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7 WAYS

TO EASE WISDOM TEETH PAIN

WHEN OCD IS NOT A JOKE

WHY IS MY VISION BLURRY?

HOW TO EAT HEALTHY WHEN YOUR FAMILY DOESNâ&#x20AC;&#x2122;T

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“4Health” is an editorial-based medical magazine (the "Magazine") provided by Moo Publishing Corp. and by other sources. DISCLAIMER This Magazine is for consumer educational use only. Nothing contained in this Magazine is or should be considered, or used, as a substitute for medical advice, diagnosis or treatment. The opinions in this Magazine are here to educate consumers on health care and medical issues that may affect consummers’ daily lives. This Magazine does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment. The Magazine advises readers to always seek the advice of a physician or other qualified health care provider with any questions regarding personal health or medical conditions. Never disregard, avoid or delay obtaining medical advice from your doctor or other qualified health care provider because of something you have read in this Magazine. If you have, or

suspect that you may have, a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and are experiencing a medical emergency, please dial 911 or call for emergency medical help on the nearest telephone. WARRANTIES AND LIMITATION OF LIABILITY We do not make any expressed or implied warranties, representations or endorsements of any kind whatsoever with regard to the magazine, or with respect to any information, product, service, merchandise or other material provided in or through the magazine. We do not warrant or guarantee the accuracy, completeness, correctness, timeliness or usefulness of any information, products, services, merchandise or other material provided throughout the magazine. We are not liable to any reader or anyone else for any decision made or action taken based on their reliance upon the information contained in this magazine. 4HEALTH | 877.807.0989

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7 Ways to Ease Wisdom Teeth Pain

8 13

Why Do We Have These Teeth Anyway?

11 10 Who Needs a Bone Mineral Density Test? Should All Women be Tested After Menopause?

15 When OCD Is Not a Joke

Scientists Looking for Clues that May Lead to a Cure

14 19

How to Eat Healthy When Your Family Doesn’t Small Changes Can Get You Closer to Your Goals

20 Why Is My Vision Blurry?

10 Reasons Why Your Vision May be Changing

How to Reduce Your Risk

UTERINE FIBROIDS? YOU DON’T NEED A HYSTERECTOMY! New Minimally Invasive Treatments Effective

COULD YOUR BALD HEAD INDICATE RISK OF HEART DISEASE? Study Indicates Hair Loss May be Linked with Heart Health

WHAT’S CAUSING YOUR BELLY FAT? By Dr. Prab R. Tumpati

TAKING TYLENOL? IT MAY DAMAGE YOUR HEARING OVER TIME

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

TIGHT JEANS MAY CAUSE NERVE DAMAGE & OTHER HEALTH PROBLEMS

10 WAYS TO PROTECT YOUR FEET WHEN YOU HAVE DIABETES

TOO MANY PEOPLE STILL DYING OF STROKE

33 34 35

Other Options for Pain Relief

Ulthera Treatment Tightens Skin with Minimal Downtime

Survey Indicates Rise in Twisted Testicles and Urinary Tract Infections

How to Avoid Infections, Ulcers, and Other Foot Damage

HARD-TO-TREAT NAIL FUNGUS Dr. Leon Stepensky on a New Treatment

WHAT DO YOU THINK SCHIZOPHRENIA REALLY IS? Mental Illness Commonly Misunderstood

10 WAYS LOVE CAN BENEFIT YOUR HEALTH From Sharper Brains to Healthier Hearts

IS BRONCHITIS CONTAGIOUS? How to Keep from Catching It

VEIN PROBLEMS

SHOULD YOU AGREE TO ROBOTIC SURGERY?

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Your questions answered

Benefits and Risks with This New Technology

COULD YOUR KIDNEY STONES BECOME CHRONIC? How to Avoid a Repeat Experience

5 THINGS YOUR DOCTOR MAY NOT TELL YOU What You Need to Know to Protect Your Health

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TOO MANY PEOPLE STILL DYING OF STROKE HOW TO REDUCE YOUR RISK

■■■ By Morgan Rice We’ve learned a lot about our health in recent years. We know that if we eat right, exercise avoid smoking, and maintain a health weight, we can reduce our risk of many of today’s biggest killers, including heart disease and stroke. But a recent report from the Centers for Disease Control and Prevention (CDC) shows that our progress in preventing deaths from stroke has stalled all over the country. Worse, in certain population groups, the rates of death from stroke are rising. Overall, a person suffers a stroke every 40 seconds in the United States, and someone dies from a stroke once every four minutes. What’s going on, and how can you avoid becoming a victim?

WHAT IS A STROKE? A stroke occurs when a blood clot inhibits or blocks blood flow to the brain, depriving it of oxygen and nutrients. It takes only a few minutes for brain cells to start dying, which can result in permanent brain damage. There are a variety of reasons why a blood clot may form. It could be because of a blocked artery leading to the brain, or when a clot forms in another part of the body, and then travels along in the blood stream to

lodge in the brain arteries. A stroke may also occur when a blood vessel in the brain leaks or ruptures, creating a hemorrhage.

WHO’S AT RISK FOR STROKE? Because other conditions like high blood pressure increase risk for stroke, we know that we can reduce that risk by managing cardiovascular issues. About 80 percent of strokes are avoidable in this way, which is why it’s puzzling to see a rising trend in the number of stroke-related deaths. About 75 million adults in the U.S. have high blood pressure, yet only about half are controlling that condition, according to Fox News. Other risk factors include: ■ Overweight or obesity ■ Diabetes ■ Use of illegal drugs ■ Heavy or binge drinking ■ Physical inactivity ■ High blood pressure ■ High cholesterol ■ Sleep apnea ■ Cardiovascular disease ■ Family history of stroke ■ Race: African-Americans have a higher risk than other races ■ Gender: Men are more at risk than women, though women are more likely to die of a stroke than men

WHY ARE THE DEATH RATES RISING? When looking at why our progress has stalled at preventing stroke-related deaths, the CDC noted that African-Americans continue to be the most likely to fall victim to stroke, while Hispanics had a six percent increase in stroke death rate each year between 2013 and 2015. “After more than 4 decades of decline,” the CDC wrote on their website, “stroke death rates in the United States have declined more slowly, stalled, or reversed among some subpopulations in recent years.” They added that 38 states had an unfavorable change in the rate of decline in stroke death rates between 2000 and 2015. What can we do to change this? States need to do more to increase awareness of stroke and how to prevent it. Meanwhile, all of us can work to maintain a healthy weight, and control our blood pressure, blood cholesterol, and diabetes. Finally, recognize the signs of a stroke (“FAST)” and if you see them in yourself or a loved one, get emergency help immediately: F: facial dropping A: arm weakness S: speech difficulties T: time — call 9–1–1 now 4HEALTH | 877.807.0989

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7 WAYS

TO EASE WISDOM TEETH PAIN WHY DO WE HAVE THESE TEETH ANYWAY?

■■■ By Lynn Merrell When I was in my teens, I had my wisdom teeth removed. My dentist told me my mouth was just too small for them, and if they came in, they would only push the rest of my teeth even more out of alignment than they were before braces. I remember the puffy cheeks, but I had a good dentist, so the procedure wasn’t difficult. I’ve had some friends, however, who’ve suffered a lot of pain related to wisdom teeth. In case you may be in the same boat, here are seven ways you can relieve that pain, whether you decide to remove the teeth or not.

WHAT ARE WISDOM TEETH? Also called “third molars,” wisdom teeth come up behind the molars on both sides of the upper and lower jaw. They usually tunnel through between the ages of 17 and 21, though they can show up at other times. We don’t really need these teeth. We can chew just fine without them. So why do we have them? Scientists aren’t sure, but they think the teeth may have been useful to our ancestors, as they could replace any molars that had been worn out through harsh chewing. If you’re eating dried meat and gnawing away at other things you can find in nature, your teeth would likely take a beating. 4HEALTH | 877.807.0989

4HEALTH We have softer diets, today, though, and don’t have to chew so hard, so wisdom teeth are largely unnecessary.

WHAT CAUSES WISDOM TOOTH PAIN? Wisdom teeth can frequently be problematic. Sometimes they don’t come all the way up, staying buried in the gum tissue where they cause pain and inflammation. When this occurs, dentists say the teeth are “impacted,” and typically recommend removal. The teeth may not come up straight, either. If they try to erupt from the gum tissue at an angle, they’ll push against the other teeth, which are well established in the mouth by that time. This can cause pain and pressure, as well as changes in tooth alignment. Sometimes wisdom teeth come through only partially, so you have part of the tooth showing through the gum. This creates a space in your mouth in which food and bacteria can become stuck, leading to bacteria buildup, infections, abscesses, and gum disease.

7 WAYS TO EASE THE PAIN OF PROBLEMATIC WISDOM TEETH Considering all these potential issues, you can see why dentists typically want to remove wisdom teeth. Meanwhile, however, you may be suffering from pain, pressure, and difficulty eating. In that case, try these remedies, but be sure to get to your dentist for a professional consultation as soon as possible. 1. Over-the-counter pain relievers: Aspirin and ibuprofen can help relieve pain and pressure. These drugs also reduce inflammation, which can help as your wisdom teeth start to come in. 2. Use ice. Ice is a great remedy for inflammation, so if your cheek is swollen, use ice packs to help bring that swelling down. Hold the pack against the affected area for up to 15 minutes.

