4Health # 230, February Issue

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ASK A DOCTOR | FIND A DOCTOR

THE SECRET

TO BEATING OBESITY GENES

VACCINES

YOU MAY NEED AS AN ADULT

HOW TO PREVENT A LIFE-ALTERING STROKE

7 CAUSES OF HEARING LOSS

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Editorial Department: Editors Colleen M. Story Nataly Smolyanska Contributing Writers Colleen M. Story Lynn Merrell Gordon Barclay Morgan Rice

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PA I N M E D

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Is Your Child Taking Too Many Antihistamines?

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How to Watch Out for Possible Overdose

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The Secret to Beating Obesity Genes New Research Shows Genes are Not Your Destiny

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9 28 7 Causes of Hearing Loss

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Learn How to Protect Your Ears

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12 How to Prevent a Life-Altering Stroke Stroke Kills Hundreds of Thousands of Americans Each Year

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WHY ARE MY GUMS RECEDING? How to Address Sensitivity and Prevent Tooth Loss

SEX AFTER PREGNANCY: WHEN IS IT SAFE? How Moms Can Deal with Stress, Pain, and Postpartum Depression

IF MY MOM HAD UTERINE FIBROIDS, WILL I GET THEM TOO? When Your Genes May Have a Say

HORMONE THERAPY FOR MENOPAUSE—IS IT SAFE? New Studies Offer Hope for Women Suffering from Symptoms

WHAT’S CAUSING YOUR BELLY FAT?

By Dr. Prab R. Tumpati

HOW SLEEP MAY AFFECT YOUR RISK FOR GLAUCOMA Study Suggests Too Little or Too Much Can Affect Your Eyes

MY CONTACT LENSES ITCH AND HURT Causes and Solutions for Contact Lens Discomfort

WHAT TO DO WHEN YOUR BRAIN DEMANDS A CANDY BAR Healthy Sources of Brain-Feeding Glucose

FOR EXCESS FLAB: LIPOSUCTION OR TUMMY TUCK? Which Procedure Works Best for Slimming Your Stomach

ERASE SUN DAMAGE AND SHAVE YEARS OFF YOUR APPEARANCE Dr. Roman Rayham on a New Treatment Provides Dramatic Results with Little Downtime

WHEN ARTHRITIS AFFECTS A CHILD Juvenile Arthritis Can be Treated

5 REASONS WHY YOUR FEET MAY LOOK YELLOW Most Causes Are Not Serious but Watch Your Symptoms

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HOW CAN I RELIEVE THIS PAIN IN MY HEELS?

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PAINFUL LEGS AFTER EXERCISE? IT COULD BE PAD

Vaccines You May Need as an Adult

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DOES YOUR HEARTBURN DRUG INCREASE RISK OF KIDNEY DISEASE?

The Easiest Way to Protect Your Health

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Podiatrist Dr. Stepensky Has Answers

Check with Your Doctor to Avoid Serious Complications

Use Nexium, Prilosec, and Others with Caution

FEELING ANXIOUS? YOU HAVE OPTIONS Many Treatments Available to Help Promote Calm

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IS YOUR CHILD TAKING TOO MANY ANTIHISTAMINES? HOW TO WATCH OUT FOR POSSIBLE OVERDOSE

■■■ by Lynn Merrell The Centers for Disease Control and Prevention (CDC) reports that over the past year, 5.6 million children suffered from hay fever, while 8 million reported respiratory allergies.

Between 1997–2011, the prevalence of food and skin allergies among children increased significantly, with food allergies affecting about 1 in 13 children.

Allergies among children are on the rise, which means that prescriptions for allergy medications, like antihistamines, have also increased. The question now is: Are too many children taking these drugs?

WHAT ARE ANTIHISTAMINES? Antihistamines are used to relieve the symptoms of allergies, including hay fever, hives, runny nose, itchy eyes, and reactions to insect bites and stings. They work by reducing or blocking the “histamines” the body produces when it comes into contact with an allergen.

If you are allergic to pollen, for example, when you inhale pollen, your body’s immune system sees it as a dangerous invader and goes to work to eradicate it. Part of that process includes releasing histamines into the bloodstream. The histamines then cause the blood vessels to become more permeable so that immune cells can target and attack the foreign invaders.

Unfortunately, histamines also cause most uncomfortable allergy symptoms, like sneezing, watery eyes, and difficulty breathing. Antihistamines block the release of histamines into the bloodstream, reducing or preventing their release and therefore reducing or preventing allergy symptoms.

In general, there are two types of antihistamines: ■ First-generation: These are older antihistamines that are also called “sedating” antihistamines because they tend to cause drowsiness and fatigue. For this reason, they are sometimes used in sleeping pills or nighttime cold medicines. Examples include Benadryl, Dimetapp, and Antivert.

■ Second- or third-generation: These are newer antihistamines that usually don’t cause drowsiness, and thus can be used more frequently. Examples include Zyrtec, Claritin, and Allegra.

IS IT POSSIBLE TO OVERDOSE ON ANTIHISTAMINES? Antihistamines can be very helpful for children with allergic diseases and are considered safe when used as directed. It is important to make sure that kids aren’t taking them when they aren’t necessary, though, because it is possible to take too much.

Symptoms of an antihistamine overdose can include blurred vision, increased drowsiness, nausea and vomiting, increased heart

rate, confusion, and loss of balance. In general, taking too much of the first-generation sedating antihistamines is more dangerous than taking too much of the second- or thirdgeneration medicines, but it’s best to avoid an overdose in either case.

Sometimes parents may not know exactly where the antihistamines are coming from.

If you’re giving your child cold or cough medication, for example, check the label to see if it includes antihistamines, as many of these products do. If your child is already taking antihistamines for allergies and takes the cold and cough medicine as well, he or she could be getting too high a dose of antihistamines.

Doctors may also prescribe antihistamines to children with colds when it’s not necessary.

According to a recent study, physicians are likely to recommend antihistamines for children under the age of 12 with colds, even though the drugs provide little known benefit. The American Academy of Pediatrics has recommended that parents refrain from using cough and cold medicines in children under the age of six.

The best advice is to always check the labels, and then check with your doctor to make sure the doses aren’t getting too high. Antihistamines are safe in most cases, but they should always be used carefully.

SOURCE Preidt, R. (2019, July 30). Are Too Many Kids Prescribed Antihistamines? Retrieved from https://www.webmd.com/allergies/ news/20190730/are-too-many-kids-prescribed-antihistamines

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THE SECRET TO BEATING OBESITY GENES NEW RESEARCH SHOWS GENES ARE NOT YOUR DESTINY

■■■ by Colleen M. Story Perhaps one of the most discouraging things that overweight or obese people can hear is the phrase, “it’s in your genes.” Harvard Health notes that to date, “more than 400 different genes have been implicated in the causes of overweight or obesity, although only a handful appear to be major players.”

Genes can contribute to weight gain in several different ways. Some affect appetite, others affect whether you feel full, some drive food cravings, others are in charge of body-fat distribution, and still others can increase the tendency to use eating as a way to cope with stress.

The idea that your genes may be driving your struggle with weight can leave you feeling powerless, but a new study suggests you can do something about it. Researchers recently found that certain types of exercise may be able to offset the genetic effect on obesity.

GENES AREN’T EVERYTHING WHEN IT COMES TO WEIGHT GAIN First, let’s remember that it’s not only your genes that cause you to be overweight. It’s usually a combination of genetic and lifestyle factors.

Genes are not your destiny, and studies have found that the genetic factors identified that do contribute to obesity risk only make a small contribution. Many people who carry these so-called “obesity genes,” for instance, 4HEALTH | 877.807.0989

do not become overweight. That’s because a healthy lifestyle can counteract these genes, whereas unhealthy choices can exacerbate their effects.

