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SEVEN WAYS TO RELIEVE A STUFFY NOSE

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FOR 5 COMMON BABY SKIN CONDITIONS

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Seven Ways to Relieve a Stuffy Nose Breathe Easier without Medications

11 8 For Excess Flab: Liposuction or Tummy Tuck? Which Procedure Works Best for Slimming Your Stomach

13 Solutions for 5 Common Baby Skin Conditions

How to Manage that MeanLooking Red Rash

17 My Eye is Red and It Hurts— What’s Causing It? When to See Your Doctor for Keratitis

26 4 Myths About Ingrown Toenails

The Truth About the Best Prevention & Treatment

COLD? FLU? ALLERGIES? TRY THIS SOLUTION!

HEART ATTACK OR STROKE?

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Acupuncture Can Reduce Reliance on Medications

How to Tell the Difference Between These Two LifeThreatening Events

10 WAYS TO GET NATURALLY THICKER, FULLER HAIR Exercise, Natural Oils, and Oat Flour May Help

4 SIGNS YOU MAY NEED A ROOT CANAL Possible Symptoms that Signal a Need for Treatment

PREGNANT? BREASTFEEDING? WHY YOU STILL NEED TO EAT FISH

SUBTLE SIGNS OF ADHD

WHAT KIND OF HEADACHE DO I HAVE?

SUBSTANCE ABUSE AFFECTS MORE PEOPLE THAN CANCER DOES

I HURT ALL THE TIME—IS THIS CHRONIC PAIN?

HARD-TO-TREAT NAIL FUNGUS

FDA Issues New Guidelines to Protect Unborn and Young Children

More Clues You or Your Child May Be Affected

Identifying Your Type Can Help Lead to Effective Treatment

Surgeon General Seeks to Expand Awareness and Decrease Risk

Symptoms and Treatment

Dr. Leon Stepensky on a New Treatment

EXERCISE HEADACHES? TRY THESE 10 SOLUTIONS

WHY YOU NEED TO KNOW MORE ABOUT VASCULAR DISEASES

TIGHTEN SAGGY SKIN AND LOOK GREAT THIS SPRING!

WHAT TO EXPECT FROM GALLBLADDER SURGERY

HOW TO TALK TO YOUR DOCTOR ABOUT ERECTILE DYSFUNCTION

I WAS JUST DIAGNOSED WITH ENDOMETRIOSIS—NOW WHAT?

Get to Know the Triggers of Workout Migraines

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Non-Invasive Treatment Creates a Lifted Look

Common Procedure Provides Relief to Many Patients

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SEVEN WAYS TO RELIEVE A STUFFY NOSE BREATHE EASIER WITHOUT MEDICATIONS

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By Lynn Merrell

It doesn’t seem possible to go into the spring season without having a stuffy nose. If it’s not the common cold, it’s allergies, or maybe just irritants in the air. Whatever it is, you can’t breathe, and you’re reaching for a tissue about every other minute. There are over-the-counter medications, but sometimes they can lead to drowsiness or other side effects. If you’re looking for other way to clear your sinuses and enjoy breathing again, try one of the following seven treatments.

1. SALINE SPRAY You may have avoided nasal sprays for fear that you would become addicted. After all, some nasal decongestant sprays can cause a rebound effect that causes you to have to use the spray more and more. The Mayo Clinic states that your nose can become less responsive to over-the-counter nasal decongestant sprays over time, and your symptoms actually get worse if you stop — worse than when you started. Saline sprays, though, aren’t the same as decongestant sprays. These are simple sprays that contain no medication. Instead, they’re made up of a simple salt solution that helps rinse and moisturize the nostrils.

You can use it as often as you like without worry.

2. USE A NETI POT. When you flush out your sinuses with a neti pot or similar product, you’re following the same principal as when you use the saline spray. You’re cleaning out the nasal passages, flushing out allergens and irritants, and moisturizing the nostrils so that you can breathe more easily. You’re also getting rid of that extra mucus, at least temporarily, in a very natural way. Just be sure to use distilled or previously boiled water to avoid exposure to bacteria. Never use tap water.

3. USE STEAM. You can moisturize, flush out, and soothe the nasal passages with steam. How you do it doesn’t really matter. Maybe you take a nice hot bath or shower, or pour some boiling water in a bowl and breathe in the steam. The hot vapor helps to drain mucus and provides temporary relief.

4. TRY AROMATHERAPY WITH EUCALYPTUS OIL. Eucalyptus oil is extracted from the eucalyptus tree, and has a number of natural health benefits. Not only is it a powerful anti-bacterial, it has been found in studies to actually help decongest the airways. It even boosts the

immune system, so if you have a cold, using eucalyptus may help you to get over it more quickly. Simply inhale the oil through an aromatherapy diffuser, add a few drops to a hot bowl of water and inhale.

5. DRINK A CUP OF HOT TEA. When you drink hot tea, you naturally inhale the steam, which can help ease congestion. The flavonoids in both green and black tea can also help reduce inflammation. Add in some honey and crushed black pepper and you can make the tea even more effective at opening the nasal passages.

6. HAVE SOME CHICKEN SOUP. Mom may have given you chicken soup when you were sick as a child. Turns out she knew what she was doing. Recent studies have suggested that chicken soup may help shorten the duration of a cold. Serve it up nice and hot for the steam effect, and inhale all the herbs and spices that help ease inflammation and improve breathing.

7. USE A HUMIDIFIER. When you have a stuffy nose, a humidifier is almost required to help you find relief. If nothing else, use it overnight in your bedroom to add moisture to the air and help loosen up congestion. www.4health.net

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HEART ATTACK OR STROKE? HOW TO TELL THE DIFFERENCE BETWEEN THESE TWO LIFE-THREATENING EVENTS

nnn By Colleen M. Story Heart attacks and strokes. According to the American Heart Association, they killed about 800,000 Americans in 2013, claiming more lives than all forms of cancer combined. Most of us know that eating a healthy diet, exercising regularly, and managing our stress can help us avoid falling victim to one or the other. But what is the difference between them? Do we need to do something to prevent a stroke that’s different from what we do to prevent a heart attack? Are there different steps to take in an emergency situation?

WHAT IS A HEART ATTACK OR STROKE? Heart attacks and strokes are similar in many ways, but there are important differences. Both are usually caused by a disease called “atherosclerosis,” which is a narrowing of the arteries, veins, and other blood vessels. As we age, our arteries can become clogged with plaque, which is made up of cholesterol and other substances that harden and create an inflexible border inside the blood vessels. Over time, this plaque continues to buildup, and in some cases, a piece of it may break off and cause a blood clot. That clot can then block the artery, refusing to allow blood to flow through. If the blood clot occurs in one of the heart’s blood vessels, then the person may suffer from a heart attack. Without the proper blood supply, the heart suffers. The part of the muscle that is deprived of blood may begin to die. The amount of damage to the heart depends on the size of the area supplied by the blocked artery and how long the person goes before getting treatment. If the blood clot occurs in one of the arteries or blood vessels leading to the brain — usually, the carotid artery in the neck — the clot stops the blood from going to the brain, which causes a stroke. Again, the brain may suffer damage, depending on how much blood fails to get through, and how long the patient suffers before getting treatment. Sometimes, people call this a “brain attack,” because it is so similar to a heart attack.

WHAT’S THE DIFFERENCE IN SYMPTOMS BETWEEN A HEART ATTACK AND STROKE Even though both of these conditions are caused by a blood clot, their symptoms are usually different. This can be helpful in determining which you or a loved one may be experiencing. Symptoms of a heart attack usually include: n Chest pain or discomfort n Pressure, squeezing, or fullness in the center of the chest, some-

times extending down the arm, shoulders, back, and abdomen; women may also experience abdominal pain that feels like heartburn n Shortness of breath n Breaking out in a cold sweat; clammy skin n Nausea and vomiting Symptoms of a stroke usually include: n Sudden confusion; difficulty speaking or understanding speech n Vision problems n Sudden numbness or weakness in the face, arm, or leg, usually on n n n n

one side of the body Loss of balance Severe headache with no known cause Lightheadedness Shortness of breath

If you notice any of these symptoms in yourself or in a loved one, call 911 right away. Both of these conditions are survivable if you get treatment quickly, as the heart and brain can recover. The outlook greatly depends on the severity of the event and how fast treatment is administered. Prevention for both of these conditions involves the same steps: avoid smoking, exercise regularly, maintain a healthy weight, eat nutritious foods, keep your blood pressure and blood sugar under control, and see your doctor regularly. www.4health.net

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10 WAYS

TO GET NATURALLY THICKER, FULLER HAIR EXERCISE, NATURAL OILS, AND OAT FLOUR MAY HELP

nnn Shay Morrigan Look at any list of celebrities people find attractive, and you’ll see that the majority of them have one trait in common—thick, lustrous, shiny hair. Though people who actually have thick hair may bemoan their fate because it takes a long time to dry or feels heavy on their heads, we still can’t help but believe that thick hair is the best hair. Unfortunately, many Americans have thinning hair caused by aging, genetics, or medical conditions, and want to find ways to bring back a little bulk. If you fall into the category of hair types that are more “fine” than “full,” try these tips to help create more volume. 1. Use hair-volumizing products: Thickening shampoos and conditioners, volumizing mousses, and weekly thickening treatments can all help boost the diameter of the hair shaft. Hair may be fine because it lacks the nutrients and chemical bonds it needs to bulk up. These products infuse the strands with these nutrients, which can help the hair appear fuller over time. Look for products that say “volumizing” or “for fine hair” or “thickening.” Stay away from extra moisturizing products as they will be too heavy and weigh hair down, and be careful not to use too many styling products, as they will do the same thing. Mousse is typically best for promoting volume. 2. Increase circulation to the head: In one word, exercise! Exercise has so many health benefits, and this is one of them. When you exercise, you increase blood circulation in the body, which can help get critical nutrients to the hair follicle. 3. Take a break from styling: If you typically use hair dryers, curling and flattening irons, gels, and wax on your hair, try to take a break once or twice a week. All that styling can encourage breakage, giving you less hair to work with. It can also dry out and damage your hair strands, making them appear not only thin and fine, but dull. 4. Try natural oils: Essential oils like jojoba, rosemary, coconut, and cedar wood massaged into the scalp have shown some evidence of helping to stimulate hair growth. First of the all, the massage increases circulation. Second, the oils moisturize the skin of the scalp and the hair, fortifying it against breakage. Finally, some of the nutrients in the oil may help cleanse and stimulate hair follicles. 5. Try oat flour: Mix in about two tablespoons of oat flour into your conditioner for a natural volumizer. Work the product into the scalp and all the way to the ends. 6. De-stress: Have you had your stylist ask you what’s going on in your life lately? Stress is a definite factor in thinning hair. Practice stress-busting activities like regular exercise, meditation, yoga, and journaling. 7. Get regular hair cuts: Keeping your hair trimmed at least every six weeks will keep it healthy and reduce split ends, which can make hair look thin and damaged. A shorter hair cut with layers will also help fine-hair types look like they have more body. 8. Eat more protein: The hair shaft is made up of a lot of protein, so be sure you’re getting enough with lean meats, eggs, beans, and nuts. Overall, make sure you’re eating a healthy diet. If you’re missing critical nutrients, your hair could pay the price. 9. Try vitamins: B vitamins aid the body in hair growth. If you’re not getting enough in your diet, consider a B-complex supplement. Vitamin C may also be helpful, as it is necessary for the production of protein, as well as an omega-3 supplement like fish oil or flax seed oil, as these are known to promote healthy skin and hair. 10. Look for natural products: Some ingredients in standard hair products are harsh and can damage fine strands. Try more natural brands that cut the chemicals and infuse your hair with nutrients, moisturizers, and proteins. www.4health.net

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FOR EXCESS FLAB: LIPOSUCTION OR TUMMY TUCK?

