Better Health - Heart Health - Feb 2019

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Better Health D

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HYPERTENSION: new treatment, D2 KNOW THE SIGNS: cardiac surgery saved his life, D3 GUM DISEASE: more serious than you think, D4

| SUNDAY, FEBRUARY 17, 2019

“IF YOU HAVE DIABETES AND YOU

MODIFY YOUR RISKS

YOU CAN LIVE YOUR FULL LIFE AND

NOT HAVE A HEART ATTACK OR STROKE” - DR. ABRAHAM THOMAS

Statistics from the American Heart Association state that adults with type 2 diabetes are about twice as likely to die from heart disease as adults who do not have diabetes. By Anne-Gerard Flynn

Special to The Republican

The country’s high rate of obesity in recent years has highlighted the condition’s correlation in the media with the onset of type 2 diabetes. Less highlighted is the fact that many of the factors that cause diabetes also contribute to heart disease. One veteran Western Massachusetts endocrinologist likes to highlight the importance of heading off both chronic diseases - or at least minimizing their impact - by earlier identification and better management of risk factors. “When I was in training it was not uncommon for people with diabetes to have an amputation or lose their eyesight, but we don’t see as much of that now,” said Dr. Abraham Thomas, who received his medical degree from New York’s Columbia University and his master’s in public health from Harvard. “We can make a huge difference if we are following all the things that we should.” This, Thomas said, means taking the better medications that can be prescribed today if needed, keeping current with recommended screenings and visits to health care providers and adhering to a healthy lifestyle. Chair of Baystate Health’s department of medicine, Thomas talked about diabetes and heart disease as a participant in Baystate’s annual February series on heart and

vascular health. the risk factors. make insulin and as a result men and women by seven“Many of the risk factors for He cited the importance the pancreas produces little or to eight-and-a-half years. It heart disease usually exist in of the management of blood no insulin. is more than just the aging. people with type 2 diabetes. cholesterol levels with “We also do the risk factor Aging makes it worse. It is the For example high blood pres- medications in people with modification for heart disease combination.” sure,” said Thomas in a recent diabetes as abnormal levels for people with type 1. So, if While people with type 1 interview. can cause blocked arteries they have high blood pressure, diabetes have to take insulin “Many people with diabetes and lead to cardiovascular we want to treat that, if their since their bodies do not make have high blood pressure. disease. weight goes up, which can be it or enough of it to regulate People with diabetes have abHe added other risk factors more common in people with the body’s blood sugar levels, normal cholesterol patterns.” include being insulin resistype 1 diabetes, we make sure Thomas said “not everyone He added smoking and obe- tant, a condition common they have a healthy lifestyle needs to be on insulin” with sity are traditional risk factors with obesity. and address their cholestertype 2 diabetes and that there ol.” for heart disease that many “We look at risk factor are “many more medical Thomas added statin drugs options in treating type 2 diapeople “with type 2 types modification - things we can betes in recent years.” are used to lower blood already have.” change,” Thomas said. The American Diabetes “There is also damage from “If patients have high blood cholesterol levels, and that angiotensin-converting enzyme Association’s 2018 “Standards the high glucoses that affect pressure, can we get their (ACE) inhibitors or angioten- of Medical Care in Diabetes” blood vessels both large and blood pressure to a target. sin II receptor blockers (ARBs) was released with new recomsmall. Some of it impacts For those with diabetes, the mendations for people with are often used to treat high the heart. Some of it impacts recommendation is usually blood pressure in people who cardiovascular disease and vessels in other parts of the 130/80. If they have abnormal diabetes. are diabetic. body,” said Thomas of the cholesterol, we treat them The lengthy document Thomas was asked about impact of type 2 diabetes even before they have their discusses how the complex on blood sugar levels and diabetes. If they are smoking, the estimate that at least 68 disease is diagnosed the ability of the and treated and hormone insulin to how this sometimes regulate these levels includes addressing by getting cells to behavioral health absorb the glucose or issues. Medical thersugar that is stored apy for type 2 often for energy. starts with addressStatistically, people ing blood glucose with diabetes are levels, as well as said to be at twice self-management. the risk for ischemic “The recommenstroke, that is, developing a blockage dation now is that if within a blood vessel you are diagnosed supplying blood to with diabetes you the brain, than those start with medication as well as without diabetes lifestyle. It used to and to have a higher be you were just risk factor for heart treated for lifestyle disease at a younger at the beginning age. depending on the Treatment, ThomDr. Abraham Thomas is an endocrinologist and chair of medicine at Baystate as said, is key. severity of your Health as well as at UMass Medical School-Baystate. (ANNE-GERARD FLYNN PHOTO) “There are some diabetes when they features of heart disease found it out,” Thomas said. that may be a little bit differwe have them stop smoking. If percent of people age 65 or ent in people with diabetes “Not everyone is successful they are sedentary, can we get older with diabetes die from but in many ways, we do the with lifestyle and they did not some form of heart disease them to change their activity same types of treatment,” want to wait six months to a and 16 percent die of stroke level.” Thomas said. year before putting someone could be attributed to the Thomas added that with “For example, the risk for on a medication. That has body’s aging process. type 1 diabetes the “likelihood of having heart disease heart disease goes up for been my recommendation for “There is greater impact women, compared to men, af- is much earlier” and “higher quite a while now. “ with diabetes. If you have ter menopause but if you have than the average person.” He added, “If we treat it, we diabetes you are more likely to diabetes that risk is earlier in “This is because most lower the risk of something have a heart attack or stroke life and that earlier risk is true people with type 1 diabetes and then if you have one, your happening.” also for men with diabetes.” start with the disease much “As an endocrinologist - and risk of having another is highHe added, “However, for the younger in life,” said Thomas, er,” Thomas said. for all physicians who take “The average life span is most part, if we want to avoid adding that type 1 is an autocare of people with diabetes immune disease that attacks about 78 years and diabetes heart disease in people with - when we talk about treatdiabetes, we want to modify the cells of the pancreas that shortens that life span in ing diabetes as well as heart

