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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

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PA I N M E D

4HEALTH

Which Cooking Oil Options are Healthy? Best Options for Sauteing and Frying

11 8

14 16

Why Am I Losing My Voice? Home Remedies to Help You Speak Clearly Again

Coping Techniques to Avoid Accidents and Falls

26 Do I Need to See a Neurologist? How the Brain and Spinal Cord May be Damaged

Why Dentists Urge Caution

I’M PREGNANT AND I CAN’T SLEEP! Insomnia During Pregnancy: Causes and Solutions

10 TIPS FOR A STRESS-FREE MENSTRUAL PERIOD You Can Make it Easier On Yourself!

HOW BIRTH CONTROL PILLS MAY PROTECT WOMEN’S KNEES

WHAT’S CAUSING YOUR BELLY FAT?

How Dementia Affects Vision

CHARCOAL TOOTHPASTE—SAFE FOR WHITENING?

Hormonal Changes Can Weaken Women’s Knee Ligaments

By Dr. Prab R. Tumpati

NEARLY HALF OF DOCTORS BURNED OUT—HOW THAT AFFECTS PATIENTS How to Tell if Your Doctor is Burned Out

BREAST CANCER SURVIVORS GETTING REALISTIC NIPPLE TATTOOS

ERASE SUN DAMAGE AND SHAVE YEARS OFF YOUR APPEARANCE

HOW CAN I RELIEVE THIS PAIN IN MY HEELS?

WHY “TREAT MY VARICOSE VEINS”

38 40

How an Artist Can Help You Feel Normal Again

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

Podiatrist Dr. Stepensky Has Answers

Should be On Your New Year’s Resolutions List!

SHOULD YOU BE SCREENED FOR LUNG CANCER? Most Insurances will Now Cover the Test

BACK PAIN AND INCONTINENCE: A NOT-SO-UNLIKELY PAIRING What to Do When You Have Both Symptoms

5 Ways to Make Sure Your Feet Stay Healthy Healthy Feet Means a Healthy Body!

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4HEALTH

WHICH COOKING OIL OPTIONS ARE HEALTHY? BEST OPTIONS FOR SAUTEING AND FRYING

nnn by Morgan Rice I cooked with butter for a long time, because my mother always did, and her food was delicious! But lately, I’ve been thinking that maybe butter isn’t the healthiest option. It seems that plant-based oils are better in general because they contain more “good for you” fats, whereas butter contains the type of fat that has been connected to heart disease. So what type of oil is best? If you’ve ever gone to the store and looked at the selection, you may have been just as confused as I was. I did some research on the issue, and here’s what I found.

WHY PLANT-BASED OILS ARE BEST Oils that come from plants are made from the fats that exist in those plants — usually from the seeds. These oils help make foods taste bet-

ter, but they also add in mono- and polyunsaturated fats. It used to be that we thought all fat was bad, believing it would build up in our arteries and slow down the blood flow. Now we know, however, that not all fats are equal. Some increase risk of artery narrowing, but others — like those in olive oil and canola oil, for example — have unsaturated fats that have been linked with a healthier heart and vascular system. So-called omega-3 fats, for example, are a type of polyunsaturated fat that can help lower blood cholesterol levels and reduce inflammation in the body. Monounsaturated fats can help increase HDL “good” cholesterol and may decrease your risk for heart attack and stroke. Both of these types of fats are found in plant-based oils, which means these oils can play an important role in your healthy diet. 4HEALTH | 877.807.0989

4HEALTH HOW TO FIND AND PRESERVE THE HEALTHIEST OIL When choosing any plant-based oil, look for the terms “coldpressed” or “expeller-pressed.” This refers to how the oil was processed and indicates the most natural processing methods available that help preserve the nutrients in the oil. Refined oils, on the other hand, undergo additional manufacturing processes that may include heating, chemical solvents, bleaching, and deodorizing. These processes can sap the nutrients from the oil, leaving it a much less healthy product than it was to begin with, so it’s always best to look for cold-pressed or expeller-pressed oils, no matter which oil you’re buying. Once you take the oil home, keep an eye on the expiration date. All oil goes rancid eventually and you can tell because the oil will have an unpleasant smell and taste. Once it goes rancid, you must dispose of it. Heat, light, and air accelerate the degeneration process, so keep the oil in a dark, cool place.

BEST PLANT-BASED OILS TO COOK WITH You may already be using olive oil, as it’s the most popular plantbased oil in use today. It has heart-healthy omega-3 and monounsaturated fats and adds a nice light taste to many dishes. When choosing your olive oil, you may want to be sure that you get the extra-virgin kind. The “extra-virgin” means the oil is pressed from the olives rather than being extracted with heat or chemicals. This process helps preserve the nutrients in the oil, including the healthy fats.

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You can cook with olive oil as long as you don’t let the heat get too high. If the oil starts to smoke, that’s not good news, because that means it’s gotten too hot and that heat is not only destroying the good nutrients, it’s creating unhealthy free radicals. Olive oil has a “smoke point” of about 375–400 degrees Fahrenheit. Other plant-based oils that work well in cold dishes and cooking include the following: Avocado oil: Great for searing, frying, grilling, and roasting, with a high smoke point of 520 degrees Fahrenheit. Canola oil: With a smoke point of 400 degrees, it is suitable for panfrying and baking, and usually adds little to no taste. Sesame oil: Works great in Sauteing and stir-fries, as it has a definite flavor to it. Peanut oil: Also works well in stir-fries and Sauteing, adding a nutty flavor to vegetables, tofu, and tempeh dishes. It has a high smoke point and can also be used for frying. Smoke point of 450 degrees. Sunflower oil: Mildly flavored with a high smoke point, which makes it perfect for all types of cooking, including frying. Smoke point of 440 degrees. Grapeseed oil: Clean, light flavor that is ideal for dressings and for flavoring dishes. Smoke point of 400 degrees Fahrenheit. Coconut oil: Adds a rich, sweet taste to baked goods and cooked foods. Smoke point of 350 degrees.

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4HEALTH

WHY AM I LOSING MY VOICE? HOME REMEDIES TO HELP YOU SPEAK CLEARLY AGAIN nnn by Lynn Merrell I tried to talk to my mom the other day on the phone, but it was a difficult conversation. She was losing her voice, and I was having a hard time hearing what she was saying. I felt so badly for her! I asked her what was causing it, and she thought she was getting a cold, but why it was affecting her voice we werenâ&#x20AC;&#x2122;t sure. Turns out there are many different reasons why our voices may leave us. Fortunately, we can do some things to help get them back more quickly.

REASONS WHY YOU MAY BE LOSING YOUR VOICE As my mom suspected, she was getting a cold, and that was the most likely reason for her voice problems. Sometimes when your body is fighting off a virus, the throat becomes inflamed and sore, and that can affect how the vocal cords vibrate, causing hoarseness or laryngitis. Other potential reasons you may be having a hard time speaking include: Using the voice too much: Maybe you had to yell a lot at a recent event, or you spent too much time singing at the top of your lungs in

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4HEALTH the shower. That can lead to fatigue and strain in your vocal cords, bringing on hoarseness. Smoking or exposure to smoke: Smokers are notorious for having hoarse voices and are about three times more likely than nonsmokers to have voice problems. When you inhale the toxins in cigarette smoke, they can damage the vocal cords or even cause growths to form on them. The same thing can happen if you’re in an environment where you’re frequently inhaling smoke or other potentially dangerous fumes. Thyroid problems: The thyroid gland, which sits in the lower neck, delivers hormones to the body that control various functions. If your thyroid slows down and doesn’t produce enough of these hormones, one of the symptoms can be a hoarse voice. An enlarged thyroid or one with a growth or nodule on it can cause the same problem. Allergies: An allergic reaction to a food, beverage, or airborne allergen can cause in-

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flammation and swelling in the throat and vocal cords. Antihistamines are also known to dry out the mucus in your throat, which can leave you hoarse. Rheumatoid arthritis: This autoimmune disease usually damages the joints, but it can also affect the tiny joints in the face and throat, affecting the way you speak.

