, and enjoy a short downtime, but only subtle results. Now, with the new Sciton Halo laser, customers can take the middle road: enjoy great results with little downtime. The Halo is a “hybrid” fractional laser machine that offers both ablative and non-ablative resurfacing at the same time.

DOUBLE ACTION OF THE HALO LASER PROVIDES CUSTOMIZED OPTIONS This “double-action” of the Halo laser allows plastic surgeons to address both surface issues in the skin, and flaws in the deeper layers. That means they can, in one pass, address both hyperpigmentation

on the surface, while also treating deeper skin tissues to tone and tighten skin. The technology is so advanced that the doctor can tailor the treatment to each individual, treating each patient in a way that uses only the energy needed to address the problem, while offering a precise, even treatment that allows for faster healing.

WHAT CAN THE HALO HYBRID LASER DO FOR ME? Dr. Rayham is excited to introduce this new treatment just in time for fall. If you’ve suffered sun damage over the past several months, this is the treatment for you. You can choose to go in for just one treatment, and after a weekend’s rest, head back to work looking like you turned back the clock. The Halo can do much more, though. In addition to treating sun damage, it can also: n Reduce the appearance of scarring, such as n n n n n

acne scarring Reduce fine lines and wrinkles Fade age spots hyperpigmentation Smooth out uneven skin tone Reduce the appearance of pores Improve the overall texture of skin

CUSTOMIZED TO YOU! Dr. Rayham invites readers to call his office today for a personal consultation. No matter what you’re seeing in the mirror, the Halo Laser Skin Rejuvenation system can help improve your appearance and boost your confidence. Do you have sun damage and sagging skin? Age spots and wrinkles? Whatever your concerns, treatments can be customized to target exactly what you need, and no more. You’ll notice improvements within days, and be able to return to work with a healthy glow. If you’re looking for a more aggressive treatment, you can have that, too. It just depends on the results you’d like to see. Treatments generally take 30 minutes to an hour, and a topical anesthetic is used to increase comfort. After the first 24 hours, patients are able to return to most of their normal activities. Within a few days to a week, you’ll start to see more smooth, vibrant skin that has a youthful glow. For more information, check with Dr. Rayham. He has offices in Manhattan, New York City, Brooklyn, and Staten Island. Call the RR Plastix/New York Plastic Surgery Center, 1-877-582-0400, or visit our website at www.rrplastix.com. 4HEALTH | 877.807.0989

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SHOULD YOU GET A BUTT LIFT? WHAT’S INVOLVED IN ENHANCING YOUR BACKSIDE nnn Lynn Merrell When you think of plastic surgery, you may think of breast enhancement or facelifts. But according to a recent American Society of Plastic Surgeons report, it may be time to turn around and look at your backside. Last year, doctors performed over 10,000 butt lifts—more than in any previous year. Also called “buttock augmentation,” “butt implants,” or “gluteoplasty,” butt lifts are catching on, with 16 percent more people going for it in 2013 than in 2012. What’s the big deal, and could you be a candidate for backside enhancement?

WHAT IS A BUTT LIFT? The butt lift is a procedure intended to create youthful, perky buttocks that enhance the body profile. The basic surgery tightens the appearance, removing any excess skin and repositioning the surrounding tissue to create a smoother, more rounded look. If the patient wants a little more junk in the trunk, so to speak, doctors may also extract fat from other parts of the body through liposuction, purify it, and inject it back into the buttocks to create a fuller appearance. (The extra fat is typically taken from the stomach, thighs, and lower back.)

The Brazilian butt lift, which you may have also heard about, is a particular type of butt lift that involves adding some padding. The surgeon will either add in extra fat, as noted above, or will use implants to create the more rounded, lifted look. Fat redistribution is often preferred for creating overall body sculpting, and surgeons like working with it because it is pliable and gives them more control over shaping.

WHO IS A CANDIDATE? You may be a candidate for a butt lift if: n You feel you have flat, unshapely butn n n n n

tocks You are tired of sagging buttocks You have lost a lot of weight and you want to reshape your backside You want to improve the appearance of cellulite You don’t smoke and you’re in good health You have a positive outlook and realistic expectations for the surgery

WHAT ARE THE RISKS? The risks of a butt lift are similar to the risks for any surgery, and include infection, an allergic reaction to the anesthesia, a blood clot, and excess bleeding. Potential complications include poor wound healing, asymmet-

ric of flattened buttocks, fat creating lumps in the backside, swelling and fluid accumulation, and bleeding under the skin. Most of these risks are rare, however, as long as patients go to an experienced, legitimate plastic surgeon. There have been some horror stories of women actually dying after going through a butt lift with the wrong doctor. In March 2014, for example, police charged Tamira Mobley of Wood-Ridge, New Jersey, with manslaughter and felony assault after she gave a young woman a botched butt lift that resulted in her death.