Scientists also point out that we’re facing an obesity epidemic in this country that is only a few decades old. Because the human gene pool has remained fairly stable for many generations, genes alone cannot explain this epidemic. What has changed over the last several decades is our lifestyle. We now tend to eat more and move less, and our environment has made it increasingly difficult to resist gaining weight.

Earlier studies suggested that physical activity could offset the effects of obesity-promoting genes, and now more recent research has added to that evidence, showing us that the solution may reside in finding more ways to include activity into our daily lives.

CERTAIN EXERCISES CAN OFFSET OBESITY GENES For this study, scientists examined data from 18,424 participants who were between 30 and 70 years of age. They looked at five measurements of obesity: 1. Body Mass Index (BMI) 2. Body fat percentage 3. Waist circumference 4. Hip circumference 5. Waist-to-hip ratio They also figured up genetic risk scores for each of the five obesity measurements and

gathered data from the participants concerning what types of exercise they regularly did.

They then compared each person’s genetic risk and their exercise routines, and found the following results: 1. Jogging was the best exercise for reducing obesity. It offset the genes that contributed to BMI, body fat percentage, and hip circumference. The researchers reported that across all five obesity measures, regular jogging was the most effective against obesity genes.

2. Other exercises that were effective against obesity genes included mountain climbing, walking, exercise walking, international standard dancing, and a longer practice of yoga.

All of these were effective against the genes linked with a higher BMI. 3. Exercises like cycling, stretching, swimming, dance dance revolution, and qigong had no effect on obesity genes. (They do help burn calories and promote a healthy cardiovascular system.)

In conclusion, the scientists wrote that the genetic effects on obesity can be decreased by performing different types of exercise. This is good news for everyone who has overweight and obesity in their families — exercise can help you live a healthier life.

SOURCES Harvard Health Publishing. (2019, September 24). Why people become overweight. Retrieved from https://www.health.harvard.edu/ staying-healthy/why-people-become-overweight Lin, W., Chan, C., Liu, Y., Yang, A. C., Tsai, S., & Kuo, P. (2019).

Performing different kinds of physical exercise differentially attenuates the genetic effects on obesity measures: Evidence from 18,424 Taiwan Biobank participants. PLOS Genetics, 15(8), e1008277. doi:10.1371/ journal.pgen.1008277

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7 CAUSES OF HEARING LOSS LEARN HOW TO PROTECT YOUR EARS

■■■ by Morgan Rice According to the National Institutes of Health, about 15 percent of American adults (37.5 million) aged 18 and over report some trouble hearing. Men are almost twice as likely as women to have hearing loss between the ages of 20 and 69.

Hearing loss isn’t a trivial occurrence. It can affect every dimension of the human experience, including physical health, emotional and mental health, social skills, family relationships, and work and school performance.

Below we review the many different conditions that can affect your hearing and give you some tips for how you can avoid ear damage.

7 FACTORS THAT CAN AFFECT HEARING Hearing loss is usually the result of damage to the inner ear. This damage affects the

transmission of sound from the outer to the inner ear.

1. AGE This is the most common type of hearing loss. It’s gradual and gets worse over time, and is caused by changes that occur in the inner ear as a person ages. It can also come about because of changes in the nerve pathways leading to the brain. Symptoms include difficulty hearing higher-pitched sounds like children’s voices and birds chirping, and being able to hear but not completely understand the words that are spoken.

2. NOISE TRAUMA Also called “noise-induced” hearing loss, this is caused by prolonged exposure to loud noise like traffic, construction work, loud music, and weapons fire. Veterans often fall victim to this type of hearing loss.

3. ILLNESS-RELATED HEARING LOSS Several other health disorders can cause hearing loss. These include Meniere’s disease, middle-ear infections, sleep apnea, iron deficiency, autoimmune diseases (like rheumatoid arthritis), and mumps. Other diseases like heart disease, stroke, high blood pressure, and diabetes can also affect blood flow to the inner ear or the brain, resulting in hearing loss.

4. VIAGRA Research shows that men taking Viagra and other similar medications are twice as likely to have hearing loss and may experience sudden hearing loss in one or both ears.

5. HEAD TRAUMA Injuries to the head can affect hearing, depending on the location and the severity. Sudden changes in pressure, such as that which 4HEALTH | 877.807.0989

4HEALTH may occur when flying or scuba diving, can damage the eardrum, middle ear, or inner ear.

Tumors located near or inside the ears — including both benign and cancerous tumors — can also affect hearing and may cause tinnitus (ringing in the ears).

6. MEDICATIONS Some medications list hearing loss as a side effect. Check with your doctor. Certain antibiotics and cancer drugs create the highest risk, though regular use of non-steroidal anti-inflammatory drugs like aspirin and ibuprofen can also increase the risk of hearing loss.

7. EAR WAX BUILDUP Earwax normally protects the ear canal against dirt, bacteria, and other potential invaders. It exists in the outer third of the ear canal, and also helps moisturize the skin and

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remove debris. If the wax builds up and hardens, however, it can create a blockage that affects hearing.

HOW TO AVOID EAR DAMAGE To avoid ear damage, follow these tips: ■ Never stick anything, like a cotton swab, into your ear. Even if you use them carefully, they can push wax and debris further into the ear canal. In rare cases, the swab can damage the inner ear. Clean the outside of the ear with a cloth or towel after a shower instead.

■ If you have excess wax causing hearing loss inside your ear, check with your ear doctor. There are some over-the-counter solutions like Debrox that can help remove the excess wax.

■ Avoid using ear candling, a method of inserting a wax-covered cone into the ear

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and lighting the other end of it. Studies show it does not remove wax from the ears, and creates a danger of burning the eardrum.

■ Use earplugs when exposed to loud noises — always protect your ears. And when using headphones, turn the volume down.

■ When exposed to loud noises for a long period of time, like at a concert or bar, use earphones if possible, and step away frequently to allow your ears time to rest.

In general, your ears need about 16 hours of quiet to recover from one loud night out.

■ If you notice any symptoms of hearing loss, or if your friends or family members point out symptoms, check with your ear doctor for help.

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WHY ARE MY GUMS RECEDING? HOW TO ADDRESS SENSITIVITY AND PREVENT TOOTH LOSS

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Morgan Rice

Abby had been suffering from tooth sensitivity for years, but sensitive toothpaste seemed to take care of the problem most of the time. But then she started experiencing pain in one area of her mouth, above two of her teeth, and it was getting worse. She decided to check with her dentist.

Abby was diagnosed with receding gums, or “gingival recession,” as it’s termed medically. Fortunately, her dentist had many treatment options for her, and told her it was a good thing she came in. Without treatment, receding gums can lead to infection, tooth decay, and even tooth loss.

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WHAT ARE RECEDING GUMS? The gum usually comes down and over the root of the tooth, protecting it from exposure to food and bacteria. Over time, however, that gum can start to pull back and up, exposing the root. It actually “recedes” from its former position, drawing back like a low tide.

There are a number of causes for receding gums. These include the following: ■ Aggressive brushing and flossing. If you tend to brush “too hard,” you may actu-

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ally traumatize the gums, causing them to recede. This can also happen if your brush is too hard.

Grinding the teeth: Some people grind their teeth and don’t even know it. Unfortunately, teeth grinding can lead to receding gums.

Tooth misalignment: If your teeth don’t line up right with each other, gums may recede over time.

Gum tissue trauma: If your gums suffered trauma for some reason — an infection or injury — the gums may recede.

Genetics: Some people are genetically more predisposed to gum recession. If your parents suffered from it, your risk is higher.

Inflammation: If the gums are inflamed for some reason — lack of oral care, or other health issues that promote inflammation — the gums may recede.

