4Health Magazine # 202 issue

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ASK A DOCTOR | FIND A DOCTOR

ARE E-CIGARETTES BETTER FOR YOUR TEETH AND GUMS?

WHY THINGS HURT MORE WHEN YOU GET OLDER

HOW TO TELL

IF YOU’RE SUFFERING FROM A BLOOD CLOT

YOUR EYE DOCTOR

MAY SOON SCREEN YOU FOR ALZHEIMER’S

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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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How to Tell if You’re Suffering from a Blood Clot

Signs of a Serious Medical Emergency

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11 8 Are E-Cigarettes Better for Your Teeth and Gums?

What the Research Shows So Far

10 Is America Getting Smarter About Food Choices?

New Study Shows Our Preferences are Shifting

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26 Why Things Hurt More When You Get Older

EH? DO YOU HAVE TOO MUCH WAX IN YOUR EARS? Some People More at Risk than Others—and It’s Not About Hygiene!

IF YOU HAVE EPILEPSY, BE AWARE OF SUDEP Rare but Deadly Sudden Deaths Occur Each Year

STABBING, EXTREMELY PAINFUL HEADACHES How to Find Out if You Suffer from Cluster Headaches

WHAT’S CAUSING YOUR BELLY FAT?

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IF I GO THROUGH TREATMENT FOR UTERINE FIBROIDS, CAN I STILL GET PREGNANT?

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ERASE SUN DAMAGE AND LOOK GREAT FOR FALL!

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New Study Shows Signs of Alzheimer’s Exist in the Retina

You Don’t Have to Suffer From Stomach Upset

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35 Your Eye Doctor May Soon Screen You for Alzheimer’s

4 COMMON DIGESTIVE PROBLEMS & HOW TO DEAL WITH THEM

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By Dr. Prab R. Tumpati

Women Get Answers from USA Fibroid Centers

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

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

PELVIC ORGAN PROLAPSE? WHAT’S THAT? Women Have Options When It Comes to Treatment

THE “GENDER GAP” IN CYSTIC FIBROSIS Recent Research Sheds Light on Why the Disease is So Hard on Women

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PAINFUL LEGS AFTER EXERCISE? IT COULD BE PAD

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RENTERS MORE LIKELY TO SUFFER FROM INDOOR POLLUTION

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COLD? FLU? ALLERGIES? TRY THIS SOLUTION!

Check with Your Doctor to Avoid Serious Complications

Study Shows Home Owners Better at Taking Preventative Steps

Acupuncture Can Reduce Reliance on Medications

Studies Show that Taming Inflammation May be Key

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HOW TO TELL IF YOU’RE SUFFERING FROM A BLOOD CLOT SIGNS OF A SERIOUS MEDICAL EMERGENCY

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By Lynn Merrell

A blood clot can be very serious. You’ve probably heard that it can cause a heart attack or stroke, but it can also a pulmonary embolism, which is a blood clot in the lungs. All of these are potential life-threatening situations, but here’s the question: Would you know if a blood clot was lodged in one of your veins or arteries?

You may imagine that you would suffer noticeable symptoms like chest pain or an inability to breathe, but it’s not always that clear-cut. Find out the typical symptoms of blood clots below.

the blood from leaking out. The body also creates messages that tell more platelets to come and help.

Gradually, the plug grows and becomes tougher, sealing the wound so no more blood can escape. Once the danger has passed, the body sends messages to stop the process so it doesn’t get out of hand. Blood flow is restored.

The process that you see when you cut yourself is similar to what can happen inside your body. Just like platelets form a blood clot to stop the bleeding from your cut, they can also form a blood clot inside the artery if they think they need to, or if something messes with how your blood normally works.

(DVT) are other circulatory conditions that can increase risk of blood clots.

SIGNS YOU MAY HAVE A BLOOD CLOT If you have been diagnosed with heart disease, DVT, peripheral arterial disease (PAD), or other similar illnesses, you are already at risk for a blood clot, and may be taking medication to reduce that risk. But sometimes, a blood clot can come as a surprise.

Here are some signs to watch for: ■ Pain, swelling, tenderness, and/or discol-

oration in your lower leg, often the calf.

■ Chest pain and a feeling of heaviness in

the chest.

■ Vomiting and severe pain in the abdo-

men.

WHAT IS A BLOOD CLOT? Blood typically flows through our veins and arteries smoothly, but there are occasions when we need it to stop. If you cut yourself, for example, and the body had no way of stopping the blood, it would just keep dripping out of the cut until you bled to death.

Fortunately, the body does have a system that blocks blood flow. You can think of it as your body’s own first-aid repair against bleeding. When you cut yourself or suffer from another wound that breaks the skin, the body releases messages that tell tiny platelets in the blood to go to work. These platelets begin to stick to each other, forming a plug that stops

WHAT CAUSES BLOOD CLOTS? In addition to outside injuries, internal injuries can also cause blood clots. If you have cholesterol buildup inside your arteries, for example (called atherosclerosis), that buildup can harden into clumps of plaque. If part of that plaque then breaks off, the body sees it as an injury and goes to work forming a clot over it.

The clot, however, since it’s inside an artery, can cause a heart attack or stroke.

Blood clots can also form if you have a vein condition that causes blood to pool in your legs. Blood that simply sits there is more likely to activate platelets, increasing risk of a clot.

Atrial fibrillation and deep vein thrombosis

■ Sudden, super intense headache accom-

panied by confusion or difficulty speaking.

■ Shortness of breath, pain when breathing deeply, hacking cough, and fast heart rate.

If you have any of these symptoms, particularly if they’re accompanied by weakness, vision changes, coughing up blood, or just a feeling that something is really wrong, see your doctor immediately.

To reduce your risk of blood clots, get regular checkups with your doctor, take all prescribed medications as instructed, and avoid sitting for long periods of time.

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ARE E-CIGARETTES BETTER FOR YOUR TEETH AND GUMS? WHAT THE RESEARCH SHOWS SO FAR

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By Morgan Rice

Smoking cigarettes increases risk of a number of health problems, including cancer, lung disease, heart disease, type 2 diabetes, and more. The Centers for Disease Control and Prevention (CDC) states that cigarette smoking causes more than 480,000 deaths each year in the U.S., and increases risk of death from all causes in both men and women.

Beyond these deadly risks, smoking also causes something else that most people hate: icky teeth. In addition to yellowing the teeth themselves, it also leads to bad breath, gum disease, and tooth loss, while increasing risk of oral cancer.

Still, it’s not easy to quit. Many people who smoke know about the risks and want to change, but find it extremely difficult. Then along came e-cigarettes. Companies advertised them as being “healthier” than regular tobacco cigarettes, so many people have switched, thinking they were doing something good for their health.

It’s true that e-cigarettes don’t contain the toxic chemicals and tar produced by tobacco, but recent studies show they still have a number of potentially dangerous chemicals that can damage the lungs — and unfortunately, the teeth and gums.

HOW SMOKING DAMAGES THE TEETH AND GUMS Regular smoking is horrible for your mouth. The CDC states that it is an important cause of severe gum disease in the U.S., because it weakens the body’s ability to fight off infection-causing bacteria. It also makes

it harder for the gums to heal once they are affected by gum disease.

Turns out that if you smoke, you have twice the risk for gum disease as non-smokers. That risk increases the more cigarettes you smoke and the longer you smoke. Once you have gum problems, smoking lowers your ability to benefit from treatment. That means that even if you go to the dentist for help, he may not be able to heal your gum disease as well because the smoking affects your body’s ability to recover.

Regular smoking also stains your teeth, discolors your tongue, and creates bad breath.

It increases risk of gum recession, which causes tooth sensitivity; raises your odds that you’ll need root canal treatment, damages tooth enamel, and makes you twice as likely to lose your teeth.

Smoking spells disaster for your mouth, period. In addition to all these problems, it also increases your risk of oral cancer, which is extremely dangerous. Studies show that the 5-year survival rate for oropharyngeal cancer is only about 50 percent.

they contain a number of other chemicals, including solvents and flavorings.