TO INCREASE YOUR ODDS OF A POSITIVE OUTCOME You can significantly reduce your risks by going to a reputable surgeon. Do your research. The American Society of Plastic Surgeons provides a website where you can put in your zip code and find a board-certified plastic surgeon at: http://www1.plasticsurgery. org/find_a_surgeon/. The surgery itself can take several hours, depending on the extent of fat repositioning needed. Your doctor will advice you not to sit for a week afterwards, though you’ll probably be able to return to work within two weeks. You’ll still need to take it easy as you heal. Swelling typically goes away after four to six weeks, though it may take months to see the final results.

MYTHS AND FACTS ABOUT THE SHINGLES DISEASE HOW TO INCREASE YOUR ODDS OF AVOIDING PAIN

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By Gordon Barclay

I had an uncle who suffered from shingles, so I have some idea of what it’s like, but if you don’t know anyone who’s gone through it, you may be a little confused. What are shingles, and how do they affect you? We decided to help with a few myths and facts about this disease.

1. MYTH: SHINGLES IS A VERY RARE CONDITION. Fact: According to the Centers for Disease Control and Prevention (CDC), almost one out of three people in the United States will develop shingles over the course of their lifetime. There are an estimated one million cases diagnosed each year. The risk increases with age, which is why the CDC recommends that people aged 60 and over get the shingles vaccine.

2. MYTH: SHINGLES IS THE SAME DISEASE AS CHICKENPOX. Fact: Shingles and chickenpox are caused by the same virus — the varicella zoster virus — but they are two different diseases. Chickenpox is actually a milder condition that typically affects children, and causes a blister-like rash, itching, tiredness and fever. The rash usually appears first on the face and trunk, and then spreads to other areas of the body. Most patients feel better within one-to-two weeks. Shingles also causes a blistering rash, but it rarely moves below the waist, and forms only above nerves that are affected by the virus, usually on just one side of the body. The rashes result in more severe symptoms, especially pain, and can cause complications like lingering pain (postherpetic neuralgia), weight loss, anxiety, depression, and eye complications that can lead to vision loss.

3. MYTH: THE BIGGEST ISSUE WITH SHINGLES IS THE RASH. Fact: Though a rash is part of the shingles disease, the pain is by far the most difficult thing for patients to deal with. It can be severe, and it can last for up to a year or more, even after the rash is long gone.

Symptoms vary from person to person. Some people get shingles and get over it in a week. But for others, the pain can be excruciating and long-lasting, and up to one in five people with shingles will suffer form postherpetic neuralgia. The pain can really intense because the disease irritates the nerve. Doctors recommend patients get help as soon as possible if they notice symptoms of shingles, including nerve pain (itching, stabbing, shooting) and rash formation. Early treatment with antiviral medications can help reduce severity and duration of the rashes, as well as reduce the risk of lingering pain. Doctors can also recommend pain medications, over-the-counter pain-relieving creams (those containing capsaicin can be helpful), and other pain-relieving options. Seeing a medical team that focuses on pain relief is often the best move.

4. SHINGLES ONLY AFFECTS OLDER PEOPLE. Fact: Though the risk of getting shingles does increase with age, younger people can get it, too. Those who had chickenpox as children, and then go on to suffer from autoimmune conditions (like HIV AIDS), or go through diseases that weaken the immune system, such as cancer, are more at risk for early-onset shingles. In fact, about half of those who get shingles are under the age of 60, so it’s important for everyone to be aware of the potential signs of the disease.

5. THERE’S NOTHING YOU CAN DO TO AVOID SHINGLES. Fact: There is a vaccine available that can help reduce your risk of shingles. Currently, it is recommended for people 60 and older. Even if you still get the disease, the vaccine can help reduce its severity. The CDC also recommends two doses of the chickenpox vaccine for kids, adolescents, and adults who haven’t had chickenpox. In addition to that, you can do your best to keep your immune system strong. Scientists believe that shingles takes hold after trauma, stress, illnesses, and other events that weaken the immune system. Get enough rest, eat a healthy diet, exercise regularly, and when you’re down, consider immune-boosting supplements like probiotics, vitamin C, ginseng, vitamin D, elderberry, garlic, and zinc.

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Podiatry | 4HEALTH33

WALKING WITHOUT PAIN WHAT CAUSES HEEL SPURS AND HOW ARE THEY TREATED?