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3. Try pain-relieving gels: You can find numbing tooth gels at your local grocery or department store. You can use these directly on the gum tissue to help numb it between meals. 4. Rinse: Sometimes bacteria get into the space around where your wisdom tooth is poking through to cause pain. A healthy rinse may help relieve. Try a saltwater rinse — studies show that it helps reduce bacteria. Or you can rinse with any non-alcoholic mouthwash to get rid of any bugs that may be trying to cause an infection. 5. Make a cup of tea: You know tea is good to drink, but it can also help relieve pain in your mouth. That’s because tea contains natural anti-inflammatories and natural antibacterial components. Brew your cup of tea, then put it into the refrigerator. Let it cool, then remove the bag and place it over the affected area. Hold in your mouth for about 20 minutes if you can. 6. Try clove oil: You’ve heard of cloves in baking, but it turns out that clove oil can also produce a numbing effect. In fact, in a 2006 study, researchers found that it worked just as well as benzocaine, which is the same ingredient used in Orajel. Put two drops on a cotton ball and place it on the affected area until the pain recedes. 7. Use a cucumber. You’ve probably heard about how cucumbers decrease swelling and puffiness under the eyes. They can do the same in your mouth. If you’re suffering from inflammation and swelling, slice a fresh piece and hold it over the affected area. If you’re sensitive to the cold, allow the vegetable to come to room temperature first. These steps can all help relieve pain in the short-term, but remember that the problem won’t go away on its own. See your dentist as soon as possible.

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UTERINE FIBROIDS? YOU DON’T NEED A HYSTERECTOMY! NEW MINIMALLY INVASIVE TREATMENTS EFFECTIVE Lisa had all the symptoms: heavy bleeding during her period, frequent urination, and lower backache. She had a feeling that she already knew what was wrong — uterine fibroids. Her mother had gone through a hysterectomy when she was Lisa’s age to treat her uterine fibroids. Lisa talked to her mom, and, sure enough, her symptoms were very similar to those her mom experienced. When she hung up the phone, her heart sank. She really didn’t want to undergo a hysterectomy. She knew it could cause early menopause, and she wasn’t ready for that. The symptoms didn’t improve, however, so Lisa went to her doctor. She wasn’t surprised when he diagnosed uterine fibroids. She waited with downcast eyes to get the news about treatment, but when her doctor suggested a minimally invasive option, she sat up straight. “What?” she said. “I don’t have to have a hysterectomy?”

WHAT ARE UTERINE FIBROIDS? Uterine fibroids are benign (non-cancerous) growths or tumors that develop in the lining of the uterus. They are very common in women and typically show up during the childbearing years. Some exist for years and never cause any problems, but others can create difficult symptoms like heavy menstrual bleeding, pelvic pressure and pain, frequent urination, difficulty emptying the bladder, constipation, backache, and leg pains.

HYSTERECTOMY USED TO BE THE ONLY OPTION According to the National Women’s Health Network, hysterectomy — the removal of all or part of the uterus — is the second most frequently performed surgical procedure (after cesarean section) for U.S. women of reproductive age. About 600,000 hysterectomies are performed each year, for a variety of gynecological disorders, including fibroids. According to Drs. Patricia Evans and Susan Brunsell in an article for American Family Physician, the presence of uterine fibroids “is the most common indication cited for hysterectomy, accounting for more than 30 percent of these procedures.”1 Yet in 2015, researchers reported that one in five women don’t need a hysterectomy, and almost 40 percent aren’t offered alternative treatments.2 The non-profit social welfare organization AARP lists hysterectomy for uterine fibroids, in particular, as one of their “four surgeries to avoid.”3 That’s because there are less invasive, alternative treatments that can get rid of the fibroids without removing the uterus, and that are just as effective with a shorter recovery time and less scarring.

NEW TREATMENTS GIVE WOMEN OPTIONS The gold standard in fibroid treatment today is a minimally invasive procedure called uterine fibroid embolization (UFE). The doctor uses a small tube to inject small particles into the uterine arteries that are feeding the fibroids with blood. These particles block blood flow to the fibroids, essentially starving them to death. 4HEALTH | 877.807.0989

UFE requires only a local anesthetic, involves only a small incision in the upper thigh, and results in a much shorter recovery period than a hysterectomy. Women can return to their regular activities much sooner than they would with hysterectomy, yet the overall results are similar. According to a 2016 study, in about two-thirds of women with uterine fibroids, a hysterectomy can be avoided and UFE used instead. Results showed similar healthrelated quality of life 10 years after both procedures. 4

USA FIBROID CENTERS OFFERS UFE USA Fibroid Centers, a nationwide network of physicians, nurses, and specialists, offers personalized treatments for fibroids without invasive surgery and no hospital stay. If you are experiencing symptoms like Lisa’s, talk to the interventional radiologists at USA Fibroid Centers about your options. They can help you decide which type of treatment is best for you. You can find USA Fibroid Centers in 10 locations in the New York metro area. Call today at 718–504–6525, or go to www.USAFibroidCenters.com to schedule a consultation. SOURCES Patricia Evans and Susan Brusnell, “Uterine Fibroid Tumors: Diagnosis and Treatment,” American Family Physician 75, no. 10 (2007):1503-1508, http://www.aafp.org/afp/2007/0515/p1503.html#afp20070515p1503-b26. 2 Honor Whiteman, “Almost 1 in 5 hysterectomies are ‘unnecessary,’ study finds,” Medical News Today, January 11, 2015, https://www.medicalnewstoday.com/articles/287736.php. 3 Karen Cheney, “4 Surgeries to Avoid,” AARP, August 2014, https://www.aarp.org/health/conditions-treatments/ info-05-2011/4-surgeries-to-avoid.html#slide7. 4 Annefleur M. De Bruijn et al. “Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 10-year outcomes from the randomized EMMY trial,” American Journal of Obstetrics & Gynecology 215, no. 16 (2016): 745.e1-745.e12, doi: 10.1016/j.ajog.2016.06.051. 1

(718) 504-6525 www.USAFibroidCenters.com

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COULD YOUR BALD HEAD INDICATE RISK OF HEART DISEASE? STUDY INDICATES HAIR LOSS MAY BE LINKED WITH HEART HEALTH

■■■ By Colleen M. Story The American Hair Loss Organization estimates that by the age of thirty-five, about two-thirds of American men will experience some degree of hair loss. By the age of 50, about 85 percent have significantly thinning hair. Most men aren’t happy about it, but the reasons usually have to do with self-image, perceived attractiveness, and the ability to maintain a level of success in the professional world. A new study, however, indicates that certain types of hair loss may actually be connected with heart disease. So far, they don’t know why this association exists, but the findings point to another way men may be able to detect health problems early, when they can be easily treated.

WHAT THE STUDY FOUND Researchers from the University of Tokyo, Japan, combed the Medline and Cochrane Library databases for studies published on male pattern hair loss and coronary heart disease (CHD), to see if there might be any link between the two. (CHD is when a waxy buildup occurs inside the coronary arteries, narrowing the arteries and increasing risk of a blood clot and heart attack.) They found 850 possible studies published between 1950 and 2012, but only six qualified for inclusion in the final analysis. All of these had been published between 1993 and 2008, and involved about 40,000 men total. Results indicated the following: ■ Men who had lost most of their hair were a third more likely to

develop coronary artery disease than those who had retained a full head of hair. ■ Men between the ages of 55–60 who were bald or extensively balding were 44 percent more likely to develop CHD. ■ The risk of CHD depended on the severity of the baldness, particularly on the top of the head. Extensive balding on the crown boosted risk by 48 percent; moderate balding by 36 percent; and mild balding by 18 percent.

■ Men with both frontal and crown-up baldness were 69 percent

more likely to have CHD than those with a full head of hair. Those with crown-top baldness were 52 percent more likely to have CHD. Those with just frontal baldness were 22 percent more likely to have CHD. ■ In analysis of three studies, those in younger age groups who were bald or balding were 84 percent more likely to have CHD. ■ A receding hairline made little difference to risk.

WHAT DOES HAIR LOSS HAVE TO DO WITH CHD? Scientists don’t know why baldness may be linked with CHD. They did speculate that baldness may indicate insulin resistance, which is a precursor to diabetes. Other possibilities are that baldness may indicate a state of chronic inflammation, which is connected with CHD; or it may indicate an increased sensitivity to testosterone, which can promote heart disease. “Our findings suggest that vertex baldness [crown of the head] is more closely associated with systemic atherosclerosis than with frontal baldness,” the researchers wrote. “Thus, cardiovascular risk factors should be reviewed carefully in men with vertex baldness, especially younger men” who should “probably be encouraged to improve their cardiovascular risk profile.”

WHAT TO DO? Though we can’t be positive that a link exists between baldness and CHD, this study raises concerns. It doesn’t mean that men who are balding need to panic or go onto medications, but we can use the results to our advantage by further examining risk. Men who are smoking and bald, or who are overweight and bald, may want to take more seriously their approach to avoiding heart disease, for example. In other words, baldness or hair loss can be used as potential evidence concerning a man’s overall health — a sign that can give us important information if we’re willing to pay attention. 4HEALTH | 877.807.0989

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WHO NEEDS A BONE MINERAL DENSITY TEST? SHOULD ALL WOMEN BE TESTED AFTER MENOPAUSE?

