G R E AT E R A U S T I N
NSIDE
MD MAY.JUNE 2012
THE RED FLAGS IDENTIFYING
PATIENTS WITH EATING DISORDERS
VeinSolutions A MODEL OF MEDICAL EXCELLENCE HIGH-CALIBER CLINICAL MASSAGE The Austin Bodyworker
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nsidethisissue may/june 2012
NSIDE Austin MD Magazine May/June 2012
CO-PUBLISHER Angela Strickland
EDITOR
Erin O’Brien
creative director Elisa Giordano
account executive Mandy McFarland
contributing writers Myles Cooper Taylor Davis Tracy Ganske Ashley M. Halligan Dr. Kevin Kim Jody Joseph Marmel Dr. Jose Pliego Dr. Samantha Symons
Under the guidance of Drs. Emery Dilling and Jeffrey Apple, the highly qualified staff at this patientoriented practice provides topquality care, establishing the practice as one of the leaders in cosmetic and therapeutic vein care.
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cover story | veinsolutions
24patient 28md
A clinical approach to massage
Eating disorders: The warning signs
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PHOTOGRAPHY
fieldphotography.com Jonathan Garza Gerry Hanan De Ann Hoeft Margaret Licarione
editorial intern Desiree Johnson
NSIDE is a proud member of the Austin Chamber of Commerce.
www.getnside.com For advertising and/or editorial information, please call 512.506.1248 or email adminatx@getnside.com.
departments 08 18 20 26 28
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nonprofit feature patient health & wellness md
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NSIDE Publications Austin • San Antonio • Corpus Christi Copyright © by NSIDE Magazine Inc. All rights reserved. Reproduction without the expressed written permission of the publisher is prohibited.
Dear Doctor: Interim Homecare provides a comprehensive array of healthcare services in your patients’ home. Helping your patients with new medications, diabetes management, CHF and other related cardiac complications, COPD, wound care, helping regain strength and mobility or other services that will aid in your patients’ recovery process. We at Interim Healthcare look forward to serving all your needs.
Dear Doctor: Interim Hospice will assist you with those difficult conversations with patients about end of life decisions. We will address pain and other symptoms that your terminal patient may have so they are comfortable during their last days and months. We will help families prepare for the death of their loved one – spiritually, emotionally, and financially.
Interim Hospice 800.678.5711 / 512.454.5711 Austin
Interim Homecare 800.678.5711 / 512.454.5711 Austin NSIDE AUSTIN MD
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[ nside / nonprofit ]
Out and About With Citizen Generation The organization continues to provide opportunities for fun philanthropy through the spring and into the summer with a number of CharityLadies, CharityBash and CharityVolunteers events.
by Taylor Davis
March CharityLadies
On the evening of March 21, avid CharityLadies followers flocked to Gallery D boutique on 2nd Street to unwind while enjoying fashion and helping a worthy local nonprofit. Attendees donated grocery store gift cards, stamps, yoga mats, translation books, jump drives and more for Con Mi MADRE, an organization that provides a spectrum of support services for junior high and high school Hispanic girls and their mothers, aiming to prepare the students for college. At no cost, more than 700 girls and their mothers
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receive that extra mile of help that will allow them to achieve their personal, educational and career goals. The CharityLadies also supported women entrepreneurs Emily Keast and Beth Newill, who reached their own lifelong goals when they opened Gallery D in 2009. Both of these young women exude the fresh style Austin is known for, while adding their own unique twist in the fashions the boutique carries. Another breath of fresh air at the March CharityLadies was the private fall 2012 collection debut of Dekla, local fashionista Jordan Martin’s clothing line. The line featured a mix of feminine, yet sexy and versatile piec-
es in a refreshing color palette of gold, cream, emerald and cobalt. Martin utilizes vintage trims and details with U.S.-sourced fabrics, making the Dekla pieces extra special. In addition to being entertained by fashion, networking and the Generous Art sale, the CharityLadies enjoyed treats by GoodPop, Cornucopia and Bon Bons by Serena while sipping on St-Germain and champagne cocktails from Twin Liquors. Supported by Austin Woman and Austin Tidbits, the CharityLadies gathering truly embodied its goal of supporting women, all while soaking up the newest fashion trends for summer and beyond. Be sure to visit Citizen Generation’s website and Facebook page to view event photos by Genesis Escobar Photography.
April CharityBash
On April 1, CharityBash put its own twist on a relatively new social phenomenon: Sunday Funday. The young philanthropists gathered at Javelina, Rainey Street’s brand-new gem, to support multiple sclerosis research and advocacy, and to celebrate the April issue of Austin Fit Magazine. The laidback atmosphere, full brunch menu and drink specials made this event the perfect way to spend a Sunday afternoon. More importantly, though, was that everyone in attendance donated $10 to the MS Society: Bailey’s Bikers’ MS 150 fund. The local Bailey’s Bikers group is a team dedicated to raising money for multiple sclerosis research and awareness through participation in the MS 150 bike ride. Led by Capt. Leslie Bailey, who was diagnosed with the condition several years ago, this
team is a true testament to living life to the fullest, and this CharityBash captured that spirit through fun and philanthropy. Special thanks go to Austin Fit Magazine, Do512, TRIBEZA, Pure Austin Fitness, Papermud, Deep Eddy Vodka, Solange Phillips Photography and Austin Tidbits for making this event a success.
