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OPIOIDS NOT VERY EFFECTIVE FOR LOW BACK PAIN

AVOID A SUNBURN ON YOUR EYES! EAR SURGERY

CAN HELP INCREASE CONFIDENCE

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“4Health” is an editorial-based medical magazine (the "Magazine") provided by Moo Publishing Corp. and by other sources.

DISCLAIMER This Magazine is for consumer educational use only. Nothing contained in this Magazine is or should be considered, or used, as a substitute for medical advice, diagnosis or treatment. The opinions in this Magazine are here to educate consumers on health care and medical issues that may affect consummers’ daily lives. This Magazine does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.

The Magazine advises readers to always seek the advice of a physician or other qualified health care provider with any questions regarding personal health or medical conditions. Never disregard, avoid or delay obtaining medical advice from your doctor or other qualified health care provider because of something you have read in this Magazine. If you have, or

suspect that you may have, a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and are experiencing a medical emergency, please dial 911 or call for emergency medical help on the nearest telephone.

WARRANTIES AND LIMITATION OF LIABILITY We do not make any expressed or implied warranties, representations or endorsements of any kind whatsoever with regard to the magazine, or with respect to any information, product, service, merchandise or other material provided in or through the magazine. We do not warrant or guarantee the accuracy, completeness, correctness, timeliness or usefulness of any information, products, services, merchandise or other material provided throughout the magazine. We are not liable to any reader or anyone else for any decision made or action taken based on their reliance upon the information contained in this magazine. www.4health.net

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7 Ways to Reduce Risk of Drug Interactions

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Taking More than One Medication May Cause Side Effects

11 8 The Longer Women

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are Overweight, the Higher the Cancer Risk New Research Suggests Weight Loss Important at Any Time

13 Avoid a Sunburn On Your Eyes!

How to Protect Yourself This Summer

22 Opioids Not Very Effective for Low Back Pain Other Options that DO Work

28 My Ears Stick Out Too Far from My Head!

Ear Surgery Can Help Increase Confidence

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QUITTING SMOKING HELPS YOUR HEART Ask Your Doctor for Techniques to Help

BATTLE ROSACEA WITH THE HELP OF YOUR DERMATOLOGIST Don’t Let This Skin Condition Tear Down Your SelfEsteem

10 BEST AB EXERCISES Several Options to Strengthen Your Tummy

I DELIVERED MY BABY, AND NOW I’M LEAKING! Studies Show Vaginal Delivery Increases Risk of Incontinence

RAPID CYCLING IS A DIFFERENT FORM OF BIPOLAR DISORDER Help for People Who Suffer from Frequent Mood Cycles

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FEEL GOOD ON YOUR SUMMER VACATION

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MOM IS FORGETTING THINGS: IS IT ALZHEIMER’S OR VASCULAR DEMENTIA?

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TREATMENT FOR YOUR PAD MAY HELP PREVENT AMPUTATIONS

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NEW RESEARCH SHOWS PROMISE FOR TREATING PHANTOM LIMB PAIN

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EASE YOUR MIGRAINE PAIN WITHOUT MEDICATION SIDE EFFECTS

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AN EASY WAY TO LOOK MORE TONED AND TIGHT THIS SUMMER!

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WHAT DOES STRESS DO TO YOUR CHILD’S BRAIN?

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HOW TO TREAT AND PREVENT SUMMERTIME FOOT INFECTIONS

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WHAT ARE THESE THINGS ON MY FEET?

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RETIRED TEACHER RECOVERS FROM VARICOSE VEINS

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TREATMENTS THAT MAY HELP SLOW THE PROGRESSION OF EMPHYSEMA

Seven Ways to Avoid Body Breakdown

Two Different Types of Memory Problems Require Different Treatments

USA Vascular Centers Offers Minimally Invasive Procedures

Cross-Training the Brain with Robot Limb Technology

Studies Show Acupuncture Helps Reduce Frequency of Headaches

Get Bathing-Suit Ready with SkinTyte

Study Expresses Concern Regarding Early Life Neglect and Abuse

Dr. Leon Stepensky on a New Treatment

All About Plantar Warts and How to Get Rid of Them

Busy Lady Finally Says Goodbye to Years of Pain

Lifestyle Changes Can Help Delay Lung Damage

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7 WAYS

TO REDUCE RISK OF DRUG INTERACTIONS TAKING MORE THAN ONE MEDICATION MAY CAUSE SIDE EFFECTS ■■■ Gordon Barclay Many people today take more than one medication at a time. You may take a blood-thinning drug, for example, at the same time that you take a pain-relieving drug. When this happens, you have to be cautious about drug interactions.

Even if your second drug is an over-thecounter drug, it may affect how the prescription drug is processed in your body, which could put you at risk of some health complications.

Following are seven steps to take to be sure that when you swallow more than one pill, you can rest easy that they will work as they’re supposed to.

WHAT ARE DRUG INTERACTIONS? A drug interaction is when one drug interferes or interacts with another after you’ve taken both. This can change the way one or both of the drugs acts in the body, or may cause unexpected side effects. Drug interactions are possible with prescription medicawww.4health.net

4HEALTH tions, but also with over-the-counter medications and even with herbal products.

When you take two or more medications together, if you’re not completely aware of what the medications are and how they may interact, the following complications are possible: ■ One drug makes the other less effective ■ One drug increases the action of the other ■ The interaction creates unexpected side effects

If you take a blood-thinning medication like Pradaxa or warfarin (Coumadin), for example, and then take an aspirin, the two medications together could cause excessive bleeding, since they both work to prevent blood clots fro forming. Some antacids, on the other hand, can block the absorption of other medications, like antibiotics, so that they don’t work like they’re supposed to. The two drugs may interact in a way that causes side effects, like nausea or stomach upset, or a rapid heartbeat.

That’s why it’s important to talk to your doctor about any drugs you may be taking, to be sure that they are safe in combination.

7 WAYS TO MINIMIZE DRUG INTERACTIONS To minimize your risk of drug interactions, follow these seven steps:

1. Ask your doctor about each medication: Each time you get a new prescription, ask your doctor about possible drug interactions. Don’t forget to tell him or her about other medications you are taking, including over-the-counter drugs, herbs, and vitamins.

2. Learn how to take each drug. Sometimes it’s best to take a medication with food, and other times it’s best on an empty stomach. Talk to your doctor or pharmacist about what’s best with each medication.

Ask, too, about whether any type of food or drink will interfere with the drug. Some bone-loss drugs, for example, are weakened by coffee and juice.

3. Use the same pharmacy for all your prescription drugs. By purchasing all your prescription drugs from the same pharmacy, you increase the odds that your pharmacist will catch any potential dangerous drug interactions. You can also develop a relationship with that pharmacy that will help you keep track of everything you’re taking.

4. Ask about herbs and supplements. We often think these are harmless no matter what, but that’s not necessarily true. Some vitamins have a slight blood-thinning action, for example, that if combined with a prescription blood-thinner, could increase risk of bleeding. Make sure your doctor knows about all the pills and supplements you’re taking.

5. Be cautious with grapefruit juice. Grapefruit juice is normally very healthy for you, but it can interact with some prescription medications. Ask your doctor if it may affect any of the drugs you take.

Sometimes simply taking the drug at a different time of day from when you enjoy your juice will prevent any issues.

6. Limit alcohol intake. Alcohol can irritate the lining of the stomach, which may affect drug absorption or potentially exacerbate the stomach effects of other drugs, such as aspirin. It can also increase drowsiness, so if you take it along with medications that increase drowsiness, like antihistamines and antidepressants, you could increase your risk of getting into an accident, particularly if you drive.

7. Take advantage of your pharmacist’s knowledge. Most of us purchase our medications from the pharmacist and walk out the door.

Instead, talk to your pharmacist about each medication when you pick it up. That person is well trained in prescription drugs, and can help you understand any possible interactions. www.4health.net

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QUITTING SMOKING HELPS YOUR HEART ASK YOUR DOCTOR FOR TECHNIQUES TO HELP

■■■ Lynn Merrell The National Cancer Institute states that quitting smoking reduces the risk of cancer and other diseases. Smokers who quit at the age of 30 reduce their chances of dying prematurely from smoking-related diseases by more than 90 percent, while those who quit at age 50 reduce their risk by 50 percent.

There are a lot of reasons to try to quit smoking, including short-term perks like less coughing and wheezing and a better sense of smell and taste. But what about weight gain?

Couldn’t that actually make things worse, health-wise?

Many smokers are worried they will gain weight when they quit. But now, a recent study has put that worry to rest. According to research published in the Journal of the American Medical Association, the heart benefits of quitting far outweigh the risks of any weight gain.

STUDY FINDS HEART BENEFITS For the study, researchers looked at data from several thousand people for 25 years.

Those who had quit smoking in recent years had half the risk of having a heart attack or stroke compared to smokers, regardless of

how much weight they gained. More good news — those who gained the most weight (about eight pounds in four years) had less weight gain after that.

Another study found similar results.

Researchers from the University of Alabama at Birmingham found that while previous research showed quitters needed 15 years to experience a drop in risk of heart disease similar to that of non-smokers, it may actually take as few as eight years.

Scientists looked at 13 years’ worth of data from the Cardiovascular Health Study, which compared 853 people aged 65 and older who quit smoking to 2,557 who had never smoked. After a median of eight years, those who smoked 32 “pack years’ or less (number of packs smoked per day multiplied by the number of years smoked), reduced their heart disease risk to one equal that of a non-smoker.

“Now there’s a chance for even less of a waiting period to get a cleaner bill of cardiovascular health,” said John Higgins, cardiologist at the University of Texas Health Science Center in Houston.

they succeed. Those who continue to smoke, however, take huge risks with their health, and are more likely to die of cancer, heart disease, stroke, pneumonia, and more.

Quitting is not something you have to do by yourself. There are a number of ways you can get help. Here are just a few. And don’t forget to check with your doctor — he or she is also likely to have other ideas to help.

■ Go to smokefree.gov for a step-by-step quit

guide.

■ Call

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GETTING HELP TO QUIT Quitting smoking is hard. Most people who try it have to try several times before

the NCI Smoking Quitline (1–877–44U-QUIT) for individualized counseling.