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By Morgan Rice

Judy was going through menopause. There was no doubt about it. She was 55 years old, had just suffered her tenth hot flash, and hadn’t had a period in a year. But she was managing her symptoms okay. Her main question was: What about my bones? Judy had heard that postmenopausal women are at risk for osteoporosis, or thinning bones, which could put her at a higher risk for fracture, and she was an active lady with too much to do to be laid up in a hospital. She asked her gynecologist: Do I need a bone density test?

WHAT IS A BONE DENSITY TEST? A bone mineral density test (BMD) helps measure the strength and health of your bones. The most common test for this is called the “DEXA scan,” and is similar to an X-ray. It’s painless, and measures the bone density in the hip and spine. There are other tests called “peripheral” BMD tests that measure bone density in the lower arm, wrist, finger, or heel. Bone “density” means how dense or strong the bone is. You can imagine a young, strong bone, how solid it is, and then imagine an old, dried up bone. The older bone is more fragile because it doesn’t have as much matter packed into it as that young bone does. Scientifically, density refers to the amount of bone mineral in the bone tissue. During a DEXA scan, a small dose of ionizing radiation is used to measure how many grams of calcium and other bone minerals are packed into one segment of the bone. The more that are there, the healthier and stronger the bones are.

HOW TO READ THE RESULTS OF A DEXA SCAN Once you get the scan, the doctor compares your results to the standard or “normal” results for a healthy 30-year-old adult. A score of 0 means that your bone density is equal to that of an average 30-year 4HEALTH | 877.807.0989

old. Anything other than that is considered a deviation from the norm, and the extent of that deviation determines the health of your bones. In general, the lower your score, the higher your risk of fracture. So a “T-score,” which is how it’s referred to with a DEXA scan, between +1 and –1 is considered a standard deviation, or a “normal” or healthy score. A T-score between –1 and –2.5 means you have low bone density, and could be at risk for osteoporosis. A score lower than that — of –2.5 or lower — means that you already have osteoporosis, or thinning of the bones. The lower that number (–3.0, for example), the more severe your osteoporosis is.

WHAT HAPPENS AFTER A BMD TEST Once your doctor has your score, he will evaluate the results, and work with you on a treatment plan, if you need one. If your bones are healthy, then it’s likely that you’re doing well in staying active and keeping your bones strong. If your score is low, though, the doctor may recommend lifestyle changes (such as more weight-bearing activity), supplements like calcium and vitamin D, or medications to help you improve the health of your bones. A BMD can be very helpful, because it can indicate unhealthy changes in the bone long before osteoporosis sets in. That means you can reduce your risk of fractures and take action to get your bones healthier while you still can.

WHO SHOULD GET A BMD TEST? The U. S. Preventive Services Task Force recommends that all women over the age of 65 be tested, as well as women under the age of 65 who are at high risk for fractures. Those who are at high risk may include younger women who smoke or drink heavily, have a low body weight (127 pounds or less), have a family history of osteoporosis and/ or fractures, used corticosteroid drugs for three months or more, have rheumatoid arthritis, or who have already broken a bone. Women going through early menopause (before the age of 45), or who have a chronic disease should also talk to their doctors about bone density.

4HEALTH

WHEN OCD IS NOT A JOKE SCIENTISTS LOOKING FOR CLUES THAT MAY LEAD TO A CURE ■■■ By Lynn Merrell When I go to wash my hands for the third time, my husband sometimes tells me I’m OCD about it. We laugh over my obsession with germs, but in truth, obsessive-compulsive disorder is no laughing matter. An estimated one to three percent of Americans suffer from it, including one in every 200 children. So far, there is no cure, but there are treatments that can help patients deal with their symptoms. Meanwhile, scientists continue to look for more clues as to how this disorder works, and recently, they

discovered one that may shed more light on what causes the disorder in the first place.

WHAT IS OCD? OCD is a mental illness that leads individuals to perform repetitive behaviors, such as washing their hands over and over again for no reason. These behaviors occur because the person gets caught up in a series of obsessions and compulsions that they have difficulty controlling. They have unwanted thoughts that trigger difficult feelings, and they respond through these repetitive behaviors. 4HEALTH | 877.807.0989

4HEALTH It’s true that all of us can get caught up in obsessive thoughts now and then, but usually they do not cause us to repeat behaviors to the point that we miss appointments, fail to go to bed at night, or leave a friend waiting for us at the restaurant. For people with OCD, the intrusive thoughts are unwelcome and the resulting behaviors frustrating, but often near impossible to avoid doing. Many know that their thoughts or obsessions are untrue (my hands aren’t clean enough), but it’s extremely difficult for them to stop the compulsive actions (I’ll just wash them one more time). The degree of OCD varies from mild to severe. Some people may have both obsessions and compulsions, but others may have only one or the other. One might be obsessed with germs, for example, but instead of repetitive washing, simply fears being touched. Another might feel driven to wash again and again, but have no clear thoughts associated with them, only a general anxiety. In extreme cases, people have a hard time going about their regular daily activities because the impulsive actions take up a lot of time.

where they had to catch coin-like objects in a bucket. After several trials, researchers asked them to state where they thought the coins were coming from. The healthy participants set their buckets to catch the coins based on their belief, but the ones with OCD continued to second-guess themselves, disregarding the confidence they felt and chasing every coin by constantly moving the buckets around. The researchers concluded that the actions of people with OCD “often don’t take into account what they’ve already learned,” according to senior author Benedetto De Martino. In other words, the participants knew where the coins were coming from, but didn’t use that knowledge to guide their behavior. The scientists gave this example: When you know it’s going to rain, you take your umbrella with you. But a person with OCD is lacking this link between certainty and decisions, and would likely keep guessing themselves about whether or not they should take the umbrella. Those with the most severe form of the disease had the biggest divide between these two things.

WHAT CAUSES OCD? Scientists don’t know yet what causes OCD, but they have some theories. It may simply be a genetic defect, though we don’t yet know which genes may be affected. Because it usually shows up in adolescents, it could be related to puberty and the changes the body and mind go through at that time. Or it could have something to do with other factors, like an infection. There are still a lot more questions than answers when it comes to this illness. Scientists tried to answer some of those questions in a recent study. Researchers observed 49 volunteers-24 with OCD and 25 without — while they were playing a video game

SCIENTISTS LOOKING FOR NEW SOLUTIONS Researchers hope that this study will help provide more insight into how the brain works, and may eventually lead to better treatments. According to a press release on the study, the results could lead to new approaches for diagnosis, which could lead to early detection and intervention. Meanwhile, those with OCD need to continue to rely on available treatments, which include psychotherapy, medications, and in rare cases, deep brain stimulation. All of these treatments have shown success in helping those with OCD to enjoy a higher quality of life.

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Obesity Medicine | 4HEALTH19

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. 4HEALTH | 877.807.0989

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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HOW TO EAT HEALTHY WHEN YOUR FAMILY DOESN’T SMALL CHANGES CAN GET YOU CLOSER TO YOUR GOALS

■■■ By Morgan Rice You go out to lunch. You’re planning on ordering the strawberry salad, but then your sister, who’s come to visit with you, orders a cheeseburger with fries. That sounds good, you think, but you know that it

contains more calories and fat than you wanted to consume. It’s only one lunch, you say to yourself. Why not splurge? You end up ordering the cheeseburger. Try not to feel too badly about it. According to research, it can be very difficult to “go against the current,” so to speak, when you’re eating with family and friends. 4HEALTH | 877.807.0989

4HEALTH Those who are closest to us have a big influence on our behaviors, and that includes our diet. So if you’re trying to lose weight, or trying to get healthier, what can you do to increase your odds of success?

HOW FAMILIES INFLUENCE OUR EATING From the time we’re little kids, our dietary habits are influenced by others, mainly, our parents. According to a 2007 study, evidence suggests that the food choices a mother makes even during her pregnancy can set the stage for what the baby likes later on. Scientists have even found certain flavors from the mom’s diet present in the amniotic fluid! Later, flavors from the mom’s diet appear in breast, milk, too, influencing infant taste buds. When kids transfer to solid foods, they are dependent on parents and caregivers for what they eat and how much. Unfortunately, some research suggests that more and more children are getting unhealthy foods, potentially setting the stage for weight gain as adults. French fries, for example, were the most common vegetable consumed among 15- to 18-month olds in one analysis, while about half of kids were already consuming dessert, sweets, and sugar-sweetened beverages by that age. Later, parents model their eating behavior by example, shaping children’s experiences with food and eating and influencing their dietary patterns. By the time we reach adulthood, we’ve been strongly conditioned to eat a certain way — and that way may not be healthy.

SOCIAL CUES ALSO AFFECT HOW AND WHAT WE EAT The “brainwashing” doesn’t stop there. Even as well-conditioned adults, we can be influenced by social cues when it comes to how we eat. We eat differently when we are with others, for example, then we do when we’re alone, our choices reflecting those of the people around us.

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Our friends, too, can influence our health, for if we have healthy friends interested in eating right and exercising, we are likely to be healthier, too, according to studies. In fact, one global study found that family and social networks played as strong a role on an individual’s health as health professionals did. So what can you do if your family and friends are not particularly healthy, but you want to be?

