by Peter Hamilton
LASEK vs LASIK
Emil W Chynn, MD, FACS, MBA
First Surgeon in NYC to get LASIK NYC’s ONLY NO CUT - NO FLAP CENTER Park Avenue LASER Vision stopped cutting flaps 5 years ago.
Dr. Chynn, Medical Director of Park Avenue Laser Vision Center (PALV), explains why he made the change from LASIK to NoCut, No-Flap LASEK years ago. He also explains why PALV, which has 4 MD’s (more than any other Laser Correction Center in New York), gives the most comprehensive, safest procedure in NYC. Dr. Chynn was one of the first refractive surgeons in NYC to perform the NO-CUT NO-FLAP LASEK, as well as one of the first in the New York/Tri-State area to combine LASEK with CustomVue, for “SuperVision.” Of all the ophthalmologists in New York, Dr. Chynn is the only Harvard trained surgeon who has had LASIK himself and has had perfect vision for over 10 years now. A highly specialized refractive surgeon who has performed over 1000 NO CUT, NO FLAP LASEK procedures per year, Dr.Chynn has published over 100 articles in leading medical journals across the US. Dr. Chynn offers his vast expertise to teach other surgeons not only in the Ukraine and Japan, but worldwide. Dr. Chynn has performed over 15,000 procedures throughout his career. These include LASIK, PTK, PRK, AK, PK, and of course, LASEK. He has come to the conclusion that the older refractive surgery techniques, where the cornea is cut, are all out-dated and dangerous procedures. In 2003 he was the first refractive surgeon in NYC to stop performing the older, cutting LASIK procedure and perform exclusively, the more modern, safer, less invasive, NO-CUT, NO-FLAP, All-Laser LASEK and Epi-LASEK procedures. Other surgeons sometimes perform LASEK and Epi-LASEK over Lasik in cases where it is not safe to cut a Lasik flap; thin corneas, high prescriptions, irregular astigmatism, dry eyes, nervous patients who might squeeze during the flap cutting process. Dr Chynn wisely decided to do the NO-CUT, NO-FLAP LASEK procedure for every patient. He informs us how logic dictates and common sense must prevail: “The only way to eliminate, rather than simply reduce, the chance of a flap-related complication is by not cutting a flap in the first place. In LASEK and Epi-LASEK, your cornea is not cut at all; no corneal flap is created, so your chance of flap-related complications is zero. That’s right: 0! This philosophy, combined with his oustanding medical reputation , and his unwavering acumen and attention is the main reason that Dr Emil Chynn has earned such a prestigious reputation within the global medical community. 2
November 2010
Park Avenue Laser Vision 102 E. 25th St. Park Avenue South New York, NY 10010
212.741.8628
1.888. I-WANT-2020 [Toll Free] 1.888. 492.6820 P a r k A v e n u e L a s e r. c o m
However, he is more proud of a different accolade. “I have zero lawsuits!” Peter Hamilton sat down with Dr. Chynn at PALV to discuss why he is at the cutting edge of vision correction and why patients considering Laser Correction should consult with him first. PH: Chynn, PALV has been performing the NO-CUT, NOFLAP LASEK procedure, exclusively. This is a departure from the older LASIK procedure performed at the majority of vision correction centers in the US. You have been doing this exclusively since 2003. What was your reason for changing exclusively to the no cut,was your reason for changing exclusively to the NO-CUT, NO-FLAP LASEK procedure, and what are the benefits to the patient? Dr. Chynn: First, let me point something out to the readers of Manhattan Medical Magazine and then I will answer that question. PALV has, in our opinion, the most highly trained, best qualified staff of any laser center in New York. We have 4 MD’s working here, and most of our staff have had LASEK themselves, understand the procedure, and can explain it better to our patients. Indeed our patients say this is the main reason they have chosen us! We also have had zero lawsuits so it is important that anyone considering Laser Vision Correction comes to see us first. I believe we offer the safest procedure which is NO-CUT, NO-FLAP LASEK. To answer the question why we changed over, let me explain it to you this way: The majority of Laser Centers in NYC (and in the US) perform mostly the cutting procedures. This is usually LASIK, where your cornea is cut with a metal blade, and/or Intralase, also known as I-LASIK. With this, a flap is still cut into your eye, though its cut with a laser. Many clinics advertise this as a non-cut procedure. This is inherently false advertising as the cornea is STILL cut and could STILL cause complications down the road. I will explain why later. Yes, studies have shown that IntraLase has moderately decreased the risk of flap related complications as compared to LASIK. Fine. But, it is my opinion that we must ELIMINATE COMPLETELY, not just reduce, the risk
LASEK vs LASIK ... Cont.
Park Avenue
Laser Vision
of flap related complications. The only way to do this with a 100% guarantee is by not cutting the flap in the first place. When we perform LASEK or Epi-LASEK, your cornea is not cut at all, thereby creating no corneal flap. Therefore, the risk factor is zero, and I mean ZERO! PH: Tell us about the difference between PALV and other practices in NYC. What is the distinction? Dr. Chynn: Well there are many, but I’ll just tell you a few. First, there are 4 MD’s working here, each one uniquely proficient in vision correction. At other centers, when you are tested, to determine whether you are a good candidate and to calibrate the numbers to navigate the laser, you will usually find this conducted by either an optometrist or a technician. These “technicians”, though knowledgeable, are essentially button pushers. At PALV, you have Dr. Chynn, Dr. Elias Almeida, Dr. Jyoti Puri, and Dr. Nishit Shah. It is their job to spend as much time with you as is necessary to make sure all your testing is both accurate and complete before you schedule your procedure date. You will also find that at other centers you will meet “closers” who really do nothing more than sell. At PALV, our patient coordinators have been trained to ease you throughout the entire process with care and understanding. Those who come here for the procedure will tell you how they often hear us sharing stories with patients about their family and pets. This is because we get to know our patients. You don’t just come in get LASEK’D then leave. Our follow up is an essential part of the entire process. You come in 1 week later, 1 month later, 3-4 months later, or whenever you want to say hello. Patient care is a priority. PH: Dr. Chynn you were recently featured on CBS as having the most reputable vision correction practice in Manhattan. Other practices were guilty of lying to their patients. Can you explain in more detail what that was about? Dr. Chynn: I was featured, on CBS News TV in NYC, as having the most ethical laser Vision Center in NYC. Some centers were caught on “hidden cameras” saying things to customers that were not true. I find it disturbing and unethical that many surgeons in the city, and centers using IntraLase, are hiding the truth from the public. Essentially the “all laser” IntraLase Lasik procedure is still a cornea cutting procedure. There is a FLAP, and therefore the risk of FLAP complications. This is never mentioned on the IntraLase website. I have a problem with people telling patients that there is no cutting when using IntraLase. Your eyes are cut with a laser. This is cutting the cornea, so there is still the risk of intra-operative or post-operative flap complications. IntraLase Lasik procedures have the added complication
of persistent severe photophobia (sensitivity to light), which can last weeks to months. They were forced to report this to the FDA and it can be seen in many medical journals. However, they always seem to avoid these points when talking about IntraLase, leaving out it’s disadvantages for obvious reasons. PH: Canyou explain in more detail what goes on during the NO-CUT NO-FLAP LASEK procedure? Dr. Chynn: First, LASEK (Laser Assisted Sub-Epithelial Keratectomy) is the most recent technique used for laser vision correction. It is not only the most advanced, but also the safest laser vision correction procedure as it combines the best of LASIK (rapid recover, no pain) and PRK (no cutting, no flap, improved safety). I was one of the first refractive surgeons in the New York Tri-State area to combine LASEK and CustomVue for what we call “Super-Vision.” During LASEK, the epithelial tissue is softened, using a special solution, and gently pushed aside. This allows us to reshape the central cornea using the VISX Excimer laser. The epithelial tissue regenerates on its own, and a BCL, or Bandage Contact Lens is put in place to protect the epithelium until recovery is complete. After a few days I remove the BCL and the patient stops using the anti-biotic drugs. At this point the epithelium is healed and your vision is great. This is particularly important in treating patients with wafer thin corneas, because no flap is cut at all. This means that more tissue is made available to treat with the laser. More corneal tissue is preserved which means that there is greater structural strength after the procedure. Studies have been done with eye bank eyes that show that eyes that have been treated with LASIK instead of LASEK show a weakened globe. This is not good. If you get punched in the eye after LASIK there is a higher chance of a ruptured ... Cont. page 24 ManhattanMedicalMag.com
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WHY PATIENTS SHOULD CONSIDER SPINAL DICOMPRESSION BEFORE SPINAL SURGERY by Dr. Steven Moalemi BACK OR NECK PAIN If you are one of the millions of Americans that are experiencing back or neck pain, then help is here. Whether you have an occasional discomfort or you have a constant pain, or even if your pain makes sleeping difficult or causes fatigue, irritability, and a feeling of isolation, the first step is to make an accurate diagnosis. Treatment can then be much more effective. Overall, the initial treatment could include rest, medications, physical therapy or even injections, depending on the severity of the pain. Physical therapy could include modalities to increase blood flow and promote healing to injured tissues, massage, stretching, and strengthening or stabilizing exercises. Certain yoga and pilates exercises can be incorporated to a physical therapy program, depending on the particular condition. When there is pain or discomfort, not every movement or exercise is beneficial. Actually, doing the wrong exercise can be harmful. However, a well trained physical therapist is able to pick the right exercises for the diagnosis being treated. In addition, there is a non-surgical treatment with DRX-9000 which is Spinal Decompression therapy. It is very effective and has helped many patients avoid surgery. The best candidates that will benefit from the DRX9000 may be those with herniated discs, bulging discs, sciatica, or degenerative disc disease. HERNIATED DISCS -Discs are gel like structures which may protrude and cause mechanical pressure on nearby sructures-resulting in pain and inflammation. SCIATICA - is a condition associated with a herniated or ruptured disc. It can produce a shock like pain that travels down the buttocks to the legs with numbness . D E G E N E R AT I V E DISC DISEASE - a gradual erosion of the discs as they deteriorate, they become more susceptible to injury from physical stress. It can also contribute to conditions such as disc bulges, disc herniations and stenosis. 4
November 2010
by Patrick Fratellone M.D. EMPIRE PHYSICAL MEDICINE & PAIN MANAGEMENT 551 5TH AVENUE (Corner of 45th St.) Suite 525, New York, NY 10017 DOWNTOWN SPINE, SPORTS, & ORTHOPEDIC REHABILITATION, PC 55 BROAD St. (Corner of BEAVER St.) Suite 15F, NEW YORK, NY 10017
1.866.610.4162 The above practices offer comprehensive non-surgical treatments for sports, orthopedic and overuse injuries. As indicated, the physical therapists also incorporate pilates and yoga into their treatment program.
