120.4 The Future of Surgery with Dr. Vladimir Sinkov by topdoctormagazine

March 2021 Issue 120.4

SPECIAL ISSUE

The Future of Surgery with Dr. Vladimir Sinkov Pg 1

Why People with COVID Lose Their Sense of Smell Pg 13

TOP DOCTORS OF THE WEEK

An Interview with Dr. Timothy Trainor

Pg 06

The “Winning Strategy” of Sports Medicine Surgeon Daryl C. Osbahr Pg 10

Contents WHAT'S INSIDE? 01

The Future of

THE PANDEMIC: BEN

Vladimir Sinkov

KENUK, HIS RPM APP,

An Interview with Dr.

AND ULTIMATELY THE

The “Winning

MARK OF A HERO 48

HOW RESEARCHER'S

Medicine Surgeon

REMARKABLE SUCCESS

Daryl C. Osbahr

MIGHT BE AN UNDOING

Why People with

COVID Lose Their

Serving the Underserved: An

Interview with

and How it Boosts Your Immunity 66

Profile Spotlight: Tom

Doctor Spotlight: Dr. Leon Vajabedian

Kenji Oyasu: Fighting Stigmas and the Opioid Crisis

The Freedom of Health with the Jiu-Jitsu Doctor: An Interview with Dr. Neil Morris

Profile Spotlight: Dr. Michael Greiwe

Doctor Spotlight: Dr. Arvind Mahadevan

Profile Spotlight: Dr. Shivesh Kumar

Blue 28

Dr. Burak Ozgur Spotlight

Dr. Lipi Roy 25

Discovering the Benefits of CytoSyde

Sense of Smell 16

DISTRUST AMID VACCINATION:

Strategy” of Sports

SURVIVING THROUGH

Surgery with Dr.

Timothy Trainor 10

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Issue 120.4.1

The Future of Surgery with Dr. Vladimir By Brianna Connors Sinkov More than twenty-five years ago, Dr. Vladimir Sinkov came from Russia to study as a high school exchange student in Kansas. Enthralled by experiences in a new world, he decided to stay in America and study medicine at John Hopkins University. In 2010, he completed his spine surgery fellowship from St. Joseph Hospital in Baltimore. After ten years of mastering spine surgery, Dr. Sinkov finally decided it was time to open his own private practice. In June 2020, Dr. Sinkov and his wife launched Sinkov Spine Center in Las Vegas. However, opening a new business right smack in the middle of a pandemic did present quite a few challenges that Dr. Sinkov discusses a little bit more of below. Despite the less-than-ideal circumstances, Dr. Sinkov told Top Doctor Magazine that he feels very blessed by the continual growth of his practice.

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Issue 120.4.1

The Real Issue of Opening a Practice During a Pandemic The COVID-19 pandemic has been a struggle for many business owners. Countless enterprises had to shut down, but for those fortunate enough to continue running, the new reality challenged them to adapt to new safety precautions like constant disinfecting, temperature-checking, and social distancing; this, however, was not a struggle for Dr. Sinkov. Since he opened his business during the height of the pandemic, the new "normal" of doing things is, well, just "normal." The real issue, aside from the unpredictability of running a business in these unprecedented times, was dealing with insurance companies that reduce reimbursement rates for doctors, especially those in smaller independent practices. Dr. Sinkov revealed to Top Doctor Magazine the shockingly offensive rates that one insurance company tried to offer him: "Probably the worst was Blue Cross Blue Shield. They offered us less than 50% of what Medicare pays. And, just to put it into perspective, when I was in the Northeast, Medicare was the lowest reimbursing insurance that we had." Dr. Sinkov said that the company offered less than $13 for a visit with a fellowship-trained spine surgeon with ten years of experience. "Some people pay more for a cup of coffee," he said. Dr. Sinkov believes that health insurance companies are not in the business to help patients or doctors, but rather, they are in the business with the sole purpose of making money. That is why Dr. Sinkov is choosing to opt-out from working with them and going for a direct-pay model, wherein the patients pay their physicians directly. Contrary to popular belief, if you consider the ever-increasing health insurance premiums, patients overall spend less this way because you cut out billing, collection, and service expenses. This type of arrangement is more beneficial to both the patient and the physician. Patients also regain control over their care because there are no referrals needed and there is no insurance company clerk to deny payment for care.

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Issue 120.4.1

What's So Cool About Spine Surgery Anyway? So now, let's dig a little deeper into the backbone of Dr. Sinkov's practice (no pun intended). Dr. Sinkov specializes in surgical treatments of spine such as decompression, fusion, disc replacement, minimally invasive, and robotic spine surgery. When people get spine surgery, it is usually because of a degenerative condition like arthritis or a herniated disc. Nerve compression causes patients to experience pain in their legs or arms. Dr. Sinkov can address this with decompression surgery. When a patient has more significant structural problems in the spine, like deformity or instability, Dr. Sinkov treats it with fusion surgery, wherein he fuses two or more bones so that they no longer move. The excessive motion of the bones can cause severe back and leg pain, so by linking them, Dr. Sinkov alleviates the problem.

However, performing surgery on the spine is not a walk in the park. The biggest challenge that spine surgeons face is how to get to the spine without too much damage to the surrounding tissues. Because the spine is located in the middle of the body, a surgeon has to get through a lot of muscles and safely around major organs and blood vessels to get to the vertebra and the nerves. With traditional fusion surgeries this means big incisions, significant bleeding, a lot of pain, long recovery, and a risk of complications. This makes a lot of people afraid to undergo spine surgery because it is so invasive with many potential negative repercussions. Dr. Sinkov utilizes new minimally invasive techniques to get to the spine safely through small incisions to fuse the bones and get the pressure off the nerves. This results in less bleeding, less pain, and quicker recovery and return to normal function with much lower risk of complications.

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Issue 120.4.1 To aid in this minimally invasive process, Dr. Sinkov uses the ExcelsiusGPS® robot that he helped develop together with Globus Medical. Dr. Sinkov walked us through the process of how it works: "We'll get a CT scan of the spine before surgery and then load it into the robot. I pre-program the trajectory of all the screws where they need to go. During the surgery, we basically tell the robot where to go with a push of a button. The robot orients a little tube over the trajectory for the screw, and I put it in through a minimal incision with high precision. The robot knows the anatomy of the patient, so I'm avoiding all the tissues and organs I don't want to hurt." Helping his patients feel better with minimally invasive robotic spine surgery is where Dr. Sinkov's passion lies. When asked about his take on regenerative medicine and stem cell surgery, Dr. Sinkov admits that he uses stem cells when performing fusion surgery. He incorporates his patient's own stem cells or sometimes a cadaver bone's stem cells to help speed up the fusion and healing process. However, he does not necessarily use stem cells to regenerate the spine structures because the technology is not at that level yet. When it does arrive, he will be sure to apply it in his practice. Meanwhile, his best advice for rejuvenating your spine is staying healthy, avoiding bad habits, and keeping your spine and muscles in good shape.

Robots and Augmented Reality Are The Future As we continue moving forward in this digital age, Dr. Sinkov sees a bright future for minimally invasive surgeries. Aside from upgrading the spine assistant robots' functions, he is also excited to see how augmented reality will play a key role in future surgeries. Although augmented reality technology is still in its early stages of development, Dr. Sinkov looks forward to one day being able to navigate through a patient's tissue layers to the spine by using special goggles. He believes that minimally invasive surgeries will be the only way to do surgeries in the near future. It takes time to learn how to do it, but he is happy to teach the new techniques to aspiring surgeons. After a brief pause due to COVID, Dr. Sinkov is back to teaching medical students how to treat patients with spine problems and how to perform this kind of surgery in a real-life hospital setting.

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Issue 120.4.1

The Reason Why Healthcare Is So Expensive Of course, with all the fantastic perks that come with being a surgeon, there are also some downsides. Dr. Sinkov opened up about the poor state of the American medical system. "There's tons and tons of waste and inefficiency in healthcare because it's not really a market economy-driven industry. A doctor’s ability to care for their patients is constantly stifled by a mixture of burdensome government regulations, unreasonable insurance rules, and fear of litigation." Dr. Sinkov cited the HIPAA and HITECH laws as an example. Initially, the laws sounded like a great idea that would help protect patient's health information and create accessible electronic medical records. The implementation of the laws, however, was extremely burdensome and poorly thought through. The compliance requirements ended up causing doctors to pay hundreds of thousands of dollars for legal consultants and new computer systems and software to store medical information electronically - which, in turn, made healthcare more expensive to the patient. Another reason why healthcare is so expensive is that suing doctors for medical malpractice is so common in the U.S that, in most places, it is a requirement for a doctor to have malpractice insurance before they are allowed to practice. Dr. Sinkov even got sued one time for not ordering an extra MRI, which in his opinion was unnecessary. Although he was proven innocent and the charges were dismissed, Dr. Sinkov spent precious time and money to get through the lawsuit, the time he could have spent treating patients. "The efforts required to avoid unnecessary and frivolous lawsuits are causing doctors to do a lot of work that has nothing to do with helping patients," Dr. Sinkov stated. In a healthcare system where insurance companies are only concerned about the dollars they pocket from the unsuspecting public, Dr. Sinkov refuses to be a part of a rigged system. Instead, he would go about medicine the old-fashioned way, where his patients get high quality care without administrative hurdles or unnecessary expenses.

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Issue 120.4.2

An Interview with Dr. Timothy Trainor By Brianna Connors

About Dr. Trainor Dr. Timothy Trainor is a Board-Certified Orthopedic Surgeon based in Las Vegas, NV. He graduated from the University of Notre Dame, IN, with a B.A. in Pre-Medicine & Communications. He continued his post-graduate work at the University of Massachusetts, Amherst, MA, and received his medical degree from the Northwestern University Medical School, Chicago, IL. He completed his residency training at the Georgetown University Medical Center in Washington, D.C. Dr. Trainor focuses on various orthopedic conditions and performs several orthopedic procedures, such as arthroscopic surgery in the knees and shoulders, adult and pediatric orthopedic care, joint replacement, and fracture care.

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By Brianna Connors

Issue 120.4.2 Outside the operating room, Dr. Trainor maintains close ties with several institutions renowned in the orthopedic field, such as the American Association of Orthopedic Surgeons and the Society of Military Orthopedic Surgeons. He has won multiple awards from Nevada-based journals, and he regularly publishes articles on the subject of sports medicine.

From an Athlete to an Orthopedic Surgeon Born and raised in eastern Massachusetts, Dr. Trainor, taking his parents’ example, was all about sports - baseball and basketball, to name a few! – as a young man. However, after suffering from a boxing-related injury, he had to look for professional help. That’s when Dr. Trainor discovered the wonders of orthopedic surgery and began to dream about following the same career path. A simple idea took a turn towards reality, and Dr. Trainor has never looked back since: “Right when I got into the medical school, I was certain that I wanted to be an orthopedic surgeon.”