For the study, researchers exposed the gum tissue of nonsmokers to either tobacco- or menthol-flavored e-cigarette vapor. They found that e-cigarette vapors caused damage to gum tissue cells — damage that was comparable to that caused by exposure to regular tobacco smoke.

The researchers noted that nicotine, which is the main addictive component of all cigarettes, is a known contributor to gum disease.

E-cigarette flavorings may actually exacerbate the damage that nicotine causes, with mentholflavored vapor considered the most dangerous.

In a second study, researchers exposed oral cells to e-cigarette vapor, and found that it caused a high rate of cell death, which could indicate a risk for cancer. “Damage to the defensive barrier in the mouth,” said lead author Dr. Mahmoud Rouabhia, “can increase the risk of infection, inflammation, and gum disease. Over the longer term, it may also increase the risk of cancer.”

BOTTOM LINE: IT’S STILL BEST TO QUIT ARE E-CIGARETTES BETTER FOR THE TEETH? E-cigarettes don’t contain tobacco.

Instead, they contain nicotine in a chemical solution that is heated and vaporized so you can inhale it.

Yes, you are spared the teeth-yellowing effects of tobacco, but that doesn’t mean you’re “home free” when it comes to oral health. According to a recent study, e-cigarettes may be just as harmful as regular ones when it comes to your teeth and gums. That’s because while they may not contain tobacco,

E-cigarettes are fairly new on the market, so we are still discovering what harms they can do. We need more studies to be sure, especially when it comes to oral health. For now, it seems the best approach is to quit smoking.

Some e-cigarette manufacturers say that they can help you quit. That remains to be seen. A better approach would be to talk to your doctor about methods that can help you quit. Most people have to try multiple times before they finally succeed. If you need motivation, simply look in the mirror. A healthy smile is worth the effort!

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DIGESTIVE PROBLEMS & HOW TO DEAL WITH THEM YOU DON’T HAVE TO SUFFER FROM STOMACH UPSET

■■■ Colleen M. Story How often have you suffered an upset stomach in the last week? The last month?

Did you tell anyone, or did you just suffer in silence? Have you talked to your doctor, or did you assume it wasn’t serious enough to discuss?

Digestive problems can be difficult to solve, often because they can be difficult to talk about. Yet more and more of us are suffering from them. Stephen Bickson, professor of internal medicine at Virginia Commonwealth University, notes that digestive disorders are a growing burden on Americans, causing an unprecedented number of clinic visits and hospitalizations.

Here are four of today’s most common digestive problems, and some potential remedies. Remember to check with your doctor if you suffer any of these frequently, as he or she may have a more lasting solution for you.

1. REFLUX (INDIGESTION AND HEARTBURN) This is one of the most common digestive ailments, and can range from the occasional bout of heartburn after a big meal to regular reflux symptoms that may indicate a person has gastroesophageal reflux disease (GERD).

You’re likely to feel a burning feeling in the upper abdomen and chest, accompanied by a sour taste in the mouth. If you have heartburn once a week or more, check with your doctor.

He or she may prescribe acid-reducing drugs to help ease your symptoms. (Always ask

about potential side effects.) Other solutions include eating less but more often, cutting back on carbohydrates, chewing your food well (slow down), and chewing gum, which helps neutralize stomach acids. Don’t eat right before lying down, as that can encourage reflux, and cut back on alcohol if needed.

2. IRRITABLE BOWEL SYNDROME (IBS) IBS affects up to 23 percent of Americans.

Symptoms include abdominal pain, cramping, bloating, diarrhea or constipation, and gas, typically coming and going but bothering you for three months or longer. These symptoms can also be connected to other, more serious gastrointestinal problems, so it’s important to check with your doctor. Treatments may include fiber supplements, anti-diarrheal medications, or other medications like antidepressants and antibiotics. You may also be able to tame symptoms yourself by eliminating carbonated beverages, salads, and raw produce like cabbage, broccoli, and cauliflower from your diet (cook them instead). Other potential solutions include eating smaller mails, reducing the intake of dairy products, drinking plenty of water every day, and exercising regularly.

3. CONSTIPATION Everyone hates feeling backed up, particularly if it results in a big, distended belly. In addition to the discomfort, constipation keeps toxins in the stool hanging around for longer in your body, where they can be reabsorbed, potentially causing other symptoms. The main solutions include

drinking more water and eating more fiber in the form of bran, fruits and vegetables, and whole grains. Fiber supplements may help, as well. Physical exercise does the trick for many people. Stress relief may be key, as stress causes us to tighten up rather than relax, which can affect the colon. Stimulant laxatives may be necessary in some situations, but don’t use them regularly, as they can cause dependence and may interfere with your body’s ability to absorb vitamin D and calcium.

4. GAS & BLOATING Do you frequently blow up like a balloon after you eat? Does the beach-ball feeling stay with you for hours afterward? Bloating is unpleasant overall, and can also be embarrassing. It may be related to your diet, or there may be other medical conditions causing it. Check with your doctor, and then try to keep a “diet journal” where you track exactly what you eat and drink and when you suffer from gas and bloating. Carbonated beverages, coffee, and artificial sweeteners are culprits for many people. Lactose intolerance is common, and may be causing your symptoms. Fructose, which is a sugar found in fruit juice and as a sweetener in other drinks and processed foods, is also a common irritant for many people.

Your doctor can test you for both of these. Slow down when you eat, eat smaller meals, and work to reduce your stress. Consider digestive enzymes before each meal, as they can help the body better break down the nutrients. Other potential natural remedies include dandelion tea, magnesium supplements, and probiotics (such as those found in yogurt).

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EH?

DO YOU HAVE TOO MUCH WAX IN YOUR EARS?

SOME PEOPLE MORE AT RISK THAN OTHERS — AND IT’S NOT ABOUT HYGIENE! ■■■ By Gordon Barclay I’m not someone who obsesses about earwax, but a friend of mine recently told me about his strange experience. Seems he was going about his life like usual when he suddenly started having trouble hearing. He made a point to clean out his ears, but it didn’t help. In fact, it seemed to make it worse. His ear actually started to ache, and he suffered from tinnitus (ringing in the ear).

Finally, he went to see his doctor. Turns out he had an earwax buildup in his ear. Apparently, when he tried to clean it, he just pushed the wax deeper into the ear canal. When I asked him what would cause

the buildup in the first place — I mean, my friend’s a pretty hygienic guy — he told me that his doctor said that some people are just more at risk for this sort of thing.

Turns out it usually has nothing to do with how well you clean your ears. Instead, it’s all about your genetics, age, and other factors that can affect how much earwax your ears produce!

WHO’S AT RISK FOR EARWAX BUILDUP? You may wonder what we have earwax for anyway. I did. Turns out that scientists don’t really know, though they think it has something to do with trapping dust and other small particles to keep them from 4HEALTH | 877.807.0989

4HEALTH reaching the eardrum. We do know that the wax itself has antibacterial and antifungal properties, so it has to be protecting us on some level.

(I know — who conducted those tests?)

Now this is a little gross, but it’s important to understand: most of the time, the ear wax we produce dries up and falls out of the ear, along with any dust and debris. That’s why most of us don’t have any trouble with it, even if we’re not really careful about washing our ears.

Some people, though, are at risk for earwax buildup for a number of reasons. If they have small or differently shaped ear canals, for example, the wax may have a harder time falling out and therefore remain where it is, eventually leading to a buildup. People who naturally produce dryer earwax than normal may also be at risk for clumping. Those who frequently use hearing aids or earplugs may be more prone to earwax blockages. Older people, frequent swimmers, and those who suffer from the skin condition “eczema” may also produce excessive earwax.

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give you instructions on how to remove the earwax at home. If he decides to treat you in the office, he may remove the wax with a small tool, or flush it out with eardrops or suction.

HOW CAN I REMOVE THE EARWAX MYSELF? If you know that earwax buildup is the problem — maybe you’ve had it in the past — you can address it yourself. Just be sure you check with your doctor first, to be sure there isn’t something else going on.

