Issue 152 - Dr. Daniel J. Gould by topdoctormagazine

I S S U E 1 5 2 | AESTHETICS AND WELLNESS

WHAT’S THE SECRET TO HAPPINESS? Well, Science Says It’s Our Relationships

PG 52

PRACTICE, RESEARCH, BUSINESS: A VIEW OF PLASTIC SURGERY WITH DR. DANIEL J. GOULD, MD, PH.D. PG 49

“Take care of yourself, be healthy, and always believe you can be successful in anything you truly want.” - ALESSANDRA AMBROSIO

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TEAM EDITOR IN CHIEF Brianna Connors JUNIOR EDITOR Riley George PROJECT C O O R D I N AT O R Lillian Myers

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CONTRIBUTORS A d r e a n a M e n d e z , A n n Y. , D r e w B . , G a y e Newton, Gentry Shannon, Ionuț Raicea, Louisa Emhof, Luke Argue, Mălina O. R., Nathan Pipkin, Peter C., Yuko Tabasa

A WORD FROM THE EDITOR Leading a healthy, well-balanced life is a challenging undertaking for many of us. New advancements in lifestyle or nutrition come to life daily, and the busy rhythm of our lives often prevents us from keeping up with what’s fun and fresh. Here at Top Doctor Magazine, we are on a mission to bring these advancements to your attention and become a source of inspiration for those who want to live their lives to the fullest. Our contributors will constantly keep you up to speed with fresh, entertaining, and reliable content, from nutrition and travel to lifestyle choices! We hope that our handpicked ideas will guide you towards self-realization, selfimprovement, and willingness to help those around you better themselves.

C ONTE N TS MEDICAL NEWS

“It’s Not Just All In Your Head”: Post Covid Brain Fog: What We Know So Far And Strategies To Help Lift The Cloud

Practice, Research, Business: A View of Plastic Surgery with Dr. Daniel J. Gould, MD, Ph.D.

NUTRITION

The Emerging Field of Regenerative Medicine: Part 3, Personalized, Precision Medicine

Elderberries: Everything You Need to Know About Them

Gummy Vitamins vs. Pills

LIFESTYLE

Gardening: The Secret Form of Meditation

Healthy Food Habits

What’s the Secret to Happiness? Well, Science Says It’s Our Relationships

S E X UA L WELLNESS

Does an Orgasm Take Two to Tango? Health Benefits of Solo vs. Shared Orgasms

Dealing with Sexual Performance Anxiety. 3 Helpful Things to Remember in the Bedroom

Hormonal Acne

DOES AN ORGASM TAKE TWO TO TANGO? Health Benefits of Solo vs. Shared Orgasms WORDS BY NATHAN PIPKIN

hether you’re single, in a committed relationship or somewhere in between, you deserve a fulfilling sex life! Unfortunately, poor communication and cultural stigma surround-

ing sexuality often make it challenging to achieve fulfilling sex lives. But,

no matter how difficult, overcoming these barriers and understanding your body will be worth the effort!

Does Masturbation Have Health Benefits? It may come as a surprise, but the answer is yes! Solo orgasms provide various benefits to your physical and mental health, and it’s essential to understand their potential value. Research has demonstrated that white blood cells, especially those that fight off infection, increase during sexual arousal and orgasm. This benefit should not be underestimated since white blood cells are a critical element of our immune systems. Another unexpected benefit of orgasm is headache relief. One study found that over 50% of migraine sufferers found their pain decreased after orgasm. Of those who suffer from cluster headaches, however, 50% said that sexual arousal and orgasm worsened their headache symptoms. So, while masturbation and orgasm are not a cure-all for severe headaches, we shouldn’t rule them out either.

Top Doctor Magazine / Issue 152 / 9

TO EXPERIENCE AN INCREASED LEVEL OF OXYTOCIN IS TO BECOME LESS ANXIOUS, WHICH MEANS THAT ORGASMS MIGHT HELP THOSE WHO SUFFER FROM SOCIAL ANXIETY.

The last physical health benefit worth mentioning

These feel-good hormones are responsible for the

has to do with sleep. Anything we can do to improve

“runners’ high” phenomenon, providing a sort of

our sleep should be considered! Research has

natural high resulting from vigorous physical activity.

indicated that masturbation and orgasm can help

It’s no surprise, then, that endorphins can also come

in this regard. Sexual activity releases oxytocin and

from sexual activity, whether solo or with a partner.

vasopressin, hormones that help your body regulate stress. Higher levels of these hormones will not only make your day more pleasant; they’ll help you drift off to sleep faster, too! To experience an increased level of oxytocin is to

This phrase, which has been picking up a lot of traction recently, refers to the different rates of orgasms experienced by men and women. Even in

become less anxious, which means that orgasms might

relationships, for example, it’s reported that men

help those who suffer from social anxiety. Research

experience orgasms considerably more frequently

indicates that over 15 million Americans currently deal

than women. One study found that 85% of men and

with this type of anxiety, so it is by no means an isolated

only 65% of women reported experiencing orgasms

issue. If you’re one of them, the oxytocin increase

during their last episode of relationship sex.

resulting from orgasm might be worth exploring.

The good news is that there is a solution, and it’s easier to come by than you might think. A benefit

Can Orgasms Really Affect My Mental Health?

of masturbation is becoming more familiar with

A healthy relationship with masturbation, for many

stimulation type you need to reach orgasm. This is the

people, leads to increased confidence in their bodies.

key to closing the orgasm gap: communicate with your

your body, your processes of sexual arousal and the

This increased confidence, in turn, leads to a more

partner what kind of stimulation brings you to orgasm

generalized boost in self-esteem. One study found that

when you’re on your own and add that stimulation

women in relationships who masturbate have higher

when you’re engaging in sexual activity together.

self-esteem than women in relationships who do not masturbate. Masturbation and orgasms aren’t the only ways to boost your self-esteem, but they’re worth trying!

This process will require you to pay additional attention to your communication, but it will be worth it! Whether you’re in a relationship or not, you deserve

In addition to the anxiety-reducing effects of oxytocin,

to understand your body and your needs, and, hopefully,

sexual activity and orgasms provide other helpful

these physical and mental health benefits will be

hormones. One example is endorphins, which you

enough of an encouragement to improve your sex life!

might have heard about in the context of exercise.

What Is the “Orgasm Gap”?

Elderberries everything you need to know about them

WORDS BY PETER C.

The elderberry plant is one of the most widely used medicinal plants globally with century-old health benefits. Elderberries are rich in vitamins and minerals and contain powerful antioxidants that can boost your immune system. Elderberries can be eaten fresh, dried or made into syrup, tea or essential oils. You can also find them in supplements and skincare products.

What Is an Elderberry? Elderberry is a shrub-like plant that can grow up to 10 feet high. It has dark green leaves and clusters of white flowers that bloom in the summer months. The berries, harvested in the fall, are small and dark purple. Elderberry is a popular medicinal herb because it’s believed to have immune-boosting properties which means it’s often used for treating colds, flu, congestion and sore throat.

Can I Eat Raw Elderberries? There are many different ways to consume elderberries, with one of the most popular ways being eating them raw as a berry or in a salad with fruit and vegetables. They are also often consumed as syrup, juice or tea. Raw elderberries can be toxic if consumed in large quantities. Therefore, it is recommended that you only eat one cup of raw berries or drink two tablespoons of tincture per day if you consume them regularly. Otherwise, elderberries should be cooked as much as possible before consumption.

Top Doctor Magazine / Issue 152 / 13

Is the Elderberry Plant Poisonous? Elderberry is not poisonous, but it does contain chemicals that can be toxic to humans. The toxicity of the elderberry plant is due to the presence of cyanogenic glycosides in its leaves and stems. These chemicals are found in many other plants, such as apple seeds and apricot kernels.