Talk to your doctor about potential nicotine replacement products or other medicines that may help you.

If you’re over the age of 50, go to this website on Smokefree.gov for tips made specifically for your age group. (http://smokefree.gov/ free-resources?rid=2) If you’re pregnant and wanting to quit, the same website mentioned in the last bullet has several booklets that may help.

Try your state’s toll-free telephone quitline.

Call 1–800-QUIT-NOW to get one-onone help, support, coping strategies, and referrals to local programs. www.4health.net

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4HEALTH

BATTLE ROSACEA WITH THE HELP OF YOUR DERMATOLOGIST DON’T LET THIS SKIN CONDITION TEAR DOWN YOUR SELF-ESTEEM

■■■ Colleen M. Story Redness. Flushing. Bumps and pimples. All of these can describe rosacea, a skin condition that affects an estimated 16 million Americans.

Unfortunately, rosacea doesn’t just show up on the skin—it can also take a terrible emotional toll. Those who suffer from rosacea may feel self-conscious about their appearance, and find themselves canceling plans with friends or calling in sick to work when they experience flare-ups. A survey by the National Rosacea Society found that three out of four people with rosacea said the way the disease makes them look reduced their selfconfidence and self-esteem.

Though there is no cure for rosacea, you can control the symptoms enough to help yourself feel confident again. The first step?

Check with your dermatologist.

WHAT IS ROSACEA? Rosacea is a chronic disorder of the skin, characterized by flare-ups and remissions. It typically begins around the age of 30 with redness on the cheeks, nose, chin or forehead that may come and go. It may also show up on the neck, chest, scalp and ears. Over time, the redness can become darker and more persistent, with visible blood vessels. Untreated, it will continue to progress, and may result in bumps and pimples and swelling. Eventually, it can also affect the eyes.

Though rosacea can affect most anyone, those with fair skin who tend to flush or blush easily are at a higher risk. The cause is unknown, but therapy is available to control symptoms.

SIGNS AND SYMPTOMS OF ROSACEA Symptoms of rosacea may include flushing, persistent redness, bumps and pimples, visible blood vessels, eye irritation, burning or stinging, a dry appearance, and swelling. If you suspect you may have rosacea, check with your dermatologist to confirm the diagnosis.

Once you’re sure that rosacea is causing your symptoms, you can work with your dermatologist to come up with a treatment that’s best for you.

TREATMENTS AND SELF-CARE The signs and symptoms of rosacea vary from one person to another, which is another reason why it’s best to see a dermatologist, as he or she can help tailor a customized treatment regimen. Treatment methods may include: ■ Oral antibiotics to reduce symptoms ■ Topical medications to treat bumps, pimples, and redness ■ Various light and laser procedures to reduce redness and visible capillaries ■ Surgical devices to reduce extensive redness or correct disfigurement of the nose Doctors may combine some of these treatments—antibiotics and topical medications, for example—to achieve the best control of your symptoms. The initial treatment is targeted toward getting the redness and flare-ups under control, and then the long-term use of topical therapy helps maintain remission.

LIFESTYLE REMEDIES AND HOME SKIN CARE In addition to treatments prescribed by your dermatologist, you can make changes in your home care routine that will help:

■ Use mild, fragrance-free cleansers that

are non-abrasive and moisturizing ■ Wash and rinse with lukewarm water,

and blot dry with a thick cotton towel— never pull or tug at skin ■ Protect your skin from the sun with hats, umbrellas, and a sunscreen with an SPF of 15 or higher; zinc oxide and titanium dioxide are less irritating than other chemicals in sunscreens ■ Avoid skin care products with alcohol, menthol, peppermint, eucalyptus oil, sulfates, or other ingredients that may sting or burn ■ Try green-tinted concealers to counter redness, then follow with your regular foundation In addition, it’s important to identify your triggers—those lifestyle and environmental factors that aggravate your symptoms. Common triggers include sun exposure, emotional stress, hot weather, wind, heavy exercise, alcohol consumption, hot baths, spicy foods, and certain skin care products. Keep a rosacea diary to help you identify what you were doing right before a flare-up.

Finally, accept your feelings about your condition, and talk to your doctor and close friends. For severe cases, a rosacea support group may be helpful. To find an online support group, go to rosacea-support.org.

SOURCE Dennis Thompson Jr., «Easing the Emotional Impact of Rosacea,» Everyday Health, February 26, 2010. http://www.everydayhealth.com/ rosacea-awareness/rosacea-and-emotions.aspx.

«All About Rosacea,» National Rosacea Society, Rosacea.org. http:// www.rosacea.org/patients/allaboutrosacea.php.

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THE LONGER WOMEN ARE OVERWEIGHT, THE HIGHER THE CANCER RISK NEW RESEARCH SUGGESTS WEIGHT LOSS IMPORTANT AT ANY TIME

■■■ Colleen M. Story People who are overweight or obese often try dieting, but it’s not easy to lose weight.

Even when diets are successful, the weight often returns within a year or so. It’s a discouraging experience, and you may feel like throwing up your hands.

Not so fast, say researchers. According to a new study, how long a woman remains overweight is significant to her cancer risk. In other words, it’s never too late to try again, because losing even just a little weight can help you enjoy a longer, healthier life.

STUDY SHOWS HOW LONG YOU’RE OVERWEIGHT MATTERS For the study, researchers examined data from the Women’s Health Initiative on over 70,000 women in the U. S. They were looking at those who had a body mass index (BMI) of over 25 (defined as being overweight) and over 30 (defined as being obese) who were all free of cancer at the start of the study. They then followed their progress over a period of ten years to determine how excess weight affected cancer risk over time.

Results showed that the longer a woman carried around extra weight, the more her risk of cancer increased. For every 10-year increase in www.4health.net

overweight duration, women were 7 percent more at risk for obesity-related cancers, 5 percent more at risk for breast cancer, and 17 percent more at risk for endometrial cancer. Both duration and degree of overweight increased cancer risk.

FAT CELLS HAVE A WAY OF OPENING THE DOOR TO CANCEROUS CHANGES We already knew that overweight and obesity are risk factors for cancer. According to the National Institute of Cancer (NCI), a BMI of 18.5 to 24.9 is considered normal, and 25 or above is overweight or obese (30 and above). They add that being overweight or obese increases risk of several types of cancers, including endometrial, esophageal, liver, kidney, pancreatic, colorectal, gallbladder, breast, ovarian, and thyroid.

This is one of the first studies, however, to show that how long we remain overweight may also be a factor. Scientists believe that being overweight creates a low level of inflammation in the body that over time, can damage DNA. Fat tissue also produces excess amounts of the female hormone estrogen, which has been associated with increased risk of breast, endometrial, and ovarian cancers. Obese people often have increased blood levels of the hormone insulin, which has also been linked with colon, kidney, prostate, and endometrial cancers. Fat cells may also stimulate cancer growth in other ways.

Melina Arnold, a scientist at the International Agency for Research on Cancer (IARC), stated that longer exposure to overweight has been found “to increase the risk and severity of hypertension, insulin resistance, chronic inflammation, DNA damage and changes in hormone metabolism — key mechanisms increasing also the risk of cancer.”

Considering these theories and the study results, it appears that anytime is a good time to try to lose some weight.

LOSING EVEN FIVE PERCENT OF YOUR WEIGHT WILL HELP Not everyone who has been overweight for much of their lives will develop cancer.

There are always many factors involved, but this study does show the danger involved in remaining overweight.

Losing weight isn’t easy, but it’s definitely a worthwhile goal for long-term health. Yo-yo dieting isn’t the answer. Instead, scientists recommend a slow, purposeful change in lifestyle habits that help you to approach food in a more balanced way. Losing as little as five percent of your weight can result in changes internally that reduce your risk of cancer and other health issues. Don’t try to go it alone.

Talk to your doctor and consider weight loss programs like Weight Watchers to help you reach your goals.

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4HEALTH

10 BEST AB EXERCISES SEVERAL OPTIONS TO STRENGTHEN YOUR TUMMY

■■■ Lynn Merrell America is obsessed with abs. Magazines are covered with headlines about how to get slimmer abs. We’re bombarded with infomercials advertising the latest ab-crunching gadget. Celebrities love to show off their chiseled, narrow abs. And the rest of us seem to feel just a little under par if ours don’t look as good.

The truth is that even though we may be obsessed with how strong abs look, there really is a health benefit to having them as well.

Strong abdominal muscles indicate a strong core, which supports your spine (critical in today’s world of increasing back pain), promotes good posture, and helps you avoid injury as you go about your daily activities, particularly the more strenuous ones. Attractive abdominals also means little belly fat—vital to lowering risk of heart disease, diabetes, and cancer.

No matter your motivation, if you’re longing for a firmer set of abs, we gathered ten specific exercises that should help you reach your goal. Choose the one that works best for you, or feel free to alternate among your favorites. Don’t overdo it, as that will only weaken the muscles and delay your results.

Try twice a week, and don’t forget to accompany your work with a smart diet.

Bicycle: Lie on the floor, hands behind your head. Bring your knees in toward your chest, lift the shoulder blades off the floor, then straighten the left leg while turning the left elbow toward the right knee. Continue in an alternating pattern for 1-3 sets of 12-16 reps.

Abdominal hold: Sit on the edge of a square, sturdy chair. Place your hands on the edge, fingers toward your knees. Bring your toes 2-4 inches off the floor and lift your buttocks off the chair. Hold for 5-10 seconds. Lower and repeat for about 10 reps.

Side crunch: Kneel on the floor and lean all the way to your right, placing your right palm on the floor. Extend your left leg straight out, your left arm behind your head. Slowly lift your leg to hip height and extend your arm along it, palm forward. Lower to the floor and repeat 8 times, then switch sides.

Vertical leg crunch: Lie on the floor, extend your legs straight up, and cross your knees. Contract the abs and lift the shoulder blades off the floor. Lower and repeat for 1-3 sets of 12-16 reps.

The paddler: Sit on the floor, knees bent, feet flat. Hold the ends of a resistance band or towel in both hands out in front of you.