HOW TO GET YOUR VOICE BACK FASTER Whatever may be causing you to lose your voice, your main concern is probably getting it back. It can be very challenging to communicate without it! Below are some home remedies for a hoarse voice that will help soothe the vocal cords and promote healing: Rest: This is what your voice needs the most — rest. Try to speak as little as possible until you’re feeling better. By the way, whispering doesn’t help as it actually puts more strain on the vocal cords than speaking does.

Drink!: Drink a lot of water and other healthy beverages to help soothe and moisturize your vocal cords and throat. Warm liquids can be extra helpful, so make more tea and soup. Breathe in moist air: Use a humidifier to keep the air in your home moist. You can also try inhaling steam from a bowl of hot water or while in a hot shower. Gargle with salt water: This can provide relief from pain and swelling, as the salt helps heal irritated tissues. Add a teaspoon of salt to a glass of water and gargle a few times a day. Try to avoid decongestants: These are drying and will make your hoarseness worse. Avoid irritants: Try to stay away from smoke, dust, pet dander, and other potential throat and voice irritants. Talk to your doctor: If your voice doesn’t return within a week or so, check with your doctor.

CHARCOAL TOOTHPASTE — SAFE FOR WHITENING? WHY DENTISTS URGE CAUTION

nnn

by Gordon Barclay

We all want white teeth these days. In our selfie-obsessed world, we’ve grown more aware of our appearance, and one of the things we know we can do to improve it is to make sure our teeth look healthy and white. The American Academy of Cosmetic Dentistry reports that more and more patients are purchasing whitening treatments each year. In addition to getting them from dentists, we can now get whitening toothpaste, whitening mouthwashes, whitening strips, whitening gels, and more at the grocery store and pharmacy. One of the latest whitening crazes is charcoal toothpaste. You may have heard about it online or via other media channels. Proponents say that it’s a good alternative to peroxide for whitening teeth. The question is, does it work, and is it safe for you to use?

WHAT IS CHARCOAL TOOTHPASTE? Charcoal toothpaste is toothpaste that contains activated charcoal. When you think of charcoal, you may think of those black briquettes you use in barbequing, but activated charcoal is a slightly different type that has been used in medicine. A fine-grain powder typically made from wood, activated charcoal is highly absorbent.

Doctors use it in emergency rooms to treat certain kinds of poisoning and overdose since the charcoal absorbs the substance and prevents it from being digested by the stomach. It may be for this reason that people think adding it to toothpaste will help “absorb” stains from the teeth.

DOES CHARCOAL TOOTHPASTE HELP WHITEN TEETH? Results vary from person to person. The short answer is that activated charcoal may help slightly brighten your teeth. It’s mildly abrasive and can help absorb some of the surface stains, but don’t expect miracles. In a 2017 review of over 100 studies, scientists could find no good evidence showing that activated charcoal was effective at whitening, nor could they even say that it was safe to use. Indeed, if you talk to your dentist about it, he or she may warn you to be careful, as there are some risks involved in using it. Charcoal is abrasive, so it can harm the teeth over time, wearing down the enamel that protects teeth. Once you damage the enamel this way, that damage is permanent — you can’t get the enamel back. Without it, your teeth may also be more sensitive to sweet tastes, hot, and cold. With less enamel, teeth have a more yellow than white appearance, as when the enamel wears away, what you see is more of the soft

tissue underneath, and that typically appears yellowish. That means that using charcoal toothpaste could make your teeth look worse rather than better. You could also get tiny charcoal particles accumulating in the cracks and crevices of your teeth, which could add to that stained appearance. If you already have sensitive teeth or receding gums, you should avoid charcoal toothpaste, as it could make that sensitivity worse. Because of the abrasiveness, it may also encourage even more gum recession. Finally, dentists don’t know yet how charcoal toothpaste may affect crowns, white fillings, veneers, and bridges. It could build up in those areas, leaving behind a black or gray outline.

SHOULD YOU TRY CHARCOAL TOOTHPASTE? Considering all these risks, we don’t recommend you use this toothpaste. If you want whiter teeth, choose an over-the-counter approved whitening product or talk to your dentist. If you still want to try it, ask your dentist first, then use it only once in a while as it will most likely damage your teeth and your smile. SOURCE Brooks, J. K., Bashirelahi, N., & Reynolds, M. A. (2017). Charcoal and charcoal-based dentifrices. The Journal of the American Dental Association, 148(9), 661–670. doi:10.1016/j.adaj.2017.05.001

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4HEALTH

I’M PREGNANT AND I CAN’T SLEEP! INSOMNIA DURING PREGNANCY: CAUSES AND SOLUTIONS

nnn

by Lynn Merrell

Sheree tossed and turned in her bed, and finally got up and wandered into the kitchen. She patted her extended belly as she went, noticing that even the baby seemed to be resting. Why couldn’t she sleep? It made no sense. She was exhausted when her head hit the pillow, but now she just couldn’t relax. Many pregnant women find sleep difficult now and then, but about one-fifth (20 percent) suffer from outright insomnia. A 2018 study found the numbers even higher during the first trimester — over 44 percent of women struggled. If you’re having sleep problems, it’s important to try to find solutions, as sleep deprivation can not only leave you tired and grouchy, it can also negatively affect labor and delivery. Researchers from the University of California at San Francisco found that women who slept fewer than 6 hours per night had longer labor times and were 4.5 times more likely to have cesarean deliveries.

WHAT CAUSES SLEEP PROBLEMS DURING PREGNANCY? When you’re pregnant, many factors come together to affect sleep. First, there are hormonal changes. Rising progesterone levels can cause daytime sleepiness, particularly during

the first trimester. Other hormonal changes can lead to frequent bathroom trips in the middle of the night, snoring, and nausea. Then there are the emotions that go with being pregnant. Women may feel anxious about the pregnancy, worry about the labor and delivery, or doubt their ability to manage childcare. First-time moms, in particular, often suffer from these sorts of stressful emotions. Research has also found that pregnancy can increase the risk of restless leg syndrome (RLS), a condition in which unpleasant and tight sensations in the legs wake women up in the middle of the night. Heartburn becomes more likely during pregnancy too. Altogether, these changes can lead to difficulties falling asleep and staying asleep.

HOW TO GET MORE SLEEP WHEN YOU’RE PREGNANT If you’re struggling with severe insomnia during pregnancy, be sure to talk to your doctor. You need your rest to keep both your baby and yourself healthy during this time. Though most insomnia medications are off the table as they have the potential to harm the baby, other treatments may be available. You can also try these home remedies: Prenatal vitamins: Make sure you’re getting these during pregnancy, as a lack of folate and iron can increase your risk of RLS.

Massage: Massaging the legs and back before sleep can help you relax. Exercise: Moving more throughout the day helps your muscles relax at night, making it easier to fall asleep. Eat small: Eating more small meals throughout the day (rather than large ones) can help you avoid heartburn and get to sleep more easily. Use pillows: When lying on your side, place pillows between your knees, under your abdomen, and behind your back. This can help you feel more comfortable. Consider therapy: If you’re struggling with stress and anxiety, it can help to talk to a therapist. Research has shown that cognitive therapy can improve sleep during pregnancy. Keep a schedule: Go to bed and get up at the same time, even on weekends. Banish technology: Make sure that all computers, televisions, cell phones, and tablets are kept out of the bedroom at all times. The screens emit blue light that disturbs sleep. Try relaxing teas: Drinking a cup of relaxing tea before bed can help you wind down. Good options are chamomile, lemon balm, lavender, passionflower, and valerian root. SOURCES Sleep Foundation. (n. d.). Pregnancy & Sleep. Retrieved from https:// www.sleepfoundation.org/articles/pregnancy-and-sleep Villines, Z. (2018, October 26). Insomnia during early pregnancy: The 5 best natural remedies. Retrieved from https://www.medicalnewstoday.com/articles/323475.php

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4HEALTH

HOW TO BREAK

A JUNK FOOD ADDICTION It may be hard for most of us to eat just one brownie or to stop at two bite-sized donuts, but for people fighting with obesity, it seems downright impossible. A new study says that in fact, we can become addicted to junk food, similar to how we can be addicted to cigarettes or alcohol. How is that possible, and what can we do to break the addiction?

nnn Colleen M. Story JUNK FOOD SIMILAR TO COCAINE Researchers at the Scripps Research Institute in Florida recently published results of their study on junk food.1 What they found: Rats allowed to eat a bunch of cake, cookies, and candy bars gained weight, and wouldn’t stop eating these foods even when they received electric shocks. When researchers took the junk food away and replaced it with healthy food, the rats starved themselves. The scientists say it has to do with the chemical balance in the reward part of the brain. As the pleasure centers become less responsive, rats start to overeat—the same behavior seen in rats that over-consume heroin or cocaine. “When the animal overstimulates its brain pleasure centers with highly palatable food,” said associate professor Paul J. Kenny, “the systems adapt by decreasing their activity. However, now the animal requires constant stimulation from palatable food to avoid entering a persistent state of negative reward.” He goes on to say that drug addiction and obesity are based on the same kind of neurobiological mechanisms.

