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FERTILITY IS FINITE.
Planning for a pregnancy should not be limited to the attempted time to conceive.
If you’ve lost your job, or are changing jobs, you may be wondering what to do with your 401(k) Page 12 plan.
UNDERSTANDING THE TERM ‘IRRITABLE BOWEL SYNDROME’.
IBS is a common gastrointestinal disorder that affects the colon or large bowel.
Page 11
Photo by Tracy Harman Photography.
Page 5
CHANGING JOBS? KNOW YOUR 401(K) OPTIONS.
Pictured above is Christine L. Matus, Esq., Founder of the Matus Law Group. Christine and her extraordinary staff have been helping people protect assets for special needs children and conduct smooth real estate closings for over two decades. Read more on pages 18 & 19.
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Medical Professionals
2 HEALTH NEWS (FREEHOLD, NJ)
A NEW SENSATION IN NEUROPATHY CARE Advanced FDA-Cleared Vascular Treatment Provides New Hope!
DO YOU SUFFER FROM PERIPHERAL NEUROPATHY? Peripheral Neuropathy is a nerve disorder known to affect the lives of millions of Americans with debilitating symptoms such as numbness, tingling, burning and prickling pains in the legs, feet, arms and hands. Over time, many people also develop difficulty with walking, balance and muscle weakness. It is a complication associated with several different medical conditions, including Diabetes, Cancer, Peripheral Vascular Disease and Metabolic disorders most commonly. While some cases improve when the underlying cause is managed effectively, sometimes the cause may not always be detectable. As nerve damage tends to worsen over time, it is crucial to be proactive with proper treatment, avoiding any negative impact on quality of life.
NUMBNESS, ALTERED SENSATION TINGLING OR BURNING SHARP, SHOOTING PAIN MUSCLE WEAKNESS, CRAMPING LOSS OF BALANCE, COORDINATION DIFFICULTY WALKING When functioning normally, the peripheral nerves relay messages from the central nervous system, brain and spinal cord to the rest of the body. However, this key function becomes disrupted by disease processes that may impair circulation to peripheral blood vessels, particularly the smaller ones (capillaries), which enter nerve tissues. Without sufficient blood flow making it through the capillaries, essential oxygen and nutrients cannot get into the nerve tissues while the waste products of metabolism cannot get out. The peripheral nervous system eventually becomes distressed and damaged due to starvation and toxicity.
MicroVas is a FDAcleared, advanced treatment option that delivers electromagnetic energy to the affected limb(s), stimulating increased circulation to the surrounding tissues. This innovative technology causes blood to pump and circulate much more efficiently by elevating tissue oxygen levels, laying the groundwork for new tissue growth and repair, while accelerating the healing process. Microvas therapy may also promote lymphatic drainage, notably reducing swelling in some instances and positively influencing the body’s immune response. In our experience, MicroVas’ therapeutic effects are often substantial and our unique approach of implementation including manual hands-on therapy and functional conditioning for strength and balance is designed to help you achieve optimal results for long-term relief. "My neuropathy made me miserable day and night and I just learned to live with it. After five weeks of MicroVas treatments at Rehability, I'm already seeing a difference. They have given me hope and now I feel more motivated to stay active. Thanks so much." -David M. "Since starting treatment at Rehability, I've noticed less tingling and burning sensations from the neuropathy and the MicroVas has made a big difference. Thank you for your kindness and patience." -Grace R. “WE PERSONALLY INVITE YOU TO SCHEDULE A COMPREHENSIVE EVALUATION TO DETERMINE IF YOU ARE A MICROVAS CANDIDATE AND TO LEARN MORE ABOUT OUR EXCLUSIVE NEUROPATHY PROGRAM” - The REHABILITY Team...We Can Help!
PHYSICAL THERAPY | CHIROPRACTIC | ACUPUNCTURE | SPORTS MEDICINE | WWW.REHABILITYNJ.COM
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July/August 2020
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The County Woman
Monmouth County Monmouth County Welcome to the July/August 2020 Issue of the Monmouth County Woman! Since 2008
Since 2008
Woman
Woman
Dear Readers, The last few months have been filled with uncertainty, angst, and a great deal of panic over the pandemic. We have had to work a bit harder at managing emotions and most importantly, staying healthy. While the quarantine gave New Jersey one big collective pause, it has also wreaked havoc on the economy. However, the time also provided folks an opportunity to reflect and discover long held passions and interests that were possibly forgotten in normally hectic times. There was certainly ample time to spend with loved ones and more family dinners minus the frenetic rush of activities which normally fill up the calendar this time of year. While we are not out of the woods just yet, a return to a more normal pace is happening all over the state. We are embarking on summer at the jersey shore and after the long hibernation, folks are eager to get out, socialize (safely) and enjoy everything the shore has to offer. In other exciting news, I added two baby Nigerian dwarf goats to my family. Their names are Butter and Biscuit and they have brought our family a great deal of joy! Wherever you decide to spend your summer, please do so safely!
Inside... Medical Professionals
REHABILITY.................................................................. 2 Reproductive Science Center of NJ.............................. 5 All correspondence should beAll addressed to: correspondence should be addressed to: Relievus......................................................................... 7 Best, The County The County Reliance Medical Group................................................ 8 Butter & BiscuitWoman Lauren Shover, Production Manager,Woman & the Ocean Hematology & Oncology.................................... 9 P.O. Box 619 P.O. Box 619 Staff at the Monmouth County Woman Publication Kathy A. Banks, DMD.................................................. 10 Turnersville, NJ 08012 Turnersville, NJ 08012 Gastroenterologists of Ocean County......................... 11 The County Woman’s Newspaper is published bi-monthly and isWoman’s available Newspaper free of charge at Derma The County is published bi-monthly and isBella available free ofMedi chargeSpa. at ................................................ 13 display stands in approved private and public establishments and authorized display stands in approveddistributors private andonly, public establishments and authorized distributors only, Advanced Memory Research Institute........................ 14 or by paid mail subscription. or by paid mail subscription. Paonessa Colon & Rectal Surgery.............................. 15 Trademark and U.S. Copyright Laws protect The County Woman’s Newspaper. No Laws part ofprotect The County Woman’s Newspaper. No part of Trademark and U.S. Copyright Toms River X-Ray, CT & MRI Center........................... 16 this paper may be reproduced without the written permission of the publisher. this paper may be reproduced without the written permission of the publisher. University Associates of NJ........................... 20 The County Woman’s Newspaper is not responsibleThe for any editorial comment (other isthan County Woman’s Newspaper not responsible for any editorial commentUrology (other than its own), typographical errors from advertisements submitted as camera ready or any Veinready Center forreproducWomen............................................... 21 its own), typographical errors fromreproducadvertisements submitted as camera or any tions of advertisements submitted as camera ready.An tions Educational Resource for Women and Their Families of advertisements submitted as camera ready. Personal Enhancement Center.................................... 39 ra leb Ce
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If an advertisement does not meet our standards of acceptance, we may does revisenot or meet cancelour it atstandards of acceptance, we may revise or cancel it at If an advertisement any time, whether or not it has been already acknowledged previously The acknowledged and/or previously published. The any time,and/or whether or not itpublished. has been already Portraits & Headshots Publisher Chris chris@thecountywoman.com advertiser assumes sole responsibility for Lam all statements contained in submitted copy and will advertiser assumes sole responsibility for all statements contained inFamily submitted copy and will protect andProduction indemnify the Woman’s Newspaper, its owners, publishers, and employees, against Carmella Caracappa Photography. ............................... 3 protect and indemnify the Woman’s Newspaper, its owners, publishers, and employees, against Manager & Advertising Sales Lauren Shover any and all liability loss or expense arising out of claims for libel, unfair loss tradeornames, any and all liability expensepatents, arising out of claims for libel, unfair trade names, patents, staff@thecountywoman.com copyrights and propriety rights, and all violations ofcopyrights the right ofand privacy or other violations propriety rights, and all violations of the right of privacy or other violations Financial Management resulting from the publication of this newspaper or resulting its advertising Billing Manager Jennifer Hartsig billing@thecountywoman.com from copy. the publication of this newspaper or its advertising copy. Garden State Trust Company........................................ 6 The publisher shall be under no liability for failure, The for any reason,shall to insert an advertisepublisher be LLC under no liability for failure, for any reason, to insert an advertiseGraphic Designer error, Golden Design ment. The publisher shall not be liable by reason of ment. omission and/or failure to insert any The publisher shall not be liable by reason of error, omission and/or failure to insert any K. Wolf part of an advertisement. The publisherCEO will not beLynn liable or failure inThe performance part offor andelay advertisement. publisher will not be liable for delay or failure in performance Financial Independence in publication and/or distribution if all or any portion of an issue isand/or delayed or suspended in publication distribution if allfor or any portion of an issue isFreedom delayed or suspended for Capital Management. ................................... 12 For advertising any reason. The publisher will exercise reasonableinquiries, judgment in these instances will andcall: will make any reason. The please publisher exercise reasonable judgment in these instances and will make adjustments for the advertiser where and when appropriate. adjustments for the advertiser where and when appropriate. Home The Woman’s Newspaper assumes no responsibility The for unsolicited material orassumes reproducWoman’s Newspaper no responsibility for unsolicited material orHealth reproduc- Care tions made by advertisers. tions made by advertisers. UM Communities HomeWorks.................................... 17 This newspaper will be published by the 15th of every month.will be published by the 15th of every other month. Thisother newspaper 2008. County Woman, LLC TM COPYRIGHT 2008. Representations by The Monmouth County Woman, LLC TM COPYRIGHT Representations by The Monmouth
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July/August 2020
Medical Professionals
5#
Fertility is Finite In our rush to experience the world, whether it is through educational, work, or travel opportunities, many women are choosing to delay childbearing until later in their lives. When the time does arrive and they are considering getting pregnant, women may be surprised to learn that their age directly impacts the likelihood to conceive on their own. When is it time to think about having children? Planning for a pregnancy should not be limited to the attempted time to conceive. Rather it should include proper pre-pregnancy nutrition and vitamin intake, recommended daily physical activity, and an overall healthy lifestyle. In addition, an understanding of a woman’s “fertility clock” should be an integral complement to this preconception care model.
How common is infertility and when does my fertility start to decrease?
Helping Small Miracles Miracles Happen Happen
at a faster rate. It is for this reason the American College of Obstetricians and Gynecologists (ACOG) recommends that a female ≤35 years of age attempting pregnancy seek a formal infertility evaluation if unsuccessful after a period of 12 months, and if >35 years of age, after 6 months of trying.
What are my fertility options?
Whether a woman is attempting pregnancy in her 20s, 30s, or 40s, an understanding of her pregnancy chances is necessary to formulate a plan for success. Hormonal testing and formal fertility evaluation can accurately assess ovarian function, and may influence a woman’s timeline to begin planning for pregnancy. Increases in medical knowledge and technological advancements allow the use of medications to maximize pregnancy rates, and enable fertility clinics to freeze eggs if wanting to delay childbearing, or create embryos that may be cryopreserved for later use.
Should I freeze my eggs?
• Comprehensive Fertility Care • Comprehensive Fertility Care • InVitro Fertilization (IVF) • InVitro Fertilization (IVF) • Intrauterine Insemination • Intrauterine Insemination • Intracytoplasmic Sperm Injection (ICSI) • Intracytoplasmic Sperm Injection (ICSI) • Preimplantation Genetic Testing • Preimplantation Genetic Diagnosis and Screening • Egg Freezing • Egg Freezing • Donor Egg • Donor Egg • Treatment for Recurrent Pregnancy Loss • Treatment for Recurrent Pregnancy Loss • Advanced Robotic Reproductive Surgery • Advanced Robotic Reproductive Surgery
The TheCompassionate CompassionateConnection Connection
If you are considering delaying your Infertility affects 1 in 8 couples in the United cahildbearing into your 30s, then it becomes vital States. Many causes of infertility exist, stemming to consider your biological clock. Elective fertility from both the female and male perspective. A preservation involves stimulation of your ovaries “fertile couple” has approximately a 20% chance with medications and retrieval of your eggs in an of achieving pregnancy in a given month, with Pictured (L-R): 85% achieving pregnancy over the course of 1 year. office setting. Your eggs can then be cryopreserved Dr. William F. Zeigler • Dr. Alan M. Martinez Pictured (L-R): and stored for later use. At the Reproductive Research shows that maximum female fertility is Dr. Alan M. Martinez • Dr. William F. Zeigler Center of New Jersey, we are available begin your personalized • Comprehensive Fertility Care seen between the ages of 20 and 24, after which (IVF) Science Dr. Virginia A. Mensah • InVitro Fertilization Wetreatment are Open and Offering fertility plan today to answer your fertility questions, perform a • Egg Freezing time female fertility begins to• decline, albeit at a Intrauterine Insemination Appointments complete fertility evaluation, and present you TomsTelehealth RiverDR. • Eatontown • Lawrenceville WILLIAM F. ZEIGLER slow rate, until age 30. • Intracytoplasmic Sperm • Treatment for Recurrent Pregnancy with individualized options for conception, all DR. ALAN M. MARTINEZ Loss Injection (ICSI) When should I start to be concerned 732-240-3000 • FERTILITYNJ.COM VIRGINIA A. MENSAH in a• comfortable, Donnor Egg caring setting. We are a fullEatontown DR. • Toms River • Lawrenceville • Preimplantation Genetic about my fertility chances? service fertility center experienced in all the latest Diagnosis Screening • Advanced Robotic Reproductive 732-918-2500 • FERTILITYNJ.COM A woman is born with a finite numberand of eggs, technologies Surgery and look forward to helping you TOMS RIVER • EATONTOWN • LAWRENCEVILLE and as a woman ages, so do her eggs. It is this achieve success. 732-240-3000 • FERTILITYNJ.COM “ovarian aging” that contributes to the observed FREE SECOND OPINION • FREE PHONE CONSULTATION • PERSONALIZED TREATMENT PLANS decrease in female fertility and overall egg quality. For more information call At the age of 30, there is a shift in egg aging that our Toms River office number may make it more difficult to achieve pregnancy, at 732-240-3000 or visit and after the age of 35, this rate further increases, PersonalizedTreatment TreatmentPlans Plans Personalized and the chance of pregnancy continues to decline www.FertillityNJ.com.