Hormonal changes: Hormonal changes, such as those that occur during puberty, pregnancy, and menopause, can lead to gum recession.

Smoking: Smokers are more likely to suffer from receding gums.

Poor oral health: If you don’t take good care of your teeth and mouth, bacteria

and plaque can build up on the teeth, and the gums may recede as a result.

The good news is that receding gums are common, so if you have them, there are several treatments available.

HOW DO I FIX MY RECEDING GUMS? Most dentists recommend you start with good at-home care, as long as your condition is mild. This includes brushing more gently, finding a brush with a softer head, and making sure you’re brushing and flossing every day. Avoid acidic foods and drinks that wear away enamel (like soda, wine, and citrus juices) or drink them through a straw and rinse with water afterwards.

Beyond home care, a good dental cleaning can help, and antibiotics may be prescribed to help reduce inflammation and kill off any harmful bacteria. If you grind your teeth at night, a night guard may help. Your dentist may also have advanced cleaning measures that can control the condition. Desensitizing agents, varnishes, and bonding agents can help reduce any related sensitivity. Only in more severe cases is surgery recommended, where the dentist grafts a piece of healthy tissue, such as from the roof of your mouth, to the receding area.

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HOW TO PREVENT A LIFE ALTERING STROKE STROKE KILLS HUNDREDS OF THOUSANDS OF AMERICANS EACH YEAR ■■■ by Morgan Rice Every year, stroke kills about 140,000 Americans — that’s one out of every 20 deaths. Every year, 795,000 people suffer from a stroke but

don’t die from it. In these individuals, stroke is a major cause of longterm disability.

Like heart disease, stroke is a disease that can be prevented with the right lifestyle. If it does occur, however, your ability to recognize the 4HEALTH | 877.807.0989

4HEALTH symptoms and act quickly could mean the difference between living or dying and could help you avoid significant, long-term disabilities.

WHAT IS A STROKE? A stroke occurs when blood flow in the brain is disrupted. Because the brain controls most of the rest of the body’s functions, any damage that occurs in the brain because of disrupted blood flow can cause lifelong disabilities.

The two main types of stroke are: 1. Ischemic stroke: This occurs when the arteries carrying blood from the heart to the brain become narrowed or blocked, causing reduced blood flow. About 80 percent of strokes are ischemic strokes.

2. Hemorrhagic stroke: This occurs when a blood vessel in the brain leaks or ruptures. The blood then hemorrhages, increasing pressure on the brain.

Either of these types of strokes can be fatal, as they can cause brain damage and other injuries that leave the body unable to function correctly.

HOW TO SPOT THE SYMPTOMS OF A STROKE Being able to identify the symptoms of a stroke can mean the difference between life or death. An easy way to remember the main symptoms is to think of the acronym “BE FAST.” Each letter stands for: Balance: The person struggles to maintain balance. She may find it difficult to walk or experience a loss of coordination.

Eyes: The vision blurs, or the person experiences double vision. A loss of vision in one or both eyes is another potential symptom.

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Face: If one side of the face feels numb or droops lower than the other, a stroke could be occurring.

Arms: Weakness, numbness, and tingling in one arm or leg is a potential sign of a stroke.

Speech: People suffering from a stroke may have slurred speech, or may suddenly find it difficult to get their words out.

Time: If you notice any of these symptoms, call for emergency help immediately. Time is of the essence when it comes to treating stroke.

The faster you can get treatment, the more likely you are to avoid longterm disability.

The good news is that speedy treatment of stroke can help protect the brain from damage and improve your recovery.

CAN I PREVENT A STROKE? Studies have shown that many of the choices we make on a daily basis can help keep our blood vessels healthy and help us avoid suffering from a stroke. Some of the most effective activities include: ■ Exercise every day for at least 30 minutes.

■ If you smoke, stop.

■ Eat a healthy diet filled with fruits, vegetables, and lean proteins, and low in high-sugar and high-fat treats.

■ Practice a stress-relieving activity daily. Good options include a daily walk, yoga routine, time with a pet, deep breathing, meditation, tai chi, and reading.

■ Get a yearly physical during which you check your numbers: blood pressure, blood cholesterol, and blood sugar levels. If any of these are high, talk to your doctor about treatments to help you bring your levels back to normal.

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VACCINES YOU MAY NEED AS AN ADULT THE EASIEST WAY TO PROTECT YOUR HEALTH

THE VACCINES YOU NEED TO PROTECT YOUR HEALTH

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by Gordon Barclay

The increase in measles cases in 2019 reminded us all of the importance of vaccines. According to the Centers for Disease Control and Prevention (CDC), from January 1 to September 5, 2019, there were over 1,200 cases of measles confirmed across 31 states. This is the greatest number reported in the U.S. since 1992. The majority of those who developed the disease had not been vaccinated against it.

Diseases that used to be common can now be prevented with vaccinations, yet many people have been scared away from them because of false information about their potential risks. It’s important that we all understand the misconceptions concerning vaccines, and realize that most have an important role to play in protecting us from devastating illnesses.

MYTHS ABOUT VACCINES Despite some information spread on the internet, vaccines do not cause autism. The one paper that suggested a link between the two involved less than 10 subjects and has since been completely discredited as containing many flaws. Subsequent studies including thousands of subjects have failed to find any link between vaccines and autism.

Neither do vaccines contain levels of toxins that will harm you or your child or present dangers to your immune system. They are overwhelmingly safe and help protect the entire population from illnesses that have caused devastating losses in the past.

If you’re not sure what vaccines you may need as an adult, here’s an overview: Pneumonia: If you’re 65 or older, you should have the pneumococcal vaccine to protect yourself from pneumonia, which becomes more likely as we age. The vaccine comes in two parts: a dose of PVC13 (Prevnar 13), followed a year later by a dose of PSV23 (Pneumovax 23). Do check with your doctor about conditions that may qualify you to receive the vaccinations at an earlier age. They include some types of cancer, HIV, diabetes, alcoholism, COPD, chronic liver disease and chronic kidney disease.

Shingles: The FDA approved a new shingles vaccine in 2017 called “Shingrix.” It was found to work better than Zostavax, which was the only shingles vaccine available up to that point. Shingles are a painful rash that can affect anyone who had chickenpox in the past. It can also create complications like nerve pain and vision loss. Shingrix is given in two doses to adults 50 and over.

Chickenpox: If you’ve never had chickenpox or received the chickenpox vaccine, ask your doctor about vaccination. Though the disease usually affects children, it can also affect adults and the elderly. The vaccine is given in two shots at least 28 days apart.

Tetanus: Tetanus (also called lockjaw) is a serious illness, but completely preventable with vaccines. You need a tetanus/diphtheria/pertussis (Td/Tdap) booster every 10 years.

Meningitis: Most of the time, you get this vaccine only if you’re going to travel to a location where the disease is common. But if you have a damaged spleen, you may still need it. Check with your doctor.

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SEX AFTER PREGNANCY: WHEN IS IT SAFE?

HOW MOMS CAN DEAL WITH STRESS, PAIN, AND POSTPARTUM DEPRESSION ■■■ By Lynn Merrell It’s a common question from women and their partners: After giving birth to a baby, how soon can we safely have sex?

How each partner feels will likely differ, of course. New moms may be so absorbed with their babies that sex is the last thing on their minds.

Their partners, however, may be eager to resume normal relations.

Some moms, too, may wonder how long they need to wait.

Of course, mom’s health needs to be the priority. What do women and their partners need to know about sex after pregnancy?

FACTORS THAT MAKE SEX AFTER DELIVERY DIFFICULT In general, most gynecologists recommend that women avoid sexual intercourse for the first 4–6 weeks after delivering a baby. There can be many exceptions, however, so it’s important for each mom to talk with her doctor.