WHICH PROCEDURE WORKS BEST FOR SLIMMING YOUR STOMACH nnn By Lynn Merrell Melinda was tired of carrying around her muffin top. After giving birth to four kids, she was done expanding her family, and ready to flatten her stomach. She’d tried everything — sit-ups, aerobic exercise, dieting, and even those electric pulse things she’d seen on television. The fat was still there. Otherwise, she was a healthy, middle-aged woman and wanted her body to reflect her energetic attitude. She was ready to try plastic surgery, but she wasn’t sure which procedure would work best for her. She’d heard of both the tummy tuck and liposuction, but when she asked her friends, they didn’t really seem to know the difference. If you’re facing a situation similar to Melinda’s, you may wonder which procedure would best get rid of your belly fat and help you look slimmer and more youthful. Is a tummy tuck or liposuction for you?

A DEFINITION OF THE TWO PROCEDURES Both of these procedures are commonly used to get rid of belly fat. They are quite different, though. In general, liposuction is considered the less serious procedure, with patients recovering and returning to their normal daily activities a little sooner. A tummy tuck is more involved, and patients need about a month before they start to get back into their normal daily routines. n Liposuction: Liposuction removes excess fat from many areas

of the body, including the abdomen, thighs, hips, buttocks, upper arms, back, and chest. But in this case, we’re referring to the stomach area. The fat is removed through a small tube that is inserted under the skin via a small incision. This tube is attached to a powerful vacuum that “sucks” the fat out. It may be used alone, or may be combined with other plastic surgery procedures (such as a tummy tuck). www.4health.net

n Tummy tuck: Also called “abdominoplasty,” a tummy tuck re-

moves not only excess fat, but skin, as well. Surgeons often restore weakened or separated muscles to help restore a firmer, more toned look. The surgery can last from one to five hours. The surgery also typically leaves scars, though they will fade. This procedure usually costs more than liposuction, as well.

WHICH PROCEDURE IS BEST FOR YOU? How do you know which of the above is best for you? Let’s look at a few more differences. Whereas liposuction removes only stubborn areas of fat, it does not remove excess skin or do anything with the underlying tissues. It is a shorter and less painful procedure, but produces less drastic results. n When to get liposuction: You are close to your ideal body weight,

and you have good abdominal muscle tone. You just have some areas of stubborn fat that you can’t get rid of, like a muffin top or love handles. You don’t really want an extensive surgery, just a little help to look your best. n When to get a tummy tuck: You lost a lot of weight, and now you have excess skin hanging around your middle. Or after having several children, you have a lot of flabby skin and fat left behind around your tummy. Your muscles may be stretched or weakened in your abdomen, and you have stretch marks you’d love to get rid of.

CHECK WITH YOUR DOCTOR These guidelines can give you an idea, but your best bet is to check with a board-certified plastic surgeon to find out which procedure will work for you. Be sure to consider the cost, how much time you’ll need to take off work, and what you’ll need for your recovery.

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4 SIGNS

YOU MAY NEED A ROOT CANAL POSSIBLE SYMPTOMS THAT SIGNAL A NEED FOR TREATMENT nnn Gordon Barclay Daren had a toothache. He didn’t think much about it at first, but after three days with no relief, he started to get concerned. He looked in the mirror, but he couldn’t see anything unusual. He was conscientious about his dental care, brushing and flossing every day, so he couldn’t quite figure it out. What could it be? Daren made an appointment with his dentist and soon had the answer: he needed a root canal. The idea didn’t sound the most appealing, but after his dentist explained it he felt a little bit better. At least it was good to know that it wasn’t his fault!

WHAT IS A ROOT CANAL? A root canal, as the name suggests, is all about the “roots” inside of the tooth. Like a plant has roots going into the ground, we have root-like structures in our teeth that extend into the jawbone. These “roots” are actually canals or spaces that contain the soft tissue (called “pulp”) at the center of the tooth. This soft tissue also contains blood vessels, nerves, and connective tissues. It’s when the pulp inside the canal becomes inflamed or infected that we suffer problems. What causes this to happen? There are a number of possibilities:

n n n n n

Deep decay in the tooth Trauma to the tooth (chips or cracks) Faulty crowns Repeated dental procedures on the tooth A “dying” tooth, caused by aging or past trauma

SYMPTOMS AND SIGNS OF A DAMAGED ROOT CANAL How might Daren have been able to tell that his tooth was aching because of a damaged root canal? It can be difficult. That’s why it’s important to have regular checkups with your dentist. You may notice some symptoms, however, which may include: Pain: Not everyone experiences it, but if you do, it may feel like throbbing, and may get worse when you get up from a sitting position. It may also occur when you chew or bite down on something, or when you eat something hot or cold. Gum swelling: It may be only slight or more noticeable, and may spread into your face or neck. Unlike gum disease swelling, it doesn’t usually occur where the tooth and gum meet, but closer to the root tip. Comes and goes: Pain and swelling may come and go, flaring up at some times and calming down at others. Symptoms never totally disappear, though. Pimple-like swelling: In some cases, the gum forms a pimple-like sore (or abscess)

close to where the tooth’s root is located. It may get bigger at times, and then recede, and may taste badly as the pus drains from it. Remember—you may experience no symptoms at all, or they may be too mild to notice.

DENTAL TESTS TO DETERMINE WHETHER YOU NEED A ROOT CANAL Once you go to your dentist, he or she will conduct some other tests to determine if the root is the problem. X-rays may show a dark spot at the tip of the tooth’s root, which is a sign that treatment is needed. He’ll look for symptoms like gum swelling and pimple-like sores, and exposure of the nerve. Finally, he’ll likely perform a series of simple tests: Tapping: When the dentist lightly taps on the tooth, if you feel pain, the tooth likely needs treatment. Hot and cold: Cold will usually provide pain relief to a tooth with a damaged root, whereas hot will feel painful. Electrical current: A low-level electric current will cause a healthy nerve to tingle, but a dead nerve (or root) will feel nothing. If you do need a root canal, try not to worry. The treatment is necessary to preserve the tooth and to prevent pain and infection from recurring. Most patients experience little if any pain. Talk to your doctor about the details so you can feel as relaxed about the procedure as possible. www.4health.net

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PREGNANT? BREASTFEEDING? WHY YOU STILL NEED TO EAT FISH FDA ISSUES NEW GUIDELINES TO PROTECT UNBORN AND YOUNG CHILDREN

nnn Colleen M. Story Expectant moms who like fish are often confused about the potential dangers. Once you’re pregnant, can you still eat certain kinds of fish, or is it best to avoid it all? Is it really a concern, or an overblown danger? Is there anything wrong with just staying completely away from all fish while pregnant and/or breastfeeding? For the longest time, women have been told it’s best to be safe than sorry, and just stay away from fish. Recent studies, however, have shown that when women don’t eat fish at all, they can actually rob their unborn children of critical fatty acids that are important for development. It’s time to take a second look at what’s best for mom and baby during this critical time.

MOMS NEED OMEGA-3 FATTY ACIDS As adults, we’re often told to eat several servings of fish every week, particularly the fatty kind that are good sources of omega-3 fatty acids. These are vital for brain function, eyesight, and healthy blood vessels, and may help to reduce risk of heart disease. These nutrients are equally important for a developing fetus. They help the baby’s brain and eyes develop properly, and are important for other areas of development as well. Studies have found that when moms get enough omega-3 fatty acids in their diet during pregnancy, children grow

up to have better fine motor coordination, IQ scores, and communication skills. Because these nutrients are so important, moms need to be sure they’re getting enough. There are other foods that have them, including grass-fed beef, flaxseed oil, and walnuts, but some moms may have difficulty getting enough with these foods alone. Supplements may seem like a good option, but research has found that fish oil supplements don’t seem to work as well or provide the same benefits as eating fish.

MERCURY IN SOME FISH IS DANGEROUS Some fish are just the perfect sources of the critical fatty acids that baby needs, but at the same time, some of these same fish can be dangerously high in mercury. In adults, the level of mercury is small enough that it’s not considered a health concern, but those same levels can harm the developing nervous system of an unborn child. Some studies have found links between a woman’s exposure to mercury from eating fish and an increased risk of attention-deficit hyperactivity disorder (ADHD). Other studies have found, however, a reduced risk of ADHD in babies born to moms who ate fish—because they ate “safer” fish with extremely low levels of mercury.

CURRENT RECOMMENDATIONS So the key is to eat the right kind of fish that give your baby the omega-3 fatty acids

that he or she needs, with an extremely limited exposure to mercury. The Food and Drug Administration (FDA) recently announced updated advice for fish consumption in pregnant and breastfeeding women. They noted that over the past decade, emerging science has pointed out that women and children need fish in their diets for the nutritional benefits. “For years many women have limited or avoided eating fish during pregnancy or feeding fish to their young children,” said Stephen Ostroff, M.D., the FDA’s acting chief scientist. “But emerging science now tells us that limiting or avoiding fish during pregnancy and early childhood can mean missing out on important nutrients that can have a positive impact on growth and development as well as on general health.” Now, the FDA advises women to eat at least eight ounces and up to 12 ounces (2-3 servings) of fish per week that are low in mercury to support fetal growth and development. The fish to avoid that have been linked to higher levels of mercury: 1. Swordfish 2. King mackerel 3. Shark 4. Tilefish from the Gulf of Mexico Low-mercury fish that are good choices during pregnancy include shrimp, salmon, canned light tuna, tilapia, cod, catfish, and pollock. www.4health.net

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SOLUTIONS FOR 5 COMMON BABY SKIN CONDITIONS HOW TO MANAGE THAT MEAN-LOOKING RED RASH

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By Morgan Rice

As parents, we worry about a lot of things. We fear something happening to our children, and do everything we can to protect their safety. One of the things we may not think about, though, is the skin, and the many types of things that can affect it. Skin conditions can show up suddenly and without any obvious cause, and they can also be confusing: Just what do you do about a mean-looking red rash? Below are five of the most common skin conditions that may affect children. Learning more can help you be more prepared if you find your child’s skin looks red, flaky, scaly, or has other unusual characteristics. Of course, if you’re not sure what’s going on, always check with your pediatrician.

