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EARLY SIGNS OF THE SHINGLES DISEASE

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MORE COMMON THAN YOU MAY THINK

WHY COPD PATIENTS NEED TO “KEEP COOL”

WHICH TREATMENT IS BEST FOR URGE INCONTINENCE?

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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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10 Ways to Soothe a Sinus Infection

Doctors Resisting Overuse of Antibiotics

11 10 This Rash Hurts— Could It Be Shingles? Early Signs of the Shingles Disease

12 Don’t Let This Disease Steal Your Sight Away

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Glaucoma More Common Than You May Think

20 Why COPD Patients Need to “Keep Cool” Study Shows Hot Temperatures Can Be Dangerous

38 Which Treatment is Best for Urge Incontinence?

WHY IT’S IMPERATIVE TO YOUR HEALTH TO TAKE CARE OF YOUR GUMS Research Connects Gum Disease to Heart Disease and Memory Problems

WHY YOU SHOULD SEEK EMERGENCY TREATMENT FOR A MINI-STROKE Signs that You Need to Get to the Doctor Immediately

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

HOW MUCH DO FATTY FOODS AFFECT YOUR BREAST CANCER RISK? Studies Show Conflicting Results

BACK PAIN? FIND HELP AT THE USA VASCULAR CENTERS! The Story of Sophia Verner

ARE MIND-BODY APPROACHES BETTER FOR BACK PAIN THAN OPIOIDS? Studies Show Exciting Benefits from Yoga and Meditation

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ARE YOUR FEET ACHING BECAUSE OF FALLEN ARCHES? Signs and Symptoms Your Arches Need Help

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WHY IT’S IMPERATIVE TO YOUR HEALTH TO TAKE CARE OF YOUR GUMS RESEARCH CONNECTS GUM DISEASE TO HEART DISEASE AND MEMORY PROBLEMS

nnn By Lynn Merrell Brush your teeth. Floss every day. See your dentist. Is it really that important to be so vigilant in your oral care? Yes, and for one big reason: if you aren’t, your gums could become infected with bacteria, and that bacteria can then go on to cause a number of other serious problems in your body. It’s true — a number of dangerous health conditions can actually get started in your mouth! If you’re not convinced, read on, because when it comes down to it, brushing and flossing is a small price to pay to stay healthy.

ORAL BACTERIA CAN CAUSE GUM DISEASE We don’t like to think about it, but our mouths are homes for a whole community of bacterial species. Some of these are helpful to us, but others are destructive. It’s the destructive ones that can take hold if we don’t take good care of our teeth and gums. Every time we eat, food particles settle in around the gums and teeth, and they stay there until they’re washed away. If you don’t get them out with regular brushing, flossing, and rinsing, those food particles can attract destructive bacteria. Together, these elements form “plaque,” a hardened material on the tooth surfaces. That plaque then goes on to irritate the gum tissue, and to release toxins that cause inflammation — swelling and redness that can lead to bleeding. If it’s not removed (usually at

the dentist’s office), the plaque can go on to cause a “gingivitis,” which can progress into periodontal disease. This is a type of infection of the gums that can gradually destroys teeth and bones, as well as the gum tissues. This is all very bad news for your oral health, but it can also create additional problems elsewhere in your body.

HOW TO MAKE SURE YOUR MOUTH BACTERIA STAYS IN CHECK To be sure that the bacteria in your mouth doesn’t become destructive, brush and floss every day (or use a water flosser), and consider adding a disinfecting rinse to your routine, as well. In addition, try the following tips to help keep the balance of good bacteria to bad bacteria where it needs to be:

ORAL BACTERIA CAN CAUSE OTHER HEALTH PROBLEMS

n Don’t smoke or stop smoking — smok-

Bacteria present in gum disease can enter your bloodstream and travel to other areas in the body. Usually your immune system takes care of them, but if you’re under stress, or if you have other illnesses — even the flu or common cold — your immune system could be overwhelmed, and the bacteria from your mouth could take hold. Researchers have connected oral bacteria to a number of other health problems, including:

n Eat foods rich in probiotics, as they en-

n n n n n n n n

Cardiovascular disease Heart attack Stroke Diabetes complications (difficulty controlling blood sugar levels) Preterm birth Memory problems and dementia Rheumatoid arthritis Chronic respiratory disease

Keeping your mouth healthy, on the other hand, gives you a more attractive smile and increases your odds of avoiding these other issues.

ing increases risk of periodontal disease.

courage “good” bacteria to thrive. You’ll find them in yogurt and other fermented foods like miso, kefir, kombucha, and sauerkraut. Cut back on sugary treats. Sugar, more than any other type of food, sticks to your teeth and encourages the growth of destructive bacteria. Eat a balanced diet rich in fruits and veggies. These foods contain healthy nutrients that prevent inflammation. Eat more fatty fish or take a fish-oil supplement. Research has connected the healthy omega-3 fatty acids in these to a reduced risk of gum disease. Other foods rich in omega-3s include nuts, flaxseeds, and chia seeds. See your dentist regularly. A hygienist gets any plaque that you may have off your teeth, and a dentist can help alert you to any problems early on, before they cause additional health issues. 4HEALTH | 877.807.0989

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10 WAYS TO SOOTHE A SINUS INFECTION DOCTORS RESISTING OVERUSE OF ANTIBIOTICS

nnn By Morgan Rice The Centers for Disease Control and Prevention (CDC) states that about 29.4 million Americans suffer from sinusitis, or sinus infections. Though these infections may last for only a few weeks or several months, they are extremely unpleasant, causing symptoms like headaches, fever, weakness, cough, and congestion. We all live busy lives, so it’s difficult to slow down and rest with a sinus infection comes along. We prefer to go to the doctor and get a prescription for antibiotics, hoping they will get us back on our feet in a hurry. Researchers have found, however, that antibiotics often don’t help. Worse, using them frequently can contribute to the growing problem of antibiotic-resistant diseases. Today, doctors are recommending other treatment options for sinus infections. Might these work just as well for you?

WHAT IS A SINUS INFECTION? A sinus infection occurs when the sinus passages become inflamed because of a bacterial, viral, or fungal invasion. The body fights off the invaders by creating inflammation. That leads to a stuffy nose, inability to breathe well, excess mucus, and other miserable symptoms. Eventually, though, if we take care of ourselves, the body will succeed in killing the infection. Antibiotics help only if bacteria cause the infection. Harvard Health and other health authorities, however, say that most sinus infections are viral in nature, and antibiotics don’t work against viruses. So in essence, in

most cases, antibiotics do nothing to help heal a sinus infection. “Everybody sort of thinks of antibiotics as the magic cure-all,” says Dr. Jeffrey Linder, a primary care physician and associate professor of medicine at the Harvard-affiliated Brigham and Women’s Hospital, “but the vast majority of people will get better without ever having to consider an antibiotic.”

HOW TO SOOTHE AND RELIEVE SYMPTOMS OF SINUS INFECTIONS If antibiotics don’t work, what does? Doctors now recommend the following steps to soothe symptoms and speed healing:

1. Use a neti pot or other method to regularly rinse the nasal passages. This can help flush out the excess mucus and improve breathing. Make sure you use distilled water — always avoid tap water as it can increase risk of other types of infections. 2. Use saline sprays. These are non-addictive saltwater rinses that help soothe and clear out the nasal passages. You can use them as often as needed. 3. Use decongestants. These restrict the blood vessels in the nasal passages, opening them up so you can breathe. Oral decongestants are often long-lasting and effective. You can also use spray decongestants, but be careful as they can be addictive and may end up making your congestion worse. Limit their use to only two doses per day for no longer than three days. 4. Try steroid sprays. These can help with nasal congestion symptoms without being addictive. They reduce swelling and mucus and can be used as needed for relief.