Elderberry Health Benefits Elderberry has been used medicinally for centuries. The Greeks and the Romans describe it as a healing plant. It is an herbal remedy for fever, diarrhea, flu and infections in traditional Chinese medicine. Elderberries effectively reduce inflammation, lower

“Elderberries effectively reduce inflammation, lower fevers and relieve pain.”

fevers and relieve pain. Elderberries also have several skin benefits. When applied topically, elderberries can help with various skin conditions or help reduce the appearance of wrinkles and age spots.

Is Elderberry Safe for Pregnant Women? There have been no reports of toxicity or adverse effects in breastfeeding or pregnant women taking el-

derberry supplements in recommended doses. It is recommended that breastfeeding and pregnant women speak with their healthcare providers before taking any herbal supplements.

Elderberry and Breastfeeding There isn’t enough information available to determine if elderberry is safe for nursing moms. There are no studies on breastfeeding mothers consuming elderberries due to the ethical concerns in attempting to perform a double-blind scientific study on pregnant or breastfeeding mothers. More in-depth medical study is required to establish dosage and whether or not it impacts a breastfed baby. Ensure that your doctor knows you are nursing before asking for advice on elderberries.

Elderberries and Prescription Drugs There are no well-known interactions between elderberry and other medications. However, elderberries may decrease the efficacy of immunosuppressants and medications that lower the immune system, such as Tacrolimus (Prograf), cyclosporine (Neoral, Gengraf), Prednisone, Mycophenolate (CellCept, Myfortic), azathioprine (Imuran), Sirolimus (Rapamune) and Everolimus (Zortress). You should discuss the combined consumption of these medicines and elderberries with your doctor.

Elderberry syrup can be a natural remedy for colds and flu. It is made from the elderberry plant and has been used for centuries to help people fight illness.

Elderberry Syrup 1 pound (4 cups) fresh

1. To make juice, place berries in a large, heavy saucepan

or frozen elderberries,

along with water. Cover and bring to a simmer for 20 to 30

picked over and all stems

minutes, mashing berries with a potato masher until they

removed 3 cups of filtered water 1/4 cup honey or 1/3 cup sugar (can increase quantity to taste) 1/4 cup lemon juice

soften and release their juices. 2. Press berries through a food mill or fine mesh sieve. Discard solids. Strain juice a second time through a finemesh sieve lined with cheesecloth to remove any remaining solids. You should have about 2 2/3 cups of juice. 3. Pour 2 1/2 cups of prepared juice into a saucepan with honey, lemon juice and ginger. Bring to a simmer, occasionally

1 small piece of fresh

stirring, until the syrup has thickened slightly and reduced to

ginger, peeled (optional).

about 2 1/2 cups, 10 to 15 minutes. Discard the ginger. Once cooled, the syrup will stay fresh in the refrigerator for up to two weeks or in the freezer for up to six months (pour the syrup into ice cube trays for easy dosing). 4. If you are canning the syrup, fill a large stockpot or canning pot 2/3 full with water while the berries are cooking. Place a rack of some sort in the bottom and place over medium-high heat. Wash your jars and submerge them in a water bath as it heats. The pot should be just about boiling when the syrup is reduced and ready to go. Keep jars in hot (not boiling) water until ready to use. 5. Ladle hot syrup into sterilized jars, leaving 1/8-inch of headspace. Wipe jar rims and screw on lids. Process in boiling water for 10 minutes (seven if using smaller jars), then transfer to a wire rack to cool completely. Check seals. Any unsealed jars should be refrigerated and used within two weeks.

Top Doctor Magazine / Issue 152 / 17

Elderberry juice is a great way to consume elderberries. This recipe is easy to follow and yields a delicious drink, giving about 1 cup of elderberry juice. Enjoy it on its own or use it as a base for other juices or cocktails.

Elderberry Juice 3 kilograms elderberry Enough water to cover the elderberries

1. Rinse the berries several times thoroughly. Remove the berries from the vine. Add to a large saucepan, cover with water and bring to a boil. Cook for 15 minutes until the berries are soft and appear wrinkled. Pour the mixture through cheesecloth or a fine strainer into another pot. Squeeze the fruit to remove as much liquid as possible. 2. Alternatively, you can process the berries through a juicer. This approach is typically much faster and more efficient. 3. The elderberry juice will be ready after this process. If you’d like to enjoy it for an extended time, you can preserve it. To do this, you must add the juice to bottles and seal them with a rubber stopper or screw-tops. 4. Heat a pot of water, and add the bottles to the water bath. Process for at least 30 minutes to ensure that the juice is sterilized and that pathogens are deterred from forming. Cool the bottles, and keep them in a cool place.

Top Doctor Magazine / Issue 152 / 19

Another way to enjoy the benefits of elderberries is to make dried elderberry tea.

Elderberry Tea 6 cups (1.40 L) of water 2 tablespoons dried elderberries 2 tablespoons honey 2 lemons

1. Pour water into a heavy saucepan. 2. Add dried elderberries and boil for 20 minutes. 3. Strain to remove berries and stir in honey and the juice from one lemon. 4. Garnish with lemon slices and serve.

A Parting Reminder The health benefits of elderberries are numerous as they are a great source of fiber, vitamin C and antioxidants while also being vegan and gluten-free. In addition, elderberries can help boost the immune system, improve heart health and reduce inflammation. They are a delicious and nutritious addition to any diet!

Top Doctor Magazine / Issue 152 / 21

Gummy Vitamins VS. PILLS WORDS BY ANN Y.

any people take vitamins to im-

dose. Furthermore, gummy vitamins decay faster

prove their health or make up for

and have a shorter shelf life than traditional tab-

nutrient deficiencies in their diet.

lets, so the vitamin content in your gummy may

These days, gummy vitamins are

have degraded by the time you take it.

trendy because they come in various tastes, colors and shapes. Strawberry, lemon, raspberry and orange are just a few tasty gummy vitamin flavors available. In fact, vitamin supplements in the form of gummies are now more popular than pills.

Gummy Vitamin Health Benefits We need to eat a healthy and balanced diet to keep up with our daily multivitamins. However, if you have problems consuming various foods, have dietary restrictions or have trouble absorbing nutrients, taking multivitamins in the form of gummies may be right for you.

Gelatin and pectin-based gummy vitamins have a shorter shelf life because they can become tough and unpleasant to eat. Gummies can last anywhere from one to two years, depending on the brand and formulation. It’s crucial to doublecheck the label for the expiration date.

Taking Too Many Gummy Vitamins: Vitamin Toxicity Consuming an excessive amount of gummy vitamins may result in diarrhea, vomiting, constipation or headaches. While undeniably more appealing than conventional vitamins, gummy vitamins make it difficult for children to distin-

The advantage of a gummy vitamin is its bioavailabil-

guish between them and candy. This may result

ity. This trait is beneficial for people who have trou-

in unintentional overconsumption. Gummy vita-

ble absorbing certain nutrients because some will be

mins contain a variety of minerals and vitamins,

destroyed by stomach acid, others will be expelled

some of which are toxic in large doses.

and others will simply not enter the body’s cells.

It is crucial to monitor the right recommended

Some people prefer gummy vitamins over pills because

dosage of gummy vitamins according to the

they are easier to swallow, have a nicer flavor and don’t

product label. If your child or someone in your

have a strange odor. These traits may increase your

household has eaten too many gummy vitamins,

likelihood of taking vitamins on a regular basis.

have them drink plenty of water, ask how many

Do Gummy Vitamins Work?

vitamins were taken, and call Poison Control.

Yes, gummy vitamins are effective. Like pills or

Taking gummy vitamins above the recommended

soft gels, gummy vitamins provide your body with

dosage for an extended time may develop into chron-

critical vitamins and minerals. Gummy vitamins

ic toxicity. Symptoms include muscle and bone pain,

may provide beneficial nutrients and can help

hair loss, headache and gastrointestinal distress.

certain people with vitamin deficiencies, such as

Which Is Better : Gummy Vitamins or Pills?

vegans, older adults and pregnant women.