HOW TO BREAK IT Many of us see food as much more than nutrition

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for our bodies. We eat to cheer up, to reward ourselves, or to satisfy other hungers that aren’t food related. It can be difficult to notice an addiction starting in our lives. Weight gain takes time, and we can’t see the fatty buildup in our arteries and around our internal organs. Besides, everyone eats junk food, so it’s difficult to take it all that seriously. If you watch your daily intake of junk food items, you can tell if you’re heading down the wrong road. Are you eating even though you’re not hungry? Are you frustrated with weight gain and finding it hard to lose? Are you obsessed with calories and exercising furiously to try to keep up? You can take a few steps to wean yourself at the early stages. Drink eight to ten glasses of water a day—sometimes when you think you’re hungry you’re actually thirsty, and water can help squelch your appetite. Eat regular healthy meals throughout the day, and add in a couple low-calorie snacks, like fruit and nuts, to keep your blood sugar steady and avoid plunges that encourage overeating. Switch junk food items for healthier choices. Try b a k e d

chips or nuts for salty snacks, or add a couple chocolate chips in with a trail mix to get your sweet fix. Exercise regularly—it not only burns calories, but sparks similar pleasure centers in the brain. Keep healthy foods within reach, like fresh fruits on the countertop, and eat less sugar overall, to retrain your senses. When you do have a craving, go for a walk, drink water, brush your teeth, or choose a healthy snack like pickles, yogurt, or wholegrain cereal. Finally, learn to reward yourself with items that aren’t food related, like DVDs, clothes, a day at the park, or time to read, paint, crochet, or do other things you enjoy. If you’re already overweight or obese and think you may suffer from a junk food addiction, talk to your doctor. Most likely, you’ll need help controlling your cravings until you can get past the “withdrawal” period. You may also want to check into helpful groups like Overeaters Anonymous, an addiction treatment center, or a mental health professional. REFERENCES 1. Paul M. Johnson, Paul J. Kenny. Dopamine D2 receptors in addiction-like reward dysfunction and compulsive eating in obese rats. Nat. Neurosci 2010 March 28.

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4HEALTH

10 TIPS FOR A STRESSFREE MENSTRUAL PERIOD YOU CAN MAKE IT EASIER ON YOURSELF!

For a lot of women, menstrual periods are stressful. Sometimes it’s so uncomfortable that women will schedule their vacation times and other important events around their menstrual cycle so that it doesn’t interfere. If you struggle with heavy bleeding or long periods, you may find yourself stressing out when you know your period is coming. Stress isn’t good for anyone, so we have some tips to help you stress less when that dreaded day on the calendar approaches.

MAKE SURE YOU’RE PERIODS ARE NORMAL, FIRST Though it’s common to experience some difficult symptoms with your period, it is important to be sure you’re not suffering needlessly. Some women with heavy periods, for example, or with other symptoms like pain in the lower abdomen and back, frequent urination, prolonged periods, or painful intercourse, may have uterine fibroids that are causing the problem. Uterine fibroids are common, non-cancerous growths that can develop in the uterine lining. If they grow large or plentiful, they can cause symptoms like heavy bleeding, prolonged periods, and abdominal pain. If you notice symptoms like these and you haven’t had them before, be sure to check with your doctor. There are minimally invasive treatments that can help get rid of the fibroids and relieve your symptoms.

10 TIPS FOR STRESS-FREE PERIODS Once you’ve ensured that your periods are normal, you can take the following steps to reduce any stress you may feel around that time of the month.

1. STOCK UP ON SUPPLIES There’s nothing worse when you’re in pain than realizing you’re out of pain-relievers. Make sure that you have enough of what you need. That means stocking up on pain relievers, pads or tampons, and other related supplies. It also means having a change of clothes handy just in case.

cise helps reduce anxiety, depression, mood and behavior changes, and focus problems, as well as reducing painful physical symptoms.

3. GET 7–8 HOURS OF SLEEP PER NIGHT Sleep helps your body and mind deal with stress, and if you’re not getting enough, it can make your period symptoms worse. Keep your bedroom dark and cool, make sure you keep all screens out (including televisions, tablets, computers, and phones), and go to bed and get up at the same time every day, even on weekends.

4. DRINK WATER Since the body retains fluid during your period, it may seem counter-intuitive to drink more, but it will actually help if you do. Water flushes waste out of your system, moves your digestion along, and might help you diminish that bloated feeling. It can also help relieve cramps and other stomach discomforts.

9. INCREASE YOUR VITAMIN B6 AND VITAMIN D INTAKE Both of these vitamins can help reduce mood swings, boost energy, and ease other symptoms of premenstrual syndrome (PMS). The sun is the primary source of vitamin D, so try to get out unprotected for about 20–30 minutes a day, or try vitamin D supplements. To get more vitamin B6, eat more bananas, nuts, chicken, and citrus fruits, or use supplements during your menstrual period.

10. GET MORE MAGNESIUM Many Americans don’t get enough magnesium in their diets, and during your period, you really need it. It can help relax muscles, reduce cramps, and even ease headaches. To get more, try supplements or eat more dark chocolate, which is rich in magnesium.

5. CHANGE FREQUENTLY Depending on your level of bleeding, it’s important to change your pads or tampons frequently to prevent infections. The standard recommendation is to change every 3–4 hours, but if you’re losing a lot of blood, change more frequently.

6. TRACK YOUR PERIOD Regularly tracking your period can help you more quickly spot any unusual symptoms or problems you may experience. Otherwise, you may not remember what was normal and what wasn’t. Keep a calendar and record the length of your period, daily blood flow, any symptoms, and note any differences that occur. This way, if something does change, you’ll have the information you need to share with your gynecologist.

USA FIBROID CENTERS CAN HELP If you have bleeding and spotting between periods as well as some of the other symptoms mentioned above, you may have uterine fibroids. USA Fibroid Centers can help. With offices all over the nation, including Florida, California, Illinois, and New York, they have doctors highly experienced in uterine fibroid treatment. Call today at 718–504–6525 or go to www.USAFibroidCenters.com to schedule a consultation. SOURCES Aganoff, J. A., & Boyle, G. J. (1994). Aerobic exercise, mood states and menstrual cycle symptoms. Journal of Psychosomatic Research, 38(3), 183–192. doi:10.1016/0022–3999(94)90114–7

7. AVOID SCENTED PRODUCTS Scented products contain unknown chemicals that can disrupt your vagina’s natural pH balance. They may also cause irritation or even infections down the road. If you’re concerned about odor, simply clean yourself more often with warm soap and water.

2. EXERCISE REGULARLY Studies show that those women who get regular exercise throughout the month have less severe premenstrual symptoms. Regular exer-

help relax your abdominal muscles and provide some needed comfort.

8. USE A HEATING PAD If you suffer from cramps during your period, try a heating pad or heating patch. These can

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4HEALTH

HOW BIRTH CONTROL PILLS MAY PROTECT WOMEN’S KNEES HORMONAL CHANGES CAN WEAKEN WOMEN’S KNEE LIGAMENTS nnn

By Morgan Rice

Did you know that women are more prone to knee injuries, overall, than men? In fact, one in 10 female college athletes suffers a major knee injury every year — five to six times more often than their male counterparts. Most of these injuries are ACL, or «anterior cruciate ligament» injuries, and it’s not just athletes who are suffering from them. Active

women of all ages are vulnerable, with some women injuring their knees while skiing or playing community sports or enjoying a game of tennis. Why are women more at risk for these types of injuries, and what can we do to protect ourselves? Surprisingly, a recent study suggests that birth control pills may help.