From an Athlete to an Orthopedic Surgeon Although he doesn’t have to deal with life-and-death situations, Dr. Trainor is proud of his practice and how it helps patients whose hip or knee issues make their lives harder to bear. “What my surgeries do for a lot of people is just really increase their quality of life,” Dr. Trainor tells us, pointing out the fact that patients who have trouble walking are less likely to spend enough time with their families due to pain that prevents them from fun activities such as going to a restaurant together. However, after a knee or hip replacement, “the patient is given back that portion of their lives that they couldn’t do before.” That is why ecstatic patients go back to his office and shower him with hugs and honest gratitude, with these words on their lips: “I have my life back.” – enough of a reason for Dr. Trainor to return to the office every day.

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Issue 120.4.2

Back to Normal or a “New” Normal? The COVID-19 vaccines came as a miracle for medical practitioners and the general population alike. The same goes for Dr. Trainor, who firmly believes that we, as a community, should put our faith in science and be vaccinated unless medical contraindications say otherwise: “For the most part, vaccines are a vital part of medicine, in my opinion.” The vaccination campaign should be integrated with an effort to dispel misinformation and bring science and facts to social media. When asked about a possible return to “normal” in the near future, Dr. Trainor shared his optimistic views with Top Doctor Magazine. He sees, for the most part, a return to the pre-COVID-19 world. However, with a few tweaks: the COVID-19 vaccine will be integrated into the yearly vaccination routine, and the medical world will look towards further developing telemedicine, with long-lasting benefits, for example, in the rural area, where the physician numbers are reduced.

Teaching Future Generations of Orthopedic Surgeons Aside from his work, Dr. Trainor took it upon himself to prepare future generations of orthopedic surgeons. In association with institutions such as the Touro Medical School or the Roseman Medical School (both based in the Las Vegas area), Dr. Trainor mentors his students in the knowledge necessary for the operating room and outside of it.

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Issue 120.4.2 Ever since they graduate, young practitioners have to deal with business management, insurance companies, and reduced reimbursement rates without any prior knowledge. Medical schools do not include these subjects in their curricula, leaving young practitioners exposed once they graduate. Fortunately, Dr. Trainor dedicated his past 15 years to business management and protection, learning how to keep his practice alive in a harsh environment. Now, he’s making sure that younger generations are equipped with the right tools to thrive in their practices as well.

“You Should Not Go Into Medicine for Money” With vast loads of work and reduced reimbursements, Dr. Trainor advises those who want to pursue a career in the orthopedic field for financial reasons to reconsider their decision: “You should not go into medicine for money.” At the end of the day, the excitement of doing what you love and helping your patients is what makes a true orthopedic surgeon. And Dr. Trainor himself is a personal testament to that: a heart for his patients, and a passion for his practice.

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Issue 120.4.3

The “Winning Strategy” of Sports Medicine By Brianna Connors Surgeon Daryl C. Osbahr As a little boy, Dr. Daryl C. Osbahr wanted to be a professional athlete. And if not that, he wanted to be a sports medicine surgeon who took care of professional athletes. "What I learned really quickly was that I couldn't keep myself healthy enough, and so I had to devote my life to working on keeping other people healthy enough to play sports," Osbahr said. Inspired by mentors Dr. Don Ames and Dr. James Andrews, Osbahr threw his passion for athletics into pursuing his doctorate in orthopedic sports medicine. His mentors taught him to pursue his work with excellence and discipline, and Osbahr keeps their advice at the forefront of his mind. 10

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Issue 120.4.3 Today, he serves as the Chief of Orthopaedic Surgery and Managing Director for the Rothman Orthopaedic Institute in Florida. He is currently preparing Rothman Florida to expand their community outreach and has helped numerous teams, ranging from ballet to basketball.

A Passion for Sports "I find myself constantly learning and falling in love with my job when working with athletes from all sports as you can become easily inspired by the dedication and work ethic of many of these athletes. It’s humbling when you have an opportunity to help them get back on track to being successful," Dr. Osbahr said. Many doctors gravitate toward helping athletes within their sport of interest. Osbahr's appreciation for the skills in each sport naturally created more opportunities to work with athletes in different fields and at different stages of life. He uses his position as Co-Chief Medical Officer of USA Baseball, Committee Member of the Florida High School Athletic Association (FHSAA), Board Member of the Florida Alliance for Sports Medicine, Medical Director for the Sunshine State Athletic Conference, and other organizations to help young athletes learn how to maintain their health. He also teaches preventative care, which helps athletes avoid and minimize injuring themselves even in contact sports.

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Issue 120.4.3

Treating the Whole Person The world of sports medicine wasn't always so intentionally-focused, according to Dr. Osbahr. Historically, sports medicine was about treating injuries. Now, the focus has become holistic - building a team of support around the athlete. "Often in medical care, we tend to just focus on the physical injury and not really address the mental effects of the injury," Dr. Osbahr added. "Optimal treatment of the patient needs to include analyzing their psychological approach and how mentally they're dealing with their injury because it will directly reflect upon their successful or unsuccessful recovery."

The Winning Strategy He believes in building trust with his patients, an authentic connection that allows him to improve their care. When past clients call him to ask for advice, he always connects with them because he believes in maintaining that relationship even past retirement. Osbahr finds fulfillment in connecting people with the right solutions and impacting their lives for the better. Building that connection allows Osbahr to maintain accountability with the athletes in his care. He ensures that, even in these times of Covid-19, his athletes are taking the appropriate steps to recover and stay healthy. If you would like to learn more about Dr. Daryl C. Osbahr and the Rothman Orthopaedic Institute, you can visit his website here. 12

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Issue 120.4.4

Why People with COVID Lose Their Sense of Smell By Odessa Kramer There are now over 29 million coronavirus cases in the U.S. From body malaise to shortness of breath, the virus presents itself in different ways. One of the most common and interesting symptoms is anosmia or smell blindness. An NIH review studied a total of 11,054 COVID-19 patients and found that this loss of smell often precedes the other, more severe symptoms of the virus. This loss of smell can suddenly occur in people infected with COVID-19 and is often associated with loss of taste, too. Loss of smell in COVID-positive patients may happen with or without a stuffy or runny nose; in some cases, this may even be permanent.

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Issue 120.4.4 Even though buying a piano is a significant investment for parents with a young child, after much begging on Dr. Roy's part and seeing her dedication, she would receive her first piano at 8. For the next twenty years, she took lessons, performed in recitals, and competed across her hometown of Toronto, Canada. She would even become a student at the Royal Conservatory of Music. Her love for music and piano would continue to be a balm as she transitioned into medical school. "Fast forward to when I was doing my residency in North Carolina at Duke Medical Center. I would work 12-14 hour days. I would be exhausted when I got home, but when I got home, I would look at my piano and go 'alright Lip, just 15 minutes'," said Dr. Roy. "Then I would play classical, I would play Simon and Garfunkel, whatever I wanted to, and I would just feel calm. Soon, I'd look up at the clock, and two hours would have passed."

Inflammation and Loss of Smell C.T. scans of people with COVID-19 who have reported anosmia reveal a cleft syndrome – this happens when swollen soft tissue and mucus block the olfactory cleft, the part within the nose responsible for smelling. The novel coronavirus makes its way into the body by attaching to cells in the upper respiratory tract. Once the virus permeates these cells, with the help of the TMPRSS2 protein and replicates, the inflammatory response is then activated. Inflammation is the immune system's response when it detects foreign and possibly harmful bodies. A column by University of London consultant rhinologist and ENT surgeon, Simon Gane, and University of Reading associate professor, Jane Parker, attributes anosmia to this inflammation and swelling phenomenon. They believe that when the immune system can rid the body of the virus, the swelling subsides, and the sense of smell returns to normal. However, the loss of smell persists even after the person tests negative for the virus in numerous recorded cases. Dr. Gane and Professor Parker present a theoretical explanation based on inflammation physiology: inflammation could trigger the release of chemicals from other systems that may damage tissues and possibly olfactory neurons– the receptors of the sense of smell – in the process. Luckily, olfactory neurons are regenerative.

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Issue 120.4.4

Post-Hospitalization Care and "Smell Therapy" The onslaught of the pandemic overwhelmed the healthcare system. Patients who were lucky enough to make it out of the hospital and "recover" often don't get the necessary post-discharge care they need, as hospitals around the country don't have enough resources and staff. Those who are declared "COVID-free" but are still showing mild symptoms must stay home and wait out these symptoms. The lack of extensive and long-term recovery treatment plans for patients is by no means hospitals' fault. The pandemic nearly paralyzed the entire healthcare system, and it doesn't help that physicians and nurses have been in short supply even before this major health crisis. The spike further exacerbates this shortage in demands for COVID-19 care professionals. Fortunately, the rise of telemedicine and remote learning is helping address this need. These strategies allow healthcare workers to care for more patients through online consultations and virtual health monitoring. More importantly, they provide training to a broader population to prepare for today's healthcare workforce demands. The pandemic has also lead to a new way in which nurses can learn new skills. For qualified nurses who want to learn new skills, there are online R.N. to BSN programs that can give them the necessary abilities to provide specialized care for patients, especially in rehabilitation. These online programs have helped ensure that today's nurses can keep up with the modern demands of COVID-19, such as loss of smell, although the pandemic has made inclassroom learning very difficult. While nurses and physicians are battling the pandemic in hospitals, other organizations take the reins during recovery. Aiding them in post-discharge care are charities and other organizations offering "smell therapy" and other services to help manage lingering effects from COVID-19. These services can last up to four months per individual and can be safely done at home.

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Issue 120.4.5

Serving the Underserved: An Interview By Brianna Connors with Dr. Lipi Roy Dr. Lipi Roy is a woman of many talents, interests, and facets. In her interview with Top Doctor Magazine, she shared that not only is she currently on the journey to publishing a book, but she is also an avid sports fan and enthusiast of the arts. Recently, she had the pleasure of being one of the COVID-19 Consultants for a special performance of The Nutcracker in Upstate New York. "I come from a big extended family… Many of whom are physicians, but I never received pressure to become a doctor," said Dr. Roy. That being said, her mom and dad always emphasized education. "They wanted me to do well in school, and they wanted me to be well-rounded. The first thing they enrolled me in was actually ballet, so there are pictures of me at 2 or 3 years old in a little tutu. Then they got me into swimming lessons, playing chess, tennis, you name it! But at the age of 7, I fell in love with piano." 16

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Issue 120.4.5 Even though buying a piano is a significant investment for parents with a young child, after much begging on Dr. Roy's part and seeing her dedication, she would receive her first piano at 8. For the next twenty years, she took lessons, performed in recitals, and competed across her hometown of Toronto, Canada. She would even become a student at the Royal Conservatory of Music. Her love for music and piano would continue to be a balm as she transitioned into medical school. "Fast forward to when I was doing my residency in North Carolina at Duke Medical Center. I would work 12-14 hour days. I would be exhausted when I got home, but when I got home, I would look at my piano and go 'alright Lip, just 15 minutes'," said Dr. Roy. "Then I would play classical, I would play Simon and Garfunkel, whatever I wanted to, and I would just feel calm. Soon, I'd look up at the clock, and two hours would have passed."