TWO WAYS TO EAT HEALTHY NO MATTER WHAT YOUR FRIENDS AND FAMILY DO There are a couple approaches you can take. In the first, you make your healthier diet a “family and friends affair.” At home, you stack the cupboards with healthier items, and you get rid of the unhealthy ones — no questions asked, no arguments, no debate. You simply make the changes that you know are good for you all. When it comes to friends, you make a point to eat healthier — you order first when going out (see if your friends copy you!), and you suggest healthier places to eat. You may receive some backlash with this approach, so be prepared. Your best bet may be to make small changes over time. Stop buying sugar-sweetened soda, for instance, and when your kids complain, offer water or milk. Let that change take hold for a couple weeks, then make another one — like offering cut-up fruit or veggies and dips for snacks instead of candy or chips. The less you make a big deal about it, the more likely your changes will take hold. The second approach is simply to go it alone. This can be really tough, and you’re likely to cave at times, so try to find at least one friend that is willing to the make the changes with you. Then the two of you can encourage each other and commiserate over the tough times. With this approach, you simply do what’s best for you, and let your family continue as they are while you set a different example. If you can stick to your guns, you may be surprised at their reaction, but either way, the important thing is to reach the goals that matter to you.

4HEALTH

WHY IS MY VISION BLURRY? 10 REASONS WHY YOUR VISION MAY BE CHANGING

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By Lynn Merrell

Abby had always had good vision. She was proud of the fact that she was in her fifties and still didn’t have to use glasses. But then one day she realized that lately, she hadn’t been seeing things so clearly. She was struggling to read the ingredient lists on food products at the grocery store, and sometimes when she was driving she got nervous, as things would look out of focus. She figured it would go away, but when it didn’t after a few weeks, she went to see her eye doctor. “Things have been blurry lately,” she told him. “Do you know what could be causing it?” The doctor told her that blurry vision could have a number of causes. If you are also finding your eyesight just isn’t as clear as it used to be, one of the following may be to blame. 1. Presbyopia: This is a very common condition that often develops when people get over the age of 40. The eyes have difficulty focusing on close objects. The condition comes on gradually, but you can tell when you start holding books at arm’s length to read them, or when you start to want a magnifying glass to read small text up close. Fortunately, you can address this easily with magnifying glasses that you can buy at the drug store, or you can talk to your eye doctor about prescription glasses. 2. Nearsightedness, farsightedness, and astigmatism: There are all conditions that oc-

cur when the shape of the eye prevents light from coming in at the right angle to focus on the retina. The light waves come in off-kilter, which makes images blurry. These problems are usually present early in life, though they can develop later in some cases, and can be fixed with corrective lenses. 3. Cataracts: If you’re middle-aged or older, cataracts could be to blame. They are caused by proteins that cluster in the lens of the eye and distort what you see, creating a “cloudy” sort of vision that may gradually get worse. Your eye doctor is likely to recommend watchful waiting until your vision gets worse, after which a common surgery can fix the problem. 4. Age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy: These are all eye diseases that can develop as you get older. AMD occurs when the center part of the retina, called the “macula,” deteriorates, affecting your center vision. Glaucoma damages the eye’s optic nerve, affecting peripheral vision, and diabetic retinopathy is caused by diabetes, and damages blood vessels in the eye. All of these can lead to blurry vision, so it’s important to check with your doctor right away, as early treatment can help preserve vision. 5. Floaters: These look like spots floating across your field of vision. They usually aren’t serious unless you see large ones that interfere with your eyesight. They tend to show up as we age, and are made up of protein fibers that clump together.

6. Dry eye syndrome: Many people are at risk for this condition these days, because of long hours at the computer, tablet, and cell phone. All those screens can sap our eyes of moisture. Dry eye may also be caused by other things, like inadequate tear production, or poor quality tears. Eye drops can help, and your eye doctor may recommend prescription drops or ointments. 7. Preeclampsia: If you’re pregnant and you notice blurry vision, talk to your gynecologist right away. It may be a symptom of preeclampsia, or high blood pressure during pregnancy. It can increase risk of problems for both you and your baby, so it’s important to get help right away. 8. Migraine headaches: In some cases, these can produce temporary blurred vision or halos. Usually your vision will correct itself when the headache lets up. 9. Stroke: Sometimes, sudden blurred vision can be a sign of a stroke. If you’re experiencing other symptoms, such as a drooping face, double vision, numbness in an arm or leg, or dizziness, get emergency help. Sudden blurred vision can also be a sign of a brain hemorrhage. 10. Eye infection: If you’ve recently developed an eye infection, or if you had an eyelash procedure or eye injury, these can all cause temporary blurred vision. Pink eye is another common eye infection that can affect vision. Check with your doctor on all of these, as an infection needs treatment before it will get better. 4HEALTH | 877.807.0989

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4HEALTH

TAKING TYLENOL? IT MAY DAMAGE YOUR HEARING OVER TIME OTHER OPTIONS FOR PAIN RELIEF

■■■ Colleen M. Story In 2005, researchers published a study involving over 9,000 participants that showed people frequently took over-the-counter pain relievers like ibuprofen and aspirin “inappropriately and potentially dangerously,” and that most users were unaware of the potential for side effects like nausea, vomiting, headaches, kidney failure, liver failure, and bleeding. A later study in 2012 noted that a significant number of adults are at risk of unintentionally overdosing on pain medications like Tylenol that contain acetaminophen, putting them at risk of acute liver failure. Now, a new study shows that popping pills like Tylenol and Advil may take a toll on your hearing. Is it time to look to other options for pain relief?

■ Women who took pills more than four

■ Ulcers and bleeding: NSAIDs can in-

times a week had a 20 percent increased risk of hearing loss. Study author Sharon G. Curhan stated, “Even though these pain relievers are widely available, they’re still medications with side effects.” Researchers theorized the pain relievers may be decreasing blood flow to the inner ear, which could be causing hearing damage.

crease risk of ulcers, particularly when taken at higher doses, regularly, for a year or longer.

OTHER CONCERNING SIDE EFFECTS Though pain relievers can be a blessing when we’re suffering aches and pains or trying to get some sleep, they can cause serious side effects — especially when taken frequently over a long period of time. In addition to potentially affecting hearing, other side effects may include: ■ Upper GI symptoms: Patients taking

WHAT THE STUDY SAID According to research, acetaminophen overdose is the leading cause of acute liver failure. In 2011, the FDA required new warnings on medications containing this ingredient, and advised manufacturers to lower the daily maximum dosage from 4,000 mg a day to 3,250 mg a day. Now, in this new study, researchers at Harvard’s Brigham and Women’s Hospital asked 62,000 female volunteers to record their use of pain relievers containing acetaminophen and ibuprofen for almost 15 years. The results showed that the more pain relievers the women too, the more likely they were to report hearing loss. Here’s a breakdown: ■ Women who took a pill 2–3 times per

week were 12 percent more likely to report hearing loss than those who took less.

non-steroidal anti-inflammatory drugs (NSAIDs like aspirin and ibuprofen) have a higher risk of heartburn and other upper gastrointestinal tract symptoms. ■ Kidney failure: Drugs like ibuprofen inhibit the production of “prostaglandins,” which help stimulate blood flow to the kidneys. When these prostaglandins are blocked, the result can be kidney failure. ■ Higher blood pressure: People with and without high blood pressure can experience increases when taking NSAIDs. In a Harvard study, even women who took them only a few times a month elevated their risk of developing high blood pressure. ■ Liver failure: People who have a history of liver disease should avoid taking NSAIDs as they can worsen liver function. Healthy individuals may also be at risk.

OPTIONS FOR PAIN RELIEF How do you know if you’re using pain relievers too much? A basic guideline is that if you’re using them for longer than a few days, or having to take more than the recommended daily dose, you’re taking too much. In addition, if you have other health problems like liver disease, high blood pressure, heart disease, or kidney disease, you want to be more careful. For regular, chronic pain, see your doctor to be sure something else isn’t going on that needs treatment. Then, try these options to cut back on your use of over-the-counter pain relievers: ■ Herbs like willow bark extract, feverfew,

■

■ ■

■

SAM-e, arnica, and capsaicin all have studies behind their pain-relieving effects. Heat and ice — ice packs can help reduce swelling and joint pain. Heat can ease long-term general muscle aches. Acupuncture — several studies have shown acupuncture can be effective at relieving pain. Massage is particularly beneficial for muscle aches and pains. Meditation — stress increases the perception of pain. Try regular meditation, which has been shown to make people less sensitive. Yoga or Tai Chi — these exercises help enhance flexibility and relax the body, which can help ease tight muscles, arthritis pain, and fibromyalgia. 4HEALTH | 877.807.0989

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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.” 4HEALTH | 877.807.0989

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BEFORE TREATMENT

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TIGHT JEANS MAY CAUSE NERVE DAMAGE & OTHER HEALTH PROBLEMS SURVEY INDICATES RISE IN TWISTED TESTICLES AND URINARY TRACT INFECTIONS ■■■ Lynn Merrell They’re everywhere this year—trendy skinny jeans. All the stores have them out in cute, fashionable colors and prints, and you can find adorable long sweaters to go with them that work well for just about any size or figure. Pair them with high boots and you have a great outfit for a winter night out. The trend is hot in men’s fashions as well, with skinny jeans giving the illusion of length and height. No matter what you think of the trend, one thing you should know—skinny jeans could cause health problems, for both genders.