1. CRADLE CAP (SEBORRHEA) This shows up as a red rash on the baby’s scalp, and may extend behind the ears or onto the neck. It’s most common in infants six months and younger. The skin may look flaky and crusty, with dead pieces of skin easily brushed off. It can also look cracked and scaly. No one knows exactly what causes cradle cap, but mild baby shampoo and soft brushing can help treat it. Do check with your pediatrician, as there are medical creams that can help to clear it up. The condition usually goes away once the child grows past the age of one.

2. ROSEOLA This is an actual illness caused by two viruses: the human herpes virus (HHV) type 6 and type 7. These are different from the herpes virus that causes genital sores, but they are contagious and can be spread through bodily fluids from the nose and throat. The condition usually shows up as a pinkish-red rash on the trunk, and can spread over the body. It may also cause high fever and mild upper-respiratory illness. Children aged 6 months to 2 years are most commonly affected. To treat roseola, take your child to the doctor immediately to be certain of the cause. Roseola is like other viral infections, and can’t be treated with antibiotics. Doctors recommend acetaminophen or ibuprofen to reduce fever, and lots of fluids. www.4health.net

3. FIFTH DISEASE

This is another viral disease caused by the human parvovirus, and is spread by sneezing and coughing. It creates a red rash on the face, mainly on the cheeks, but it can spread to the arms and legs. Other symptoms include cold-like symptoms, fever, aches and pains, lack of appetite, and irritability. Take your child to the doctor to confirm diagnosis, and then treat like you would other viral infections — with fluids, Tylenol, and rest.

4. PRICKLY HEAT This condition affects infants and is simply the result of the skin getting too hot. Also called “miliaria,” a red rash shows up on the head and neck, or on the back or bottom, and may include pimply eruptions or tiny red bumps. Baby’s skin can overheat more easily than adult skin, so that tight clothing, car seat straps, and other restrictive items can cause this type of rash. The solution is simple: Remove the heat source and dress your child in cool, loose clothing. Once you do that, the rash will typically go away within about 30 minutes.

5. ECZEMA This is a common skin condition that most parents are aware of. It can develop in babies starting around three-to-four months, and can show up anywhere on the body. It tends to develop in smaller, dry patchy areas that turn red. Over time, they may ooze pus and crust over. Babies with a family history of allergies are more at risk for it, although certain harsh soaps and clothing can also cause it. To treat it, wash the area with a very gentle, fragrance-free cleanser, and then apply a natural moisturizer onto the skin at least twice a day. (Look for those with more natural ingredients like calendula, chamomile, oatmeal, and the like.) You can also sprinkle in a bit of baking soda or uncooked oatmeal into baby’s bath to soothe skin. Then watch for triggers that may be causing the eczema, things like pet dander, dust, smoke, or other allergens. If your baby is allergic to any of these, reducing his or her exposure may help clean up the skin condition. If the condition doesn’t improve, check with your doctor or dermatologist.

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7 HEALTHY FOODS FOR DIABETES nnn Colleen M. Story If you have diabetes, or even if you’re at risk and want to prevent the disease, diet plays a large part in how healthy you feel. The key is to avoid overeating, stick to regular mealtimes, and eat a variety of fruits, vegetables and whole grains. Meanwhile, avoid sugary drinks and refined carbs like cookies and cakes, white flour, white rice, and pasta— all of which break down quickly and spike your blood sugar levels. You don’t have to avoid these foods completely, but they should be a minor part of an overall healthy diet. While figuring out your meal plan, you can count on these foods to break down slowly and help keep blood sugar levels even. 1. Beans: High in protein and fiber, beans help you feel full and stay full longer, so you can avoid munching on any sugar-laden

treats. Enjoy kidney, pinto, navy, black and other types of beans. 2. Dark, leafy vegetables: These are not only full of good-for-you nutrients, they’re low in carbs, so they will take time to break down in your body, keeping blood sugar levels even. They’re also low in calories so you can eat all you want. Choose spinach, collard greens, mustard greens, and kale. 3. Sweet potatoes: If you’re craving a potato, which has a high glycemic index (breaks down quickly in the body), switch to a sweet potato instead. It’s full of healthy vitamin A, high in fiber, and low in glycemic index. 4. Citrus fruits and berries: These are high in fiber, as long as you eat the whole fruit and not the juice. Fruit fibers slow sugar absorption so you get the sweet taste without hiking your blood sugar. Choose oranges, grape-

fruits, lemons, blueberries, raspberries, and blackberries. 5. Fat-free milk and yogurt: Full of bonebuilding calcium and vitamin D, these foods help curb cravings and make perfect betweenmeal snacks. 6. Whole grains: You probably already know about these—they’re high in fiber and break down slowly. The good thing about them is you can use them to replace your usual white-fiber foods. Look for whole grain pastas, breads, and cereals for your regular meal items. 7. Nuts: Yes, they’re high in fat, but these fats are the “good fats” that improve heart health, among other benefits. Keep your portions in control—no more than a small handful a day—but otherwise the high protein and good fats will help balance your diet. Choose almonds, walnuts, and cashews. www.4health.net

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SUBTLE SIGNS OF ADHD MORE CLUES YOU OR YOUR CHILD MAY BE AFFECTED

nnn By Colleen M. Story Parents often struggle with their kids for years before they finally receive a diagnosis of attention deficit hyperactivity disorder (ADHD). They can be long, frustrating years, with behavioral problems at home and in school. The struggle can affect not only the child’s development, but relationships within the home, too, as everyone tries to deal with the stress of the issue without even knowing what the issue really is. Now, researchers say they may have discovered some new, subtle signs displayed by those with ADHD that could identify them more easily and quickly. These are signs that parents can watch for, and which may lead to an earlier diagnosis that can then turn into helpful treatments and coping techniques.

Here’s what the researchers found. Are you seeing these symptoms in yourself or in a loved one?

WHAT IS ADHD? ADHD is a brain disorder that interferes with functioning and development. It typically affects attention, concentration, memory, motivation and effort, impulsivity, hyperactivity, organization, and social skills. Doctors aren’t sure yet what causes it, but they know that it has something to do with the chemicals in the brain, and how they communicate with each other.

WHAT ARE THE TYPICAL SIGNS OF ADHD? We already know some of the signs of ADHD, but it can be difficult to separate them from otherwise ordinary behavior in children. A child www.4health.net

4HEALTH with ADHD may have a hard time paying attention, for example, but then all kids have a hard time with that now and then, so if you’re child isn’t paying attention, that doesn’t necessarily mean he has ADHD. Another sign is hyperactivity, but again, all children can get hyper on occasion, especially if they’re excited. Doctors warn parents not to jump to conclusions, but to watch for these and other symptoms like non-stop talking, dashing around, interrupting, failure to listen when spoken to directly, and having a hard time sitting still. Only when these symptoms seem to be more severe than those in other children, or to occur more often, might they be signs of ADHD. Doctors also note that the symptoms should appear before age 7, and continue for at least six months to indicate possible ADHD. In adults, they may include things like anxiety, problems at work, impulsiveness, substance abuse, procrastination, low self-esteem, chronic boredom, mood swings, and depression.

WHAT THE STUDY FOUND In a recent study by researchers from Pennsylvania State, young adults who had ADHD had more difficulty inhibiting a motor response compared to those who didn’t have the disorder. While performing a continuous motor task, participants were told to apply more force with their index finger and thumb in response to a visual cue. As long as the cue was any color but blue, they were to apply force, but when it turned blue, they were supposed to withhold force. Results showed that those who didn’t have ADHD were able to withhold force in response to the blue cue, while those who had the disorder actually produced more force in response to the blue cue.

It’s difficult to apply the findings from this study to normal life, but parents could potentially watch how their children color, for example, or perform other small motor tasks, and see how they respond when told to color lightly, or to push a toy car easily across the floor. Is your child able to withhold force, or does he or she actually use more force in those instances?

OTHER SUBTLE SIGNS OF ADHD In addition to the motor skills issue, there are other subtle ways that ADHD can show itself. In children, these may be: n n n n

Constant fidgeting Verbal aggressiveness (particularly in girls) Eating disorders Low self-esteem

In adults, they may be: n n n n n n n

An aversion to reading, because if requires a lot of attention Thrill-seeking behavior Overspending Difficulty with organization Forgetfulness Lack of follow-through Relationship problems

If you believe that you or a loved one may be affected by ADHD, check with your psychiatrist. He or she can conduct tests and observations that can help determine if this brain disorder may be causing problems, and can help you find treatment to help. Do feel free to take your time, and to ask questions of your doctor.

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WHAT KIND OF HEADACHE DO I HAVE? IDENTIFYING YOUR TYPE CAN HELP LEAD TO EFFECTIVE TREATMENT

nnn By Colleen M. Story If you have a headache now and then, usually an over-the-counter pain reliever will fix it, and you can go on about your life. If you tend to get headaches once a week or more, however, they can really slow you down. Some don’t respond well to aspirin or ibuprofen, either, which can mean that you end up suffering many days without being able to find a solution. Rochelle was having that problem. Starting in her 30s, she had suffered headaches several times a month, and when she turned 35, it got to the point where she could basically count on having a headache 2–3 times a week. She was frustrated, to say the least. The problem was she didn’t know what the problem was. She thought at first that maybe she was just tired, but then there were days when she was full of energy and still got a headache. Other times she thought it was tension, but then she got headaches when she felt relaxed, too. Unfortunately, many people end up in a situation like Rochelle’s, and have to put on their detective hats to try to figure out just what’s causing their headaches. It may be one thing they didn’t think of, or it could be a combination of things. Keep a diary of your symptoms for at least a couple weeks, talk to your doctor, and check out the following information to see if you can discover what’s causing your pain.