To remove earwax at home, use over-the-counter softening drops, or simply flush the ear out with water. To use the drops, put some into the affected ear, then drain the ear by holding your head to the side for a few minutes. To flush out your ears with warm water, use a bulb-type syringe to put some water in the ear, then turn the head to let it drain out. Use water that is at room temperature.

Note that doctors don’t endorse “ear candling.” It presents a fire hazard, and studies have shown that it is not effective at removing wax.

WHEN TO SEE THE DOCTOR ABOUT YOUR EARWAX How can you tell if earwax may be affecting your hearing, or causing other problems? Watch for symptoms like sudden decreased hearing, dizziness, ringing in the ears, a “plugged” or “full” feeling in the ear, itching inside the ear, ear pain, or some sort of drainage coming out of the ear (which can indicate an infection).

It’s important to see your doctor as soon as you notice problems.

Left untreated, an earwax buildup can lead to an infection inside the ear canal, which is much more serious and can cause long-term damage.

The doctor can easily diagnose an earwax buildup by looking into your ear with an ear-scope. He may then treat the blockage himself, or

HOW TO PREVENT AN EARWAX BUILDUP My friend doesn’t ever want to experience an earwax buildup again, so he’s taking some precautions. Doctors recommend the following tips: ■ Don’t use cotton-tipped swabs or any other small tools to clean

out the ear, as they only push the wax deeper into the ear canal.

■ Use over-the-counter eardrops that break up wax as a preventive

measure. Use about once every two weeks.

■ You can also use natural, warmed olive or almond oil to soften

earwax and allow it to drain out.

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4HEALTH

IF YOU HAVE EPILEPSY, BE AWARE OF SUDEP RARE BUT DEADLY SUDDEN DEATHS OCCUR EACH YEAR

■■■ By Colleen M. Story The good news for people with epilepsy is that in most cases, the condition can be controlled and is not life threatening. Unfortunately, sudden, unexpected death in epilepsy (SUDEP) occurs each year in about one in 1,000 adults, and in one in 4,500 children. It is the leading cause of death in those who have not been able to control their seizures.

The stories are tragic. One family who shared their story with the Epilepsy Foundation lost their 19-year-old son to SUDEP. He was a student at the University of Virginia when he went home one December to enjoy some time off with family and friends. Three days after he arrived, his family found that he had passed away in his sleep. They had no idea that he was at risk.

This is the danger of SUDEP. Many people with epilepsy and their families remain unaware of the risks. Organizations like the Epilepsy 4HEALTH | 877.807.0989

4HEALTH Foundation are trying to help people to make sure they get the treatment they need to avoid a similar tragedy.

WHAT IS SUDEP? SUDEP is defined as death that occurs because of the epilepsy itself — not because of any related problems like an injury or drowning, even if these were brought on by a seizure. Instead, the person dies because the disease itself causes a life-threatening issue. The death is usually unexpected, and the person is likely to have seemed in normal health before that.

People with epilepsy may suffer a seizure that causes pauses in breathing while sleeping, which can lead to a tragic death similar to the one suffered by the young man from the University of Virginia. A seizure may also cause a sudden, dangerous heart rhythm change or even heart failure, or may create both a breathing problem and a heart issue at the same time.

WHAT CAUSES SUDEP? Scientists are still unsure as to why SUDEP occurs. They do know that it usually happens at night or during sleep, which is why it’s difficult to find out more about it. The person is dead the next morning, and no one knows why. Autopsies typically find no evidence of cause of death.

Current research shows that a seizure may bring on some problem with breathing, heart rhythm, and brain function, or a combination of these. Scientists have found that after a seizure, it can be common for the brain to shutdown, and in people who die of SUDEP, it may be that it just wasn’t able to recover.

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Seizures are also known to affect heart rhythms, and in one study, researchers found that those who experienced a greater increase in heart rate during a seizure had a greater risk of SUDEP. In other words, if your seizures are already causing heart rhythm issues, you may be more at risk, and it’s important to talk to your doctor about preventive measures.

Changes in breathing, as noted, can also lead to SUDEP, and these changes are common during seizures. People with uncontrolled epilepsy may have low oxygen levels associated with their seizures, which if they are severe, may affect the brain or the heart enough to increase risk of SUDEP.

HOW TO REDUCE YOUR RISK OF SUDEP If you have epilepsy, or if a loved one has epilepsy, talk to your doctor about SUDEP. Then take the following precautions to reduce your risk: ■ Control your seizures as best you can. Take your medications

regularly and keep your medical appointments. Let your doctor know if your medications aren’t working as they should.

■ Do your best to avoid your seizure “triggers,” which include things like stress, illness, missed medications, alcohol, and fatigue.

Get enough rest, eat well, exercise regularly, and take good care of yourself.

■ Check with your doctor about your cardiovascular health. Make sure that you have a healthy heart, and address any related issues completely.

■ Consider a companion dog that can help sense seizures. Having this sort of helper nearby at night could alert you to any seizures that occur when your loved one is asleep. A seizure alert monitor during sleep may also help.

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STABBING, EXTREMELY PAINFUL HEADACHES HOW TO FIND OUT IF YOU SUFFER FROM CLUSTER HEADACHES ■■■ By Gordon Barclay Jim didn’t just get headaches. He got what he called “murderous” headaches, horrible things that were so painful he couldn’t do anything but go to bed, and still he couldn’t rest because as he said, it felt like someone was sitting on his chest stabbing an ice pick into his head. It was so bad that he had to get up and rock himself back and forth.

He’d gone to the doctor for help, but was told it was likely migraines.

He tried pain relievers, meditation, antihistamines, and more, and nothing was working. He started living in fear of when the horrible headaches would come back.

Jim finally went to see a neurologist, and was diagnosed with “cluster headaches.” Finally, his symptoms made sense, and he got some medications that though not perfect, were more effective than any others he had tried.

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4HEALTH Could you be a victim of this rare type of headache? Read on to find out.

WHAT ARE CLUSTER HEADACHES? Cluster headaches are rare, and occur in cyclical patterns or clusters. In other words, they come on in groups, attacking the victim for a series of weeks to months, and then backing off for a “remission period” that lasts for months and sometimes even years.

These headaches are believed to be the most painful kind there is.

Symptoms include sudden, excruciating pain, usually on one side of the head behind the eye, though the pain can radiate to the rest of the head, face, and neck. Other accompanying symptoms may include redness in the affected eye, stuffy nose on one side, flushing, tearing, and swelling.

The victim may also be sensitive to light and noise.

A cluster of these headaches typically lasts from six to 12 weeks.

Then they will go away for a period of a couple weeks or months. Each time they come back, they tend to last about the same length of time.

During these cluster periods, a headache occurs usually every day and sometimes several times a day. Most attacks actually come on in the middle of the night, usually a couple hours after you fall asleep. One attack will last from 15 minutes to 3 hours, and will end as suddenly as it began.

WHAT CAUSES CLUSTER HEADACHES? Scientists don’t know what causes these headaches, but they believe that the hypothalamus, which regulates the body’s biological clock, may play a role. They’ve also been called “alarm clock headaches” because they so typically show up at the same time each day.

Cluster headaches aren’t associated with any “triggers” though.

Whereas a tension headache may be brought on by stress and anxiety,

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or a sinus headache by allergies, or a migraine by eating certain foods, cluster headaches don’t seem to respond to any of these things.

We do know that men are more at risk for cluster headaches than women, and that they usually begin between the ages of 20 and 50.

Smoking, alcohol use, and having a family history of these headaches can also increase risk.

WHAT CAN I DO ABOUT CLUSTER HEADACHES? The good news is that like Jim, you can find relief from this painful condition. The key is to get a correct diagnosis. If you notice a clear pattern to your headaches, and if they are particularly painful, talk to your doctor and consider talking to a neurologist as well. A neurologist will assess your brain function, and may conduct a CT or MRI scan to look at the brain and rule out any other potential causes of your pain.