If you had a C-section, for example, or a perineal tear or episiotomy, it’s best to wait for your 6-week checkup and your doctor’s okay before having sex. The body needs time to heal, to be sure that all the bleeding has stopped, the tissues have recovered, and the cervix has closed.

Couples who have sex too early risk postpartum bleeding or a uterine infection.

Moms also need to wait until everything feels healed before pushing themselves into sex. Six weeks is usually enough time, but if you’re still feeling sore, don’t be afraid to give it a little longer. Realize, too, what your body is going through. Hormones are changing, the uterus is shrinking, and you’re likely to be exhausted and overwhelmed. Many moms suffer from excess fatigue, and may feel overwhelmed caring for a new baby. Breastfeeding can come with many challenges, as well, and because of the hormones involved may dampen your sex drive.

Talk to your doctor. Couples may want to make an appointment together to calm any fears they may have. Doctors can also help with side effects like stress and fatigue, and may recommend supplements, dietary changes, or nursing help where needed.

While you’re waiting for your body to even out, discuss with your partner about other ways you may be able to feel close. Assure him or 4HEALTH | 877.807.0989

her that your body will heal with time, and meanwhile you can kiss, cuddle, and find other ways to feel intimate without pushing it beyond what you’re comfortable with.

On the other hand, if you’re ready and your doctor has given you the green light, there’s no reason not to enjoy sex again.

WHAT ABOUT POSTPARTUM DEPRESSION? Some moms suffer from postpartum depression (PPD) after delivery, and this can significantly affect the relationship between the partners. This disorder often dampens sex drive, and can result in mom just feeling uninterested in the whole idea.

In fact, studies have shown that moms experiencing PPD have a lower sex drive and reduced sexual functioning when compared to moms without PPD. If you notice this and other symptoms (like appetite changes, difficulty sleeping, frequent mood changes, feelings of worthlessness), check with your doctor to see if you may be suffering from PPD. If so, getting help for the disorder can also help you get back to feeling sexy again.

OTHER ISSUES THAT CAN MAKE SEX DIFFICULT Sometimes, women have other issues that make sex difficult after pregnancy. Things like vaginal dryness, looseness or tightness, pain during intercourse, difficulty achieving orgasm, and bleeding or irritation can make the whole experience very unpleasant.

Again, talk to your doctor. Kegel exercises can help get your vagina back in shape, and there are creams available that can address the dryness. (Realize that breastfeeding reduces vaginal lubrication, so a cream or gel may be necessary for awhile.) If you have pain because of a stitch or tear, or an irritated C-section, give yourself more time to heal, and make sure that you and your partner take it slow. You can also try different positions to make sure you’re not experiencing pressure on your wounds.

In fact, in almost all cases, a little more time is all you need. Try not to stress about it, and keep communication open with your partner. You will recover, and you will enjoy sex again — you both may just need to be a little more patient.

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504-6525

924 Flatbush Ave, Brooklyn, NY 11226 Q B 2 2965 Ocean Pkwy, #200 Q B Brighton Beach, NY 11235

BRONX 5221 Broadway Ave, Bronx, NY 10463 1 LONG ISLAND 384 E 149th Str, Ste 201, Bronx 2 5 260 Sunrise Highway, Valley Stream, NY 11581 NY 10455 2157 White Plans Rd, Bronx D 2 5 MANHATTAN 122 Fulton Street, New York, NY 10038 A C J Z 2 3 NY 10462 FOXHURST 1264 St. Nicholas, Washington Heights, A C 1 947 Southern Blvd., Bronx, NY 10459 2 5 6 NY 10026 FORDHAM BROOKLYN 11 E Fordham, Suite A, Bronx D 4 2444 86th St, Ste A, Bensonhurst, NY 11214 D NY 10468

TM

www.USAFibroidCenters.com 4HEALTH | 877.807.0989

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IF MY MOM HAD UTERINE FIBROIDS, WILL I GET THEM TOO? WHEN YOUR GENES MAY HAVE A SAY

Rachel was soon to celebrate her 40th birthday, and she was a little worried. Her mother had suffered from uterine fibroids when she was Rachel’s age, and she had to undergo a hysterectomy to get rid of them.

Rachel worried that she may have to go through the same thing.

Risk factors for uterine fibroids include age, ethnic origin, obesity, and a diet high in red meat, but there’s no doubt that there is a genetic link as well. If a woman’s mother has uterine fibroids, that woman’s risk for having them is about three times higher than average. Fortunately, there are much less invasive treatments available today.

In a 2002 study, for instance, researchers found that 145 genes that “are overexpressed or underexpressed in the uterus of women with fibroids.” Still, scientists hope to find a “master switch” gene that regulates tumor growth, as such a gene could open the door to prevention or at least to early identification and/or diagnosis.

Scientists seemed to make some strides toward that goal in a 2015 study. They identified the mammalian target of rapamycin (mTOR) gene, which they called a “master regulator of proliferation,” that is activated in many uterine fibroids. Still, the same conclusion applied — that there are likely several key mechanisms involved in the disease.

WHAT ARE UTERINE FIBROIDS? The National Uterine Fibroids Foundation (NUFF) estimates that as many as 80 percent of women may have uterine fibroids, but most will never know it. Only a few will notice problematic symptoms that require treatment.

Uterine fibroids are muscular tumors that grow in the wall of the uterus. They are almost always benign (non-cancerous) and rarely cause symptoms. If they grow particularly large, if many grow at once, or if they grow in problematic locations such as on the outside of the uterus, they can cause symptoms like the following: ■ Heavy bleeding ■ Frequent urination ■ Lower back pain ■ Pelvic pain or fullness ■ Painful periods ■ Pain during intercourse ■ Reproductive problems When these symptoms start to interfere with quality of life, women should talk to their doctors. A minimally invasive treatment called “uterine fibroid embolization (UFE)” eradicates fibroids without large incisions or long recovery times, and requires no hospital stay.

USA FIBROID CENTERS CAN HELP While scientists continue to research the genetic component of fibroids, women should understand that while having a genetic connection may increase risk, it’s not the final word. A woman’s lifestyle, hormone levels, history of childbirth, diet, and weight management all affect her risk as well.

If you have a family member who had trouble with fibroids, or if you’re experiencing any of the symptoms mentioned above, check with USA Fibroid Centers for more information. 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 Eggert, Stacey L., et al. “Genome-wide Linkage and Association Analyses Implicate FASN in Predisposition to Uterine Leiomyomata.” The American Journal of Human Genetics 91, no. 4 (2012), 621–628. doi:10.1016/j. ajhg.2012.08.009.

Medikare, V. “The Genetic Bases of Uterine Fibroids; A Review.” J Reprod Infertil 12, no. 3 (July/August 2011), 181–191. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719293/.

NUFF. “National Uterine Fibroids Foundation: Statistics.” Nuff.org. Accessed November 20, 2019. http://www. nuff.org/health_statistics.htm.

Vastag, Brian. “Genes and Uterine Fibroids.” JAMA 288, no. 11 (2002), 1342. doi:10.1001/jama.288.11.1342jha20009–4–1.

WHEN FIBROIDS MAY BE INHERITED Scientists are looking into the genetic characteristics of uterine fibroids, and have identified certain genes that may be involved in increasing risk.

In a 2012 study from Brigham and Women’s Hospital, for example, researchers analyzed genetic data from over 7,000 white women. The found certain genetic variants that were significantly associated with uterine fibroid status involving three specific genes. One of these is called FASN, which is responsible for encoding a protein called FAS (fatty acid synthase).