You step out of bed and ouch! Your heel hurts. Or maybe the pain develops gradually as you go about your day. Either way, it’s unpleasant, and you don’t know why it’s happening. Is it because you gained a few pounds, or because you’re wearing the wrong shoes? How can you get the pain to stop? Today we’re talking with Doctor Leon Stepensky, who’s worked as a podiatrist for over 15 years in Brooklyn, and who specializes in leg and foot conditions. He tells our readers about boney overgrowths in the heels, what causes them, and some of the standard treatments that can help to reduce pain and discomfort when walking. What are bony overgrowths in the foot? When we have bone overgrowth in the foot, it’s often in the area of the heel. We call these “heel spurs.” The medical name for this disease is a plantar fasciitis, and heel spurs are a consequence of this underlying disease. The main symptom of plantar fasciitis is pain in the heel arising from or aggravated by stress. In most cases, the pain occurs because of inflammation and damage to the plantar fascia — the coat that covers the muscles. When a person stands on his feet, about a half of his body mass puts pressure on the fascia. Muscles become strained and stretched, they act on the heel bone, and micro tears in the fascia cause chronic inflammation — which is why you feel pain. Against the background of the plantar fasciitis, the formation of marginal bone outgrowths is possible. These are the heel spurs, so named because they usually have a point on the end. Heel spurs typically affect people over the age of 40. Excess weight, back problems, arthritis, flat feet, joint diseases, calcaneus injuries, gout, and poor circulation in the legs — all of these can increase the probability of heel spurs. The soreness from heel spurs usually occurs after waking up in the morning, because when we sleep, the legs are relaxed, and the muscles and tendons are loose. When we get back on our feet, muscles suddenly expand and traumatize heel spurs, causing a sharp pain. What are the treatment options for heel spurs? There are several treatments for heel spurs: n conservative methods (stretching, use of orthopedic insoles, physical therapy, injections of anti-inflammatory drugs) 4HEALTH | 877.807.0989

n and two types of surgical operations.

In the first type of the surgery, the surgeon finds the area of the greatest tension of the muscles and makes a small incision, allowing the muscle to lengthen so it doesn’t pull at the heel knot. This procedure helps the majority of our patients. When the bony growth on the heel is big, another type of surgery is needed. In this case, the heel spur is completely removed, wherein the pain in the heel decreases significantly. Physical therapy and the use of special shoe insoles also help reduce pressure on the foot. Can you give us more details about painrelieving injections? Sometimes people say that medications injected into the heel (mostly, steroids) contribute to the resorption of the spurs. But that’s incorrect. A heel spur is a bone and it can’t dissolve. Steroids can soften the tendon connected to the heel, so that it acts on the heel spur with less force. There are different types of shots and they each works differently. We select medications for the injections individually, depending on how the patient reacts to them. All injections include such analgesics as lidocaine and markain. These drugs give the patient temporary pain relief. How much time does it take for conservative treatments to work? It depends on the process. Usually, I make three injections over 4–6 weeks. We start with two shots, and if, after those two injections, the patient feels at least a 50 percent improvement, then I do the third injection. If the patient experiences only 5 to 10 percent relief after those two injections, I don’t make a third one. In that case, we’d look at some other treatment options. As mentioned above, physical therapy can be really helpful for patients, as well. Therapists typically assign a series of regular exercises and stretches that retrain the muscles and ligaments to be in softer and more relaxed positions, so they don’t irritate the heel or the spur. If patients commit to regularly performing these therapy routines, they’ll likely experience lasting relief. Heel spurs are fairly common, especially in people of advanced age. There is no need to put up with the pain. Come to our clinic, and we’ll help you to feel better.

NAME:

Leon Stepensky, DPM CERTIFICATION: Trained surgeon in minimally invasive surgery, endoscopic and arthoscopic procedures with a specialty in Diabetic Neuropathy

SPECIALTY: Board Certified Podiatrist

INSURANCE: We accept all major insurance plans & Medicaid

CONTACT: 3111 Brighton 2nd St., Brooklyn, NY 11235 235 Wyckoff Ave, Brooklyn, NY 11206 99 Moore St., Brooklyn, NY 11206

(718) 874-0224

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WHY YOU SHOULD SEE A DOCTOR ABOUT THAT NON-HEALING WOUND LEG ULCERS CAN INDICATE OTHER CIRCULATORY ISSUES

“I can’t take it anymore,” Marc told his buddy, Allen. “These sores keep showing up on my legs! I didn’t think much about them at first; I cleaned them up, bandaged them, and moved on. But it’s been three months now, and they’re not getting better. They hurt, they’re messy, and they’re a pain, as I have to keep changing the bandages all the time. They’re even affecting how I walk!”

Allen urged his friend to go to the doctor, where Marc found out that he had something called “vascular ulcers.” The term sounded a little ominous, but Marc only cared about one thing: “Can you fix it?”

WHAT ARE VASCULAR ULCERS? Vascular ulcers — also called venous ulcers or leg ulcers — are sores that develop on the legs, usually between the knee and the an4HEALTH | 877.807.0989

4HEALTH kle, that stubbornly resist healing. Whereas most sores usually get better in a couple weeks, these sores take much longer, and, even if they do heal, they’re likely to recur. They often itch and burn, may cause swelling in the leg, and may ooze a foul-smelling liquid. The skin may be discolored or hardened around the ulcer. If the sore becomes infected, it can cause more problems, like worsening pain and increased discharge. Venous leg ulcers are fairly common in individuals aged 50 and older, though those who are younger may develop them, too. Those who are most at risk include those who have one or more of the following: n n n n n n n n n n

deep vein thrombosis (DVT) peripheral arterial disease (PAD) cardiovascular disease osteoarthritis diabetes hip or knee replacement varicose veins obesity leg injury paralysis