If you are diagnosed, there are several preventive medications that that help shorten the length of the cluster and lessen the severity of the headaches. These include calcium channel blockers (such as those used to treat high blood pressure), anti-seizure medications, corticosteroids, and lithium. Some studies have suggested that 10 milligrams of melatonin taken every night may also help.

If you’re suffering from one of these clusters, a shot of Imitrex (sumatriptan), along with oxygen therapy, can help stop the pain. In fact, breathing in oxygen on its own has been found to provide dramatic relief in most people. Other injectable medications can also help relieve pain and reduce frequency of the headaches.

Some nasal sprays can help, too. Talk to your doctor about our options. Surgery, in which the surgeon blocks the trigeminal nerve to reduce pain, is recommended only in the most rare, serious cases.

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IS AMERICA GETTING SMARTER ABOUT FOOD CHOICES? NEW STUDY SHOWS OUR PREFERENCES ARE SHIFTING

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By Gordon Barclay

What did you have for breakfast today?

It was a big one for me — scrambled eggs, patty sausage, wheat toast and a few sliced strawberries. You may have had something similar, or perhaps you grabbed a muffin while running out the door, or swallowed some cereal while checking your Facebook feed.

Whatever you chose for your breakfast, and whatever you will choose for lunch and dinner, scientists now say there’s more to it than simply picking what tastes good or what’s convenient.

There’s no doubt that how much time we have and what we may be craving can play a part in what we decide to eat, but a new study suggests that we’re getting smarter overall. We’re making healthier choices that we feel are better for the environment. In fact, we’re getting so smart that food manufacturers are scrambling to figure out how to get our attention!

PEOPLE MORE CONCERNED ABOUT HEALTH AND ENVIRONMENTAL IMPACT Researchers from the Deloitte Food Marketing Institute studied consumer behavior with regard to food and beverage shopping, and noticed that there has been a shift in spending. As people are able to communicate more efficiently with each other via the Internet and social media, they’re becoming better at accessing the “real” information about a certain food, and are therefore less vulnerable to marketing messages put out by food producers.

As technology facilitates improved information-sharing, consumers are thinking

about new things when purchasing food.

Whereas decisions used to be driven mostly by taste, price, and convenience, now consumers are just as likely to consider a series of what researchers call “evolving drivers” before making choices. These factors include: ■ ■ ■ ■ ■

Health and wellness Safety Social impact Experience Transparency (how “honest” the manufacture is, according to consumer perception)

Researchers noted that these value drivers “have become meaningful for a sizeable number of consumers surveyed; roughly half say their purchase decisions are significantly influenced by these evolving drivers.”

We still care about taste, price, and convenience, but we’ve been paying attention to what we’re hearing about healthy eating and environmental protection, and we’re starting to consider these things more carefully when we head to the grocery store.

SUPERMARKETS AND FOOD MANUFACTURERS CAN NO LONGER FOOL US This is really good news, as it means that food manufacturers may not be able to manipulate us as well as they have in the past.

It’s a well-known tactic in grocery stores and supermarkets, for example, for management to place fresh-baked bread or fresh flowers at the front of the store where people may be more drawn to them.

They also use special lighting to make the produce look better than it is, put staples like milk and eggs at the back of the store so you have to pass by a lot of other tempting items to get to them, and hang posters of happy, attractive people with full carts of groceries to inspire you to buy more.

The names manufacturers use in their products can also influence you to buy, even if you’re unaware of the effect they’re having on you. Words like “homemade,” “wholesome,” and “natural” mean nothing in terms of what’s really inside the package, but they can make you feel like you’re getting something that’s good for you.

This recent research shows that we’re now more aware of these tactics, which is why we are less trusting of stores and food companies than we used to be. That basic sense of mistrust is driving us to dig deeper to find out exactly what we’re buying.

“Focusing on the issue of trust,” Deloitte Consulting Partner Jack Ringquist told Consumer Goods, “big brands must engage consumers in genuine, two-way dialogue that increases transparency and assures alignment with consumer preferences.”

In fact, we’re demanding that manufacturers do a better job of using healthy ingredients, label their products clearly and honestly, and reduce their reliance on artificial ingredients.

The researchers concluded that only those companies who can better understand what our values are will grow in the future.

Nice job, America. Keep it up — healthy food with real ingredients that are good for us and good for the environment is what we want, and we’ll settle for nothing less.

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GENERATIONS

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Obesity Medicine | 4HEALTH23

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WHAT’S CAUSING YOUR BELLY FAT? YOU MAY HAVE INSULIN RESISTANCE!

During the past 20 years, there has been a dramatic increase in obesity in the United States. More than one-third of U.S. adults (35.7%) and approximately 17% (or 12.5 million) of children and adolescents aged 2–19 years are obese. Another 33% of all adults are in the overweight category.

Though there are a lot of things that can cause weight gain, I find the following four factors often play a crucial role in expanding my patients’ waistlines.

THREE THINGS HAVE CHANGED ABOUT HOW WE EAT Hippocrates, father of medicine, is quoted as saying, “Let food be your medicine, medicine be your food.” Over the past several decades, however, we’ve moved away from this concept, and now see food merely as “calories in, calories out,” which has changed our relationship to what we eat.

Three things happened to the modern diet that now contribute to the high levels of inflammation we currently see in the population at large, leading to increased health problems and disease. Understanding these three fundamental principles forms the foundation for a healthy and long life.

Belly fat and insulin resistance: Insulin resistance, or metabolic syndrome, affects one in three Americans and leads to excess belly fat. Unlike the subcutaneous fat that is protective, studies have shown that belly fat produces cytokines and other inflammation-causing chemicals that lead to the increased risk of cardiovascular disease, diabetes and other conditions. In fact, waist circumference of over 40 inches in men and 36 inches in women (lower in Asian Populations), is one of the five criteria for metabolic syndrome. This leads to belly fat which increases the risk of diabetes, heart disease and even cancer risk!

Lack of antioxidants: Before the modern food processing era, our diet used to have more than 50 percent unprocessed and uncooked food items such as colored fruits, vegetables, and other natural ingredients that are high in antioxidants such as polyphenols. Studies have shown that lack of polyphenols leads to increased inflammation in the body.

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Ratio of fats: The ratio of omega-3 to omega-6 fatty acids used to be 1:1, but is now at 1:16, which also increases inflammation.

THE FOURTH FACTOR More recent research has revealed a fourth factor in this list—lack of quality sleep. According to the National Institutes of Health, 50 to 70 million Americans are affected by chronic sleep disorders and intermittent sleep problems. The Centers for Disease Control and Prevention (CDC) adds that sleep insufficiency is linked to motor vehicle crashes, industrial disasters, and occupational errors.

Lack of proper duration and quality of sleep also contributes to insulin resistance, which in turn leads to weight gain. A 2012 study, for example, found that sleep deprivation impaired the ability of fat cells to respond to insulin, the hormone that regulates blood sugar. Unfortunately, this can set in a vicious cycle where sleep problems lead to weight gain and weight gain in turn—particularly if it leads to sleep apnea—can make sleep problems worse!

PHYSICIAN ASSISTED WEIGHT LOSS CAN HELP Reversing the many factors leading to weight gain such as insulin resistance, sleep apnea, lack of proper sleep, stress, nutritional deficiencies, food sensitivities, eating disorders, hormonal imbalances etc., can be very difficult to do on your own. Diet fatigue, discouragement, and the constant ups and downs can deter even the most disciplined person from his or her goals.

A physician familiar with weight loss, sleep disorders and wellness can be the helping hand you need to get back on track with your weight and your health. Realizing the bidirectional relationship between sleep disorders and weight gain, we are able to address these very inter-related fields together so you can lose weight, sleep better, and enjoy a healthier and perhaps even longer life.

Our delicious and affordable W8MD weight loss meal replacement supplements start as low as $2.25 cents per meal replaced and can save up to 15% on grocery food cost.

The biweekly program cost of $45.00 includes up to two appetite suppressant weight loss medications such as Phentermine, Topiramate etc. when appropriate.