Spring and summer volunteer opportunities
With the novelty of New Year’s resolutions wearing off, you may be looking for some new ways to de-clutter your life or get involved in the community. You’re in luck, because spring and summer offer the perfect opportunities to do just that. To make this year’s spring cleaning a little easier to bear, try donating some gently used work attire to Dress for Success, a nonprofit that provides interview and business clothing for women who are struggling financially, but looking to get back in the workforce. Also for the ladies, pull out those old prom and bridesmaid dresses and donate to Prom Rack, a local organization that provides prom dresses for Central Texasarea girls with financial limitations. As the weather continues to warm up, a great volunteer option for this time of year is at Austin Pets Alive!, where adorable dogs and cats that need daily feeding and exercise are sure to brighten even the gloomiest spring days.
Check www.citizengeneration.org and the Citizen Generation Facebook page regularly, as upcoming CharityBashes, CharityLadies and CharityVolunteers are just around the corner, providing Austinites with fun and fulfilling opportunities to get involved. NSIDE AUSTIN MD
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march nside networking event at edge boutique benefiting american gi forum national veterans outreach program
Photography by Jonathan Garza
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april nside networking event at russell gallery benefiting austin children’s shelter
Photography by de ann hoeft NSIDE AUSTIN MD
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kendra & cocktails
Fleming’s Prime Steakhouse & Wine Bar and Kendra Scott Designs partnered on an event on April 5 featuring drinks from the new Fleming’s cocktail menu and Scott’s spring jewelry line. The event, called Kendra & Cocktails, was held in the private dining room at the Downtown Austin Fleming’s at 320 E 2nd Street. Proceeds benefitted LifeWorks, a local nonprofit organization. photography by gerry hanan
red, hot & soul
ZACH Scott Theatre’s biggest fundraiser of the year took place on April 21, 2012. This year’s event focused on one of the most significant moments in ZACH’s storied history: the opening of the new Topfer Theatre in fall 2012.
Celebrando Austin
The Greater Austin Hispanic Chamber of Commerce’s annual awards banquet, benefitting the chamber, took place on April 14, 2012. Now in its 39th year, Celebrando brings together the most distinguished and accomplished leaders in Austin’s Hispanic community.
photography by fieldphotography.com
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“
When you combine our VeinSolutions practice with our office-based endovascular treatment center, you really have a one-stop, comprehensive venous treatment center.�
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Quality of Care is Key For Drs. Emery Dilling and Jeffrey Apple, patients are always top priority at VeinSolutions, one of the leaders in cosmetic and therapeutic vein care.
by Jody Joseph Marmel photography by margaret licarione
H
aving a demand for a comprehensive, patient-oriented practice for the treatment of venous disease in Austin, VeinSolutions opened in 2003. Dr. Emery Dilling, medical director and the lead physician of this unique office for both medically debilitating and cosmetic venous problems, is proud of the excellent quality of care and the success rate of their evergrowing patient population. “There clearly was a need for both surgical and non-surgical treatments, and a single office where all of that could be offered would be advantageous,” Dilling says. “We also believed it was important that we staff the clinic with board-certified vascular and cardiovascular surgeons. Using the VeinSolutions model developed in Indianapolis, the clinic took off immediately.” Being a division of Cardiothoracic and Vascular Surgeons, PA (CTVS) in Austin, both Dilling and Dr. Jeffrey Apple agree on the advantages. “We already had a great administrative team in place, so we could concentrate on taking care of the patients,” Dilling says. “Having served the community for over 54 years, CTVS is a well-known brand in the Austin medical community, and it gave us instant credibility for the vein clinic.” “It gave primary care providers and referring physicians peace of mind that they were sending their patients to a dedicated and well-respected physician group here,” Apple adds. With hundreds of new patients every year, VeinSo-
lutions is the type of medical facility Central Texans welcome and admire. “We used VeinSolutions as a practice model and startup due to the experience and brand name that VeinSolutions has across the country,” Apple says. “Beginning with the VeinSolutions franchise, it allowed us to learn from others’ experiences.” Each VeinSolutions office is completely independent. “While we share a name and common philosophy in approaches to treatment,” Dilling says, “we are all connected in a way that allows sharing of knowledge between groups at regular meetings, as well as contracting with vendors. This has been a great advantage to all of the VeinSolutions offices.” Noting that VeinSolutions is extremely popular within the Austin community says a great deal for the practice. “The goal of the practice was never meant to be a cosmetic practice,” Apple says. “Being a separate division of CTVS, however, did allow our cosmetic patients a nice office setting in order to relax and discuss their needs outside of our busy cardiothoracic and vascular surgery practice. The patient demographics and degree of illness are drastically different between the two practices.” Dilling agrees. “We were concerned with the medical needs of patients with painful varicose veins, as well as accommodating the cosmetic service we could offer.” And the results have been excellent in all areas of their practice. NSIDE AUSTIN MD