WHAT CAUSES VASCULAR ULCERS? In the majority of cases, vascular ulcers are caused because of a malfunction in the veins or arteries in the legs. Either the blood isn’t getting to where it needs to be, or too much of it is collecting in one place rather than moving on. In the first case, the patient may have PAD, a condition that gradually narrows the arteries that supply blood to the legs. This can affect blood flow, which means the sores lack access to the nutrients they need to heal. To check for this condition, doctors may take the blood pressure in the ankle and the arm, and then compare the two in a ratio called the ankle-brachial pressure index (ABPI). If the ratio is less than 0.8, the cause of the ulcer is likely to be poor circulation rather than vein problems and will require different treatment. In the second case, there is an issue with the veins, which are supposed to carry blood back to the heart. They have little valves inside them that close to stop blood from pooling in the legs, but these valves can become damaged and weak over time. When this happens, the blood has a harder time flowing uphill, so to speak, and tends to pool in the veins in the legs. This increases blood pressure in this area, which can weaken the structure of the skin that covers it. Then, if you happen to cut or scrape your leg, the area fails to heal like it should, because of what’s going on underneath. The problem often occurs in areas where the skin is thinner, such as around the ankle.

HOW ARE VENOUS LEG ULCERS DIAGNOSED? To diagnose a venous ulcer, a doctor usually has only to examine the wound. A practiced eye can tell what a leg ulcer looks like, and a vascular doctor will likely recognize it right away; however, most doctors will continue with a thorough examination to find out exactly why the sore is there. A number of tests are available to help develop a correct diagnosis. In addition to the blood pressure ratio test mentioned 4HEALTH | 877.807.0989

above, the doctor may also conduct other tests, like blood tests, urine tests, or even x-rays, to figure out what is causing the sore. Once the diagnosis is complete, it’s time to treat the problem.

USA VASCULAR CENTERS PROVIDE INDIVIDUALIZED VENOUS ULCER TREATMENT Treatment for venous ulcers will vary depending on what’s causing them. If PAD is the culprit, for example, doctors may encourage lifestyle changes to help improve blood flow — like quitting smoking and managing high blood pressure — and suggest medications that can help with these goals. If blood flow becomes blocked in one of the arteries, surgical procedures may be required to restore blood flow to the legs and feet. If venous insufficiency, varicose veins, or another similar vein problem is causing the sores, doctors will start by treating the sores themselves to encourage healing. After that, if the ulcers return, a minimally invasive vein surgery may help to solve the problem. It all depends on the individual, what’s causing the sores, and how chronic they are. USA Vascular Centers, a nationwide network of physicians, nurses and specialists, have the latest diagnostic technology to help zero in on what’s creating the problem. Once a diagnosis is made, they work with you to create a customized treatment plan. If you are experiencing symptoms like Marc’s, talk to the doctors at USA Vascular Centers about your options. They can help you decide which type of treatment is best for you. You can find USA Vascular Centers in Bensonhurst, Valley Stream, Mott Haven, and St. Nicholas, New York. Call today at 718–393–5331 or go to www.USAVascularCenters.com to schedule a consultation.

718-393-5331 www.USAVascularCenters.com

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SHOULD YOU ASK YOUR FRIEND FOR A DOCTOR RECOMMENDATION? HOW TO DETERMINE THE RIGHT DOCTOR FOR YOU nnn Colleen M. Story You’re new in town, and you need a good doctor. Maybe you just had a baby, and are looking for a good pediatrician. Perhaps your spouse has heart problems and needs a good cardiologist. Whatever the situation, should you ask your friends for their recommendations? Common sense would say that gathering opinions from people you trust would be a good way to find a good doctor. But according to some healthcare experts, that may not always be the case.

WHEN ASKING YOUR FRIEND MAY BACKFIRE Would you buy a car strictly on your friend’s recommendation, without first checking consumer ratings? Would you buy a house just because your friend liked it? According to the New York Times (9/29/2008), finding a good doctor is even more important to your health and well being, yet people often rely completely on recommendations. «The truth of the matter is that people are hard pressed to make well-informed decisions when they choose a doctor…,» said Joyce Dubow, a senior advisor in the office of policy and strategy at AARP. «We don’t have any objective data, so we use family and friends. And that’s not objective.» For example, your friend may value different things about a doctor than you do. Whereas he or she may appreciate efficiency,

you may want more of a bedside manner. Your friend may appreciate a firm, outgoing and decisive physician, whereas you may be looking more for someone who will really listen to you. Secondly, you may have different health issues than your friend does, so whereas she thinks her gynecologist was great delivering her baby, you may be looking for someone to help you reduce the symptoms of menopause. It all depends on what you’re looking for, and what type of doctor works best for you. And though asking friends may be a good way to get started, you may need to do a little more research.

