August is

Transcription

August is

Immune
Sufficiency
August is
Immunization
Awareness Month
•
SAME
les
Urology problems Can have a huge impact 00 one's quality of life.
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________________________ www.swfHulthandWeliness.com ________________________
Think Foot ... Think Ankle
Avoid Disaster
Myles Samotin, MD
Naples ONLY Orthopaedic Surgeon
Fellowship Trained in Foot & Ankle Problems.
fyou are looking forexcelience in FOOT and ANKLE care; if you are
looking for a doctor who practices state-of-the-art medicine; if
you are educa ted enough to understand that you may only want
an ORTHOPAEDIC SURGEON tOlouch your feet, then you owe it to
yourself to make an appointment
There are many people with very serious problems of the foot and ankle
who go from doctor to doctor and remain undiagnosed or poorly treated.
The typical P<ltien\ coming to set' Dr. Samotin has been evaluated by many
other doc tors. The patien t usually finds that Dr. Samotin is the last doctor
they have to see.
Myles Rubin
motin, MD
Board Certifi ed
Su rg eon
Fellowship Trained, Sub-specialist in Foot and An kle Surgery
Columbia Unl .erSlty, Hospital for Joint Ol seases, New Yor k Cit y
713 E. Marion Ave, Suit e 13S (3rd floor), Punta Gorda, FL 339S0
Call for information on our next seminar.
941.661.6757 or 239.514.4200
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Contents
August 2011
6
Planning a Vacation?
Don 't Let Your Hearing Loss
Prevent You From...
8 Sun Safety Tips:
Here Comes the Sun...
9 Your "Arch" Enemy
10 What's in a Name?
11 Stop Overlooking Signs
of Incontinence
12 Cutaneous T-Cell Lymphoma
16 Sports Injuries Common in
High School Athletics
18 The Seven Steps to Natural
22
Relief From Depression:
The Best Treatment For You
24
25
EJder Law Answers
"Snakes on a Plane or...
Par1<inson's Disease Psychosis~
26 August is National
Immunization Awareness
27
28
29
30
FULL RADIOLOGICAL SERVICES
Facts on Colon Cancer
142,670 is the Number...
3T MRI • NUCLEAR MEDICINE ' CT/CAT SCAN
ULTRASOUND · CT/PET SCANS , CARDIAC PET EXAMS
X·RAY' OPEN MRI • PROSTATE MRI • EXTREMITY MRI
Brain Attack
Proper Treatment Can Help
Kids With ADHD Thrive
Spiritual Wellnes s
Condition Of The Heart
Immune Sufficiency
20
Find us on
Facebook
10 Tips For Losing Weight
After Pregnancy
WOMEN'S CENTER
BREAST MRI • DIGITAL MAMMOGRAPHY · BONE DENSITY
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6
w
August 2011
Charlotte/South Sarasota Edition
Planning a Vacation?
Don't let your hearing loss prevent you from getting
the most out of your time off!
G
By Or.
~ Crosby, Au.O.
o! a vacation corning up? If you
do. chances arc you have a chcdlisl of things that need 10 be done
before yoo head out "flOwn ... i.e. cancel yourmail and
paper delivery. fill prescriplions and pack medications,
give CQntact infonnat;on to family and friends, etc.
And even more imponan1!y, if you "'car hearing
aids, don't forget to add these critical steps to your
planning and vacation su3tegies!
1. Prepare for vacation travel.
• [fyou an: traveling by air. arrive at the airpon early.
If you struggle to understand the public address
system at the airpon, alen the airline desk personnel
at your gate that you cannot hear the boarding
announcements well. Request that they personally
notify Y{)\l. Sit ncar the personnel count"'.
• Make sure you have an adequate supply of batteries with you, in case you get stranded.
• Make sure you have a dehumidifier with you'
• Try to avoid taking your hearing aids out while
On the plane, but if you must do so, make sure you
take the time to put them away. Do not let them
lay in your lap or on your lap tray, otherwise they
may be lost when you de-board.
• When staying overnight in a hotel. ask the hotel
if they have a hotel kit for the hearing impaired.
These kits typically include:
Visual smoke det~tor. door knock signaler
and phone alen
Strap-on phone amplifier
Tactilc vibrator alarm clock
TIY (tcletext)
Closed caption convener
2. Make an appointment with an audiologist
BEFORE you leave t own .
• If you are a cu""nt hearing aid wearer. schedule
an appointment before you head out of town 10 have
your hearing aids cleaned and checked to make sure
thcy functioning well and are programmed corrtttly. AI!O) have your audiologist make sure you
don't have any wax in your e~!
• If you do not wear hearing aids, but are not
hearing as well as you once did, schedule an
appointment before your vacation to have your
hearing checked. Your hearing loss could be
caused by an abundance of car wax. Don'tlet
something as common as ear wu prevent you
from getTing the most out of your vacation.
• If you have a spare, back-up set of hearing
aids. make sure they are al!O) in working order
and don't forget to take them along! AI!O) make
sure if they usc a different size battery that you
bring those along too!
3. Plan ahead.
• Noisy e''''iron",tn's: If you are in a difficult
listening situation, like at a family Or class
reunion. and are trying to have a conversation
with another person, go to another rOOm Or
quieter area to talk. Keep away from the middle
of the room. Instead, have the person to whom
you are talking sit down or stand with his or her
back to the wall. By following this simple tip.
adaptivc dual microphones in hearing aids can
more easily focus on the sounds you want to
hear awhile reducing Or eliminating irritaTing
and distracting background noise.