Lean back about 45 degrees and lift bent legs parallel to the floor. Turn to the left and right, keeping band or towel taut. Return legs to floor and repeat 6-8 times.

Bird dog: Start on all fours, knees under your hips, hands under your shoulders. Raise your left arm to shoulder height, right leg to hip height. Hold for two counts, then lower and repeat on the opposite side, 15-20 reps.

Long arm crunch: Lie on the floor, extend the arms behind the head and close to the ears, hands clasped. The arms should help support the head. Contract the abs and lift the shoulder blades off the floor. Hold for 3-5 seconds, lower and repeat for 1-3 sets of 1216 reps.

Windshield wiper: Lie on your back with arms out to sides. Extend the legs toward the ceiling, feet together. Slowly lower legs together as far right as you can, then lift back to center. Again, lower to the left as far as you can, and lift back to center. Repeat 16 times, alternating sides.

The plank: Get into a pushup position with palms beneath the shoulders. Make sure your back is straight and not arched or humped.

Hold for 30 seconds, then gradually build up until you can hold up to a minute.

The hundred: Lie down with your knees bent and palms down. Exhale and raise your head and shoulders off the mat. Pump your arms up and down, inhaling and exhaling, until you do 100 pumps. Lower, rest, and repeat 3-5 times. www.4health.net

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I DELIVERED MY BABY, AND NOW I’M LEAKING! STUDIES SHOW VAGINAL DELIVERY INCREASES RISK OF INCONTINENCE ■■■ Lynn Merrell New moms have a zillion things to worry about. There’s the baby, of course, and their own health and recovery, and the rest of their families, and getting back to work, and trying to lose the baby fat, and on and on.

The last thing they want to worry about is urinary incontinence.

Unfortunately, according to a recent study, the risk increases after vaginal birth. What are new moms to do?

WHAT IS URINARY INCONTINENCE? Urinary incontinence is the loss of bladder control. Most women just call it “leakage.” It ranges in severity from mild cases, where it happens only when you cough or sneeze, to more moderate cases where you have to go all the time.

Doctors generally diagnose women as having one of the following:

1. Stress urinary incontinence (SUI): This is where you experience leakage when laughing, sneezing, coughing, bending, or even with exercise. It’s the most common type of urinary incontinence, and is usually caused by weakened or stretched pelvic floor muscles.

2. Overactive Bladder (OAB): This is also called “urgency” incontinence, and makes you feel like you have to run to the bathroom every few minutes. It is also common and affects about 40 percent of women in the U. S. It can have many causes, but the main issue is that the brain is telling the bladder to empty even when it isn’t full.

3. Mixed Incontinence: Women who experience both SUI and OAB have mixed incontinence. www.4health.net

4. Overflow Incontinence: This form of incontinence occurs when the body makes more urine than the bladder can hold, or the bladder can’t empty correctly for some reason. It’s rare in women, and more common in men with prostate problems.

Most doctors would recommend that you not worry about it too much. After three to six months, the muscles will typically recover and women will regain bladder control. There are a number of things you can do to speed up the process, though, including the following:

In a 2016 study, researchers found that vaginal delivery was associated with a nearly two-fold increase in the risk of SUI compared to a caesarean section.

■ Kegel exercises: These are a series of exer-

STUDY SHOWS VAGINAL DELIVERY INCREASES RISK OF SUI Researchers analyzed 16 studies on how delivery affected continence. The studies, in total, involved over 45,000 women. Results showed the following: ■ Vaginal delivery was associated with an

almost two-fold increase in the risk of SUI, compared to caesarean section.

■ The effect was larger in younger women, and decreased as time passed from the delivery.

■ Vaginal delivery was also associated with an increased risk of OAB as well, but the increase was much lower.

The researchers concluded that “delivery mode has impact on the pelvic floor health.” In other words, vaginal delivery can stretch pelvic muscles to the point of causing SUI in some cases.

HOW WOMEN CAN DEAL WITH POSTDELIVERY URINARY INCONTINENCE This isn’t the first study to show that having a baby can lead to urinary incontinence.

There have been several others showing a connection. The question is, what can women do about it?

cises designed to strengthen the muscles in the pelvic floor, which are the muscles that help control leakage. To perform them, the next time you go to the bathroom, stop the stream for 10 seconds, then release, then do it again. (You accomplish this by squeezing and holding the vaginal and pelvic muscles.) Once you understand how it feels, you can do the same exercises anytime throughout the day. Doctors typically recommend doing 20 ten-second holds about five times a day.

■ Watch what you eat and drink: Cut back on alcohol, caffeine and acidic foods.

These can all stimulate and irritate the bladder. Try limiting your intake until you regain control.

■ Medications: If these steps don’t help after a few months, you can ask your doctor about medications. There are some common ones used to treat incontinence.

■ Medical devices: In more serious cases, where the problem doesn’t improve after several months and the incontinence is interfering with your daily life, your doctor can give you a pessary, which is a stiff ring that goes into the vagina to help hold up the bladder and prevent leakage, or a urethral insert, which is a small tampon-like device that you insert before activities that can trigger incontinence.

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4HEALTH

RAPID CYCLING IS A DIFFERENT FORM OF BIPOLAR DISORDER HELP FOR PEOPLE WHO SUFFER FROM FREQUENT MOOD CYCLES ■■■ Colleen M. Story Most people understand that bipolar disorder is a mental illness that causes extreme mood swings, from deep depression to flyinghigh mania or euphoria. These massive shifts in emotional experience, energy, and activity can be both physically and mentally exhausting, and frequently make it difficult to maintain relationships or to continue to advance in a career.

The National Institutes of Health (NIH) states that about 5.7 million adult Americans suffer from bipolar disorder every year. It’s

usually diagnosed in young adults around the age of 25, though sometimes it doesn’t manifest until a person reaches their 40s or 50s. There is a genetic component to the illness, in that those who have parents with bipolar are at a higher risk themselves.

Fortunately, we understand more about bipolar today than we used to, and there are treatments that can help people cope, including mood-balancing medications. One facet of the illness that still baffles researchers to some extent, however, is called “rapid cycling,” a type of frequent mood swing that can leave even patients confused as to what’s going on. www.4health.net

4HEALTH WHAT IS RAPID CYCLING? In general, people with bipolar experience about two cycles per year, with “cycles” meaning a change from the depressive to the manic state.

Those who experience four or more of these cycles a year are said to experience rapid cycling.

This sort of cycle may include an episode of depression, for example, followed by an episode of mania, then a period of remission, followed by another period of mania followed by a period of depression. The cycles may occur in any order, but usually are separated by a period of remission.

Rapid cycling is rare, and is believed to occur in only about 10 to 20 percent of people with bipolar disorder. It is also thought to be more common in women than in men, and may be associated with some medical issues such as hypothyroidism, multiple sclerosis, or some sort of head injury.

WHAT IS RAPID CYCLING LIKE? People who experience rapid cycling often state that it is frustrating and exhausting. Some may suffer multiple highs and lows in a very short period of time, affecting energy levels and interpersonal interactions.

It can be confusing and scary, and feel like the mind is playing tricks, because you feel sad, then happy, then giddy, then teary. Underneath all the emotions anxiety may be lurking, making patients fear what is to come next.

Those suffering from rapid cycling may also experience “mixed states,” which is a period during which symptoms of both mania and depression are present. They may feel their energy shooting out the window while simultaneously feeling anguish and despair.

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Meanwhile the person lives at the extremes of his emotional range, pushing physical and emotional endurance to the edge. It’s a roller coaster ride with dangerous highs and lows that can result in reckless behavior, appetite changes, social withdrawal, substance abuse, and recurrent thoughts of suicide.

Researchers have found that rapid cycling may be triggered by stress in some cases, or by unexpected life events that create stress or anxiety.

Use of illegal drugs and alcohol can increase risk, and those who are diagnosed at an early age, or who have had bipolar for a long time, may also be more at risk for rapid cycling.

TREATMENT FOR RAPID CYCLING Doctors advise people with bipolar to be persistent, as there are treatments that can help. If the first round of medications doesn’t do it, they encourage people to speak up about their experiences and be willing to try something else. It also helps to keep a journal or diary of your experiences and how the medications affect (or don’t affect) you.

Therapy is usually an important part of any treatment plan, and is definitely critical for those with rapid cycling to help them understand what’s going on. In some cases, having a therapist to talk to can be a life-saving strategy.

Bipolar support groups are also important parts of treatment, as they help people realize they’re not alone, and provide an open venue to share experiences. The important thing is to remember that rapid cycling is different from standard bipolar disorder, and may be more difficult to manage. Work closely with your doctor and mental health professionals to find a treatment plan that works for you.

NEUROLOGICAL CLINIC

DOCTOR DMITRIY GRINSHPUN, MD Chief of Neurology, Director of Stroke Center and Professor WOODHULL MEDICAL CENTER / NEW YORK UNIVERSITY AFFILIATE

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

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

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

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

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

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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: ■ traumatic injuries to the brain, skull, spinal cord, or nerves ■ tumors in the brain, spinal cord, nerves, skull, or spine ■ back pain caused by pinched nerves, infections, fractures, and ruptured or bulging disks ■ neurovascular disorders such as aneurysms, strokes, and brain hemorrhages ■ brain disorders like epilepsy and Parkinson’s disease ■ infections of the brain and/or spinal cord

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

“I would venture to say that more than 25% of human beings have problems with this,” he says, “and that’s the group I’m focused on right now as they also require surgical treatment.”

He notes that back problems often come from 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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GENERATIONS

5 East 84th St, New York, NY 10028

Erico CARDOSO, MD TOLL FREE

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FEEL GOOD ON YOUR SUMMER VACATION SEVEN WAYS TO AVOID BODY BREAKDOWN

Ah, the joys of a summer vacation. No work, no housecleaning, just a good strong dose of rest and relaxation. There’s no doubt that a little time off can be great for your physical and mental health.

However, you’ve heard the stories—some unfortunate souls, instead of returning rested and rejuvenated, end up suffering some sort of illness or discomfort while they’re away. To help keep you and your family from the same fate, follow these few tips.