OTHER METHODS TO TRY How else can you narrow down your choices? First, determine what your needs are. Do you have special medical challenges, like arthritis or diabetes? Or do you just need regular checkups? Does your lifestyle put you at risk in some way? Write down the main things you need from your doctor. Next, determine what you most value about a doctor. Is it his knowledge, his mannerisms, his ability to make you feel cared for, or his access to new treatments? Note what is most important to you. Next, review the list of doctors in your health plan. Where are they located? Which offices would be more convenient to you? When are they open? Do their hours accommodate your schedule? You may be able to find additional useful information on websites like Angie’s List

(angieslist.com), which sometimes has consumer ratings for doctors, or Consumer’s Checkbook (checkbook.org). The American Board of Medical Specialties (abms.org) may have the doctor’s certification status available, as might HealthGrades.com and Docfinder (docboard.org). Once you have about five names to choose from, check on where each doctor got his training—the hospital where he did his residency, and where he practices. Call the office and ask questions, and note how helpful (or not) the staff is, and whether or not they treat you with respect and kindness. Finally, see if you can set up an appointment when you’re not feeling sick, so you can evaluate how you feel about the doctor.

HOW TO GET BETTER INFORMATION FROM YOUR FRIENDS The best way to find a great doctor is to combine both of these methods—ask friends and family, and follow-up with your own research. It also helps if you ask your friend specific questions, like those below, to gather more detailed information. In the end, trust your gut—your friend’s doctor may or may not be the best doctor for you. n Do you think your doctor would be compatible with my personality? n What is it you like best about your doctor? n Give me an example of when he/she really helped you. n What is an office visit like? Do you wait a long time? How does the staff treat you? n Do you completely trust your doctor? 4HEALTH | 877.807.0989

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DON’T LET SWIMMER’S EAR RUIN YOUR FUN TIPS FOR TREATMENT AND PREVENTION

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By Gordon Barclay

Most of us have experienced that “water in the ear” thing, where you emerge from the pool and have to turn your head to the side to drain it. Usually, that takes care of it, but sometimes, there are bacteria or other microorganisms in the water that get into the ear, and then you’re in trouble. If those bugs multiply and grow, they can cause an ear infection, often referred to as “swimmer’s ear.” You know you have it because your ear feels blocked, and it affects how well you can hear. It’s not fun, and sure not something you hope to experience just because you went swimming. The question is: How can you prevent it from happening?

WHAT IS SWIMMER’S EAR? Swimmer’s ear is just another term for an ear infection, but it does refer specifically to an infection developed after swimming. There are other types of ear infections, most commonly those that occur in children, but this is a particular type that comes about because you were exposed to microorganisms in the pool, lake, or ocean where you took a dip. The infection itself develops in the outer ear canal, which goes from your eardrum to the outside of your head. When the water sits in there after swimming, it creates a moist environment that the bacteria thrive in, and they start to grow and multiply.

WHAT ARE THE SYMPTOMS OF SWIMMER’S EAR? Medically termed otitis externa, the infection starts out causing only mild symptoms like that blocked-ear feeling, itching, redness inside the ear, and maybe some yellowish fluid drainage. You may also notice that you can’t hear as sharply as usual, which is because of the inflammation the infection creates in the ear canal. 4HEALTH | 877.807.0989

If you get treatment right away, that’s all that usually happens, but if you wait and the infection grows, you could experience more difficult symptoms. These usually include increasing itching and even pain, pus discharge, continued hearing problems, and more redness in the ear. As the infection worsens, it can cause swelling in the lymph nodes in the neck and fever, and may completely block the ear canal.

HOW IS SWIMMER’S EAR TREATED? To avoid more difficult symptoms, it’s important to see your ear, nose, and throat doctor as soon as you notice a problem. She will examine the ear, ask about your swimming activities, and make a diagnosis. If it is swimmer’s ear, she may clean the ear canal before sending you home, to get the discharge and other debris out of there. Once your ear canal is clean, you can apply the treatment, which is a bottle of eardrops. These drops typically contain antibiotics to kill the bacteria, and may also contain antifungal medication, steroids to reduce inflammation, and other ingredients to help restore your ear canal to a healthy state. Your doctor may recommend over-the-counter pain relievers to ease any discomfort. Expect the infection to clear up within a week. You’ll need to keep the ear canal dry during that time.

HOW TO PREVENT SWIMMER’S EAR Thankfully, swimmer’s ear is usually easily treated, particularly if you catch it early, but your best bet is to prevent it in the first place. To do that, follow these tips: n Always make sure your ears are dry after exposure to water. n If you were swimming in an area that may be contaminated, clean out your ears afterwards with rubbing alcohol and white vinegar. Mix equal parts in a bowl, then use a dropper to add three to four drops into the ear while you’re lying on your side. Let the liquid remain in place for several minutes, then tip your head, allow it to drain out, and repeat on the other side.

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INSOMNIA? TURN OFF THE GADGETS! STUDY SHOWS BLUE LIGHT AFFECTS SLEEP HORMONE

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Colleen M. Story

According to the Centers for Disease Control and Prevention (CDC), insufficient sleep is now a major public health issue. It has been linked with motor vehicle crashes, industrial disasters, and medical errors. Those who get less than the optimal hours of sleep per night have also been found to be more at risk for hypertension, diabetes, depression, obesity, and cancer, and even to be more likely to die before those who regularly get enough sleep. Though there are a myriad of reasons why someone may not get adequate sleep, from stress to a lack of exercise to changing work schedules to tending young children, a new study has found that there’s one more reason you may not have thought about — technological gadgets.

