Ocean County Woman - 2015 March/April by The County Woman

Medical Professionals

Continuing Rehabilitation with Yoga By Erin Silber, Facility Manager, All-Care Physical Therapy, Jackson Location

s a physical therapist treating many active adults on a daily basis, I am frequently asked about the options for exercise when clients have recovered from injury and wish to return to an active lifestyle. One form of exercise that I receive many questions about is yoga and if it is a beneficial and safe route to promote a healthy lifestyle after rehabilitation. Yoga has become an increasingly popular form of exercise over the past several years. Many people believe this form of exercise is only for the young and fit. However, when done correctly, it can be a valuable addition to the life of every person.

What is yoga?

Yoga is a form of exercise that encompasses the physical, mental, and spiritual aspects of wellbeing. During every practice, all three of these disciplines are touched upon. Each yoga instructor is taught to adapt the practice to the specific student based on past injuries and illnesses. One of the key elements in any yoga class is the breath. You will be taught to breathe in and out fully, which in turn will help to fully expand the ribcage, lower your heart rate, and clear your mind. Another element you will find in all yoga classes is the posture or pose. Your teacher will lead you in transitions through several poses that help to create a balance in the body, the goal being that no unnecessary stress should be placed on any part of the body. Yoga can be done in various positions such as seated in a chair or standing while holding onto the wall, barre, or chair for balance for older adults or those with instability and balance difficulties.

Why do I need yoga in my life?

Extensive research has been done to assess the correlation of a yoga practice and the health benefits it yields. As we age, our bodies can become stiff as our joints lose motion. Stiffness can promote a sedentary lifestyle that can lead to a decrease in muscle and bone mass, elevated blood pressure, poor circulation, chronic pain, insomnia, and breathing complications. Any and all of these health issues can decrease home and community ambulation, limiting one’s freedom and decreasing quality of life. Yoga has been found to: • Improve respiratory function • Decrease heart rate • Decrease blood pressure • Decrease fear of falling • Increase static balance • Improve relaxation, promoting better sleep • Improve joint and muscle flexibility • Improve hip extension, which can improve stride length, improve gait and ambulation, and counteract age-related changes that can cause gait dysfunction

exercises such as standing in place with the eyes closed, a small lunge, and a low bridge (lifting the hips while lying down) can all be seen in countless physical therapy centers as well as numerous yoga studios. Physical therapy focuses on many aspects of health, from strengthening, to flexibility, to achieving and maintaining balance and stability during daily functions. These fundamental basic principles are also incorporated into yoga practice. While in physical therapy, a therapist will assist a client in establishing proper form and body mechanics during every activity. The therapist will ensure that all exercises are done properly without pain, and if a deficit is observed, it is quickly and efficiently addressed to improve function and decrease risk of injury. Assisting a client in body awareness and the correct technique of a movement will ready a patient for alternative activities after physical therapy is complete. The goal is to improve the client’s body awareness so that after physical therapy is concluded, the client will know what movements are to be avoided to prevent further injury. Yoga instructors must go through rigorous training and are familiar with how the body moves, therefore are ideal practitioners to continue a client’s elevated activity level.

Knowing your limits

Every person, young and old, has limitations when it comes to exercise. As stated by Larry Payne, creator of Prime of Life Yoga (yoga aimed at students ages 40-70) “…by midlife, the focus is on maintaining optimum health including injury prevention through yoga lifestyle.” When completing a yoga practice, especially for the older adult, care should be taken to not put undue stress on the joints, muscles, or organs. Yoga should be completed to improve quality of life. Moving slowly through the poses allows your body to make the transition peacefully and allow your joints and muscles to deepen into the stretch. Yoga’s aim is to quiet the mind and strengthen the body. Always speak to your instructor before class to make him/ her aware of your limitations and to make sure the class is in tune to your needs. To find a senior yoga near you, contact your local clubhouse, fitness center, or community college to get more information. Jackson Facility opening this Spring in the Cooks Landing Plaza on North County Line Road, 4,400+ Square feet!

Yoga after physical therapy In a physical therapy facility, many activities that are given to patients are very similar to those seen in a yoga practice. Although most physical therapists are not trained in the art of yoga, many yoga poses are incorporated into physical therapy programs and sessions. Gentle

Erin Silber

Jackson Facility Manager

As a physical therapist Erin strives to provide her patients with the necessary tools and information to live a pain free independent life style while in a comfortable, nonintimidating atmosphere. Her treatment programs include hands on stretching, joint and soft tissue mobilization, PNF patterns, muscle energy techniques, and strengthening to decrease pain and retrain body movements. Her approach is personalized for every individual patient and is geared toward their weaknesses. Erin works with patients experiencing a variety of conditions including but not limited to Parkinson’s disease, joint replacements, back pain, stroke, balance deficits, and pediatric conditions such as Torticollis and slight delays in motor milestones. She has taken continuing education courses to further her knowledge in Parkinson’s disease through LSVT BIG training which has shown great success in the clinic. Other continuing education courses include advancing knowledge in the treatment of Torticollis, functional strengthening, and thoracic and lumbar dysfunction. Erin is continually striving to learn more to assist her patients in reaching their fullest potential while at All-Care Physical Therapy.

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

^ A rticles Medical Professionals

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Medical Professionals Professional Dentistry Elder Life Management All Care Physical Therapy......................................................... 2 Aesthetic Dental Creations ..................................................... 12 Elder Life Management .......................................................... 50 Leah Schwartz: Certified Barre Instructor...............................48 Contemporary & Rattan Furniture AtlantiCare Regional Medical Center: ^ Health & Wellness ^ Assisted Living Jersey Shore Pharmacy.........................................................53 All Care Physical Therapy, LLC..........................................2, 84 Heritage House Interiors.........................................................56 ^ Elder Life Management 5 Meridian The Heart Institute ................................................................. Fitness & Wellness ................................................... 13 Spring Oak Assisted Living .................................................... 51 Meridian Fitness & Wellness............................................60, 61 Bella Derma Medi Spa........................................................5, 41 IT Service ............................................. 12 of................................................... Elder Life Management .......................................................... 50 Acuity Specialty Hospital New Jersey..................................6 Shore Vascular & Vein Center 6 Ocean Nutrition Health & Weight Loss .................................................. 23 ^ Education & Wellness RS Technical Services, Inc. ..................................................56 Assisted Regional Medical^Center: TheLiving Heart Institute . .....77 JenniferFor Nosti, RDH.............................................................. ...............................................................11 BellaAtlantiCare Derma Medi Spa.............................................................. Hypnosis Women 30 OceanYoga County College ........................................................... 52 Therapy University Urology Associates of New Jersey......................8, 9 ............................................. 13 Spring Oak Assisted Living .................................................... 51 Ocean Plastic Surgery, PA ........................................................ 9 HolisticProfessional Care Services Dentistry ............................................................ 38 ^Yoga Business Storage Heals&4 Personal Life...................................................................57 Ocean Plastic Surgery andEducation Laser Center.......................12 ............................................. 23P.A. ^ Aesthetic Dental Creations. ....................................................13 Atlantic NeuroSurgical Specialists ......................................... 17 Jersey Shore Pharmacy ......................................................... 57 Airship Storage ....................................................................... 52 Awning Shore Vascular and Vein .....................................14, 15 ............................................. 30 Center. Ocean County College ........................................................... 52 ................................................. 61 ^Giglio LawMind/Body Studio 59 AtlantiCare-Bariatric ......................................................... 20, 21 Yoga Nine Wigs Awning. & Hair...................................................................58, Replacements Stephen L. Newman MD MBA................................................16 ............................................. 38 ^ Business & Personal Storage & Straffi, Attorneys Law............................................21 Gallery Bio-Behavioral Health. ............................................................17 Kathy A. Banks, DMD ............................................................. 22 ^ Straffi Contemporary & RattanatFurniture AbstraxArt Hair Design................................................................ 53 Kathleen M. Dotoli, Esq.. . .......................................................23 ............................................. 57 Airship Storage ....................................................................... 52 The Oasis Gallery...................................................................62 Children’s of Philadelphia. .................................17 TomsThe River X-Ray, Hospital CT & MRI Center ................................ 24, 25 Heritage House Interiors................................................... 14, 15 ^ Acupuncture Matus and Connell LLC..........................................................25 Atlantic Neurosurgical ............................................. 61Specialists.....................................18,19 Wigs & Hair Replacements Stephen L. Newman, MD, MBA^............................................. 26 ^ Jay Financial Management KoehlerEducation Acupuncture .............................................................. 54 Turnbach, Esq., LLC........................................................33 Institute for ComplementaryAbstrax and Alternative Medicine...........20 urniture Hair Design................................................................ 53 Ocean College...........................................................62 Premier Centers.............................................................. 27 Mark S.Alzheimer’s Rushwald .................................................................. 16 ^ Adult County Community Community SouthPain Jersey Fertility Center..................................................24 Crawford-Rodriguez Elementary School................................76 ....................................... 14, 15 ^ Acupuncture Garden State Foot &DMD. Ankle ..................................................... 28 Fountainhead Properties ........................................................ 55 ^ Alcoeur IT Services Gardens.....................................................................28 Kathy A. Banks, ........................................................... 26 Business & Finance Koehler Acupuncture .............................................................. 54 Gastroenterology of Ocean County ........................................ 29 RS Technical Services ............................................................ 18 ^ Fashion & Beauty AtlantiCare Regional Medical Center: Assisted Living Copiers Plus, Inc....................................................................63 ............................................. 16 ^ Adult Community TheOrthopeadics Center For Surgical Weight Loss & Wellness ............27 of Toms Seaview & Medical Associates ........................ 31 ^ Spring Home Oak Health CareRiver......................................................29 Lynne’s Boutique ...................................................... Toms Fashion River Chamber of Commerce. ......................................7756 Fountainhead Properties ........................................................ 55 River X-Ray, & MRI Center....................................30 NinaToms J. Paonessa, DO,CT, FACOS .............................................. 39 Senior Elder HelpersLaw ........................................................................ 19 Barbara’s Boutique ................................................................. 66 Business & Personal Storage Gastroenterologists of18Ocean County....................................31 ............................................. ^....................................... Fashion & Beauty Rice Elder Law.......................................................................34 Ocean Hematology & Oncology 40, 41 ^ Law Leisure & Lace ........................................................................ Airship Storage.......................................................................6467 Seaview Orthopaedic & Medical Associates........35, 36, ...................................................... 37, 38 Lynne’s Fashion Boutique 56 Wigs & Hair Replacement Barnabas Health Medical Group Ocean County Ob/Gyn ...... 42 Matus and Connell ................................................................. 32 ^ Consignment Shop Acupuncture Barnabas Health Medical Group: Ob/Gyn. .............................39 ............................................. Barbara’s Boutique ................................................................. Abstrax Hair Designs. .66 ............................................................40 NJ Community & 19 Pain .................................................. 43 Straffi & Straffi, Attorneys at Law ........................................... 33 Treasures Heaven.............................................................65 .......................................................... 58 Koehler From Acupuncture. Premier PainSpine Centers.............................................................43 & PC..............................44 Lace ........................................................................ Elder Life Paonessa RectalLeisure Surgery, Whiting HealthColon Care and by Revera .............................................. 45 Jay Turnbach, of Ocean County ......................................... 60,6761 Esq.Management LLC67 ................................................... 34, 35 ^ Women Women of Ocean County . ................................66, Life Management..........................................................42 Consignment Shop ............................................. Ocean &32 Oncology.............................................45 Institute ForHematology Complementary &^ Alternative Medicine ....... 46, 80 ^ Elder Carpet & Flooring ^ Business CASA & Finance Barnabas Health Medical Dr. Sumy Chang...........51 In-Home Care........................................................... Treasures FromH.Heaven .......................................................... 58 w ........................................... 33 Group: CASAPlus for children. ............................................................68, 7162 Total Hearing Care .................................................................. 47 Best Carpet & Flooring 36 Copiers ........................................................................... Caring Heart & Brain Imaging. ................................................52 Karing with Kindness. .61 ............................................................46 ^ Women of Ocean County ......................................... 60, ....................................... 34, 35 Barnabas Health: Dr. Sumy H. Chang .................................... 48 ^ Home Improvement Toms River Chamber of Commerce ....................................... 65 Business Opportunity Whiting Health Care Center by Revera..................................54 Adult Community ^ Business & Finance Nerium. . ................................................................................. 69 South Jersey Fertility Center .................................................. 49 Progressive Dimensions Countertops .................................... 36 ^ Find Us On Facebook Fountainhead..........................................................................47 Precious Metal Buyer ............................................. 36 Copiers Plus ........................................................................... 62 Theatre & Entertainment Caring Heart Metal & Brain Imaging ................................................. 59 ^ Awnings Facebook Coupons ................................................................ 73 Precious Buyers, LLC. ....................................................3 Fashion & Beauty 65 Gazillion Bubble Show............................................................78 ^ Precious Metal Buyer Toms River Chamber of Commerce ....................................... Giglio Awnings ........................................................................ 37 ^ Theatre & Entertainment Barbara’s Boutique.................................................................48 Chiropractor 36 ^ Find Us On Facebook It Shoulda Been You...............................................................79 rtopsPrecious .................................... Buyers ............................................................. 3 ^ Leisure Ultimate Day Spa Iluminate ................................................................................74 and Lace. ...................................................................49 WavesMetal of Transformation Wellness Center, Inc.......................5 Facebook Coupons ................................................................ 73 Whiting Association. ............................81 ^ Elder Law Simply Copy, Skin............................................................................. 38 Gazillion BubbleBusiness Show ..........................................................74 Fax & Notary Services Health & Wellness ............................................. 37 ^ Theatre & Entertainment Travel Wordstation, Copy Fax +.................................................50 RiceOcean Elder Law.......................................................................... 8 ^ The Bathroom Remodeling Buyer & Cellar........................................................................75 Health & Weight Loss.................................................10 Vagabond Travel Agency, Inc................................................82 Iluminate ................................................................................74 ^ Education Beautiful Bathrooms & More .................................................. 44 50 Shades-The Musical.........................................................75 Book Corner Hypnosis for Women..............................................................22 Photography ............................................. 38Studio. 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TheArtArt Of Precious Avoid Scammed! The of Precious Metals…Metals… What Do You NeedBeing To Know Before You Sell? o You Need To Know Before You Sell? Part II

Written By: through a completely transparencourages his customers to shop Written By: should weigh three grams or two pennyweights/dwt. You should The County Woman Staff transaction. Precious (i.e. Metal before The County Woman Staff alsoent know the fineness/purity 10-14 around k) and the valuecoming of yourto see Buyers is fully licensed and him. Never let your items out of your sight and be sure and watch As shop the owner of just precious tely transparencourages his customers to price to get theirgold. customers bonded with thebuyer state of New the following n theto last owner very carefully as the tests your gold. HeHehashasheard of jewelersimporMetal Buyers,the Oppenheim Precious Metal around before coming see issue, inDov the door.of Jersey and they are subject to tant tips to for you to know Precious Buyers, buys, Metal melts and tradesDov gold and that actually replaced an item with lower purity ones. Some ensed and him. monitoring Manchester before your precious metOppenheim, gave our readers customers have by toldthe Dov that the items that theyselling were selling Tip # 3 Best To Shop Around. other precious metals. His busistate of New He has the following imporPolice Department. Dov is als. some important insight before were identified as 10-14k. In these sale occasions, it is actually the It is best to shop around. Make ness is about giving people what e subject to tant tips to for you to know confident in his prices and even years ago by selling them a Dov Oppenheim, Owner you sell your precious metals. that cheated their customers suretheir youvaluables go to a fewjewelers places they deserve e Manchester before selling your precious met- for Tiponly #1 10-14k. Do Business Locally. In this article, he dispels some pair of jewelry as 14-18k that were actually nt. Dov is als. Dov Oppenheim, before Owner making your final decibusiness locally and of the myths and stigmas that Lastly, andyour negative reputation sion. Legitimate buyers shouldDov shared with us the stigma Do rices and even Must Call beware of “one day” are commonly to the their summers the industry has acquired. Unfortunately, many fraudulent and temnever pressure Tip #1 Do Business Locally. attached To Schedule porary hotel and andunder mall buying business of sellinginto gold.selling anythingbusinesses take advantage of consumer misknowledge they are not your business locally and Your Do Personal pay up to 80 percent of what the consumer truly deserves. events. Some sellers will leave Tip and #4 Avoid Scammed selling. Try and do beware of “one day” tem- Beingcomfortable Private As the owner of Precious Metal Buyers, theLLC, nextDov day Oppenheim and you won’t have It is buying critical to always a complete so get within 24-48 hours as gold porary hotel and mall Appointment buys, meets and trades gold and other precious metals. His to when (if ) anyone to go back saleswill receipt. yourchange item, daily. prices events. Some sellers leaveIf you sell business is about giving people what theyyou deserve for their find you were cheated out of sure the buyer you with the next day andbe you won’t have provides Stay tuned for more important tips valuables through a complete transparentyour transaction. is fullyAlso, avoid valuableHe metals. a complete detailed anyone to go back to when receipt (if ) with in the next issue. licensed and bonded with the state of New Jersey services and is subject to you have mail-in because informationyou in case dispute afterout theofsale. Call This 732-597-2225 information to schedule find ayou werearises cheated monitoring the Manchester Police Department. little control over the sale. must include thevaluable following: name and the buyer, date of your metals. Also,address avoid of your appointment with transaction,mail-in names services of the precious purchased, the lineman becausemetals you have Dov Oppenheim. Call 844-762-8937 to schedule yourtrust a quote Tip #2 Don’t of the precious metals purchased and their weights, the prices paid little control over the sale. www.pmbuyers.com appointment with Dov Oppenheim. for the metals at the standard measure of weight and finally, the given over the phone. name, address and signature of the seller of the precious metals. Never believe a price quote given Must Call To www.pmbuyers.com Tip #2 Don’t trust a quote Tip #5 Weigh Your Gold At Home First over the phone. Many buyers Schedule Your given overthat the you phone. Dov recommends weigh your gold at home firstPrivate or will offer you a much higher Personal “Stay tuned for more important Never a price quoteon given test the sellers scalebelieve by putting a penny their scale.Appointment The penny tips in the next issue.” over the phone. Many buyers www.TheCountyWoman.com www.TheCountyWoman.com TheCounty County Woman Woman Magazine The will offer you a much higher visit www.pmbuyers.com The County Woman Magazine www.TheCountyWoman.com

tyWoman.com ntyWoman.com

May/June 2014 May/June 2014

price just to get their customers in the door.

Tip # 3 Best To Shop Around. It is best to shop around. Make sure you go to a few places before making your final decision. Legitimate buyers should never pressure their summers into selling anything they are not comfortable selling. Try and do so within 24-48 hours as gold prices change daily. Stay tuned for more important tips in the next issue. Call 732-597-2225 to schedule your appointment with Dov Oppenheim. www.pmbuyers.com Must Call To Schedule Your Personal Private Appointment visit www.pmbuyers.com

May/June 2014 May/June 2014 March/April 2015

Publisher’s Note

An Educational resource for Women and Their Families Since 2008

Monmouth County Woman Since 2008

Ce leb ra

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Publisher........................................................ Lynn K. Wolf lynn@acwoman.com • 609-929-4189 Art & Production Executive.......................Meghan Morse staff@thecountywoman.com • 856-885-8066 Public Relations Executive ...................... Lauren Shover staff@thecountywoman.com • 856-885-8066 Feature Cover Writer..........................Gena Ansell-Lande Graphic Designer, Real Grafix Design.......... Cathy Tveici Graphic Designer, Golden Design, LLC...... Laura Golden golden.design@verizon.net Graphic Designer, Designer Photos........... Paula Brewer designerphotos@rocketmail.com Website Designer.............................................P.J. Santos www.digitalartstation.com Distribution Manager..................................... Mike Dziuba

Welcome to the March/April 2015 Issue Of Ocean County Woman! “Knowledge is Power” is a phrase most often attributed to Francis Bacon, in his Meditationes Sacrae (1597). I interpret this phrase to mean that knowledge allows people to reach their full potential and abilities in life. The Ocean County Woman publication is dedicated to providing you with knowledge from contributing writers who are prominent in their professions. It is a true blessing working and learning from the professionals in each issue. I have utilized their information in times of need on several occasions and cannot image what would have happened if I had not had this wonderful information at my fingertips! This issue is no exception! Our long, gray winter will make the arrival of spring especially welcome this year. It is a pleasure to feel the sun gradually warming up the earth, drawing out the crocus, daffodils, forsythia and other early bloomers. Our shore communities will be bustling with activities in preparation for the arrival of summer residents. Some of us may be in need of nutritional counseling/exercise routine (Jen Nosti, page 11) or beauty regimen ( Simply Skin, page 32). Helpful information on these topics and much more can be found in the Medical, Health, Fashion and Beauty Sections. And as usual, we bring you in-depth expertise from our legal professionals whose valuable advice may save you countless hours of time and trouble. If you haven’t already planned your summer vacation, it’s time to begin. There are still lots of last minute deals to some great destinations. Of course, being at the shore, you don’t have to travel far to find wonderful summer activities for the whole family. Follow us on Facebook and Twitter to check out local events and investigate the many informative articles in this issue. We wish you a “Happy Spring” in eager anticipation of the warmer months ahead! Best, We are the Media Partner with NJAWBO Monmouth, Ocean,, Middlesex Region. We are members of Toms River Ocean County Chamber of Commerce

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Featured On The Front Cover The Doctors of Seaview Orthopaedic & Medical Associates Sitting, Row 1, (left to right) - Drs. Berkowitz, Mittman, Demetriades Sitting, 2nd Row, - Drs. Vasen, Thacker Standing, 1st Row - Drs. Garla, Mark, Meyers, Greaves, Chern, Spagnuola, Nguyen Standing, 2nd Row - Drs. McDaid, Fahoury, Yalamanchili, Green, Chopra, Fechisin, Haynes Not pictured - Drs. DePaola & Pannullo. Meet all of the doctors on pages 35, 36, 37, & 38.

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March/April 2015

Chiropractor

How To Move From Pain To Progress

Written by Daniel Eric Mutter, DC

There are three major steps that help people move from pain to progress.

are affected by the pain, and to change what you were doing or how you were doing it.

body, your self, and your ability to navigate the stresses of the modern world.

The first step is evaluating what pain means.

The second step is understanding what making a change means.

Principled chiropractic in general and the chiropractic discipline of Network Spinal Analysis in specific is a support system that cultivates healthy change. Since life is experienced through and expressed by the nervous system, having clarity and efficiency in this aspect of our body is essential. When the brain and the body are able to communicate effectively, the innate wisdom that organizes and coordinates every function of our body - from pain to healing to wellness and everything in between - is better able to do its job. There is always a choice. We can choose to reorganize our bodies and our lives in order to consciously move forward and deepen the experience of life. By following the three steps discussed above we can choose to move from pain to progress. We have chosen to provide the highest level of reorganizational chiropractic care to our practice members and to serve as a support system for those looking to make a change in their lives. Let us know when you are ready for change! To learn more about Waves of Transformation contact us at 732-244-5008

If we consider pain to be an experience of discomfort in our physical bodies, then it makes sense that we want this discomfort to go away as quickly as possible so that we can go back to what we were doing before. Indeed, many of the interventions available to “alleviate” pain simply block the ability of the brain to register that the pain signals are there. They often do nothing to address why the pain presented to begin with or to change the ability of the body to be more efficient at adapting to the stress that caused it. Pain is your body’s way of alerting you that something needs to change. It is analogous to the blaring alarm of a smoke detector that goes off when there is a fire. The alarm is not designed to be pleasant, because its purpose is to move you to action. Blocking pain without addressing the cause is like taking the batteries out of the smoke detector. Sure, it will make the alarm stop, but it won’t address the fire. If we consider the meaning of pain in a broader context, we see it as a signal to stop what you have been doing, re-evaluate the elements of your life that

Pain is an opportunity to reorganize how your body is able to adapt to stress and how this reorganization will translate in the way you live your life. In order to truly address the cause and the consequences of pain, you need to understand that something in your life is correlated with that something in your body that is giving you grief. Ultimately, healing is about having congruence in your body and in your life. When things are not lined up, the way our body alerts us to this is the experience of pain. Change means understanding that we cannot go back to the way things were. The progression of life always has been and always will be in one direction, and it is forward.

The third step is finding a support system that will not only mediate this change, but help you during and after to find new depths of experience and greater connection to your

Waves of Transformation Wellness Center, Inc. Location: 309 Main St. Toms River, NJ 08753

732-244-5008 wavesoftransformation.com njwavesoftransformation@gmail.com

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Dr. Donna M. Mutter, DC Dr. Daniel Eric Mutter, DC Services: b Family Wellness Chiropractic b Network Spinal Analysis b Somato-Respiratory Integration b Reorganizational Healing Workshops b CORE Score Neural Efficiency Testing

Dr. Donna M. Mutter, DC has been serving Ocean County for 30 years. She practices a reorganizational approach to health and wellness utilizing a form of chiropractic known as Network Spinal Analysis. She has been on both the clinical and Dr. Donna M. Mutter, DC and Dr. Daniel Mutter teaching staff for this work since 1986. Her practice, Waves of Transformation, is located in Toms River, NJ. Dr. Daniel Mutter, DC practices reorganizational chiropractic at Waves of Transformation. After studying Philosophy edical Professionals at The College of New Jersey and graduatingM salutatorian from Life Chiropractic College West, he joined his mother in practice in 2013.

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The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Medical Professionals

Acuity – A Facility That Is Dedicated To Creating Miracles Health &Wellness Written by Claire Brown, BSN RN Director of Provider Relations.

Law

ften understated and behind the scenes, Case Managers and Social Workers can hugely impact the way in which a patient will transition from an acute care setting into another level of care ranging from a rehabilitation unit to home or to an extended care facility. Acuity Healthcare assigns a Case Manager to every patient upon admission. The purpose of this role is to be the patient’s advocate, while helping the physician to coordinate and manage the personalized plan of care through the inpatient stay. Case Management also helps to ensure proactive, safe discharge planning while moving the patient appropriately across the continuum of care. A case manager oversees the processes of care delivered to patients. Their role is to work collaboratively with the entire interdisciplinary health care team and is often referred to as the “Driver of the Bus or the Captain of the Ship” by bringing both leadership and patient advocacy to each case that they oversee. By working collaboratively with the entire interdisciplinary team, case management plays a vital role in achieving quality outcomes and the timely provision of care. Many of the general public do not realize the multi-faceted role of the Social worker and Case Manager within the healthcare system. Acuity Specialty Hospital is extremely fortunate to be staffed with three dedicated, experienced Case Managers whom are RNs, as well as a Director of Case Management who holds a Masters Degree in Social Work. Mr. Newell, a former patient of Acuity, had been on a trip to Virginia in November 2014 when he experienced some shortness of breath and exhaustion. He waited until he reached home to see his own doctor. Unfortunately, he ended up in a local hospital and had to be placed on a ventilator. Mr. Newell, 75, had suffered from numerous health problems prior to his admission to the hospital, but had tried to live as independently as he could. He lives alone in his own home with his daughter living next door. While in the hospital, Mr. Newell Mr. Newell at Mainland Manor. underwent a Video Thoracoscopic Surgery (VATS) to remove excess fluid around his lungs and he began Hemodialysis treatments due to acute kidney failure. Following these procedures, he was transferred to Acuity Specialty Hospital on December 8th 2014 and was successfully weaned from the ventilator. He also received management of his complex medical needs. His daughter was very involved in his care and medical progress. She worked closely with the Case Management Department to help them plan his discharge. Mr. Newell was discharged from Acuity Specialty Hospital to Mainland Manor Sub Acute rehabilitation unit on January 10th, 2015, for continued rehabilitation following his stay at Acuity. The Case Management team at Acuity Specialty Hospital had referred Mr. Newell to Mainland Manor, which is just one of many facilities where patients are sent to following their stay at Acuity. Mainland Manor Skilled Nursing Facility has the ability to provide patient’s short term physical and occupational therapy. “I can’t wait to see Ms. Cali and Mr. Blue; I have missed them so much.” Mr. Newell said about his beloved cats. “I haven’t seen them since Thanksgiving.” sighed Mr. Tracey and Kathy at the Newell, during my visit to him at Mainland Manor. patient’s bedside.

Before Mr. Newell could be transitioned to his next level of care, the Case Management department had to make sure he got The Case Management Department, Left to Right: Kathy Hoffmann RN, a permanent intravenous access (an Cathy Reedy RN, Christa Fries MSW arteriovenous device) for his hemodialysis Director of CM, Tracey McNally BSN, RN. treatments. The Case Manager assigned to his case, (Tracey) had to discuss the progression of his medical condition daily with the nephrologist and surgeon to determine which facility would be equipped to either perform the Hemodialysis or could send Mr. Newell out to outpatient dialysis. Tracey also had to ensure that Mr. Newell would receive transportation to and from Mainland Manor to his place of Dialysis treatments. Mr. Newell was finally discharged to his own home from Mainland Manor Facility on Friday 1.23.15. It was a wonderful moment for him to see his cats again, Ms. Cali and Mr. Blue. The Case Management team at Acuity is proud to be a part of the care and final discharge of Mr. Newell from Acuity Specialty Hospital and that he is finally reunited with his cats.

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inside of AtlantiCare Regional Medical Center in Atlantic City. Our hospital-

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within-a-hospital provides 30 private rooms to the medically complex and critically ill. Patients

meeting acute care criteria are seen by physician specialists daily and typically discharged to

Acuity Specialty Hospital celebrates its 5th year in Atlantic City, New Jersey.

acute and sub-acute rehabilitation centers, skilled nursing facilities or their homes.

Our team specializes in the care of patients with needs that include:

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Ventilator weaning

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Let’s Have a Heart-to-Heart about Your Risk of Coronary Artery Disease Vicky Miesemer and her daughter Taylor Egg Harbor Township, NJ

Follow Your Heart to AtlantiCare

Coronary artery disease (CAD) is caused by the gradual buildup of fatty plaques in the arteries that carry blood to the heart — which can lead to a heart attack. Without prompt treatment to open a blocked artery, blood stops flowing to the brain, causing disability or even death, and heart muscle can be permanently damaged.

In southern New Jersey, thousands of people have chosen the Heart Institute at AtlantiCare Regional Medical Center (ARMC) for the expert cardiac care they need. ARMC is designated by the State of New Jersey as a STEMI Center for treatment of the most serious and potentially fatal type of heart attack: ST-elevation myocardial infarction (STEMI).

Risk Factors for CAD • High cholesterol • High blood pressure

I believe

you’re never too old for a new lifesaving procedure. At age 87, Vicky Miesemer was diagnosed with aortic stenosis. Open-heart surgery is usually recommended. But Dr. Dib, her cardiologist, suggested TAVR—a minimally invasive procedure. During a TAVR procedure, a surgeon inserts a new aortic valve within a diseased valve—while the heart is beating. Vicky’s daughter Taylor wanted a second opinion, believing the best of the best are in Philly or New York. However, Vicky trusted her cardiologist and decided on AtlantiCare for the surgery. Her two-hour procedure couldn’t have gone more smoothly. After three days in the care of Drs. Dib, Levite, Axelrod, Dralle and Van Hook, Vicky went home, without needing rehab or pain medication. Her Valve Program Coordinator, Dawn Christensen, MHA, BS RT (R) (CV), was especially appreciated during and after Vicky’s hospital stay, and is now like a member of the family. “The procedure was miraculous,” says Vicky. And it changed Taylor’s belief about where excellent doctors can be found: “The best of the best are right here. I thank them for giving my mom the heart of a 30-year-old!”

Healthcare you can believe in.

1-888-569-1000 www.atlanticare.org/TAVR

• Family history of heart disease • Not getting enough exercise • Smoking • Obesity • Diabetes • Advancing age Because the development of coronary artery disease is a long-term process, many people with CAD don’t know something is wrong until they have chest pain or end up in the hospital after a heart attack. In addition, because conditions such as high blood pressure and high cholesterol have no symptoms, it’s important to take steps now to protect your good health — even if you think you’re too healthy, too physically fit, or too young right now to worry about suffering a heart attack in the future.

The County Woman Magazine www.TheCountyWoman.com

Our skilled emergency medicine physicians and heart-care specialists are here for you 24 hours a day, seven days a week, to evaluate chest pain and treat blockages caused by CAD. Call 1-888-569-1000 or visit www.atlanticarewell4life.org to learn more about our healthy-heart resources and services.

Two minutes today can start you on the road to being well for life. Take our free online heart risk assessment.

www.atlanticarewell4life.org REGIONAL MEDICAL CENTER

1-888-569-1000

March/April 2015

edical P Professionals rofessionals M Medical edical P rofessionals Medical Professionals

18 8 18

Enlarged Prostate And Urinary Tract Enlarged Prostate And And Urinary Urinary Tract Tract Issues Issues Enlarged Prostate

Live Life Dry: Treating Urinary Incontinence Q My husband just just turned 68 68 yearsold old and is My husband My husband just turned turned 68years years oldand and is is waking three fourtimes timesper pernight nightto waking upup three ororfour waking up He three or four times per night to toHe urinate. has also complained that heto urinate. has also complained that he strains t would behas difficult to watch an hour primetime urinate. also Our complained that strains to strains to He pass urine. primary careofhe physician television today without seeing an advertisement for pass urine. Our primary care physician diagnosed diagnosed him with BPH (Benign Prostatic pass overactive urine. Our primary care physician diagnosed bladder medication or adult diapers. Hyperplasia). Is (Benign there anyProstatic hope for Hyperplasia). us to get a good him with BPH him with TheBPH fact is(Benign more thanProstatic 37 million Hyperplasia). adults in the United night’s rest again? ~ Sarah Q. Is there any hope for– suffers us to get a good night’s rest Statesany – one in six fromaoveractive bladder, Is there hope for us to get good night’s rest I am frequency, happy to or tell you with a little medical urinary Unfortunately, many people again? ~ Sarah Q.urgency. again? ~ Sarah Q.symptoms intervention, getting a fulltonight’s sleep is definitely dismiss such urinary be a part of “getting older”

We see many men BPH who andpossible. doInot medical intervention. fact is, overactive amseek happy to tell you with withThe a little medical I and amurinary happy to tell you with a little medical ultimately find relief from their symptoms. bladder retention (the inability to completely intervention, getting full night’s is process, empty the bladder) are not a aanormal part of sleep the aging intervention, getting full night’s sleep is Understanding BPH can definitely cause embarrassment, the quality of daily possible. and We can see diminish many men with BPH definitely We see many with BPH living The prostatepossible. is a walnut-sized gland men that produces dramatically. whothe ultimately relief from semen, fluid thatfind transports spermtheir and symptoms. is located who ultimately find relief from their symptoms. Facts: below the bladder and surrounding the urethra (the Women are twice as likely as men to experience urinary Understanding BPH tube that carries of the body). BPH ismenopause a incontinence. Thisurine is dueout to pregnancy, childbirth, Understanding BPH common, non-cancerous condition in men where the prostate ofis the a walnut-sized gland produces andThe the structure female urinary tract.that Older women The prostate is a walnut-sized gland that produces prostate gland becomes enlarged. An enlarged prostate semen, theurinary fluid that transports sperm is younger located experience incontinence more oftenand than semen, thebladder fluid sperm and isvariety located can con¬strict thethat urethra and cause a wide below the andtransports surrounding the urethra (the of tube women. below the bladder and surrounding the urethra (the tube symptoms including urination that carriescontrol urine problems outfrequent of themay body). BPH or is adifficulty common, Bladder also affect younger people, that carries urine out of the BPH is aprostate common, non-cancerous in body). men urinating. especially womencondition who have just givenwhere birth.the In fact, a recent non-cancerous condition in men where the prostate gland becomes prostate canstates con25%enlarged. of womenAn over 18 years(NIH) old hasdata experienced study Thefound National Institutes of enlarged Health gland becomes enlarged. An enlarged prostate canofconstrictmore the and wide variety of symptoms episodes ofurethra leaking urineofcause involuntarily, and one-third men that than 50% mena in their 60’s and as many strict the urethra and cause a or wide variety oftheir symptoms including frequent urination difficulty urinating. have experienced loss of bladder control during adult as 90% in their 70’s and 80’s have some symptoms of including frequent urination difficulty urinating. lives. The National Institutes of or Health (NIH) data states BPH. The National Institutes of Health (NIH) data states Only one in eight Americans who have experienced loss as of that more than 50% of men in their 60’s and as many The common signs50% andofsymptoms of BPH include: that more than men in their 60’s and as many as bladder control have been diagnosed. Recent data has shown 90% in their 70’s and 80’s have some symptoms of BPH. •90% An often recurring, sudden urge to urinate. in their 70’s and 80’s have of time BPH. wait average of 6.5some years symptoms from the first •that Anwomen increase in and frequency of urination they experience symptoms until they obtain a diagnosis for - especially at night. their bladder control problems. • APeople weak or interrupted urinary stream. experiencing bladder control issues often suffer •diminished Difficultysocial starting and stopping urination. lives. Even mild symptoms affect social,

commonorsigns andofsymptoms BPH include: •The Dribbling leaking urine. of The signs andsudden symptoms include: • Ancommon often recurring, urgeoftoBPH urinate. ••Inability torecurring, completely empty thetobladder. An often sudden urge urinate. • An increase in frequency of urination - especially at night. An increase in frequency of urination - especially at night. Diagnosing BPH urinary ••sexual, A weak or interrupted stream. interpersonal and professional function. People with A weak or interrupted urinary stream. •• Diagnosing BPH is often initially done through Difficulty starting andoften stopping urination. bladder control problems struggle with simple everyday Difficulty starting and urination. a••routine digital rectal exam (DRE) in conjunction Dribbling orasleaking ofstopping urine. activities, such working, shopping, or seeing a movie, • Dribbling or leaking of urine. with a UroFlow test. The empty UroFlow test allows us to for •fear Inability to completely theor bladder. of embarrassing wetting episodes not being near a • Inability to bladder completely emptyurinary the bladder. evaluate your capacity, flow rate, Diagnosing BPH restroom. Also, overactive bladder sufferers are two to three and any post-void BPH residual urine in your bladder. Diagnosing times more likely to regularly experience disturbed sleep, Diagnosing BPH is often initially done through a Additionally, weBPH routinely order a common blood test Diagnosing is often initially done through a overeating, and poor self-esteem. routine digital rectal exam (DRE). Additionally, we known asdigital PSA (prostate specific antigen) to explore routine rectal exam (DRE). Additionally, we also order a common blood known as PSAincluding (prostate and rule out other causes fortest these symptoms Diagnosis: also order a common blood test known asother PSAcauses (prostate specific antigen) to explore and rule out prostatitis (infection of the and prostate Bladder controltoissues can prostate) be caused by aother multitude of specific antigen) explore and rule out causes for these symptoms including prostatitis (infection of cancer. In certain cases, we recommend our patients factors. In certain cases, pregnancy and childbirth, obesity, for these symptoms including prostatitis (infection of the prostate) and prostate cancer. In certain cases, we have apelvic cystoscopy, which allows to certain see thetocases, size ofwethe weakprostate) muscles or diabetes canuscontribute overactive the and prostate cancer. In recommend our patients a cystoscopy. This also bladder. and Additionally, certain medications or inactivity prostate evaluate the have degree of obstruction. recommend our patients have a cystoscopy. This and procedure allows us to see the size of the prostate can contribute to such issues. procedure allows us to see the size of the prostate and Treating BPH evaluate thepeople, degreebladder of obstruction. In some controlBPH problems are caused by the have degree of obstruction. evaluate Men who symptomatic will eventually miscommunication between nerves. Specifically, and Treating BPH require some medical intervention. BPH canthe be brain treated Treating BPH sacral nerves, which control the bladder, do not communicate Men who have symptomatic BPH will eventually by taking daily medications, however, many men find Mensome who have BPH will can eventually properly, thesymptomatic nerves to tellmany the bladder to release urine require medical intervention. BPH be treated this to be causing a burden. Ultimately patients often require some medical intervention. BPH can be treated at the wrong time. by taking daily medications, however, many men find find minimally invasive treatment or surgery to be the by however, many men findfind The firstadaily stepmedications, towards treatment is diagnosing the type of thistaking to treatment be burden. Ultimately many patients often correct option for them. Such treatments this to be a burden. Ultimately many patients often find incontinence and then pinpointing the underlying cause or minimally invasive treatment or surgery to be the correct are done in invasive the office or at theorsame day to surgery minimally treatment surgery bearethe correct causes. Weoption ask our patients toSuch complete a “voiding treatment for them. treatments done department and rarely require any admission todiary” the treatment option for them. Such treatments are done which in diagnosis. in the provides office orgreat at theinsight sameand dayaids surgery department and hospital. in the office orany at the same day surgery department and The gold standard for diagnosing urinary issues, including rarely require admission to the hospital. rarely Untreated BPH can lead totopermanent damage to require any admission the hospital. incontinence, calledcan Urodynamic testing Urodynamic Untreated to permanent damage to the the bladder orisBPH kidneys. Ilead would urge youorto take your Untreated BPH can lead tourge permanent damage to the study. This series of tests, all done in one visit, along with bladder or kidneys. I would you to take your husband to kidneys. a urologist for further evaluation and to the bladder or I would urge you to take your data fromto your voiding diary will giveevaluation the physician husband a urologist for further to discuss theto treatment options that evaluation are best forand him. husband a related urologist for further to objectivethe data tooptions bladder functions. Additionally, discuss treatment that are best forand him. discuss theoften treatment options that are forassess him.the physicians perform a cystoscopy to best further Forthat more information, urinary tract. A cystoscopy is a test allows the doctor to For more information, call 609-581-5900, look at the inside of the bladder and the urethra using a thin, call 609-581-5900, (732)928-5300 lighted instrument called a cystoscope. This study helps find (732)928-5300 or visit www.UUANJ.com or visit www.UUANJ.com

Mukaram Gazi, MD, FICS, FACS Mukaram MD,Surgery FICS, FACS Director, RoboticsGazi, & Laparoscopic

Director, Robotics & Laparoscopic Surgery Board Certified Urologist Board Certified Assistant ClinicalUrologist Professor Rutgers/RWJ Medical School Assistant Clinical Professor Rutgers/RWJ Medical School NJ Monthly Magazine Top Docs Recognition; 2012 - 2014 NJ MonthlyResearch Magazine Top Docs Recognition; 2012 - 2014 Consumer Council, America’s Top Urologist; 2008 - 2013 America’s Top Urologist; - 2013 Consumer Research Council, Compassionate Physician2008 Award; Consumer Research Council, Compassionate Physician Award; 2008 - 2013 2008 - 2013 Director, Robotics & Laparoscopic Surgery Board Certified Urologist Board Certified Urologist Fellow American of Surgeons Assistant ClinicalCollege Professor, Rutgers RWJ Medical School -New Brunswick Adjunct Associate Professor; Fox Chase Cancer Center NJ Monthly Top Docs In practice County since 1974 Top Urologist: 2008-2013 Consumer Research Council, America’s Adultin &Ocean Pediatric Urology Consumer Compassionate AdultResearch & Pediatric Urology Specializing inCouncil, Ambulatory Urology Physician Award: 2010-2013 Specializing in Ambulatory Urology 5 Years of Post Graduate Clinical Research Experience 5 Years of Alpha Post Graduate Clinical Research Experience MemberOmega Alpha Medical Honor Society Member--Alpha Omega Alpha Medical Honor Society Member American Urological Association Director, Robotics & Laparoscopic Surgery Member - American Urological Association Vitals - 2014 Compassionate Physician Award Board Certified Urologist Adult Vitals & Pediatric Urology - 2014 Compassionate Physician Award Assistant Clinical Professor, Rutgers Specializing in Ambulatory UrologyRWJ Medical School- New Brunswick NJ Monthly Top Graduate Docs: 2011-2014 5 Years of Post Clinical Research Experience Consumer Research Council, America’s Top Urologist: 2008-2013 Membner - Alpha Omega Alpha Medical Honor Society Consumer Research Council, Compassionate Physician Award: 2010-2013 Vitals - 2014 Compassionate Physician Award Board Certified Physician Assistant Board Certified Physician Assistant Professor - Physician Assistant Program, Philadelphia University Professor - Physician Assistant Program, Philadelphia University

Mukaram Gazi, MD, FICS, FACS Parvez Mahmood, MD, FACS Alexander Gotesman, MD Alexander Gotesman, MD

Mukaram Gazi, MD, FICS, FACS Alexander Gotesman, MD Robert Peterson, DC, PA-C Robert Peterson, DC, PA-C

Alexander Gotesman, MD Robert Peterson, DC, PA-C Adult & Pediatric Urology

Specializing in Ambulatory Urology Board Certified Physician Assistant 5Professor Years of -Post Graduate Clinical Research ExperienceUniversity Physician Assistant Program, Philadelphia Member- Alpha Omega Alpha Medical Honor Society Vitals - 2014 Compassionate Physician Award

Dominique Etienne, PA-C Dominique Etienne, PA-C Board Certified Physician Assistant

Board Certified Physician Assistant Howard University Physician Assistant Michael Nazmy Jr., MDProgram Howard University Physician Assistant Program Cum Laude Honors Fellowship trained in Urologic OncologyPA-C Dominique Etienne, Cum Laude Honors College of Pharmacy, Nursing and Health: Fellowship trained in Minimally Invasive & Allied Robotic Surgery College of Pharmacy, Nursing and Allied Health:

Board Certified Physician Assistant Dean’s List,Association 2008-2013 MemberAmerican Urological Dean’s List, 2008-2013 Howard University Physician Assistant Program, Cum Laude Honors Scholar, 2009-2011 MemberAmerican Trustee Medical Association Trustee Scholar, 2009-2011 College of Pharmacy, Nursing and Allied Health: Dean’s List, 2008-2013 Trustee Scholar, 2009-2011

For more information,

Treatment: In some instances, behavior modification may be sufficient to deal with urinary incontinence. You may be asked to limit fluid intake, avoid bladder irritants such as caffeine and alcohol, and do pelvic Patient Testimonials: floor exercises – “kegels”. There are also medication Patient Testimonials: Patient Testimonials: commonly used treat at overactive bladder ❇ II have been patient at University Urology since 2005.My have been aato patient University Urology since 2005. MyIfamily family doctor referred me to Dr. Gazi because of hisMy have been areferred patient at University Urology since 2005. (OAB) anddoctor are sometimes prescribed to treat stress me to Dr. Gazi because of his good good reputation amongst the doctors and he was right. I family doctor referred me to Dr. Gazi because of his good urinary incontinence. In certain of right. incontinence reputation amongst the doctors and cases he was I was suffering was suffering day and night with urinary issues. At my worst, reputation amongst the doctors and he was right. I was suffering involving thewith miscommunication the going to the day and night urinary issues. Atof mynerves worst,to I was I was to the bathroom every andI was dribble day andgoing night with urinary issues. At myhour worst, going to the bladder, aevery neurostimulator (commonly called awould Bladder bathroom hour and would dribble urine. I was diagnosed urine. I was diagnosed with BPH. I tried the Imedications and bathroom every hour and would dribble urine. was diagnosed with BPH. I tried the medications and they helped but I did Pacemaker) may be the best treatment option. they helped but I did not feel completely better. After a flow with BPH. I tried the medications and they helped but I did not Incontinence feel completelyisbetter. a flow test, the doctors a notAfter a hopeless problem. ThererecomareAfter test, doctors recom¬mended Itest, havethe a doctors procedure. not feelthe completely better. AfterAfter a flow recommended I have a procedure. reviewing allonly the information, many treatment options available, however, proper reviewing all the information, I was willing all to proceed. Within mended I have a procedure. After reviewing Idiagnosis was willing to proceed. Within a few weeksAlthough afterthetheinformation, procedure, will lead proper treatment. behavior a few weeks afterto the procedure, Iweeks noticed a remarkable II was willing to proceed. Within a few after the procedure, noticed a remarkable change. I amtherapy peeing like I was 20 again! modification and pharmaceutical work for some, they change. I am peeingchange. like I was 20 peeing again!like I was 20 I~noticed a remarkable I am again! S.P., North Brunswick, NJ may be ineffective or poorly tolerated by other patients. ~ S.P., North Brunswick, NJ ~ S.P., North Brunswick, NJ met Dr. Gotesman It is Idefinitely possible at tothe livehospital life dry.in July. We consider

T T

❇ IIourselves met thewas hospital July.weekend. Weconsider consider met Dr. Gotesman Gotesman atatthe hospital ininJuly. We blessed that he on-call that We ourselves blessed that he was on-call that weekend. We were ourselves blessed that he was on-call that weekend. were very surprised that he took the time to discuss my issues very surprised thatthat he he took thethe time toto discuss my were very surprised took time discuss my issues and answer my husband’s questions. He even took theissues time and answer my husband’s questions. He even took the time and answer my husband’s questions. He even took the timeIto to draw a picture of the kidney and bladder and explain why • Stress Urinary Incontinence (SUI) – Leakage on draw a picture of the kidney and bladder and explain why to draw a picture of the kidney and bladder and explain why I I am having issues. He issneezing, like an encyclopedia for Urology. We effort, exertion, or coughing. am having issues. He is like an encyclopedia for Urology. am havingtoissues. is feel like an Urology. switched UUANJHe and so encyclopedia lucky to have for found such We We switched to UUANJ and feel so lucky to have found switched to UUANJ and feel so lucky to have found such such • Urge Incontinence – Leakage accompanied by or a caring doctor. ~ Mary R., Toms River, NJ caring doctor. ~ Mary R., Toms River, NJ a acaring doctor. ~ Mary R., Toms River, NJ preceded by urgency (an overwhelming need to

Types of Incontinence

urinate…”Gotta go, gotta go!”) University Urology Associates of New Jersey was established in 2003 call 609-581-5900, University of New Jersey established and is proud toUrology be servingAssociates Mercer, Monmouth and Oceanwas Counties. Ourin 2003

• Mixed Incontinence – Leakage associated with (732)928-5300 and is proud to abesolutions serving Mercer, Monmouth and Ocean Counties. Our mission is to be based urgency practice, maximizing the value of the service we AND effort, exertion, sneezing, or coughing. or visitour mission iswww.UUANJ.com topatients be a solutions based practice, maximizing the value of the service we deliver with commitment to excellence, integrity, innovation deliver our patients with commitment to excellence, integrity, innovation and treatment. We continually strive to provide comprehensive state of the University Associates ofdecision New Jersey was in 2003 and treatment. WeUrology continually strive provide comprehensive stateestablished of the art urological services with emphasis on patient education andtoshared making. Treating and is proud to be serving Mercer, Monmouth and Ocean Counties. Our art urological services with emphasis on patient education and shared decision making. Treating patients with compassion, dignity, mutual respect, and trust remains out steadfast goal. patients with compassion, dignity, mutual and trust outmaximizing steadfast goal. mission is to berespect, a solutions basedremains practice, the value of the service we deliver our patients with commitment to excellence, integrity, innovation and LOCATIONS: treatment. We continually strive to provide comprehensive state of the art LOCATIONS: Hamilton urological services with emphasis on patient education and shared decision making. Treating patients with Hamilton 1374 Whitehorse Hamilton compassion, dignity, mutual respect, and trust remains out steadfast goal. 1374 1 Whitehorse Hamilton Square Road 1 Square Road Hamilton, NJ 08690 2 Hamilton, NJ 08690 2 LOCATIONS: Howell Howell 2364 Route 9 South Hamilton 2364 Route 9 South Howell, NJ 07731 1374 1 Howell,Whitehorse NJ 07731 Hamilton Square Road Lakewood 2 3 Lakewood 900 Route 70NJ East Hamilton, 08690 3 900 Route 70 Lakewood, NJEast 08701 Lakewood, NJ 08701 Howell Toms River: Toms River: Drive 4 20 Hospital 2364 Route 9 South 4 20 Hospital Toms River, Drive NJ 08755 Howell, NJNJ07731 Toms River, 08755 3

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Adult Urology • Pediatric Urology • Urologic Oncology • Male Infertility Adult Urology • Pediatric Urology • Urologic Oncology • Male Urology Infertility Sexual Dysfunction • Urodynamics • Stone Disease • Female Sexual Dysfunction • Urodynamics • Stone Disease • Female Urology Laparoscopic Surgery • Robotic Surgery • Reconstructive Urology Laparoscopic Surgery • Robotic Surgery • Reconstructive Urology

www.TheCountyWoman.com The County Woman Magazine www.TheCountyWoman.com The County Woman Magazine The County Woman Magazine www.TheCountyWoman.com Adult Urology • Pediatric Urology • Urologic Oncology • Male Infertility Sexual Dysfunction • Urodynamics • Stone Disease • Female Urology

the cause of symptoms such as blood in the urine (hematuria), painful urination (dysuria), urinary incontinence, urinary frequency or hesitancy, an inability to pass urine (retention), or a sudden and overwhelming need to urinate (urgency) and much more.