5. Steam it up. Hot water vapor can help moisten the sinuses, release mucus, and ease inflammation. You can take a hot shower, or boil some water, put it in a glass bowl, and breathe in the vapors. 6. Use essential oils. If you add eucalyptus or menthol to your steam bowl or hot bath, you’ll breathe them in as you inhale. These herbs are known for helping to open up the sinus passages. Other infection-fighting essential oils include oregano, peppermint, lemon, and pine. 7. Use pain relievers as needed. If you have headaches or sinus pains, over-the-counter pain relievers can help. Chose aspirin or ibuprofen. 8. Use a humidifier. Keeping the air moist, particularly in your bedroom, can help ease sinus pressure and pain. Just make sure to keep your humidifier clean as a dirty one can spread mold. 9. Eat chicken soup. Your mom may have recommended this remedy. Recent scientific research shows that it can help soothe the nasal cavities and provide important infectionfighting nutrients. 10. Beef up the supplements. When you have an infection, taking a few extra supplements can help support your body’s efforts to eradicate it. Try vitamin C, garlic, Echinacea, zinc, and grapefruit seed extract. If you have a fever with your infection, sharp pain in the cheeks or teeth, or if you don’t feel better after 10 days, see your doctor for more help. These symptoms may indicate a bacterial infection that would benefit from antibiotics. 4HEALTH | 877.807.0989

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THIS RASH HURTS — COULD IT BE SHINGLES? EARLY SIGNS OF THE SHINGLES DISEASE nnn By Colleen M. Story John jumped in his chair. There it was again, that electric zap feeling through the nerves on his forehead. This time it was bad. He stopped typing on his keyboard and gritted his teeth. When the pain didn’t pass, he made his way to the restroom and looked in the mirror. He tried to touch the area that was hurting, but that made it worse. He turned his head and saw a bit of redness just under his hairline. His heart beat faster. He’d heard about this before. Could this be shingles?

WHAT ARE SHINGLES? Shingles are painful red rashes that usually appear on one side of the body, often around the torso but also on or around the face, head, and neck. The first symptoms usually include pain (which may be intense), numbness, and tingling in the area, followed by a red, itchy rash that shows up on the skin. These rashes eventually blister, then break open and crust over. Other symptoms include fever, headache, fatigue, and sensitivity to light. The disease comes from the chickenpox virus, which is called the “varicella-zoster virus (or herpes zoster virus).” If you had chicken4HEALTH | 877.807.0989

4HEALTH pox as a child, you have this virus in your body, because it never goes completely away. Instead, it lies dormant in the central nervous system. In some people, the virus can reawaken later in life, travel down the nerve fibers and cause shingles. The rash that develops corresponds to a single sensory nerve, which is why the rashes appear in a distinct band on the skin. Some people will live out the rest of their lives and never experience shingles, but the Centers for Disease Control and Prevention (CDC) states that almost one in three people in the United States will develop shingles — about one million each year.

WHY DOES THE VIRUS COME BACK? Scientists aren’t sure why the virus awakens in some people and not in others. They do believe that the immune system has something to do with it. As we age, the immune system weakens, and may no longer be able to protect us from the virus. People who suffer from weakened immune systems — such as those with HIV/AIDS and cancer — are more at risk, as are those who are over the age of 60. But the disease can affect younger people, too, and even children in some cases. Though the rashes and the pain are bad enough, in some cases, shingles can cause other complications including continued nerve pain, vision loss (when the rashes develop around the eyes), facial paralysis, skin infections, and hearing and balance problems.

EARLY SIGNS OF SHINGLES Early treatment is always best, so keep your eye out for symptoms. Days before the rash shows up, you may experience other symptoms like fever, weakness, muscle aches, and nausea, as well as pain and

itching. When the rash shows up, it usually appears in a band-like or striped pattern, often on the trunk or face. After about 7–10 days, the blisters are likely to break open, crust over, and scab. The rash typically clears up in 2–4 weeks. Some people may be confused, though, as to whether their symptoms signal shingles or another skin condition. The main difference is in the rash itself, and in the intense pain it may cause. A shingles rash looks like small raised dots in a regular pattern. Other rashes, such as those related to hives, eczema, or psoriasis, are more raised and look like welts, or have white scales through them. They also develop in a more random pattern. If you experience any of the symptoms noted, however, it’s best to see your doctor right away. Early treatment can help reduce risk of complications and help the rashes to heal more quickly.

DO THE SHINGLES GO AWAY? If you get treatment right away, your odds of leaving shingles behind you are good. It usually clears up within 2–6 weeks, and you may never experience it again. Some people do suffer from recurrences, though. A doctor can also prescribe creams and medications that can help you better manage the pain. Because there is no cure, however, it’s best to do everything you can to prevent the disease. The CDC recommends that adults 60 and over get the shingles vaccine to help increase the immune system’s defense against the disease. Talk to your doctor to see if you’re a candidate. You can also work to keep your immune system strong by eating a healthy diet, getting regular exercise, and making sure you get 7–8 hours of sleep per night.

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WHY YOU SHOULD SEEK EMERGENCY TREATMENT FOR A MINI-STROKE SIGNS THAT YOU NEED TO GET TO THE DOCTOR IMMEDIATELY

nnn By Colleen M. Story Beth’s vision went blurry. Her heart was racing. She was making dinner for her family. At first she thought maybe she was just tired, or that the boiling water was making her too hot, but then her chest gripped and her knees buckled. She dropped the stirring spoon, her fingers numb. She went to bed and rested. After dinner, she took a bath and retired early. The next day, she went to work like usual, but she didn’t feel “right.” It seemed silly to call the doctor, but when she still didn’t feel like herself that afternoon, she did just that. The nurse listened to her experience, and advised her to get to the emergency room immediately. “I think you may have had a ministroke,” she said. Beth frowned. Impossible. She was only 32 years old!

WHAT IS A MINI STROKE? Medically termed a “transient ischemic attack (TIA),” a mini-stroke is the same as a regular stroke, except for one difference: how long it lasts. The cause is the same: a blood clot becomes lodged in an artery that goes to the brain, and blocks blood flow to the brain. The symptoms are similar too, and include: n Dizziness n Racing heart rate n Blurred vision n Difficulty speaking n Numbness or weakness, usually on one side of the body n Confusion n Rapid and severe headache With a mini-stroke, the effects are temporary, and blood flow eventually returns to normal. Since the flow was interrupted for only a short amount of time, there is no permanent disability. A full-blown stroke, on the other hand, usually lasts longer, requires treatment to correct, and can cause permanent brain damage.

GET HELP FOR A MINI-STROKE RIGHT AWAY Though a mini-stroke often corrects itself, it is a definite warning that a future, full-blown stroke is likely to occur. According to a 2007 study, those who have a mini-stroke are 10 percent more likely to have a regular stroke over the following four weeks. More than 40 percent of these second strokes occur within the first 48 hours, which is why it is critical for people suffering these symptoms to get emergency care right away. Doctors can help determine if you did, indeed, have a mini-stroke, and can get you on treatment to reduce your risk of another one. A 2016 study found that those who went to the doctor within 24 hours of a mini-stroke had only a four percent risk of having a major stroke within the next three months, compared to a 12 to 20 percent average risk for those who suffer a mini-stroke. Women, especially, need to be sure they see a doctor. Research has shown that on the whole, they are less likely than men to seek help for their symptoms.

MINI-STROKE OFTEN A SIGN THAT BRAIN DAMAGE HAS ALREADY OCCURRED You may not realize it, but a mini-stroke can create some damage to the brain, even if it doesn’t cause symptoms or disability. Neurologists have found that after a mini-stroke, the white matter of the brain showed evidence of damage that had accumulated over time. This type of damage is thought to contribute to 45 percent of dementia cases, so it’s very serious. In fact, if you have a mini-stroke, it’s likely that you’ve already gone through a few “silent strokes” prior to that. These are related occurrences where the blood flow to the brain is interrupted briefly, with minor symptoms that you may not have realized were related to a stroke, or even no symptoms at all. To protect your brain and your memory, get treatment immediately for a mini-stroke, and make sure that you’re controlling blood sugar, blood pressure, and blood cholesterol levels. Eat a healthy diet, and get regular exercise to keep your blood pumping like it should. 4HEALTH | 877.807.0989

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Obesity Medicine | 4HEALTH17

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.