GADGETS EMIT SLEEP-DISTURBING LIGHT Researchers from the Lighting Research Center (LRC) at Renssalaer Polytechnic Institute tested the effects of self-luminous tablets on melatonin suppression. Melatonin is a hormone produced at night and under conditions of darkness that signals the body to slow down and rest. When something interferes with melatonin production — like bright light — it disrupts the body’s normal circadian rhythms, which can lead to sleep disturbances and related health issues. For the study, researchers gave 13 individuals self-luminous tablets to read, 4HEALTH | 877.807.0989

play games, and watch movies. These are activities performed by thousands of people across the nation every night, often right before bed. The results? “Our study shows that a two-hour exposure to light from self-luminous electronic displays can suppress melatonin by about 22 percent,” said Mariana Figueiro, associate professor at Renssalaer and director of the LRC’s Light and Health program. “Stimulating the human circadian system to this level may affect sleep in those using the devices prior to bedtime.”

OTHER STUDIES SHOW SIMILAR RESULTS This isn’t the first study to suggest that using our gadgets right before bed could interfere with sleep. Another published in 2003 in the Journal of Applied Physiology found that computer use at night significantly affected melatonin production and body temperature, throwing off the person’s “biological clock.” Another published in the December 2011 issue of the Journal of Sleep Research concluded that the use of computers and mobile telephones in the bedroom were related to poor sleep habits. Manufacturers are already looking into designing devices that adjust for natural circadian rhythms. In the future, we may see some that increase or decrease the light their emitting depending on the time of day, or that reduce the amount of light stimulation at night to help users sleep better. In the meantime,however,it’s up to individuals to make changes to ensure a good night’s sleep.

The first step? “Keep electronic gadgets out of the bedroom,” says Associate Professor Delwyn Bartlett from the Woolcock Institute’s Sleep and Circadian Group.

TIPS FOR A GOOD NIGHT’S SLEEP In addition to removing all computers, televisions, cell phones, and tablets from your bedroom, try these tips to encourage a more restful night: n Go to bed at the same time every night and rise at the same time every day. n Avoid stimulating foods and beverages before bed, like caffeine, alcohol, and high-sugar snacks. n Shut all technological gadgets down at least an hour before sleep. Reserve that time for quiet, low-key activities like taking a warm bath, reading a book (not backlit on a tablet), and listening to quiet music. n Exercise for at least thirty minutes sometime during the day, but avoid vigorous exercise right before bed. A brisk walk even up to three hours before bedtime can help tire your body out and encourage rest. n Keep your bedroom quiet, dark, comfortable, and cool. Make sure you have a comfortable, quality mattress. n Try to spend some time outside in the sun each day to help secure your body’s natural rhythms. SOURCES Centers for Disease Control and Prevention, “Insufficient Sleep is a Public Health Epidemic,” http://www.cdc.gov/features/dssleep/. “Light from Self-Luminous Tablet Computers Can Affect Evening Melatonin, Delaying Sleep,” Renssalaer Polytechnic Institute, August 27, 2012, http://news.rpi.edu:80/update.do.

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AFTER A STROKE — HOW TO AVOID GOING THROUGH THAT AGAIN TIPS TO REDUCE THE RISK OF THE DREADED SECOND STROKE nnn By Lynn Merrell Nearly 800,000 Americans suffer a stroke every year. If you’re one of them — even if you suffered only a mini-stroke — it’s best to watch your health very carefully for at least five years afterwards, according to a new study. Most patients are told that the “high-danger” period lasts for about 90 days after leaving the hospital. Then, the thinking goes, the risk of a recurring stroke remains a concern, but goes down with each successive year. This new study warns that the risks for a second stroke or other health problems could be higher than we believed for at least five years

after that first stroke. Here’s more, and what you can do to protect yourself from a repeat occurrence.

STUDY SHOWS RISKS REMAIN EVEN AFTER FIVE YEARS For the study, researchers analyzed data from about 24,000 patients who had suffered a stroke or a mini-stroke. All of them had survived the first 90-day “danger period.” Results showed the following: n After one year, 9.3 percent of the patients had died; had a repeat stroke, mini-stroke, or heart attack; or were admitted to longterm care. n The rate of these events stayed at 5 percent in each of the following four years. 4HEALTH | 877.807.0989