FOR APPOINTMENTS: FOR Lakewood APPOINTMENTS:

 (609) 581-5900 900 Route 70 East (609) 581-5900

(732) 928-5300 Lakewood, NJ 08701 (732) 928-5300 UUANJ.COM UUANJ.COM

FOR APPOINTMENTS: September/October 2014

September/October (609) March/April 581-5900 2014 2015

(732) 928-5300

Business Spotlight

~ UUANJ Welcomes Urologist Dr. Michael Nazmy Jr. ~ An Interview With Dr. Nazmy University Urology Ever since he was a young boy, Dr. Michael Nazmy had always been intrigued by Associates of New Jersey isolating a problem and working to repair it. This keen sense of curiosity is what led • Parvez Mahmood, MD, FACS • Mukaram Gazi, MD, FICS, FACS • Alexander Gotesman, MD • Michael Nazmy Jr., MD For more information, call 609-581-5900, (732) 928-5300 or visit www.uuanj.com

him to a career in medicine. However, it was when he became a volunteer EMT that his interest in people and the human body really took flight. He adds, “That early experience helped me see how medicine is done on a common sense level and what it really looks like to go to a patient’s home, stabilize them, load them onto an ambulance and bring them to a hospital for a higher level of care.” He also credits working as an EMT with showing him a more humanistic view of the medical field. Dr. Nazmy eventually chose to specialize in Urology; a specialty that deals with a broad area around the urinary system. Urologists perform surgery on the kidneys, bladder, urinary system, female pelvis and male reproductive system.

What attracted you to the field of urology?

This is a field that combines the worlds of medicine and surgery, often referred to as “surgical subspecialties.” I chose urology because it allows for a range of patients, from young to old, male to female, from healthy to sick, and a range of surgeries, from minor to quite major. None of the other subspecialties offer such a vast variety, with the chance to actually resolve problems with surgery, rather than just treat them with medications.

Briefly describe the type of surgery you perform.

Business Spotlight

I perform the full range of Urologic surgeries, however, I am fellowship trained in minimally invasive surgery including laparoscopic and robotic surgery. Robotic surgeries involve making small incisions in the body through which cameras and surgical tools are placed. The surgery is performed by “remote control” a few feet away from the patient’s body. It allows magnified vision, true 3D vision inside the body, and wrist motion replication. All of these factors increase precision and in certain surgeries, decrease bleeding. The robotic approach has revolutionized major surgery; in most situations longer incisions equals longer healing time. Offering a patient multiple small incisions, like those in laparoscopic and robotic surgery, may dramatically decrease recovery time.

What is the most challenging part of your job?

~ Interview with Mukaram Gazi, MD ~ The challenges facing physicians today seem to be multiplying very rapidly. Unfortunately, our medical system is heavily biased toward helping the bottom lines of insurers, pharmaceutical companies and hospital organizations. Instead, the focus should be on improving actual access to care, quality of care, and keeping reimbursements reasonable for physicians. The health care landscape is quickly changing and our responsibilities as physicians to advocate for patients will bebecome ever increasing. I am extremely confident in my and my medical you involved in the field ofteam urology? training; it’s the bureaucracy that challenges all physicians today.

Dr. Gazi Shares His Experience As A Urol rsity Urology How did I always knew that I wanted to be a surgeon. During medical school I cho s of New M Jersey N J ., M.D. elective surgical rotations. I took a liking to urologic surgery and found that I Photo By Tracy Harman Photography

ichael

MD, FACS

od, MD, FACS

sman, MD

tion, call 32) 928-5300 nj.com

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Why did you choose to work with UUANJ? “The medical team at UUANJ has the model that I believe After completing school atsame the solutions-based University ofpractice Miami, I went on to com in. They treat the full-range of urological cases; some patients require a tumor training in Urology at UMDNJ RWJ Medical School in 2001. I have been in removed to save their life, others may need a kidney stone taken out to relieve urology everpain, since. and still others need help regaining sexual function to experience a healthy relationship with their partners. All the providers at UUANJ are devoted to the goal

What is the most rewarding part about your profession? of delivering cutting-edge, compassionate care to patients. I am honored to be

part ofcare this team.” I find patient to be the most rewarding part of medicine. In my practi with multiple conditions that affect In movies manyand cases When Dr. Nazmy is not caring their for his daily patientslives. he enjoys quiet we are ab dinners with close friends. He enjoys scuba diving, off-roading, and fishing. that ultimately give the patients a also better quality of life.

What sets your practice apart from others like it?

In ourwww.TheCountyWoman.com practice we cover all The County Woman Magazine

facets of urology. We treat both and2015 male an March/April issues and pediatric and adult urology. We also offer minimally invasive sur

Health

Is Your Body Ready For The Wellness

IS YOUR BODY H READY FOR THE SUMMER? ealth & Wellness

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osing weight takes effort and a great support system. Ocean Health & Weight Loss is here to help you reach your goal of a better you.

Health

started itâ&#x20AC;&#x2122;s not usually glamorous. Have you ever been at those Itâ&#x20AC;&#x2122;s not always exciting. Itâ&#x20AC;&#x2122;s not Weight Loss meetings and noticed always fun. It is, however, always several people there who are slim necessary and very rewarding in and trim? What about those a short period of time. Weight Loss adâ&#x20AC;&#x2122;s on TV with Together with Ocean Health their before and after pictures? & Weight Loss we can create a They make losing weight look game plan to get you back on so effortless, but remember, in track right away without beatreality, these people have been ing yourself up and devastating dieting for years. This is just 40 your self-esteem. My game plan days to begin the new you. HCG work for men is ^ takingDoes it a day at a time. We Without effortas and action, will put you on a 40 program to you will not succeed. You canâ&#x20AC;&#x2122;t well as women? start. You will start to lose anywish your weight away but we produced only where fromAlthough a 1/2 of aHCG poundistonaturally definitely make it easier for you. in pregnant women, as a diet aid it works the same 1 pound per day. You have to work at it and be forHave menI got andyour women. So far I havenâ&#x20AC;&#x2122;t found the HCG attention? prepared for the times information as to how it works in men since they when You will not be hungry and where we come donâ&#x20AC;&#x2122;t produce the hormone but you the slip, truththatâ&#x20AC;&#x2122;s is that men your energy level will start to You can text on us or call every lose just as effectively as women.in.Most people increase and are you awill just begin today There lot of benefits most diets out if you need to ask this program report losing about a half of poundthere, to question to but feel better and look better as 40-day none compare to our weight loss proor just to say how good a pound per day or more, and claim it is the only pro-you are thetocol. inchesGive just melt You us aaway. call and will giveweight youwea help to doing. So the together gram where they have beenwe able togladly keep lose the bad fat that you want pick yourself up, dust complimentary consultation so you may see how off afterward. HCG I lost about 3/4 pound per day, and AMAZING to lose in those stubborn placesa half yourself off, and move easy and fast it is to lose a pound a day and that was with some variations in the eating program. WEIGHTLOSS! and keep muscle. Maybe on...You WE love what take offtheinches theeating same time. check However, as withatany program, orcan even withus itâ&#x20AC;&#x2122;s taking it a day at oceanhealth4you.com a time, but # Amazing results in we do here at Ocean out on our web and join food (e.g., allergies), there is individual variation inthe its tomorrow will get better and bet- Health & Weight Loss the First many already morecravings healthyor lifestyle. results. YouWeek mayliving have asugar habit cravings and youPictured will too.Above: ter. Maybe.5-1 itâ&#x20AC;&#x2122;s getting angry day and # pound at Lose the very start but per they should subside onceActual your becoming more determined then all Individual Healthclients. FOR YOUR CONSULT CALL 732-608-9681. # Noadjusts. Hunger on the hCG dietWhere results body may vary. ever to succeed. Breaks Loose!!!!! #OUR Easy toHCG Makeis Recipes MEDICALLY TRAINED STAFF WILL BE effective for weight loss if it is taken

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program to start. You will start to lose anywhere from a 1/2 of a pound to 1 pound per day. Have I got your attention? You will not be hungry and your energy level will start to increase and you will just begin to feel better and as the inches just melt away. Youentail Written by: Jill Houston, heretoistake a lot of information out there look In order advantage of losing weight ^better Does the HCG program Clinical the that you want toDirector losetoin thosesugar, Thebad morefatinsulin your body releases process and being successful, you must prepared. and lose about this weight lossbeprogram Ocean Health & Weight Loss injections today? stubborn and keep the muscle. Maybe itâ&#x20AC;&#x2122;s the moreplaces we store sugar as fat. for usFAQs to helpare youhere on your journey Be ready these HCG to help you to learn takingThe Absolutely. 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HCG FAQs: OCEAN HEALTH & WEIGHT LOSS

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Your Body Ready For The Summer?

The Not-So-Sweet Side of Sugarâ&#x20AC;Ś

Your Brain on Sugarâ&#x20AC;Ś

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for itasand tells have â&#x20AC;˘ No Hunger on the hCG an Health Your brain to feelrewards better andyou look better justyou tocompleted saytohow good you are tion to weight loss, many people whoorhave Diet the inches just melt away. You more sugar. doing. So together we help to timeisofassociated challenge. with all of the ight Loss Just because â&#x20AC;˘ Easy to Makedopamine Recipes theisHCG program also experienced other health benefits, lose the bad fat that you wantwhen pick Before headaches or After HCG. Some might experience mild yourself up,certain dust same thing happens people take Nothing is more mean frustrating to helpsuch youasThe above-mentioned â&#x20AC;&#x2DC;riskyâ&#x20AC;&#x2122; business doesnâ&#x20AC;&#x2122;t that a drop pressure, and blood to loseininblood those stubborn placescholesterol yourself off, and move - George F even dizziness during the early days of the diet. due drugs. Thatâ&#x20AC;&#x2122;s why people want more and more of these than toInseefact, thatdopamine you are gaining keepwomen the muscle.find Maybe h your sugar goal and and dopamine is inherently bad. can many it subsides the on... many WE loveof what â&#x20AC;˘ No hunger on the HcG diet to detoxing. However, this is only reported in a slight things and become 6 !))1 21 weight, or have high cholesterol, it a dayaddicted. at a time, but we do here at Ocean help you be MORE nutritious. Thatâ&#x20AC;&#x2122;s because when symptomsitâ&#x20AC;&#x2122;softaking menopause. better you. Join the hundreds of men and women who have More Questions about HCG? part inhas thetaken diet.over Most acAndtomorrow yes, your sugar&does willbrainâ&#x20AC;&#x2122;s get betterreaction and bet- toHealth Weightlead Lossto number of people that take orover diabetes your 5 = â&#x20AC;˘ Easy to make recipes you eat the same thing and over, you donâ&#x20AC;&#x2122;t react dropped 20 to100 lbs. at Ocean Health! and you will too. ter. Maybe itâ&#x20AC;&#x2122;s getting angry and If you have another question about HCG, counts of HCG information show that such side effects -6'29)5 % 758/< 5)0%5.%&/) to take advantage sugar addiction. life.This with asand much dopamine. causes our bodies to NOT A 500else CALORIE becoming more determined then if :%< 72 /26) :)-+,7 48-'./< Where all Health ight and being chances are someone has that sameDIET!!! question so are rare do not last beyond the first days of com^suc-How do you know HCG Thatâ&#x20AC;&#x2122;s the reason dieting can be so hard! Either you in%1( 6%*)/< adifferent position tastes. to)6)7 <285 benefit RESETS YOUR METABOLISM! ever to succeed. constantly seek newresearch foodsBeand Food Breaks Loose!!!!! must be prepared. ocmwi@hotmail.com and we ask it. E-Mail us at mencement. Quality shows that this is a safe avoiding sugars that sneak into restaurants and Call 732-608-9681 your 0)7%&2/-60 72 ,)/3 <28 .))3 from your failure. Make the causes Want to go from overweight tofor overjoyed? is arenâ&#x20AC;&#x2122;t reliable? us to help you on and drink variety begets more dopamine; which 7,) :)-+,7 2** !7236 <285 will Call return with an answer product with no knownright side choice effects. foodsâ&#x20AC;Śor youâ&#x20AC;&#x2122;re Client Testimonial . . . having legitimate sugar 732-608-9681 forpromptly. your complimentary begin a weight y to weight loss processed suc- HCG complimentary consultation! information derives from years and &2(< *520 6725-1+ );')66 *%7 us to try new foods and have moretobalanced nutrition. consultation or visit OceanHealth4You.com. how our hCG iswithdrawal! the Iâ&#x20AC;&#x2122;ve Tried Everything But Nothing loss program that works. To get years of scientific study. The process of using HCG for NO FAKE DROPSOcean Health & Weight Loss has cracked the Worked Like hCG performed weight loss started in 1950. It was originally just pharmaceutical code and is helping thousands overcome their Since starting hCG I have lost 47lbs, in 58 days, and Iâ&#x20AC;&#x2122;m 26) 72 281( )5 %< the formdown of injections and was known to deliver program is in medically less than $500. The expensive part is buying a whole Whether addiction to sugar. :-7, , >",) %7 851-1+ -)7 o you can get the quick and effective results. new Wardrobe, but itâ&#x20AC;&#x2122;s fun. When I lost the first 25lbs, I also

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e you need at this went off my blood pressure medicine and I sleep like a baby. I started at 255lbs and Iâ&#x20AC;&#x2122;m now down to 208lbs, and Iâ&#x20AC;&#x2122;m lenge. within 8lbs of my high school weight. I love hCG.â&#x20AC;? is more frustrating - George F has sugar receptors, just like your brain. that you are gainingYour gut ave high cholesterol, When you eat sugar â&#x20AC;&#x201C; your gut will actually send a Join the hundreds of men and women who have has taken over your warning up to your brain. dropped 20 to100 lbs. at Ocean Health!

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you have 10 pounds or 100 people get addicted to sugar â&#x20AC;&#x201C; you keep eating it and pounds or www.OceanHealth4 ')%1 )%/7, #)-+,7 266 it keeps feeling good! One of the biggest offenders of even more. 20081-7< )(-'%/ )17)5 www.TheCountyWoman.com sugar overload is SODAThe POP.County But youâ&#x20AC;&#x2122;llWoman be shockedMagazine to Female or %.),8567 2%(ketchup, even in know how much is in tomato sauce, "206 -9)5

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osition to benefit RESETS YOUR METABOLISM! full ailure. Make the 1) You feel Want to go from overweight to overjoyed? 732-608-9681 your complimentary insulin spikes in for response to excess sugar. to begin a weight 2) Your Call consultation or visit OceanHealth4You.com. After m that works. To Before get

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The Countywww.OceanHealth4You.com Woman Magazine www.TheCountyWoman.com

March/April 2015

Nutrition & Wellness

Cleansing for Weight Loss

It seems like everyone is talking about doing “cleanses.” But what exactly is a cleanse? Should you be doing one?

leansing has been around since the ancient Egyptian times, when it was believed that waste remaining in the bowel could lead to fever and infections. While science has disproved that theory, there are still many people who believe the practice of helping the body rid itself of toxins can help alleviate many ailments such as allergies, arthritis, or even asthma.

Jennifer Nosti, RDH

are several methods of 1There cleansing.

Some cleanses are called colon cleanses. These can be natural colon cleanses which involve taking natural powder or liquid supplements, oral or suppositories, that will help flush the colon, or colon cleansing with irrigation, which involves a technician using water and possibly herbs or supplements to physically flush the colon.

is a right 1There and a wrong

way to cleanse. When deciding which cleanse to do, it is always a good idea to check with your doctor if you have any preexisting Fig. 1- MRI shows the reduction in visceral fat in the medical conditions. The artery from Image A to image B. colon cleansing is very extreme for most people and is generally not recommended by doctors due to the risks involved, unless it’s for a medical procedure, such as a colonoscopy. With cleanses, it is very important to be getting enough nutrition and consuming enough liquid while doing the cleanse. That is why I recommend a system that is scientifically proven to be safe and effective. When cleansing it’s important to know that what you are consuming is giving you all the nutrients that you need so you can get a great result so you know you will not be starving your body of nutrients and causing more harm than good.

However, these methods of cleansing can cause some unwanted side effects such as abdominal bloating, cramping, nausea or vomiting. They can also lead to potentially harmful or dangerous side effects as well, such as dehydration, infection, bowel perforation and disrupting the balance of electrolytes. So, while there are believers in both of these methods, http://www.nutritionandmetabolism.com/ Improvement in coronary heart disease according to the Mayo Clinic, they lack the scientific evidence to support their efficacy. risk factors during an intermittent fasting/calorie restriction regimen: Relationship to adipokine modulations. Nutrition & Metabolism 2012, 9:98 doi:10.1186/1743-7075-9-98

1Another type of cleansing is based on the concept of fasting.

“Intermittent fasting” is a pattern of eating that involves going without food for several hours or up to a couple days. And it can become a lifelong habit. Again, this can be dangerous if not done correctly. Water cleanses are done by only drinking water for a period of time ranging from a day to several days. This can be very extreme, especially for a beginner. Severely restricting calories for too long a period of time can also lead to muscle breakdown and malnutrition. This can slow your metabolism, causing weight gain when resuming a normal diet. So initially you may feel great and lose weight, but you will likely gain it all back.

For more information on my nutritional cleansing system, please email me at nutritionempowerswealth@gmail.com or jennosti@gmail.com

There is also a “nutritional cleanse” that is designed to cleanse the body on a cellular level and can be done in one day without the laxative side effects. It detoxifies more than just the colon; it detoxifies the body on a cellular level. During this cleanse, you drink a special drink that is loaded with antioxidants and botanicals that aid in detoxifying, along with specific snacks and chocolates (YES! Chocolate!). According to a study from Nutrition & Metabolism, this type of intermittent fasting with calorie restriction, when done safely, can actually help your body break down visceral fat (lose weight) and reduce your LDLs (“bad cholesterol”), which can help protect against coronary heart disease and improve insulin sensitivity. (Fig. 1)

“READY TO LOSE WEIGHT?

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*Actual results from following 30 day nutritional plan.

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Medical Professionals

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14 6

Health &Wellness

Varicose Veins? Painful Swollen Legs? Help Is Available! underlying cause, known as V venous reflux disease, are the most

An Interview With Dr. Jeffrey S. Gosin...

aricose veins and their

common circulatory problems that affect individuals of all ages. These conditions are twice as common as coronary heart disease. They occur when vein valves in the legs become damaged, damage, causing abnormal blood flow in the affected veins. Consequently, blood is allowed to pool in the lower legs. This causes a variety of physical symptoms such as leg pain, leg swelling, heaviness and fatigue, and skin itching. It can also cause the appearance of unsightly varicose and spider veins. People who have occupations that require standing, such as casino employees, food servers, school teachers, and many other similar jobs are especially prone to these problems. In addition, people who have a family history of varicose veins, who are overweight, or who have been pregnant are at risk. It is also possible to have varicose veins without any of these risk factors. Venous reflux disease and varicose veins become more common with age. Existing varicose veins can also become more prominent or symptomatic, as individuals get older. In more severe cases, people with long standing varicose veins and chronic leg swelling can develop permanent loss of integrity and discoloration of the skin, leg wounds, and blood clots.

Hospitalization and painful vein stripping surgery areusually not necessary. are not necessary.Jeffrey JeffreyGosin, Gosin, M.D., a Board Certified Vascular Surgeon with Shore Vascular & Vein Center states, “In our practice, we have been caring for individuals with vascular problems, such as varicose veins, for our entire careers. In recent years there have been fantastic advancements in the treatment of vascular disease. In many cases we can offer these state-of-the-art treatments to our patients. As a result, we are able to treat most of the vein problems that people experience with minimally invasive, outpatient procedures. Many of these are performed right in the office. These procedures have the advantage of being very safe and effective. Patients usually experience minimal discomfort, are able to walk immediately following the procedures, and have fast recovery.” One of the advancements in vein care is the *Venefit® Procedure (formerly known as Closure). This procedure treats varicose veins at their underlying source, by eliminating venous reflux. Dr. Gosin states, “The Venefit Procedure has greatly improved the way that we treat patients with varicose veins and venous reflux disease. It is performed in a comfortable office setting. General anesthesia is not necessary. The whole procedure is guided by ultrasound. Therefore, incisions and sutures are not needed. That means less pain and faster recovery for our patients. The procedure takes about 20 minutes to perform and is over 95% successful in eliminating venous reflux, which is the cause of most varicose veins. We have now performed thousands of these procedures and results have been excellent.” “One of the significant advantages to seeing a vascular surgeon for vein care is that we treat the full spectrum of vascular diseases, from routine to very complicated ones”

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Theater &Entertainment The good news

Fine says A rt Photography Dr. Gosin. “We have experience with conventional

Education

The good news is that modern vein care allows for treatment of many of these problems in a far less invasive way than in the past.

442 Bethel Road Somers Point, NJ 08244

Eliminate your veins, don’t hide them!

(609) 927-VEIN (8346) www.GetGreatLegs.com

open surgery, and are certainly prepared to do that when necessary. However, more commonly and more we are able to treat our patients with minimally invasive procedures. This is especially true for varicose veins and venous reflux.” If you you are are suffering sufferingfrom fromthe thesymptoms symptomsororappearance appearance If of varicose veins, or if you think you have leg symptoms of varicose veins, or leg symptoms orififyou youthink haveyou leghave symptoms thatyou youthink thinkmight mightbeberelated relatedtotoyour yourcirculation, circulation, that thethe BoardCertified CertifiedVascular VascularSurgeon Specialists of Shore Vascular Board of Shore Vascular & & Vein Center are available help.health Mostinsurance is Vein Center is available to help.to Most health insurance is accepted. accepted.

Business &Finance Please feel free to call for a consultation or

Get Great Legs for Summer! Jeffrey Gosin, M.D. F.A.C.S.

is that modern vein care allows for treatment of many of these problems in a far less invasive way than in the past.

for additional information.

(609) 927-VEIN (8346) or visit us on the web www.GetGreatLegs.com Jeffrey S. Gosin, M.D. FACS

My legs look and feel so much better! Making appointments was easy and they worked with my crazy schedule. Dr. Gosin and his staff were very understanding about my care. Highly recommend! - K.R.

Dr. Jeffrey Gosin is a graduate of University of Pennsylvania and Jefferson Medical College. He completed his General Surgery Residency and an accredited fellowship in Vascular Surgery at Robert Wood Johnson University Jeffrey S. Hospital. He is Board Certified in Gosin, Surgery and Vascular Surgery. Dr. Gosin M.D. FACS is a fellow of The American College of Surgeons and a member of The Society for Vascular Surgery, The Society for Clinical Vascular Surgery, and numerous other national surgical and vascular societies.

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September/October 2014 March/April 2015 January/Feb

Business Spotlight

~ Interview With Surgeon Dr. Jeffrey Gosin ~

Shore Vascular & Vein Center Jeffrey S. Gosin, M.D. FACS 442 Bethel Road Somers Point, NJ 08244 (609) 927-VEIN (8346) www.GetGreatLegs.com

s a young man, Dr. Jeffrey Gosin was very interested in science so it was a natural progression for him to pursue a career in medicine. His specialty is the treatment of disorders of the circulatory system – also known as vascular surgery. He grew up in a “surgical” family and his dad was his partner for 17 years until he retired last year. He adds, “When I was a child my Dad would bring me to the hospital to make rounds with him on weekends. I really looked up to him and what he did for a living.” It was his father’s dedication and satisfaction with his own career that had a lasting impression on the younger Gosin.

Describe what you do in your chosen field.

Dr. Gosin: My specialty involves treating vein problems, such as varicose veins and spider veins. I also treat diseases of the arteries such as aneurysms, blockage in the arteries to the brain, called carotid artery stenosis, and peripheral artery disease (PAD). As a surgeon, I am able to perform surgery when necessary. However, in many cases I am able to treat these vascular problems using modern, minimally invasive non-surgical methods.

What is the most rewarding part about your profession?

Dr. Gosin: I feel quite fulfilled when I check my patients after they have had a treatment or surgery. They come back to my office feeling better and healthier. In some cases, people experience dramatic improvements in their quality of life. It is a wonderful feeling to know that I was able to provide that.

What is the most challenging?

Dr. Gosin: Every case can provide its own unique challenge. It is important to remember that each patient I treat is an individual. Certain elements of his or her care may be more challenging than a similar condition in another person. It is that variation that makes my job so interesting.

Are varicose veins a genetic problem? Can they be prevented?

Photo by Donna Andrews Photography

Jeffrey S. Gosin, M.D. FACS Dr. Gosin grew up on the Jersey Shore, and after graduation from the University of Pennsylvania and Jefferson Medical College, he completed his training and was delighted to come back and begin his practice. He completed his residency in general surgery and a fellowship in vascular surgery at Robert Wood Johnson University Hospital. He has three children and enjoys spending time at the beach and boating. Dr. Gosin is a fellow of The American College of  Surgeons and a member of The Society for Vascular Surgery, The Society for Clinical Vascular Surgery, and numerous other national surgical and vascular societies.

Dr. Gosin: Genetics are one of the most important risk factors in the development of varicose veins. Individuals with a family history are more likely to develop the condition themselves, than individuals who do not have that family history. However, genetics are just one of a number of recognized risk factors. Other risk factors include prolonged standing, pregnancy, increasing age and being over weight. It is also interesting to note that some people will develop varicose veins without any of those risk factors. Although there is no way to absolutely prevent the development of varicose veins, certain precautions, like wearing compression stockings, may help to keep the symptoms at bay.

What is the most effective way to treat this condition?

Dr. Gosin: Treatment varies based on an individual’s particular situation. That is one of the reasons why it is so critical for people to obtain their care from a specialist. While varicose veins may cause cosmetic concerns for some people, others with this condition will actually have an underlying abnormality with the valves in the leg veins. That is a specific vascular disease called venous reflux or venous insufficiency. Leg pain and fatigue, swelling and a variety of other symptoms are common. If the varicose veins are treated without first diagnosing and treating the underlying condition, then treatment will likely be incomplete and provide only temporary improvement. Therefore, it is essential that an individual receive a thorough evaluation. Most all of the treatments for varicose veins that I offer are minimally invasive and do not require major surgery. There is a fast recovery with minimal pain and “down time.”

How do you stay current with trends happening in your profession?

Dr. Gosin: Vascular surgery is a specialty that has seen fantastic changes in recent years. It is critical that I offer the most up to date care to my patients. My Board Certification ensures that I participate in a program of “lifelong learning” and maintenance of my certification. I stay current with the major specialty journals and regularly attend conferences.

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March/April 2015

Medical Professionals

Dr. Newman Answers Your Sleep-Related Questions ⌘What is sleep apnea?

Obstructive sleep apnea (OSA) is a condition in which the person stops breathing repeatedly during sleep. This occurs whenever the person sleeps or even naps. Although interrupted for talking, laughing, and sneezing, the breathing cycle of inhalation and exhalation normally does not stop. OSA is aggravated by alcohol and sedatives. It can occur in anyone but is mostly seen in obese people and affects children as well as adults.

Health &Wellness

stop breathing during sleep, are prone to moving, have morning headaches or feel unrefreshed in the morning. If you have heart problems, especially a condition called atrial fibrillation, a sleep study would be very important.

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⌘What does a sleep study involve?

The sleep study is done privately in one of our 8 spacious hotel-style bedrooms. Each is equipped with a flat-screen TV, private bathroom with shower, and a closet for belongings. During a sleep study, the person is hooked up to a number of electrodes ⌘How do I know if I need a sleep study? (by small, soft skin pads to the head for brain wave You probably need a sleep study if you snore, recording called EEG, to the chest for heartbeat recording called EKG, and to a pulse-ox Do you or a family member experience finger clip to record oxygen). This is all snoring, daytime sleepiness or wake hooked into a small box that a technician up unrefreshed in the morning? can detach if the person needs to get up, go to the bathroom, etc. There is video and audio recording to monitor for restlessness and snoring. There is one professional technician assigned to monitoring one or two patients at most.

to vital organs, which need oxygen continuously without interruption. If left untreated it can lead to heart attacks, hypertension, and stroke.

⌘What sleep conditions can be diagnosed with a sleep study?

Obstructive sleep apnea, periodic leg movement disorder, and seizures are only some of the problems that can be diagnosed with a sleep study.

Elder Law ⌘What is narcolepsy?

Narcolepsy is a sleep disorder in which the person, who is fully awake, falls asleep suddenly in the daytime. It is also called a “sleep attack.” It is usually triggered by extremes of emotions such as laughing or joking. The person goes directly from awake to REM stage sleep without going through the lighter stages of sleep first. A full-night sleep study, followed the next day by a daytime napping study, is done to test for this.

Theater &Entertainment ⌘What if I don’t sleep?

Stephen L. Newman MD MBA

Education

Diplomat American Board of Sleep Medicine

• • • • • • • • •

Fatique Evaulation Sleep Apnea Abulatory, at home, sleep studies Overnight in laboratory diagnostics Driving evaluation CPAP/BIPAP therapy Provent therapy Snoring Evaluation and Treatment Narcolpesy evaluation

35 Beaverson Blvd, Suite 7C Brick, NJ 08723 Any questions, please call us at 732-920-8022, email drslnewman@drnewman.org. or visit

www.DrNewman.org.

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⌘What is CPAP?

Fine Art Photography

Usually six hours of sleep is needed even if it is “light sleeping.” If there is not enough data collected, then it can be rescheduled. This is called “First Night Effect” of sleeping in a strange place. Usually the second night is fine.

⌘Is sleep apnea dangerous?

YES! Sleep apnea can be dangerous. Because air and oxygen are blocked repeatedly, it can lead to harm and damage

CPAP is the acronym for Continuous Positive Airway Pressure. This is a medical device that prevents the obstructions of apnea mechanically by pushing air pressure to the throat to keep the airway open. It is delivered by a soft triangular mask that covers the nose and/or mouth or by soft nasal pillows that sit in the nostrils. It usually comes with a heated humidifier to give moisture and prevent dryness.

Better sleep means better health! For more information contact us at 732.920.8022

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Dr. Stephen L. Newman, a graduate of Albert Einstein College of Medicine, is the first Board Certified Sleep Specialist in Ocean County. He also established the first Sleep Disorder Laboratory in Southern and Central New Jersey. A resident of Ocean County since 1986, he is married to Merrell Newman and has two children. The pride and joy of his life is his granddaughter, Madeleine.

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CHOP PRIMARY CARE LOCATIONS AND HOURS: Harborview/Cape May Harborview/Smithville Harborview/Somers Point Saturdays 1315 Route 9 South 48 South New York Road 505 Bay Ave. 10am - 5pm Sundays 12pm - 5pm Cape May Court House, NJ 08210 (Route 9) Bayside Commons 609-465-6100 Smithville, NJ 08205 Somers Point, NJ 08244 or by appointment: 609-748-2900 609-927-4235 Monday – Friday P: (732) 657-3930 • C: (732) 575-5851 • E: nolan2032@yahoo.com 8:30 a.m. – 5 p.m. Monday – Friday Monday and Friday 8:30 a.m. – 5 p.m. 8:30 a.m. – 5 p.m. OUR CLINICIANS: Tuesday, Wednesday and Thursday George P. Bross Jr., D.O. • Yasmin D. Deliz, D.O. • Christopher W. Drexler, D.O. 8:30 a.m. – 7:30 p.m. • Sharon L. Held, D.O. • Mark P. Jacobson, D.O. • Christopher J. Keenan, D.O. • Saturday Courtney G. Kivel, C.R.N.P. • Lisa J. Share, M.D. • Andrea R. Thorp, D.O. • 8:30 a.m. – Noon Gerald E. Vekteris, D.O.

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Medical Professionals

ANS RAISES Concussions and

Through education, we want to help coaches, parents, and young athletes learn the signs and symptoms of concussions, seek proper treatment, and follow appropriate return- to- play protocols to avoid the significant dangers of multiple concussions. Concussions are a form of traumatic brain injury (TBI), which account for 75% of TBIs. There are 1.6-3.8 million sportsrelated concussions per year. The word concussion may sound benign, but it is a brain injury. Many athletes suffer knee injuries, ankle injuries, shoulder injuries, and a variety of musculoskeletal injuries. Some of these injuries we can play through, others require rest, and a very small percentage requires surgery. Unlike musculoskeletal injuries, we cannot play while still suffering from the effects of a concussion.

What is a concussion?

Atlantic NeuroSurgical Specialists (ANS) joins the nation in observing Brain Injury Awareness Month and honoring those who live with traumatic brain injuries.

A concussion is a blow to the head or body that causes shaking of the brain, causing damage to the tissue of the brain. Common examples include an athleteâ&#x20AC;&#x2122;s head hitting a stationary object, such as the ground in field sports (football, soccer, etc), boards/ice in hockey, and floor in basketball. A hard blow to the body that shakes the head can cause a concussion. The head doesnâ&#x20AC;&#x2122;t have to be hit directly.

What do we look for? Symptoms: headache, nausea, vomiting, confusion, ringing in the ears, dizziness, seeing stars or flashing lights, double vision, feeling dazed, and being unaware of the period, opposition, or score of the game. Signs: loss of consciousness, seizure, slow to answer questions, easily distracted, poor concentration, vacant stare, nausea/ vomiting, slurred speech, inappropriate playing behavior, poor coordination, poor balance. Remember loss of consciousness occurs in less than 10% of athletes with concussion.

When do kids come out of games?

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If there is any doubt that a young athlete has had a concussion, he or she must be removed immediately from the game and monitored over several days. It is common for an athlete to feel much better within a few minutes on the sideline. However, the symptoms may not manifest for several hours to several days. If we return the athlete back to the field (even though they feel better) and it turns out they did have a concussive episode and sustain more hits, we can turn a simple 1-3 week recovery

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2/13/15 2:23 PM March/April 2015

Medical Professionals

AWARENESS

other Brain Injuries

process into a 4-6 month recovery process. During that time the student athlete may miss time from school, social life, and sports.

SOMETIMES there is MORE to the picture.

If it turns out the athlete doesn’t manifest the symptoms of concussion over the next several days, they, in most cases, can safely return to sports after a proper medical evaluation without incident. It is important for our young athletes to learn the signs and symptoms of concussion and be honest about reporting how they are feeling. This is the most important step in protecting the ability of our young athletes to continue playing the sports they enjoy.

What are the short and long term consequences of concussions and their treatments? Both short, and long-term symptoms can include difficulty with headaches, sensitivity to light, sensitivity to noise, fatigue, poor concentration, poor memory, dizziness, difficulty with balance, feeling foggy, trouble falling asleep, sleeping too much, nausea, ringing in the ears, depression, anxiety, sadness, feeling more emotional, irritability.

How do I prevent a concussion? • Make sure your helmet fits and your chin strap is snug and secure at all times.

Concussions can happen even in the absence of external head injury. Concussions most often occur while playing contact sports such as

• Under no circumstances lead with your head.

football, hockey, soccer, or wrestling.

• Keep your head up. It helps you see what is coming, and minimizes direct head contact into the boards.

If your child injures his head or you believe he may have a concussion,

• Improving neck strength may also benefit.

it is important that the child discontinues play immediately and gets an

ANS Spine & Sports Concussion Center

evaluation. All concussions are serious and should be monitored right

The Spine & Sports Concussion Center at ANS was designed to address the comprehensive needs of the athlete who has sustained a concussion or other sports-related neurological injury in order to facilitate his or her recovery and safe, confident return to play. Our services include detailed screening and assessment of concussions, including computerized neuropsychological testing and the treatment, evaluation, and follow-up of these disorders while incorporating additional computerized neuropsychological testing as needed. ANS also does preseason testing for athletes. This test provides an individual baseline measurement for use in determining treatment progress if the athlete is subsequently injured later in the season. For more information about. For more information about ANS visit www.ansdocs.com or call 973-285-7800.

away. ANS neurosurgeons can properly diagnose the concussion and its severity, and then make appropriate treatment recommendations. For more information visit www.ansdocs.com or call 973.285.7800.

ANS. LEADERS IN THE DIAGNOSIS & TREATMENT OF CONCUSSION.