WHAT IS AN ACL INJURY? The Centers for Disease Control and Prevention (CDC) states that overall, girls are 8 times more likely to suffer an ACL injury than boys, 4HEALTH | 877.807.0989

4HEALTH while Medical News Today states that female athletes are 1.5 to 2 time more likely than their male counterparts to injure the ACL. This ligament connects the top and bottom portions of the knee, and runs diagonally across in the middle of the knee. It provides stability to the joint, and runs opposite to the posterior cruciate ligament, which performs the same function in the back of the knee. Both together help control the back and forth motion of the joint. When the ACL is injured, there are usually three levels of severity:

1. Grade 1 Sprain: The ligament is mildly damaged or stretched, but can still help keep the knee stable. 2. Grade 2 Sprain: The ligament is stretched to the point where it becomes loose. This is also called a «partial tear» of the ligament. 3. Grade 3 Sprain: The ligament has been split into two pieces, and the knee joint is unstable. This is also called a complete tear of the ligament. The majority of ACL injuries are partial or complete tears. These are usually caused by rapid changes of direction during athletic activities, stopping suddenly, landing from a jump incorrectly, or trauma such as a collision in a contact sport.

WHY ARE WOMEN MORE VULNERABLE TO ACL INJURIES? Researchers aren’t completely sure why women are more at risk, but they have some theories. One reason may be that women tend to have stronger quadriceps muscles (in front of the leg) than hamstring muscles, so they rely on these to slow down from a sprint, which can cause instability in the knee. Males are more likely to decelerate using the hamstring muscle, which helps protect the knee ligaments. Another possible reason is that women have smaller ACLs in general, which are more prone to injury. They also have wider pelvises, which makes the thighbones angle downward more sharply than in men, which puts more pressure on the knee. Women’s ligaments tend to have more «give» than men’s, as well. Finally, women’s hormones may be to blame. Some studies have suggested that changes in estrogen levels during a woman’s menstrual cycle can actually affect the strength of the ACL. More ACL injuries occurred during the points in the menstrual cycle when estrogen levels were high.

HOW BIRTH CONTROL PILLS MAY HELP REDUCE RISK OF KNEE INJURY For this study on birth control and knee injuries, scientists examined data from a national insurance claims and prescription database of about 23,500 women between the ages of 15 and 19. They found that women with an ACL knee injury who were taking birth control pills were less likely to need corrective surgery than women with ACL injuries who weren’t using the pill. «Birth control pills help maintain lower and more consistent levels of estrogen,» said lead author Aaron Gray, «which may prevent periodic ACL weakness.»

HOW WOMEN CAN PROTECT THEMSELVES So far, the idea that birth control pills might help is only a theory, but if you’re already using them, you may find some peace of mind in the study results. To truly protect your knees, however, consider these tips: n Try the «Prevent Injury and Enhance Performance (PEP)» pro-

gram, a series of stretches and strength training exercises that 4HEALTH | 877.807.0989

n n n

helps to balance muscle strength and teaches proper technique when landing from a jump, stopping after a sprint, and the like, to help reduce force on the knee. (smsmf.org/smsf-programs/pepprogram) Concentrate on strengthening your leg muscles — both front and back — and core muscles. Work on bending your knees more often, particularly when landing from a jump. Avoid straight-knee landings. Make sure you have good shoes when doing any sort of exercise. See your podiatrist to be sure you’re getting the right fit, and to check on orthotics to help correct incorrect foot placement. Don’t push yourself too far — exercise only to your abilities.

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NEARLY HALF OF DOCTORS BURNED OUT — HOW THAT AFFECTS PATIENTS HOW TO TELL IF YOUR DOCTOR IS BURNED OUT nnn

by Colleen M. Story

Today, it’s common for patients to be stressed out about their healthcare. Prices for both healthcare services and insurance continue to rise, and solutions are few and far between. Patients aren’t the only dealing with stress, however. Doctors are, too, which can make it doubly difficult for patients. The question is: Is your doctor burned out? And if so, what can you do about it?

SURVEY REVEALS DOCTORS ARE BURNED OUT AND DEPRESSED According to the Medscape National Physician Burnout & Depression Report 2018, burnout continues to be a pervasive issue among

physicians. Investigators surveyed more than 15,000 physicians from 29 specialties-42 percent of them reported burnout. Additional results included the following: n Fifteen percent reported experiencing clinical (severe) or nonclinical “feeling down” forms of depression — which is a much higher percentage than that experienced in the general population (6.7 percent). n As to what was causing the burnout, over half (56 percent) chose an excess of bureaucratic tasks, and more than one-third (39 percent) noted too many hours at work. Sixteen percent chose government regulations. Nearly a third wanted a more manageable schedule, while more than a quarter believed less regulation would help. 4HEALTH | 877.807.0989

4HEALTH n Among those who reported depression, 40 percent believed their

feelings had no effect on patient care, but about one-third (33 percent) reported they were more easily exasperated by patients or less engaged with them because of their depression. Fourteen percent also reported their depression led to errors they wouldn’t normally make. n The highest rates of burnout occurred among intensivists and neurologists (48 percent), family physicians (46 percent) and emergency medicine physicians and radiologists (45 percent). n Fourteen percent said they were both burned out and depressed. The highest rates of specialties suffering from both were found among ob/gyns (20 percent), public health physicians (18 percent) and urologists and neurologists (17 percent).

HOW TO TELL IF YOUR DOCTOR IS BURNED OUT These results are concerning, particularly for patients who are relying on doctors for their care. The first thing you may wonder is, “How can I tell if my doctor is burned out or depressed?” It may not be possible for you to tell, as many doctors will do their best to hide it for the benefit of their patients, but you can watch for these signs: n The doctor has a hard time listening to you and seems continually distracted. n The doctor is not very empathetic and seems rather callous to your concerns. n The doctor may not be as responsive to your questions during appointments. n The doctor is easily irritated. n It may take longer to hear back from your doctor when you call, email, or text. n The doctor seems “not himself ” or “not herself ”—different from the personality you’re familiar with. Often the most caring doctors are most at risk.

WHAT TO DO TO PROTECT YOURSELF FROM DOCTOR BURNOUT If you suspect your doctor may be struggling with burnout or depression, what can you do? Try these steps: n If you feel grateful for your doctor’s care, be sure to let him/her know with a few words of thanks during your visit. n If you notice clear signs of burnout or depression, feel free to express your concern with something like the following: “You seem particularly tired today. Are you okay?” Just this simple concern can be enough to encourage a doctor to connect with you more personally. He is not likely to share his personal issues, but knowing you care and have noticed his demeanor, he may return to his more usual care. In addition to these steps, try to find medical practices and hospitals that help reduce physician burnout by hiring adequate staff and putting other systems in place that help support physicians. Watch for these signs: n Do you get prompt attention from staff when you go in? n Do you get timely responses to phone inquiries? n Is the doctor accompanied by a nurse during the visit — someone who helps take notes and insert data into the computer? (This practice has been found to help ease the load on physicians.) n Do you feel rushed and harried after your appointment, or relaxed and satisfied? (If you feel rushed, your doctor may too.) 4HEALTH | 877.807.0989

Changing doctors should be a last resort, but if you fear that doctor burnout could put your safety and health care at risk, don’t hesitate to look for better care elsewhere. SOURCE Medscape. (2018, January 17). Medscape National Physician Burnout & Depression Report 2018. Retrieved from https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235

4HEALTH

HOW DEMENTIA AFFECTS VISION COPING TECHNIQUES TO AVOID ACCIDENTS AND FALLS

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by Morgan Rice

If you or a loved one has been diagnosed with Alzheimer’s disease or another form of dementia, you know to expect changes in memory and thinking. What you may not be aware of is that these diseases can also cause changes in vision. This is dangerous, as vision problems can increase the risk of falls, which can quickly erode the quality of life.