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HOW MUCH DO FATTY FOODS AFFECT YOUR BREAST CANCER RISK? STUDIES SHOW CONFLICTING RESULTS nnn By Colleen M. Story Recent media reports about fat in our foods has caused quite a bit of confusion. Whereas we were told for decades to cut down on fat because it was linked to a higher risk of heart disease and cancer, recent research has suggested that some types of fat can actually be good for us. Women in particular are likely to be puzzled as to what to eat and what to avoid to reduce their risk of breast cancer. Here, we help clear it up a bit.

WHAT IS THE LINK BETWEEN DIETARY FAT AND BREAST CANCER? For decades, scientists told us that a high-fat diet increases risk of breast cancer. In 1993, for example, researchers examined data from the Food and Agricultural Organizations of the United Nations, and concluded that there was a positive association between dietary fat (minus fat from fish) and breast cancer mortality. A much later 2014 study involving more than 300,000 women in 10 European countries also linked diets high in fat — particularly saturated fat — to a 28 percent higher risk of cancer. And in 2003, researchers 4HEALTH | 877.807.0989

4HEALTH again found that those who averaged more than 90 grams of fat a day had roughly double the risk of breast cancer than those who ate just 37 grams of fat a day. The more fat the women consumed, the higher their risk of breast cancer, even if they weren’t overweight or obese. But other research has produced conflicting results. The Natural Medicine Journal noted in 2016 that “newer, prospective studies no longer support the association between dietary fat and breast cancer.” Researchers in a 2013 study stated, “the role of dietary fat in breast cancer is still unclear… Associations between dietary total or saturated fat and breast cancer have been inconsistent in prospective studies.” Susan G. Komen takes it a step further to state on their website that “eating a high-fat diet as an adult appears to have little, if any, impact on breast cancer risk.” They go on to say, however, that “the type of fat in your diet may be important.”

DIFFERENT TYPES OF FAT — WHICH IS BEST? What type of fat are you eating? It can be confusing, but in general, the studies that have found a connection between fat intake and breast cancer have found it with “saturated fat,” which is found primarily in animal-based foods like meat and dairy, and in some plant-based oils (coconut, palm). Other types of fat, such as monounsaturated (found in nuts and olive oil) and polyunsaturated (found in fish and fish oil) have actually been found to be protective against breast cancer. It also seems to make a difference “when” we consume saturated fats. Recent research from the University of Maryland School of Medicine suggests that consuming these foods during the adolescent years can affect the development of the breasts in a way that may increase breast cancer later in life.

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Researchers followed up on about 177 women ages 25 to 29 who had participated in a dietary study when they were 10 to 18 years old. They found that those who had consumed the most saturated fat during their adolescent years had higher breast density as adults. Dense breasts have more glandular and connective tissues relative to fatty tissues, and are believed to create a higher breast cancer risk. Meanwhile, another study showed that a high fruit intake during adolescence was associated with a 25 percent lower risk of breast cancer later in life.

BOTTOM LINE: EAT MORE FRUITS AND VEGGIES! So what are women to do with these conflicting studies? Most health experts recommend following a healthy diet that includes a variety of foods. That means avoiding processed foods and eating more fruits, vegetables, lean meats, and healthy fats (like those in fish, nuts, and olive oil). What about dairy? While we’ve been told to go for low-fat options in the past, more recent research has found some benefits of whole-fat dairy products — as long as you get the low-sugar options. Full-fat options may help reduce your cravings for other unhealthy foods. Work with your doctor to find the best options for you. Don’t allow recent research to convince you that all fatty foods are fine. Fried foods and trans fats are still strongly connected to heart disease. But you may be able to enjoy full-fat yogurt now and then, or whole milk on your morning cereal, as long as you’re exercising daily and watching your weight. A healthy lifestyle is more about combining a number of healthy habits than it is about cutting out any particular one food.

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DON’T LET THIS DISEASE STEAL YOUR SIGHT AWAY GLAUCOMA MORE COMMON THAN YOU MAY THINK

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By Morgan Rice

Here’s one thing you need to know about glaucoma: once it causes vision loss, you can’t get it back. That means that early diagnosis is extremely important, because if your doctor finds it and starts treating it early on, you can preserve your vision. Estimates are that as many as two million Americans have glaucoma, but don’t know that they have it. You could be one of them, so read on to find out what you need to do to be sure to protect your eyes as you age.

WHAT IS GLAUCOMA? Glaucoma is a disease that damages the eye’s optic nerve. This nerve connects the eye to the brain, and sends light signals to the brain to interpret. Without the optic nerve, you wouldn’t be able to see. Glaucoma is the leading cause of blindness in people over 60 years old, but it can affect younger people, too. In general, there are two different types of the disease: 1. Open-angle glaucoma: This is the most common type. Because the eye is unable to drain fluid as well as it should, fluid pressure builds up in the eye and gradually damages the optic nerve. This type of glaucoma is very sneaky, as it can work its damage in the background without you being aware of it. It causes no pain at first, and you are not likely to notice any vision changes. 2. Angle-closure glaucoma (also called “closed-angle” glaucoma): This type of glaucoma occurs when the iris blocks the drain-

age angle in the eye. It’s like something clogging the drain in your sink, and fluid pressure builds up very quickly. This type of glaucoma comes on suddenly, and is usually considered an eye emergency, requiring immediate treatment. You will notice this one, as you will experience sudden blurry vision, headaches, severe eye pain, and other uncomfortable symptoms.

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three to four times more likely to suffer from glaucoma than Caucasians.) You are female. You have diabetes or hypothyroidism. You have suffered eye injuries in the past, like eye inflammations, eye tumors, or retinal detachment. You’ve had eye surgery. You are nearsighted. You took corticosteroids for a long while.

AM I AT RISK FOR GLAUCOMA? Since open-angle glaucoma is the most common type, we’ll talk only about that one for the rest of the article. As noted, there are typically no symptoms at first, so it can exist for a while without you knowing it. That’s why some refer to it as the “silent thief of sight,” because even though you may not be aware of it, it can be damaging your eyes and your vision. Unfortunately, many people fail to get medical help until some damage has already occurred. If you don’t catch the disease early, you may eventually notice some symptoms including disturbances in your peripheral vision, and eventually, tunnel vision. Though scientists aren’t sure yet what causes the fluid drainage system in the eye to gradually malfunction, they do know that some people are more at risk than others. If you see yourself in any of the following descriptions, you need to check with your eye doctor about glaucoma: n You’re over 60 years old. n You are of East Asian or African-Amer-

ican descent. (African-Americans are

HOW GLAUCOMA IS TREATED Your best bet for detecting glaucoma early is to see your eye doctor on an annual basis. He or she can find signs of the disease in its very early stages and get you started on eyesaving treatments. These may include prescription eye drops that help improve fluid drainage, and medications to reduce the amount of fluid the eye produces and/or help improve drainage. If these methods aren’t effective enough, surgery is an option. The doctor will use laser beams to help unblock clogged drainage canals and relieve pressure on the eye. These and other treatment methods can help preserve vision.

HOW TO PREVENT GLAUCOMA Since glaucoma is a fairly common disease, it’s wise for everyone to take steps to try to prevent it. Know your family’s eye health history, get regular check-ups, and be sure to regularly wear sunglasses and other forms of eye protection. Studies have also shown that a healthy diet and regular exercise help to lower pressure in the eye and keep the eyes healthy. 4HEALTH | 877.807.0989

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BACK PAIN?