Journey into Medicine There was no single "defining moment" for Dr. Roy on her journey to become a physician. Instead, a series of events captured her attention, fascinated her, and grew her desire to learn. From getting malaria as a child to doing a project in Biology class on leprosy, Dr. Roy always had an interest in the disease. Her interest would eventually lead her to India, where she would learn about international health and tropical diseases. "I started volunteering in hospitals and talking to other people who were in the health profession. Later, I worked for Pharma as a scientist and biomedical researcher and came to realize that I didn't enjoy being in a lab all the time," said Dr. Roy. This realization eventually led her to complete a dual degree at Tulane University in New Orleans, earning both a medical degree and her Master's in Public Health. Following, Dr. Roy's selfproclaimed first academic and public swaray into public health was actually during Medical School when Hurricane Katrina struck.

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Issue 120.4.5 Due to the immense flooding, the medical school closed, and Dr. Roy's class was moved to Houston for nine months to continue training. Upon returning, she remembers coming back to a very different New Orleans. As a result, Dr. Roy and several of her fellow classmates began volunteering at grassroots clinics in the area where they were confronted with patients who had lost everything in the natural disaster. "We took care of the residents of the city, especially the Ninth Ward, who just lost everything. They lost medications, their clothing, everything they needed that related to health," explained Dr. Roy, "And when you lose such vital necessities, things start to break down. We took care of patients with florid heart failure, diabetic complications, and vision problems, all because they were disconnected from the healthcare system and their own medications. That was my first real touch with what public health means." Throughout her career, Dr. Roy has been able to serve underserved populations in a wide variety of ways. Early on, it became evident that she would be drawn to the dedication in caring for the vulnerable homeless and addiction medicine populations. "They teach you on the first day of medical school that your best teacher will be your patients, and I sure learned that first and foremost," Dr. Roy told Top Doctor Magazine. As Dr. Roy immersed herself even deeper into working with the vulnerable homeless, she quickly discovered the link between living on the streets and drug overdose.

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Issue 120.4.5 This realization completely reshaped Dr. Roy's approach, opening up a certain path towards the subject of addiction and addiction medicine: "We discovered that the leading cause of death among my homeless population of patients was drug overdose. That completely transformed the way we provided our care. I learned a lot more about addiction; we hired a lot of substance use counselors, just learned a lot. I became board-certified in addiction medicine. All of this in an effort to learn more about addiction as a chronic medical disease, a disease of the brain. We learned that most people with addiction, once connected to the appropriate treatment and care, get better." Eventually, her dedication and expertise landed her the position of the first chief of addiction medicine for New York City jails, where the gravity of the situation unfolded before her eyes even more dramatically: a population riddled with criminal activity, high poverty, and substance use disorders, who distrusted the authorities, and who was treated as just another statistic. "Because men and women who are experiencing homelessness, or in and out of emergency departments and hospitals, are also often in and out or in touch with the criminal justice system in large part because they all have such a large mistrust of authority and for good reason," Dr. Roy shared with Top Doctor Magazine.

An Empathic Approach to Serving the Underserved Only in a moment of crisis do true heroes emerge, and Dr. Roy was ready to put on her cape and bring change to how we care for patients with substance use disorders. While health professionals receive some degree of training concerning addiction, it is not always put to good use: "Most of us never got trained in treating people with substance use disorders or drug addictions, alcohol addictions, not in a way that was evidence-based or empathic. It was more, I'm the doctor, you're the patient, this is what you need to do." Instead, Dr. Roy followed a path sprinkled with empathy, trying to understand her patients' history, their traumas, all to forge real connections and build trust with those in need of help, one baby step at a time: "I discovered that a vast

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Issue 120.4.5 majority of my patients are men and women that are in and out of the housing systems, the criminal justice systems, a vast majority of them have some type of trauma history, neglect, verbal, physical, sexual assault, you name it. Some form of abuse, trauma, and suffering. So when you come at it from that angle, just listen without judgment. It goes a long way to building trust." With the pandemic sweeping the nation and exposing the cracks within our society at a deeper level, the misfortunes of the vulnerable grew exponentially. When asked about liquor stores being allowed to stay open during the quarantine, Dr. Roy saluted this decision, although begrudgingly, since there was no better alternative to manage cravings for people with alcohol addiction: "Many people, they resort to alcohol and other drugs to deal with loneliness, isolation, anxiety, depression, that's not necessarily the safest or healthiest thing to do, but unless you present an alternative like a society that fills in those gaps of isolation, that manages and treats and prevents anxiety and depression then we need to find other tools that are from a harm reduction standpoint." However, with COVID-19's notorious fame taking over TV, social media, and day-to-day interactions, addiction issues became of lesser interest. One example that perfectly illustrates how every major health issue fell second to COVID-19 is opioid addiction, which, from Dr. Roy's stand, is alive and thriving on the streets: "It didn't magically disappear just because COVID is here; we're just not talking about it. It's just not making headlines the way COVID is because COVID for what it is, it has taken over every headline."

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Issue 120.4.5 A strong feeling of isolation exacerbated inadequate care, leaving the vulnerable praying for a miracle. That's when Dr. Roy stepped up and proposed a more proactive approach by keeping in touch with the ones in need in an empathic and compassionate setting: "We need to work even harder and find creative ways to connect to people. So what you are doing right now by via phone, via zoom, using technology, picking up the phones, how are they paying visits, but in a safe way, say dropping off food, dropping up reading materials, clothing, you know, doing things, but from a distance, mask, you know, they're safe ways to do these things. We just need to really be outside the box and approach it from an empathic and compassionate point of view."

Such an empathic approach to vulnerable populations does not have to be the exception, but the rule, coming from each member of our society as a whole, especially from those who interact with alcohol or substance use disorders or mental illnesses daily. "We need to provide it (i.e., mental health training) to police officers, fire department folks, again, not to make them mental health experts, but to give them this important training, to make their jobs easier, to make their interactions with clients and patients easier and government and policymakers, you know, we need significant funding towards these areas that have been grossly underfunded health in general, typically mental illness and substance use, but you got to educate folks in government that are in decision-making areas, policymakers so that they're all aware that mental illness needs to be addressed," Dr. Roy explained to Top Doctor Magazine. After all, when dealing with another human being, we often distance ourselves from their issues, forgetting that we are all dealing with personal issues, such as job insecurity or eviction. And it's not just adults – young students, who, in extreme cases, end up resorting to suicide, are suffering from isolation and lack of human interaction. For them, going back to school is the best, most straightforward solution: We have to keep making it so schools are safe to open them up, so students can go back."

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Issue 120.4.5

The Long-Term Effects of COVID-19 Turning towards a more COVID-19-oriented discussion, Dr. Roy spoke about the unpredictability of the virus and its long-term effects. From cardiac issues and hypercoagulability to pulmonary embolism and strokes, the COVID-19 virus can leave terrible scars on those who suffer from it, enough of a reason for society to pay closer attention to preventive measures and the ongoing vaccination campaign. "We need to really continue practicing preventative measures, so we can reduce the number of cases, and then, of course, encourage as many people as possible to get the vaccine because, without 70, 80% of the population vaccinated, we just won't achieve herd immunity, and we just won't be able to contain this pandemic," Dr. Roy shared with us. Another long-term effect, or, to put it in a better way, an exacerbated effect of the COVID-19 pandemic has been the social and racial inequality which are plaguing our society: "We need to dismantle racial injustice in every sector, medicine, government, education, criminal justice, you name it. And last, but certainly not least, we need to really educate and empower and compensate girls and women, because we've seen that this pandemic has again disproportionately affected women, in terms of unemployment, it's affected women far more than it has men. And we need to compensate for childcare. We need to because without that 50% of the population is being handcuffed. And, without that, society will just never succeed."

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Issue 120.4.5 "Will the vaccination campaign be enough to bring the COVID-19 virus down?" "Not at all," Dr. Roy shared with Top Doctor Magazine, giving the example of countries with fewer resources who kept the pandemic in check through hard work and humility: "Other countries have handled this pandemic far better than the US even though we have far more resources and wealth, so we need to learn from other countries, and you have to be humble." Furthermore, a strong administration, committed to bringing the pandemic to a halt, will bring the much-needed support to the frontline medical heroes engaged in all-out warfare with the virus: "I'm hopeful of the leadership; we now have an administration, at least in the United States that is committed to addressing the first problem right now, which is the COVID-19 pandemic."

The Importance of Self-Care However, the strongest sign of resilience must come not from the medical community but from every one of us, translated into self-care. As long as we put general health first and follow official guidelines to the letter, our triumphs against the virus will overcome our past defeats. "Let me tell you. You do not have to have an MD or an RN, or have a Ph.D. behind your name to be able to practice self-care and to have the tools to take care of yourself." To help people understand what self-care is and how they can achieve it, Dr. Roy will be leading seminars designed for her colleagues. Although people might expect some sort of deus ex machina stories, Dr. Roy is here to disappoint, in an unexpected way: "I'll just share with what I do every morning. I meditate for 20 minutes. I try to eat healthy meals throughout the day, plenty of fruits and vegetables and lean proteins and whole grains, and drink plenty of water. And I also treat myself to things that I enjoy, like say cookies or ice cream. And then, I even get a little bit of a workout, a little bit of exercise." As she tells us, this exercise time doesn't have to be marathon-style since it's all about enjoying oneself.

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Issue 120.4.5 It would be more helpful to socialize regularly with the people we love and care for, whether through a Skype or Zoom call, and, at the top of the list, enjoy eight hours of sleep every night: "I know it's hard, but getting seven to eight hours of sleep because poor sleep hygiene has been associated with every chronic illness from heart disease and diabetes to cancer and Alzheimer's, so getting that good sleep also reduces your rates of anxiety and depression, so good sleep and mindful practice." Throughout the COVID-19 pandemic, the general population has been lamenting the loss of day-to-day activities that brought joy and community amongst each other, such as seeing a musical or watching a game at the Madison Square Garden. However, this is not a reason to despair, as Dr. Roy tells us, but, on the contrary, to rejoice: "There's plenty of other things you can do. And I'll share with you what I do. I now have a piano, so I can play that, but in other cases, find things that you enjoy. Coloring, drawing, dancing, writing, listening to music, watching TV and movies. I watch comedy every night because it relaxes me. I like laughing." Such an approach teaches us that staying mentally sane during a pandemic is not so hard, as long as we embrace novelty with an open heart and try our best to let go of our anxiety constructively. By following this road, we will keep our heads up until we bring the COVID-19 virus down, staying away from anxiety, depression, and addiction. As a parting reminder, Dr. Roy reminds us that, in the end, laughter and enjoying oneself genuinely are the best medicine: "Laughter is in many ways the best medicine because it relie anxiety. So I really want to emphasize to people, do what you enjoy, what makes that fun, but that's also safe." We wish Dr. Roy the best of luck in her future endeavors and all the strength and resilience she needs to bring her patients back on the right track.

