4Health Magazine # 201 issue

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ASK A DOCTOR | FIND A DOCTOR

ARE YOU ADDICTED TO NASAL SPRAYS?

YO-YO DIETING

MAY INCREASE RISK OF HEART ATTACK

ARE YOUR RESTLESS LEGS CONNECTED TO YOUR FIBROMYALGIA?

HOW TO HELP A FRIEND WITH DEPRESSION

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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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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.

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Are You Addicted to Nasal Sprays?

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Signs You May Be Using Too Much

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Hearing Loss: It Can Lead to Loneliness

Symptoms of Hearing Loss and Important Treatments

10 Yo-Yo Dieting May Increase Risk of Heart Attack

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The Better Way to Lose Weight

15 Are Your Restless Legs Connected to Your Fibromyalgia?

Studies Show Two Conditions Go Together

28 How to Help a Friend with Depression

COLD? FLU? ALLERGIES? TRY THIS SOLUTION! Acupuncture Can Reduce Reliance on Medications

GRINDING TEETH: IS IT DANGEROUS? Long-Term Grinding Can Lead to Jaw Pain and Broken Teeth

DIABETIC? A GASTRIC BYPASS MAY MAKE LIFE BETTER When Diet and Exercise Don’t Work

STUDY SHOWS TREATMENT FOR UTERINE FIBROIDS IMPROVES SEXUAL FUNCTION UFE Reduces Painful Symptoms and Boosts Quality of Life for Women

CHRONIC STRESS MAY LEAD TO PANIC ATTACKS One in Ten Will Feel the Effects

THIS SIMPLE DIETARY CHOICE MAY LOWER YOUR RISK OF ALS Lou Gehrig’s Disease Affects 5,000 Americans Each Year

DON’T IGNORE THOSE HEADACHES—THEY COULD BE SERIOUS

By Dr. D. Grinshpun

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NEARSIGHTEDNESS IS ON THE RISE—AND MAY INCREASE RISK OF VISION LOSS

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LOOK YOUNGER IN TWO WEEKS WITH THE NON-SURGICAL FACE-LIFT!

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How to Protect Your Eyesight

Ulthera Treatment Tightens Skin with Minimal Downtime

MY CHILD’S FOOT LOOKS ABNORMAL—WHAT DO I DO? Dr. Stepensky Addresses Foot Deformities and Walking Issues

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YOUR SHORTNESS OF BREATH MAY BE PULMONARY HYPERTENSION

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DIAGNOSED WITH CHRONIC VENOUS INSUFFICIENCY

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COULD YOUR CONSTIPATION BE HURTING YOUR KIDNEYS?

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DID YOU GET THE RIGHT DIAGNOSIS FROM YOUR DOCTOR?

High Blood Pressure in the Lungs Can Cause Fatigue

Definition, Symptoms, & Treatments

Study Finds Link Between Constipation and Kidney Disease

Medical Mistakes Lead to Damaging Consequences

Forget Logic—Try These Tips Instead

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Compression Fracture Vertebral Disc Vertebra

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ARE YOU ADDICTED TO NASAL SPRAYS? SIGNS YOU MAY BE USING TOO MUCH

■■■ By Colleen M. Story There they are, lined up on the counter at your corner Wal-mart or other grocery store or pharmacy. Surely they’re safe to use, right?

Not necessarily. Yes, some nasal sprays are okay to use over and over again, but some can be addictive, causing more problems than they solve. How do you know which is which, and whether or not you may be addicted to the wrong one?

4 DIFFERENT TYPES OF NASAL SPRAYS There are a few different types of nasal sprays on the market:

1. Saline nasal sprays: These contain a small amount of salt and sterilized water. They help clean out the nasal passages, loosen and thin mucus, and flush out allergens, dust, and other irritants. They are not addictive and you can use them as much as you need to.

2. Steroid nasal sprays: These contain “corticosteroid,” an anti-inflammatory drug that helps treat nasal allergy symptoms. Though it is recommended that children not over-use them, and that adults use them only during those seasons when they are needed, they are not addictive, and are safe to use daily for most people.

3. Antihistamine nasal sprays: These contain an antihistamine drug that blocks the release of histamine in the body. Histamine causes allergy symptoms like sneezing and runny nose. These are not addictive, but doctors do recommend that most people limit use to no more than 12 weeks.

4. Decongestant sprays: These contain a decongestant medication that actually shrinks the blood vessels in the nose on a temporary basis so you can breathe. These nasal sprays can be addictive, and if used too often, can create a “rebound” effect, in which you feel more congested than you did before.

WHY ARE DECONGESTANT SPRAYS ADDICTIVE? Though decongestant sprays can be helpful in a pinch, they are not made for long-term use. The problem is that in some people, the nasal

passages may adapt to the medication used in the spray, and start to “need” it to operate correctly. As the medication wears off, the blood vessels swell up again, sometimes more than they did before.

Pretty soon, the person feels congested anytime he isn’t using the spray, which means that he has to use it more and more. This sets up a snowball situation that can eventually lead to chronic congestion, where the blood vessels in the nose are constantly swollen. Long-term use has also been linked with tissue damage, infection, and pain.

It can take as little as just a few days of use for the body to start adapting to the spray. That’s why it’s recommended that you use these products for a very limited time.

SIGNS YOU MAY BE SUFFERING REBOUND CONGESTION How can you tell if you may be experiencing rebound congestion?

Signs and symptoms include: ■ ■ ■ ■

Feeling like you have to use the spray more than directed Feeling stuffed up on a regular basis unless you’re using the spray Feeling congested again shortly after using the spray Feeling like the spray isn’t helping you anymore

To avoid these types of symptoms, use decongestant sprays no more than twice a day for no more than three days at a time. If you’ve been using yours more than that and you’re experiencing some of the symptoms above, check with your doctor. In addition to stopping use of the spray, you may also be prescribed another medication to get the swelling in your nasal passages back down to normal.

Products that may cause rebound congestion include Afrin, Zicam Extreme Congestion, Neosynephrine, Dristan, Sinex, Four-Way, and others. You can tell if your spray is a decongestant spray by looking for the word “decongestant” on the label, and by checking the directions for use. All of these recommend using them for no more than three days.

In addition, look for the active ingredient “oxymetazoline” or “phenylephrine.”

You can use any of the other products listed above instead, or try a neti pot with distilled water to flush out nasal passages.

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HEARING LOSS: IT CAN LEAD TO LONELINESS

SYMPTOMS OF HEARING LOSS AND IMPORTANT TREATMENTS ■■■ By Colleen M. Story When my dad was in his sixties, he started telling us all to stop mumbling. When he was in his seventies, “What?” became his favorite word. By the time he was in his eighties, he often just sat quietly watching the rest of us talk, but not contributing anything. I remember watching him at dinner one night and feeling badly for him, as he seemed alone over there.

It wasn’t because he didn’t want to talk to us. It was because he couldn’t hear us. According to The Hearing Loss Association of America (HLAA), about 20 percent of Americans-48 million — report some

degree of hearing loss. By the age of 65, an astonishing one out of three people has a hearing loss.

This isn’t just a matter of asking people to speak up. Hearing loss has been linked in studies to irritability, stress, impaired memory, reduced job performance, and loneliness. It has a huge negative effect on quality of life, and without treatment, can wreak havoc on your health, occupation, and social life.

If you’re noticing some changes, in that people seem to mumble more often, or you’re finding yourself left out of conversations because you can’t hear them clearly, talk to your doctor. He or she can help you get the treatment you need so you can get back into your life.

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4HEALTH WHAT CAUSES HEARING LOSS? There are a number of factors that can cause hearing loss. The most common cause is aging. Over the years, as we’re exposed to loud noises, the hairs and nerve cells inside the inner ear (cochlea) get worn down.

As they become damaged or even lost, the electrical sound signals aren’t transmitted as well as they used to be, and as a result, we can’t hear as well. Tones become muffled, and it’s harder to pick out words when there is a lot of background noise.

Other things like earwax buildup, ear infections, ruptured eardrum, head injuries, certain diseases, and even some medications (including some chemotherapy drugs, antibiotics, and diuretics) can also lead to hearing loss.

SYMPTOMS OF HEARING LOSS How can you tell if your hearing is not what it used to be? Watch for these symptoms: ■ It’s hard to understand what people are saying, especially when

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you’re in a restaurant or other location with a lot of background noise.

You have to frequently ask people to repeat what they said.

You turn up the volume on your TV or music player higher than you used to.

You often just nod and smile even though you didn’t hear what the other person said.

You find yourself trying to read lips to improve your understanding.

You turn your attention elsewhere during a conversation because it’s too hard to follow.

If you’re experiencing these or other similar symptoms, it’s time to talk to your doctor.