The researchers also discovered in additional studies that FAS protein expression was three times higher in uterine fibroid samples compared to normal uterine tissue. Over-expression of the FAS protein has been found in various types of tumors and is thought to be important for tumor cells to survive. These findings may help scientists develop a personalized approach for women who have these gene variants.

An earlier study also identified genetic abnormalities connected with uterine fibroids affecting specifically the HMGIC and HMGIY genes, as well as others that may be involved in promoting cell growth.

The research is complicated, though, as most likely there are many genes involved. Narrowing it down to one or two may not be possible.

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(718) 504-6525 www.USAFibroidCenters.com

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HORMONE THERAPY FOR MENOPAUSE — IS IT SAFE? NEW STUDIES OFFER HOPE FOR WOMEN SUFFERING FROM SYMPTOMS ■■■ by Colleen M. Story Estimates are that about 75 percent of women suffer from hot flashes while going through menopause. Many will also suffer from night sweats, mood swings, muscle and joint pain, sleep problems, and weight gain.

It wasn’t that long ago that doctors prescribed hormone therapy (HT) to ease these symptoms, but then in 2002, researchers published a landmark study. They found that the risks of HT outweighed the benefits, so most doctors stopped recommending this effective treatment.

Since that time, however, scientists found several flaws associated with that study, and newer research has shown that HT can be effective and safe for many women. Here’s where we stand now.

THE STUDY THAT CAST A SHADOW ON HT FOR MENOPAUSE That 2002 study was called the “Women’s Health Initiative,” and though it showed that HT seemed to elevate the risk of heart attacks, strokes, blood clots, and breast cancer, later analysis of the data came up with different results.

It turns out that the study was initially set up to examine the effects of HT on chronic diseases — not on menopausal symptoms. Most of 4HEALTH | 877.807.0989

4HEALTH the women recruited to participate were older women who were years past menopause and who had taken hormones for longer than what is usually recommended today. Some of the results of the study were then misinterpreted to apply to all women when they simply did not.

Several more recent studies have shown that HT can help prevent bone loss and reduce fractures in postmenopausal women.

It can also help reduce the uncomfortable symptoms associated with menopause and is usually the most effective treatment for hot flashes and vaginal dryness.

Today, the North American Menopause Society, the Endocrine Society, and other medical and health organizations agree that most healthy, recently menopausal women can use HT for relief of their symptoms while enjoying a low risk of dangerous side effects. In a controlled trial of over 1,000 women, Danish researchers found that those entering menopause who were given hormones for 10 years enjoyed clear benefits — including a reduced risk of cardiovascular disease and breast cancer — with nominal risks.

Every woman is different, however, so it’s best to always discuss your options with your doctor.

HOW HT CAN HELP AND WHEN YOU SHOULD AVOID IT There are different ways to take HT, and depending on which method you use, you’ll likely experience different results.

1. Systemic hormone therapy: These pills, skin patches, gels, creams, or sprays provide hormones that circulate throughout the body. These are the most effective treatments for hot flashes and night sweats as well as for vaginal dryness. Some studies suggest that systemic hormone therapy can also reduce the risk of heart disease if taken early in postmenopause, as well as protect against osteoporosis.

2. Low-dose vaginal products: These come in cream, tablet, and ring forms, and also provide hormones throughout the body, but the dose is much lower. That means the risks are lower too, but this treatment doesn’t help with hot flashes, night sweats or osteoporosis. Instead, they mainly treat vaginal and some urinary symptoms.

The safest way to take HT is to start early in menopause and to limit use to a short period of time, like five years or less. Risks rise with age and with distance from the onset of menopause.

If any of the following describe you, you may want to avoid HT, as you are naturally at a higher risk for side effects and complications.

■ You have already had breast cancer at least once ■ You have suffered from ovarian or endometrial cancer ■ You have had blood clots in your legs or lungs ■ You’ve suffered a stroke ■ You have liver disease If you decide to try HT, the following steps will reduce your risk of having any problems: ■ Ask your doctor about the best delivery method — low-dose options create lower risks and they may work for you depending on your symptoms.

■ Use the lowest dose possible to get the relief you need.

■ Regularly check back with your doctor to re-evaluate how you’re doing.

■ Make healthy lifestyle choices — eat well, exercise regularly, don’t smoke, limit alcohol, and minimize stress.

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HOW SLEEP MAY AFFECT YOUR RISK FOR GLAUCOMA STUDY SUGGESTS TOO LITTLE OR TOO MUCH CAN AFFECT YOUR EYES ■■■ by Colleen M. Story The Glaucoma Research Foundation states that over 3 million Americans are estimated to have glaucoma, but only half of those aren’t aware of their condition. The disease is the leading cause of blindness in

the U.S. for people over the age of 60, with more than 120,000 people blind because of it.

Everyone is at risk, so it’s important to be aware of what you can do to protect your eyes.

In addition to eating a nutritious diet and maintaining a healthy weight, one of those

things may be to get a good night’s sleep — but don’t overdo it.

STUDY LINKS SLEEP PROBLEMS WITH GLAUCOMA A recent study suggests that sleep deprivation — in addition to increasing your risk for 4HEALTH | 877.807.0989

4HEALTH obesity, diabetes, heart disease, and even death — may also increase your risk of glaucoma.

Scientists looked at data from over 6,700 glaucoma patients. All of them were 40 years or above, and had provided information on their disease and their sleep habits, including: ■ how long they usually slept, ■ any sleep disorders they had, ■ and any medications they used to go to sleep.

Results showed that those who slept for more than 10 hours per night or less than 3 hours per night were more at risk for developing glaucoma than those who slept the optimal 7 hours per night.

In addition, those who fell sleep in 9 minutes or less, or those who needed more than 30 minutes to fall asleep, were twice as likely to have glaucoma than those who took 10–29 minutes to fall asleep. Finally, people who said they had trouble remembering things because of daytime sleepiness were twice as likely to have some vision loss than those who were not sleepy during the day.

“We already know that doctors should talk with their patients about the importance of healthy sleep for good overall health,” said study author Michael Boland, M.D., Ph.D. “With studies like this, we can add that glaucoma may be related to sleep health issues.

HOW TO PREVENT GLAUCOMA Glaucoma is a disease that damages the optic nerve in the eye. Fluid builds up in the front part of the eye, increasing pressure and damaging that nerve. There are two main types: 1. Primary open-angle glaucoma: This is the most common type, and happens gradually as the eye loses its ability to drain fluid.

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2. Angle-closure glaucoma: This is a more rare type and happens when the iris of the eye is close to the drainage angle in the eye, and the iris blocks that drainage.

Much of the time, glaucoma produces no symptoms until it reaches a more advanced stage. Meanwhile, any vision loss it creates is not reversible, so it’s important to see your eye doctor regularly. He or she can test for glaucoma, and help identify it early when treatments are still effective.

When symptoms do show up, they typically include tunnel vision and patchy blind spots in the side or central vision. For an acute attack of glaucoma — the rare kind — sudden symptoms may include severe headache, eye pain, nausea and vomiting, blurred vision, and eye redness.

Doctors don’t know what causes glaucoma, but they do know that age, family history, certain medical conditions (like diabetes and heart disease), and taking corticosteroid medications for a long time can increase the risk of developing it.

To prevent glaucoma, follow these tips: ■ Exercise regularly ■ Get regular eye examinations ■ Wear eye protection as needed ■ Eat a healthy diet ■ Maintain a healthy weight ■ Keep your blood pressure at a normal level ■ Don’t smoke SOURCE Qiu, M., Ramulu, P. Y., & Boland, M. V. (2019). Association Between Sleep Parameters and Glaucoma in the United States Population. Journal of Glaucoma, 28(2), 97–104. doi:10.1097/ijg.0000000000001169

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MY CONTACT LENSES ITCH AND HURT CAUSES AND SOLUTIONS FOR CONTACT LENS DISCOMFORT

■■■ By Colleen M. Story Contact lenses allow many people to see clearly without having to wear glasses, which is a wonderful thing. Wearing contact lenses, however, can be uncomfortable. There’s the dryness, itching, blinking, and blurriness, and sometimes, rewetting drops don’t help.