■■■ Colleen M. Story 1. Protect your stomach. The stomach is usually the first part of the body to suffer when you’re out of your normal environment. To protect yours, stick with bottled water, avoid raw items, and be careful when venturing into unknown culinary territory.

Lettuce, in particular, is known to be hard to clean, so make sure if you eat it that the source is trustworthy. Instead of berries and grapes, which can easily carry bacteria on the skin, choose fruits with peels like oranges, bananas, and mangoes. (Bananas also help you weather indigestion.) Raw fish, as you probably know, can carry a host of pathogens, so make sure you’re eating it at a reputable establishment.

Finally, avoid milk altogether until you get back home.

2. Continue to exercise. Going for days without exercise can set you back months in your weight and fitness goals as well as make you feel lethargic and bloated. Staying active will keep your energy levels up for all that sightseeing. You can walk just about anywhere, so get going through the airport on your layovers, and once you arrive at your destination, take a family walk or jog around the area. Many hotels are now

equipped with small gyms, as well, which are perfect for early morning workouts. And don’t forget the swimming pool!

3. Watch your alcohol content. Vacations can seem like the perfect time to overindulge.

Unfortunately, blended alcohol treats are usually full of calories and sugar, which can drag you down in a hurry. To keep your body feeling good, stick with a glass of wine or light beer at the end of the day, and otherwise avoid the alcohol.

4. Stay clear of germs. We all know the increased risks of contracting some sort of illness when flying. Any new place, however, can carry risks, so follow a few smart rules.

Wash your hands often, inspect utensils before using them, keep your mouth closed when showering (so you’re not “drinking” the water), keep your hands away from your

face, and take immune-boosting supplements with you, like vitamin C, zinc, and selenium.

5. Carry insect repellant. Choose a formula that contains at least 30% DEET, and apply liberally when you’re outside. Insects carry a host of bacteria and viruses, so don’t become their next buffet.

6. Take medications with you. If you do get stomach sick or come down with an unwanted cold, having your own stash of medications will help. The last thing you want to do is to search unknown territory for familiar drugs.

Take along some Echinacea supplements to help ward off head colds and bronchitis, and start taking them at the first sign of a problem. Diarrhea and nausea solutions may come in handy, as well as cold-fighting medications, allergy pills, pain relievers, any regular prescriptions, and a little ginger supplement to settle the stomach.

7. Make time to reflect and relax. Sometimes, vacations can be such hurried affairs that we return home more exhausted than when we left. Along with all the sight-seeing and fun activities, make sure to schedule some down time for reflection and/or meditation. Quiet walks, journaling, or just sitting with the scenery are all good ways to recharge your batteries and avoid vacation burn-out.

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MOM IS FORGETTING THINGS: IS IT ALZHEIMER’S OR VASCULAR DEMENTIA? TWO DIFFERENT TYPES OF MEMORY PROBLEMS REQUIRE DIFFERENT TREATMENTS

■■■

Gordon Barclay

Usually when we think of dementia, we think of Alzheimer’s disease, but there are other types as well, including vascular dementia. Though both of these conditions are similar, there are some key differences that can affect prevention, diagnosis, and treatment. If you or a loved one is noticing changes in memory, problem solving, or decision-making, it’s important to talk to your doctor about what may be causing the issues, to improve your chances of limiting the effects as soon as possible.

WHAT IS VASCULAR DEMENTIA? Vascular dementia is the second most common cause of dementia after Alzheimer’s disease. It’s related to changes in the blood vessels, or vascular system.

There are blood vessels throughout the body, including those that lead to the brain. The most common changes that can cause dementia are narrowing and stiffening of the blood vessels that supply the brain with nutrients and oxygen.

You probably already know that one of the main risks to your health is heart disease, and that one of the main causes of heart disease is a stiffening and narrowing of the blood vessels around the heart. This caused by a buildup of cholesterol-laden plaque that over time, slows and sometimes even blocks blood flow. If a blood clot develops and seals off the blood, a heart attack may result.

The same thing can happen to the blood vessels leading to the brain: cholesterol-laden plaque can build up inside these vessels, making it harder for blood to get through. Blood pressure increases, raising the risk that a blood clot may form. If a blood clot occurs in a vessel leading to the brain, it may cause a stroke. Vascular dementia may also occur as a result of blood-vessel-narrowing in the brain, or as the result of a stroke or mini-stroke.

SYMPTOMS OF VASCULAR DEMENTIA As vascular disease slowly affects the various blood vessels in the brain, it can affect thinking. Symptoms usually start out subtly, and vary from person to person, depending on which blood vessels are www.4health.net

most damaged and in which part of the brain they’re located. If a stroke occurs, the changes are likely to be more noticeable, but patients can also go for years with vascular disease experiencing only minor changes in thinking.

There are some signs, however, that may include confusion, disorientation, vision loss, or trouble making decisions or solving problems. Symptoms may be similar to those with Alzheimer’s disease, like problems with short-term memory, trouble managing money, difficulty concentrating, wandering or getting lost, and loss of bladder or bowel control.

WHAT’S THE DIFFERENCE BETWEEN ALZHEIMER’S AND VASCULAR DEMENTIA? Though the symptoms of these types of dementia may be similar, the causes are quite different. Vascular dementia is caused by unhealthy change to blood vessels, and results in damage to the white matter in the brain. Alzheimer’s is caused by a buildup of protein and a destruction of brain cells in the gray matter of the brain.

We also more clearly understand what precedes vascular dementia.

If someone has cardiovascular disease, high blood pressure, high blood cholesterol, or diabetes, or if they suffer from a stroke or mini-stroke, they are more at risk for vascular dementia, because all of these conditions affect the health of the blood vessels. What precedes Alzheimer’s has been more difficult to pin down.

Finally, symptoms of vascular dementia may show up suddenly, after a stroke or mini-stroke, whereas symptoms of Alzheimer’s come on more gradually.

WHAT TYPE OF DEMENTIA TREATMENT IS BEST? Though treatment for both types of dementia may involve medications, they are likely to vary depending on what is thought to be causing it. Treatment for vascular dementia, for example, may involve medications to help prevent blood clots and treat high blood pressure. Medications for Alzheimer’s usually include disease-specific medications for memory loss. That’s why it’s important when facing memory and other cognitive problems to examine a person’s entire medical history to determine the best approach.

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AVOID A SUNBURN ON YOUR EYES! HOW TO PROTECT YOURSELF THIS SUMMER

■■■

Colleen M. Story

You know that when you go outside, your skin is at risk for sunburn. But did you know that your eyes, too, can get burned?

It happened to CNN newsman Anderson Cooper. Back in 2012, according to an article in USA Today, he spent two hours on a boat in Portugal. He wasn’t wearing his sunglasses.

Later that night, he woke up feeling like his eyes were on fire, and he couldn’t see.

Splashing his eyes with water didn’t help. He went to the doctor, who promptly diagnosed him with “photokeratitis.”

Here’s more on the condition, and you can avoid suffering from it.

WHAT IS PHOTOKERATITIS? Also called “snow blindness” because skiers often suffer from it, photokeratitis is a condition in which the sun’s rays burn the eyes’ corneas — the outermost layers that cover the front of the eyes. When this happens, it can cause a painful, temporary blindness. It may feel like you’ve got sand stuck in your eyes, or as if your eyes are on fire.

Those with lighter colored eyes are believed to be at a higher risk for photokeratitis because they don’t have as much pigmentation to protect the eyes. Treatment includes cool,

wet compresses and artificial tears to reduce pain and keep eyes moist while they heal.

Doctors recommend you see your ophthalmologist immediately, as he or she can diagnose the condition and may also prescribe eye drops that can help reduce eye pain and speed along healing.

Recovery usually takes about one to three days, depending on how severe the burn was.

During that time, the gritty feeling will likely remain, as the cornea will actually peel to make way for new tissue.

UV RAYS CAN CAUSE LONG-TERM DAMAGE TO EYES Though photokeratitis isn’t serious — your eyes will recover — exposing eyes to UV rays can cause a number of other problems over time. Scientific studies have shown that unprotected eyes are more likely to develop cataracts and macular degeneration. The Skin Cancer Foundation also warns that years of unprotected exposure to UV rays can increase risk of eyelid cancers and conjunctival cancers (malignant cancers that grow on the surface of the eye).

HOW TO PROTECT YOURSELF FROM “EYEBURN” My eye doctor has always called the sun “enemy number one” when it comes to the health of the eyes. If you want to enjoy your

best vision for the rest of your life, be sure to take these precautions.

Protect when tanning: Tanning isn’t good for your skin, and it’s equally hard on your eyes. Avoid it! If you insist on stepping into the tanning booth, be sure to always wear eye protection — closing your eyes isn’t enough!

Get the best protection you can: There are a lot of sunglasses out there to choose from.

Always make sure that whatever ones you buy have 100% UV protection for both UVA and UVB rays.

Wear your sunglasses! Even on cloudy days UVA rays penetrate even inside your car to potentially cause damage. Protect your eyes with a lighter shade of sunglasses if you need, but get used to wearing your sunglasses every time you step out the door.

Use hats and umbrellas: If you’re going to be out in the sun for more than a few minutes, consider wearing a hat or using an umbrella. Sunglasses help, but if you have the sun beating down on you for any length of time, extra protection from above can help protect your eyes from rays that can sneak in over the top of your glasses. Wrap-around glasses also help.

Power it up when around the water: Water, snow, sand, and pavement can all reflect UV rays, putting your eyes at risk. Make sure you wear the strongest protection you have when around these surfaces. www.4health.net

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TREATMENT FOR YOUR PAD

MAY HELP PREVENT AMPUTATIONS USA VASCULAR CENTERS OFFERS MINIMALLY INVASIVE PROCEDURES Has your doctor diagnosed you with peripheral arterial disease (PAD)? Or have you noticed symptoms like fatigue and heaviness in your legs, cramping in the calf muscles, pain in your legs that disrupts your sleep, or sores or wounds on your legs and feet that don’t heal?