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Medical Professionals

38 edicalTherapy Professionals SubcutaneousM Pellet

HORMONE IMBALANCES: Health &Wellness WOMEN DON’T SUFFER ALONE. Your Health – Your Choice

NOT ALL FORMS OF HORMONE TESTOSTERONE: ADMINISTRATION ARE “The Co-Ed Hormone” CREATED EQUAL Demand better care . . . n this month’s article I would like to present to you Lowthe “T”concept is among the most common issues facing so then what is the answer? agingthe male. It affects multipleOkay aspects of their lives, choice. Inreceiving nearly every day experience ability Are youofcurrently treatment for low wethehave Simple! Demand better aw sexwant drive,to incontinence and maintenance of care! to makehormones? a choice. We what we and don’t or imbalanced Arechoose you feeling anywantincluding muscle mass. In men, testosterone pellet therapy can of a restauWould you be accepting Copingbetter? with your symptoms isn’t controlling your Perhaps you worse? eat and drink, whatare wefeeling watch on TV, our friends, what wesymptoms! do for improve erectile functioning thus often)cold eliminating rant (very that serves coffee, warm Don’t alet... thewe need for “The Blue Pill”. In addition to improving living, etc. As far as our healthcare is concerned, have limited beer and uncooked food? How Without enough testosterone, gaining and sustaining Whether you are a man or a woman, this month’s energy, drive, motivation and assertiveness, pellet HOT FLASHES •ofNIGHT SWEATS • purchase INSOMNIA •focus, ANXIETY lean body mass can be difficult. Testosterone is also the choices in terms the coverage we and what is affordable carpenter that is building your home and chooses all the fixtures, colors and article is going to set you straight regarding the most therapy with testosterone willabout ensurea regardless of age that hormone of desire and arousal – women experiencing low DEPRESSION • JOINT PAIN • HEADACHES • LOSS OF SEXUAL DESIRE and and afforded to us. effective safest “bio-available” form of hormone appliances for your “custom” home? Ofmay course not, lose so why thisininsex your healthyou will keep up with your high-profile job and those levels simply theiraccept interest forever without

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VAGINAL DRYNESS • the BRAIN WEIGHT GAIN... restoration therapy available in worldFOG today.• Pellet care? your not life’s mostrestoration precious commodity? youthful youIs to failhealth and fall. to optimal levels. But, in regards to what treatment we receive from ourco-workers waiting for therapy has been aroundnorm’! since the 1930s. This concept become the ‘new physicians and healthcare providers, we are told what we is similar to the once most prescribed drug in America Complementary and Alternative PROCEDURE: Medicine . . . -Premarin, but much like other bioidentical hormones, a Despite popular (mis)belief, CAMInsertion physiciansis serve to complement not replacepainless must do and rarely given an explanation why. a simple in-office non-invasive Take contol your and symptoms at their lack of approval from the FDAand has leftsolve an unnecessary current medical practices. It is theminimal conventionally close-minded practitioners thatincision feel is surgery under local anesthesia. A ¼” unjustified fearful of the associated relief through source for“consequences” natural, lasting You mustpublic legally be informed ... made in the upper hip area by“should placement intimidated by CAM physicians and principles that make the followed decision of I orof the with their use. small pellets which areproblem about half thefor size of awith Tic-Tac. The reality is that your healthcare provider legally must offer you choices after Bio-Identical Hormone Replacement Therapy (BHRT). shouldn’t I” consider alternative therapies. The biggest arises those In 2008, the FDA gave its blessing to Slate No sutures are required as the incision is small and can be all pros and cons,Testopel, including risks and benefits. Unfortunately, most of us do not critical illness. Despite a patient’s failing health and mental, emotional and physical Pharmaceutical’s - athe bio-identical testosterone closed through the use of a butterfly bandage. exercise this right and believe that for the men. “doctor pellet therapy designed exclusively (Toknows date, best” and you should follow his/ ailing, the only time a traditional provider will “allow” CAM therapies is when it is the has yet to admit the NEED for testosterone in herFDA recommendations. often too late to benefit from them. Reasons to Opt for Pellets Over Other women). Patients understand discuss options Don’t be a victim of misinformation when it comes to your health. Speak up and As moremust practitioners and and patients experience thefor easetheir care . . . Forms of BHRT this rapidlyofchanging toxicmethod environment, it is essential that you as a patient play ask questions. Demand answers and alternatives. Run away fromisthe closed-minded and In effectiveness this delivery for testosterone 1. Ease of administration-it painlessly implanted (and estrogen women), become increasingly an active and in integral partitofhas your own healthcare team. It is confusing, troublesome practitioners and play an active and integral role in your own healthcare. under the skin and lasts four to six months. popular for bothscary sexestodespite its unapproved FDA in and downright hear conflicting reports anduse opinions regarding various treat2. No fluctuating levels as is seen with all other forms Invest in life’s most precious commodity-your health. or most people, the first thought Women that comes to mind regarding hormone women. too often tread carefully at the mere suggestion of administration. (See Diagram) ments in conventional mainstream medicine, not to mention “alternative therapies”. Testosterone (and in women, estrogen) delivered of and testosterone therapy. have beenmore brainwashed imbalance isuseda towomen indoctor, menopause. A decline inThey a woman’s hormone levels To learn about CAM and providers these services patientimplant, is placedhas in been the middle between their CAM (Comple3. medical Maintains constantoffering levels throughout the day byA pellet treat migraines and specialist into believing that they don’t need testosterone and that mentary and Alternative andtestosterone) don’t know where is to turn or who seensearch avoiding the fatal web atlife ACAM.org or A4M.the ups and downs seen with other forms of menstrual headaches. Itprogesterone isMedicine) also a veryphysicians effective treatment (estrogen, and generally a stage inoutcomes. known it is dangerous and flooded withat risks and BHRT for dryness, urinary urgency to vaginal believe or trust. incontinence, As a traditionally trained familyand physician, This I wasisnot taught how nothing but nonsense! and In fact,isa women’s risk as menopause. The decline isits usually rapid and dramatic, As anaccompanied aside, I would like toby announcebody my direct andonly indirect involvement frequency. In both men and women, testosterone has and reliability. 4. Your absorbs what it requires based on to interpret a medical study and determine value We were taught of premature death from any cause including cancer been shown to increase energy, relieve depression, increase in the fight against the Ebola Epidemic through the use of Bio-Oxidative activity level and metabolic needs during the day. markedly increased without optimal and balanced such asrepresentatives hot flashes, moodofswings, weight gain, sleep disorders and a loss tosymptoms trust the pharmaceutical interpretation theisstudy that was biased sense of well-being, relieve anxiety and improve memory Therapies. In addition, I am pleased and proud toother announce theofaddition 5. Convenienceforms hormone hormone levels--period!!! towardsex theirdrive, drug or product. Theaintent of this article is not to bash the medical to name andof concentration. Testosterone pelletsfew. increase lean body When testosterone runs low in womenstarting administration require a once or twice daily dosing. of two new staff members at ICAM. Lucia, our front desk coordinator and system or its strength, providers bone but rather enlighten the reader right and need to mass (muscle density) and decrease fat as to their very often in their twenties, it affects multiple aspects of 6. The difference between a medication and a poison Melanie, our new nurse practitioner. communicate betterand with their medical providers. Aus, patient must understand their mass. BOTH men women need levels of however, Unbeknownst toadequate most of men too their go through a period or phase their lives not unlike same age counterparts (men). is the dose. Pellet form of BHRT utilizes 1/20th the testosterone for optimaland mental physical health in care. Testosterone is the hormone that helps women manage underlying condition fully and discuss options to their Wish us well and as always, Be Well GodofBless. sameand dose hormone that other forms would require similar to aorwoman in menopause known as andropause. Andropause, sometimes addition to protect thehave prevent chronic illness, such aswho My life’s experiences taught me that the people aretheir the emotions, most against an ensuring the little things, like a happy to achieve optimal levels over the same time frame of Yours Health,tears. Heart Attack, Stroke, Cancer, Colon Cancer, Breast chick-flick doesn’t Low male referred to asorColon “man-o-pause” experienced by innearly every act, thought, theory medical treatment and or “bad“midlife mouth it” ending arecrisis,” always theisones that evoke uncontrollable pellet therapy (3-6 months). Cancer, Prostate Cancer Alzheimer’s, Parkinson’s Disease Mark James testosterone impacts a woman’s weight, focus,Bartiss, energy,MD drive know the leastpoint about it.in This is less than arrogance, islevels counterproductive atOsteoporosis, some their lifetime aswith hormone decline, although the onset is much and which have allnothing been associated low and For more information contact us (motivation) and libido just like it does in men. - Proof and misleading. To schedule an appointment, call ICAM at 609-978-9002. testosterone levels. at 609-978-9002 that even in year 2015 women are notas treated equals. sympmore gradual than in women and therefore not as readily noted are asthose

Theater &Entertainment

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Education

Business &Finance

toms affecting women in menopause. Mark James Bartiss, MD is a medical writer, lecturer, and author, REMEMBER…. When and isMD recognized as awriter, top ten specialist in the and fieldis of Bio-Identical it comes to your health, Mark James Bartiss, is a medical lecturer, and author, recognized as a top ten specialist in the field of Bio-Identical Hormone Replacement (BHRT). He has helped numerous take their lives backyou anddoreclaim their health. have options HormoneTherapy Replacement Therapy (BHRT). He hasindividuals helped numerous

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www.TheCountyWoman.com TheCounty CountyWoman Woman Magazine November/December 2014January/Feb The March/April 2015 www.TheCountyWoman.com The Magazine County Woman Magazine www.TheCountyWoman.com

Law

Thinking of Bankruptcy? It’s critical that your case be handled correctly. Part II F

or the last decade, Daniel Straffi has been passionate about helping people find financial peace. His law firm, Straffi and Straffi is a debt relief agency that helps people file for relief under the bankruptcy code. In the last issue, Daniel Straffi gave readers some insight on bankruptcy and what bankruptcy can do for you. It is important to know that bankruptcy rules can be very technical and it is critical that your case is handled correctly.

Is a chapter 7 bankruptcy right for me? There are many factors that apply to whether a Chapter 7 is appropriate for an individual. The most important considerations pertain to whether the assets a person wishes to keep (like a home, vehicle, personal injury claim, etc..) would be protected under a Chapter 7 liquidation analysis. There is also an income test that a person must meet in order to qualify. It is imperative that a person speaks with a bankruptcy attorney in order to evaluate these considerations before filing.

Is a Chapter 13 bankruptcy right for me? A Chapter 13 is the means by which we are able to stop a foreclosure, wage garnishment, bank levy or repossession in its tracks. It allows a debtor the opportunity to reorganize their debts and pay back arrearages on their important assets interest free over a

three to five year period. A Chapter 13 is also a means for folks who may earn more than Chapter 7 eligibility would allow them to repay a portion of their unsecured debt over time. There are other forms of relief a Chapter 13 can accomplish that would be reviewed, such as income tax debt and discharging second mortgages or home equity lines of credit, which would be reviewed with you by an experienced bankruptcy attorney.

What does it cost to file bankruptcy? A Chapter 13 is more involved and, therefore, more expensive than a Chapter 7 bankruptcy. Depending on the level of representation a person seeks fees may vary between attorneys. However, most any professional will offer payment plans with respect to said fees and costs.

In New Jersey, what property can I keep? This answer depends on a complete and thorough analysis of a person’s assets and liabilities. The bankruptcy laws afford debtors certain exemptions – or protections – against their property in order to keep it. Sometimes the value of property can be in excess of these exemptions, which is the reason why a liquidation analysis is so imperative to whether a person qualifies for a Chapter 7 or Chapter 13 bankruptcy. A person should only be filing a Chapter 7 bankruptcy if there is complete certainty that those assets – most importantly a home – are protected. At Straffi & Straffi, our ultimate goal is to help you find financial peace. Bankruptcy is a setback, sure. But your situation, no matter how bad, is never hopeless.

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March/April 2015

&Wellness

Change Your Mind, Change Your Life, ealth With the Power of Hypnosis

~ Interview with Rhoda Kopy ~

22Hypnosis for

Oily or dry scalp

Professional Hypnosis Hypnosis for & Coaching Law Women

Women

You’re Designed For Change –

Rhoda Kopy is a woman who has always been fascinated with the workings of the mind, the mind-

body connection, and factors that influence behavior. Before becoming a hypnosis counselor, she studied nursing and earned a degree in biomedical communications. Her positions have always involved helping

Giving Up Shouldn’t Be An Option

people make smarter choices and providing strategies to help them reach their goals.

It was approximately 11 years ago when Rhoda attended a women’s conference that would have a last-

ALP IS TALKINGATO E YOU L

igs

ing impact on the trajectory of her career. After an enlightening conversation with a business owner who

Rhoda Kopy,

Professional Hypnosis Owner & Coaching Rt. 37 East, Suite E Oily 1541 or dry scalp

had quit smoking with the help of hypnosis she was intrigued – and very curious. This innocuous conver-

The people I’ve worked with who were successful in re you someone who has given up making changes had a few things in common: She adds, “At the trying time, I wasto dealing with anpositive unhealthy pattern of nighttime eating and figured that if make changes hypnosis could help someone quit smoking, it might be able to help me release that nasty eating habit. Toms River, NJ 08753 Rhoda Kopy, Director your Or,sessions.” do you • They gave themselves permission to believe I was amazed at the in changes afterlife? just a few She know began investigating lder awhypnosis for personal 1541 37 East, Suite E Phone:Rt. 732-270-0080 growth and eventually sought training at a state-licensed school. Most of Rhoda’s clients now are folks they could change. someone who has pretty much thrown in Toms River, NJ 08753 www.hypnoforwomen.com dealing with ordinary life issues who have courageously decided to address what it is that’s been holding • They agreed to focus on future successes Seasonal or 732-270-0080 the proverbial Do these sorts of stress management, and them back. Some of these issuestowel? include weight control, smoking cessation, medical hairloss instead of past failures. www.HypnoForWomen.com sleep problems. She has also noticed an increase in clients coming for pain management when traditional statements sound familiar? & air eplacement • cli-They were willing to give up a “poor me” methods aren’t working well. Her certification in complementary medical hypnotism enables her to help Itchiness

sation would ultimately become a springboard for her new career.

Theater &Entertainment • I’ve been heavy most of my life, and nothing 47

victim mentality. They were willing to release excuses. Dry, brittle or phone to make certain this is a good fit. Hypnosis counseling taps into the power of the subconscious works, so I’ve stopped trying. Psoriasis • They were open to using new tools and dull hair mind and helps people establish smarter patterns,” she says. Because many of her clients’ problems lie or eczema • I’ve smoked for years and the damage is done. within the subconscious mind, it is most effectively dealt with at that level, which is what she does using techniques. I’ve tried quitting and can’t do it. • They committed to devote time and energy hypnosis. • hypnotic I’m anstate uptight person, and that’s who I am. Entering a light is something we’ve each done just spontaneously thousands of times – for to changing. example, or get immersed in a book. Hypnosis practitioners are trained to coach cliI’ve never been comfortable in social situations, Seasonal or when• we daydream, ents into that state, and then use a variety of techniques and suggestions to assist them in makingAs desired human beings, we develop various thought and behavior medical hairloss so I avoid them. changes. patterns; and as we reinforce and repeat these patterns, they Dry or oily • It would be great to be able to fly, but I get too become For Rhoda, it is her clientele who continue to motivate and inspire her. “They are courageous people more deeply embedded within our mind. Sometimes it Androgenetic dandruff hyper; weOily just do driving vacations. hair who are ready for loss change. To know thator I’vedry hadscalp a hand in helping people feel more feels as though we’re operating on automatic pilot. Think about • amazing! I haven’t slepttoowell for years; nothing empowered feels It’s never late to change – and hypnosishas can help.” the person who grabs a cigarette when she gets nervous; or the Dry, brittle or Itchiness Psoriasis helped, so I’ve stopped trying. person who gets heart palpitations at the thought of flying or dull hair or eczema • Yes, I have things I’d like to accomplish, but I’m a being in an elevator; or the person who stuffs down candy bars when she’s upset. procrastinator; always have been. ents better manage the stress and symptoms of health conditions, with physician approval.

Oily or dry scalp

“This approach is not appropriate for everyone, so I screen people as carefully as possible over the •

ALP TALKING TO YOU NG TOIS YOU.

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ONS

Itchiness

to theby taking ay y hair if NG YOU. nalysis offer. ly the TO Local business women TO YOU. YOUR SCALP TALKING When Eow.ducation ADV ANCEDISCARE FORbuying YOUR Constantly into theseSCALP self-limiting beliefs is the

Patterns can be changed. There is even a field of medicine called neuroscience that explains, from a physiologic perspective, how these patterns can be altered. Neuroplasticity is a term that relates to the brain’s ability to restructure itself through training and practice. It’s what makes personal growth possible. It means that you absolutely have the ability to release negative habits and thought processes, and establish better ones. You have been gifted with your life – with all its joys and challenges. It’s your responsibility to live it in the best way possible – and not to waste it – because it doesn’t go on forever.

featured on the cover be in the Make Your Mind Work FOR You – problem. Ashealthy long ashair you’re alive,a healthy you arescalp! capable of changing. In You can’t have without are all in the service Instead of Against You! er than my practice, I’ve worked with people who have chosen to shed Dry or oily While conventional industry. The ladies hair products cater to the calp of speech Rhoda Kopy medfreedom at Androgenetic their fears, their what-ifs, and their negative dandruff hair shaft, Capilia are the having fun Scalp Health range, basedpatterns, and have WE HAVE REAL SOLUTIONS ou will be to is a nationally certified Rhoda Kopy ONS hair loss of Trichology, hology is astonished forward into happier, healthier, more vibrant lives. onmoved the science is itself specifically holding signs during aryand health. consulting hypnotist and wellness gy designed to address the common problems of the photo Hear whatinyour scalp has toshoot sayby byItchiness taking coach, with specialty certification honly.of your the scalp. Ask us about our hair care products! air isn’t cycle complementary medical hypnotism. Tracy Harman to alpthe analysis offer. advantage of our free scalp Photography. yfrom hairwhere if She earned a B.S. degree in Biomedical soluCommunications fromare Richard ly s,thethe our Appointments required. Please call for your FREE consultation! 333.3333 capilia.com hology, rather Stockton College of N.J., has an thru March 31st 2012 – give your scalp freedom of speech ow. When Now art www.TheCountyWoman.com The County Woman Magazine September/October 2014 ADV ANCED CARE FOR YOUR SCALP at the health academic background in nursing, and with a complimentary scalp analysis. You will be astonished to be in the alysis of You can’t have healthy hair without a healthy scalp! at the cross- 20+ years’ experience in community discover that your scalp is key to capillary health. We are a Member of: er than specifiThis offer ends on June 1 , 2014. Limit of (1) coupon per client. Valid at Capilia London only. bring back health While conventional hair products cater to the education and coaching. Rhoda alp freedom of speech med at ur scalp, hair shaft, the Capilia Scalp Health range, based adheres to strict of the HAVE REAL SOLUTIONS ou will be astonished to ethical standardsWE 732-255-1733 hology oncity thetown science of Trichology, is itself specifically depth is National Guild of Hypnotists. 123, street avenue boul., 333.333.3333 capilia.com www.HypnoForWomen.com aryare health. Heads First Capilia Center sts trained and designed to address the common problems of dgy scalp are Hear what your scalp has to say by taking .only. After an the scalp. Ask us about our hair care products! 2494 Moore Rd.Ste #1 air cycle easant for free scalp analysis offer. advantage of our m specifically Toms River, NJ 08753 ess, danning home (In the Stone Hedge Professional Building) tain ments of the capilia.com s, ourcases, Appointments are required. Please call for your FREE consultation! 333.3333 be unpleasNow thru March 31st 2012 – give your scalp freedom of speech art with a complimentary scalp analysis. You will be astonished to , dandruff, $25 Gift Certificate to Abstrax Hair Designs alysis of Enter to Win a ay discover that your scalp is key to capillaryWe health. “DURING MY hinning and are now seeking We are a Member of: specifiThis offer ends on June 1 , 2014. Limit of (1) coupon per client. Valid at Capilia London only. manVisit to Enter or Clip and Return the Coupon Below! CHEMO new hairwww.thecountywoman.com stylists: ur scalp, ng. You can o begin TREATMENTS, 732-255-1733 full or part time. depth t is crucial 123, street avenue boul., city town 333.333.3333 capilia.com Name: __________________________________________________________________________ fests. Heads First Capilia Center CAPILIA ests. Askare a To apply, please call scalp provide Address: ________________________________________________________________________ 2494 Moore Rd.Ste #1 alp with the OFFERED easant Abstrax at 732-255-1733 visit ourfor Toms River, NJ 08753 ME MUCH City: ___________________________________ State: _________ Zip: _______________ ess, / ordanfor more info. (In the Stone Hedge Professional Building) MORE THAN tain cases,

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Filing A Worker’s Compensation Claim: aw 23 What the Security benefits? Will You Qualify Forare Social Disability? 5 Questions to Ask Yourself Now Ok, let’s face it. When you hear I about someone collecting Workers’

for any of the bills associated with your injury. Not one and I am only paid if I cent. No co-pays, no deductibles. Why should you pay get you RESULTS. anything if you don’t have to? Take care and work safely! 4. Canisyou the work you • The wagedoreplacement, alsodid in the past? Even if f you or a loved is considering whether to file an second benefit If you have more quesyour medical condition is debilitating, disability payments. This meansbut not on the SSA’s application for disability benefits, let meknown help as temporary tions determine and would like to list of severe medical conditions, thedue SSAtowill then that if your authorized doctor says you can’t work you understand the criteria the Social Security schedule anIfappointment if you ablemonetary to work inweekly a job that you held in the past. it your injury, you will are receive benefits Compensation benefits, the to first thing Administration (SSA) uses review your file. with Kathleen M. Dotoli, would be difficult to do any of your past jobs because of your from your employer’s workers’ compensation insurcall 732-228-7534. that crosses your mind is “Give me medical condition, you wage may qualify for benefits. ance carrier commensurate with your and rate. The SSA uses a five step process to make their decision. 5. Can you as dolong anyasother type of job? The SSA Dotoli will is a licensed Kathleen a break, I go to work with aches and Those payments will continue you are receivlook at your background, education, medical conditions and attorney for over 20 years ing authorized care, awaiting surgery or recovering. 1. Are pains all theyou time! People should be aptitude to determine if there’s another type of job you could helping residents of Ocean Written by: Protecting your right to wage replacement is just another presently Written by: working, notworking? complaining!” do that would allow you to work full time without interference and Monmouth CounKathleen M. Dotoli, reason to file a claim. Kathleen M. Dotoli, Esq Esq. If you are not working, ties.other Her types practice from your disability. It’s a for good idea to consider of focuses on • The third benefit compensates you the long your application Well, I want to dispel some of the Workers’ benefits. Compensation and Kathleen Dotoli is a licensed before filing an application for disability term effects of employment your injury, also known as permanency will be reviewed Social Security Disability attorney Claims. She the present Co-Chair myths bythat are associated with forisover 20 years helping benefits. Let’s say you experienced a lifting injury that a Disability of the Workers’ Compensation Committee for the Ocean County The decision to leave your job due to illness or residents of Ocean and Monmouth resulted in a herniated disc in your back. Hopefully you Workers’ Compensation Determination Services claims. Bar Association and a Member of the Workers’ Compensation injurygetshould be and taken sure Counties. Her practice focuses office. If you are make a full recovery, back tonot work, havelightly. little Making Executive Committee for the NJ State Bar Association as well People who file Workers’ Compensation claims are and you are in the best possible position to qualify for working, then almost by definition, you are demonstrating that or no residuals from that injury. Unfortunately, there as a member of the VincentonJ. Workers’ Apruzzese Compensation Mock Trial JUST LIKE YOU. They are hardworking, honest, dediSocial Security Disability Claims. you CAN work and probably won’t qualify for benefits. This people Social Security Disability benefits is anCommittee important are many who go on to have physical limitafor the NJ State Bar Foundation. cated employees who true unfortunately experienced injuShe is the present Co-Chair of is especially if you are making moreanthan abouttions $1070 despite the best care. That doesn’t mean you can’t part of that decision. If you need guidance with your ry at theirper job. I’m not talkingthis about strains.spot. work month. I realize putssprains you inand a terrible You are the Workers’ Compensation or enjoy life! It just means thathesitate you havetotocontact be application, don’t me for Instead, think broken bones, herniated discs, torn medical rotator condition, struggling with a serious and debilitating Committee for the Ocean County more careful. How you are paid depends on your a freemuch consultation. at the same you need money to live careinjury, occupation, job function and personal cuffs, andbut traumatic braintime injuries. In other words, theand health Bar Association and a Member unique insurance and cannot job. Ifbythat is the case, it is of the Workers’ Compensation types of serious injuries proven quit and your supported medical lifestyle. Receiving compensation for your permanent important to speak to me to determine how to balance your Executive Committee for the NJ injury is something you are unlikely to get without filing evidence that have long term limitations. day-to-day financial needs with your disability application. State Bar Association as well as a a claim. 2. a Is claim your medical so severe that it But is filing reallycondition necessary? member of the Vincent J. Apruzzese I hope you see now why Workers’ Compensation ben225 Washington St. The Cottage interferes with basic work related activities? For instance, Mock Trial Committee for the NJ By law in New Jersey, injured workers are entitled to efits are so important! Without them, thousands of NJ are you a secretary who can no longer use her hands due Toms River, 08753 State BarNJ Foundation. three really important benefits - benefits they need in to carpal tunnel syndrome? That might prevent youworkers from each year would find themselves lacking medical order to get better, pay their bills, and provide compentreatment, being able to type, file, or use the phone for long periods of income and compensation for their injuries. Phone: (732) 228-7534 sation for their permanent injury. If you’re ever hurt at There’s time. Are you a long haul truck driver who cannot sit for no two ways about it. Workers’ Compensation work, you’ll need to know about these three benefits. Have you or a loved one been long periods of time due to a severe back injury? If benefits that’s thehelp thousands of New Jersey workers each year • The case, first and most important benefit is payment 225 Washington St. The Cottage and are if you need them. your condition will dictate how long you can drive andthere for YOU injured at work and don’t know in full forwhether medicalyou treatment. Thattomeans emergency Have you or a loved one been injured at work and will be able meet delivery deadlines. That’s where to turn to ensure ALL of Toms NJ 08753 room bills, MRIs and X-rays, diagnostic testing, surgery, don’t know where to turn to ensure ALLRiver, of your rights what is meant by “interference with your basic work related your rights are protected? Don’t physical therapy and even psychological testing to help are protected? Don’t navigate this maze alone! Call me activities”. navigate this maze alone! Call deal with catastrophic injuries. You are not responsible to discuss your injury. The consultation is FREE 3. Is one or more of your medical issues on today the SSA me today to discuss your injury. list of disabling conditions? Some diagnoses are so severe The consultation is FREE and that the SSA will automatically deem them to be totally I am only paid if I get you Children’s Boutique disabling. Others may be severe but require documentation, RESULTS.

Phone: (732) 228-7534

doctor’s reports, evaluations to assess your condition and perhaps your testimony. If you’re not sure if your condition is Stop by to see all that they offer! Take care and work safely! on the SSA list, consult with me to help you navigate throughSea La Vie Children’s Boutique just made its debut in Ventnor City. It is not your average this most important step. children’s boutique. They offer a mix of hand-made and store brands, embroidery services, fun sewing classes and more! Sea La Vie carries both boys and girls clothing from sizes Newborn to Girl’s size 16 and Boys size XL. The owner, Christina Rubenstein, has been in business for five years making children’s clothing out of her home, selling at craft shows Theonline Leukemia & the Lymphoma (LLS) the world’s agency and under business,Society Too Too Cuteis Tutus. She largest will bevoluntary creatinghealth clothing anddedicated to embroidering in the andCure will leukemia, feature other local crafters. La Vie to and be improve blood cancer. The LLSstore mission: lymphoma, Hodgkin’sSea disease and strives myeloma, unique andofaffordable and and newtheir merchandise comes in lifesaving frequently! the quality life of patients families. LLS funds blood cancer research around the world and provides free information and support services. Visit Us On Facebook 6616 Ventnor Ave • Ventnor, NJ, 08406 • 609-226-3010 • SeaLaVieBoutiqueNJ@gmail.com

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March/April 2015

Medical Professionals

8 Medical Professionals What is PolyCystic Ovary Syndrome (PCOS)?

Erratic Periods. Sometimes Even Absent. --

Irregular Periods? It Might Be Polycystic Ovary Syndrome (PCOS)

Treatment Goal The single most prevalent human hormonal disorder, The treatment goal for Polycystic Ovary Syndrome (PCOS), is present in up to 10% a woman with PCOS is to of reproductive age women. Itâ&#x20AC;&#x2122;s most common symptom, alleviate all her particular and also its most easily definable characteristic, is a fairly symptoms (such as unpredictable menstrual period. Skipping 2 to 3 months can haphazard uterine bleeding, unwanted hair growth, feel PCOS. Such women are much 00the norm for a women with Medical Professionals or infertility) and to limit more likely to have difficulties conceiving a pregnancy. herbecome risk for developing Presented by: South Jersey Fertility Center getting too thick. This can make periods lin and even more Failure To Launch cancer of the uterus.with The lighter and reduce the risk for cancerous resistant to it. Women Presented by: South Jersey Fertility Center By: The number one cause of female infertility is when the ovary fails to ovulate (release most common treatment Dr. Van Deerlin localtofertility specialist. Two ofhormonal these tests spontaneously abort.those The common reason for similarly aged woman with(FSH). good eggThese reserve.shots changes the lining. Another PCOS, particularly stimulating hormone a mature egg) consistently. This erratic or non-existent ovulation is theOne reason for assays erratic formiscarriages irregular periods (and require a tube of blood. of these these is a chromosomal imbalance But it doesnâ&#x20AC;&#x2122;t mean she has to give up hope. Endometriosis isI a female medical condition often optionhas isbeen to give progesterone alone forswell a who are overweight, are atfurther an increased risk Itdirectly stimulate the ovaries, but must or absent periods. and Ovaries that stutter during the egg â&#x20AC;&#x153;My husband didnâ&#x20AC;&#x2122;t meet untiland I misfire utilized for ripening 20 years. process It looks at thatprevention is not compatible withcancer) fetal still pill. only â&#x20AC;&#x153;The takes one egg. For of uterine is the birth control pillâ&#x20AC;?good provides boththose estrogen 10-12 days each month, though this of diabetes and benefit most from losing be used with care because patients nd rd bit with dozens the usual ofFSH small cysts (mostonsmaller wasassociated 38 years old. more Now I am and we number are and andfollicular Estradiol, obtained the 2 ,than 3 development. want tothe settle for aoflow and progesterone to regulate the menstrual women periodswho anddonâ&#x20AC;&#x2122;t to protect lining thewith uterus withthan painful periods pelvic discomfort. (PCOS) is40 the th option unintended oftoodiet and exercising moreforchance PCOS can have anaisexcessive response to to start my body doesnâ&#x20AC;&#x2122;t by ordoesnâ&#x20AC;&#x2122;t 4 dayexam ofprevent the. menstrual cycle. Apreghigh are weight. It Change is getting also important to understand success, there the option ofofusing aready tic tac mint)a family, that arebut easily observable ultrasound Androgenic hormones from thick. This effectthe allows lighterofperiods and reduced risk cancerous It consists of the endometrial tissue from inside mostproduced common hormonal seem to be in cooperating.â&#x20AC;? This isusual a common FSH means the body is struggling bit of your malelining. partner. He can have eggs donated by a woman with prevent atoo normal more thanuterine their amount during this ovarian turmoil. Some,just butanot nancies. arefertility the usual recommendations forhormonal such a option these medicines and make many eggs, changes to the Another that doesnâ&#x20AC;&#x2122;t necessarily pregnancy refrain hear in PCOS the fertility world. Most to polycystic find nice egg to ripen thatmore month. a semen analysis to identify ifand his lessen egg reserve. Naturally, easier to become all, women with notice bodies reacting thisuterus. androgen excess. Examples is a to prescription of progesterone (or another â&#x20AC;&#x153;progestinâ&#x20AC;?) 10-12 days each the wombgrowing intheir areas outside oftoathe The ovary makes tes-Theof woman lessendone herform symptoms increasing the riskforitâ&#x20AC;&#x2122;s ofjust multiple pregnandisorder inweare women, affecting women already the sobering fact numbers. other blood test is fairly new, but yields more â&#x20AC;&#x153;swimmersâ&#x20AC;? are plentiful and moving well. pregnant if a woman does not wait until her these reactions areaware facialofhairs in substantial The symptoms of PCOS usually month. tosterone than usual. High testosterone herThere risks. Medications can be tried to pos- late cies30â&#x20AC;&#x2122;sincluding the possibility of triplets or 5-10% the femaleasbut population. that fertility declines their advances results detecting mildly low egg is a gradual decline in sperm numbers or beyond. But in todayâ&#x20AC;&#x2122;s society of start inDuring a pelvic exam endometriosis may be suspected by paladolescence, canagestart in the 20â&#x20AC;&#x2122;s orconsistent 30â&#x20AC;&#x2122;s.lead There is a in large variety ofand body Shaving Is Okay, But Beware Stubble. levels can to excess facial hair sibly help control insulin and help with higher-order pregnancies. Therefore, past the 35 year mark.inBut all ranks. heard This syndrome reserve. It imparts is called Anti-Mullerian Hormone as men age, but it is not as steep thatâ&#x20AC;&#x2122;s not always a choice. Egg reserve testingthese pating tender nodules behind the uterus or by visualizing a persistent weights represented theweâ&#x20AC;&#x2122;ve PCOS a tendency to gain weight and quality Excess hair growth, as well as acne, are sometimes caused by PCOS and these symptoms Again, thesmall birthamount control is isansecreted weight loss. medication is metmedicines besituations. monitored carefully by It is characterized by irregular menstrual of examples someone having a baby at ageacne. (AMH). of pill AMH a decline as One seen insuch women. Men donâ&#x20AC;&#x2122;t have can often helpmust in these ovarian cyst on ultrasound that has certain echogenic characteristics (an easily unlessofthe individual is rather strict in either theirAexercise regimen or their calorie can be quite distressing. Again the easiest treatment is the birth control pill (though it takes 44 orinfertility a similar age. There is large individual by all of her remaining egg follicles. as So it a low formin an absolute reproductive cut-off analogous effective treatment for this symptom (Glucophage), which can result in a trained Fertility Specialist (Reproductive â&#x20AC;&#x153;endometriomaâ&#x20AC;?). Many times endometriosis can be found even in the periods and due to a lack of ovurestriction. PCOS sometimes turns milder with weight loss and exercise and limiting sugar months to see anSome improvement). estrogen it contains counteracts to some extent variability when it comes to reproductive lowersAMH number correlates with a low more to aseveral womanâ&#x20AC;&#x2122;s menopause. men have The Endocrinologist). absence of symptoms or signs. The diagnosis can only be confirmed or testosterone levels. Itdirectly takes several regular menstrual cycles, ovulation, Some patients will ation (release intake.of an egg), and by signs of the androgen influences on when the hair follicles by slowing the formation of new thick hair aging. The age-related decline depends on the number of remaining eggs. The third test is fathered children in to their 70â&#x20AC;&#x2122;s they excluded by undergoing a laparoscopy. Endometriosis is staged based months see improvement. Otherdifficulties mediand pregnancy. frominintheVitro (IVF), The chance overproduced of being born with an ovary that istoprone to having ovulatory excess male hormones byuterus. the follicles acne-promoting sebumbenefit production skinâ&#x20AC;&#x2122;sFertilization oil glands. Additional womanâ&#x20AC;&#x2122;s eggs, not the aging of her It a careful internal pelvic ultrasound to count have a youngand wifedecrease (think movie stars like Tony on the depth of the lesions and the extent of the involvement in the seems to be related to genetics. Female relatives of a woman with PCOS have a 50% chance cines that block testosterone production Infertility problems occur with PCOS where eggs are removed from the ovaries ovaries. pelvis. Stages 1 and 2 are termed â&#x20AC;&#x153;minimalâ&#x20AC;? and â&#x20AC;&#x153;mildâ&#x20AC;? endometriosis, Unwanted hair is tosometimes medicines thatcontinues block testosterone can be usefulfacial to a woman get an assessment the number of visible follicles (egg sacs) in the Randall). A man to make newproduction such as spironolactone (Aldactone) rarely of having PCOS themselves. such as spironolactone can be because ofany theday lack of ovulation. The stimulation fertility shots and haveevery side whenlives, combined with theafter birth control pill.with A prescription facial of her â&#x20AC;&#x153;egg reserveâ&#x20AC;? when she might be ovaries. The number(Aldactone) of such medium-sized sperm ofeffects their adult so most a sign ofwhile stages 3 and 4 are â&#x20AC;&#x153;moderateâ&#x20AC;? and â&#x20AC;&#x153;severeâ&#x20AC;? disease. The presence excess male hormones. The sympcausing them to adhere to other pelvic structures, and thereby distort cream called Vaniqa is also available to help slow facial hair growth. However, the hormone making decisions about when to reproduce. follicles correlates directly with the number of their reproductive cells are at most prescribed. A prescription facial cream, common treatment for inducing ovulation then introduced to sperm in a laboratoms usually start in adolescence, but canImplies, Promotes Gestation Progesterone, As The Name of an endometrioma in an ovary usually translates to at least stage 3. understand ovarian reserveknown assessment wecalled (microscopic) follicles held in reserve that is only a few old.methods One do not causecitthe existing hairs embryos. to fall out.One Bleaching or Vaniqa, is also available to the normal anatomy. Having a normal anatomical relationship of the help slow to manipulation give thedays fertility pillstudy clomiphene toryunwanted dish to create or more While PCOS is widely for its excesstiny of one type of hormone described above, appear in To the 20â&#x20AC;&#x2122;s or 30â&#x20AC;&#x2122;s. Many patients The prevalence of endometriosis has been calculated to be 3-10% must first review the workings of a womanâ&#x20AC;&#x2122;s have not yet begun the ripening process. reported a slightly higher ovary and fallopian tube are crucial for natural conception since the egg hair removal by tweezing or waxing are commonly used for temporary removal of that hair it is are also a direct cause for a dramatic absence another important hormone. That facialofhair growth. Electrolysis and laser rate (Clomid,). Eighty percent of patients embryos then can be placed into the uterwith PCOS in the general population of reproductive age women; however, it is ovaries. overweight, but not all of Just because a woman is over 40 years the fallopian tube where fertilization can take place. riskfrom of schizophrenia infollicles. must reach the existing hormone is progesterone. Its productionhair by the ovary commences only after the follicular will ovulate and half of those who ovulate can also us. Any remaining embryos can be frozen, found in 40% of infertile patients. Endometriosis often runs in families. them. The ovaries are isusually enlarged and A woman born with all of the eggs she removal of age doesnâ&#x20AC;&#x2122;t meanbe sheused needstototemporarupThere are a number of treatment options to boost fertility for all the offspring of new give Excess Insulin cyst ovulates its egg out. Progesterone stabilizes the endometrial lining of the uterus and Most experts agree that endometriosis impairs fertility. One mechanism hair,a once testosterone will ultimately within several if desired, to limit the risk if higher order will ever have. cannot be made ily remove hope ofthe having baby. the Many women have fathers over ageconceive 50. contain multiple smallNew cystsones seen on an these women with endometriosis. Probably the easiest treatment from Many women with PCOS are relatively insensitive to their own bodyâ&#x20AC;&#x2122;s insulin. The signals when the egg has been released so the womb can prepare for the incoming embryo. for infertility is the inflammatory response incited by the endometriosis later â&#x20AC;&#x201C; but eggs do need to ripen before they fears that their chances of having a baby with A woman who levels are suppressed. attempts. There is a modest increase in multiple pregnancies (triplets or more) and ultrasound exam. The small cysts are actuthe patientâ&#x20AC;&#x2122;s perspective is to have the endometriosis lesions surgically resulting high levels of insulin promote the storage of fat, making it hard to lose weight. However, there is ano embryo growing by 12 Downâ&#x20AC;&#x2122;s days after ovulation the progesterone lesions. White blood cells, the warriors in the bodyâ&#x20AC;&#x2122;s defense system, can ovulateifand have chance of getting Syndrome orPCOS other chromosomal hasrisk a diminished Many women with are relatively the of having twins (7%) with clofor use in future fertility attempts. eradicated during a laparoscopic procedure, which is done so that the ally follicles (2-8 mmsperm sized small fluid Women production off to and then thesacs suddenly unstable endometrium sheds inhigh. an orderly try to eradicate the abnormally located endometrial tissue and release fertilized by afalls then become an abnormalities is outrageously In fact, number of with PCOS, particularly those who are overweight, are at an increased risk of resistant to their own bodyâ&#x20AC;&#x2122;s insulin. Thetoo tall,miphene. Some do not respond doctor can make the definitive diagnosis. Laparoscopy is an outpatient diabetes andpatients benefit most from losing weight. Change in diet and physical exercise help fashion. Without the stabilizing influence endometrium that house the eggs) that not organs grown substances into the pelvic cavity which have been shown to be toxic to embryo. Other cellshave in other in the of progesterone, at age 40, the the chances of having a grows pregnancy remaining eggs In Summary . . . procedure commonly referred to as â&#x20AC;&#x153;band-aidâ&#x20AC;? surgery owing to the fact resulting high levels of insulin promote to clomiphene and may require other some women to lessen both their symptoms and their risks. Medications can be tried to shedding at erratic times andnew in varying factanwhen the growth arge enough tobody release egg. human are their replaced with ones as amounts. withIn such abnormality reachof theendometrium 4th has a lower sperm, eggs, and embryos. In addition, as the body tries to heal the inthat the necessary incisions are so small as to be sufficiently covered by There hope formedication women affected by possibly help control insulin and help loss.isOne such is metformin storage fat, making ituterine hard lose3%. therapies. option is metformin to with weight is it can leadthe to cancerous to the weunchecked age, but notbysoprogesterone for the egg cells in the month of ofchanges pregnancy is fairly lowto â&#x20AC;&#x201C;lining. only chance ofOne flamed areas it may inadvertently scar the fallopian tubes and/or ovaries standard band-aids. In cases of moder(Glucophage), which can also result in more regular menstrual cycles, ovulation, this common syndrome called PCOS to Causesovaries. of PCOS So a 40 year old has only 40 year- weight. One however, IS increased is the conceiving a A risk, vicious cyclethat is created because help the ovaries ovulate. Another option ate or severe endometriosis it has been and pregnancy (see below). old eggs. Not all eggs are perfectly normal. chance of miscarriage. On average 40% of pregnancy with SJFC Celebrating 25 Years of Creating Families in the South Jersey Area! regulate their periods or to conceive a baby. overweight women make even more insuis to use fertility shots that contain follicle The actual cause of PCOS is unknown. well-established that surgical removal of The eggs that ripen earlier in her life have pregnancies in women over the age of 39 will her own eggs than a Dozens Of Negative Urine Pregnancy Tests It appearsa that women are genetically both endometriosis lesions and adhesive South Jersey Fertility Center higher chance of being normal. And For those women actively wanting to conceive a child, the treatment prone to since this disorder. ofRegional scar tissue improves fertility by restoring a womanâ&#x20AC;&#x2122;s Female supply ofrelatives eggs isof limited it Division Womenâ&#x20AC;&#x2122;s Health Group, LLC most commonly chosen for inducing ovulation is a 5-day fertility pill regimen the correct anatomical relationship of the a patient eventually with PCOS chance runshave low. aAs50% the reserve of eggs utilizing estrogen modulators like Clomid, Tamoxifen or the newer Femara Full Service Infertility Center With: fallopian tubes and the ovary. The addilow, the percent oflifestyle eggs that are of havingbecomes SOUTH JERSEY FERTILITY CENTER (letrozole). Eighty percent of women not already ovulating on their own will Âˇ it Allthemselves. Of The DoctorsCertain Are Board Certified In Reproductive 'LYLVLRQ RI 5HJLRQDO :RPHQÂˇV +HDOWK *URXS //& tional use of medications such as Lupron, normal (perhaps is now offering a discount for IVF to Endocrinology And Infertility factors such as adrops highconsiderably calorie, high carbo-to 10% ovulate with these pills. Half of those who ovulate will conceive within several a GnRH-agonist, to suppress any residual or so).Doctor Menopause the time Âˇ Top Awards marks For 7 Years In A when Row no ACTIVE MILITARY AND VETERANS Â&#x2014;Â&#x17D;Â&#x17D; Â&#x2021;Â&#x201D;Â&#x2DC;Â&#x2039;Â&#x2026;Â&#x2021; Â?Â&#x2C6;Â&#x2021;Â&#x201D;Â&#x2013;Â&#x2039;Â&#x17D;Â&#x2039;Â&#x2013;Â&#x203A; Â&#x2021;Â?Â&#x2013;Â&#x2021;Â&#x201D; Â&#x2039;Â&#x2013;Â&#x160;ÇŁ â&#x20AC;&#x153;cyclesâ&#x20AC;?. This treatment yields a moderately increased twin rate of 7 percent. hydrate diet and inadequate exercise may Âˇ Laparoscopic Tubal Reversals Call 856.596.2233 ext. 1227 for more information. more usable eggs remain. The average age of endometriosis has been advocated by Č&#x2030; Â&#x17D;Â&#x17D; Â&#x2C6; Â&#x160;Â&#x2021; Â&#x2018;Â&#x2026;Â&#x2013;Â&#x2018;Â&#x201D;Â&#x2022; Â&#x201D;Â&#x2021; Â&#x2018;Â&#x192;Â&#x201D;Â&#x2020; Â&#x2021;Â&#x201D;Â&#x2013;Â&#x2039;Ď?Â&#x2039;Â&#x2021;Â&#x2020; Â? Â&#x2021;Â&#x2019;Â&#x201D;Â&#x2018;Â&#x2020;Â&#x2014;Â&#x2026;Â&#x2013;Â&#x2039;Â&#x2DC;Â&#x2021; Another pill, 6287+ -(56(< )(57,/,7< &(17(5 metformin (Glucophage), when used daily for months has a 17% Âˇ Money Back Guarantee Available For Ivf And Donor Egg worsen many of theissymptoms. PCOS menopause 50. some. Âˇ Full Service Fertility Center Â?Â&#x2020;Â&#x2018;Â&#x2026;Â&#x201D;Â&#x2039;Â?Â&#x2018;Â&#x17D;Â&#x2018;Â&#x2030;Â&#x203A; Â?Â&#x2020; Â?Â&#x2C6;Â&#x2021;Â&#x201D;Â&#x2013;Â&#x2039;Â&#x17D;Â&#x2039;Â&#x2013;Â&#x203A; incidence of ovulation but no increase in the twin rate. Some patients do not LV QRZ RIIHULQJ D GLVFRXQW IRU ,9) WR causes a woman not tohas ovulate reliably.300,000 By A woman approximately However, numerous studies have Âˇ Robotic Surgery Available Č&#x2030; Â&#x2018;Â&#x2019; Â&#x2018;Â&#x2026;Â&#x2013;Â&#x2018;Â&#x201D; Â&#x2122;Â&#x192;Â&#x201D;Â&#x2020;Â&#x2022; Â&#x2018;Â&#x201D; Íš Â&#x2021;Â&#x192;Â&#x201D;Â&#x2022; Â? Â&#x2018;Â&#x2122; 8 respond to fertility pills alone and may require the addition of daily injections immature eggs, eachher in abody tiny follicle $&7,9( 0,/,7$5< $1' 9(7(5$16 not ripening an egg fully, fails in her failed to show that these medications imČ&#x2030; Â&#x192;Â&#x2019;Â&#x192;Â&#x201D;Â&#x2018;Â&#x2022;Â&#x2026;Â&#x2018;Â&#x2019;Â&#x2039;Â&#x2026; Â&#x2014;Â&#x201E;Â&#x192;Â&#x17D; Â&#x2021;Â&#x2DC;Â&#x2021;Â&#x201D;Â&#x2022;Â&#x192;Â&#x17D;Â&#x2022; that contain follicle stimulating hormone (FSH) which directly stimulates the ovaries, at puberty. So what &DOO H[W IRU PRUH LQIRUPDWLRQ Robert A. Skaf, MDbecame FACOGof those to make an important female hormone, prove fertility rates beyond that of surgery Top Row (left to right): Č&#x2030; Â&#x2018;Â?Â&#x2021;Â&#x203A; Â&#x192;Â&#x2026;Â? Â&#x2014;Â&#x192;Â&#x201D;Â&#x192;Â?Â&#x2013;Â&#x2021;Â&#x2021; Â&#x2DC;Â&#x192;Â&#x2039;Â&#x17D;Â&#x192;Â&#x201E;Â&#x17D;Â&#x2021; Â&#x2018;Â&#x201D; Â&#x2DC;Â&#x2C6; Â?Â&#x2020; Â&#x2018;Â?Â&#x2018;Â&#x201D; Â&#x2030;Â&#x2030; ovaries. Close monitoring of the egg ripening process by blood test and pelvic egg follicles between pubertyMD and FACOG menopause? Peter G. Van Deerlin, Dr. Gary Packin, alone. This may be, in part, due to the progesterone. Progesterone protects the ultrasound are needed to allow optimal dosing and duration of treatment in Č&#x2030; Â&#x2014;Â&#x17D;Â&#x17D; Â&#x2021;Â&#x201D;Â&#x2DC;Â&#x2039;Â&#x2026;Â&#x2021; Â&#x2021;Â&#x201D;Â&#x2013;Â&#x2039;Â&#x17D;Â&#x2039;Â&#x2013;Â&#x203A; Â&#x2021;Â?Â&#x2013;Â&#x2021;Â&#x201D; Were they all released during theFACOG once-aDr. Stephen Sawin, Stephen W. Sawin, MD fact that patients must avoid becoming uterine lining from overgrowth and from order to limit the chance for side effects. The risk of triplets is a real possibility daVinci Robotic Surgery Available Č&#x2030; Â&#x2018;Â&#x201E;Â&#x2018;Â&#x2013;Â&#x2039;Â&#x2026; Â&#x2014;Â&#x201D;Â&#x2030;Â&#x2021;Â&#x201D;Â&#x203A; Â&#x2DC;Â&#x192;Â&#x2039;Â&#x17D;Â&#x192;Â&#x201E;Â&#x17D;Â&#x2021; Dr. Peter Van Deerlin, month ovulation process? No. Usually only Gary S. Packin, DO FACOOG, Dist. pregnant while on these medications for Dr. Oumar Kuzbari potentially changes. (5%) from this treatment. Some infertile PCOS women will benefit from in onecancerous eggOumar will reach the fully mature state Kuzbari, MD, FACOG fear of possibly inducing birth defects. Yet Bottom Row (left to right): Vitro Fertilization (IVF), where eggs are harvested from the ovaries matured necessary to ovulate during each menstrual A woman with PCOS is not necessarBarbara Alice, APN-C, MSN Â&#x2018;Â&#x201E;Â&#x2021;Â&#x201D;Â&#x2013; Ç¤ Â?Â&#x192;Â&#x2C6;ÇĄ Barbara Alice, APN-C, MSN, the optimal time to achieve pregnancy cycle. The average woman has 450 menstrual by these FSH shots and then introduced to sperm in a laboratory dish. The Tracy APN-C,MSN ly going to exhibit allKrause, of the aspects of the Dr. Robert Skaf, may be immediately following the surgery Â&#x2021;Â&#x2013;Â&#x2021;Â&#x201D; Ç¤ Â&#x192;Â? Â&#x2021;Â&#x2021;Â&#x201D;Â&#x17D;Â&#x2039;Â?ÇĄ

cycles during her lifetime. The other 299,550 resulting embryos can be returned (typically one at a time) to the uterus Tracy Krause, APN-C, MSN syndrome. Some may be lean and others (when the fallopian tubes have just been Â&#x2013;Â&#x2021;Â&#x2019;Â&#x160;Â&#x2021;Â? Ç¤ Â&#x192;Â&#x2122;Â&#x2039;Â?ÇĄ

or so eggs slowly degenerate over time at a rate (sometimes after having been stored frozen indefinitely in liquid nitrogen). may not of have any25unwanted hair growth. flushed and before any scar tissue has about per day. Fertility medications willour Website Visit us on www.sjfert.com

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Fertility after Age 35 Fertility? Could Pelvic Endometriosis Be Interfering with Your

Polycystic Ovary Syndrome

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the patientâ&#x20AC;&#x2122;s biggest concern.

used to fight cancer. Smoking cigarettes also woman with PCOS is directed toward alle appears to hasten the depletion of usable eggs. www.TheCountyWoman.com The County Woman and Magazine viating her particular symptoms limitfact, County menopause typically arrives one or two www.TheCountyWoman.com In The Woman Magazine ng her risk developing of the yearsfor earlier in womencancer who smoke.

