4Health Magazine # 200 issue by MOO Publishing

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AM I TAKING TOO MUCH IBUPROFEN?

7 COMMON CAUSES OF FOOT FRACTURES

DOES MY CHILD HAVE ADHD, OR SLEEP APNEA?

CAN COSMETIC SURGERY FADE MY STRETCH MARKS?

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

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5 REASONS TO AVOID SMOKING MARIJUANA

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WEIGHT LOSS IMPROVES SLEEP AND MOOD

HOW MUCH DOES SUGAR REALLY AFFECT TEETH?

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(ISSN 1942-6801) is published monthly by MOO Publishing Corp.Copyright © 2007-2017 by MOO Publishing Corp. All rights reserved. Printed in Canada. All requests for permissions and reprints must be made in writing. Reproduction in whole or in part without written permission is prohibited. Printed in July 2017.

TERMS AND CONDITIONS OF USE

“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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When An Allergic Reaction Turns Deadly Be Aware of Potentially Serious Triggers

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Am I Taking Too Much Ibuprofen?

Studies Link High Doses to Heart Failure

14 Can Cosmetic Surgery Fade My Stretch Marks?

28 Does My Child Have ADHD, or Sleep Apnea? Lack of Sleep Can Cause ADHD-Like Symptoms

32 7 Common Causes of Foot Fractures

The Truth Revealed About Expensive Products and More

DO MY DENTURES NEED TO BE ADJUSTED? How to Tell When Itâ&#x20AC;&#x2122;s Time for Repair

EASE YOUR MIGRAINE PAIN WITHOUT MEDICATION SIDE EFFECTS Studies Show Acupuncture Helps Reduce Frequency of Headaches

DIABETES PATIENTS MISSING SIGHT-SAVING EYE EXAMS

PAIN, OR FIBROMYALGIA?

BACK PAIN? IT COULD BE A SPINAL FRACTURE

Options Include Laser Therapy and Tummy Tuck

5 MYTHS ABOUT SKIN CARE

Study Shows Concerning Results

How Can You Tell if You Suffer from This Syndrome?

Minimally Invasive Treatment Can Have You Feeling Normal Again

AN EASY WAY TO LOOK MORE TONED AND TIGHT THIS SUMMER! Get Bathing-Suit Ready with SkinTyte

HOW TO TREAT AND PREVENT SUMMERTIME FOOT INFECTIONS

SHOULD MENOPAUSAL WOMEN RECONSIDER HRT FOR BONE LOSS?

LEG PAIN COULD BE AN EARLY SIGN OF CARDIOVASCULAR DISEASE

WHAT DOES THE COLOR OF YOUR URINE SAY ABOUT YOU?

IS YOUR GYNECOLOGIC SURGEON EXPERIENCED ENOUGH?

Dr. Leon Stepensky on a New Treatment

New Studies Suggest Hormone Therapy May be Appropriate in Some Cases

Check with Your Doctor to Avoid Suffering a Heart Attack

When Changes Warrant a Trip to the Doctor

Study Shows Number of Surgeries Performed Affects Outcomes

How to Avoid Breaking Your Feet!

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WHEN AN ALLERGIC REACTION TURNS DEADLY BE AWARE OF POTENTIALLY SERIOUS TRIGGERS

■■■ By Gordon Barclay I was playing a friendly game of football with some buddies a few weeks back when a friend of mine suddenly stopped midfield and bent over his knees. We weren’t sure what was up at first, but as we gathered around him, we could hear that he was wheezing pretty badly. When he looked up at us, his face was swollen and his eyes red. He pointed to the bench and said two words: “My injector!” Turns out he was having a severe allergic reaction. We found out later that it was a combination of his regular spring allergies, the exercise, and the fact that he had taken an aspirin before the game that had all combined to create the perfect storm of a reaction in his body. Fortunately, once he used the injector, he was able to breathe more easily and the swelling went down. We called the game and I took him to the doctor. My friend ended up being just fine, but it got me thinking: What if he hadn’t had his injector with him? Thankfully, he did, but I know now that these types of allergic reactions can be deadly if you’re not prepared.

WHAT IS A DEADLY ALLERGIC REACTION? Though most of us experience only mild symptoms of allergies, like itchy eyes and snuffling, some people experience more severe symptoms in certain instances. A child that is allergic to peanuts, for example, who mistakenly ingests some of the allergen, may actually have trouble breathing. A severe, life-threatening allergic response is called “anaphylaxis.” The body sees the allergen as an invader and www.4health.net

4HEALTH mounts a serious immune response against it. Unfortunately, that causes dangerous symptoms that typically appear almost immediately after exposure to the allergen. Certain substances are known to cause anaphylaxis more than others in allergic people. Foods like shellfish and nuts, for example, can trigger life-threatening symptoms in those who are sensitive to them. Insect stings and bites are another common source of serious allergic reactions, as are some medications, like penicillin. Some people may experience a severe reaction in response to exercise, particularly if they took an aspirin prior to starting their workout. Pollens and grasses, which are also common allergens, are less likely to cause severe symptoms.

WHAT ARE THE SYMPTOMS OF ANAPHYLAXIS? The symptoms of an anaphylactic reaction come on quickly, usually within minutes of exposure to the substance. Symptoms are not always the same from person to person, but usually include at least one of the following: ■ ■ ■ ■ ■ ■ ■ ■ ■

Tightness in the throat Hives and itching Flushing Swelling of the lips, tongue, and roof of the mouth Chest tightness Difficulty breathing Dizziness Headaches Low blood pressure

The person may be exposed to the allergen by ingesting it, touching it, inhaling it, or being injected with it (in the case of some medications).

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Anaphylaxis is a life-threatening situation, and if not treated immediately, may result in more serious reactions such as an abnormal heart rhythm, heart attack, inability to breathe, shock, unconsciousness, and even death.

HOW IS ANAPHYLAXIS TREATED? Fast treatment is necessary, as anaphylaxis can turn deadly in as little as 15 minutes. Most people at risk for this sort of reaction will carry an epinephrine injector with them. This is an injection containing epinephrine or “adrenaline,” and it can be a lifesaver. It quickly constricts blood vessels, relaxes the lungs to improve breathing, and stimulates the heart to reduce swelling around the throat, mouth, and lips. Even if you go to the hospital, the staff there will most likely treat a case of anaphylaxis with epinephrine. Even after receiving an injection, people suffering from anaphylaxis should still go to the doctor afterward. Sometimes other symptoms can appear later on, so it’s important to be sure the allergen is fully neutralized. If you don’t have an auto-injector at the time of the attack, do your best to stay calm, and call for emergency help immediately.

HOW DO I PREVENT ANAPHYLAXIS? First, be sure you understand your triggers. See your allergy specialist for testing so you know what to avoid to reduce the risk of any allergic reactions. Let others know about your triggers, and carry your auto-injector with you at all times. Realize that once you’ve experienced an allergic reaction to something, your body may react more severely next time. Ask your doctor to create an allergy response plan for you and your family.

4HEALTH

LOUD NOISES COULD LEAD TO HEART PROBLEMS

■■■ Colleen M. Story We live in a world full of noise. Highway and air traffic have all increased over the last few decades. TVs and radios blare from the majority of public places. Construction equipment roars and beeps outside many of our workplace windows, say nothing of the constant noise of the subways and city streets. Unfortunately, unlike our eyes, our ears can’t be closed, so we’re often helpless victims when it comes to suffering modern-day racket. New research reveals, however, that it’s time to start protecting ourselves. Like other types of pollution, noise pollution can pose serious threats to our health—including increasing the risk of heart disease.