“The recommendation now is that if you are diagnosed with diabetes you start with medication as well as lifestyle.”

disease prevention we are talking about taking care of the ABC’s,” said Thomas of the phrase popularized a few years ago by American Diabetes Association and the American College of Cardiology that refers to A1C (blood sugar level), blood pressure and cholesterol. “You have to treat those as well as all the risk factors.” He added, “There are lots more medications than ever before to treat diabetes, and good medications to treat blood pressure and cholesterol.” “If you have diabetes and you can modify your risks you can actually live your full life and not have to have your heart attack or stroke,” said Thomas, referring to such statistics as that from the American Heart Association that adults with type 2 diabetes are about twice as likely to die from heart disease as adults who do not have diabetes. “You can make a big difference taking care of yourself and working with your health care provider.” Other speakers in Baystate’s heart and vascular health series, held this month from noon to 2 p.m. at the Baystate Health Education Center, 361 Whitney Ave., Holyoke, include “Advances in Stroke Treatment,” presented today, Feb. 17, by Dr. E. Jesus Duffis, director of Baystate’s neurointerventional surgery division. The talk will focus on the warning signs of strokes as well as what is being done to enhance recovery. Also, “Surgical Treatment of Coronary Artery Disease 2019: Modern Treatment for an Age-Old Disease,” to be presented Feb. 24 by Dr. Thomas Schwann, Baystate’s chief of cardiac surgery, will focus on coronary artery bypass graft surgery and who qualifies for it. Registration is required for each session and can be done online or call (413) 794-5200. The lecture series is sponsored by Health New England.


D2 | SUNDAY, FEBRUARY 17, 2019

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THE REPUBLICAN | MASSLIVE.COM

New treatment of hypertension individual to each patient Main photo: This is hypertension specialist Via Cintron demonstrating use of the NICaS system, used to perform a non-invasive test to diagnose hypertension. Top right: This is an ambulatory blood pressure monitor patients can wear while at home or work. The control unit shown here clips onto the patient’s belt or waistband. Bottom right: Co-Directors of the RTANE Hypertension Center are Dr. Balaji Padmanaban Athreya and Dr. Barbara Greco. (DON TREEGER / THE REPUBLICAN)

By Dr. Barbara Greco It is estimated that nearly half of the U.S. adults have what is sometimes known as “the silent killer”- high blood pressure, or hyper-

tension, and often have no symptoms. Yet, complications from hypertension can lead to cardiovascular disease, chronic kidney disease, stroke, and even vascular dementia, a type of cognitive impairment linked to reduced blood flow to the brain.