TREATMENT FOR HEARING LOSS Hearing aids are the most common type of treatment for hearing loss, but estimates are that only one in 7 people over the age of 50 with hearing loss use them. Why would this be?

There are a number of reasons. For one, hearing aids can be expensive, usually $2,500 or more, and most types of insurance don’t cover the costs. In addition, many people don’t realize that they’re hearing has deteriorated, or are simply denying that it has, afraid of “declining” with age.

Hearing experts say that going without treatment is a travesty, as hearing loss is so detrimental to your life. Studies have linked it to physical, psychological, and social consequences, including increased risk of falls, more anxiety and stress, depression and loneliness, and even increased mortality. At the very least, it can affect relationships, as victims suffer from irritability and gradually withdraw from social activities.

Hearing loss even affects cognitive function — our ability to think well — with some studies connecting it to a potentially increased risk in dementia. Wearing a hearing aid, on the other hand, makes social interactions easier, improves mood, and boosts general health.

If you notice symptoms of hearing loss, ask your doctor for help. You can start with a simple screening with your primary care doctor, and if he suspects some hearing loss, he will likely refer you to an audiologist or otolaryngologist for further screening. If these physicians determine you need a hearing aid, you will be fitted for one if you choose. Remember that today’s models are smaller and less noticeable than they used to

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be, and they work better, too. There are a number of other technological systems that can help too — your doctor can tell you about those.

The most important thing is to address your hearing loss as soon as you can.

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GRINDING TEETH: IS IT DANGEROUS? LONG-TERM GRINDING CAN LEAD TO JAW PAIN AND BROKEN TEETH

■■■ Morgan Rice Do you grind your teeth at night? Has your dentist told you he’s noticed wear and tear on your teeth? If so, you probably have “bruxism,” a common condition that affects an estimated eight percent of Americans.

Is this a serious condition? Should you be worried? Turns out that without treatment, bruxism can sometimes lead to more serious conditions, like jaw joint disorders and damaged teeth.

WHAT IS BRUXISM? The word “bruxism” comes from the Greek word brychein, which means “gnashing of teeth.” The condition occurs when people push or clench the top and bottom teeth together, and then grind them back and forth. The action is in response to the chewing reflex.

Though some may do it during the day, most people grind their teeth while they’re sleeping, and don’t even know they’re doing it. It’s only when the dentist points out the wear and tear that they may realize what’s happening.

WHAT CAUSES BRUXISM? There can be a number of reasons why people may grind their teeth. These include:

■ Stress: Stress and anxiety can lead to brux-

ism in some people. A study published in 2010 found that experiencing stress and poorly coping with stress can increase risk.

Participants who said they felt high levels of stress because of work problems, exhaustion, health issues, or other struggles were more likely to be heavy teeth-grinders.

Those who tried to escape or ignore their problems were also more likely to process stress with bruxism.

■ Uneven teeth: Some dentists think that when the teeth don’t line up correctly, people are more likely to grind their teeth.

■ Sleep problems: A 2009 study linked teeth grinding with sleep apnea. Researchers found that one in four patients with sleep apnea also suffered from bruxism.

■ Emotional issues: A 2010 study examined personality traits and bruxism, and reported that traits like neuroticism and anxiety were related to teeth grinding.

Other potential causes include medical conditions, medications, and substance abuse.

POTENTIAL COMPLICATIONS & TREATMENTS Once you find out you are a teeth grinder, it’s important to talk to your dentist about the possible treatments. If you let it go too long, you increase your risk of tooth pain and

damage, headaches, mouth and muscle pain, hearing loss, sore gums, and jaw joint pain and deterioration.

Potential treatments include: ■ Relaxation techniques to help minimize

and cope with stress ■ Counseling to help deal with stress ■ Cut back on caffeine and alcohol in the

hours before bed ■ Lifestyle changes, such as limiting caffeine,

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improving your bedtime routine, and stopping smoking Treatment for sleep apnea Orthodontia may help align the teeth and reduce grinding Grinding mouth guard — your dentist can make one for you that helps protect the teeth, muscles, and jaw joint from the pressures of clenching and grinding Apply a heating pad to the cheek in front of the earlobe at night to help encourage relaxation of the jaw joint

HOW CAN I TELL IF I’M GRINDING? Since most people grind their teeth at night, they aren’t aware of the problem. This is why it’s important to have regular dentist appointments. Other clues include headaches or jaw pain upon awakening.

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DIABETIC? A GASTRIC BYPASS MAY MAKE LIFE BETTER WHEN DIET AND EXERCISE DON’T WORK ■■■ Morgan Rice If you have diabetes, you probably already know that losing weight can help. Shedding a few pounds can help lower your blood sugar, improve your heart health, and reduce your risk of other complications like kidney disease, depression, and eye problems.

It’s not so easy, however, to succeed at weight loss, particularly when you have type 2 diabetes. Studies have shown that even when patients are put into diet and exercise programs, their weight loss is modest. Blood sugar variations, sleep problems, medications, thyroid problems, and more can all make weight loss difficult.

A recent study suggests another alternative—gastric bypass surgery. Those with type 2 diabetes who underwent the surgery reported a higher quality of life afterwards. Might this be a healthy option for you?

WHAT IS GASTRIC BYPASS SURGERY? During gastric bypass surgery, doctors reduce the size of the stomach so that patients can’t eat as much as they usually do. They do this by stapling off a large part of the stomach so that it is no longer available to store and digest food. What is left is a small pouch that can handle only a few ounces at a time. That pouch is then connected to the small intestine. When the surgery is com-

pleted, the stomach is reduced by as much as 90 percent.

Patients who undergo gastric bypass usually experience dramatic weight loss. Does it last? A 2013 study looked at a similar, but different surgery—gastric banding (where a band clamps off part of the stomach). Researchers found that all patients experienced a mean of 47 percent excessive weight loss after 15 years. Another 2013 study found that bariatric surgery led to greater weight loss and better blood sugar control than nonsurgical treatment among diabetes patients who were mildly obese, though evidence for lasting weight loss was limited.

Now, a new 2014 study indicates that gastric bypass may not only produce weight loss for diabetics, but may improve quality of life as well.

STUDY FINDS GASTRIC BYPASS IMPROVES QUALITY OF LIFE For the study, researchers looked at the effects of weight loss on 38 patients with type 2 diabetes. A total of 19 of them went through gastric bypass surgery, and the other 19 went through a medical diabetes and weight management program that involved exercise, diet, and meal replacements. Researchers followed up with all the patients at 18 and 24 months.

Results showed the following:

■ Two years after treatment, those who

went through surgery had lost an average of 64.4 pounds. Those who had gone through the weight management program lost only 11 pounds.

■ At 18 and 24 months after treatment, those who had gone through surgery reported a 60 percent greater reduction in problems managing their diabetes. These problems included emotional distress, eating behaviors, and trouble with selfmanagement.

■ Up to two years after treatment, those who went through surgery had nearly twice the improvement in the adverse effects of weight on their quality of life.

IS GASTRIC BYPASS FOR YOU? You may be a candidate for gastric bypass if you: ■ Have a body mass index (BMI) of 40 or more.

■ You have a BMI of 35 to 39.9 and you have type 2 diabetes.

Though there are clear benefits to gastric bypass for type 2 diabetes patients, there are risks as well. Talk to your doctor about your options. If you’ve struggled with obesity and diabetes for awhile now, and lifestyle modifications haven’t helped, this surgery may be the treatment you’re looking for.

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YO-YO DIETING MAY INCREASE RISK OF HEART ATTACK THE BETTER WAY TO LOSE WEIGHT

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By Lynn Merrell

In the midst of our obesity epidemic, a lot of people are trying to lose weight. It’s an admirable goal, and important for health, because overweight and obesity have been linked with a higher risk of heart disease, diabetes, stroke, cancer, and more.

Losing weight is not an easy thing to do, unfortunately, and even if you succeed, you’re likely to gain most if not all of the weight back within a short period of time. That means that somewhere down the road, you’ll probably go on another diet in another attempt to lose, and may go through the whole experience again.

Dieting, gaining the weight back, dieting, and gaining it back again is a process known as “yo-yo dieting.” According to a recent study, is very dangerous, to the point of increasing risk of death from heart disease. What can you do to actually lose the weight and keep it off without causing your body more harm?

YO-YO DIETING NOT THE ANSWER In the study mentioned above, researchers looked at data from over 150,000 postmenopausal women over a period of 11 years. They found that even women who were considered to be of normal weight who lost weight and then regained had about 3.5 times the risk for sudden cardiac death than women who maintained a stable weight.

In addition, “weight cycling,” the process of going up and down in pounds, was also associated with a 66 percent increased risk of coronary heart disease death.

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Other studies have suggested that repeated cycles of weight loss and weight gain can cause other health problems, including a risk in gallstones, additional weight gain, increases in blood pressure and blood cholesterol, and digestive problems. Weight fluctuations also stress the body, increasing risk of other chronic diseases.