FIND HELP AT THE USA VASCULAR CENTERS! THE STORY OF SOPHIA VERNER According to the American Chiropractic Association, back pain is one of the most common reasons for missed work and the second most common reason for visits to the doctor (outnumbered only by upper-respiratory infections). There a number of causes, ranging from overloading of muscles to vertebral fractures and even cancer. In many cases, back pain can be relieved with physical therapy or other conservative methods. Other spine problems require surgery. If your pain is caused by a spinal fracture or osteoporosis that has caused the vertebrae to collapse, you know the agony of chronic pain. The USA Vascular Centers are acknowledged experts in the treatment of pain due to spinal fractures and spinal tumors with minimally invasive, nonsurgical procedures, such as kyphoplasty and radiofrequency ablation. Treatments are performed on an outpatient basis, using the most modern equipment, and are customized for each individual patient. One of the key advantages to going to USA Vascular Centers, as opposed to the hospital, is a minimal recovery period. For the treatment of back pain caused by spinal fractures due to trauma or osteoporosis, USA Vascular Centers perform a minimally invasive, highly effective procedure called kyphoplasty. For longterm elimination of severe pain caused by cancer metastases in the spine, they use one of the most modern and effective methods, called radiofrequency ablation. Today, we talk with Sophia Verner, a patient of USA Vascular Centers, who got rid of back pain with the help of kyphoplasty. Sophia, why did you go to The USA Vascular Centers? My back was aching very badly, especially when I stood or walked. The pain was nagging and strong, and I wanted to sit or lay down. Then I fell, and during a medical examination, my doctors discovered I had two fractures in my spine. How I got them, I didn’t know. I had already seen my primary physician, a neurologist, and a physiotherapist about my back pain, but none had discovered these fractures. I was told to take painkillers and try physical therapy, but none of these methods helped. When the pain got really bad, I started to look for a way to cure it. I came across the Medical Office Magazine, and I found an article about Dr. Halpert, who was an expert in the kyphoplasty procedure for the treatment of compression fracture of the spine. After reading the article, I immediately made an appointment. During the visit, I liked the doctor right away—he was knowledgeable and very compassionate. He was also the first person who said, “I can help you.” And he has kept his promise. I feel much better. How was the treatment performed?

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I came to the doctor for a consultation, then again for a CT scan, and then went through the treatment, which consisted of only two procedures with an interval of three weeks. Each procedure was performed under general anesthesia and took about 20 minutes. After each session I was told to rest on my back for two hours, and then I was allowed to go home. How soon did you experience relief? I felt better after the first treatment. Now, one month after my treatment, I still experience some minor pain, but it can’t be compared to what I experienced before. To promote healing, I now go to physical therapy and get acupuncture treatments. What would tell our readers who are plagued by back problems? To anyone who suffers from the same pain after fractures as I did— don’t wait until the pain becomes intolerable, and don’t agree to go to the hospital for surgery. Instead, contact Dr. Halpert at USA Vascular Centers, and I’m sure you won’t regret it! The treatment is very easy, and the results can be felt instantly. The staff there is very responsive, nice, and compassionate. I am very grateful to all of them and especially to Dr. Halpert for caring, understanding, and—the main thing—for giving me a life without pain!

718–504–5984 www.USAVascularCenters.com

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ARE MIND-BODY APPROACHES BETTER FOR BACK PAIN THAN OPIOIDS? STUDIES SHOW EXCITING BENEFITS FROM YOGA AND MEDITATION

nnn By Morgan Rice We’ve got an opioid epidemic in America. The Centers for Disease Control and Prevention (CDC) states that 91 Americans die every day from an opioid overdose (including prescription opioids and heroin). Since 1999, the number of opioid deaths has quadrupled, with more than half a million people dying between 2000 and 2015. These sobering statistics have inspired health organizations and physicians to cut back on their opioid prescriptions. Many people with back pain, however, are prescribed these drugs for relief. What can they use instead? According to a few recent studies, the solution may be all in your head — literally. Studies now show that mindfulness meditation and cognitive therapy may provide better and longer-lasting relief for chronic back pain. Before you scoff, you might want to try it!

NEW STUDY FINDS MINDFULNESS AS EFFECTIVE AS OXYCODONE A more recent 2017 study found similar results with mind-body therapies. About 250 participants with chronic pain were assigned to receive a 15-minute session in mindfulness, hypnosis, or simple paincoping education. Patients who participated in the hypnosis experienced a 29 percent reduction in pain, and those participating in mindfulness experienced a 23 percent reduction in pain. Those who received the education experienced only a 9 percent reduction. Even better: patients receiving the mind-body therapies were able to reduce their reliance on opioid medications. “About a third of the study participants receiving one of the two mind-body therapies achieved close to a 30 percent reduction in pain intensity,” said lead author Eric Garland. “This clinically significant level of pain relief is roughly equivalent to the pain relief produced by 5 milligrams of oxycodone.”

STUDY FINDS MINDFULNESS HELPS IMPROVE BACK PAIN For the study, researchers recruited 342 participants aged 20 to 72. They split them into two groups: the first used a mind-body approach for their pain, while the second sought out the usual care. Researchers followed both groups for about a year, checking for improvement along the way. Results showed that at 26 and 52 weeks, patients using the mindbody approach had a greater improvement in function and back pain compared to the group that remained in standard care. Those using the mind-body exercises continued to see improvement throughout the entire year. What was this mind-body approach? Participants attended a twohour session on yoga and meditation per week for eight weeks, and also worked on both exercises at home with workbooks and CDs. They then continued to practice the techniques they had learned on their own. “The results from this research affirm that non-drug/non-opioid therapies, such as meditation, can help manage chronic low-back pain,” said Josephine Briggs, M.D., director of the National Center for Complementary and Integrative Health (NCCIH).

HOW TO TRY MINDFULNESS FOR YOURSELF If you’re suffering from chronic back pain and you’re looking for alternatives to opioid medications, you should give mindfulness a try. If you’re not sure how to get started, realize that you can’t really do it wrong. Simply try to incorporate both yoga and regular meditation into your life. You could sign up for a yoga class in your area, for example, or look for a guided DVD that is made specifically for relieving back pain (there are a lot of them out there). A class is usually best as an instructor can help you do the poses correctly, but if you can’t fit a class into your schedule, at-home work can help too. Just make sure you have a mirror nearby and that you follow the instructor’s guidance carefully. You can do the same with meditation — many yoga classes include it, or you can get some DVDs or books to help you get started. Talk to your doctor — he or she may have some good recommendations. When you think about it, you have nothing to lose. It doesn’t take much of an investment to take a class or try a new book or DVD. In the end, a lifestyle change may create more benefits for you in terms of pain relief and quality of life than a prescription drug ever could. 4HEALTH | 877.807.0989

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PA I N M E D

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10 WAYS

TO AVOID HOSPITAL ERRORS KEEP YOURSELF SAFE WHILE UNDER THE DOCTOR’S CARE nnn Colleen M. Story A 1999 study by the Institute of Medicine (IOM) estimated that at least 44,000 people— and perhaps as many as 98,000—die in hospitals each year as a result of medical errors. The American Association for Justice adds that if the Centers for Disease Control and Prevention (CDC) were to include preventable medical errors as a category, the IOM’s conclusions would make preventable errors the sixth leading cause of death in America. American hospitals have been working to improve patient safety, but even today, about

18 percent of patients in hospitals are injured during the course of their care. Many of those injuries are life threatening, or even fatal. In 2010, research from the Office of the Inspector General of the U.S. Department of Health and Human Services found that one in seven Medicare patients are injured during hospital stays.

10 TIPS FOR AVOIDING HOSPITAL ERRORS To keep yourself or a loved one from falling victim to a medical mistake, follow these recommendations the next time you enter the hospital doors.

Bring someone with you. If you’re the one who’s sick, it can be difficult to keep track of everything that’s going on. Bring a friend or family member with you to be your advocate. Make sure it’s someone who isn’t afraid to ask questions, and someone who will listen carefully to the doctors’ and nurses’ instructions.

Avoid going in the summer months. June, July, and August are the months when new residents start working and older ones move up. You want the most experienced professionals possible working on you, so avoid scheduling surgery during these 4HEALTH | 877.807.0989

4HEALTH months. If you can, avoid scheduling surgery on a Friday or on weekends. Monday through Thursday are better days.

Take a copy of your medical records. Storing your medical information, including the medications, vitamins, and herbs you take, in a three-ring binder can help your doctor avoid prescribing the wrong medication or creating dangerous drug interactions. Make sure you include everything you’re taking, and inform your doctor of any allergies that you have. Having the information in a binder helps make it available to all the professionals who will be working with you.