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Delivering the full spectrum of venous care, from cosmetic sclerotherapy all the way to the treatment of deep vein thrombosis and its long-term consequences, is an amazing feat. “No other practice can provide that with as much experience as we have. We offer both surgical and nonsurgical interventions for patients and incorporate office-based ultrasound to improve treatment planning and convenience
“Our office staff is exceptional and has been with the practice from the beginning. This translates into patient comfort and security - two essential ingredients when visiting your doctors.” for our patients. When you combine our VeinSolutions practice with our office-based endovascular treatment center, you really have a one-stop, comprehensive venous treatment center. “Our office staff is exceptional and has been with the practice from the beginning. Knowledgeable and friendly
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staff grants VeinSolutions extra credit points. This translates into patient comfort and security – two essential ingredients when visiting your doctors.” Emphasizing the importance of having board-certified vascular and cardiovascular surgeons delivering the vein treatments is a part of their mission statement. Offering only state-of-the-art procedures is another important component to add to their list of exceptionalism. Their easygoing personalities and wonderful bedside manner are appreciated by all patients. This creates a winwin situation for all parties involved. Having their patients’ best interests at heart is the key element to their medical success story. Both doctors place this at the top of the list. “We realize that sometimes just providing education is the best option for our patients,” Apple says. “As we have all treatment modalities at our disposal, we can try to remain objective about which treatment options are best for the patients.” Being “the leaders in cosmetic and therapeutic vein care,” Dilling adds, “We offer state-of-the-art vein care both medically necessary and cosmetic. There is no limit to treatments offered due to skill issues, and options are varied.” Again, with these doctors, the patient is and always will be the No. 1 priority. Ron Acuna, a patient of Dilling, had two procedures on his right leg. He had a greater saphenous vein (GSV) ablation and a small saphenous vein ablation. He also had the
removal of visible varicose veins (phlebectomy). Acuna’s pain level prior to the procedures was seven out of 10. “Prior to the surgery, local anesthetic was administered in the area,” he says. “I felt no pain after the anesthetic. I left the office pain-free. After the procedure, I felt better and I was lighter on my feet, which was the biggest tangible benefit.” Mentioning that the aesthetic look of his legs was another benefit, Acuna emphasizes that the staff and Dilling were very accommodating throughout the process. “They made sure I was comfortable, and the quality of care was excellent.” Susan Campion, a patient of Apple, had a right GSV ablation and phlebectomy in both legs. Her experience echoes that of Acuna. From all the procedures performed by Apple, she says, “I felt better in a matter of days. I was up and about within three days, and I felt better than I had in years. As time has passed, my circulation has improved and the aches I used to feel have disappeared completely. “I would recommend VeinSolutions to anyone, and if I had to, I wouldn’t hesitate to do it all over again under Dr. Apple’s care. His concern for my well-being was apparent from the very beginning.” Dilling and Apple’s shared interest in venous
disease and their passion for medical and cosmetic results that go beyond the boundaries of superior medical care are another reason VeinSolutions is a highly respected practice in Austin. Having been a cardiothoracic surgeon for 25 years, Dilling was ready to move on to a new challenge. “VeinSolutions came along, and I had an instant new career.” Treatment of deep vein thrombosis (DVT) and its long-term effects on the venous system brings an additional level of commitment to all of their patients with deep vein disease. “My practice is filled with patients who received the ‘standard of care’ treatment for DVT years ago. But now they have debilitating venous disease. It’s very rewarding that we can offer these patients treatment and often, they return to full functional capacity.” While interviewing the physicians, it became obvious that within the field of medicine, venous disease is a misunderstood and often mistreated condition. Before visiting VeinSolutions, patients opt to wear support hose and elevate their legs for relief. As they become more aware of their condition and visit these doctors, they realize that so much more can be done for their discomfort and pain. “So many patients don’t know what we can do.
Once they step into our office, they begin to learn that there are options. The relief on both a physical and mental level is apparent, and that is the beginning of their road to recovery.” Both physicians are well aware that their patients want to know why they have leg pain. “We take the fear away as we explain venous disease to the patient,” Apple says. “I tell them about the difference between the arteries and veins. It is essential for the arteries to circulate well. With veins, it is not a rush.” Imagine how their patients feel after hearing this. They are already being cured with words. “This job is the best job any doctor can have,” Dilling says. “We have pleasant patients because most of them are here voluntarily for either discomfort or cosmetic reasons. The immediate danger is totally eliminated from the equation. We make people happy on a daily basis, and in turn, we are rewarded with smiles and pain-free patients.”