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Issue 120.4.6

Profile Spotlight: Tom Blue By Oyalola Lateef & Brianna Connors

Tom Blue made his mark in the healthcare industry when he set up Virginia's first concierge medical practice in 2002. He has dedicated the last 20 years to researching and synthesizing new approaches around the commercialization of root cause medicine and precision health, either directly through the delivery of services or through the creation of tools and technology that essentially make the services more efficient to deliver. Also, Mr. Blue is the Strategic Advisor for the Institute of Functional Medicine. As a board member of the American Nutrition Association, he spends a lot of time on personalizing nutritional supplements focusing on the root cause of health conditions and how nutrition can support the immune system and immune response. 25

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By Brianna Connors

Issue 120.4.6

Root Cause Medicine Amid Pandemic "When COVID-19 hit, my colleagues and I pulled together what we called a Rapid Response Initiative for COVID. We set out to assemble the tools, approaches, protocols, and kind of ideas for virtualizations to educate independent practice on how to navigate their practice in the era of the pandemic," said Mr. Blue in an interview with Top Doctor Magazine. As an expert specializing in functional medicine in the U.S, Mr. Blue focused on assisting independent practices to weather the impact of COVID-19, which put healthcare professionals under immense pressure.

Functional Medicine And The Pandemic: How Disease Reversal Is Better Than Disease Management While the COVID-19 pandemic has caused devastating damage to our healthcare system, Mr. Blue believes that it has elevated the significance of addressing health conditions' root cause. "For example, we saw the severity of COVID-19 in people with a low level of Vitamin D, and COVID further exposed that there are certain population and health profiles that are obviously at risk, like type 2 diabetic, and people with hypertension," he said.

Blue explained that this reality kind of exposed the fact that disease management is different from disease reversa: "If your diabetes is well-managed by medication, COVID-19 looks right past that. On the other hand, if you simply reverse your diabetes by making a lifestyle adjustment, correcting underlying causes, it becomes invisible to COVID." Dr. Blue further described that COVID-19 has done quite a job by highlighting the difference between those two pathways.

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Issue 120.4.6

Functional Medicine And The Future Of Public Health Even though functional medicine takes more time and effort to deliver, Blue revealed that there is a 25% increase in the number of doctors joining functional medicine annually. Blue further disclosed that patients have also been finding their ways to functional medicine. "Culturally, we are evolving into a new generation of people who are not willing to depend on chronic medication anytime they visit the doctors and discover that something is wrong," Blue revealed. Mr. Blue also mentioned that people are eager to be in charge of their health and not follow doctors blindly. They want to take control of their lives as they are increasingly becoming interested in the long-term efficiency of functional medicine. "Ultimately, we are all beginning to realize that our health is not a matter of chance or fate. Rather, our health is firmly in our control. The great majority of our life is determined by sleep, nutrition, exercise, lifestyle, environmental exposure, how we socialize, and how those interact with our genome to create health or disease," Blue concluded.

Telemedicine And Functional Medicine Functional medicine leaned itself well to virtualization because it is a very consultative method of managing health. There is an investigative process and also requires a visit somewhere. It is mainly about data interpretation, unpacking, and interpreting stories of a patient told by them. "The practice lends itself well to a virtual delivery approach, and fundamentally, functional medicine is an education followed by behavior change," said Mr. Blue.

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Issue 120.4.7

Doctor Spotlight: Dr. Arvind Mahadevan By Brianna Connors By Oyalola Lateef & Brianna Connors

Dr. Arvind Mahadevan is a Family Medicine Specialist with over 16 years of experience in the medical field. Dr. Mahadevan is a diplomate of the American Board of Family Medicine and the American Board of Obesity Medicine. Since he began practicing in 2008, Dr. Mahadevan has provided full-spectrum medical care to hundreds of patients. Dr. Mahadevan enjoys providing care to multiple members of the same family to establish long-term optimal health across generations. Even though he provides full-spectrum care, Dr. Mahadevan takes a particular interest in sports medicine, geriatrics, clotting disorders, high cholesterol, and hypertension.

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Issue 120.4.7

Providing Optimal Care And Patient Satisfaction "We try very hard to work with our patients and make ourselves accessible to them. We also use technology to facilitate communication, and we try as much as we can to be innovative in providing care. All these make it easier to provide care to our patients. As a result, we create a very positive ecosystem for healthcare," said Dr. Mahadevan in an interview with Top Doctor Magazine. Dr. Mahadevan dedicates his time and energy to improving patient's experience in the context of primary care because of the capacity to be more proactive rather than reactive to problems.

Obesity And Its Impact On Optimal Health Dr. Mahadevan explained that obesity is not just a cosmetic concern but a condition that involves excessive fat and increases the risk of other diseases and health problems. "We know pretty much every problem you have is made worse by being too heavy, and I think that prevention is key, but we are struggling as a society because we do not emphasize the dangerous effect of obesity. We don't reward a patient's efforts to overcome it, so every progress on it doesn't count for anything," said Dr. Mahadevan. He further discloses that if people valued a healthy lifestyle, burning fats, and achieving health milestones more, we would have more success than we do.

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Issue 120.4.7

COVID-19 Impact on Family Medicine When the pandemic was at its peak, patient volume dropped, and it became clear that family medicine and major healthcare practices will transition to telemedicine. "Thankfully, our practice had set up telemedicine before COVID-19. So, we hit the ground running when it became necessary." Even though healthcare professionals responded swiftly to the pandemic, Dr. Mahadevan explained that the whole dynamic became very much politicized. As a result, many people put their regular care to the side. "We told our patients that COVID-19 doesn't care who you vote for. The best way to protect yourself from COVID-19 is to take care of everything else," said Dr. Mahadevan.

COVID-19 And The Vaccine The vaccine development process created serious concern across the medical community regarding its safety, efficacy, and reliability to provide permanent immunity. Although Pfizer and AstraZeneca have done a great job, there are many answers healthcare providers can't give with confidence. "I try to tell my patients that there is a lot that we don't know. If the COVID-19 vaccine can create a sense of normality, whether we eradicate it will take years, but we can try to put it under control by taking the right steps which will help us get closer to normal," said Dr. Mahadevan.

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Issue 120.4.7

The Pandemic And Its Effects On Medicine The COVID-19 pandemic created emotional and mental stress for healthcare providers as they were forced to stay away from their families for fear of exposing them to the virus. This disturbing reality addresses the notion that medicine is immune to recession and depression because everyone goes to the doctor. "This is true except during a pandemic when nobody wants to go to a doctor. That was a big stressor for us," said Dr. Mahadevan. wants to go to a doctor. That was a big stressor for us," said Dr. Mahadevan. Dr. Mahadevan warned that we're looking at a long period of abnormal before we'll eventually ease our way back to normal as it was pre-COVID. "Since it's not a flip of a switch to go abnormal, it won't be a flip of a switch to go back to normal, but it is going to be a slow and methodical return back to normal," he concluded. If you would like to learn more about Dr. Mahadevan and his practice visit his website: http://www.tridenthealthcenter.com/

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Issue 120.4.8

Doctor Spotlight: Dr. LeonByVajabedian Brianna Connors By Oyalola Lateef & Brianna Connors

Dr. Leon Vajabedian is an experienced interventional cardiologist with multiple years of experience in the medical field. He takes an interest in cutting-edge minimally invasive cardiac procedures, including coronary arterial disease, peripheral vascular disease, and Structural heart disease (i.e. Valvular heart disease). Dr. Leon Vajabedian is a board-certified member of the American Society of Nuclear Cardiology, National Board of Echocardiography, and ABIM-Cardiovascular disease. Aside from being a career choice, Dr. Vajabedian has several publications to his name, including CardioMEMS in a Busy Cardiology: Less than Optimal Implementation of a Valuable Tool to Reduce Heart Failures Readmissions, Cardioprotection by Metformin: Beneficial Effects Beyond Glucose Reduction, and several other related publications in the medical journal.

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Issue 120.4.8

COVID-19 Pandemic and Reality “We saw three different waves of the virus. People were markedly confused and frightened during the first wave in spring of 2020 because no one understood clearly what we were dealing with, this led to patients unnecessarily avoiding hospital visits. During the second wave mid summer of 2020, the misinformation subsided immediately after the CDC guidelines were shared, however public deception was prevalent mostly via social media, but in the third wave starting November 2020, we had a lot of patients that are occupying the ICU beds. We had difficulty finding a bed for critically sick cardiac patients because COVID-19 patients have occupied all the beds, this led to cardiac procedures being postponed for an extended period of time resulting in non COVID related morbidity.,” said Dr. Leon Vajabedian in an interview with Top Doctor Magazine.

Pandemic and Telemedicine: How to mitigate the challenge through Telehealth Telemedicine is an effective alternative to inpatient service, especially during the pandemic, when patients were scared to visit the hospitals. Patients are generally relieved with telemedicine. Still, it falls short regarding the physical exam part of the service. “With telemedicine, the element of touching patients and physically examining them is lost. We depend so much on history and subtle signs we see during the video session, which is not enough for physicians to make an accurate clinical judgment,” explained Dr. Leon Vajabedian.

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Issue 120.4.8

Overcoming the pandemic through Vaccination, Socialdistancing, and Specific Antiviral medication Vaccination is the most vital tool to help create a population that is immune from the virus. In this regard, Pfizer and Moderna have done a great job by developing a vaccine in a very short time. Social distancing guidelines are crucial as well. People need to change the way they socialize until there is a drastic improvement to the status quo. Ultimately, specific antiviral medication towards treatment can also help. “Unfortunately, this virus will not completely disappear by itself. There are a lot of proactive things that we have to do,” Dr. Vajabedian informed.

Coronavirus and its Mutating Variants Dr. Vajabedian warned that the reports of the virus mutation are disturbing. There is a feeling of uncertainty whether the vaccines developed so far will be efficacious against this new mutation. For Dr. Vajabedian, a mutation that is so fast and that superseded the vaccine efficacy would be a big problem. “If the population is not vaccinated before the virus takes a chance to mutate and become more dangerous, that is worrisome for me,” Dr. Leon Vajabedian complained.

COVID-19 Devastating Effect and The Future of Medicine 2020 was a very gloomy year for many physicians. Many patients suffered and died alone in miserable conditions, which affected everyone, including the health care providers. The situation was so much for physicians to handle. Dr. Vajabedian hopes that things will improve in the New Year. Ultimately, the vaccine was developed at a record speed, and it will be a game-changer for new ways of approving treatments in the future. Traditionally, medications go through phases of trials for years before getting approved. Dr. Vajabedian hopes that we can take advantage of this to cut back on the bureaucracy and the slow process necessary to approve new medications.

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Issue 120.4.9

By Brianna Kenji Oyasu: Fighting Stigmas andConnors the By Brianna Connors Opioid Crisis "Don't worry. He won't die; he'll just wish he was dead." Dr. Kenji Oyasu stood shocked at the words coming from his senior medical professional. Oyasu just had his first encounter with a person in heroin withdrawal in the ER, and his concern led him to ask how he could help. This moment inspired him to dig deeper into emergency medicine, particularly dealing with drug addiction. Dr. Oyasu has twenty years of experience in emergency medicine and acts as the physician executive and founder of ModernMed Recovery. He created ModernMed Recovery to provide lasting change to those with drug addictions and is board certified in addiction and emergency medicine.