IT’S MORE THAN IRRITATING Noise pollution shows no signs of abating. In fact, it continues to grow in extent, frequency, and severity as a result of population growth, urbanization and technology developments.1 Right here in New York City, CBS News reports that 98 percent of the measurements taken in 60 spots

around the city were above 70 decibels, which can cause irreversible damage over time.2 It’s not that all this noise has hammered at our ears unnoticed. As far back as 1971, the World Health Organization (WHO) concluded that noise is a major threat to human well-being.3 So far, however, nothing much has been done about it, mainly because there have been few studies showing real human harm. That’s starting to change. Researchers at the University of British Columbia in Vancouver, Canada, recently examined data from over 6,000 participants of the National Health and Nutrition Examination Survey. They found that chronic exposure to workplace noise was strongly associated with heart disease, especially for young men who smoked. In fact, the risk was nearly threefold for angina pectoris and twofold for coronary heart disease and high blood pressure.4

noises can keep you from sleeping well, interrupt concentration, and jump-start your body’s stress reaction, elevating hormone levels. Loud noise is like a fearful stimulus—it triggers the body to react even before you may be consciously aware of what’s happening, and within seconds you’re ready to fight or flee. This wouldn’t be a problem if it was happening only now and then, but expose yourself to this sort of stimulus on a constant basis and you’re overwhelming your body with stress. Studies have found that even chronic low-level noise from local traffic raised the levels of stress hormones in children, as well as their blood pressure and heart rates.5 Imagine what’s happening if you are working eight or more hours a day in an environment where you are constantly exposed to the noise of loud machines, traffic, or technological devices?

WHAT YOU CAN DO HOW DOES IT HAPPEN? How can loud noises affect the heart? It all boils down to stress. Prolonged exposure to loud

First of all, get used to thinking about noise pollution. During a typical day, how often are you exposed to loud noises? During

your commute? After work? Get a pair of economical earplugs and carry them with you. They’re easy to insert, comfortable to wear, and significantly reduce the noise getting inside your head. If you need more protection than what the standard earplugs will allow, look for advanced and ultra-high blocking types, readily available online. Next, try to reduce your noise exposure in other ways. Turn the television down, listen to music at a moderate level, and try to give yourself at least 30 minutes a day of silence, or at least very low-level sound. Not only will your ears thank you, but so will the rest of your body and mind. REFERENCES Lisa Goines and Louis Hagler. Noise Pollution: A Modern Plague. Southern Medical Journal March 2007, Volume 100: pages 287-294. 2 Study: Manhattan Street Noise May Be Deafening. CBS News. October 27, 2010. http://newyork. cbslocal.com/2010/10/27/study-manhattan-streetnoise-may-be-deafening/. 3 Suter AH. Noise and its Effects. Administrative Conference of the United States, 1991. Available at: http://www.nonoise.org/library/suter/suter.htm . 4 Wen Qi Gan, M.D., M.P.H.; William W. O’Neill, M.D., Occupational and Environmental Medicine, Oct. 6, 2010. 5 Traffic Noise Increases Stress Hormones in Children. The Franklin Institute. Resources for Science Learning. http://www.fi.edu/learn/brain/stress. html#stressnoise. 1

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5 MYTHS ABOUT SKIN CARE THE TRUTH REVEALED ABOUT EXPENSIVE PRODUCTS AND MORE

■■■ Colleen M. Story In today’s beauty-obsessed culture, most of us know just as much about the supposed «flaws» on our skin as on the rest of our bodies. Good skin has become a sign of youth and vitality, which means a lot of us are trying to find the key to perfect skin—even if such a thing doesn’t exist. Unfortunately, what we think we know can do more harm than good. Below are nine myths about skin care, followed by true revelations that may surprise you. But don’t take our word for it—make an appointment with your dermatologist today for clearer, healthier skin tomorrow.

MYTH #1: ADULT ACNE IS RARE Actually, according to acne.org, adult acne affects 25 percent of all adult men and a whopping 50 percent of adult women at some point in their lives, and cases are increasing. One third of adults with facial acne also have acne elsewhere on their bodies. Treatment options vary, depending on your skin type and acne variation, but there are several very effective products. Talk to your dermatologist, and look up acneadulttreatment.org for a ranking of the top five acne treatments, according to in-depth analysis.

MYTH #2: THE MORE EXPENSIVE A SKIN CARE PRODUCT IS, THE BETTER IT WORKS This is a prevailing myth in our culture, which got its start when manufacturers

started using higher quality ingredients. They had to raise the price to pay for them, but when advertisers discovered the market for such quality products, price inflation soon followed. There is some truth to the fact that you “get what you pay for.” Quality skin care products typically have ingredients like peptides, natural extracts, CoQ10, and deep moisturizers that cost more to produce than the run-of-the-mill ingredients you’ll find in many department store products. But beware—certain brands use exotic ingredients like crushed pearls or caviar that have limited evidence as to their true effectiveness. Your best bet: read the ingredient list and go with quality care, but don’t sink your savings on remedies that may or may not give you results.

MYTH #3: HOW YOUR SKIN LOOKS DEPENDS ONLY ON WHAT PRODUCTS YOU USE The skin is an organ just like the heart and lungs, and therefore reacts just like the rest of the body to diet, exercise, and lifestyle. Foods rich in antioxidants protect skin from free radicals and environmental pollutants. Tuna, nuts, and flaxseed— all rich in omega-3 fatty acids—can help keep skin moisturized and supple. On the other hand, foods high in fat, sugar, and carbohydrates can actually encourage dry and aging skin. It’s true that you are what you eat!

MYTH #4: BEAUTIFUL SKIN IS EASY IF YOU CAN JUST FIND THE RIGHT PRODUCT Just like a toned, slim body takes a lot of time and effort, so does clear, vibrant skin. One product or one system won’t do it. Particularly if you’re fighting with acne, hyperpigmentation, or dryness, bringing your skin back to a state of smooth suppleness could take months. Check with your dermatologist, then be ready to make changes that may be more extensive than you expected. A healthy skin-care routine usually includes a healthy diet; daily activity; morning and night cleansing, toning, moisturizing, and treatment; daily sun protection; a thorough review of all products you’re using on your skin (like your makeup); and perhaps extra appointments with your dermatologist or esthetician. If beautiful skin is your goal, you can do it— just realize that it’s a gradual process and won’t occur overnight.

MYTH #5: IF ONLY YOUR SKIN LOOKED LIKE THAT OF THE CELEBRITIES, YOU WOULD FEEL BETTER ABOUT YOURSELF Many people hope to shore up a drooping self-esteem with beautiful skin, but just like plastic surgery can’t supply confidence, neither can the latest cosmetic miracle. Healthy skin—just like a healthy body—is a worthy goal, but most dermatologists will tell you that it won’t make you a new person overnight. www.4health.net

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DO MY DENTURES NEED TO BE ADJUSTED? HOW TO TELL WHEN IT’S TIME FOR REPAIR

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By Lynn Merrell

My grandfather has been really happy with his dentures. It took him awhile to adjust to them when he first got them, but since then he’s enjoyed how natural they look, and how they have allowed him to continue to enjoy eating like he always did without the pain and irritation his old teeth were giving him. Lately, though, he’s been suffering some discomfort. Chewing isn’t as easy as it used to be, and he says his dentures actually hurt sometimes. I wondered if maybe something had changed. Was it possible for dentures to stop fitting after awhile? I decided to dig into the topic and find out. I discovered that though dentures are made to last for up to 30 years or more, they can start to show signs of wear and tear along the way.