CARPAL TUNNEL SYNDROME Know the warning signs of carpal tunnel syndrome. Do you have tingling or numbness in your fingers or hands that cause you to wake during the night? Does your hand or wrist feel tight or swollen? Difficulty grasping objects or find yourself dropping objects? Do you have a weak feeling in your hands when you wake up? Do you feel hand or wrist pain that radiates up your shoulders? YOU MAY HAVE CARPAL TUNNEL SYNDROME, which is a pinched nerve at the wrist. The diagnosis can be made with physical examination and at times a nerve test would also help to determine the severity and localize any other pinched nerves. Treatment options for carpal tunnel syndrome can be simple or complex, depending on the severity of the symptoms. Non-surgical treatments include physical therapy, ergonomic correction, stretching, special braces or splints, ice, strengthening exercises or cortisone injections. The earlier it is treated, the more likelihood that permanent nerve injury can be avoided and surgery prevented. [Toll Free Number]
1.866.610.4162
EDITORIAL Manhattan Medical Magazine Volume 1 • Issue 1 Editorial Office: 209 West 40th St. Suite 2, 2nd floor New York, N.Y. 10018 Published monthly by Dunbar Media Corp. Print run 100,000 copies Free Distribution Publisher Peter Hamilton Associate Publisher Xavier Estronza Editor Megan McCombs Medical Editor Patrick Fratellone, MD Brand Creative Director Diego Rios Public Relations Petra Brokeshova Photography Robert Buchan Cover Photo by Luis Gullen Model, Viktoriya Zueva Publicity, Petra Brokeshova Designed by DiegoRios.com Contributors: Emil Chynn, MD, FACS, MBA Leornard Farber, MD Patrick Fratellone, MD Dov Goldstein, MD Dr. Errol Gluck William Greenberg, MD Zev Kaufman, DDS Rajesh Kamdar, DDS George Liakeas, MD Steven Moalemi, MD Ritu Saini, MD To advertise call 1-866-726-9237 or
e-mail: megan@manhattanmedicalmag.com
PUBLISHING A FREE MEDICAL MAGAZINE in New York City during the midst of a near depression may, for many, seem a daunting task. However, the further this publication came together the clearer the need for a free medical publication made available to Manhattanites became. As our economy teeters there is one thing that people are giving more thought to than ever before - their health. So when we went to visit medical professionals within the New York community there seemed to be nothing but positive responses and emails quickly began to arrive in my inbox. You are holding in your hand the first issue of Manhattan Medical Magazine. Manhattan Medical Magazine will be a monthly publication; something to look out for at subway stops, on the tables of medical offices, skin clinics and spas, dental offices, and doorman buildings around the city. We are honored to have this first issue feature articles from Patrick Fratellone, MD - New York City’s only integrative cardiologist. Dr. Emil Chynn of Park Avenue Laser Vision discusses the advantages of LASEK over LASIK. On October 16th Dr. Leonard Farber opened The Farber Center for Radiation Oncology, a unique state of the art facility which represents a paradigm shift in how cancer-stricken patients are treated in the US. Utilizing the Elekta Infinity with Volumetric Modulated Arc Therapy (VMAT) technology, the next generation in radiation treatment for cancer and the reason those in search of the most advanced care often travel abroad. We wish him the best. Each month we will feature articles from top dermatologists, dental surgeons, LASIK doctors, and various medical professionals. We hope you find an interesting article or two to peruse as you make your way to or from work. And remember - New York City is still the best city in the world! We also have the best doctors.
Yours,
Megan McCombs Manhattan Medical Magazine, Editor ManhattanMedicalMag.com
Manhattan Medical Magazine is copyrighted and may not be reproduced without the express permission of Manhattan Medical Magazine. Advertisers and contributors assume all liability for the content and photographs they supply and assume any responsibility resulting from any claims against the publisher and the publication. Readers please be aware that any article in this publication does not constitute medical advice. If you think you may have a medical condition, consult a medical professional.
ManhattanMedicalMag.com
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CHEAT ON YOUR AGE
Skin Thera P
R
by William Greenberg M.D.
Learn the secrets to younger skin with lasers and injections At Skin Thera PR you can correct sun damage, fine lines and wrinkles with an assortment of anti-aging treatments that are performed or overseen by Dr. Greenberg. Reversing the signs of aging is the first step towards maintaining a youthful appearance. All of our facial treatments, masks, and peels are performed with pharmaceutical grade products, which have a direct biological effect on your skin. Skin Thera PR also specializes in medical grade, scientifically based Cosmeceuticals that work together with your treatments in an effort to continue to make your skin look its best. In addition to our own skin care line we carry brands such as Obagi, Skin Medica, Neocutis and others.
Problem 1. Brown Spots
Question: I have been noticing that I have developed a lot of brown spots on my face and chest from the sun. What can I do to correct this Answer: At Skin Thera PR Medical Spa we use the ELOS laser Photo rejuvenation (Fotofacial) system to treat skin imperfections caused by sun damage, age spots, pink, red, and brown spots, sun induced freckles, rosacea, and broken capillaries to even out your skin. The use of pulse laser light induces skin regeneration and collagen production. The radio frequency component allows for deeper penetration and better results. Skin tone becomes more even for a younger looking appearance. Usually several treatments are needed to obtain the best results.
301 E 81 St. Off 2nd Ave. New York, NY
212.253.7138 SkinTheraP.com
William Greenberg M.D. Dr. Greenberg is the founder and medical director of Skin Thera PR Medical Cosmetic Spa in New York. Dr. Greenberg plays an integral role in making Skin Thera P™ an innovative and unique destination for those seeking the best in medically supervised skincare, providing 18+ years of medical experience and his expertise in assessing and implementing new technologies to improve the practice of medicine. Dr Greenberg has been featured in Time Out New York, Channel 11 News, New York Magazine, Manhattan Bride and so many more. He offers all clients a complimentary consultation to decide which treatments are right for you.
Problem 2. Sagging and Droopy Skin
uestion: When I look in the mirror I am beginning to notice that my face is drooping? What can I do Answer: As you age, the firmness of your skin decreases resulting in sagging and the creation of deeper lines. If the lines are not severe and there isn’t much volume loss, a good procedure we perform at Skin Thera PR Medical spa is ReFirm skin Tightening. This helps to help improve skin laxity, sagginess, loss of elasticity and textural irregularities. ReFirme features the revolutionary elos™ combination of Bi-Polar Radio Frequency and Light energies to precisely heat the dermal tissue within the targeted treatment area. This stimulates collagen production and produces a firming effect in lax skin. Fine wrinkles are reduced, noticeable lifting can be observed and the texture of your skin becomes smoother, more luminous and toned. Because of the lower level of energies needed to power ReFirme, patients are able to achieve the skin tightening and wrinkle improvement they desire without the risks or pain historically associated with treatments. This is possible even on the forehead or on a bony prominence. Patients I have treated using the ReFirme procedure had 6
November 2010
After 5 elos™ skin rejuvenation treatments. Courtesy Ronald Russo M.D.
CHEAT ON YOUR AGE
... cont.
by William Greenberg M.D.
smoother, plumper skin. They see results more quickly than other skin tightening treatments I have used. Most patients see gradual and cumulative results throughout the treatment regime. Think of this as a workout for you skin, multiple treatments are required separated by 3 – 4 weeks. It is like a face lift with out the surgery or down time.
Problem 3. Frown Lines
Question: My skin used to be smooth but now is showing lines between my eyes and forehead even when I am not stressed out. What is the best treatment Answer: These lines are being caused by the fact that your skin is aging, has lost collagen, and isn’t as elastic as it used to be. Your muscle movements are causing the lines to form, so the first step in getting these lines to improve is to stop the underlining cause of the formation of the lines. This is achieved by using Botox or Dysport which paralyses the muscles.
1
This treatment is extremely popular because it works so well. The most common areas for treatment with Botox or Dysport are Horizontal forehead lines, Glabellar frown lines (vertical line between the eyebrows caused by squinting), and Crows feet (wrinkles on the side of the eyes). A treatment typically lasts between 3 to 4 months.
Problem 4. Still have lines after Botox
Question: I have developed deeper lines that don’t disappear even when I am relaxed or have had Botox treatments. What can I do to help these lines without resorting to injections Answer: Fortunately there are alternatives to fillers for lines that are not that sever. We use the Matrix IR applicator which uses a proprietary synergy of light (a diode based laser) and conducted Bi-Polar RF to create the deep thermal heating needed to both shrink and generate new collagen while protecting the epidermis. By selectively traumatizing the collagen under specific lines we can cause your body to generate more collagen in these areas. Improvements can be seen with as few as one session, but typically multiple sessions are needed for best results. Mild to moderate wrinkles are reduced for a younger appearance. At Skin Thera PR we offer a complimentary consultation to make sure this treatment is right for you.
2 Photos courtesy of Sue Gerads CSA, CME, David Whiting, M.D., Joffe MediCenter. Before and After 2 months post 1 Matrix IR treatment
Before
After
One week post 3 elos™ skin treatments. Courtesy Dr. Tess Mauricio
ManhattanMedicalMag.com
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CHEAT ON YOUR AGE
... cont.
by William Greenberg M.D.
Problem 5. Deeper Lines – Lost Volume
Question: The lines around my mouth have become much deeper and it seems that my cheeks have lost volume also. This is making me look older. What can I do to turn back the clock Answer: Filler injections are the preferred choice to correct deeper lines and loss of volume in these areas. The great thing about fillers is that the results are immediate with minimal side effects and no downtime. There are many types of fillers on the market with different characteristics. Depending on the type of filler used, they usually can last 6 months to years when using the newest non resorbable filler called Artefill. You can take 10 years off your face and skin within minutes without surgery or down time.
About the doctor:
Dr. William Greenberg is renowned on the upper eastside for facial aesthetics and cosmetic fillers. Skin Thera PR Medical Spa and Dr. Greenberg have been featured in Time out New York, Channel 11 News, CBNC.com, New York Magazine, Manhattan Bride, and more. Rated the “Prada of Skincare” by the Beauty book. Skin Thera PR and Dr. Greenberg have become a skin transformation destination, where clients can take years off their skin without surgery or downtime. All treatments at Skin Thera PR are performed with prescription strength products for real results. Complimentary consultations with Dr. Greenberg are available for all treatments.
Coupon specials: 30% of any single laser treatment or medical injection. 20% off any purchased prepaid package at Skin Thera PR Skin Thera PR – Voucher Dr. William Greenberg
All coupons are for new patients only. This voucher entitles bearer 30% of any single treatment or medical injection. Cannot be combined with any other offer.
Bring voucher to appointment
Skin Thera PR – Voucher Dr. William Greenberg
All coupons are for new patients only. [For a Friend] This voucher entitles bearer 30% of any single treatment or medical injection. Cannot be combined with any other offer.
Bring voucher to appointment
8
November 2010
Before JUVERDERM
After 2.5 Syringes JUVERDERM
Before Botox
After 1 Week Botox
Stem Cell Facial - Utilizing the newest technology from stem cell research, this facial will stimulate cellular regeneration to the max while pampering you during the treatment. As an anti-aging skin care ingredient, the use of engineered stem cell skin care treatments work to heal sun damaged, wrinkled skin to stimulate rejuvenation of the skin so that it becomes firmer, and younger looking. ......... $350 Signature Facial ........................... $120 Mini-Facial (30minute) ................... $65 Acthyderm Facial ......................... $165 Bio-Boost Facial ........................... $300 Gold Facial ................................... $350
212.253.7138 | SkinTheraP.com “The Science of Beautiful Skin”
Primary Care Internal Medicine
Treatment of Neurological Disorders
Intravenous Treatment Protocols
Treament of Cardiovascular Disease
Treatment of Allergies and Digestive Disorders
Treatment of Diabetes and Weight Management
Treatment of Infectious Diseases FRATELLONE MEDICAL ASSOCIATES, LLP OUR SPECIALIZED SERVICES INCLUDE: • OPTIMAL NUTRITION
• CARDIOVASCULAR PREVENTATIVE TESTING • EECP TREATMENT ON-SITE • ANTI-AGING MEDICINE
• DIABETES AND OBESITY MANAGEMENT • FOOD SENSITIVITY SCREENING
• CANCER PREVENTION AND TREATMENT • TREATMENT FOR HEAVY METALS
• MALE AND FEMALE HORMONAL MANAGEMENT
• ACTIVE HOSPITAL ADMITTING PRIVELEGES IN 3 NY CITY HOSPITALS
The principles of integrative medicine underlie the practice of Fratellone Medical Associates, which offers the highest standards of excellence in a full array of treatments. Our guiding philosophy is an individualized approach to total health and well being that results from nurturing the intrinsic healing of the whole person. We believe that mind, spirit and body are connected, thereby impacting each individual’s health. Our mission is to serve, empower and partner with our patients and community on the path to wellness, transformation, and wholeness.