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Issue 120.4.9

Red Tape Regulations As Dr. Oyasu began working in the ER, he and his peers watched the opioid crisis develop before their eyes as overdoses and opioidrelated complications began to increase. The increase came at the hand of changes in opioid regulation that took, according to Dr. Oyasu, "a billion pills off the market." The decrease in the available drug led people to seek out heroin and deadly cocktails like morphine mixed with fentanyl. A mom of two in her 30s, a young kid just beginning his life, a 78-year-old man - Dr. Oyasu has seen people from all walks of life during his practice. The drug addiction, which he recognizes as a disease process, does not discriminate. However, medical practices do. A cursory search on the Internet seems to provide a host of practices and resources for those seeking recovery, but calling up those practices will most likely get you a "no room at the inn" notice. Complicated regulations surrounding prescriptions for lesser opioids, such as buprenorphine, make it difficult for any practice to increase their patients past 30. If they want to prescribe lesser opioids as a treatment for drug addiction, they need an extra waiver on their DEA license. "Ironically, I can write for all the oxycodone patches I want unlimited, but for buprenorphine, which is a partial opiate, I have to take an 8-hour course which I can take online, and then I can only see 30 patients," Dr. Oyasu said.

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Issue 120.4.9 "There are millions of people needing treatment that we over-prescribed for the last 16 years, and you're telling me I can only treat 30 patients at a time." Since the opioid crisis became more mainstream, some regulations have changed. If a practice can have 30 patients successfully for a year, it can apply for a 100-patient license. But getting past the red tape to start treating patients is just one hurdle.

Creating Real Change "Addiction medicine is very difficult to treat. Why? Because addiction is all about compulsive behavior, so once you're speaking to addiction, it doesn't matter the substance. It becomes a lie, cheat, and steal lifestyle," Dr. Oyasu said. Dr. Oyasu works with his team to fight the stigmas attached to treating those with addiction. "We now know about the neurochemical nature of the disease," he said. "All the PET scans in the MRI that we see just demonstrate how this is a narrow biologic disease process, but people still have it in their heads that [drug addiction] is a moral failure or a character flaw." Educating patients and anyone who will listen about drug addiction and the appropriate way to treat it is Dr. Oyasu and his team's passion.

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Issue 120.4.9 Currently, many drug rehabilitation programs create a controlled environment where patients quit cold turkey. Dr. Oyasu compares this to a diabetes program that teaches patients what to do but sends them off without insulin access. Patients are prone to failure if they don't receive the best opportunities and tools to succeed.

Compassion First Oyasu's approach involves listening to the stories of his patients. Every single one of his patients receives his personal phone number so that if they have a breakdown, they can have immediate access to someone who will talk with them. Dr. Oyasu is determined to restore people to healthy lives free from addiction. "I don't honestly know how long people need to be treated, but you have to treat it with the same compassion and respect you with any other chronic medical condition, whether it's heart failure, diabetes, and so on." If you would like to learn more about Dr. Oyasu and his practice ModernMed Recovery, you can visit his website here.

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Issue 120.4.10

The Freedom of Health with the Jiu-Jitsu Doctor: An Interview with Dr. Neil Morris About Dr. Neil Morris Dr. Neil Morris is a naturopathic medical doctor practicing in Mesa, AZ. He graduated from Troy University with a bachelor’s in Nursing and practiced as a registered nurse for 16 years before graduating from the Southwest College of Naturopathic Medicine, SCNM. He focuses on regenerative therapy, providing specialized treatments such as Hormone Optimization and Regenerative Injection Therapy. As a registered nurse, Dr. Morris gained significant experience in the fields of Cardiovascular Intensive Care, Surgical Trauma Intensive Care, Post-Surgical Anesthesia Recovery, Endoscopy, and Special Procedures, such as Bone Marrow Biopsy.

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By Brianna Connors

Issue 120.4.10

Meeting “The Jiu-Jitsu Doctor” With a cheerful voice and a strong sense of humor, Dr. Neil (as his patients call him) opens up about his past to our Top Doctor Magazine. His proactive life, with college football and Brazilian Jiu-Jitsu at its core, guided Dr. Morris towards effective, less dramatic alternatives to surgical treatment. After suffering from an accident during a Brazilian Jiu-Jitsu match many years ago, Dr. Morris was close to letting go of his passion. However, after receiving regenerative injections, not only is he back doing what he loves, but he’s also helping patients recover from sport-related medical issues such as knee or shoulder injuries. Hence, “The JiuJitsu Doctor” nickname.

Regenerative Medicine and Nursing For more than ten years, regenerative medicine's popularity has been growing. Dr. Morris links this trend to the extended time spent by naturopaths with their patients. "More people are looking forward to working with a naturopath, now more than before. To be a naturopath ten years ago would not have been as easy as it is nowadays," he tells us. Looking back to his training, Dr. Morris sees his background in nursing as a crucial factor in his naturopath development: "When a patient comes to me, I look at things from both sides." Apart from other naturopaths, Dr. Morris' expertise helps patients reach the end of the recovery road with maximum results.

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Issue 120.4.10

Approaching Patient Treatment Differently As a specialist in regenerative therapy, Dr. Morris focuses on Regenerative Injection Therapy. However, as he noticed beforehand, to heal correctly, one must prepare the body for optimal work. For that reason, he introduced Hormone Optimization as the first step towards proper healing. "If your body is not ready to repair, you're not going to get the most out of it," said Dr. Morris.

The Power of Regenerative Medicine When asked about his favorite patient case, Dr. Morris recollected the story of a 70year-old with extensive surgery to her back. At first, he was unsure whether stem cell products could improve her quality of life due to her advanced age. Dr. Morris' doubts did not disturb the patient, who was ready to take a shot and receive treatment. Within two weeks, she returned to him with improved posture, dramatically reduced pain levels, and quite an exciting complaint: "Her new big complaint was, I get tired because I'm walking so much now."

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Issue 120.4.10

“The Freedom of Health” Although the pandemic's initial months took their toll on his practice, Dr. Morris was one of the privileged few to have kept his practice open. Nowadays, he sees even more patients than regular, who are looking at self-care from a more serious perspective. The COVID-19 pandemic led towards more self-care awareness. However, while talking about his concept of "freedom of health," Dr. Morris believes that we, as a society, need more than just awareness: "We should start taking ownership of our health more, and not rely on a drug to make us healthy." He stresses the obesity factor as an" epidemic inside the pandemic:" "If our overall health was better, we would not be as affected as much as we are." As a parting reminder, Dr. Morris advises us to look towards our health more seriously and boost our immune system as much as possible through exercise, proper diet, and through supplements, such as vitamins A, D, C, or Zinc. If you would like to learn more about Dr. Morris and regenerative medicine, you can check out his website here.

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Issue 120.4.11

SURVIVING THROUGH THE PANDEMIC: BEN KENUK, HIS RPM APP, AND ULTIMATELY THE MARK OF A HERO The COVID-19 pandemic made an enduring mark on our healthcare system and affected the lives of billions worldwide. The virus spread across the globe at an unprecedented rate creating disturbing morbidity and mortality statistics that put everybody on high alert. As many of us grapple with the new reality by staying away from people to avoid illness, healthcare workers put their lives on the line by gearing up and running into the fire. Healthcare workers have emerged as the new soldiers in countries across the world. But, as F. Scott Fitzgerald said: "show me a hero, and I'll write you a tragedy." During the pandemic, the risks to frontline heroes are considerably more significant than those encountered in standard practice. In addition to the risk of contracting the virus, health care workers suffer mental and physical exhaustion and emotional pain. Even though some personal dangers are inherent in working in the medical field, these risks have been amplified in a way that justifies associating the word 'heroism' with the medical profession.

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Issue 120.4.11 During a discussion with Top Doctor Magazine, Ben Kenuk, a physical therapist at the University of Pennsylvania hospital, told us, "Adjusting to the new reality is pretty overwhelming and exhausting. I have been on the COVID-19 therapy team since May. We had to adjust all of our schedules to make sure there weren't too many therapists in the department at one time." Ben worked in heart failure and on cardiac surgery patients pre-pandemic, but his role changed to accommodate the new reality. Even when the pandemic was at its worst, the hospital only minimizes the number of therapists working on COVID-19 patients just in case of exposure so that other available therapists will proceed with the treatment.

As everyone tries to practice social and physical distancing, healthcare workers rose to action and worked round the clock to provide care to patients with the virus despite the risk of being infected. While discussing the impact of the pandemic on his practice, Ben explained that "patients who require different levels of care couldn't proceed with their treatment because a lot of the facilities were closing their doors off because they were a lot more selective with who they will accept. Most of our patients stayed a little longer than they should have, which doubled our effort and affected the time we could have spent providing care to other patients."

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Issue 120.4.11 Unfortunately, as the frontline heroes strived to keep us safe, the lockdown and the pandemic's effect became too much for people to handle. Consequently, they were complacent and less careful with the virus. As a result, over 400,000 people have died from COVID-19 related complications since the pandemic began. Ben Kenuk studied physiotherapy at the University of Southern California and graduated in 2017. His dedication to the practice led to the creation of Mobile Measures, an app for physical therapists to help optimize the use of functional outcome measures. When the hospital was getting crowded during the pandemic outbreak, physiotherapists were doing a lot less than other physicians. Still, Ben wanted to help people get access to care through a unique approach. The Mobile Measure app provides access to patient assessment tools proven to measure critical aspects of a patient's health and functional status, including hospitalization, risk of falling, frailty, and much more. This app guides users to the best test, calculates scores, interprets the results and uploads them into a patient's documentation. Physicians can track progress, visualize their patient's current condition, and determine the impact of treatment immediately at the point of care. When asked why he created the app, Ben shared that he wanted to help people access care and improve healthcare providers' efficiency. "I use it, and a lot of my coworkers use it. However, I don't feel comfortable pushing people to use it. I have been telling people about it because I believe it will help our practice and help our hospital, but I am now in the process of partnering with other health organizations and software companies to get widespread use of the app and help everyone's practice."

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Issue 120.4.11 As Ben put in the hard work to help people by creating the Mobile Measure app, he faced a really tough challenge to convince people to use the app. He thought that the app would be utilized more during the pandemic. Still, many organizations were reluctant to incorporate a new app into their system. "Theoretically, you think it should be used more, but some health organizations that I told about it put it on hold because their therapists were overwhelmed with the COVID, and they didn't want to add something new to their practice. Even though it would help them to identify which patients actually needed therapy and improve their efficiency allocating resources a little bit better and minimize the time going to patient's house, it was just from an administrative standpoint that it is not the right time to implement something new in their practice." To overcome the challenge, Ben hired a marketing company to help create awareness so that more people could get to know about the Mobile Measure app. "I was initially doing it myself, just trying to write all these articles on social media, but it is stressful. So I hired a marketing company for a short period of time." When his savings depleted, Ben struggled to continue with the marketing campaign because it was not really sustainable for him. "It is kind of a balance between time and money. Pay someone to do it or lose another hour of sleep. It is a balance I am struggling with."