Take antibacterial wipes. Hospitals are filled with germs. Take antibacterial wipes and wipe down surfaces like the television remote, phone, doorknobs, bed rails, and other areas that are often missed in cleaning. Be cautious with other regularly used surfaces, too, particularly elevator buttons. Use a tissue or other hand protection before touching them.

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Know who’s in charge. Though you may have a team of healthcare professionals working with you, one doctor is usually in charge. Know who this is, and get the person’s office number or cell phone number so you can call if you have any concerns. Choose an experienced hospital. Some hospitals have more experience treating certain conditions than others. If you have more than one hospital in your regional area, consider asking them for records concerning their success with your type of surgery or treatment. Research shows that patients have better results when treated in hospitals that have significant experience with their condition.

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Check and double check. If you’re having surgery, make sure that everyone around you—doctors, nurses, family members—are very clear about exactly what is going to be done. If you’re having knee surgery, for example, be sure your doctor marks which knee is to be operated on. Confirm the procedure the day you go into the hospital, and make sure you have all your questions answered before going ahead.

Be clear about home care. Some research has shown that doctors think patients understand more than they do about how they should care for themselves after they are discharged from the hospital. Ask your doctor to explain carefully all the steps you need to take. What medicine should you take, and how often? What are the possible side effects? When can you get back to your regular activities? Do you have any dietary restrictions? Ask as many questions as you need to be completely clear. Request a copy of the discharge summary, which will list additional information.

Request a review before a shift change. Records show that medical errors are more likely during shift changes, when miscommunication can result in you getting the wrong medication or other incorrect treatment. Before your nurse leaves, ask to review your chart and your next scheduled treatment. Meet with your new nurse when he/she comes to confirm your treatment.

Bring or ask for skidproof socks. Falls can result in serious injuries, particularly in a hospital where floors are slippery and hard and legs are unsteady. Bring your own skidproof socks or ask an aide for a pair. If you feel at all unsteady on your feet, ask for help.

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| Plastic Surgery

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

NAME:

Roman RAYHAM, MD SPECIALTY: Plastic and Reconstructive Surgeon

CERTIFICATION: Board-certified, American Board of Surgery and American Board of Plastic Surgery.

TRAINING & EDUCATION: SUNY Downstate College of Medicine, Staten Island University Hospital (Residency), Training at Mayo Clinic, Post-graduate fellowship at New York Eye and Ear Infirmary.

MEMBERSHIPS: American Medical Association, Medical Society of the State of NY, Medical Society of Kings County, Arnold Society, Priestley Society.

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

(877) 582-0400 www.NYPlasticSurgeryCenter.com

LANGUAGES: ENGLISH • RUSSIAN

What do you see when you look in the mirror lately? Are you noticing dryness, hyperpigmentation, age spots, or wrinkling? Do your pores seem to be getting larger? Are you noticing, in essence, the effects of aging? According to the Skin Cancer Foundation, more than 90 percent of the visible changes we see and call “aging” are caused by the sun. Harsh weather conditions, heating systems, dry air, pollution, stress, poor diet, and more can also cause lasting damage that makes it difficult for skin to recover. Fortunately, Dr. Rayham of the RR Plastix/New York Plastic Surgery Center has a solution. There’s a brand new way to erase sun damage, fade dark spots, and get your youthful glow back with minimal downtime. It’s called “Halo Laser Skin Rejuvenation,” but this isn’t the laser you’re used to hearing about. Forget the weeks of downtime. Now, you can come in Thursday, get one treatment, and go back to work Monday looking fabulous!

WHAT IS HALO LASER SKIN REJUVENATION? Dr. Rayham’s office is one of the first in the area to have the new Sciton Halo laser, a breakthrough new technology that combines the effectiveness of laser treatments with the accelerated healing experience customers love. Laser resurfacing is a treatment that uses a laser to treat facial flaws and improve the appearance of skin. An ablative laser removes thin layers of skin, allowing new and improved skin to form in its place. A non-ablative laser is less invasive, and stimulates collagen growth while helping to tighten and firm skin. In the past, patients had only two options: 1) get ablative, or “fractional” laser treatments, and spend weeks to heal, but enjoy dramatic results, or 2) get non-ablative, or “non-fractional” laser treatments, and enjoy a short downtime, but only subtle results. Now, with the new Sciton Halo laser, customers can take the middle road: enjoy great results with little downtime. The Halo is a “hybrid” fractional laser machine that offers both ablative and non-ablative resurfacing at the same time.

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

on the surface, while also treating deeper skin tissues to tone and tighten skin. The technology is so advanced that the doctor can tailor the treatment to each individual, treating each patient in a way that uses only the energy needed to address the problem, while offering a precise, even treatment that allows for faster healing.

WHAT CAN THE HALO HYBRID LASER DO FOR ME? Dr. Rayham is excited to introduce this new treatment just in time for fall. If you’ve suffered sun damage over the past several months, this is the treatment for you. You can choose to go in for just one treatment, and after a weekend’s rest, head back to work looking like you turned back the clock. The Halo can do much more, though. In addition to treating sun damage, it can also: n Reduce the appearance of scarring, such as n n n n n

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

CUSTOMIZED TO YOU! Dr. Rayham invites readers to call his office today for a personal consultation. No matter what you’re seeing in the mirror, the Halo Laser Skin Rejuvenation system can help improve your appearance and boost your confidence. Do you have sun damage and sagging skin? Age spots and wrinkles? Whatever your concerns, treatments can be customized to target exactly what you need, and no more. You’ll notice improvements within days, and be able to return to work with a healthy glow. If you’re looking for a more aggressive treatment, you can have that, too. It just depends on the results you’d like to see. Treatments generally take 30 minutes to an hour, and a topical anesthetic is used to increase comfort. After the first 24 hours, patients are able to return to most of their normal activities. Within a few days to a week, you’ll start to see more smooth, vibrant skin that has a youthful glow. For more information, check with Dr. Rayham. He has offices in Manhattan, New York City, Brooklyn, and Staten Island. Call the RR Plastix/New York Plastic Surgery Center, 1-877-582-0400, or visit our website at www.rrplastix.com. 4HEALTH | 877.807.0989

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Podiatry | 4HEALTH33

HOW CAN I RELIEVE THIS PAIN IN MY HEELS? PODIATRIST DR. STEPENSKY HAS ANSWERS

During a typical lifetime, a person travels by foot an average of 170,000 kilometers (about 105,600 miles), which is the same as walking around the globe more than four times. The complex anatomy of the foot allows us to move the body—often while carrying heavy loads— for enormous distances. Sometimes, however, our feet require care and attention, or we end up having trouble doing all that walking. Heel pain is one of the most common conditions that can arise as we age. If you’re experiencing heel pain, that is your first signal that your feet need help. We asked Dr. Leon Stepensky, a foot treatment specialist, to tell us what causes heel pain and how we can treat and prevent it.

DOCTOR, WHAT CAUSES HEEL PAIN? The main cause is an extremely common condition—flat feet. The arch of the foot begins to sag, and as a result, the muscles and ligaments in the foot must take on a greater burden when standing and walking. Over time, these overstressed ligaments become damaged and inflamed, and the heel, the most vulnerable area of the foot, may develop bone spurs, which are areas of bony overgrowth. In most cases, the pain comes not from the spur itself, but from the inflammation around it. Many patients experience severe pain in the heels first in the morning when they get out of bed. They take their first steps and, “Ouch!” The problem is that during sleep, small damaged areas in the ligaments heal, and they become shorter. When you step on the floor in the morning, you stretch and injure them again.

WHAT ELSE BESIDES FLAT FEET CAUSES HEEL PAIN? Other factors causing heel pain include toe deformities, nervous tissue swelling, and pinched nerves.