HOW DEMENTIA AFFECTS VISION Unfortunately, dementia can affect not only the parts of the brain associated with thinking and memory but vision, too. That means a person can have perfectly healthy eyes, but still have vision problems because the brain can no longer properly interpret the messages coming in from the eyes. Depth perception can become more difficult, for example. People with dementia may have more difficulty judging distances, such as how far away the curb is, or how high the step is. This can lead to trips and falls. They may also mistake a picture of an apple for the real thing, and reach for the apple. This sort of behavior is sometimes mistaken for evidence the person is experiencing hallucinations when actually it’s just a sign of vision problems.

Peripheral vision also tends to deteriorate faster in those with dementia. Though we all lose some side vision as we age, dementia can accelerate that loss, sometimes severely. A person with dementia can have a field of vision that stretches only 12–18 inches across. Try holding up your hands in front of your eyes at about that distance and you can see how much that would affect your ability to get around in your world. Finally, dementia can affect how well a person differentiates between colors. A person may no longer be able to tell the difference between colored pills or traffic signals, particularly in environments with lower light, such as during sunrise or sunset. He or she may also struggle to tell shades of the same color apart, such as a white floor from a white bathtub. Aging in general increases the risk of other eye problems, such as cataracts and macular degeneration. All of these factors together can increase the risk of falls, accidents, and other injuries.

HOW TO COPE WITH DEMENTIARELATED VISION LOSS It’s always best to check with your eye doctor to make sure your eyes are healthy. Cataracts, macular degeneration, and glaucoma can all be treated. If there is nothing physi-

cally wrong, however, the brain is to blame. Medications that help slow the progression of dementia may help, but meanwhile, try these tips to help yourself or someone you love to cope: n Mark the steps: Apply brightly-colored tape to the edge of the top and bottom steps to help improve depth perception. n Avoid dark throw rugs: If you place a dark rug on a light background, it may be mistaken for a hole or step-down. n Approach from the front: If you’re approaching a loved one with dementia, approach from the front where they can see you. Place food and drinks right in front of them where they are most likely to see them. n Point out handrails: When helping your loved one up the steps, point out the handrails, as they may be out of the person’s field of vision. n Color up the bathroom: Place a colored seat or cover over a white toilet. n Use red plates: One study showed that using a red plate resulted in better eating for people with dementia. n Add more lights: Older people — even without dementia — need more light to see clearly. Provide bright light (100 watts) in lamps and light fixtures. 4HEALTH | 877.807.0989

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4HEALTH

BREAST CANCER SURVIVORS GETTING REALISTIC NIPPLE TATTOOS HOW AN ARTIST CAN HELP YOU FEEL NORMAL AGAIN

nnn Lynn Merrell Having to lose one’s breasts through a mastectomy leaves women struggling with their body image. Reconstruction helps, but it doesn’t include recreating the nipple, at least at first. Though plastic surgeons do offer nipple and areola reconstruction once the initial reconstruction of the breast has healed, some women would rather not go through surgery all over again. Today, there is another option — nipple tattoos. Women who thought they would never consider getting a tattoo may think twice after going through breast cancer surgery. Tattoo artists are able to create nipples with such artistry that even doctors are hard-pressed to tell the difference between a tattoo and the real thing.

WHAT IS A NIPPLE TATTOO? According to a recent report in the journal Plastic and Reconstructive Surgery, tattoo artists can achieve “aesthetically superior” results by creating three-dimensional tattoos of the nipple and surrounding areola (called the “nipple-areola complex,” or “NAC.”) “The application of “3D” techniques or “realism” in tattoo artistry has significant potential to improve the aesthetic outcomes of reconstructive surgery,” the researchers wrote.

Though the procedure of creating the nipple was typically performed by plastic surgeons using very basic techniques and limited ink colors, today, tattoo artists have become so advanced that they can typically use their artists’ touch to get much better looking results. New techniques involve using a variety of ink colors, needle types, shadow effects, and other illusory methods to make the nipple look closer to the real thing. Today’s artists can even recreate the tiny Montgomery glands surrounding the nipple. “The technique of 3D NAC tattoo presented is, in our opinion,” the researchers wrote, “a significant advance in obtaining improved aesthetic results for women undergoing breast reconstruction.”

PERSONAL INK PROVIDES SURVIVORS WITH IDEAS Breast cancer survivor Molly Ortwein went through a double mastectomy and wanted to do something about her scars, so she decided to try a tattoo artist. She later talked to her brother-in-law, Noel Franus, about her plans. Franus, realizing that more women options when recovering from breast cancer surgery, founded “Personal Ink” in December 2012. The non-profit organization seeks to provide ideas and inspiration to survivors and to connect patients with tattoo artists who are qualified to

work on scars. In the future, they hope to host more events across the country where cancer survivors can meet tattoo artists in person. “It’s a neat option, said Inga Duncan Thornell, a Seattle life coach who had tattoos completed after her double mastectomy. “You step out of the shower and you look like yourself. You don’t look scarred. I understand why women would reconstruct and totally respect their decision to do that to be more normal, but the thought of having more surgery, more discomfort, didn’t appeal to me at all.” Some insurance companies may partially reimburse a tattoo — be sure to check your policy.

MAKE SURE TO STAY SAFE Are breast tattoos safe? Most doctors believe they are, but recommend women do their research. Be sure you’re going to a reputable artist who uses sterile inks and has an extremely clean facility. Find one that will allow you to watch them open new packs of needles and tubs of ink so you know they haven’t been used. Make sure they use a heat sterilization machine that cleans all nondisposable equipment, and that they wear gloves and follow other important infectioncontrol procedures. If you notice any unusual symptoms after receiving the tattoo, check with your doctor right away. 4HEALTH | 877.807.0989

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4HEALTH

HIGH BLOOD PRESSURE—IN KIDS? High blood pressure is commonly tested for and treated in adults in order to prevent a number of serious diseases. However, it isn’t just adults who need to keep an eye on it. Today, kids and even babies can have high blood pressure.

nnn James Buchanan WHAT IS IT? “Blood pressure” describes the pressure exerted on the artery walls as the heart expands and contracts to move blood through the body. High blood pressure means that the heart has to work harder than it should to move blood, which puts extra strain on the arteries. Over time, the arteries and heart will lose optimal function, which can cause a number of serious health issues. These include heart disease, stroke, loss of vision, kidney failure and more. High blood pressure—also called hypertension—is known as the silent killer because it rarely displays any symptoms until it has caused some larger health issue to appear. However, some children and adults experience headaches, difficulty sleeping, fatigue, visual changes,

dizziness, nosebleeds, heart palpitations and nausea.

WHAT ARE THE RISKS? Though symptoms are rare, there are known risk factors for high blood pressure in kids. These include being overweight, lack of exercise, type 2 diabetes, too much salt, and a poor diet in general that includes foods high in fat and sugar. High blood pressure in kids can also be caused by underlying diseases or issues such as premature birth, heart and kidney issues, some medications, genetic disorders and hormonal disorders. Children may inherit high blood pressure from their parents. If a parent has high blood pressure, she may want to consider this as a risk factor in her child.

WHAT’S NORMAL? Normal blood pressure in kids depends on their age, height and sex. As kids grow and physically mature, their blood pressure will naturally rise from a starting point around 70/90 (systolic/diastolic). Children whose blood pressure is higher than about 90 percent of other kids at or near the same age, height and sex are diagnosed as having high blood pressure. According to KidsHealth.org, about three percent of kids have high blood pressure. Even though a small proportion of children have high blood pressure, the American Heart Association recommends that all kids have their blood pressure checked regularly beginning at age three. Early detection can prevent serious health consequences later in life. Other than that, parents can help kids prevent this condition by encouraging regular exercise, monitoring for a healthy diet, and teaching emotional coping techniques to reduce stress and anxiety.

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4HEALTH

DO I NEED TO SEE A NEUROLOGIST? HOW THE BRAIN AND SPINAL CORD MAY BE DAMAGED

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by Colleen M. Story

According to a report from the United Nations, up to one billion people — nearly 1 in 6—suffer from neurological disorders such as Alzheimer’s disease, Parkinson’s disease, strokes, multiple sclerosis, and epilepsy. Up to 6.8 million people die from these diseases each year. What do all these conditions have in common, and is there anything you can do to prevent getting them?

tric lines. These fibers are wrapped in a protective material called “myelin.” When the embryo first starts to develop, it creates a neural tube that then goes on to develop into the brain and spinal cord. The spinal cord becomes the interface between the brain and the environment (sensation and movement), with nerves connecting the spine to the rest of the body gradually forming as the baby grows. Neurological disorders are diseases that affect some part of this system.