January/February 2015

March/April 2015

Medical Professionals

Erratic Periods. Sometimes Even Absent. -8

What is PolyCystic Ovary Syndrome (PCOS)?

Irregular Periods? It Might Be Polycystic Ovary Syndrome (PCOS)

Treatment Goal The single most prevalent human hormonal disorder, The treatment goal for Polycystic Ovary Syndrome (PCOS), is present in up to 10% a woman with PCOS is to of reproductive age women. Itâ&#x20AC;&#x2122;s most common symptom, alleviate all her particular and also its most easily definable characteristic, is a fairly symptoms (such as unpredictable menstrual period. Skipping 2 to 3 months can haphazard uterine bleeding, unwanted hair growth, feel the norm for a women with PCOS. Such women are much 00 Medical Professionals or infertility) and to limit more likely to have difficulties conceiving a pregnancy. herbecome risk for developing Presented by: South Jersey Fertility Center getting too thick. This can make periods lin and even more Failure To Launch cancer of the uterus.with The lighter and reduce the risk for cancerous resistant to it. Women Presented by: South Jersey Fertility Center By: The number one cause of female infertility is when the ovary fails to ovulate (release most common treatment Dr. Van Deerlin localtofertility specialist. Two ofhormonal these tests spontaneously abort.those The common reason for similarly aged woman with(FSH). good eggThese reserve.shots changes the lining. Another PCOS, particularly stimulating hormone a mature egg) consistently. This erratic or non-existent ovulation is theOne reason for assays erratic formiscarriages irregular periods (and require a tube of blood. of these these is a chromosomal imbalance But it doesnâ&#x20AC;&#x2122;t mean she has to give up hope. Endometriosis isI a female medical condition often optionhas isbeen to give progesterone alone forswell a who are overweight, are atfurther an increased risk Itdirectly stimulate the ovaries, but must or absent periods. and Ovaries that stutter during the egg â&#x20AC;&#x153;My husband didnâ&#x20AC;&#x2122;t meet untiland I misfire utilized for ripening 20 years. process It looks at thatprevention is not compatible withcancer) fetal still pill. only â&#x20AC;&#x153;The takes one egg. For of uterine is the birth control pillâ&#x20AC;?good provides boththose estrogen 10-12 days each month, though this of diabetes and benefit most from losing be used with care because patients nd rd bit with dozens the usual ofFSH small cysts (mostonsmaller wasassociated 38 years old. more Now I am and we number are and andfollicular Estradiol, obtained the 2 ,than 3 development. want tothe settle for aoflow and progesterone to regulate the menstrual women periodswho anddonâ&#x20AC;&#x2122;t to protect lining thewith uterus withthan painful periods pelvic discomfort. (PCOS) is40 the th option unintended oftoodiet and exercising moreforchance PCOS can have anaisexcessive response to to start my body doesnâ&#x20AC;&#x2122;t by ordoesnâ&#x20AC;&#x2122;t 4 dayexam ofprevent the. menstrual cycle. Apreghigh are weight. It Change is getting also important to understand success, there the option ofofusing aready tic tac mint)a family, that arebut easily observable ultrasound Androgenic hormones from thick. This effectthe allows lighterofperiods and reduced risk cancerous It consists of the endometrial tissue from inside mostproduced common hormonal seem to be in cooperating.â&#x20AC;? This isusual a common FSH means the body is struggling bit of your malelining. partner. He can have eggs donated by a woman with prevent atoo normal more thanuterine their amount during this ovarian turmoil. Some,just butanot nancies. arefertility the usual recommendations forhormonal such a option these medicines and make many eggs, changes to the Another that doesnâ&#x20AC;&#x2122;t necessarily pregnancy refrain hear in PCOS the fertility world. Most to polycystic find nice egg to ripen thatmore month. a semen analysis to identify ifand his lessen egg reserve. Naturally, easier to become all, women with notice bodies reacting thisuterus. androgen excess. Examples is a to prescription of progesterone (or another â&#x20AC;&#x153;progestinâ&#x20AC;?) 10-12 days each the wombgrowing intheir areas outside oftoathe The ovary makes tes-Theof woman lessendone herform symptoms increasing the riskforitâ&#x20AC;&#x2122;s ofjust multiple pregnandisorder inweare women, affecting women already the sobering fact numbers. other blood test is fairly new, but yields more â&#x20AC;&#x153;swimmersâ&#x20AC;? are plentiful and moving well. pregnant if a woman does not wait until her these reactions areaware facialofhairs in substantial The symptoms of PCOS usually month. tosterone than usual. High testosterone herThere risks. Medications can be tried to pos- late cies30â&#x20AC;&#x2122;sincluding the possibility of triplets or 5-10% the femaleasbut population. that fertility declines their advances results detecting mildly low egg is a gradual decline in sperm numbers or beyond. But in todayâ&#x20AC;&#x2122;s society of start inDuring a pelvic exam endometriosis may be suspected by paladolescence, canagestart in the 20â&#x20AC;&#x2122;s orconsistent 30â&#x20AC;&#x2122;s.lead There is a in large variety ofand body Shaving Is Okay, But Beware Stubble. levels can to excess facial hair sibly help control insulin and help with higher-order pregnancies. Therefore, past the 35 year mark.inBut all ranks. heard This syndrome reserve. It imparts is called Anti-Mullerian Hormone as men age, but it is not as steep thatâ&#x20AC;&#x2122;s not always a choice. Egg reserve testingthese pating tender nodules behind the uterus or by visualizing a persistent weights represented theweâ&#x20AC;&#x2122;ve PCOS a tendency to gain weight and quality Excess hair growth, as well as acne, are sometimes caused by PCOS and these symptoms Again, thesmall birthamount control is isansecreted weight loss. medication is metmedicines besituations. monitored carefully by It is characterized by irregular menstrual of examples someone having a baby at ageacne. (AMH). of pill AMH a decline as One seen insuch women. Men donâ&#x20AC;&#x2122;t have can often helpmust in these ovarian cyst on ultrasound that has certain echogenic characteristics (an easily unlessofthe individual is rather strict in either theirAexercise regimen or their calorie can be quite distressing. Again the easiest treatment is the birth control pill (though it takes 44 orinfertility a similar age. There is large individual by all of her remaining egg follicles. as So it a low formin an absolute reproductive cut-off analogous effective treatment for this symptom (Glucophage), which can result in a trained Fertility Specialist (Reproductive â&#x20AC;&#x153;endometriomaâ&#x20AC;?). Many times endometriosis can be found even in the periods and due to a lack of ovurestriction. PCOS sometimes turns milder with weight loss and exercise and limiting sugar months to see anSome improvement). estrogen it contains counteracts to some extent variability when it comes to reproductive lowersAMH number correlates with a low more to aseveral womanâ&#x20AC;&#x2122;s menopause. men have The Endocrinologist). absence of symptoms or signs. The diagnosis can only be confirmed or testosterone levels. Itdirectly takes several regular menstrual cycles, ovulation, Some patients will ation (release intake.of an egg), and by signs of the androgen influences on the hair follicles by slowing the formation of new thick hair aging. The age-related decline depends on the number of remaining eggs. The third test is fathered children in to their 70â&#x20AC;&#x2122;s when they excluded by undergoing a laparoscopy. Endometriosis is staged based months see improvement. Otherdifficulties mediand pregnancy. benefit from in Vitro (IVF), The chance overproduced of being born with an ovary that istoprone to having ovulatory xcess male hormones by the follicles acne-promoting sebum production in the skinâ&#x20AC;&#x2122;sFertilization oil glands. Additional womanâ&#x20AC;&#x2122;s eggs, not the aging of her uterus. It a careful internal pelvic ultrasound to count have a youngand wifedecrease (think movie stars like Tony on the depth of the lesions and the extent of the involvement in the seems to be related to genetics. Female relatives of a woman with PCOS have a 50% chance cines that block testosterone production Infertility problems occur with PCOS where eggs are removed from the ovaries ovaries. pelvis. Stages 1 and 2 are termed â&#x20AC;&#x153;minimalâ&#x20AC;? and â&#x20AC;&#x153;mildâ&#x20AC;? endometriosis, Unwanted hair is tosometimes medicines thatcontinues block testosterone can be usefulfacial to a woman get an assessment the number of visible follicles (egg sacs) in the Randall). A man to make newproduction such as spironolactone (Aldactone) rarely of having PCOS themselves. such as spironolactone can be because ofany theday lack of ovulation. The stimulation fertility shots and haveevery side whenlives, combined with theafter birth control pill.with A prescription facial of her â&#x20AC;&#x153;egg reserveâ&#x20AC;? when she might be ovaries. The number(Aldactone) of such medium-sized sperm ofeffects their adult so most sign ofwhile stages 3 and 4 are â&#x20AC;&#x153;moderateâ&#x20AC;? and â&#x20AC;&#x153;severeâ&#x20AC;? disease. The presence excess male hormones. The sympcausing them to adhere to other pelvic structures, and thereby distort cream called Vaniqa is also available to help slow facial hair growth. However, the hormone making decisions about when to reproduce. follicles correlates directly with the number of their reproductive cells are at most prescribed. A prescription facial cream, common treatment for inducing ovulation then introduced to sperm in a laboraoms usually start in adolescence, but canImplies, Promotes Gestation Progesterone, As The Name of an endometrioma in an ovary usually translates to at least stage 3. understand ovarian reserveknown assessment wecalled (microscopic) follicles held in reserve that is only a few old.methods One do not causecitthe existing hairs embryos. to fall out.One Bleaching or Vaniqa, is also available to the normal anatomy. Having a normal anatomical relationship of the help slow to manipulation give thedays fertility pillstudy clomiphene toryunwanted dish to create or more While PCOS is widely for its excesstiny of one type of hormone described above, ppear in To the 20â&#x20AC;&#x2122;s or 30â&#x20AC;&#x2122;s. Many patients The prevalence of endometriosis has been calculated to be 3-10% must first review the workings of a womanâ&#x20AC;&#x2122;s have not yet begun the ripening process. reported a slightly higher ovary and fallopian tube are crucial for natural conception since the egg hair removal by tweezing or waxing are commonly used for temporary removal of that hair it is are also a direct cause for a dramatic absence another important hormone. That facialofhair growth. Electrolysis and laser rate (Clomid,). Eighty percent of patients embryos then can be placed into the uterwith PCOS in the general population of reproductive age women; however, it is ovaries. overweight, but not all of Just because a woman is over 40 years the fallopian tube where fertilization can take place. riskfrom of schizophrenia infollicles. must reach the existing hormone is progesterone. Its productionhair by the ovary commences only after the follicular will ovulate and half of those who ovulate can also us. Any remaining embryos can be frozen, found in 40% of infertile patients. Endometriosis often runs in families. hem. The ovaries are isusually enlarged and A woman born with all of the eggs she removal of age doesnâ&#x20AC;&#x2122;t meanbe sheused needstototemporarupThere are a number of treatment options to boost fertility for all the offspring of new give Excess Insulin cyst ovulates its egg out. Progesterone stabilizes the endometrial lining of the uterus and hair,a once testosterone will ultimately within several if desired, to limit the risk if higher order will ever have. cannot be made ily remove hope ofthe having baby. the Many women have fathers over ageconceive 50. ontain Most experts agree that endometriosis impairs fertility. One mechanism multiple smallNew cystsones seen on an these women with endometriosis. Probably the easiest treatment from Many women with PCOS are relatively insensitive to their own bodyâ&#x20AC;&#x2122;s insulin. The signals when the egg has been released so the womb can prepare for the incoming embryo. for infertility is the inflammatory response incited by the endometriosis later â&#x20AC;&#x201C; but eggs do need to ripen before they fears that their chances of having a baby with A woman who levels are suppressed. attempts. There is a modest increase in multiple pregnancies (triplets or more) and ultrasound exam. The small cysts are actuthe patientâ&#x20AC;&#x2122;s perspective is to have the endometriosis lesions surgically resulting high levels of insulin promote the storage of fat, making it hard to lose weight. However, there is ano embryo growing by 12 Downâ&#x20AC;&#x2122;s days after ovulation the progesterone lesions. White blood cells, the warriors in the bodyâ&#x20AC;&#x2122;s defense system, can ovulateifand have chance of getting Syndrome orPCOS other chromosomal hasrisk a diminished Many women with are relatively the of having twins (7%) with clofor use in future fertility attempts. eradicated during a laparoscopic procedure, which is done so that the lly follicles (2-8 mmsperm sized small fluid Women production off to and then thesacs suddenly unstable endometrium sheds inhigh. an orderly try to eradicate the abnormally located endometrial tissue and release fertilized by afalls then become an abnormalities is outrageously In fact, number of with PCOS, particularly those who are overweight, are at an increased risk of resistant to their own bodyâ&#x20AC;&#x2122;s insulin. The miphene. Some patients do not respond doctor can make the definitive diagnosis. Laparoscopy is an outpatient diabeteseggs and benefit most from losing weight. Change in diet and physical exercise help fashion. Without the stabilizing influence endometrium too tall, remaining hat house the eggs) that not organs grown substances into the pelvic cavity which have been shown to be toxic to embryo. Other cellshave in other in the of progesterone, at age 40, the the chances of having a grows pregnancy In Summary ... procedure commonly referred to as â&#x20AC;&#x153;band-aidâ&#x20AC;? surgery owing to the fact resulting high levels ofthe insulin promote tohas clomiphene andtomay require othersymptoms and some women lessen both their their risks. Medications can be tried to shedding at erratic times andnew in varying factan when growth of arge enough tobody release egg. human are their replaced with ones as amounts. withIn such abnormality reach theendometrium 4th a lower sperm, eggs, and embryos. In addition, as the body tries to heal the inthat the necessary incisions are so small as to be sufficiently covered by There hope formedication women affected by possibly help control insulin and help loss.isOne such is metformin storage fat, making ituterine hard lose3%. therapies. option is metformin to with weight is it can leadthe to cancerous to the weunchecked age, but notbysoprogesterone for the egg cells in the month of ofchanges pregnancy is fairly lowto â&#x20AC;&#x201C;lining. only chance ofOne flamed areas it may inadvertently scar the fallopian tubes and/or ovaries standard band-aids. In cases of moderwhichoption can also result more regular menstrual cycles, ovulation, thisincommon syndrome called PCOS to Causesovaries. of PCOS So a 40 year old has only 40 year- weight. One however, IS increased is the conceiving a (Glucophage), A risk, vicious cyclethat is created because help the ovaries ovulate. Another ate or severe endometriosis it has been and pregnancy (see below). old eggs. Not all eggs are perfectly normal. chance of miscarriage. On average 40% of pregnancy with SJFC Celebrating 25 Years of Creating Families in the South Jersey Area! regulate their periods or to conceive a baby. overweight women make even more insuis to use fertility shots that contain follicle The actual cause of PCOS is unknown. well-established that surgical removal of The eggs that ripen earlier in her life have pregnancies in women over the age of 39 will her own eggs than a Dozens Of Negative Urine Pregnancy Tests t appearsa that women are genetically both endometriosis lesions and adhesive South Jersey Fertility Center higher chance of being normal. And For those women actively wanting to conceive a child, the treatment prone to since this disorder. relatives of scar tissue improves fertility by restoring a womanâ&#x20AC;&#x2122;s Female supply of eggs is limited it Division of Regional Womenâ&#x20AC;&#x2122;s Health Group, LLC most commonly chosen for inducing ovulation is a 5-day fertility pill regimen the correct anatomical relationship of the patient eventually with PCOS chance runshave low. aAs50% the reserve of eggs utilizing estrogen modulators like Clomid, Tamoxifen or the newer Femara Full Service Infertility Center With: fallopian tubes and the ovary. The addilow, the percent of eggs that are of havingbecomes it themselves. Certain lifestyle SOUTH JERSEY FERTILITY CENTER (letrozole). Eighty percent of women not already ovulating on their own will Âˇ All Of The Doctors Are Board Certified In Reproductive 'LYLVLRQ RI 5HJLRQDO :RPHQÂˇV +HDOWK *URXS //& tional use of medications such as Lupron, normal (perhaps is now offering a discount for IVF to Endocrinology And Infertility actors such as adrops highconsiderably calorie, high carbo-to 10% ovulate with these pills. Half of those who ovulate will conceive within several a GnRH-agonist, to suppress any residual or so).Doctor Menopause the time Âˇ Top Awards marks For 7 Years In A when Row no ACTIVE MILITARY AND VETERANS Â&#x2014;Â&#x17D;Â&#x17D; Â&#x2021;Â&#x201D;Â&#x2DC;Â&#x2039;Â&#x2026;Â&#x2021; Â?Â&#x2C6;Â&#x2021;Â&#x201D;Â&#x2013;Â&#x2039;Â&#x17D;Â&#x2039;Â&#x2013;Â&#x203A; Â&#x2021;Â?Â&#x2013;Â&#x2021;Â&#x201D; Â&#x2039;Â&#x2013;Â&#x160;ÇŁ â&#x20AC;&#x153;cyclesâ&#x20AC;?. This treatment yields a moderately increased twin rate of 7 percent. hydrate diet and inadequate exercise may Âˇ Laparoscopic Tubal Reversals Call 856.596.2233 ext. 1227 for more information. more usable eggs remain. The average age of endometriosis has been advocated by Č&#x2030; Â&#x17D;Â&#x17D; Â&#x2C6; Â&#x160;Â&#x2021; Â&#x2018;Â&#x2026;Â&#x2013;Â&#x2018;Â&#x201D;Â&#x2022; Â&#x201D;Â&#x2021; Â&#x2018;Â&#x192;Â&#x201D;Â&#x2020; Â&#x2021;Â&#x201D;Â&#x2013;Â&#x2039;Ď?Â&#x2039;Â&#x2021;Â&#x2020; Â? Â&#x2021;Â&#x2019;Â&#x201D;Â&#x2018;Â&#x2020;Â&#x2014;Â&#x2026;Â&#x2013;Â&#x2039;Â&#x2DC;Â&#x2021; Another pill, 6287+ -(56(< )(57,/,7< &(17(5 metformin (Glucophage), when used daily for months has a 17% Âˇ Money Guarantee Available worsen many of Back theissymptoms. PCOSFor Ivf And Donor Egg menopause 50. some. Âˇ Full Service Fertility Center Â?Â&#x2020;Â&#x2018;Â&#x2026;Â&#x201D;Â&#x2039;Â?Â&#x2018;Â&#x17D;Â&#x2018;Â&#x2030;Â&#x203A; Â?Â&#x2020; Â?Â&#x2C6;Â&#x2021;Â&#x201D;Â&#x2013;Â&#x2039;Â&#x17D;Â&#x2039;Â&#x2013;Â&#x203A; incidence of ovulation but no increase in the twin rate. Some patients do not LV QRZ RIIHULQJ D GLVFRXQW IRU ,9) WR auses a woman not tohas ovulate reliably.300,000 By A woman approximately However, numerous studies have Âˇ Robotic Surgery Available Č&#x2030; Â&#x2018;Â&#x2019; Â&#x2018;Â&#x2026;Â&#x2013;Â&#x2018;Â&#x201D; Â&#x2122;Â&#x192;Â&#x201D;Â&#x2020;Â&#x2022; Â&#x2018;Â&#x201D; Íš Â&#x2021;Â&#x192;Â&#x201D;Â&#x2022; Â? Â&#x2018;Â&#x2122; 8 respond to fertility pills alone and may require the addition of daily injections immature eggs, eachher in abody tiny follicle $&7,9( 0,/,7$5< $1' 9(7(5$16 not ripening an egg fully, fails in her failed to show that these medications imČ&#x2030; Â&#x192;Â&#x2019;Â&#x192;Â&#x201D;Â&#x2018;Â&#x2022;Â&#x2026;Â&#x2018;Â&#x2019;Â&#x2039;Â&#x2026; Â&#x2014;Â&#x201E;Â&#x192;Â&#x17D; Â&#x2021;Â&#x2DC;Â&#x2021;Â&#x201D;Â&#x2022;Â&#x192;Â&#x17D;Â&#x2022; that contain follicle stimulating hormone (FSH) which directly stimulates the ovaries, at puberty. So what &DOO H[W IRU PRUH LQIRUPDWLRQ Robert A. Skaf, MDbecame FACOGof those o make an important female hormone, prove fertility rates beyond that of surgery Top Row (left to right): Č&#x2030; Â&#x2018;Â?Â&#x2021;Â&#x203A; Â&#x192;Â&#x2026;Â? Â&#x2014;Â&#x192;Â&#x201D;Â&#x192;Â?Â&#x2013;Â&#x2021;Â&#x2021; Â&#x2DC;Â&#x192;Â&#x2039;Â&#x17D;Â&#x192;Â&#x201E;Â&#x17D;Â&#x2021; Â&#x2018;Â&#x201D; Â&#x2DC;Â&#x2C6; Â?Â&#x2020; Â&#x2018;Â?Â&#x2018;Â&#x201D; Â&#x2030;Â&#x2030; ovaries. Close monitoring of the egg ripening process by blood test and pelvic egg follicles between pubertyMD and FACOG menopause? Peter G. Van Deerlin, Dr. Gary Packin, alone. This may be, in part, due to the progesterone. Progesterone protects the ultrasound are needed to allow optimal dosing and duration of treatment in Č&#x2030; Â&#x2014;Â&#x17D;Â&#x17D; Â&#x2021;Â&#x201D;Â&#x2DC;Â&#x2039;Â&#x2026;Â&#x2021; Â&#x2021;Â&#x201D;Â&#x2013;Â&#x2039;Â&#x17D;Â&#x2039;Â&#x2013;Â&#x203A; Â&#x2021;Â?Â&#x2013;Â&#x2021;Â&#x201D; Were they all released during theFACOG once-aDr. Stephen Sawin, Stephen W. Sawin, MD fact that patients must avoid becoming uterine lining from overgrowth and from order to limit the chance for side effects. The risk of triplets is a real possibility daVinci Robotic Surgery Available Č&#x2030; Â&#x2018;Â&#x201E;Â&#x2018;Â&#x2013;Â&#x2039;Â&#x2026; Â&#x2014;Â&#x201D;Â&#x2030;Â&#x2021;Â&#x201D;Â&#x203A; Â&#x2DC;Â&#x192;Â&#x2039;Â&#x17D;Â&#x192;Â&#x201E;Â&#x17D;Â&#x2021; Dr. Peter Van Deerlin, month ovulation process? No. Usually only Gary S. Packin, DO FACOOG, Dist. pregnant while on these medications for Dr. Oumar Kuzbari potentially changes. (5%) from this treatment. Some infertile PCOS women will benefit from in onecancerous eggOumar will reach the fully mature state Kuzbari, MD, FACOG fear of possibly inducing birth defects. Yet Bottom Row (left to right): Vitro Fertilization (IVF), where eggs are harvested from the ovaries matured necessary to ovulate during each menstrual A woman with PCOS is not necessarBarbara Alice, APN-C, MSN Â&#x2018;Â&#x201E;Â&#x2021;Â&#x201D;Â&#x2013; Ç¤ Â?Â&#x192;Â&#x2C6;ÇĄ Barbara Alice, APN-C, MSN, the optimal time to achieve pregnancy cycle. The average woman has 450 menstrual by these FSH shots and then introduced to sperm in a laboratory dish. The Tracy APN-C,MSN ly going to exhibit allKrause, of the aspects of the Dr. Robert Skaf, may be immediately following the surgery Â&#x2021;Â&#x2013;Â&#x2021;Â&#x201D; Ç¤ Â&#x192;Â? Â&#x2021;Â&#x2021;Â&#x201D;Â&#x17D;Â&#x2039;Â?ÇĄ

cycles during her lifetime. The other 299,550 resulting embryos can be returned (typically one at a time) to the uterus Tracy Krause, APN-C, MSN yndrome. Some may be lean and others (when the fallopian tubes have just been Â&#x2013;Â&#x2021;Â&#x2019;Â&#x160;Â&#x2021;Â? Ç¤ Â&#x192;Â&#x2122;Â&#x2039;Â?ÇĄ

Â&#x192;Â&#x201D;Â&#x203A; Ç¤ Â&#x192;Â&#x2026;Â?Â&#x2039;Â?ÇĄ ÇĄ Â&#x2039;Â&#x2022;Â&#x2013;Ç¤ had a chance to re-form). Post-operative Most, however, have menstrual cycles that In summary, there are effective treatments for the various not400 alter this rate of egg degeneration. Some Lippincott Drive Harbor Pavilions Burlington Prof Campus AtlantiCare Life Center Â&#x192;Â&#x201D;Â&#x201E;Â&#x192;Â&#x201D;Â&#x192; Â&#x17D;Â&#x2039;Â&#x2026;Â&#x2021;ÇĄ ÇŚ ÇĄ medication IS recommended, however, Suite 130 570 â&#x20AC;˘ Suite B4 500 English Creek Ave. â&#x20AC;˘ #225 1900 Mt. Holly Rd #4A are known speed upEgg theHarbor loss of Rd eggs, requentlythings go longer thanto40 days from symptoms of this most common syndrome, PCOS. Marlton, NJ 08053 or radiation Sewell, NJ 08080 Burlington, NJ 08016 Egg Â&#x201D;Â&#x192;Â&#x2026;Â&#x203A; Â&#x201D;Â&#x192;Â&#x2014;Â&#x2022;Â&#x2021;ÇĄ ÇŚ ÇĄ Harbor Twp. , NJ 08234 when pelvic pain from endometriosis is such chemotherapy treatments one period toasthe next. The treatment for a

Fertility after Age 35 Fertility? Could Pelvic Endometriosis Be Interfering with Your

Polycystic Ovary Syndrome

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856.596.2233

856.218.8863

609.813.2192

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the patientâ&#x20AC;&#x2122;s biggest concern.

used to fight cancer. Smoking cigarettes also woman with PCOS is directed toward alle appears to hasten the depletion of usable eggs. www.TheCountyWoman.com The County Woman and Magazine viating her particular symptoms limitIn fact, menopause typically arrives one or two www.TheCountyWoman.com The County Woman Magazine ng her risk developing of the yearsfor earlier in womencancer who smoke.

January/February 2015

March/April 2015

28 26

M edical rofessionals M edicalP P rofessionals

How Do I Know If My Wisdom Dr. Banks Explains Oral And Maxillofacial Surgery Health &Wellness Teeth Need Treatment? M

axillofacial The most recognized form of oral surgery is tooth surgery is a extraction. Reasons for tooth extraction can range specialization from: impacted (not visible, or partly visible in the of dentistry that focuses create gum disease. thewisdom University of North mouth) teeth, primary teeth (baby teeth) onBy problems around we mean FUNCTIONAL, Carolina. that have failedImportantly, to fall out, and are preventing the the mouth, and another that the toothjaw, contacts partofofpermanent the project coneruption teeth, the presence of extra neck. Doctors who tooth during chewing. Usually, centrated on what hapteeth, teeth that are beyond repair due to tooth decay, decide pursue this Prognathic Jaw Retrognathic Jaw but not to always, a non-functional pens when molars root fracture, or third trauma, and sometimes orthodontic specialty as a career tooth will be in a location that are not removed. treatment plans may require the removal of teeth to attend dentaland school is not normal will become Third molars with the optimum result. and then anbecause additional bothersome it causes achieveperiodontal infection residency program. cheek biting, ulcerations or other don’t necessarily cause Wisdom tooth with Dental are signs changingImpacted the way wisdom people tooth Wisdom tooth and Dr. Banks practices a related problem. pain implants or show overt Kathy A. Banks, DMD cyst causingforbone periodontal pathology live. They are designed to providewith a foundation neighboring tooth fullSo, scope of oral and teeth removal of wisdom of infection like swellmaxillofacial surgery loss and damge to the replacement teeth that look, feel and function like with decay is always appropriate when there ing or pus. The studies withheexpertise rangingtofrom corrective jawpresent surgery molar tooth. naturalmentioned teeth. The person who has second lost teeth regains initial decision is pathology such as gum above actually to wisdom teeth removal. She diagnoses and treats disease, dental decay, or infecshowto that 60% of the ability eatsome virtually anything, knowing that remove third molars Open bite Treatment of facial injuriesteeth) and pathology, disorders tion.TMJ Another obviousand reason teeth to appear patientsnatural with asymptomand that facial contours bemolars change anofImpacted (wisdom is most and seek the advice your general Canine that thewill third preforms a full range of dentalremove implant and bone wisdom teeth is whenpreserved. atic third molars (wisdom in the mouth over time, dentist, orthodontist or oral and Patients with teeth teeth implantsposition can smile often made by a general grafting procedures. problems surgeon. when only there is a cyst or a tumor present with no symptoms of pain) had Everythe teeth are and the eruption ofcan thesecorrect teeth bitemaxillofacial with confidence. dentist or orthodontist. at or around the wisdom tooth, signs of infection with increased involved. Orthognathic surgery may be required for patient considering wisdom is unpredictable. There are other MostDr. patients who are maxillarydepths-canineand (cupid, or upper eye or if the wisdom tooth is causing Thepocketing that the Banks’ surgical-anesthesia team members the jaws the upper tooth surgery isofunique. Basedjaw and/or publications that discuss the when repositioning referred to the oral maxil- with IV tooth)periodontal is a very common tooth totobe impacted. damage a neighboring tooth. status is expected are trained in and assisting and to general an examination your to match up. movement, or eruption of thirdjaw isonnecessary the lower for theofteeth lofacial surgeon (OMS) do not BUT… if your dentist or worsen in the area of the second The canine tooth is a critical tooth in the dental mouth, and adone dentalinpanoramic molars; generally speaking, the procedures anesthesia in our state of the art office setting, Often these are conjunction with have healthy wisdom teeth that orthodontist determines that arch and andplays third an molars in aboutrole 40%in your important “bite.”and angulation x-ray or cone beam scan, yourappearance, position of the and have current ACLS, BLS/AED, and in office each other. This not only improves facial have erupted, or grown into a your wisdom teeth are not The canine of the teeth patients within 2 years.biting wisdom OMS can tell you about the con-function tooth within the jaws, are very strong teeth and emergency but also ensures that teeth meet correctly and cleansable and/orpreparedness functional training. healthy, cleansable or functional, The good news is touch that thewhen studyyourand dition of your wisdom teeth, and theclose presence or absence of are the first teeth that jaws properly. position in the mouth. or that retaining your wisdom also showed that the periodonthe position of the wisdom teeth available space to accommodate together so they guide the rest of the teeth into the By HEALTHY we mean free to teeth What are some reasons visit may an Oral lead toand these probtal disease is likely to improve After an accident, a patient may be to oral in the jaws. The OMS canreferred tell the teeth, seem to be the best properfollowing bite. Sometimes is necessary for the oral of gum disease and caries (dental lems in the future, you will need Maxillofacial Surgeon? removal ofitthe third youif ifhethere is pathology associpredictive factors. But again, and maxillofacial or she has suffered severe facial surgeon to surgically expose an decay). So there are no pockets expert consultation to furtherand maxillofacial molars. ated with the wisdom teeth that there is no formula or forjaw predicting injuries. The oral and maxillofacial surgeon can present inTothereplace gums between the tooth canine and to that bond a specialized review your options and studytooth also showed a missing with a dental seek impactedThe you simple are not aware of, orinjuries the wis-involving what a wisdom tooth is going and treat diagnose to severe wisdom tooth and the next tooth treatment. orthodontic andwhose chainthird that willtobedo.used by among bracket the patients implant. dom teeth are likely to the bones and tissues of the face mouth and jaws, and forward, or around the wisdom molars were to visible in the mouth, the orthodontist reposition the canine tooth Pain free doesn’t necessarily cause future problems. When into in doubt—get them can also correct cosmetic and other damages to the face tooth itself, and there will be no 28-77% of thewithin patients have arch. Have oral surgical procedures such as wisdom a normal position thewill dental mean disease free… checked out! redness ortooth swelling or other signs and extraction of baby as a result of theSchedule accidentyour withappointment reconstructive surgery. cavities in these teeth, depending surgery, biopsy, If you have wisdom teeth, Foron thetheir average patient, these procedures and Results Of A Study... with Dr. Banks byphysical calling appearance of infection. A healthy wisdom In addition to improving the age. teeth performed in the office under sedation the best course of action is to Practice Limited To Oral & most other minor oral surgical procedures can be tooth willorhave no cavities, or Dr. Banks was a member of In patients who chose to of a damaged 609-488-2325. face, the surgeon can address nerve general anesthesia. Maxillofacial surgery there was a cavity that has been the American Association of performed thethird officemolars, settingit with retainintheir was local anesthesia damage and other issues that may cause pain for the treated successfully with a dental and Maxillofacial Surgeons (numbing) without cleaning sedation or general shownwith that or mechanical To have impacted canineOral (cuspid) teeth patient. Especially patient is treated the 249 ifS.the Main Street, Unit quickly, 4 filling. surgically exposed. (AAOMS) Task Force on Third of theMajor third molar teethfacial did not anesthesia. jaw and procedures, and long-term impact of accident damage can be greatly Barnegat, NJ 08005 By CLEANSABLE, we mean Molar Clinical Trials in 2011 certainlower the levels of pathogenic physical or medical conditions will require reduced. that the wisdom tooth is in a 2012. The Task Force was bacteria andoperating inflammatory mediHave your jaw surgicallyand aligned Tel: 609-488-2325 treatment in the room setting. For more information visit www.myoms.org, position (orthognathic in the mouth where charged with reviewing some ators. There is new evidence that surgery). the official public website ofBanks, the American all the surfaces of the tooth can Kathy A. DMD Association 80 different scientific publica- Examples kbanks@drbanksoms.com these bacteria from the problems that of can jawtravel alignment Practice Limited To Oral & Maxillofacial Surgery of Oral and Maxillofacial Surgeons be successfully maintained, at tions resultingfollowing from a long term, mouth to the bloodstream, and Have facial and jaw reconstruction are commonly managed surgically are overbite 249 S. Main Street, Unit 4 home, bycancer brushing and flossing. Kathy A. Banks, DMDBarnegat, NJ 08005 ongoing study of third molars may cause illnesses affecting the Fellow of The American Association surgery. (protruding upper jaw), If the area is difficult to clean, of Oral & Maxillofacial Surgeons (wisdom teeth) conducted at Tel: 609-488-2325 heart, kidneys and other organs. 249 S. Main Street, Unit 4 Diplomate of The American Board underbite (protruding lower Fax: 609-488-2342 then bacteria can colonize and Barnegat, NJ 08005 the University of Kentucky and And finally, the study showed Have a consultation to determine whether you are of Oral & Maxillofacial Surgery jaw), cross bites, and open bite. Tel: 609-488-2325 Specialty Permit #4070 a candidate botox or other injectable cosmetics. Practice Limited To Oral & Fax: 609-488-2342 Whereas orthodontics alone Maxillofacial surgery Dr. Banks is a graduate of Rutgers University College of Arts and Sciences, Camden with a B.A. in biology, and Temple University Dentistry,College Philadelphia. a one year Advanced Dr. Banks is a graduate of School RutgersofUniversity of Arts She and completed Sciences, Camden with a 249 Main&Street, Unit 4 Practice Limited ToS. Oral Education in General Dentistry Residency Program at the University of Medicine and Dentistry B.A. in biology, and Temple University School of Dentistry, Philadelphia. She completed a one year of Maxillofacial surgery Barnegat, NJ 08005 Advanced General Dentistry Residency Program ata the MedicineResidency and New JerseyEducation in Camdeninand Stratford, NJ, and then completed fourUniversity year Post- ofGraduate Dentistryin of Oral New Jersey in Camden and Stratford, NJ,University and then completed a four Post-Graduate S. Main Street, Unit 4 Program and Maxillofacial Surgery at the of Medicine andyear Dentistry of New Jersey in Newark. She is a Diplomate of the 249 American Board of Oral and Tel: 609-488-2325 Residency Program in Oral Surgery at the University of Medicine and Dentistry of Barnegat, NJ 08005 Maxillofacial Surgeons andand theMaxillofacial American Board of Dental Anesthesiology. New Newark. is a Diplomate of the American Board ofMedical Oral andCenter Maxillofacial Surgeons SheJersey is a in member of She the dental staff at Jersey Shore University in Neptune, New Jersey and is involved with teaching the postgraduate GPR A. residents in the kbanks@drbanksoms.com Kathy Banks, DMD Tel: 609-488-2325 and the American Board of Dental Anesthesiology. Practice Limited To Oral & Maxillofacial Surgery clinic and in her private office setting. She has been instrumental in the development of several New Jersey State Board of Dentistry approved continuing education courses Kathy A. Banks, DMD 249 S. Main Street, Unit 4 kbanks@drbanksoms.com offered by J.S.U.M.C Department of Dentistry Continuing Education Department for dentists, hygienists and dental assistants. Practice Limited To Oral & Maxillofacial Surgery

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1 1 1

Education

Business &Finance KATHY A. BANKS, DMD

1 1 1

Practice Limited To Oral & Maxillofacial Surgery

KATHY A. BANKS, DMD Fellow of The American Association of Oral & Maxillofacial Surgeons Diplomate of The American Board of Oral & Maxillofacial Surgery Specialty Permit # 4070

Fellow of The American Association of Oral & Maxillofacial Surgeons Diplomate of The American Board of Oral & Maxillofacial Surgery Specialty Permit # 4070

KATHY A. BANKS, DMD

She is a member of the dental staff at Jersey Shore University Medical Center in Neptune, New Fellow of The Association Barnegat, NJ American 08005 Kathy A. Banks, DMD 249 S. Main Street, Unit&4 Maxillofacial Surgeons of 609-488-2325 Oral Jersey and is involved with teaching the postgraduate GPR residents in the clinic and in her private Practice Limited To Oral & Maxillofacial Surgery Tel: Kathy A. Banks, DMDBarnegat, NJ 08005 Fellow of The American Association Diplomate of The American Board Practice Limited To Oral & Maxillofacial Surgery officeCounty setting. She has been instrumental in the development of severalwww.TheCountyWoman.com New Jersey State Board of Fax: 609-488-2342 249 S. Main Street, Unit 4 The Woman Magazine November/December 2014 of Oral & Maxillofacial Surgeons Tel: 609-488-2325 of Oral & Maxillofacial Surgery Barnegat, NJ 08005 249 S. Main Street, Unit 4 Dentistry approved continuing education courses offeredMagazine by J.S.U.M.C Department of Dentistry www.TheCountyWoman.com Diplomate of The American Board January/Feb The County Woman Fax: 609-488-2342 Barnegat, NJ 08005 Specialty Permit #4070 Tel: 609-488-2325 of Oral & Maxillofacial Surgery Continuing Education Department for dentists, hygienists and dental assistants. Tel: 609-488-2325 Fellow of The American Association of Oral & Maxillofacial Surgeons Diplomate of The American Board of Oral & Maxillofacial Surgery Specialty Permit # 4070

Fax: 609-488-2342

The County Woman Magazine www.TheCountyWoman.com

Fellow of The American Association of Oral & Maxillofacial Surgeons Diplomate of The American Board of Oral & Maxillofacial Surgery Specialty Permit # 4070 Specialty Permit #4070

Fax: of609-488-2342 Fellow of The American Association Oral & Maxillofacial Surgeons Diplomate Fellow of TheofAmerican Board of Oral &ofMaxillofacial Surgery The American Association Oral & Maxillofacial Surgeons DiplomateSpecialty of The American Board Permit # 4070of Oral & Maxillofacial Surgery Specialty Permit # 4070

March/April 2015

Medical Professionals

Be Active After Weight Loss Surgery: Helpful Ideas from AtlantiCare After bariatric surgery, exercise is a critical success factor for reaching and maintaining a healthy weight.

a walking path or local running track and get moving. If you don’t have time for one long walk, try shorter walks at different times. For example, if your goal is 30 minutes of walking per day, try two 15-minute walks or three 10-minute walks.

“For the best outcomes, patients must make a lifetime commitment to making changes in their daily lifestyle, including incorporating more activity into their daily routine. We recommend that you start out slowly and move your body a • Sneak in more steps. Park your car little more every day,” says Alexander away from your workplace or the store. Onopchenko, MD, FACS, medical Use the stairs over the elevator or director of the Center for Surgical escalator. If you sit a lot at work, take Weight Loss & Wellness at AtlantiCare short activity breaks throughout the Regional Medical Center (ARMC). day — or spend your break time doing something active. According to Dr. Onopchenko, “For our bariatric patients, ultimately, the goal is to • Pedal it out. Bike rides are a great exercise for at least 60 minutes every day; way to burn calories, strengthen however, most people can benefit from your muscles, and improve your increased physical activity levels — not cardiovascular fitness. just those who’ve had weight-loss surgery.” • Strike a pose. The health benefits of Easy Ways To Get More Exercise yoga are numerous. Try a beginner’s yoga class to help you increase • Get up and go. Spring is a great time to take your workout outdoors. Take a brisk flexibility, muscle strength and endurance, balance, self-confidence, stroll on the beach or boardwalk. Walk and inner well-being. the dog a little farther than normal. Find

WEIGHT LOSS SURGERY SEMINAR Minimally Invasive Bariatric Surgery Join us to learn about these minimally invasive surgical procedures for weight loss: • Laparoscopic Sleeve Gastrectomy • Laparoscopic Biliopancreatic Diversion (BPD) with Duodenal Switch (DS) • Laparoscopic Gastric Bypass Roux-En-Y • Laparoscopic Adjustable Gastric Banding (LAP-BAND®) Registration required, call 1-888-569-1000.

REGIONAL MEDICAL CENTER The Center for Surgical Weight Loss & Wellness

View our weight loss webinars at www.atlanticare.org/bariatricseminars

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Health

Wellness 2015 Upcoming Events WORKSHOPS - TRAINING - COMMUNITY April 10-12: Jim Bennitt Tantric Vinyasa Weekend May 16-17: Erik Marrero Sanskrit Weekend Immersion

MIND/BODY STUDIO 609.404.0999 SMITHVILLE

June 24-July 3: Andrey Lappa 100 hour Universal Yoga Sequencing Training

609.494.9299 SHIP BOTTOM LBI

WWW.YOGANINE.COM

Call for information or go to www.yoganine.com

Gift Certificates Available for Classes or Massages

New to the studio?

Kick start your practice

60 days for $125 (50% off)

Buy Classes at Yoga Nine and get 10% off classes at PYOUR. Offer good for 30 days after class card purchase.

we take OSPREY CARDS Student discounts

Fair Trade, Green & Unique Gifts and Ritual Items

Yoga 101: Welcome Beginners 5 Week Sessions Begin March 1 or 5 through April 2 April 12 or 16 through May 14

Unique Jewelry, Bags & Gifts From Around the World

Photo by Paul Dempsey

Alzheimer’s Community

“We understand memory impairments and we have worked to design a community that brings the warm familiar feel of an ordinary home, while providing the comfort, safety, and peace that are so vital to the memory impaired.” Denise Van Tassell, Owner

Alzheimer’s Conference

March 18, 2015

9:30AM - 12:00PM Monmouth County Library 125 Symmes Dr. & Rt. 9 Manalapan, NJ

Alzheimer’s Support Group: 1st Saturday of Each Month at Noon. Call for details.