Can Gummy Vitamins Go Bad?

For various reasons, gummy vitamins are a pop-

Because the FDA does not regulate gummy vita-

ular alternative to traditional vitamins, and they

mins, their nutrients may differ from what is list-

come in a range of shapes, dosages and tastes. In

ed on the label, making it impossible to establish

addition, gummy vitamins are chewable and easy

the exact amount of vitamins and minerals in a

to take for those who have trouble swallowing pills.

Top Doctor Magazine / Issue 152 / 23

However, gummy vitamins don’t work as well as

Gummy Vitamins vs. Pills Absorption

pills because they often contain inconsistencies

Gummy vitamins are chewable and will be broken

in the levels of nutrients listed on the labels and

down before they reach your stomach, so they’re

degrade more quickly than pill vitamins.

significantly easier to take in. Your body will

There are certain disadvantages to taking gummy vitamins. Sugars are commonly added to gummy vitamins to give them a pleasant taste. Also, gummy

absorb the vitamins faster than if you took a tablet. In a contest between gummy vitamins vs. pills absorption, the gummy vitamins take the crown.

vitamins can promote dental decay because the

Are Gummy Prenatal Vitamins Effective?

sugary gelatin can get stuck in your teeth.

Getting the daily need for iron during the nine

Sugars added to gummy vitamins have been related to obesity, heart disease and tooth cavities. Some manufacturers may add sugar alcohols listed under total carbohydrates on the label.

months of pregnancy is imperative. Unfortunately, iron is not present in gummy prenatal vitamins. Iron is absent from gummy prenatal vitamins because iron makes the gummies larger and can often result in an upset stomach. Instead of gummy

As a consumer, you must be careful with gummy

prenatal vitamins, you can opt to eat green leafy

vitamins, even if they are labeled sugar-free.

vegetables that can provide a lot of iron.

Furthermore, because gummy vitamins typically

Best Gummy Vitamins

taste like candy, taking vitamins in more than the prescribed amount can be tempting.

Gummy Vitamins: FAQ Are Gummy Vitamins As Effective As Pills? There are some drawbacks to gummy vitamins, such as manufacturers having a more challenging

According to one study, while almost 80% of gummy vitamins had incorrect labeling, some were more reliable, such as Flintstones Kid Gummies and Nature’s Way Women’s Gummies. Both of these products have the proper amounts of vitamins listed on their labels.

time getting as many vitamins and minerals into

A Parting Reminder

the gummy candies.

If you want to try gummy vitamins, look for ones

Gummy vitamins may fall short when compared to their pill equivalents. According to independent studies, many gummy vitamins do not contain all of the nutrients listed on the label, and in

that have been third-party tested and have low sugar content. If you are concerned about the sugar content, you can still take it as long as you monitor your food and sugar consumption.

certain circumstances, they may have too many

Gummy vitamins may be ideal for you, especially

of some vitamins.

if you have children who find it difficult to take

If you want to try gummies as dietary supplements, you should do your homework before

pills. They have a candy-like flavor and are simple to consume and digest.

choosing a gummy vitamin. You must take a look

If you’re unsure about which vitamin to take,

at the label and examine the components as well

consult your doctor. Your doctor may advise you

as the supplement information.

to take the appropriate vitamins in the form of gummy candies or pills.

Gummy vitamins may fall short when compared to their pill equivalents. According to independent studies, many gummy vitamins do not contain all of the nutrients listed on the label, and in certain circumstances, they may have too many of some vitamins.

IT’S NOT JUST ALL IN YOUR HEAD Post Covid Brain Fog: What We Know So Far And Strategies To Help Lift The Cloud By Ayushi Chugh, MD, Consultant Neurologist, Phoenix, Arizona

ver experienced mental fogginess, slowness during recuperation from illness? Simply put, you may be

suffering from ‘Brain fog’. Though not a medical term, it’s not such a simple medical condition.

More recently, brought to the fore by the onslaught of COVID -19. Brain fog is a common, yet

troublesome

cognitive

impairment

phenomenon experienced by many patients weeks to months after suffering from COVID-19, to describe feeling mentally slow or feeling not as sharp a thought process as before. This is part of the CDC’s umbrella term ‘Long COVID-19’ or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), which includes the various symptoms someone can experience during or even after being infected with COVID-19. PASC occurs when patients experience persistent, new or recurring symptoms four or more weeks after the initial COVID-19 infection. Even weeks after being infected with COVID-19, some people will continue to experience symptoms, including brain fog, which can stick around for many weeks after you’ve recovered from the disease.

SYMPTOMS OF BRAIN FOG Brain

fog

broad

term

that

encompasses

variety of symptoms. The

commonality

through

these

symptoms is some impaired mental function that can make it harder to think clearly, hence the term ‘fog.’ For example, individuals may have a hard time finding the right word or remembering the names of things. They may also find it hard to focus or multitask. Brain fog impairs more than one’s ability to focus; it can also slow or impair brain function. Normally, the brain controls and accesses information by encoding and retrieving, meaning the brain encodes information into its memory to remember it, and the brain retrieves it from where it was encoded to access that information.

Top Doctor Magazine / Issue 152 / 27

However, brain fog slows this process, making it harder to learn, encode or retrieve the information you already know. This process also makes decision-making more difficult by reducing

Our learning of the SARS-CoV-2 virus is occurring in real time,

the brain’s processing speed and creating mental fatigue.

but one thing is clear: brain fog is not entirely a psychological

The most severe symptom of COVID-19 brain fog affects middleaged adults and is called dysexecutive syndrome. It occurs when someone has a hard time organizing information with impairments in speed processing, memory encoding, recall and category fluency, implying an impact on frontoparietal and

phenomenon. Instead, brain fog has been found to have a biologic basis and can affect anyone who was infected with COVID-19, not limited to those that were extremely sick, hospitalized or on a ventilator. The exact cause of brain fog is difficult to determine, but some of the most common factors are:

frontostriatal brain networks. Basically, the brain has a reduced

Poor brain oxygenation caused by brain injury, lung/

ability to function, indicating that the brain networks responsible

multi-organ damage or ventilator use;

for motor, behavioral and mental functions may be affected. Researchers agree that COVID-19 may be behind this syndrome. According to a research letter published in October 2021 in JAMA Network Open, researchers tested 740 COVID-19 patients in New York with a mean age of 49. Even months after being infected with COVID-19, individuals manifested a dysexecutive syndrome.

Inflammation of the coverings of the brain (i.e., viral encephalitis) or blood vessels (i.e., microvascular injury); Cytokine storm (i.e., heightened immune response to the virus or its remnants in the body) leading to a postinfectious autoimmune response;

Researchers also noted that the subjects tested positive for

Autonomic and small fiber neuropathy from complex

COVID-19 or its antibodies and had no history of dementia.

viral mechanisms could potentially lead to dizziness and

Therefore, their symptoms were caused by COVID-19’s effects on

lightheadedness.

their brains, not underlying dementia.

“NOT JUST IN YOUR HEAD”: CAUSES OF BRAIN FOG

These factors can affect the brain’s surrounding tissue or the

amount of oxygen the brain receives, resulting in impaired function and the brain fog associated with COVID-19.

STRATEGIES FOR BEATING COVID-19 BRAIN FOG

Other medical conditions can contribute to COVID-19 brain fog

Once your doctor is sure that there is no other explanation for

as well. According to a study of non-hospitalized post-COVID-19

cognitive difficulties, certain lifestyle strategies may be of help.

patients’ cerebrospinal fluid (i.e., the fluid which bathes and surrounds the brain), even COVID-19 patients without severe conditions still experienced brain inflammation. This implies

Mindful Planning

that the body’s inflammatory response to COVID was still

Plan, prioritize and pace your daily schedule with time for rest,

present even months after the initial infection and that the

rotating between mental and physical tasks. Write down on sticky

body’s inflammatory systems, which are activated during the

notes, planners and calendars to place on your refrigerator, laptop

infection, were still active even after the infection had passed.

or door for easy access and repetition. This strategy can help you

The researchers also found that patients with brain fog were also

avoid forgetting important things because of your brain fog.

likely to have conditions such as hypertension, diabetes, sleep apnea, depression, anxiety, heavy alcohol and stimulant use, and learning disabilities.