Perhaps even worse, yo-yo dieting can take an emotional toll on the dieter. The elation at having lost the weight is replaced with the disappointment at gaining it again, which can reduce motivation to lose weight at all, and may leave people feeling defeated.

Instead, scientists and doctors now recommend that people simply change their habits to include more exercise and smaller meals in general. Eat healthier foods, like fruits and vegetables, and focus on making little changes that lead to gradual results. Set a goal of losing one or two pounds per week, and take your time. Going slow allows your body to adjust to the change, and is more likely to result in longterm success.

If you’d like to lose weight and feel healthier, skip the diets, and talk to your doctor. Then keep these tips in mind: ■ Consider adopting the Mediterranean

WHAT TO DO INSTEAD It’s difficult to avoid yo-yo dieting. Even if you intend not to fall into the trap, if you go on a diet and lose weight, and then start gaining back, you’re in it, whether you want to be or not. So what is the best way to lose weight?

Most health experts today say that we should avoid diets altogether. In fact, researchers at UCLA stated in 2007 flat out that dieting does not work, because the weight always tends to come back. “Diets do not lead to sustained weight loss or health benefits for the majority of people,” said Traci Mann, UCLA Associate professor of psychology and lead author of a study on the subject.

Indeed, Mann and her co-authors analyzed 31 long-term studies on dieting, and found that most people would have been better off not going on a diet at all. Their weight would be about the same either way, and without the fluctuations, they would not have suffered the related wear and tear.

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diet — instead of a real “diet” program, it is simply a lifestyle of eating more fruits and vegetables, whole grains, legumes, and olive oil, with fish and lean protein instead of red meat.

Slowly change the amount of food you eat. Get smaller plates and eat smaller portions.

Work with a support team, including family, friends, and your doctors, to help you reach your goals.

Consider joining a program like Weight Watchers — it has shown in studies to be successful at helping people to lose weight and keep it off.

Commit to an exercise program that you enjoy and will stick with. It can be as simple as a daily walk.

Try to eliminate nighttime munchies, and drink tea and water to curb cravings.

Ditch “liquid calories” and drink flavored water instead.

Add protein to every meal and snack.

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STUDY SHOWS TREATMENT FOR UTERINE FIBROIDS IMPROVES SEXUAL FUNCTION UFE REDUCES PAINFUL SYMPTOMS AND BOOSTS QUALITY OF LIFE FOR WOMEN ■■■ By Morgan Rice Women who undergo nonsurgical treatment for uterine fibroids may find that they not only feel better, but that their sex lives improve. This, according to a new study published in April 2016.

Researchers examined the outcome of a minimally invasive, imageguided treatment for uterine fibroids that requires a much smaller incision and shorter recovery time than traditional surgical treatment.

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

WHAT ARE UTERINE FIBROIDS? Uterine fibroids are benign (noncancerous) growths in the smooth muscle tissue of the uterus. They usually do not develop into cancer, though in rare cases, they can. Instead, they are simply the result of excessive cell growth that results in a mass that can be as small as a seedling or many times larger, in some cases becoming bulky and enlarging the uterus.

Many women develop fibroids and aren’t even aware of it. They can grow slowly, causing no problems, or they may grow for awhile and then shrink again. Some appear during pregnancy, and then go away after childbirth. The Mayo Clinic estimates that as many as three out of four women have uterine fibroids at some time in their lives, but because they don’t cause symptoms, women aren’t bothered by them.

In some cases, though, fibroids can cause trouble. When they do, symptoms may include heavy menstrual bleeding, prolonged menstrual

(718) 504-6525 www.USAFibroidCenters.com

periods, pelvic pressure or pain, constipation, frequent urination, pain during sex, reproductive problems, and backache or leg pains.

HOW ARE UTERINE FIBROIDS TREATED? Women who are diagnosed with uterine fibroids and who are experiencing difficult symptoms usually have several options. If the symptoms are mild, doctors will usually recommend watchful waiting, to see if the fibroids or the symptoms will go away on their own. If symptoms are more serious, there are some medications that may help. Some target hormones to help treat heavy menstrual bleeding, for example, and potentially shrink the fibroids. Other medications like birth control pills may do the same, and nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain related to fibroids.

If these steps don’t help, doctors usually suggest some type of surgical treatment. It used to be that the only option was a hysterectomy or myomectomy (removes fibroids and leaves uterus intact), but now there is also a minimally invasive treatment called uterine fibroid embolization (UFE) that helps resolve fibroid-related symptoms without the hassle of traditional surgery.

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

Researchers from the Centre Hospitalier Universitaire in Montpelier, France, researched the effectiveness of UFE in their study. They followed 264 women who went through the procedure, and asked them to fill out a questionnaire before and one year after treatment.

At the start of the study, 189 of the women suffered from abnormally heavy bleeding, and 171 experienced pain and other symptoms associated with pelvic pressure. A year later, only 39 still suffered from excessive bleeding, and only 41 still had uncomfortable pelvic pressure.

In addition, nearly eight in 10 stated that they experienced improvement in sexual function, including reduced pain during intercourse, and increased desire, arousal, and satisfaction. About nine in 10 reported an overall better quality of life.

Researchers concluded that compared to surgeries like hysterectomy, UFE helps women return to their daily routines much more quickly, and still reduces symptoms and improves well being.

If you’re suffering from symptoms of uterine fibroids, ask your doctor or interventional radiologist about your options. UFE may be an effective treatment for you.

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CHRONIC STRESS MAY LEAD TO PANIC ATTACKS ONE IN TEN WILL FEEL THE EFFECTS ■■■ Colleen M. Story “My heart races, I feel dizzy, and I think I’m going to pass out, though I never do,” Annie said. “It seems like I have a panic attack every time I get in the car.”

“On the outside I was a confident person,” Bill said. “But inside I was a nervous wreck, and I had this terrible feeling something terrible was about to happen.”

Panic attacks come on suddenly, making it difficult to breathe and mimicking the symptoms of a heart attack. Many sufferers end up in the emergency room, only to be told nothing is wrong with them. Yet panic disorder is a real condition, affecting over two million Americans per year. The attacks can develop in response to a major life event, such as a loss of a job, death of a loved one, or new disability.

Researchers have recently discovered, though, that chronic, daily stress can also build up until it explodes in panic attacks.

Might you be at risk?

WHAT IS A PANIC ATTACK? A panic attack occurs when a person feels a rush of intense symptoms such as the following: ■ ■ ■ ■ ■

Fast heart beat or heart palpitations Sweating and trembling Nausea Difficulty breathing; sense of chocking Dizziness or feeling faint

■ Chills or hot flashes ■ Overwhelming sense of fear and anxiety

Once a person has suffered a panic attack, the fear of suffering one again can increase the overall sense of stress and anxiety. That’s because panic attacks are very frightening and intense. Fortunately, they are not dangerous, and do not cause lasting damage or injury to the body or mind.

duced steadily increasing levels of panic for 12 weeks afterward.

■ Daily stressful life events tend to cause panic symptoms to gradually increase over the succeeding months, rather than spike immediately.

■ Panic symptoms did not seem to increase in advance of stressful life events, even if they were predictable, such as a divorce becoming final. Instead, they increased over the weeks and months afterward.

WHAT CAUSES A PANIC ATTACK? Scientists don’t yet know what exactly causes a panic attack, but they do know that some people are more at risk than others.

Those with a family history of panic disorder, who abuse alcohol or drugs, or who suffer stressful life transitions may be more likely to experience attacks. Medical conditions like hypothyroidism, low blood sugar, and mitral valve prolapse can also cause panic attacks.

Now a new study suggests that panic can also build gradually, from chronic stress.

Researchers from Brown University looked at annual assessments from over 400 adults with panic disorder who were enrolled in the Harvard/Brown Anxiety Research Project between 1998 and 2004. Volunteers answered detailed questions about important events in their lives and their levels of anxiety. Results showed: ■ Stressful life events such as a demotion or

layoff at work or family argument pro-

Researchers concluded that panic attacks may not be a reaction to one, severe event, but rather, a result of gradual and steady accumulation of stress over a period of weeks, and advised patients to watch for these sorts of after effects of stressful occurrences in life.

HOW THERAPY CAN HELP If you’ve been under a lot of stress lately, or have experienced a panic attack, don’t worry—at least one in 10 people experiences occasional panic attacks. There are solutions, but it’s best if you get some support from your psychologist or psychiatrist. Treatments may include medications like antidepressants or anti-anxiety medications, cognitive behavioral therapy, and “exposure” therapy, which gradually increases confidence in formerly stressful situations. Professional therapy can help you regain control of your life and your body, so you can face any situation you need to with confidence.