Doctors estimate that up to half of all contact lens wearers experience contact lens discomfort (CLD). What causes it, and what can you do to make your contacts easier to wear?

WHAT CAUSES LENS DISCOMFORT? Contact lenses can be uncomfortable for a number of reasons. Here are a few of them: Allergies: Pollen, dust, dander, and other thing in the air can stick to the surface of the lenses, causing irritation, weeping, and redness.

Poor fit: Everybody has a unique shape to their eyes, and the lenses need to be shaped to fit properly. If they’re not quite right, you may experience irritation and vision changes.

Improper cleaning: If you’re not regularly cleaning your lenses, debris and germs can build up on the surface, irritating the eyes and potentially causing infections.

Cleaning solutions: Some brands of cleaning solutions work better than others for certain types of contact lenses. If you’re using one that’s failing to remove build-up, you may experience discomfort. Some people may be sensitive to some of the ingredients in the

contact lens solution, as well — often to the preservatives.

Age: As contacts age, they are more likely to have buildup on the surface. It’s important to always replace old contacts with new ones as the doctor suggests.

Time of wear: If you wear your contacts for a long time without taking them out to clean them, they can create irritation, dryness, and itching. Always follow the manufacturer’s recommendations for wear-time.

Dry eyes: If you have dry eyes in general, contact lenses will be uncomfortable. Dry eyes may be caused by age, medications, hormonal changes, smoking, long hours in front of the computer, and more.

HOW TO MAKE CONTACT LENSES MORE COMFORTABLE If you love your contact lenses, but don’t love the irritation and redness, try the following tips to enjoy more comfortable wear.

Check with your doctor: This is the only way you can determine if your contact lenses are fitting improperly. Tell your doctor about the discomfort, and ask him or her to check the fit. If the fit is good, ask for other recommendations to make them more comfortable.

Make sure your hands are clean: If your contacts burn when you put them on, it may be because they are picking up traces of soap, lotion, or other substances on your hands.

After you wash your hands, make sure you rinse them really well before handling your

contacts. You may also want to try fragrancefree soaps.

Try a preservative-free option: If you still notice burning when you first put your contacts on, you may be sensitive to the solution.

Try one of the preservative-free options on the market. You may also want to ask your doctor about daily disposable contact lenses that you can throw away at the end of each day.

Check your medications: Some medications, like antihistamines and blood pressure medications, can dry out your eyes, making contacts uncomfortable. You can check with your regular doctor about alternatives, or take eye drops with you. You may also ask your eye doctor about prescription eye drops and contacts that are made specifically for dry eyes.

Ask about silicone hydrogel lenses: If you regularly wear your contacts all day long and find you’re experiencing discomfort at the end of the day, as your doctor about these.

They allow more oxygen into the eye, limiting dryness and irritation. There are also some contact lenses that have been specially developed to help relieve dryness, like CooperVision’s Proclear.

Consider supplements: Research has shown that omega-3 fatty acids (in salmon and other fatty fish and flaxseed oil) can help improve tear quality, which may reduce the symptoms of dry eyes. Try a fish oil supplement or add more fish, flaxseed, and walnuts into your daily diet.

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WHAT TO DO WHEN YOUR BRAIN DEMANDS A CANDY BAR HEALTHY SOURCES OF BRAIN-FEEDING GLUCOSE

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by Colleen M. Story

You’re going along working on your project, your fingers flying over the keyboard when suddenly you get a craving for a Snickers bar. You cast your gaze to the vending machine, but you hesitate. You’ve been working on improving your diet, and for the last week, you’ve done really well. Can you afford this indulgence?

You try to direct your focus back to your work, but you keep thinking about that Snicker’s bar. Soon your brain is screaming at you: “Go get the candy for cripe’s sake!”

You cave, eat the candy, and then you feel guilty. But you shouldn’t. You see, the odds were stacked against you. Here’s why, and what you can do next time to stick with your health goals.

YOUR BRAIN NEEDS ITS GLUCOSE FIX When we think of using food for energy, usually we think about fueling our bodies, but the brain takes up energy, too. In fact, the brain is one of the most energy-hungry organs in the body. Though it takes up only two percent of the body’s weight, it gobbles up more than 20 percent of your daily energy intake.

Like the other cells in your body, brain cells use glucose (a form of sugar) for energy. The body takes in the foods you eat and breaks

them down into glucose, fats, and nutrients, then delivers those substances to the cells that need them. Whereas glucose is the primary source of energy for all cells, the brain uses about one-half of all the sugar (glucose) energy in the body for its own functions.

If you don’t have enough glucose for the brain, communication between the nerve cells breaks down, which can lead to poor attention and slower thinking. When this happens, your brain will demand more energy — and you’ll feel that craving for the candy bar.

Scientists now know that getting sufficient glucose speeds up glucose metabolism in the body and is a must for mental performance.

So what is the healthiest way to go about getting enough?

WHAT’S THE BEST SOURCE OF GLUCOSE FOR THE BRAIN? Supplying your brain with sufficient glucose doesn’t mean piling up on the candy bars and donuts. These foods do contain glucose, but they also contain other sugars that can increase insulin levels — which over time, can put you at risk for type 2 diabetes.

Instead, the best foods for boosting brain power are the same ones that are good for your body: fruits, vegetables, and whole grains. These foods provide the glucose the brain needs without taxing your system with too much sugar, so you can maintain energy without destroying your diet or health goals.

Interestingly, a recent study following participants for three years found that those who followed a Mediterranean diet — which is rich in fruits, veggies, and healthy fats — preserved more glucose in their brains than those following the traditional Western diet, which is high in processed foods, sugary treats, and simple carbohydrates.

The key to eating well while satisfying your cravings is to take your own snacks with you and choose wisely when it’s time for a meal.

The following items are all rich in glucose and will keep your brain happy while you focus on your work.

■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

Scallions Turnips Dried apricots Pineapple Dates Raw honey Plums (fresh or dried) Mango Pickles Figs Blueberries Raisins Kiwi fruits Grapes Red beets Whole grains (like in whole-grain cereal and bread) 4HEALTH | 877.807.0989

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FOR EXCESS FLAB: LIPOSUCTION OR TUMMY TUCK?

WHICH PROCEDURE WORKS BEST FOR SLIMMING YOUR STOMACH ■■■ By Lynn Merrell Melinda was tired of carrying around her muffin top. After giving birth to four kids, she was done expanding her family, and ready to flatten her stomach. She’d tried everything — sit-ups, aerobic exercise, dieting, and even those electric pulse things she’d seen on television. The fat was still there. Otherwise, she was a healthy, middle-aged woman and wanted her body to reflect her energetic attitude.

She was ready to try plastic surgery, but she wasn’t sure which procedure would work best for her. She’d heard of both the tummy tuck and liposuction, but when she asked her friends, they didn’t really seem to know the difference.

If you’re facing a situation similar to Melinda’s, you may wonder which procedure would best get rid of your belly fat and help you look slimmer and more youthful. Is a tummy tuck or liposuction for you?

A DEFINITION OF THE TWO PROCEDURES Both of these procedures are commonly used to get rid of belly fat. They are quite different, though. In general, liposuction is considered the less serious procedure, with patients recovering and returning to their normal daily activities a little sooner. A tummy tuck is more involved, and patients need about a month before they start to get back into their normal daily routines.