• Private bedrooms Four Locations: • Professional nurses available 24 hours Brick • 320 Herbertsville Road Ocean Township • 111 Bowne Road • 3 meals daily, snacks & beverages Matawan • 447 Matawan Avenue Toms River • 1126 Lakewood Road • Housekeeping and laundry service Call Alcoeur Gardens: 732.290.CARE (2273) • Special diets available to schedule a tour and visit our website at www.alcoeurgardens.com. • Stimulating activities New Jersey’s Premiere Alzheimer’s Community • 24 hour supervision • Alzheimer’s specialists Fully licensed, R.N. directed community regulated by the New Jersey division of Community Affairs and County Board of Social Services.

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Assisted Living

Do You Believe In Magic?

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Come find out about the Free Exercise Classes offered at Spring Oak of Toms River.

pring Oak of Toms River is proud to invite anyone over 55 years of age to join us for Fox Rehab’s Strength, Mobility and Balance Programs at no cost. A Fox Exercise Physiologist supervises this program with extensive work history in cardiac and pulmonary rehabilitation every Tuesday and Friday morning from 10am to 11am. The Strength, Mobility and Balance Program is an evidence-based progressive exercise program for active 55+ adults designed to relieve everyday aches and pains, increase strength and improve cardiovascular stamina. In an editorial published in the Journal of American Medical Directors Association (JAMDA), exercise has been described as the “Magic Bullet” available for clinicians to treat dementia along with a multitude of other diseases and dysfunctions. Editor in Chief of JAMDA, Dr. James Morley MD, BCH, states, “Exercise clearly is better than medications for dementia.” Exercise also has proven to: • Decrease depression • Decrease risk of frailty • Decrease incontinence • Reduce pain • Enhance sleep • Reverse sarcopenia • Improve Glycemic control

• Decrease falls/injuries • Decrease constipation • Decrease behavior disturbances • Decrease cognitive impairment • Slow bone loss • Improve quality of life

Dan Dexter, Fox Rehab Exercise Physiologist instructs Spring Oak’s seniors at the morning exercise class.

Prescribed by Physicians and administered and dosed properly by Fox Physical and Occupational Therapists, therapeutic activity can help ward off cognitive impairment and help older adults achieve optimal function to rehabilitate their lives. Fox specializes in reversing the detrimental effects of muscular weakness, regardless of age or cognitive status. By partnering with Fox Rehab, Spring Oak has therapists that can help lead enriching exercise programs for the community. Additionally, Fox Rehab therapists

can also perform regular screening for residents and communicate any potential medical issues needing attention to healthcare providers. Residents also benefit from additional wellness programs and educational seminars. When a resident’s physician prescribes therapy, there is no need for transportation to an outside facility, and no need for coordination with home health agencies. Fox Rehab has licensed therapists that are on-site at Spring Oak of Toms River at least 3 days a week and will perform the prescribed therapy according to a residents treatment plan. Continuity of care is imperative for successful therapy and Fox Rehab ensures that resident’s receive quality care from the same therapists who build strong relationships with the residents over time.

To learn more about Spring Oak and what they have to offer, please call Tara Heisman at 732-905-9222. Tara Heisman has been working with seniors and their families in assisted livings in NJ since 2003. She enjoyed being an Activities Director before becoming a Marketing Director. A resident of Toms River since 2007 , Tara is married to her husband Steve and has a 4 year old boy named Lucas. Please call or email Tara to schedule a tour. 732-905-9222, theisman@springoak.net

Free Exercise Classes Open to the Public!

Spring Oak Of TOmS river TeSTimOnialS “If I knew it was going to be this good, I would have gotten here sooner. Everyone at Spring Oak has been so good to me. I have always been a family person and everybody here is like family. It is a beautiful place just like home. I am always doing things, I have been to the aquarium and went on a boat ride. They have the library, the theater, and pool table. Everybody is right there to help you.” ~ Mary E. “I love it here. I do not want to leave ever. It is the best place for me. Thank God for my concerned children. They have helped me feel alive again. I thank you from my heart.” ~ Mary M.

Tuesday & Friday: 10 am 3

www.TheCountyWoman.com The County County Woman Woman Magazine Magazine www.TheCountyWoman.com The

November/December 2014 March/April 2015

Medical Professionals

The Next Generation “Open” MRI A Friend’s Experience My friend named Sharon who lives in Washington DC called me with a medical problem.

he recently started having mild backaches as well as the sensation of “lightening” shooting down her left leg. Her doctor in Washington was concerned she could have a herniated disk in her spine and he recommended an MRI to diagnose the problem. It was explained to her that an MRI is basically a large magnet that images the body. The advantage of the MRI is that unlike some other tests there is no radiation and the detailed images obtained are of excellent quality. The disadvantage is that the test can take up to 45 minutes and one’s entire body enters the MRI through a narrow tube surrounded by the machine. The space between a patient’s body and the machine can be tight. Unfortunately, Sharon is extremely claustrophobic. After arranging for the procedure at a radiology facility near her home in Washington DC, she attempted to have an MRI on an older magnet but couldn’t go through with it. She was even given a little valium to relax her but the tight space

was too much to bear. Sharon called me wanting to know what she should do. I told her that the MRI is the best test to detect a herniated disks in her spine. She needed the MRI. Sharon then asked me about an “open” MRI. Open MRIs became very popular in the 1990s. Instead of being surrounded by the machine while lying in a tube, the machine was in the shape of a clam with the sides of the MRI being open. There were still a few problems with the open MRI. Although the sides were open, the top of the machine was very close to the patient’s face. This design still bothered some patients who suffered from claustrophobia. The bigger problem with the Open MRIs was the strength of the magnet. Weaker magnet strength means lower image quality. Most standard MRIs have a strength of 1.0 Tesla which gives good images. Most open MRIs have a magnet strength of 0.4 Tesla. This markedly degrades the image quality, compared with standard MRIs. Additionally, many advanced MRI techniques cannot be performed with these weaker magnets. Sharon asked what do we do at my office. I told her we have the very latest in “open” MRI

technology, which addresses both of these issues. Our brand new MRI has a magnet strength of 1.5 Tesla which is stronger than most standard MRIs. This produces superior images and allows us to perform advanced MRI techniques and sequences. The stronger magnet strength also decreases the scan time allowing the patients to finish their exams faster. The opening (also called the bore) in our new MRI is very wide with the machine far from the patient’s face. The standard MRI would be several inches from the patient’s face; however our wide bore open MRI is one foot from our patient’s face. This dramatically decreases the sensation of claustrophobia. This wide bore is approximately 2.3 feet wide, which is ideal for claustrophobic patients and larger patients who need more room. With the older model MRIs, one’s entire body has to enter the MRI. Our new MRI is 4 feet long. This is much shorter than most MRI’s and is in the shape of a donut (rather than a long coffin-like tube). This means that for a majority of tests, our patient’s head is outside of the machine, helping to ease the sensation of claustrophobia. I told Sharon that since we placed our new MRI, we practically haven’t had

“Open” wide bore MRI provides the best comfort for all body types and those with claustrophobia.

MRI Of The Spine: Quality of Images

Traditional Open MRI any patients complain of claustrophobia. Our referring physicians, especially our surgeons and neurologists, have also been very pleased with the image quality produced by our machine. Sharon came to my office in Toms River and had her examination without any problems. She was so

732-244-0777 • PET/CT • Diagnostic X-Ray • Ultrasound • Digital Mammography • CT Scan • Nuclear Medicine • High Field Open Bore MRI • Bone Densitometry

Deer Chase Professional Park • 154 Route 37 West • Toms River, NJ 08755

Tel: 732-244-0777 • Fax: 732-244-1428

Dr. Cyrus Khorrami, M.D.

www.TomsRiverXray.com5

comfortable in our MRI she actually fell asleep! The good news for Sharon is she did not have a herniated disk. She had a small tear in her disk that was causing her symptoms and will heal in several months without surgery.

As always, contact our office where our staff will be more then happy to assist you.

About The Author... Dr. Cyrus Khorrami is an

Ocean County native who attended kindergarten through twelfth grade in Toms River. He is a graduate of Temple University Medical School and completed his radiology residency at Cooper University Hospital. Dr. Khorrami completed a Cross Sectional Imaging Fellowship at Johns Hopkins Medical Center. He has returned to Toms Ricer to work with his family as Medical Director of Toms River X-Ray, CT, and MRI Center.

Advanced “Open” MRI

The County Woman Magazine www.TheCountyWoman.com

PARVIZ KHORRAMI, M.D. Founder CYRUS KHORRAMI, M.D. Medical Director PARVIN MOTEMADEN KHORRAMI, M.D.

EXPERIENCE & EXPERTISE you can count on. March/April 2015

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Health &Wellness

Is Colon Cancer Awareness Month TheMarch Importance of Colorectal Cancer Screening Q

How common is Colorectal Cancer, and do I have to worry about it?

Colorectal cancer is the 3rd most common cause of cancer in both men and women. The lifetime probability of developing colorectal cancer is approximately 1 in 20 for both men and women, making it very common.

Written by: Jai Mirchandani, MD, Gastroenterologists of Ocean County

Dr. Mirchandani Answers Your Questions . . .

What is Cancer Screening?

A screening test is a recommended medical test to examine for precancerous lesions prior to the development of cancer. Examples of these kinds of tests include: Mammography- to detect early breast cancer; Pap Smears- to detect cervical cancer; and a Prostate Exam- which examines for early prostate cancer. Colonoscopy is a screening test to detect and prevent colorectal cancer.

Patient

Testimonials

What is the colon and rectum?

The colon is a 6 feet long tube, which absorbs excess water and salt into the blood, and converts waste into stool. The rectum is the end of the colon, where waste/ stool is stored until it leaves the body during a bowel movement.

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Symptoms of Colorectal cancer include blood in the stool, anemia (low blood counts), changes in bowel habits, abdominal pain, and weight loss. Often, however, patients have no symptoms at all.

“The Nursing and Technical staff displayed extraordinary compassion and put me at ease from the moment I arrived. Since I have no memory of the actual procedure, I commend Dr. Mirchandani and the staff. Overall, I was extremely satisfied.” ~ Joe, age 46, Toms River

Who should be screened for colorectal cancer?

Family history and genetic factors are one of the biggest predisposing factors to the development of colorectal cancer. If you have a close family member who had either colorectal cancer or colon polyps, you are at an increased risk for developing colorectal cancer. Environmental or dietary factors, such as diets high in red meats, alcohol or tobacco use can predispose patients to colorectal cancer. Also patients who are overweight or have advanced diabetes are also at an increased risk for developing colorectal cancer.

What is a polyp and why are they important?

A polyp is a growth out of the wall of the colon. Polyps are either benign (non-cancerous), or premalignant (pre-cancerous). Polyps are important because certain polyps can grow large over time into colon cancer. Usually patients have NO SYMPTOMS, if they have a polyp. Polyps are caused by genetic and hereditary factors, as well as dietary and environmental factors.

Education

make them comfortable throughout the entire procedure. The day before the procedure patients must drink a solution to clean their intestines prior to the procedure. If a patient’s colonoscopy is normal, they most likely will not need another procedure for 10 years.

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Any man or woman over the age of 50 years old should be screened for colorectal cancer. Patients with family members with a history of colorectal cancer, or colon polyps, as well as certain symptoms may need to be screened at an earlier age.

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How do patients get screened?

A patient can get screened by stool tests to check for blood, X-ray or CT scan tests, as well as certain blood tests that can assess if patients are at risk for developing colorectal cancer. The best test for screening for colorectal cancer is a colonoscopy, as this test can visualize precancerous polyps, as well as remove these polyps before they have a chance to grow and become colorectal cancer.

What happens to patients who develop colorectal cancer? Patients who develop colorectal cancer must undergo further treatments, including possible surgery, chemotherapy and radiation. Ultimately they have a shorter life expectancy.

What is the most important thing to know about colorectal cancer?

The most important things to know about colorectal cancer is that is a common form of cancer, and all patients, including men and women are susceptible to developing colon cancer. Most types of colorectal cancer are preventable however, with appropriate screening. Colonoscopy is covered as a screening tool by Medicare and most insurances. Make sure to talk to your doctor to see if you should be screened for colon cancer.

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What are protective factors for colorectal cancer?

Diets high in fruits, vegetables and fiber are protective for col-

What is a colonoscopy?

A colonoscopy is a test where a flexible tube is inserted into the rectum. Through this tube, a gastroenterologist can visualize the inside of a patient’s colon. Using a colonoscope the gastroenterologist can identify small polyps, and remove them internally. The procedure takes approximately 30 minutes. Patients are given sedation to

Call to schedule your appointment at Gastroenterologists of Ocean County.

B usiness &Finance Meet The Doctors Of Gastroenterologists Of Ocean County.

(Sitting l-r) Omar Tamimi, MD, Jill Collier, MD, and Allan Cohen, MD. (Back row l-r) Jai Mirchandani, MD, Edgar Bigornia, MD and Kenneth Glazier, MD. We perform endoscopic procedures in the convenience of our two office based endoscopy centers. We aim to provide the highest quality of compassionate medical care and perform endoscopies in a convenient, friendly, non-threatening office setting. We serve patients from many different backgrounds which is mirrored in the diversity of our physicians.

Hospital

Gastroenterologists of Ocean County

Board Certified Gastroenterologists

Allan Cohen, MD • Omar Tamimi, MD • Jill Collier, MD • Edgar Bigornia, MD • Kenneth Glazier, MD • Jai Mirchandani, MD Hospital Privileges at Community and Ocean Medical Centers

• Colonoscopy and colon polyp removal • Swallowing disorders • Endoscopic treatment of hemorrhoids • Colon cancer detection & screening disorders • Colonoscopy and colon polyp removal • Swallowing • Capsule Endoscopy • Rectal bleeding evaluation • Endoscopic treatment of hemorrhoids • Colon cancer detection & screening • Bravo pH Monitoring • Ulcerbleeding pain evaluation and treatment • Capsule Endoscopy • Rectal evaluation • Bravo pH Monitoring • Ulcer pain evaluation and treatment Hospital Privileges at Community and Kimball Medical Centers Endoscopy Center of Toms River Endoscopy Center of Ocean County •

473&&477 477Lakehurst LakehurstRoad Road 473 Toms River, NJ 08755 Toms River, NJ 08755 732-349-4422 732-349-4422

7 Sherwood Drive 7 Sherwood Drive Lakewood, NJ 08701 Lakewood, NJ 08701 732-367-3338 732-367-3338

Medicare, Medicare, HMO’s HMO’s and and most most insurance insurance accepted. accepted.

What are risk factors for developing colorectal cancer?

“Dr. Mirchandani and his staff were very professional and caring. They made me comfortable and less apprehensive.” ~ Joan, age 49, Whiting “I felt comfortable and safe! The warmth I felt from Dr. Mirchandani and his team left me feeling relieved. “A piece of cake!” Excellent.” ~ Dortha, age 84, Toms River

orectal cancer. Also a diet high in calcium has also been seen to be protective for colon cancer as well. Exercise has been seen to be a protective factor as well to prevent colon cancer.

What are some potential symptoms of Colorectal Cancer?

Now Now you you can can have have your your Colonoscopy, Colonoscopy, Polypectomy Polypectomy and and Upper Upper Panendoscopy Panendoscopy in in our our tranquil tranquil and and private private endoscopy endoscopy centers. centers. You You will will receive receive intravenous intravenous sedation, sedation, which which will will make make you you sleepy sleepy and and comfortable. comfortable. Our Our colonoscopy colonoscopy preparation does not require preparation does not require you you to to drink drink aa gallon of solution of Golytely or Colyte. gallon of solution of Golytely or Colyte. Now seeing patients in our NEW

in Cherry Tree Plaza! 939 Lacey 355 Route 91617 Routeoffice 355 Route 9 Road 939 Lacey Road 88 West seeing 2360 RouteNow 9 South ForkedNJ River, NJ 08731Forked River, NJ Bayville, Bayville, 08721* 08731NJ 08721*Brick, NJ 08724 patients in our new Howell, NJ 07731* 609-971-5949 732-349-4422 732-249-4422 Brick office location! 732-349-4422 609-971-5949 * Limited hours by appointment. 732-349-4422 * Limited hours by appointment.

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* Limited hours by appointment.

March/April 2015 2014 March/April January/Feb

Health

& Wellness

Health Wellness Are32You Running On & Empty? 00

Are YoutoRunning Empty? It’s Time Spring Into On A New Beginning

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Professionals dedicated to total wellness. any of us feel stressed, exhausted, anxious and empty. Let our exceptional staff offer you our many years of Professionals dedicated to total wellness. Once to handle it “all”, now feeling irritable or letting unable go of the past because they any ofable us feel stressed, exhausted, and empty. eople have aanxious difficult time experience along with compassionate, individualized attention. We understand total wellness includes services Let our exceptional staff offer you our many years of about more thing”, wefeeling feel empty,or unable Once doing able to“one handle it “all”, now irritable are held back bylike unfinished business. They may regret choices for experience along individualized both your mindwith andcompassionate, body! attention. understand total wellness Pick one We service or choose them all... includes services doing “onetrue more thing”, feel like empty, battered about remnants of our selves. they havewe made or feel guilty about past actions. As long as for both your mind and body! We are here to meet your individual needs! Pick one service or choose them all... battered our selves. guilt and regret are tonot it We is difficult to move forward. We don’tremnants often think of about it,true but we aren’t limited ourresolved, physical being. We are here to meet your individual Individual, Couple, and Child needs! Counseling We don’t often think about it, but we aren’t limited to our physical being. We Regret is an emotion that feels similar to depression or sadness. It also feels forget about our mental and spiritual components. Individual, and ChildServices Counseling WeightCouple, Loss/Nutrition forget about our mental andlike spiritual components. Weight Loss/Nutrition Services guilt, but it isn’t the same thing. You might become aware of it when you lose We eat for fuel, but what fuels you mentally? Groups and Classes on a variety of subjects We eat for fuel, but what fuels you mentally? (Please check ourand websiteClasses for our latest on schedule. Pre-registration is required.) a variety of subjects Groups something or someone, or when you meet someone from your past, or it may What inspires and nurtures you? (Please check our website for our latest schedule. Pre-registration is required.) What inspires andcome nurtures you? Hours of Operation: 8am-8pm Mon-Fri seem to is a common feeling in our culture for several It may be going for a long, leisurely walk, from readingnowhere. a book, orItsoaking in the tub, Hours of Operation: 8am-8pm Mon-Fri Weekends by appointment. It may be going for a long, leisurely walk, reading a book, or soaking in the tub, Weekends by appointment. reasons. taking taking in in the the latest latest art art exhibit, exhibit, or or simply simply sitting sitting appreciating appreciating the the sounds sounds of of nature. nature. www.MarinIntegrativeTherapy.com www.MarinIntegrativeTherapy.com When we compare our lives with others, we can feel regret. We learn to act as Whatever Whatever itit is, is, you you need need it. it. wecaught are inup. control compare ourselves This We guilty because are This isis where where many many of of us usifget get caught up. We feel feeland guilty because there there are so sowith our friends, coworkers, neighbors, Beth Kane, M.S.W., even characterslist. onThere’s television. When we to don’t many other other things things yet yet to to do doand on that that never-ending list. There’s reason we refer refer to many on never-ending aa reason we itit look as good as we think they LCSW, co-founder of Marin Integrative Therapy, Therapy, LLC, LLC, weanywhere. feel like This failures. Integrative as aa never-ending never-ending list. list. ItIt isn’t isn’tdo, going anywhere. This isis the theWe key.have a list of “shoulds” inside our heads—things we as going key. started her career working started her career working People will will often often not not do do things things for themselves because they feel feel selfish. selfish. They They expectfor ourselves tobecause do. they People themselves with individuals individuals with with severe severe with often feel guilty taking the time to do usually the things that inspire and nurture them. Guilt results from violating a rule—either our own or someone else’s. medical and mental health often feel guilty taking the time to do the things that inspire and nurture them. medical and mental health But there is a difference. Nurturing, feeding, and fueling yourself mentally is about issues. Sought after for profes If you want and to move whatmentally is keeping you stuck, you will need to But there is a difference. Nurturing, feeding, fuelingpast yourself is about issues. afterand forarticles professional Sought interviews being the best “you” you canacknowledge be so you can be even better to those around you. these things and tell the truth about them. Sometimes just writing sional anddeveloped articles being the best “you” you can be so you can be even better to those around you. in her interviews field, she has You benefit. They benefit. It’s a gift really. in her field,forshedepression, has developed a specialty or talking about it is enough to lessen its impact. You can write about it in a You benefit. They benefit. It’s mind a gift really. So, go ahead. Nourish your and spirit. If someone accuses you of being selfish, you can look aanxiety, specialty for depression, coping with chronic private journal or talk about it with a trusted friend or counselor. So, go ahead. Nourish your mind and spirit. them in the eye and honestly say, “This is my gift If tosomeone you”. accuses you of being selfish, you can look medical coping illness, with and grief. anxiety, chronic say,Ifyou you would like to see how we balance can help you with them in the honestly “This isthe myway gift to obtaining you”. medical illness, and grief. Please calleye usand so we can help find to better in your life a new beginning and shake Marin Integrative Therapy, (732) 244-2210. off you the burdens of tothe past, please call us atin(732) 244-2210 Marin Integrative Therapy, today! 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September/October 2014 March/April 2015

Law

Minimize Your Attorney Fees In Divorce

Two Big New Changes In Divorce Law: Here’s What They Mean

end up costing hundreds if not thousands of dollars. I walk three minutes to the courthouse and my clients benefit from ALIMONY REFORM: that fact. After years of percolating around Trenton, an agreement was finally reached among 2. Organization of paperwork: There is an entire the politicians to change the alimony laws. Those changes do little to alter the ultispectrum of information which family lawyers must have of alimony to effectively do their work. We mate reviewoutcome tax returns, bank decisions, but do contain some revisions of the process by which alimony modifications and terminations are adjudicated. statements, brokerage and other investment statements, real estate holdings, pension andThe 401(k) accounts, and include: major highlights Divorce can be expensive. Dividing assets and sometimes even minute details involving medical bills, (1) Dispensing with the phrase “permanent alimony” in favor of “open duraThe first is the New Jersey Family allocating debts can lead to the destruction of some tuition bills, auto repair bills and the tional like. Be aware that alimony.” This, in reality, is little more than a change in jargon to soften wealth which comes with pooling marital assets. whether edge it’s an attorney, a paralegal, or a law clerk, it takes Collaborative Law Act which represents the cutting 4. Compromise: The court will do what the court the psychological blow to payors. Investment fees and savings rates are often more time to organize documents, and you are charged for thinks is fair to you and your spouse. The court will not of dispute resolution, andforced the moves second is a purported (2) on A limitation on alimonynecessarily terms to see no fairness more than thesame length thesee marriage favorable with larger accounts, and leave that time. If you bring the paperwork time, in date in the wayofyou it. Settled except in cases where marriages are more than twenty years in length; little“alimony opportunityreform” to shop for the best mortgage rates order, and reasonably complete you are saving yourself matters are almost universally better than litigated matters. law. or lease options. This is the unavoidable consequence of hundreds of dollars of staff time collating, organizing (3) A more regularized process for alimony modificationAgain, in cases where athe payor Be prepared to compromise. shortening time untangling shared economic lives. and understanding financial documents. are (where also relief should to resolution is the surest limit the costsevent of your losesYou a job be faster under theway newtostatute in the of a THE NEW JERSEY FAMILY COLLABORATIVE LAW The cost of the transaction, the fees and minimizing theACT: chances of error. Attorneys, like everyone divorce. job loss); Having been a founding member of the Jersey Shore Collaborative Law give Group opportunity expenses of divorce on the other hand, else, can only advice based upon the facts we know; if Domodification it Alone: While it’swhere tempting to say (4) A more regularized process5.forDon’t alimony in cases a payor can be managed if you are careful. Understand that myself – the first collaborative divorce group in New Jersey – there it is with great pride are missing documents or unknown information, our the greatest savings can come of from not having anofattorney wishes to retire, whereby there is now a presumption reasonableness a attorneys only charge the Jersey time they to passing ofadvice is similarly It is far cheaper for you to track that we cancanannounce thatforNew has,devote with the this statue, giveninexact. all at all, savings is illusory. Whether mistakenly payor’sand retirement hethe or she is entitled to receive fullyou social security your matter. There are few flat fee opportunities in down missing statements, account numbers receipts at the age divorcing parties an alternative to contentious, costly litigations. The collaborative fail to account for an issue, you fail to understand your benefits; and family law, and divorces almost never work on that is to In paya acollablaw firm to do it for you. process is thoughtfully designed to put family interests ahead than of allitelse. entitlements, or worse, you fail to anticipate the challenges in basis. divorce, Thus, it’strained wise to divorce stay focused on the time your (5) Ameans slightly more liberal definition of cohabitation, making itformore thatyou 3. divorcing Plan: Understand re-evaluating orative professionals work together with the couple that divorce setting up co-parenting arrangements yourlikely children, attorney will have to expend on your matter. having a boyfriend or girlfriend will result in a downward modification or and re-prioritizing your budget, your housing, your are likely to run into trouble requiring an attorney toterfix it. to reach optimal divorce solutions in a private, confidential out of court setting. This mination of alimony. (This allows finding ofand cohabitation even expensive, when employment, your schooling, your leisure time, and many Thechange fix is often lessapalatable, potentially more new legislation ensures the process remains confidential and secure. other aspects of your life. Between attorney explore parties visits maintain separate than residences if other indicia of proper “couple-hood” are met. the result had you sought representation in the Consider If you havethese children,tips: complex business interests, a desire for privacy, or simply a all of your options. Then, let your attorney know what first place. If money is an issue, be honest with friends and desire move forward in divorce by building a healthy relationship Allyour in all,sort dependent made out fairly well in the reform process. Of course, 1.toLocation, Location, Location: Hiring an new post-divorce you’ve learned and let him or her help through spouses family about your need for help. If the shoe were on the with yourwhose soon-to-be thenisyou shouldtheabsolutely investigate attorney office isex-spouse not closeastoco-parents, the courthouse it remains to be seen how the courts are going to interpret this legislation. If you are options. Some are likely to be attainable. Others, for other foot, you’d likely help them. Don’t be afraid to ask for a potentially losing proposition. Before the court date and consider a collaborative divorce. It is truly “the thinking reasons person’s”driven way to divorce. an alimony you would be wise consider impact of any relamore by the economics or the recipient, practicalities assistance in to your time ofthe need; after all, thatromantic is what friends starts, paid forand 30 visit to 60the minutes Call myyou’ve officeprobably for morealready information Jersey ShoreofCollaborative upontheyour alimony benefits, because the rules seem to have changes materidivorce, may Law not be advisable.tionship Either way, more and family expect to do for each other. of travel time, and traffic jams are always Group Website at www.jsclg.org. Be sureontoyour seekdime. out a trainedyou collaborative law proLikewise, if you are an alimony recipient expecting to remain single through prepare yourself, the quickerally. you can make decisions. If there is Lawyers an attorney closeintothe thecollaborative courthouse, processThe fessional. notyou yettrust trained cannot giveyou youcommit the fullto a position, quicker the sooner your retirement age and beyond, this legislation makes it clear that you need to plan careIf divorce is in your future, consult with us you’ve efficiently managed this issue. It’s cheaper for you to divorce will end. Since time is, quite literally, money, in benefit of the process. Again, call my office for a list and locations to find other colfully for the day the alimony may end, which is likely to be the date upon travel to the attorney, then for the attorney to travel to the before you make any decisions. divorce, the shorter the process, the cheaper transaction laboratively trained attorneys, mental health professions and financial advisors. which your the payor becomes eligible for full social security benefits. courthouse in most cases. Five or six trips to the court may costs.

ast month’s installment of this divorce article dealt with Writtenlaw by: Jay Turnbach, Esq. the happiness available to divorcing spouses and the peace can bring toGovernor your children. In a In itSeptember, Christie thematic change, I thought I’d dole out some signed twopractical new pieces of on keeping nuts and bolts advice legislation family law. your transactionimpacting costs underthe control.

Jay Turnbach, Esq., LLc

732.286.4860 732.286.4860 ree T Telephone elephone FFree onsulTaTion C ConsulTaTion

Divorce Divorce Collaborative Divorce Divorce Mediation, Litigation, Collaborative Post-Judgment Divorce Divorce Post-Judgment Enforcement of Divorce Judgments, Judgments, Child Child Support Support and and AliAlimony Modifications, Out of State State Relocations Relocations with with Children Children Family Law Law General Family Child Custody/Parenting Time Time Issues, Issues, DYFS DYFS Matters Matters Violence Domestic Violence Restraining Order Hearings, Motions Motions to to Vacate Vacate Old Old Orders Orders

www.NJFamilyLawyer.net www.NJFamilyLawyer.net

Certified by the Supreme Court of the State State of of New New Jersey as a Certified Matrimonial Attorney Attorney

Schedule an appointment with Jay Turnbach, Esq., to further discuss your concerns.

732-286-4860.

Washington Street 2229 Hooper Ave, Suite 6A Toms TomsRiver, River,NJ NJ 08753 08753

Magazine www.TheCountyWoman.com The County Woman Magazine

Jay Turnbach has 19 years’ experience handling family law matters in Ocean and Monmouth Counties. He is certified by the Supreme Court of New Jersey as a Certified Matrimonial Law Attorney. He is qualified as a divorce mediator pursuant to Rule 1:40 of the New Jersey rules of Court. He is the immediate past president of the Jersey Shore Collaborative Law Group, and a former chairman of the Family Law Committee of the Ocean County Bar Association.

March/April 2015 November/December 2014

Elder Law

Legal Documents For All Ages 18-118 Part 3 Of 3

Q: Q: Legal Documents For All Ages 18-118 - Part 1 18

By: Nancy M. Rice, Esq., CELA

of this marriage, the surviving spouse or domestic partner is entitled to the entire intestate estate. If the decedent has no children, grandchildren, or parents surviving, but is survived by one or both parents, the surviving spouse or domestic partner is entitled to the first 25% of the estate (but not • Health Care Proxy thanCare $50,000 more than $200,000), plus •less Health Power nor of Attorney remaining balance of the •three-fourths Medical Powerofofthe Attorney •intestate Medical Proxy estate.Directive

Other than stating who gets my property following my death, why else do I need a What are the “top 3” legal documents Will? everyone should have? You want to decide who will act as your 1. Advance Medical Directive/Living Will Executor, Trustee, and Guardian for minor or 2. Durable General Power of Attorney disabled children. You want to put provisions in By: Nancy M. YourtoWitnesses cannot be your attending 3. Rice, LastEsq., WillCELA and Testament yourc)Will reduce or eliminate death taxes physisuch cian or the Administrator or Employee of the health as New Jersey Inheritance Tax, New Jersey Estate care institution you are residing in unless he or she What are the “top 3” legal documents TRICK QUESTION: What happens to Tax,isand Estate Taxes. Your attorney can alsoFederal your relative. everyone should have? your assets if you die without a Will? also advise you how to best minimize or eliminate I favor the term “Advanced Medical Directive/Living Will” If all of the decedent’s surviving children are of 1) Advanced Medical Directive/Living Most people believe that their Will assets income taxesare on some assetsofsuch IRA’stoand 401(k)’s. What the as issues consider so that people can figure out from the title what 2) Durable General Power of Attorney the current marriage or domestic partnership and will pass to the State of New Jersey if they die it is. when making a Living Will? 3) Last Will and Testament the surviving spouse or domestic partner has one or without a Will; but think about it . . .if this really If I already have a Will, how often more surviving children who are not descendants A: Perhapsshould the most importantchanging thing to keep happens, we wouldn’t have to tax toilet paper or I consider it? in mind is Why do they ask me for my Living Will Which document is most important? to choose a person or persons whom you of the when decedent; or,the if one or more of the decedent’s that you need sell highways in order to balance the State budget, Whenever family circumstances change I go to Hospital? know will carry out your wishes. You are not required Arguably, the documents are listed above surviving children is not a descendant of the would we? (birth, death, or disability of a family member), to In 1990, Congress passed a law, known as the “patient name family members, and you might not want to tell in order of importance, meaning that the Advanced surviving spouse or partner, the surviving your assets increase or decrease Self-Determination Actdomestic which requires all Hospitals & anyone who you have named if youor feelchange that others may Medical Directive/Living Will is arguably the most spouse or domestic partner is entitled to the first OK, what REALLY happens if I die substantially, add oryour losemind. life insurance Nursing Homes to ask you, upon admission, whether put pressure on or, youyou to change You should important. you an Advance follow the always 25%have of the intestateDirective/Living estate (but notWill, lesstothan namewhenever a “backup” person in the first without a Will? coverage; you decide youevent wantyour to change When a child attains the age of eighteen (18) years, Directive if you have one, and to offer dispute resolution Representative falls ill or dies. Remember, you can only $50,000.00 nor more than $200,000.00), plus look“legally to seecompetent” how assetsand are parents TITLED who you named as Executor, Trustee, or Guardian; he or sheFirst, becomes lose in the event there is a question regarding your Directive. sign this document NOW when you are healthy! one-half of the balance of the intestate estate. (for example, if a medical house isdecisons ownedfor bythe a husband if you want to consider creating a Trust for your their right to make child. In fact, HIPAA privacy lawpass canto make impossible for In Part because 2, we willofdiscuss another which and the wife, jointly, it will theitsurvivor marital issues;document or, if your state AnyWhat part of thetheintestate estate not passing to the children are Legal Requirements to make parents to gain access to the child’s medical information, all of us should have in place: Durable automatically) and whether an asset has a of residence changes, you should consider a review surviving spouse or domestic partner as indicated a valid Living Will in New Jersey? let alone make medical decisions in the event the child Power of Attorney. beneficiary named (for example, all IRA’s and life of General your estate planning. above, or the entire intestate estate if there is no becomes incapacitated. Of course, this same HIPAA priIn order to sign an Advance Directive, New Jersey and insurance policies and annuities name beneficiaries, vacy law applies to the elderly, and everyone in between. surviving spouse domestic partner, passes as most other state’s lawsorrequire: and these beneficiary forms dictate In order to allow your loved ones to havewhere accessassets to your follows to descendant’s: 1) That the signer be over 18 and competent to sign a Call to Schedule an Appointment medical information and make whether decisions aforWill you says when pass upon death, regardless legal document; • Descendants; and if none, to: Call toOcean Schedule an Appointment City: 609.398.3447 you can’t (without a court, you must haveand otherwise. Assetsinvolving which are not titled jointly • Parent or parents equally; and if none, to: 2) That the witnesses must attest to the fact that you OceanCherry City: 609.398.3447 awhich properly and witnessed Advancedwill Medical Hill: 856.673.0048 dosigned not designate a beneficiary pass, in are of sound mind and free of duress or undue • Parents’ descendants; and if none, to: Directive/Living Will.) Cherry Hill: 856.673.0048 absence of a Will, to your “heirs” as defined by the • One influence when you signgrandparents; the document; and if or more surviving State Intestacy What is aLaws. “Living Will”? 3)none, That to: the document be witnessed and/or notarized. Nancy Rice has been Nancy Rice has been • The descendants of grandparents (e.g., aunts and The term “Living Will” was coined in the midpracticing Estate practicing Estate a) New Jerseyand law nephews); requires either (2) witnesses 1970’s following themy Karen Ann under Quinlanthe matter Who are “heirs” NJ which uncles, nieces andtwo if none, to: Planning and Elder Planning and Elder or a Notary Public. Pennsylvania law (which we reached the New Jersey Supreme Court. The Court Intestacy Laws? • Step-children orbecause their descendants. Law in New Jersey Law in New Jersey and must consider many patients choose or end strongly recommended that every person over the age of The New Jersey intestacy law changed a and up in a Philadelphia hospital for certain procedures) eighteen (18) have a document in writing- with his or If there are no relatives surviving, the intestate Pennsylvania since few years ago. Generally, the surviving spouse or requires two (2) witnesses, and does not recognize Pennsylvania since her wishes concerning life support. estate passes (escheats) by default to the state of 1986. She was just a notary. For this reason, I set up my Advance domestic partner is first in line to receive assets 1986. She was NewDirective Jersey. Thus, if you want to make a bequest document for both two (2) witnesses and Certified as an ElderCertified as an Elder from the intestate estate. However, the amount What is a “Health Care Proxy”? Is it thea to people or Public organizations a Notary to sign. other than those listed Law Attorney in 1997, surviving or domestic partner is entitled to Law Attorney in 1997, samespouse as a “Living Will”? above, or if Witnesses you wantcannot to exclude certain people, b) Your be one of the peoand has maintained varies as followed: and has maintained offices in Camden The New Jersey Advance Directive law went into you ple must a Will andastake to review youmake have designated yourcare Health Care all offices in Camden effect in January, 1992. After that time, a Living Will and Cape May counties, specifically in If the decedent has no children or grandchildren of your beneficiary This designations onimportant life insurance, Representative!! is especially to and Cape May counties, specifically in came to be known by many different terms such as: remember if you areannuities. signing your Living Will or parents surviving, or if all of the children are retirement plans, and Cherry andOcean Ocean City. Cherry Hill Hill and City. • Advance Directive around the kitchen table . . . . Call Call 609-398-3447. 609-398-3447. • Advanced Medical Directive

Q: Q Q Q:

Q Q:

Q Q

Q Q: Q

• Estate/Trust Administration • Guardianships • Will Contest • Special Needs Trust

• Medicare, Medicaid, Long-Term Care ELDEr AND DiSAbiLiTy Nancy M. rice, Esquire, CELA Certified as an Elder Law Attorney by the National Elder Law Foundation

& Disability Planning

200 Asbury Avenue • Ocean City, NJ 08226 • 609.398.3447 1236 Brace Road, Suite F • Cherry Hill, NJ 08034 • 856.673.0048

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www.riceElderLaw.com March/April 2015

November/December 2014

Medical Professionals Medical Professionals

35 00

Warning Signs Of Hip And Knee Arthritis, The Spine: A Common Of Back And Leg Pain AndAging What To Expect When YouCause See Your Orthopedic Surgeon

M I

Written byost Frederick MD, FAAOS peopleDepaola will experience back

pain at some point in their life. As people age, their joints (such as hips and knees) experience wear and tear. The spine also consists of a complex set of joints that t is not unusual to see a patient with an arthritic problem of can degenerate. When this degeneration leads to a narrowing of the spinal the hip or knee, and the patient has mistaken his problem for canal in the lower back, it is referred to as lumbar spinal stenosis. another condition. Anatomy Most commonly hip arthritis will present as either right or left groin pain that

It is important to understand some of the basics of the anatomy of the spine to understand

worsens with stenosis. activity and withconsists rest. But theofpain may occur on lumbar spinal The improves spinal column of often a series bones connected to the one outside or posterior aspect of the hip or pelvis, making the diagnosis more difficult. another by intervening discs, joints and ligaments. The bones are referred to as vertebrae. Things such ashave bursitis, tendon even the hernias cause pain thesecord areas. The vertebrae a space withinstrains, them called spinalmay canal where theinspinal and nerve roots travel. Generally in as thetorn low back region thefemoral spinal cord has ended and there are Pre-arthritic conditions such cartilage and acetabular impingement nerve roots these that supply the legs. The sections of the spinal have can mimic symptoms as well. Back problems maycolumn also can be different mistakennames, for a hip where the low back section is referred to as the lumbar spine. condition, such as sacroiliitis which is inflammation or arthritis of the sacroiliac joint. happenspain as may the occur spinein ages? What Uncommonly the thigh and people frequently believe they are With aging, the normal discs and joints that have connect vertebrae suffering from sciatica when in reality they an the arthritic hip. degenerate. This leads to narrowing of the discs and arthritic changes of the joints, which can subsequently lead to painOther key symptoms of an arthritic hip are joint stiffness and loss of motion of in the low back. In addition, the ligaments overgrow and bone spurs form. All of these the hip.together cause the spinal canal to get narrower over time. Once the spinal canal narfactors rows Knee generally has a that more straightforward withlumbar pain orspinal to a arthritis certain point, the nerves travel to the legs getpresentation pinched causing stenosis.around the joint, and occasionally swelling and deformity in more advanced stiffness cases. time patients will report pain in the back of the knee or calf, or WhatFrom aretime the tosymptoms? The symptoms of lumbar spinal back pain, which can vary depending on pain running down the lower legstenosis makinginclude the diagnosis more difficult. severity the arthritis.isThere also be pain in theand buttocks can travel theOnce theofdiagnosis madecan treatment for hip knee that arthritis are down the back of the legs, for oftentimes referred to as “sciatica.” can also bedependent numbness orontingling individualized each patient’s symptoms, butThere are frequently the in the buttocks or legs. As the pressure on the nerves roots worsens, weakness can occur, patient’s disability and other conditions. especially in the foot. Patients will often times report that the pain is worse by standing up straight Theseand treatments may include activities thatAs aggravate the condition walking, but gets better the withavoidance sitting and of leaning forward. time progresses, such as stairclimbing, twisting, jogging andpain heavy lifting. patients will not be able kneeling, to walk assquatting, far they once did without feeling in their legs.Weight Some loss is often cited as a common recommendation to reduce joint pain in overweight patients, however, note that leaning forward on a shopping cart will allow them to walk farther without pain. patients. Often times, non-steroidal anti-inflammatories medications such as Ibuprofen or Naprosyn, may be recommended to reduce inflammation and pain in the joints. How is it treated? The treatment withshown seeingto a physician trained in dealing with thearound spine and Physical therapy begins has alsofirst been increase flexibility and strength the obtaining an accurate diagnosis. The diagnosis is made based on the history and physical joint to reduce pain. and also injections with X-raysfor andthe MRI. Generally, is started with non-surgical options. exam, Sometimes knees, such astreatment cortisone or viscosupplementation will This includes physical therapy, medications, acupuncture and steroid injections. Oftentimes help prolong the time before a joint replacement is needed. Braces are another option. patients will feel good pain relief from these treatments. If a patient has a poor quality of life In who are stenosis, too disabled or ill to undergo joint have replacement surgery, walker or duepatients to lumbar spinal and non-surgical treatments not worked or onlya worked specialized may be isrequired. temporarily, cane then surgery considered. The main stay for treating lumbar spinal stenosis is to remove In patients who do not respond to these treatments, the ligaments, bone spurs and other initial compressive factorsjoint fromreplacement placing pressure on the nerve roots. This process is referred to as decompression, or a laminectomy. surgeon becomes an option. Advances in total joint replacement in recent years haveThe been many. does not remove all of the vertebrae, only the elements in the back that are placing pressure These include medications to reduce pain and bleeding, newer prosthesis with the hope on longer the roots. Sometimes and a spinal fusion is also needed for joint various reasons. TheIlaminectomy of survivorship, newer techniques to insert replacements. personally can be done using a traditional incision, a small “mini-open” incision or a minimally invasive have begun doing the direct anterior approach for hip joint replacements in most of approach. The choice of approach will be determined based on the severity of the stenosis, my patients who require hip replacement surgery. have foundgood the use a special the individual patient and surgeon factors. Most peopleI experience painofrelief in their operating table and imaging during thenormal procedure toafter be helpful in obtaining more legs after surgery andx-ray are able to resume their lifestyle recovering from surgery. However, improvement in theaccurate back is variable. results. As you can see, it is interesting to talk about the In Conclusion . . . Lumbar spinal stenosis is diagnosis one cause of back and leg pain peoplearthritis, as they age. and treatment forthat hipaffects and knee the It is important to see a physician trained in treating this disease to obtain an accurate diag-the first step is to see your orthopedic surgeon to make nosis. Once that is achieved, there are multiple treatment options that can help improve a proper diagnosis and obtain the treatment plan that patient’s quality of life. most fits your needs.

Seaview Orthopaedic & Medical Associates

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Board Certified And Fellowship Trained Physicians

Spinal Surgery Total Joint Re STEVEN BERKOWITZ, M.D., P.A. Bone Density T ROY D. MITTMAN, M.D., P.A. Workers’ Compe ARTHUR P. VASEN, M.D., PH.D., P.A. Foot & A ■ OCEAN OFFICE KENNETH Y. CHERN, M.D., P.A.■ BRICK OFFICE 1200 Eagle Avenue 1640 Route 88 West HARALAMBOS DEMETRIADES, M.D., P.A. Ocean, NJ 07712 Brick, NJ 08724 222 ARTHUR K. MARK, M.D., P.A. Ph: (732) 458-7866 Ph: (732) 660-6200 CHRISTOPHER J. SPAGNUOLA, M.D., P.A. HOAN-VU T. NGUYEN, M.D., P.A. 120 ARON M. GREEN, M.D., P.A. B SUNIL R. THACKER, M.D., P.A. 16 KEVIN C. MCDAID, M.D. Clea PAUL T. HAYNES II, M.D. 294 Appl JOEL P. FECHISIN, M.D. Sa ROBERT P. PANNULLO, M.D. ■ MONROE OFFICE ■ FREEHOLD OFFICE 294 Applegarth Road, Suite C 222 Schanck Road D.O. ADAM M. MEYERS, Freehold, NJ 07728 KEIRON W. GREAVES, M.D. Monroe Twp., NJ 08831 Ph: (609) 495-1888 Ph: (732)GARLA, 462-1700 ww SUDHA M.D.

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IN LAKEWOOD

Seaview & Medical Medical SeaviewOrthopaedic Orthopaedic & Associates thehighest highest Associateshas hasprovided provided the quality of care in Monmouth and quality of care in Monmouth, Middlesex Ocean Counties forfor over and Ocean Counties over3030years. years.