People with ill-fitting dentures will be tempted to stick with soft foods to avoid exacerbating the pain. Soft foods are fine for a day or two, but a consistent diet of them can cause digestive problems, and later on, nutrition deficits. Fortunately, there’s no reason to live with painful dentures. Most dentists recommend that people with dentures get them checked at least once a year. Because of normal wear and tear, they may need to be relined, or otherwise repaired so that they continue to work as they should.

up in white patches on the gums and tongue. ■ Your speech changes, or you find it difficult to say certain words. ■ Your dentures become discolored. If you experience any of the above symptoms, or if your dentures start feeling uncomfortable in any way, check with your dentist right away. It could be your dentures simply need to be relined, which is an easy and typically affordable in-office procedure that reshapes the underside of the denture to make it more comfortable against your gums.

SIGNS YOUR DENTURES NEED REPAIR How do you know if your dentures need repair? Rely on what you feel, first. Ill-fitting dentures are uncomfortable and painful. They may also cause the following symptoms:

HOW DENTURES MAY CHANGE OVER TIME

■ You develop painful mouth sores or sores

Making sure your dentures are comfortable is extremely important to your overall health. If the dentures become loose or misaligned, they can cause sores on the gums. The more uncomfortable the dentures are, the more difficult it will be to eat. That could lead to more serious problems like malnutrition.

■ You notice areas on the gums that feel

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■ You develop an oral infection that shows

on the gums. raw, are inflamed and swollen, or are bleeding. ■ You have difficulty chewing. ■ You experience jaw soreness. ■ Your dentures seem to apply uneven pressure on your gums.

PERSONAL CHANGES THAT MAY CHANGE THE FIT OF YOUR DENTURES In addition to regular wear and tear, other factors may also cause your dentures to become uncomfortable. With age, for example, your gums may naturally recede or shrink, which can affect the fit. A lack of teeth causes a gradual loss of bone in the jaw, which can also cause shrinkage underneath the gums that may require denture adjustment. These sorts of changes happen slowly over a number of years, so your best bet is to see your dentist regularly for a checkup to be sure your dentures are fitting properly.

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10 BEST AB EXERCISES SEVERAL OPTIONS TO STRENGTHEN YOUR TUMMY

AM I TAKING TOO MUCH IBUPROFEN? STUDIES LINK HIGH DOSES TO HEART FAILURE ■■■ By Gordon Barclay I have to admit I’ve taken my share of ibuprofen over the years. I’ve always tried to stop as soon as I could, though, and mostly I’ve succeeded. I take it for a few days, the pain goes away, and I don’t need it anymore. Lately, though, I’ve been a little concerned. I hurt my back recently and can’t seem to sleep unless I taken an ibuprofen before bed. It’s been going on for over a month now, an ibuprofen every night, and I started to wonder: am I taking too much? There’s no doubt that regular over-the-counter pain relievers like ibuprofen are generally safe. There have been some recent studies,

however, suggesting that when we take them too often, or if we take too many, we are increasing our risk of health problems.

WHAT IS IBUPROFEN? Ibuprofen belongs to a class of pain relievers known as “nonsteroidal anti-inflammatory drugs,” or NSAIDs. Other similar drugs include aspirin and naproxen. These drugs work by preventing an enzyme called “cyclooxygenase (COX)” from doing its job. This helps reduce inflammation and calm nerve stimulation so people experience less pain. NSAIDs are commonly used to treat headaches, muscle aches, backache, arthritis pain, toothaches, and body aches that come with the cold and flu.

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4HEALTH IBUPROFEN LINKED WITH INCREASED RISK OF HEART ATTACK Doctors and scientists have become a little more cautious about using too much ibuprofen recently because of studies showing it can cause health problems. In 2016, for example, a large study involving more than 7 million people showed that taking prescription-strength NSAIDs like ibuprofen could increase risk of heart failure. The risk was highest in those who took the drugs on a daily basis and in very high doses. Another recent study found similar results. Researchers studied 29,000 people who had suffered a heart attack over a 9-year period. About 3,400 had taken ibuprofen-type drugs 30 days before. The researchers determined that these drugs could increase risk of heart attack in certain cases. Back in 2005, the Food and Drug Administration (FDA) warned that taking NSAIDs like ibuprofen and naproxen increased risk of having a heart attack or stroke. They required manufacturers of these drugs to add this warning to their product labels 10 years later, in 2015. Though aspirin is also an NSAID, it doesn’t pose the same risk of heart attack or stroke. The problem seems to be with blood pressure. These drugs at high doses can elevate blood pressure and cause heart failure. Harvard Health advised people to be careful. Taking a pain reliever for a few days isn’t likely to cause any problems, but prolonged use — especially if you have other risks for heart disease — may increase your risk. They suggested taking only the lowest effective dose, limiting the time you take it, and never taking more than one type at a time.

TOO MUCH IBUPROFEN MAY CAUSE STOMACH BLEEDING The other main risk with these types of drugs is stomach bleeding. The enzyme they affect also protects the stomach lining from harsh

acids and digestive chemicals, so when these drugs disrupt the action of that enzyme, they leave the stomach more vulnerable to these acids. High doses or long-term use can increase risk of stomach problems. A 2005 study, for example, found that people who take high doses of ibuprofen on a regular basis are three times more likely to experience stomach bleeding than those who don’t take painkillers. The researchers were most concerned for people dealing with chronic pain, like arthritis, who often increase the dose for pain relief, without realizing the risks. If you’re experiencing nausea, vomiting, or severe stomach pain, you could be experiencing ibuprofen-related stomach bleeding. Check with your doctor.

BOTTOM LINE: JUST BE CAREFUL In most cases, occasional use of NSAIDs like ibuprofen is not going to hurt you. To help prevent serious complications like heart failure or stomach bleeding, always use the lowest dose for the shortest amount of time possible. Read the product label, and stick with the recommendations there. Also be careful that you’re not inadvertently taking it in two medications. Ibuprofen is sometimes included in cold, flu, and allergy medications, so double check to be sure of the total amount that you’re getting. If you have a chronic pain condition and you find yourself using these medications more than you’d like, ask your doctor about other painrelieving options. Acupuncture, meditation, biofeedback, massage, and other similar alternative care therapies can be very effective at relieving pain without creating additional complications.

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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 212–328-0135, or visit their website at www.nyneurosurgerypc.com.

Generations Neurosurgery, PC

(212) 328-0135 (844)-95-SPINE (77463) www.4health.net

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GENERATIONS

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Erico CARDOSO, MD

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BEETS GOOD FOR THE BRAIN Did you ignore that little slice of beet on your lunch plate today? You may want to think again! Beets are good for you—and new evidence shows that these red vegetables may actually help you fend off the dementia that often develops with age. Beets as brain food? Studies say it’s so!

■■■ Colleen M. Story HEALTH BENEFITS OF BEETS Beets have no trans fat and no saturated fat, plus they’re low in calories. They’re a great source of iron, calcium, and magnesium, as well as fiber, vitamins A and C, niacin, and biotin. They also have phytonutrients that provide antioxidant and anti-inflammatory benefits. Early studies have shown that beets have the potential to be great cancer-fighters and heart protectors. In 2002 researchers found that beet pigments may help detoxify cancercausing substances and purge them from the body.1 British scientists found that drinking beet juice lowered blood pressure to healthy levels within 24 hours—just as protective as prescription nitrate.2 A study in the International Journal of Cancer found that eating more beets and carrots appeared to reduce the risk of kidney cancer.3 A recent study, however, shows that beets— and beet juice, in particular—helps open up blood vessels, which may help reduce the risk of dementia.

BEETS AS BRAIN FOOD Beet roots contain a lot of nitrates, chemical compounds that can widen blood vessels, allowing more oxygen flow to the heart.