Patrick Fratellone, M.D. Executive Medical Director
beyond low carbohydrate, low-fat or low-calorie approaches to tailor a dietary program that is right for you. We use a wider range of tests as predictors for the development of heart disease than most cardiologists do. Tests go beyond evaluating cholesterol levels and include tests for c-reactive protein, fibrinogen, homocysteine and lipoprotein (a). Dr. Fratellone is the only integrative physician in New York City with active hospital admitting privileges in three New York City Hospitals.
The practice is unique for a number of reasons: Every member of our health care team is conventionally trained and certified as well as knowledgeable about integrative medicine. Your treatment program is tailored to your individual medical situation, including a customized diet and supplement plan. We also prescribe each patient a personalized exercise program, as fitness must be incorporated into any lifestyle change, in consultation with exercise physiologists, physical therapists and personal trainers. We go
47 West 57th St. 5th floor New York, NY 10019
212.421.3202
FratelloneMedical.com
ManhattanMedicalMag.com
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by Patrick Fratellone M.D.
EECP BYPASSING the BYPASS
Dr. Patrick Fratellone has the distinction of being one of the few integrative cardiologists in the United States. He is also the only integrative physician in New York City with active hospital admitting privileges at three city hospitals: St. Luke’s Hospital, Roosevelt Hospital and Beth Israel Hospital. Dr. Fratellone is a Fellow of Integrative Medicine with a degree from the University of Arizona, where he studied under the directorship of Dr. Andrew Weil, M.D. The first angioplasty, a dilation of a coronary (heart) artery was performed in this great city at Lenox Hill Hospital. Since that time the cardiovascular technology has widened and broadened the field of Cardiology, saving thousands of lives. I would have never thought as a Cardiology Fellow in training at Lenox Hill, that a disease we once thought was fatal, can now be treated and prevented through new and innovative techniques. One of these techniques is called Enhanced External Counter Pulsation (EECP). EECP is a noninvasive treatment for blocked coronary arteries in patients having chest pain who otherwise would be treated with invasive stents/ angioplasty and even surgery (coronary artery bypass grafting). EECP was first introduced in the United States in the 1980’s but with the advent of angioplasties and the size of the EECP device, the first company producing EECP, Vaometrical ® went abroad to perfect the device. I started using EECP in 1997. The treatment uses tradiional blood pressure cuffs applied to the lower extremities (legs). With each pulse these inflated cuffs squeeze the legs bringing more blood back to the heart while the heart is in its resting or diastolic phase. This extra blood fills the heart arteries during diastole increasing blood volume and producing collateral circulation. These collateral vessels are used to bypass the partially blocked arteries, instead of surgical grafting and/or angioplasty/stents. This FDA and insurance-approved treatment is NON invasive. The treatment protocol is one hour per day for 5 days per week for a total of 35 treatments. Since 1997, more than 200 research papers have been written about the benefits of EECP and the production of collateral vessels for coronary artery ischemia (angina).
10 November 2010
Fratellone Medical Associates
212.421.3202 FratelloneMedical.com
At the yearly American College of Cardiology scientific meetings, EECP treatment protocols have been presented with beneficial results. Long term data from the EECP registry has tracked patients for more than 10 years. Since 1997, EECP has been administered to more than 500 patients in my New York City office. All of these patients presented with chest pain, an abnormal nuclear stress test and were recommended for surgery. Some of these individuals, I did refer for surgery revascularization. Those with advanced age, other comorbidities such as diabetes and previous bypass grafting were recommended for EECP treatment. The success rate for EECP has been estimated to be more han 85%. In our office with dietary and exercise lifestyle changes, and the implementation of vitamin/minerals, the success rate is 92%. For more information contact Fratellone Medical Associates at 212.421.3202. Prior to forming Fratellone Medical Associates, Dr. Fratellone was Chief of Medicine and Director of Cardiology at the Atkins Center for Complementary Medicine under the direction of the late Robert C. Atkins, M.D. Previously, the held positions as Medical Director of the Fifth Avenue Comprehensive Medical Group and Regional Director of cardiology programs for the Ultrasound Diagnostic Schools. As a result of his development of programs and teaching in these positions, he is recognized as a forerunner in the field of echocardiography.
VITAMIM B6 and B12 ESSENTIAL TO HEALTHY LIVING
by Patrick Fratellone M.D. Fratellone Medical Associates
212.421.3202 FratelloneMedical.com
Since
New York is a fast paced city, we all want the “magic bullet”. The answer lies in you taking some vitamins. Two of the most important vitamins are B6 and B12.
In our busy lives, do we all get the required amount of any vitamin? The answer is probably “no”.
This occurs due to our busy schedule, fast food restaurants and not eating enough greens. Vitamin B6 is a water-soluble vitamin and is part of the vitamin B complex group. Pyridoxal phosphate (PLP) is the active form and is a cofactor in many reactions of amino acid metabolism. Vitamin B6 is a water-soluble compound that was discove red in the 1930s during nutrition studies on rats. In 1934, a Hungarian physician, Paul Gyorgy discovered a substance that was able to cure a skin disease in rats (dermititis acrodynia), this substance he named vitamin B6.In 1938, Lepkovsky isolated vitamin B6 from rice bran. Harris and Folkers in 1939 determined the structure of pyridoxine, and, in 1945, Snell was able to show that there are two forms of vitamin B6, pyridoxal and pyridoxamine. Vitamin B6 was named pyridoxine to indicate its structural homology to pyridine. All three forms of vitamin B6 are precursors of an activated compound known as pyridoxal 5’-phosphate (PLP), which plays a vital role as the cofactor of a large number of essential enzymes in the human body. The dosage of B6 must be regulated as an overdose of this vitamin can lead to peripheral neuropathy (damage of the nerves). At least one preliminary study has found that this vitamin may increase dream vividness or the ability to recall dreams. It is thought that this effect may be due to the role this vitamin plays in the conversion of tryptophan to serotonin.
The intake of vitamin B, from either diet or supplements, could cut the risk of Parkinson’s disease by half according to a prospective study from the Netherlands. Pyridoxine has a role in preventing heart disease. Without enough pyridoxine, homocysteine builds up in the body. Homocysteine damages blood vessel linings setting the stage for plaque buildup when the body tries to heal the damage.Vitamin B6 prevents this buildup, thereby reducing the risk of heart attack. Pyridoxine lowers blood pressure and blood cholesterol levels and keeps blood platelets from sticking together. All of these properties work to keep heart disease at bay. Nutritional supplementation with high dose vitamin B6 and magnesium is one of the most popular alternative medicine choices for autism Vitamin B12, vitamin B12 or vitamin B-12, also called cobalamin, is a water soluble vitamin with a key role in the normal functioning of the brain and nervous system, and for the formation of blood. It is one of the eight B vitamins. It is normally involved in the metabolism of every cell of the body, especially affecting DNA synthesis and regulation, but also fatty acid synthesis and energy production Historically, vitamin B12 was discovered from its relationship to the disease pernicious anemia, which is an autoimmune disease that destroys parietal cells in the stomach that secrete intrinsic factor. Intrinsic factor is crucial for the normal absorption of B12, so a lack of intrinsic factor, as seen in pernicious anemia, causes a vitamin B12 deficiency. Vitamin B12 deficiency can potentially cause severe and irreversible damage, especially to the brain and nervous system. At levels only slightly lower than normal, a range of symptoms such as fatigue, depression and poor memory may be experienced. There is so much to write on B12. Usually we would give B12 to lower the cardiac risk factors, homocysteine. Some individuals have an enzyme defect. Thus the type of B12 as also in folate requires methylation. It is essential to have these vitamin levels tested by your physician. If you are taking any medications, please consult your physician before taking any nutritional supplements. ManhattanMedicalMag.com
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by Patrick Fratellone M.D.
TACKLING THE EMBARASSING PROBLEM OF IRRITABLE BOWEL SYNDROME by Patrick Fratellone M.D.
Irritable Bowel Syndrome is a group of gastrointestinal (GI) disorders that share a variety of lower abdominal symptoms. These include pain, cramping, bloating, gassiness, diarrhea and constipation. Symptoms typically occur after a meal or during stressful situations. The gastrointestinal tract is sensitive to various stimuli, so stress, diet, pharmaceuticals, hormones and any other irritants may aggravate the colon’s tendency to contract. There are many treatment options, including the prescribing either antispasmodic drugs or bulk-producing agents. In either case, the practitioner’s sympathetic approach plays a major role in treatment. Conventional treatments focus on relieving symptoms, but the integrative approach we use at Fratellone Medical Associates addresses the causes of various gastrointestinal disorders. As with many conditions, nutrition plays a large role. Food allergies can cause or aggravate most GI disorders and must be addressed to provide lasting relief.
Irritable Bowel Syndrome (IBS) is also known as spastic colon or nervous indigestion. IBS is one of the most common disorders that doctors see. Yet in retrospect it is one of the diseases that patients are not comfortable talking about because they feel that the signs and symptoms may be embarrassing. Some of the symptoms are: 1. Abdominal cramping 2. Bloating and gas 3. Diarrhea, constipation or both. As many as one in five Americans has irritable syndrome. Once you learn to control the symptoms after some various testing is done, the patient improves. Although IBS can compromise more serious intestinal diseases, as Ulcerative colitis (UC) and Crohn’s Disease, or regional enteritis, IBS doesn’t cause inflammation or changes in bowel tissue that increase your risk for colorectal cancer. Other diseases sometimes associated with IBS include: 1. Lactose Intolerance 2. Diveticular Disease 3. Candidiasis (Yeast/Fungus) 4. Celiac Disease. Herbs can be used to treat both irritable bowel syndrome (IBS) and IBD (which is Crohn’s and Ulcerative Colitis). The first herb is Cat-Nip. Nepeta cataria (also known as catnip, catswort, or catmint) is a plant in the Lamiaceae family. Remember also in the Mint Family is Spearmint, Peppermint and Lemon Balm. Nepeta cataria is mostly used as a recreational substance for feline enjoyment. Roughly two out of every three cats will be affected by the plant. The leaves and the flowers can
12 November 2010
be used. It is used a gastric nervine, whichs means used for a person with nervousness and some stomach problem. It would be safe to say that half of the New York City population should be on Catnip. It can be used as a tea or tincture. It can be combined with other herbs. It will not stop your bleeding if you have Crohn’s or Ulcerative colitis but recommended for IBS. The second herb is Chamomile. I know you know this herb, as many of you readers use is to fall asleep. I have tried it with little success as I was buying it in the supermarket. If you are also, you will need 4 tea-bags to get a decent night sleep. Chamomile or Camomile meaning, “earth-apple” is a common name for several daisy-like plants. These plants are best known for their ability to be made into a tea which is commonly used to help with sleep and can be served
TACKLING THE EMBARASSING PROBLEM OF IRRITABLE BOWEL SYNDROME ... Cont.