WHO IS MORE LIKELY TO SUFFER FROM HEEL PAIN? With age, most people gradually develop flat feet. The body tries to adapt to it, but in some cases, it happens too quickly and the body has no time to adjust and redistribute the load on the foot. The ligaments become inflamed, and the person experiences discomfort and pain. Women suffer pain in their heels more often than men. This is because many of them wear 4HEALTH | 877.807.0989

high-heeled shoes for long periods of time, and then abruptly switch to a flat sole. When the foot loses the support of the heel, the complete weight of the body drops upon the ligament, and a sharp, very severe pain develops.

WHAT WE NEED TO DO TO PREVENT HEEL PAIN? The best solution is to perform special exercises designed to stretch the muscles in the feet after sleeping. I also recommend wearing shoes that provide a small heel raise for the optimal load distribution in the foot.

IF HEEL PAIN DEVELOPS, HOW DO YOU FIND OUT WHAT’S CAUSING IT? Unlike other medical offices, at the Fit Feet Podiatry, we perform digital radiography, which allows us to immediately identify the presence of heel spurs or inflammation. We also use digital ultrasound, which helps us to see the condition of the soft tissues and ligaments of the foot without the use of magnetic resonance imaging (MRI). Most medical offices have to send patients to other hospitals to undergo these diagnostic procedures. We have the capacity to do them directly in our office, which significantly reduces time and stress levels for patients.

HOW DO YOU TREAT HEEL PAIN? Treatments include physical therapy, injections, orthopedic devices, wearing appropriate footwear and, in rare cases, surgery. When the patient turns to us for help at an early stage, usually three therapeutic procedures are sufficient, and the entire course of treatment takes from three to four weeks. If you follow the recommended regimen, it is possible, in most cases, to completely eliminate pain and other symptoms. During treatment, patients are not required to take sick leave from work, and they can continue to wear regular shoes. Our office is open late in the evenings and on weekends to allow patients to combine their work schedule with treatment. If you experience even slight pain in the legs, seek medical help immediately. The sooner you begin to treat the disease, the less aggressive treatments we have to use, and the more chances for a full recovery. Dr. Leon Stepensky performs all procedures necessary for the treatment of foot pain, including surgery.

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

ARE YOUR FEET ACHING BECAUSE OF FALLEN ARCHES? SIGNS AND SYMPTOMS YOUR ARCHES NEED HELP nnn By Gordon Barclay Paul was a supervisor at an automobile parts plant, which mean that he stood on a cement floor most of the day. He enjoyed his job for years, but then when he got into his forties, he started to notice that his feet hurt more than usual after a day at work. Within a few months the pain had worked its way up into his calves, knees, and lower back, to the point that he was starting to get concerned. He figured he was just getting older, but he needed to do something if he wanted to continue to perform on the job, so he went to see his podiatrist.

Paul found out that he had fallen arches, or “flat feet,” as they’re often called. Though the condition is common, there is no cure for it, but doctors can help ease symptoms.

WHAT ARE FALLEN ARCHES? Most adults have a strong arch in the middle of the foot. You can see it in the upward curve, supported by tendons that go from the heel to the front of the foot. Some people, however, are born with fallen arches or flat feet, which means that there is no upward curve in the foot. (The condition is medically termed “pes planus.”) Others develop flat feet over time

because of damage to the tendons, broken or dislocated bones, nerve problems, or health issues like rheumatoid arthritis. Certain people are more at risk than others when it comes to developing fallen arches. These include those who are overweight or obese, those who have diabetes, and women who are pregnant. The condition can also appear with age, as a result of wear and tear on the tendons in the feet.

FALLEN ARCHES VARY IN SEVERITY Paul found out from his doctor that he had “flexible pes planus,” which means that he still had an arch in his foot when resting, but when standing, the foot flattened out and the arch went away. This condition is less severe than “rigid pes planus,” where the arch is gone no matter whether you’re sitting or standing. Flexible flatfeet are normal in young children because they haven’t developed their arches yet. The upward curve usually shows up sometime between the ages of 7 and 10. Some people retain flatfeet into adulthood, however, because of an inherited condition. They can also develop with aging or with damage to the tendons. Rigid flatfeet are most commonly the result of major problems in structure or alignment of the bones around the foot’s arch. Most cases are present at birth, and others develop because of a bone dislocation.

DO I HAVE FALLEN ARCHES? Some people can live with their flatfeet and never experience any problems. Many, however, start to notice symptoms including tired, aching feet — especially after standing or walking for awhile — as well

as heel pain, arch pain, leg and back pain, and foot swelling. If you’re experiencing these or other similar symptoms, see your podiatrist for a diagnosis. You can also do a little test at home, as well, to see if your arches may be disappearing. Wet the bottom of your bare foot, and then step onto a paper towel, piece of regular paper, or piece of cardboard. Observe the imprint. (You can also do this at the pool — observe your footprint on the concrete.) If you have fallen arches, the strip of the mid-foot is the same width as the front of the foot. If you have a normal arch, the strip will be only about half the width as the front of the foot.

HOW TO TREAT FALLEN ARCHES Since fallen arches can’t be cured, doctors focus on reducing symptoms and helping to support the foot. One or more of the following treatments can help. Surgery is reserved for severe cases, and usually involves adjusting the bones to help create a more natural arch. Rest and ice help reduce swelling Losing even a little weight eases pressure on the feet Stretching exercises increase flexibility in the muscles and tendons Physical therapy helps strengthen tendons and muscles, providing more support for the arch n Over-the-counter and injected medications help reduce inflammation and pain n Orthotic devices and more supportive shoes reduce pain and swelling and help bring the rest of the body into alignment n n n n

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LEGS SORE AT THE END OF THE DAY? CHECK WITH YOUR DOCTOR ABOUT ONE IN 20 AT RISK FOR PAD

nnn By Lynn Merrell Do you find that it’s harder to walk long distances lately? Do your legs and feet ache at the end of the day? Do you find yourself needing to sit down more often? You may think that this is all just because you’re getting older, but healthcare experts warn that it could be more than that. About one in every 20 Americans over the age of 50 has peripheral arterial disease (PAD), a potentially dangerous condition that increases risk of heart attack and stroke. If your legs are sore at the end of the day, here’s why you should check with your doctor right away.

WHAT IS PAD? You’ve probably heard of atherosclerosis, the condition in which your arteries become narrowed because of plaque buildup inside them. That plaque is made up of extra cholesterol and other fats circulating in the blood that collect, stick, and harden on the walls of the arteries, gradually creating a smaller and smaller opening, so the blood has a harder time going through.

IMAGINE A CLOGGED HOSE OR DRAIN — THAT’S KIND OF WHAT CLOGGED ARTERIES ARE LIKE. PAD is similar to atherosclerosis, only it involves the arteries that carry blood to your head, organs, and limbs. In most cases, it’s the arteries in the legs that are affected, though if your arteries are narrowed there, it’s likely that they will be in other places, too. That’s why if you have PAD, you’re at a higher risk for heart attack and stroke. These life-threatening conditions can be caused by narrowed arteries going to the heart and/or the brain.

Though joint pain can cause similar symptoms, you can sometimes tell the difference by focusing in on the source of the pain. PAD typically causes muscle — not joint — pain, so if your pain is in your thighs, calves, buttocks, or other muscles rather than your knees or ankles, it could be that PAD is to blame. It’s difficult to be sure without a medical diagnosis, though. That’s why it’s important to check with your doctor about any type of leg pain.

HOW IS PAD TREATED? When you go to your doctor, he or she will likely perform a thorough exam, and may use imaging techniques to check the arteries in your legs. A PAD diagnosis is not all bad news, as there are some very effective treatments that can help you feel better right away. Depending on your individual case, you may be able to make simple lifestyle changes like quitting smoking, losing a little weight, and eating a healthier diet. Your doctor may prescribe medications to improve blood flow and control blood pressure. If these aren’t enough, there are interventional techniques that can. Doctors can open blocked arteries with stents and balloons, for instance, and in severe cases, can perform bypass surgery to create a new path for the blood to go around the blocked area. The important things are to realize that PAD is fairly common and not to ignore the warning signs. Left untreated, PAD can be dangerous. Over time, it can lead to painful symptoms and even the loss of a leg, and it always increases risk of coronary artery disease, stroke, and heart attack. Addressing it early gives doctors and patients a chance to take care of it so it doesn’t interfere with living a long, healthy life.