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Ben was actively connecting with people hoping that he could build relationships to spread the message about the Mobile Measure app. Still, he immediately surrendered his pursuit for a greater cause when the pandemic ramped up. "It has been a lot harder to develop the kind of relationship with a potential client because I can't meet them in person." He hoped that he could start all over again when the pandemic is over. Talking about his experience at the hospital at the time, "We had to shuffle things around a lot, I was brought onto the COVID-19 therapy team, and I saw COVID-19 patients. When the cases started going back down, I went back to usual business. A few weeks later, the number went up again, and I went back to seeing COVID-19 patients again."

The COVID-19 vaccine was developed rapidly to help combat the raging virus, but the FDA EUA approval triggered mixed feelings across the medical community. In this regard, Ben said, "I am cautiously optimistic. We have heard a lot about the vaccine.

Issue 120.4.11 We have been told that healthcare workers will be the first to have access to it, and it would be optional for us to get it or not. Many people are afraid because of how quickly they came out because they don't want to be the first to take it. But I guess someone has to. I am optimistic that FDA did it after making sure it is safe. I plan to take it when it is available. I definitely have my reservation about it. I am not totally confident, but I think it is necessary." He told us that widespread use of the vaccine would take a while because many people will hold off at least a year to see what happens. In his opinion, Ben believes that the vaccine might help with the virus but ultimately, we need to have an extended lockdown again. However, this time it needs to be consistent across states because when the restrictions were enforced in Pennsylvania, people went to New Jersey for social engagements. If there is consistency across the border, we will have fewer cases, and more lives will be saved. As the whole world struggles with the virus, Ben hopes that the rest of 2021 will be different. Although healthcare providers will likely honor their oath in a time of great need, Ben cautioned that we have to respect the virus because it will not go away. We have to work as a team and do our part to control the spread.

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Issue 120.4.12

DISTRUST AMID VACCINATION: HOW RESEARCHER'S REMARKABLE SUCCESS MIGHT BE AN UNDOING The novel coronavirus pandemic triggered an unprecedented global emergency in a way that disrupted every aspect of our lives. As countries worldwide come up with different strategies to curtail the spread of the virus, the global healthcare system's repercussions have been intense. Aside from the fact that the pandemic put our health system under immense pressure, we have also seen health facilities stretched beyond capacity in a way that affects health care provider's personal and professional lives. Traditionally, we expect the military or financial bodies to take control during crises. Still, the COVID-19 pandemic switched the pendulum towards the medical community and created opportunities for healthcare professionals to honor their oaths in a time of great need. As these fantastic professionals went to work, the pandemic ravaged on, threatening to undermine their selfless service to keep us safe. More than 300,000 people have died from COVID-19-related complications, including frontline workers – researchers are struggling to tally global mortality statistics and gauge the outbreak's actual toll. This grim reality put us all on high alert regarding the future. Nothing seems normal about life as we envisage a time when things will go back to normal. 48

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Issue 120.4.12 Today, staying healthy has taken on more meaning for those still alive than it used to be. As the pandemic gravely affected the economy at its core, the impact varies from person to person. It necessitates the need to focus more attention on our healthcare system and providers. Dr. Steffini Stalos, a lab consultant practicing at Blood Associate in Texas, commented to Top Doctor Magazine, saying, "we are now in the coronavirus time, and this is a new thing for a lot of people. Some labs have been able to cope, and some have not. I think this is a public health issue that we want people to help us with." She went on to encourage lab consultants to offer more help. "This is the opportunity for those in the lab world. We have to be adaptive and creative to bring what people's needs are to the table," she said. Even though our healthcare system is in a problematic state, the pandemic further exposed the design flaws and dragged the topic into the spotlight. In reality, every one of us has a role to play during this challenging time. Speaking on the need for help, Dr. Mark Merlin, an MD1 physician in Emergency Medicine in New Jersey – a non-profit 24/7 physician response unit said, "When COVID hit, my docs were on the road even when paramedics were getting COVID-19. I told my doctors to put on their PAPR (Powered Air Purifying Respirator). While we were putting people on ventilators, paramedics started calling us since they don't want to be exposed because they do not have PAPR. The reason they do not have one is that they cost more than a thousand dollars, and the health care system didn't provide that."

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Issue 120.4.12 They do this at no charge to the patient. Speaking further on the request for help, Dr. Mark said, "There are so many potential people we can save on the roadside who are trapped in the car, some services we can provide to patients who can't get to the hospital. I am hoping that I could get someone to donate for us. All the money around is earmarked for 911 EMS. It is difficult to explain to government agencies that we are doctors who are trying to get reimbursed so that we can help people during a challenging time like this," he disclosed. Less than a year after the pandemic started, researchers have worked tirelessly to develop a vaccine at record speed. Ideally, the process takes ten to fifteen years, but the US FDA has granted EUA – a green light of sort which is not the same as official approval – to vaccines from Moderna and Pfizer. Before now, the fastest vaccine that was developed for mumps took 48 months in 1960. The FDA can authorize unapproved medical products in response to public health emergencies to diagnose and treat patients when there are no alternatives. This unusual process polarized the medical community regarding the efficacy of the virus. Dr. Gross, a neurosurgeon who resides in Nevada, California, spent over two decades providing care to patients in need. He stated that "the FDA does not regulate the practice of medicine; they evaluate and approve claims in terms of efficacy and safety for certain medication and devices.

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So if they haven't evaluated certain medication, it doesn't mean it is not useful, just not approved. Not approved doesn't mean unapproved. It is just not yet evaluated, and I think people see prejudice in the phrase "not approved by the FDA." Dr. Gross encouraged people to be optimistic about the vaccine and told us to trust the scientists. He explained that "for example, we use a medication that is off the label all the time like aspirin, which has not been investigated by the FDA. One of the reasons for that was because the FDA was formed in the 70s, and we were already doing certain things. They didn't look backward but only forward. We need to try what is best for the patients sometimes. That comes before long term population study by the FDA."

The media played a crucial role in influencing people's opinions during the pandemic. Unfortunately, the bias in information sharing subject audiences to a skewed reality, distorting the general knowledge about what is right and wrong.

Issue 120.4.12 Dr. Topher and Dr. Thomas Pearson were partners in the medical school, and they decided to start practicing immediately after residency. They started Alevea Mental Health Clinic in Tempe, Arizona. The duo had just one goal in mind: creating a simple and easy clinic for patients to get access to adult psychiatrist care. Unfortunately, the pandemic caused so many issues in people's lives. Dr. Topher and Dr. Pearson saw an increase in depression and anxiety among their patients in all demographics, including patients working in the medical field. "Our patients in the medical field, especially those in ICU who saw COVID-19 patients that are acutely ill, are having really high anxiety and depression." As their patients' numbers grew amid the pandemic, they transitioned to telemedicine to make their service more straightforward and faster. Dr. Topher has a similar view about the media. He stated, "Although some people have some mistrust triggered by the misinformation and different opinion coming out right now. It is challenging to figure out what is true and what is not. I think social media is further worsening the situation and creating misinformation. There is a lot of work to be done to build trust and get everyone vaccinated. My biggest advice is that you should listen to your health care providers. Obviously, I think you need to listen to the scientist and what they are telling you. The vaccine is important and what these people can do in such a short time is a monumental task. I would encourage people to listen to health care professionals and follow their guidance."

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There are a lot of assumptions everywhere, but he told us, "We are running out of time, so we have to do what is right to keep people safe." Dr. Manuel Diaz attended Christopher Columbus High School before he proceeded to medical school in New York. His family lived briefly in South Florida and relocated to New Jersey for a couple of years for work reasons and relocated twelve years later. When the interstate relocation took its toll, Dr. Diaz never lost sight of his dream of becoming a doctor. A few years later, he started Executive Health with a senior partner in South Miami, Florida. Dr. Diaz was quick to express relief about the progress researchers made on the vaccine after a gloomy monologue about the virus's effect on the healthcare industry. He said, "I am actually optimistic, I believe there is real light at the end of the tunnel, but there are precautions that need to be taken. The hope is that perhaps sometime in the spring or summer of 2021, we will start leaving this behind us."

Issue 120.4.12 The human race has experienced multiple crises, but at no point – since the beginning of time – has a health crisis crippled the entire global economy, demonstrating how interconnected healthcare and the economy have become. The pandemic exacerbated fear, influenced political choices, and threatened to shut down our lives in a way that pushed professionals towards self-abnegation. Although our healthcare system has improved over time, it is simply not designed to withstand a monumental crisis as unpredictable as COVID-19. Because the pandemic is opposed to our health care system's direction, every branch of medicine was caught off guard, and experts scrambled to rise to the challenge and keep people safe. As expected, health care professionals expressed concerns and a unified desire to help, even as their businesses struggle to stay afloat. "We were low on testing kits and modalities. In that low, I did briefly get involved in the PPE. I created Core Medical Industry, which is the medical device side of Blood Associate, to advance more or better PPE for protection against pandemic pathogens. I am not a big medical device maker, but I was worried about the lack of PPE and how other supply chains will affect the lab world. I pivoted, hoping I could play any part and help people get access to the care they so much need." Dr. Stalos, the lab consultant, explained the reason why she started a medical device company. As Dr. Topha and Dr. Pearson specialized in young adults between 18-35 years, they saw a lot of anxiety and depression associated with the pandemic among their clients.

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Issue 120.4.12

"You know, people were losing their jobs, there was a lot of financial stressors and depression from having to isolate at home. A lot of increased anxiety associated with school and college because a lot of those who converted to online studying were having a hard time keeping up with school work from transitioning to online versus being in class." Speaking of how they helped, the duo decided to transition into telemedicine. "We spend a lot of time with patients about the COVID situation and advise them to follow the guidelines of the CDC, and that has helped a lot of these people, especially those that live on campus." MD1, the non-profit medical organization, was stretched beyond the limit. As a flexible healthcare provider, they switched to COVID-19 emergency cases to provide care to patients. "When COVID really hit us, we wound up initially throughout the country, putting several patients in the ventilators. As care providers, we run the risk of getting COVID. We were on the road almost all the time. We got a lot of 911 calls from morning to night attending to COVID- patients." Dr. Merlin explained. When we asked how they could stay safe from being infected, he told us that they use the PAPR, the spacesuit health officials wear, to avoid exposure to COVID-19. The COVID-19 vaccine's arrival, less than a year into the pandemic, trumped the previous record of four years when a vaccine was developed for mumps. Pharmacists now face a significant challenge to convince those who are hesitant to take the vaccine. "Everything depends largely on the vaccine which just hit the street. Another issue is, are they going to be safe? Are we going to see in five years people being damaged by vaccines and people calling to hire an attorney? We don't know, because the FDA did not go to its usual, very stringent, scientific, longer-term approval process, because it is more important on an emergency basis to help people at risk to get immunity." Dr. Gross informed us.