*Most major insurance plans accepted. VeinSolutions Austin is located at 1010 W 40th Street, Austin, Texas 78756. For more information, please call 512-452-VEIN (8346) or 866-452-VEIN (8346). You may also visit www.veinsolutionsaustin.com. NSIDE AUSTIN MD
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Inconceivable Conception With the aid of assisted reproductive technology, couples with fertility issues have a better chance than ever of enjoying the opportunity to bring life into the world. by Tracy Ganske and Myles Cooper When conventional conception and pregnancy is rendered outrageous for some couples due to extenuating medical circumstances, the audacity to nurture Mother Nature with a little technology and hope becomes a necessity. When Sammie and Sonny Johns started dating in 1996, Sonny had already been diagnosed with testicular cancer. Before Sonny underwent chemotherapy at Virginia Mason of Seattle in 1998, he participated in
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a progressive program in which the hospital froze and stored his sperm at no cost. After moving to Austin, Sonny and Sammie had the 10 vials containing Sonny’s sperm sent to them by FedEx in 2005, the same year Sonny underwent a vasectomy. Those 10 vials were the only 10 chances they would ever have to get pregnant. In July 2010, when Sammie was almost 43 years old, she started researching methods to prepare her
“With new technology like the da Vinci Surgical System, the likelihood of reversing a tubal ligation is about 90 percent.” body for pregnancy. According to the American Medical College of Homeopathy, a healthy 30-year-old woman has about a 20 percent chance of getting pregnant each month, whereas a 40-year-old woman’s chances drop to about 5 percent a month. The odds were not in the Johns’ favor. Sammie spent about a year fine-tuning her body, taking vitamins, lowering her gluten levels and decreasing the levels of lead and toxins in her system. “I was much more worried about my age than the [13-year-old] sperm,” she said. On July 2, 2011, Sammie became pregnant after undergoing her third intrauterine insemination, or IUI, at Texas Fertility Center. According to AmericanPregnancy.org, an IUI is a procedure that involves directly placing washed sperm into the uterus with a catheter. Sperm washing involves separating the sperm cells from the semen, helping get rid of dead or slow-moving sperm, as well as additional chemicals used in the preservation process. After 14 years, 2,000 miles and millions of Sonny’s sperm, Sonny and Sammy gave birth to a baby boy in April of this year. “The whole process has been fascinating,” Sammie said. Delia and Peter Singer also had a unique journey to their pregnancy. Delia had undergone a tubal ligation after the birth of her second child from a previous marriage, never realizing that she and Peter would later meet, fall in love and want children of their own. “I basically played dad to my stepchildren from the ages of 10 and 8,” Peter said. “So I missed out on the earlier years.” The Singers’ OB/GYN, Dr. Christopher Seeker, suggested he could conduct the operation using the minimally invasive robotic assistance of the da Vinci Surgical System. “This is becoming a more common scenario, and years ago, the likelihood of reversing the tubal ligation has only been about 50 percent,” Seeker said. “Now with new technology like the da Vinci, it’s about 90 percent.” In May 2011, the Singers became the first couple to undergo a tubal ligation using the da Vinci Surgical System at St. David’s Hospital in Austin. Four weeks after the surgery, the Singers were pregnant, and on April 5, 2012, they gave birth to a baby girl. “Where there’s a will, there’s a way,” Peter said. The utilization of assisted reproductive technology (ART) is becoming one of the primary solutions for the many couples that cannot conceive by natural means due to fertility issues. Both couples are thrilled to have the opportunity to bring life into this world. Both had a great deal of perseverance and hope, the astounding capabilities of modern medicine and of course, the utterly joyous outcome. And with the hurdles they overcame to have these babies and the likelihood that neither baby would have been born at all without advanced health care techniques, a nearly incomprehensible amount of luck always helps, too.
Tracy Ganske, MSNED, CEO and director of Balanced Hormones and Health and Lean Science, is a serious scientist and engaging national speaker who has a professional passion rooted in personal experience. When she was in her early 30s, Ganske was given the wrong treatment for adrenal fatigue by a clinic that claimed to specialize in women’s wellness and natural hormone replacement. This “treatment” – which she discovered had been administered by a person who was not in fact a physician, but claimed to be – had a major impact on her heart, emotions and life. She was slated to receive a pacemaker at the age of 36 when she and her doctors discovered the foul play. This experience compelled Ganske in a direction that eventually led to the successful creation of Balanced Hormones and Health. Due to her own personal experiences, she is extremely passionate about serving clients in a safe environment that is supported with experienced clinicians who truly care. Today, Ganske and her CFO husband, Greg, are the happily married parents of three young children. Ganske enjoys an active Austin social life, and somewhere in between all of her other responsibilities, she is finishing her Ph.D. in integrative nutrition. At Balanced Hormones and Health and Lean Science medical weight centers, the Ganskes partner with exceptional medical doctors and other top-tier professionals, and take a comprehensive approach to wellness which includes world-class testing and analytics, prescriptive remedies and Eastern approaches such as acupuncture and Yoga. Balanced Hormones and Health currently has offices in Austin, Dallas and San Antonio, and it will soon feature offices in Houston and Nashville. NSIDE Austin magazine is proud to have Ganske as its co-publisher for the new wellness section of the magazine. “Tracy has a breadth of experience in the wellness field, which makes her a strong contributor to our magazine,” says Angela Strickland, co-publisher for NSIDE Austin. “We are excited to be working with Tracy and tap her knowledge in the wellness world, which will be truly informative to all of our readers.”