Helping Small Miracles Happen
Infertility Stops Here...
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For more information call 732-918-2500 or visit www.FertilityNJ.com.
FreePhone PhoneConsultations Consultations Free
Recipe Barbecued Short Ribs By: Cutting Board Creations
-Serves 8
5 lbs of beef chuck short ribs 1 1/2 cups ketchup 1/2 cup white vinegar 1/3 cup brown sugar, packed 1 T Worcestershire sauce 2 tsp lime zest 1 1/2 tsp dry mustard 3/4 tsp garlic powder
• In large Dutch oven, cover short ribs with water and bring to boil over high heat. • Reduce heat to low, cover and simmer for 2hrs. • Cover and refrigerate before eating. • About 1 hr before ready to serve, heat grill to medium. • In smal bowl combine ingredients. • Place ribs on grill for 20-25 minutes. • Basting occasionally with sauce mixture and turning often.
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July/August 2020 2019 July/August
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Financial Management
Financial Exploitation By Ira J. Brower, President and Founder Garden State Trust Company
While working from home during this difficult time due to COVID 19 my telephone rings incessantly with scam phone calls. I attempt to block each number but a new one seems to always take its place. As hard as I try to block, many of these scam calls end up in voicemail. There is one call in particular that made its way to VM that I want to share with you. I saved the transcript. Here is just a part of the message: “….a complaint was filed on your Social Security number for criminal activities so when you get this message kindly call as soon as possible on our number that is 828-***-**** I repeat 828-***-**** before we begin with legal proceedings and have a nice day when you get this message…” Don’t you just love how they made sure to tell me to have a nice day? All kidding aside, these types of scam messages resulting in financial exploitation are becoming more and more prevalent and are targeting our older population. Scammers target our seniors because they believe they are the most vulnerable because of a perceived decline in cognitive ability and that they have accumulated wealth. Unfortunately, many will respond resulting in a monetary loss to those that can least afford to lose their hard-earned savings. In May 2018, Congress passed the Senior Safe Act, a law that targets Elder Financial Abuse. The purpose was to encourage cooperation between financial professionals—bankers, brokers, insurance agents—and regulators as well as legal organizations in order to prevent senior financial abuse by providing
immunities for reporting under the bank privacy laws. Since financial professionals are on the front lines, they may be in the best position to spot, stop and report such exploitation. The Seniors Safe Act was modeled on a law previously enacted in Maine. Institutions are encouraged to provide training for their employees on “how to identify and report the suspected exploitation of a citizen internally, and, as appropriate, to government officials or law enforcement authorities, including common signs that indicate the financial exploitation of senior citizens.” After the training has been completed, the institution and the individuals will be held immune from any lawsuit over privacy invasions that come up as a result of the vigilance. It is comforting to know that bankers and other financial professionals may now be active allies in the fight against this type of exploitation. Of course, assuming their customer shares these calls with them. On our Garden State Trust Company website, you will find a booklet, “Keeping Our Seniors Safe Watch Your Wallet” that discusses these issues, provides examples of financial exploitation and shows who to contact in New Jersey if you believe you have been scammed. https://gstrustco.com/assets/Garden-State-WYW.pdf If you do not have access to the internet you can call 732-255-5000 to request a Free copy be mailed to you. We encourage you to share this booklet with your older relatives and friends. Stay well!
Our focus is where it should be... On You. On Your Family. On Your Future.
Trust & Estate Services Investment Services Lifestyle & Money Management True independence and understanding are at the core of our unique value proposition. Caring for and thoughtfully guiding our clients has created the strong trusting relationships we have nurtured over many decades. That’s why so many people rely upon our independent company for wealth management and trust & estate services: Garden State Trust Company. To learn how we can focus on you and your family, contact Adam Brower or Siobhan Connolly. 1886 Hinds Road • Suite 2 • Toms River, NJ 08753 Toms River, NJ | Cherry Hill, NJ | Lebanon, NJ | Linwood, NJ
732.255.5000 | gstrustco.com
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July/August 2020
Medical Professionals
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July/August 2020
Medical Professionals
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The Benefits of Telemedicine
A Message From Reliance Medical Group
Cruz
Boris Furman
One of the prevailing tenants at Reliance Medical Group is that access to quality healthcare is an absolute right, not a privilege. That statement rings true now more than ever before as we navigate our way through this pandemic.
DO
Covid-19 has impacted every part of the way we live and forced us to make social and behavioral changes in practically every area of our lives. As long as social distancing guidelines are in place, these behavior changes will become new habits and part of our “new normal.” This is precisely why the technology of telemedicine is so critical. Reliance Medical Group continues to lead the way as a progressive, multi-specialty practice with various locations through the state. Their patients will continue to access the affordable managed medical care and their experienced physicians. Although healthcare today has a very different look, the level of care remains the same. One of the ways they are doing this is through telemedicine. Essentially, telemedicine allows health care professionals to evaluate, diagnose and treat patients in remote locations using telecommunications technology. Patients in remote locations can access medical expertise quickly, efficiently, and most importantly without travel. By using remote monitoring and telemedicine they can continue to monitor their patients health without skipping a beat. Whether it’s pediatrics, women’s health, or adult medicine, Reliance Medical Group has implemented systems to continue their effective treatment. Keep in mind, telemedicine doesn’t mean that you’ll never visit a doctor’s office again. But it does make care more accessible and affordable in many cases. Most importantly, it can help reduce the time you spend in your doctor’s waiting room. The need for more accessible healthcare is a driving force behind the growth of telemedicine. Whether a patient lives in a remote area or has a busy schedule that doesn’t allow time to visit a physician, this technology allows them to have access. Further, using telemedicine has been shown to allow for better long-term care management as well as patient satisfaction. For the patient it becomes extremely convenient and encourages them to assume greater responsibility for their own care. It can also help the providers treat clients earlier in some cases and enhance follow up care. As advances in technology are made, telemedicine becomes even more sophisticated. It can also serve a myriad of clients in multiple locations. Researchers have found that what tends to linger after a large scale pandemic such as what we are seeing is that the world we live in becomes a bit more unpredictable and that life feels a bit more fragile. Taking care of your health is the greatest gift you can give to yourself as well your family.
“Quality Healthcare Is A Right, Not A Privilege”
ADULT MEDICINE I GERIATRICS NEUROLOGY I HOUSE CALLS 4013 Route 9 North, Suite 1N Howell, NJ 07731
(732) 905-5255
NEW PATIENTS WELCOME • MOST INSURANCES ACCEPTED
HEALTHIER HAPPIER YOU Reliance Medical Group is using telemedicine and remote monitoring to help your family remain healthy as possible!
Please call our office, Reliance Medical Group, to learn more about how we can help you.
The County Woman Magazine www.TheCountyWoman.com
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Patient Monitors Breathing, Temperature, Blood Pressure - Report On The Mobile App Notifications For Concerning Results “Quality Healthcare Is A Right, Not A Privilege”
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Call Us To Get Started Today!
(855) 735-4262
RELIANCEMEDICALGROUP.NET July/August 2020
9 Medical Professionals Beware BloodLung Clots: Understanding DVT and PE Novemberof Is National Cancer Awareness Month #
What You Need To Know
Did you know that lung cancer is the leading cause of cancer
Deep vein thrombosis, commonly known as DVT, is a condition deaths in both men and women in the U.S.? Approximately where blood clots form inside the deeper veins, block the blood 200,000 new cases are diagnosed each year and 27 percent flow, and cause blood to back up. DVT most commonly affects of all cancer deaths are from lung cancer. the lower half of the body, especially the legs. But thrombosis can alsoWhat occurcauses in thelung armscancer? and other internal organs. Smoking. Smoking is the number factor for lung Even though When blood clots breakone offrisk and travel tocancer. the lungs, it isnon-smokers called can also get lung cancer, the risk is much higher in those who smoke. The more pulmonary embolism. Most often, these clots arise fromyou thesmoke, legs.the
higher your risk. The likelihood of getting lung cancer decreases after you quit smoking. Tobacco smoke damages cells inblood the lungs, causing the cells to grow abnormally. Regular exposure to What causes clots? smoke from someone cigarettes, pipesvessels (calledissecond-hand can increase The smooth flowelse’s of blood insidecigars our or blood regulated bysmoking) several factors. aWhen person’s riskisofalung cancer, even ifblood they are there cut or a wound, clotsnon-smokers. form at the site and prevent excessive bleeding. Certain jobs suchcoagulation as shipbuilding, asbestos insulation TheExposure formationtoofasbestos. clots is initiated by the system, whichmining, includes a cascadeorof automotive brake repair may cause exposurefactors. to asbestos. canare irritate the lungs chemical reactions involving the clotting TheseAsbestos clottingfibers factors controlled by and causeanticoagulants cancer. When in combined with the risk within of developing lungvessels. cancer When is much natural the blood to smoking, prevent clotting the blood higher. there is any imbalance between the coagulants and their opposing anticoagulants within the Radon. Radon an invisible, odorless gas released by soil and some rocks. Exposure to body, clotting can isoccur. higher levels of radon can cause cancer, lungand cancer. Clots also form when blood flow especially slows down blood pools in one part of the body. What types lung cancer? Clots canare alsothe occur whereof there is trauma to the blood vessels. Thereare are two different of lungfor cancer: small cell and non-small cell. This difference is What the risk types factors blood clots? based on the type DVT of cancer cells.after Mostbeing lunginactive cancers are non-small for cell.some Among theWhen non-small Most often, occurs or immobile time. cell lung cancers, there are several subtypes: squamous cell and large cell. we move our legs, it helps to pump bloodadenocarcinoma, back to the heart. After a long plane ride or car/train/bus ride, when the legs don’t move much, blood from the legs is not pumped What are the symptoms and signs? effectively, andand blood pool in the veinshemoptysis for too long. This can stagnation Symptoms signscan include coughing, (coughing upcause blood), shortnessof of blood flow and lead to formation of clots. breath, chest pain, fatigue and weight loss. Anything makesdo a person immobile periodisofadvanced. time, such as fractures, Most often, the that symptoms not manifest untilfor theacancer Sometimes lung cancer surgeries, accidents, etc., can increase the risk of getting blood clots. can be detected as a shadow in the lung on an X-ray done for other reasons. Sometimes very active people can also get DVT. This is usually due to a defect in the How is it diagnosed? coagulation/anticoagulation system. These defects can be genetic and present from birth. Once your doctor suspects that you have lung cancer, you will be sent for CT scans and in Examples include protein C or protein S deficiency, factor V Leiden, and prothrombin some cases, a PET scan. A PET scan can detect cancer more accurately than other tests. The gene mutation. Someby defects occur of later life, suchlesions as lupus cardiolipin diagnosis is confirmed takingcan a biopsy thein suspicious seenanticoagulant, on the X-ray or CT antibody, etc. scans. The scans also help to see if the cancer has spread to any other organs, a process called Certain cancers increase the risk of blood clots. Obesity also is another risk factor for metastasis. developing DVT. In addition, certain medications, such as birth control pills, can increase Are there different the risk of blood clots. stages? Staging is different for small cell and non-small cell lung cancers. Small cell lung cancer has What are the symptoms DVT only two stages: limited stage (confinedof within theand lungs) PE? or extensive (spread outside the lungs). DVT: Non-small cell lung cancer has four stages: stages I to IV. Stage I is a small tumor that is confined Pain to the lung, that has not spread to the lymph glands. Larger tumors and those that are spread to the lymph glands come under stages II and III. When the cancer has spread to other Swelling in the legs organs, it is stage IV.
(DVT: vein thrombosis; PE: pulmonary embolism) What youdeep should know:
• If you are a heavy smoker, and have been smoking for risk of DVT andask PE.your doctor if you need to do an several years, X-ray Treatment prevention of blood clots is part of the treatment now for patients who or a CTand scan. hospitalized •are Ask your MD with aboutCOVID-19. different methods to help you quit smoking. Preventing DVT: • If you are diagnosed ask about the type cancergetting you have, When going on awith longlung trip,cancer, take these precautions toof prevent blood stage and other features such as EGFR mutation. clots: • What is your treatment plan? • Stand up and walk around every 1 to 2 hours • What are the side-effects of treatment? • Do not smoke just before your trip • Are there support services available?
• Wear loose, comfortable clothes
Immunotherapy in lung cancer. • Shift your position while seated, and move your legs and
Over the last few decades, immunotherapy agents have been studied in the treatment of feet often many cancers, including lung cancer. Several immunotherapy drugs are now approved for use. Our immune system fights cancer cells normally, and thus reduces the chance of • Wear knee-high compression stockings transforming normal cells into cancer cells. But this does work always, people with • Avoid alcohol and medicines that not make you as sleepy, normal immune systems also develop cancer. The principle of immune therapy is based on because they can impair your ability to move around boosting the immune system so that it can efficiently destroy cancer cells. immune checkpoint inhibitors been aormajor in cancer research. The Useuse of of blood thinners immediately afterhas surgery otherbreakthrough periods of immobilization will These drugs helpthe to development take the “brakes” off the immune system, so that they can recognize and kill help to reduce of DVT. cancer cells more Weight loss effectively. can reduce the risk of blood clots in obese people. OPDIVO, KEYTRUDA, and TECENTRIQ are some of the immune checkpoint inhibitors that are usedin in next lungissue) cancer. EvenII: though these drugs of don’tBlood have theClots: typical side effects you of (Continued Part Treatment What chemotherapy, they still can cause reactions such as inflammatory disorders.
need to know about blood thinners more about lung cancer and the To Forlearn questions about blood clots and treatment ortreatment any other of other cancers, contact Dr. Sarah Easaw at 732-961-0010 or 732information on cancer or blood disorders, please contact Dr. Easaw: visit www.oceanhemonc.com. 961-0010 (www.oceanhemonc.com) or oceanhemoncdr@gmail.com.