HOW DOES PAD CAUSE PAIN? If the arteries in your legs are narrowed, that means that the blood has a harder time going through them. When you’re walking or exercising, your muscles need more blood to meet the increased work demand. Narrowed arteries can’t deliver that blood, so the result is cramping pain — a warning that something isn’t quite right. PAD also increases the risk for blood clots. If blood clots form in a narrowed artery, they can actually block the artery, refusing to allow blood to go through. This situation causes pain, numbness, and inflammation in the legs, and can also result in open sores or ulcers on the surface of the leg. If allowed to go untreated, these sores can become very serious, and may lead to gangrene (tissue death), and a need for amputation.

HOW PAD CAN FOOL YOU Though PAD is easily treated, many people don’t realize they have it. They think that leg pain is a normal sign of aging. They imagine that maybe arthritis is causing it, or that they’re simply stiff and not as agile as they once were. Those who have diabetes may think that their neuropathy is acting up.

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718–393–5331 www.USAVascularCenters.com

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WHY COPD PATIENTS NEED TO “KEEP COOL” STUDY SHOWS HOT TEMPERATURES CAN BE DANGEROUS nnn By Gordon Barclay If you have chronic obstructive pulmonary disease (COPD), you may want to make sure your air conditioner is in good working order. According to a recent study, high temperatures can be dangerous for you, and may worsen your symptoms. That means you may want to “keep your cool” no matter what time of year it is.

WHAT IS COPD? COPD is a disease that damages the lungs, making it difficult to breathe. The disease usually includes both emphysema and chronic bronchitis, and causes wheezing, frequent coughing, tightness in the chest, and breathlessness. Smoking is the leading cause of COPD, but about a quarter of those who develop the disease never smoked. Exposure to air pollution, chemical fumes, and dust, particularly over years at a time, can also increase risk of COPD. Symptoms occur because of damage in the lungs, usually to the air sacs and the walls of the airways. They become inflamed and thick, and lose their elastic quality and flexibility. The airways also make more mucus, so they clog more easily. Unfortunately there is no cure for the disease. Doctors usually focus on delaying its progress, and on relieving symptoms.

more often because of difficulty breathing. If there were higher levels of indoor pollution, the results were even worse. The effects were felt immediately, and continued for one to two days. The researchers cautioned that high temperatures are particularly dangerous for people with COPD. “Given that participants spent an overwhelming majority of their time indoors,” said lead author Dr. Meredith McCormack, “which we believe is representative of patients with COPD generally, optimizing indoor climate and reducing indoor pollution represents a potential avenue for improving health outcomes.”

HOW TO REDUCE INDOOR AIR POLLUTION If you or a loved one has COPD, you can work to keep the house cool with air conditioning, ice-cold liquids, and other methods, but how can you cut down on indoor air pollution? Particularly when the Environmental Protection Agency (EPA) says that indoor air pollution is often worse than outdoor air pollution? Fortunately, there are several steps you can take. These can all help clean up the air in your home, and cut down on the severity of COPD symptoms at the same time. n Open a window. Indoor air becomes trapped in our homes, where

pollution tends to build up. Open a window to allow air exchange. n Ban smoking. Do not allow anyone to smoke in your home. n Dust carefully. When you dust your furniture, use a damp rag or

HIGH TEMPERATURES MAKE COPD SYMPTOMS WORSE For the study mentioned above, researchers followed 69 people with COPD who regularly suffered symptoms like coughing, wheezing, and breathlessness. They wanted to see how high temperatures affected those symptoms, so they assessed them on the hottest days of the year, when the mean outdoor temperature was 85 degrees Fahrenheit and the mean indoor temperature was 80 F. Most of the participants had air conditioning in their homes, but it wasn’t turned on during 37 percent of the study days. The patients spent most of their time inside, and when they did go out, it was for an average of two hours. Results showed that as the temperatures went up, patients had more trouble with COPD symptoms. They had to use their rescue inhalers

n n

electrostatically charged duster. Otherwise you’ll just spread the dust around. Vacuum often. Use a machine that has a HEPA filter and vacuum at least once a week. Avoid air fresheners. They can contain dangerous chemicals like phthalates and VOCs, spewing them into the air. Use baking soda or essential oils instead. Keep animals out of the bedroom. Animal dander can be very irritating to those with COPD. Keep animals out of the bedroom and ideally, off the furniture. Ventilate. Regularly use exhaust hoods and fans to move potentially dangerous fumes out of the home, and when you use your fireplace, make sure the flue damper is open. 4HEALTH | 877.807.0989

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SITTING TOO MUCH MAY LEAD TO INFERTILITY HOW TO INCREASE YOUR SPERM COUNT nnn Lynn Merrell Recent studies have indicated that sitting too much on a daily basis can be terrible for our health. Scientists have linked it with an increased risk of diabetes, high blood pressure, excess body fat around the waist, high cholesterol levels, and even death. Now, a new study shows that it may also affect a man’s fertility. With ABC reporting that one in six couples in infertile, with 40 percent of those cases caused by male infertility (40 percent by female infertility, 10 percent by both, and another 10 percent unknown), it may be worth the effort to get up off the couch a bit more frequently.

WHAT THE STUDY FOUND Researchers from the Harvard School of Public Health studied 189 healthy men between the ages of 18 and 22 who lived in New York. These participants answered questions about their TV, tobacco, eating, and exercise habits, and submitted semen samples for analysis between 2009 and 2010. The results showed that those men who sat in front of the TV for 20 hours per week had 44 percent less sperm than those who watched no TV. On the other hand, men who exercised for 15 or more hours weekly at a moderate to vigorous rate had a 73 percent higher sperm count than those who exercised less than five hours per week.

Why would sitting and watching TV affect a man’s semen count? Researchers speculated that it may heat up the testicles for too long, whereas regular exercise protects against oxidative stress, which can damage sperm cells. “The results are intriguing,” said Dr. Allen Pacy, Senior Lecturer in Andrology, University of Sheffield, “and suggest that men who do regular exercise have higher sperm counts than men who watch a lot of television.” He went on to say that he would agree that there is evidence to suggest that moderate exercise could change men’s physiology sufficiently to improve testicular health.

WEIGHT GAIN ALSO AFFECTS FERTILITY A sedentary lifestyle may contribute to infertility in other ways, as well. If it leads to weight gain, for example, it could cause hormonal disturbances, which could then translate to fertility problems. A review published in 2010, for instance, noted that the result several studies pointed to an increased risk of fertility problems among couples in which the male partner was obese. “Obesity is, therefore,” the researchers wrote, “associated with a higher incidence of male factor infertility.” A sedentary lifestyle can also increase the risk of diabetes — which, in turn, increase the risk of infertility. A 2008 study, for example,

found that diabetes affects male fertility at a molecular level. Researchers examined semen samples from men who had diabetes, and found that the cells showed evidence of DNA damage.

HOW TO INCREASE SPERM COUNT If you’re wanting to start a family, there are several things you can do to try to increase your sperm count. If you and your partner are having conception problems, however — if you are unable to get pregnant after a year of unprotected intercourse — check with your doctor first. In the meantime, try these tips: n n n n

n n n

n n

Don’t smoke, or make efforts to quit. Cut back on your alcohol consumption. Maintain a healthy weight. Cut out junk food with trans fats — they can kill sperm and decrease sperm quality. Avoid hot baths, spas, and saunas. Get regular exercise at a moderate level. If you sit for long hours for work, make a point to get up and walk every hour to decrease scrotal temperature and increase sperm production. Make sure you’re getting enough vitamin C, zinc, selenium, and vitamin E. Try to stay away from toxins like pesticides, insecticides, radiation, and heavy metals like mercury. 4HEALTH | 877.807.0989

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WHICH TREATMENT IS BEST FOR URGE INCONTINENCE? MANY OPTIONS AVAILABLE TO HELP IMPROVE QUALITY OF LIFE

nnn

By Lynn Merrell

Christina suffered for a long time before she contacted her doctor. Who wants to talk to a medical professional about…leaking? But when she ended up laughing at a friend’s joke and having to change afterwards, she knew something had to be done, so she made the appointment. Her doctor diagnosed her with urge incontinence. Christina was kind of relieved. At least she could put a name to the embarrassing symptoms she’d been experiencing. The big question was, what could be done about it? A recent study compared treatments for Christina’s type of incontinence, and determined which one was likely to work best.