If so, don’t wait to talk to your doctor about it. Left untreated, PAD can lead to amputations, heart attacks, and strokes. The good news is that newer, minimally invasive treatments can make a big difference, improving symptoms, saving limbs, and saving lives. USA Vascular Centers, which specializes in treatment for PAD, has offices in the New York area, as well as nationwide, and can help guide you to customized treatments that will keep you walking comfortably for years to come.

ADVANCED PAD LEADS TO AMPUTATION, WHICH HAS POOR OUTCOMES Statistics show that about 150,000 Americans have to go through leg or foot amputations every year, mostly because of PAD. Those who have the disease have too much plaque buildup in the blood vessels in the legs, which decreases blood flow. Other blood vessels that lead to the heart, head, and organs may also be affected.

Without adequate blood supply, legs can get painful and numb.

They can also have a more difficult time healing wounds and fighting off infections. If the blood flow becomes blocked, the tissues may die, which can lead to leg amputation. Unfortunately, though amputation saves the life of the person initially, amputations don’t have good outcomes overall. Over half of people end up dying within 18 months of the procedure.

That’s why the doctors at USA Vascular Centers want to help people with PAD avoid amputation at all costs. New treatments are helping them do just that.

WHEN TO ASK FOR MORE TREATMENT How do you know if you need more treatment than you’re getting? After all, sometimes doctors are warned not to overtreat conditions like PAD. Consider other conditions you may have. Diabetes and kidney disease increase your risk of complications from PAD. Other clues include sores that don’t heal. These can lead to dangerous infections.

If you’re experiencing pain and discomfort on a regular basis in your legs and feet, don’t be afraid to ask your doctor to test your blood flow.

Finally, realize that there are a number of minimally invasive treatments to improve blood flow in the legs. Check with your local USA Vascular Centers, and find out which treatments may be best for you. Your future doesn’t have to be one of immobility. Many of today’s treatments can get you back and walking comfortably in less time than you imagine.

USA VASCULAR CENTERS OFFERS TREATMENT FOR PAD USA Vascular Centers, a nationwide network of physicians, nurses and specialists, offers PAD 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.

SOURCES “Testing and treating PAD patients prevents loss of legs, feet,” MedicalNewsToday, February 4, 2015; http:// www.medicalnewstoday.com/releases/288793.php.

Steven Reinberg, “Imaging Tests May Help Stem Amputations for Circulatory Disorder,” HealthDay, February 4, 2015, http://consumer.healthday.com/public-health-information-30/health-cost-news-348/imaging-tests-mayhelp-stem-amputations-for-circulatory-disorder-696148.html.

NEW TESTS AND TREATMENTS HELP PATIENTS AVOID AMPUTATIONS The overall goal of treatment is always to reduce uncomfortable symptoms; improve mobility; prevent complications like heart attack, stroke, and amputations; and improve overall quality of life. The doctors at USA Vascular Centers perform thorough medical examinations to make a diagnosis, and then look at all potential treatments to provide the best outcome possible. These may include lifestyle changes (like stopping smoking or lowering blood pressure), medications, and special surgical procedures.

Minimally invasive treatments like atherectomies (procedure in which plaque is removed from the artery by a roto-rooter type device), stents (to keep arteries open), and hyperbaric oxygen therapy all help to improve blood circulation and mobility, reduce pain, and heal sores.

By creating a customized treatment plan in each case, USA Vascular Centers helps patients maintain the health in their legs, reducing the risk of amputations.

718–393–5331 www.USAVascularCenters.com

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NEW RESEARCH SHOWS PROMISE FOR TREATING PHANTOM LIMB PAIN CROSS-TRAINING THE BRAIN WITH ROBOT LIMB TECHNOLOGY

■■■ Colleen M. Story According to a Congressional Budget Office report released in 2014, of the more than 50,000 American troops wounded in action in Iraq and Afghanistan, 2.6 percent have suffered a major limb amputation — a higher rate than for those who served in Vietnam.

Meanwhile, there is an estimated two million people living with limb loss in the U.S., caused by diabetes, peripheral artery disease, trauma, and cancer.

One of the most difficult consequences of limb loss for patients is phantom limb pain. Though it can sometimes go away with time, for many patients, it is a chronic, recurring problem that can be difficult to manage. Fortunately, new research has revealed some things previously unknown about how the pain works, which may help scientists to develop new treatments.

WHAT IS PHANTOM LIMB PAIN? Phantom limb pain is the sensation of pain coming from a limb that is no longer there. It affects people who have gone through a limb amputation, and seems to center on the area where the amputation took place.

For years, researchers have believed that the brain is the main factor in causing phantom limb pain. Nerve endings at the amputation site were thought to continue to send messages to the brain, making it think the limb was still there. The brain interpreted those messages as pain messages, thus making the patient feel pain. Patients could also experience other symptoms like cramping, burning, pressure, tingling, and hot and cold sensations.

Treatments so far have focused on restoring normal motor function in the limb to help relieve pain, as researchers believed that would help “re-wire” the sensorimotor cortex in the brain. A recent study, however, challenges that perception.

NEW STUDY SHOWS CROSS-TRAINING THE BRAIN EASES PAIN In the new study, researchers had 10 patients with phantom limb pain learn to control a robot hand with their brains, either opening the hand or grasping with it. First, they focused on trying to move the hand with their missing hand, and then with their intact hand.

What the results showed was that when patients focused on trying to move the robot hand with their missing limb, their pain got worse.

Yet when they were asked to move the robot hand by focusing on the intact hand, pain was reduced.

Researchers theorized that the pain got worse when patients thought about moving the robot hand with their missing hand because the brain registered a discrepancy. It was telling the robot hand to move and the robot hand was moving, but the real, missing hand was not.

That seemed to cause pain.

When the patient moved the robot hand by focusing on the intact hand, they actually forced the brain to learn new things, and that helped relieve the pain. The results were promising and researchers believe that new treatments based on this technique could be available within the next 5–10 years.

OTHER NEW TREATMENTS ON THE HORIZON Current treatments for phantom limb pain include medications, biofeedback, physical therapy, nerve stimulation, relaxation techniques, and massage. Other newer techniques are on the horizon, however. Virtual reality goggles, for example, help patients see the amputated limb restored, and practice moving it around, which has shown promise in helping to relieve pain. Nerve stimulators that send the brain pleasant signals have also done well in studies, but the technique is still in research.

Doctors encourage patients who are experiencing phantom limb pain to talk to their doctors. The issue is better understood than it used to be, and often a multi-pronged approach to treatment works best. www.4health.net

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OPIOIDS NOT VERY EFFECTIVE FOR LOW BACK PAIN OTHER OPTIONS THAT DO WORK

■■■ Colleen M. Story In 2016, the Centers for Disease Control and Prevention (CDC) issued new guidelines for prescribing opioid drugs for chronic pain.

The new guidelines were released in response to the growing occurrence of opioid addiction and abuse, which the CDC describes as an “epidemic.” They state in their guidelines that more than 40 people die every day from overdoses involving prescription opioids.

Though doctors can still prescribe opioids in certain instances when they have the highest possibility of providing pain relief, the CDC has encouraged them to turn to other pain-relief options first. According to a recent study review, that’s good advice, particularly when it comes to back pain.

Results showed that for over 3,000 participants, opioids did not provide significant relief in patients suffering from chronic low back pain.

WHAT ARE OPIOIDS? Opioids are a class of pain-relieving drugs including oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and others. The class also includes the illegal and extremely addictive drug, heroin.

These drugs all work in a similar way — they interact with opioid receptors we naturally have in our brains to help block pain messages

so we no longer feel pain. Though often effective in the short-term, they can be addictive because they can produce a sense of euphoria in addition to pain relief. When abused, they can lead to serious addiction issues and fatal overdoses.

OTHER OPTIONS FOR BACK PAIN Though opioid drugs are commonly used to help treat lower back pain, the increasing issue of addiction and overdose has prompted doctors and researchers to look for other, safer options. In a recent 2016 study review, researchers looked at current scientific research on opioids and low back pain in 13 studies involving nearly 3,500 patients.

Results of most of the studies showed that the drugs seemed to help reduce pain in the short-term, but that the effect wasn’t really “clinically important,” meaning that the relief was not significant enough to help improve quality of life. Evidence on long-term effectiveness was lacking. In fact, in half of the studies reviewed, at least 50 percent of the participants withdrew from the studies because the opioids weren’t helping or because of difficult side effects.

“This review dispels the common public misconception that opioid analgesics are powerful analgesics,” the researchers wrote, “showing this is not the case for chronic low back pain.”

OTHER TYPES OF PAIN RELIEF FOR BACK PAIN Fortunately, there are several other options that work for low back pain, and many it seems are even better than opioids. A 2015 study, for example, found that Naproxen, a non-addictive prescription strength pain reliever that is not an opioid, actually provided just as much pain relief as oxycodone with acetaminophen.

There are many non-drug options, however, that may be even more effective than drugs. A 2016 study, for example, found that mindfulness-based stress reduction and cognitive behavioral therapy were actually more effective than usual treatments in alleviating chronic back pain.

Other studies have found that yoga, infrared therapy, chiropractic care, physical therapy, acupuncture, biofeedback, and nerve block therapies are just as effective or more effective than medications in soothing lower back pain. Many of these therapies are also preferred for long-term treatment, because they don’t create the negative side effects that drugs can cause.

If you’re suffering from low back pain, talk to your doctor or pain relief specialist about your options. Together, you can find safe and effective methods that will have you feeling better without risking further health issues because of a medication. www.4health.net

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| Plastic Surgery

AN EASY WAY TO LOOK MORE TONED AND TIGHT THIS SUMMER! GET BATHING-SUIT READY WITH SKINTYTE

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

Have you lost a lot of weight, only to be left with saggy skin on your belly, arms, and legs? Are you embarrassed by “bat wings” or excess skin on your thighs? Are you looking forward to summer, but feel self-conscious about wearing a swimsuit?

Exercise usually doesn’t help much with these types of issues. Aerobics and weight-lifting can tone and firm the muscles, but does little to address that excess skin that most of us don’t like.

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 — no matter where it is on your body. For a limited time, the doctor is offering a special price on this treatment for belly, arms, and inner thighs. You owe it to yourself to check it out, because there is no downtime, which means you can go right back to your regular activities when you’re done.