4 MAIN TYPES OF HEADACHES In general, there are four different types of headaches. See if you can identify which type sounds most like the ones you get:

1. Tension headaches: These are the ones that show up on your stressful days. They are caused by tension in the neck and shoulders, usually because you’re contracting these muscles without realizing it because you’re stressed out. They are the most common of any type of headache, and affect almost everyone at one time or another. The pain usually feels like a steady, dull ache or band of tightness around both sides of the scalp, and is usually mild. Your upper neck may also feel tender.

2. Migraines: The bane of many women’s existence, migraines affect about 13 percent of Americans, with women outnumbering men by about three to one. They can be caused by a number of “triggers,” including hormonal changes, lack of sleep, alcohol, hunger (caused by skipping meals), changes in caffeine intake, weather changes, strong odors or noises, bright lights, and allergies. They are genetic — those with family members who suffer migraines are more likely to suffer them, too. The pain typically occurs on one side of the head (though it can spread to the rest of the head), is pulsating and throbbing, and varies from moderate to severe. It may be accompanied by nausea and vomiting, fatigue, sensitivity to light and noise, light-headedness, and gets worse with activity. 3. Cluster headaches: These are less common, strike men more often than women, and are extremely painful. The pain is often focused behind one eye, and may be accompanied by tearing and redness, along with congested sinuses. These headaches can occur during sleep and wake someone up. Sometimes they are linked to previous head injuries. Alcohol may also be a trigger. 4. Exertion headaches: These are caused by strenuous physical activity, and are common in athletes like football players and weightlifters. Researchers aren’t sure of the cause, but believe it has something to do with abrupt dilation or constriction of blood vessels. These headaches usually show up during or after exercise, are very painful, and are described as “explosive.” Medical attention is advised, as the headaches may be a sign of other issues in the brain.

HOW TO DETERMINE YOUR HEADACHE TYPE Once you determine which type of headache you most likely have, you can talk to your doctor about treatments. As mentioned above, keep a headache diary for at least two weeks, and record all of your experiences around the headache, including where you were, what you were doing, what the atmosphere was like (sounds, light, etc.), how you were feeling (stressed or relaxed), what you ate and drank, and whether or not you were active. Then share this information with your doctor. www.4health.net

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SUBSTANCE ABUSE AFFECTS MORE PEOPLE THAN CANCER DOES SURGEON GENERAL SEEKS TO EXPAND AWARENESS AND DECREASE RISK

nnn By Gordon Barclay If I were to ask you which affects more people, addiction or cancer, what would you answer? I thought cancer for sure, but according to a recent report from the U.S. surgeon general, I was wrong. More people use prescription opioids today than use tobacco, and more suffer with substance abuse disorders than people with cancer. These disorders cost the country more than $420 billion a year, say nothing of the personal costs to individuals and their families. Yet only about 10 percent of people with a substance use disorder receive any kind of special treatment. The surgeon general is hoping to change that.

ALCOHOL AND DRUG MISUSE ARE MAJOR PUBLIC HEALTH CHALLENGES The report was released in November of 2016, and according to the U. S. Department of Health and Human Services, its aim is to “galvanize the public, policymakers, and health care systems to make the most of these new opportunities so that the individual and public health consequences associated with alcohol and drug misuse can be addressed effectively.” Studies show that in 2015, over 27 million people in the U.S. were using illicit drugs or misusing prescription drugs, while over 66 million reported binge drinking in the past month. The surgeon general named alcohol and drug misuse as “major public health challenges that are taking an enormous toll on individuals, families, and society.” Related problems include unsafe neighborhoods, crime and violence, child abuse and neglect, and increasing health care costs. Many more people now die because of alcohol and drug overdoses than are killed in car accidents each year, and in 2014, nearly 30,000 died of a heroin or prescription opioid overdose. An additional 20,000 died after overdosing on alcohol, cocaine, or non-opioid prescription drugs. Along the way, abuse of alcohol and drugs can lead to other negative consequences, including deteriorating physical and mental health, unplanned pregnancies and damage to unborn children. And as www.4health.net

mentioned, the problem is bigger than cancer-20.8 million Americans were affected by substance abuse disorders in 2015, which is more than 1.5 times the annual prevalence of all cancers combined (14 million). The surgeon general gives a shocking statistic: one in 7 Americans is expected to develop a substance use disorder at some point in their life.

TREATMENT PROGRAMS ARE IMPROVING One thing that can give us all hope is that medical research has helped us to understand more about addiction, which is helping doctors to fashion treatments that are more effective for patients. These treatments can help restore people’s health and well being, and can save lives. Some effective programs include mutual aid groups like Alcoholics Anonymous, as well as recovery housing and recovery coaches. Some health insurers are now covering substance use disorder services, while government incentives are encouraging general health systems to control costs. Finally, the criminal justice system is working to place non-violent offenders into treatment facilities rather than in jail. If you or a loved one is struggling with a substance abuse disorder, don’t wait to get help. Studies are now showing that early intervention and treatment helps prevent more severe disorders. The goal of early treatment is to not only help the person get over the addiction, to reduce risky behaviors and improve social function. Health care providers and counselors can help to conduct interventions where needed, and to refer them to the best treatment plans.

PREVENTION IS POSSIBLE The surgeon general also notes that prevention is key, and that most prevention programs are focused on adolescents, since substance abuse often begins between the ages of 12 and 17. School-based and classroom centered programs seek to teach children about the dangers of addiction, while helping them manage the social difficulties they may face. Other programs, like Focus on Families and Coping Power, train children how to identify and cope with difficult emotions, and teach family management skills to families as a whole to help reduce the risk for future drug abuse.

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BACK OR NECK PAIN? HEAD TRAUMA? SOPHISTICATED TREATMENT AVAILABLE NEAR YOU! AWARD-WINNING DOCTOR SUNDARESAN OFFERS EXPERIENCED NEUROLOGICAL CARE Did you know that if you’re suffering from back pain, neck pain, head trauma, spinal problems, or other disorders related to the central nervous system, you can find some of the top doctors in the field right in your home town? We had a chance to speak with Dr. Narayan Sundaresan — one of the top neurosurgeons at Memorial Sloan-Kettering Cancer Center for seven years — about his practice in the New York City area. Dr. Sundaresan has authored over 100 abstracts and peer-reviewed articles in the top oncology and spine journals, and currently works with a team of neurosurgical specialists of NY Neurosurgery, PC and Generations Neurosurgery, PC at the largest medical center.

WHAT DO NEUROSURGEONS TREAT? Neurosurgeons like Dr. Sundaresan specialize in disorders of the central and peripheral nervous system, including the following: n traumatic injuries to the brain, skull, spinal cord, or nerves n tumors in the brain, spinal cord, nerves, skull, or spine n back pain caused by pinched nerves, infections, fractures, and ruptured or bulging disks n neurovascular disorders such as aneurysms, strokes, and brain hemorrhages n brain disorders like epilepsy and Parkinson’s disease n infections of the brain and/or spinal cord

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

“I would venture to say that more than 25% of human beings have problems with this,” he says, “and that’s the group I’m focused on right now as they also require surgical treatment.” He notes that back problems often come from work-related injuries, especially with patients who are in the construction business, or who have been in car accidents. “The majority of my patients come in because they have a herniated disc or ruptured disk in the neck or back and they’re in excruciating pain from pressure on the nerves. And it’s taking care of them that’s a big part of my practice.”

THE IMPORTANCE OF A GOOD DOCTORPATIENT RELATIONSHIP As one of the youngest neurosurgeons in the nation, Sundaresan was working in the field before technology became so critical in the care of the central nervous system. Prior to the heavy use of CAT scans and MRIs, for instance, it was important for a doctor to be able to make a diagnosis without a lot of special equipment. “In the early days there was a lot of good judgment involved,” he says. “Surgeons of my generation learned by talking to the patient, listening to their history, being personally involved. The clinical skills were very, very important. The way that we were taught was we had to assume personal responsibility not only in surgery, in their preoperative care, their postoperative care, and ongoing care, so there was a very complete relationship.” In the NY Neurosurgery PC, the doctors pride themselves on continuing the idea that complete care must involve a solid foundation of communication and trust between doctor and patient.

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

ticularly at his Coney Island location, where he works with Generations Neurosurgery, PC. “Coney Island Hospital is unique because it is the hospital for a very large group of Russians,” he says. Most of the physician’s assistants at Coney Island Hospital speak Russian, so patients are very comfortable there. “We have hired for our group a Russianspeaking neurosurgeon,” he says, “who wants to settle in this community and build a practice and serve the Russian community. It’s very difficult for us to find someone with that background. But we have now gotten an extremely well trained doctor who wants to join us.” In fact, the doctor’s practice is well suited to take care of all types of neurosurgical issues in the local community, and encourages patients in the Brooklyn area to visit Coney Island. “I think for the outsider who looks at Coney Island or looks at another hospital you’re not aware as to how sophisticated the services are,” he says. “But this hospital does have a lot of advanced tech in neurosurgery, and we have a very, very experienced neurosurgical team taking care of this. Patients don’t have to go to Manhattan — they have it right here.”

CONTACT DR. SUNDARESAN TODAY In addition to treating back and neck pain along with other neurosurgical conditions, Dr. Sundaresan is often sought out by patients overseas because of his expertise in dealing with complex tumors. He and his team have offices and treat patients in Manhattan, the Bronx, and Brooklyn. For more information, contact the clinic at 212–876–7575, or visit their website at www.nyneurosurgerypc.com.

Generations Neurosurgery, PC

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

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MY EYE IS RED AND IT HURTS — WHAT’S CAUSING IT? WHEN TO SEE YOUR DOCTOR FOR KERATITIS

nnn By Gordon Barclay A friend of mine was complaining about his red eyes the other day. “They’re always red,” he said. “I mean, I look like I’m drunk in the middle of the day.” He’d been using drops and using drops, but they weren’t helping much. He thought maybe it was allergies, or dry eyes, but he couldn’t be sure. I told him to stop wondering about it and go see his optometrist. He finally did that, and good thing, as it turns out he had a condition called “keratitis.” Here’s more on this, just in case you’re suffering from red eyes and you’re looking for a solution.

WATCH OUT FOR SYMPTOMS OF KERATITIS At first, the symptoms of this disorder are similar to other eye problems, but then they often tend to get worse. They start out with redness and excess tears, sensitivity to light, and a feeling like you’ve got something in your eye. You may think that you got some dust in there, or that your allergies are bothering you. Over time, however, you’ll notice some more serious symptoms, like eye pain, difficulty opening your eye, blurred vision, and sometimes a colored discharge. If you notice these symptoms, get to your doctor right away. Keratitis is an inflammation in the cornea, which is the transparent, dome-shaped tissue in the front of the eye that covers the pupil and the iris. The cornea works to protect the eye from foreign material, like dust and bacteria, and serves as a protective layer between the eye and damaging UV radiation. It also provides a smooth surface through which the eye can absorb oxygen and nutrients from tears.