COMMON NEUROLOGICAL DISORDERS WHAT ARE NEUROLOGICAL DISORDERS? Neurological disorders are disorders of the brain, spine, and the nerves that connect them, called the central and peripheral nervous system. To understand it more clearly, it helps to have a basic idea of how these systems work. During pregnancy, the brain undergoes a complicated development process that involves the formation of millions of brain cells and trillions of connections between them. The brain itself is made up of two major structures: 1. Gray matter: consists of neurons or nerve cells and synapses. 2. White matter: consists of billions of axon fibers that connect various regions of the brain together, sort of like phone or elec4HEALTH | 877.807.0989

Though there are over 600 different neurological conditions, below are some of the most common: Epilepsy: This disorder is caused by abnormal electrical activity in the brain, which results in seizures. Alzheimer’s disease and dementia: These conditions damage the brain and affect a person’s ability to think. Parkinson’s disease: The brain normally produces dopamine, a neurotransmitter, to help communication between nerve cells. Those with Parkinson’s disease have brains that don’t produce enough dopamine, which affects movement and can cause tremors. Multiple sclerosis: This disease affects the nerve cells in the body and brain, damaging the protective myelin that surrounds them

and leading to nerve damage and movement difficulties. Brain tumors: These are abnormal growths that form in the brain. They may be cancerous or benign, but depending on their size and location, they can cause symptoms like headaches, seizures, sleep problems, and more. Stroke: A stroke occurs when the blood supply to the brain is diminished or blocked by a clogged artery or hemorrhage. Without a proper supply of blood, parts of the brain can die, leading to brain damage. Migraine: This type of headache causes pain on one side of the head that can last for hours to days, accompanied by sensitivity to light and sound. Scientists aren’t sure what causes them, but they believe they involve problems in the nerve pathways and brain chemicals. Muscular dystrophy: This is a disease present at birth caused by malfunctioning genes. It causes muscle weakness and muscle loss. Spina bifida: This is a defect in the neural tube that occurs before birth. The tube doesn’t develop as it should and doesn’t close completely, which can result in nerve and spinal cord damage. If you have any of these conditions — or any others that may be related to the brain and spinal cord — you may be referred to a neurologist for treatment.

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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: 2748 Ocean Ave, 3rd Fl. Brooklyn, NY 11229 161 Madison Ave, Ste 11W New York, NY 10016

(877) 582-0400 www.rrplastix.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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Sincerely, Dr. Roman Rayham, RR Plastix

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Podiatry | 4HEALTH35

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

4HEALTH

5 WAYS TO MAKE SURE YOUR FEET STAY HEALTHY HEALTHY FEET MEANS A HEALTHY BODY!

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by Gordon Barclay

I don’t know about you, but if my feet hurt, I’m miserable for most of the day. It can be even worse if you have a foot condition that doesn’t go away. Common foot conditions, without treatment, can discourage you from staying active, and over time, may cause you to avoid exercise and ultimately, make choices that aren’t good for your overall health. We all have to take care of our feet if we want to enjoy long and active lives. Below are some tips on how you can do that.

1. BUY QUALITY, SUPPORTIVE SHOES Each time I see someone go walking by in flip-flops or sky-high heels, I cringe. These shoes are horrible for your feet, and with time, can cause chronic pain and other conditions that make walking more difficult. High heels, for example, are connected with the formation of bunions — those bony deformities at the base of the big toe. Tight, narrow shoes also increase risk.

Flip-flops can cause even more problems. They offer no support, so wearing them regularly can lead to hip, knee, and back injuries, problems in the arch of the food, heel pain, bone problems, bone spurs, and more. For the majority of the time, wear shoes that provide good cushioning and stable arch support to keep your feet healthy and painfree. Make sure they have enough room in the toe area, too.

2. PRACTICE GOOD FOOT HYGIENE Foot fungus and other types of foot infections can be extremely unpleasant. To reduce your risk of developing one of these, make sure to wash and dry your feet thoroughly when you bathe, protect your feet in public pools and lockers, and cut toenails straight across to avoid ingrown nails. If you regularly use toenail polish, give your toes a few days to “breathe” in between paintings.

3. MOISTURIZE YOUR FEET As we get older, the skin gets thinner and drier on the feet as well as on the rest of the body. That’s a sign that the skin is not as

healthy or strong as it used to be, making it more vulnerable to wounds and infections. To keep the outer layer of skin strong and able to resist pathogens, moisturize your feet after every washing. If feet are extra dry, use a moisturizing butter at night and put on socks before bed.

4. STRETCH YOUR FEET We don’t remember to stretch our feet very often, but regular stretching can help you avoid muscle and tendon injuries that can take a long time to heal. Raise and point your toes, spread and contract the toes, and practice ankle circles to keep feet flexible.

5. REGULARLY INSPECT YOUR FEET Particularly as we get older, we can be oblivious to any minor injuries that develop on the feet. Regularly check your feet out to be sure everything is okay. Use a pumice stone to gently rub away calluses, and check between toes and on the ball of the foot and heel to be sure there are no wounds you need to tend to. It’s also a good idea to see your podiatrist at least once a year to deal with any issues that may come up. 4HEALTH | 877.807.0989

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WHY “TREAT MY VARICOSE VEINS” SHOULD BE ON YOUR NEW YEAR’S RESOLUTIONS LIST! Have you made your New Year’s resolutions for 2020? Not everyone sets new goals, but most of us do feel a sense of renewal when we swap out our old calendars for new ones. A new year brings an opportunity to start over, to clean the slate, so to speak, and begin again to create the lives we’d most like to live. Many of your resolutions, unfortunately, are unlikely to last. We all know how that exercise program we started so vigorously in January can be all but forgotten by March. But here’s one resolution that’s worth making, because it will create long-term changes in your health: deal with your varicose veins. Sure, they may seem to be a small problem right now. You might not like how they look, or how they make your legs feel tired faster than they used to, but you’re not overly concerned about them. Here’s why you should be: Left untreated, varicose veins can lead to swelling, bleeding, eczema, painful ulcers, and blood clots. Putting «treat varicose veins» on your list of resolutions can lead to bigger changes in the future. Imagine what you’ll feel like when your legs not only look better, but feel better. Suddenly that exercise program may be a lot more attractive!

RESOLUTION #1: REALIZE THAT VARICOSE VEINS MAY SIGNAL A SERIOUS MEDICAL CONDITION If your mother or father had varicose veins, you may think they’re no big deal. On the contrary, vein problems of any kind typically signal a serious medical condition. Tiredness, heaviness, swelling, aching, burning, itching, cramps, and non-healing wounds are all symptoms of vein disease — a condition in which the valves in the veins no longer work as they’re supposed to. Blood circulation to and from the legs suffers as a result, which is why symptoms occur in the first place. 4HEALTH | 877.807.0989

When blood circulation through the veins is compromised, it’s a medical condition called «venous insufficiency,» and treatment of it is covered by most insurance plans. That means that in most cases, treatment for your varicose veins is covered by your insurance. USA Vein Clinics has a dedicated insurance department that will verify your benefits and answer your insurance questions.

RESOLUTION #2: FIND A DOCTOR THAT SPECIALIZES IN VEIN TREATMENT This is the most important resolution when it comes to treating varicose veins. An experienced doctor who’s keeping up with the latest in technology and has access to newer treatment options — which are less invasive than the oldstyle treatments — is your best option. It used to be that «vein stripping» was the only treatment available for patients. This procedure involved actually removing the affected vein through small incisions, and required several weeks of recovery. Newer procedures are much less invasive, and typically allow you to return to your daily activities much more quickly. USA Vein Clinics offers a network of stateof-the-art facilities dedicated to the treatment of venous insufficiency. Our doctors specialize exclusively in problems with circulation, and use the most modern equipment and an individual approach to create the most comfortable solutions for our patients. Our clinic in New York City has been named the number one vein clinic numerous times.