MANAGEMENT OF POST-COVID-19 BRAIN FOG Make a diary of your symptoms and seek advice from a doctor through medical examination, lab tests, imaging and neuropsychological studies as deemed appropriate. There are myriad situations which could cause or potentiate brain fog symptoms. Unhealthy diet, poor sleep quality, chronic stress, hormonal changes, may be contributory, as have been the use of certain medications and medical conditions such as anemia, post chemotherapy, and depression, to name a few.

You should also maintain a symptom diary to find triggers and helpful avoidance strategies. Such a diary will help you better understand your brain fog, what makes it worse and what helps. Ask for assistance when overwhelmed. In some instances, professional cognitive therapy may be helpful to your recovery process.

Mindful Sleep According to The Sleep Foundation, adults (18-64 years) need an average of 7-9 hours of rest every night. Sleep helps the brain and body recharge appropriately for optimal functioning and healing. It is especially important when you’re struggling with brain fog impairing your brain function. So make sure you get extra sleep to give your brain

Top Doctor Magazine / Issue 152 / 29

all the energy it can to push through brain fog. To help you sleep better at night, try to avoid coffee after 2 p.m., create a relaxing ritual like a warm bath before bedtime, turn off the TV, block blue light on digital devices at least a few hours prior and use the bedroom only for sleep and intimacy.

Be Mindful of Other Conditions Make sure that you keep an eye out for other conditions as well. Seek medical help for conditions such as refractory headache, numbness, hypertension, diabetes, depression, substance abuse and liver, kidney, heart, lung or other multiorgan involvements.

Mindful Diet The brain-healthy Mediterranean or a plant-predominant

Luckily, brain fog is unlikely to become a permanent

diet consisting of whole grains, beans, olive oil, fruits,

condition. An optimistic study shed some light at the end of

nuts, vegetables and fish has been shown to have anti-

the tunnel that this fog may not be permanent. The latest

inflammatory properties. Avoid processed foods that are

research published in Brain Communications suggested

inflammatory. Remember to drink water throughout the day

that COVID-19 survivors showed a substantial reduction in

and avoid tobacco, alcohol and drugs.

attention retention on demanding tasks up to nine months

Mindful Exercise Exercise can be very beneficial even when you’re battling brain fog. However, start slow, with gentle movements, stretching from a few minutes a few times a day, and build

after COVID-19 and an even worse memory for up to six months. The researchers found that previous COVID-19 patients had brain functions that were not significantly different from normal after 6-9 months.

up in a graduated manner toward working out 30 minutes a day, five days a week. Remember to warm up and cool down before and after workouts to get the best out of your session.

and repetition for rewiring and eventually getting back on

Socialize Mindfully

track. The same is true with dealing with brain fog. The best

Be intentional when socializing. Surround yourself with

way to overcome it is simply giving your brain enough rest.

mindful, mood-enhancing people and activities. You can also pursue reading, listening to music, breathwork, practicing mindfulness, meditation and maintaining a grateful and positive attitude.

Remember, our brain functions best with a balance of rest

A PARTING REMINDER Brain fog and other persistent symptoms of COVID-19 may seem challenging to those experiencing them. After all, dealing with symptoms of an illness you think you’ve gotten over is discouraging. Optimistic research with newer/ repurposed medicines is on the horizon. But, with these strategies, tips, and a tincture of time, you should be able to weather the fog. **This article

is a compilation from

different medical sources and the author’s views and opinions are her own. This is to raise awareness on medical issues, not personal medical advice. Please ask your doctor about any questions/ concerns. Life is precious**

Top Doctor Magazine / Issue 152 / 31

DEALING WITH SEXUAL PERFORMANCE ANXIETY 3 Helpful Things to Remember in the Bedroom WORDS BY DREW B.

umerous factors have a say in a healthy rela-

Sexual anxiety can be caused by various factors, including

tionship, one of which is healthy sex life. Ide-

relationship problems, body image issues and trauma. It

ally, we can open up with our partners, be in-

can also result from another mental health condition,

timate and try different things under the sheets. However, because of sexual performance anxiety, some couples cannot enjoy the perks of a healthy relationship. Being in bed with the person you love is supposed to be fun and exciting, and it’s tough to have that kind of fun when you are constantly thinking about how well you are performing.

What Is Sexual Performance Anxiety?

Sexual anxiety or sexual performance anxiety is a form of sexual dysfunction in which a person experiences sexual difficulty due to fear or anxiety. Sexual performance anxiety symptoms include difficulties with sexual arousal, sexual performance and sexual satisfaction and premature ejaculation.

such as depression or anxiety. Sexual performance anxiety affects 9-25% of men and 6-16% of women. While others who are unaware that they are experiencing the problem can overcome the issue through lifestyle changes, others have a more challenging time as they don’t have a support system or enough knowledge for overcoming sexual performance anxiety.

Causes of Sexual Performance Anxiety

There are many reasons someone can experience sexual performance anxiety and does not realize it or is already suffering but decides not to deal with it. Here are some of the indicators that you are experiencing SPA:

Top Doctor Magazine / Issue 152 / 33

1. You are conscious about your body and do not feel confident that your sexual partner would appreciate your image (e.g., concerns about being overweight or the size of your penis, especially with new sexual partners). 2. It is difficult for you to think about sexual encounters healthily because of past abusive relationships. 3. It is difficult for you to trust your sexual partner due to fear of intimacy. 4. You have relationship issues with your partner, causing the inability to be open and honest with your partner and constant fighting, arguing or microaggressions. 5. You are experiencing sexual dysfunctions such as low libido or erectile dysfunction. 6. You are not in the moment during sexual activities because you overthink about your performance and try to manage how your partner experiences you.

How to Overcome Sexual Performance Anxiety

Treating sexual performance anxiety depends on what’s causing it. In general, SPA is a mental health problem linked with other mental health conditions such as depression, as these two intensify one another. Sexual performance anxiety treatment includes professional medical advice, medications and psychotherapy. The most common type of psychotherapy is Cognitive Behavioral Therapy (CBT), which is used on both men and women. It focuses on changing automatic negative thoughts that contribute to emotional difficulties, depression and anxiety. Identifying these behaviors is difficult, especially if the person involved has a hard time opening up. However, this process leads to new self-discovery and insights essential in the treatment process. It is essential to have a partner to talk to and be open with the problem you are dealing with. Your partner is the one on the receiving end of this issue, and having your partner with you during these difficult times can be very helpful in finding your way back to intimacy.

Hypnosis for Sexual Performance Anxiety

Hypnosis, a state of relaxation and focus that a trained therapist can induce, is a healthy place to start your sexual anxiety treatment. In this state, you are more open to suggestions and more likely to focus on positive thoughts. Hypnosis has been used to treat various conditions, including pain, anxiety and depression. It is also sometimes used to improve sexual function.

Sexual Anxiety and Meditation

Mindfulness meditation training is another technique that is useful for treating anxiety. The goal of practicing mindfulness is to focus on the sensations that are occurring in the present moment while being intimate with your partner and not pass judgment. Mindfulness-based interventions help individuals regulate their emotions, destress and manage their anxiety, which has positive implications for managing sexual performance anxiety.