Results from the survey indicated that 50 percent of men suffering from skinny jeans experienced groin discomfort, more than 25 percent suffered bladder problems, and one in five experienced a twisted testicle. A twisted testicle or “testicular torsion,” as it’s termed medically, can cause severe pain, swelling, and nausea, and can cut off blood supply to the testicle, potentially affecting male fertility. Doctors also advise men to avoid skinny jeans and other tight jeans, because they can cause the testicles to overheat, lowering sperm count. Wearing them can also increase the risk of thrush, a type of yeast infection.

HEALTH DANGERS FOR MEN Doctors are reporting an increase of painful testicular problems related to the increased wearing of skinny jeans. According to a recent survey of 2,000 British men, tight-fitting jeans can cause urinary tract infections, twisted testicles, bladder weakness and other long-term health consequences. Dr. Hilary Jones, who is a TENA Brand Ambassador and campaign spokesperson, told Men’s Health: “Men who wear tight or illfitting trousers or underwear which is restrictive around the groin area could be damaging their health. I have seen several cases of men who have twisted their testicles due to wearing jeans that are far too tight. Please don’t put style before health.”

NERVE DAMAGE FOR BOTH GENDERS Another problem that may occur when wearing skinny jeans is nerve damage. Dr. Karen Boyle from Greater Baltimore Medical Center, recently told ABC News that tight jeans can increase the risk of “meralgia paresthetica,” a disorder that occurs when one of the nerves that runs in the other part of the thigh is compressed. “The pressure on it causes symptoms of tingling, numbness and pain in the outer part of the thigh,” Boyle said. Wearing high heels with skinny jeans can exacerbate the symptoms, as the heels tilt the pelvis in a way that increases the pressure on the nerve. Boyle stated that those who experience symptoms can find relief by wearing

jeans with a bit more leg room or stretch, but warned that continuing to wear tight jeans could cause serious permanent nerve damage. In addition to potential nerve damage, jeans that are too tight can also limit the mobility of the hip joints, causing stretching of the joint capsules and negatively affecting the spine. A too-tight waist can constrict the abdominal area, potentially causing reduced lymph flow from the pelvis and hindering proper immune function and blood circulation.

FASHION ALTERNATIVES What if you want to be trendy without suffering the consequences? Maybe you like the slim look, but don’t like the pain. Here are some options that will still look great without killing your nerves: ■ Buy stretch denim, which can still cling to

you, but without cutting off your circulation. ■ Go for straight-legged jeans. They’re similar to skinny jeans, but not so tightly fitted. ■ Try leggings. They give you a slim look, but have a lot more stretch. You can even find them in denim fabrics—these are usually called “jeggings.” ■ How about flare jeans? They’re trendy too, and usually slim through the thigh with a flattering flare at the hem. 4HEALTH | 877.807.0989

4HEALTH

10 WAYS TO PROTECT YOUR FEET WHEN YOU HAVE DIABETES HOW TO AVOID INFECTIONS, ULCERS, AND OTHER FOOT DAMAGE

■■■ By Morgan Rice You’ve probably heard it from your doctor: If you have diabetes, you need to take special care of your feet. The disease can cause nerve damage that makes it more difficult for you to detect a foot injury, and it can also cause skin changes that result in peeling and cracking. The two factors together increase the risk of getting ulcers that can become infected, and may not heal as they’re supposed to. That means you need to be extra diligent, but what exactly does that mean? We’ve got 10 tips to help you avoid the pain of diabetic foot injuries. 1. Keep your blood sugar under control: You know this, but it’s important not only for your overall health, but your foot health, as well. Controlling blood sugar levels will help you reduce your risk of nerve damage and other changes that can affect your feet. 2. Inspect daily: Because nerve damage can make any wounds you may suffer unnoticeable, it’s important to look your feet over every day to be sure everything is okay. Look for blusters, sores, calluses, and other issues, and if you find them, address them right away so they don’t get worse. 3. Smooth hardened areas: If you find calluses or corns, gently smooth them down with a pumice stone. Don’t be too harsh, though, or you’ll break the skin. Work in one direction, gently getting rid of that dry, hard skin. 4. Moisturize: Diabetes affects the skin, causing it to become dryer than usual. That can make your feet more likely to flake and crack, which can lead to wounds and infections. That means you need to moisturize your feet every day. Butters work better than lotions — look for shea or cocoa butter, and apply it every day after your bath or shower, and before bed. 4HEALTH | 877.807.0989

5. Keep your toenails trimmed: The goal here is to avoid ingrown toenails. You can do that by regularly trimming your nails, cutting straight across (not curved), and smoothing the edges with an emery board. 6. Wear good shoes: One of the main causes of a diabetic foot injury is a poor-fitting shoe. Make sure the ones you wear are soft against your skin, have sufficient arch support, and have enough room to accommodate your foot. Remember that your foot size may change as you get older, so have your foot measured every few years. Avoid opentoed shoes and sandals — use shoes that protect the whole foot. 7. Wear good socks: In addition to good shoes, you need good socks, too. Look for quality socks that provide sufficient cushioning, and that are made of materials that help wick away moisture. Athletic socks or hiking socks work well. Ask your podiatrist for recommendations. 8. Keep moving: Standing or sitting for long periods of time isn’t good for your health, and can also affect your blood circulation, which is bad for your feet. Move around frequently. If you’re sitting, get up and walk around. If you’re standing, sit down for a few minutes. When you have time, elevate your feet so the blood runs back to your heart. Consider yoga or tai chi or another type of stretching exercise, too, to keep your foot and leg muscles loose and flexible. 9. Avoid super hot water: A hot bath can be relaxing, but if you’re suffering from diabetic nerve damage in your feet, you could inadvertently injure them. You may not be able to feel how hot the water actually is, and could burn yourself. Ask someone to test the water for you. Never “dip your toe” into hot water until you know that it’s safe. 10. See your podiatrist regularly: Those with diabetes need to have their feet checked more often than those without the disease. An annual foot exam is a must, but you’d be smart to go in at least twice a year — more often if you’re experiencing foot problems.

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Podiatry | 4HEALTH31

HARD-TO-TREAT NAIL FUNGUS

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

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

WHAT ARE THE SYMPTOMS? Once onychomycosis takes hold, it attacks the nail, making it thicker, brittle, ragged, distorted, and dull, and usually darkening the color because of the debris build-up underneath it. The thickened nails may become more difficult to trim, and may cause pain when walking, reducing mobility. Nails may also separate from the nail bed, causing pain, while the fungus creates a foul odor. Treatment for this infection can be especially challenging, as it tends to hang on and keep 4HEALTH | 877.807.0989

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

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

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

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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IS IT LOVE, OR JUST ATTRACTION? HOW TO TELL IF YOU AND YOUR PARTNER WILL LAST

■■■ Colleen M. Story We all love to feel that giddy, happy, “Ithink-I’m-in-love” feeling, but unfortunately for many of us, it comes with a shadow. Hanging over our drunk-like bliss is that ever-present worry: “Is it love, or just attraction?” It’s hard to tell when our pulses are racing and our neurotransmitters flooding us with feel-good emotions. It seems like everything is going to be rosy forever, but we’ve all lived long enough to know that love can make us fools. Is there any way to tell if this lover will be around when the fire cools, or if this is just another biological head-trip?

THE RULES OF BIOLOGY There’s no doubt that our bodies have minds of their own when it comes to sexual attraction. Studies show, for example, that women in their fertile phases fantasize about macholooking men with pronounced chins, strong jaws, and well-defined brows—regardless of how intelligent they may or may not be.1 Another study showed that men rated as most physically attractive by women had the lowest levels of oxidative stress.2 The statistics go on. Men like long legs. Women like certain facial scars. Men like women who look healthy—not too skinny, not too overweight, with a nice difference between waist and hip measurements. Women like a man who looks like he can protect them.

One study even found that women are more attracted to men dressed in red. (Have you checked your wardrobe lately, guys?) With all this biology and unconscious communication going on, how are we to separate the wheat from the chaff?

SEPARATE LOVE FROM LUST One thing all these studies do for us—besides make the whole notion of love and attraction immensely confusing—is to arm us with knowledge of our own biological tendencies. We know that our bodies aren’t always looking out for what’s best for us, which means we can use our minds to make clearer decisions. First clue. How long have you been in this relationship? If you think you’re “in love” within a few weeks, it’s probably more infatuation than anything real. It’s impossible to truly know someone within such a short time, so it’s probably the pheromones talking. Real love takes into account the good and the bad, and make no mistake—your new partner will have things about him you won’t like. Keep a cool head and give yourself a few more dates to discover more and see if you still feel the same. Second clue. What do you love about your relationship? If you’re really in love, you enjoy doing almost anything with your partner, from making love to going to a museum to watching sports. If you find ordinary activities boring,

however, and focus mostly on sex with your partner, you’re more likely to be in lust. Third clue. What do you love most about your partner? If your first answer is “her legs” or “his butt,” again, this is probably not real love. Couples who have been together awhile and are truly in love will list characteristics like sense of humor, loyalty, compassion, or gentleness. Fourth clue. How do you think your partner feels about you? Most likely, if he’s after you mostly for your body, you’ll know it on some level. Does he spend the whole day with you, or tend to text you for a late-night booty call? Is she happy to spend time with your family, or is she more likely to want to meet you at your apartment? Go with your gut, and zero in on those things that show your partner is truly interested in you as a person. Last clue. What do you imagine a lifetime would be like with this person? If you tend to hesitate at this question, or feel a little concerned, it may not be true love. When you know and care for your partner well enough to say, “It would be wonderful. I can’t imagine living without him/her,” then most likely you’ve found the real thing. REFERENCES Neil Katz. Fertile Women Fantasize About Macho Men, Smart Guys Not So Much. CBS News, January 12, 2011. http://www.cbsnews. com/8301-504763_162-20028272-10391704.html. 2 5 Biological Reasons You May Be Attracted to Someone. Readers Digest.com. http://www.rd.com/living-healthy/5-biological-reasonsyou-may-be-attracted-to-someone/article186743.html. 1

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4HEALTH

WHAT DO YOU THINK SCHIZOPHRENIA REALLY IS? MENTAL ILLNESS COMMONLY MISUNDERSTOOD

■■■ By Colleen M. Story If you hear that someone has been diagnosed with schizophrenia, what do you think? You may imagine someone who’s violent, or who suffers from a split personality. But would you be right? According to a recent survey by “Rethink Mental Illness,” you’d have the wrong idea, but you wouldn’t be alone. Researchers asked 1,500 people what they thought schizophrenia was, and found that in general, the illness was widely misunderstood. The group is hoping to change that with a campaign to increase awareness about what it really means to have schizophrenia.