The American Heart Association and the American College of Cardiology, along with nine other partners, introduced new and lower guidelines in 2017 for what is to be considered high blood pressure to enable earlier intervention against the development of chronic health problems

Barbara Greco, M.D.

is a Board Certified Nephrologist and a Certified Hypertension Specialist. Having received her undergraduate degree from Yale University, she went on to earn her medical degree from Harvard Medical School and Nephrology training at Vanderbilt University Medical Center. As President of RTANE and Nephrology Director of the Baystate Renal Transplant Program, Dr. Greco treats patients with all types of kidney disorders.

medications are achieving from this serious condition. New England (RTANE) was optimal blood pressure conA normal blood prescertified by the American sure for the force of blood trol throughout the day and Society of Hypertension night. These portable deflowing through the vessels as the first hypertension vices do not interfere with is less than 120/80 millimepractice center in the state. ters of mercury as the heart usual activities and allow This certification is given contracts and then relaxes for multiple blood preswhen a practice demonstrates the ability to provide sure readings to be taken between beats. comprehensive diagnostic every 20-30 minutes. The Elevated blood pressure and treatment approaches readings are then recorded under the 2017 guidelines for review by the doctor and by certified hypertension is when systolic is between patient. specialists. 120 and 129 while the diastolic remains less than 80. In addition, we use a All physicians and Stage I hypertension is now bio impedance tool to mid-level providers have defined as systolic between individualize the choice of some training in the 130 and 139 or diastolic medications based on padiagnosis and treatment tient-centered information. between 80 and 89. of high blood pressure but This device measures heart The first or top number certification indicates providers with more advanced and blood vessel paramereferred to as “systolic” ters such as the degree of training. Hypertension measures the pressure the resistance to blood flow, the specialists at RTANE often heart generates for blood work load the heart is exsee patients with more to circulate. The lower or periencing and bottom number the amount referred to as of total body “diastolic” measures the pressure water an individual has-all when the heart is of which may relaxed between be contributbeats. ing to raising The 2017 guidelines generally blood pres• Normal: Less than 120/80 mm Hg sure. Patients recommend lifestyle changes such with hypertension have as weight loss, • Elevated: Systolic between very different exercise, and low120-129 and diastolic less than 80 ering intake of salt patterns of measurements. to address Stage I • Stage 1: Systolic between 130-139 Medications and early hyperor diastolic between 80-89 tension. These to lower blood guidelines help pressure each health care providhave different • Stage 2: Systolic at least 140 or ers to estimate a effects on these diastolic at least 90 mm Hg patient’s 10-year parameters. We can then select and lifetime risk treatments for cardiovascular with the dedisease and thus “resistant” hypertension, sired effects while following better evaluate the need for treatment guidelines. that is, it remains above earlier medical interventions in some patients. Finally, at RTANE, we use targeted levels despite technology that allows us For many patients with treatment with a number of to measure pressures in the hypertension, the initial medications. blood vessels close to the treatment may be unsucAt the RTANE Hypertencessful or medications may sion Center, we have found heart, called “central blood cause unacceptable side that successful treatment pressure” which has been effects. It is not unusual of hypertension requires shown to better predict cardiovascular risk. This, along for patients with Stage an individualized approach with measures of “pulse II hypertension - blood custom-fit for each patient. wave velocity,” can provide pressure greater than 140/90 As recommended by the important information - to require more than two U.S. Preventive Task Force, about the overall cardiovasmedications. we use 24-hour blood pressure monitoring to guide cular health as measured in In 2015, Renal and treatment and to ensure the the blood vessels. Transplant Associates of This state-of-the-art and patient-centered approach to diagnosing and treating high blood pressure allows Mental Health and Addiction Recovery Services for tailoring the treatment for each patient. The ultiAvailable to all in the Pioneer Valley mate goal is to hit the target of normal blood pressure with treatment that makes sense and is well tolerated. The Co-Directors of the RTANE Hyperten• Treatment for depression, anxiety, traumatic stress, and sion Center are Dr. Balaji other mood problems Padmanaban Athreya and • Psychiatric evaluations and medication services, as needed Dr. Barbara Greco. Un• Immediate openings available - no waiting der the leadership of Dr. Michael Germain, RTANE • Mass-Health and private insurances accepted physicians are active in Call for an immediate appointment at clinical trials related to the a convenient location near you: treatment of hypertension. Agawam 786-6410 Many of our physicians are certified hypertension Holyoke 536-5473 specialists. Springfield 733-1423 For more information Ware 967-6241 on RTANE, please call Westfield 568-1421 413-733-9666 or visit www.rtane.org.