■ Liposuction: Liposuction removes excess fat from many areas

of the body, including the abdomen, thighs, hips, buttocks, upper arms, back, and chest. But in this case, we’re referring to the stomach area. The fat is removed through a small tube that is inserted under the skin via a small incision. This tube is attached to a powerful vacuum that “sucks” the fat out. It may be used alone, or may be combined with other plastic surgery procedures (such as a tummy tuck).

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■ Tummy tuck: Also called “abdominoplasty,” a tummy tuck re-

moves not only excess fat, but skin, as well. Surgeons often restore weakened or separated muscles to help restore a firmer, more toned look. The surgery can last from one to five hours. The surgery also typically leaves scars, though they will fade. This procedure usually costs more than liposuction, as well.

WHICH PROCEDURE IS BEST FOR YOU? How do you know which of the above is best for you? Let’s look at a few more differences. Whereas liposuction removes only stubborn areas of fat, it does not remove excess skin or do anything with the underlying tissues. It is a shorter and less painful procedure, but produces less drastic results.

■ When to get liposuction: You are close to your ideal body weight,

and you have good abdominal muscle tone. You just have some areas of stubborn fat that you can’t get rid of, like a muffin top or love handles. You don’t really want an extensive surgery, just a little help to look your best.

■ When to get a tummy tuck: You lost a lot of weight, and now you have excess skin hanging around your middle. Or after having several children, you have a lot of flabby skin and fat left behind around your tummy. Your muscles may be stretched or weakened in your abdomen, and you have stretch marks you’d love to get rid of.

CHECK WITH YOUR DOCTOR These guidelines can give you an idea, but your best bet is to check with a board-certified plastic surgeon to find out which procedure will work for you. Be sure to consider the cost, how much time you’ll need to take off work, and what you’ll need for your recovery.

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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: ■ Reduce the appearance of scarring, such as ■ ■ ■ ■ ■

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

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

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

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

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

For more information, check with Dr. Rayham.

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

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WHEN ARTHRITIS AFFECTS A CHILD JUVENILE ARTHRITIS CAN BE TREATED

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by Morgan Rice

Arthritis is challenging no matter what age you are, but it can be particularly ruthless when it shows up in kids. Unfortunately, nearly 50,000 children are affected by some form of juvenile arthritis in the United States, with juvenile rheumatoid arthritis (also called juvenile idiopathic arthritis or JIA) being the most common type.

If one of your children develops this disease, here’s what you need to know.

WHAT IS JUVENILE RHEUMATOID ARTHRITIS? This disease usually begins before the age of 16 years and causes painful swelling in the joints. Doctors aren’t sure what causes the condition, but they do think that it is similar to adult rheumatoid arthritis, which is caused by an immune system malfunction. Symptoms can appear anytime, and may even affect infants.

WHAT ARE THE SYMPTOMS OF JUVENILE RHEUMATOID ARTHRITIS? Symptoms of this disease include redness, swelling, warmth, and soreness in the joints, though some children don’t complain of joint pain. The disease may affect any joint in the body, and may also make it hard for children to move the affected joints.

Other symptoms that may accompany this disease include fever, swollen lymph nodes, and a rash. When these symptoms occur, they usually get worse at night. As with adult rheumatoid arthritis, the symptoms tend to come and go, getting worse during a “flare” and then easing off.

Still other potential symptoms may include fatigue and poor appetite.

WHAT ARE THE POTENTIAL COMPLICATIONS OF JUVENILE ARTHRITIS? Seeking medical attention early can help soothe symptoms and prevent complications. If complications occur, they may include the following: Eye problems: Like adult rheumatoid arthritis, juvenile rheumatoid arthritis can also cause inflammation in the eyes. Without treatment, this inflammation can increase the risk of cataracts, glaucoma, and blindness. The symptoms of eye inflammation can be subtle and easily missed, which is why it’s important for children to regularly see an eye doctor.

Growth problems: The disease can interfere with a child’s normal growth and development.

Some medications used to treat the disease (like corticosteroids) may also inhibit growth.

IS MY CHILD AT RISK? Though scientists are still learning about this disease, they have discovered

that some children seem to be more at risk for it. It seems that a combination of certain genes and environmental factors make it more likely for some children to be affected. One study review found that children with allergies were more likely to develop juvenile arthritis, and others have identified certain genes that seem to increase risk.

HOW IS JUVENILE ARTHRITIS TREATED? Treatment for juvenile arthritis is similar to treatment for adult arthritis, and typically involves medications that help decrease pain, improve joint function, and minimize joint damage. These include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, disease-modifying antirheumatic drugs (DMARDs), biologic agents, and corticosteroids.

Doctors may also recommend treatment with a physical therapist, and are likely to suggest lifestyle changes like regular exercise and a healthy diet to help reduce flares. Only rarely is surgery necessary to improve joint positioning.

The good news is that many children who develop the disease will go into remission as they grow older. For some, the disease remains a challenge into adulthood, but with medications and other treatments, they can go on to live a full life.

4HEALTH | 877.807.0989

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5 REASONS WHY YOUR FEET MAY LOOK YELLOW

MOST CAUSES ARE NOT SERIOUS BUT WATCH YOUR SYMPTOMS ■■■

by Gordon Barclay

Have you ever noticed a yellow skin one on your feet? Sometimes it shows up only in certain areas, like on the heels or around the toes.

Other times the whole foot seems to have a yellowish look to it. If so, do you need to worry about it?

WHAT CAUSES YELLOW FEET? Several different conditions can cause the feet to look yellow. Most are not serious and don’t require medical treatment, but sometimes it is wise to see your doctor. Below we share the most common reasons why your feet may look yellow, and what you can do about it.

1. JAUNDICE Often when we think about yellow skin we think about jaundice.

This is a condition that occurs when the liver isn’t working as it should.

The liver typically eliminates bilirubin, which is a natural yellow byproduct that forms when the body breaks down old red blood cells. If the liver doesn’t remove the bilirubin, it builds up in the bloodstream and can leak into the skin, creating a yellowish tint.

Liver diseases and liver failure are the most common reasons for jaundice, but it can also result from using certain types of medications that destroy red blood cells, or because of certain herbal supplements.

If you have symptoms of jaundice — such as yellow skin not only on the feet but on other areas of skin and in the whites of your eyes — check with your doctor right away.

2. CALLUSES These are thick areas of hardened skin that develop on the bottom of the feet, typically on the heels and balls of the foot. Because they 4HEALTH | 877.807.0989

are made up of thicker skin than the rest of the foot, they may appear discolored, so if you see a yellowish color only in these areas, it’s likely nothing to worry about.

3. ANEMIA Pale or yellow skin can be a sign of anemia, which occurs when there aren’t enough red blood cells in the body. But the yellow skin will appear in many areas, not just the feet. Anemia usually includes other symptoms like fatigue, hair loss, brittle nails, headaches, and weakness.

If you are experiencing these symptoms, check with your doctor for treatment.

4. TURMERIC Turmeric is a popular spice that has shown in studies to have potential in reducing inflammation and helping to relieve inflammatory pain. Manufacturers have developed many dietary supplements that contain turmeric to treat chronic pain and other conditions, which means that more people are consuming this spice today than in the past. Taking too much turmeric can create a yellow discoloration on the soles of the feet. If you notice this symptom and you’re taking turmeric, stop taking it for about a week and see if the condition improves.

5. RAYNAUD’S DISEASE This is a disease that causes blood vessels to overact to cold temperatures. They can narrow and sometimes completely shut down, which can cause the skin in the peripheral limbs like the arms, hands, legs, and feet, to turn white or blue. It can also cause the toes to appear yellow, so if you notice that your toes alone look a little yellowish, this could be the reason why. If your symptoms are mild, wearing warm socks and gloves can help. If you notice more serious symptoms, talk to your doctor.