with either honey or lemon. Chrysin, a specific flavonoid found in chamomile, has been shown to be anxiolytic in animals and is believed to be at least partially responsible for chamomile’s reputation as a sleep aid. Chamomile is the national flower of Russia. It is known to reduce stress. The flora labelled “chamomile”, all of the family AsteraceaeMatricaria recutita (syn. M. chamomilla), German or blue chamomile, commonly used in tea. There is a Roman type of this herb, which is another herb and family. A similar herb to Chamomile is Pineapple weed. Matricaria discoidea, commonly known as pineapple weed and disc mayweed is an annual plant native to North America and Northeast Asia but which has become a cosmopolitan weed. It is in the family Asteraceae. The flowers exude a chamomile/pineapple aroma when crushed. They are edible and have been used in salads (although they may become bitter by the time the plant blooms) and to make herbal tea. Pineapple weed has been used for medicinal purposes, including for relief of gastrointestinal upset, infected sores, fevers, and postpartum anemia. The difference between using catnip or chamomile for an irritable gut is that catnip is a gastric nervine and can be used for IBS. Catnip does not have anti-inflammatory properties, whereas Chamomile does have antiinflammatory properties. Therefore if I have a young patient with Crohn’s or Ulcerative colitis, I would use German Chamomile instead of Catnip. The third herb which has anti-inflammatory properties is Filipendula ulmaria, commonly known as Meadowsweet, is a perineal herb in the family Rosaceae, which grows in damp meadows. It is native throughout most of Europe and western Asia though it has been introduced and naturalized in North America. Meadowsweet has also been referred to as Queen of the Meadow, Pride of the Meadow, Meadow-Wort, Meadow Queen, Lady of the Meadow, Dollof, Meadsweet and Bridewort. Since Meadowsweet has anti inflammatory properties it can be used for both IBS and the two diseases, Crohn’s and Ulcerative Colitis. These two diseases are known as Inflammatory Bowel Disorders (IBD).
To make an appointment call
212.421.3202
Fratellone Medical Associates
Unlike Catnip Meadowsweet is more about the anti-inflammatory properties and less about the nervous system properties. It is not only specific for the gastrointestinal tract, but acts as a good general anti-inflammatory herb. It is best used as a tincture, fresh or dried herb. Meadowsweet is unique in that in contains methylsalicyclates. It acts like another herb, ‘wintergreen’. Other herbs that have this compound are the birch tree. This herb has three active ingredients: compounds of salicylic acid, flavone-glycosides, essential oils and tannins. The treatment of IBS or IBD in our practice involves many medical modalities. In this new age of insurance and evolving changes, I feel all patients should have an option of using and treating their diseases with other modalities, in addition to their conventional medications. Irritable Bowel Syndrome can affect both men and women, however there is a predominance in women. 10-20% of the world’s population have symptoms associated with IBS. Mild symptoms affect about 70% of people diagnosed with IBS. Moderate symptoms affect about 25% of people diagnosed. 5% of the people diagnosed report severe symptoms. If you think you have IBS it is important to be tested by a doctor. At Fratellone Medical Associates we utilize Metametrix Laboratories (www.metametrix.com). Their comprehensive IgG food allergy tests for 90 antigens.This is the most convenient method of testing. Once the specific food allergen is identified, the doctor will discuss elimination diet, and desensitization techniques using weekly allergy injections or sublingual immunotherapy. Fratellone Medical Associates uses Allergy Choices (www.allergychoices.com). Either treatment used is on an individual basis. The usual length of treatment is 9 months to one year. Our approach at Fratellone Medical Treatment Center is to provide our patients for extensive ongoing conventional medical care, while providing the most effective integration with alternative treatments.
ManhattanMedicalMag.com
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14 November 2010
PROSTHODONTIST and DENTAL IMPLANT SURGEON ZEV KAUFMAN DDS
by Megan McCombs 121 East 60th St. Suite 5-D Newy York, NY 10022
212.758.2758 DrZevKaufman.com
When I stepped into Dr. Zev Kaufman’s dental office, I immediately knew there was something a little different. I felt as if I had stepped into someone’s home. This is because Dr. Zev Kaufman is not your usual NYC cosmetic dentist. “My focus has always been on providing my patients with close, dedicated personal oral health care … something that has disappeared from Medicine and Dentistry, with our fast-paced, impersonal, hi-tech lives,” he tells me. “Whether it is a simple cleaning or a full mouth implant reconstruction, the focus is always on what the patient needs and wants, rather than what procedure we can perform or what is the gadget of the day.” “I want to treat my patients the same way I’d like to be treated,” he says. Once you sit down with him, you realize very quickly that this is a specialist who takes his job very seriously. He is, after all, one of only a few dental specialists formally trained in the specialties of Prosthodontics (cosmetic and reconstructive dentistry) and surgical implant dentistry, a qualification that took him an extra five years of post-dental school training to attain. He also has extensive background in Orthodontics and Dental Radiology. He’s the one you call on when things need to be fixed. The main advantage of treatment from a surgically trained Prosthodontist is that it’s like going to a “one-stop-shop”. One person does the surgery and the restoration, instead of two doctors running from office to office. The buck stops here. Whether surgically or prosthetically; the question remains: “Why not go to Zev Kaufman in the first place?” In an elegant wooden varnished office overlooking Bloomingdale’s on East 60th street, family pictures and flat-screen monitors adorn the walls. The office is extremely up to date and takes advantage of the latest advancements in digital technology, digital radiography, color-corrected lighting, a water filtration system, state of the art sterilization equipment, and more. We get down to business and start flipping through hundreds of “before and after” shots. The level of intricate detail in his work makes me feel as if I just taken his course at NYU Dental School in Implant Surgery and Prosthodontics myself. But something tells me he pays this much attention to each and every one of his patients. He schedules no more than 20 to 25 appointments per week, hence
the reason he can afford to dedicate his time to each one. So I tell him I’ve needed an implant for ten years now but have been too scared. I had gotten some conflicting advice from dental surgeons on Park Avenue and decided I was not comfortable with the procedure. It was at that moment that I found myself staring at an X-ray image of a patient that looked like she had a mouth full of screws. “This was a complete mouth restoration, a fair amount of work we did. Here is the before and after.” If I wasn’t told, I would have never known it was the same person! “We replaced all of her failing teeth with implant restorations. And we did all of that without her wearing a removable denture at all. She had beautiful ‘teeth in a day’ and was always comfortable, looked great, and never had to remove her teeth at night.” With predictable regularity, Dr. Kaufman has earned a reputation of excellence in dentistry and restorations for over 15 years. He tells me, “I’m still amazed at what the human body allows us to do, and how far we have come in this field.” As the National Oral Health advisor to WebMD, as well as a top-rated expert on AllExperts.com, you can see why people come from afar to see him. “I have patients coming from all over the US, and many come from the UK, Israel, Russia, Ukraine, Singapore, Japan, Canada, and other countries to see me. I take great pride in that.” There is also, he tells me a growing demand for his expertise among ‘the New York medical community.’ “I can’t show you my patient list for privacy reasons,” he tells me, “but many of my patients are physicians and medical professionals seeking the kind of personal, top-notch care they would like to provide, but sometimes cannot in this economic environment. I’m happy to be of service.” And with that, I realized that I have spent an hour with a dentist, and actually enjoyed the experience. I have to admit that I’m reconsidering my fears and former opinion of implant dentistry. To find out more about Dr. Zev Kaufman and his “patient centered treatment approach” go to DrZevKaufman.com, or just call him at the office. Believe it or not, he’d be more than happy to speak to you directly. ManhattanMedicalMag.com
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TEETH IN A DAY
by Peter Hamilton
Dr. Zev Kaufman discusses “Teeth in a Day” or “Staged Placement Restoration” and how a patient that normally would seem like a candidate for removable dentures can have fixed teeth. Since the Mayans it has been known that man has attempted to give patients dental implants, unfortunately with very little success. However, in 1959 a Swedish Orthopedic Surgeon discovered that bone fuses to titanium in a process later termed: osseointegration. Dr. Branemark and colleagues used small screws to attach dental prosthesis to the jaw and the current field of oral implantology had its start. Since then millions of dental implants have been performed worldwide resulting in a revolution in the field of dentistry. Dr Zev Kaufman has spent his career placing and restoring
implants, anything from one implant to full mouth restorations. He explains how there really is no need for a person to walk around without fixed teeth anymore. Implants and restorations can be placed within one day creating a stable fixed prosthesis. The result is a happier patient who does not have to wear removable dentures at all, even while waiting for the implants to “take” to the bone, whereas traditionally a patient had to wait for up to six months for integration wearing a removable denture, or no teeth at all.
PH: Dr. Kaufman, how long have you been placing dental implants and giving patients full mouth restorations?
Prosthodontic Department at NYU 15 years ago, we were taught to remove all the teeth, give our patients removable dentures (plates), and then, when they suddenly realize how tormented they are with dentures, they will come back and inquire about implants. For over a decade, my philosophy has been completely and totally different. I insist on my patients never having to wear a removable denture, if at all possible. It is a major shift in thinking.