Researchers already knew that, but up until recently, they weren’t aware that beets could also increase blood flow to the brain as well as the heart. In this study, researchers observed 14 adults age 70 years and older for a four-day period.4 The participants committed to a specific diet that included a high-nitrite breakfast with 16 ounces of beet juice. MRI scans showed that after eating the high-nitrite diet, the participants had increased blood flow to the white matter of the frontal lobe—the area of the brain that is usually affected by dementia. Since beet juice isn’t the most savory of vegetable juices, Wake Forest University (who conducted the study) is working with a company to create a new beet juice beverage that tastes good. In the meantime, what can you do to take advantage of these findings?

HOW TO GET MORE BEETS Beets are available all year around, so they’re easy to find and incorporate into your diet. You can heat them up to have with dinner, or use them chilled as a lunch side dish or as an addition to salads. You can eat them raw, or boil, steam, roast, or saute them, or even use them in soups, like the popular vegetable soup called “borscht.” To make your own juice, choose beets that are colorful, firm, and free of any blemishes.

Fresh beets are best. You can peel and cut the beets into small squares, or half each one and place it inside your juicer, skin and all. Beets by themselves are very powerful, and can be overwhelming. Some people experience side effects like vomiting, diarrhea and weakness when drinking pure beet juice. Others experience a temporary paralysis of the vocal chords, a form of allergy. So start with small quantities, and mix the beets with other fruits and vegetables. For example, use only 1/2 a small beet or 1/4 of a large one, and mix with carrots, apples, and spices like ginger and parsnip. Finally, as with any fruit or vegetable juice, don’t overdo it. Beets have a powerful cleansing effect on the body, so large amounts of undiluted juice can transfer a lot of toxins into the liver, overwhelming it. If you have liver or kidney conditions, consume beet juice in small doses. Otherwise, mixing it with other vegetables and fruits will allow you to enjoy the health benefits without any of the potential side effects. REFERENCES Madeline Fisher. Beet pigments may help prevent cancer. University of Wisconsin-Madison News. December 10, 2002. http://www.news.wisc. edu/8108. 2 Beet juice lowers blood pressure. Cancer Health. http://www.cancerhealth.info/?p=23262. 3 Review of Int J Cancer. 2005;113(3):451-55. 4 News release, Wake Forest University.Presley, T. Nitric Oxide: Biology and Chemistry, November 2010. 1

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DIABETES PATIENTS MISSING SIGHT-SAVING EYE EXAMS STUDY SHOWS CONCERNING RESULTS

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By Colleen M. Story

If you have diabetes, you need to really watch out for your eyes. Diabetes increases risk of eye problems, including retinopathy, cataracts, and glaucoma. Early detection of these diseases can greatly improve outlook and help preserve your vision. That means regular check-ups with your eye doctor are critical for your long-term eye health. Unfortunately, many people with diabetes are skipping their regular eye appointments. That’s what researchers found in a recent study. If you’re one of these people, read on, as we want to encourage you to do everything you can to preserve your sight.

WHY DIABETES AND EYE DISEASES GO TOGETHER Diabetes is actually the leading cause of blindness in adults aged 20 to 74. It’s that serious. Excess sugar in the blood can affect all parts of the body, but especially the eyes. The good news is that according to the Centers for Disease Control and Prevention (CDC), about 90 percent of diabetes-related vision loss can be prevented. Gaining control of your blood sugar levels will help. If high blood sugar remains high, however, it can weaken and damage the blood vessels at the back of the eye. This creates a

condition known as “diabetic retinopathy,” which causes fluid leakage in the eye. Over time, the condition can lead to blurry vision. This isn’t the only eye problem that diabetes patients may face. The disease also increases the risk of cataracts. This is a condition in which a cloudy film forms over the lens of the eye, blurring vision. Cataracts can develop with age, anyway, but high blood sugar causes the lens to swell, affecting vision and damaging the lens over time. Those who have diabetes are also at a greater risk for glaucoma than those who don’t have diabetes. In fact, studies so far show that diabetes doubles the risk of glaucoma. This eye condition messes up the eye’s usual fluid drainage system. It creates a block, and fluid becomes trapped in the eye, resulting in a pressure buildup that may cause nerve damage. People with diabetic retinopathy are more at risk for glaucoma, as the condition can develop as a complication of diabetic retinopathy.

DIABETES PATIENTS SKIPPING SIGHTSAVING EXAMS Because diabetes can be so damaging to eyes, patients should see their eye doctors at least once a year. But according to a 2016 study, most diabetes patients do not have sight-saving annual exams. Researchers from the Wills Eye Hospital in Philadelphia reviewed medical data from about

2,000 patients aged 40 or older who had type 1 or type 2 diabetes. They followed the data for four years, and found the following: ■ Fifty-eight percent didn’t have regular

follow-up eye exams. ■ Smokers were 20 percent less likely to

have eye exams. ■ Those with a less severe form of diabetes

and no problems were least likely to follow recommendations for eye health. ■ Those with diabetic retinopathy were 30 percent more likely to have follow-up exams. The American Academy of Ophthalmology notes that eye exams are critical, as they can reveal hidden signs of disease before patients are aware of them. That allows for early treatment, which is always the best approach when trying to preserve vision. “People with diabetes need to know that they shouldn’t wait until they experience problems to get these exams,” said Rahul N. Khurana, M.D., clinical spokesperson for the AAO. “Getting your eyes checked by an ophthalmologist can reveal the signs of disease that patients aren’t aware of.” Even if you’re able to control your blood sugar levels most of the time, diabetes can still cause eye damage. Don’t ignore your annual eye doctor visits, for the good of your sight! www.4health.net

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PAIN, OR FIBROMYALGIA? HOW CAN YOU TELL IF YOU SUFFER FROM THIS SYNDROME?

■■■ Shay Morrigan You’ve been in pain for months now, but you can’t be sure what it is. When you checked with your doctor he couldn’t find anything physically wrong. Are you just getting older? Could it be arthritis? Maybe you’re not exercising enough? Or could it be that syndrome you’ve heard about that’s supposed to have something to do with pain—fibromyalgia?

WHAT IS FIBROMYALGIA? The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) describes fibromyalgia as a disorder that causes muscle pain and fatigue. The condition also seems to amplify painful sensations by affecting the way the brain processes pain signals. People suffer from tender points on the body, usually on the neck, shoulders, back, hips, arms, and legs, which hurt when pressure is put on them. They may also have trouble sleeping, feel stiff in the morning, and suffer from headaches, restless leg syndrome, tingling or numbness in the hands and feet, painful menstrual periods, and problems with thinking and memory (often called «fibro fog» or «cognitive fog»).

ACCOMPANYING CONDITIONS As if the muscle pain and fatigue wasn’t enough, people with fibromyalgia typically have coexisting chronic pain conditions like chronic fatigue syndrome, tension headaches, anxiety and depression, endometriosis, inflammatory bowel disease, interstitial cystitis, and temporomandibular joint dysfunction (TMJ). So far, however, researchers don’t know if all these conditions share a common cause.

WHAT CAUSES FIBROMYALGIA? At this point, scientists have only theories as to the cause of fibromyalgia. Some feel that the syndrome may have a genetic cause, while others feel it may be a side effect of repetitive injuries, stressful or traumatic events, or other illnesses. Most seem to agree that people with fibromyalgia have a lower threshold for pain because of

the brain’s increased sensitivity to pain signals.