Praveen Yalamanchili, MD. Dr. Yalamanchili is a fellowship-trained Spine Surgeon, who completed his training at Emory University in Atlanta, Georgia. A native of New Jersey, Dr. Yalamanchili has returned home after completion of his Fellowship training. He attended medical school at UMDNJ – Robert Wood Frederick DePaola MD, FAAOS Johnson Medical School and completed his orthopaedic residency at UMDNJ- New Jersey Medical School. He specializes in the treatment of spinal disorders www.seav i ew orparticular t h o. interest comin cervical • (neck) 732660 -6as2minimally 0 0 invasive and motion sparing procedures. including degenerative, deformity and trauma and has surgery as well

www.seaviewortho.com • 732-660-6200 www.TheCountyWoman.com The County Woman Magazine www.TheCountyWoman.com

March/April 2015

M edical Professionals M edical Professionals

36 24

The Doctors The DoctorsOf OfSeaview SeaviewOrthopaedic Orthopaedic&&Medical Medical Associates Associates

• STEVEN BERKOWITZ, MD, PA, FAAOS ••KENNETH CHERN, MD,MD, PA,PA, FAAOS STEVEN BERKOWITZ, FAAOS ••VINAY CHOPRA , MD, CAQ KENNETH CHERN, MD, PA, FAAOS • HARALAMBOS DEMETRIADES, MD, PA, FAAOS • VINAY CHOPRA, MD • FREDERICK DEPAOLA, M.D., FAAOS HARALAMBOS DEMETRIADES, ••JOEL FECHISIN, MD, PA, FAAOSMD, PA, FAAOS JOEL FECHISIN, MDMD ••KEIRON GREAVES, • KEIRON GREAVES, MD FAAOS • ARON GREEN, MD, PA, • ARON GREEN, MD, PA, FAAOS • PAUL HAYNES II, MD, PA, FAAOS • PAUL HAYNES II, MD • ARTHUR MARK, MD, PA, FAAOS ARTHUR MARK, MD, ••KEVIN MCDAID, MD,PA, PA,FAAOS FAAOS ••ADAM KEVIN MEYERS, MCDAID,DO, MD,FAAPMR PA, FAAOS ••ROY MITTMAN, ADAM MEYERS,MD, DO,PA FAAPMR ••HOAN-VU NGUYEN, MD, PA, FAAOS ROY MITTMAN, MD, PA ••ROBERT PANNULLO, HOAN-VU NGUYEN,MD, MD,FAAPMR PA, FAAOS ••CHRISTOPHER SPAGNUOLA, MD, PA, FAAOS ROBERT PANNULLO, MD, FAAPMR ••SUDHA GARLA MD CHRISTOPHER SPAGNUOLA, MD, PA, FAAOS • SUNIL THACKER, MD, PA, FAAOS • SUNIL THACKER, MD, PA, FAAOS • ARTHUR VASEN, MD, PHD, PA, FAAOS • ARTHUR VASEN, MD, PhD, PA, FAAOS • PRAVEEN YALAMANCHILI, MD, PA, FAAOS PRAVEENJ.YALAMANCHILI, MD ••GEORGE FAHOURY, JR., D.P.M., F.A.C.F.A.S.

{Steven Berkowitz,

MD,

FACS, FAAOS, CIME

Dr. Berkowitz attended medical school at the College of Medicine, SUNY Health Science Center at Brooklyn, NY and completed a residency at NYOH/ New York (Columbia) Presbyterian Medical Center. He is board certified by the American Board of Orthopaedic Surgery, as well as the American Board of Independent Medical Examiners. He is an attending physician at Jersey Shore University Medical Center and Ocean Medical Center.

{Kenneth Chern,

MD,

FAAOS

Dr. Chern is a graduate of the College of Physicians and Surgeons Columbia University, NY and completed his residency at NY Orthopaedic Hospital/ Columbia Presbyterian Medical Center, NY. He completed a Fellowship in sports medicine at Southern Sports Medicine and Orthopaedic Center in Nashville. He is board certified by the American Board of Orthopaedic surgery with a subspecialty certification in sports medicine. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center.

{Vinay Chopra,

MD CAQ MD,

Dr. Chopra earned his undergraduate degree from Rutgers University, and medical degree with honors from Ross University School of Medicine. He completed his residency in Family and Community Medicine at University of Maryland Medical Center in Baltimore, and completed his fellowship in Sports Medicine at Atlantic Health, Morristown Medical Center, in affiliation with the prestigious Mount Sinai School of Medicine. Dr. Vinay Chopra specializes in non-surgical orthopaedics, concussion management, sports performance, and rehabilitation.

Dr. Chopra is the head team physician at Felician College and school physician for Manalapan and Feehold High Schools. He is certified in Combat Medicine and appointed by the New Jersey State Athletic Control Board as a ringside physician. He has covered numerous mixed martial arts events such as Cage Fury Fighting Championships, Ring of Combat, and Dead Serious.

{Haralambos Demetriades,

MD, FAAOS

Dr. Demetriades attended Mt. Sinai School of Medicine in New York and completed his residency training at Mt. Sinai Medical Center. Dr. Demetriades continued on to obtain a Fellowship in Spinal Surgery Fellowship at Beth Israel Medical Center. He is board certified by the American Board of Orthopaedic Surgery. His specialties are spine surgery, spine trauma and deformity and scoliosis. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center.

{Joel Fechisin,

MD, MD, FAAOS PA

Dr. Fechisin is a graduate of UMDNJ-Robert Wood Johnson Medical School. Following a one-year surgical internship at Abington Memorial Hospital in Abington, Pennsylvania, he completed his residency in orthopaedic surgery at Monmouth Medical. He went on to earn his Fellowship in Adult Reconstruction at Insall Scott Kelly Institute in New York, NY. Dr. Fechisin specializes in all disorders and injuries of the knee, total joint replacement, and also has subspecialty training in arthroscopy and cruciate ligament reconstruction. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center.

{Keiron Greaves,

Dr. Greaves graduated UMDNJ Robert Wood Johnson Medical School. He completed his residency in Anesthesiology at SUNY Downstate Medical Center in 1993. Dr. Greaves completed his Fellowship training in Pain Management at SUNY Heath Science Center at Brooklyn University Hospital, Kings County Department of Anesthesiology, and Long Island College Hospital Veterans Administration Hospital in Brooklyn, NY. Dr. Greaves is board certified in pain management. He is an attending physician at Monmouth Medical Center.

{Aron Green,

MD, FAAOS

Dr. Green is a graduate of the University of Medicine and Dentistry of New Jersey/New Jersey Medical School. He also completed a Foot and Ankle Fellowship at Allegheny General Hospital in Pittsburgh, PA. He is board certified by the American Board of Or-

www.TheCountyWoman.com The TheCounty County Woman Woman Magazine Magazine

thopaedic Surgery and is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center.

{Paul Haynes II,

MD, MD FAAOS

Dr. Paul Haynes completed medical school at UMDNJ/New Jersey Medical School in Newark New Jersey. Following medical school, he completed internship and residency at Albert Einstein College of Medicine at Montefiore Medical Center, Waters Place, in Bronx New York. He went on to complete his fellowship in Orthopaedic Surgery and Pediatric Sports Medicine, Limb & Pediatric Deformity at Albert Einstein College of Medicine Montefiore Medical Center at Waters Place, in Bronx New York. He also completed an Arthroscopic Fellowship at Staten Island Orthopedics & Sports Medicine, in Staten Island, New York. Dr. Haynes is a general orthopaedic surgeon, specializing in Pediatric Sports Medicine, Limb & Pediatric Spine Deformity as well as General and Pediatric Orthopaedics/Surgery. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center, Monmouth Medical Center and Saint Peter’s University Hospital.

{Arthur Mark,

MD, FAAOS

Dr. Mark is a graduate of Temple University School of Medicine. He completed his residency training at Albert Einstein Medical Center. Dr. Mark then obtained a Fellowship at Massachusetts General Hospital in Adult Reconstruction. He presently is a Clinical Assistant Professor of Orthopedic Surgery at Drexel University College of Medicine. His specialties are general orthopaedic surgery and total joint replacement and revision. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center.

{Kevin McDaid,

MD, FAAOS

Dr. McDaid is a graduate of Thomas Jefferson University in Philadelphia, Pennsylvania. He completed his residency at Monmouth Medical Center and his Fellowship training in upper extremity/hand surgery at The Hand Center of San Antonio in Texas. He specializes in general orthopedic surgery and upper extremity and hand surgery. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center. ABOUT SEAVIEW ORTHOPAEDICS: At Seaview Orthopaedic & Medical Associates, we have been committed to providing you with quality orthopedic care for over 30 years! Our patients’ total experience with our practice is our number one priority.

March/April 2014 2015 July/August

Medical Professionals

Seaview Orthopaedics is committed to providing quality care in Monmouth and Ocean Counties. We specialize in surgical and non-surgical care of orthopaedic-related injuries. Adam Meyers, DO, FAAPMR Dr. Meyers received his medical degree from the University of Health Sciences College of Osteopathic Medicine and also trained at the University of Pennsylvania and the Hospital of the University of Pennsylvania. He completed his residency training at The Hospital of the University of Pennsylvania and is certified by the American Board of Physical Medicine and Rehabilitation and the American Academy of Electrodiagnostic Medicine. He is an attending physician at Monmouth Medical Center.

Roy Mittman, MD Dr. Mittman attended Albert Einstein College of Medicine in New York. He completed his residency at Montefiore Medical Center in New York. He specializes in general orthopaedic surgery, total joint replacement and arthroscopic surgery. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center.

Hoan-Vu Nguyen, MD, FAAOS Dr. Nguyen is a graduate of Temple University School of Medicine and completed his residency training at Penn State Milton S. Hersey Medical Center. From there he obtained his Fellowship in spine surgery at San Diego Center for Spinal Disorders. He specializes in general orthopaedic surgery, neck and back surgery and disc replacement. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center.

Robert Pannullo, MD, CIME, FAAPMR Dr. Pannullo is a graduate of Wayne State University School of Medicine and also trained at KDV Orthopaedics and Rehabilitation in York, PA. He completed his residency at New York Hospital/Cornell Medical Center (currently NY Presbyterian Hospital) and completed an Interventional Spine Techniques and Pain Management Fellowship at KDV Orthopaedics & Rehabilitation, LTD. He is a specialist in Physical Medicine and Rehabilitation and EMG Testing. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Independent Medical Examiners. He is an attending

physician at Jersey Shore Medical Center, Ocean Medical Center and Monmouth Medical Center.

Christopher Spagnuola, MD, FAAOS Dr. Spagnuola is a graduate of The University of Medicine and Dentistry of New Jersey. He completed his residency at Monmouth Medical Center. He received his Fellowship at Thomas Jefferson University in Sports Medicine. He completed further training at Monmouth Medical Center and Children’s Hospital of Philadelphia. He is board certified by the American Board of Orthopaedic Surgery with sub-specialty certification in sports medicine. Dr. Spagnuola worked as an Assistant Team Physician for the Philadelphia Phillies and Wings organizations. He specializes in arthroscopic surgery. He is presently a Clinical Assistant Professor of Orthopaedic Surgery at Drexel University College of Medicine. He is an attending at Jersey Shore University Medical Center, Ocean Medical Center, and Monmouth Medical Center.

Sudha Garla, MD She is Board Certified in Internal Medicine with focus on Occupational Medicine. Dr. Garla received her Electrical/Biomedical Engineering Degree with the highest honors from Rutgers State University in New Jersey. She then attended UMD&J at Robert Wood Johnson Medical School where she received her medical degree. Dr. Garla trained in Internal Medicine at UMD&J, Robert Wood Johnson Medical School. She is a fellow of the American College of Gastroenterology. She is a member of the American College of Physicians, the American Medical Association, the Institute of Electrical & Electronic Engineers and the Society of Women Engineers. Dr. Garla has certification as a Medical Review Officer (MRO).

Sunil Thacker, MD, FAAOS Dr. Sunil Thacker is a graduate of UMDNJ-New Jersey Medical School. He also completed his residency at UMDNJ-New Jersey Medical School. He went on to earn his Fellowship in sports medicine at the University of Pennsylvania in Philadelphia, PA and is board certified by the American Board of Orthopaedic Surgery. His practice also focuses on joint preservation arthroplasty in active adults. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center, Monmouth Medical Center and Saint Peter’s University Hospital.

The County Woman Magazine www.TheCountyWoman.com

Arthur Vasen, MD, PhD, FAAOS Dr. Vasen attended the University of Medicine and Dentistry of New Jersey- Robert Wood Johnson Medical School. He completed his residency at Case Western Reserve University Cleveland, OH. He earned his Fellowship at Brigham and Women’s Hospital in hand and upper extremity surgery. His specialties are general orthopaedics, trauma surgery, hand and upper extremity surgery and arthritis surgery. Dr. Vasen is board certified by the American Board of Orthopaedic Surgery. He is presently an Assistant Clinical Professor at Drexel University College of Medicine. Also, he is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center and Monmouth Medical Center.

Praveen Yalamanchili, MD, FAAOS Dr. Yalamanchili attended medical school at UMDNJ - Robert Wood Johnson Medical School and completed his orthopaedic residency at UMDNJ- New Jersey Medical School. He specializes in the treatment of spinal disorders including degenerative, deformity and trauma and has particular interest in cervical (neck) surgery as well as minimally invasive and motion sparing procedures. Dr. Yalamanchili is a fellowshiptrained Spine Surgeon, who completed his training at Emory University in Atlanta, Georgia. He is an attending physician at Jersey Shore University Medical Center, Ocean Medical Center, Monmouth Medical Center and Saint Peter’s University Hospital.

George J. Fahoury, Jr., D.P.M., F.A.C.F.A.S. Dr. Fahoury received his Doctorate degree in Podiatric Medicine from the New York School of Podiatric Medicine in New York, N.Y. and completed his residency at Baptist Medical Center in Brooklyn, N.Y. Dr. Fahoury achieved his Board Certification in Foot & Ankle Surgery from the American Board of Podiatric Surgery in 1987 as well as his Fellowship within the same year from The American College of Foot & Ankle Surgeons. He specializes in reconstruction of foot and ankle deformities such as flat feet, bunions, hammertoes, sports injuries, foot & ankle trauma, arthroscopic joint surgery and fractures. Facility Appointments: Jersey Shore University Medical Center, Neptune, NJ and Clara Mass Hospital, Belleville, NJ.

March/April 2015

Medical Professionals

WELCOME

Dr. DePaola

to Seaview Orthopaedic & Medical Associates!

Frederick DePaola MD, FAAOS

Seaview Orthopaedics Welcomes Dr. DePaola Seaview Orthopaedics is pleased to welcome Dr. Frederick DePaola to their practice. As a board certified orthopaedic surgeon specializing in General Orthopaedics, Joint Replacement, Fractures and Arthroscopic Surgery, Dr. DePaola makes an ideal addition to the already exceptional practice.

Prior to joining Seaview Orthopaedics, Dr. DePaola has been providing orthopaedic care in the Wall area for over 15 years. One of his main area of interests is performing the anterior approach for Hip and Knee replacements. He is excited about the prospect of working in a large group practice. “I have found that practicing as an individual without the benefit of coverage of a larger group to be quite difficult. I know it will fSitting, Row 1, (left to right) - Drs. Berkowitz, Mittman, Demetriades benefit myself and my patients to be in a group that comprises almost all orthopedic Sitting, 2nd Row, - Drs. Vasen, Thacker Standing, 1st Row - Drs. Garla, subspecialties with well trained surgeons to allow greater continuity of care,” he adds. Mark, Meyers, Greaves, Chern, Spagnuola, Nguyen Standing, 2nd Row Dr. DePaola became interested in orthopedic surgery during his last year of medical school. “I had the opportunity to work with my cousin who is a surgeon in Jersey City, Drs. McDaid, Fahoury, Yalamanchili, Green, Chopra, Fechisin, Haynes Not pictured - Drs. DePaola & Pannullo. he got me very interested in surgery. From that experience and from discussions with several orthopedic surgeons, I decided to enter an orthopedic residency.” Most of the patients he sees suffer from hip, knee or shoulder disorders. His medical philosophy isost one that iswill patient inclusive.back “I treat patient as aninindividual people experience paineach at some point their life. and As avoid factorypeople type medicine. encourage be knees) active participants their age, theirWejoints (such patients as hips to and experienceinwear orthopaedicand decision whether be a surgical non-surgical tear.making, The spine alsoitconsists of a or complex set ofapproach,” joints that If you have questio hecan says.degenerate. When this degeneration leads to a narrowing of the spinal concerns, call Seav Orthopaedic & Med & Medical Associates He is excited about some of the new advances happening in his field. “Hip Associates, 732-660 canal in the lower back, it is referred to as lumbar spinal stenosis. Call one of our convenient locations to schedule your appointment. replacements with anterior incisions and intraoperative imaging show significant Call one of our convenient locations to schedule your appointment. Anatomy promise. Similarly, in knee replacements smaller incisions have become popular over Spec It is important to understand some of the basics of the anatomy of the spine to understand thelumbar last few years.” The nonoperative options, including injections, physical therapy, Spinal Surgery/Scolios spinal stenosis. The spinal column consists of a series of bones connected to one Fellowship Trained Physicians Board Certified And and bracing is also good news for and patients seeking to surgery. Total Spinal Joint Replacem another by intervening discs, joints ligaments. Thealternatives bones are referred to as vertebrae. Surger Fellowship Trained Physicians STEVEN BERKOWITZ, M.D., P.A. The Dr. vertebrae DePaola have attended medical at Ross University Schooltheofspinal Medicine, a space within school them called the spinal canal where cord and If you have questions or Total Joint R ROY D. MITTMAN, M.D., P.A. If you questions or concerns, call have Seaview nerve rootsWest travel. Generally the low back the spinal cord hasHospitals ended andMedical there are Dominica, Indies, andincompleted hisregion internship at United ■ OCEAN OFFICE ■ BRICK OFFICE ■ FREEHOLD OFFICE ■ MONRO concerns, callP. Seaview Orthopaedic & Eagle Medical ARTHUR VASEN, M.D., PH.D., P.A. 1200 Avenue 1640 Route 88 West 222 Schanck Road 294 Applega & Medical Associates nerve roots that supply thefinished legs. Thehis sections of theatspinal column haveofdifferent names, STEVEN BERKOWITZ, M.D., P.A. Foot &Density Ankle • Orthopaedic & Medical Bone Center, Newark, N.J. He residency the University Medicine and Associates, 732-660-6200. & Medical Associates Ocean, NJ 07712 Brick, NJ P.A. 08724 Freehold, NJ 07728 Monroe Tw KENNETH Y. CHERN, M.D., Associates, 732-660-6200. where the low back section is referred to as theCalllumbar spine. one of our convenient locations to schedule your appointment. Ph: (732) 660-6200 Ph: (732) 458-7866 Ph: (732) 462-1700 Ph: 609-49 ROYHARALAMBOS D. MITTMAN, M.D., P.A. M.D., P.A. Dentistry of New Jersey. Pa Call one of our convenient locations to schedule your appointment. DEMETRIADES, Workers’•Comp Ofﬁcial Team happens spinehigh ages? www.seaviewortho.com 732 Doctors Of:Ofﬁcial Team 222 Schanc Specializing in: ARTHUR K. MARK, M.D., P.A. What With over 30 yearsas of the providing quality healthcare, Seaview Orthopaedics Doctors Of: ARTHUR P.Specializing VASEN, M.D., in: PH.D., P.A. Foot & With aging, the normal discs and joints that connect the vertebrae degenerate. This leads Spinal Surgery/Scoliosis • Hand & Upper Extremity ■ OCEAN OFFICE ■ BRICK OFFICE Spinal Surgery/Scoliosis • Hand & Upper Extremity has earned their stellar reputationFellowship inFellowship the area. Trained They believe in earning the trust of Physicians Physicians KENNETH Y. CHERN, M.D., P.A. to narrowing of the discs and arthritic changes of the Trained joints, which can subsequently leadTotal to Total Joint Replacement • Trauma/Fracture Care Joint Replacement • Trauma/Fracture Care 1200 Eagle Avenue 1640 Route 88 West their only by addressing their orthopedic needs, but by treating each painpatients, in the lownot back. In addition, the ligaments overgrow and bone spurs HARALAMBOS DEMETRIADES, M.D., P.A. STEVEN BERKOWITZ, M.D., P.A.form. All of these STEVEN BERKOWITZ, M.D., P.A. patient theircause familythewith compassion. Dr. DePaola istime. a perfect addition to their Ocean, NJ 07712 Brick, ■NJ 08724 factorsand together spinal canal to narrower over Once the spinal canal narROY D.get MITTMAN, M.D., P.A. ■ SATELLITE ROY D. MITTMAN, M.D., P.A. SATELLITE 22 ■ OCEAN OFFICE ■ BRICK OFFICE ■ FREEHOLD ■ K. MONROE OFFICE M.D., BARNEGAT ■ ARTHUR MARK, P.A. ■ OCEAN OFFICE ■ BRICK OFFICE ■ FREEHOLD OFFICEOFFICE ■ MONROE OFFICE OFFICE OFFICE ■ BARNEGAT OFFICE ARTHUR P. VASEN, M.D., PH.D., P.A. OFFICE team. rows to a certain point, the nerves that travel to the legs get pinched causing lumbar spinal 294 Applegarth Road, Suite C 500 Barnegat Blvd, Bldg. 200 1200 Eagle Avenue 1640 Route 88 West 222 Schanck Road ARTHUR P. VASEN, M.D., PH.D., P.A. Ph: (732) 660-6200 Ph: (732) 458-7866 Foot & Ankle • General Orthopaedics 294 Applegarth Road, Suite C 500 Barnegat Blvd, Bldg. 200 1200 Eagle Avenue 1640 Route 88 West 222 Schanck Road IN Foot & Ankle Monroe • General Ocean, NJ 07712 Brick, NJ 08724 Freehold, NJ 07728 Twp., Orthopaedics NJ 08831 Barnegat, NJ 08005

Medical Pro

essionals

The Aging Spine: A Common Cause Of Back And Leg Pain

Seaview Orthopaedic Seaview Orthopaedic & Medical Associates

Seaview Orthopaedic Seaview Orthopaedic

IN KENNETH Y. CHERN, Ocean, NJ 07712CHERN, Brick,M.D., NJ 08724P.A. Freehold, NJ 07728 CHRISTOPHER Monroe Twp., NJ 08831 Barnegat, NJ 08005 M.D., P.A. J. SPAGNUOLA, KENNETH M.D., LAKEWOOD Ph: (732) Y. 660-6200 Ph: P.A. (732) 458-7866 Ph: (732) 462-1700 Ph: 609-488-3988 Ph: 609-495-1888 Patriot’s Park LAKEWOOD Ph: (732) 660-6200 Ph: (732) 458-7866 (732) 462-1700 Ph: 609-488-3988 Ph: 609-495-1888 HARALAMBOS DEMETRIADES, M.D.,Ph: P.A. Patriot’s Park HARALAMBOS DEMETRIADES, M.D., P.A. www.seaviewortho.com • 732-660-6200 HOAN-VU T. NGUYEN, M.D., P.A. What are the symptoms?ARTHUR K. MARK, M.D.,www.seaviewortho.com 222 Schanck Road • Freehold, NJ P.A. 732-660-6200 222•Schanck Road • Freehold, NJ ARTHUR K.include MARK,back M.D., The symptoms of lumbar spinal stenosis pain,P.A. which canor varyth depending on www.s eav i ew o. com • 73266 0 -6M.D., 2 0 0 P.A. ARON M. GREEN, the severity of the arthritis. There can also be pain in the buttocks that can travel down the SUNIL R. THACKER, M.D., P.A. back of the legs, oftentimes referred to as “sciatica.” There can also be numbness or tingling The County Woman Magazine www.TheCountyWoman.com March/April 2015 in the buttocks or legs. As the pressure on the nerves roots worsens, weakness can occur, KEVIN C. MCDAID, M.D. especially in the foot. Patients will often times report that the pain is worse by standing up

stenosis.

1 Cle

Medical Professionals

Meet the Midwife: Q&A with Lori Sherman, CNM, MPH, APN While midwives have been delivering babies for decades, you may be hearing more about this birthing option thanks to the popular BBC television series “Call the Midwife” featuring nurse midwives working in London in the 1950s. Many women across the nation, and here in Ocean County, are choosing midwives to deliver their babies. Lori Sherman, a Certified Nurse Midwife with Ocean Gynecological and Obstetrical Associates (OGOA), stopped keeping track of the number of babies she’s delivered after she reached 1,000. Here, she sheds light on midwifery.

Q: What is a midwife? A: Midwives offer comprehensive,

gentle care to patients from annual gynecological care, contraception counseling, pre-natal care, labor and delivery, through menopause. We provide oneon-one nurturing care to support laboring mothers’ individual choices for labor and delivery.

Q: What type of training do most midwives receive? A: A Certified Nurse-Midwife

(CNM) is educated in the two disciplines of nursing and midwifery, certified by the American Midwifery Certification Board and licensed to practice in the State of New Jersey. Most midwives have a bachelor’s degree in nursing, master’s in nursing and a midwife certification.

Q: What’s the biggest myth about midwifery? A: Many people think it means

that women have to go through an unmedicated child birth and have a home birth. This is absolutely not the case. Ninety-five percent of midwives practice in-hospital birth. We help guide women through the decision process – whether it’s medicated (epidural) or unmedicated child birth.

Q: What do you want women to know about midwives? A: Because we’re not doing surgery,

we have more time to spend with women during the course of their

Ocean Gynecological and Obstetrical Associates has two convenient office locations: For more than 50 years, women in Ocean County have trusted Ocean Gynecological and Obstetrical Associates (OGOA) to provide comprehensive obstetric and gynecological care. In 2012, OGOA took the bold step of expanding to include a team of experienced, boardcertified nurse-midwives to join its seasoned group of board-certified physicians. Today, OGOA is one of the only practices in the region that offers daily appointments with a midwife for in-office gynecological or prenatal care and around-the-clock midwifery coverage for pregnant women in the hospital. OGOA has one of the lowest C-section rates for obstetrical practices in the region.

Toms River Office 368 Lakehurst Road, Suite 303 Toms River, NJ 08755 732.349.0485

Lakewood Office 475 Route 70, Suite 101 Lakewood, NJ 08701 732.364.8000

Office Hours Monday through Friday: 8:30 a.m. to 5 p.m.

About Barnabas Health Medical Group Barnabas Health Medical Group is a multi-specialty group practice comprising highly trained and experienced world class primary and specialty care physicians. Barnabas Health Medical Group physicians provide compassionate and innovative cutting edge care for people at every stage of life at easily accessible facilities conveniently located throughout New Jersey. Backed by the vast continuum of resources of Barnabas Health, the largest not-for profit integrated health care delivery system in New Jersey and one of the largest in the nation, our dedicated physicians and expertly trained supporting staff continuously strive for clinical excellence. To learn more, visit barnabashealthmedicalgroup.org. labor and birth and during prenatal care. Our job is to empower women to make the best choices for them and their families throughout pregnancy and their lifetime.

Q: What, exactly do midwives do? A: We are so much more than

“hand holders.” By attending thousands of births, my colleagues and I know and respect normal pregnancy and the physiologic birth process. From this base, we are able to recognize when the process is not progressing normally and consult with our highly experienced collaborating physicians from OGOA. Midwives also do more than deliver babies. We offer comprehensive care and guidance for women starting with a teen’s first gyn exam through pregnancy and into menopause.

Q: How do midwives and OB/GYNs work together? A: Midwives and physicians at

Ocean Gynecological & Obstetrical Associates work collaboratively to ensure the best care for women and their babies. Generally, midwives work with women who are low-risk. Should a high-risk complication like high blood pressure or gestational diabetes arise, obstetrician/gynecologists (OB/GYNs) and midwives provide collaborative care. If a cesarean section or operative birth is needed, there’s an OB/GYN and midwife available 24 hours a day. Women can rest assured a midwife will be present for delivery.

The County Woman Magazine www.TheCountyWoman.com

We are one of the only groups that guarantees 24-7 midwifery and physician coverage. If a woman chooses a midwifery experience she can rest assured that a midwife will be present for her birth. Yet, if an c-section is needed a physician is always available too.

Q: What services do you offer for women opting for natural childbirth? A: We offer many of the comforts

of a birth center with the safety of a hospital. We offer intermittent monitoring, jacuzzis, birth balls, ambulation during labor, alternative birthing positions, immediate skinto-skin contact, and more.

Lori Sherman, CNM, MPH, APN Lori Sherman earned both a B.S. and a M.S. in nursing from the University of Pennsylvania in Philadelphia. Specializing in nurse-midwifery and women's health, Lori is dual-certified as a certified nurse-midwife and women’s health nurse practitioner. She is a member of the American College of Nurse Midwives and the Association for Reproductive Health Professionals. Prior to a career as a CNM, Lori earned a Master of Public Health degree from Boston University. Lori is on staff at Ocean Gynecological & Obstetrical Associates and delivers babies at Community Medical Center.

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Elder Life Management

00 42

Planning AdultAre Children With Disabilities Baby For Boomers The New Babysitters By Judith S. Parnes, L.C.S.W., C.M.C., By Judith S. Parnes, L.C.S.W., C.M.C. Gerontologist And Elder Care Consultant is Gerontologist And Elder Consultant Executive Director Of Elder LifeCare Management, Inc.,isOcean, NJ.

Executive Director Of Elder Life Management, Inc., Ocean, NJ generation of parents are now growing n entire

older and facing the reality that their children

Welcome TowillThe with disabilities outliveWorld them. Presently, Of Nana 2015 close to a million developmentally disabled adults are living with

caregivers over the age of 60 in the United States. ow many of you reading this column are over 60 years young? How

While parents older, possibly many are not for their own parents but many areare stillgrowing employed, full only time,caring and have also added also caring for an adultgrandchildren” child with special They may From feel financially stretched. “babysitting toneeds. your resume? spontaneous, Medical advances have enabled people with developmental disabilities to live longer. infrequent relief to an actual commitment of 1-2 days a week? Maybe you At the same time, these early advances have enabled their parents to livelife longer as well. are now considering retirement or cutting your work down to part However as both populations age, theyBabysitters! have increased care has needs. time. Baby Boomers are the new Nana become the Nanny. Consider the circumstances of Helen P. Helen first called Elder Life Management Grandparents have always had a unique role – our connection to the past, and to discuss herto concerns. As the provider for and her 49 year old often the key what shapes oursole future. Theyand are caregiver our history, in turn, we son, become Ted, Helenofknew “different”Grandparents but he was never diagnosed. Had Ted been reflections theirthat livesTed andwas experiences. set the values and standards born today, he would been diagnosed as being the autism spectrum. by which families live.have It is surely through traditions passed alongonthrough generations by However, in the veryremain few sought schools or outside agencies. Her grandparents that1950’s families stronghelp andfrom together. For many younghelp parents is that fear grandparents are needed to to reason for seeking fromthe thiseconomic office andreality her biggest was what would happen step andaged help.(she Today’s “Nana” suffered the babysitter is stroke) representative of all Ted in as she had already a minor and both of socioeconomic their care needs and ethnic groups and lives in every state of the U.S. The reasons for taking care of increased . grandchildren are many and varied. Sometimes the situation is temporary, caused I worked with Helen to develop a plan including short term solutions and long by such things as illness of a parent, military service, or transitions that come with term planning. We were able to obtain Social Security benefits for Ted as a disabled divorce. Other times, Nana becomes the long-term solution: the early death of adult. Our agency found a local program to assist with substance developingabuse, socialization skills parents, long-term and incapacitating illness, parental incarceration, to increase his ability to ultimately live independently. Simultaneously, a care manger homelessness, or worse. For some the part-time grandparent role then shifts to full begansometimes to meet with Ted and named as a result, developed and trusting relationship. time, even being guardian of thea rapport minor. Grandparents are the Ascaregivers Helen’s health continued decline,children she knew time had come that she could main for more than 3tomillion in the USA today, a significant 20% increase from turn of millennium. no longer live the at home andthecare for Ted. Together we sought alternative living arrange The Sandwich Generation a termwent many are familiar Thisand phrase ments for both Helen and Ted.isHelen intoofanusassisted living with: program Ted iswas frequently used to describe the caregiver sandwiched between elderly parents and able to obtain housing in an apartment that offered limited help and supervision. raising children. This new and growing phenomenon should be called the “Club We continue to assist Ted even now, 15 years later. A commitment was made that Sandwich Generation”! Three slices of bread: Top – grandparents, mid slice – adult Ted would remain a client of Elder Life Management. Ted now continues to live children and then the grandchildren as the final slice. Each layer represents individual in supervised housing. Elder Life Management oversees his medical and care needs

and also pays his monthly bills. A care manager continues to “check –in” with Ted and of course, is available in an emergency. Elder Life Management is now Ted’s family.

In Summary, below is a list of things you should consider when developing a plan for your special needs loved one. 1. Tell your child’s story. Take the time to put together some guidelines on caring for your loved one with special needs. This will be a non-legal docuit will bemost a useful needsment, to bebut addressed, oftenresource. in different areas, but can combine together and

2. Identify Guardians and trustees will be who willlayer. be guardians and/or offer support to each Here at Elder Lifetrustees. Management, the multi-generational family is the norm, is with of most this magazine’s readers. responsible for as theitwelfare yourofloved one, so think carefully before naming I recently met with R toDon’t reviewassume both shortand long-term for her any individual to Mrs. this role. that the closest relativeplans is always the best husband, Alan. Alan choose was recently diagnosed stage disease. We choice. Instead, a person who youwith feel early will be ableAlzheimer’s to handle the respondiscussed many options specific to her needs, including some assistance at home and sibility and look out for the best interest of your loved one. A professional Care potentially adult care. It was then that Ruth laughingly said to me, “Am I the Manager canday be consulted. only one you’ve ever met with who is researching adult day care for their spouse and 3. Work Involve rest of together with your relatives to coordinate planning. child day care for a grandchild?” The honest answer is no, this is not such the an unusual your family in your planning efforts. This will ensure that everyone is aware of scenario here at Elder Life Management. is going on, which the riskoffers of disruption and conflict after your Inwhat summary, while caringwill for minimize grandchildren many rewards and benefits, death. it goes without saying it certainly can present challenges as well. Planning for a special needschild family member can be Find a supportive community. • 4. Changing relationships: Your relationship with your adult may change. a challenge, but you are not alone. Seek out other families who are dealing with the You are now involved on a much more intimate level with your adult child’s family, samethings issuesthat as you. They be able tobeprovide support and guidance to seeing would notwill necessarily seen if valuable not for this new family dynamic. help you in your planning efforts. • Change in lifestyle: both leisure and/or work time

• 5. Your own health: postponing elective for procedures or follow-up Financial Seek Professional help in planning now andand/ beyond.

appointments. Your health sometimes becomes your adult child and institutions are now including professional caresecondary managerstoand advisors who can grandchildren’s needs. address, monitor and develop optimal care plans for enhanced quality of life and • Finances: Are you willing to provide moreneeds thanare justmet. babysitting relief, and will it increase assurance that health and safety also include more generous financial support?

Planning forManagement your future and the surprising events face can always Elder Life provides quality elder care we planning, be management challenging. and Knowing whoapplication to turn toservices for helptobecomes the pathway Medicaid older adults forand success Whether the nana role is infrequent, scheduled or surrogate their families. Please visit www.elderlifemanagement.org parent. “Women in the Middle” need to always be educated consumers.

or call (732) 493-8080 for more information. 931 West Park Avenue, Ocean, New Jersey, 07712.

Testimonials Say It All . . .

I was so pleasantly surprised at how quickly I received my father’s Medicaid approval. I know this is your job but I am so grateful for your help. I don’t believe this would have happened without you and Elder Life Management. James B., Toms River, NJ Once Again, It is amazing to me that anyone can expect an elderly person to actually make sense of this all. I am a lawyer and my wife is an accountant and if we 3 didn’t have Elder Life Management helping, there is no way we could have navigated this maze. Robert D, Aberdeen, NJ

Just wanted to say thank you again for all your help, guidance, expertise, patience and understanding. Elder Life Management saved my life and sanity. I could never 3 have done it without you. Barbara G., Red Bank, NJ

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MarchWhat Is National Colorectal Awareness Month Here’s You Should Know:Cancer How To Prevent And Treat Colorectal Cancer alization of the inside of How common is colorectal cancer and who is at risk? the colon and rectum. A Colorectal cancer is the second most common cancer in the H ealth &W ellness colonoscopy is a safe, painUnited States among both men and women. It affects 140,000 Nina Paonessa, DO, FACOS, an established colorectal surgeon practicing in Ocean County, answers questions about colorectal cancer, one of the leading cancers in both men and women. Dr. Paonessa specializes in the evaluation and treatment of patients with colon and rectal conditions/ diseases and frequently performs laparoscopic surgery for her patients. She also offers conservative and minimally invasive treatment options for many common anorectal disorders. She frequently explains to her patients that “just because I am a surgeon, doesn’t mean everyone needs surgery. There are other options I can offer you.” Dr. Paonessa has been named Proctologist Board-certified in general of the Year by the American College ofand Osteopathic surgery proctology Proctologists, and a fellowawarded of the the Patient’s Choice Award American College ofand the Compassionate Doctor’s Osteopathic Surgeons, Award by Vitals.com for six Dr. Paonessa specializes consecutive years, and is on the in colon and Honor rectal Roll. HealthGrades surgery.Board-certified She has been in in general surgery and proctolopractice for 10 years. She gy and a fellow the American completed herof colon and College of Osteopathic rectal surgery fellowship Surgeons, Dr. Paonessa specialatizesLehigh Hospital in colonValley and rectal surgery. SheAllentown, has been in practice foris9 in PA. She years. She completed her colon co-editor of the textbook and rectal surgery fellowship Surgical Treatment at Lehigh Valley Hospital in Allentown, PA. of Hemorrhoids, 2nd She is co-editor edition. Dr. Paonessa of the textbelieves in patientbook Surgical centered Treatment care of and Hemorrhoids,each patient’s preserving 2nd edition. independence, well being Dr. Paonessa and dignity. She provides believes in the latest, up-to-date patient-centered care andand preserving treatments tailorseach patient’s independence, well each of careShetoprovides the being plan and dignity. individual patient’streatments needs. the latest, up-to-date and tailors each plan of care to Call 732-282-1500 the individual patient’s needs.

•

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people annually and causes 50,000 deaths. The average person has a one in 20 chance of developing colorectal cancer in his/her lifetime. This risk is increased if there is a family history of colorectal polyps or cancer, and is even higher still in those patients with a history of breast, uterine or ovarian cancer, and patients with a history of extensive inflammatory bowel disease such as ulcerative colitis or Crohn’s colitis. Although colorectal cancer may occur at any age, more than 90% of patients diagnosed with colorectal cancer are over age 40 and this risk doubles every ten years. Translated, this means that a person’s risk for developing colorectal cancer increases significantly with age.

less, outpatient procedure performed under a light sedation. Most patients undergo a gentle oral bowel prep/cleanse in preparation for a colonoscopy. A narrow, flexible tube with a lighted camera on its tip is passed from the rectum to the beginning of the colon, called the cecum. Biopsies of any growths or tumors seen can be done at this time and provide the definitive diagnosis. Based upon the findings on colonoscopy, your colorectal surgeon or other specialist may recommend other testing such as blood work, a CT scan of the abdomen and pelvis, pelvic MRI and/or ultrasound. The best way to diagnose polyps and early colorectal cancers is to undergo routine screening colonoscopy.

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How is colorectal cancer treated? Theater &Entertainment Nearly all cases of colorectal cancer require surgery. Radiation and

What causes colorectal cancer?

It is generally agreed that nearly all colon and rectal cancer begins in benign polyps, called adenomas. These pre-malignant polyps, or growths, occur in the wall of the colon and/or rectum and may eventually increase in size and become cancer, or medically speaking, carcinoma. This is known as the “adenoma-carcinoma sequence”. Several factors have been mentioned in the literature that may increase a person’s risk for developing colorectal cancer and include: age, a diet high in fat and cholesterol, an inactive/sedentary lifestyle, obesity, smoking and environmental exposures.

What are the symptoms of colorectal cancer?

chemotherapy are sometimes required in addition to surgery. If the cancer is diagnosed and treated in the earliest stages, approximately 80-90% of patients are restored to their normal health. The cure rate decreases to 50% or less when the cancer is diagnosed in the later/advanced stages. Less than 5% of all colorectal cancer patients require a colostomy or “bag”, thanks to modern technology. Dr. Paonessa prides herself in being able to maintain this standard of care in her own practice. Not only is she able to minimize the number of colostomies/”bags” created for her patients, but she performs a majority of her colorectal cancer surgeries using laparoscopic surgery. Laparoscopic colorectal surgery is a minimally invasive surgery in which small incisions are made to perform major surgery. This allows for shorter hospital stays, decreased incisional pain and earlier return to work and other activities.

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Unfortunately, polyps and early cancers do not produce any physical signs or symptoms. Therefore, symptoms usually indicate late or advanced disease. The most common symptoms of colorectal cancer are rectal bleeding and changes in bowel habits such as constipation or diarrhea. These symptoms are common in many other disorders of the gastrointestinal tract so it is very important to have a thorough examination should you experience them. NOT ALL RECTAL BLEEDING IS DUE TO HEMORRHOIDS. It is very important for patients to remember this and seek evaluation if they are experiencing rectal bleeding. Other symptoms such as abdominal pain and weight loss are usually late symptoms and quite possibly indicate advanced/extensive disease.

Education

Can colorectal cancer be prevented?

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How is colorectal cancer diagnosed?

Evaluation of colorectal cancer is first begun with a complete history and physical exam, including a digital rectal exam and possibly testing the stool for blood. A colonoscopy is the most definitive test used to diagnose colorectal cancer. A colonoscopy is performed by a colorectal surgeon or other specialist in order to get a direct visu-

Colorectal cancer is one of the few cancers that is preventable. Obtaining a screening colonoscopy at regular intervals is the single best way to prevent colorectal cancer. Your colorectal surgeon or specialist is able to review the guidelines for screening colonoscopy based upon your age, medical history and family history. Although not definitively proven, studies published in the literature mention additional factors that may lower your risk of developing colorectal cancer and include: eating a high fiber, low fat diet, maintaining a healthy weight, and engaging in regular, vigorous exercise.

Paonessa Colon and Rectal Surgery, P.C. Nina J. Paonessa, DO, FACOS

Colon and Rectal Surgery Board Certified in General Surgery and Proctology

2101 Route 34 South, Suite H • Wall, NJ 07719

732-282-1500 • Office Hours: M-F 9AM to 5PM ¢ ¢ ¢ ¢ ¢

laparoscopic surgery abdominal/pelvic surgery fecal incontinence endoanal/rectal ultrasound anorectal manometry/physiology

¢ ¢ ¢ ¢

colonoscopy anorectal surgery pelvic floor disorders office proctology

Call For An Appointment, Client 732-282-1500... Testimonials

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addition to being a skilled surClientIn Testimonials geon, Doctor Paonessa is so caring, Josephine B.

“After I had a colonoscopy and foundI out had colon compassionate and attentive, feltIlike she cancer, my primary physician recommended I see Dr. was my good friend. goingbut to a Paonessa. Not only is she Ianconsidered excellent surgeon, she’s such a compassionate person as well. would New York hospital until I met Dr.I Paonessa, recommend Dr. Paonessa to anyone and everyone.” but because of her I decided to stay local Patricia E. glad I did. I can’t say enough good and I am “I credit Dr. Paonessa for saving my life. Her things about Dr. Paonessa, and I highly recthoroughness and attention to detail made the difference for I’ve Inever met a doctor like ommend hermytorecovery. everyone know. her—so attentive and caring.” ~ Marie S.

March is National Colorectal Cancer Awareness Month

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Quit Smoking,Live LiveLonger Longer Quit Smoking,

Submitted by: Dr. Sarah J. Easaw, MD, FACP Ocean Hematology & Oncology

igarette smoking is injurious to health… It is written right on the package itself. Then why do 45 million adults continue to smoke? Maybe they don’t know how negatively cigarettes can affect your health. The number of smokers has gone down consistently in the last few decades. In 1965, 42% of the population smoked; it is decreased to 19 percent by 2010. This is due to the increasing awareness about the adverse effects of smoking. Nineteen percent is still a significant part of the population. Tobacco-related illnesses are a major cause of death in adults.

Why do people smoke? Most people start smoking at a young age. 1 in 3 male and 1 out of 5 female high school students used some form of tobacco, based on a survey in 2009. Often, the habit is started due to peer pressure, to impress people who are smokers. The tobacco industry also spends millions of dollars

Patient Testimonials:

on marketing that attracts youngsters. Once started, smoking is difficult to control. Nicotine is a very addictive substance. It gives a pleasant feeling by working on the brain cells, altering the chemistry, making the person want to smoke more. The habit-forming potential of nicotine is similar to that of drugs that can cause addiction. Smokers develop emotional and physical withdrawal symptoms when attempting to quit. So even when someone wants to quit smoking, the process becomes very difficult.

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I was already diagnosed with cancer; what is the point of quitting now? This is very common attitude among smokers when they are hit with a diagnosis of cancer. Actually, the treatment of cancer will be more difficult if a person continues to smoke. Side effects such as nausea, mouth sores and loss of appetite are more pronounced in those who choose to smoke than those who decide to quit. The following is an excerpt from cancer.net, the official website of American Society of Clinical Oncology:ASCO, on smoking cessation:

act

successfully quit smoking without any medication or other support, there are treatments that can significantly improve smoking cessation rates. Among people with cancer, quit rates often exceed 50 percent.

Education

What are some of the cancers that are related to smoking? Smoking accounts for 30 percent of cancer related deaths in the U.S., and causes 80 percent of all lung cancers. The risk of developing lung cancer is also proportional to the number of cigarettes smoked in one’s lifetime. Smok-

Myths about quitting smoking

resources are available for people who want to stop smoking, including medications and counseling. Your likelihood of successfully quitting is greater if you use a comprehensive plan that includes steps such as setting a quit date, developing strategies to deal with smoking triggers, and building a network of support. Talk with your doctor about which approach may work best for you.

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Myth: Quitting smoking is not

helpful for a person diagnosed with cancer. Fact: Quitting smoking can improve the results of treatment and a person’s overall health, survival rate and quality of life. Myth: Quitting smoking is too stressful for patients undergoing cancer treatment. Fact: Although nicotine dependence is hard to break because the withdrawal process can be uncomfortable, the benefits of quitting smoking outweigh the discomforts.

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What are the diseases that are related to smoking? Heart disease, atherosclerosis, lung disease (COPD, Emphysema), vascular disease (blockage of arteries), stroke, cancer… the list goes on. Heart disease is the number one cause of death in the Unites States. Smokers are at high risk of getting heart attacks and of sudden death from heart disease. Smoking especially damages the lining of the lungs, resulting in chronic lung diseases such as COPD. COPD is the fourth leading cause of death in the US. There are 12 million people in the US suffering from COPD and 75 percent of those cases are related to smoking. The risk of developing COPD is related to the number of cigarettes smoked and the duration.