ZK: I’ve been involved in surgical implantology and restoration very successfully for well for over a decade. I love dentistry and implant dentistry is the core of my work. I am also an Assistant Professor at the Department of Periodontics and Implant Dentistry and the seminar course director of the Advanced Inter-disciplinary Concepts in Implant Prosthodontics for the department at NYU. I particularly enjoy teaching my peers the science of implant surgery and restoration, as technology and science evolves. It helps me stay on the cutting edge of the profession. PH: Who is the perfect candidate for an implant? ZK: In simple terms, if you are missing teeth or you have been told by your dentist that your teeth are hopeless or that they are compromised, then you are probably a candidate for an implant restoration. The only people that are not good candidates are people with uncontrolled diabetes, which impedes proper healing and people on high doses and prolonged use of drugs called bisphosphonates (Fosamax, Zometa, Boniva, etc.), which sometimes affect bone healing as well. Even then, the evaluation is on a patient by patient basis. We used to say that smokers were not candidates but studies have proven that there is only a 7-10% lesser success rate for smokers than average healthy individuals. This should not preclude one from getting implants either. Informed consent is the key to any procedure, and implant dentistry is no different. As long as the risk/benefit ratio is evaluated and discussed, there is hope. Overall my success rate has been well over 90%, and considering the complexity of most of my cases, this is excellent. My patients and I have been very happy with the results. PH: Explain the concept and the procedure behind teeth in a day. ZK: The concept is really very simple. After careful planning, the patient comes into the office. At the end of the procedure the patient walks out with beautiful, functional fixed teeth. The procedure and planning are a little trickier. The first thing I would like to point out is that I do not tailor make my patients to a procedure, I tailor make the procedure to my patients. Every person is unique, and every person requires dedicated planning and custom execution of the plan. No two people are alike. Teeth in a day means exactly as it sounds - the patient comes into my office, they are in need of replacement of their failing dentition and with careful planning I take immediate control of the case. We then remove any compromised teeth and clean up all infections. Then, using any remaining teeth, temporary implants and sometimes the final implants themselves, we deliver fixed teeth. This allows the patient to leave my office with an esthetic, functional, fixed restoration. Essentially what I have done is prevented this person from having all their teeth removed and having a removable denture put in. I save them humiliation, frustration, embarrassment and loss of self esteem. They can now eat, smile and chew to their hearts content--during which time, the implants are integrating. At a later date, usually two to four months later, I will fabricate and deliver the new, final restoration onto the implants. When I was a post-graduate student in the
16 November 2010
PH: What should be said to someone who is unsure about the process? Implant surgery sounds serious? ZK: It is actually a very benign and routine process and we have to be thankful that the human body allows us to do all these procedures and achieve success. What could be worse than losing your teeth? Teeth are a sign of how healthy the body is. Even when you choose a pet the first thing you look at is its teeth. The process for me is so routine by now that I could put an individual in my chair and an hour later the patient could get up from the chair not even knowing that I had put an implant in the empty space. Most times a single implant to replace a back tooth is just as uneventful as getting a filling. It is all done under simple, local anesthetic. The recovery process is typically uneventful as well, with very few individuals reporting more than discomfort. The larger treatment plans can take several days to recover from completely, but after all, it is surgery and the body needs time. It is so well worth it, though. PH: What technology do you use that puts you ahead of the game? Can you show anyone what their teeth will look like before they have been done? ZK: Technology is only as good as the knowledge, judgment and expertise that the doctor has. I have a very modern office equipped with top-notch instrumentation and a laboratory which allows me to plan and fabricate surgical guides, provisional restorations, dentures and other prosthetic treatment on premises. After years of performing and teaching the procedures, I have thousands of pictures and presentations of essentially every possible treatment or alike. I can show a potential patient a similar situation and the results I have obtained in the past, not just some photos in a text book. You can actually evaluate my work for yourself. Some imaging software actually allows me to show a person what they will look like after the new teeth are fabricated. However, that is sometimes tricky, since it is far easier to “doctor” a photo than to deliver the work in real life. I tell every person that they have to be realistic. However it is possible to show them using technology with 90% certainty what their teeth will be like. To any person considering dental implants who would like to discuss their situation, my door is open. I will gladly sit down and explain the work in detail with actual treatment photos of my past work. They are pretty interesting and I think they will be more than impressed with the work I have done with my patients. I am grateful for the wonderful reviews my patients give me and I know that they are happy, and that is the bottom line. With missing teeth people lose the vertical dimension and fullness to their face and removable dentures can be terribly embarrassing and cumbersome. Restoring teeth has the ability to transform lives. There is nothing more gratifying than giving a
person their smiles back… ask any dentist.
COSMETIC by NATURE?
Dentistry, by nature is cosmetic. Cosmetics mean change, and we spend our careers changing the looks of peoples damaged teeth, mouths, and smiles. The esthetic aspect of dentistry is natural…who wants to have ugly teeth? Our smiles are what define us. It is a known fact that the facial expression babies recognize from a mile away is a smile. A friend approached me the other day and asked: “Do you know a good cosmetic dentist?” Surprised, I of course pointed to myself and said: “What about me?” “Aren’t you a specialist in implants?” she replied. When did we start specializing in procedures? When people ask me: “Do you do implants?” or “Do you do veneers?” My answer has always been: “I treat people.” When Dr. Buonocore introduced composite bonding to the profession in 19 , he ushered a revolution in the cosmetic aspect of dentistry. No longer did one have to cut back a healthy tooth to place a crown, even if the tooth was slightly chipped. One could easily repair the chip with some tooth colored material. At first the colors and properties were very limited…essentially a matted chalk white. As time went by different colors, formulations for strength and shine were introduced, techniques were perfected and the ability of the dentist to transform smiles has increased. Once we knew that composite materials have strength and durability, the focus changed on the ability to “bond” other materials to tooth structure, mainly ceramics (porcelain). While composite materials change color over time (mainly become darker and more opaque), and imbibe (absorb) saliva, porcelain materials have excellent color and dimensional stability. They stay shiny and beautiful over years, and provide a much better value over time. Composite material “veneering” of front teeth is affordable and esthetic, but it will discolor, become opaque looking and wear and chip over time. However there is a solution. Bonding a thin ceramic “cover” to the front of a tooth will create a color stable, strong, long lasting restoration. The stage was set for cosmetic dentistry to become an industry by itself.
by Zev Kaufman DDS
Courses and Cosmetic Dentistry institutes (such as LVI) started popping up and organizations such as the American Academy of Cosmetic Dentistry (AACD) were formed. The focus of these organizations is on promoting cosmetic dentistry and teaching dentist how to make a perfect “Hollywood smile,” generally referred to as “the Chiclets Effect.” Just like that, the wonderful, conservative, treatment modality such as veneering a tooth became a pseudo-specialty by itself. As the US went through the “boom economy” in the 90’s, so did cosmetic dentistry. Everyone was getting veneers, whether needed or not. Chipped one tooth? Let’s veneer all your front teeth so we can “match!” Can’t bleach your teeth to “toilet-bowl white” with bleaching solutions? Get “super white” veneers. Have we lost our sense of what a natural smile is? Better yet, have we lost the sense of what being a dentist is all about? Maybe not? A positive side effect of every recession is that people are forced to reconsider their own priorities. This recession is no different. People are not looking at veneers as a fashion accessory anymore. This is good. It is time to relabel veneers as only one of the wonderful treatment options available to us through our dentists. But what about the “veneer look?” What is important to understand is that the “Hollywood, chicklet smile” is not a result of the veneer process itself, but of the technical work involved. Any dental coverage, be it a porcelain fused to metal crown, full ceramic crown, direct composite bonding, or the porcelain laminate veneer, can be made to look as natural, or un-natural as the dentist, technician and of course, the patient desires. So how does one decide if veneers are the right treatment? The decision is based on the amount of remaining tooth structure. The best veneers, composite or ceramic are on teeth that require ManhattanMedicalMag.com
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COSMETIC DENTISTRY ... Cont
by Zev Kaufman DDS
minor preparation. If a front tooth has restorations (fillings) from the back, chances are that by the time a proper veneer preparation is made, most of the tooth will be missing. In that case, a full coverage crown (essentially a veneer that goes all the way around the tooth) is a much better restoration in strength and longevity. In essence, a smile “makeover” might consist of a combination of crowns and porcelain veneers. Several new materials have been introduced to our profession over the past few years which allow us to fabricate “metal-free” crowns with life-like esthetics and done properly, even a trained dentist cannot tell the difference between a porcelain veneer and a metal-free crown. As in many other fields, manufacturers have been advertising directly to the public, pouring large sums of money into
name recognition (e.g. Lumineers). There are many brands of ceramics out there and some are more suitable for certain cases. The discussion is well beyond the scope of this article, yet it is a discussion which a person should have with their dentist to optimize the esthetic outcome of his/her case. The final question to address is who to go to for cosmetic dentistry? Essentially any family/general/cosmetic dentist can execute your treatment. Some dentists take many continual education courses specifically on cosmetics and focus their practices on cosmetic dentistry. However, there is actually a specialist designated by the American Dental Association in the field of cosmetic, restorative, and implant dentistry—the Prosthodontist. Prosthodontists go to three years of post-graduate education following a competitive admission process after receiving their DDS or DMD degree (both are the same). A major part of the Prosthodontist’s training is in diagnosis and treatment of complex situations and the proper materials to use thereof. If you need more than one or two veneers/ crowns, consider going to the specialist. You might pay more, but naturally, you will be treated by the best trained person.
The American College of Prosthodontist’s website: prosthodontics.org will have a link to locating a Prosthodontist near you. For more information please call or E-mail at: zk@DrZevKaufman.com
Zev Kaufman, DDS
Proshodontics & Implant Surgery of Manhattan, PC 121 East 60th St. Suite 5-D Newy York, NY 10022
212.758.2758 DrZevKaufman.com
18 November 2010
MICRODERMABRASION
one of the most popular treatments at SPAs Nicole Contos of Smooth Synergy Cosmedical Spa in Midtown East discusses microdermabrasion, one of the most popular requested treatments at spas and skin clinics in the US today, with our editor Megan McCombs.
by Megan McCombs Smooth Synergy Cosmedical Spa 686 Lexington Ave. Suite 3N, New York City, NY 10022
1.866.662.9647 SmoothSynergy.com
MMc: Nicole, what exactly is microdermabrasion? NC: Microdermabrasion is an extremely popular treatment in the US today. Here at Smooth Synergy, we use a specialized machine to spray micro-crystals across the skin’s surface. This mechanical exfoliation buffs away the uppermost layer of dead skin, removing all damaged and dead skin cells, reducing fine lines and wrinkles, improving acne scarring and age spots, removing excessive oil, and leaving skin silky, smooth, fresh, and youthful-looking. MMc: How
often would you recommend?
NC: While it varies from person to person, I would recommend a series of treatments, depending on what expectations you have; facials can also be very beneficial in conjunction with Microdermabrasion. We offer packages of 6 and 12 (with 1 or 2 free treatments included, respectively). It’s beneficial to have a Microdermabrasion treatment once a month – you need to give your skin time to replenish itself between treatments. Of course, I would also recommend that you use it in conjunction with skin care products designed for your skin type. MMc: So
what are the main benefits?
NC: Well, Microdermabrasion diminishes the appearance of fine lines and wrinkles, enlarged pores, and coarse textured skin. After Microdermabrasion there is no ‘downtime’ needed for the skin to recover. In one to two days, any redness will disappear and you will have healthy, dewy skin for that special event.
NC: Here are a few important tips: • Check out the training of the person who is going to give you the Microdermabrasion treatment. Here at Smooth Synergy all of our skin technicians are trained and licensed – a must if you’re considering treatment! Results depend on the expertise of the individual using the machine, as well as the machine itself. • Always make sure that all traces of the crystals are removed from your skin. • After Microdermabrasion, apply sunscreen and stay out of direct sunlight. This is important because along with the dead skin cells, you have removed some of the protective layer of skin. Microdermabrasion should be performed at a reputable medical spa by an esthetician. Microdermabrasion is the noninvasive, nonsurgical beauty secret which leaves your skin softer and healthier-looking, while reducing the signs of aging.
MMc: Are there any dangers with microdermabra-
sion?
NC: As with any cosmedical procedure, care has to be taken. Microdermabrasion can be uncomfortable around the sensitive tissue of the mouth and nose, but you should not feel any pain; it produces a mild tingling sensation. After the treatment, the technician vacuums away the traces of the powder, leaving your skin clean and radiant.
The cost of Microdermabrasion can vary. At Smooth Synergy, our Microdermabrasion treatment is $160. Right now, we’re offering a special promotion for a limited time only with this voucher: Microdermabrasion for only $99 – call 1.866.662.9647 to book your appointment today!
ManhattanMedicalMag.com
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Park Avenue
Laser Vision
LASEK vs LASIK ... Cont.
Park Avenue Laser Vision 102 E. 25th St. Park Avenue South New York, NY 10010
1.888. I-WANT-2020 [Toll Free] 1.888. 492.6820 212.741.8628 P a r k A v e n u e L a s e r. c o m
globe, not to mention a flap dislocation. Eyes that have had LASEK are more structurally sound than with LASIK. Statistics show that they are as strong as eyes that never had the procedure at all.
NOT CUT with a blade. We DO NOT CUT with a laser. We DO NOT CUT, PERIOD. Secondly, there is NO CHANCE OF FLAP WRINKLES, STRAIE, DEBRIS, or EPITHELIAL INGROWTH.