SCHIZOPHRENIA WIDELY MISUNDERSTOOD In the survey, researchers found that half of the respondents thought that people with schizophrenia had a split personality, and a quarter of them thought the condition led to violent behavior. But both of these perceptions were incorrect. According to the American Psychiatric Association, symptoms of the illness can include delusions, hallucinations, trouble with thinking and concentration, and lack of motivation. Patients have trouble separating what is real from what is imaginary, and may have difficulty expressing normal emotions in social situations. They may also have trouble making decisions, or holding down a job, and finding pleasure in life. Though there is a risk of violent behavior, they’re not automatically violent. In fact, people living with this illness are usually more likely to be harmed by others than to commit harm. Other common symptoms include hearing voices, depression, and sensations of physical pain. Those with the illness usually experience shortened lifespans, dying 15 to 20 years earlier than the rest of the population, on average.

WHAT CAUSES SCHIZOPHRENIA? Schizophrenia is not as common as most people think it is, affecting only about one in 100 people. Scientists aren’t sure what causes it, but they have some theories. They believe that it’s probably genetic, meaning that if someone in your immediate family had it, you are at a 4HEALTH | 877.807.0989

higher risk of developing it, too. They also think that it may be caused by viral infections, immune disorders, or abnormalities in the brain’s chemistry or structure. Some studies have found, for example, that those with the illness have an imbalance of neurotransmitters in the brain that affect how the brain reacts. Others have shown that the illness coincides with problems in the connections and pathways in the brain that fail to form as they should while the child is in the womb.

WHAT ARE THE EARLY WARNING SIGNS? Schizophrenia can be difficult to diagnose, because symptoms can mimic those that are associated with illegal drug use. Those who have the illness also don’t believe that there’s anything wrong with them. There is no screening method to determine for sure, so it’s up to the doctor to evaluate the symptoms over a period of time to make a correct diagnosis. The most telling symptoms are delusions and hallucinations. Early warning signs that the illness is present include hearing or seeing something that isn’t there, the feeling of being watched, speaking or writing in nonsensical ways, increasing social withdrawal, irrational responses to loved ones, inappropriate or bizarre behavior, and a downward trend in work or school performance.

HOW IS SCHIZOPHRENIA TREATED? Rethink Mental Illness hopes to show people that this disease can be treated and managed, just like any other mental illness. Brian Dow, director of external affairs at the organization, told BBC News that “we can all play a role in rethinking schizophrenia, and helping to change attitudes, by learning to separate the myths from the facts.” Treatment typically includes individual counseling, medications, rehabilitation programs, and group therapy. Mental Health America says that while there is no cure, many people with the illness “can lead productive and fulfilling lives.” Coordinated Specialty Care (CSC), which combines medication, therapies, case management, family involvement, and employment services, often works the best at helping people to manage their own lives.

4HEALTH

10 WAYS LOVE CAN BENEFIT YOUR HEALTH FROM SHARPER BRAINS TO HEALTHIER HEARTS ■■■ Colleen M. Story Everybody knew it. Caroline was in love. Her eyes sparkled, her skin glowed, and she bounced around the office like she had springs on her shoes. “It will fade,” predicted Marge, the secretary. “Give it a few months. She’ll slow down just like the rest of us.” Though romantic love may, indeed, “fade,” the benefits of a strong, loving relationship remain, helping us live happier, healthier lives. Some of the proven benefits? You may be surprised. 1. Better brains. According to a Swedish study, cohabitating with a partner can help delay mental decline. Couples going through midlife together had a lower risk of cognitive impairment during old age.1 “People cohabiting with a partner in midlife (mean age 50.4),” wrote the researchers, “were less likely than all other categories (single, separated, or widowed) to show cognitive impairment later in life at ages 65-79.” 2. Less drinking. Several studies suggest that a happy marriage can reduce heavy drinking and overall alcohol consumption for both young men and young women, with the couple enjoying the health benefits of their changed behavior.2 3. Fewer doctor visits. According to the U.S. Department of Health and Human Services, married people go to the doctor less fre-

quently, have shorter hospital stays, and are less likely to be admitted to a nursing home.3 Loving partners also tend to encourage good behaviors like preventive care, exercise, and even flossing. 4. Better moods. Happy couples are less likely to experience depression, according to studies.4 Good relationships also help us cope with stress. Having someone to turn to for emotional support can make stressful situations a lot easier to handle. 5. Healthier hearts. A University of North Carolina study found that couples who hugged each other regularly showed increased levels of oxytocin, a “bonding” hormone, and reduced blood pressure, which reduces the risk of heart disease. People in loving relationships were found to have even higher levels of oxytocin than others. The study also found that all the women had reduced levels of the stress hormone cortisol following the hug, which could also benefit heart health.5 6. Stronger immune systems. Having sex once a week has been linked with higher levels of antibodies that can protect against colds and infections.6 7. Cancer-fighting power. According to a study from the University of Iowa, ovarian cancer patients in satisfying relationships had more vigorous “natural killer” cells working on their tumors than those who didn’t.7

8. Longer life. Several studies have shown that a lack of love—or social isolation—can increase the risk of early death. Those in happy, loving relationships tend to live longer. 9. Smoother skin. There’s a reason they call it the “blush” of new love. Being in love increases the body’s production of feelgood endorphins, which can increase blood flow to the skin, keeping it soft, smooth, and vibrant. 10. Faster wound healing. The Ohio State University found that supportive couples helped each other recover from an injury at least one day faster than couples who showed hostility toward one another.8 REFERENCES Krister Hakansson, et al. Association between mid-life marital status and cognitive function in later life: population based cohort study. BMJ 2009; 339:b2462. 2 Miller-Tutzauer, C; K.E. Leonard, and M. Windle. “Marriage and Alcohol Use: A Longitudinal Study of “Maturing Out”. J Stud Alcohol., vol. 52, no. 5, September 1991, pp. 434-40. 3 U.S. Department of Health and Human Services. ASPE Research Brief. The Effects of Marriage on Health. June, 2007. http://aspe.hhs.gov/ hsp/07/marriageonhealth/rb.htm. 4 Kim, Hyoun K., and Patrick McKenry. “The Relationship Between Marriage and Psychological Well-Being.” Journal of Family Issues, vol. 23, no. 8, 2002, pp. 885-911. 5 How hugs can aid women’s hearts. BBC News August 8, 2005. http:// news.bbc.co.uk/2/hi/4131508.stm. 6 Top 10 Reasons to Have Sex Tonight. CBS News Healthwatch. March 24, 2008. http://www.cbsnews.com/stories/2008/03/24/health/webmd/ main3961093.shtml. 7 Sarah Mahoney. How Love Keeps Us Healthy. Prevention Magazine. http://health.msn.com/womens-health/articlepage. aspx?GT1=7756&cp-documentid=100123218. 8 Earle Holland. Stress Substantially Slows Human Body’s Ability to Heal. Ohio State University. http://researchnews.osu.edu/archive/wounheal. htm. 1

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4HEALTH

IS BRONCHITIS CONTAGIOUS? HOW TO KEEP FROM CATCHING IT

■■■

By Gordon Barclay

I was standing in line the other day at the grocery store, and this guy ahead of me struck up a conversation. He was talking about an old car he was working on, which was fun, but I couldn’t help but notice that he sounded stuffed up and his eyes were red. I mentioned it, and he nodded. “I have bronchitis,” he said. “Stinks, huh? But I’ll get over it.” I nodded and smiled, but I couldn’t help my instinct to step back. I mean, I didn’t want to catch it. But then I got to thinking: bronchitis is an infection in the lungs. Is it contagious? Did I need to be worried?

WHAT IS BRONCHITIS? I was actually a little bit wrong when it comes to what bronchitis is. I thought it was an infection in the lungs, which can be true, too, but bronchitis actually occurs when the bronchial tubes, which carry air to and from the lungs, become inflamed. And there are a number of things that can cause that inflammation. An infection is only one of them. Common symptoms of bronchitis include a cough, often with sputum, shortness of breath, fever and chills, chest pressure, and fatigue. In some cases, people may also experience headaches and body aches. There are two types of bronchitis: acute and chronic. The first one comes on quickly, and then goes away within a couple weeks. The second kind lasts at least three months, and may go on even longer than that.