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THIS SIMPLE DIETARY CHOICE MAY LOWER YOUR RISK OF ALS LOU GEHRIG’S DISEASE AFFECTS 5,000 AMERICANS EACH YEAR

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By Gordon Barclay

Amyotrophic Lateral Sclerosis (ALS), or “Lou Gehrig’s disease,” affects as many as 30,000 people in the U.S., with about 5,000 new cases diagnosed each year, according to Hopkins Medicine. A progressive neuromuscular disease that damages nerve cells in the brain and spinal cord, it gradually increases muscle weakness, and eventually leads to paralysis. Notable individuals diagnosed with the disease include baseball great Lou Gehrig, and scientist Stephen Hawking.

Anyone can develop the disease, but those with a family history of it are more at risk, as are those exposed to heavy metals in their occupation, those who smoke, and perhaps those who were exposed to metals and chemicals as part of their military service.

A recent study also suggests something else — that your level of physical fitness in young adulthood may affect your risk of ALS. Why would that be?

STUDY REPORTS CONFUSING FINDINGS ON HEALTHY YOUNG MEN AND ALS For the study, researchers collected data on physical fitness, body mass index (BMI), IQ, and stress resilience from nearly two million men aged 17–20 years between the years of 1968 and 2010. They then compared that information with ALS diagnoses, and found that those with the highest levels of physical fitness had a higher risk of ALS before the age of 45 years, compared with others.

In addition, those with a BMI of over 25 had a lower risk of ALS at all ages, compared with those with a BMI lower than 25. Those with a high IQ also had a significantly increased risk of ALS at 56 years and older.

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The findings were confusing, obviously. These young men were among the healthiest in the study group, and yet they were at an increased risk for ALS. That doesn’t mean it was because they were healthy that their risk went up, however. It simply showed a link between the two. We don’t know why yet.

Young men shouldn’t forego their healthy activities because of this study, as physical and mental fitness benefit your health and life in so many other ways. At best, the study gives researchers some more clues in trying to determine the cause of ALS, and suggests that healthy young men may want to take other steps to reduce their risk of the disease.

HOW CAN THEY DO THAT? How to Reduce Your Risk of ALS. According to another recent study, reducing your risk of ALS may be as simple as eating a healthy diet.

Researchers analyzed data on 302 patients with ALS, and found that those who had higher intakes of antioxidants and carotenes from vegetables had better overall functioning than those who had lower intakes of these foods.

Lead author Jeri W. Nieves, Ph.D., stated that nutrition seems to play a role “both in triggering the disease and why it progresses,” and suggested that ALS patients should “eat foods high in antioxidants and carotenes, as well as high fiber grains, fish, and poultry.”

Milk and lunch meats, on the other hand, were associated with lower function, and more severe ALS disease.

An earlier 2013 study found similar results: diets high in colorful carotenoids prevented the onset of ALS. Carotenoids are antioxidants that make fruits and vegetables a bright red, orange, or yellow color, and are a key source of vitamin A. These studies seem to suggest that oxidative stress plays a role in the development of ALS, and that consuming more antioxidants, which reduces that stress, may help.

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Neurology | 4HEALTH21

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DON’T IGNORE THOSE HEADACHES — THEY COULD BE SERIOUS WHEN YOU SHOULD SEE A NEUROLOGIST

Most people have suffered their share of headaches. We all know what it feels like to have that familiar pain crawl up the back of our necks after a hard day, or to feel the pressure of our sinuses aching behind our eyes. But though a headache may be a minor nuisance for some, for others it can be a serious, chronic condition that affects daily life. In some cases, a headache can signal a life-threatening problem.

Recently published studies have reported that recurrent headaches are associated with anxiety, depression, and behavioral problems in teens. Women who suffer from migraines are 40 percent more likely to develop depression. A study published in 2005 found that people who have migraines are more at risk of suffering a stroke. About 30,000 Americans suffer an aneurysm every year, and 40 percent of those die because of it. Singer Bruno Mars lost his mother to a brain aneurysm. She was only 55 years old.

Chief of Neurology and professor at Woodhull Medical Center Dmitriy Grinshpun, M.D., knows how serious headaches can be.

He’s Director of the Stroke Center and has years of experience in treating all types of headaches.

TYPES OF HEADACHES Though it may seem like a headache is a headache, there are a number of different types, all requiring a different approach in treatment.

■ Tension headache: This is the most common kind. It’s believed to be caused by the contraction of the muscles covering the skull. If you didn’t get enough sleep, have had a stressful day, or didn’t eat right, you may start to feel that band of pain wrapping up across the top of your head.

■ Migraine headache: Migraines can make life miserable. They’re usually characterized by pain on one side of the head that last for hours to days, accompanied by sensitivity to light and sound. They may also cause nausea and vomiting.

■ Cluster headache: This is a unique type of headache that occurs more often in men than women, though both genders may suffer from it. The cause is unknown. The pain is usually sharp and sudden, and then 4HEALTH | 877.807.0989

just as quickly gone. It may return the next day or a few days later, reoccurring for weeks and then going away for months. It may be accompanied by a runny nose and watery eyes.

■ Thunderclap headache: This is the scary one. It hits like a clap of thunder, feels like the worst headache you’ve ever had, and gets worse in a short period of time. This signals a serious problem such as a ruptured artery. These headaches require immediate medical attention.

Some people also suffer headaches after exercise, headaches that go on for days and come with vision problems, headaches that wake them up in the middle of the night, or headaches caused by traumas, such as car accidents, concussions, or assault.

WHEN TO GET TREATMENT How do you know when a headache requires a trip to the doctor? Here are some tips: ■ It’s different: This headache feels extremely painful, more intense, and different from any other headache you’ve had. It’s time to see a neurologist.

■ It’s getting worse: Nothing you’ve tried is working, and your headaches are getting worse. They could signal another health problem. Don’t wait to check with your doctor.

■ It’s affecting the rest of your health: You’re experiencing vision problems, nausea and vomiting, depression, or other symptoms.

It’s time to find out what’s going on.

■ It’s interfering with your life: Your headaches are keeping you home, away from work and family activities, or interfering with your life in some way. It’s time to see a specialist.

FOR MORE INFORMATION Dr. Dmitriy Grinshpun offers a number of treatment options for all types of headaches. In addition to standard medications, he also works with ultrasound, electrotherapy, nerve blocks, massage, traction, homeopathic treatment, thermotherapy, and more. If you’re looking for a headache solution, he’ll help you find it!

NAME:

Dmitriy GRINSHPUN, MD SPECIALTY: Neurology

TRAINING & EDUCATION: SUNY Health Science Center at Brooklyn Fellowship, Clinical Neurophysiology SUNY Health Science Center at Brooklyn Residency, Neurology

MEMBERSHIPS: Director of a Stroke Center and Chief of Neurology at Woodhull Medical and Mental Health Center/NYU Affiliate.

CONTACT: 174 Brighton 11th St., 1st fl., Brooklyn, NY 11235

(888) 747-8009 INSURANCE: Accept All Major Insurance Plans

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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) 4HEALTH | 877.807.0989

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GENERATIONS

5 East 84th St, New York, NY 10028

(212) 328-0135 TOLL FREE

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NEARSIGHTEDNESS IS ON THE RISE — AND MAY INCREASE RISK OF VISION LOSS HOW TO PROTECT YOUR EYESIGHT

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By Colleen M. Story

Nearsightedness, or “myopia,” is a type of vision disorder in which close objects appear clear, while distant objects appear blurry. It’s a common disorder, and the reason why many Americans wear glasses. According to recent studies, though, nearsightedness is on the rise, and may increase risk of other eye disorders later in life. Here’s more, and how you can protect your vision far into your senior years.

WHAT CAUSES NEARSIGHTEDNESS? Eye shape is often what causes nearsightedness. The eye is either too long or has a cornea that is curved too steeply. This affects the road the light rays take as they enter the eye, so that they don’t land on the retina, but in front of it, which causes blurry images. Corrective lenses redirect the light rays to land where they should.

Doctors aren’t sure why some people develop nearsightedness and others don’t.

Some people are just born with misshaped eyes, or develop them in childhood. Family history can increase risk, but recent evidence has also suggested that our modern world may be affecting our vision, too.

NEARSIGHTEDNESS IS INCREASING A 2009 study indicated that the amount of people suffering from nearsightedness is on the rise. The proportion of Americans aged 12 to 54 who need corrective lenses for myopia

increased from 25 percent in the early 1970s to 42 percent in 2004. That’s nearly half of us needing glasses or contacts for this condition.

The good news is that nearsightedness is easily treated, but researchers did wonder why the increase. Other studies have given us some clues. In general, scientists have discovered that focusing on items close up — such as our phones, tablets, and computers — combined with decreased time spent outdoors, is changing how our eyes work. In Asian countries where children spend most of their time indoors to study, nearsightedness is even more prevalent than it is in countries where children still spend a lot of time outdoors.