WHO’S AT RISK? Women are much more likely to get fibromyalgia than men, a fact that may indicate female hormones could have something to do with the syndrome. A family history also increases risk— you’re more likely to suffer from the condition if your mother or sister has it. Finally, people with rheumatic diseases like rheumatoid arthritis and lupus are also more likely to experience fibromyalgia.

WHAT’S THE DIFFERENCE BETWEEN FIBROMYALGIA AND OTHER TYPES OF PAIN? The main difference between other types of pain and fibromyalgia is that fibromyalgia is chronic, or ongoing, and long lasting. Pain that goes away usually isn’t fibromyalgia. It can feel similar to arthritis, however, though it doesn’t damage joints like arthritis does. It usually is severe enough to interfere with daily activities, with pain and fatigue often making patients feel like spending a lot of time in bed. Fibromyalgia is also not just one pain, or one uncomfortable feeling. It’s a collection of symptoms that together describe the syndrome. Doctors usually diagnose fibromyalgia through a process of elimination. Are you experiencing widespread pain that’s lasted at least three months? Do you have at least 11 positive tender points? Is there anything else that could be causing the pain?

HOW TO FEEL BETTER Your doctor is best suited to help you with treatments. Several medications are available that can help reduce pain and improve sleep, including analgesics, antidepressants, and anti-seizure drugs. Since fibromyalgia includes a range of symptoms, other treatment methods include reducing stress, getting enough sleep, exercising regularly, and eating a healthy diet. Acupuncture, massage therapy, and yoga or tai chi may also help you to get back to your regular daily activities.

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PA I N M E D

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Compression Fracture Vertebral Disc Vertebra

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BACK PAIN? IT COULD BE A SPINAL FRACTURE MINIMALLY INVASIVE TREATMENT CAN HAVE YOU FEELING NORMAL AGAIN Dan was out working in the yard when a sharp pain seized his back. He grimaced and dropped his tools. Ouch! This was a bad one. Eventually, he was able to get back to the house, but the walking was difficult. He figured he would wait it out, but the next day it was still there. That’s when his wife insisted he go to the doctor. Dan was diagnosed with a spinal fracture — something that more than a million people suffer from every year. Though there are different types, all of them can cause sudden back pain that fails to go away. Fortunately, there is a minimally invasive treatment that can repair the fracture and ease the pain. USA Vascular Centers offers this treatment in the New York area, and urges anyone experiencing this type of pain to come in for an evaluation.

WHAT IS A SPINAL FRACTURE? Spinal fractures occur when the bones in the spine (vertebrae) weaken, break, and collapse. They may be caused by a trauma or injury, such as a fall, car accident, sports injury, or act of violence. Osteoporosis, cancer, or benign lesions can also cause the vertebrae to become weak and brittle, resulting in fractures. If you have only a mild fracture, you may experience only mild pain. A more severe one, like Dan’s, may force you to walk hunched over to avoid worsening the pain. Usually this means the vertebra has affected the spinal cord or nerves. Other symptoms of spinal fracture, besides pain and difficulty walking, may include numbness, tingling, weakness, or bowel/bladder dysfunction. You may be surprised to learn that spinal fractures are quite common — twice as common as hip fractures, and three times more common than breast cancer. www.4health.net

HOW DO I KNOW IF I HAVE A SPINAL FRACTURE? The only way to find out for sure is to see your spinal doctor. A complete physical examination, along with x-rays and imaging technology, can help determine why you’re experiencing pain.

DO I REALLY NEED TREATMENT? Treatment is important to long-term mobility and comfort. If you leave the fracture without addressing it, it may heal in the “broken” or “caved in” position, which could cause you to walk with a permanent hunched-forward posture. Untreated fractures can also affect the overall alignment of the spine, which can lead to additional complications down the road, like joint pain, reduced mobility, loss of balance, and a greater difficulty performing daily activities. Untreated spinal fractures also tend to increase the risk that more of your vertebrae will weaken and break.

TREATMENT FOR SPINAL FRACTURE If you and your doctor determine that you have a spinal fracture, you may be scheduled for kyphoplasty surgery. This is a minimally invasive procedure that is designed to stop the pain, stabilize the bone, and restore your normal height and mobility. Also called “balloon vertebroplasty,” the procedure actually involves an orthopedic balloon that helps gently elevate the fractured vertebra. This helps to restore it to its original position, and helps you regain the height you lost when the vertebra collapsed. The incision required is usually only about one-third inch, after which the surgeon typically inserts two balloons into the affected area and gently inflates them to return the bone to its correct place. Once everything looks good, the balloons are removed, and the

resulting cavity is filled with thick bone cement to stabilize the fracture. It’s like having a cast in your spine that helps keeps everything in place.

WHAT WILL BE MY EXPECTED RECOVERY? Patients usually experience pain relief within the first week after the procedure, and can return to their regular activities within a few days. Studies have shown that this type of kyphoplasty is more effective than non-surgical care for this sort of fracture, and usually results in faster improvement in pain, mobility, posture, height, and quality of life.

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

718–504–5984 www.USAVascularCenters.com

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CAN COSMETIC SURGERY FADE MY STRETCH MARKS? OPTIONS INCLUDE LASER THERAPY AND TUMMY TUCK ■■■ By Morgan Rice A friend of mine just had twins, and though she’s thrilled with her two new baby girls, she’s not so thrilled about the stretch marks that her pregnancy left behind. She’s tried creams and massage and essential oils, but nothing has helped. Meanwhile, she’s been working out and getting her body back in shape, and she’d love to wear her bikini again to the beach, but

she’s embarrassed. She asked me: “Morgan, is there anything that would really help fade these ugly marks?” I decided to do some research to find out.

WHAT ARE STRETCH MARKS? Stretch marks are lines that develop on the skin during pregnancy in response to the stretching required to accommodate the growing fetus (or in my friend’s case, fetuses!).

When the skin stretches too quickly, small tissues and fibers in the skin may actually tear. When they heal themselves, the new skin is lighter and thicker, similar to how your skin heals when you suffer from a cut or scrape. Stretch marks are often long and narrow, and are a lighter color than the rest of the skin around them. They may form on the belly, but also the thighs, hips, and even the lower back. They are extremely common, affecting over 70 www.4health.net

percent of pregnant women, and can also be caused by weight gain or puberty.

HOW CAN I GET RID OF STRETCH MARKS? Usually, stretch marks fade with time, becoming less noticeable within a year of giving birth, and then fading even more after that. There is no evidence that creams or oils prevent these marks, but they can help reduce skin dryness and prevent itching. Cosmetic therapy options, though, can significantly diminish the appearance of stretch marks. Microdermabrasion, for example, removes the skin’s top layers, helping to smooth out the stretch marks to make them less noticeable. Chemical peels work in a similar way, burning the top layer of skin away and allowing new skin cells to replace them. Both of these procedures are non-surgical and can be performed in a dermatologist’s office. They will not result in the disappearance of the stretch marks, but they will help fade their appearance.

LASER THERAPY MAY BE BEST Currently, the best option appears to be laser therapy. The American Society for Dermatologic Surgery (ASDS) recommends laser therapy as one of the proven ways to help fade stretch marks. The surgeon uses a laser that emits strong bursts of light toward the skin. He will set the wavelength, frequency, and duration of the pulse depending on your particular stretch marks. Different lasers can target different colors of stretch marks (from darker to lighter). So even if you have very dark marks, laser treatment may still help to fade them. The light goes deep into the layers of the skin, breaking up the scar tissue and stimulating the body’s own healing processes. Then, over time, new collagen and elastin form where the stretch mark was, making the skin appear smoother and improving the color so it looks more like the skin around it. Most patients heal within a few days, and are pleased with the results. Additional treatments may be required for optimal results.