WHAT CAUSES BRONCHITIS? As I suspected, most types of acute bronchitis are caused by viruses. These are the same viruses that can cause the common cold and flu, but in the case of bronchitis, they work their way down into the lungs to wreak their havoc there. Chronic bronchitis, though, is most often caused by cigarette smoking. You’ve heard of the “smoker’s cough.” That’s evidence that those 4HEALTH | 877.807.0989

bronchial tubes are inflamed. Air pollution, dust, toxic gases, and other elements in the air at work or in the environment can also cause the condition.

SO IS IT CONTAGIOUS? The answer to my original question — is bronchitis contagious?— depends, then, on what’s causing it. If it’s a virus, then yes, it’s contagious, and you can catch it easily, especially if the person coughs close to you. Even if they sneeze, they shed infected droplets into the air and onto surfaces nearby. If you then breathe in those droplets, or touch the surfaces and then touch your face, you could develop bronchitis, too. If smoking or environmental toxins caused the bronchitis, however, it’s not usually contagious. The problem is, when you are interacting with people, you usually can’t tell which kind they have. That means it’s best just to assume that they’re contagious, and to do what you can to protect yourself.

HOW TO KEEP FROM CATCHING BRONCHITIS If you end up in a situation like I did, or if you have a loved one or work colleague with bronchitis, try these steps to reduce your risk of catching it: ■ Avoid close contact. ■ If you can’t avoid close contact — if you’re caring for a child, for instance — consider wearing gloves, and always wash your hands completely after contact. ■ Wipe down surfaces with an antiseptic wipe or cleaner to kill germs. ■ Keep your hands away from your face at all times. ■ Consider getting your flu shot — since the same virus that causes the flu can cause bronchitis, it may help protect you. If your efforts don’t work and you get bronchitis too, remember that in most cases, antibiotics won’t work because they don’t kill viruses. Instead, concentrate on treating your symptoms, and take some time off to recover.

4HEALTH

VEIN PROBLEMS:

YOUR QUESTIONS ANSWERED

YAN KATSNELSON, MD CARDIOVASCULAR SURGEON FOUNDER OF THE USA VEIN CLINICS, USA VASCULAR CENTERS, USA FIBROID CENTERS

FLORA KATSNELSON, MD FOUNDER OF THE USA VEIN CLINICS, USA VASCULAR CENTERS,

USA FIBROID CENTERS A lot of us have heard about vein disease before, but may be confused about what it is, when to seek treatment, and how dangerous it can be. To help clear up the confusion, we asked leading specialists at USA Vein Clinics to answer some of our questions.

WHAT IS VENOUS INSUFFICIENCY? CAN IT BE DANGEROUS? Venous insufficiency is when your leg veins cannot pump enough blood back to your heart. Veins in the lower parts of your legs are usually affected. Early detection is a challenge â&#x20AC;&#x201D; quite often it takes years 4HEALTH | 877.807.0989

4HEALTH for this disease to show its ugly face, and, by that time, it could be very dangerous. Complications can include deep vein thrombosis (DVT), bleeding, and phlebitis, but some patients can also get ulcers, serious inflammations, and even cancer.

SPIDER VEINS ARE NOTORIOUS FOR LOOKING UNATTRACTIVE AND STUBBORNLY RESISTING TREATMENT. WHAT IS YOUR APPROACH TO SPIDER VEINS? Spider veins appear alongside with venous insufficiency, so they are, so to speak, “allies” of the veins affected by the disease. To get rid of them, doctors need to find and treat the main source of the problem — the malfunctioning vein. If it’s treated properly, spider veins disappear, never to come back.

PHYSICAL EXERCISES — ARE THEY GOOD OR BAD FOR YOUR VEINS? Moderate physical activity is great for your veins! There are no specific types of exercises that target the venous system, but walking, cycling, jogging, swimming, and most any other aerobic activity is very beneficial. Those who have already been diagnosed with poor veins should avoid heavy lifting and strenuous exercise, but can still benefit from regular walking.

WHAT ABOUT CROSSING YOUR LEGS WHILE SITTING, BRIGHT SUN EXPOSURE, OR WEARING HIGH HEELS? WILL ANY OF THESE THINGS CAUSE VEIN DISEASE? None of these factors contribute to venous insufficiency development; however, when you already have vein problems, it’s more challenging (and often painful) to wear high heels, and crossing your legs can become uncomfortable. As for sunlight, only after certain procedures like sclerotherapy do people need to avoid sun exposure to prevent possible skin pigmentation.

WHAT IS SCLEROTHERAPY? Sclerotherapy is an injection therapy that fixes small veins, such as spider, reticular, and small varicose veins. Using a very tiny needle, we administer injections of a sterile solution into the vein. We use ultrasound technology to ensure the injections are precisely placed. The solution irritates the vein lining, which causes it to swell and seal. The vein eventually becomes scar tissue, which is absorbed into the surrounding tissue, and the healthy veins around it take over circulation.

It’s important to remember that this procedure is only helpful when the main vein problem is treated. This is why the doctors at USA Vein Clinics work beyond the cosmetic issues to find the underlying cause. Also, if sclerotherapy is improperly done, this could lead to DVT, which is very serious. Our doctors aren’t merely “beauty” doctors; they are vascular surgeons who have years of knowledge, experience, and skill to treat your veins and get you back to great health.

WHAT IS ENDOVENOUS LASER THERAPY (EVLT)? EVLT is a minimally invasive, non-surgical, outpatient procedure for treating varicose veins. After applying a local anesthetic and using ultrasound technology for precision, a very thin laser fiber is inserted into the diseased vein. Heat from laser energy is applied, sealing the vein shut. The healthy veins around it immediately take over normal circulation. The procedure only takes 15 minutes, and you can resume your daily activities afterward. EVLT is considered the gold standard in vein disease treatment.

TELL US MORE ABOUT DVT DVT can be very serious. Illness, injury, vessel damage, and inactivity can all slow blood circulation, causing blood to pool in your lower limbs. This stagnating blood creates an ideal environment for a clot to form in the deep veins of your legs. Without proper and timely treatment, DVT can sometimes lead to life-threatening complications, such as a pulmonary embolism (blood clot in the lungs). Fortunately, with increased awareness of symptoms and patient risk factors, DVT can be diagnosed early and treated successfully.

WHAT IS THE BEST COURSE OF ACTION FOR A PATIENT WITH ANY OF THESE VEIN ISSUES? The best and shortest way to an effective treatment is to get an accurate and timely diagnosis. USA Vein Clinics is well known and highly recommended in the New York metro area. We perform all the tests you need for correct diagnosis, and then we customize your treatment to your needs. There’s no reason to put off consultation — if you’re having pain or discomfort in your legs, or know you have vein problems, put your faith into the hands of the leading vein specialists at USA Vein Clinics. To schedule your consultation, call (718) 509–0906, or go to www.usaveinclinics.com. Treatments at USA Vein Clinics are covered by Medicare, most insurance plans, and Medicaid.

(718) 509-0906

(718) 393-5331

www.USAVeinCinics.com

www.USAVascularCenters.com

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(718) 504-6525 www.USAFibroidCenters.com

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SHOULD YOU AGREE TO ROBOTIC SURGERY? BENEFITS AND RISKS WITH THIS NEW TECHNOLOGY ■■■ Lynn Merrell The next time to meet with your doctor to discuss an upcoming surgery, don’t be surprised if he suggests enlisting the help of a robot. You may have to ask him to repeat that. Yes, a robot may very well be operating on you. Is this something you should agree to?

WHAT IS ROBOTIC SURGERY? Over the past several years, robots have been infiltrating our hospitals across the country. The most popular one so far is called the da Vinci robotic surgery system, developed and manufactured by Intuitive Surgical. Approved by the Food and Drug Administration (FDA) in 2000, it may be used in urologic, gynecologic, and non-cardiovascular thoracoscopic surgical procedures. The device has four mechanical arms and is operated by a surgeon who sits at a console with a high definition video screen. It costs about two million dollars for a hospital to purchase, and over $100,000 a year to maintain. Because of this high cost, hospitals that invest in the new technology typically market it heavily to patients, in an effort to recoup their cost.

WHAT ARE THE BENEFITS? Intuitive Surgical lists a number of benefits to robotic surgery in their marketing materials. It may be used to correct obesity,

endometriosis, throat cancer, prostate problems, kidney cancer, and gallbladder issues, as well as for hysterectomies and heavy uterine bleeding. The machine is reported to be incredibly accurate, and capable of performing minimally invasive surgeries with smaller incisions with less blood loss. The robotic arms can bend and twist just like a surgeons hands and arms, but they are steadier and potentially more accurate. The result can be a faster recovery and less scarring for patients.

WHAT ARE THE CONCERNS? This new technology is not without its potential drawbacks. Intuitive Surgical is currently defending a number of personal injury lawsuits around the country brought by patients who were seriously injured during robotic surgical procedures. An Alabama couple, for instance, filed a lawsuit against the company after the plaintiff ’s da Vinci hysterectomy allegedly caused injuries to her left ureter and bladder. Other injuries that have been linked with robotic surgery include tears and burns to the uterus and intestines, tears and burns to the blood vessels, and vaginal cuff dehiscence (complication of total hysterectomy). Early in 2013, the FDA noticed a 34 percent increase in reports of problems associated with the robot, and started surveying physicians to gain more information on the potential strengths and weaknesses of the system.