Based on this information, it is likely that the number of people with myopia will continue to increase, and may be double what it is today by the year 2050.

MYOPIA MAY INCREASE RISK OF OTHER VISUAL IMPAIRMENTS Most of us don’t think much about suffering from nearsightedness. Glasses and contacts fix the problem, and we go on with our lives. But a recent study suggests we may want to be more careful.

Researchers looked at data from more than 15,000 participants, and found that individuals with “high myopia,” a severe form of myopia in which the eyeball continues to grow, were at a higher risk for visual impairment as they aged.

In fact, the risk was 39 percent by the age of 75. The scientists concluded that myopia

“will bring major threats to the visual health of the public” in many areas, and encouraged increased awareness of the risks associated with it.

The Mayo Clinic also states that severe nearsightedness can increase risk of retinal detachment, glaucoma, and cataracts. You can ask your eye doctor about your level of myopia, to see if you may be at risk for these other conditions. If so, it’s best to keep regular annual appointments to watch for any changes, as early treatment most always helps preserve vision.

HOW TO PROTECT YOUR EYES No matter what your current eye health is, you can take steps to protect your vision and reduce your risk of disease.

■ Always wear sunglasses that protect you

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from UV rays — check the label and look for “broad-spectrum UV protection.”

Eat a healthy diet with lots of colorful fruits and vegetables — these contain key nutrients that keep your eyes healthy.

Watch out for your general health. Diabetes, high blood pressure, and other conditions can affect your vision. Make sure you see your doctor and keep these conditions under control.

Don’t smoke.

Reduce eyestrain. Spend some time outside every day, and take regular breaks to look up from your computer, tablet, and phone.

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ARE YOUR RESTLESS LEGS CONNECTED TO YOUR FIBROMYALGIA? STUDIES SHOW TWO CONDITIONS GO TOGETHER

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By Morgan Rice

Do you wake up in the middle of the night kicking your legs? Does your partner complain that you seem to be running in your sleep? Do you have trouble falling asleep because of your restless legs?

If you answered “yes” to any of these questions, you may have restless leg syndrome (RLS). If you also have fibromyalgia, you’re even more likely to have RLS, as the two conditions are often seen together. Here’s how you can manage both.

WHAT IS RESTLESS LEG SYNDROME? Also called “Willis-Ekbom Disease,” RLS is a condition that causes leg discomfort and uneasiness. It comes with a nearly uncontrollable urge to move your legs, especially when you’ve been sitting or lying down for a while.

It often disrupts sleep, and can make traveling uncomfortable too.

Researchers don’t know what causes RLS, but they think it may have something to do with an imbalance of neurotransmitters in the brain.

It tends to run in families, and often gets worse with age. Pregnant women also seem to be at a higher risk for it.

In addition to the sudden urge to move your legs, RLS also causes nighttime leg twitching,

a “creeping/crawling” sensation, and sometimes aching and throbbing. Moving the legs brings temporary relief, though the feelings usually do come back again.

WHAT IS FIBROMYALGIA? Fibromyalgia is a chronic disorder that causes severe pain and tiredness, so much that it affects an individual’s ability to maintain daily activities. The pain may occur anywhere on the body, and may migrate from one place to another, attacking muscles, ligaments, and tendons. It can also cause other symptoms like headaches, nausea, anxiety, numbness in the hands and feet, insomnia, and difficulty concentrating.

Scientists don’t know what causes fibromyalgia either, but they believe it’s linked to certain diseases like Lupus and rheumatoid arthritis, repetitive injuries, and stressful or traumatic events.

HOW ARE RLS AND FIBROMYALGIA RELATED? Studies have shown that people with fibromyalgia have a high prevalence of RLS, too. In one 2010 study, researchers found that 33 percent of fibromyalgia patients had RLS, compared with only 3.1 percent of healthy controls. They were also more likely to suffer from insomnia. In an earlier study,

65 percent of those with fibromyalgia also had RLS. Researchers also pointed out that the two conditions share other characteristics. Both tend to occur more often in women than in men, and both run in families. Finally, both tend to cause excessive daytime sleepiness and problems with concentration.

HOW YOU CAN FEEL BETTER The good news is that RLS is treatable with drugs called “dopamine agonists.” These help boost the level of dopamine in the brain.

Patients who find relief with these medications are usually able to sleep better, which also helps reduce symptoms of fibromyalgia.

Some home remedies can help with RLS, too. Get regular exercise, try a hot bath before bed, maintain a regular sleep schedule, and enjoy a leg massage as often as you can.

If you have both of these conditions, talk to your doctor. There are several options for treatment, and you may need to try a few before you find one that works well. You may need to change medications periodically, too, as some lose their potency over time.

It helps to know, though, if you have RLS in addition to fibromyalgia. Treating the RLS at the very least could help you get more sleep, which could greatly improve your quality of life.

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PA I N M E D

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| Plastic Surgery

LOOK YOUNGER IN TWO WEEKS WITH THE NON-SURGICAL FACE-LIFT! ULTHERA TREATMENT TIGHTENS SKIN WITH MINIMAL DOWNTIME

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 thought about a face-lift? If you’re like many women, you probably have. According to a report by RealSelf.com, one in five women said they’re actively planning or considering plastic surgery.

The results are hard to dispute. A new study released in March 2017 found that women who go through cosmetic procedures like face-lifts to look younger and more attractive actually do help themselves to become more successful.

What if you don’t really want to go under the knife? You’re not alone. The same RealSelf survey found that those who were unhappy with their appearance but didn’t want to talk to a plastic surgeon were afraid of pain and complications, and worried they would look worse after the surgery was over.

If that sounds like you, you should consider “Ultherapy.” Named the “Best In-Office Treatment” in NewBeauty’s 2013 Beauty Choice Awards, Ultherapy is a skin-lifting procedure, FDA-cleared to lift skin above the brow, on the neck, under the chin, and on the decolletage area. Non-invasive, it requires no incisions, yet it helps create a more youthful appearance with minimal downtime.

“If you’re in the 30-plus age group,” says plastic surgeon Dr. Rayham of the RR Plastix/New York Plastic Surgery Center, “and you’re starting to see the first signs of jaw drooping, marionette lines, turkey neck, and sagging eyes, this is the non-surgical facelift you need to continue to look your best.”

WHAT IS ULTHERAPY? As we age, the structure in the skin starts to break down and loosen, and the skin tends to “fall” around the cheeks, eyes, jaw line, and neck. What we need is something to help firm and lift that skin again.

Surgery works because doctors physically lift and tuck the skin back in place. It has been more difficult for scientists to find non-invasive therapies to do the same thing — Ultherapy is one of the first techniques actually shown to work.

The “Ulthera System” is a therapeutic ultrasound medical device. It uses a signature imaging technology that allows physicians to see beneath the surface of the skin, and to deliver focused ultrasound energy to deep layers, targeting key areas of tissue. The energy from the ultrasound triggers the body’s natural healing response, which stimulates the production of collagen — the skin’s own firming component. Over time, the patient experiences a gradual tightening and lifting of the skin.

WHAT HAPPENS DURING AN ULTHERAPY SESSION?

Ultherapy typically requires no anesthetic or sedation, but if patients are sensitive to the ultrasound energy, physicians can choose to use local anesthetic.

There are no needles or lasers or incisions. Instead, the physician passes an ultrasound wand over the surface of the skin to deliver ultrasound energy to the deeper layers. Some patients describe this part as “uncomfortable,” but recent adjustments to the intensity of the procedure have helped minimize the risk of pain.

Each procedure lasts only about 30–90 minutes, and you can go back to your regular activities immediately. You don’t even have to perform any special treatment measures at home — once you’re done, you’re done! Some patients may experience some minor swelling or redness, but most notice little immediate change.

WHAT ARE THE RESULTS OF ULTHERAPY? The ultrasound energy actually stimulates the collagen to start working again, so that it acts within the skin more like it did when you were younger.

Within about two to three months, you’ll see the full effects, but even after a couple weeks, you’re likely to notice the gradual firming and tightening. Your jaw line and cheeks will take on new definition, your double chin will fade, and your eyes will appear more open and refreshed. You’ll see a younger you in the mirror, without the startling changes that can be the result of traditional face-lifts.

Most patients require only one treatment, but some may benefit from a series of them, depending on the results desired. Additional touch-ups in the future can help keep the skin looking young.

WHO IS THE BEST CANDIDATE FOR ULTHERAPY? Ultherapy works best for candidates 30 to 65 years of age who want to experience a lifting effect.

These patients have mild to moderate skin sagging, such as the following: loose skin on the neck, or turkey neck; sagging under the chin — double chin; lines and wrinkles on the chest and decollet; lowered eyebrow line; sagging skin above the eyes.