Blood pressure categories in the new guideline are:

Board certified Nephrologists dedicated to the highest quality care for all aspects of kidney disease. Certified Hypertension Center

By the American Society of Hypertension

Exemplary Practice Award in 2017 From the Renal Physicians Association

Treatment Services: • Dialysis • Hypertension Diagnosis and Management • Kidney Disease • Renal Transplantation • Renal Biopsy • Outpatient and Inpatient Consultative Nephrology • Pediatric Nephrology • Treatment of Kidney Stones

Our RTANE Physicians Balaji P. Athreya, MD

Nasreen Azam, MD

Krishnan Babu, MD

Shaji Daniel, MD

Dennis DiCampli, MD

George Fares, MD

Michael Germain, MD

Barbara Greco, MD

Hemant Magoo, MD

Deetu Simh, MD

Amit P. Singh, MD

Jonathan Slater, MD 03105357

Ashish Verma, MD

se habla español

Offices in Springfield, Holyoke, Palmer, Belchertown & Enfield

03105804

413-733-9666 | www.rtane.org 100 Wason Avenue • Suite 200 • Springfield, MA

Crisis Services available 24 hours, 7 days a week: 413-733-6661 | bhninc.org


SUNDAY, FEBRUARY 17, 2019 | D3

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THE REPUBLICAN | MASSLIVE.COM

Know the signs

Cardiac surgery saved his life

Cardiac rehab, such as working out on exercise bike, was an important part of Peter Zimmerman’s journey back to health.

By Keith O’Connor

performed by Baystate’s Dr. Ashequel Islam, an intervenLife was good for Peter tional cardiologist, confirmed Zimmerman. He considered Dr. DiPillo’s suspicion. A few himself an active, healthy hours after the procedure, person and at 73-years-young, cardiac surgeon Dr. David he loved gardening and playDeaton met with Zimmerman ing with his grandchildren and explained that he needed and great-grandchildren. On open-heart surgery. top of that, he was looking “I felt comfortable with Dr. forward to his daughter’s Deaton and appreciated his upcoming wedding. humble nature given his inThen Zimmerman noticed credible success as a cardiac when he worked in the yard, surgeon,” Zimmerman said. he needed to rest quite freOn the day of surgery, quently. Concerned, Zimmer- Zimmerman’s family waited man, of Leverett, went to see at Baystate Medical Center as Baystate Health cardiologist Dr. Deaton operated with his Dr. Steven DiPillo of the expert clinical team. Not long Heart & Vascular Program, after he began, Dr. Deaton who knew him from previous stopped the surgery to visit visits for his irregular heart Zimmerman’s family in the rate, known as AFib, and waiting room. other heart conditions. This It’s rare that a surgeon time, Dr. DiPillo suspected interrupts an operation in that his patient had coronary that manner, but Zimmerman artery disease, a serious, even required a more complicated deadly, condition. procedure than had been A cardiac catheterization expected. In addition to the Special to The Republican

planned five-way bypass, his aorta, the body’s main artery carrying blood from the heart to the rest of the body, needed repair. Dr. Deaton wanted Zimmerman’s family involved in the decision to do the longer, riskier surgery. They had to make a difficult decision without input from him, still asleep on the operating room table and awaiting Dr. Deaton’s return. “I am honored that they trusted my opinion and agreed to proceed with the larger operation,” Dr. Deaton said. The operation was a success, and as Zimmerman recovered his goal was to be able to walk his daughter down the aisle at her wedding. He worked hard on his walking exercises, building his strength, determined to succeed. And, only 17 days after surgery, with a little

help getting into a suit on the wedding day, he did. “It was pretty awesome to be able to do that,” Zimmerman said. Zimmerman feels great now and is continuing his cardiac rehabilitation at Baystate Franklin Medical Center in Greenfield. Thinking back on what could have been if he hadn’t had his symptoms checked out, Zimmerman said, “I’m extremely grateful to be here. Dr. Deaton really saved my life.” Knowing the signs of a heart attack can be a matter between life and death. “Education is key to knowing the symptoms,” said Dr. Amir Lotfi, a cardiologist in the Baystate Heart and Vascular Program. “When you realize that you are having symptoms that you are unfa-

miliar with, whether jaw pain or shoulder or arm discomfort, and it doesn’t necessarily have to be on the left side and can occur on the right, it’s better to be on the safe side and get to an emergency room immediately, because time is muscle.” The phrase “time is muscle” refers to the fact that once a heart attack strikes, the person immediately begins to lose precious heart muscle. That muscle can continue to suffer damage until the person receives life-saving angioplasty to open the blocked vessel and restore blood flow to the heart. Classic heart attack symptoms, whether for women or men, can include chest pain or discomfort, unusual upper body discomfort, shortness of breath, breaking out in a cold sweat, unusual or unex-