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Issue 120.4.12 Dr. Diaz supported the rush when he responded to questions regarding the vaccine, "In the trials, the vaccine is deemed very safe, and that is the primary reason why the FDA granted them Emergency Use Authorization." He disclosed that we'd eventually be in control once everyone is vaccinated; at this stage, we'll have "herd immunity, meaning that people that get the vaccine will join those who have been infected." While it was incredibly disruptive and challenging, crises usually nurture the emergence of common purpose, creativity, solidarity, and improvisation, which was evident among the healthcare experts. "I feel very positive now, and also about the New Year. There is always development in the CDC, FDA weekly meeting regarding the progress. That is very promising about the pandemic. Basically, we are getting our act together." Suggesting a more comprehensive approach to combating the virus, Dr. Stalos said, "We need to amplify testing. Even if we amplify the testing, how do we use all the different pieces of testing to create a cohesive picture for the patients? For instance, if a patient is having a PCR test, serology test all at once, how do we relate this information together to talk about what the patient is experiencing? There are even new inflammatory markers coming into play that can differentiate between patients who have coronavirus and those that will experience more severe pain than other patients." As the vaccination process progresses, healthcare providers beamed with satisfaction, hoping that life quickly returns to normal. But Dr. Stalos cautioned that it is not a time to relent; instead, a time to look inward and fix our healthcare system. "Pandemics have periodicity. That means, even after we overcome the coronavirus challenge, we can expect another pathogen in the next five or six years." Ultimately, the government has a role to play. "I think this new political administration needs to be forward-looking that this is going to happen again that we as a nation need to step forward and act proactively because the next agent pathogen may be deadlier than the coronavirus. We won't have the luxury of time as it was when the coronavirus hit," says the consultant, Dr. Steffini Stalos.

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Issue 120.4.13

Discovering the Benefits of CytoSyde and How it Boosts Your Immunity

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Issue 120.4.13

Discovering the Benefits of CytoSyde and How it Boosts Your Immunity By Brianna Connors Fast approaching the one-year anniversary of the United States’ first COVID-19 related lockdown, we see a nation still struggling to control case numbers and outbreaks. Confusion and fear still abound, creating the overarching issue of misinformation. Experts across the country harbor varying opinions, offering advice that aligns most of the time, some of the time, or not at all. For Dr. Hassan Bennani, CEO of KellBenx, Inc, acknowledging the issue at hand led him on a personal journey to discover the best research and results-backed solution. 57

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Issue 120.4.13 The solution he discovered and presented is a product composed of eight natural ingredients that have been used successfully in China for hundreds of years. Sitting down with him in an interview, Top Doctor Magazine learned that Dr. Bennani’s philosophy to overcome the public health crisis that is the COVID-19 Pandemic has to be thinking for oneself and choosing a product based on the research that convinces you.

“Ever since I was a kid, I never imagined myself doing something else [than being a doctor],” said Dr. Bennani. “My background is that I am an MD by training, but for the last 25 years, one of my best passions is to research. And when it comes to research, it opens up a lot of opportunities to explore, to find something that is new that can have an impact and make a difference.” With extensive experience working alongside numerous companies to bring their products to market, educate clinicians about them, and position the products for people to use correctly, Dr. Bennani opened his lab in Long Island, New York, in 2010. At KellBenx, Inc., the focus is on developing new diagnostic tests such as prenatal testing. But when the pandemic hit, Dr. Bennani’s focus shifted to finding a true solution to help as many people as possible.

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Issue 120.4.13 “The key here is that everyone is going to get [COVID-19] one day; even if you get the vaccine, you’re still going to get it. It is just a matter of time,” explained Dr. Bennani. “I think it was the CDC that said it’s going to take about five years for everyone worldwide to come into contact with this virus. And even after that, it’s going to be here like the flu virus. We have to get used to it, live with it, and carry on with our lives. This is why we want to talk today about how we are going to change the long-term side effects and make it as simple as the flu virus.”

Breaking Down COVID-19 To begin the process of overcoming COVID-19, we must first understand how it affects us. The coronavirus is a family of nine viruses, of which seven affect humans. We have experienced previous coronaviruses (like SARS and MERS), but we contained them. The coronaviruses that have come before made those who became infected symptomatic, so they were quickly identified and isolated. The coronavirus (SARS-CoV-2) that causes COVID-19 is different because it features an incubation period of 5 days during which an infected person is asymptomatic and yet still contagious. “The transmission was so quick and so difficult to contain because of the incubation period,” said Dr. Bennani, “And that’s why people were able to travel from China to other countries without knowing they had the virus. Now it is too late. We cannot contain it; it has to go through everybody.” This coronavirus is one of the cold viruses and exhibits two distinct phases. Phase one sees the virus entering the body and targeting the ACE receptors in the lungs. It moves inside the cells, hijacks the mechanism of replication, and starts duplicating. And by doing this, the virus uses the cell to print itself and increase, all while inside the cell and protected from the antibodies that the body is producing.

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Issue 120.4.13 Phase two is when the virus promotes the ACE receptor cells in other organs to colonize them. As a result, Dr. Bennani and many others in the medical field have discovered that COVID-19 was only located in the lungs for some people, but now it is going into the heart, kidneys, and other body systems. Through all of this, we see the most prominent effect COVID-19 has on those it infects. “The third part of what it does is lower your immunity so other pathogens can also harm the patient,” explained Dr. Bennani. “Once it is inside the cells, we cannot do much.” To stop the COVID-19 virus from getting into the cells - and ultimately stop a person from becoming ill - we must combat it from the three ways it attacks.

Step 1: Virus Load First, the essential step to combating COVID-19 is to lower the virus load. “Proven by all the studies today, what’s going to dictate the severity of symptoms and the complications is the virus load in the lungs,” says Dr. Bennani. “If you get exposed to high loads of the virus, the disease will be severe, and you might have severe complications, so we need to lower the virus load. This step is crucial so we can shorten symptoms and save lives.” The virus load is essentially a way to quantify the number of viruses to which you have been exposed. With any virus, you can be exposed to a small amount or a large amount. For COVID-19, in particular, it is critical that the amount of viruses you are exposed to is small. If you are exposed to a small virus load, you will likely experience light symptoms; if you are exposed to a high virus load, you are more likely to experience severe symptoms. “That’s why wearing a mask is very important. The mask protects, and it is vital to emphasize that,” explained Dr. Bennani.

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Step 2: Cytokine Storm The second way the coronavirus attacks the body and proves deadly is its ability to trigger what is known as a cytokine storm. A cytokine storm is a condition in which an infection triggers the immune system to flood the bloodstream with inflammatory proteins called cytokines. These cytokines can damage and even kill tissue and organs. “Your reaction to the virus can work against you,” says Dr. Bennani, “[You] go into a stage where inflammation is out of control and releasing too many cytokines, which can start a cytokine storm in which the organs start to shut down. And that can kill the patient.”

Step 3: Immunity Finally, the third step we must be aware of in combating COVID-19 is promoting immunity. Because the virus lowers the immune response while attacking the cells, it puts the body in a dire situation of susceptibility to other pathogens. For example, many of the people who end up in the ICU with COVID-19 also have pneumonia. As a result, it is imperative to boost the body's immune response- this will help lower COVID-19’s severe symptoms and protect the infected person from contracting other illnesses or complications.

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Introducing CytoSyde For Dr. Bennani, the answer to COVID-19 is in answering the three ways it attacks and compromises the body. In his search to understand the virus and find a way to treat it, he discovered a product initially from and patented in China called Shufeng Jiedu - a compound made up of 8 natural ingredients. Scientists from Germany investigating the influenza virus looked to China to understand why the number of flu virus-related deaths was so low in the country. Since 2016, the scientists were able to bring to light that the Chinese were taking Shufeng Jiedu and that it considerably lowered the chance of dying or having complications. After further study, Shufeng Jiedu has more than 90 published publications, and it’s been proven that more than 100 million people in China have used the remedy. From the success rate they found, the German scientists were able to bring Shufeng Jiedu back to their country, compound the product, and now have more than 30 thousand people who have taken it to excellent outcome. With its marked track record, Dr. Bennani has worked to bring Shufeng Jiedu to the United States for its abilities to combat the COVID-19 virus, rebranding it to the name CytoSyde. The product comes in a box of thirty-six capsules. As a threeday treatment, a person would take four capsules three times a day. Dr. Bennani’s company has taken worldwide exclusivity on CytoSyde and registered it with the FDA as a supplement. Currently, he is working on establishing various distribution channels to allow for ready access to CytoSyde as Dr. Bennani believes it is a remedy every household in America should have. “How we counter the [COVID-19] virus is this product,” says Dr. Bennani. “The mode of action for this product lowers the virus load, regulates and modulates the inflammation, therefore, preventing a cytokine storm, and finally, it promotes your immunity.”

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Why CytoSyde Works CytoSyde meets the COVID-19 virus at all three points in which it attacks the body. First, it lowers the virus load count by binding directly to the main proteins of the virus, preventing it from entering the cells. “With this understanding, we know that the earlier we take this product, the later outcome of the virus will be dictated because it is going to shorten symptoms and stop complications,” says Dr. Bennani. The second mode of action of CytoSyde is found in how it regulates and modulates inflammation. Through such regulation, it is possible to ward off the cytokine storm. As a result, having organ failure or difficulties in the organs is much lower if not eliminated. “All doctors fear the cytokine storm,” said Dr. Bennani, “Once it settles, there is nothing you can do.” And finally, the third mode of action is that CytoSyde promotes the body’s immunity. “[The product] promotes the body to secrete more antibodies and more T cells, enabling you to fight the virus that has invaded,” Dr. Bennani explained. “But it also protects against other pathogens that can take advantage of the body’s weakness and cause more damage.” Dr. Bennani told Top Doctor Magazine of a personal story from one of his close friends who experienced firsthand the remarkable capabilities of CytoSyde in combating COVID-19. “I have a friend, and I was talking to him on the phone two weeks ago. He sounded like he was having difficulty breathing, and I know he has asthma, so I asked him why he was breathing like that. He responded that he had worked late and felt tired. I insisted he tell me everything, to which he replied that his body ached and he felt hot. Immediately, I told him he had to go get tested even though it was late on Friday,” he said.

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Issue 120.4.13 When the test came back positive, the doctor was able to take Bennani’s friend, put him on an IV, and give him vitamin C. In addition, Dr. Bennani sent a box of CytoSyde, which arrived the same day. “The next day, my friend called me,” said Dr. Bennani, “and he explained how much better he was breathing. Three days later, upon completing the CytoSyde treatment, he had absolutely no symptoms, no complications, no coughs. Nothing. It even helped his asthma.” Cases like these motivate Dr. Bennani to continue his work in bringing awareness to CytoSyde to help more and more people. As he put it, he is doing this for the joy of saving lives.