Warmth and redness
What PE: are the treatment options?
Treatment is based on the stage and the type of lung cancer. Small cell lung cancer is mainly Sharp pain in the chest treated with chemotherapy. In limited stage small cell lung cancer, radiation can be combined Difficulty in breathing with chemotherapy. Cough, coughing Early stage non-small cellup lungblood cancer is best treated by surgical resection. An experienced surgeon removes the tumor, surrounding normal lung tissue and the lymph glands around it. Palpitations, increased heart rate Even after removing the tumor, cancer cells can remain and and causeneed recurrent cancer,attention. either in the Any of these symptoms could be due to blood clots immediate lung itself or in other organs. Chemotherapy, radiation or both are used after surgery to reduce If DVT is not treated in time, there is a high risk of developing pulmonary embolism the chance of recurrent cancer. and death. Advanced stage lung cancer is treated with chemotherapy. The types of chemotherapy drugs Superficial and age thrombophlebitis: used are based onthrombosis the type of lung cancer, of the patient, other medical illnesses, etc. There is ongoing When blood clots are formed in the closewith to the surface, it is called research to improve the outcome inveins patients lungskin cancer. superficial thrombosis. Superficial phlebitis is inflammation of these veins. When there is What’s newalong in lung cancer? inflammation with blood clots, it is called superficial thrombophlebitis. Targeted agents: Medicines that target proteins theusually cancer dangerous, cells Superficial thrombophlebitis causes paincertain and redness in or thereceptors legs. It isonnot are being developed for the treatment of various cancers. These targeted agents attack the but sometimes it can extend to the deep veins and cause DVT. People with varicose veins cancer cells specifically, sparing other cells. Targeted agents cause less severe side effects than and venous insufficiency are more likely to get superficial thrombophlebitis. chemotherapy. Distal proximal A fewvs different targeted DVT: agents are found to be beneficial in lung cancer. Tarceva (erlotinib) is a drug thataworks certain typesinofthe lungveins cancers carrying a mutation in a receptor When bloodinclot forms above the knee (proximal DVT),called it is EGFR. A newto drug called approved for the lung cancerthe that more likely break offcrizotinib and go was to the lungs,recently compared to treatment clots thatofare below carries a gene called ALK fusion oncogene. knee (distal DVT). Therefore proximal DVT is treated more aggressively. No two tumors are alike! Even among lung cancers, there are different distinguishing COVID-19 and blood clots: features. Your oncologist chooses the type of treatment based on a number of factors, including the cell Autopsies of many patients who died of COVID-19 thereother was evidence type, stage, different biological markers on the cancershow cells, that and your medical of blood clots in their internal organs. Hospitalized patients with COVID-19 have a higher problems.
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July/August 2018 2020 November/December
Medical Professionals
10
Oral Surgery For Children You may not realize it, but sometimes children need to have oral surgery. Tongue tie: This is a condition present at birth where the soft tissue frenum or tissue band
Kathy A. Banks, DMD Oral & Maxillofacial Surgery
Your Expert in the Face, Mouth and Jaws 249 S. Main Street Barnegat , NJ Specialty Lic #4070
609-488-2325 www.drbanksoms.com Office Hours: 8 AM - 5 PM (Mon. - Fri.)
attachment on the underside of the tongue binds the tongue in an abnormal position to the inner surface of the lower jaw or the floor of the mouth. In infants this may cause inability to feed properly. In young children this attachment may cause speech problems because the tongue function and mobility are limited. When someone with tongue tie tries to stick out their tongue it will be notched, or heart shaped. The earlier this condition is treated, the better; Dr. Banks has treated patients as young as one day old for this condition.
Excessive maxillary frenum: The soft tissue band attachment of the lips to the
dental ridge sometimes is abnormally large or is attached onto the gum ridge between the front teeth. Often this attachment needs to be surgically modified if there is a space (diastema) between the front teeth that is going to be treated with braces. Dr. Banks provides this service for children on a routine basis. Often the treatment can be performed by her with a LASER and without stitches.
Extractions of “baby teeth”: Let’s face it: Sometimes no matter how hard you try, some children are prone to decay affecting their primary teeth (“baby teeth”). Not all primary teeth can be restored, and some children are not able to sit through dental appointments, or have already had bad experiences in the dental chair. Dr. Banks and her well-trained surgical anesthesia team will make your child’s experience a good one. Extractions for braces: Your orthodontist may recommend removal of certain teeth for orthodontic purposes. These may be perfectly healthy primary teeth that are not falling out on time and therefore are preventing eruption of the adult teeth; or the teeth may be perfectly healthy adult teeth that need removal to treat dental crowding. Whatever the situation, Dr. Banks and her well-trained surgical anesthesia team will provide care for your child in a safe, clean, and friendly environment Unerupted or impacted teeth: Some teeth will not erupt into the mouth on their own. A common example is an upper canine tooth. If the tooth is going to be positioned into the dental arch, the tooth needs to be surgically uncovered and a special bracket will be bonded to the tooth. The orthodontist can then use this bracket to coax the tooth into position.
• Bone Grafting •Dental Implants • General and Intravenous Anesthesia • Jaw Pathology and Reconstuctive Jaw Surgery
Supernumerary (extra) teeth: In general, a supernumerary tooth that develops in the bone of the top jaw between the two front teeth (called a mesiodens) needs to be removed. The same holds true when there are extra teeth in other regions of the mouth. The presence of these teeth can cause disturbances in the normal eruption pattern of the surrounding teeth. If your dentist recommends removal of supernumerary teeth, see Dr. Banks. These procedures may be complex, and Dr. Banks has 3-D imaging capabilities right in the office to carefully plan the treatment for optimal results. Anesthesia options include local anesthesia (numbing), nitrous oxide gas (“laughing
gas”), sedation, and general anesthesia. Treatment is usually performed in the office; however, some patients may require treatment in the outpatient hospital setting. Dr. Banks will evaluate your child carefully with you and make specific recommendations so that treatment is safe and comfortable for your child.
For more information, call 609-488-2325 or visit www.drbanksoms.com.
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July/August 2020
Medical Professionals
11
Understanding The Term ‘Irritable Bowel Syndrome’ Written by: Dr. Omar Termini, Gastroenterologists of Ocean County
Do you suffer with chronically recurring abdominal pain and/or abdominal bloating that makes you feel or even look nine months pregnant? Do you suffer with chronic diarrhea that makes you uneasy to leave your house for even short trips? Do you have to rush home from a dinner out or even rush to the bathroom before leaving a restaurant because of the urgency to have a bowel movement? Do you know where every bathroom facility is located on your ride to work? Or do you have difficulty having bowel movements with resulting pain and cramping? If you answered yet to any of these questions, you are in very good company and may be suffering with a common condition called Irritable Bowel Syndrome.
What Is IBS?
Irritable Bowel Syndrome or IBS is a common gastrointestinal disorder that affects the colon or large bowel. It is the most common complaint for which a gastroenterologist is consulted. It is estimated that 1 in 6 Americans suffer with some symptoms of IBS. Women suffer with the disorder more frequently than men and the initial onset of symptoms occur most often in adolescence and early adulthood but man manifest at any age. Though IBS is considered a benign condition with no risk of cancer, intestinal damage or associated inflammation, it is quite debilitating in many patients. IBS is one of the most common reasons for absence from work in the U.S. Symptoms of IBS vary by the subtype but all commonly include abdominal pain, bloating, pain relieved by defecation, mucus rectal discharge and alteration in bowel habits.
During this troubling time the doctors and staff at Gastroenterologists of Ocean County remain available to care for your needs. We offer telemedicine visits as well as in person visits for screened patients. Our endoscopy centers remain open for procedures , with pre-procedure COVID testing as mandated. Please call if you have any questions or concerns 732-349-4422
Omar Tamini, MD
What Is The Cause Of IBS?
Jill Collier, MD
Despite the common frequency of this disorder, there is no defines cause of IBS. Research has failed to detect any specific defect in the gastrointestinal tract that explains the illness. It has been theorized that a motility disorder (nervous system dysfunction that prevents proper muscle function of intestines) is the prime defect but this has yet to be confirmed. Most experts believe that there are likely multiple contributing factors.
Edgar Bigornia, MD Kenneth Glazier, MD
How Is IBS Diagnosed?
Experts in the field have developed clinical criteria to help diagnose IBS. This is based on history a patient gives a doctor during a visit. These criteria can only assist your doctor in making the diagnosis but are not definitive. This means that one must exclude other illnesses that mimic IBS before the diagnosis of IBS is confirmed. Disorders that can mimic or cause similar symptoms of IBS include: Infections, Inflammatory Bowel Disease (Crohn’s Disease and Ulcerative Colitis), Celiac Sprue (gluten sensitivity), Lactose Intolerance and Colon Cancer and other abdominal cancers. To exclude these disorders, when signs and symptoms are present, physicians will often perform blood and stool tests as well as place patients on selective diets. Colonoscopy is often necessary to exclude Colon Cancer or Colitis. Only once these more serious conditions have been excluded by patient history and necessary exams can patients by reassured of the diagnosis and treatment recommended.
Should I Be Concerned?
Jai Mirchandani, MD Teresa Menadier, MD
• Colonoscopy and colon polyp removal • Colon cancer detection and screening • Rectal bleeding evaluation • Ulcer pain evaluation and treatment • Swallowing disorders
• Endoscopic treatment of hemorrhoids • Capsule Endoscopy • Breath testing • Esophageal and anorectal manometry
If your symptoms include bleeding, weight loss, bowel movements that wake you from sleep, oily stools or new symptoms presenting later in life, than it is urgent that you see your doctor right away to have appropriate evaluation as these may be symptoms of much more serious conditions. But even if you do not have these alarm symptoms, you should seek medical advice for treatment of IBS if you suspect you suffer with this disorder.
How Is IBS Treated?
There is no cure for IBS so the goal of therapy is to properly diagnose the disorder and thereafter tailor a treatment to the individual. Doctors will often give advice on diet and prescribe medications depending on the nature of the symptoms. Laxatives, antidiarrheals, and antispasmotics are commonly ordered. Probiotics and alternative therapies can be of great value as well. In conclusion, IBS is a treatable condition that must be properly diagnosed for optimum therapy and to minimize the likelihood of more serious conditions remaining undiagnosed. There is no reason why the symptoms of IBS should stop you from enjoying what pleasures life has to offer. So speak to your doctor soon if you suspect that you suffer with the symptoms of Irritable Bowel Syndrome.
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For more information on IBS, please contact the Gastroenterologists of Ocean County today!
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ty Woman Magazine
July/August 2020
March/April 2018
Financial Independence
12
Changing Jobs? Know Your 401(k) Options If you’ve lost your job, or are changing jobs, you may be wondering what to do with your 401(k) plan account. It’s important to understand your options.
Geeta K. Brana Senior Vice President Financial Advisor
Freedom Capital Management 960 Holmdel Road Building 1 Holmdel, NJ 07733 Email:GBrana@fcmadvisor.com Tel: 732-546-9315 Web: FCMADVISOR.COM Geeta K. Brana provides comprehensive wealth management and asset management advisory services to women in transition. Geeta has over twenty years of experience in the international capital markets. Her career started in London in 1995 with Lloyds Capital Markets, where she trained in all aspects of international finance and credit analysis. She joined Sumitomo Mitsui Banking Corporation in 2000, where she gained extensive experience of structuring and trading debt packages for multinational corporations throughout the United Kingdom, Eastern Europe, US and Japan. In 2003, Geeta began her career in the U.S. with Smith Barney’s Wealth Management Division (Citigroup), turning her extensive knowledge to helping individuals. In a primarily male-dominated environment, she was able to build a successful wealth management practice in Washington, DC and later New York City, working with high net worth individuals and institutions. After a career break while her children were young, Geeta has returned to wealth management through Freedom Capital Management (FCM), a boutique independent advisory firm with deep roots in Monmouth County, NJ. Geeta is also the Founder of WHEEL (Women Helping Educate & Enhance Life). Currently, the focus of Geeta’s practice is on “Women In Transition”; assisting women in all phases of their lives.
WHEEL.WOMEN.POWER WWW.WHEELFORWOMEN.COM Securities and investment advisory services offered through Royal Alliance Associates, Inc. (RAA), member FINRA/SIPC. RAA is separately owned and other entities and/or marketing names, products or services referenced here are independent of RAA. RAA does not provide tax or legal advice.