TUMMY TUCK TOTALLY REMOVES STRETCH MARKS The only other option for treating stretch marks is to actually remove them during a tummy tuck operation. If you have excess fat around the belly and the stretch marks are in that area, a cosmetic surgeon can remove them completely in a tummy tuck, while tight-

ening abdominal muscles at the same time. Unfortunately, this procedure works only for those marks on the abdominal area. There is no comparable removal surgery for marks on the thighs, back, or other areas. A tummy tuck operation is more complicated than the other options listed here, though, and will require a longer recovery. It may also leave behind scars of its own, so it’s important to ask your doctor about all the details so you know what to expect. Candi-

dates for a tummy tuck procedure include those who are in good health and have a significant amount of skin on the stomach. It’s also best for women who don’t plan to have more children. After filling my friend in on her options, she decided to start with microdermabrasion and go from there. If you do decide to consider laser therapy or a tummy tuck, be sure to find a highly experienced cosmetic surgeon for the best results.

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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 August. 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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DOES MY CHILD HAVE ADHD, OR SLEEP APNEA? LACK OF SLEEP CAN CAUSE ADHD-LIKE SYMPTOMS ■■■ By Lynn Merrell You’ve likely heard of sleep apnea. It’s that sleep disorder that causes people to wake up many times during the night. They often snore, too. Those who have been diagnosed with the disorder frequently use a CPAP machine (continuous positive airway pressure) to help them breathe better and thus sleep more soundly through the night. What you may not have heard is that even children can be affected by sleep apnea. If you’ve noticed that your child has gained weight, is snoring loudly at night, or is breathing through his mouth a lot, these may be symptoms of pediatric sleep apnea. Unfortunately, the condition can be just as dangerous in children as it is in adults, so if you suspect your child may have it, check with your pediatrician immediately.

WHAT IS SLEEP APNEA? Obstructive sleep apnea (OSA) is a condition that causes your child to stop breathing periodically during sleep. It’s usually caused by an obstruction in the airway, which blocks airflow. The lack of oxygen wakes the child up so that he can breathe again. In just one night, the child may wake up many times and then go back to sleep. He may not even realize it’s happening, however, as usually the brain wakes him up just enough to open the airway and then he will fall back to sleep. Unfortunately, these interruptions result in a very restless sleep that doesn’t meet your child’s needs. You can imagine what it’s like by pretending you have a phone calls waking you up throughout the night. You’d likely wake up groggy and grouchy. Your child likely feels the same way after a night spent battling sleep apnea. www.4health.net

4HEALTH WHAT CAUSES SLEEP APNEA IN CHILDREN? The most common cause of sleep apnea in children is enlarged tonsils and adenoids. These can swell up and block the airway during sleep. They don’t cause problems during the day because the child is upright and the muscles in the head and neck keep the airway open. At night, though, when the child is sleeping, the tissues and muscles in the neck and throat relax, allowing the tonsils and adenoids to get in the way. Childhood obesity can also cause OSA in children, as it does in adults. The more fatty tissues there are in the throat, the more likely those tissues are to obstruct the airway during sleep.

WHAT ARE THE SYMPTOMS OF CHILDHOOD OSA? How can you tell if your child is affected by OSA? Watch for the following symptoms: ■ ■ ■ ■ ■ ■

Snoring Mouth breathing Daytime sleepiness Breathing stops and starts during sleep Gasps or snorts when awakened to breathe Heavy sweating during sleep

Children who suffer from sleep apnea may also exhibit behavioral problems during the day, such as irritability and grouchiness, and be more likely to have trouble in school. A shortened attention span and difficulty concentrating may result, as well as daytime sleepiness and bedwetting.

THE DANGERS OF CHILDHOOD OSA Parents need to pay attention to their children’s sleep habits because sleep apnea can cause other issues. In addition to behavioral problems, it can also cause symptoms similar to attention deficit hyperactivity disorder (ADHD), and may lead to an incorrect diagnosis of ADHD if you’re not careful. In fact, an estimated 25 percent of kids with ADHD may actually have OSA instead. Researchers reported in 2013 that sleep apnea was associated with increased rates of ADHD-like behavioral problems in children, as well as adaptive and learning problems. More specifically, the odds of having behavioral problems were four to six times higher in children with sleep apnea. Children with sleep apnea are also more at risk for high blood pressure and other cardiovascular problems as they age.

HOW IS PEDIATRIC SLEEP APNEA TREATED? Your doctor will likely recommend your child stay overnight at a sleep facility so he can monitor her sleep and determine if she may have OSA. If so, and your child has enlarged tonsils and adenoids, the most common treatment is to have surgery to remove these tissues. For those children who have OSA because of obesity, weight-management programs can help, and CPAP therapy may be recommended. In some cases, respiratory issues like allergies and asthma cause sleep apnea, and medications to help treat these will improve sleep quality. OSA can affect children as young as two years old, so don’t hesitate to check with your doctor. Treatment is most always successful, and a good night’s sleep could go a long way toward helping you and your child enjoy a happier life. www.4health.net

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Podiatry | 4HEALTH35

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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7 COMMON CAUSES OF FOOT FRACTURES HOW TO AVOID BREAKING YOUR FEET!

■■■ By Gordon Barclay A broken foot. It doesn’t sound like a fun experience, but according to the American Academy of Orthopaedic Surgeons (AAOS), it’s actually quite common. There are 26 bones in the foot that can be fractured (or broken). That’s one-quarter of the bones in the human body! Sometimes you just get into a bad situation and you can’t help it, but no one wants to suffer a broken bone in the foot. To help you avoid it, we put together the five most common causes of foot fractures below.

1. FALLS If you trip and fall, you can break the bones in your feet or in your ankles. This is especially true if you jump off of a ledge or surface several feet above the ground and land on your feet. Not a good idea! Whenever you’re moving around, think about your feet and be sure that you take care with your steps.

2. ATHLETIC INJURIES High-impact activities put a lot of stress on the feet, and can result in breaks if you land on your foot incorrectly, or if you’re involved in rough sports like football, soccer, and rugby. Injuries are even more likely if you’re out of shape, or if you suddenly increase your intensity or frequency of an athletic activity. The AAOS states that the most common cause of stress fractures in the feet is “sudden increase in physical activity.” It can happen simply because

you exercise more days of the week, or suddenly start running longer distances. Changing the surface you work out on, too, such as going from a grass court to a hard court, can cause a fracture if you’re not careful. Always progress slowly and carefully, and make sure your muscles are strong enough to support your joints and bones.

3. IMPROPER SHOES Shoes that don’t provide enough cushioning for your feet, don’t fit right, or are too old and stiff can gradually wear down the muscles and tendons in your feet, increasing your risk of a fracture down the road. High heels are also horrible for your feet, and long-term wear can lead to stress fractures of the metatarsal bones. Try using walking shoes for your commute and wear your heels for only short periods of time.

4. OSTEOPOROSIS As we age, bones become less efficient at repairing and regenerating themselves. Decreasing bone density causes bones to become thin and fragile, which can increase your risk that you’ll suffer from a broken bone, especially if you fall or trip. Check with your doctor, especially after the age of 50, to be sure your bones are healthy.

5. CHANGE IN WALKING PATTERN If you suffer an injury that causes you to change how you walk, you could put undue strain on a part of your foot that could increase risk of

fracture. If you have a bunion, for example, and it hurts when you walk, you may start walking differently to ease that pain, but that can cause other problems in your feet. Always check with your podiatrist about any painful issues to avoid difficult complications like foot fractures.

6. IMPACT Many people have stories of breaking their foot or a toe when they dropped something heavy on it. This is a common cause of fractures, but it’s easily avoided. Never carry something that is too heavy for you, and always use tools like carts and wagons when you can.