Sexual Performance Anxiety Tips 1: Be Open to Trying New Things Many people have a minimal view of how sex after marriage should be. However, it is essential to evolve our sex life and try new things even after the honeymoon phase. Couples should not limit themselves to the routine but find new ways to spice up their sex life. There are many ways to spice up your sex life, such as toys, role-playing and new trying positions. 2: Identify Your Turn-Offs Take the time to identify your turn-offs. For example, if the messiness of the room is too much of a distraction and stresses you out, you can tidy it up before initiating foreplay. Such small changes can render significant improvements in your sex life. 3: Communication Is Key Communication is always the key to a good relationship. Τtalk to your partner about what feels good or bad, not just with what’s currently happening in your relationship but with your sex life as well. This way, you and your partner would have a better understanding of what you want and what you need in bed, as well as address concerns or worries that you have.

Top Doctor Magazine / Issue 152 / 35

A Parting Reminder

Sexual performance anxiety can be challenging physically and mentally and will have a negative impact on your relationship unless you find ways to overcome it. It is essential to understand that you are not alone in this battle, as you have your partner who can help you get through these difficult times. There are a lot of treatments available to help you in your journey to be a better person and be a better life partner. The first step is always the hardest, but when you start opening up about your problem, everything will fall into place.

GARDENING

The secret form of meditation WORDS BY PETER C.

ith all the distractions of our current world, one must dedicate time each day to find peace and bring focus back to their mind. A great way to do this is through gardening. One could even say that gardening is a secret form of meditation.

There are many benefits to meditation, with mindfulness, stress relief and improved focus on the forefront. Meditation can also help reduce depression and anxiety, create a sense of calmness in stressful situations and increase your self-awareness.

Gardening as Mindfulness Practice Mindfulness can be described as a state of being present in the moment and aware of our thoughts, emotions, bodily sensations and surroundings through a more nurturing perspective. Gardening can be a great way to get in touch with your inner self and achieve a state of mindfulness. By paying attention to the plants in your garden, you can learn to focus on the present moment and clear your mind of distractions. Gardening helps you focus on a single-hand task - watering plants or removing weeds, for example. Furthermore, gardening requires two essential skills: care and control. It forces you to take care of your plants as if they were sentient beings while also allowing you to control what happens to them in the future.

Gardening as Stress Relief Some studies have shown that people who garden are less stressed, happier and have better mental health. These are the same outcomes we get from daily meditation. Gardening can create a space where minds are distracted by the surrounding nature. This allows us to redirect our attention away from ourselves and our problems, relieving stress and boosting positivity in our minds.

Top Doctor Magazine / Issue 152 / 39

Gardening can also be a more physical activity with its own health benefits. Physical activity greatly reduces stress and can also be looked at as a moving meditation. Gardening as a physical activity is amazing for all ages because it doesn’t feel as exhausting as going to the gym, although it uses a comparable amount of calories. Some people don’t even have to leave their homes to garden because they can have a small outdoor space specially designed for gardening and flower planting.

Gardening to Improve Focus Mental health is one of life’s most important aspects. One way to improve mental health is to reduce social media consumption and reduce the time spent on screens because excessive screen use has been linked to diminished goal-driven attention. Reduce your screen time, and you’ll be better focused. You can reduce screen time by engaging in other activities that require more physical movement and attention, which gardening is perfect for. Gardening isn’t just a terrific method to reduce screen time; it also helps us focus on the right things. By nurturing plants, we can create a more positive outlook toward life. Taking care of a living being and seeing it flourish can create a sense of fulfillment. Gardening is a great way to slow down, take in the surroundings and cultivate a healthier lifestyle away from a digital life and social media, which have been shown to have many adverse mental health effects such as isolation, depression and anxiety.

A Parting Reminder Gardening is an excellent way for anyone to stay mentally healthy. Just like meditation, it can be calming and therapeutic. Planting flowers and other plants in a garden or on your porch can lead to a calming environment and a calmer mind. The wonderful color of the flowers, soft, soothing sounds from the birds and even the dirt under your fingers can lead to a meditative state of relaxation.

Top Doctor Magazine / Issue 152 / 41

hormonal acne WORDS BY PETER C.

ave you ever wondered why you sometimes

Considering the varying effects of birth control pills on acne,

get those huge, inflamed zits that seem to take

it is wise to consult your doctor if you are concerned about

over your chin for no apparent reason? Is there

how taking them can affect your skin.

anything you can do about it other than crossing your fingers and hoping for the best? Luckily, we nowadays have many ways you can alleviate your hormonal acne.

hormonal acne reasons

According to Medical News Today, hormonal acne is not a term used in research or medical practitioners, but on the Internet, in

hormonal acne areas

Hormonal acne can cause breakouts in numerous skin areas, such as: Face: The most common place for acne to appear on the face is around the forehead and cheeks.

magazines or by people selling natural remedies. Therefore, it

Chest: Hormonal acne on the chest usually appears as a rash

can simply be called acne or by its medical term: acne vulgaris.

of small red bumps that can look like a sunburn.

Contrary to popular belief, hormonal acne is not caused

Back: Back acne usually starts as blackheads or whiteheads

by overeating sugar or chocolate. It’s actually caused by a

on the shoulders and upper back, spreading to more concen-

hormone imbalance, which can result from many different

trated areas over time.

things that naturally occur as we go through our stages of life: puberty, pregnancy or menopause. It can also be caused by stress and lack of sleep that mess with your estrogen and testosterone. And while it’s not entirely understood why some people get hormonal acne and others don’t, it is suspected to have a genetic factor.

hormonal acne from birth control

Can birth control pills cause hormonal acne? The answer might be different for everyone; sometimes, yes, but sometimes it can reduce acne. Certain pills with progesterone only can cause acne to become worse. However, other birth control pills can help with hormonal acne because they change how hormones work in your body. For example, some birth control pills cause a reduction in the amount of acne-causing androgen hormones.

Buttocks: Buttocks are one of the most common places for hormonal acne because sweat can irritate pores in this area and cause acne.

hormonal acne in pregnancy

Other than teenagers, the population most affected by hormonal acne are pregnant women because hormonal acne affects most pregnant women in the second and third trimesters of pregnancy. The two types of hormonal acne affecting pregnant women are: 1. Acne due to the rise in androgen levels, or male hormones: This type is commonly seen in women during their second trimester and lasts until the end of the third. 2. Acne due to the decline in estrogen levels or female hormones: This type is commonly seen later in pregnancy.

Top Doctor Magazine / Issue 152 / 43

Some people swear by vitamin C supplements to reduce the severity of acne and control breakouts. This is due to vitamin C being a powerful antioxidant that helps protect the skin against the irritants in cosmetics and environmental pollutants.

Accutane (Isotretinoin) is an oral medication for

• Using a hydrocortisone cream. Hydrocortisone re-

treating severe acne, but you should be careful

duces inflammation and is good for all types of skin.

about taking it during pregnancy as it can cause

• Using a benzoyl peroxide cream or gel that

nasty side effects to a developing fetus.

cystic acne

Cystic acne is a severe form of acne caused by a buildup of bacteria and oil in the hair follicle and

antibacterial properties and can help treat acne.

how to treat hormonal acne Hormonal Acne Supplements

can be painful, taking weeks or months to heal. Dry

There are many different types of supplements

skin is a common problem that may result from an

available on the market for acne reduction, and

infection, a reaction to certain medications or aging.

they work in various ways.

In mild cases, topical treatments applied twice dai-

One popular supplement contains vitamin A,

ly can be effective. In more severe cases, cleansing

which helps reduce sebum production in the skin

three times daily and sometimes taking oral antibi-

pores and reduces inflammation. You can also

otics is recommended. In most severe cases, it can

find supplements containing zinc, which helps

be treated with a corticosteroid injection called tri-

reduce inflammation, kill bacteria and decrease the

amcinolone. This injection into the lesion aims to

number of acne bumps.

reduce inflammation and scarring.

You can also try supplementing with green tea extract

will hormonal acne go away?

and caffeine, which may help prevent clogged pores.