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A Smile-Worthy Solution
With Six Month Smiles, patients looking for a brighter smile enjoy more discreet braces and results in a fraction of the time, compared to traditional braces. by Dr. Kevin Kim
When you look in the mirror, are you tired of The benefits of Six Month Smiles seeing gapped or crooked teeth? Are you search• Faster treatment time: Unlike regular braces ing for a new job and longing for the confidence and other cosmetic options such as Invisalign, Six a straight smile would give you during interviews? Month Smiles completes your perfect smile in six Do you have a wedding or other big event on the months, on average. This is due to its concentrahorizon and wish you could get straight teeth in tion on your front teeth that show when you smile time for all the photo opportunities? rather than all of your teeth. If you answered yes to any or all of these ques• Cosmetic: Tooth-colored wires and Lucid-Lok tions, I have a solution for you: Six Month Smiles®. clear brackets result in braces that are barely noSix Month Smiles does what you would expect ticeable. from the name: It straightens front teeth in gener• Predictable: Six Month Smiles is straightforally about six months, but it can vary from four to ward in its treatement and realities of fixing your nine months depending on the individual. The Six teeth into a permanently beautiful smile. Though Month Smiles technique utilizes clear brackets and the treatment times may vary slightly, the result is tooth-colored nickel-titanium wires to gently move always the same. front teeth. As a result, these braces are both effi• Affordable: Six Month Smiles is often less excient and discreet. pensive than traditional braces, aligner therapy Patients tend to function well in spite of non- term orthodontics, the only option for adults who (such as Invisalign) and the veneers smile makeover. wanted to improve their smiles without wearing Let’s face it: Smiling can have a myriad of effects ideal, mal-positioned teeth, and many adults do such as raising your confidence, decreasing stress not pursue comprehensive orthodontic treatment traditional braces for two years was veneers. While veneers provide a wonderful alternative and increasing your immune system. Whether you because they are unwilling to wear braces for the in the right situation, fixing crooked teeth with believe it or not, smiling can change your attitude. length of time typically associated with traditional veneers is not always the optimal choice. Placing If you have any doubts, next time you feel down, braces. veneers typically requires removal of healthy tooth start smiling and thinking positive thoughts and The Six Month Smiles system is a practical apstructure, which is not an attractive option for some see what happens. proach for adults who want to significantly improve The results of Six Month Smiles can be dramatic their smile, focusing on the front teeth that show patients. If your teeth are attractive, but merely crooked and life-changing. Following treatment, you’ll no when smiling. While highly skilled and trained oror misaligned, Six Month Smiles is a much healthier longer face the world with crooked, crowded or thodontists provide the profession with an invaluoption. If your teeth are unattractive and crooked, widely spaced teeth. Instead, you’ll show the world able service for achieving ideal, comprehensive combining Six Month Smiles to line up the teeth a truly beautiful smile! results, Six Month Smiles offers general dentists to Just think of a new you with a new smile. It can correct specific patient-focused concerns and treat with the placement of veneers to improve the apa large pool of potential adult patients who desire pearance of the teeth is a great combination. actually be only six months away. the benefits and confidence a straight smile can offer. Of course, there are some cases in which a patient’s mal-occlusion is Kevin Kim, DDS, is the owner of NuYu Dental and a general dentist who provides cosmetic severe (e.g., skeletal open bites, arch and comprehensive dental services, including Six Month Smiles. He is a proud member of discrepancies, etc.). In such instances, the following professional organizations: the American Dental Association (ADA), the Textraditional orthodontics would provide as Dental Association (TDA), the Capital Area Dental Society (CADS) and the Round Rock a tangible functional benefit for these Chamber of Commerce. patients. However, when patients’ motivaA homegrown Californian, Kim is excited to bring his years of dental expertise to the greater tions for straightening their teeth are Austin-Round Rock community with exceptional dentistry. Since completing his dental decosmetically driven, Six Month Smiles gree at Loma Linda University, one of the nation’s leading Christian universities in dental is the short-term orthodontic and sysresearch, he has made a continual effort to stay abreast with dental technologies and extematic cosmetic braces solution. tensive continuing education, and he has trained with the leading specialists in comprehensive, sedation and cosmetic dentistry. For more details, visit www.nuyudental.com.
Are you a candidate?
Prior to the introduction of short-
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Diagnosis The diagnosis of PCOS is made based on physical signs and symptoms. Blood tests can be used to confirm the diagnosis and direct management. Treatment depends on the particular patient’s signs and symptoms, as well as her goals. Treatment options include: • For women who are not ready to become pregnant, birth control pills are an excellent way to replace progesterone, establish regular periods and lower androgen levels. • If a woman wants to become pregnant, treatment is aimed at establishing regular ovulation. • For women with PCOS and insulin resistance, medication to improve insulin sensitivity may be useful.