The cornea also helps to bend or refract the incoming light onto the lens of the eye, so it’s involved in focusing images. If something is wrong with it, your vision won’t be as clear, which you may notice as things become fuzzy or blurry.

WHAT CAUSES KERATITIS? When the cornea becomes inflamed, as happens when you have keratitis, it may swell up a bit, which is what causes the eye pain, redness, and discharge. It also leads to blurry vision. Sometimes, it’s referred to as a “corneal ulcer” instead of keratitis, but they both mean the same thing. The inflammation is most commonly caused by some type of infection, either from bacteria, a virus, fungus, or parasite. You can pick up these infectious materials from contaminated contact lenses, contaminated water (such as may be in swimming pools, rivers, lakes, or hot tubs), or if an object scratches your eye and introduces bacteria or fungi into the damaged surface of the cornea. Of course, swimming or getting hit in the eye doesn’t always result in keratitis. It depends on the circumstances, and on your own immunity. If your immune system is weakened, for example, due to disease or medications, you’re at a higher risk for developing keratitis if you’re exposed to something that may cause it. Other risk factors include previous eye injuries, wearing improperly cleaned contact lenses or extended-wear contacts, living in a warm climate, and using corticosteroid eye drops.

WHY YOU SHOULD SEE YOUR EYE DOCTOR RIGHT AWAY The problem with keratitis is that it can lead to other complications if you’re not careful. They can be so serious that they can

lead to vision loss, so don’t wait to make an appointment. Without treatment, the inflammation can become chronic, the swelling can get worse enough to cause scarring, and vision can be reduced. The condition can even lead to blindness in some cases. The good news is that keratitis is very treatable, especially if you catch it early. Once your doctor makes a diagnosis, he or she will recommend one of the following treatments: n Watchful waiting: If your condition was

caused by dirty contacts or a scratch on the eye, your body may be able to defeat the infection on its own. Your doctor may prescribe eye drops and an eye patch to reduce pain and discomfort while your eye is healing. n Medications: For bacterial keratitis, your doctor may prescribe antibacterial eye drops or oral antibiotics to help your body fight off that bacteria. The same is usually true with fungal keratitis and viral keratitis. Only in very severe cases will the doctor have to resort to surgery — if the infection keeps coming back, or doesn’t respond to medical treatment. In some cases, if the problem is caused by a tiny parasite, surgery may also be required. Usually, the doctor recommends a cornea transplant to restore vision. To help protect your eyes and prevent keratitis, make sure to follow your doctor’s directions for cleaning your contacts, keep your immune system strong, and protect your eyes with sunglasses and safety glasses when needed.

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I HURT ALL THE TIME—IS THIS CHRONIC PAIN? SYMPTOMS AND TREATMENT

nnn Lynn Merrell Everyone has aches and pains at one time or another. Sometimes it can last for a week or more. But what if it lasts longer than that? Could it be chronic pain? If so, what does that mean? Can you get treatment for it? Is it dangerous?

WHAT IS CHRONIC PAIN? According to the National Institute of Neurological Disorders and Stroke, a department in the National Institutes of Health, chronic pain is pain that goes on an on, persisting beyond what would typically seem normal. Pain is a natural response to injury, and the body’s way of alerting us to a problem. It’s a trigger in the nervous system that sets up a red flag—pay attention! This body part needs your help! Chronic pain, on the other hand, just keeps coming back and coming back for weeks, months, and sometimes even years. One standard measurement of chronic pain is pain that lasts six months or longer. The pain itself can range from mild to moderate, or in some cases, may be excruciating. It may come and go, or it may be there all the time. For some people it’s a nuisance, while for others it becomes totally incapacitating, interrupting regular daily activities.

WHAT CAUSES CHRONIC PAIN? Chronic pain can stem from many things. Sometimes an initial injury starts it off, like a

sprained back, hurt neck, or serious infection. Other times there may be underlying conditions causing the pain, like arthritis, cancer, or other types of infection. For some people, however, there may be no visible cause, no past injury or body damage, but yet the pain is there. Common types of chronic pain include headaches, lower back pain, cancer pain, arthritis pain, neurogenic pain (resulting from nerve damage), or what’s called “psychogenic” pain, where there seems to be no cause.

WHAT ARE THE SYMPTOMS OF CHRONIC PAIN? It may seem that the symptoms of chronic pain would be self-explanatory. Consistent pain! That pain can come in different forms, however. It may be mild to severe. It may be shooting, burning, aching, or electrical. Or it may just feel uncomfortable, sore, and stiff. Chronic pain is also often accompanied by other difficult symptoms, like fatigue, the inability to sleep well, a weakened immune system and the tendency to get sick often, moodiness, depression, irritability, anxiety, stress, withdrawal from activity, an increased need to rest, and even disability.

THE EMOTIONAL EFFECTS The emotional effects of chronic pain can be just as frustrating and debilitating—if not more so—than the physical effects. The constant pain without relief can lead to depression, a lack of interest in life, and even suicidal tendencies. One study in 2003 found that

people in chronic pain were less able to make decisions, and were considered cognitively impaired.1 According to a recent Pfizer health report, one in 29 percent of Australians living with chronic pain had considered suicide.2

TREATMENTS FOR CHRONIC PAIN Chronic pain can sometimes be particularly stubborn in response to treatment, especially in those cases where the cause of the pain is unclear. Still, there are several effective treatments available. Medications, local electrical stimulation, brain stimulation, and even surgery are all options your doctor may consider. Acupuncture, specifically, seems to hold a lot of promise in this area. Psychotherapy, relaxation and meditation, biofeedback, and other similar methods may also prove helpful. Certain exercises have also proved effective in some cases. What’s important is to keep trying, and to keep the conversation open with your doctor. Especially if you start to feel depressed or if the condition interferes with your daily activities, it’s time to get help. Contact your regular doctor, and consider making appointments also with a psychologist and/or a neurologist. Many people, even if they are unable to cure their chronic pain, experience relief when they approach the condition from multiple angles, taking a variety of steps to gain relief. REFERENCES .A. Vania Apkarian, et al., “Chronic Pain Patients are Impaired on an Emotional Decision-Making Task,” Pain 108 (2004) 129-136. 2 .Jordanna Shriever, “Chronic Pain a Suicide Danger,” Adelaide Now June 7, 2011. http://www.adelaidenow.com.au/chronic-pain-a-suicidedanger/story-e6frea6u-1226070584638. 1

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HARD-TO-TREAT NAIL FUNGUS

DR. STEPENSKY HAS A SOLUTION NEW TECHNOLOGY MORE EFFECTIVE THAN TOPICAL CREAMS According to Diabetes Digest, a highly contagious nail fungal infection called “onychomycosis” seems to be on the rise in the U.S.—and people with diabetes are particularly at risk. Even more concerning is the fact that those with diabetes who develop the infection have to worry not only about their nails, but other serious potential complications such as ulcers and gangrene. Treatment of onychomycosis can be difficult. Anti-fungal creams typically can’t penetrate deep enough under the nail to be effective. Oral anti-fungal medications can have side effects, may damage the liver, and may not protect from infection relapses. Fortunately, Dr. Leon Stepensky, a graduate of the prestigious New York College of Podiatric Medicine, has another option that he says is far more effective. It’s called the Fotona Laser Treatment. We spoke to Dr. Stepensky about this exciting new technology.

WHAT CAUSES ONYCHOMYCOSIS? According to the doctor, onychomycosis spreads easily in damp areas such as public gyms, shower stalls, and swimming pools. Even a tiny, microscopic crack in the nail or a slight separation between the nail and nail bed can weaken the nail and allow fungal spores to creep in and establish an infection. People who are prone to sweaty feet and who wear heavy shoes may be more at risk, as are people with diabetes, as an impaired circulatory system makes it more difficult for the body’s immune cells to detect and fight off the infection.

WHAT ARE THE SYMPTOMS? Once onychomycosis takes hold, it attacks the nail, making it thicker, brittle, ragged, distorted, and dull, and usually darkening the color because of the debris build-up underneath it. The thickened nails may become more difficult to trim, and may cause pain when walking, reducing mobility. Nails may also separate from the nail bed, causing pain, while the fungus creates a foul odor. Treatment for this infection can be especially challenging, as it tends to hang on and keep www.4health.net

coming back. It may also spread to other nails, or to other members of the family, so it’s important to see your doctor as soon as possible.

WHAT IS FOTONA LASER TREATMENT? Because creams rarely provide a lasting solution and medications may create side effects, Dr. Stepensky advises his patients to undergo treatment with the Fotona laser. The Fotona XP Focus is now FDA-approved for the destruction of onychomycosis, and has consistently turned in impressive results. “This new-generation laser with an integrated temperature control system is the most effective system for the treatment of onychomycosis,” Dr. Stepensky says. “This technology allows you to warm up the nail with the help of laser energy, which decreases the size of the affected nail fungus and stimulates the growth of healthy nail.” The difference in this new laser technology is that it delivers destructive high-energy pulses to specific targets with minimal damage to the surrounding tissue. A study published in the Journal of the Laser and Health Academy (Vol. 2010, No. 1) showed that the Fotona laser was highly effective at treating onychomycosis. A total of 72 participants with nail fungus infections in multiple nails were treated with the laser, and at the 3-month follow up, over 95 percent were cleared of all fungal infections. The three patients who still had the infection were treated again, and at the 6-month follow-up, all patients were clear. There were no noticeable side effects and all patients were satisfied with the treatments. “The effectiveness of laser treatment procedures for nail fungus amazes patients and satisfies the most demanding physician,” says Dr. Stepensky.

CALL DR. STEPENSKY TODAY If you or someone you love is suffering from a difficult nail fungal infection, you owe it to yourself to contact Dr. Stepensky. Call his office today at (718) 874-0224. SOURCE Jasmina Kozarev, et al., “Novel Laser Therapy in Treatment of Onychomycosis,”Journal of the Laser and Health Academy, Vol. 2010, No.1, http://www.laserandhealthacademy.com/media/objave/academy/ priponke/novel_laser_therapy_in_treatment_of_onychomycosis.pdf.