There are many ways to deal with hormonal acne,

reduce the severity of acne and control breakouts.

but there is no one-size-fits-all solution. The best

This is due to vitamin C being a powerful antiox-

way to find out what works for you is through trial

idant that helps protect the skin against the irri-

and error over time. The best ways to get rid of

tants in cosmetics and environmental pollutants.

hormonal acne are:

It also helps control excess sebum production, pro-

• Clearing your skin of dead skin cells;

you apply to your skin. Benzoyl peroxide has

Some people swear by vitamin C supplements to

moting acne formation.

• Exfoliating twice a week;

You can find supplements that contain aloe vera gel,

• Using gentle products that don’t irritate the skin.

which offers relief from dryness and irritation caused

You can use makeup removers, baby soap or nat-

by acne. Aloe also has anti-inflammatory properties

ural skincare products such as cucumber slices.

that help treat inflammation and reduce redness.

Hormonal Acne and Accutane The standard treatment options for acne are topical creams and antibiotics. However, these treatments are only temporary and will not cure the condition completely. Accutane (Isotretinoin) is a medication that has been used for over 30 years to treat severe acne that has not responded to other treatments, such as antibiotics or topical creams. Accutane should be used only in severe acne cases characterized by large, painful cysts and scarring.

Hormonal Acne and Retinol Hormonal acne can be caused by an imbalance in the body’s natural hormone levels. Retinol, a form of vitamin A, can be used to remedy hormonal acne. It helps reduce inflammation and redness, unclogs pores and helps with acne scars. Retinol also reduces fine lines, wrinkles and hyperpigmentation problems while improving the overall appearance of your skin.

How to Treat Hormonal Acne Naturally at Home Natural remedies for hormonal acne are cheaper and maybe more gentle on the skin. In addition, they do not have as many side effects as using harsh chemicals on the face. Here are some natural remedies for hormonal acne: • Drink plenty of water to hydrate your skin and flush out toxins from your body. • Apply ice packs on your face for 15 minutes every day. • Eat foods rich in antioxidants, like blueberries, strawberries, dark chocolate or spinach. • Use apple cider vinegar as a toner.

a parting reminder

Now that you know more about hormonal acne, you are better prepared to face future breakouts and prevent them in the first place. As always, consult your doctor to find out if you’re at risk for or dealing with hormonal acne and what else you can do to keep your skin healthy.

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PRACTICE, RESEARCH, BUSINESS A View of Plastic Surgery with Dr. Daniel J. Gould, MD, Ph.D. BY GAYE NEWTON

he medical profession is a continu-

STARTING A CAREER

ous progression of new medicines,

Dr. Gould followed in his physician father’s

techniques and knowledge devel-

footsteps while pursuing his affinity towards

oped through theory and applied research.

research. Mentors pushed him toward an

The combination of science and business

MD Ph.D. program and encouraged his

promotes the restoration of good health.

developing love for reconstruction and

Dr. Daniel J. Gould, MD, Ph.D., employs his dual degrees to embrace both theory and application.

“I became more focused on bioengineering

He has played key roles in businesses where he

and tissue engineering. That was a great

contributes to his patients’ well-being and the

overlap for reconstructive surgery. Now, I

advancement of science.

like taking care of patients, researching

Dr. Gould is a plastic and reconstructive surgeon at Dr. Gould Plastic Surgery in Beverly

and putting those two things together to improve outcomes,” Dr. Gould said.

hundreds of peer-reviewed articles and pre-

PRACTICE: RESTORING PATIENTS’ WELL-BEING

sentations on cosmetic and reconstructive

Dr. Gould’s practice involves anti-aging

surgery. Dr. Gould is also involved in other

procedures for the face, breast and abdomen,

Hills, California. His research has produced

health and wellness-related businesses. “It allows me to contribute on a deeper level

plastic surgery.

including the state-of-the-art deep plane facelift and drainless tummy tuck.

and change the way I approach each patient,

“There’s an overlap between science and

my practice and my contributions back to

surgery with facial aging,” Dr. Gould

science,” Dr. Gould said.

said. “It’s challenging—the technical skill,

perioperative management, understanding aging and what

tension and putting the structures back where they belong.

patients need and want. My practice is all about allowing

I don’t see myself as a special cultivator of beauty. I see

the patient to recognize who they see in the mirror. We’re

myself as an anatomist or a scientist,” Dr. Gould said.

here to make you look better, not different.”

RESEARCH: CONTRIBUTING TO SCIENCE

For Dr. Gould, success means the patient looks natural, not like they’ve had work done. He is essentially returning things to their natural state. “I’m putting your anatomy back where it belongs. I don’t want people thinking, I want to be a 10. I don’t create strange, unnatural beauty,” Dr. Gould explained.

“My residency and Ph.D. were focused on researching ways to further the science of plastic surgery. As a result, I’ve written about 120 peer-reviewed publications, and I’ve given about 600 talks at big meetings,” Dr. Gould said. He is currently an editor for the Aesthetic Surgery Journal and has also helped launch a new open-access journal, publishing several articles in each. “The new journal is more focused on consumers and giving

My practice is all about allowing the patient to recognize who they see in the mirror. We’re here to make you look better, not different.

transparent information about plastic surgery. My goal is to ultimately be a high-level editor or maybe editor-inchief for one of those journals,” he said.

BUSINESS: MULTIPLE PATHS TO PROMOTING WELLNESS

Managing a Business and Creating a Niche To practice medicine and conduct research successfully, a doctor must also manage the business side. “I’ve learned how to manage a practice, open an office, grow,

PATIENT CASES His goal of resetting natural balance produces happy patients. He gave an example of a woman who, after having babies, developed weakness in her abdominal core muscles. “She had urinary incontinence and sexual dysfunction. With one surgery, I can put her muscles back together. I can give her body back,” Dr. Gould said. Other patients come in for breast augmentations, not to enlarge their breasts but to correct an imbalance. “My ideal breast augmentation is when you look at the patient and have no idea they had surgery. They’re not going beyond natural anatomy,” Dr. Gould added. Dr. Gould does not perform or promise miracles. Instead, he helps patients understand that procedures are consistent with the patient’s health, skin condition and natural body type, not what they see on television or social media. “The deep plane facelift, for example, is all about releasing

develop marketing and leads and create a brand. I think one of the biggest mistakes doctors make is failing to establish a niche,” Dr. Gould said. Doctors often see themselves as jacks of all trades, but they cannot do everything. Instead, they should focus on two or three things they do well and become known for that. “In a market largely based on referrals from other providers, other doctors won’t send you referrals if you overlap with what they do. You’re a competitor. You’re a better referral source as an expert in a niche,” Dr. Gould explained.

Partnerships A doctor with an established niche can form partnerships with doctors with other expertise, thus building the community of medicine. “By building those partnerships, relying on your medical and surgical colleagues and developing referral streams, you can grow. But you need to network in order to know who to send people to,” Dr. Gould said.

As a community, the more interlinked doctors are, the more supportive they are of one another, and the better their patients’ outcomes will be.

YouTube On his YouTube channel, Dr Gould Plastic Surgery, he discusses such topics as procedures, patient expectations and aftercare. “YouTube Health reached out to me to become a part of a vetted medical knowledge base. As a result, I’m creating knowledge about cosmetic procedures focused around outcomes,” Dr. Gould said.

Love My Delta, Milk + Honey Spas Love My Delta, a cloud-based software platform, offers analytical tools for people working in beauty, wellness and aesthetic medicine. “I’ve created a company called Love My Delta with a few friends and partners. We’re using crowdsourcing to identify outcomes in aesthetic surgery and aesthetic beauty,” Dr. Gould added. Dr. Gould is also the medical service operator for Milk + Honey spas. This business features medical aesthetics along with traditional high-quality spa services and products. “We’re hoping to become an industry leader in aesthetic beauty and expand our locations,” Dr. Gould said.