NAME:

PRAB R. TUMPATI, MD CERTIFICATION: Board Certified in Internal Medicine & Sleep Medicine; Board Eligible in Obesity Medicine Member of the American Society of Bariatric Physicians

SPECIALTY: Internal Medicine, Sleep and Obesity Medicine

INSURANCE: Accept All Major Insurance Plans

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

(888) 283-0399 www.w8md.com

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IF I GO THROUGH TREATMENT FOR UTERINE FIBROIDS, CAN I STILL GET PREGNANT? WOMEN GET ANSWERS FROM USA FIBROID CENTERS Many women, when facing surgery for uterine fibroids, choose the minimally invasive procedure called “uterine artery embolization (UAE).” It used to be that the only options were to undergo a hysterectomy or myomectomy, but women can now enjoy less scarring and faster recovery with UAE, which has shown in studies to be safe and effective.

After the procedure, though, women often have questions about pregnancy. Can I still get pregnant? Are there any potential complications? Will my baby be okay?

The physicians at USA Fibroid Centers regularly hear questions like these. We asked them to share what women need to know.

WHAT IS UAE? Uterine fibroids are very common non-cancerous tumors that can form in the female reproductive tract. In most case, they simply exist, unnoticed, but sometimes, they can cause difficult symptoms. Women may experience pelvic pressure and pain, heavy menstrual bleeding, frequent urination, difficulty emptying the bladder, constipation, and backache or leg pains.

When the symptoms start to interfere with quality of life, doctors may suggest removing the fibroids. It used to be that the only way to do this was through a hysterectomy or myomectomy, but now women have another option. In a UAE procedure, doctors make very small incisions, and then inject tiny particles into the arteries supplying the uterus.

These particles cut off blood flow to the fibroids, causing them to shrink and die, relieving symptoms.

Though UAE isn’t the right option for all women (it depends on the location and number of fibroids), it works for many, and provides a much less disruptive way to get back to normal life.

HOW DOES UAE AFFECT SUBSEQUENT PREGNANCIES? The simple answer is that pregnancy after UAE is possible, but there are some risks. In a 2007 study, for instance, out of 18 infants born to women who had undergone UAE, 5 had low birth weights, and 1 had a very low birth weight. The other 12 had appropriate weights for their gestational ages. Researchers concluded that pregnancy is possible after UAE, and that patients can have successful births and deliveries, but that they should undergo careful obstetric monitoring.

Another study published in 2011 reported that pregnancy following uterine fibroid embolization (UFE, another name for the same procedure), appeared to be safe. Out of 74 women who went through the procedure and wanted to become pregnant, 44 became pregnant. Of those, there were four spontaneous abortions and one induced abortion, along with one stillbirth. The rest of the babies were fine, though two were preterm deliveries and five had low birth weights.

A third study in 2013 found that pregnancy after UAE was a viable option for women under the age of 40. This time, 21 out of 24 births proceeded normally without any complications (86.3%).

WHAT ARE THE RISKS? In some rare cases, women who go through UAE may lose their menstrual periods and go into menopause after the procedure. These are most often women who were close to menopausal age anyway, however.

Studies show that it is very rare for women under the age of 45 to lose menstrual periods.

It also seems that the chance of pregnancy after the procedure may depend on the extent of the fibroids. Those few patients who have a lot of them and are experiencing a number of difficult symptoms may have more difficulty getting pregnant after a UAE, but then, they would likely have trouble anyway, because of the problems created by the fibroids themselves.

USA FIBROID CENTERS OFFERS UAE

(718) 504-6525 www.USAFibroidCenters.com

USA Fibroid Centers, a nationwide network of physicians, nurses and specialists, offers evaluation and individualized treatment for uterine fibroids. If you are experiencing symptoms, but want to become pregnant in the future, talk to their doctors about your options. They can help you decide which type of treatment is best for you. You can find USA Fibroid Centers all over the nation, including in Florida, California, and Illinois, and several in the New York area.

Call today at 718–504–6525 or go to www.USAFibroidCenters. com to schedule a consultation.

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YOUR EYE DOCTOR MAY SOON SCREEN YOU FOR ALZHEIMER’S NEW STUDY SHOWS SIGNS OF ALZHEIMER’S EXIST IN THE RETINA

■■■ By Colleen M. Story Believe it or not, someday you may be able to go to your regular annual eye exam to get screened for Alzheimer’s disease.

According to the Alzheimer’s Foundation of America, estimates are that as many as 5.1 million Americans have Alzheimer’s disease, and the numbers are rising. The Alzheimer’s Association states that one in ten people 65 years and older are affected. Almost two-thirds of those victims are women. The estimated risk of developing the disease by the age of 45 is about one in five for women and about one in ten for men. The risks are slightly higher by the age of 65.

All of us want to prevent this disease. We know that eating a healthy diet, sticking to a regular exercise routine, and regularly challenging ourselves to learn new things can help keep the brain healthy. Meanwhile, researchers continue to try to find methods of early detection. The earlier they discover it, the better the outlook for the patient, as newer medications can help delay the disease’s effect on memory and cognition.

Recently, scientists from the University of Texas Medical Branch at Galveston discovered new insights into how Alzheimer’s begins in the brain. Their findings suggest that in the future, your eye doctor may actually be able to see these changes during a typical eye exam.

STUDY SHOWS CHANGES IN RETINA MAY INDICATE ALZHEIMER’S “Early detection of Alzheimer’s warning signs would allow for early intervention and prevention of neurodegeneration before major brain cell loss and cognitive decline occurs,” said lead study author Ashley Nilson.

One of the telltale signs of Alzheimer’s is the presence of a toxic type of protein called a “tau protein.” These proteins clump together in the brain, producing toxic effects and leading to the death of brain cells. Scientists now know that inflammation is a key factor in the development of these toxic proteins, and that it starts before tau proteins start to clump together.

With these things in mind, they looked into the relationship between inflammation, tau proteins, and the beginning of Alzheimer’s disease. To do that, they analyzed brain and retina (from the eyeball) samples from people with Alzheimer’s and from a mouse model of Alzheimer’s.

Results showed that the toxic tau might actually be responsible for starting the inflammation in the brain. As it spreads between the brain regions, it leaves its toxic effects behind, causing inflammation and cell death.

What was especially interesting was that the retina (eye) tissue they studied also showed evidence of toxic tau and inflammation!

SCREENING FOR ALZHEIMER’S DURING AN EYE EXAM Your eye doctor can already alert you to the early presence of high blood pressure, high blood cholesterol, and diabetic complications just by doing a thorough eye exam. All of these conditions affect the eyes, and optometrists can find clues when they look inside the eye.

The results of this study show that in the future, optometrists may also be able to detect changes that would indicate early Alzheimer’s disease (AD). When examining the retina, they could find signs of inflammation and the presence of toxic tau, which would indicate changes that lead to the disease.

“Using the retina for detecting AD and other neurodegenerative diseases,” said Nilson, “would be non-invasive, inexpensive and could become a normal screening done at patient check-ups.”

Some scientists have already tested this idea. Back in 2014, NBC News reported that researchers in Australia tested 40 volunteers during an eye exam. The test accurately determined each patient who had Alzheimer’s, and also correctly ruled out those who didn’t.

“If further research shows that our initial findings are correct, it could potentially be delivered as part of an individual’s regular eye check-up,” said lead author Shaun Frost of Australia’s Commonwealth Scientific and Industrial Research Organization.

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WHY THINGS HURT MORE WHEN YOU GET OLDER

STUDIES SHOW THAT TAMING INFLAMMATION MAY BE KEY ■ Anti-inflammatory proteins that typically tame inflammation in

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By Colleen M. Story

Darrell thought it was just his imagination. Truth was, running wasn’t as enjoyable for him as it used to be. Now, it seemed like every step hurt. No matter what he did — new shoes, softer running surfaces, more cross-training — he just couldn’t get back to the comfortable exercise he experienced before turning forty.

Ellen experienced similar problems. She’d worked at a desk job her whole life, but when she turned forty-five, she started experiencing pain while sitting in her office chair. She tried cushions, stretches, and pain medications, and felt frustrated at the constant irritation. Since when did it have to hurt to work?