Treatment
Polycystic Ovary Syndrome: The Basics
Identify and control the condition to manage your symptoms and help with infertility. by Dr. Jose Pliego
While no one knows the exact cause of polycystic ovary syndrome (PCOS), an estimated 5 to 10 percent of women of childbearing age have it. In women with PCOS, the ovary doesn’t make all of the hormones it needs for any of the eggs produced to fully mature. They may start to grow and accumulate fluid, but no one egg becomes dominant. Instead, some may remain as cysts. Since no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent. Also, the cysts produce male hormones, which continue to prevent ovulation and can lead to acne, excessive hair growth and weight gain.
Cause of PCOS The cause of PCOS is not completely understood. It is likely that a genetics tendency is involved.
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Women with PCOS can have a wide spectrum of signs and symptoms from very mild to severe. They may include: • Irregular or absent menstrual periods • Heavy vaginal bleeding • Oily skin and acne • Acanthosis nigricans (darkening and thickening of certain areas of the skin, especially in skin folds) • Excessive hair growth on the face, chest, abdomen or thighs • Thinning of hair on the crown of the head • Type 2 diabetes • Obesity • Cardiovascular problems, including high cholesterol • Multiple tiny ovarian cysts; some women with PCOS have a large number of tiny follicle cysts (visible by ultrasound) on their ovaries
Because there is no cure for PCOS, it needs to be properly managed by a physician. Treatments are based on the symptoms each patient has and whether she wants to conceive or needs contraception. Some of these treatments are as follows: • Birth control pills can help regulate the menstrual cycle and prevent endometrial problems. • Diabetes medications can decrease testosterone production, causing abnormal hair growth to slow down and ovulation to return. • Medicine for increased hair growth or extra male hormones. If a woman is not trying to get pregnant, there are some other medicines that may reduce hair growth. Spironolactone is a blood pressure medicine that has been shown to decrease the male hormone’s effect on hair. Propecia, a medicine taken by men for hair loss, is another medication that blocks this effect. Both of these medicines can affect the development of a male fetus and should not be taken if pregnancy is possible. Other nonmedical treatments such as electrolysis or laser hair removal are effective at getting rid of hair. A woman with PCOS can also take hormonal treatment to keep new hair from growing. • Surgery. Although it is not recommended as the first course of treatment, surgery called ovarian drilling is available to induce ovulation. This surgery can temporarily lower male hormone levels and help with ovulation. • A healthy weight will help the body lower glucose levels and use insulin more efficiently, and it may help restore a normal period. While PCOS cannot be prevented or cured, it can be controlled with varying degrees of success and healthy lifestyle choices.
Jose Pliego, M.D., is a reproductive endocrinologist at Scott & White Hospital – Round Rock. For more information, call 512-509-0200.
Eating Disorders Treatment Center
Specializing in the care of anorexia, bulimia and related eating disorders
10 and 6 hour partial hospitalization programs, 7 days a week Intensive outpatient programs, 3 days a week Treatment for adult and adolescent females and males Most major insurance plans accepted Ted Weltzin, MD, FAED, Executive Medical Director, CEO Kim McCallum, MD, FAPA, COO Brad Kennington, LMFT, LPC, Executive Director Bridget McCauley, LPC, Clinical Director Samantha Symons, MD, Staff Psychiatrist 4613 Bee Caves Road, Suite 104 • Austin, Texas 78746 Toll free: 877.755.2244 • Phone: 512.732.2400 • Fax: 512.732.2404 email: info@cedarspringsaustin.com
www.cedarspringsaustin.com NSIDE AUSTIN MD
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“We think of ourselves as a team of therapists.”