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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

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EXERCISE HEADACHES? TRY THESE 10 SOLUTIONS GET TO KNOW THE TRIGGERS OF WORKOUT MIGRAINES

nnn Lynn Merrell For most people, vigorous exercise produces endorphins that help ease pain throughout the body. For some people, however, exercise can trigger headaches and migraines, discouraging regular workouts. Since daily activity is linked to better health and longer life, skipping the gym isn’t the answer. Instead, try the following solutions to relieve your discomfort. If none of these work, check with your doctor, who may be able to prescribe medications that will help. 1. Drink plenty of water. Even if you’re just a little dehydrated, it can trigger a headache, especially if you’re prone to migraines. Start an hour before your workout with a full glass of water, then have a glass or bottle nearby during your routine to quench your thirst. 2. Choose pre-workout foods carefully. Some people can reduce their risk of headache by eating a banana before a workout, but others may be sensitive to certain amino acids in bananas, citrus fruits, nuts, soy, and yogurts. About an hour before you exercise, try a protein shake mixed with berries or some whole-wheat crackers. 3. Warm up. Jumping full bore into a flatout run slams your body with a flood of blood, which can trigger a headache. Always

warm up. Spend 10-15 minutes slowly walking or marching (for cardio), and lifting lighter weights (for strength training), gradually increasing your intensity every five of those minutes. 4. Breathe! If you’re exercising super hard, you may be holding your breath, which can ramp up your blood pressure, triggering a headache. Make sure you exercise at an intensity where you can continue to inhale and exhale regularly. 5. Don’t work too hard at a new exercise. If you’ve taken the winter off, or if you’re just starting a new exercise program, it’s going to take awhile to build up your muscle strength and endurance. If you push it too hard too soon, you could strain your muscles and trigger a headache. Be especially careful of straining muscles in the neck, such as when you’re doing crunches, pushups, shoulder raises, and chest presses. Check your technique to be sure you’re doing the exercise correctly. 6. Get into a regular yoga routine. Studies have found that yoga can actually decrease the intensity of migraines.1 Yoga also helps improve your overall posture, which can ease the pressure you may be putting on your neck or back during exercise. Besides, it’s a great way to stretch out and relax those muscles after working them so hard.

7. Avoid extreme temperatures. According to the Mayo Clinic, exercise headaches are more common when the weather is hot and humid. Reschedule your workout for cooler mornings and evenings, or exercise inside where you can manage the temperature. 8. Get enough sleep. If you’re really tired before your workout, your body may not be able to keep up. Be sure you’re getting at least 7 hours of sleep a night. 9. Avoid alcohol and excess caffeine before exercise. Both of these may trigger a headache for you, so try avoiding them for several hours before and after a workout. 10. Check with your doctor. Particularly if your headache is severe, comes on abruptly, or has never happened before, check with your doctor. If it is accompanied by vomiting, double vision, a stiff neck, or even loss of consciousness, it’s a serious condition and you should get to the hospital immediately. If it’s not an emergency, but you have regular headaches and none of the above solutions work, talk to your doctor about possible medications. REFERENCES 1

P. J. John, N. Sharma, C. M. Sharma, A Kankane. «Effectiveness of Yoga Therapy in the Treatment of Migraine Without Aura: A Randomized Controlled Trial.» Headache 47 (5): 654-61 (May 2007).

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4 MYTHS ABOUT INGROWN TOENAILS THE TRUTH ABOUT THE BEST PREVENTION & TREATMENT

nnn

By Gordon Barclay

If you’re an athlete or someone who’s on her feet all day and have frequently suffered from ingrown toenails, you may have heard some myths about them. “Cut a V-notch in the nail,” some say, and that will stop it from happening. Or, “cut the nail straight across, not curved,” and that will do the truck. Are these common recommendations true? We decided to do some research to find out.

MYTH #1. CUTTING A V-SHAPED NOTCH IN THE NAIL WILL PREVENT INGROWN TOENAILS. The myth is that if you cut a v-shaped notch into the top of the nail, right in the middle of it, it will help draw the edges together as the nail fills in the space left by the notch. The idea is that the nail grows up and out, and that the notch will help pull the corners out instead of down into your skin. There are many reputable sites that recommend this approach, including Dr. Weil and the Virginia Tech Schiffert Health Center. Most podiatrists, however, state that it doesn’t work. Contrary to popular belief, the notch doesn’t affect how the nail grows. Since they grow from the base, they will likely continue to curve downward as they always have.

MYTH #2: KEEP TRIMMING THE CORNERS AND THE PROBLEM WILL GO AWAY. This myth states that if you are diligent about trimming the borders or corners of the nails, you won’t have anything there to grow into the skin. Unfortunately, this is unlikely to help you, either. Repeated trimming of the corners doesn’t correct how the nail grows, and can actually make the condition worse.

MYTH #3: CUTTING THE NAIL STRAIGHT ACROSS WILL PREVENT INGROWN TOENAILS. We hear this one all the time: cut the nail straight across, not curved. There’s more debate on this one than the previous two. Some podiatrists will recommend that you trim the nails straight across, for fear that curving them will encourage the nail to grow into your skin. Others, www.4health.net

however, state that how you trim the nails is much less important than how the nail grows before you trim it. There’s nothing wrong with taking this precaution if you think it will help, but just keep in mind that it may not.

MYTH #4: PLACING A PIECE OF COTTON UNDER THE NAIL WILL RELIEVE THE PAIN AND FIX THE PROBLEM. This myth can be particularly dangerous as it can lead to an infection. It states that if you lift the corner slightly and put the piece of cotton underneath, it will help prevent the nail from continuing to grow into the skin. The problem is that if you already have an ingrown toenail and you start messing with it, you can cause more damage and possibly an infection. Leaving the cotton there for more than a very short time can attract bacteria to the site.

THE BEST WAY TO TREAT INGROWN TOENAILS If all these myths are incorrect, what is the truth? First of all, ingrown toenails are typically genetic, and caused by the way the nail grows out. Wearing shoes that are too tight or that crowd your toes can also cause them, as can repeatedly cutting your nails too short, injuring your toenail, or by simply having nails that are unusually curved. Athletes are more frequently at risk for ingrown toenails, as are those who have diabetes or arthritis. They occur when the corner or side of the nail grows into the flesh nearby. This can cause pain, redness, inflammation, swelling, and sometimes, an infection. Ingrown toenails most often occur in the big toe, and can usually be treated at home. Try soaking your feet in warm water 3–4 times a day, apply antibiotic cream to the area to reduce risk of infection, and choose comfortable, roomy shoes to wear. If they don’t get better within a couple weeks, the pain continues to worsen, or if you notice signs of infection (such as warmth, pus, or swelling), see your podiatrist. He will likely remove part of the nail so that it can heal properly. This is typically an in-office procedure. If you have a recurrent ingrown toenail, surgery may be necessary to prevent that part of the nail from growing back, but this is a last resort. To prevent ingrown toenails, keep them at a moderate length (not too short, not too long), wear shoes that fit right, wear protective footwear when needed, and avoid digging into the sides of the nail.

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WHY YOU NEED TO KNOW MORE ABOUT VASCULAR DISEASES P.A.D. KNOWN TO INCREASE RISK OF AMPUTATION AGE ALSO AFFECTS RISK

nnn Lynn Merrell Vascular diseases. They’re not something we talk about in regular conversation. We all know about heart disease, and cancer, and diabetes, and other major diseases. But vascular disease? What’s that? The word «vascular» is defined as relating to or affecting vessels. Blood vessels include veins, arteries, and capillaries — all those tubes in our bodies that carry blood through the tissues and organs. Lymph vessels, too, carry waste and damaged cells out of the body. Vascular diseases, then, are any diseases that affect these vessels. Most of the time, when we’re talking about vascular diseases, we’re talking about atherosclerosis (narrowed arteries), peripheral artery disease (PAD), carotid artery disease, varicose veins, and deep vein thrombosis, but there are many others. What we need to know is that as we age, our risk for these diseases naturally goes up. Gender, as well, can be a factor in whether or not we are vulnerable. It’s important for all of us to learn more about these diseases, because if they go untreated, they can create serious complications, including heart disease, blood clots, heart attacks and strokes, and amputations.

In addition to gender, age also affected the risk for these diseases. The higher prevalence for PAD was most dramatic in younger women than in younger men, and the higher prevalence for carotid artery stenosis was more dramatic in older men than in older women. For both men and women, diabetes increased risk of PVD of the legs or the carotid artery. Those with diabetes and heart disease were at a higher risk of PVD. That means that those who have these diseases need to be asking their doctors about PVD, and taking steps to help monitor and prevent it. Researchers concluded that overall, the study shows that vascular diseases are not all the same, and women and men have different risks. The most important thing is to realize that these disease can be dangerous, increasing risk of heart attack and stroke. Fortunately, treatments can be very effective, and include lifestyle changes, medications, and surgery in more serious cases.

USA VASCULAR CENTERS OFFERS TREATMENT FOR PVD USA Vascular Centers, a nationwide network of physicians, nurses and specialists, offers PVD evaluation and individualized treatment. They have offices all over the nation, including Florida, California, and Illinois, several in the New York area. Call today at 718-393-5331 or go to www.USAVascularCenters. com to schedule a consultation.

STUDY SHOWS GENDER AFFECTS RISK OF VASCULAR DISEASES A recent study reported that a person’s age and gender affects the prevalence of certain kinds of peripheral vascular diseases (PVDs). These include those diseases that affect blood vessels outside of the heart and vein, so those in the veins and arteries of the veins and arteries. Usually, these vessels become narrowed as plaque builds up inside them. They may also lose flexibility and become harder. As a result, the amount of blood and oxygen supplied to the arms and legs may be reduced, and risk increases for blood clots, as well. Untreated, PVD can increase risk of heart attack, stroke, and even amputation. For the study, researchers reviewed data from 3.6 million people who were screened for cardiovascular disease. They discovered that overall, women were more at risk for peripheral artery disease (PAD), which is a condition in which the peripheral arteries become narrowed by a buildup of fatty deposits. In most cases, it is the arteries in the legs that are affected. Symptoms of PAD include leg weakness, numbness in the legs, pain when walking or climbing stairs, slow-growing or brittle toenails, ulcers on the legs and feet that are slow-healing, and shiny skin on the legs. As many as 10 million people in the U.S. have PAD, and those who are 65 or older who have the disease are two to three times more likely to have an amputation, according to a 2001 study. Worse, the rate of death after an amputation is about 48 percent at one year and 71 percent at 3 years. This is why early treatment is paramount. The study results also showed that men had a higher prevalence of carotid artery stenosis, a narrowing or restriction of the carotid artery in the neck, and a higher prevalence of abdominal aortic aneurysm, which is a condition in which the main blood vessel that supplies blood to the abdomen enlarges or balloons out.