What will I be entitled to? If you leave your job (voluntarily or involuntarily), you’ll be entitled to a distribution of your vested balance. Your vested balance always includes your own contributions (pre-tax, after-tax, and Roth) and typically any investment earnings on those amounts. It also includes employer contributions (and earnings) that have satisfied your plan’s vesting schedule. In general, you must be 100% vested in your employer’s contributions after 3 years of service (“cliff vesting”), or you must vest gradually, 20% per year until you’re fully vested after 6 years (“graded vesting”). Plans can have faster vesting schedules, and some even have 100% immediate vesting. You’ll also be 100% vested once you’ve reached your plan’s normal retirement age. It’s important for you to understand how your particular plan’s vesting schedule works, because you’ll forfeit any employer contributions that haven’t vested by the time you leave your job. Your summary plan description (SPD) will spell out how the vesting schedule for your particular plan works. If you don’t have one, ask your plan administrator for it. If you’re on the cusp of vesting, it may make sense to wait a bit before leaving, if you have that luxury. Don’t spend it While this pool of dollars may look attractive, don’t spend it unless you absolutely need to. If you take a distribution you’ll be taxed, at ordinary income tax rates, on the entire value of your account except for any after-tax or Roth 401(k) contributions you’ve made. And, if you’re not yet age 55, an additional 10% penalty may apply to the taxable portion of your payout. (Special rules may apply if you receive a lump-sum distribution and you were born before 1936, or if the lump-sum includes employer stock.) If your vested balance is more than $5,000, you can leave your money in your employer’s plan at least until you reach the plan’s normal retirement age (typically age 65). But your employer must also allow you to make a direct rollover to an IRA or to another employer’s 401(k) plan. As the name suggests, in a rollover the money passes directly from your 401(k) plan account to the IRA or other plan. This is preferable to a “60-day rollover,” where you get the check and then roll the money over yourself, because your employer has to withhold 20% of the taxable portion of a 60-day rollover. You can still roll over the entire amount of your distribution, but you’ll need to come up with the 20% that’s been withheld until you recapture that amount when you file your income tax return. Should I roll over to my new employer’s 401(k) plan or to an IRA? Assuming both options are available to you, there’s no right or wrong answer to this question. There are strong arguments to be made on both sides. You need to weigh all of the factors, and make a decision based on your own needs and priorities. It’s best to have a professional assist you with this, since the decision you make may have significant consequences — both now and in the future. Reasons to consider rolling over to an IRA: • You generally have more investment choices with an IRA than with an employer’s 401(k) plan. You typically may freely move your money around to the various investments offered by your IRA trustee, and you may divide up your balance among as many of those investments as you want. By contrast, employer-sponsored plans generally offer a limited menu of investments (usually mutual funds) from which to choose. • You can freely allocate your IRA dollars among different IRA trustees/custodians. There’s no limit on how many direct, trustee-totrustee IRA transfers you can do in a year. This gives you flexibility to change trustees often if you are dissatisfied with investment performance or customer service. It can also allow you to have IRA accounts with more than one institution for added diversification.
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With an employer’s plan, you can’t move the funds to a different trustee unless you leave your job and roll over the funds. • An IRA may give you more flexibility with distributions. Your distribution options in a 401(k) plan depend on the terms of that particular plan, and your options may be limited. However, with an IRA, the timing and amount of distributions is generally at your discretion (until you reach age 72 and must start taking required minimum distributions in the case of a traditional IRA). • You can roll over (essentially “convert”) your 401(k) plan distribution to a Roth IRA. You’ll generally have to pay taxes on the amount you roll over (minus any after-tax contributions you’ve made), but any qualified distributions from the Roth IRA in the future will be tax free. Reasons to consider rolling over to your new employer’s 401(k) plan (or stay in your current plan): • Many employer-sponsored plans have loan provisions. If you roll over your retirement funds to a new employer’s plan that permits loans, you may be able to borrow up to 50% of the amount you roll over if you need the money. You can’t borrow from an IRA — you can only access the money in an IRA by taking a distribution, which may be subject to income tax and penalties. (You can give yourself a short-term loan from an IRA by taking a distribution, and then rolling the dollars back to an IRA within 60 days; however, this move is permitted only once in any 12-month time period.) • Employer retirement plans generally provide greater creditor protection than IRAs. Most 401(k) plans receive unlimited protection from your creditors under federal law. Your creditors (with certain exceptions) cannot attach your plan funds to satisfy any of your debts and obligations, regardless of whether you’ve declared bankruptcy. In contrast, any amounts you roll over to a traditional or Roth IRA are generally protected under federal law only if you declare bankruptcy. Any creditor protection your IRA may receive in cases outside of bankruptcy will generally depend on the laws of your particular state. If you are concerned about asset protection, be sure to seek the assistance of a qualified professional. • You may be able to postpone required minimum distributions. For traditional IRAs, these distributions must begin by April 1 following the year you reach age 72. However, if you work past that age and are still participating in your employer’s 401(k) plan, you can delay your first distribution from that plan until April 1 following the year of your retirement. (You also must own no more than 5% of the company.) • If your distribution includes Roth 401(k) contributions and earnings, you can roll those amounts over to either a Roth IRA or your new employer’s Roth 401(k) plan (if it accepts rollovers). If you roll the funds over to a Roth IRA, the Roth IRA holding period will determine when you can begin receiving tax-free qualified distributions from the IRA. So, if you’re establishing a Roth IRA for the first time, your Roth 401(k) dollars will be subject to a brand new five-year holding period. On the other hand, if you roll the dollars over to your new employer’s Roth 401(k) plan, your existing five-year holding period will carry over to the new plan. This may enable you to receive tax-free qualified distributions sooner. When evaluating whether to initiate a rollover, always be sure to (1) ask about possible surrender charges that may be imposed by your employer plan, or new surrender charges that your IRA may impose, (2) compare investment fees and expenses charged by your IRA (and investment funds) with those charged by your employer plan (if any), and (3) understand any accumulated rights or guarantees that you may be giving up by transferring funds out of your employer plan. What about outstanding plan loans? In general, if you have an outstanding plan loan, you’ll need to pay it back, or the outstanding balance will be taxed as if it had been distributed to you in cash. If you can’t pay the loan back before you leave, you’ll still have 60 days to roll over the amount that’s been treated as a distribution to your IRA. Of course, you’ll need to come up with the dollars from other sources.
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Medical Professionals Women and Alzheimer’s Disease Alzheimer’s disease affects 13 million women in the United States. Almost two-thirds of Americans living with Alzheimer’s are women. In their 60s, women are twice as likely to develop Alzheimer's disease during the rest of their lives as they are to develop breast cancer.
Memory Center
Women are also more likely to be a caregiver for someone living with Alzheimer’s disease.
9 Mule Road Suite E 9 Toms River, NJ 08755
More than 60% of Alzheimer's and dementia caregivers are women.
(732) 341-9500
More than three in five unpaid Alzheimer’s caregivers are women. While these statistics can be unnerving, it is important that those who need support receive it. At AMRINJ, we offer free memory evaluations for those who may be experiencing symptoms of memory loss. We also offer access to the most up-to-date research opportunities to help find a treatment or cure for Alzheimer’s disease. We also offer our support group, Caring for Caregivers, to help those caring for someone with memory loss. This group meets at AMRINJ every second and fourth Wednesday of the month.
Call today to schedule your FREE memory evaluation.
732-341-9500
Dr. Sanjiv Sharma is a boardcertified geriatrician who specializes in memory loss. His mission is to educate all patients and families on memory loss, Alzheimer’s disease and dementia and bring the latest research to those directly affected by these diseases.
www.AMRINJ.com
Statistics and information from the Alzheimer’s Association website: “Women and Alzheimer’s” https://www.alz.org/alzheimers-dementia/what-is-alzheimers/women-and-alzheimer-s
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July/August 2020
Medical Professionals
15
Hemorrhoids: The Bottom Line Nina Paonessa, DO, FACOS Did you know we are born with hemorrhoidal tissue, it’s a part of our anatomy? Hemorrhoidal tissue lies within the anal canal and perianal area and consists of blood vessels, connective tissue, and a small amount of muscle. Hemorrhoids are described as varicose veins of the anus and rectum because they are enlarged, bulging blood vessels in the anus and lower rectum. The only time we actually feel hemorrhoids is when they become enlarged or symptomatic. Dr. Paonessa likes to use the analogy: “We all have teeth, but we all don’t have cavities.” Likewise, we all have hemorrhoids, but we all don’t have symptomatic hemorrhoids. There are two types of hemorrhoids: internal and external. Both can have different symptoms and often different treatments. Internal (inside) hemorrhoids form in the anus beneath a lining called mucosa, which is not sensitive to touch, pain, stretch or temperature. As such, internal hemorrhoids are commonly associated with painless bleeding and protrusion during bowel movements. It is only when the hemorrhoid completely prolapses from the opening of the anus and cannot be pushed back inside that it becomes severely painful. Internal hemorrhoids are classified in four grades: Grade One: The hemorrhoid is not protruding from the opening of the anus (no prolapse). Grade Two: The hemorrhoid protrudes from the anus but it goes back in on its own. Grade Three: The hemorrhoid protrudes and requires the patient to push it back inside the anus. Grade Four: The hemorrhoid cannot be placed back into the anus by the patient. This is often very painful. External (outside) hemorrhoids form around the anus and are covered by very sensitive skin. The most common complaints associated with external hemorrhoids are occasional swelling, pressure or discomfort. When a hemorrhoid is symptomatic it becomes a bluish-colored, painful lump outside the anus. If the external hemorrhoid develops a clot (thrombosis), it becomes a hard, painful lump. When the pressure becomes elevated, it can cause the thrombosed hemorrhoid to break down the overlying skin and the clot begins to leak out. Even after the hemorrhoid has healed, some patients complain about soft tissue outside the anus called an anal skin tag. An anal skin tag is the residual effects from the thrombosed external hemorrhoid. A skin tag may hinder a patient’s ability to clean after a bowel movement. Although there is no treatment for anal skin tags, they can be removed if hygiene becomes an issue for the patient. There are several factors that can cause hemorrhoids, although the exact cause is unknown. Upright posture alone increases pressure on the rectal veins and can cause them to bulge. Additional factors include aging, chronic constipation or diarrhea, straining during pregnancy, heredity, straining during bowel movements, overuse of laxatives or enemas, and extended periods of time on the toilet (i.e., reading). Here are some symptoms you should be aware of to determine if you may have a hemorrhoid problem: bleeding during bowel movements, itching in the anal area, pain, sensitive lumps or prolapsing during bowel movements. If you do experience any of the symptoms, do not treat with over-the-counter medication. Call and make an appointment with your doctor. It is very important to understand that NOT all rectal bleeding is caused by hemorrhoids. As such, it is crucial to seek consultation with a specialist such as a colon and rectal surgeon to be sure that the rectal bleeding is not caused by a serious disease such as anal or colorectal cancer. How hemorrhoids are treated depends on how severe the condition is. If the symptoms are mild, your doctor may simply have you increase the fiber intake in your diet (i.e., fruits, vegetables, breads and cereals) or add an oral fiber supplement. It is recommended that you consume 20-35 grams of fiber per day. It is very important to make sure that you drink 8-10 glasses per day of water. Other beverages that contain caffeine or alcohol will dehydrate you, so try to decrease your intake of those beverages. These measures help to create a soft, formed stool, thereby eliminating excessive straining during bowel movements. This, in turn, will decrease the pressure on the hemorrhoids. The use of warm water soaks (sitz baths) will also provide relief. There are several outpatient treatments that may be performed in the office to
help treat symptomatic hemorrhoids. These include rubber band ligation, infrared photocoagulation, and sclerotherapy. All of these procedures are painless. Dr. Paonessa’s procedure of choice in the office is sclerotherapy. Sclerotherapy involves an injection of a chemical irritant into the hemorrhoid which causes scarring and shrinkage of the blood vessels present within the hemorrhoidal tissues. This procedure is painless and has few, if any, complications. Sclerotherapy is safe for patients on blood thinners. As with any procedure, you will need to discuss this with your physician. External hemorrhoids may be treated on an outpatient basis as well. Excision of the hemorrhoidal tissue can be performed. The hemorrhoid will be injected with a numbing agent and excising of the hemorrhoid along with all blood clots (thrombus) is done. In this case the entire external hemorrhoid is removed, not lanced, so as to avoid any residual skin tag once healed. This procedure provides instant pain relief for those patients suffering from severe pain. Often hemorrhoids that are not thrombosed can be treated with dietary change and sitz baths. There are other procedures that can be done on an outpatient basis at surgery centers or hospitals. These include traditional hemorrhoidectomy, transanal hemorrhoidal dearterialization (THD), and stapled hemorrhoidectomy. As with any surgery, you will need to have your physician evaluate your condition and see what the best option for you is. With advances in local anesthetic and surgical technique, hemorrhoidectomy is not the painful procedure it had been associated with in the past. If you are experiencing any of the symptoms or conditions discussed, please contact Paonessa Colon and Rectal surgery to make an appointment with Dr. Paonessa. Dr. Paonessa is well trained in all aspects of hemorrhoid management and surgery. In fact, she is the co-editor of the textbook Surgical Treatment of Hemorrhoids, 2nd edition, and authored three of the chapters within this textbook.
Testimonial “My experience with Dr. Paonessa was exceptional. She made me feel so comfortable and at ease. I’ve never met a doctor like her. For many years, I thought I had hemorrhoids and was completely uncomfortable. After being diagnosed with a prolapsed rectum, I met with Dr. Paonessa. She immediately put me at ease and explained everything. Dr. Paonessa performed prolapsed rectum surgery and now I feel wonderful. I feel like I came out as a better person.” - Natalie H.