More severe sagging skin that occurs after the age of 65 is usually best treated with a traditional face-lift.

Dr. Rayham performs Ultherapy treatments often, and states that they help jump-start the patient’s own collagen-producing process.

“Ultherapy isn’t a face-lift,” he says, “but it’s a clinically proven way to lift and firm the skin without going under the knife. Our patients have been very happy with the results.”

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Podiatry | 4HEALTH33

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MY CHILD’S FOOT LOOKS ABNORMAL — WHAT DO I DO? DR. STEPENSKY ADDRESSES FOOT DEFORMITIES AND WALKING ISSUES You give birth to a brand new baby. He’s healthy and strong, and everything seems to be okay until you look at his feet. You frown. Something’s not quite right. The child’s foot is definitely not formed correctly.

What do you do?

We asked podiatrist Leon Stepensky, who specializes in foot diseases and surgical corrections, and frequently helps children to walk comfortably again.

What types of foot deformities occur in children?

There are three main types of foot deformities in children. Flatfoot (planus): the arch of the foot disappears when she stands. Clubfoot: the child’s foot seems to have been rotated in our out abnormally at the ankle. The tissues connecting the muscles to the bones and tendons are shorter than usual. Metatarsus adductus: the front part of the foot is turned inward.

Most of these types of deformities can be traced to hereditary causes, but they can also develop because of how the fetus forms. The infant is in a collapsed position in the mother’s womb, and his hips, knees, and ankles are bent. If the fetus is too large, he does not have enough space inside the uterus. His feet, while in the process of development, experience stress, which can lead to their deformation.

Many of these deformities go away by themselves, but not all of them. Flatfoot and clubfoot inward and outward are the most common foot deformities in children. The clubfoot inward is more common than the clubfoot outward.

How do you treat these deformities?

If the foot deformity is very serious, we begin to treat the baby immediately after birth. Therapeutic methods include the phased imposition of a plaster bandage or cast on the lower limbs of the child — on the full foot and part of the ankle — to support their correct positions. This bandage should be changed from one to two times a week. This is the best treatment for any kind of foot deformity, as the baby isn’t walking, and his ligaments are softer and easier to fix.

Usually, we assess the severity of the foot deformity when the child is three years old, except in those cases when the child experiences trouble walking earlier on. At the age of three, the child starts to walk heel-to-toe, like a normal adult. Before that, she moves with a gait called “step-by-step,” which is not a complete cycle of walking in the foot.

By the time the child begins to walk, a cast is no longer the best solution. Instead, we use various kinds of manipulation, including physical exercises, rehabilitation therapy, and orthopedic brackets 4HEALTH | 877.807.0989

(bandages), depending on the severity of the deformity and its location.

If a child has flatfoot (a drop of the middle or inner arch of the foot, usually accompanied by a valgus deformity of the heel, when the heel bulges out), it causes pain, difficulty walking, and tired feet. In the future, it may lead to pain in the knees, hips, and lower back.

In the child has one of the other foot deformities, he usually walks with the front part of the foot turned inward or outward. This also leads to an unstable gait, frequent stumbles, and falls. A child can’t play sports; he feels embarrassed by his awkward gait. Such deformities can also lead to compensation — the knees, hips, and lower back change to compensate the deformity, which can cause other types of joint pain down the road.

Depending on the type of the deformity and its location in the foot, we carry out a simple test that indicates which type of treatment is needed — either conventional braces or the foot-ankle type, which is applied over the feet and ankles.

Such treatment requires time. As the child grows, it is necessary to periodically change orthopedic devices and braces, so they feel comfortable and properly support his feet during the treatment process.

How do exercises and massage help in the treatment of foot deformities?

These types of treatments play a significant role in addressing the weakening of the ligamentous apparatus of the foot and its tension. If a child has a flatfoot, for example, and his ligament is more flexible and weak, exercises and massages will help to strengthen the foot muscles. If the muscles of the foot more rigid and uptight, exercises will contribute to their relaxation, and stretching the ligaments will allow the child to walk normally.

When should parents see a podiatrist for advice?

Usually, we want to see the young patients as early as possible. Unfortunately, we can’t rely on pediatricians to send these children to us. It’s best that parents watch their children and let us know directly about anything that seems wrong or abnormal in their children’s feet or walking gaits.

Pediatricians often tell parents that this is a normal process and that the gait will eventually improve by itself. In many cases this is true, but we advise parents not to take the risk. Check with us instead. Simple braces ensure that the deformity will not progress or cause future pain or walking problems.

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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HOW TO HELP A FRIEND WITH DEPRESSION FORGET LOGIC — TRY THESE TIPS INSTEAD

■■■ By Lynn Merrell The World Health Organization (WHO) estimates that 350 million people are affected by depression around the world, making it the leading cause of disability. It not only causes serious symptoms in the patient suffering with it, but it can also cause stress and confusion among friends and families.

It’s really hard to watch someone you care about suffer when you don’t know what to do.

If you know someone with depression, we have some suggestions for you.

WHAT IS DEPRESSION? First it’s important to realize that true depression is more than feeling blue for a few days. The American Psychiatric Association (APA) states that it is a common and serious medical illness that causes symptoms from mild to severe that last for six to eight months or longer. Those symptoms may include: ■ Loss of interest in activities you used to ■ ■ ■ ■ ■ ■

enjoy Sad and down mood Trouble sleeping Changes in appetite Feelings of being worthless or guilty Difficulty concentrating Thoughts of death or suicide

A lot of things can cause depression, including life events like a death or divorce, giving birth to a baby, or going through a traumatic event. It can also be inherited, so that the person experiences it even without an event to set it off. Sometimes there is an imbalance of neurotransmitters in the brain that can result in depression, or a psychological condition that increases risk.

WHAT FRIENDS AND FAMILY CAN DO If you see signs of depression in a friend or loved one, the first thing to do is to express your concern. Sometimes people aren’t aware of just how serious their symptoms have become, and it can help to have an outside opinion. Explain how various changes in the brain or environment can cause the condition, and that the person is not to blame. Allow the other person to express his feelings, and gently suggest he seek treatment from his doctor or counselor.

Above all, avoid becoming critical or judgmental. This will only shut the conversation down and encourage the other person to hide their true feelings. Offer to help find a good counselor if your friend doesn’t have one, or to make a list of the symptoms he is experiencing. If he is going through a life-threatening episode, contact a doctor or emergency services immediately.

One key thing to remember is to refrain from logic. A person under the throes of depression will not respond to logic. Instead, validate the person’s feelings again and again.

Her experience is unique, and only she knows what it’s really like. Acknowledge that, and avoid offering advice. Instead, gently offer to help her get treatment from a professional.

Remind her that this is a medical problem, like an infection, and that only a doctor can help her to feel better.

Stay in contact. If the person doesn’t respond to your initial efforts, try again a few days later. Reinforce the fact that you care, and want to help. Enlist other friends and loved ones to help too, but don’t bombard the person. Take turns spending time, going by to chat, taking the person to lunch, and that sort of thing. Act like a friend, but remember that the person is suffering from a medical problem, and that treatment is key.

Finally, don’t forget to take care of yourself.

Caring for someone with depression, particularly if that person is under the same roof, can be stressful and exhausting. Make a point to take breaks, talk with others who understand, and replenish your own positive energy. It will help you to remain patient and compassionate when you need to.

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YOUR SHORTNESS OF BREATH MAY BE PULMONARY HYPERTENSION HIGH BLOOD PRESSURE IN THE LUNGS CAN CAUSE FATIGUE

■■■

By Gordon Barclay

A little while ago, a friend of mine ran a marathon. Even though he trained hard, about halfway through he had to stop. Soon after that, he went to the hospital. I was really concerned about him, so was grateful to hear a day later that he was okay. He told me he had “pulmonary hypertension.”

I said, “You have what?”

blood disorders, and certain types of congenital and other heart diseases.

Once the injury occurs, it changes the way the cells work, causing the muscle to contract more than it should around the lung’s blood vessels. In short, these muscles cut off the blood flow, squeezing the vessels so they become narrowed, thick, and stiff. That makes it harder for the heart to pump blood through them, creating a high blood pressure in the heart-to-lung system.

COMPLICATIONS OF PULMONARY HYPERTENSION WHAT IS PULMONARY HYPERTENSION? I’d heard of hypertension. Most of us have. It’s high blood pressure, and it means your heart has to work too hard to pump blood through your arteries. Doctors usually prescribe medication to lower it, because high blood pressure over a long period of time can increase risk of heart attack and stroke.

But I’d never heard of pulmonary hypertension. Turns out that “pulmonary” refers to the lungs, so pulmonary hypertension means high blood pressure in the lungs.