SOURCES Age and gender influence risk for certain peripheral vascular diseases,” MedicalNewsToday, April 4, 2016, http:// www.medicalnewstoday.com/releases/308596.php. “ Facts About Peripheral Arterial Disease (P.A.D.),” National Institutes of Health, https://www.nhlbi.nih.gov/health/ educational/pad/docs/pad_extfctsht_general_508.pdf. E .B. Jude et al, «Peripheral Arterial Disease in Diabetic and Nondiabetic Patients,» Diabetes Care 24 (2001):143337. A parna Swaminathan, et al., “Lower extremity amputation in peripheral artery disease: improving patient outcomes,” Vasc Health Risk Manag., 2014; 10:417-424, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107174/. “

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| Plastic Surgery

TIGHTEN SAGGY SKIN AND LOOK GREAT THIS SPRING! NON-INVASIVE TREATMENT CREATES A LIFTED LOOK

NAME:

Roman RAYHAM, MD SPECIALTY: Plastic and Reconstructive Surgeon

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

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

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

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

(877) 582-0400 www.NYPlasticSurgeryCenter.com

LANGUAGES: ENGLISH • RUSSIAN

Spring weather is here, and you may be feeling the lively energy. Warmer temperatures, new flowers, and green grass inspire fewer layers of clothing and more fun, flirty fashions. When you look in the mirror, though, you may wish that your skin better matched your mood. Those long winter months can exacerbate fine lines and wrinkles, and it seems nothing can stop that inevitable sagging and bagging that occurs around the jowls, under the chin, under the eyes, and even on the upper arms. Dr. Rayham of the RR Plastix/New York Plastic Surgery Center has a non-surgical treatment system that helps you say goodbye to sagging skin. When lotions and creams and facial exercises aren’t enough, you don’t have to settle. Dr. Rayham has an affordable, effective way to tighten, lift, and tone your skin, so that you can really rock the spring season this year. SkinTyte Stimulates Collagen for Firmer, Tighter Skin “SkinTyte” is a laser treatment for patients who want to tone and tighten the appearance of their skin. Made by the laser company “Sciton,” SkinTyte uses advanced infrared light technology to heat the collagen deep in your skin. At the same time, it protects the surface of the skin with a sophisticated cooling element. SkinTyte is so minimally invasive that it doesn’t even require anesthetic. It delivers laser energy in gentle, rapid pulses that stimulate collagen. A cooling gel may be applied to skin, and patients experience no more than a slight warming sensation. Yet the results are impressive. According to a 2010 study, clinical results show real tissue tightening. How Does SkinTyte Work? Collagen is the main protein found in the skin and other connective tissues, and is used by the body to create the latticework that forms the foundation of the skin. Over time, however, that latticework can break down and loosen, due to exposure to UV rays, pollution, and other environmental assaults. Age, poor diet, and stress also damage and distort those tissues. The body produces less collagen as we age, so we have fewer resources for repair and restoration. This gradual collagen breakdown results in loosened, stretched, and saggy skin. It’s why you may be noticing more fine lines and wrinkles, as well as sagging under the eyes and around the jowls. SkinTyte stimulates the collagen in skin, and then the

body’s own natural healing processes help repair and tighten it again. The treatment takes only about 30 minutes, and there is no downtime — you can immediately return to your regular daily activities. Full results take up to four months, as the collagen is repaired, strengthened, and rebuilt. Gradually, you notice tighter skin, with reduced fine lines and wrinkles, increased definition of the jaw line, and softening of the lines around the mouth and eyes. What Types of Skin Problems Does SkinTyte Treat? SkinTyte is not only for the face. Because it stimulates collagen, and collagen exists in all skin, it can be used to improve a variety of skin issues. These include: n n n n n n n n n n n

Fine lines and wrinkles on the face Saggy under eye skin Eleven lines on the forehead Marionette lines around the mouth Saggy jowls or a fatty chin Saggy skin on the neck Stretch marks Cellulite Uneven skin tone and texture Saggy abdominal skin (such as after pregnancy) Saggy upper arms

Am I a Candidate for SkinTyte? This type of treatment is non-invasive, requires no incisions, and no anesthesia. The risks are much lower than for more invasive treatments. For most people— men and women—it is completely safe. If you wish to enjoy tighter, plumper, more youthful looking skin, talk to Dr. Rayham about what you’re looking for. Chances are you will be eligible for SkinTyte. The only precautions you must take after treatment are to carefully protect skin from the sun. It will damage the tender collagen after the procedure, so it’s critical to protect the skin for several weeks. Diligently use sunscreen and other sun-protecting items like hats and umbrellas. Look Your Best This Spring! If you’d like to spruce up your look this spring, talk to Dr. Rayham about SkinTyte. A personal consultation is the best way to see if this gentle treatment will work for you. For more information, stop by and see the doctor at his offices in Manhattan, New York City, Brooklyn, and Staten Island. You can also call the RR Plastix/New York Plastic Surgery Center, 1–877–582–0400, or visit his website at www.rrplastix.com. www.4health.net

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WHAT TO EXPECT FROM GALLBLADDER SURGERY COMMON PROCEDURE PROVIDES RELIEF TO MANY PATIENTS nnn Colleen M. Story Experts estimate that about 500,000 people go through gallbladder surgery each year, so if you’re facing this treatment, you’re not alone. According to the New York Times, gallbladder removal is one of the most common surgical procedures, with the purpose of relieving the symptoms of gallstone disease. You may be wondering what to expect from the surgery. Here’s more about it, and what you can do to increase your odds of feeling much better in the future.

WHY DO DOCTORS PERFORM GALLBLADDER SURGERY? Gallbladder surgery—also called “cholecystectomy”—is performed to remove the gallbladder. A pear-shaped organ beneath the liver on the right side of the abdomen, the gallbladder typically stores “bile” created by the liver and releases it into the small intestine when you eat, to help you digest fatty foods. Bile is made up of cholesterol, fats, salts, calcium, and waste products, and typically flows through the intestine and out of the body without an issue. In some people, however, these substances sometimes collect and harden into small stones. This may occur because the materials in the gallbladder are out of balance, or because of other factors

WHAT IS INVOLVED IN THE SURGERY?

der general anesthesia, so you won’t remember anything. Most patients leave the hospital the same day or the day after the procedure. You may experience some nausea or vomiting from the anesthesia or from the gas used to inflate the belly during the procedure. You may also experience some post-operative pain, but your doctor will have pain-relieving medications available for you. Most patients return to their regular activities within a week, though those undergoing open surgery will need a little longer.

The most common way to remove the gallbladder today is via “laparoscopic” surgery. The laparoscope is a thin, lighted tube with a camera that the doctor inserts into the abdomen via a small incision. It helps him to see inside the body without having to make larger incisions. He then makes other small incisions, and uses medical instruments to cut the gallbladder away from the liver and other tissues and remove it. This type of surgery is usually recommended because it’s less invasive than open surgery, and allows for a faster recovery. Not all patients are good candidates for it, however, and some will have to undergo open gallbladder surgery, which is essentially the same surgery done through a larger incision so the doctor can see the entire area. Either surgery usually lasts about two hours or less, during which you will be un-

Both of these procedures are considered generally safe with a low risk of complications, but rarely some complications may occur, so be sure to check with your doctor if you have any questions. Be especially careful to follow the nurses’ directions concerning the incisions, as infections in these areas are the most common complications to occur. Life without a gallbladder is pretty much the same as life with it. Instead of going through the organ, the bile simply moves from the liver into the intestinal tract. Some people may experience bloating and/or diarrhea after eating fatty or spicy foods, but this can be avoided by recognizing your triggers and learning to stay away from them.

like pregnancy, age, obesity, a high cholesterol diet, a family history of gallstones, diabetes, or cholesterol-lowering medications. If these stones are small, they may pass through without causing any problems. The larger ones, however, can create a lot of pain as they work their way into the digestive system. People who are regularly plagued by gallstones can find relief by the complete removal of the gallbladder.

LIFE WITHOUT A GALLBLADDER

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HOW TO TALK TO YOUR DOCTOR ABOUT ERECTILE DYSFUNCTION AVOID MORE SERIOUS HEALTH PROBLEMS WITH THESE TIPS

nnn Lynn Merrell According to the National Institutes of Health, about 5 percent of men between the ages of 40 and 65 experience erectile dysfunction (ED) on a regular basis, while about 15 – 25 percent of those 65 years and older may be diagnosed. Many other men may experience the occasional failure to achieve an erection, but don’t require medication. The key to successful treatment is to talk to the doctor to find out what is causing the issue. For many men, however, talking to a doctor can be difficult. Below are some tips to help make it easier.

WHAT IS ERECTILE DYSFUNCTION? Erectile dysfunction is the inability to achieve and/or sustain an erection suitable for sexual intercourse. It is the most common sexual disorder in men, and is more likely as men age. There are degrees of the disorder, however, and doctors use these degrees to determine the best treatment. They include: n Mild: successful erection 7–8 out of 10 attempts n Moderate: successful erection 4-6 times out of 10 attempts n Severe: successful erection 0–3 times out of 10 attempts Doctors agree that occasional erection trouble is usually not cause for concern. Only when erectile dysfunction becomes an ongoing problem, leading to stress, relationship problems and self-esteem issues, does it become serious.

WHAT CAUSES ERECTILE DYSFUNCTION? There are many factors that may contribute to erectile dysfunction. It may be a sign of heart

disease, for instance, or poorly controlled diabetes. The fact that the condition may indicate the presence of another serious health problem is another reason why it’s so important to talk to the doctor about it. Causes of erectile dysfunction may include: n Heart disease or atherosclerosis (narrowed and clogged arteries) n High cholesterol or blood pressure n Obesity n Diseases like Diabetes, Parkinson’s, Multiple Sclerosis, and others n Some prescription medications n Tobacco use n Alcoholism or other forms of substance abuse n Treatments for prostate cancer or enlarged prostate n Surgeries that affect the pelvic area or spinal cord n Psychological disorders like depression or anxiety n Every day stresses or relationship problems

n Remember the doctor is trained to han-

n n n

WHY SHOULD YOU TALK TO YOUR DOCTOR? Erectile dysfunction is rarely a simple condition. Though medications may be necessary, they can come with side effects, and aren’t always the best solutions, particularly if they fail to treat other underlying conditions like heart disease or depression. A thorough examination from your doctor will help ensure that you protect your overall health, as well as your sexual health. To help overcome any uncomfortable feelings you may have about talking to your doctor, try these tips:

dle these types of issues—to him, it’s just part of his job. Don’t worry about offending the doctor—he’s used to discussing these issues. Remember you’re not alone—millions of men have been in the same boat. You don’t have to tell the receptionist all the details when making an appointment—just tell her you want to see your doctor, and that you’ll discuss the issue with him. Get straight to the issue—don’t beat around the bush talking about other problems hoping your doctor will drag it out of you. Just say, «Doc, I think I may have erectile dysfunction.» Prepare a list of questions in advance and write them down. It will make it easier for you to communicate if you feel nervous during the appointment. Also consider summarizing your symptoms and the issues you’ve been having. Be ready to answer questions that may seem personal—the clearer you can be in your answers, the more likely your doctor will be able to help you. Understand that you may have to go through some tests and an examination so the doctor can gather all the evidence he needs. It’s just a few minutes of potential discomfort to safeguard your health.