Colon and Rectal Surgery
Board Certified in General Surgery and Proctology • laparoscopic surgery • abdominal/pelvic surgery • fecal incontinence • endoanal/rectal ultrasound • anorectal surgery 603 Higgins Avenue Brielle, NJ 08730
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• pelvic floor disorders • office proctology • anorectal manometry/ physiology
1364 Route 72, Suite 5 Manahawkin, NJ 08050
Phone: (732) 282-1500 • Fax: (732) Office Hours: M-F 9AM to 5PM
292-9600
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Medical Professionals
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37
3D Mammography
Pros and Cons of Radiation
Breast cancer is the second leading cause of death among women.IOne in 8 women As a radiologist, often receive questionswill aboutdevelop radiation. breast Much of the cancer in her lifetime. Each year it is estimated that over images. We allwomen know thatin large of radiation canwill be dangerous, but how 252,710 thelevels United States be diagnosed dangerous is the radiation one receives from an X-ray or CT scan? I am here to with breast cancer and more than 40,500 women will answer some of the more common questions that are of concern. die from the disease. This is why early detection is so detection, Q:important. What is myWith risk early of being exposedthe to five-year radiation?survival is everywhere and we are exposed to on afight daily against basis. It rateA: is Radiation nearly 100%. The latest weapon in itthe comes from the ground, mostly in the form of radon gas. Radiation also breast cancer is 3D mammography (also known ascomes breast tomosynthesis). This new technology has increased early atmosphere and increases our radiation exposure. Because of Denver’s high detection traditional mammograms, especially in elevation, peopleover who live in Denver are exposed to more radiation women with dense breasts. Greater accuracy than people in NJ. Sun exposure we receive during the summer means months exposes us tocancer ultravioletdetection. radiation, which is why better breast protective sunblock is important. We are always exposed to low levels of radiation, and for the most part it does
Q: What is a 3D mammogram? How is it different from high levels mammograms? of radiation, it can slightly increase our regular risk of developing cancer in our lifetime. However, A: 3D mammogram--also called breast tomosynthesis--is one of the most for the average person, this is not the case.
suspicious, patients need to be called back for additional views. very The multiple far outweigh the potential low risks. Patients who need more frequent scans, images created by 3D mammograms as well as young adults and children, who have a Cancer higher sensitivity to radiation, in have such increased accuracy that this breast we recommended imaging machines which do not use there is decreased using need for this. On is difficult to radiation, such as ultrasound MRI. Otherwise, receive average 3Dand mammograms reducethese patients should detect on the absolute lowest levels of radiation obtaining images possible. . callbacks by up towhile 40% still compared to the best this standard traditional mammograms. This means mammogram. Q: media talksincreased a lot about the high levels of radiation in lessThe radiation exposure, CT scans. Why CTand scans convenience for ourcan’t patients, moreuse less radiation? CT scans give extremely detailed images of the human body to detect A: peace of mind. disease, infection, trauma, and cancer. CT scans do have higher levels of
Q: What can I expect when be adjusted; however, setting a CT to emit a very low level of having a 3D mammogram? radiation produces very poor image quality. Image quality is A: The process of having a 3D
mammogram is the samecancer. as a As a doctor and a radiologist, it is extremely conventional 2D exam. Theimportant to me to reduce the radiation exposure to my patients as low as possible while still creating hightechnologist will position you, compress your breast, and take images implement the latest techniques using our new ultrafrom different angles. There’s no fast, 64-slice CT scanner, which gives the highest Using 3D mammogram additional compression required, andquality it image while reducing the radiation dose by technology, the only takes a few extra seconds.up to 60%. cancer was able to be In summary, clearly radiation seen. is all around us in low Q: Do insurance companies doses. Most medical imaging exposes us to low
advanced forms of breast cancer detection. It uses a very low level of radiation to Q: Why is radiation dangerous? take multiple pictures of the breast. The x-ray tube moves over the breast in an A: Whenmultiple the cellsimages of ourofbody exposed arc, capturing eachare breast from different angles. A computer to radiation, these it canpictures create something free reconstructs to create acalled 3-dimensional picture of the breast. A regular radicals. Free radicals damage the DNA of that cell. mammogram takes a single picture of the breast. Most of the damage is repaired by the cell, but if cover 3D mammograms? the damage things couldofhappen: the Q: Whatisissevere, the two advantage 3D mammogram? cell can die or the cell’s DNA is repaired incorrectly. A: Medicare, and many private insurers, cover 3D mammograms. thelifetime. past, not increase our risk of developing cancer inInour A: One the challenges interpreting mammograms If the cellofdies, a new cell of is created; however, if many is normal dense breast all private insurance companies covered mammograms. However, in August As adults grow3D older, radiation exposure becomes less tissue hiding breast cancer. overlapping cells die and the damage is Additionally, severe, it could take a longareas of normal dense breast and less dangerous. And thereallarethe some who believe that 2018, New Jersey enacted a mandate requiring nearly major health insurers tissue look suspicious. is why detecting breast cancer in women with dense time tocan recover. If the cell’sThis DNA is repaired incorrectly, occasional exposure to very low levels of radiation can be to cover 3D mammograms. breasts more 3-dimensional images of breast tomosynthesis help that cellishas thedifficult. potentialThe to become cancerous. decrease the tissue overlap that can obscure cancers. It also helps distinguish normal Toms River X-ray has been performing mammograms Imaging is a miraculous tool which provides us the ability to Q: Is all radiation overlapping breast tissuedangerous? from breast cancer. and serving the community for over 30 years. Our 3D A: Studies have shown that 3D mammograms significantly improve the mammogram is the latest onWhat the ismarket and most X-rays far outweigh the potential risks. important is tohas limitthe the amount detection of breast cancer, especially inand women denser breast tissue. It also sick cells before they can cause disease theywith are replaced by new healthy cells. advanced technology. It is our mission to provide the very picks up breast cancer at an earlier stage, which may be missed by traditional using which doWe not use radiation as ultrasound and MRI). bestimaging for ourtools patients. thank you(such for trusting us with your mammography. 3D mammograms find 20-65% more invasive breast cancers Although CT scans do have higher levels of radiation, the occasional CT scan health and the health of your loved compared to springs. traditional 2D mammograms, with an average increase of 41%. of those hot ones.CT, We X-ray, andlook MRI forward Center, weto areoffering committed to using the absolute lowest levels
Q: Is there increased radiation a 3D Q: What types of medical imagingperforming expose us to radiation? If I need an X-ray or CT scan, how worried should I be? mammogram? emittoradiation including conventional Xrays, A: Medical devices A: Mammograms expose that patients very low–levels of radiation. The level of CT radiation exposure from a 3D mammogram is the same as that from a traditional mammogram. So a Imaging patient receives all the benefits without any increased risk. to developing cancer. is a miraculous tool which provides us the ability With traditional mammograms, when a radiologist finds an area that is
you this significant advance in breast cancer screening.
machine uses the latest technology and computer software to dramatically reduce our patients’ radiation dose by up to 60%. I strive to provide the highest level of care and safety for my patients as if it was my own family. As always if you have
Cyrus Khorrami, M.D. Medical Director happy to assist you. 732-244-0777.
PARVIZ KHORRAMI, KHORRAMI, M.D. M.D. CYRUS CYRUS KHORRAMI, KHORRAMI, M.D. M.D. PARVIZ Founder Medical Director Director Founder Medical PARVIN MOTEMADEN MOTEMADEN PARVIN KHORRAMI, M.D. M.D. KHORRAMI,
732-244-0777
PET/CT PET/CT Ultrasound Ultrasound CT CTScan Scan Diagnostic High FieldX-Ray Open Bore MRI
1.5 T and 3X-Ray T High Diagnostic Field Open Bore MRIs Digital Mammography 3-D Mammography Nuclear Medicine Nuclear Medicine Bone Densitometry Bone Densitometry
Deer Chase Professional Park • 154 Route 37 West • Toms River, NJ 08755 • Fax: 732-244-1428 732-244-1428
www.TomsRiverXray.com5
5
www.TheCountyWoman.com The County County Woman Woman Magazine Magazine www.TheCountyWoman.com The The County Woman Magazine www.TheCountyWoman.com
September/October 2017 2018 November/December July/August 2020
Home Health Care Ageism and the COVID-19 Pandemic
17
Deborah Walsh,
Seniors are a source of generational knowledge and wisdom. They contribute to the workforce in increasing numbers, they volunteer, and they are a key strength to our economies and our families. Despite clear indications of ageism, there are also encouraging As the debate rages on when signs of intergenerational solidarity emerging. There are many and how to resume public life, examples of younger people supporting older adults during their older adults have increasingly isolation: dropping off groceries, looking after their lawn or garden, witnessed behavior and rhetoric and working to keep them socially connected. that implies their lives are not as We need to consider what we stand to lose if we let ageism valuable as others. influence how we discuss and treat older adults during and after the Ageism has been quietly pervasive in COVID-19 pandemic. American culture for decades, but this A few reminders: particular form of discrimination has become magnified during the • Schedule a doctor’s appointment and get a checkup – discuss your pandemic. particular risk factors with your doctor. It is important for older people to question negative stereotypes • Wear a mask when going outside and do not be afraid to tell and resist them if possible. Seniors who value and affirm their people around you to wear a mask. Use the line, “I am protecting own meaningful contributions to society can avoid internalizing you by wearing a mask, please do the same for me.” those stereotypes. Research shows that older adults with negative • Wash your hands frequently with soap and water. attitudes about aging may live 7.5 years less than those with positive • If you go to the grocery store, go during non-peak hours. Most attitudes. stores now have senior shopping times. Seniors are vital contributors to the economy. Many older adults • Stay physically active – there is nothing wrong with going out for are frontline health care workers or work in support services such a walk – sit on the park bench six feet away from others. Have a as housekeeping and food service. Almost two million older people conversation with a stranger. serve as caregivers for their grandchildren and 25% of children • Reach out to your local senior center. Many are holding on-line under the age of five are taken care of by grandparents for working activities like yoga and dance exercise classes. parents. Executive Director, HomeWorks
Stay safe – stay active. You are valuable!
For more information, call 732-838-1950 or visit www.UMCHomeworks.org. In-home care for seniors. Call today for a free in-home assessment.
732-838-1950 • UMCHomeworks.org. 54 Olin St, Ocean Grove, NJ
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Legal Professionals
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HELPING PEOPLE PROTECT ASSETS FOR SPECIAL NEEDS CHILDREN AND CONDUCT SMOOTH REAL ESTATE CLOSINGS FOR OVER TWO DECADES. • Special Needs Trusts • Wills & Estate Planning • Guardianships • Health Care Proxies • Long Term Care • Powers of Attorney • Inheritance Tax Planning • Trusts 81 East Water Street Suite 2C, Toms River NJ 08753 732.281.0060 www.MatusLaw.com 125 Half Mile Road, 200 Red Bank, New Jersey 07701 This office by appointment only.
Christine L. Matus, Esq.
Why a Living Will and Appointing a Health Care Representative are Necessary Written by Kristine Gurski, Esq. You probably think that having a Living Will is something that people only need when they are seriously ill or elderly. After all, many hospitals ask you to complete this form upon admission, often when you are already in pain or under extreme stress. You might also think that your family can make these decisions for you if you become unable to decide for yourself.
Having a Living Will and appointing a Health Care Representative when you can make thoughtful decisions as to your care are key to ensuring that your wishes are carried out, even when you are not able to express them. A Living Will (also called an “Advance Directive”) allows you to express your desires related to end-oflife care by affirming your personal choice regarding various life sustaining treatments. You can also express your choices as to whether you will continually be kept comfortable with pain medication or be provided with fluids and nutrition. Appointing a Health Care Representative (also known as a “Medical Power of Attorney” or a “Health Care Proxy”) allows you to choose a person to be your voice in making medical decisions and receiving the proper care for your when you are unable to do this for yourself. In choosing your Health Care Representative, you should consider who knows what your preferences and values are, so that they can carry out your wishes in the manner that you want and make decisions with your best interest in mind.
But think about a situation where a beloved elderly mother is admitted to the hospital already unconscious. With no direction from her as to whether to allow the hospital the resuscitate her after her heart stopped three times, the decision was left on her adult children to sign the Do Not Resuscitate form when it was clear that her quality of life had completely deteriorated as she was no longer conscious of her surroundings. Her son stepped up to sign the form, but the guilt of knowing it was his signature that ended his mother’s life was unbearable. Think about the asthmatic 30-something male who walked into the emergency room, having breathing problems. After signing a Living Will but thinking he was having an asthma attack, he checked off on the form that he did not want to intubated as a life sustaining treatment. After several days of being in the hospital, it turns out he was COVID-19 positive. At that point, and due to other complications, he was not conscious or not lucid to modify his Living Will given the new diagnosis. Although intubation could have provided him with a fighting chance against the virus, the hospital had to honor his wishes, and he died. When we do not prepare for these situations, it becomes necessary for others to make decisions for us. Sometimes, their decisions are not the ones we would have made for ourselves, as we may have wanted to take a different route given unexpected circumstances.
At The Matus Law Group, we believe in planning for these situations. We can provide you with the guidance that you need and the options you have to make these decisions now instead of when you’re under stress – or worse, when it is too late. A medical crisis could happen at any age but with the proper legal documentation in place, you can ensure that your wishes for end-of-life care are known and that your medical needs are provided for, when you are unable to speak for yourself. If you would like to know where to start, call The Matus Law Group today.
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BYOB - Bring Your Own Bag! July/August 2020
Featured On The Cover
19
A Lawyer With a Heart of Gold Christine Matus is an attorney that cares an awful lot about the relationships she has with her clients. Her practice helps protect the assets of those families who have loved ones with special needs. She does this in two areas: estate planning and real estate. “I have always had a desire to help those who can’t help themselves,” she adds. This area of the law was a perfect fit for her, as she is the proud Mother to two beautiful daughters, one who was born with Down syndrome. She became focused on helping other families with special needs children by sharing the information she has gathered in an effort to make their lives a little bit easier. Assisting families’ plan for their future is what she does best. After Christine helps her clients create a plan she follows up and calls them regularly. She adds, “We invite our clients to workshops, outings and provide the latest news via our newsletters.” CW: What is the most rewarding part about your profession? Christine: I love to see the relief we bring to families when we create a plan that gives them peace of mind and security.
death and dying, but if you have a special needs child, you cannot delay. If something happens to you, isn’t it better to know that your loved ones will be taken care of? They will be so thankful for your foresight and wisdom to protect them in the long run instead of wishing you did things differently. CW: What are some common misconceptions about your area of the Law? Christine: A common misconception is that attorneys don’t have the time to explain the information to the client. A majority of lawyers that I know, and especially our firm take the time to make sure our clients are heard and they understand our solutions. CW: How does your experience having a child with disabilities affect what you do in your practice? Christine: As a mother of a special needs child, we live in a land of extremes. There is an indescribable high we get when our child accomplishes a goal like saying a two-syllable word or walks up and down the stairs with little, or no help. Then, there are the lows that hit when you start worrying about the future or their progress. I can honestly say to a parent or guardian, “I know what you’re going through” and help them with the tough issues.