PH: What would you say to someone who is scared of the procedure, and needs to know more about the operation before finally undergoing NO CUT, NO FLAP LASEK?
LASEK allows for IMPROVED NIGHT VISION. With NOCUT, NO-FLAP LASEK, there is improved safety after the procedure. Structurally the eyeball is more resilient. Third, if necessary, enhancements can be easily performed since there is no need to re-lift any flap. This is not an easy process and is, at times, impossible with LASIK. Finally, you can actually see BETTER than 20/20 with NO-CUT, NOFLAP LASEK. It’s incredible technology. PALV made the switch to NO-CUT, NO-FLAP LASEK for improved patient safety reasons. We care about our patients more than anything else. Our reputation proves this.
Dr. Chynn: I have many patients that are afraid of the procedure and need to understand the process more. It is important to remember I have zero lawsuits. We hold LASEK seminars whereby prospective LASEK candidates can come in and watch a NO-CUT , NO-FLAP LASEK procedure taking place. There are important points to remember regarding NO-CUT, NO-FLAP LASEK. There is no chance of intra-operative flap complication during LASEK. We DO
Educator in the Medical Field: Dr. Chynn is a well-known and respected educator in his field, and has taught dozens of ophthalmologists how to perform LASIK and the more-advanced LASEK and epiLASEK techniques, both in the US and internationally (in India, China, Taiwan, and Ukraine). He holds or has held numerous appointments at some of the most prominent teaching hospitals in New York, including: Director of Refractive Surgery at St. Vincent’s Hospital and Medical Center Clinical Assistant Professor of Ophthalmology at Long Island College Hospital / State University of New York Attending Surgeon and Resident Instructor at Manhattan Eye, Ear, & Throat Hospital Attending Surgeon and Cornea Clinic Instructor at the New York Eye & Ear Infirmary
20 November 2010
CENTRAL PARK WEST DENTAL Dr. Howard Vogel is in partners with Dr. Philip Shipper at Park Avenue West Dental. The practice has a long and outstanding reputation for dental excellence and has been here for over 60 years, where Dr. Vogel’s grandfather Dr. Philip Shipper started the practice. Howard Vogel DDS discusses the benefits of DIAGNOdent® and CEREC and their how these can benefit patients. Dr. Howard Vogel is in partners with Dr. David Shipper at Central Park West Dental. Since 1947 the practice has had a long and outstanding reputation, where Dr Vogel’s grandfather, Dr. Philip Shipper, started the practice. Howard Vogel DDS discusses the benefits of DIAGNOdent, CEREC, and VELscope and how these advances in technology can benefit patients treatment.
DIAGNOdent® Laser Caries Detection Device
The first and foremost priority at Central Park West Dental is to help you maintain and improve both your oral health and your general health, as the two are very closely related. To achieve this goal, the dental care that you and your family receive in our office always includes state-of-the-art equipment. Among the newest technologies is a small laser instrument called the DIAGNOdent, which scans your teeth with harmless laser light searching for hidden decay. Locating hidden decay before it destroys tooth structure (from the inside out) is a major goal for modern dentistry. The widespread use of fluoride supplements in dental materials, toothpastes, and drinking water has made tooth surfaces harder and more resistant to decay. However, diagnosing cavities beneath the hard surfaces is more challenging because the disease process can start through microscopic defects in the hard surface enamel and can readily spread into the softer tooth structure beneath the surface. X-rays and probing with an explorer are limited in detecting sub-surface decay, particularly when a cavity is in its early stages. Fortunately, the DIAGNOdent is a major breakthrough that allows the dentist to monitor the areas within and below the hard surfaces. The DIAGNOdent allows the dentist and hygienist to locate hidden decay, and, with treatment, stop the spread of this infectious disease before it destroys the tooth from within.
Dr. Howard Vogel Central Park West Dental 101 Central Park West New York, NY 10023 New York City, NY
1.866.768.9703 CentralParkWestDental.com
tion of problems minimizes the expenses related to major tooth repair. New technologies take us a giant step forward to help you achieve the goal of minimally invasive dentistry.
CEREC CEREC is a relatively new technology that is used for restoring damaged (decayed or broken) teeth. The restoration is usually completed in a single visit. It makes your tooth stronger, more beautiful, and natural looking. The restoration is metal-free; a high-grade ceramic material is used that is compatible with the teeth. A CEREC restoration is precisely designed, color-matched to the tooth, and highly durable. Crowns, veneers, and inlays/onlays are made in one visit using state-of-the-art CAD-CAM technology (computer aided design and computer aided manufacturing). After a tooth is examined and determined to require a CEREC restoration, it is prepared by the dentist. An optical impression of the tooth is then made with a digital 3-D camera. The CEREC software assists the dentist in designing a customized restoration. The design specifications are sent wirelessly to an on-site milling chamber that creates the restoration, usually within 10 to 15 minutes. The restoration is then fitted, polished, and bonded to the tooth thereby returning the tooth to its natural form, function, and beauty. Learn more about CEREC on their website at centralparkwestdental.com.
This unique instrument provides instant feedback on the health of the tooth. A pen-like probe simply glides over tooth surfaces, constantly checking the health of the tooth. A visible number scale and an audible alarm signals the operator when there are signs of hidden decay. This new technology is completely safe and pain-free. We encourage regular dental checkups, cleanings, and home care. Early detecManhattanMedicalMag.com
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A BOARD CERTIFIED Ritu Saini, M.D.
DERMATOLOGIST and DERMATOLOGIC SURGEON
A board certified dermatologist and dermatologic surgeon, specializing in Mohs mirographic surgery,cosmetic dermatology,dermatologic and laser surgery, Dr. Saini obtained a dermatologic surgery fellowship under the direction of world-renowned Mohs micrographic surgeon, Dr. Perry Robins. During that year, she received additional training in Mohs, reconstructive, and laser surgery along with cosmetic dermatology at Cosmetique Dermatology, Lasers, and Plastic Surgery. I first met Dr. Saini several years ago when she was working with Dr. Perry Robins. Dr. Robins, who had been my dermatologist for two decades, said to me, “someday Dr. Saini will be taking care of you.” He considered her the “brightest penny” he ever met. Now Dr. Saini has operated on basal cell and squamous cell carcinomas on my Irish face. She is a surgical artist as each scar is nearly invisible. She is as charming and lovely as she is talented.” Bob O’Brien, Retired Channel 5 News Reporter
Board-Certified Dermatologist 345 E. 37th St., Ste. 209 New York, N.Y. 10016
1.866-229-4132 NYMedSkin.com
Dr. Saini obtained a dermatologic surgery fellowship under the direction of worldrenowned Mohs micrographic surgeon, Dr. Perry Robins.
A native New Yorker, Dr. Ritu Saini received her medical degree with an honors distinction in biochemistry at the New York University School of Medicine after graduating magna cum laude from the University of Pennsylvania.
ing Mohs surgery. If more advanced reconstruction is required, you will be referred to one of several premier facial plastic reconstructive surgeons that our office has had a professional relationship with for decades.
During medical school, she spent a year performing basic science research in the Ronald O. Perelman Department of Dermat-ology at NYU and was the recipient of several prestigious research grants from the American Federation for Aging Research and the American Dermatological Association. She then went on to complete a dermatology residency at the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine. At Miami, she was awarded several mentorship and training grants by the Women’s Dermatologic Society and American Society for Dermatologic Surgery.
Dr. Ritu Saini is specially trained in Mohs Micrographic Surgery under the direction of world-renowned Mohssurgeon Dr. Perry Robins, Professor Emeritus of New York University Department of Dermatology.
Skin Cancer Solutions at NY Medical Skin Solutions, we strongly advocate yearly total body skin exams and strict sun protection This in conjunction with monthly self-examinations are vital to the early detection and treatment of skin cancers. Knowing what to look for is vital: Skin cancer often has roots that are not visible to the naked eye. MOHs Micrographic Surgery is a specialized method to remove skin cancer that spares healthy tissue surrounding the tumor and provides the patient with the peace of mind in knowing that there are free of skin cancer upon leaving the office. In addition to basal cell and squamous cell cancer, MOHs surgery is used to treat many other less commonly see skin cancers such as atypical fibroxanthoma, sebaceous carcinoma, dermato fibrosarcoma protuberans, etc. Conventional surgical removal of skin cancers consists of taking wider margins without knowing whether or not the margins are clear. With Mohs surgery, complete removal of skin cancer approaches 99% and has the lowest rate of recurrence as compared with other modalities used to treat skin cancer. In most cases, after the skin cancer is completely removed, the defect created from the surgery will require closure or reconstruction. Dr. Saini will design and carry out an appropriate repair that will maximize the best cosmetic outcome and minimize the scar. The vast majority of repairs are done the same day in the office follow-
22 November 2010
Aesthetics
Injectable Treatments: N.Y. Medical Skin Solutions offers a wide variety of facial fillers and injectables with the understanding that every patient is unique and has different needs and concerns. Often, several of these products must be used in conjunction with one another in order to maximize results. Dr. Saini will determine which products are most suitable to help you achieve you aesthetic goals. We offer Botox, Radiesse, Restylane and Perlane Sculptra, Evolence and Prevelle Silk.
Laser and Light-based Treatments
We offer a variety of laser and light-based treatments at NY Medical Skin Solutions including: • Laser Hair Removal • Laser Genesis • Skin Rejuvenation
Skin Care Regimens
There can be so many different, subtle variations between the quality of a one person’s skin and that of another. Allow us to create a skin care regimen and educate you on products that will specifically address your needs whether it be for sun and environmental damage, acne, rosacea, natural aging, or simply prevention and anti-aging:
Sclerotherapy
• Chemical Peels • Acne Peels and Surgical Dermatology • Surgical Dermatology
MEDICAL AESTHETICS BioSkinErgy is a cutting edge medical spa founded by board certified Dr. Dov Goldstein Dr. Goldstein, founder of BioSkinergy explains how with the help of new technology to can treat yourself to a new smoother, sexier figure. Velashape is a proven non-surgical alternative to liposuction. This method contours, shapes and slims the body by improving cellulite and reducing circumference in as little as 4 procedures. This is perfect for women who have had children and experience an increase in skin laxity, and dissatisfaction with body image.
Dr. Dov Goldstein BioSkinErgy 55 Central Park West Suite 1C New York, NY 10023
1.866.637.7679 BioSkinErgyNewYork.com
Dr Goldstein, explain how Velashape works and how it can remove stubborn cellulite Velshape™ is very simple and very precise. It uses special technology to target the fatty tissues. It cause the fatty tissue heat up. The process then vaccuums and manipulates the tissue causing the skin to be evened out which results in a smoother and tighter composure of the skin.
Dr. Dov Goldstein and Shani Vaynshenker, Clinic Director.
How many inches can a patient lose in circumference It is possible for a patient to lose as much as 1 inch post treatment. However it was reported in clinical trials that the average patient lost 0.5-3 inches.
How safe is Velashape and does it come with FDA approval Velashape™ has been FDA approved and is a safe and alternative treatment as opposed to liposuction. It can be performed on all skin types and colors, and has not reported any long-term or short-term effects on an individuals health.
Does the treatment need to be continued in order to maintain the results I would reccomend that each patient follows a regimen and has treatment at later stages depending on how severe the signs of cellulite are that re-appear. The results will definitely last longer if the individual eats a balanced, nutritous diet and excercises regulary.