Much as we may wish it to be otherwise, getting older tends to make things hurt more than they used to. According to the University of Florida Health, as we age, we become more sensitive to pain, and it’s not all in our heads.

STUDY SHOWS OLDER BODIES REACT TO PAIN WITH MORE INFLAMMATION For the study, researchers observed older adults with an average age of 68, and compared them with younger adults with an average age of 21. They inserted a catheter into each participant, which allowed them to collect blood at various times over the course of the experiment.

The researchers then induced a low level of pain in the participants by applying heat or a cold ice bath to the feet, and observed how the participants reacted. The participants also rated their pain on a scale from 1 to 10.

Results showed the following: ■ When they induced pain in older adults, proteins associated with

inflammation increased more than they did in younger adults.

These proteins also stayed in the body longer.

the body took longer to do their job in older adults. Levels peaked later in their blood than in the younger adults’ blood.

Researchers theorized that the elevated level of inflammatory proteins and the slower reaction of the anti-inflammatories resulted in higher sensitivity to pain in older people. They also expressed concern that the higher level of inflammation over time could cause changes in the body that lead to chronic pain and possibly to autoimmune disorders.

They suggested that older adults who suffer from injuries or go through medical procedures may benefit from early treatment with overthe-counter anti-inflammatory medications.

OLDER AGE DOESN’T HAVE TO MEAN MORE PAIN This study adds to the evidence that things often hurt more as we get older. That doesn’t mean we just have to accept it, however.

In a 2012 study, researchers reported that the idea that pain is a “natural” part of getting older is a myth. They referred to a number of other studies that linked older age to less frequent chronic pain disorders. Back pain, for example, as well as headache pain, was found to occur less in older adults compared to younger adults in some studies.

The scientists warned that some patients and some doctors may buy into the stereotype that getting older naturally means having to suffer more pain. The truth is, there’s no reason why pain at any age can’t be successfully treated.

If you’re suffering from chronic pain, don’t give up on your goal of feeling better. In addition to medications and physical therapy, realize that there are a number of other options for dealing with pain, including massage, acupuncture, biofeedback, injection therapy, supplements and vitamins, therapy, stress-reduction therapies, and more. Since inflammation seems to be at the core of aging-related pain, talk to your healthcare team about other ways to soothe the inflammation in your body.

Check with your local pain management center for more information.

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| Plastic Surgery

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

What do you see when you look in the mirror lately? Are you noticing dryness, hyperpigmentation, age spots, or wrinkling? Do your pores seem to be getting larger? Are you noticing, in essence, the effects of aging?

According to the Skin Cancer Foundation, more than 90 percent of the visible changes we see and call “aging” are caused by the sun. Harsh weather conditions, heating systems, dry air, pollution, stress, poor diet, and more can also cause lasting damage that makes it difficult for skin to recover.

Fortunately, Dr. Rayham of the RR Plastix/New York Plastic Surgery Center has a solution. There’s a brand new way to erase sun damage, fade dark spots, and get your youthful glow back with minimal downtime. It’s called “Halo Laser Skin Rejuvenation,” but this isn’t the laser you’re used to hearing about. Forget the weeks of downtime. Now, you can come in Thursday, get one treatment, and go back to work Monday looking fabulous!

WHAT IS HALO LASER SKIN REJUVENATION? Dr. Rayham’s office is one of the first in the area to have the new Sciton Halo laser, a breakthrough new technology that combines the effectiveness of laser treatments with the accelerated healing experience customers love.

Laser resurfacing is a treatment that uses a laser to treat facial flaws and improve the appearance of skin. An ablative laser removes thin layers of skin, allowing new and improved skin to form in its place. A non-ablative laser is less invasive, and stimulates collagen growth while helping to tighten and firm skin.

In the past, patients had only two options: 1) get ablative, or “fractional” laser treatments, and spend weeks to heal, but enjoy dramatic results, or 2) get non-ablative, or “non-fractional” laser treatments, and enjoy a short downtime, but only subtle results.

Now, with the new Sciton Halo laser, customers can take the middle road: enjoy great results with little downtime. The Halo is a “hybrid” fractional laser machine that offers both ablative and non-ablative resurfacing at the same time.

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

on the surface, while also treating deeper skin tissues to tone and tighten skin.

The technology is so advanced that the doctor can tailor the treatment to each individual, treating each patient in a way that uses only the energy needed to address the problem, while offering a precise, even treatment that allows for faster healing.

WHAT CAN THE HALO HYBRID LASER DO FOR ME? Dr. Rayham is excited to introduce this new treatment just in time for fall. If you’ve suffered sun damage over the past several months, this is the treatment for you. You can choose to go in for just one treatment, and after a weekend’s rest, head back to work looking like you turned back the clock.

The Halo can do much more, though. In addition to treating sun damage, it can also: ■ Reduce the appearance of scarring, such as ■ ■ ■ ■ ■

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

CUSTOMIZED TO YOU! Dr. Rayham invites readers to call his office today for a personal consultation. No matter what you’re seeing in the mirror, the Halo Laser Skin Rejuvenation system can help improve your appearance and boost your confidence.

Do you have sun damage and sagging skin? Age spots and wrinkles? Whatever your concerns, treatments can be customized to target exactly what you need, and no more. You’ll notice improvements within days, and be able to return to work with a healthy glow. If you’re looking for a more aggressive treatment, you can have that, too. It just depends on the results you’d like to see.

Treatments generally take 30 minutes to an hour, and a topical anesthetic is used to increase comfort.

After the first 24 hours, patients are able to return to most of their normal activities. Within a few days to a week, you’ll start to see more smooth, vibrant skin that has a youthful glow.

For more information, check with Dr. Rayham.

He has offices in Manhattan, New York City, Brooklyn, and Staten Island. Call the RR Plastix/New York Plastic Surgery Center, 1-877-582-0400, or visit our website at www.rrplastix.com.

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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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PELVIC ORGAN PROLAPSE? WHAT’S THAT?

WOMEN HAVE OPTIONS WHEN IT COMES TO TREATMENT

■■■ By Lynn Merrell A friend of mine has five children. Needless to say, she’s always busy, but she loves being a mom. That is, she loved it until about a month ago, when her gynecologist diagnosed her with pelvic organ prolapse, otherwise known as POP. According to a 2014 study, about a quarter of women suffer from POP, though some estimates put that number much higher. Over 200,000 inpatient procedures performed each year in the U.S. address the condition, though whether a woman needs surgery depends on choice and necessity.

My friend is considering her options now. In case you’re in the same boat, here’s more about this condition and what you need to know to safeguard your health.

WHAT IS POP? Pelvic organ prolapse occurs when a woman’s pelvic organs slip out of place and create a bulge in the vagina. This bulge usually starts out small and may be only slightly noticeable, but over time it can become larger to the point that it begins to create uncomfortable symptoms.

Strain during childbirth causes most cases of POP. When a woman carries a child and then gives birth, her pelvic muscles are stretched.

Typically they recover, but over time and with multiple children, they can weaken and become more permanently stretched. When that happens, they are no longer able to hold or support the pelvic organs as well as they used to. As a result, they may allow organs to drop and bulge into the vaginal canal. These bulges are called prolapses.

In addition to childbirth, other factors can cause POP: ■ Age ■ Menopause — drops in estrogen levels can cause pelvic muscles

and tissues to weaken.

■ Obesity ■ Chronic constipation ■ Heavy lifting

WHAT DOES POP FEEL LIKE? My friend first noticed her POP as something that just didn’t feel right “down there,” especially when she was going to the bathroom.

Other women may experience similar sensations, or may actually have pain, particularly during intercourse.

Other symptoms include discomfort or pressure in the pelvis area or vagina, difficulty going to the bathroom, lower back pain, and increased discomfort when standing for long periods of time. Upon self-examination, some women may actually be able to see the bulge protruding from the vaginal opening.