CW: How do you balance your career with motherhood? Christine: I am so grateful for my family CW: How did you become interested in Christine L. Matus, Esq. support system. My husband is patient and Real Estate? supportive with not just me, but with both of Christine: My parents exposed me to our children. I am also grateful that my parents are so involved in our lives. They the buying, selling and renting of property early in my childhood. Although know the children’s schedules better than I do and help me concentrate on my my father was a physician and my mother a nurse, they both liked investing in clients when I am at work so I do not have to worry about what is happening at property. They would often take me along during their transactions whether it home. was negotiating terms or interviewing a prospective tenant. In fact, when I was Christine has been practicing law since 1995. She graduated with a degree just 18 years old they left me in charge of their property while they went on in Economics from Douglass College, Rutgers University and then went on vacation. As luck would have it, one tenant called because of a backed up sewer to study law at Touro Law School. She was awarded the highest grade for and another one called about a broken furnace. Talk about trial by fire! the Course on Mental Disability Law and was Senior Staff Member for the CW: What is the most challenging part about your field? International Law Review. Recently, she was awarded Special Needs Lawyer of Christine: The most challenging part is making sure we address as many issues the Year by Corporate Live Wire. She and her husband Steven live in Ocean as possible for our families. We may not have all the answers with the changes County and have two daughters, Emma, and Juliana, ages 12 and 10. in real estate and special needs planning, but we make sure to find those answers Recently I was named Superlawyers for Estate Planning and both lawyers for our clients. in our firm have been named Best Lawyer for Families in the area of estate planning, special needs, and real estate for another year in a row. CW: What are the most common issues you see in your profession? Christine: I see a great deal of procrastination when trying to help families with estate planning. It can seem overwhelming or just morbid talking about
732.281.0060 • www.MatusLaw.com
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July/August 2020
Medical Professionals
20
Live Life Dry: Treating Urinary Incontinence bladder medication or adult diapers. frequency, or urgency. Unfortunately, many people dismiss such urinary symptoms to be a part of “getting older” and empty the bladder) are not a normal part of the aging process, can cause embarrassment, and can diminish the quality of daily living dramatically.
FACTS
DIAGNOSIS
TREATMENT
Bladder control issues can be caused • Women are twice as likely as men by a multitude of factors. In certain cases, to experience urinary incontinence. menopause and the structure of the female urinary tract. Older women experience urinary incontinence more often than younger women.
• Bladder control problems may
women who have just given birth. In
fact, a recent study found 25 percent of women over 18 years old have experienced episodes of leaking urine involuntarily, and one-third of men have experienced loss of bladder control during their adult lives.
• Only one in eight Americans who have experienced loss of bladder control have been diagnosed. Recent
data has shown that women wait an
pregnancy and childbirth, obesity, weak pelvic muscles or diabetes can contribute to overactive bladder. Additionally, certain medications or inactivity also can contribute to such issues. In some people, bladder control problems are caused by miscommunication between nerves. sacral nerves, which control the bladder, do not communicate properly, causing the nerves to tell the bladder to release urine at the wrong time. diagnosing the type of incontinence and then pinpointing the underlying cause or causes. We ask our patients to complete a “voiding diary” which provides great insight and aids in diagnosis.
urinary issues, including incontinence, is called urodynamic testing or urodynamic experience symptoms until they obtain a study. diagnosis for their bladder control problems. visit, along with the data from your voiding diary, will give the physician objective data • People experiencing bladder related to bladder functions. Additionally, physicians often perform a cystoscopy to social lives. social, sexual, interpersonal and professional further assess the urinary tract. A cystoscopy is a test that allows the doctor to look at the function. People with bladder control inside of the bladder and the urethra using a problems often struggle with simple thin, lighted instrument called a cystoscope. everyday activities, such as working, shopping, or seeing a movie, for fear of such as blood in the urine (hematuria), painful embarrassing wetting episodes or not being urination (dysuria), urinary incontinence, near a restroom. Also, overactive bladder urinary frequency or hesitancy, an inability to pass urine (retention), or a sudden and to regularly experience disturbed sleep, overwhelming need to urinate (urgency) and much more. overeating, and poor self-esteem.
You may
bladder and are sometimes prescribed to treat stress urinary incontinence. In certain cases of incontinence involving the miscommunication of nerves to the bladder, a neurostimulator (commonly called a Bladder Pacemaker) may be the best treatment option.
Incontinence is not a hopeless problem.
are many treatment options available, however, only proper diagnosis will lead to proper treatment. Although behavior
TYPES OF INCONTINENCE •
Stress Urinary Incontinence (SUI) – exertion, sneezing or coughing
•
Urge Incontinence – Leakage
•
Mixed Incontinence – Leakage associated with urgency
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accompanied by or preceded by urgency (an overwhelming need to urinate… “Gotta go, gotta go!”)
For more information, call (609) 581-5900 or (732) 928-5300 or visit www.UUANJ.com.
July/August 2020
discussed the pathophysiology of Varicose Veins and treatment of larger Varicose Veins.Today we will talk about the treatment of Spider Veins.
Medical Professionals
21
Can Sclerotherapy Help Treat My Spider Veins? Girija Surya, M.D.
Board Certified in Thoracic & Cardiovascular Surgery
Hi! Friends In earlier articles we have discussed the pathophysiology of Varicose Veins and treatment of larger Varicose Veins.Today we will talk about the treatment of Spider Veins. Sclerotherapy
Sclerotherapy is the name of a non-surgical procedure to treat spider veins. The procedure involves injecting a solution through a very fine needle directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together and the blood to clot. Over time, the vessel turns into scar tissue that fades from view. Sclerotherapy is a proven procedure and has been in use since the 1930s. During the procedure, you may experience mild discomfort for one to two minutes, especially when larger veins are injected. The procedure itself takes approximately 15 to 30 minutes. The number of veins injected in one session varies and depends on the size and location of the veins, as well as the general medical condition of the patient. Agents used for Sclerotherapy are Polidocanol and Asclera, 1% & 0.5%. Sotradecol, hypertonic saline and glycerine are some of the agents commonly used. Foam sclerotherapy is used more and it is the solution of polidocanol or sotradecol mixed with air and agitated to make foam just before injecting. This is very effective and reduces the amount of the chemical solution used at the session.
What Happens After Sclerotherapy?
After sclerotherapy you will be able to drive yourself home and resume your reg¬ular daily activities. Walking is encouraged. You will be instructed to wear support stockings to compress the treated veins. Following the injections, avoid aspirin, ibuprofen, or other antiinflammatory drugs for at least 48 hours. Tylenol may be used if needed. Also, you should avoid the following for 48 hours after treatment: • Hot baths • Hot compresses • Whirlpools or saunas • Direct exposure to sunlight up to two weeks at least. Showers are permitted, but the water should be cooler than usual.
Side Effects of Sclerotherapy
There are milder effects, such as itching, which can last for one or two days after the procedure. Also, you may experience raised, red areas at the injection site. These should disappear within a few days. Bruising may also occur around the injection side and can take several days or weeks to resolve.
Other Side Effects Include:
• Larger veins that have been injected may become lumpy and hard and may require several months to dissolve and fade or might need needle aspiration to remove the painful clot.
Sclerotherapy Sclerotherapy is the name of a non-surgical procedure to treat spider veins. The procedure involves injecting a • Brown lines or spotssolution may appear at the through vein site. In most cases, they disappear a very fine needle within three to six months. directly into the vein. • Neovascularization: the of Thedevelopment solution irritates new, tiny blood vessels may occur at the the lining of the site of Sclerotherapy treatment. These tiny blood vessel, causing veins can appear days or weeks after the it to swell andthree stick to procedure, but should fade within together and the blood twelve months without further treatment. to clot. Over time, the Should any of the following side effects vessel turns into scar occur, contact your doctor immediately. These include: tissue that fades from • Inflammation withinview. five inches of the is a Sclerotherapy groin proven procedure and • A sudden onset of a swollen leg has been in use since • Formation of small ulcers at the injection the 1930s. During site. the procedure, you Sclerotherapymay experience mild Effectiveness:discomfort for one to Studies have showntwo thatminutes, as manyespecially as 50%-80% of injected veins may when larger veins are be eliminated with each session of injected. The procedure itself takes approximately 15 to 30 Sclerotherapy. Although this procedure minutes. Theare number veins injected in one session varies works for most patients, the results alwaysof variable and are somewhat
What
yourse Walki suppo the in inflam used i hours • H •
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unpredictable. In general, spider veins respond in three to six weeks and larger veins respond in three to four months. If the veins respond to the treatment they will not reappear. However, new veins may appear at the same rate as before. If needed, you may return for injections. Usually follow-up sessions are necessary for complete resolution.
VEIN CENTER FOR WOMEN
Please contact Dr. Surya at the Vein Center for Women by sending an email to msgs@veincenterforwomen.com.
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July/August 2020
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Acupuncture
74 Brick Blvd. Bldg 1,Ste 102 • Brick, NJ 08723
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July/August 2020
Community
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Staying Home While Staying Connected
STAY HOME!
Feel good knowing that 100% of your tax-deductible “price of admission” donation will help thousands of individuals struggling with behavioral health issues in Ocean County this year. You read that right the OceanCares Foundation is Couching It for a Cause... No need to clutter your calendar or take away from an evening with friends, family or Nettix. You don't even need to get dressed up. So put down the hair bush, curl up on the couch and join us from the comfort of your own home... NO ZOOM REQUIRED!
V isit
OceanMHS.org to learn more Recipe
Cantaloupe Sherbet 1 small cantaloupe, very rip & cut into bite size chunks 1 quart milk 2 envelopes unflavored gelatin 3/4 cup light corn syrup 1/2 cup sugar 3 drops yellow food color, if desired 1 drop red food color, if desired
Blend catalaoupe and 1 cup of milk in a food processor until smooth. Put 1 cup milk in a 3qt saucepan and sprinkle the gelatin into it. Cook over medium/low heat and stir mixture. Add remaming milk and remaining ingredients. Don’t worry if the mixture looks curdled here. Pour mixture into a 13x9 pan, cover and freeze for 3 hours. Stir periodically. Use a mixer at medium speed, beat until smooth but still partially frozen. Return to freeze until fully frozen, about 3 hours. Then enjoy!
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By: Cutting Board Creations
Serves-12 July/August 2020
Women Of Monmouth County
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Siobhan M. Connolly, CTFA Vice President and Trust Officer Garden State Trust Company Siobhan Connolly moved from New York with her husband and two girls to Howell, NJ in 2008 to be closer to her father who lives in Manasquan. While in New York she taught high school, worked with at risk students teaching career skills and employment preparation and owned a retail business. Siobhan joined Garden State Trust Company, Toms River, NJ, in January of 2009. As Vice President and Trust Officer and senior relationship manager her responsibilities include meeting the needs of trust & estate, investment management and charitable foundation clients. With a Master’s Degree in Education and as a Certified Trust and Financial Advisor Siobhan has found her passion focusing on Special Needs Trusts which often require navigating the dilemmas faced by special needs clients and their families. Siobhan is honored to work with these families and takes pride in helping them provide the best life possible for their loved one. Siobhan currently serves on the Board of Directors for SCAN (Social Community Activities Network) serving the large retiree population of Monmouth and Ocean Counties providing education and resources to enhance their quality of life. Siobhan resides in Howell, NJ with her husband and her daughters. You can reach Siobhan at 732/255-5000 or Email: sconnolly@gstrustco.com. Visit www.gstrustco.com to learn how Siobhan may be able to help you.
Patricia L. Morello Certified Medical Assistant Paonessa Colon & Rectal Surgery Patricia L. Morello lived in Manhattan with her father and two siblings before moving to New Jersey. She was always outgoing and had a passion for helping others as such she has pursued a career in healthcare. She first began working with patients as a pharmacy technician. At the same time, she attended Brookdale Community College and then went on to Star Career Academy to become a certified medical assistant in 2012. Patricia has a passion for caring for others, especially the elderly. As a certified medical assistant, Patricia has gained experience in the specialties of nephrology, cardiology, and most recently in colon and rectal surgery with Dr. Nina Paonessa at Paonessa Colon and Rectal Surgery. It is here that she has gained experience in office-based surgery and treating acute and chronic diseases of the colon and rectum. She is directly involved in the care of patients. The patients recognize her dedication and commitment to providing excellent patient care and outcomes. Throughout her career, Patricia has demonstrated her dedication and passion for working in healthcare. Her patients recognize her as being kind hearted, caring, friendly and compassionate. In her free time, Patricia enjoys cooking, baking, walking on the beach and drinking coffee. For more information, call 732-2821500 or visit www.paonssacrs.com.
Photo by Tracy Harman Photography
Girija Surya, MD
Geeta K. Brana Senior Vice President, Freedom Capital Management Geeta K. Brana is a Senior Vice President at Freedom Capital Management in Colts Neck, NJ. Geeta provides comprehensive wealth management and advisory services to Women in Transition, assisting women in all phases of their lives – with a special focus on divorce. Geeta has a long history in the financial services sector and she uses her diverse international banking background to help simplify complicated wealth planning issues for her clients. “My goal is to build long-term relationships with my clients based on education and trust,” Ms. Brana said. Geeta started her investment banking career in London (1995) where she was trained in all aspects of international finance and credit analysis. She has extensive experience structuring and trading debt packages for multinational companies throughout the UK, Eastern Europe, Japan and the U.S. In 2002, Geeta began her career in the U.S., turning her extensive knowledge to helping individual investors. In a primarily male-dominated environment, she was able to build a successful wealth management practice in Washington, DC and New York, working with high net worth individuals and institutions. For more information, call 732-546-9315 or visit www.fcmadvisor.com.