Does the treatment hurt
The Velashape™ non-invasive, body shaping and contouring device, available at BioSkinergy, was created by Syneron, maker of VelaSmooth™, and delivers noticeable results beginning with the first 30 minute treatment. BioSkinergy offers financing options to make this amazing new treatment affordable to virtually anyone. Contact us today to learn more .
Patients experience a warm sensation that has been likened to a deep tissue massage.We have settings that adjust to your particular comfort level. Most patients experience a warm sensation that will last for a few hours after the treatment. There may also be a slight redness of the skin for a few hours afterwards. ManhattanMedicalMag.com
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Dr. Rajesh Kamdar
“The Key to a Healthy Life and Heart is Healthy Teeth and Gums”
Dr. Rajesh Kamdar explains the direct link between gum disease and cardiovascular Disease and why a healthy mouth and gums can reduce your risks dramatically. Dr Rajesh Kamdar will not have been the first you heard it from, but he will tell you over and over again - “ key to a healthy life, and a healthy heart is healthy teeth and gums.” From his office in Chelsea in Manhattan, Dr. Kamdar takes the utmost care in explaining the importance of a healthy mouth and the need for regular cleaning and examination. He cites recent articles about the important link between gum disease (periodontitis) and cardio-vascular disease. “There were a number of studies done in 2000 that were important discoveries that proved an undisputable link between gum disease and coronary heart disease. There are a number of theories.” A study done at the University of Otago Dunedin in New Zealand, investigators found that bacteria involved with gum disease was linked to “hardening of the arteries” also known as atherosclerosis. Atherosclerosis is known to be a main cause of heart attacks. The bacteria that harbours in the mouth and causes gum disease produces dangerous proteins that trigger the immune system to release white bloods cells. The white blood cells build up in the walls of the arteries and indefinitely lead to atherosclerosis. The conclusion: GUM DISEASE CAUSES HEART DISEASE.
135 W. 27th St. New York, NY 10001 [btwn 6/7 Ave.]
212.594.7171 www.pdc.ms
Moderate Periodontitis - How can you avoid gum disease and it’s unpleasant consequences? The answer is simple. Brush properly and floss everyday. Also see your dentist for regular cleanings. If you have negelected to do this, start today by visiting your dentist. If periodontal disease can be treated in the early stages many times it can be reversed.
Another study in Germany found similar findings and scientists urged dentists to treat and diagnose gum disease as early as possible. The statistics are alarming. In the US. Gum disease is the major cause of tooth loss in adults over 40 years old and affects 90% of individuals over 60 years old. The number one killer in the world today - CORONARY HEART DISEASE. Dr. Kamdar says it is important that steps are taken quickly if a patient thinks they have gum disease. Tell-tale signs may be bleeding or receding gums, bad breath or even loose teeth. Fortunately, gum disease in the early to middle stages can usually be stopped by practicing good hygiene and dental treatment. Dr. Kamdar is dedicated to helping and showing patients how to take care of their teeth and reduce the effects of gum disease.
FREE Examination $239 value. Bring this voucher to your appointment
212.594.7171 24 November 2010
www.pdc.ms
HYPNOSIS Q&A
by Dr. Errol Gluck Gluck Solutions - Hypnosis 420 Lexington Ave. New York, NY
1.866.971.2104 GluckSolutions.org
Who is Dr. Errol Gluck? Dr. Gluck is a world renowned Medical Hypnotist, Executive Live Coach, and Motivational Speaker. Dr. Gluck has helped thousands of people change and improve their lives. He is able to use hypnotherapy as a tool to transform a person’s desire to do something into the ability to do it. Hypnosis changes not only the way you think, act, and feel - it actually changes the way the brain functions. In a few short sessions you will start to see the changes that you have longed for physically and mentally.
What is Hypnosis?
There are many different definitions for hypnosis. What is most important to understand is that by changing the way we think we not only change the way we feel but we change the way the brain operates. Many people have grown up with belief’s that limit their potential or have experienced traumatic events that have shaped their beliefs. Hypnosis puts you in a relaxed state making different parts of your brain available to powerful life changing suggestions that will produce outcomes such as the ability to stop smoking, reach an ideal weight, change eating habits, decrease anxiety, alleviate depression, overcome fears and phobias, combat addiction, decrease shyness and increase selfesteem, etc. Hypnosis is the most effective tool that will change your life in a short period of time with permanence.
Is Hypnosis safe?
The induction of hypnosis is NEVER dangerous to you. You remain in complete control during the entire session and can terminate at any time. You will not be subjected to do anything you do not feel is acceptable or are not comfortable with. It is not addictive, absolutely no drugs are used and there are no unwanted side effects. Both the American Medical Association and American Psychiatric Association have approved hypnotherapy as being safe and effective.
How can Hypnosis change my life?
Hypnosis is a therapy tool that can give you the power to take charge of your life from our first session. Hypnosis works faster and more effectively than any other therapy without the use of any drugs.
How many sessions will I need in order to see results?
For something as simple as weight control or smoking, two sessions might be needed depending on our individual
goal. For more complex issues such as anxiety and depression, additional sessions may be necessary. [Each individual may vary depending on the severity of the issue at hand.]
Are the results of Hypnosis permanent?
The effects of hypnosis are cumulative. Suggestions stay with some individuals indefinitely, while other people find they need the reinforcement. The more techniques and practices put into play, the more permanent results you will see.
Where is Hypnosis most effective?
While it is effective in treating any behaviour that is brain related, it is often used to treat areas such as weight-loss, eating-disorders, phobias, anxiety, depression, addictions, shyness and sports performance. Q: I am an owner/manager of a company - how can hypnosis help my company? The Velashape™ non-invasive, body A: Hypnosis can help your company by: device, available shaping and contouring at BioSkinergy, was created by Syneron, Helping your employees to become non-smokers. Not maker VelaSmooth™,and delivers only will this improve theirof health and self-esteem, noticeable results beginning with the first but it will also improve your bottom line by reducing 30 minute treatment. BioSkinergy offers absenteeism and improving productivity. financing options to make this amazing new improving treatmentthe affordable virtually Increasing your sales, morale oftoyour sales people and reducing stress. anyone. their Contact us today to learn more. Creating powerful focus and concentration and improving your employees’ performance. “GROUP DISCOUNTS AVAILABLE FOR CORPORATE ACCOUNTS.” ManhattanMedicalMag.com
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Ruby Gelman, DMD
PEDIATRIC DENTISTRY
Dr. Ruby Gelman’s pediatric dental service provides check-ups, crowns, dental sealants, fillings, fluoride treatments, and teeth cleaning as well as ‘first dental visits for young patients. After graduating from Maimonides School in Brookline, MA, Dr. Ruby attended Barnard College of Columbia University for her undergraduate education. She then received her dental degree at the University of Pennsylvania School of Dental Medicine in 1998. Dr. Gelman completed her Specialty Training in Pediatric Dentistry from The Children’s Hospital of Buffalo/SUNY at Buffalo in 2000, where she also served as a clinical instructor in the department of Pediatric and Community Dentistry. For much of the last decade, Dr. Gelman has happily made New York City her home. Dr. Gelman is an active member in the Academy of Pediatric Dentistry, The New York Academy of Collaborative Dentistry, and the American Association of Women Dentists and participates extensively in continuing education programs both for pediatric dentists and dental professionals in general. Dr. Gelman is proud to have written and been quoted in several published articles. Dr. Gelman is extremely proud to have been chosen by Nickelodeon Parents Picks as the best pediatric dentist in New York City for 2009! Dr. Gelman’s office offers comprehensive dentistry for infants, children, and adolescents, including those with special needs. Services include, but are not limited to, the following: First Dental Visit, Exams & Cleanings, Prevention, Restorative treatment (with or without nitrous oxide gas), and Space maintenance and management.
BEFORE THE FIRST VISIT May we make the following suggestions to make your child’s first visit to Dr. Ruby Gelman’s office easier? Tell your child that Dr. Gelman will be gentle and friendly and will count their teeth. Please do not tell your child that the dentist will not hurt, as this may never have entered their mind. Please do not use words such as needle, shots, drill or other words suggesting unpleasantness. Expect your child to do well and enjoy the first visit to our office and chances are they will! 26 November 2010
155 East 38th St. Suite 2D
[btwn Lexington and Third Avenue in Murray Hill]
New York, NY
1.866.767.3740
RubyGelman.com info@rubygelman.com
The initial appointment is reserved specifically for your child. Any change in this appointment affects many patients. If a cancellation is unavoidable, please call the office at least 24 hours in advance so that we may give that time to another patient. Please complete the health history form on the website and bring it with you to the first appointment.
THE FIRST VISIT We will review the Health History Form with you at the first visit. At that time, you and your child will be introduced to our dental team. Parents are welcome to accompany their child during their visit. This gives you an opportunity to see us working with your child and allows Dr. Gelman to discuss dental findings and treatment needs directly with you. While we are interacting with your child, please assume the role of a silent observer. If more than one person is talking, your child may become confused. Siblings are encouraged to remain in the reception room. Dr. Gelman will perform a head and neck examination and evaluate the health of the teeth and gums. Radiographs (x-rays) are taken only as Dr. Gelman feels they are necessary. If no treatment is needed, the teeth will be cleaned and a fluoride treatment will be discussed. Additional services will be scheduled for a later visit. Please contact our office if you have questions regarding payment or dental insurance.
THE FARBER CENTER
Exactly what is the Farber Center? The Farber Center is a highly specialized state of the art Radiation Oncology treatment center, based in Manhattan. The mission of the Farber Center is simple: To provide outstanding, unparalleled, and innovative care while catering to patients real lives both at the center and beyond. We feature the first and only freestanding radiation oncology facility of its kind in Manhattan. Patients who have experienced radiation treatments, particularly in a hospital setting, can attest to the sometimes impersonal environment. When you’re fatigued, anxious, and vulnerable, these cold, sterile surroundings can make an already trying experience unnecessarily unpleasant for you and your family. The Farber Center trades in the typical basement treatment center for a warm, welcoming environment that allows you to focus on getting well. Following your session, you’ll speak to your radiation oncologist oneon-one in a comfortable setting that invites you to ask the many questions that are on your mind. Cancer patients endure enough physical challenges—it is the Farber Center’s mission that they never endure the fear, embarrassment, and anxiety that so often accompany treatment.
What makes us different? When you walk into the Farber Center, the first question you’re asked is what you’d like to drink—not what insurance you have. Instead of hours of waiting in an antiseptic environment in a paper gown, you can expect a short rest by the fireside before slipping into a plush robe in a private dressing room. No freezing, basement treatment facilities here—treatment sessions take place in a warm, welcoming room. Exams are done on a spa like table with a real fitted sheet. At The Farber Center, your life doesn’t stop for cancer—cancer is stopped so your life can go on.
What are the goals of the Farber Center? Radiation oncologist Dr. Leonard Farber founded the Farber Center for Radiation Oncology with the goal of providing unparalleled, innovative care while catering to patients real lives both at the center and beyond. The first and only freestanding radiation oncology facility of its kind in Manhattan, the Farber Center represents a warm alternative to the sterile and often daunting hospital environment without compromising quality of medical care and they accept most insurance plans. Drawing on his longstanding experience as one of the most respected radiation oncologist in the field, Dr. Farber handpicked the most innovative technology, sought-after physicians, and superior facilities in the
for Radiation Oncology The Farber Center for Radiation Oncology 21 West Broadway New York, NY 10007
212-300-0663 thefarbercenter.com world to establish what is first and foremost a superlative treatment center. In fact, the Farber Center’s independent status allows the facility to take advantage of the most sophisticated technology available,offering superior treatment under the guidance of highly regarded professionals while treating patients as people.