A PARTING REMINDER Dr. Gould has created a successful practice by identifying his niche within the plastic surgery field, advancing the science through research and publications and getting involved in other businesses that serve aesthetic patients. “You have to have your hand in a few different things to push your practice,” Dr. Gould said. The real bottom line, though, is the patients. “The one thing that motivates me is the best results for the patients,” Dr. Gould explained. Between the care a doctor provides and referrals for other needed services, patients get the best information and treatment. “That’s the whole goal—the best care always,” Dr. Gould concluded.

Healthy Food Habits WORDS BY MĂLINA O. R.

veryone is unique in their way, which means our food habits differ. No one says you can’t enjoy a hamburger from time to time, but it’s

essential to have healthy foods and a balance in your diet. After all, no one said that healthy food habits couldn’t be a treat to our minds and taste buds.

Healthy Food Habits If you’re searching for healthy food habits, there are a few things you have to follow. Choosing a healthy food habit is a great idea. By adding small changes to your diet, you will notice huge differences in your health. It may sound scary to change such a big part of your life, but the good news is that you can build healthy food habits one step at a time.

2: Eat Fish Seafood is full of protein, minerals and omega-3 fatty acids. Add some steamed salmon, tuna or trout to the meal’s main course. Try some crab, oysters or mussels if you prefer shellfish over fish. However, avoid cooking them in too much oil as over-fried food is unhealthy.

3: Whole Grains You will quickly experience significant health changes by switching some of the grains you eat to whole grains. For example, switch from white bread to whole-wheat bread. Next time, try whole-grain pasta, whole-grain crackers in the morning or whole wheat tortilla when you carve a veggie wrap. Read the ingredients of products and keep an eye out for ingredients such as whole wheat, oatmeal, quinoa, wild rice and buckwheat.

4: Stay Away from Sugary Drinks Having sugary drinks in your diet is expected but not healthy. Beverages such as sodas and energy drinks have high sugar levels and, as a result, are full of calories that damage your health. Switch from these sugary drinks to plain water or unsweetened beverages. If you feel water is just too dull, don’t be afraid to add a slice of lemon, lime or watermelon in the glass for flavor.

Food Habits in America The U.S. is one of the largest food-consuming countries

1: Add Fruits and Vegetables to Your Meal

worldwide. Our country holds around 330 million people, so it is only natural there are a few different food habits.

It may sound obvious that fruits and vegetables are part of a

1: Ranch

healthy food diet, but some people forget how efficient they

People in America have a genuine obsession with ranch, a

are. Pick dark-green, red and orange vegetables to integrate into

sauce made primarily with sour cream, mayonnaise, garlic and

your dish. Add them to the main dish, side dish or garnish if you

buttermilk. The ingredients already tell us this sauce is not a

don’t want to suddenly change your diet. Don’t forget about the

healthy addition to America’s food habits. Nevertheless, peo-

delicious fruits that go perfectly as a dessert. The more colorful

ple add it to almost everything, from french fries, chicken nug-

your dish is, the more vitamins and minerals it contains.

gets and buffalo wings to salads and different fried vegetables.

Top Doctor Magazine / Issue 152 / 53

2: Fast-Foods We all know that America is the perfect country if you are in love with fast food. The many varieties make it possible for everyone to find a place they will enjoy. Because of this, people can’t seem to know when to stop eating at these establishments. Therefore, it is perfectly fine to enjoy some McDonald’s or KFC from time to time, but never let it become a habit because overeating fast-food is quite unhealthy.

3: Frying Almost Everything Fried food is one of the tastiest foods in the entire world. But the fantastic taste comes at the price of calories and harmful fats. The list seems endless, from fried chicken, potatoes, mac and cheese, turkey, onions and even butter. These fried meals

A healthy diet helps the body repel diseases and keeps our mental health thriving. It may be hard at first, but the results are solid and impressive over time.

have to be kept away from your diet as they are high in calories, cooked in high-fat and oils and are harmful to your entire body.

Healthy Food Habits for Adults As adults, we have to switch to healthy food habits for a long and healthy life. Besides the provided list of tips, you can try other approaches such as: • Switch from solid fats to vegetable oils when cooking; • Reduce the salt and sodium intake; • Eliminate fast-foods from your diet; • Moderate your alcohol intake; • Add high fiber foods to your healthy food habits; • Never skip breakfast.

Why Healthy Eating Habits Are Important Healthy food impacts our life more than we think. A healthy diet helps the body repel diseases and keeps our mental health thriving. It may be hard at first, but the results are solid and impressive over time. You will be happier and healthier and enjoy what you are eating. After all, no one said healthy food habits consist of tasteless and unpleasant food. On the contrary, healthy food can be and is delicious!

A Parting Reminder Don’t be afraid to change your food habits. It may seem scary and not worth it at first, but the results of healthy food habits are outstanding in the long run. Your health is essential, so you have to be careful when managing it.

What’s The Secret To Happiness? Well, Science Says It’s Our

RELATIO WORDS BY MĂLINA O. R.

ur lives reflect what we surround ourselves with. If we choose to live around cheerful, positive people, our lives will be the same. Surrounding ourselves with negative, grumpy and pessimistic people will take a toll on our lives.

The Social Side of People and How It Affects Our Demeanor

Humans are social creatures. Without socializing with other people around us or social media, our mental health suffers. Our sociable nature is the one thing we can’t lack. To live a long and happy life, we need people around us to form relationships with. The constant nature of these relationships gives the impression that they can never end. Some of us might believe that we can neglect our relationships without consequences. But that is not the case, as the damage we do affects us as well.

The Relationship with Family

To create and maintain a relationship, you need to interact with the people on the other side. From a very young age, we build a tight relationship with our family. Because we interact with our family daily, we tend to take up very much from this relationship. For example, living in a happy, joyful family will reflect in our lives. Our personalities will be optimistic and cheerful, and the relationship will be stronger.

ONSHIPS

The Relationship with Friends

Some think these are the most influential relationships we develop throughout our lives. We surround ourselves with people that become our friends at school, work or in our community. Some people tend to interact and befriend problematic individuals, leading to a shift in personality, especially in mental health. That’s why surrounding ourselves with understanding, positive people is essential for our mental health. We need that joy and happiness to function and be the best version of ourselves.

The Relationship with Partners

The intimacy between two particular individuals that forms a relationship defines our lives later in life. We need someone next to us that can understand and love us for who we are. Unfortunately, some people will try and change their partner for their benefit. This process is so damaging that it can lead to serious mental health problems like anxiety and depression.

How to Maintain a Relationship

The most important thing anyone can do is be positive and build a happy and fulfilling relationship with the other side. Relationships can drastically improve just by showing interest and care. Taking some time out of your day to call your family, meet up with some friends for a chat or cook a delicious meal for your partner can work wonders.

Positive Alacrity

Practice Positive Alacrity, the art of creating experiences with an emotionally uplifting impact on others. Voicing positive thoughts in a relationship creates an emotional and positive response from the other side. An incredibly fulfilling sense of satisfaction will engulf you. By practicing Positive Alacrity, you’re improving your relationship with others and uplifting yourself. Positivity only works if it’s perceived as genuine. As long as you truly believe in what you are saying, there will be a positive outcome.

A Parting Reminder

Improving our relationships takes time and effort. Interacting positively with the ones dear to us and showing them that we care keeps a relationship healthy. And happy relationships equal happy lives!

Top Doctor Magazine / Issue 152 / 59

THE EMERGING FIELD OF REGENERATIVE MEDICINE

by Dr. Ian White and Dr. Ivel De Freitas

Part 3: Personalized, Precision Medicine

very patient is unique — their biology, genetics and biomolecular makeup — and should be treated uniquely,

as each patient is likely to respond differently to specific

medical treatments and therapies. This emerging reality is

rapidly driving medicine from the traditional ‘one-size-fits-all’ approach toward a ‘personalized’ or precision-based viewpoint. This revolution is

rapidly being adopted across the medical world, perhaps none more so than within the emerging field of regenerative medicine.