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.

Collagen is a key component in keeping your skin strong and taut, but over time, it becomes damaged and we don’t produce as much of it. SkinTyte uses infrared thermal energy to warm collagen down in the deeper layers of skin, encouraging increased firmness. At the same time, it protects the surface of the skin with a sophisticated cooling element.

The treatment is so minimally invasive that it doesn’t even require anesthetic. While it delivers laser energy in gentle, rapid pulses, it also creates a powerful cooling effect that maintains the outer surface of the skin to create a safe, comfortable procedure. A cooling gel may be also applied to skin, so that 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 used by the body to create the latticework that forms the foundation of the skin.

Over time, 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 that floppy skin on your upper arms, around the elbows, above the knees, and over the abdomen.

SkinTyte encourages the body’s own natural healing processes to help repair and tighten it again.

The treatment takes only about 30 to 45 minutes, is safe for all skin colors, and can be performed on any area of the body where skin is saggy and loose.

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’ll notice smoother, more toned and tighter skin.

What Types of Skin Problems Does SkinTyte Treat?

Because it stimulates collagen, and collagen exists in all skin, SkinTyte can be used to improve a variety of skin issues. These include: ■ ■ ■ ■ ■ ■ ■ ■

Saggy skin on the neck Stretch marks Cellulite Saggy abdominal skin (such as after pregnancy) Saggy upper arms Sagging skin above the elbows and knees Saggy under eye skin Saggy jowls or a fatty chin

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.

Look Your Best This Summer!

If you’d like to look your best this summer, talk to Dr. Rayham about the special price he has available for 4Health readers in the month of July. 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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MY EARS STICK OUT TOO FAR FROM MY HEAD! EAR SURGERY CAN HELP INCREASE CONFIDENCE

■■■

Lynn Merrell

Lana hated her ears. She had always hated them, but now that she was in middle school, the problem was getting worse. The other kids whispered about her, pointing at her in class. They thought they were doing it behind her back but she knew they were talking about her.

She told her mother about it. “My ears!” she said. “I’m so embarrassed, Mom. I don’t want to wear my hair up like the other girls because then they stick out even more.” Everyone else’s ears stayed close to their heads, she went on, while hers stuck out like Dumbo ears, big and floppy.

Her mom told her she was beautiful just the way she was, but that didn’t help Lana feel better. Turns out there is a very simple and effective procedure that could help Lana and anyone else embarrassed by overly large, prominent, or deformed ears: otoplasty.

children born with prominent ears, the surgery can be completed as early as three years if necessary. The procedure has no effect on hearing.

MANY CHILDREN BORN WITH MALFORMED EARS Doctors acknowledge that ears that “stick out” can greatly affect a child’s self-esteem and confidence, as other children tend to tease and bully them because of their appearance. Even adults with protruding ears suffer from embarrassment, often wearing their hair long or making other adjustments in their life to try to hide their ears.

Ears may be prominent for a number of reasons, often because of the overdevelopment of the cartilage in the outer ear, or an underdevelopment of the cartilage at the top of the ear. Deformities like this are fairly common in children, with 20–30 percent born with ears that are misshapen. Sometimes these ears straighten up on their own, but often they remain malformed until surgery corrects them.

WHAT IS OTOPLASTY? Otoplasty is a fancy name for ear surgery, and is performed by plastic surgeons to help correct defects or injuries to the ears to make them look normal. The surgeon can change the shape, size, or position of the ears, and can even help fill in areas that are missing because of a trauma or other injury.

Patients may consider otoplasty for the following reasons: ■ Ears stick out too far from the head ■ Ears are misshapen because of a birth defect or injury ■ Ears are overly large in proportion to the head ■ Ears need to be reconstructed after an injury like a severe burn or cut Otoplasty helps create a more natural shape for the ears, bringing them into balance with the head and face, and if necessary, “pinning” them back to the head so they don’t stick out so much. The surgery could be an option for Lana, as it can be done anytime after the age of about five or six years, when the ears have fully developed. In fact, in

RECOVERY FROM OTOPLASTY TAKES A COUPLE WEEKS During otoplasty, the surgeon remodels the cartilage of the ear, either reducing it, augmenting it, or pinning it back. In children, general anesthesia is used during the procedure, though with adults local anesthesia may be enough. Incisions are made behind the ear where they are less noticeable.

Recovery usually takes several days, and after the initial bandages are removed, patients wear headbands over the ears to protect them while sleeping. Most patients can return to their normal activities within a week, and to more strenuous activities like exercise in two weeks. Doctors do advise that patients avoid physical-contact sports like football, soccer, karate, and the like for at least three months to avoid damaging the ears.

Otoplasty is considered a very safe procedure, and satisfaction rates are high. Just be sure to use a highly reputable surgeon for the best results. www.4health.net

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WHAT DOES STRESS DO TO YOUR CHILD’S BRAIN? STUDY EXPRESSES CONCERN REGARDING EARLY LIFE NEGLECT AND ABUSE

■■■ Colleen M. Story A little stress can help keep us on our toes, but too much is bad for our health. Chronic stress can lead to headaches, insomnia, weight gain, high blood pressure, heart problems, and more. And that’s for adults. When we’re talking about stress and children, the effects can be even worse.

Researchers recently looked a little more closely into the issue. How do stresses like poverty, neglect, and abuse affect children?

What they found is no less than alarming.

Not only do children suffer from these types of stresses, but the consequences can last long into adulthood.

EARLY LIFE STRESS AFFECTS BRAIN DEVELOPMENT For the study, researchers from the University of Wisconsin-Madison interviewed 128 children around the age of 12 who had experienced poverty, neglect, or physical abuse in early life. They also talked to the children’s caregivers, and took images of the children’s brains. They then compared the data to that gathered from similar children who had not been mistreated and who were from middleclass families.

The results showed the following: ■ Children who had experienced early life stress had smaller amygdalas — the part of the brain involved with emotion — than children who had not suffered that type of stress.

■ Children who had lived in poverty and/ or who had been physically abused had www.4health.net

smaller hippocampuses — the area of the brain responsible for memory and learning.

The researchers concluded that early life stress could affect brain development, affecting those parts of the brain involved in emotion processing and regulation, learning, and memory.

OTHER RESEARCH SHOWS SIMILAR RESULTS This isn’t the first study to indicate that early life stress can affect children’s brains. In 2012, researchers came to a similar conclusion after studying 61 children ages 9 to 14. They found that the “anterior cingulate”—which is involved in emotional and cognitive tasks — took up less space in children who had been highly stressed. They also found lower levels of both gray and white matter — areas that control communication between neurotransmitters in the brain — in those children who were overly stressed.

HOW DOES STRESS AFFECT THE BRAIN? Why would this happen? Scientists don’t yet have all the answers, but they think that high levels of stress alter chemicals in the brain and the body, affecting cellular development. They don’t know, however, how long the effects last.

Do these areas of the brain achieve further growth as the children age? Do the children recover full development with time?

“We’re not trying to argue that stress permanently scars your brain,” said researcher Jamie Hanson. “We don’t know if and how it is that stress affects the brain. It could be that,

because the brain is very plastic, very able to change, that children who have experienced a great deal of stress catch up in these areas.

HOW PARENTS CAN HELP Though stress is part of life, parents can take steps to help their children cope.

■ Monitor your own stress: Kids take their cues from their parents. How stressed out are you? Taking steps to control your own stress — so you can be more genuinely calm around your kids — will go a long way toward helping them feel calm.

■ Take care of your relationship: Marital conflict is extremely stressful for children. If you and your partner aren’t getting along, consider couples counseling for yourselves and for your children.

■ Schedule time for stress-relief: This goes for both parents and children. Take a family walk or bike ride. Get out into nature on the weekends. Play a game of catch or badminton together. Do a family art project. Allow kids time to play and relax. Adults are extremely busy these days, but children are too. Try not to overschedule every hour, and allow some free time.

■ Communicate: Parents who talk to their kids on a regular basis can head off problems before they start. Create a regular routine of open, honest conversation.

The dinner table is the perfect place!

■ Cultivate routine: Kids feel safest when they know what to expect. Try to create a weekly routine and stick to it, with regular meal times and bed times.

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Podiatry | 4HEALTH35

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HOW TO TREAT AND PREVENT SUMMERTIME FOOT INFECTIONS Dr. Leon Stepensky has been practicing podiatry in Brooklyn for over 15 years. A trained surgeon in both minimally invasive surgery and endoscopic and arthroscopic procedures, he treats all sorts of foot problems, from the most complicated cases to everyday irritations.

According to Dr. Stepensky, warm weather increases risk of foot infections. Going barefoot more often, wearing sandals, and spending time around public swimming pools exposes our feet to bacteria and fungal parasites. In the right conditions, these microorganisms can find a home in our toes.

To help keep your feet healthy and infectionfree this year, we asked the doctor his advice on any precautions we should take during the summer months.

Foot infections are possible year round.

Why we should pay special attention to them in the summer?

As a podiatrist, I see more cases of foot infections in the summertime, mostly because patients notice these infections when wearing open shoes. Women get their pedicures done, and they notice their nails and the skin on their feet — things they probably didn’t pay much attention to during the winter. The most common infections I see are the fungal infections on the skin, fungal infections on the toenails, and warts on the feet. These are all seen in kids as well as in adults.

Tell us more about these diseases and how you treat them.

Let’s start with the toenails. The most common sign of infection is a thick, discolored, painful nail, often filled with fungal debris that looks like a dried, dust-like material underneath the nail. Sometimes it can have a sour odor, and it may feel painful when wearing shoes.

Topical medications help 20–30 percent of patients, depending on the infection and the medications used. Oral medications, which help about 70–80 percent of patients, may have some side effects, but they do create very good results. Our laser procedure is often most effective. It targets the small capillaries that feed the nail, cutting off the blood supply. Without that blood, the fungus can no longer survive, and dies off. This procedure helps up to 90 percent of patients.

The second common foot infection is a fungus infection of the skin, commonly referred www.4health.net

as “athlete’s foot.” Fungal parasites like dark, warm, moist environments. They grow in shallow water in the shower, and can also find a home in our shoes.