I was confused. How do you get high blood pressure in the lungs?

CONDITION CLOSES OFF THE LUNG’S BLOOD VESSELS The lungs have their own blood vessels that collect oxygen and take it back out to the heart. The heart takes that oxygenated blood and pumps it out to the rest of the body. The American Heart Association (AHA) calls this the “heart-to-lung” system that regularly circulates blood in and out of the lungs to pick up oxygen.

Experts say that pulmonary hypertension is actually not related to regular hypertension. Weird, right? You’d think it would be! But apparently this is a separate condition that is actually quite rare, and is caused by injury to the cells that line the small blood vessels of the lungs.

Scientists don’t know what causes this initial injury, but they believe it may run in families, and may also be caused by some illegal drugs, medical conditions like lupus or cirrhosis, other lung diseases, 4HEALTH | 877.807.0989

Symptoms of pulmonary hypertension include shortness of breath, like my friend experienced, as well as chest pain, a racing heartbeat, fatigue, decreased appetite, and pain in the upper right side of the abdomen. As the disease progresses, it can also cause fainting, lightheadedness, and swelling in the ankles and legs.

More severe complications of the condition may include arrhythmias (irregular heartbeat), bleeding in the lungs, heart enlargement, and heart failure.

HOW IS PULMONARY HYPERTENSION TREATED? Doctors usually turn to medications first to help improve symptoms and slow the progression of the disease. That’s what happened with my friend — he started taking medications right away. Some blood vessel dilators, for example, can help open up the affected blood vessels, while other medications may also allow the blood to flow through the lungs more easily.

Oxygen therapy can help in some cases, particularly in people who also have sleep apnea. Surgery is a last resort, and doctors suggest it only if the medications stop working. Typical procedures include openheart surgery to relieve pressure on the heart, and heart-lung transplants.

If you’re having trouble breathing, and you also feel tired and dizzy, check with your doctor. Early treatment for pulmonary hypertension is your best approach for living with the disease.

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DIAGNOSED WITH CHRONIC VENOUS INSUFFICIENCY DEFINITION, SYMPTOMS, & TREATMENTS

■■■ By Colleen M. Story If you’ve just been diagnosed with chronic venous insufficiency (CVI)—or if you have a loved one who has — you may have a lot of questions. What is this condition, and what does it mean for the future?

WHAT IS CHRONIC VENOUS INSUFFICIENCY? Estimates are that over 30 million Americans suffer from CVI, but many of those are undiagnosed and untreated. The condition occurs when the veins in the body aren’t working correctly.

While arteries take oxygen-rich blood from the heart out to the rest of the body, veins return oxygen-deprived blood back to the heart.

They often have to work against gravity to do so, and have “valves” inside them that keep blood from falling back down into the feet, for example. Sometimes, these veins become unhealthy, though, and start having problems doing their job. When this happens, the blood may pool into the wrong places, causing pressure and pain.

THREE TYPES OF VEINS There are three general types of veins in the body: ■ Superficial veins — you can see these through your skin ■ Deep veins — these lie within groups of muscles ■ Perforating veins — these connect the superficial veins to the deep veins When you’re standing up, the veins in your legs have to work against gravity to get blood back to your heart. This involves leg muscles that squeeze the veins and valves to keep blood from sinking back down.

When the veins are working properly, the blood flows as it should. In someone with CVI, however, all is not well.

cording to the Cleveland Clinic, an estimated 40 percent of people in the U.S. have it, usually after the age of 50.

HOW IS CVI TREATED? Catching CVI early is the best way to treat it. If you have any of the symptoms mentioned above, or if you have a family history of the disease, check with your doctor. He or she may use an ultrasound to examine the veins in your legs. If you catch the condition early enough, you may be able to manage it with regular exercise, weight loss, and by elevating the legs above your heart whenever possible. Compression stockings and some medications may also help.

There are nonsurgical treatments that can cause dysfunctional veins to collapse and disappear, helping you to feel less pain and even improving the appearance of your legs. “Sclerotherapy,” for example, involves injecting a solution into the vein to cause it to collapse. A newer treatment called “endovenous thermal ablation” uses a laser or highfrequency radio waves to create heat in the affected vein, which closes it off with minimal bleeding and bruising.

If you’re suffering from sore legs, varicose veins, and/or skin ulcers, check with your doctor. There are many treatment options available, so there’s no reason for you to live with the pain.

WHAT HAPPENS IN PEOPLE WITH CIV? People with CVI have veins that are damaged somehow. Maybe the vein walls have weakened over time or because of illness. Maybe the valves aren’t working right anymore, and allow blood to sink back through. Maybe the vein is blocked, which stops blood flow.

All these issues cause blood to stop and pool in certain locations in the body, often in the legs and feet. This can cause symptoms like swelling, painful legs, difficulty walking, tight calves, varicose veins, brown-colored skin, and sometimes, leg ulcers. These problems often get worse the longer you sit still or stand.

WHAT CAUSES CVI? Lack of exercise, pregnancy, obesity, surgery, leg trauma, smoking, aging, deep vein thrombosis (blood clot deep in the leg), and a family history of the disorder can all increase your risk of developing it. Ac-

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718-509-0906 www.USAVeinClinics.com

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COULD YOUR CONSTIPATION BE HURTING YOUR KIDNEYS? STUDY FINDS LINK BETWEEN CONSTIPATION AND KIDNEY DISEASE

■■■ By Lynn Merrell Few of us make it through our lives without experiencing constipation at least one time or another. But what if your constipation is signaling you that something else is going wrong?

It’s rare, but it can happen. One study of over 70,000 women, for example, found that women with severe constipation had a 23 percent increased risk of heart disease.

Now, a more recent study suggests there may be a connection between constipation and kidney disease. These studies alert us to the fact that sometimes, constipation isn’t just a problem of not getting enough water or exercise. Find out how you can stay alert to what your bowels may be telling you.

WHAT IS CONSTIPATION? The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) defines constipation as a condition in which you have fewer than three bowel movements a week, or hard, dry, and small bowel movements that are difficult to pass. It’s a very common condition, affecting about 42 million people in the U.S., and usually lasts for only a short time.

Common causes of constipation include lack of dietary fiber, lack of daily exercise, routine changes (such as occurs with travel or pregnancy), and some medications. Health problems like diabetes, inflammatory bowel disease, and thyroid issues can also increase risk.

CHRONIC CONSTIPATION IS MORE SERIOUS In addition to the common occasional constipation that affects most people, there is also another kind that is more rare, but causes more health issues: chronic constipation. This type lasts longer, and can significantly affect a person’s quality of life.

It can also cause complications like hemorrhoids, anal fissures, rectal prolapse, and impaction, all of which typically require medical attention.

Chronic constipation is more common in older adults, and in those with other health problems like multiple sclerosis, Parkinson’s disease, and in those who have suffered as stroke.

STUDY FINDS LINK BETWEEN CONSTIPATION AND KIDNEY DISEASE Researchers from the University of Tennessee Health Science Center and Memphis Veterans Affairs Medical Center examined about 3.5 million veterans in 2004, 2006, and 2013. All had healthy, normal kidneys at the start of the study, but then some developed kidney disease down the road.

The scientists analyzed all the data and found that patients with constipation were 13 percent more likely to develop chronic kidney disease (CKD), and 9 percent more likely to suffer from kidney failure. They also found that severe constipation was linked to a higher risk of developing kidney disease.

“Our results suggest the need for careful observation of kidney function trajectory in patients with constipation,” said study author Dr. Csaba Kovesdy, “particularly among those with more severe constipation.”

CONNECTION BETWEEN THE GUT AND THE KIDNEYS Why would constipation affect the kidneys? Researchers aren’t sure yet, but they have some ideas. The authors of this study, for example, suggested that constipation may create changes in the natural microflora that exists in the gut. This is the balance of bacteria that we all have, and that helps to keep the immune and digestive systems healthy.

Constipation can rob the gut of healthy bacteria, or it could be that a lack of healthy bacteria causes constipation. Either way, the imbalance can then result in inflammation inside the gut, and is also likely to result in an accumulation of toxins that would normally be expelled as waste.

These changes can all make it harder for the kidneys to do their job. If patients use laxatives to deal with the constipation, that too can cause additional problems for the kidneys, leading to dehydration and electrolyte imbalance.

If these ideas prove to be true, it could be that in treating and curing constipation, we could also be protecting our kidneys.

Researchers suggested that everyone do their best to eat a high-fiber diet, exercise regularly, drink plenty of water, and try to avoid laxatives to prevent not only constipation, but kidney problems. In addition, they suggested using probiotics (which you can find in supplements and in fermented foods like yogurt, miso soup, and kefir) rather than laxatives to treat constipation.