• Dear Dr Easaw, John and I want to thank you so very much for your medical and emotional support during this difficult time in our lives. you always give kind and compassionate attention to John’s needs. We honor you for your dedication to a most delicate population dealing with cancer. ~ Sincerely, Regina

NEXT ISSUE: METHODS TO QUIT SMOKING

Call us with your concerns:

Sarah J. Easaw, MD, FACP

ine rt hotography Compassionate Cancer Care, Close to Home

732.961.0010 www.oceanhemonc.com

Myth: Smoking is a personal choice.

Fact: Although more

than half of all Americans who ever smoked quit, tobacco contains the addictive chemical nicotine, and many people experience nicotine dependence for a long time after they start smoking.

Myth: Smokers can quit by themselves; a doctor’s advice isn’t needed.

Fact: Doctors provide support, information and any necessary drug therapies to help people to quit. Myth: Most smoking

cessation treatments have a low success rate.

• Thank you for your gentle touch, your open heart, for your compassionate caring. I will always be thankful that you have come to Ocean County. ~Mary • I would just like to sayhow grateful I am for the great care you have given me over the years. You and your entire staff has helped me in so many ways. You will always be in my thoughts. ~ Donald

Visit www.oceanhemonc.com

HF ealth &Wellness : Although very few people A variety of treatments and

ing can also cause cancers of the throat, mouth, nasopharynx, larynx (voice box), esophagus and urinary bladder. Cervical cancer and pancreatic cancer are also linked to smoking.

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W We offer a full range of Hematology & Oncology services. W We are dedicated to providing state-of-the-art cancer care in a warm and personalized manner. W Our newly renovated, spacious infusion room provides a peaceful and friendly atmosphere to patients while they receive chemotherapy and other infusions. W Our staff is highly qualified, experienced and compassionate.

Sarah J. Easaw MD, FACP Diplomate of the American Board of Hematology, Oncology & Internal Medicine

Ocean Hematology & Oncology 1255 Route 70, 31S Easily Accessible Location, Near Exit 88 on GSP

Lakewood, NJ 08701

732.961.0010

www.oceanhemonc.com Accepts Most Insurances Affiliated with Kimball Medical Center, Ocean Medical Center and Community Hospital Access to Clinical Trials

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Adult Community

Adult Less Stress For Home Owners 00Community- Land Lease Options, Adult Community 47

f you are looking to invest the proceeds of your home efficiently into a senior community or an adult community home, consider the homes available in land leased communities. The land lease- new home combination offered by Fountainhead and others in the adult community market are the right recipes for conservative retirement. Instead of reinvesting into a mortgage, seniors are finding the budget –friendly prices and carrying costs at Fountainhead a stress-free solution. Turn-key prices range between $80,000 and half of where what another land-included of As we grow into the latter stages of life and$150,000: chooseabout to move simplification home purchase might cost. responsibility will give us the opportunity to spend more our free timea new participating Like any homeof purchase, financing or preowned home is easy for those who’ve maintained in the things we enjoy most, it is time to consider all the choices. reasonably responsible credit. Fixed rate terms are Finding The Right Match For You Andavailable Yourwith Budget amortizations from 10 to 25 years. Lenders are licensed as allto other mortgage Adult communities can be over-the-top offering amenitiesthewesame hope enjoy or loan originators and adhere to all the same plan to enjoy- even currently enjoy. The key isdisclosures. to find Expect the one that matches your several factors to be part of the amount of down payment, comparedall wishes and does not break the bank. Breakingprocess, out ofthethe same old and exploring to the overall contract amount. The process is often the options are two of the skills we’ve honed along life’s trail. Look into land leased faster and less complicated by deed searches and other communities; you will find as wide of a selection ofofamenities as mortgage any other aspects a conventional as the55+ landchoice is not part of the sale in a land lease community. locations without the land cost and with much less ongoing ownership expense. The construction of the homes offered for sale at Homes may vary in age from proposed-to-be-built, new and there is always Fountainheadto55+ community in Jackson is quality construction. Every aspect of the construction is “vintage” too. If you are a conservative buyer and/or not a big risk taker, land leasing similar to any site built home. Six-inches of highmay be the right choice for you. A hybrid home ownership option that allows you grade insulation with increased R-factors (R-factor is freedom to be the homeowner you have alwaysthebeen with less costly measure of the ability of theresponsibilities. insulation to protect the dwelling from gaining or losing heata and effects Fountainhead, a 55+ community in Jackson, New Jersey is one that offers selection the frequency that the furnace or air conditioner will of homeowner services that you choose as youbeneed homeowners choosein calledto. uponMost to maintain an even temperature) the ranch-style homes are in complete conformance a home from a model or a blueprint and customize the interior/exterior colors and to the state and federal mandated construction codes. design features. Then they move onto designing and maintaining their lot. Maximum Energy conscious adults at least 55 years of age are privacy due to large lots, mature trees and widefinding streets evoke neighborhood thatat feels that the utilityabills in a single level ranch Fountainhead are delightfully frugal. This is directly familiar and where nice people reside. attributed to the increased insulation standard at

Fountainhead, heavily insulated crawl spaces and attic areas- the savings really is built-in. Low E vinyl thermal windows keep the inside of the home from fading from sunlight and from taking on heat that would only have to be air-conditioned away. Look up “Energy Star” certification when you have time. One of the major differences in the construction is that building materials for these systems-built homes are any budget. The denominator stored indoors, protected from the common weather, which allows the quality of theThe raw construction material remain as simpl cost. lease is easy to toread and it was when first milled or produced. New Newercertified Homes Are Great C Cabinetry built or by tradesman as cabinet makers offerThe manynewest choices ofhomes, finish andsome style in the estab Personalized floor plans can be made available for or longer than any other new home. Yo buyer specific wants and needs, allowing you to plywood highapeaked personalize will helpsub-floor, aide in completing stress free roof, co move. Our experienced staff can help ease the anxiety budget friendly version that is also energ of packing and moving. of commitment, with carpet and Landsymbol leasing is secure, buyer-oriented relationship betweenelement Fountainhead the home-buyer. It is experienced usually to and please you. Our less costly than buying a land-home package, a show and demonstrate the benefits of bu townhouse or condo and definitely less than renting. Some ofconservative the moreand popular op The land lease fees are protectedinterior by township ordinance. It is a win/win for the home ances, composite countertops or circle w buyer that is ready to save more in their home alsocosts thewhile option toa great go with ownership keeping home ceramic in a very tile fl pleasantsays neighborhood. Housing professionals are are on “you”. The possibilities endless w site to show home buyers how the decision to buy home, so why not see what is offered? A at Fountainhead will increase the buyer’s financial security.spective buyer can imagine, each manufa

So Many Houses For Sale, So Many Adult Com

t is a great and sometimes undervalued privilege to have a choice. It is one of the great things about our country- we have many choices, an endless supply of them.

Land Leases Are Another Option Land leases are very secure, and designated by municipal land use zoning. Leases are auto renewable, and the homeowner’s lease is protected by law. Security, mutual understandingANand cooperation, communication; these are some of the elements that ACTIVE 55+ ADULT COMMUNITY make very good long-lasting lease relationship. Thea Source of a New Worry-Free Lifestyle in JacksonAt ! Fountainhead, while there are nearly one hundred to build, 75% of the households have resided in • Top Qualitymore Homes • new Naturalhomes Gas and Central Air their homes for 10 years more. This has allowed for a very good market to satisfy • Deluxe Appliances • Energy or Efficient Insulation • 2 and 3 Bedrooms

Fountainhead • Beautiful Kitchens • Land Leasing Saves You Money • Spacious Lots, Mature Trees, Wide Streets, Off-Street Parking

Stop at the Office for The Best Home Choice For 55+ Population About Location ~ Great Homes Long TermInformation Affordability 1 Rose Drive, Jackson, NJ~08527 New homes for 2015!

• 25 min. to Trenton, 20 min. to the Shore • New and Pre-Owned Homes Available

For directions call, 732-928-3100, or visit our website www.njfountainheadhomes.com.

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survive hurricane style winds and At Fountainhead, Jackson NJ buyers will find a the na rural suburban atmosphere that isatright in the heart all materials to stay their strongest, fo of this growing residential township spanning 110 squareOnce miles. One of the largest townships in in th you choose to stay Ocean County Jackson offers seniors top-shelf middle ofand I-195 between the Shor amenities, recreation entertainment for people of all ages andFountainhead 6Flags amusement park. Just a visit 55+. short drive to area beaches, it is a short drive to is home to Fountainhead about 60,000 peo the TrentonJackson area and Staten Island. is a milewe from medical all the allnew need just facilities, down the block from Fo shopping an conveniences as well as necessities. award-winning recreation facilities for al It is worth a drive from anywhere to see the benefitsand of this location. a great location. If you must contin Just two miles from Exit 22 of I-195 the Ocean County you won’t find a better to directions to reach Fountainhead are available on access tocalling the main routes. W the website or by Nancycommuter at 732-928-3100.

For directions to the sales Jackson, NJ 08527 call 73 www.njfountainheadho For directions to the sales center at 1 Rose Drive, Jackson, NJ 08527 call 732-928-3100 or visit www.njfountainheadhomes.com

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March/April 2015

Fashion

Beauty

elcome the first day of spring on March 20th with a visit to Barbara’s Boutique, where a sensational selection of this year’s popular styles and colors are already awaiting you! “Figure-flattering” fashions are the look this year, designed to fit your form well, rather than hugging you tightly or hanging loosely. This is also the year of flower power, with designs ranging from bold to delicate. You’ll see floral prints on crimson backgrounds, delicate abstract floral motifs and cutouts, multi-floral retro patterns, and more. My daughter was thrilled to see that the retro look is back, featuring the classic elements of embroidered floral art, maxi and midi length dresses, blouson tops, earthy tones, and fringing and tassels on dresses, skirts, tops, jackets and accessories. The spring color scheme is quiet and minimalist, consisting of soft, cool hues blending with warm tones. Topping the list of popular colors this season is aquamarine, followed by scuba blue, lucite green, strawberry ice, toasted almond, tangerine, masala, glacier gray and custard. This soothing color pallet may reflect a growing trend toward taking breaks from the hustle and bustle of daily life by creating technology-free “quiet zones” in which to unwind and reflect. For some of us, the best way to unwind is with a shopping spree, especially at Barbara’s Boutique, where a friendly, professional staff makes your experience pleasant and stress-free. To make it even easier, I’ve started a shopping checklist for you! 3 Try on a “Comfy” USA line of fashion. It is designed for the woman who wants modern clothing that balances casual and career. The clothing is frequently described as young in spirit with a realistic fit - timeless, season-less, ageless and great for traveling! 3 You are going to love an Isabella Tote. No other fashion accessory offers as much value as the designer leather handbag, now available at Barbara’s in a variety of colors for your spring/summer fashion. 3 A large selection of Elliott Lauren’s incredible jackets, pants and tops is available at Barbara’s this spring. If consistent fit and quality are high on your list of priorities, you’ll love this clothing! 3 Last but not least, put the finishing touches on your wardrobe with accessories from Barbara’s. Check out the fun and stylish jewelry as well as the great selection of belts in beautiful shades of Italian leather.

Revamp your closet this spring by mixing and matching items from your existing wardrobe with new pieces in the latest styles. Take risks – pair a floral top with a skirt dotted with a tiny geometric print. You can’t be sure what works for you until you try it! But one thing you can be sure of: you’ll find the perfect options in spring fashions at Barbara’s Boutique.

Health & Wellness

What is Barre?

Barre is a ballet-inspired, Pilates based workout. It’s a great way to develop lean muscle mass while improving your strength, balance and flexibility. With a mix of cardio, yoga, core strengthening and ballet, you will sweat, shake, tone and burn all while moving to upbeat music. The hour flies by as you are having fun and working hard. The class format always stays the same, but the exercises change and advance just as your body will.

Leah Schwartz, certified Barre Instructor I started my journey when I took my first barre class. Barre challenged my body in ways that nothing else had before. Each week I watched as I became leaner and stronger. Soon I was committed to a 6-day a week routine that helped me focus on form and alignment. My hard work paid off, not only did I see results, but I found my passion and soon became a certified barre instructor. Teaching is a fulfilling experience for me. I am excited with each opportunity to teach and love to inspire my students to reach their goals just as I had.

The County Woman Magazine www.TheCountyWoman.com

For more information, contact Leah Schwartz by phone,

609-226-3696 or email,

Schwartz88@aol.com

March/April 2015

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Glamorous Evenings Start At Leisure And Visit Leisure and Lace For Your Dreamy Holiday Gifts from prom season and bridal seasonSleepwear approaches be prepared with Oh SoAstheSoft Winter proper bra before the search for the perfect dress begins.

Lace

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It is time to gear up your winter sleepwear for the fierce winter reports. Cozy, warm flannel and thermal sleepwear in fun prints or contemporary stylingBrides, are hereBridesmaids waiting to make comfyofand Another big realize hit, Prom goers, and you Mothers the happy. bride and groom, that what you put Not sure what to get? A gift certificate from Leisure and Lace is always our warm soft lounge jackets and robes will not only keep you comfortable, but make you even happier with under will make you look like a wonder. We have the experience not often found in larger stores. a winner. Hand written and beautifully wrapped, our gift certificates Leisure and Lace carries quality intimate apparel, which delivers exceptional wear, comfort andare our 20 percent discount. personal average plastic card. support. Wacoal and Chantellemore among somethan of theyour superior bras we carry. If you need a no back Sleepwear is aare great holiday gift. Our cute prints may or low back bra we can solve those problems too. remind you of a certain person on your list. We try to make gift For the woman looking for control, fit and invisibility under tight clothing we have the answer. giving easy and fun, and we wrap your gifts compliments of Leisure and Do you need to eliminate the muffin top, flatten your tummy, shape your derriere, or eliminate Lace. visible panty lines? We have stylish slimming products for today’s multi-tasking woman. Do love has a oday’syou sleepwear t for the Bride to Be... if G We are receiving reports that our customers are sleeping better in garready to wear look. RelaxNow on the look of leggings but hate the lines they leave at the waist? Try a pair of our high-waisted, control te a c tififrom the rstyle. your front porch in your We carry everything a bride could Cechip, ments made Modal fabric madewith fromany wood top leggings. Theyfrom slimModal. and shape and lookisgreat shoe need for her special day. Your dress PJs and no one will ever have beech tree. It absorbs moisture, is light in weight and oh so soft. We offer to know! is in, your fitting is near and we everything from pajamas and nightgowns to panties and camisoles made have the undergarments to make Leisure and Lace toyou thank you for being our loyal customer out of this luxurious fabric. wants We assure will sleep better. it all work. While you’re here, you by Parties... offeringholiday you 20% off most of looking our merchandise. Holiday party wear, remember good will notice we offer bridal chemises, onsider giving a Make great look greater when shop atresults. Leisure and Lace. starts from underneath. Small changes canyou add up to great peignoir sets, and bridal sleepwear robe for a gift that We do not cater to just one body type.anky WePanky willhas work with you, so bring your adorned with “Bride” in rhinestones staple in every does not look like problem garment and we help you become find aasolution. that can be customized for your woman's wardrobe, from your grandmothers. Today 's styles are entire bridal party. We also carry Bras, bras and more bras. Wetohave a sleepwear the most computer jackets, sleeveless vests, cocoon Black Friday Sale comfortable thongs and comfowith coobie, playful Hanky Panky thongs in a and hooded styles that are marshmallow soft great selection of bras starting panties on the market. A and cozy. PJ Salvage robes are creative with a young girl’s first bra to women’s comfortable 30% oFF rainbow of colors, a treat for the Panky gift is always cute, fun prints. Now for the grandmother sports bras or easy everyday bras.Hanky groom and much more exciting than But, let’s not EvErything appreciated. on your list, we offer zip front robes too! nov. 28 - All Day a toaster! forget about the serious supporting bras that will Starting 9 am lift, separate and give you the middle that your old bras have been hiding. addi Murphy softies combines We pay special attention to fashion with function, they make you look and feel beautiexceptional support and comfort. We ful. They We look for superb fit in the frontare designed especially carry the for women experiencing hot while eliminating ride-up in the oday’s busy woman has moved brands flashes, menopause, chemoback and solving the infamous away from the long gown to therapy, pregnancy or diabetes. “double bubble.” Finding the the pretty above the knee chemise. you love! The chemise is cute, more correct fit can be challenging, but contemporary and much easier the is help the women of of your Don’t forget, Leisure andwith Lace thefrom place to get all to move about in. Leisure and Lace, the properly holiday outfit needs, from bras and shape wear to hosiery and bra and undergarment is accessories that willfitting look your very best. nomake longeryou a myth.

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“The perfect “ Youundergarment will see such a difference in your clothing with a good completes the perfect – A dress” quote from one woman in the dressing room to another.

bra.”

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Before: A Bra that does not fit properly is unflattering and uncomfortable.

“The perfect fitting bra might as well be a myth, unless you shop at Leisure & Lace!”

After: A visit to Leisure & Lace Assures a proper fit every time. See for yourself!

Betty Vasser (Seated) Owner, Phyllis Doran, 24 Year Employee

199 New Road, Suite 9 • Central Square • Linwood, NJ 08221 • 609 927 5572

www.TheCountyWoman.com The www.TheCountyWoman.com The County County Woman Woman Magazine Magazine

March/April2014 2015 November/December

Copy, Fax

Notary Services

Do You Need Typing, Copy, Fax, or Notary Services? The Wordstation, Ltd. provides specialized business support services for writers, attorneys, insurance agencies, students, and small businesses in general, and all who require precision and accuracy in their communications. At The Wordstation, we pride ourselves on our friendly service and strive to deliver what you need in a timely, professional manner.

with over 25 years of experience. We can provide that extra set of eyes for all your important documents.

 What services does The Wordstation provide?

 How are you able to help students?

In our self-service area, you can make your own letter-size copies, send your own faxes, and have access to the Internet and printer. In our full-service area, we can make copies for you in letter, legal or ledger size, black-and-white or color. We can send and receive faxes, or scan and email your documents. Your signature can be notarized; there is always a notary on site during office hours. (You must have a photo ID.) We type for you: anything from a one-page letter to a fulllength book manuscript. And we are professional proofreaders

 What is your most popular service during the months of March/April? Our same-day, confidential copy service. We can handle those endless documents that your accountant requires before tax day. Just drop them off and pick them up at your leisure. We know how those end-of-term papers pile up. We’re experts at APA style and would be happy to help type up those papers for you. The work is still your own; we fix only grammar, spelling, punctuation, and style, not content.

 What is unique about The Wordstation?

We’re a friendly, family business. We really care about our clients and about the quality of our work, whether it’s making a single photocopy or typing a book manuscript.

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Book Corner: Buzzin’ With Kindness

“I

wrote this children’s book because this subject is dear to my heart. Many children are bullied day after day in school and out. Everyoneevery parent, every teacher, and every administrator should reach out to their children to help them deal with bullying, and the best way to start is with this must-read book for children: Buzzin’ with Kindness. It is recommended for Early Childhood Learners: Pre-K and Kindergarten through 4th grade. I believe that the best way to start teaching our children about bullying is by laying a strong educational foundation early in life. Bullying hurts all of us.” Dr. Sophia Z. Domogala: Author of a New Children’s Book About “ANTI-BULLYING”



Available at: Amazon, Barnes & Noble, E-Z Book, Kindle, & Nook Website: http://sophiazdomogala.wordpress.com

Like us on Facebook!

ABOUT THE AUTHOR:

Dr. Sophia Z. Domogala, (Doctorate in Education), grew up in Uniondale, Long Island and attended Uniondale High School in New York. She is a long time resident of Eatontown, New Jersey for over 40 years. Dr. Domogala came to this country at the age of four and worked her way up the ladder in her career. She graduated with a Master of Arts degree and a Bachelor’s degree in education from Hofstra University, New York, as well as a doctorate degree from Nova Southeastern University, Florida, in Educational Leadership. In addition, Domogala attended Monmouth University in West Long Branch, New Jersey for postgraduate course work in School Law. She served as a banking business consultant and pursued a career in the public education field for twenty years as a special education teacher, elementary school teacher, middle school teacher, principal, and director in the education field. She enjoys the arts, music, theater, traveling, cooking, and enjoys drawing, oil painting, and sketching. You can check her out on her YouTube channel: http://youtu.be/SbobY9PdCBg (sophiazdomogala).

Follow on Twitter: https:twitter.com/sophiazdomogala

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Medical Professionals

After Your Breast Cancer Diagnosis: A Review of Your Surgical Options “You have breast cancer.” After undergoing a mammogram, perhaps followed by subsequent screening like a breast MRI, an ultrasound or a core-needle or surgical biopsy, you still were not ready to hear those four words. Fortunately, fellowship-trained Sumy H. Chang, MD, FACS, a boardcertified general surgeon dedicated to breast health, can help you navigate your options. A member of Barnabas Health Medical Group, in partnership with Community Medical Center, Dr. Chang provides Ocean County women with access to the latest prevention, detection and treatment options for breast-related issues – including surgical options to remove breast cancer. “A breast cancer diagnosis can be frightening, but I work with each of my patients to develop a treatment

plan that’s right for her,” says Dr. Chang. “Breast cancer surgery is not one-size-fits-all – women should speak with their surgeons who will guide them through their options and help determine the right course of treatment.” The surgical options include a lumpectomy (partial tissue removal) or a mastectomy (full tissue removal). Many times, women opt to undergo a lumpectomy to maintain the natural look and feel of the breast. During a lumpectomy, the cancerous tissue (and a portion of healthy tissue) is removed, whereas all breast tissue is removed during a mastectomy.

Barnabas Health Medical Group is a multispecialty group practice comprising highly trained and experienced world class primary and specialty care physicians. Barnabas Health Medical Group physicians provide compassionate and innovative cutting-edge care for people at every stage of life at easily accessible facilities conveniently located throughout New Jersey. Backed by the vast continuum of resources of Barnabas Health, the largest not-for-profit integrated health care delivery system in New Jersey and one of the largest in the nation, our dedicated physicians and expertly trained supporting staff continuously strive for clinical excellence. To learn more, visit barnabashealthmedicalgroup.org.

Here, Dr. Chang discusses the basics of a lumpectomy.

What is a lumpectomy? Also known as breast-conserving surgery, partial mastectomy or a lumpectomy is usually performed under anesthesia. During this

Sumy H. Chang, MD, FACS Breast Surgeon Board Certified in General Surgery Dr. Chang is affiliated with Community Medical Center in Toms River and the Jacqueline M. Wilentz Comprehensive Breast Center at Monmouth Medical Center in Long Branch. To schedule an appointment with Dr. Chang, contact: Community Medical Center 67 Highway 37 West Riverwood 1 Building, First Floor Toms River, NJ 08755 732.557.2153 Jacqueline M. Wilentz Comprehensive Breast Center at Monmouth Medical Center 300 Second Avenue Long Branch, NJ 07740 732.923.7702

About Barnabas Health Medical Group

procedure, the surgeon makes an incision in the breast to remove the tumor and a small area (or margin) of “normal” tissue surrounding the tumor. At this time, the surgeon may also remove some lymph nodes in the underarm area for testing.

Will the entire tumor be removed during the surgery? Your surgeon will remove the tumor and the tissue immediately surrounding it. The removed tissue is sent to the pathology lab to assess its margins. If there is a rim of “normal” tissue that was removed along with the tumor, then the tissue sample has clean margins and further surgery is not required. If the tissue sample tests positive, it has “involved” margins, which means the tissue surrounding the tumor contains cancer cells and more surgery is needed to obtain clean margins. The tissue may be characterized as having “close” margins – meaning that cancer cells approach, but do not touch, the edge of the biopsy. Additional surgical procedures may be needed, but Dr. Chang advises that should be discussed with your surgeon.

The County Woman Magazine www.TheCountyWoman.com

Will my breasts look different after surgery? While lumpectomy does not change the look and feel of the breast to the same extent as mastectomy, the breast may appear smaller and feel firmer after undergoing the procedure. Your surgeon should discuss the possible results of a lumpectomy as it relates to the size and position of your tumor, as it may affect the cosmetic result of the procedure. Some women may opt for reconstructive surgery to minimize the change in appearance, according to Dr. Chang, who offers women the chance to work with a reconstructive surgeon at the time of the procedure.

What is recovery like? Women may feel soreness in their chest, underarm and shoulder following a lumpectomy. However, many women are able to go home the same day. According to Dr. Chang, lumpectomies are best suited for women whose tumors are small and limited to one area within the breast. She notes that women may need additional treatment, such as radiation or chemotherapy, afterward to completely eradicate the breast cancer.

March/April 2015

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Medical Professionals Health &Wellness

Caring Heart & Brain Is Dedicated To Creating Miracles Written by Lorraine Catalano, CNMT and Imaging Director

Q Why Should I Ask My Doctor About A Cardiac Perfusion Study?

Law

aring Heart & Brain Imaging has made the latest cardiac technology available to residents of the Jersey Shore, who could only benefit from this same testing if they traveled to New York City, Philadelphia or Southern Jersey. A Cardiac PET Scan is the newest version of a cardiac stress test. Also called a cardiac PET PERFUSPECT PET SION study, it allows your cardiologist to determine if your heart muscle is receiving adequate blood flow Cardiac Perfusion Cardiac Perfusion and if that blood flow is evenly distributed. The Cardiac PET Scan is far superior to the present stress testing and will further eliminate any unnecessary procedures such as cardiac catheterization. Patients will benefit from the scan by dealing with speedier scan times-approximately 45 minutes as opposed to a two to four hour SPECT scan. More importantly, it cuts patient exposure in half because the Attirius scanner reduces patient exposure to radiation. PET Scans also 2414 Highway 35, provide clearer, more precise 2D images better suited for detection of disease. We use applications exclusive Manasquan, N 08736 to CHCI that provides extensive data and measurements that guarantee appropriate diagnosis and treatment. We have a great deal of compassion for our patients well being and like to do whatever it takes to make Phone: them comfortable, including playing their favorite music, something from our gourmet coffee bar or the company of our very attentive therapy dog, Dillinger. This is the only system that uses CFR-cardiac flow reserve-to guarantee accurate calculation of presence of obstruction: the only true way to determine if blood flow is compromised. Above all, Cardiac PET is the only technology that identifies early disease invaluable to younger patients with high risk factors.

Elder Caring Law Heart &

Theater &Entertainment

CHCI is the only facility in New Jersey offering this technology! Fine Art

Brain Imaging

732.292.1008 www.CHCI.biz

Photography

Q What Can BeEDone About Memory Loss Or Family History Of Alzheimer’s Disease? ducation

At Caring Heart & Brain Imaging, you are in our caring hands.

Let’s talk about the brain…Caring Heart & Brain Imaging is the first imaging center in New Jersey to be able to detect plaque in the brain, the precursor to Alzheimer’s disease. Although fighting the disease of Alzheimer’s continues to be an uphill battle, there is great hope on the horizon. That hope comes in the form of new treatments, medications, and most important new methods of early detection. The AMYVID Pet Scan is the new “weapon” on the market to combat this heartbreaking disease. If you are experiencing memory loss, and/or have a family history of Alzheimer’s disease, the Amyvid PET Scan could help you do just that.. help your children. Alzheimer’s disease affects the entire family. Help protect your children by getting an early diagnosis; the neuritic plauque that is a precursor to Alzheimer’s disease can be present in our brains years before symptoms occur. The AMYVID PET SCAN may enable diagnosis of Alzheimer’s disease by identifying beta-amyloid plaque in brain tissue. This means that the disease can be diagnosed several years before symptoms actually appear and an individual can receive groundbreaking treatments before the disease develops to advanced stages. Just as important, the incorrect diagnosis of Alzheimer’s may be eliminated for patients thought to have it and appropriate treatment decisions can be made based on the patient’s actual form of dementia. Another important benefit to undergoing a PET scan is the reduced radiation exposure. The scanner does not use CT in obtaining brain images. This is a huge factor for patients who may have had substantial radiation in the

Business &Finance

past. This scan will give the information needed for doctors to make appropriate treatment decisions. Be sure to stop by and tour their impressive facility and meet their friendly, talented staff.

NORMAL No plaque present

MEMORY LOSS Plaque Present

Don’t let this oppurtunity to receive the best and most accurate technology for cardiac care slip away from you. Tell your doctor you want only the best. We are happy to answer any questios you or your doctor may have.

Lorraine Catalano, CNMT and Imaging Director

CARING HEART & BRAIN IMAGING We can be reached at 732-292-1008, or visit our website at www.CHCI.biz E-mail: service@caringheartcoronaryimaging.com

www.TheCountyWoman.com TheCounty CountyWoman Woman Magazine www.TheCountyWoman.com The The Magazine County Woman Magazine www.TheCountyWoman.com

March/April 2015 March/April 2015 January/Feb

Medical Professionals

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Accessed April 18,Accessed 2012. hmf/hmf-newsletter/making-lifestyle-changes-that-stick/. April 18, 2012. www.jerseyshorepharmacybarnegat.net Phone: 609-660-1111 check your body mass index (BMI) 580 North Main St., Barnegat, 08005 We also offer a 609.927.8900 3. Hungtington Medical Foundation: "Making lifestyle changes that stick." Available at: http://www.huntingtonmedical.com/aboutcheck your body mass index (BMI)3. hmf/hmf-newsletter/making-lifestyle-changes-that-stick/. We also offer a 609.927.8900 Hungtington Medical Foundation: "Making lifestyle changes that stick." Available at: http://www.huntingtonmedical.com/aboutAccessed April 18, 2012. www.jerseyshorepharmacybarnegat.net Phone: 609-660-1111 or see if you can Competitive get the zipper up Jersey Shore Pharmacy ships Pricing! medication disposal program. hmf/hmf-newsletter/making-lifestyle-changes-that-stick/. 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Sources 1. American Psychological Association: "Making lifestyle changes that last." Available at: http://www.apa.org/helpcenter/lifestyleSources changes.aspx. Accessed April 18, 2012. 1. American Psychological Association: "Making lifestyle changes that last." Available at: http://www.apa.org/helpcenter/lifestylechanges.aspx. 18, 2012. 2. AmericanAccessed Council April for Exercise: "Reaching Your Goals the SMART Way." Available at: http://www.acefitness.org/fitfacts/fitfacts_ display.aspx?itemid=2637. Accessed April Your 18, 2012. 2. American Council for Exercise: "Reaching Goals the SMART Way." Available at: http://www.acefitness.org/fitfacts/fitfacts_ display.aspx?itemid=2637. April 18, 2012. 3. Hungtington Medical Accessed Foundation: "Making lifestyle changes that stick." Available at: http://www.huntingtonmedical.com/abouthmf/hmf-newsletter/making-lifestyle-changes-that-stick/. Accessed AprilAvailable 18, 2012.at: http://www.huntingtonmedical.com/about3. Hungtington Medical Foundation: "Making lifestyle changes that stick." hmf/hmf-newsletter/making-lifestyle-changes-that-stick/. Accessed April 18, 2012.

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Sources Sources 1. American Psychological Association: "Making lifestyle changes that last." Available at: http://www.apa.org/helpcenter/lifestyle1.changes.aspx. American Psychological Association: Accessed April 18, 2012."Making lifestyle changes that last." Available at: http://www.apa.org/helpcenter/lifestylechanges.aspx. Accessed April 18, 2012. 2. American Council for Exercise: "Reaching Your Goals the SMART Way." Available at: http://www.acefitness.org/fitfacts/fitfacts_ 2.display.aspx?itemid=2637. American Council for Exercise: "Reaching Your Goals the SMART Way." Available at: http://www.acefitness.org/fitfacts/fitfacts_ Accessed April 18, 2012. www.jerseyshorepharmacybarnegat.net * For more information on customized hormones, call our professional compounding agency. display.aspx?itemid=2637. Accessed April 18, 2012. www.jerseyshorepharmacybarnegat.net 3. Hungtington Medical Foundation: "Making lifestyle changes that stick." at: http://www.huntingtonmedical.com/about* Available For more information on customized hormones, call our professional compounding agency. 3.hmf/hmf-newsletter/making-lifestyle-changes-that-stick/. Hungtington Medical Foundation: "Making lifestyle changes that stick." www.TheCountyWoman.com Accessed April Available 18, 2012. at: http://www.huntingtonmedical.com/aboutThe County Woman Magazine www.TheCountyWoman.com hmf/hmf-newsletter/making-lifestyle-changes-that-stick/. Accessed April 18, 2012. The County Woman Magazine

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Medical Professionals

A lifesaver for families As the number of U.S. seniors continues to grow, so does the rate of age-related diseases. Over 75 million Americans today are living with heart disease, Alzheimer’s, Parkinson’s, or the effects of a stroke. As a result, many families today face the challenge of caring for a loved one with serious medical needs. Last year alone, over 15 million caregivers provided more than 17 billion hours of unpaid care to loved ones with Alzheimer’s and dementia. For most family caregivers, theirs is a labor of love, inspired by gratitude, devotion and duty. But caregiving can be physically exhausting and emotionally draining, and at some point, even the most dedicated spouse or child can reach a state of burnout. That’s where Independence Place Adult Heath Center comes in.

Independence Place: A haven for families and caregivers Independence Place is a specialized center located adjacent to Whiting Healthcare in Whiting, NJ. Designed as a day health facility, Independence Place offers medical supervision and activities programming for adults with neurological, cardiovascular and other conditions. Each weekday morning, the Independence Place bus picks up clients at their homes and transports them to the center. There, a warm welcome and a light breakfast awaits, followed by a full day of fun and purposeful activities. “We are all about quality of life here,” says Cathy Harmon, BSW, director of Independence Place. “Not just for the clients who come here each day, but also for the families we serve. There are many people today who have taken on the responsibilities of caregiving. They may be trying to hold down a full-time job, or raise a family at the same time – and feeling overwhelmed. We’re here to offer support, so caregivers can live a balanced life.” A typical day at Independence Place starts early. After enjoying breakfast, clients can choose from a variety of games, exercises and activities designed for enjoyment and therapeutic value. “We keep it varied and fun,” says Harmon. “There are activities to help with fine and gross

Need help for a senior with medical needs? Independence Place Adult Day Health Center in Whiting is here for you.

motor skills, plus memory games, puzzles, trivia contests, group crossword challenges and other activities to stimulate the mind. “ A nutritious lunch is served each day, prepared in accordance with each client’s dietary requirements. After lunch, a chair-level exercise and movement program helps clients maintain flexibility and strength. Next up might be a game of bocce, bowling, pet therapy, or even a visiting musician. Clients who like card games can sit outside on the patio, or just enjoy the fresh air. At Whiting Healthcare Center, we adapt our sports and games to suit clients with all physical and cognitive abilities. “Our goal is to provide clients with a medically supervised enjoyable and rewarding day,” says Harmon. Most Independence Place clients take advantage of the bus service included in the program to get them to and from the center. Independence Place also offers overnight care as part of its respite program for families. Clients can stay at Whiting Healthcare for one or more nights, while they continue to receive medical supervision. “Our respite program can be a lifesaver for families,” says Harmon. “For instance, if there’s an important trip or family event, they can feel free to travel, knowing their loved one is being cared for.”

“I urge people to give us a call if they’re struggling with care and finance-related questions.” she says. “We work with many state and local funding programs including the New Jersey Alzheimer’s Grant program, JACC, Horizon NJ Health, Amerigroup, United Healthcare, Well Care, a state-wide respite program, and NJ Medicaid.” Independence Place was awarded a grant from the state of New Jersey to help cover the costs of caring for clients with Alzheimer’s and progressive neurological disease. Under the terms of the grant, clients who meet the State’s criteria for eligibility can enjoy the services of Independence Place up to three days per week on a shared cost basis. According to Harmon, about half of Independence Place clients are currently being served under the grant, which is renewable annually. For Harmon, connecting families with resources is a vital part of the Independence Place mission. Her message to families? “Reach out for support,” says Harmon. “Call us at 732-849-4969. We can help.” reveraWhiting.com

A higher level of care While Independence Place shares some of the qualities of a senior center and adult day care center, Harmon notes that it’s actually “a medical day health facility” —with a full-time nurse on duty to monitor and supervise clients’ medical needs. “We consult with our clients’ personal physicians to coordinate the care we provide,” says Harmon. “We can also provide occupational, speech, and physical therapy services onsite. Our goal is to help clients maintain a stable level of health, and to prevent premature nursing home placement.”

Skilled care you can count on 24/7 STAR short-stay rehab | Pulmonary rehab Adult day care | Extended residential care Respite care | Hospice care

“You are not alone.” One thing Harmon is passionate about is getting the word out to families and caregivers that “help is available.”

Call: 732-849-4400 Whiting, NJ

Independence Place at Whiting Healthcare offers daily activities programs, meals and medical supervision as well as short-term respite and hospice services to families of adults with medical needs. For more information contact Jennifer Causer, Executive Director at Whiting Healthcare at (732) 849-4400 or visit the center online at www.reverawhiting.com.

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Interior Decorating

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March/April 2015

IT ITSS Services ervice IT ervices

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IsInternet Your Security: Business Network Worth It? Internet Are You At Risk? Security: Are You At Risk?

Gucci©, Prada© Christian The reliability of RSTS to Louboutin© products have more deliver products and services is updates. UseUse wide-rangIt seems like these two words go together like like oil and systems updates. wide-rangIt seems like these two words go together oil and systems than style. Sure theyTrojan look great to none. Our rates are virus protection onsecond all all systems. water.water. E-mailE-mail scams,scams, viruses, malware, Trojan horses, key key ing ing virus protection on systems. viruses, malware, horses, but what you extremely Be sure your Internet connectioncompetitive and we loggers; listgoes just on goes onelse and are on. What is a person your Internet connection loggers; the listthejust and on. 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RS Technical Services has resources •access Neveryour let any person Do younot do share not know, remotely system. In a small business there are many things you can do computer. passwords. Business Apple iPad mini of the same value. been delivering top grade services andyou products access your computer. Do not share passwords. Business In to a small business there are many things can do computers and business networks are for business use. help prevent attacks or data breaches. companies like Hewlett Packard, computers andthem business networks are for business use. or tofrom helpHere prevent attacks or Cisco, data breaches. Do not use to access personal e-mail, web sites are some highlights: Lenovo, Microsoft, Eaton, computer and others forpolicy over in Do not other use to that access e-mail, webfrom sites oryou. 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Yoga Therapy

Strengthen Your Bones With Therapeutic Yoga Take an active role in your journey to healing Yoga and Bone Density Research: Robyn Tiger, MD, PYT, RYT-500, CRMT

❧ In the cold winter months with shorter sunlit days, we tend to be less active and stay inside where it is comfortable and warm. Too much inactivity can be harmful to our health, including the health of our skeletal system. Without movement, bones become thin and weak, increasing their risk of fracture.

Roles of the Skeletal System:

The bones are made of a strong outer layer called the cortex and a spongy inner layer called the marrow. The cortex is responsible for providing strength by creating the internal frame for the body. It also protects the internal organs. A strong vertebral system allows for good posture which improves the body’s ability to breathe and digest. The marrow produces red blood cells which carry oxygen to tissues and organs, white blood cells which fight infection, and platelets which help with blood clotting.

Osteopenia and Osteoporosis:

Bones begin to develop in infancy and reach their maximum strength at about 30 years of age. Bone strength then declines after this age. Osteopenia is a decrease in the normal amount of bone density. It is the forerunner to osteoporosis; a critical level of bone loss.

Statistics show that osteoporosis affects 44 million Americans, more than half over the age of 50. A person with decreased bone density has a significantly greater risk of fracture, especially involving the hip and spine. A research study performed by Dr. Loren Fishman at Columbia University in New York showed that bone density increased in both the hip and spine in patients with osteopenia and osteoporosis who practiced yoga regularly. Bone density decreased in those who did not practice yoga.

Bone is Living Tissue:

Although we may visualize the skeleton as something very hard and rigid, bone is actually living tissue and is constantly changing. Bone cells called osteoclasts, “the cleaner – uppers”, take away the old, weak bone so that bone cells called osteoblasts, “the builders”, can create new strong bone.

Cancer and Osteoporosis:

Cancer patients have an increased risk of osteoporosis. They are more inactive due to the effects of treatment. Chemotherapy kills cells that actively multiply, such as osteoblasts, the “bone builders”. Also, estrogen, which helps to stimulate bone growth while preventing bone loss, is blocked and decreased by some cancer medications.

Yoga Therapy and Osteoporosis:

Private yoga therapy sessions and classes include postures and movements that safely stress the bones to stimulate bone growth. Modifications are made for people at risk for and already diagnosed with osteoporosis. This allows for a mindful active practice to effectively strengthen the bones and improve the overall health of the body and mind.

Call today and receive a free consultation!

How Yoga Strengthens the Bones and Prevents Fractures:

Yoga safely stresses the bones. This stimulates the formation of new bone in several ways:

❧ Compressive stress is created by weight bearing. ❧ Tensile stress is created by the pull of working

muscles which attach to bones. ❧ Dynamic tension is formed as the body moves in and out of poses. ❧ Sustained resistance is created by holding poses.

Yoga also further aids in fracture prevention by improving range of motion, sense of balance, dexterity and grace of movement.

Testimonial After my first class, I was more relaxed than I have been for over a year. Cancer is so devastating emotionally and of course physically but this is the first time since my diagnosis that I feel I am learning how to relax without the use of drugs. I like moving my body again and knowing I am doing it in a safe way led by a knowledgeable and caring person. ~ Nancy

Traditional Western Medicine Integrated with the Eastern Science of Yoga

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7802 Long Beach Blvd. Harvey Cedars, NJ • 609.494.3004 • www.GiglioAwning.com • www.facebook.com/giglioawning?fref=ts The Ronald McDonald House of Long Branch & New Brunswick, now known as Ronald McDonald House of Central & Northern New Jersey, provides a “home away from home” for families of seriously ill children who recieve care at medical facilities near our locations in Long Branch and New Brunswick, NJ. Your donation will help us further our mission.

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Long Branch House 732-222-8755 New Brunswick House 732-249-1222 www.rmh-cnj.org

March/April 2015

Awning

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Business Spotlight

~ Interview With Dave Voris ~

Giglio Awning

Giglio Awning Helps His Customers Take Cover

Your Full Service Shading Solutions Provider

7802 Long Beach Blvd., Harvey Cedars, New Jersey 08008

Interestingly enough, the original owner of the business, Tom Giglio lived on the same street as Dave did in Beach Haven. He adds, “We got to talking in 2000 and I began working for him on my days off from my other full time job as a steward at the Little Egg Harbor Yacht Club. One thing led to another and I purchased the business from him in 2001.”

609-494-3004

www.GiglioAwning.com

s the owner of Giglio Awning, Dave Voris is involved with many different aspects of the business. For example, a typical day for him includes service, scheduling, customer service, and visiting with commercial clients to ensure that products are where they need to be. Giglio Awning has been in business since 1976. Their popular showroom is located on Long Beach Island, in Harvey Cedars and they are a full service awning company that specializes in sales, installation, and service of retractable awnings, window awnings, and stationary awnings for both residential and commercial applications, and hurricane shutters.

What is the most rewarding part of your profession? Dave: That’s a tough question because there are so many aspects of the business I enjoy. One that sits close to the top is working with clients who have sun issues, or other “around the home” weather related issues. Usually, we can provide a solution that results in a very positive customer service interaction.

What is the most challenging? Dave: We pride our organization on customer service and are continually trying to improve our systems. That could mean focusing on response time on a service call or a new install. The overall goal is to ensure the whole process from our first meeting to completion is a smooth and positive outcome for our customer.

What are most people looking for when making a screen or awning purchase? Dave: The number one reason is protection from the sun, but screens provide many other attributes such as wind, rain, and bug protection. Many of which the consumer did not realize until we help to educate them on the benefits of retractable screens or retractable window walls.

What are wnings the advantages of purchasing an awning over an umbrella?

Dave: An awning is more durable and it can shade a much larger area. It can be designed and constructed to meet your home’s unique configuration. An umbrella is highly susceptible to wind damage and must always be handled manually.

What is the average wait time for installation of an awning? Dave: From the time you place your order our professional staff can have your new awning installed within two weeks.

Which type of screen is your most popular seller? Photo by Tracy Harman Photography

Dave Voris, Owner

Dave: The most popular screen is the Sunesta Sentry. This is a remote-control-operated retractable wall system that can come in any material from bug screen to a solid acrylic, to even a clear window. We see a lot people using these to enclose an outdoor area that would otherwise be unusable due to sun, wind, rain or cold. We have had a relationship with Sunesta since 1981. We were their first client and are now continually their largest.

How long do most awnings last? Dave: This depends mostly on its location. Endless direct sunlight, tree sap, and smoke (from an outdoor grill) are the worst enemies of your awning’s fabric. In general, the stitching is the weakest link and will need to be replaced first. With proper maintenance, you can usually expect seven to ten good years from acrylic fabric. The hardware usually carries a limited lifetime warranty and, as a rule, can be reused with new fabric. Dave has lived on Long Beach Island for over 25 years. He and his wife Karin have a 7-year-old son named Kai. The family enjoys surfing, snowboarding and other outdoor activities. He has been a lifetime member of the Beach Haven Volunteer Fire Company as well as a lieutenant in the Barnegat Light Volunteer Fire Company.

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

00 H Wellness Health ealth & &W ellness

Featured On T 5

~Fitness For Every Be Healthy, BeReal Active This Real Holiday Season Real Life. People. Results. Law Written by: Julianne Dods, VP, Tilton Fitness & Wellness By Julianne Dods, VP, Meridian Fitness & Wellness

vegetables that are in abundance this time of year.” Also, Stubley notes that while we tend toFunctional eat “comfort foods” in the fall Training: and winter months (soups, stews and breads are always favorites) these choices exercise that simulates everyday are actually packed with healthy nutrients like fiber, protein and Vitamin C, activities such as walking, jogging, provided they are made fresh, rather than canned or pre-packaged. standing, picking something up “As long as we make sure to load up on vegetables, choose overhead. lean meats and are or lifting something cognizant of serving sizes, soups and stews can be hearty and healthy.” Functional Training will not only Spacing meals throughout the day and planning lowbalance, calorie snacks willand also improve your mobility help to curtail junk food temptations and the desire to overindulge during the coordination but also your strength holiday season. and stamina.