plained fatigue, lightheadedness or sudden dizziness, and nausea. “The most common symptom of a heart attack continues to be chest pain where you hear many people say it feels like an elephant is sitting on their chest. But not all women experience chest pain and they need to be aware of the more subtle symptoms they might be unfamiliar with such as unusual fatigue, sweating or shortness of breath, and neck, jaw and back pain,” said Dr. Lotfi. To learn more about Baystate Medical Center’s life-saving cardiac capabilities or to make an appointment with a cardiologist, visit baystatehealth.org/ heart.

Heart Lecture Series Baystate Medical Center is holding its annual free Heart & Vascular Health Lecture Series during the month of February. Presented by the Baystate Heart & Vascular Program and sponsored by Health New England as part of American Heart Month, two lectures remain in the series: TODAY – Dr. E. Jesus Duffis, director, Neurointerventional Surgery Division, Baystate Medical Center, will present “Advances in Stroke Treatment.” The session will focus on warning signs, treatments, and the latest advances to help minimize adverse effects and enhance recovery. FEB. 24 – Dr. Thomas Schwann, chief, Cardiac Surgery, Baystate Medical Center, will present “Surgical Treatment of Coronary Artery Disease 2019: Modern Treatment for an AgeOld Disease.” Coronary artery bypass

graft surgeries are some of the most commonly performed major operations today. Participants will learn who qualifies for this heart surgery and discover the latest advances in treatment for those who suffer from coronary artery disease. Heart healthy light refreshments will be served at the lectures and educational handout on heart and vascular health will be provided. There will also be time for questions and answers. Parking is free. Registration is required for each session by visiting baystatehealth.org/ events, or calling 413-794-5200.

I'M EXTREMELY

GRATEFUL TO BE HERE.

- Peter

Just weeks before his daughter's wedding, Peter Zimmerman unexpectedly underwent open-heart surgery. Earlier in the summer, he found himself having to rest often while exercising or gardening. Concerned, Peter went to his cardiologist, Dr. Steven DiPillo, who had previously cared for his irregular heart rate. It was during that visit that Dr. DiPillo suspected Peter had coronary artery disease - a serious, even deadly, condition. A cardiac catheterization confirmed Dr. DiPillo's suspicion and within a few hours of the diagnosis,

Peter met with cardiac surgeon Dr. David Deaton to discuss his need for a five-way bypass. "Dr. Deaton really saved me," Peter says. Following a successful surgery, and knowing how lucky he was to be alive, Peter made it a goal to walk his daughter down the aisle. And, only 17 days after his surgery, he was able to take that very memorable walk. Visit baystatehealth.org/heart to learn more about the cardiovascular surgery program that saved Peter's life or call 413-794-2273.

CS10539


D4 | SUNDAY, FEBRUARY 17, 2019

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Advanced Artery & Vein Care Close To Home

Gum disease More serious than you think By Keith O’Connor

THE REPUBLICAN | MASSLIVE.COM

HMC’s vascular and endovascular surgery services offer complete care for an array of vascular conditions—from varicose veins and ulcers to complex wounds, arterial blockages and aortic aneurysms.

noted Dr. Dores. Gingivitis is completely reversible if treated by a dentist along with good home care. At this stage, gums look puffy, red, and bleed when brushing or flossing. It is not normal to see blood when brushing or flossing and is a sign that there could be a problem. The next form is mild periodontitis, where minor bone loss is evident on X-––– rays. At this stage, the loss that occurs cannot be gained back, but the condition can be halted with professional