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DID YOU GET THE RIGHT DIAGNOSIS FROM YOUR DOCTOR? MEDICAL MISTAKES LEAD TO DAMAGING CONSEQUENCES

■■■ By Colleen M. Story Did you know that hospital errors are the third leading cause of death in the U.S.? Research published in the Journal of Patient Safety reported that up to 440,000 Americans die each year from preventable hospital errors. Some of those errors occur when doctors make the wrong diagnoses.

We expect, when we go to see the doctor, that he or she will be able to wave a magic wand and tell us what’s causing our symptoms. It’s not always that easy, however. Mistakes can be made, and made more easily than you may think.

Fortunately, you can do to help your doctor come up with the right diagnosis. Follow these tips can reduce your risk of receiving treatments that could do you harm, or of having serious conditions ignored.

4HEALTH | 877.807.0989

4HEALTH 1. WRITE DOWN YOUR SYMPTOMS.

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Place: Where on your body does it hurt?

When you’re sitting in the doctor’s office, it’s easy to forget all the symptoms that brought you there in the first place. Your doctor needs details, however, to discover telltale patterns in what you’re experiencing.

If you’re having consistent headaches, for instance, there are a myriad of things that could be causing them. It’s important to help your doctor determine which one it is in your case. Do you get headaches after stressful days at work? Do they get worse when pollen counts are high? Are they more frequent after you eat certain foods?

Get in the habit of writing your symptoms down, and include everything you can think of — what you ate, what you did that day, how well you slept, and any other details that may be important. Keep a list nearby and add to it each night until you see the doctor, and then take the list in with you to share.

2. TAKE A PICTURE. This is especially effective if you’re suffering from skin conditions (like rashes or allergic reactions), long-lasting wounds, tremors, infections, or the like. It may gross you out a bit, but realize that it can help your doctor to make a more accurate diagnosis.

3. USE THE ALPHABET FORMULA. Think of the letters “O-P-Q-R-S-T” and write down your answers to the corresponding questions.

Onset: When did the problem start? What were you doing at the time? Was it sudden or gradual?

Quality: Describe what you’re feeling. Is the pain stabbing and sharp or aching and dull? If you’re having stomach problems, is it bloated and heavy or cramping and squeezing? Try to describe your symptoms as accurately as you can.

Radiation: Do you feel the pain in other areas of the body, even if they seem unrelated? For example, does the pain in your back radiate down to your heel? Or does the pain in your belly extend up to behind your shoulder? These can be key clues as to what’s going on.

Severity: How bad is it? Most doctors ask you to rate your pain on a scale of 1 to 10, with 10 being the worst you’ve ever experienced. Be cautious, however — some people rate their pain too low to avoid being seen as wimpy or too sensitive, but this can work against you when doctors are trying to figure out what’s wrong. Be as accurate as you can, and take into consideration your own personality. If you’re the “strong and silent” type, maybe up your number by a notch or two.

Time: This is where you let the doctor know how long you’ve been suffering. A couple days? Weeks? Does it go on all day, or come and go?

Is there something that makes it worse — a “trigger?” In other words, does it hurt more when you first get up in the morning, or only when you twist from the waist?

The more details you can give your doctor, the more likely he or she will be to correctly diagnose your issue, which leads to the correct treatment and a faster healing time.

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CLASSIFIEDS

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To Place an AD in the Classifieds Section, Please Call (212) 738-9230 Per Diem Covering CHIROPRACTIC PHYSICIAN (NY/NJ Lic.)

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.

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

718-854-5100

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

(917) 750-2275

Dental Office in Brooklyn is looking for a part time Hygienist (Wednesdays, Fridays).

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

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

Call (718) 259-3828

Telephone (917) 412-3797

Good reimbursement.

718-954-2202

For details call (646)251-6646.

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

Excellent phlebotomy, medical terminology, computer skills.

Bilingual – English, Russian.

Medical Office is looking for PA or NP for Internal Medicine Doctor.

An opportunity exists for a Nurse Practitioner (NP) to care for Dermatology and Aesthetic patients in our outpatient clinic. The NP will be covering a full range of medical, aesthetic and minor office procedures.

Full-time job. Experience: NP - 1 year. NP License, Active DEA License, Russian Speaking a must.

Contact: info@allureclinic.com 347-683-3589 Richard

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.

(347) 587-3777

Call 347-713-6871

New multispecialty clinic looking for any specialty doctors.

347-453-0523

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

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

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Medical practice is looking for a Board-Certified Dermatologist.

Call 718-676-2565, ask Richard

Orthopedic Medical Office in Brooklyn is looking for an English-Russian speaking Front Desk Receptionist.

For more information please call 718-336-2258 ext.1 4HEALTH | 877.807.0989

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DENTISTRY - GENERAL

Vladimir LEMPERT, DMD

3037 Ave U Brooklyn, NY 11229

(888) 607-9725

DENTISTRY - PEDIATRIC

Marina KREPKH, DDS

7708 4th Ave Brooklyn, NY 11209

(888) 502-6245

INTERNAL MEDICINE

Victoria ALEKSANDROVICH, MD

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

(718) 207-7071

DERMATOLOGY

NEUROSURGERY

Narayan SANDARESAN, MD

5 E 84th St New York, NY 10028

(212) 328-0135

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

(844) 957-7463

Yekaterina LEVIN, DDS

7000 Bay Pkwy, Ste C Brooklyn, NY 11204

(888) 838-6212

Leonard LEVITZ, MD

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

(718) 528-1503

(718) 375-4747

321 Edison St Staten Island, NY 10306

Tariq LAMKI, MD

5 E 84th St New York, NY 10028

(212) 328-0135

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

GASTROENTEROLOGY

(844) 957-7463

Nataliya SAFONOVA, DDS

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

(888) 283-0399 OB/GYN - GENERAL

Anella BAYSHTOK, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160

158-06 Northern Blvd Flushing, NY 11358

(718) 445-3700 www.brooklynroc.com

Hayama BRILL, MD

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

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

Paul GLIEDMAN, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160 OPTOMETRY

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

Lilia LEVITZ, MD

2211 Ocean Ave Brooklyn, NY 11229

1749 E 16th St Brooklyn, NY 11229

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

(718) 375-4747

321 Edison St Staten Island, NY 10306

Irina BERLIN, MD

Margarita BAUMAN, OD

NEUROLOGY

40 West Brighton Ave, Ste 104 Brooklyn, NY 11224

1910 Ave U Brooklyn, NY 11229

Erico CARDOSO, MD

(718) 627-8300

5 E 84th St New York, NY 10028

(212) 328-0135

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

Namik YUSUFOV, DDS, MDT

(718) 759-6979

Hanna JESIONOWSKA, MD

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

(888) 455-6619

(844) 957-7463

305 W 28th St New York, NY 10001

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

Prabhakara R. TUMPATI, MD

ONCOLOGY

Faina SHNAYDMAN, MD

1749 E 16th St Brooklyn, NY 11229

170 Morris Ave, Ste A Long Branch, NJ 07740

OBESITY MEDICINE

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

PAIN MANAGEMENT

Amit SCHWARTZ, MD

948 48th St, Fl 2 Brooklyn, NY 11219

(718) 283-7219

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

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

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

Allure Clinic

nd

(718) 360-9550 nyurology.com

VASCULAR SURGERY

Ada KULAGINA, LAC

8635 21st Ave Brooklyn, NY 11214

(888) 600-2262

(718) 934-8484

PHYSICAL THERAPY

Alina VASILYEVA, DPM

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

(718) 646-0131

PSYCHOLOGY

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

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Globe SURGICAL SUPPLY Yuly CHALIK, MD

USA VEIN CLINICS

(347) 508-3991

2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

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

www.nyui.org

1153 First Ave New York, NY 10065

2444 86Th St, Ste A Brooklyn, NY 11214

Albert GROSS, CNS, NYS, CDN

2029 Bath Ave Brooklyn, NY 11214

(888) 418-0442

1942 E 8th St Brooklyn, NY 11223

(718) 376-8317 www.nylifex.com

MULTI SPECIALTY

116-02 Queens Blvd Forest Hills, NY 11375

1901 82nd St Brooklyn, NY 11214

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

www.magichandspt.com

4159 Broadway Washington Heights, NY 10033

(718) 490-2416 PLASTIC SURGERY

USA VASCULAR CENTERS

1975 Hylan Blvd Staten Island, NY 10306

Vladislav RUDNER, PT

Chloe CARMICHAEL

230 Park Ave, Fl 10 New York, NY 10196

(212) 729-3922 PSYCHIATRY

Vitaly RAYKHMAN, MD

2632 E 14 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

th

(347) 508-3991

30-33 Steinway St Astoria, NY 11103

2444 86th St, Ste A Brooklyn, NY 11214

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

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

(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

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

Michael PATIN, MD

(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

4HEALTH | 877.807.0989

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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