CHANGING THE NARRATIVE The German physicist Max Planck said that science advances one funeral at a time. Put another way, he realized that new scientific truths do not win out by convincing opponents and making them ‘see the light,’ but rather because opponents eventually die and are succeeded by a new generation more familiar with it. Historically, paradigm-changing scientific innovations rarely make their way by gradually winning over and converting their opponents. Prior to being awarded the Nobel prize in 1945 for the discovery of

Top Doctor Magazine / Issue 152 / 61

penicillin, Alexander Fleming spent over a decade and

Because of the biohacking revolution, it has become

a half attempting to convince his peers of the medical

critical to broadcast accurate scientific information

potential of his discovery. By the time of the award,

to counteract false narratives that undermine the

many of Fleming’s opponents had retired or passed

mainstream adoption of this medical revolution.

away. Now we can barely imagine a world without

One of the biggest issues facing this field is where to

antibiotics like penicillin.

obtain reliable, scientifically accurate information.

Regenerative

medicine,

conjunction

with

personalized medicine, is responsible for the next major

In this regard, Top Doctor Magazine has taken the initiative to provide this resource to physicians and

paradigm shift in modern medicine. However, neither regenerative nor personalized precision medicine are subjects traditionally found in the curriculum of U.S. medical schools. As such, this emergence has been met with skepticism, doubt and confusion. The difference between Fleming’s time and today is that patients have unlimited access to information and

“Regenerative medicine, in conjunction with

personalized

responsible

for

the

medicine, next

major

paradigm shift in modern medicine.”

choice regarding healthcare. The medical industry is no longer willing to sit by for 17+ years and wait for new technologies to make it into the market. The current

other stakeholders to help guide the evolution of

COVID-19 pandemic is a good example of how patients

regenerative medicine and educate the future medical

choose their own treatment based on ideas from

community. Early adopters understand the biophysical

opinion leaders, blogs and online forums. As patients

and biochemical complexity of human diseases and

navigate the web, biohacking is becoming a driving

that current ‘boxes’ in which we’ve historically placed

force for a paradigm shift in self-care, moving medicine

patient diagnoses are not rigid as once thought but fluid

towards a new age of patient-driven wellness. Patients now recognize that understanding their

and personal — welcome to personalized, precision medicine.

biological makeup will allow them to choose the best diet, lifestyle and even medical and regenerative therapies to activate internal, ‘natural healing.’ They are

FROM ‘ONE-SIZE-FITS-ALL’ TO

more willing than ever to try innovative technologies

PERSONALIZED, PRECISION

to enhance and optimize their overall health, wellness and longevity. This biohacking revolution is not only

MEDICINE

evolving patients from passive users to proactive

Recognition that physicians need to consider individual

seekers but is also a powerful driving force moving

variability has played a fundamental role in the rise of

medicine forward after decades of stagnation.

media interest in a new healthcare industry trend. Since

Top Doctor Magazine / Issue 152 / 63

2015, when President Barack Obama announced a $215 million

the medical community, although there is a lack of consensus

national Precision Medicine Initiative, which included,

on their definitions. It is widely accepted that precision

among other things, the establishment of a national database

medicine incorporates the concept of bio-individuality to

of genetic and other data from one million people in the U.S.,

create groups of similar people and develop a more targeted

the industry has responded. Numerous pharmaceutical and

approach toward their shared similarities. Personalized

technology companies are now investing in a more precise

medicine, on the other hand, implies that treatments and

and personalized medicine, including a common goal of

preventative strategies can be developed uniquely for the

improving optimal longevity that takes health span — the

specific biomolecular makeup of each patient. Although a

period of life spent in good health, free from chronic diseases

worthwhile goal, personalized medicine is considered by

and the disabilities of aging — into consideration.

many to be impractical and unscalable at this time.

Diverse terms, such as ‘personalized medicine,’ ‘precision medicine,’ ‘genetic medicine’ and ‘personalized genomics,’ have emerged to describe a range of genetics-related healthcare practices through which we define patients’ bio-

PRECISION-BASED APPROACH INTO

individuality. Understanding bio-individuality as a myriad of factors — medical, biomolecular, genetic and environmental,

REGENERATIVE MEDICINE

etc. — helps shape a patient’s health, longevity and treatment

Mounting

outcomes.

population variations can significantly impact the outcome

From the model of bio-individuality, ‘personalized medicine’ and ‘precision medicine’ have become popular concepts in

INCORPORATING A PERSONALIZED,

evidence

suggests

person-to-person

and

of regenerative therapies. As we age, our stem cells age with us, losing viability and, eventually, shutting down and

“Optimizing the ‘inner chemistry’ of the niche and optimizing the body’s microenvironment in preparation for therapeutic interventions is critical to positive treatment outcomes. Indeed, ignoring such observations while providing regenerative therapies could be compared to pouring the therapy into a pot of boiling water.”

dying. Studies have linked this process to the deterioration

is responsible, in large part, for the beneficial effects seen in

of the microenvironment (the ‘stem cell niche’) in which

unrelated donor amniotic fluid transplants.

these cells are embedded. As the micronutrient reserve of the niche deteriorates — mostly a result of stress, inflammation, poor diet, sugar consumption, nutrient absorption impairment and use of certain drugs, alcohol and medications — our healing and tissue regeneration capacity becomes compromised. This leads to accelerated aging, agerelated functional decline and chronic diseases. Hence, the quality of the niche is key to the health and function of stem

These observations support the philosophy that optimizing the ‘inner chemistry’ of the niche and optimizing the body’s microenvironment in preparation for therapeutic interventions is critical to positive treatment outcomes. Indeed, ignoring such observations while providing regenerative therapies could be compared to pouring the therapy into a pot of boiling water.

cells within our tissues. This is where personalized biomolecular and regenerative medicine merge to optimize niche quality and enhance stem cell function and viability. Examples from our research suggest that stem cells respond positively to hormones, like oxytocin — the love hormone produced in our bodies when giving or receiving love. Oxytocin is most abundant during pregnancy, when both mother and child need their stem cells to be most healthy. Interestingly, many in the field of regenerative medicine believe that oxytocin in amniotic fluid

SUMMARY Cellular or acellular therapies must be adjusted according to patient-specific profiles for physicians and healthcare providers to achieve the best outcomes for their patients. Moreover, the patient should be prepared by optimizing their physiology using a personalized biomolecular approach, a phase of treatment referred to as ‘priming.’ The use of patient-specific IV nutrient therapies, diet modifications, sleep adjustments, detoxification, stress reduction and

Top Doctor Magazine / Issue 152 / 65

modulation of inflammation are all key components of priming that will enhance the outcome of regenerative therapies. These treatments are essential to any reparative, regenerative or restorative therapy. As we advance our knowledge of personalized medicine, we not only benefit the patient but also progress toward understanding the nuances that have historically undermined the field of regenerative medicine due to inherent variations in outcomes. Progress is inevitable, but we still have a long way to go until these emerging fields gain universal acceptance. We can only hope that it is our generation of scientists and physicians who ultimately adopt these advancements, and we don’t have to wait on the next generation.

Dr. Ian White is an aging and regenerative medicine expert with over 20 years of experience in academia and industry. He is the founder and CSO of Neobiosis, a perinatal tissue manufacturing CDMO, the scientific advisor to Top Doctor Magazine and Vice President of The American College of Regenerative Medicine. Dr. Ivel De Freitas is an internationally recognized longevity expert. She has over 20 years of professional experience as a medical doctor specializing in functional, precision, and personalized biomolecular medicine. Dr. De Freitas is the founder and CEO of ONOGEN, a healthcare technology company delivering personalized biomolecular, anti-aging and regenerative medicine using pioneering algorithm-based technology.

Top Doctor Magazine / Issue 152 / 67

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