Girija Surya is an American citizen by naturalization, was born in India and currently resides in Monmouth County. Dr. Surya attended Stella Maris College and Madras Medical College, where she received her medical degree in 1975. In Medical school she received awards and merits in Anatomy, Physiology, Organic Chemistry, Internal Medicine and Preventative Medicine. In the USA, she started her residency in surgery with a desire to ultimately train in Obstetrics and Gynecology. Her exposure during training, particularly in Cardiac and Vascular surgery, gave her a new passion. She went on to complete an additional 3 year fellowship in cardiovascular and thoracic surgery and got certified by the American Board of General Surgery and Cardiovascular and Thoracic surgery. She has been practicing in Monmouth County since 1994. She has served on the faculty of cardiac surgery in Robert Wood Johnson University Hospital from 1987 - 1990 and subsequently with Thoracic and Cardiovascular group of N.J. at St. Michael’s Medical Center in Newark, N.J. She has two successful Vein Centers, where she treats Vascular disease (both arterial and venous), and also educates women on other connected problems such as diabetes and hyperlipidemia. Dr. Surya has a daughter and a son. She loves biking, dancing, tennis, and watercolors. Contact Dr. Surya at Vein Center for Women / Absolute Vein Care at (732) 254-0500 or visit: www.veincenterforwomen.com
Photo by Carmela Caracappa Photography
Vein Center for Women
The County Woman Magazine www.TheCountyWoman.com
Photo by Annette Jenkins Photography
July/August 2020
Women Of Monmouth County Cynthia B. Clark
Teresa Menadier, MD,
Client Relations Coordinator The Matus Law Group
Gastroenterologists of Ocean County
Doctor Teresa Menadier recently joined Gastroenterologists of Ocean County after completing her Gastroenterology fellowship at the University of Virginia. She is a graduate of Tufts University. She obtained her medical degree from Rutgers-New Jersey Medical School in 2012 where she was elected President of the NJMS chapter of the Alpha Omega Alpha Honors Society. Dr. Menadier went on to complete her Internal Medicine residency at the University of Pennsylvania. Sponsored by the ANMS Clinical training program in GI Motility and Neurogastroenterology in October 2017, Dr. Menadier received specialized training in high resolution esophageal and anorectal manometry and pH/impedance interpretation under the supervision of Dr. Henry P. Parkman at Temple University. Her clinical interests include esophageal and anorectal motility disorders, as well as liver diseases. Doctor Menadier loves spending time with her family, baking, dancing and listening to flamenco guitar. For more information, call 732-349-4422 or visit www.GastroOfOcean.com.
Cynthia is the first person to greet you at the firm with her warm and friendly personality. Cynthia is full of energy, has excellent inter-personal skills and is always willing to go that extra mile to assist clients and her co-workers. Her experience comprises 15+ years serving in the public sector. She has been in customer service industries, including law enforcement, event planning and coordination as well as disaster case management for Superstorm Sandy. Cynthia enjoys big family gatherings, spending time with her daughters, grandsons and going for motorcycle rides with her fiancé in her free time. For more information, call 732-281-0060 or visit www.TheMatusLawGroup.com.
Photo by Donna Andrews Photography
Photo by Tracy Harman Photography
Jennifer Bavaro
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Pure Romance
When Jennifer first started her business, she was working full-time as the COO of an environmental company. It was the “fun time” that complemented her “full time.” Flash forward four years and Jennifer is a Director with Pure Romance, operating a thriving business that allows her to empower, educate and entertain women while balancing work and family. Pure Romance, in its 26th year, is the largest direct seller of relationship enhancement and intimacy products in the US. During their in-home parties, Jennifer’s customers laugh, learn and shop. As the former Director of Development for Planned Parenthood, sexual health education has always been a focus in Jennifer’s life. “Our bodies and relationships evolve over time. We are constantly learning how to understand our needs and the needs of our partner. I love that I get to provide information, access to amazing products and meet new people every day!” Jennifer graduated Summa Cum Laude from the University of Delaware with a degree in Social Work. She lives in Freehold with her husband and two children. For more information, call 610-329-0863 or visit www.mildtowildbypr.com.
Laurie Lombardi, CDN, The Natural Pharmacy Laurie Lombardi is a Clinical Nutritionist, and a Two time Emmy Awardwinning Make-up Artist, for her work on, The Late Show with David Letterman. She is also a Certified Para-Medical Skincare Clinician. She most recently developed a Natural Skincare Line, and Natural Dual Lip Stain/Gloss that are infused with Vanilla & Peppermint Essential Oils, for The Natural Pharmacy’s Organic Skin Bar, where you can also enjoy a Medical Facial Treatment with, NO DOWNTIME! A Facial Treatment includes an Organic Mask that is formulated for your skin type and compounded on the premises, “Always Fresh!” The Organic Skin Bar Concept is “feed your skin as you would your body.” Some of Laurie’s natural skincare products include a 20% Vitamin C Cream, DMAE, a skin tightening agent, Organic Face & Eye Serum, and more. All of her products are, Hormone Free, Chemical Free, GMO Free, and Vegan. Learn more about Laurie Lombardi and her skincare line by visiting www.laurielombardi.com today.
Photo by Melissa Amorelli Photography
The County Woman Magazine www.TheCountyWoman.com
July/August 2020
26
Networking For Moms
Moms Of Business is a community of mom entrepreneurs that uplift, motivate and help one another online and in person on their journey to abundance. Not only do we strive to educate and empower each other through our Facebook groups & resourceful website, but we're all about having fun, making new friends and growing our businesses too. NEW VIRTUAL PERKS JUST ANNOUNCED!
I would advise any mom-boss if you want to stay in business then jump right in with both feet!! You are around me began to unfold before my eyes and another selling yourself as much as you sell your product, be mom-boss, now lifelong friend, gave me a necessary the best version of you. The business won’t work itself, push. Two things I knew to be true aided in a reckoning so make it work for you. That means find your best time of one event that became a calling. I find great to work your business. Work when the kids are in satisfaction planning our annual family trips to Disney, karate and after they go to bed. Get up early. Find out what works for you and hit it f ull force. Your business even when the family consisted of only me and my requires your attention and dedication, so talk with your husband. Our oldest son has high-func tioning autism spouse and children. Also, go and join a tribe of other which presents its challenges especially on vacations. I moms. Find one in your company and one with other became very invested in finding ways to overcome mom-bosses. If you can’t find one make one. My EOE obstacles and understand accommodations that are Besties are my lifeline. Meeting with other moms working their business is what will keep you fresh. Draw available. strength from others around you. You be You!! Wake up tomorro w and go crush it!! II was inspired to start my own business as the world
The County Woman Magazine www.TheCountyWoman.com
July/August 2020
Theatre & Entertainment
2 1 B RID GE AV E N UE , R E D BAN K, N J
The County Woman Magazine www.TheCountyWoman.com
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73 2 . 3 4 5.1 4 0 0 July/August 2020
Community
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Stay Active | Stay Healthy | Stay Connected What is Social Community Activities Network (SCAN)?
Social Community Activities Network’s mission is to enhance the quality of life for all adults ages 50+ in Monmouth and Ocean Counties through socialization, education, technology, and assistance with community resources.
A MESSAGE FROM SCAN: These last months have been particularly challenging for all of us. COVID-19 impacted family, friends, colleagues and many others both locally and throughout the entire world. The senior population was hit particularly hard, both those who were healthy and sheltering at home and those who fell ill. Our hearts go out to all of those who lost loved ones during this unprecedented time. Throughout the pandemic, SCAN has tried to continue to do our part for the community. By pivoting quickly from our “normal” programs and adapting to the new reality of social distancing, we have been able to continue to offer the services and resources that are needed by the senior population. We have made calls to check on members, delivered grocery gift cards to those in need, surveyed general needs of our community and last but not least, we have been offering a modified slate of online programs that are free of cost to our members and others in the community. Together we have learned Zoom, Facebook Live and other digital platforms and have continued to tape our 3 television programs remotely. At this time, we would like to give a huge thank you to our staff because none of this would have been possible without them. Whether you join a class, watch our exercise video, attend a diabetes workshop, tune in to our 3 part information series on telehealth or watch our television programs on YouTube (https://www.youtube.com/ScanMonmouthCounty), we hope many of you will be able to take advantage of these new opportunities from home while our offices are still closed. And the good news is that once it is safe again to meet in person, SCAN plans to offer a dual platform of both in-person classes and resources as well as online options. Stay tuned for more information in future months.
SCAN SPOTLIGHT:
ONLINE DIABETES SELF-MANAGEMENT WORKSHOP- FREE
SCAN Instructor and Monmouth County’s Favorite “Jazz Man”: Jack Livingstone Beginning in 1973, Jack Livingstone (former State Librarian of NJ, and director of the Monmouth County Library, 1969-1991) brought Jazz musicians to play for the Monmouth County community so that this great American musical art form would be available - at no cost to all people. SCAN’s Jazz Classics Club has been meeting weekly at the Monmouth Mall with Jack at the helm for over 10 years. Our members join him as he walks down memory lane on a ‘sentimental journey’ with stories, music and photos. With COVID-19 keeping everyone at home for the past several months, and seniors being considered in a higher risk category to get the disease, one might think that we would have had to cancel our beloved Jazz Classics Club, but no… Jack, the 93 year old legend, who does not consider himself to be at all technically savvy embraced the opportunity to work with SCAN to continue to bring his class to people in their homes. With a few tweaks to the class’ format, Jack dials in to an online Zoom broadcast now called Jazz Radio Hour and spends the hour with our members and the community reminiscing and listening to the jazz greats that he has been sharing with residents of Monmouth County for 45 years! Jack is a shining example that it is never too late for seniors of any age to adapt and learn to use technology! Thanks to him, our radio show goes on! Visit our class listing to learn how to register.
Begins Thursday, July 16, 9:30AM-11:30AM, runs for 6 weeks This 6-Week Online Workshop is ideal for those who want to better manage their diabetes as well as those who are prediabetic or care for someone who has diabetes. All who are aged 60+ are invited to participate. To register or get additional information, email atarr@scannj. org and include your name, address and phone number.
180 Route 35 Eatontown
(basement level of Monmouth Mall)
732-542-1326 • www.scannj.org
Pat Bohse
Executive Director
SCAN Hours: Monday to Friday 9:00 AM to 4:00 PM
The County Woman Magazine www.TheCountyWoman.com
July/August 2020
Community
29 TaiChi Easy Tues, 2-3PM
TaiChi Easy program is easy to learn. It promotes health, vitality and inner peace and can be done by anyone sitting or standing. Consists of movements from simple Quijong, including four essential energy cultivation methods: postural alignment and gentle movement; breath practice; self-applied massage; and relaxation, visualization and meditation practices.
Jazz Radio Hour Wed, 10-11AM
Each week you’ll enjoy and learn more about the Big Band Era’s Glen Miller, Woody Herman and Duke Ellington, as well as smaller combos and outstanding vocalists like Sinatra, Sarah Vaughn and Ella Fitzgerald. See SCAN Spotlight about our instructor, Jack Livingstone.
SCAN’S UPCOMING ONLINE ZOOM CLASSES: We plan to offer our online classes as outlined below now through July 31. Email MarybethK@scannj.org if you are interested in joining a class. Please write Zoom Class Registration in the email subject line and include first and last name, phone number and the name of the class(es).
Floor Yoga
TV & Film Aesthetics Fri, 12-1:30PM
Using the Emmy-award winning series, “Mad Men”, which aired from 2007 to 2014 on AMC, students will explore the way production is performed including, scripting, production technology, production design, directing, lighting, sound and editing among other elements. Based upon an actual course taught at the college level at Brookdale College by Adjunct Professor Robin Kampf, an award-winning filmmaker and TV producer/director/ editor.
Wed & Fri, 9-10AM
Increase flexibility, range of motion and core strength while achieving greater peace of mind. Class include yoga breathing, yoga poses and relaxation.
Chair Yoga
Wed & Fri, 11:30AM-12:30PM
Gentle movements that anyone can practice sitting on a chair or standing with the support of the chair. You receive all the benefits of yoga while supported by a chair.
Bone Up Against Osteoporosis Tues & Thurs, 11AM-12PM
Exercise strengthens bones and muscles and improves balance, coordination, and flexibility, key for people with osteoporosis and ostopenia. Join us for a fitness class designed to improve strength, balance and flexibility.
Classic Literature
Fri, 10AM-11:30AM
Travel with SCAN’s Classic Literature class as we wend our way to Canterbury via Geoffrey Chaucer’s The Canterbury Tales. These stories have beguiled and amused readers for hundreds of years.
Call SCAN at 732-542-1326 with questions.
SAVE THE DATES
Wed, July 29 and Tues, August 25 The format of our Lunch & Learns will be a little bit different. We’ll still offer great presentations so you can learn about important resources but you’ll enjoy your own lunch at home. Details will be available soon at scannj.org or by calling SCAN at 732-542-1326.