SHOULD YOU TRY IT? If your surgeon recommends robotic surgery, should you agree? Though some patients have experienced serious injuries, many have also experienced faster recovery and reduced scarring. The first thing you’ll want to do is to find out how experienced your surgeon is with the equipment. The Wall Street Journal reported in 2010 that Intuitive Surgical offers limited training, and it’s up to the hospital to be sure physicians get enough practice on the machine before actually operating on patients. Some surgeons have suggested that two hundred or more procedures are necessary before becoming fully proficient with it. Once you know that your surgeon is well versed in using the robot, check on cost. Will your insurance cover it? If you have to pay extra, it may not be worth it. In addition, ask your surgeon what benefits you are to expect. A March 2012 study published in the Journal of Clinical Oncology, for example, found that women treated for endometrial cancer with the robot experienced no additional benefits than those who went through traditional surgery. Realize that in their eagerness to pay for the system, some hospitals and doctors may inflate the expected benefits. Robotic surgery may one day become a common part of our lives, but for now, it remains a new treatment option. Treat it as such, and be sure to gather good information before you decide to proceed. 4HEALTH | 877.807.0989

4HEALTH

COULD YOUR KIDNEY STONES BECOME CHRONIC? HOW TO AVOID A REPEAT EXPERIENCE

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By Gordon Barclay

A friend of mine suffered a kidney stone once. Suffice to say, he didn’t want to suffer it again. Kidney stones are notoriously painful and difficult, and after his was over, he was quick to adopt lifestyle habits he hoped would present future recurrences, like drinking lots of water and changing his diet. I hope he doesn’t ever have to go through that again, but the truth is that sometimes kidney stones come back again and again. They’re called “chronic” kidney stones, and they can make life miserable. Is there any way we can avoid them?

WHAT IS A KIDNEY STONE? A kidney stone is made up of minerals and salts that form in the kidneys. Often these stones are too small to notice, but sometimes they get big enough that they get stuck somewhere along the way between the kidneys and the bladder. You can imagine a rock in a hose, and how difficult it can be to dislodge that rock. Usually the stones will move on of their own accord, though it’s not fun waiting it out. In some cases, surgery is needed to encourage them. You’ll know a kidney stone by the pain. You’ll feel it in the side and back, below the ribs, or in the lower abdomen and groin. It comes and goes in waves. You may also suffer from pain during urina4HEALTH | 877.807.0989

tion, frequent urination, and pink, red, or brown urine. If the pain is bad enough you can’t get comfortable, if you have pain with nausea and vomiting or blood in the urine, or if you can’t pass your urine, see your doctor right away.

WHAT CAUSES KIDNEY STONES? As for what causes kidney stones, it depends. Basically, they form because your urine isn’t diluted enough. That lets the crystal-forming substances clump before you can flush them out. But there are often a number of factors involved. Could be you haven’t been drinking enough water, but it could also be because you have gout, you’re eating a diet really high in protein, or you’ve gone through gastric bypass surgery — all of which increase your risk. Obesity, inflammatory bowel disease, and other medical conditions can also increase the likelihood of you getting kidney stones.

TREATMENT DEPENDS ON THE TYPE OF STONES YOU HAVE Sometimes, the kidney stones come back. If they do more than once, you may have chronic kidney stones, which is not fun, to say the least. How do you address them? It depends on what’s causing them. To find out, you need to work with your doctor. It helps to know the type of stones your passing. Uric acid stones, for example, can be treated by adjusting urine pH levels. Cysteine stones

are hereditary and require more specialized treatment. Struvite stones usually form because of a kidney infection, so your doctor will need to address that to stop them. Calcium stones are the most common, and can be treated through dietary changes. Your doctor can find answers through urine tests, imaging tests, and blood tests. You can help by collecting any stones you pass for analysis. Once you know more about what’s causing the stones, you can decide how to treat them.

HOW TO PREVENT KIDNEY STONES The main way to prevent kidney stones is to drink enough water throughout the day. Particularly if you’ve already suffered a stone, you need to make sure you’re thoroughly flushing out your system. On hot days, and when exercising, you need to drink more. Next, choose a diet low in salt and animal proteins. Consider using a salt substitute like Mrs. Dash, and cut back on the animal foods, choosing beans and legumes instead. Talk to your doctor about calcium supplements — calcium in food is a safer way to go. If your doctor has discovered that you have calcium/oxalate stones, she will likely recommend that you eat fewer oxalate-rich foods, like beets, spinach, sweet potatoes, nuts, tea, chocolate, and soy. Target your treatment to the type of stone you have, and you’ll be most likely to succeed in putting kidney stones behind you.

4HEALTH

5 THINGS YOUR DOCTOR MAY NOT TELL YOU WHAT YOU NEED TO KNOW TO PROTECT YOUR HEALTH ■■■ By Lynn Merrell Sometimes we tend to think of doctors in a certain way, as professionals who are tasked with “fixing” whatever ails us. But doctors are people, too, and have their own thoughts and feelings. Some they share with us — but some they don’t. Have you ever wondered what your doctor may be thinking during your examination? Did he tell you everything, or did he hold something back? Is there something you’re doing she wouldn’t recommend? Did she really give you all the advice she could have?

We gathered some information from doctors on what they don’t tell you — but probably should. It all comes down to the relationship between doctor and patient. If you want to make sure you’re getting the best healthcare possible, follow these tips.

1. NO QUESTION IS EVER STUPID. Do you hold back on asking questions because you’re embarrassed, or because you’re afraid the doctor will think you’re stupid? Doctors say you shouldn’t, because it’s your health at stake. Sometimes, doctors make mistakes, so it’s always good to double-check 4HEALTH | 877.807.0989

4HEALTH on things like prescriptions and diagnoses. Are you confused about something? Speak up. Doctors like patients who take an active role in their own health, and see the doctor as a partner in meeting their goals.

potential symptoms that are outside the norm for you, and be a more effective detective when it comes to discovering the source of any health issues.

4. PRIORITIZE YOUR GOALS. 2. YOU MAY NOT NEED MORE TESTS. Doctors say that sometimes, patients insist on every test in the book. Scans, blood work, x-rays, etc. are often requested by patients who are worried they have serious health problems. A doctor may acquiesce to the request, but secretly feel that all the extra tests aren’t necessary. In some cases, particularly with tests like CT scans that expose you to radiation, they can be potentially harmful. Additional scans may discover benign conditions that then require additional follow-up tests that can be stressful and may add to your overall radiation exposure — but in the end, don’t do anything to make you healthier. Additional tests can also add up to unnecessary costs. A conscientious doctor will recommend only the tests necessary to make an accurate diagnosis — and will appreciate patients who take a more careful approach to testing.

3. YEARLY CHECKUPS ARE STILL IMPORTANT. Some recent studies have indicated that for some healthy people, yearly physicals may not be necessary. One study found, for instance, that people who got annual checkups didn’t seem to be healthier or live longer than those who didn’t. Still, most doctors will tell you that yearly checkups are beneficial for other reasons. It helps your doctor get to know you better, which is likely to help him or her pick up on any subtle clues about impending illnesses. Knowing your typical health condition makes it more likely a doctor will be able to detect

Because of insurance requirements, doctors are under pressure these days to keep visits short — typically 10–15 minutes. They love patients who come in with two to three goals for the visit. You may have other things you want to ask about as well, but letting your doctor know your priorities can be immensely helpful for both of you. So instead of asking about your diet and your blood pressure and your latest joint pain and digestive troubles, narrow it down to the few things that you’re most concerned about, then let your doctor know what those things are right at the beginning of the visit.

5. DON’T IGNORE YOUR EMOTIONS. During a doctor visit, it can feel like you need to leave your emotions outside the door. After all, you’re both talking about your body like you may talk about your car: how it’s functioning, what it needs, future potential issues, etc. But doctors say that you don’t have to stuff all your emotions. In fact, if you’re feeling strongly about something, they’d prefer you speak up, because it could be a clue to a potential health issue, or even an issue in the doctor-patient relationship. If you don’t feel okay about something the doctor told you, or even if you’re feeling ignored or misunderstood, don’t be afraid to say something like, “I don’t feel good about what you just said. Can we revisit that?” Being open and honest is the best way to be sure you leave the office feeling satisfied.

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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 Dentist.

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

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Medical Office is looking for PA or NP for Internal Medicine Doctor. (347) 587-3777

Call 347-713-6871

Dental Office in Brooklyn is looking for a Dental Assistant (2 years experience). Call (718) 259-3828

Medical office seeks a Russian-Speaking Registered Nurse Practitioner. Please submit your resume to medicaloffice41@gmail.com

Per Diem Covering CHIROPRACTIC PHYSICIAN (NY/NJ Lic.) available for PT. Own Malpractice Ins. Call Dr. Joseph Juliano 973-752-9559

Medical Office for Rent (917) 826-5101

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

Medical space for subleasing at 500 Brightwatercourt in Brooklyn (b/n Brighton 4th street and Brighton 5th Street) for any medical specialist (not for internal medicine doctor and podiatrist). The office is located in the building for senior citizens. There is a big potential for new patients referrals. For details call (646)251-6646.

Licensed Ultrasound Technologist (RDMS) is looking for part time or full time position. Resume available upon request. Tel. 718-608-7402; Email at violasvu@gmail.com.

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