Who is Leonard Farber M.D. and his medical team? A Board Certified physician in Radiation Oncology, Dr. Farber has been in private practice for over a decade, recently serving as Chairman of Radiation Oncology at Staten Island University Hospital. Dr. Farber specializes in adult radiation oncology, with particular focus on breast and gastrointestinal malignancies, lymphomas, head and neck cancers and lung cancers. He is an expert in HDR brachytherapy for various types of cancers, including breast, skin, gynecologic malignancies, and intracranial and body radiosurgery. After receiving his B.S. and B.A. at the State University of New York at Binghamton, Dr. Farber pursued his M.D. at the Mt. Sinai School of Medicine in New York. Following an internship in internal medicine at Beth Israel Medical Center in New York, he did his residency in Radiation Oncology at the Hospital of the University of Pennsylvania in Philadelphia, where he served as Chief Resident. Dr. Farber is a member of the American Society for Therapeutic Radiology and Oncology, the American College of Radiation Oncology, the American Radium Society, the American Brachytherapy Society, the New York Cancer Society, the New York Metropolitan Breast Cancer Group, the New York Head & Neck Society, and the Long Island Oncology Network.
Dr. Marnee Spierer (Radiation Oncologist and Partner): A Board Certified physician in Radiation Oncology, Dr. Spierer recently served as Assistant Professor of Radiation Oncology at Montefiore Medical Center/Albert Einstein College of Medicine, where she served as residency program director and was instrumental in the education of residents and ManhattanMedicalMag.com
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medical students. Dr. Spierer also played an integral part of the multidisciplinary sarcoma, pediatric and breast tumor boards. She specializes in adult radiation oncology, with particular focus on breast cancer, sarcoma, and stereotactic body and CNS radio surgery. After Receiving her B.A. at the University of Michigan, Dr. Spierer pursued her MA at the teachers College at Columbia University. Dr. Spierer then went on to pursue her M.D. at Columbia University in New York. Following an internship at St. Barnabas Medical Center in New Jersey, she did her residency in Radiation Oncology at Memorial Sloan Kettering Cancer Center in New York.
Dr. Lauren Shaiova is Board Certified in Hospice and palliative medicine. Currently Dr. Shaiova is Chief of the department of pain medicine and palliative care for Metropolitan Hospital Center in New York City where she has developed the only Department and ACGME fellowship in a public hospital in the country. Dr. Lauren Shaiova Trained as a fellow in Pain Medicine and Palliative Care at Memorial Sloan Kettering Cancer Center. After her training she accepted a position as an attending physician in the Department of Pain and Palliative Care at Beth Israel Medical Center in NYC, and was appointed assistant professor at the Albert Einstein School of Medicine.
Dr. Michael Jackowitz (Patient Liaison): He did his undergraduate work at Emory University in Atlanta, GA and completed his osteopathic medical training at NOVA/Southeastern College of Medicine with a D.O. degree. After completing his residency in Internal Medicine at Beth Israel Medical Center in New York City, Dr. Jackowitz practiced as a hospitalist with Stamford Hospital for a number of years before going into primary care in Yorktown Heights, NY with a special emphasis on preventive medicine. Dr. Jackowitz then became the Director of Clinical Affairs for Imaging Heart in NYC and helped pioneer the protocols for non-invasive coronary CT-angiography. He also became one of the house doctors for NYC Ballet and NYC Opera at Lincoln Center.
What types of cancer are treated at The Farber Center? 28 November 2010
We are all inclusive for adults cancers including: Anal, Bladder, Bone Metastases, Breast, Brain Tummors, Cervical, Colorectal, Esophageal, Gastric, Hodgkins Lymphoma, Hypopharyngeal, Laryngeal, Lung, Multiple Myelona & Plasmacytoma, Nasopharyngeal, Non-Hodgkins, Lymphoma oral, Cavity Oropharyngeal, Ovarian Pancreatic, Prostate, Salivary Gland, Sarcoma, Sinus, Skin, Testicular, Uterine, Vaginal, Vulvar.
What is radiation therapy? Radiation is energy carried by waves or a stream of radioactive particles. The radiation comes from special machines or directly from radioactive substances. At high doses it can be used to treat cancer and other illnesses. Special equipment is used that can direct the radiation to particular parts of the anatomy-tumors or areas where there is disease. This method of treating disease is known as radiation therapy. It’s known as radiotherapy, x ray therapy, electron beam therapy or irradiation.
How does radiation therapy work? As cancer cells divide rapidly and grow quicker than many of the normal cells around them radiation therapy is used to treat the cancerous cells and by irradiating them with high doses of radiation that either kill the cells or keep them from growing or dividing. Some of the normal cells are affected by radiation but most of them recover more fully than the cancer cells. We use our expertise to restrict or shape the radiation beam so that the cancerous area is affected more than normal tissue.
How is radiation therapy delivered? Radiation therapy can be delivered in two ways, externally and internally. The majority of pediatric cancers are treated with external radiation. During external beam radiation therapy, radiation beams come out of a machine called a linear accelerator. The beams are aimed at the tumor (either where it is or where it was before surgery and/ or chemotherapy). You don’t see it, feel it, or taste it; it is completely invisible. To minimize side effects, treatments are typically given five days a week, Monday through Friday, for a number of weeks. This allows enough radiation to get into the body to kill the cancer while giving healthy cells time to recover.
THE FARBER CENTER ... Is radiation theraphy safe? Radiation has been used successfully to treat patients for more than 100 years. In that time, many advances have been made to ensure that radiation therapy is safe and effective. Before you begin receiving radiation therapy, your radiation oncology team will carefully tailor your plan to make sure you receive safe and accurate treatment. Treatment will be carefully planned to focus on the cancer while avoiding healthy organs in the area. Throughout your treatment, members of your team check and re-check your plan. Special computers are also used to monitor and double-check the treatment machines to make sure the proper treatment is given. Radiation therapy will not make you radioactive after treatment.
What are the benefits and goals of radiation therapy? Radiation therapy is an effective way to treat many kinds of cancer in almost any part of the body. The Majority of people with cancer are treated with radiation, and the number of cancer patients who have been cured is rising every day. For many patients, radiation is the only kind of treatment needed. Thousands of people are free of cancer after having radiation treatments alone or in combination with surgery, chemotherapy, or biological therapy.
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patient has side effects. The risk of side effects is usually less than the benefits of killing cancer cells. Your doctor will not advise you to have any treatment unless the benefits -control of disease and relief from symptoms -are greater than the known risks.
Although it will be many years before scientists know all of the possible risks of radiation therapy, they now know that it can control cancer Is radiation therapy expensive? The treatment of cancer is a costly procedure. The use of complex equipment and the expertise of many health care professionals make this unavoidable. However the radiation therapy will depend on the type and the number of treatments you need. Most insurance policies, including Part B of Medicare, cover charges of radiation therapy. If you need financial aid you may contact the Cancer Information Service, the local office of the American Cancer Society. If you need to talk with someone and have recently been diagnosed and want to discuss your options then call us at the number below. We are here to help.
Doctors can use radiation before surgery to shrink a tumor. After surgery, radiation therapy may be used to stop the growth of any cancer cells that remain. Your doctor may choose to use radiation therapy and surgery at the same time. This procedure is known as intraoperative radiation. In some cases, doctors use radiation along with anticancer drugs to destroy the cancer, instead of surgery. Even when curing the cancer is not possible, radiation therapy still can bring relief. Many patients find the quality of their lives improved when radiation therapy is used to shrink tumors and reduce pressure, bleeding, pain, or other symptoms of cancer. This is called palliative care.
Are there risks involved? Like many other treatments for disease, there are risks for patients who are receiving radiation therapy. The brief high doses of radiation that damage or destroy cancer cells also can hurt normal cells. When this happens, the
“The Farber Center for Radiation Oncology is the first and only radiation oncology center in the area to acquire the Elekta Infinity with Volumetric Modulated Arc Therapy (VMAT) technology, the next generation in radiation treatment for cancer and the reason those in search of the most advanced care often travel abroad.�
ManhattanMedicalMag.com
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Why The Farber Center We will be the first in New York to use the Elekta Infinity with VMAT technology that uses real-time 3D imaging to conform the radiation beams to the shape of your tumor, which allows us to develop a treatment plan tailored to your individual needs, resulting in maximum accuracy and precision, and a lower incidence of side effects. The flexibility to deliver treatments in uninterrupted rotations of the linear accelerator allows for faster treatment times We will be the first in Manhattan to offer Accuboost. This technology allows High Dose Rate (HDR) brachytherapy treatment of breast cancer in a non- invasive way. In breast conservation therapy, it is important to administer a “boost” dose of radiation to the lumpectomy site to further protect against recurrence. Before each session, AccuBoost helps our doctors visualize the treatment area, providing an extremely precise digital map of the target for unmatched accuracy. We will be the first in Manhattan to offer Flexitron. This
30 November 2010
advanced HDR brachytherapy delivery system brings a whole new world of safety to brachytherapy,providing tothe-millimeter accuracy while allowing our physicians to administer higher, more concentrated doses of radiation directly to cancer cells. Without having to pass through healthy tissue first, the radiation is delivered precisely and accurately to the tumor–leaving you with shorter recovery time and fewer side effects. We will be the first and only in New York to offer the same state-of-the-art system used by renowned MD Anderson’s BrainSuite®. Anatom-e combines interactive, highly detailed diagrams with CT scans and intensity modulated radiation therapy to streamline the diagnostic process and prevent the treatment of healthy tissue, sparing organs at risk, reducing side effects and cutting off pathways of spread.
The Farber Center for Radiation Oncology 21 West Broadway, New York, NY 10007
212-300-0663 thefarbercenter.com
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Ritu Saini, M.D. I first met Dr. Saini several years ago when she was working with Dr. Perry Robins. Dr. Robins, who had been my dermatologist for two decades, said to me, “someday Dr. Saini will be taking care of you.” He considered her the “brightest penny” he ever met. Now Dr. Saini has operated on basal cell and squamous cell carcinomas on my Irish face. She is a surgical artist as each scar is nearly invisible. She is as charming and lovely as she is talented.” Bob O’Brien, Retired Channel 5 News Reporter
Board certified Dermatologist and Dermatologic Surgeon specialty care for all your skin needs Cosmetic procedures and injectables Mohs surgery for skin cancer Screening treatment and diagnosis of skin cancer Removal of moles, cysts and warts Nail and hair disorders Treatment of sun damaged skin Treatment of acne We accept most insurances A board certified dermatologist and dermatologic surgeon, specializing in Mohs micrographic surgery, cosmetic dermatology, dermatologic and laser surgery, Dr. Saini obtained a dermatologic surgery fellowship under the direction of world-renowned Mohs micrographic surgeon, Dr. Perry Robins. During that year, she received additional training in Mohs, reconstructive, and laser surgery along with cosmetic dermatology at Cosmetique Dermatology, Lasers, and Plastic Surgery.
345 E. 37th St., Ste. 209 New York, NY 10016
1.866-229-4132 NYMedSkin.com