RESOLUTION #3: LIVE A BETTER LIFE AS A RESULT OF TREATING YOUR VARICOSE VEINS Vein treatment isn’t just about improving your circulation. It’s about allowing you to live the

active, joyful life you were meant to live. You may not realize it, but «living with» the discomfort and pain has an affect on your overall well being, and may be hindering your ability to enjoy your daily activities. What might your life be like if you could wear dresses, skirts, and shorts without feeling selfconscious about your legs? How would it feel if you could come home at the end of the day without suffering from leg aches and fatigue? What if you could enjoy a walk with loved ones without suffering from cramps and pain? 2020 could be your best year yet if you give yourself the gift of varicose veins treatment. Solutions are a lot more manageable than you may think, and are now available in an outpatient setting at USA Vein Clinics. They have offices all over the nation, including several in the New York area. Call today at 718–509–0906 or go to www. USAVeinClinics.com to schedule a consultation.

718-509-0906 www.USAVeinClinics.com

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SHOULD YOU BE SCREENED FOR LUNG CANCER? MOST INSURANCES WILL NOW COVER THE TEST nnn by Colleen M. Story According to the American Lung Association, lung cancer is the leading cancer killer of both men and women in the United States. It also has one of the lowest five-year survival

rates of all cancer types, killing an estimated 154,040 Americans in 2018. A few years ago, Medicare agreed to cover lung cancer screenings in some cases. That brings up the question — should you or your loved one take advantage of this?

SCREENING CAN CATCH CANCER EARLY Unfortunately with most types of cancer, there are no noticeable symptoms until the disease has developed to a significant degree. With lung cancer, in particular, symptoms don’t appear until the cancer advances to the 4HEALTH | 877.807.0989

4HEALTH point where treatment is much more difficult, and survival rates much worse. That’s why scientists have been working on early screening methods that can detect cancer in its earliest stages. It’s why women get mammograms and Pap screens, and why individuals over 50 are encouraged to get a colonoscopy. Up until fairly recently, however, we had no such screening for lung cancer. Now we do, but it works well only under certain circumstances.

PROS AND CONS OF LUNG CANCER SCREENING Doctors use low-dose computerized tomography (LDCT) scans of the lungs — also called a low-dose CT scan — to look for signs of lung cancer. During the test, an X-ray machine scans the body, using low doses of radiation to create images of the lungs. Healthcare professionals then examine those images, looking for any signs of cancer. It might seem that such a screening test would be good for everyone, but so far, that’s not the case. The U. S. Preventive Services Task Force recommends yearly lung cancer screening only for people who: n have a history of heavy smoking (an average of one pack of ciga-

rettes a day for one year, for a total of 30 years or more, or two packs a day for 15 years or more), and n smoke now or have quit within the past 15 years, and n are between 55 and 80 years old. Why so many restrictions? Because though screening sounds great, sometimes it can make mistakes, leading to false results that put peo-

ple through a lot of unnecessary stress and potentially harmful treatments. A screening may suggest that a person has cancer when she doesn’t, for example, which could lead to tests and unnecessary surgeries that could present more risks to her health. Or, a screening might find cases of cancer that may never have caused any problems, again leading to unnecessary treatments. Small spots on the lungs, for example, may indicate cancer, but they may also indicate infection scars or noncancerous growths. On top of that, though radiation at low levels is considered safe, radiation from repeated tests can actually increase the risk of cancer.

HOW TO AVOID LUNG CANCER If you are at a high risk for lung cancer, talk to your doctor about your options. The good news is that health insurance companies and Medicare typically cover lung cancer screening for those who meet the U. S. Preventive Services Task Force guidelines (as outlined above). Then consider the following tips to help increase your odds of avoiding this disease: Stop smoking: It’s never too late! Stopping always helps improve lung health. Avoid second-hand smoke: It has also been linked to lung cancer. Check for radon: Radon gas comes from rocks and dirt and can become trapped in houses and buildings. Check your home for radon with a simple test purchased from the home store. Eat a healthy diet: Natural nutrients from fruits and vegetables may have a protective effect against cancer.

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BACK PAIN AND INCONTINENCE: A NOT-SO-UNLIKELY PAIRING WHAT TO DO WHEN YOU HAVE BOTH SYMPTOMS nnn by Lynn Merrell The American Chiropractic Association (ACA) states that back pain is one of the most common reasons for missed work, with one-half of all working Americans admitting to having back pain symptoms each year. Experts estimate that up to 80 percent of the population will experience back pain at some point in their lives. Incontinence is not quite as pervasive as back pain, but it’s still common. It’s estimated to affect 25 million Americans and is twice as common in women as in men, often because of pregnancy, childbirth, and

menopause. For women over the age of 60, about 23 percent deal with incontinence — nearly a quarter. Sometimes, these two disorders can occur together, and then the question becomes: Are they related? Are they both part of the same problem, or symptoms of different problems?

BACK PAIN AND URINARY INCONTINENCE CAN OCCUR TOGETHER Scientists have noticed a connection between these two symptoms for decades, but they still don’t have all the answers as to why they may 4HEALTH | 877.807.0989

4HEALTH occur together. In a 1976 study, for example, researchers reviewed data from 5,000 patients with back pain and found a small subset (16) also suffered from incontinence. After 12 of those 16 had spine surgery, 11 experienced a complete cure of their incontinence as well. In a more recent 2013 study, researchers looked at medical data from over 2,300 women and found that reports of stress urinary incontinence (leakage that occurs with coughing, lifting, or laughing) were higher among women who also reported chronic back pain than among those not reporting back pain. The researchers concluded that women who struggle with chronic back pain also seem to have a higher risk of stress urinary incontinence.

IT MAY BE PELVIC FLOOR DYSFUNCTION Scientists believe that these two conditions may be related to a condition called “pelvic floor dysfunction.” This term describes a group of disorders that are caused by problems in the muscles, ligaments, and connective tissue in the lowest part of the pelvis. These muscles and tissues together form a hammock shape that supports organs like the bowel, bladder, uterus, vagina, and rectum, holding and preventing them from falling down or out of the body. Age, overweight, childbirth, menopause, and more can affect how these muscles work, weakening, tearing, and stretching them so they are less able to do their job. Then they can cause problems like constipation, pelvic organ prolapse (where one or more of the organs drops down and may protrude from the vagina), pelvic pain, and yes, urinary incontinence and sometimes back pain. Other conditions can cause both of these symptoms at the same time. A rare condition called cauda equina syndrome (CES) develops

4HEALTH | 877.807.0989

because the cauda equina, which is a bundle of nerves in the lower back, are compressed, causing pain and urinary dysfunction. Usually, the compression is caused by a herniated disc in the spine, but an abscess, spinal tumor, or epidural hematoma (buildup of blood in the epidural space of the spine, usually after childbirth) may also cause the condition. Other possible causes include kidney stones, a spinal cord injury, and a burst artery wall in the abdomen. These are all serious conditions, so if you experience sudden back pain and incontinence together, check with your doctor right away. If your symptoms tend to come on more gradually, however, pelvic floor dysfunction may be to blame. Talk to your gynecologist or urologist for help, and meanwhile try these tips: n Avoid alcohol, carbonated beverages, and caffeine, as they can ir-

ritate the bladder. n Address the back pain with over-the-counter pain relievers, ice

and heat packs, and gentle stretches such as yoga poses. n Ask your doctor about potential physical therapy exercises that

may help strengthen the pelvic floor muscles. SOURCES ACA. (n. d.). Back Pain Facts and Statistics. Retrieved from https://www.acatoday.org/Patients/Health-WellnessInformation/Back-Pain-Facts-and-statistics Bush, H. M., Pagorek, S., Kuperstein, J., Guo, J., Ballert, K. N., & Crofford, L. J. (2013). The Association of Chronic Back Pain and Stress Urinary Incontinence. Journal of Womens Health Physical Therapy, 37(1), 11–18. doi:10.1097/jwh.0b013e31828c1ab3 Eisenstein, S. M., Engelbrecht, D. J., & El Masry, W. S. (1994). Low Back Pain and Urinary Incontinence. Spine, 19(Supplement), 1148–1152. doi:10.1097/00007632–199405001–00010 Pheonix Physical Therapy. (n. d.). Urinary Incontinence in Women Statistics. Retrieved from https://phoenixpt. com/statistics/