Elder Law

t’s that time of year again! November officially or years, Rehabilitation Counselor Jill Anders of marks the beginning of a five-week holiday Jackson described herself as an active individual who celebration filled with high-calorie dishes and high-stress calendar obligations. Tiltonher body with nutritious exercised faithfullyThis andyear, fueled Fitness & Wellness challenges you to choose health. foods. Sheforethought was successful, confident, and happy in the life she With a little to balance and moderation, it is was possible to enjoy holidays leading. Butthethen, Jill’swithout life changed in a big way. compromising your health and fitness goals. In 2008, Jill moved to New Jersey, started a new career, married the Eat Healthy. loveindependent of her life study and became Mom a 10-year-old stepdaughter. “The the An conducted by thetoUniversity of Texas found that during healthy habits that were engrained in my daily routine and had created fall and winter months we tend to consume about 200 additional calories per day. We balance mya combination life for so long had drastically sayscanJill. “By can blame in it on of biology and holidaychanged,” parties or we take a proactive approach mindful eating. recognized myself.” Octoberto2014, I barely

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three years ago, 35 yearEach year, as summer slowly fades into fall, theAbout days become cooler, darker and old Rae-Anne Brown was treated shorter. Take advantage of the daylight hours while they last and get outside. forsunlight a suspected stroke. The culprit: According to the Center for Disease Control, is proven to stimulate the Sincesymptoms then, Rae-Ann production of the feel-good hormone serotoninher andlifestyle. helps relieve of seasonal has madeevery fitness and nutrition affective disorder which impacts millions of Americans year. While the crisp autumn air and gorgeous foliage generally provide a picturesque her top priority. “Joining Tilton “Rather than put yourself on a restrictive diet during the holidays, focus on portion Trainer Kelly with client backdrop for fall favorites from apple picking toFitness hay rides to pumpkin & Wellness hascarving, made allthe Traine control nutrient says Jennifer Stubley, professional General Manager in gained Galloway. Rae-Anne In and 6 years, thetiming,” once active and vibrant had cooler temperatures are perfect for exploring new trails orshe enjoying ourhas local thehiking difference,” says. “It “Choose fresh fruits to satisfy sweet cravings and take advantage of locally grown 70 pounds, struggled to perform activities of daily life and was beaches. and endu helped me get my life back on track and take control of my health.” Jill Anders works with Personal Trainer, Matthew Leonard-Smith. experiencing a myriad of health issues. “I was suffering from migraines, “Our bodies respond to the varying challenges of exercise, not to the amount of timeTrainer L we spend doing it,” says Stubley. According functional Training has improved almost every facet of chronic fatigue, irregular sleep patterns, as well as constant back and neck mechanicstoasRae-Anne, well as how to vary my workouts and fuel my body.” Pack a pair of running shoes tohas work and takelost your break forsizes, a brisk her life. In the past six months, she not only 20lunch pounds andoutside six pant Barba pain,” says Jill. “I had also developed sugar and caffeine addictions.” or jog.energy Pack the family up the andday, headhas to improved the beach for stroll down the and boardwalk chronic butwalk has more throughout herasleeping habits Over past 14 weeks,earlier Jill has lost 31.6 pounds and or try eating dinner 30-minutes andsuccessfully taking a family walk afterwards to boost herthe stress levels. priority Jill’s life had become a blur. While she recognized her self-sabotaging decreased gained a confidence that she hasn’t felt in years. “This process has been your metabolism. consisten behaviors, she felt too overwhelmed to do anything about it until she was very humbling for me,” she says. “I truly believePersonal that Small Group Training “Before I began Functional Training with Certified Trainer Kelly am the h Choose What Makes You Happy. forced to make a change. Under the recommendation of her primary care hasThe made all the difference. Ifpacked. it wasn’t for early the support and guidance of my holiday months are action From November through mid-January, physician, Jill stepped away from work and back into the gym. “(Before I began Functionalpeers, Training) My have fitness goals going to the gym Small Group Instructors I would stopped we spend our time planning, and shopping, cooking, traveling, and attending every event Barba consisted (solely) of losing weight and that tactic proved to be very a few short weeks after starting this journey.” imaginable all while trying to maintain our normal schedules. This year, make a number. After years away from fitness, Jill knew that small steps were her discouraging.” commitment to your health. Stay focused. of optim ticket to big changes. She started by going on hikes with her “Realistically, youMeridian may not have an hour a day to devote a workout session,” says Not only has Fitness & Wellness put Jilltoon a healthier Activate thisJill pass at any dog, Jack. When the weather forced her indoors, made her of way to Simon, Stubley, also working with twothe children. “Sotime planfitness accordingly, whether pathI but it ahas helped hernumber create quality she sogoals desired with that her focused solely onmom the on the scale. My consisted Lisa h our six locations. Meridian Fitness & Wellness. means shorterand more intense workouts or structured programs.”forshe of losing weight tactic proved be discouraging,” says. “Since stepdaughter. “Ithat finally feel like Ito am avery good example her,” says Jill. “We transform Highout Intensity Interval Training is amy great way maximize expenditure incorporating Functional Training workout regimen, have been ablethe to in she says work together, take yogainto classes and, intoturn, I amIcaloric teaching her only 20-30 minutes and can be done 2-3 times week. “In the beginning, Jill’s health goals revolved around achieving optimal redirect my stressofinbalancing a positive way and obtain measurable results.” importance life stressors while being the healthiest version of If you can’t make it to the gym every day, choose one or two weekly Small Group or challeng wellness from the inside out,” says Meridian Fitness & Wellness Certified myself that I can be.” Group Fitness classes to get the most out of your time. “Exercising in group or small cardio tr Personal Trainer Matthew Leonard-Smith. “She was committed to For Rae-Anne, the one-on-one instruction she receives from Kelly has been vital group environments provide participants with the guidance of a fitness professional as spending more quality time with family, practicing yoga, meditation and to her 609.FITNESS Take from Jill,and theencouragement first step towards healthy lifestyle wellsuccess. as the it accountability needed toastay motivated during the long Barba prayer, being cognizant of what she put into her body and adding regular www.TiltonFitness.com around h fall and winter months.” can be hard. Let Meridian Fitness & Wellness make it easy! exercise into her daily routine.” “Kelly has the ability to motivate me when I am not so motivated to work out,” Remember, while social andon family obligations can make difficult to maintain yourLisa. “I f Must be 23 years of age. ID Required. See club for details. For more information Meridian Fitness &itWellness, she healthy says. “Her constant feedback regarding my technique methrow preform lifestyle throughout the holiday season, they don’t helps have to yourthe progress call 732.928.1126 or visit us online at While she felt comfortable on the cardio floor, Jill was intimidated movements safely and effectively thattoI get theTilton most out of my workout.wishes But, you a completely off track. From our so family yours, Fitness & Wellness www.MeridianFitnessandWellness.com and overwhelmed in the strength training area. “That’s when I made happy, holiday season. fun and that’s what it’stoday! most of all,healthy she makes exercising all about!”

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an appointment with one of the Meridian Fitness & Wellness Certified Personal Trainers for a Fitness Assessment and Orientation,” she says. “She recommended that I consider Small Group Training.”

Start Changing Your Life by visiting us online at www.TiltonFitness.

Although Jill was apprehensive, she tried several classes and eventually came to love a few: Weekend Warrior, Yoga, and Kickboxing with her soon-to-be Personal Trainer, Matthew LeonardSmith. COMING

www.TheCountyWoman.com nty Woman Magazine SOON TO “Matthew has helped me establish a firm foundation for my healing journey to become healthy,” says Jill. “He has coached me through my Julianne Dods, Vice President, struggles, made me laugh when I wanted to cry and motivates me to Tilton Fitness & Wellness Meridian Fitness & Wellness keep going when I would rather quit. I have learned proper body

BRICK!

Making Fitness Your Family’s Focus

“When or separately, separately,it’s it’s “Whenfamilies familiesworkout, workout, either either together or ananideal RegionalTraining Training idealsituation,” situation,”said said Paul Paul Brones, Brones, Regional Director for Meridian Tilton Fitness && Wellness. Director for Fitness Wellness.“They “Theyfeed feedoff offeach each other’s eachother, other, other’sexcitement excitementand andenthusiasm, enthusiasm, motivate motivate each and encourage encourage each eachother othertotosucceed succeedasasa afamily. family. Tilton AtAt Meridian Fitness creating aahealthy healthy Fitness&&Wellness, Wellness,we weare are committed committed to creating and can enjoy.” enjoy.” andfun funatmosphere atmosphere the the whole whole family can

January/February 2015

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Law

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At Meridian Fitness & Wellness our dynamic, state-of-the-art facilities offer something for everyone. Whether it’s Swimming, Weight Loss, or Training, we have the tools you need to achieve the results you want. No more excuses, it’s time to

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March/April 2015

Education

EARN Your Bachelor’s or Master’s Degree from Kean University at Ocean County College!

KEAN-OCEAN provides students with the opportunity to pursue their education beyond an associate degree – right on OCC’s beautiful main campus, located in Toms River!

For information, call (732) 255-0356 or visit

www.ocean.edu.

Complete A Four-Year Bachelor’s Degree In Toms River! Are you looking to complete a four-year college degree but don’t want to travel outside Ocean County? If so, Ocean County College’s (OCC) partnership with Kean University provides students with the opportunity to pursue their education beyond an associate degree – right on OCC’s beautiful main campus, located on College Drive in Toms River! Since 2005, Kean University has been offering the extraordinary opportunity for students to complete a bachelor’s or master’s degree on the OCC campus. Currently, the Kean-Ocean partnership offers bachelor’s degrees in accounting, biology, criminal justice, elementary education, English, finance, graphic design, history, management, marketing, nursing, physical education, psychology, public administration, sociology, and special education. Several majors include teacher certification options in special education, K-5, or 5-8 subjects. Kean also offers two master’s degrees through the Kean-Ocean partnership. Master’s degree programs include counselor education with state certification for school counseling and nursing

with options in clinical management and school nursing. In 2014, a new doctoral program in nursing was added. The beautiful Kean-Ocean Gateway Building opened in 2013. A joint venture between OCC and Kean, this magnificent build¬ing sits on OCC’s upper campus. The 74,000-square foot, state-of-the-art, five-story structure is an impressive academic facility. Shared by OCC and Kean, a unique aspect of the Gateway Building is that it is “divided” in half with OCC and Kean housed in separate wings. The building features a lecture hall, student lounge, laptop labs, classrooms, and a coffee/snack kiosk. “Here at OCC, we strive continually to augment our campus such that we improve the bigger picture, and persist in realizing our primary ambition: an atmosphere where our students are comfortable but challenged, happy, and fulfilled,” said Dr. Jon H. Larson, OCC President. For more information about Ocean County College, and the Kean-Ocean partnership, call 732-255-0356 or visit www.ocean.edu.

Art Gallery

You are cordially invited to view

the works of Nolan Willence

at a newly opened Contemporary Fine Art Gallery

THE OASIS GALLERY 495 Route 9, Bayville, N.J. by appointment: P: (732) 657-3930 • C: (732) 575-5851 • E: nolan2032@yahoo.com

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Business

Copiers Plus, Inc.

icoh Americas Corporation today announced that Copiers Plus, Inc. has been officially confirmed as a Ricoh Certified Managed Document and Business Process Services and Production Printing Professional Services Provider through Ricoh’s CHAMPS program for dealer transformation. Individual workstyles continue to quickly evolve in today’s dynamic work environment, and as a result Ricoh is focused on information mobility: helping workers at organizations of all sizes access relevant information from anywhere and at any time to make critical business decisions. Ricoh’s CHAMPS program is an innovative approach that enables dealers to successfully redesign their business models and gain the proper knowhow and Ricoh expertise to offer advanced services that deliver information mobility and ultimately help customers capture, transform and manage information more effectively in today’s new world of work. The program qualifies dealers to analyze customer business challenges and prescribe custom services drawing from Ricoh’s Business Information Solutions

Finance

Now Helps Customers Unleash The Power Of Information With Ricoh Services

expertise. The CHAMPS certification program confirms that a dealer has successfully completed all Ricoh Services certification requirements for a particular specialized service or solution offering. The professionals at Copiers Plus have successfully completed expert training on delivering Ricoh’s Managed Document and Business Process Services and Production Printing Professional Services. Several of the dealer’s employees passed rigorous certification examinations that followed intensive training through the Ricoh Learning Institute, the company’s comprehensive training organization. “Congratulations to Copiers Plus and its newly certified staff,” said Jim Coriddi, Vice President, Dealer Division, Ricoh U.S.A. “This certification arises from a unique and transformative program in our industry. The overall goal is to give our dealers the tools to address their clients’ most pressing business problems. We remain committed to supporting our dealers with differentiating programs that allow them to be the best resource for information management in their region.” About CHAMPS Program Ricoh’s CHAMPS program combines a proven methodology, best-in-class

resources and Ricoh’s industryleading services to create custom solutions that improve customer business performance. The program makes it easier for the Ricoh family group of dealers to leverage what they need, when they need it, while lowering their document-related capital investment and helping accelerate profit generation opportunities. About Copiers Plus, Inc. Founded in 1986 by Robert and Debra Matthews, Copiers Plus enjoys serving as a traditional and specialty digital office equipment company. Copiers Plus represents over 28 years in the field selling and servicing office equipment. We continue to grow as a result of loyal customers who refer our company to others. This is a result of Copier Plus’ total commitment to customer satisfaction. We are grateful for their business and look forward to serving new customers as well. Copiers Plus, Inc. seeks to achieve steady controlled sales growth as a result of improvements in the value and service we provide to our customers. These improvements

become possible as employees develop superior techniques and abilities through training, experience and personal commitment. When our quality and customer service is better than our competitors, we ensure their satisfaction and ongoing patronage and thus secure our own operation and security. About Ricoh Ricoh is a global technology company specializing in office imaging equipment, production print solutions, document management systems and IT services. Headquartered in Tokyo, Ricoh Group operates in about 200 countries and regions. In the financial year ending March 2014, Ricoh Group had worldwide sales of 2,195 billion yen based on the IFRS accounting standard (approx. 21.3 billion USD). The majority of the company’s revenue comes from products, solutions and

services that improve the interaction between people and information. Ricoh also produces award-winning digital cameras and specialized industrial products. It is known for the quality of its technology, the exceptional standard of its customer service and sustainability initiatives. Under its corporate tagline, imagine. change. Ricoh helps companies transform the way they work and harness the collective imagination of their employees. For further information, please visit www.ricoh.com/about/ © 2014 Ricoh Americas Corporation.

For more information about Copiers Plus, visit www.copiersplus.com.

Three Convenient Locations! 935 West Ave. Ocean City, N.J. 08226

609-398-7676 3112 Fire Road, Unit C, Egg Harbor, Twp., NJ 08234

609-645-7587 21 East Broad Street Palmyra, N.J. 08065

1-800-834-3598

www.copiersplus.com • info@copiersplus.com

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Business

Personal Storage Take Back Your GarageWe’ve Got Space!

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Landlord / Tenant Seminars 2015 FREE PROGRAM • OPEN TO THE PUBLIC March 20, 2015 • 10:00 AM to 12:30 PM Superior Court of New Jersey, Ocean Vicinage Jury Assembly Room, 1st Floor 100 Hooper Ave, Toms River, NJ 08753

The seminar will offer information and will include the following: The Landlord/Tenant Filing Process Forms And Documentation Involved What Happens At The Landlord/Tenant Hearing Space is limited. Reservations are necessary. To reserve space, or for more information contact:

732-929-2063 or email:oceanlric.mailbox@judiciary.state.nj.us Superior Court of New Jersey, Ocean Vicinage Legal Research and Information Center This seminar is presented by the Ocean Vicinage Legal Research and Information Center in coordination with South Jersey Legal Services. Please note that your personal case cannot be discussed.

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Acupuncture cupucnture A

35 65

Understanding The Value Of Acupuncture with a specific organ and has specific physiological functions, as well as emotional and spiritual components. When the qi flow is disrupted the body can experience dysfunction, ill health and/ or pain. When the qi is flowing freely through the channels all body functions, such as Sleep, Digestion, Energy, Immunity, Concentration, and Mobility are enhanced. Submitted by: Keith Koehler, MAOM, CA Koehler Acupuncture Acupuncture, And chinese herbAl FormulAs

Answering Your Frequently Asked Questions About Acupuncture?

What is acupuncture?

Acupuncture is a treatment involving the insertion of fine needles into the skin to relieve symptoms (such as pain), strengthen the body’s immune system and balance the body to facilitate healthy body function.

How does it work?

Acupuncture works by stimulating the body’s qi (pronounced chee). Qi is the body’s life energy. It flows throughout the body in a series of channels. Each channel is connected

Does it hurt?

The insertion of the needle is generally painless. Many patients do not even realize when the needle has been inserted. This is because acupuncture needles are solid and hair- fine, unlike a medical hypodermic needle, which is thick and hollow. Once all of the needles are in place, the patient usually becomes very relaxed. The lights are dimmed and gentle music is played. Many patients fall asleep during the treatment.

How many treatments does it take to feel relief?

Some patients feel some relief after the first treatment. Typically, patients feel some consistent relief after three to five treatments. It is usually recommended to receive two to three treatments for two to three weeks, followed by an evaluation to determine the need and/or frequency of further treatment.

Conditions Commonly Treated By Acupuncture

We Feature Complementary Techniques Moxa Insomnia Tui Na Massage Menopause Cupping Nausea & Digestive Disorders Gua Sha Neuropathy Skin Disorders Electro–Acupuncture

Allergies & Asthma Anxiety & Depression Arthritis Autoimmune Disorders Back Pain & Sciatica Chronic Fatigue Genitourinary Disorders Gynecological Disorders Headache & Migraine Hypertension Infertility

Smoking Cessation Strains & Sprains Stress Tendonitis Weight Management Whiplash

Koehler Acupuncture 128 Drum Point Road • Brick, NJ 08723

732.262.0637

www.koehleracupuncture.com Complete relief varies from case to case. In general, acute symptoms resolve quicker than chronic or complex conditions.

How long is a treatment?

During a treatment needles are retained for twenty to forty minutes, depending on the patient and the condition being addressed.

Is it safe?

Yes. All needles are presterilized and packaged for single used. During treatment, the acupuncturist opens the needle packages and inserts the needles, using proper clean needle technique. When the treatment is over, the needles are removed and placed in a biohazard container, just like at a hospital or doctor’s office.

Does insurance cover acupuncture?

Most insurance companies have plans that cover acupuncture, though coverage varies from plan to plan. The best way to find out if you have coverage is to come in for a consultation, and let the acupuncturist verify your benefits with your insurance company.

Who can be treated with acupuncture?

Everyone from infants to seniors can be treated with acupuncture. Treatments vary accordingly. Infants and toddlers may be treated with acupressure techniques or acupuncture with no needle retention. Children tend to respond very quickly to very little stimulus. With adults and seniors, sensitivity and response to treatment var-

ies, therefore different treatment techniques can be used to achieve the best results for each individual.

What is the most common condition people get treated with acupuncture?

The most common complaint for adults and seniors is pain. Low back pain tops the chart, followed by neck, hips and knees. The two most commonly treated complaints for children are digestive (colic) and respiratory (asthma and allergies) conditions. Acupuncture is among the oldest healing practices in the world. It aims to restore and maintain health through the stimulation of specific points on the body. It is considered part of complementary and alternative medicine (CAM). Call and schedule your appointment today!

Koehler Acupuncture • 732-262-0637 • www.KoehlerAcupuncture.com www.TheCountyWoman.com The County Woman Magazine The County Woman Magazine www.TheCountyWoman.com

November/December 2011 March/April 2015

Women Of Ocean County

Patty Shannon, Owner

Mariah Sykes, MS, PA-C,

Physician Assistant

Copy Fax + by The Wordstation

Center for Surgical Weight Loss & Wellness at ARMC

Patty was born and raised in Ventnor, New Jersey. She graduated from Montclair State College. She lives in Brick with her husband, Brian, and son, Tom, who also work alongside her. She worked as a professional proofreader and an administrative assistant. Wanting more flexibility when her son was born, she began The Wordstation in 1989 in her home in Avon-by-the-Sea, soon moving into office space. After 20 years in Avon, they moved the office to Brick as Copy Fax + by The Wordstation. Patty types everything from letters to full-length book manuscripts. “I’m amazed by the creativity of my authors. I never rewrite; I just correct grammar, spelling, and punctuation.” She proofreads for writers, court reporters, and pharmaceutical ad agencies, gaining a large medical vocabulary. Other services include transcribing recorded phone interviews or municipal meetings for insurance agencies and lawyers. She really enjoys meeting people at her office and is always happy to take care of customers, whether they need a single photocopy or hundreds, or want to send a fax. She is also a notary public. She can be reached by calling 732-477-4800, or wordstation@comcast.net.

Mariah Sykes, MS, PA-C, is a physician assistant (PA) at the Center for Surgical Weight Loss & Wellness at AtlantiCare Regional Medical Center. In this role, Mariah works primarily in the operating room as a first assistant to the surgeon. Mariah’s philosophy is to treat each patient as she would want a member of her family to be treated. Her goal is to ensure that every patient receives individualized attention and a great experience from AtlantiCare. She enjoys working with bariatric patients, in particular, because “these individuals become AtlantiCare patients for life and it’s very rewarding to see firsthand how their lives have changed for the better. It’s more than just weight loss; some patients are now able to exercise, resolve their diabetes, or get off their blood pressure medications.” Mariah earned a B.S. degree in biology from Boston College and a master’s degree in physician assistant studies from the Philadelphia College of Osteopathic Medicine. Mariah and her husband recently fulfilled their dream of moving back home to Ocean City, where Mariah was born and raised. She enjoys traveling the world with her husband and spending quality time with her family on the beach. To learn more about AtlantiCare, visit www.AtlantiCare.org.

Photo by Tracy Harman Photography

Tina Hedin, Office Coordinator

Peg Campana, General Manager

Aesthetic Dental Creations

Meridian Fitness & Wellness

Tina Hedin is the office coordinator for Dr. Balaji at Aesthetic Dental Creations. She started in dentistry 20 years ago. A former Middletown, NJ native she now resides in Ocean County with her husband, Eric, and their funloving 7 year old, Isabella. Tina loves being a mom and enjoys all the precious moments of raising Isabella, who is “the joy of their lives.” She has had the privilege of working with Dr. Balaji and the team at Aesthetic Dental Creations. Tina prides herself in providing the highest quality of care for her patients. She handles their insurance claims, finances and treatment plans. She enjoys the relationships she has built with her patients and is thrilled when they receive the exceptional dentistry Dr. Balaji provides. The team and Tina work very hard to provide excellent customer care. When Dr. Balaji opened his state of the art office in 2007 it was a dream come true for Tina to be able to give her patients the experience of “Life Changing Dentistry”. This is Tina’s most rewarding part of her career! www.aestheticdentalcreations.com (732) 363-5370

Peg Campana, General Manager of Meridian Fitness & Wellness in Jackson, NJ, is a veteran of the health and wellness industry. With over twenty five years of experience, Peg has consulted on over twenty fitness center projects throughout her career, providing expertise in the areas of Clinical Integration, as well as, Medical Wellness programming. Aside from being an avid golfer, Peg has over thirty years of experience with the sport of volleyball, first as a player, then as a coach and, now as an NCAA Official. “I have even had the opportunity to officiate the NCAA Championships at the Division One level,” says Campana. “At Meridian Fitness & Wellness, we are dedicated to changing people’s lives. Our innovative programming and personalized approach to overall health and proactive care positively impacts the communities we serve,” says Campana. To learn more about Meridian Fitness & Wellness’ three Ocean County locations in Jackson, Manahawkin and coming soon to Brick, call 609.FITNESS or visit www.MeridianFitnessandWellness.com.

Photo by Tracy Harman Photography

The County Woman Magazine www.TheCountyWoman.com

Photo by Tracy Harman Photography

March/April 2015

Women Of Ocean County Noelle Pyatt, Case Supervisor

Cathy Harmon, CSW, Director

CASA of Ocean County Noelle Pyatt resides in Toms River, New Jersey with her two beautiful daughters. She was born in Bronx, NY where she grew up with her mother and her sister. Noelle is a Case Supervisor at CASA of Ocean County and a graduate from Georgian Court with her bachelors in Criminal Justice. She manages and provides technical assistance to children’s rights advocates in the court system. As a team, they work together to provide foster children with educational, medical and emotional needs. Noelle is most proud of the fact that she works everyday to assist foster children with finding families and the homes that they deserve. Noelle feels that all children have the basic right to be loved, have a stable family and a sense of security. She is very passionate about helping the children and enjoys this part of her job the most. Noelle has the long term career goals of becoming an attorney so that she may make a more significant impact on the children and families involved in the judiciary system. Noelle enjoys spending time with her family, reading and trying new recipes for cooking and baking. She loves the quiet community of Ocean County and touring the area with her kids. To contact Noelle, call 732-797-0590, or visit www.casaofoceancounty.com.

Independence Place Adult Medical Day Care Center Cathy Harmon graduated from Stockton State College in 1985 with a bachelor’s degree in social work and a minor in gerontology. She also studied at the University Of Copenhagen, Denmark, where she graduated from in 1985, leading to a continued year of European travel and study of social and cultural environments. She is a licensed certified social worker. Since 2000, Cathy has been the director of Independence Place adult day care center at Whiting Healthcare, where she focuses on integrating patients back into their homes following hospitalizations and providing a medically supervised day center for continued care and nutritional, social, and physical wellbeing. Cathy spends her free time raising her family of six children and attending various sporting activities and community events. She particularly enjoys her work at the day care center, where she can provide compassionate care and help to seniors. To contact Cathy for information about Independence Place and the grants available, please call 732-849-4969 or e-mail cathy.harmon@reveraliving.com.

Photo by Tracy Harman Photography

Meghan Atkins, Office Manager

Photo by Tracy Harman Photography

Jane Niemeyer, Bookkeeper

Jay Turnbach, Esq.

Meghan is a true Ocean County Woman. In fact, all of Meghan’s major life milestones occurred within this incredible county. She grew up in Brick, met her husband during high school in Toms River, was married in Lakewood, had her baby in Brick, and currently works in downtown Toms River. Meghan also attended and received her Bachelor’s degree in Criminal Justice from Georgian Court University in Lakewood. Her first position in her chosen field was as a receptionist at a law firm in Toms River. Through hard work, dedication, and a desire to learn, she has advanced through the ranks and is now the Office Manager for Jay Turnbach, Esq. Meghan uses her love of accounting and organization to help her excel in her position. She also looks forward to interacting with and supporting clients as they navigate the often-arduous family law system. Meghan currently resides in Lakewood with her husband, Carl, and one year old daughter, Jane. She balances the difficulty of working full time in a demanding position and parenting a toddler with the help of her family and friends. You can contact Meghan at (732) 286-4860 or meghana@njfamilylawyer.net.

Giglio Awning

Early on in life, Jane developed a love for photography and realized that taking X-Rays was really just another way of taking pictures. Jane did her initial X-Ray training at East Orange General Hospital in East Orange, New Jersey. Jane then moved to New York City where she continued her education and her career. Jane’s career in Radiology spanned 45 years. During her career, Jane earned a Masters in HealthCare Administration and an MBA. Throughout her career, Jane always enjoyed helping people, which is her primary job as a bookkeeper at Giglio Awning, LLC in Harvey Cedars, NJ. Jane, and her husband John, came to Ocean County 13 years ago, and immediately feel in love with the shore and Little Egg Harbor. In fact, they loved it so much that they moved here full time. Jane was born in Pennsylvania and raised in Northern Jersey. Her career was spent working and helping other people. In retirement, Jane is very active with AAUWNJ, where she serves on the State Board. With her husband John, she enjoys golfing, bicycle riding and taking care of her two dogs. In her free time, she is an avid reader. For more information, call 609-494-3004, or visit www.GiglioAwning.com.

Photo by Tracy Harman Photography

The County Woman Magazine www.TheCountyWoman.com

Photo by Tracy Harman Photography

March/April 2015

CASA

Volunteers Wanted for Aging-Out Foster Children CASA of Ocean County exists to recruit, train and supervise everyday concerned citizens to become child’s rights advocates. This non-profit organization provides a 30-hour advocate training class to individuals who are willing to donate 20 hours a month in volunteer service to make child visits, attend meetings, appear in court, and speak up for the child as they navigate the child welfare system. All volunteers receive a background screening process, interview, training and ongoing support while they assist a child on his/her journey to a safe, permanent home.

AGING OUT TEENS

Can you imagine at the age of 18 having no support network? With nearly 500 children living in out-of-home placement due to issues of abuse and neglect, CASA aims to provide aging-out teens with a volunteer advocate of their own. Teens are a special group of children who typically linger in the foster care system and have very few options for transitioning into adulthood on their own. CASA seeks to recruit 20 new program volunteers to serve aging-out teens. The advocate will assist the teen with setting goals such as securing housing, finding a job, financial planning (opening a bank account and preparing a budget), applying for college/financial aid, working with their medical needs and building life skills for the future. CASA of Ocean County developed this program to help these children so they are not faced with homelessness, teen parenthood, incarceration and other social issues that impact the entire community. It is essential for the community to dedicate time and compassion to this special age group of children who need our help.

TRAINING

The 30-hour training class covers topics such as poverty, drug/alcohol abuse, domestic violence, and child abuse & neglect. The 30 hours will be split into five 6-hour sessions. The training will also assist the advocate with court report writing, what to do when visiting the child, and making an investigation on behalf of the Children in Court Judges so that they can make the recommendations for services that are in the child’s best interest.

WHO ARE OUR PARTNERS?

CASA of Ocean County will be working with local banks, business owners, community colleges and non-profits that share the vision that aging-out teens deserve a family and a home. Aging-out teens will directly benefit from this program by attaining their GED’s, participating in transitional living programs, and most importantly, having a CASA advocate who will stand alongside them during the process of becoming an adult. Those of us who have children know that they need parents and caring people to guide them through the ups and downs that life can throw at them as they mature. Our aging-out teens are no different and truly need that support to really help them blossom.

HOW DO YOU GET INVOLVED?

For more information on how to become a CASA volunteer, please visit www. casaofoceancounty.org to access guidelines and applications. Contact the CASA office at 732-797-0590 to arrange an in-person interview and learn more about the program and its expectations.

History and Mission of CASA: Since 2006, the Court Appointed Special Advocates (CASA) of Ocean County, Inc., which is an independent, non-profit organization located in downtown Toms River, has been committed to advocating for the best interest of at risk children in foster care who are victims of abuse and neglect. The CASA volunteer serves as the child’s voice in court and is committed to moving the child towards a safe and permanent home.

Major Program Sponsor

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Business Opportunity

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March/April 2015

Community

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

CASA

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March/April 2015

Community

A WOMEN’S CAREER AND LIFE EVENT

Saturday, March 21, 2015 College Ctr. • Bldg. #9 Main Campus, Toms River, NJ 8:30 am – 12:30 pm Admission: $9.00 (includes all refreshments and workshop materials) Current OCC and Kean-Ocean students (with ID)............$6.00

Co-sponsoring Organizations

American Assoc. of University Women – No. Ocean County Branch Business and Professional Women of Southern Ocean County Family Planning Center of Ocean County, Inc. Jackson Women of Today Kean University at Ocean County College New Jersey Association of Women Business Owners Ocean County Advisory Commission on the Status of Women The Ocean County Woman Soroptimist International of Toms River Women’s Network, Ocean County College Women’s Studies, Georgian Court University

Pre-registration requested. To register or for more information, call 732.255.0400 ext. 2945

Seating is limited • Pre-registration is Requested

__________ RSVP __________

by Friday, March 20, 2015 732.255.0400 ext. 2945

www.ocean.edu

Community

Letter From NJAWBO Shore Region President Liz Milio Recently, at a networking meeting, we were asked to share our resolutions for the New Year. I don’t believe in New Year’s resolutions. When I was a kid, I made resolutions every year. I thought about them between Christmas and New Year’s Eve and then implemented each resolution on January 1st. At the beginning, they lasted until mid-February. Every year, the time between January 1st and the day they were broken got shorter and shorter. I finally realized how futile making resolutions were. What I do believe in are GOALS. We don’t need to make goals once a year, although it is nice to start out a sparkling new year with a set of goals for our personal lives and businesses. Goals, like resolutions, are something we strive toward such as increasing our client base 10% by such-andsuch a date. Goals, unlike resolutions, need to have a plan. You will need to decide if these are short-term or longterm goals.

You will need to establish a time period for each goal. At the end of that time period, you will review the results. Creating an end date gives you and your team the opportunity to measure performance, reward excellent production, and reevaluate your goals on a recurring basis. If you are a one-person shop, your reward can be as simple as that new pair of shoes or outfit you have had your heart set on.

March 26, 2015: Dinner Meeting - Guest speaker Rosemarie Conti at ABL, Englishtown 6 – 9 p.m.

Enterprising Eats, Recipes from NJAWBO Members is available for purchase for $10. If you want the cookbook mailed to you, there is an additional shipping charge.

May 21, 2015: Installation Dinner Meeting - Shore Region Installation of Executive Board at 4 JG’s Winery, Colts Neck, 6 – 9 p.m.

Interested in NJAWBO? Then please contact me at president@njawboshore.org or call me at 732-6830092. Liz Milio, President, NJAWBO Shore Region (Monmouth/Ocean/Middlesex) Upcoming NJAWBO Events: March 3, 2015: OPEN HOUSE - Free to all event Investors Bank in Freehold

www.TheCountyWoman.com TheCounty County Woman Woman Magazine Magazine www.TheCountyWoman.com The

March 13, 2015: Happy Hour and Networking Social at Bar Anticipation, Belmar, 6 – 7 pm April 23, 2015: State NJABWO Conference April 30, 2015: Members Only event

Register for all Shore Region Events at www.NJAWBOShore.org. Don’t forget to visit www.NJAWBO.org to find out about other Regions and State-wide events. All NJAWBO members may attend all Region and State events at member prices. Non-members are invited to attend a Shore Region event at member price – mention this article! To register, visit NJAWBOShore.org Limit one per person. Valid for NJAWBO Shore Region (Monmouth/Ocean/Middlesex) events only.

March/April 2015 2015 March/April

country women ad_Layout 1 2/2/15 8:14 PM Page 1

Community

March is Red Cross Month March is American Red Cross Month and this year we are honoring the everyday hero in all of us: the donor who transforms a stranger’s life by giving blood, the volunteer who provides a hot meal to someone in need, the teacher who uses CPR to help save a student from choking. We all have the potential to be everyday heroes.

Be a Hero – Make a Difference • Join us at our 32nd Annual Gala at the Eagle Oaks Golf and Country Club on March 21st honoring Dr. Steven Crawford Corporate Medical Director with Meridian Occupational Health Thomas Donovan President and Publisher of the Asbury Park Press Carol Stillwell President of Stillwell-Hansen, Inc. Sponsorships and ad journal pages are still available! • Volunteer There are many ways you can volunteer with The American Red Cross Jersey Coast Chapter – we are always looking for people with various backgrounds, talents and skill levels. Learn more here http://www.redcross.org/support/volunteer or call 732.493.9100 • Donate Blood by visiting www.redcross.org/blood • Save a life by taking a health and safety class Take a training course to learn lifesaving skills from the experts: http://www.redcross.org/take-a-class • Support our Home Fire Preparedness Campaign Your service will make a difference in the community. Be part of our mission this March. American Red Cross Jersey Coast Chapter/South Jersey Region 1540 West Park Ave. Ocean, NJ 07712 www.redcross.org/nj/tinton-falls Visit us on @RedCrossSouthNJ

American Red Cross - South Jersey Region

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March/April 2015

Community

Long Branch House 131 Bath Ave. Long Branch, NJ 07740 732-222-8755

New Brunswick House 145 Somerset St. New Brunswick, NJ 08901 732-249-1222

Celebrate RMHCNJ families

by helping to raise money and awareness 3rd Annual Garden Tea Party

Join us Sunday, May 17th in the lovely gardens of the Long Branch House at 131 Bath Avenue, Long Branch, NJ. At this event guests enjoy a quiet leisurely afternoon of conversation and fine teas accompanied by delicious finger foods and deserts. Guests also have the opportunity to win a number of exquisite prizes during our tricky tray auction.

16th Annual Walk with Ronald

Put your best foot forward on Sunday, June 7th at Six Flags Great Adventure, Jackson, NJ. Our walk is unique event without limitations! Walkers from throughout the New York/New Jersey metropolitan area come out to join us as individuals or form teams online, set team goals and watch their pledges grow! Be part of a fun and join us at our events this season!

If you are interested in becoming a sponsor or attending any of our exciting events, visit our website: www.rmh-cnj.org or call Stacey at 732-222-8755 ext. 31 or by email at Staceyh@rmh-cnj.org Follow us online!

www.facebook.com/RMHCNJ

www.twitter.com/RMHCNJ

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Community

Social Community Activities Network SCAN has launched its Digital Aging Mastery Program on February 5, 2015. This special project was created by the National Council on Aging and funded by the Verizon Foundation. We are working with 25 limited income seniors, and each of them received a Samsung tablet, free Internet service, training on how to use the Internet to research topics of interest, how to Skype to stay in touch with family and friends, and a coach to work with them throughout the year. We are very excited to be partnering with the YMCA of Western Monmouth County and providing this program at the YMCA Community Center located in Freehold. February was filled with lots of activities to promote friendship and love. We had our annual Chocolate Tasting and everyone left with a smile on their face. At our Boscov’s Campus of Courses classes, we conducted an informative workshop on “Online Dating,” but best of all, we screened a documentary movie “The Art Of Love” – it’s never too late to date! The Pat Bohse movie was shown at Seabrook and was enjoyed by all. Executive Director For those who do not know us, SCAN is an adult social education and resource center headquartered on the basement level of Monmouth Mall. Founded in 1988 as the Senior Citizen Activites Network, the agency has since updated the acronym to stand for Social Community Activities Network. This better reflects the action-oriented profile of its members and the vibrancy and social networking strength of the organization. SCAN is a not-for-profit 501C (3) overseen by a dedicated 11-member Board of Directors. The main draw of membership, which is open to anyone aged 50 and over, is the opportunity to socialize and stay healthy. SCAN is a place “where active adults meet to be Informed, Empowered and Inspired.” SCAN’s facility houses 2 classrooms, a computer lab with 14 stations, a large workout room for fitness classes, and a TV studio. Please stop by for a tour of our facility. We produce three TV shows per month, and they can be seen on Comcast, Cablevision, and FiOS networks in Monmouth and Ocean Counties as well as SCAN’s own YouTube Channel. Go to our website www.scannj. com to see when you can see our shows in your community. We offer over 30 classes each semester that are open to anyone, but discounts and freebies are available to our members. Students can choose from classes in art, computers, technology, digital photography, fitness (yoga, chair yoga, tai chi and other low-impact exercise classes), health, languages such as Italian and Spanish, music, TV production, finance and more. All are offered over the course of three 13-week semesters each year. Our classes are offered in Monmouth County and in 2015 will be offered in Ocean County.

PLEASE MARK YOUR CALENDARS: SCAN’s Behind the Scenes program will be offering a private escorted tour of Wilson Hall at Monmouth University on March 9th. Come learn about Wilson Hall’s fascinating history and enjoy some refreshments. Cost is $15. Please call the SCAN office now to make your reservation. We have a fun-filled bus trip on April 23rd to Platzl Brahaus Lobster Festival in Pomona, NY. Join us for a day of food, music, and dancing. The all-inclusive cost is $69 per person. SCAN is hosting the FoodBank of Monmouth and Ocean and their VITA (Income Tax Preparation) program on the following days: Monday/Wednesday/ Thursday from 1pm-7pm. The VITA program runs through April 13, 2015. SCAN conducts a weekly Walking Club on Thursdays in the Monmouth Mall Food Court. There is a short presentation from 9:00-9:30am followed by an escorted walk from 9:30-10:00am. SCAN’s Annual “Take Control of Your Health Fair” is on May 20th from 11:00 to 3:00. There will be 30+ vendors at the Fair which is held in Monmouth Mall and open to the public. SCAN will be doing workshops at the Boscov’s Department store in Ocean County Mall on March 11, 18, and 25. Please check our website for details of the sessions that will be offered. Free computer classes are available for Veterans every Wednesday. You must register; see class listings.

Photo Carlos Rodriguez, Executive Director of Foodbank of Monmouth & Ocean Counties and Pat Bohse, Executive Director of SCAN Photo credits: Andrea Tarr

SCAN Executive Director Pat Bohse (left), hosting Welcome to SCAN TV show, talks about the recently launched Digital Aging Mastery Program with Mel O’Neal, Outreach Director Freehold Borough YMCA Community Center and Beulah Hickman of Freehold.

We are working with the Monmouth County Office on Aging Caregivers Department, and we have a free support group for caregivers at SCAN on March 11 and March 25.

SCAN SPRING–SUMMER SEMESTER BEGINS MAY 11, 2015. The Social Community Activities Network (SCAN) is located at 180 Route 35 in Eatontown (basement level of Monmouth Mall); for more information and a schedule of other upcoming events,

call 732-542-1326 or visit www.scannj.com.

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

Community

COMIC BOOK SHOW

To m s R i v e r E l k s L o d g e , To m s R i v e r, N J

S u n d a y, M a r ch 1 5 , 2 0 1 5 Over 20 guest artists, cosplay groups, and more! Comics, Non-Sports Cards, Collectibles, Toys!

Admission $3.00 $1.00 in Costume Leprechaun Contest! Door Prizes!

10am-4pm

Call: (609)

242-7756

For more information, visit jerseyshorecomicbookshow.com Education

Education

The County Woman Magazine www.TheCountyWoman.com

March/April 2015

B usiness B usiness&F & Finance inance

79 77

Toms River - Ocean County Chamber of Commerce News A Letter from the President:

Welcome NeW members

Institute for Prevention/DART Coalition ourselves on being able to offer Michele Buldo 1691 US Hwy. 9, Toms River, NJ 08754 something to everyone. 732-886-4757, fax: 732-886-4809 Not only is our 97-year-old www.instituteforprevention.org Chamber a vibrant networking Organizations/Charities/Non Profits

Member Connect event is held on the second Friday Letter from the of each month. It is a time to talk about your Executive Director It is hard to believe the holiday season is already upon us. Chamber business, connect one-on-one withThe other members, As we head into Spring, the has had a busy fall season. In September we honored, The Jay & Linda Grunin Toms River-Ocean County Chamber and learn about what’s going on inth our area. In the as networking Distinguished Organization theitsYear at our 50 Annual few months of since inception, the event hasAwards received and educational resource for your is busyFoundation, bringing new GTS Telephone, Inc. Reception at Eagle Ridge Golf Club. We also gave special recognition “Wave such feedback as “the best coordinated chamber event business, but it is also a well-respected opportunities, educational resources, Cassandra Pierce Awards” to Ocean Technical School, County College 209 Center I have attended” and “a trueOcean networking experience”. association in our community. We Street, Lakehurst, NJ 08733 and some good out ol’ fashion funCounty to our Vocational 732-323-8620, fax: 732-323-8660 & CASA of Ocean County at that event. In our October, we had another successful Further, redesigned, user-friendly website take your business vision seriously. membership! www.gtstelephone.com Maureen Stankowitz, Business After Hours at Tuscan Bistro Bar & our Technology Committee hosted Dina M. Vicari, Esq. is up-and-running making it simple to apply for It is a great time to beInformation a part Technology & We have been listening to what Dina M.President Vicari, Esq. Chairwoman Noelle Lotano another informative Seminar on Security. The Chamber continues to offer a variTelecommunications membership, renew your existing membership, or our members need from us, and of the Toms River-Ocean County Chairwoman Interim President networkingpartnerships opportunities forregister our members takesponsorship advantage of. Please join for eventstoand opportunities. throughety ourofcooperative Wireless Zone of Toms River Chamber of Commerce! We are us for our Membership Meeting onOcean Tuesday, December 9, 2014 Toms River present If you missed anyatofRamada our Business After where Hourswe will Koerner withGeneral other local ChambersHoliday and organizations, strong andOcean growing! Denise 1334 Lakewood Road, Unit #36, CountyCounty YMCACollege, & Yourand Grandmother’s Cupboard with the “Aevents Seasoninofthe Giving – A Season of Living Award”. first quarter, consider joining us To register for this event the Joint Base, we have been Toms River, 08755 Contact the office today toNJinquire this Spring. We are adding new engagement www.oc-chamber.com News & Events able to deliver need-based results.Page. 732-818-0300, fax: 732-818-0122 For example, our new, free-to-members, monthly

opportunities to our calendar regularly. We pride

about membership - 732-349-0220. www.wirelesszone.com/tomsriver

TOMS River RIVER-OCEAN COUNTY CHAMBER OF COMMERCE Toms - Ocean County Chamber of Commerce GENERAL MEMBERSHIP HOLIDAY MEETING 22nd Annual Golf Outing and Networking honoring COUNTY TOMS RIVER-OCEAN Thursday, June 11, 2015 www.TheCountyWoman.com CHAMBER OF COMMERCE Ocean County YMCA 11:30 A.M. REGISTRATION &

Woman Magazine

Eagle Ridge Golf Club

SEPTEMBER 17, 2014 YourWEDNESDAY, Grandmother’s Cupboard 2 Augusta Boulevard,

EAGLE RIDGE GOLF CLUB, 2 AUGUSTA BLVD, LAKEWOOD, NJ

with Lakewood, NJ 08701 ATTENTION “A GOLFERS: Season of Giving - A Season of Living Award”

Special Recognition Award:9, 2014 GOLFER REGISTRATION Tuesday, December ~ Business Beautification of the Year Fee: ~ Non-Profit Partnerper Year ~ Business Partner of the Year Entry $225.00 at of theplayer Sponsorships-Submit by AUGUST 28,price 2014 of foursome - Register by March 5, 2015 for $100.00 off Ramada Toms River, 2373 Route Toms RiverHour -Networking Dinner Includes: Green Fees & Cart - Buffet Lunch -Driving Range - Awards & 9, Prizes - Cocktail ((Proper ) COCKTAIL RECEPTION SPONSOR $2,500.00 Required Jeans - Soft Spike Shoes) RegistrationAttire 11:30 a.m.–~NoBuffet Lunch 12:00 p.m. *10 Reception Tickets *your name on signage as Cocktail Reception host at Event RSVP FOR Golfers & Foursomes by: June 5, *special recognition at dinner *premium location full page color ad in 2015 virtual ad journal