1. Stress incontinence: The most common type, stress incontinence occurs when the bladder and related muscles are placed under pressure from a sudden cough, sneezing, laughing, heavy lifting, or exercise. 2. Urge incontinence: Also called “overactive bladder,” urge incontinence when bladder muscles contract suddenly, creating an urge to go that can’t be ignored. 3. Overflow incontinence: This type is most common in men, and is usually associated with a damaged bladder, blocked urethra, or prostate gland problems. Some people have a mixture of more than one type of incontinence. No matter what type a person has, it can be uncomfortable and embarrassing.

HOW IS URGE INCONTINENCE TREATED? WHAT IS URGE INCONTINENCE? According to the American Urological Association, one-quarter to one-third of men and women in the U.S. suffer from urinary incontinence, and the problem is more common in women. An estimated 30 percent of women aged 30 to 60 have it, compared to 1.5 to 5 percent of men. Urinary incontinence is when urine leaks out when you don’t want it to. It usually involves loss of muscle control, and the main symptom is leakage. When the leakage occurs and how extensive it is depends on the type of incontinence a patient has. In general, there are three basic types: 4HEALTH | 877.807.0989

For minor symptoms, doctors may recommend pelvic floor exercises to help strengthen the muscles that control urination. Bladder training can also help. For more moderate symptoms, and if exercises and training don’t work, medications are available that can help calm overactive bladder and reinforce tissues in the urethra and vaginal areas to lesson some of the symptoms. There are also medical devices available that can help control urine spillage. A urethral insert traps leaking urine, as does a pessary. Botox may be injected into the bladder muscle to help tame the symptoms of over-

active bladder. Radiofrequency therapy firms muscles in the urinary tract and may result in improved control. Finally, a “sacral nerve stimulator,” which is implanted in the buttock, emits an electrical pulse that stimulates the nerve that runs from the spinal cord to the bladder. Surgery is usually a last result, and may include the implantation of mesh under the bladder to help support the urethra and stop leakage, or the insertion of an artificial sphincter to control the flow of urine.

WHICH TREATMENT IS BEST? Researchers looked at the results of both Botox and the sacral nerve stimulator when it came to treating urge incontinence. They followed about 364 women who were treated with one or the other, and found that those treated with Botox had a greater reduction in 6-month average number of leaking episodes per day than those treated with the stimulator. They also showed greater improvement in symptoms, and felt more satisfied with the treatment. Botox did, however, increase risk of urinary tract infections, and the need for self-catheterizations, which made the authors question whether the benefits outweighed the risks. If you’ve been diagnosed with incontinence, talk to your doctor about all your options. There are many absorbent pads now available as well, so the important thing is to find a solution that works for you.

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

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

Medical Office is looking for a FT Front Desk Receptionist and a FT Medical Assistant (experience is a MUST). 718-854-5100

Call us if you need Mobile Ultrasound Services: Echo, Vascular and General Ultrasound. (917) 750-2275

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

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

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

Call (718) 259-3828

Telephone (917) 412-3797

Good reimbursement. 718-954-2202

For details call (646)251-6646.

Medical Office is looking for a Certified Medical Assistant, full/time, 3 year experience. Excellent phlebotomy, medical terminology, computer skills. Bilingual â&#x20AC;&#x201C; English, Russian.

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

An opportunity exists for a Nurse Practitioner (NP) to care for Dermatology and Aesthetic patients in our outpatient clinic. The NP will be covering a full range of medical, aesthetic and minor office procedures. Full-time job. Experience: NP - 1 year. NP License, Active DEA License, Russian Speaking a must. Contact: info@allureclinic.com 347-683-3589 Richard

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

(347) 587-3777

Call 347-713-6871

New multispecialty clinic looking for any specialty doctors. 347-453-0523

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

Medical practice is looking for a Board-Certified Nurse Practitioner (f/t). 1 year experience. Call 718-676-2565, ask Richard

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

Medical practice is looking for a Board-Certified Dermatologist. Call 718-676-2565, ask Richard

Orthopedic Medical Office in Brooklyn is looking for an English-Russian speaking Front Desk Receptionist. For more information please call 718-336-2258 ext.1 4HEALTH | 877.807.0989

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Marina KREPKH, DDS

7708 4th Ave Brooklyn, NY 11209

(888) 502-6245

INTERNAL MEDICINE

Victoria ALEKSANDROVICH, MD

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

(718) 207-7071

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Narayan SANDARESAN, MD

5 E 84th St New York, NY 10028

(212) 328-0135

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(844) 957-7463

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2101 Ave X Brooklyn, NY 11235

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Margarita BAUMAN, OD

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

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948 48th St, Fl 2 Brooklyn, NY 11219

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

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(718) 934-8484

PHYSICAL THERAPY

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

(718) 676-2565

MEDICAL SUPPLY

NUTRITION AND DIETETICS

Michael RISKEVICH, MD

3140 Coney Island Ave., 3rd Fl., Brooklyn, NY 11235

Essential Supply LLC Alina VASILYEVA, DPM

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

(718) 646-0131

PSYCHOLOGY

(732) 881-6575 www.essentialdmbs.com

Yuly CHALIK, MD

USA VEIN CLINICS

(347) 508-3991

2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

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

www.nyui.org

1153 First Ave New York, NY 10065

2444 86Th St, Ste A Brooklyn, NY 11214

Albert GROSS, CNS, NYS, CDN

1942 E 8th St Brooklyn, NY 11223

(718) 376-8317 www.nylifex.com

MULTI SPECIALTY

116-02 Queens Blvd Forest Hills, NY 11375

USA VASCULAR CENTERS

1975 Hylan Blvd Staten Island, NY 10306

2444 86th St, Ste A Brooklyn, NY 11214

1901 82nd St Brooklyn, NY 11214

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

www.magichandspt.com

4159 Broadway Washington Heights, NY 10033

Vladislav RUDNER, PT

(718) 490-2416 PLASTIC SURGERY

Chloe CARMICHAEL

230 Park Ave, Fl 10 New York, NY 10196

(212) 729-3922 PSYCHIATRY

Vitaly RAYKHMAN, MD

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

59-20 Myrtle Ave Queens, NY 11385

www.nyui.org

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

(347) 508-3991

30-33 Steinway St Astoria, NY 11103

(718) 393-5331

Multi SPECIALTY CLINIC

MEDICAL TRANSPORTATION

3023-3027 Ave V Brooklyn, NY 11229

(877) 807-0989 AESTHETIC CENTERS

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

Roman RAYHAM, MD,

156 Route 59, Ste B1, Suffern, NY 10901

BOARD CERTIFIED IN PLASTIC SURGERY

www.usaveinclinics.com

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

(718) 509-0906

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

Interborough DEVELOPMENTAL & CONSULTATION CENTER

www.nyplasticsurgerycenter.com

(888) 987-5751

(877) 582-0400

RANNETA TRANSPORTATION

1623 Kings Hwy, Fl 4 Brooklyn, NY 11229

Ridwan SHABSIGH, MD

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

(718) 283-7746

(347) 848-0049

Michael PATIN, MD

6417 Bay Pkwy Brooklyn, NY 11204

(718) 234-6767

102-30 Queens Blvd Forest Hills, NY 11375

(718) 896-2333

LSA RECOVERY

1300 Ave P Brooklyn, NY 11229

(888) 983-4055

4HEALTH | 877.807.0989

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4HEALTH | 877.807.0989

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4HEALTH | 877.807.0989

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4HEALTH | 877.807.0989