A Clinical Approach to Massage For the skilled team of therapists at The Austin Bodyworker, massage is not about luxury. It’s about health. special to nside The Austin Bodyworker owners Kate Ripley and Michelle Hittner are reorienting people to what massage can be: bringing science back into the picture, addressing specific muscle groups based on client needs and focusing on real benefits. Ripley and Hittner joined forces in 2010, combining more than 20 years of high-caliber clinical massage experience. While you won’t find any flavored waters or hot stones at their convenient downtown location, you will find topnotch, professional therapists who focus on identifying the root cause of the
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client’s pain or discomfort and improving range of motion. For example, low back pain may be caused by tight hamstrings; the clinicalminded therapists at The Austin Bodyworker are keen observers of these connections within the human body. Clinical massage utilizes in-depth knowledge of anatomy and physiology to address acute pain such as a recent injury and chronic conditions like stress and low back pain. You may have heard more common terms for clinical massage like deep tissue, neuromuscular, orthopedic and sports massage. “They all similarly describe the same concentrated, physiology-based therapy to address the client’s needs,” Ripley says. “We work hard to create a professional clinical bodywork experience while still maintaining an office environment that is warm and inviting.” The Austin Bodyworker places emphasis on a collaborative approach to treatment, and clients are encouraged to see all of the therapists for a wellrounded experience. As a complement to its massage services, the clinic offers a variety of Eastern therapies like acupuncture, Reiki, cupping and gua sha, as well as herbal and nutritional therapies. “We think of ourselves as a team of therapists. We believe that offering a variety of services treats the whole person and is the most thorough way of helping our clients get back to their activities quicker and stronger.” A visit to The Austin Bodyworker is thorough by nature, beginning with a short consultation with your therapist to discuss specific areas of discomfort, as well as contributing health and lifestyle factors. Clients are encouraged to provide feedback and ask questions during the session and receive post-bodywork exercises to enhance the healing benefits of the therapies and help maintain health between sessions. Hand-in-hand with its clinical approach to massage, The Austin Bodyworker also has a no-tipping policy. “We do not accept gratuities,” Hittner says. “We truly believe the best tip our clients can give us is the favor of their business and the referral of their friends and family.” Outside the clinic, The Austin Bodyworker has a strong presence in Austin’s athletic community and music festival scene, providing pre- and post-race massage at events like the MS 150, the LIVESTRONG Austin Marathon and the PURE Austin Driveway Series, as well as relieving neck ache for musicians at events like Fun, Fun, Fun Fest and SXSW. Hittner has been honored as Competitor Magazine’s 2011 “Best Massage Therapist” and Austin Fit Magazine’s “Best Massage Therapist 2011.” Ripley has been featured in Crave Magazine and Austin Woman Magazine. Scheduling with The Austin Bodyworker is made simple with its 24-hour online system at www.austinbodyworker.com. The clinic is centrally located downtown at 12th and has evening and weekend hours to accommodate hectic work and training schedules: Monday – Friday from 8 a.m. to 8 p.m.; Saturdays from 9 a.m. to 3 p.m.; and Sundays by appointment. Schedule with one of the therapists and see what The Austin Bodyworker brings to the table.
For more information on The Austin Bodyworker, visit www.austinbodyworker. com.
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A Health Food Haven
Mel’s Meals serves up tasty and satisfying ready-to-heat meals to Austinites who want to dismiss their diet ruts and make a positive life change. by Ashley M. Halligan
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More than simply another health food stop here in Austin, Mel’s Meals was inspired by a firsthand passion to encourage healthy eating, and is staffed with a handful of professionals who will make your journey far more feasible, all while providing powerful support along the way. Melissa “Mel” Sterns deems herself the “coach,” and is the mastermind behind Mel’s Meals. With 15 years’ experience in the Austin restaurant industry, she became frustrated with unreasonably sized entrees and made it her ultimate goal to establish a haven of sorts for folks seeking delicious food that was also
healthy. And so it began. Sterns’ staff also includes a professional nutritionist and two trainers who can help folks along the way, handcrafting plans on individual bases that are in alignment with personal goals, dietary restrictions and fitness experience. Essentially, Mel’s Meals creates weekly meal plans that include three fresh meals and two snacks daily until the individual’s personal goals are met. Among the dietary offerings are plans for balanced carbohydrates/proteins, vegetarians and gluten-free options, allowing essen-
The Mel’s Meals team can create a meal plan that’s perfectly coordinated with just about anyone’s ultimate goal.
tially anyone to embark on the journey to overcome diet ruts. Clients often seek the Mel’s team for insight with a wide range of prospective objectives. Some are seeking weight loss, whereas others may be in search of increased stamina, higher energy levels, improved medical conditions, better race performance or muscle gain. Overall, the Mel’s team can create a meal plan that’s perfectly coordinated with just about anyone’s ultimate goal.
The meals are quality, ready-toheat meals that are guaranteed to be absent of refined sugar, and include only lean meats, whole grains and always lots of veggies. The current Mel’s menu includes quite a collection of things that, quite frankly, sound really, really good. Current breakfast offerings include sweet potato pancakes and southwest chicken frittata. Lunch options include apricot pork loin, albacore cakes and chicken pesto pizza. Last but not least, dinner’s serving up spicy pork lettuce wraps, stuffed red bell peppers and shepherd’s pie. All sound pretty tasty. Whether you’re vegetarian, paleo, gluten-free or simply low-carb, Mel’s kitchen can certainly not only accommodate your dietary restrictions, but can also do so comfortably – with in-
tense flavor, guilt-free dessert indulgences (blueberry almond muffins) and snacks (kale and roasted beet salad) and a well of options so you’ll stay satisfied. Eating healthfully doesn’t have to mean deprivation, though that’s the common assumption when avoiding (or beginning) a new diet. Feeling deprived almost always leads to relapse. Let Sterns and her devoted team create a plan for you that’ll boost your confidence (and energy), and teach you that eating healthfully is actually a glorious life change.
Mel’s Meals has locations in Austin, Round Rock and Lakeway. For more information, go to www.melsmealsaustin.com. NSIDE AUSTIN MD
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Many of these patients may not have abnormal physical exams or laboratory results to help verify unhealthy dietary practices.