4HEALTH n After five years, the risk of these events occurring was double that

n Check your blood pressure: High blood pressure increases risk

the first few months. Bad idea. Stay on your meds to stay away from a repeat stroke. Check your cholesterol levels: High cholesterol can potentially contribute to narrowed arteries, which increases risk of a blood clot and stroke. Keep yours under control. Manage your diabetes: Those with diabetes are at a higher risk for stroke — keep your blood sugar within normal levels. Manage atrial fibrillation: If you’ve been diagnosed with an irregular heartbeat, realize that it increases your risk of stroke by five times. Medications can help you control that risk. Move! Getting more exercise is one of the easiest things you can do to reduce your risk. Studies show that those who exercise five or more times a week are less likely to have a second stroke. Ease up on the drinking: More than two drinks a day may increase risk of stroke by as much as 50 percent. Eat right: More fruits and vegetables and less fat and calories can help you better manage overweight, cholesterol, and trans-fats in the blood, which can all reduce stroke risk. Try meditation: Or yoga, or tai chi, or walking, or whatever helps you reduce stress. Stress can contribute to high blood pressure, which increases stroke risk. Find something that relaxes you and try to do it several times a week.

1.5-fold for a second stroke. Keep an eye on your levels, and take your medications if needed. n Take your meds: Speaking of medications, don’t stop taking yours. Most patients who have suffered a stroke are prescribed bloodthinning meds to help prevent a future clot. Unfortunately, studies show that about 25 percent of patients stop taking them after

“Health Risks After Stroke May Linger for at Least 5 Years: Study,” HealthDay, October 7, 2014, http://consumer. healthday.com/cognitive-health-information-26/neurology-news-496/health-risks-after-stroke-linger-for-atleast-5-years-study-692375.html. Heart and Stroke Foundation of Canada, “Stroke patients past 90-day danger period remain at high risk for repeat event,” Science Daily, October 7, 2014, http://www.sciencedaily.com/releases/2014/10/141007092348. htm.

of individuals of the same age and gender who had not suffered a stroke. Dr. Mandip Dhamoon, assistant professor of neurology at the Icahn School of Medicine at Mount Sanai in New York City, noted that considering these results, patients should be monitored much more closely on a regular basis after a stroke, rather than monitored closely for only a few months afterward. “We now need to identify ways to determine which people, among those who have made it through the riskiest period, remain most at risk for serious events so we can develop appropriate preventive interventions,” said Dr. Richard Swartz, lead author of the study.

REDUCE YOUR RISK OF A SECOND STROKE

n n

How can you tell if you or a loved one may be at risk of a future stroke? Remember that simply by having a stroke, you’re at a greater risk for having another one. Fortunately, you can take steps that will reduce that risk.

n n Stop smoking: If you are a smoker, step up your efforts to quit.

Smoking doubles your risk of suffering a second stroke.

SOURCES

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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

DERMATOLOGY

NEUROSURGERY

Narayan SANDARESAN, MD

5 E 84th St New York, NY 10028

(212) 328-0135

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

(844) 957-7463

OBESITY MEDICINE

Prabhakara R. TUMPATI, MD

2003 Bath Ave Brooklyn, NY 11214 1718 Welsh Rd, Philadelphia, PA, 19115 987 Old Eagle School Rd, Ste 712, Wayne, PA, 19087