We have good topical and oral medications that help eliminate this type of infection. Because the skin renews itself about once a month, the medications usually need to be used for one month to work correctly. Still, treating this type of infection is often a lot more successful than treating a nail infection, because the cycle of nail growth is from 9 to 12 months. It’s more difficult to treat the nail because the nail grows much slower, and treatment may take longer.

The third common foot infection is the viral skin infection known as “warts.” They commonly appear as calluses, but they are a lot more painful because of the virus growth. It puts pressure on the adjacent capillaries. These capillaries then widen and put pressure on the nerves, so when we step on them, it can be very painful.

Warts are successfully treated and prevented with topical medications. If the medications don’t work, we can use a laser treatment. Unfortunately, the warts may come back because the virus, like a fungus, can live in our shoes.

If we don’t disinfect our shoes and feet, these microorganisms may return.

We often see warts in children because as children grow, their feet commonly sweat more, and they’re often very active without their shoes. Gymnastics, in particular, can increase risk of foot infections because children are active, sweating, and in their bare feet over potentially contaminated surfaces. The virus makes them contagious not just to themselves, but also to other children.

What can we do to avoid foot infections?

First, wear ventilated socks, and choose white over dark, as fungus prefers the darker color.

Regularly disinfect your shoes with special prophylactic agents that prevent the growth of bacteria and fungus. Regular soap is usually not good enough for feet, so we recommend a special anti-fungus soap, which increases protection.

There’s no reason to ruin your summer with an infection! We can treat all of these infections in our office, so if you notice something that doesn’t look right, come to us and we’ll help you get rid of it.

NAME:

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

SPECIALTY: Board Certified Podiatrist

INSURANCE: We accept all major insurance plans & Medicaid

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

(718) 874-0224

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WHAT ARE THESE THINGS ON MY FEET? ALL ABOUT PLANTAR WARTS AND HOW TO GET RID OF THEM ■■■ Morgan Rice With the spring weather warming up, Marcie really wanted to get a pedicure. Her friend Sally invited her to go with her on a Saturday afternoon, but Marcie declined. She said she had other plans, but the truth was more embarrassing.

Marcie had something going on at the bottom of her left foot, and she wasn’t sure what it was. What she did know was that it wasn’t attractive, and she was embarrassed to expose the bottom of her foot to a nail technician. Little brown, crusty looking

“things” were growing there, and she was afraid to find out what they were.

Turns out Marcie didn’t need to be afraid. She had a common condition called “plantar warts.” Though they can be stubbornly resistant to treatment, there are some effective ways to get rid of them.

WHAT ARE PLANTAR WARTS? Like other types of warts, plantar warts are caused by a viral infection in the skin: the human papillomavirus (HPV), specifically, though it’s not the same strain that causes genital warts. www.4health.net

4HEALTH The good news is that these warts are not harmful. They can be slightly (but not highly) contagious, but they don’t cause other issues in the foot beyond their own unsightly presence and appearance. They can, however, cause some irritation or even pain, depending on where they’re located. Some people find that they can rub in just the wrong way when they’re walking or running, for example.

The biggest issue with these warts, however, is how embarrassing they can be, especially if you’re wanting to let your feet breathe a little bit during the spring and summer time.

WHAT CAUSES PLANTAR WARTS? Plantar warts are caused by a virus, which means that can be transmitted from person to person. Even if you are exposed, you won’t necessarily develop warts. Sometimes, the immune system can fight off the virus. Other times, however, particularly if you have a cut or scrape on your foot, they can find a way to survive and grow.

The Mayo Clinic notes that the HPV strains that cause plantar warts aren’t highly contagious, and aren’t “easily” transmitted from one person to another (though it’s best to be cautious when you have them not to expose others). You’re more likely to contract the virus when you’re in a warm, moist environment, like at a swimming pool or gym locker room.

HOW DO I GET RID OF THE WARTS? Once you develop plantar warts, it can be difficult to get rid of them, and they may recur. If it’s small and it’s not bothering you, you can just leave it alone and see if it will eventually go away. Otherwise, there are a number of treatments you can try: ■ Over-the-counter wart removal treatments: These are read-

ily available at your drug store, and they may help. Some studies have suggested they’re not as effective on warts on the feet.

■ Put duct tape on it: This home remedy may work for you.

Put a small strip over the wart and leave it on for six days (or reapply for a week). After that time, remove the tape, soak the wart in water, and gently debride it with a pumice stone or Emory board. Just be sure to be gentle so you don’t create an open wound that can get infected. Repeat the process until the wart is gone, which could take up to a couple months.

■ Ask your doctor: A doctor can freeze the wart with cryotherapy.

He applies liquid nitrogen to it, which causes it to blister over and fall off within a week or so. Repeat treatments may be required.

Laser treatments may also work.

There are some other home remedies out there you may want to try. Some people have had good luck with soaking the foot in an apple cider vinegar solution for 30 minutes a day, or applying vitamin E or tea tree oil and then an airtight bandage. Most would recommend persistence, as it can take time to see results.

HOW TO PREVENT PLANTAR WARTS To avoid getting plantar warts in the first place, don’t go barefoot in warm, moist areas like pool decks or in public locker rooms or showers. Avoid wearing other people’s shoes or socks, keep your feet clean, and tend to any nicks or scrapes right away. www.4health.net

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RETIRED TEACHER RECOVERS FROM VARICOSE VEINS

718-509-0906

BUSY LADY FINALLY SAYS GOODBYE TO YEARS OF PAIN

www.USAVeinClinics.com

When you’re a teacher, you’re on your feet a lot. Running around after kids all day definitely helps keep you active and in good shape. But for one teacher, years of dedicated work left her with something else that wasn’t so great—chronic pain in her legs.

Rachel toughed it out and kept going, but the pain continued to get worse. Soon, she found that not only was she dealing with pain on a regular basis, but embarrassment as well, as the veins in her legs bulged and became more visible and unattractive.

When she could no longer feel confident putting on a dress, she made an appointment with USA Vein Clinics, which specializes in treatment for varicose veins.

Here’s Rachel’s story of recovery, and why today, she feels better than she has in years.

WHAT ARE VARICOSE VEINS? Though varicose veins are a common problem, if left untreated, they can become serious. When they start out, they often go unnoticed, and the symptoms are mild if they appear at all. Eventually, however, they can start to cause mild to moderate pain and heaviness. Patients often describe their legs as feeling fatigued and sore at the end of the day.

“I did have throbbing, pain, and burning sensations,” Rachel says, “and I couldn’t walk or stand for any length of period.”

The problem is that the veins, which typically carry blood from the body’s tissues back to the heart, become weakened and damaged. The veins in the legs, in particular, are vulnerable to damage.

They have to work against gravity to send blood back to the heart, so they have small valves inside that act as doors to allow blood through, and to

keep it from pooling back down in the ankles and feet.

Because of a variety of factors, including genetics, smoking, weight gain, age, pregnancy, and standing for long periods of time, these valves can stop working correctly. When that happens, the veins become enlarged and gnarled looking, as the blood backs up and pools inside them. Over time, symptoms can become worse.

“You kind of get used to pain,” Rachel says, though she admits that she had trouble sleeping, too, because of the discomfort.

In some cases, varicose veins can lead to other complications, like blood clots, skin ulcers that take a long time to heal, and worsening pain. They can also signal the presence of other circulatory problems.

“I JUST DIDN’T HAVE TIME FOR MYSELF” Most people with varicose veins wait to get treatment. There are a number of reasons why.

Sometimes they are afraid the treatment will be painful, or believe that it won’t help much.

Sometimes, like in Rachel’s case, they just find it difficult to take time out for themselves.

“I just didn’t have time,” she says, “with working and children. I just didn’t have time for myself. I’d been living with them for so long I can’t tell you for how many years. I’m retired now, but I was a teacher, and I stood on my feet most of the day.”

Rachel finally made her appointment with USA Veins because she wanted to feel more confident. “I came to the clinic mostly because I was embarrassed by the way my legs looked.” After talking to the doctors, she decided to go through treatment, and she’s so glad she did.

“AFTER THE PROCEDURE, I FELT ONEHUNDRED PERCENT BETTER” Treatment for varicose veins depends on the individual case, but one of the most popular methods is “endovenous laser therapy (EVLT).”

This procedure has been used for over a decade, and involves inserting a hair-thin laser fiber into the diseased vein, and then applying laser energy to close it down. The body diverts the blood to other, healthier veins, and in time, the closed vein shrivels and disappears.

EVLT is performed in the USA Vein offices and usually takes no more than 15 minutes to complete.

Sometimes more than one procedure is needed to treat all affected veins. Patients can return to their normal activities immediately after the procedure is done.

“Now that I’ve had the procedure, I feel one-hundred percent better,” Rachel says. “I’m able to sleep without discomfort, and I don’t have any of the symptoms I had before. Also, my legs look much better. I’m not embarrassed by them.”

She adds that she was very pleased with the doctor at USA Vein Clinics. “He explained everything during the procedure and after. I think he’s wonderful. I really do.”

USA VEIN CLINICS OFFERS TREATMENT FOR VARICOSE VEINS USA Vein Clinics, a nationwide network of physicians, nurses and specialists, offers evaluation and individualized treatment for varicose veins.

They have offices all over the nation, including Florida, California, and Illinois, several in the New York area.

Call today at 718-509-0906 or go to www.

USAVeinClinics.com to schedule a consultation. www.4health.net

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TREATMENTS THAT MAY HELP SLOW THE PROGRESSION OF EMPHYSEMA LIFESTYLE CHANGES CAN HELP DELAY LUNG DAMAGE

■■■ Morgan Rice Emphysema is one of two conditions that together are called “chronic obstructive pulmonary disease (COPD).” Though many patients who have one also have the other, the Centers for Disease Control and Prevention (CDC) states that in 2014, nearly 7,500 people died from emphysema specifically.

The disease is incurable, but there are a number of treatments that can help ease symptoms and slow the progression of the disease, to help patients enjoy a greater quality of life.