Eating Disorders: The Warning Signs How to recognize patients with anorexia nervosa, bulimia nervosa and binge eating disorder by Dr. Samantha Symons
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Almost 55 percent of adult Americans are dieting at any given time. While many ask their doctors for help with weight loss, distinguishing between healthy dieting and unhealthy eating, exercise or behaviors can be a challenge for any practitioner. Patients rarely volunteer information about cognitive distortions of body shape or size, rigidity of food choices or a lack of control about eating. Additionally, many of these patients may not have abnormal physical exams or laboratory results to help verify unhealthy dietary practices. However, given the serious medical complications of eating disorders, it is up to the astute physician to identify unhealthy or dangerous eating behaviors that may indicate disordered eating. The following are some warning signs of common eating disorders. One or more of these signs should alert the physician to a more extensive evaluation.
loss and/or requesting medications for weight loss, including stimulants or medications used to treat diabetes or thyroid disease • Perfectionistic, driven, “type A” personality style • Restrictive diet, obsessive thoughts about food, rules and rigidity about eating patterns • Body dysmorphia or distortion of reality related to appearance/weight • Complaints of fatigue, cold intolerance, lack of concern about weight loss, fear of weight gain • Symptoms of chronic constipation, non-specific abdominal pain, amenorrhea or irregular menstrual cycles • Vitals showing bradycardia or hypotension, or indicating dehydration • Physical exam positive for abnormal hair growth, abdominal distension and/or lower-extremity edema
Warning signs of anorexia nervosa: • Underweight, admitting to rapid recent weight
Warning signs of binge eating disorder: • Obesity, chronic cycles of dieting, hopelessness
NSIDE AUSTIN MD
about weight loss and/or requesting medications for weight loss or bariatric surgery • Episodes of eating an abnormally large amount of food in a brief period • Description of a sense of loss of control over eating that may include dissociation, isolation, secrecy and shame • Depression and social isolation • Coping strategies of avoidance and denial • Longstanding unhealthy relationship with food that may include overeating for emotional reasons and/or stress management Warning signs of bulimia nervosa: • Underweight, normal weight or overweight • Episodes of binging plus compensatory behaviors, including purging, laxative or diuretic abuse and/or over-exercise • Impulsivity, substance abuse, self-injurious behaviors and personality disorders • Complaints of reflux symptoms, constipation or diarrhea, dental caries and/or swollen or “puffy” parotid glands • At risk for electrolyte disturbances, cardiac arrhythmias and organ damage Binging, purging and thoughts about body image are frequently a source of shame for eating disorder patients. Ask about symptom frequency and severity in a direct, nonjudgmental manner. Remember that many patients with unhealthy eating patterns or subclinical disorders may not present with warning signs. However, if a physician routinely asks questions about diet and exercise and looks for clues about disordered eating or exercise, many of these patients may be diagnosed earlier and referred for appropriate treatment. With early intervention by a treatment team including an internist, a psychiatrist, a therapist and a dietician, these patients have a markedly improved prognosis.
Samantha Symons, M.D., is the staff psychiatrist at Cedar Springs Austin, an eating disorder treatment center located in West Lake Hills. For more information, visit www.cedarspringsaustin.com, or call 512-732-2400.
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Future of Health Care Survey Conducted by The Doctors Company with over 5,000 physicians across the United States
Nine out of 10
physicians say they are unwilling to recommend the medical profession to family and friends.
A recent survey of over 5,000 physicians and surgeons on the Future of Health Care indicates that the anticipated shortage of health care professionals may be exacerbated by growing physician sentiment. The medical profession has been projecting a shortage for years, but the findings from this survey indicate two compounding factors. First, 43 percent of physician respondents indicated that they are contemplating early retirement within the next five years. Second, nine out of 10 are unwilling to recommend the health care profession to family and friends. In both instances, the responses were attributed to the transformative changes occurring within America’s health care system, more specifically as a result of health care reform. For those physicians considering early retirement, many cited the demands on their practices resulting from new legal requirements and continued reimbursement reduction as causes to inhibit
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practice growth, despite the anticipated influx of newly insured Americans into the health care system. In addition, 60 percent of respondents indicated that the pressure to reduce costs, increase volume, and improve quality will have a negative impact on patient care and how doctors practice medicine. Finally, the transformative changes that are causing practicing physicians to consider early retirement are also impacting their desire to recommend the health care profession, a career that is often viewed as a legacy being passed down from one generation to the next. “The physician sentiments expressed in the Future of Health Care Survey are deeply concerning and disheartening,” said Donald J. Palmisano, MD, JD, FACS, former president of the American Medical Association and member of The Doctors Company Board of Governors. “Today, we are perilously close to a true crisis as newly insured Americans enter the health care system and our population
continues to age. Unfortunately, we may be facing a shift from a ‘calling,’ which has been the hallmark for generations among physicians, that could threaten the next generation of health care professionals.” The survey, conducted by The Doctors Company, is the largest of its kind on the subject and includes responses from over 5,000 physicians and surgeons from across the United States. For more information about the study, please visit the Knowledge Center at www.thedoctors.com/future.
The Doctors Company is the nation’s largest insurer of physician and surgeon medical liability.
Note: This article was provided by The Doctors Company and edited according to the company’s policy and style.
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