The County Woman Magazine www.TheCountyWoman.com
July/August 2020
30
Community
The County Woman Magazine www.TheCountyWoman.com
July/August 2020
Women’s History
31
Mary Eliza Mahoney A few short months ago we were in the middle of a pandemic, a world crisis and fear placed upon us to leave our homes. It is amazing how quickly those feelings can fade with the warmth of the summer sun and some good old-fashioned laughter. On a beautiful June Sunday my sister was married in front of her immediate family and a few close friends. I was fortunate enough to be introduced to a nurse who works in a Philadelphia hospital. A nurse who, for the first time in months, was able to enjoy a day full of life and laughter. Although the day was simply magical, I took a step back and contemplated the lives of our HistoryLink.org. nation’s nurses, who may still be working on the front lines still fighting COVID-19. Then there are other nurses who may be left with some scars as they modestly continue to work their shifts and care for the sick.
needed to be greater equality for African American nurses, and in 1908 she co-founded the National Association of Colored Graduate Nurses. After working in the private nursing sector, in 1911 Mary Mahoney became the director of the Howard Orphanage Asylum for black children located in Kings Park, Long Island, New York. Then, after 40 years working in the nursing profession, Mary retired. However, Mary did not retire from her advocacy for women’s rights and the fight for equality. In fact, it is known that after the 19th Amendment was passed in 1920, Mary Mahoney was among the first women to register to vote in the city of Boston. Mary Mahoney grew her wings on January 4, 1926, and the trailblazing imprint she made upon women and nurses has continued long after her passing. The National Association for Colored Graduate Nurses started a scholarship award in Mary’s A nurse who made a life for herself in a time when African honor, and since 1936 it is awarded to nurses or groups of nurses who Americans were regarded as second-class citizens deserves promote integration within their field. Additionally, Mary Mahoney was recognition now more than ever. Mary Eliza Mahoney was inducted into the American Nurses Association Hall of Fame in 1976 a trailblazer, a civil rights advocate and a nurse. Mary Eliza and later inducted into the National Women’s Hall of Fame in Seneca Mahoney was born to freed slaves in the year 1845 in Boston, Falls, New York in 1993. Massachusetts. Mary became part of history on various levels. I have been fortunate to have the distinct pleasure to work with an Starting with her education, Mary attended the Phillips School amazing nurse who exudes that same pioneering spirit as Mary Mahoney. in Boston in the 1800s that would become known to have been I dedicate this feature to my dear friend Theresa, who has worked one of the first integrated schools in the country. As a teenager, tirelessly as a nurse for over 30 years. Theresa has been caring for not only Mary realized she had a passion for nursing and decided to extremely ill patients every day with a smile, but also her elderly parents. immerse herself in the medical field. Mary began working at Theresa has those same amazing qualities as Mary Mahoney and, just like Nurseslabs.com. the New England Hospital for Women and Children, a hospital Mary, is known for her efficiency, patience and caring bedside manner. Theresa’s that not only cared for women and children but was also run by female resilience during the COVID-19 pandemic has been unwavering. Theresa begins each new day physicians. Mary worked at the hospital for 15 years, working her way from janitor to cook to ready to take on whatever challenge is placed in front of her with an amazing smile and positive washerwoman and nurse’s aide. At the age of 33 (which was considered old back in the 1800s), outlook for a fresh new start! May we remember to recognize our nurses by our kindness, Mary was accepted into the New England Hospital graduate nursing program. The program was positivity and always a smile! an intensive 16-month program, and out of 42 students, Mary was one of four students who completed the program. Remember this is in 1879. Mary was not only one of four students who completed the program, but Mary was the first African American in the United States to earn a professional nursing license! At the time Mary received her nursing license, there was an Rita King, LCSW is a mental health clinician overwhelming display of discrimination providing psychotherapy services to adults and in the medical field. Mary did not let children. Rita has worked with individuals with that prevent her from her continuing mental illness in the community mental health her passion to care for the sick. Mary setting, criminal justice system and private practice began her nursing profession in the setting. Rita is a “De-escalation for Individuals with private sector and provided nursing care Special Needs” training facilitator and has trained for wealthy white families. Mary was approximately 1,200 law enforcement professionals known to have traveled up and down to date. Rita is also a CIT trained mental health professional. Rita the East Coast providing nursing care has a strong passion for women’s history and in her free time she for decades. Facebook.com. continues to raise awareness of the importance of women’s history Mary became active with the association of nurses in the United States and Canada. Mary through lectures and community speaking engagements. noticed that the association was comprised mostly of white members and they were not always accepting of African American nurses. Mary, who was a trailblazer, recognized that there
The County Woman Magazine www.TheCountyWoman.com
July/August 2020
ROMANCE TRAVEL Travel ravel
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55 63
Experience Primer
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The river cruising destinations, like a 12-day Bordeaux , the “Jewel of the Atlantic,” Our dedication to our clients during after everybags vacation • Lightweight sweater,before, rain poncho, and and zippered plastic • 2 shorts and 2 tees imposed for baggage, youorwill haveDanube, tovillages, stunning beaches, accentuated by whitewashed buildings. consider leaving your entire closet • Tauck offers riverfor cruises with its Tauck River cruise, 7-day offer cruise guests the local for wetfamily suits. stateroom with Verandah is perfect for a family of 4 or 5. There’s a 3 story AquaDunk body slide kids makes a world of difference. at enjoy beautiful weather, pink sand beaches home from now on.without Some airlines are charging carry-on bagsApril’s now, • 3 sundresses experience the long tour busforrides. From •program, Whatever you forget you can purchase on cooking board or at the Bridges including family and other airlines let you board first if you have no carry-on bags. So what created ✿ BEACHES, TURKS & CAICOS was to be the ultimate get with no fearFlip onflops, deck,flat or for the younger set, there’s the AquaLab with a looping waterslide. tulips to December’s Christmas Markets, hundreds of • SHOES: sandals, wedges, sneakers ports or resorts. warm friendly people. Conde’ Nast Traveler areand the essentials to pack? lessons. together getaway, where everything is Included and unlimited. The white sand beaches Enjoy Your Travel Experience. riverboats and barges glide along Europe’s historic rivers Aprotected fewor years from now what Here is a packing primer from Carole Kaiman, Travel Professional that Disney destinations vary from Caribbean cruises with Disney’s own private island cruising Europe Barbados , with beautiful beaches and great • Pashmina Readers have voted Bermuda “Best Island in the Caribbean” 17 times! (rated theand best in the Caribbean by Travel & Leisure) exciting watersports and unlimited scuba diving will rememberof is the total of canals, which span thousands of miles of Continental youExamples some the best might help with the process. There are several brand new River cruise lines restaurants to rekindle your spirit and feed the soul. experience of your Virtuoso vacation, NOT Advisor • Sunglasses (for to certified divers).connecting North Sea to BlackYour with special highlights for the kids enjoy. waterways, Sea. Vagabond Travel River Cruise Line Themes: the things you forgot to pack. are about Amazing waterparks with body slides,River lazy rivers and surf entering the market such as through Emerald Waterways ForBEACHES a week inresorts the River Caribbean: • Packable sun foldable beach bag hat and A Travel Professional with years of expertise will work for you, A Europe Cruisechildren. is one of the bestFor ways we • Viking Cruises, partnership with over 25 years, *Remember, your Vagabond* simulator are a favorite of the kids. The Caribbean Adventure with Sesame Street and the XBOX play • 2 swimsuits know to explore inland Europe, visiting cities, towns and PBS “Downton Abby” offers Viking cruise andresorts, Scenic cruises to fill can the demand. Eachguests line Virtuoso Travel Professional The options gocarry-on on towith Mexican all-inclusive exciting travel to areas • Costume jewelry, (leave the real jewels home) goand Italy where in a private chapel in Florence’s counand her only objective is to give you the best experience possible and (put 1 in your so you canships right to the beach) Carole Kaiman lounges are so popular children families. 19access. Specialty restaurants dining provide great choices. villages that traditional big usually can’t days inchildren’s England Countryside, and special tour assist 3 you inand planning a vacation tryside you can renew your vows and have a candlelit Dinner over the Arno River. has its highlights, such as the long ships and the and an evening purse 2Africa cover-ups It•will be a great vacation Alaska memory. withsummer the mostfamous valuevacation) andhouse. added South forfamily families, tours (Perfect for of the to help you realize your romantic dreams. Vagabond Travel (1 with sleeves for evenings dining on the beach & 1next Pareo) generation touches to make your experience a Space-Ships. • Avalon Waterways “Austrian Highlights” from Must Haves: and •fabulous Tauck tours of Europe. memorable one.to Munich highlighting a Beer theme. Yoga pants and 2 tank tops Vienna ✿ DISNEY CRUISE were built with families A deluxe Ocean view • Insect Repellent, Sun Protection at SPF) ships It’s a great new cruising experience! *Check outin mind. Bermuda , the “Jewel of the Atlantic,” Our dedication tofamily our clients before, during and after every vacation • 2(with shorts andleast 2 tees 30 • Tauck offers family river cruises with its Tauck stateroom with Verandah is perfect for a family of 4 or 5. There’s a 3 story AquaDunk body slide for kids Start your unforgettable vacation by contacting Travel Advisor & Romance Specialist makes a world of difference. enjoy beautiful weather, pink sand beaches • 3 sundresses • Facial and body moisturizer Start your unforgettable vacation www.virtuosolife.com Bridges program,at including family cooking by contacting Travel Advisor Carole Kaiman, at Vagabond Contact Carole Kaiman Vagabond Travel with no fearFlip onflops, deck,flat or for the younger set, there’s the AquaLab with a looping waterslide. • SHOES: sandals, wedges, sneakers and warm friendly people. Conde’ Nast Traveler lessons. Aruba • Make up Bag: waterproof mascara, eyeliner, Carole Kaiman at Vagabond Travel, a Virtuoso Agency in Little Silver, today! Enjoy Your Travel Experience. for our Digital Magazine Disney destinations vary from Caribbean cruises with Disney’s private732-222-2792 island cruisinginformation Europe • Pashmina Virtuoso Agency for or latest and Readers have voted Bermuda “Best Island in the Caribbean” 17 times! orRiver 732-842-2600. Travel, Silver own today. a Virtuoso Agency in Little There are several brand new Advisor cruise lines hair conditioner and shampoo with • Sunglasses special highlights for the kids to enjoy. Your Vagabond Travel Virtuoso and some amazing travel ideas.
✿ DISNEY CRUISE Bermuda
We hope this inspires you to keep dreaming. When you’re ready to plan again, we’ll be here.
amenities. entering thethat 732-222-2792 orsun 732-842-2600. Create will lifetime. market such as last Emeralda Waterways • Packable hat and foldable beach bag memoriesmemories A Travel Professional with years of expertise will work for you, Create that a lifetime. For will over 25last years, andresorts, Scenic exciting cruises to fill the The go on to Mexican all-inclusive travel to demand. Each line • Costume jewelry, (leave the realoptions jewels home) and her only objective is to give you the best experience possible and Carole Kaiman has its highlights, such as the and an evening purse South Africa for families, Alaska tours (Perfect forTravel summer vacation) long ships and the to help you realize your romantic dreams. Vagabond next generation Space-Ships. Must Haves: and fabulous Tauck tours of Europe. • Insect Repellent, Sun Protection (with at least 30 SPF) It’s a great *Check out new cruising experience! Start your unforgettable vacation by contacting Travel Advisor & Romance Specialist • Facial and body moisturizer Start your unforgettable vacation www.virtuosolife.com byContact contacting TravelKaiman AdvisoratCarole Kaiman, at Vagabond Carole Vagabond Travel • Make up Bag: waterproof mascara, eyeliner, Carole Kaiman at Vagabond Travel, a Virtuoso Agency in Little Silver, today! for our Digital Magazine Over Virtuoso Agency732-222-2792 for latest information and25 Years or 732-842-2600. Travel, a Virtuoso Agency in Little Silver today. hair conditioner and shampoo and some amazing travel ideas.
Carole Kaiman, Travel Specialist Vagabond Travel Virtuoso Agency 542 Prospect Ave.
amenities. 732-222-2792 or 732-842-2600. Create memories that will last a lifetime. Create memories that will last a lifetime. Little New Jersey LittleSilver, Silver New Jersey07739 07739
*Check out www.virtuosolife.com *Check out www.virtuosolife.com for our Digital Magazine and some foramazing our Digital Magazineand some travel ideas. amazing travel ideas.
The County Woman Magazine
The County Woman Magazine e County Woman Magazine The County Woman Magazine e County Woman Magazine
Carole Kaiman, Travel Specialist 732-859-5513 732-222-2792 Direct Vagabond Travel Virtuoso Agency 732-842-2600 Office 542 Prospect Ave.
Over 25 Years
Little LittleSilver, Silver New NewJersey Jersey07739 07739 website: www.vagabondtvl.com 732-222-2792 Direct
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Community
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Community
2019 Champion Lexi Thompson
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Theatre & Entertainment
CAPE MAY STAGE GOES VIRTUAL CAPE MAY STAGE'S BROADWAY SERIES
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Community
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Answering Needs. Advancing Potential. Serving infants, children, and adults with complex physical and developmental disabilities or delays in Monmouth and Ocean Counties
The obstacles that the COVID-19 pandemic presents are especially difficult for our LADACIN family because of the breadth of our network, the unique nature of each program and the vulnerability of our population. Nevertheless, we remain committed to safely providing the highest standard of care to each and every client. Our Residential facilities are operating around the clock. Staff have been coming to work in all nine residences and ensuring that our clients are safe, nurtured and stimulated 24 hours a day/ 7 days a week. Remote learning and telehealth have been implemented in the School and Early Intervention Programs, and Adult services are increasing virtual options. These are uncertain times for sure, but you can be confident that LADACIN Network is working tirelessly to ensure the health and well-being of our infants, children and clients with complex physical disabilities or delays today and into the future.
SAVE THE NEW DATE
The 18th Annual RAT Rock Open Charity Golf Classic Tuesday, September 29th
at Jumping Brook Country Club, Neptune
Sponsorships Available For More Information
Call Community Relations at 732.493.5900 ext. 263 or email communityrelations@ladacin.org LADACIN Network • 1703 Kneeley Boulevard • Wanamassa, NJ 07712 • www.ladacin.org www.LADACIN.org
/LADACIN
@LADACIN
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Theatre & Entertainment
Season 38 A Season of Hope starts September 2020 Tickets On Sale Now acballet.org
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July/August 2020
Medical Professionals
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Medical Professionals Medical MedicalProfessionals Professionals
THE UROLOGY GROUP OF CHOICE
Experienced Specialists. Compassionate Staff. State of the Art Treatments.
UUANJ.COM
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