7. OVERUSE Stress fractures are common in those who exercise “through pain.” If your feet start hurting while you’re running or performing other exercises, check with your podiatrist. Continuing to apply heavy forces to your feet when your tendons or muscles are already strained can result in a fracture.

SYMPTOMS OF A FOOT FRACTURE How can you tell if you’ve broken a bone in your foot? Common symptoms include pain and throbbing, swelling on the foot, tenderness at the site of the fracture, bruising, difficulty walking, problems getting your shoes on, and deformity or an “odd looking” part of the foot. If the swelling lasts for more than a few days, or the pain interferes with walking, check with your podiatrist right away. www.4health.net

4HEALTH

SHOULD MENOPAUSAL WOMEN RECONSIDER HRT FOR BONE LOSS? NEW STUDIES SUGGEST HORMONE THERAPY MAY BE APPROPRIATE IN SOME CASES

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By Colleen M. Story

The International Osteoporosis Foundation states that worldwide, osteoporosis causes 8.9 million fractures every year. That works out to one fracture every three seconds. In the year 2000 alone, there were about 1.6 million fractures of the hip, 1.7 million of the forearm, and 1.4 million of the spine. Bone loss is a natural side effect of aging. Unfortunately, it doesn’t take much to significantly increase risk of a fracture. A loss of just 10 percent of bone mass can create a 2.5 times greater risk of hip fracture, and doubles the risk of spine fractures. Though both women and men are at risk for osteoporosis, postmenopausal women have a higher prevalence of the disease and a greater risk of fractures than older men. A recent study shows that hormone therapy may improve bone health, reducing risk of fracture in postmenopausal women. But there are some risks with hormone therapy. How do you know if the benefits will outweigh the risks in your case?

WHAT IS OSTEOPOROSIS? Osteoporosis is a disease that causes bone loss. The body either cannot produce as much bone material as it should, or it loses too much to be able to keep up with repairs, or both. As the bones become thin, weak, and brittle, the risk of fracture increases. A simple fall, or even a bump into a wall or other surface can be all that’s needed to break a bone. Osteoporosis most commonly affects the hip, wrist, or spine. People usually can’t tell that they have it, because it doesn’t typically cause symptoms. Instead, the bones simply become weaker over time without any outward signs. Usually the first alert a person receives is when the bone breaks. As the disease progresses, though, symptoms may show up. These may include back pain, stooped posture, and loss of height.

WHAT CAUSES OSTEOPOROSIS? The older you get, the higher your risk of osteoporosis. In addition, if you have a family history of the disease, or if you’re white or of Asian www.4health.net

descent, your risk is higher than it is for those without these genetic risk factors. Finally, if you have a small body frame, you have less bone to lose, which scientists believe puts you at a higher risk for bone loss as you get older. Research has also shown that hormone levels may affect bone health. We know that when women go through menopause, their estrogen levels drop, which increases risk of bone loss, too. Men, as well, lose testosterone as they age, which is believed to contribute to bone loss risk. This hormonal connection has intrigued scientists, as they try to discover a way to prevent or cure the disease.

SHOULD WOMEN RECONSIDER HRT FOR BONE HEALTH? A study came out a few years ago connecting postmenopausal hormone replacement therapy (HRT) with an increased risk of heart disease and breast cancer. Called the “Women’s Health Initiative” study, the results scared many women and their doctors off using hormonal therapy to help reduce symptoms of menopause and slow bone loss. Indeed, prior to this study, HRT was seen as protective for women’s health. Studies showed that it helped reduce risk of colon cancer and hip fractures by over 30 percent. But then when the Women’s Health Initiative study came out, many women stopped taking hormones. Now, however, scientists are revisiting hormone therapy. We know that in women, estrogen helps protect bone, and regardless of other risks, HRT replaces estrogen lost during menopause, helping to reduce risk of fractures. In a recent 2016 study, scientists conducted bone scans in women who took HRT and those who didn’t. They found that hormone therapy improved bone mass and structure. Bone continued to show positive effects even two years after women stopped treatment with HRT. Researchers suggested that postmenopausal women should think twice about HRT when it comes to bone health. Other studies have come to a similar conclusion — that the risk is not as clear-cut as we believed, and that women shouldn’t deprive themselves of the benefits of HRT if it’s not necessary. An update on the women’s health initiative in 2013 echoed that sentiment. Lead investigator Dr. JoAnn Manson told NPR: “It was never the intention to deny hormone therapy to women in early menopause.”

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LEG PAIN

COULD BE AN EARLY SIGN OF CARDIOVASCULAR DISEASE CHECK WITH YOUR DOCTOR TO AVOID SUFFERING A HEART ATTACK ■■■ By Morgan Rice When you climb a set of stairs, do you feel a soreness or tiredness in your calves and hips? Do you often experience leg cramps? Do you have high blood pressure, high blood cholesterol, or diabetes? If you answered “yes” to any of these questions, you could be at risk for peripheral artery disease (PAD), a condition in which the arteries in the legs and arms become narrowed and stiff because of a plaque buildup. It’s not as serious as cardiovascular disease — where the arteries around the heart become narrowed and stiff — but it can be a sign of other cardiovascular problems to come. Early treatment of PAD can help protect your heart and your health as a whole. Find out when you should check with your doctor about this condition.

WHAT IS PAD? PAD is just like coronary artery disease, except it affects the “peripheral” arteries in the arms and legs rather than those around the heart or near the brain. The arteries become narrow and stiff, which affects blood flow. That’s why your legs may feel tired or cramp up during exercise, because the arteries aren’t allowing enough blood through to the muscles. PAD is a common condition and is estimated to affect about 8 to 12 million Americans, and about one out of every 20 Americans over the age of 50. Your risk goes up as you age, and is also higher in those who:

■ Have high cholesterol or high blood

pressure ■ Are overweight or obese ■ Are over the age of 50 ■ Have a family history of heart disease or PAD PAD usually doesn’t cause any symptoms at first, but over time can create the cramping we’ve been talking about, as well as pain and achiness while walking. Some people think this is just a common symptom of “getting older,” but often it’s a circulation issue instead. Without treatment, PAD can cause blood clots in the legs, erectile dysfunction, open sores on the skin that don’t heal, and infections. It can also increase your risk for heart attack and stroke.

HOW PAD IS LINKED WITH CARDIOVASCULAR DISEASE If you have arteries in the legs that are narrowed and stiff, it’s a sign that other arteries in your body may soon follow suit. If an artery near your heart or brain becomes similarly affected, you could suffer from a heart attack or stroke. A blood clot in the legs can also break off and make its way to the heart and lungs, which can cause a life-threatening situation. Both PAD and cardiovascular disease are diseases of the blood vessels in the body. They are closely related, which is why it’s so important to diagnose PAD early so you can take control of it before it affects your other more critical arteries.

PAD IS EASILY DIAGNOSED ■ Smoke ■ Have diabetes www.4health.net

The good news is that you can easily find out if you have PAD. Your doctor simply

evaluates your medical history, and uses a non-invasive test called an “ankle-brachial index” test that compares the blood pressure readings in your ankles with the blood pressure in your arms. If the two results are quite different from one another, it’s likely that you have PAD. Because PAD is related to cardiovascular disease, the goal in treatment is to protect you from a heart attack and stroke, while preventing symptoms of PAD as well. Some medications can help, along with regular exercise and a healthy diet. If you have an artery that is completely blocked and causing you pain, your doctor may recommend opening it with a stent or other similar procedure. The important thing is to make changes in your life earlier rather than later, so that your PAD doesn’t progress to more serious problems.