for early detection and we Special to The Republican routinely check the gums for Going to the dentist isn’t signs of gum disease by meajust about getting a filling or suring the space between the having a root canal done, or tooth and gum. Also, there any of the many other proceis special gum therapy to dures you visit your dentist remove the harmful bacteria for. that is stuck to the teeth beIt’s also about making sure low the gum line. Sometimes your mouth and gums are antibiotic therapy can be healthy and checking for any employed to kill the harmful signs of disease. bacteria after the hardened “Periodontal disease can bacteria is removed,” said Dr. affect all ages and everyone Dores. should be concerned. Dental Dr. Dores said the best checkups and diligent home advice he can offer to prevent care can prevent periodontal periodontal disease is to add disease,” said Dr. James flossing – with the proper Dores of Dores Dental in – to your daily “There are studies technique East Longmeadow. routine at least once per day which show a Periodontal disease is the along with brushing at least loss of supporting structures relationship or an twice per day. of your teeth, such as bone “If the correct technique association and gums which hold teeth is not used, the benefits in place. As these supporting are not realized. I recombetween heart mend flossing right before structures recede, tooth loss disease and bedtime when it is an easy occurs if no therapy is done gum disease.” time to make it part of your to halt the condition. What happens is that routine. Also, it is the best Dr. Dores harmful bacteria collects time to floss because when under the gum line. we sleep, saliva flow slows “The body then defends gum therapy and home care, down and the bacteria have a itself from the bacteria caus- and tooth loss can be prechance to grow in numbers. ing inflammation. As part of vented and the inflammation If we reduce the amount of the defense mechanism, the can be reversed. Moderate bacteria before bedtime, supporting bone structures periodontitis is similar to the the chance for bacteria to do recede away from this harm- mild form, but more bone damage is reduced,” he said. ful bacteria,” said loss is evident on X-ray. And, February is American Early stages of periodontal severe periodontitis it is unHeart Month and Dr. Dores disease are usually painless. likely that the condition can noted there is a relationship But symptoms can include be halted. Tooth loss is likely. between heart disease and tenderness in your gums. Severe bone loss is evident gum disease. Redness and any bleeding on X-ray. And, the inflamma“There are studies which from the gums are also signs. tion present can’t be easily show a relationship or an Late stages can be more pain- reversed until the affected association between heart ful, but often disease occurs teeth are removed. disease and gum disease. without pain and teeth can “I can’t stress enough the People with gum disease are become loose. importance of regular check more likely to also have heart There are different forms of ups every six months in com- disease. And people with periodontal disease, batting gum disease. Many heart disease or cardiovascular disease are also more patients, however, are prescribed more frequent check likely to have gum disease,” ups to help stay on the right he said. track. X-rays are prescribed

THE VASCULAR SYSTEM—also known as the circulatory system—is the body’s network of blood vessels. It includes arteries, veins and capillaries. Diseases affecting the vascular system are wide-ranging as are their symptoms and complications. For common conditions such as varicose veins, patients may experience minor leg discomfort while severe conditions such as atherosclerosis may result in a life-threatening stroke. At Holyoke Medical Center, patients with vascular conditions have access to a full spectrum of services. Sandip Maru, M.D., Holyoke’s chief of vascular and endovascular surgery, offers comprehensive, leading-edge vascular surgery care to the Holyoke community. Under his direction, services include state-of-the-art diagnostic test-

ing, medical treatment and surgical options— both open surgery and endovascular techniques, a specialty of Dr. Maru’s. Patients who are eligible will benefit from Dr. Maru’s expertise in minimally invasive endovascular approaches. “Minimally invasive procedures involve small incisions and result in shorter hospital stays and quicker recoveries,” says Dr. Maru who is trained in endovascular aortic aneurysm repair as well as balloon angioplasty and stenting for peripheral artery disease and blocked

arteries. HMC’s Vascular Center also provides cosmetic care for unsightly varicose veins along with therapeutic treatment for associated swelling and ulcers. Dr. Maru is experienced with radiofrequency ablation, a nonsurgical option to vein stripping. “There’s very little downtime,” he explains. “The procedure is done in our office and patients can return to work after a few days.” “We have a strong vascular program at Holyoke Medical Center that offers comprehensive care without the long waits typical of larger hospitals,” says Dr. Maru. “Patients with artery and vein conditions often face serious threats to life and limb. We make this difficult time easier by providing access to an experienced surgeon backed by a team of specialists.” The HMC Vascular Center office is located at 2 Hospital Drive, Suite 203, and is accepting new patients. To make an appointment, call 413.535.4785.

“Minimally invasive procedures involve small incisions and result in shorter hospital stays and quicker recoveries,”

James Dores, DMD,

graduated from the University of Connecticut School of Dental Medicine and completed his residency at the UCONN Health Center. Dr. Dores has been practicing dentistry in western Massachusetts since 2006 and opened his own practice, Dores Dental, in 2010. Dr Dores and his team participates in the annual Dentistry From The Heart, providing local people with basic dental care who otherwise may not afford to receive.

says Dr. Maru

Stop aching. Start moving.

Visit our NEW state-of-the art dental facility

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