Keep in mind that you’re likely to feel much better after you’ve discussed the issue and received a diagnosis from your doctor. It’s a lot better to know exactly what you’re dealing with and how to manage it than to wonder and worry. www.4health.net

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I WAS JUST DIAGNOSED WITH ENDOMETRIOSIS — NOW WHAT? WHAT TO EXPECT AND HOW TO TREAT THIS DISEASE

nnn By Lynn Merrell Kaylie had always had uncomfortable periods, but lately they were getting worse. During her last two cycles, she actually had to miss school because the pain was so bad. In a way, it was a relief when her doctor suggested she might have endometriosis. At least if that was the case, she would know she wasn’t crazy or just imagining how much it hurt. But on the other hand, a possible diagnosis scared her. After all, she didn’t really know what endometriosis was, or how it would affect her life.

WHAT IS ENDOMETRIOSIS? Inside of the uterus is a protective lining called the “endometrium.” It plays a vital role in pregnancy, providing a place for a fertilized egg to implant and supporting the development of the placenta. It thickens during the menstrual period in preparation for pregnancy, and then if pregnancy does not occur, hormones trigger the shedding of part of the endometrial layer. Endometriosis occurs when some of that tissue that makes up the endometrium grows where it’s not supposed to, like around the ovaries, fallopian tubes, and in other places inside the pelvis. Rarely, the tissue will migrate to areas beyond the pelvis. That tissue still acts like endometrial tissue, so it is still affected by a woman’s monthly hormonal changes. Every month, it builds up, breaks down, and tries to shed, but it cannot as it has nowhere to go. That can cause internal bleeding, inflammation, and other complications.

COMPLICATIONS OF ENDOMETRIOSIS Depending on where that extra tissue grows, it can cause other problems. When endometriosis affects the ovaries, for example, it can cause cysts to form. Scar tissue may develop, which can affect nearby organs. The disease causes these little growths to develop that then thicken and try to shed. When a woman bleeds during her menstrual period, the misplaced endometrial tissue may bleed, too, causing spotting, inflammation and irritation, and pain. Over time, scar tissue may develop, which can also cause pain. www.4health.net

WHAT ARE THE SYMPTOMS OF ENDOMETRIOSIS? Pain is one of the most common symptoms of endometriosis. As in Kaylie’s case, periods may be particularly painful, and may be so bad as to make women miss school or work. Pain may also get worse with intercourse, urination, and bowel movements. Women may also experience excessive bleeding, fatigue, diarrhea, constipation, and bloating. Symptoms vary widely from woman to woman, however. Whereas some women experience a lot of pain, others suffer only minor discomfort. In some cases, endometriosis can cause infertility. The Mayo Clinic estimates that about one-third to one-half of women with endometriosis have difficulties getting pregnant, but many women with mild to moderate cases can still conceive and carry to term. Even those who have difficulties may just take longer to conceive. Endometriosis can affect fertility by distorting the fallopian tubes so they are unable to pick up the egg after ovulation, or by creating inflammation that discourages pregnancy.

WHAT CAUSES ENDOMETRIOSIS? Doctors aren’t sure yet what causes the disease. They have a number of theories, but it’s likely that the cause varies depending upon the person. What we do know is that some women are more at risk than others. Those who have never given birth, who started their periods at a young age, who have a low body mass index, and who have a family history of the disease are more at risk for it.

WHAT HAPPENS AFTER I’M DIAGNOSED? Diagnosis of endometriosis can be difficult, as the symptoms are sometimes caused by other gynecological conditions. Doctors are likely to perform a number of tests, including a pelvic exam, ultrasound, or laparoscopy to actually look inside the abdomen for signs of the disease. Most cases can be managed with conservative treatments, like pain medications and hormone therapy (including birth control pills). Only in severe cases is surgery required, in which doctors remove as much of the misplaced tissue as possible. This usually helps relieve pain, though it may be only a temporary solution, as the tissue may regrow over the next couple years. Hysterectomy is reserved as a last resort. In many cases, the total removal of the uterus stops symptoms.

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(718) 512-2160 OPTOMETRY

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

Yekaterina LEVIN, DDS

7000 Bay Pkwy, Ste C Brooklyn, NY 11204

(888) 838-6212

Faina SHNAYDMAN, MD Leonard LEVITZ, MD

1749 E 16 St Brooklyn, NY 11229 th

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

(718) 528-1503

(718) 375-4747

GASTROENTEROLOGY

1910 Ave U Brooklyn, NY 11229

(718) 759-6979

5 E 84 St New York, NY 10028 th

(212) 876-7575

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

321 Edison St Staten Island, NY 10306

Margarita BAUMAN, OD

Narayan SANDARESAN, MD

(844) 957-7463

Hanna JESIONOWSKA, MD

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

(888) 455-6619

OB/GYN - UROGYNECOLOGY

Nataliya SAFONOVA, DDS

Aleksandra ZLOTNIK, OD

Lilia LEVITZ, MD

2211 Ocean Ave Brooklyn, NY 11229

1749 E 16th St Brooklyn, NY 11229

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

1910 Ave U Brooklyn, NY 11229

(718) 375-4747

321 Edison St Staten Island, NY 10306

Irina BERLIN, MD

NEPHROLOGY

40 West Brighton Ave, Ste 104 Brooklyn, NY 11224

(718) 759-6979

948 48 St, Fl 2 Brooklyn, NY 11219 th

(718) 283-7219

(718) 627-8300

PAIN MANAGEMENT

Amit SCHWARTZ, MD

OBESITY MEDICINE

Harout MARGOSSIAN , MD 7206 Narrows Ave Brooklyn, NY 11209

(888) 404-5046

1529 Richmond Rd Staten Island, NY 10304

(888) 538-2717

Namik YUSUFOV, DDS, MDT

ONCOLOGY

305 W 28th St New York, NY 10001

(212) 804-0500

170 Morris Ave, Ste A Long Branch, NJ 07740

(732) 728-7075

Alexander BRODSKY, MD

8622 Bay Pkwy, Ste 1 Brooklyn, NY 11214

(718) 333-2121

Yana SHTERN, MD

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

1642 W 9th St Brooklyn, NY 11223

(718) 513-6060

321 Edison St Staten Island, NY 10306

(718) 980-2525 NEUROLOGY

Mila MOGILEVSKY, DO

(347) 252-6732

Prabhakara R. TUMPATI, MD

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

(888) 283-0399

Anella BAYSHTOK, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160

158-06 Northern Blvd Flushing, NY 11358

(718) 445-3700

Sam WEISSMAN, MD

202 Foster Ave Brooklyn, NY 11230

(718) 854-5100

www.brooklynroc.com

Dmitriy GRINSHPUN, MD

Yevgeniy SOROKIN, DO

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

(347) 252-6732

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

(888) 747-8009

www.4health.net

4HEALTH ALTERNATIVE MEDICINE - GENERAL

Michael RISKEVICH, MD

2736 Ocean Ave, Ste 1A Brooklyn, NY 11229

(718) 934-8484

PHYSICAL THERAPY

Alina VASILYEVA, DPM

2116 Ave P Brooklyn, NY 11229 2626 E 14th St Brooklyn, NY 11235

(718) 646-0131

LSA RECOVERY

1300 Ave P Brooklyn, NY 11229

(888) 983-4055 RADIOLOGY

Ridwan SHABSIGH, MD

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

(718) 283-7746

Ada KULAGINA, LAC

8635 21st Ave Brooklyn, NY 11214

MEDICAL SUPPLY

Globe SURGICAL SUPPLY 2029 Bath Ave Brooklyn, NY 11214

(888) 418-0442

(888) 410-3442

PSYCHOLOGY

NUTRITION AND DIETETICS

Vladislav RUDNER, PT

1901 82nd St Brooklyn, NY 11214

(718) 490-2416 www.magichandspt.com

PLASTIC SURGERY

Chloe CARMICHAEL

230 Park Ave, Fl 10 New York, NY 10196

(212) 729-3922 PSYCHIATRY

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

(718) 360-9550 nyurology.com

VASCULAR SURGERY

USA VASCULAR CENTERS

2444 86th St, Ste A Brooklyn, NY 11214

Albert GROSS, CNS, NYS, CDN

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

(718) 376-8317

MEDICAL TRANSPORTATION

1942 E 8th St Brooklyn, NY 11223

(718) 393-5331

www.nylifex.com

MULTI SPECIALTY

Roman RAYHAM, MD, BOARD CERTIFIED IN PLASTIC SURGERY

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

Felix DRON, MD

7620 Bay Pkwy, Ste 1B Brooklyn, NY 11214

(718) 232-1492

Yuly CHALIK, MD

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

(347) 508-3991

(877) 582-0400

www.nyui.org

www.nyplasticsurgerycenter.com

USA VEIN CLINICS

1153 First Ave New York, NY 10065

Multi SPECIALTY CLINIC

2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

(877) 807-0989

2444 86 St, Ste A Brooklyn, NY 11214 Th

PODIATRY

RANNETA TRANSPORTATION

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

(347) 848-0049

3023-3027 Ave V Brooklyn, NY 11229

AESTHETIC CENTERS

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

Mark GURTOVY, MD

7620 Bay Pkwy, Ste 1B Brooklyn, NY 11214

(718) 232-1492

Vitaly RAYKHMAN, MD

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

Leon STEPENSKY, DPM

(347) 508-3991

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

www.nyui.org

4159 Broadway Washington Heights, NY 10033 59-20 Myrtle Ave Queens, NY 11385 30-33 Steinway St Astoria, NY 11103 122 Fulton St, 5th Fl. New York, NY 10038

Michael PATIN, MD

6417 Bay Pkwy Brooklyn, NY 11204

(718) 234-6767

102-51 Queens Blvd Forest Hills, NY 11375

(718) 896-2333

5221 Broadway New York, NY 10463

(718) 874-0224

Interborough DEVELOPMENTAL & CONSULTATION CENTER

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

(888) 987-5751

(718) 509-0906

1623 Kings Hwy, Fl 4 Brooklyn, NY 11229

www.4health.net

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

156 Route 59, Ste B1, Suffern, NY 10901 www.usaveinclinics.com

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!

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