WHAT IS EMPHYSEMA? Emphysema is a lung disease that gradually damages the tiny air sacs (called “alveoli”) in the lungs. These alveoli are balloon-like structures that exist in clusters along the branches of the bronchial passages. When you inhale, these little structures fill with oxygen, and then work to send it into the bloodstream through their flexible membranes. At the same time, they receive carbon dioxide from the blood and release it with your exhale.

Emphysema causes these alveoli to become inflamed, and over time, break down their walls, enlarge them, and weaken them to the point that they may eventually rupture. With fewer optimally functioning alveoli, the person has a harder time getting enough oxygen into the bloodstream, and also has more trouble exhaling carbon dioxide. Old air can

become trapped in the lungs, causing shortness of breath, light-headedness, and other symptoms.

WHAT CAUSES EMPHYSEMA? Smoking is believed to be the main cause of emphysema, but it can also be caused by exposure to toxins in the air, particularly when working around fumes in manufacturing industries. Long-term exposure to air pollution can sometimes cause the disease.

Some people are more at risk than others, including those who are older than 40 years, those who work around chemicals or dust, those who have a family history of the disease, and those who have suffered recurrent respiratory infections.

Symptoms of the disease include shortness of breath, wheezing, coughing, a feeling of tightness in the chest, and increased production of mucus. Patients may have difficulty doing activities they used to be able to do, such as climbing stairs or taking long walks.

Over time, emphysema can cause shortness of breath even while the person is resting.

WHAT ARE THE TREATMENTS FOR EMPHYSEMA? Medications are usually the first-line treatment for emphysema. These include bronchodilators that are inhaled to help relax the lungs and improve airflow, inhaled steroids that relieve shortness of breath over the shortterm, and antibiotics that help prevent and

fight any infections that may complicate the disease. Some medications also help to reduce mucus production, opening up the lungs.

Various types of therapy can help patients to better manage their symptoms. Nutrition therapy to help patients lose weight (if necessary) can help relieve the burden on the lungs, while some herbs and vitamins boost the immune system to improve resistance to infections. Pulmonary rehabilitation teaches patients breathing techniques that improve their ability to maintain some sort of exercise program.

Individuals can take other steps at home to help themselves as well. Joining a smoking cessation program is the most important, to avoid continual damage to the lungs and slow down the progression of the disease. Avoiding exposure to other pollutants in the air, protecting the lungs from cold air, preventing respiratory infections, and exercising regularly will all help improve quality of life and may extend survival rates.

Eventually, most people living with emphysema will need supplemental oxygen. It can provide relief during the late stages of the disease, and when patients are exercising.

Surgery is suggested only rarely, and in severe cases. Surgeons can remove some of the damaged lung tissue to help the remaining lung work more efficiently. A lung transplant is also an option for those patients who have severe cases of the disease that aren’t responding to other treatments. www.4health.net

WE ACCEPT ALL MAJOR INSURANCE PLANS

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

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

718-854-5100

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

718-975-3369

Medical Office is looking for a Certified Medical Assistant, full/time, 3 year experience.

Excellent phlebotomy, medical terminology, computer skills.

Bilingual – English, Russian.

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

(917) 750-2275

available for PT. Own Malpractice Ins. Call Dr. Joseph Juliano 973-752-9559

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

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

Telephone (917) 412-3797

Good reimbursement.

718-954-2202

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(347) 587-3777

Call 347-713-6871

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347-453-0523

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

Medical office seeks a Russian-Speaking Registered Nurse Practitioner.

Please submit your resume to medicaloffice41@gmail.com

Medical practice is looking for a Board-Certified Nurse Practitioner (f/t).

1 year experience.

Call 718-676-2565, ask Richard

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

For details call (646)251-6646.

Licensed Ultrasound Technologist (RDMS) is looking for part time or full time position. Resume available upon request.

Tel. 718-608-7402; Email at violasvu@gmail.com.

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Medical practice is looking for a Board-Certified Plastic Surgeon.

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MEDICAL OFFICE FOR RENT

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

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DENTISTRY - GENERAL

Vladimir LEMPERT, DMD

3037 Ave U Brooklyn, NY 11229

(888) 607-9725

DENTISTRY - PEDIATRIC

Marina KREPKH, DDS

7708 4th Ave Brooklyn, NY 11209

(888) 502-6245

INTERNAL MEDICINE

Victoria ALEKSANDROVICH, MD

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

(718) 207-7071

DERMATOLOGY

NEUROSURGERY

Narayan SANDARESAN, MD

5 E 84th St New York, NY 10028

(212) 876-7575

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

ONCOLOGY

Amit SCHWARTZ, MD

948 48th St, Fl 2 Brooklyn, NY 11219

(718) 283-7219 OBESITY MEDICINE

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

321 Edison St Staten Island, NY 10306

(718) 512-2160

158-06 Northern Blvd Flushing, NY 11358 www.brooklynroc.com

Prabhakara R. TUMPATI, MD

Tariq LAMKI, MD

5 E 84th St New York, NY 10028

(212) 876-7575

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

GASTROENTEROLOGY

2101 Ave X Brooklyn, NY 11235

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Yekaterina LEVIN, DDS

Anella BAYSHTOK, MD

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(888) 283-0399 OB/GYN - GENERAL

Paul GLIEDMAN, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160 OPTOMETRY

(844) 957-7463

Nataliya SAFONOVA, DDS

Lilia LEVITZ, MD

2211 Ocean Ave Brooklyn, NY 11229

1749 E 16th St Brooklyn, NY 11229

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

(718) 375-4747

321 Edison St Staten Island, NY 10306

Irina BERLIN, MD

NEUROLOGY

40 West Brighton Ave, Ste 104 Brooklyn, NY 11224

Hayama BRILL, MD

Arturo CAMACHO, MD PHD

5 E 84 St New York, NY 10028 th

(718) 627-8300

(212) 876-7575

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

305 W 28th St New York, NY 10001

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

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

Margarita BAUMAN, OD

1910 Ave U Brooklyn, NY 11229

(718) 759-6979

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

(844) 957-7463

Namik YUSUFOV, DDS, MDT 170 Morris Ave, Ste A Long Branch, NJ 07740

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

Alexander BRODSKY, MD

8622 Bay Pkwy, Ste 1 Brooklyn, NY 11214

Dmitriy GRINSHPUN, MD

Aleksandra ZLOTNIK, OD

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

1910 Ave U Brooklyn, NY 11229

(888) 747-8009

(718) 759-6979

(718) 333-2121

Erico CARDOSO, MD

5 E 84th St New York, NY 10028

(212) 876-7575

Sam WEISSMAN, MD

202 Foster Ave Brooklyn, NY 11230

(718) 854-5100

Sergey ZHIVOTENKO, MD

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

(718) 576-1212

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

Hanna JESIONOWSKA, MD

PAIN MANAGEMENT

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

(888) 455-6619

(844) 957-7463

Mila MOGILEVSKY, DO

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

(347) 252-6732

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4HEALTH PODIATRY

Yevgeniy SOROKIN, DO

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

(347) 252-6732

Leon STEPENSKY, DPM

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

(718) 874-0224

ALTERNATIVE MEDICINE - GENERAL

RADIOLOGY

Sinai DIAGNOSTICS

2560 Ocean Ave Brooklyn, NY 11229

(888) 496-2688

2071 Clove Rd Staten Island, NY 10304

(888) 496-2688 UROLOGY

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David SHUSTERMAN, MD

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

Sergey VOSKIN, MD

nd

(718) 360-9550 nyurology.com

VASCULAR SURGERY

Ada KULAGINA, LAC

8635 21st Ave Brooklyn, NY 11214

(888) 600-2262

2792 Ocean Ave, 2nd Fl, Brooklyn, NY 11229 2305 Hylan Blvd, Staten Island, NY 10306

(718) 676-2565

MEDICAL SUPPLY

NUTRITION AND DIETETICS

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 PSYCHOLOGY

Yuly CHALIK, MD

USA VEIN CLINICS

(347) 508-3991

2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

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

1153 First Ave New York, NY 10065

2444 86Th St, Ste A Brooklyn, NY 11214

Albert GROSS, CNS, NYS, CDN

1942 E 8 St Brooklyn, NY 11223 th

Globe SURGICAL SUPPLY 2029 Bath Ave Brooklyn, NY 11214

(888) 418-0442

(718) 376-8317 www.nylifex.com

MULTI SPECIALTY

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

Vladislav RUDNER, PT

(718) 490-2416 www.magichandspt.com

PLASTIC SURGERY

USA VASCULAR CENTERS

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

1901 82nd St Brooklyn, NY 11214

Chloe CARMICHAEL

230 Park Ave, Fl 10 New York, NY 10196

(212) 729-3922 PSYCHIATRY

Vitaly RAYKHMAN, MD

4159 Broadway Washington Heights, NY 10033

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

59-20 Myrtle Ave Queens, NY 11385

www.nyui.org

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

(347) 508-3991

30-33 Steinway St Astoria, NY 11103

2444 86th St, Ste A Brooklyn, NY 11214

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

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

(718) 393-5331

MEDICAL TRANSPORTATION

(877) 807-0989 AESTHETIC CENTERS

5221 Broadway New York, NY 10463 2965 Ocean Pkwy, 3rd fl, Brooklyn, NY 11235

Roman RAYHAM, MD,

156 Route 59, Ste B1, Suffern, NY 10901

BOARD CERTIFIED IN PLASTIC SURGERY

www.usaveinclinics.com

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

Interborough DEVELOPMENTAL & CONSULTATION CENTER

www.nyplasticsurgerycenter.com

(888) 987-5751

(877) 582-0400

RANNETA TRANSPORTATION

(718) 509-0906

1623 Kings Hwy, Fl 4 Brooklyn, NY 11229

Ridwan SHABSIGH, MD

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

(718) 283-7746

Michael PATIN, MD

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

(347) 848-0049

6417 Bay Pkwy Brooklyn, NY 11204

(718) 234-6767

102-51 Queens Blvd Forest Hills, NY 11375

(718) 896-2333

LSA RECOVERY

1300 Ave P Brooklyn, NY 11229

(888) 983-4055

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

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