(888) 283-0399

ONCOLOGY

Anella BAYSHTOK, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160

158-06 Northern Blvd Flushing, NY 11358

(718) 445-3700 www.brooklynroc.com

OB/GYN - GENERAL

Yekaterina LEVIN, DDS

7000 Bay Pkwy, Ste C Brooklyn, NY 11204

(888) 838-6212

Faina SHNAYDMAN, MD Leonard LEVITZ, MD

1749 E 16th St Brooklyn, NY 11229

312 Neptune Ave, Ste 1, Brooklyn, NY 11235 169-95 137th Ave, Jamaica, NY 11434

(718) 528-1503

(718) 375-4747

321 Edison St Staten Island, NY 10306

Tariq LAMKI, MD

5 E 84th St New York, NY 10028

(212) 328-0135

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

GASTROENTEROLOGY

(844) 957-7463

Hayama BRILL, MD

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

(718) 336-1909

2101 Ave X Brooklyn, NY 11235

(718) 512-2160 OPTOMETRY

629 Park Ave New York, NY 10065

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

Nataliya SAFONOVA, DDS

Lilia LEVITZ, MD

2211 Ocean Ave Brooklyn, NY 11229

1749 E 16th St Brooklyn, NY 11229

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

(718) 375-4747

321 Edison St Staten Island, NY 10306

Irina BERLIN, MD

Margarita BAUMAN, OD

NEUROLOGY

40 West Brighton Ave, Ste 104 Brooklyn, NY 11224

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

Salamon RAFAILOV, DDS

(844) 957-7463

Alexander BRODSKY, MD

8622 Bay Pkwy, Ste 1 Brooklyn, NY 11214

(718) 759-6979

5 E 84th St New York, NY 10028

(212) 328-0135

187-06 Union Tpke Fresh Meadows, NY 11336 3071 Ave U Brooklyn, NY 11229

1910 Ave U Brooklyn, NY 11229

Erico CARDOSO, MD

(718) 627-8300

(718) 736-0123

Paul GLIEDMAN, MD

Dmitriy GRINSHPUN, MD

Hanna JESIONOWSKA, MD

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

(888) 455-6619

Aleksandra ZLOTNIK, OD

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

1910 Ave U Brooklyn, NY 11229

(888) 747-8009

(718) 759-6979

(718) 333-2121

PAIN MANAGEMENT

Amit SCHWARTZ, MD

948 48th St, Fl 2 Brooklyn, NY 11219

(718) 283-7219

Radmila SHUMINOV, DDS

187-06 Union Tpke Fresh Meadows, NY 11336 3071 Ave U Brooklyn, NY 11229

(718) 736-0123

Sam WEISSMAN, MD

202 Foster Ave Brooklyn, NY 11230

(718) 854-5100

Sergey ZHIVOTENKO, MD

2707 Ocean Pkwy, Fl 2 Brooklyn, NY 11235

(646) 377-6050

20-04 Seagirt Blvd Far Rockaway, NY 11691

(718) 868-8668

Mila MOGILEVSKY, DO

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

(347) 252-6732

4HEALTH | 877.807.0989

4HEALTH PODIATRY

Julie PARITSKAYA, PA

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

(347) 252-6732

Leon STEPENSKY, DPM

3111 Brighton 2nd St., Brooklyn, NY 11235 235 Wyckoff Ave, Brooklyn, NY 11206 99 Moore St., Brooklyn, NY 11206

(718) 874-0224

ALTERNATIVE MEDICINE - GENERAL

RADIOLOGY

Sinai DIAGNOSTICS

2560 Ocean Ave Brooklyn, NY 11229

(888) 496-2688

2071 Clove Rd Staten Island, NY 10304

(888) 496-2688 UROLOGY

David SHUSTERMAN, MD

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

Universal Aesthetics 514 Ocean Pkwy, Brooklyn, NY 11218

(718) 360-9550 nyurology.com

VASCULAR SURGERY

(860) 671-1727

Ada KULAGINA, LAC

8635 21st Ave Brooklyn, NY 11214

(718) 934-8484

PHYSICAL THERAPY

NUTRITION AND DIETETICS

Essential Supply LLC (732) 881-6575 www.essentialdmbs.com

Alina VASILYEVA, DPM

2116 Ave P Brooklyn, NY 11229 1605 Voorhies Ave, Fl 5, Brooklyn, NY 11235

(718) 646-0131

PSYCHOLOGY

Yuly CHALIK, MD

USA VEIN CLINICS

(347) 508-3991

2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

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

1153 First Ave New York, NY 10065

2444 86Th St, Ste A Brooklyn, NY 11214

Albert GROSS, CNS, NYS, CDN

1942 E 8th St Brooklyn, NY 11223

(718) 376-8317 www.nylifex.com

MULTI SPECIALTY

USA VASCULAR CENTERS

116-02 Queens Blvd Forest Hills, NY 11375

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

(718) 393-5331

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

1901 82nd St Brooklyn, NY 11214

(718) 490-2416 PLASTIC SURGERY

2444 86th St, Ste A Brooklyn, NY 11214

1975 Hylan Blvd Staten Island, NY 10306

Vladislav RUDNER, PT

www.magichandspt.com

Chloe CARMICHAEL

230 Park Ave, Fl 10 New York, NY 10196

(212) 729-3922 PSYCHIATRY

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

122 Fulton St, 5th Fl. New York, NY 10038

(347) 508-3991

30-33 Steinway St Astoria, NY 11103

MEDICAL TRANSPORTATION

Multi SPECIALTY CLINIC 3023-3027 Ave V Brooklyn, NY 11229

(877) 807-0989 AESTHETIC CENTERS

5221 Broadway New York, NY 10463

RANNETA TRANSPORTATION

2965 Ocean Pkwy, 3rd fl, Brooklyn, NY 11235

Roman RAYHAM, MD, BOARD CERTIFIED IN PLASTIC SURGERY

62-69 99th St., Ste 2B, Rego Park, NY 11374

156 Route 59, Ste B1, Suffern, NY 10901

(347) 848-0049

(718) 509-0906 www.usaveinclinics.com

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

Interborough DEVELOPMENTAL & CONSULTATION CENTER

www.nyplasticsurgerycenter.com

(888) 987-5751

(877) 582-0400

MEDICAL SUPPLY

(888) 600-2262

Michael RISKEVICH, MD

3140 Coney Island Ave., 3rd Fl., Brooklyn, NY 11235

1623 Kings Hwy, Fl 4 Brooklyn, NY 11229

Ridwan SHABSIGH, MD

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

(718) 283-7746

Michael PATIN, MD

6417 Bay Pkwy Brooklyn, NY 11204

(718) 234-6767

102-30 Queens Blvd Forest Hills, NY 11375

(718) 896-2333

LSA RECOVERY

1300 Ave P Brooklyn, NY 11229

(888) 983-4055

4HEALTH | 877.807.0989

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!

4HEALTH

4HEALTH | 877.807.0989

4HEALTH

4HEALTH | 877.807.0989

4HEALTH

4HEALTH | 877.807.0989