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Podiatry | 4HEALTH37

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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

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PAINFUL LEGS AFTER EXERCISE? IT COULD BE PAD

CHECK WITH YOUR DOCTOR TO AVOID SERIOUS COMPLICATIONS Barbara got home from her trip to the zoo with her two granddaughters and flopped down in the chair. Her husband asked if she was okay.

“My legs hurt,” she said.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

4HEALTH | 877.807.0989

718–393–5331 www.USAVascularCenters.com

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4HEALTH

DOES YOUR HEARTBURN DRUG INCREASE RISK OF KIDNEY DISEASE? USE NEXIUM, PRILOSEC, AND OTHERS WITH CAUTION

■■■ By Colleen M. Story If you take common heartburn drugs like Nexium and Prilosec, you may want to talk to your doctor. According to recent studies, long-term use of these drugs have been linked to chronic kidney damage, a serious condition that can lead to kidney failure.

TWO DIFFERENT TYPES OF HEARTBURN DRUGS Today, there are essentially two different kinds of popular heartburn drugs: H2 blockers and proton pump inhibitors (PPIs). Both of the drugs reduce the amount of acid produced in the stomach, which is how they help relieve symptoms of heartburn and other related conditions like gastroesophageal reflux disease (GERD) and peptic ulcers. But they go about their jobs in different ways.

Certain cells in the stomach make the acid that helps break down and digest food.

These cells are stimulated in different ways to make them produce acid. One of the stimulants is histamine. H2 blockers block the histamine receptors on the stomach acid cells, so the histamine can’t encourage them to produce acid. Examples of H2 blockers include Zantac, Pepcid, Tagamet, and Axid.

There are also proton pumps in these cells, and these cells pump the acid into the stomach. Proton pump inhibitors (PPIs) actually inhibit these pumps so they don’t work as well. The result is less acid. Examples of PPIs include Aciphex, Nexium, Prevacid, Prilosec, and Protonix.

ADVANTAGES AND DISADVANTAGES OF EACH There are advantages and disadvantages to each of these types of heartburn drugs. H2 blockers start to work more quickly than PPIs, but PPIs last longer. H2 blockers start working within an hour of taking them, but then they last for only about 12 hours. PPIs have a delayed onset of action, but then will last up to 24 hours. PPIs also provide a greater reduction of acid in the stomach than H2 blockers do.

In general, PPIs are considered more effective for treating serious stomach-acid conditions, such as GERD, whereas H2 blockers are more often recommended for occasional heartburn. The side effects differ between the two, as well. Headache is more common with H2 blockers, while PPIs are usually associated with fewer side effects. Yet a recent study suggests that PPIs may not be as safe as believed.

STUDIES SHOW PPIS INCREASE RISK OF KIDNEY DISEASE For the study, researchers analyzed data from the Department of Veterans Affairs databases on over 125,000 individuals who had just started using a PPI heartburn drug, and about 18,500 individuals who were using an H2 heartburn medication.

They found that over five years of follow up, those taking PPIs were more at risk for chronic kidney disease and acute kidney injury than those using H2 blockers. What was more concerning was that those who did develop kidney issues didn’t experience any kidney problems beforehand, so there was no warning.

“Our results indicate kidney problems can develop silently and gradually over time,” said

Ziyad Al-Aly, M.D., the study’s senior author, “eroding kidney function and leading to longterm kidney damage or even renal failure.

Patients should be cautioned to tell their doctors if they’re taking PPIs and only use the drugs when necessary.”

Indeed, the FDA initially approved these drugs only for short-term use, but patients struggling with stomach-acid issues have often been used for months or even longer.

This isn’t the first study to link these drugs with kidney problems. In January 2016, researchers reported that people who use PPIs have a 20 to 50 percent higher risk of chronic kidney disease compared to people who don’t use these drugs. Those taking the drugs twice a day had a much higher risk than those taking them only once a day.

TALK TO YOUR DOCTOR ABOUT USING PPIS If you suffer from GERD or ulcers or other acidrelated conditions, talk to your doctor. See if you can manage your symptoms with an H2 blocker instead, or with other lifestyle modifications. Some tips for reducing stomach acid include: ■ Don’t eat too much at once — break your

meals up into smaller servings and snacks.

■ Avoid trigger foods like spicy foods, fried

foods, citrus fruits, garlic, onions, artificial sweeteners, alcohol, and coffee if you’re sensitive to it.

■ Try to relax when you eat. Stress increases stomach acid, so create a relaxing atmosphere and take your time.

■ Consider supplements like digestive enzymes and probiotics to help ease digestion.

4HEALTH | 877.807.0989

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FEELING ANXIOUS? YOU HAVE OPTIONS MANY TREATMENTS AVAILABLE TO HELP PROMOTE CALM

■■■ by Lynn Merrell When you think about the future, do you get anxious? Do you find yourself worrying about some things more than you think you should?

When you go to bed at night, do you suffer from racing thoughts that will not allow you to sleep?

If any of these sound familiar, you may have an anxiety disorder.

Fortunately, some treatments can help.

WHAT IS AN ANXIETY DISORDER? Anxiety disorders are mental health conditions in which a person feels anxiety or worry about a situation that is out of proportion with what is considered normal. If you feel anxious before speaking in public, that is considered normal, but if you suffer from a high level of anxiety before going shopping for groceries, that may indicate an anxiety disorder.

Symptoms of an anxiety disorder often include a racing heartbeat, sweating, trembling, stomach upset, and muscle tension. You may feel these types of symptoms before stepping out of the house, for instance, or before going inside an elevator. Those with an anxiety disorder may also have thoughts like, “This elevator is going to get stuck and I’ll never be able to get off,” or, “If I go out today I could get hit by a car.”

It’s natural for the body and mind to fear certain situations, but in those with an anxiety disorder, the fear system overreacts to everyday situations that should not inspire so much fear. People who are not able to function normally because of this fear are victims of an anxiety disorder. They may not be able to do their jobs, have relationships, or engage in common activities because of their anxiety.

4HEALTH | 877.807.0989

TREATMENTS FOR ANXIETY DISORDERS Fortunately, there is help for those suffering from anxiety disorders.

Therapy is the most common and most effective treatment and can help people achieve full remission.

The specific type of therapy recommended is usually “cognitivebehavioral therapy (CBT),” in which therapists focus on teaching patients coping techniques they can use to better manage their fear.

This type of therapy is prescribed for a limited amount of time — like 8–16 sessions — after which the patient can continue on his or her own.

Other treatments include breathing exercises, relaxation techniques, and mindfulness meditation. Getting more exercise and improving sleep habits can also help reduce feelings of anxiety.

Today, there are even smartphone apps available that are designed to help people feel more calm and relaxed. Some of the most popular include “Calm,” “Headspace,” and “Buddhify.” All provide some sort of meditation practice, as well as some information and helpful tools.

For those whose anxiety is disrupting their daily lives, doctors may prescribe medications. Antidepressants are the most common. It usually takes a couple of weeks or longer to feel their effects, but after that, they can help stabilize mood.

Other medications that are sometimes used for anxiety include those that help boost levels of calming neurotransmitters in the brain.

These have potential side effects like confusion and potential addiction, however, so their recommended use is limited. Talk to your doctor about the risk and benefits.

The most important thing is to get help. You don’t have to suffer from severe feelings of anxiety and worry.

CLASSIFIEDS

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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

4HEALTH | 877.807.0989

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

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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

4HEALTH | 877.807.0989

1300 Ave P Brooklyn, NY 11229

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4HEALTH

4HEALTH | 877.807.0989

4HEALTH

4HEALTH | 877.807.0989

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4HEALTH

4HEALTH | 877.807.0989