Finally, depending on the type of POP a woman has, she may also experience urinary incontinence, or stress urinary incontinence, which is leaking brought on by laughing, sneezing, or coughing.

Three Types of POP When diagnosing POP, doctors will typically define it depending on which organs are affected. In general, they may classify the condition according to the following three categories:

1. Cystocele: when the bladder protrudes into the vagina. This is the most common type.

2. Rectocele: when the rectum bulges into the vagina.

3. Uterine: when the uterus drops into the vagina.

HOW IS POP TREATED? Women have choices when it comes to treating POP. If the condition is mild and it’s not bothering you, you and your doctor may simply choose to leave it alone. This is often the best approach, and if the symptoms aren’t interfering with your daily life. Your doctor may also recommend Kegel exercises, which help strengthen the muscles that help support the pelvic organs.

If the symptoms are bothersome, though, and the exercises don’t work, the next option is usually a pessary. This is a small, cup-like device made of silicone that is custom-fitted to you, and then inserted into the vagina to help support the prolapsed organs. Adding a hormone replacement therapy (HRT) drug or cream can also help.

Surgery is an option only when these other treatment methods don’t work. There are different types, and which one is best for you is usually dependent on what kind of prolapse you have. Women need to carefully consider the risks, though. If you still want to have more children, it may be best to wait for any corrective surgery. And POP can come back even after surgery in some cases, so talk to your doctor and make sure you have all the information.

Women who may want to consider surgery are those who are experiencing a lot of pain because of POP, or who are having problems with the bladder and bowel. Otherwise, a conservative approach is usually best.

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THE “GENDER GAP” IN CYSTIC FIBROSIS RECENT RESEARCH SHEDS LIGHT ON WHY THE DISEASE IS SO HARD ON WOMEN ■■■ By Colleen M. Story According to the Cystic Fibrosis Foundation, more than 30,000 people are living with cystic fibrosis in the U. S. More than 1,000 new cases diagnosed each year. This chronic, progressive disease primarily affects the lungs and digestive system, and shortens the average lifespan to about 30 years, though some people may live into their 40s and 50s.

Cystic fibrosis is an inherited disease that is harder on women than it is on men. Women just don’t survive as long with the disease as men do, which for a long time has confused scientists. Recent research, though, indicates that the female hormone estrogen may have something to do with it, which could open up new avenues of treatment.

WHAT IS CYSTIC FIBROSIS? Cystic fibrosis (CF) is a disease that causes the body to overproduce mucus, and also causes that mucus to be sticky and thick (rather than thin and slippery like it usually is). Imagine if you had a bunch of sticky, thick mucus in your sinuses. You’d feel plugged up and find it difficult to breathe, right? The same thing happens in patients with the disease, except the mucus clogs up the lungs and the pancreas, which affects breathing and digestion.

CF is usually diagnosed in newborns. There is now a screening that can detect it in the first month of life. Symptoms vary from person to person, and depend on the severity of the disease, but they may include persistent coughing, wheezing, and stuffy nose, as well as difficulty exercising (because of difficulty breathing) and repeated lung infections. The disease also makes it more difficult for the digestive system to absorb nutrients from food, which can create constipation, intestinal blockages, and poor growth.

WHAT CAUSES CYSTIC FIBROSIS? The cause of this disease is very clear: it comes from a defective gene.

People who have the disease inherited two copies of the CF gene — one from each parent. People who have only one copy of the CF gene are 4HEALTH | 877.807.0989

“carriers,” but they will not develop the disease. They can pass it on to their children, though. But you must have both copies to have the disease.

Though screening can detect common CF gene mutations, it can’t detect them all. Turns out there are more than 1,700 known mutations that can cause the disease, so that means that even if a test shows a person doesn’t carry CF, it’s not the last word on the subject, as some CF genes can remain undetected.

WHY ARE WOMEN MORE AFFECTED BY CYSTIC FIBROSIS? Several studies have shown that women struggle with CF more than men do, though of course it is a serious disease in both genders.

In 2014, for example, researchers reported that women had a decreased life expectancy compared to men, and suffered worse outcomes with common CF infections, typically lung infections. An earlier 2013 study found similar results, and noted that even though survival for patients continues to improve overall, women continue to have lower survival rates compared to men.

It’s been called “the gender gap” in the disease, but scientists have been unable to explain it. In a 2012 study, though, they made a breakthrough when they discovered that the female hormone estrogen promoted the presence of bacteria that cause lung inflammation and infections. Interestingly, the researchers also found that those women who took birth control pills, which decrease estrogen in the body, had lower levels of these problematic bacteria.

New research appearing in 2016 confirmed these results, with scientists showing that estrogen influences the disease in women, worsening symptoms and shortening life expectancy. What does this mean for patients? Scientists are hopeful that their increased understanding will lead to better treatments down the road.

“In the long term,” said lead author of the 2016 study Wade D. Van Horn, a better understanding of how the disease works and the various things that affect it “will help to make CF and other diseases more easily treatable.”

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4HEALTH

PAINFUL LEGS AFTER EXERCISE? IT COULD BE PAD

718–393–5331

CHECK WITH YOUR DOCTOR TO AVOID SERIOUS COMPLICATIONS

www.USAVascularCenters.com

Barbara got home from her trip to the zoo with her two granddaughters and flopped down in the chair. Her husband asked if she was okay.

“My legs hurt,” she said.

“Again?” he asked. “Maybe you should check with the doctor.”

Barbara assured him she would feel better after resting. Her husband remained concerned. A few weeks later, when Barbara complained of pain again, he insisted she make an appointment. It’s a good thing he did, as the doctor diagnosed Barbara with Peripheral Arterial Disease (PAD)—a serious circulatory condition that if left untreated, could have led to increasing pain and even amputation.

Fortunately, Barbara received the treatment she needed, now she’s feeling better and able to keep up with her granddaughters — most of the time!

PAD CAN BE SNEAKY The most common symptom of PAD is pain in the legs, particularly when walking or after exercising. The pain often eases after you rest for a bit. Other symptoms may include painful cramps in the hip, thigh, or calf muscles after exercising, leg numbness or weakness, sores that won’t heal on your legs and feet, a cold feeling on the lower leg or foot, hair loss or slower nail growth on the feet and legs, and a change of color in the legs. If the disease progresses without treatment, symptoms may get worse.

PAD can be sneaky. After all, who hasn’t felt like their legs were tired after a long walk? People need to be careful, though, because PAD can signal other circulatory problems.

UNTREATED PAD CAN LEAD TO AMPUTATION PAD IS MORE COMMON THAN YOU THINK One in 20 Americans over the age of 50 has PAD, and is at risk for serious complications. Those who have diabetes are even more likely to be struck with the disease.

You’ve probably heard about how plaque can build up in the arteries around the heart. This plaque is made up of fat, cholesterol, and mineral deposits that gradually harden and collect over time, narrowing the openings within the arteries and potentially increasing the risk of high blood pressure, restricted blood flow, and blood clots.

PAD is a similar condition, only we’re talking about the arteries in the outer areas or “periphery” of the body — that is, the limbs. These are the arteries that go to your legs, arms, head, kidneys, and stomach. The disease most commonly affects blood flow to the legs, however.

Arteries are the blood vessels that take nutrient- and oxygen-rich blood from the heart out to the rest of the body. When one becomes narrowed and stiff because of PAD, it’s like an old garden hose clogged with dirt and debris. You can imagine how water through such a hose would be slow, perhaps only a trickle of what it was when the hose was new. Your arteries can be affected the same way by plaque buildup.

Your legs, as a result, suffer because they aren’t getting the blood they need.

Another serious complication of untreated PAD is a critical infection in one of the legs. The lack of blood flow can create wounds that won’t heal. Over time, those wounds can spread throughout the leg, causing tissue death (gangrene), and sometimes, if treatments don’t work, doctors may have to amputate the affected limb.

Patients don’t have to suffer these consequences. There are treatments for PAD, and the earlier you detect it, the better chance you have of keeping it from causing other serious health issues.