CytoSyde and the Future “The vaccine is here, and it is a good thing,” said Dr. Bennani when asked if CytoSyde is a replacement for getting a COVID-19 vaccine. “I’m not against the vaccine; in fact, I promote it. The only risk about the vaccine is not knowing exactly how it will react with the body long term. However, just because we don’t know doesn’t mean it’s going to be bad.” The vaccine gives a person a certain amount of immunity against the virus. However, it does not guarantee 100% against future infection. As Dr. Bennani explained, it is similar to the flu virus, which comes every year. Despite getting the flu vaccine, people still get infected, fall ill, and sometimes even die from complications. “That’s what people need to understand; even with the vaccine, you are still going to get the coronavirus. You might have mild symptoms or severe, but not as severe as without the vaccine. The product is going to shorten the symptoms and prevent complications. There is no harm if you take it; it’s a safety net.”

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Issue 120.4.13 Shufeng Jiedu means to detoxify and expel, precisely what it does to the coronavirus in the body. Used for centuries in China, it is not a new treatment or even a new discovery. What is new about it is the understanding of how it works to cancel the COVID-19 virus. For Dr. Bennani, this understanding brings light to not just the COVID-19 virus but to all other viruses as well. “It works for influenza; it works for all the viruses in the coronavirus family, and it might work for any virus in the future because it cancels the mechanism,” he explained. “This is what we want; we want to give reassurance to people. Yes, the virus is serious, but if we do the right thing, we can prevent people from dying, from ending up in the ICU.” If you would like to know more about CytoSyde or are interested in purchasing it, click here to place an inquiry. Citations: 1 - Studies on Shufeng Jiedu 2 - Shufeng Jiedu in Germany 3 - Global Literature

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Issue 120.4.14

Dr. Burak Ozgur Spotlight As a child, Dr. Burak Ozgur noticed his father's gentle spirit and humility, which he carried into his neurosurgery practice. His father's lack of ostentatious details, such as a flashy car or an expensive watch, conveyed to Ozgur a deep sense of peace and respect for the work he was doing and the people he was helping. This inspired the character Dr. Ozgur brings to his medical practice today. Dr. Burak Ozgur is a top US neurosurgeon with certification from both the American Board of Neurological Surgery and the American Board of Spine Surgery. His specialty is minimally invasive spine surgery, which involved techniques that were just coming into practice while he was in his seven-year residency.

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By Brianna Connors

Issue 120.4.14

Training to Lead "Neuroscience is like space; we have a few things we know, but it's still like a completely undiscovered field," Ozgur said. "And I think that mystery, that excitement, drove me towards neurosciences." At first, Ozgur's enthusiasm kept him away from the one place he would later gain notoriety: spinal surgery. "Before minimally invasive spine surgeries, traditional surgeries struck me as barbaric and extremely painful for the patients, and I didn't want to be involved with that," he said. But when a neurosurgeon in Brazil began experimenting with minimally-invasive spinal surgeries, Ozgur became intrigued. He began experimenting with possible minimally-invasive treatments and requested to learn from this doctor directly. His request was granted. Then, after years of training and research, Ozgur wrote and released the world's first paper on a minimally invasive spinal surgery technique called XLIF, which to this day remains in popularity. From then on, Ozgur has created programs to help patients in all conditions receive the relief they deserve. His work has slowed but not been daunted by the current pandemic, and his desire for better healthcare is evident.

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No Patient Left Behind The problem with the current healthcare system, Ozgur finds, is that many primary doctors are unaware of the options their patients have. An unfortunately typical example revolves around spinal stenosis, which typically affects older patients. "It can be a very debilitating problem, but it's also very easy to treat with the right diagnosis and skill set," Ozgur said. However, from his observations, many of his clients were told that they were too old or would have to deal with the pain because their doctors thought they were no longer suitable candidates for surgery. "Literally, it brings tears in my eyes to see these patients suffering, who can barely walk or come in a wheelchair. And I think they're great candidates for a minimally invasive cure," Ozgur said. "When they come out of a surgery, they are smiling; they have a new lease on life," he continued. "They say to me, 'I feel like I'm 20 years younger, and I can now play with my grandkids!'" These fulfilling experiences drive Ozgur to expand options for his patients and those outside of his clientele so that no one has to live in pain. Before COVID-19, Ozgur would undertake medical missions with his team, traveling to impoverished communities and giving them health care.

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Moving Forward With US travel posing a risk, Ozgur looks forward to the day when he can help his community here and abroad in person. He also would love to visit his parents, whom he hasn't seen since the pandemic began. In the meantime, his practice offers telehealth services and performs only the most urgent surgeries. He continues to look at new research that will advance non-invasive surgeries, which he believes is the future. Dr. Burak Ozgur is a frequent writer and is currently working on his second book to help patients understand spine health and treatment options.. You can learn more about him via his website.

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Issue 120.4.15

Moving Forward

Profile Spotlight: Dr. Shivesh Kumar Dr. Shivesh Kumar is a Family Medicine Specialist with over ten years of experience. He is a member of the American Board of Family Medicine, focusing on partnering with large insurance companies and hospital systems. Standing in the middle of the two prominent health care forces, Dr. Kumar also focuses on providing population help, systemic help, alleviating disparities, and helping systems overcome inefficiencies. Dr. Kumar combines a wide range of expertise, experience with clinical and transition care work, and post-hospital care.

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By Brianna Connors

Issue 120.4.15

Moving Forward

Family Medicine Amid the Pandemic "When the pandemic started, there was panic across the country because nobody knew what was going to happen. We had over mobilized, so we had to cancel vacations, cancel breaks. We needed everyone on the frontline to see as many patients as we could," said Dr. Shivesh Kumar in an interview with Top Doctors Magazine. He explained that hospitals were clogged with COVID-19 patients while patients with chronic illnesses avoided hospitals.

COVID-19 Pandemic: The Overall Impact On The Healthcare System The current market situation has affected businesses so that certain groups have been falling off since last year. Even worse was the news about two of the largest insurance groups, operating for over 18 years, both simultaneously filed for bankruptcy. As we advanced, Dr. Kumar explained that there would be a lot of uncertainty because people are losing their insurance, especially in Las Vegas.

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Creating Awareness To Help Overcome The Challenge Dr. Kumar believes that there needs to be a national movement towards a universal health care insurance type of safety net coverage. It does not have to be expensive, but it could be Medicaid level care where costs are being covered, and providers and hospitals are being paid. "I think that is the most important thing for the next administration. That kind of funding is crucial to keep the health system intact. Provider groups are going to have huge revenue shortfalls," said Dr. Kumar

Family Medicine And Technology: Remote Patient Monitoring Dr. Kumar explained that technology would help healthcare workers optimize their service in the future. He raises the point that wearable technology will aid remote monitoring so that healthcare providers can monitor and spot worsening diseases. "Although it may happen slowly, we will be there in five years. Patients will be able to use their iPad or other biometric equipment to receive care from their doctor. Also, we will see the use of holograms of a doctor providing care to patients through 3D or Virtual Reality where doctors will put on a headset and appear in front of a patient," said Dr. Kumar.

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Moving Forward Overcoming The Pandemic Through Vaccination The virus hit the U.S hard and working together to fight it is crucial. Evidence has shown that if everyone gets vaccinated and we achieve herd immunity, COVID-19 will become a common cold, and it will be treated as such. It won't be a devastating illness anymore. "If we understand and trust science and get vaccinated, we will be talking about the common cold in the next year and not a devastating illness. We all need to work together to get each other vaccinated so that all of us as a society can get past coronavirus."

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Issue 120.4.16

Profile Spotlight: Dr. Michael Greiwe By Brianna Connors

Dr. Michael Greiwe is an orthopedic surgeon with more than ten years of experience. As a board-certified orthopedic surgeon, He specializes in shoulder replacement, rotator cuff pathology, instability, and labral tears. Dr. Greiwe created a telemedicine platform dedicated to orthopedic providers to optimize care and increase practice revenue. He is determined to facilitate cutting-edge healthcare delivery for clinics in a way that offers patients incredibly convenient treatment options. Furthermore, Dr. Greiwe also specializes in advanced arthroscopic surgical techniques for sports-related injuries of the shoulder, knee, and elbow.

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Issue 120.4.16

Telemedicine amid Pandemic: An alternative medium for healthcare providers "When the pandemic hit the U.S, physicians needed an alternative way to provide care. Since we had the structure pre-COVID, we grew ten times in two months. It was really tough; obviously, there were so many bad things happening at the time, but our practice grew in a way that helped establish telemedicine as something that was very helpful for patients and providers," said Dr. Michael Greiwe in an interview with Top Doctor Magazine. It is essential to understand that Dr. Greiwe and his staff have provided care for over 50,000 patients.

Insights on Orthopaedics and Telemedicine There are a lot of ways you can use telemedicine inside orthopedics, with a focus on three basic ways. Dr. Greiwe stated that the first one is a post-operative recheck appointment, where patients answer questions. The second stage is the imaging followup, designed to review a patient's X-ray and MRI scan through screen sharing while the physicians explain everything in detail. The last stage is the injection follow-up, designed to see how a patient is doing after receiving injections.

COVID-19 effects on Orthopaedics "It has been tough. We have had to adjust significantly. We were unable to perform surgeries for six weeks in April; we were only doing urgent surgeries. That slowed us down. It allowed us to reset and make sure that we are doing the small things right. We transitioned to telemedicine, and it was what helped keep our lights on, to be honest, because, during that time, we couldn't see so many patients.," said Dr. Greiwe. He stated that orthopedic surgeons made some adjustments to survive through the challenges. Dr. Greiwe was grateful for the PPE money that was distributed because it helped tremendously.

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Orthopedic Practice and the New Normal Dr. Greiwe disclosed that the COVID-19 pandemic is forcing a couple of changes, eventually becoming the new normal. Physicians will perform many outpatient surgeries because patients don't want to spend a night in the hospital due to COVID-19. "Also, we will see more computer-guided and robotic surgery and patient-specific guides and 3D printing, which will allow us to create implants and things that are specific to patients' anatomy. New approaches are happening particularly in the shoulder where we are developing rotator cuff sparing approach for total shoulder replacement," continued Dr. Greiwe.

COVID-19: Potential change in PPE usage and Social Distancing Dr. Greiwe predicts that governments will enforce PPE use in 2021 and beyond. He also added that social distancing would continue as well. For Dr. Greiwe, it's likely that people will still maintain social distancing and the use of PPE for the next 24 to 36 months.

Telemedicine and the Future of Healthcare Services "I think we are going to continue to see telemedicine as a primary way of seeing patients. One of the things that have been holding telemedicine back in the past was rules around licensure for particular states, and that was taken away by pandemic," said Dr. Greiwe. Ultimately, the new administration needs to support telemedicine to provide healthcare access across the country and provide reimbursement for telemedicine, which will be useful for patients and physicians.

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A Word from the Editors Top Doctor Magazine is a magazine from doctors for doctors and patients. We cover everything from cutting edge medical techniques and procedures to enterprising doctors, dentists, surgeon, naturopaths, chiropaths, orthodontists and more who are thought leaders within their own medical practice and changing the way we all experience medicine for the better. We wish to be your one-stop digest for inspiration by other professionals in your field who are making waves and setting trends and if you too are a trend-setter, reach out to us so that we can interview you for your own spotlight within an upcoming Top Doctor Magazine issue!

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Brianna Connors

Justin Miller

Derek Archer

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