718–393–5331 www.USAVascularCenters.com

4HEALTH

WHAT DOES THE COLOR OF YOUR URINE SAY ABOUT YOU? WHEN CHANGES WARRANT A TRIP TO THE DOCTOR

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By Tom Anderson

Most of the time I like to leave what’s in the bathroom as quickly as I can. But then a friend started talking to me about color — of his urine. I turned up my nose. He wouldn’t be quiet about it, though, and after a few minutes I realized he was making some sense. The guy is a health nut, and he was telling me that by watching the color of his urine, he could tell how hydrated he was. I know that it’s important to stay well hydrated, so I have to admit that the next time nature called I had to check it out. Things looked dark yellow to me, which apparently meant I wasn’t drinking enough water. Hmm. Interesting. I got curious. What else can you learn from your urine color?

WHAT CAUSES THE COLOR IN URINE? A pigment called “urochrome” is the main reason why urine appears basically yellow most of the time. This is a yellow pigment that is a byproduct of liver metabolism. How much urochrome we have determines how light or dark yellow the urine is. Urine is the body’s way of flushing out all the waste after having processed our food, drink, and medications. The stomach, intestines, liver, and kidneys work to extract all the good stuff out, like the vitamins and minerals, and then put all the bad stuff, like toxins, waste products, salts, chemicals, and other things into the urine to flush out of the body. What the body is getting rid of can tell us quite a bit about our health overall.

DIFFERENT COLORS CAN SIGNAL DIFFERENT THINGS The color of your urine can give you clues about what’s going on inside you. Here are some examples of colors you may see and what can cause them: ■ Yellow: Most urine lands somewhere on

the yellow spectrum, but it can vary from light to dark depending on how hydrated you are. As you drink more water, you dilute the chemicals in the urine, including the urochrome, and lighten the color. Staying hydrated is good for your health, so a light yellow is what you should shoot for. ■ Cloudy: Cloudy white or yellow urine is most often the sign of an infection, like a urinary tract infection or yeast infection. The body uses white blood cells to fight off the bacterial invaders, which can cause that cloudy appearance. It can also be a sign of kidney disease, too much protein in the urine, or even dehydration. In men, cloudy urine may show up after intercourse because some semen gets into the urine. If it lasts for more than a few days, go see your doctor. ■ Brown: Dark muddy urine is often caused by senna, which is used in laxative drugs. It may also be caused by antipsychotic, epilepsy, or some antibiotics drugs. Check with your doctor on whether your medications may be to blame. In rare cases, liver problems can cause brown urine. ■ Red: Sometimes if you eat red fruits or vegetables like beetroot or blackberries

they may change your urine color for a short time to a more reddish shade. Blood in the urine is the most common cause of this color, but it’s not always serious. High-energy sports like running and boxing can irritate the bladder and result in short-term red urine. If it doesn’t go away within a day or so, though, it’s important to check with your doctor, as red urine can be a sign of kidney stones, other kidney problems, urinary track issues, or in rare cases, bladder cancer. ■ Blue: It may sound strange that urine could be blue, but sometimes food dyes in sweets, if you eat a lot of them, can cause this color. Some medications can do that too, but usually this will pass within a day or so. ■ Green: If you see green urine, check with your doctor. Some types of bacteria produce by-products that can cause green urine, which may mean that you have an infection. Some drugs can cause the urine to appear greenish, including those for Parkinson’s disease and some antidepressants, but it’s best to be safe and check. ■ Orange: If your urine is more orange than yellow, it could be because you’re taking medications like antibiotics, laxatives, or chemotherapy drugs. It could also be because you recently ate a lot of carrots or other orange vegetables. Usually this isn’t a concern and will clear up within a couple days. If not, it could be a sign of jaundice, so you should see your doctor. www.4health.net

4HEALTH

IS YOUR GYNECOLOGIC SURGEON EXPERIENCED ENOUGH? STUDY SHOWS NUMBER OF SURGERIES PERFORMED AFFECTS OUTCOMES ■■■ By Lynn Merrell Before you hire a contractor to build your house, you usually check around. You call a number of different places, speak to the staff, find out their prices, and above all, check on their experience. How many houses have they built? Were customers happy with the outcomes? If you take short cuts in your research process, you usually pay for it somewhere down the road in repairs you have to make, or struggles you have with a contractor who does a sub-par job. We’ve all heard the horror stories from friends who’ve suffered with one difficulty or the other, and most of us are cautious before we sign on the bottom line. Unfortunately, we may not be quite as careful when it comes to evaluating our gynecological doctor or surgeon. If you have been scheduled for gynecologic surgery, such as a hysterectomy, uterine fibroid surgery, or endometriosis treatment, take the time to check on your surgeon’s experience. According to a recent study, it really makes a difference in your outcome.

WHAT IS GYNECOLOGIC SURGERY? Gynecologic surgery is any type of surgical procedure on the female reproductive system. It’s usually performed by a gynecologist, so the same doctor that you see for your yearly appointments or when you’re pregnant may be the same one who would perform your surgery. Women may be recommended for gynecologic center for conditions related to cancer, infertility, and incontinence. Many of the procedures completed today are minimally invasive, and involve a hysteroscope, which is www.4health.net

a thin tube that the surgeon inserts through the vagina into the uterus where it transmits images, and/or a laparoscope, which is also a fiber-optic tube with a tiny camera on the end. These tools may be used to diagnose a problem, or to treat heavy bleeding, perform a myomectomy (treatment for fibroids), or to treat infertility. Some hospitals now have access to robotic surgery as well, which is usually used to perform hysterectomies. The surgeon is still in charge — he or she just uses a robotic arm to help enhance visibility and precision in the surgery. It may also be recommended for tubal ligations.

QUESTIONS TO ASK YOUR GYNECOLOGIC SURGEON This study shows that experience counts when it comes to gynecologic surgery. Other studies have found similar results in other areas. A 2009 study, for instance, found that the risk of serious complications from gastric bypass surgery fell by 10 percent for every additional 10 cases per year that the surgeon performed. How can you tell if your doctor is the best one to be performing the surgery? Ask some questions, including the following: ■ Is the surgery really necessary? Surgery

STUDY FINDS EXPERIENCE COUNTS Researchers reviewed 14 studies involving nearly 750,0900 patients. They were looking at gynecologic surgeries and their outcomes — how well the women did after the surgeries. They compared these outcomes to how experienced the surgeons were, particularly to how many of the procedures they had performed. Surgeons were labeled as being either low-volume surgeons (LVS), performing the procedure once a month or less, or highvolume surgeons (HVS), performing the procedure more than once a month. The types of surgeries performed included hysterectomy, myomectomy, procedures for endometriosis and ovarian cancer, midurethral sling placement (to treat incontinence), and pelvic reconstruction. Results showed that across the board, in all the surgeries, HVSs had better outcomes than LVSs, with lower rates of complications, lower rates of repeat operations, and lower mortality rates.

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should always be a last resort. Make sure to ask about any potential alternatives, and compare those with surgery. What is your experience? Ask how many of these surgeries your doctor has performed in the past year. Narrow it down. How many did he perform last month? When did you start performing this surgery? How long has she been doing it? What was your success, failure, and complication rate? What is the hospital’s (or medical center’s) infection rate?

Then listen closely to the answers. If your surgeon paints “too” rosy a picture, be cautious. If he or she seems uncomfortable answering your questions, that’s another red flag. Check the doctor’s credentials online, and ask around. Putting in a little time to do your research could mean the difference between sailing through your surgery and struggling with complications afterwards. Ask questions before you sign on the bottom line.

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