TREATMENT CAN HELP EASE PAIN If you are suffering from pain in your legs, wounds that won’t heal, or other potential symptoms of PAD, the doctors at USA Vascular Centers urge you to come in for an appointment. If you have diabetes, high blood pressure, high cholesterol, a family history of PAD, you smoke, or if you are obese, you are even more at risk for the disease.

USA Vascular Centers specialize in circulatory conditions like PAD, and through a simple physical exam, along with perhaps a blood test, ultrasound, or series of X-rays, they can tell you whether you may have the disease. Treatments may include lifestyle changes and medications that can help prevent blood clots and ease pain. USA Vascular Centers has offices all over the nation, including several in the New York area.

4HEALTH | 877.807.0989

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4HEALTH | 877.807.0989

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4HEALTH

RENTERS MORE LIKELY TO SUFFER FROM INDOOR POLLUTION STUDY SHOWS HOME OWNERS BETTER AT TAKING PREVENTATIVE STEPS ■■■ Colleen M. Story According to the American Lung Association, the air in your home can be dirty and hazardous to your health. Since 1970, homes have been built with fewer cracks and leaks to conserve energy, but that same construction reduces ventilation and traps indoor air pollutants inside the home. In fact, the Environmental Protection Agency (EPA) has ranked indoor air pollution among the top five environmental dangers, because it can lead to health problems like allergies, asthma, lung cancer and heart disease.

Whereas homeowners are likely to take steps to reduce indoor pollution, a recent study found that renters are much less likely to do so.

Here’s why clean indoor air is important, no matter where you live.

HEALTH PROBLEMS LINKED WITH INDOOR AIR POLLUTION The EPA warns that indoor pollution can cause all of the following and more: ■ Irritated eyes, nose, and throat ■ Headaches ■ Dizziness ■ Fatigue Long-term exposure to certain pollutants has also been linked with respiratory diseases, heart disease, and cancer. Children are even more at risk. Because they have smaller bodies and developing airways, toxins can affect them more seriously, particularly as they grow older.

SOURCE OF POLLUTANTS Where are all these pollutants coming from? The World Health Organization (WHO) notes that cooking and heating with solid fuels on traditional stoves results in high levels of indoor air pollution, as does indoor smoking and fireplaces. Some insulation may contain asbestos, while furniture can contain formaldehyde and fire retardants, both of which are linked with serious health problems.

Latex paints, foams, and rubber can contain benzene, a petrochemical linked with leukemia. Dangerous carbon monoxide is found in homes with gas stoves, and in poorly maintained furnaces. Bacteria, mold, mildew, dust mites, animal dander, and pollen can all come in from outdoors, or grow in damp, warm environments like the bath-

room or the basement. Pesticides have also been found in indoor air, while carpet dyes and fibers may contain volatile organic compounds (VOCs), which can lead to allergic reactions, fatigue, and dizziness.

RENTERS LESS LIKELY TO MAKE CHANGES The American College of Allergy, Asthma and Immunology (ACAAI) recently conducted a survey of people with indoor allergies, and found that 91 percent of those who owned their home were willing to take steps to reduce allergens, while only about 63 percent of renters were.

“By making recommended environmental changes around the home,” said the study’s lead author, Dr. Michael Schatz, “people with allergies can substantially reduce their symptoms.”

Researchers speculated that renters may be less likely to make changes for fear of backlash from their landlord. Fortunately, there are changes you can make even when renting that can help protect you from indoor air pollution.

TIPS TO REDUCE INDOOR AIR POLLUTION AND REDUCE ALLERGY SYMPTOMS Whether you rent or own, you can make the following changes to protect your family and improve your health: ■ Wrap pillows, mattresses, and upholstered furniture with dustproof covers, then wash routinely in hot water.

■ Install an air purifier.

■ Don’t allow pets in the bedroom.

■ Use a vacuum cleaner with a HEPA filter at least once a week.

■ Open windows as often as you can—even in the winter for at least a few minutes to circulate the air.

■ Check your living space for radon and carbon monoxide.

■ Use fans in the kitchen and bathroom to reduce your exposure to chemicals and minimize humidity that can cause mold and mildew.

■ Make sure the flue damper is wide open before starting a fire in the fireplace.

■ Use baking soda to freshen the air instead of air fresheners—air fresheners can contain pollutants like VOCs and phthalates.

■ Choose eco-friendly cleaners that have fewer chemicals.

■ Choose low-emitting furniture and carpet products.

■ Leave your shoes by the door.

4HEALTH | 877.807.0989

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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

35

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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4HEALTH

DENTISTRY - GENERAL

Vladimir LEMPERT, DMD

3037 Ave U Brooklyn, NY 11229

(888) 607-9725

DENTISTRY - PEDIATRIC

Marina KREPKH, DDS

7708 4th Ave Brooklyn, NY 11209

(888) 502-6245

INTERNAL MEDICINE

Victoria ALEKSANDROVICH, MD

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

(718) 207-7071

DERMATOLOGY

NEUROSURGERY

Narayan SANDARESAN, MD

5 E 84th St New York, NY 10028

(212) 328-0135

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

(844) 957-7463

OBESITY MEDICINE

Prabhakara R. TUMPATI, MD

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

(888) 283-0399

ONCOLOGY

Anella BAYSHTOK, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160

158-06 Northern Blvd Flushing, NY 11358

(718) 445-3700 www.brooklynroc.com

OB/GYN - GENERAL

Yekaterina LEVIN, DDS

7000 Bay Pkwy, Ste C Brooklyn, NY 11204

(888) 838-6212

Faina SHNAYDMAN, MD Leonard LEVITZ, MD

1749 E 16th St Brooklyn, NY 11229

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

(718) 528-1503

(718) 375-4747

321 Edison St Staten Island, NY 10306

Tariq LAMKI, MD

5 E 84th St New York, NY 10028

(212) 328-0135

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

GASTROENTEROLOGY

(844) 957-7463

Hayama BRILL, MD

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

(718) 336-1909

2101 Ave X Brooklyn, NY 11235

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629 Park Ave New York, NY 10065

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

Nataliya SAFONOVA, DDS

Lilia LEVITZ, MD

2211 Ocean Ave Brooklyn, NY 11229

1749 E 16th St Brooklyn, NY 11229

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

(718) 375-4747

321 Edison St Staten Island, NY 10306

Irina BERLIN, MD

Margarita BAUMAN, OD

NEUROLOGY

40 West Brighton Ave, Ste 104 Brooklyn, NY 11224

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

Salamon RAFAILOV, DDS

(844) 957-7463

Alexander BRODSKY, MD

8622 Bay Pkwy, Ste 1 Brooklyn, NY 11214

(718) 759-6979

5 E 84th St New York, NY 10028

(212) 328-0135

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

1910 Ave U Brooklyn, NY 11229

Erico CARDOSO, MD

(718) 627-8300

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Paul GLIEDMAN, MD

Dmitriy GRINSHPUN, MD

Hanna JESIONOWSKA, MD

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

(888) 455-6619

Aleksandra ZLOTNIK, OD

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

1910 Ave U Brooklyn, NY 11229

(888) 747-8009

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PAIN MANAGEMENT

Amit SCHWARTZ, MD

948 48th St, Fl 2 Brooklyn, NY 11219

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Radmila SHUMINOV, DDS

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

(718) 736-0123

Sam WEISSMAN, MD

202 Foster Ave Brooklyn, NY 11230

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Sergey ZHIVOTENKO, MD

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

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Mila MOGILEVSKY, DO

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

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Julie PARITSKAYA, PA

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

(347) 252-6732

Leon STEPENSKY, DPM

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

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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

102-30 Queens Blvd Forest Hills, NY 11375

(718) 896-2333

LSA RECOVERY

1300 Ave P Brooklyn, NY 11229

(888) 983-4055

4HEALTH | 877.807.0989

4HEALTH Magazineâ&#x201E;¢ gathers data from a variety of different sources, public and private. While we strive to provide the most accurate, up-to-date information possible, we can't guarantee that our listings are completely free of errors. If you feel some data is missing or inaccurate, please feel free to contact us at any time.

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