CLASSIFIEDS

To Place an AD in the Classifieds Section, Please Call (212) 738-9230

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

Professional Medical Biller with Excellent Experience at the Hospital and Physicians office will work remote. Option to provide/connect your EMR to a Billing System. Fluent in English and Russian. Please email lalter25@gmail.com or call/text 201.294.3065

Dental office is looking for a dentist (PT or FT) with option to buy the practice (25 years)

Tel (646) 250-1643

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

Medical Office is looking for an Internal Medicine Doctor, a Family Doctor, and a Nurse Practitioner (PT or FT). Please e-mail resume at Volan8913@gmail.com

Large room for rent in Medical office. 1st floor, corner of Ocean Ave and Kings Highway. Close to all public transportation. For information please call or text

(718) 541-4388

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.

or e-mail akmedtrust@gmail.com

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DENTISTRY - GENERAL

Vladimir LEMPERT, DMD

3037 Ave U Brooklyn, NY 11229

(888) 607-9725

DENTISTRY - PEDIATRIC

Marina KREPKH, DDS

7708 4th Ave Brooklyn, NY 11209

(888) 502-6245

INTERNAL MEDICINE

Victoria ALEKSANDROVICH, MD

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

(718) 207-7071

DERMATOLOGY

NEUROSURGERY

Narayan SANDARESAN, MD

5 E 84th St New York, NY 10028

(212) 328-0135

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

(844) 957-7463

OBESITY MEDICINE

Prabhakara R. TUMPATI, MD

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

(888) 283-0399

ONCOLOGY

Anella BAYSHTOK, MD

2101 Ave X Brooklyn, NY 11235

(718) 512-2160

158-06 Northern Blvd Flushing, NY 11358

(718) 445-3700 www.brooklynroc.com

OB/GYN - GENERAL

Yekaterina LEVIN, DDS

7000 Bay Pkwy, Ste C Brooklyn, NY 11204

(718) 837-1797

Faina SHNAYDMAN, MD Leonard LEVITZ, MD

248 Ave P, Brooklyn, NY 11204

(718) 376-8300

1749 E 16th St Brooklyn, NY 11229

Tariq LAMKI, MD

5 E 84th St New York, NY 10028

(718) 375-4747

321 Edison St Staten Island, NY 10306

(212) 328-0135

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

GASTROENTEROLOGY

(844) 957-7463

Nataliya SAFONOVA, DDS

1749 E 16th St Brooklyn, NY 11229

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

(718) 336-1909

2101 Ave X Brooklyn, NY 11235

(718) 512-2160 OPTOMETRY

629 Park Ave New York, NY 10065

(212) 744-0392

(718) 375-4747

321 Edison St Staten Island, NY 10306

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

Irina BERLIN, MD

Margarita BAUMAN, OD

NEUROLOGY

40 West Brighton Ave, Ste 104 Brooklyn, NY 11224

(718) 759-6979

5 E 84th St New York, NY 10028

(212) 328-0135

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

Salamon RAFAILOV, DDS

(844) 957-7463

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

1910 Ave U Brooklyn, NY 11229

Erico CARDOSO, MD

(718) 627-8300

(718) 736-0123

Hayama BRILL, MD

OB/GYN - FERTILITY SPECIALIST

Lilia LEVITZ, MD

2211 Ocean Ave Brooklyn, NY 11229

Paul GLIEDMAN, MD

Hanna JESIONOWSKA, MD

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

(888) 455-6619

Dmitriy GRINSHPUN, MD

Alexander BRODSKY, MD

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

Aleksandra ZLOTNIK, OD

(888) 747-8009

1910 Ave U Brooklyn, NY 11229

8622 Bay Pkwy, Ste 1 Brooklyn, NY 11214

(718) 759-6979

(718) 333-2121

PAIN MANAGEMENT

Amit SCHWARTZ, MD

948 48th St, Fl 2 Brooklyn, NY 11219

(718) 283-7219

Radmila SHUMINOV, DDS

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

(718) 736-0123

Sergey ZHIVOTENKO, MD Sam WEISSMAN, MD

202 Foster Ave Brooklyn, NY 11230

(718) 854-5100

2797 Ocean Pkwy, Fl 2 Brooklyn, NY 11235

(646) 377-6050

20-04 Seagirt Blvd Far Rockaway, NY 11691

(718) 868-8668

Mila MOGILEVSKY, DO

626 Sheepshead Bay Rd, 5th Fl Ste 520, Brooklyn, NY 11224 369 Lexington Ave, STE 800 New York, NY 10017

(929) 363-0303

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4HEALTH PODIATRY

Mohammad AALAI, MD

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

(929) 363-0303

Leon STEPENSKY, DPM

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

(718) 874-0224

UROLOGY

VASCULAR SURGERY

NUTRITION AND DIETETICS

Yuly CHALIK, MD

USA VEIN CLINICS

1153 First Ave New York, NY 10065

1942 E 8th St Brooklyn, NY 11223

(347) 508-3991

2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

www.nylifex.com

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

2444 86Th St, Ste A Brooklyn, NY 11214

Albert GROSS, CNS, NYS, CDN

MEDICAL SUPPLY

Essential Supply LLC (732) 881-6575 www.essentialdmbs.com

(718) 376-8317 MULTI SPECIALTY

116-02 Queens Blvd Forest Hills, NY 11375 1975 Hylan Blvd Staten Island, NY 10306

Armando IANNICELO.MD

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

(929) 363-0303

USA VASCULAR CENTERS

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

Alina VASILYEVA, DPM

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

(347) 481-5553

Vitaly RAYKHMAN, MD

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

(347) 508-3991 www.nyui.org

PSYCHOLOGY

2444 86th St, Ste A Brooklyn, NY 11214

4159 Broadway Washington Heights, NY 10033 59-20 Myrtle Ave Queens, NY 11385

Multi SPECIALTY CLINIC

30-33 Steinway St Astoria, NY 11103

(877) 807-0989

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

3023-3027 Ave V Brooklyn, NY 11229

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

(718) 393-5331

MEDICAL TRANSPORTATION

AESTHETIC CENTERS

5221 Broadway New York, NY 10463 2965 Ocean Pkwy, 3rd fl, Brooklyn, NY 11235 156 Route 59, Ste B1, Suffern, NY 10901

Michael RISKEVICH, MD

(718) 509-0906

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

(718) 934-8484

PHYSICAL THERAPY

Ridwan SHABSIGH, MD Chloe CARMICHAEL

230 Park Ave, Fl 10 New York, NY 10196

(212) 729-3922

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

ALTERNATIVE MEDICINE - GENERAL

Michael PATIN, MD

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

(347) 848-0049

7819 Bay Pkwy Brooklyn, NY 11214

(718) 234-6767

(718) 283-7746

102-30 Queens Blvd Forest Hills, NY 11375

(718) 896-2333

PSYCHIATRY

Vladislav RUDNER, PT

Ada KULAGINA, LAC

1901 82nd St Brooklyn, NY 11214

(718) 490-2416 www.magichandspt.com

PLASTIC SURGERY

RANNETA TRANSPORTATION

www.usaveinclinics.com

Interborough DEVELOPMENTAL & CONSULTATION CENTER 1623 Kings Hwy, Fl 4 Brooklyn, NY 11229

(888) 987-5751

David SHUSTERMAN, MD

800 2 Ave, Fl 9 New York, NY 10017 69-15 Yellowstone Blvd Forest Hills, NY 11375 1013 Ave J Brooklyn, NY 11230 nd

8635 21st Ave Brooklyn, NY 11214

(888) 600-2262

VK Skin Spa

162 Brighton, 11th St. Brooklyn, NY 1235

(646) 200-5856

(718) 360-9550 nyurology.com

Roman RAYHAM, MD, BOARD CERTIFIED IN PLASTIC SURGERY

2748 Ocean Ave., 3rd Fl, Brooklyn, NY 11229161 Madison Ave, Ste 11W New York, NY 10016

LSA RECOVERY

www.nyplasticsurgerycenter.com

(888) 983-4055

(877) 582-0400

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1300 Ave P Brooklyn, NY 11229

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

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