• [fyou struggle to hear lhe voices of small children.
explain to them you ..... ant to hear everything they
have to say and invite them to have a conversation
sining facing you in a quieter area of the home "The
same goes for al! convCfSations with adults.
5. Have a great time!
If you have questions about hearing loss or hearing
aids, please contact Noel Crosby. Au.D. at
Advanced Hearing Solutions, Englewood. FL al
941-474-8393.
o Restaurum,',
Plan your trips to restaurants
with small groups That way the conversation
will be easier for evcryone ... cven those without
hearing loss.
• Arr;,oe curly SO you can request a table that is
away from the kitchen Or serviee area. Reduce
bac kground noise by choosing a booth in a
comer if possible. This location will help the
advanced technology in your hearing aids do
what it is designed to do more effC<:tivcly.
4. Be assertive with friends and family at
family gatherings.
o It is up to you to lake charge of your listening
environment. Don't pretend you are hearing
when you are nOi. It will only make you Seem
out oftou.h.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandweliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
HeAP), CHARLOTTE
NEUROSURGERY
West Florida
Brain and Spine Su rgery
2525 Harbor Blvd . • Suite 20B • Po rt Charlotte, FL 33952
Phone: (941 ) 629-7920 • Fax: (941 ) 629-7926
www.charlotteneuro.com
I am pleased to announ(e my return to the
Port Charlotte mmmunity after being away
for 5 years. I enjoyed my friends, colleagues
and patients and on(eagain I am able to work
with the great staff of Fawcett Memorial.
Please don't hesitate to (all me personally if
I (an be of any help to you.
Miss
on the
cv)
Wonderful~unds (~L
of LIFE ...
Providing Quality Hearing
Healthcare for Over 20 Years
Dr. Noel Crosby, Audiologist
Noll has been W1 the audicMogy field /(:0" OV<!< 20 years.
roe.. doctorate W1 ""-'diQlogy from UFoNoiI
1\<1$ applied (hat ktI(JwIedge to her ....:wl< in many areas of
hearing; including dW1ica1. man"'actvnng and education.
HaYing rece<ved
• Three Fell owship - Trained Mohs Surgeons
• Nonsurgical Radiation Therapy
• Cosmet ic Dermatology
• Aest heti c Pla st ic Surgery
• Spa Blue MD
• Cam isa Psorias is and Phototh erapy Center
Fort Myers 239-437 -8810 • Cape Coral 239-443 - 1500
N. Naples 239-S96·907S · Downto wn Naples 239· 216·4337
Ca ll f o r A
6555.
Marco Island 239-642 -3337
FL
www.RiverchaseDermatology.com
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.sw f Heal th andWeli ness .com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
8
Health & W ne
August 2011 - Charlotte/South Sarasota Edition
Sun Safety Tips
"Here Comes the Sun: How To Protect Yourself From Its Harmful Effects"
By Senior Extra at Charlotte Regional Medical Center
s
un and fun go hand_in_hand. Protect_
ing your skin and eyes from the
harmful effects ofUV rays is essential.
In the United States. skin cancer is the ~ prevalent fonn of cancer, and according 10 the CenteJS for
Disease Control, one in five Americans win develop
!J::in cancer in the course ofa lifetime.
While it is true that fairer skinned pc<lplc ha,'c 10 be
the most vigilant. UV rays do not discriminate.
On behalf of Senior Extra at Charlotte Regioo Ia~
here are a few ways you CiWl stay safe:
• Stay out of the sun be1 .... een 10 a.m. and 4 p.m.
or seck shade during this time.
• Apply sunscreen with SPF IS or higher.
l
• Wear UV blocking sunglasses.
• O;.vcr up with long sleeves and a hat.
o Check your skin regularly for any changes.
Many people don'! know that sunscreen expires.
Befon: applying sunscreen. always check the expira-
tion date 10 ensure it is still effective. If you plan 10
be outside for more than two~, always reapply
~unsc=n
after s"'cating or swimming.
Lastly, if you notice any changes in your skin, it is
best to visit your doctor or dermatologist for a proper
diagoosis.
Outdoor activities make us happy and promote
heal!hy living. Senior Extra wants you lOenjoy your
summer by following these simple suggestions to
combat hannful UV rays and prevent ~kin cancer.
About Senior Extra
Ever-<:hanging advancements in hcahhcarc allow us
10 li"e longer and improve our overall hcalth. I'mviding the latest information about heahh advance·
ments through monthly seminars and events is just
one facet of Senior Extra. To sign up fora free memo
ber.;hip, visit www.SeniorExua.com.
About Char10He Regional Medical Center
Charlone Regional Medical Center is an award·
winning facility, wi!h Our heart program and slJOke
servioxs earning nationwide distinction. The
cmployoxs of our 20g·bed Joint Commission
Accredited full service hospital arc dedicated to
abiding by our hospital"s missi{)ll statement: Caring
professionals dedicated to serving our community.
Strides continue to be made in the medical care we
provide. Our compn:hensive eardiac can: Pl"98ratn
remains a thriving one. We have carned Top 100
Hospital distinction from the Thomson RcutCTS finn
for the cardiac and stroke services We provide. and
havc been recognized by another national ratings
finn as well for Our cardiac care, pulmonary services.
and neuroscience (stroke) services. Our commitment
to our community is evident in many other areas as
well. Much has changed over !he past half-<:enlury.
However. our past and our future hay<: {)1lC thing in
common: Our commitment to providing you with
quality health care administered by a caring staff.
11>c journey continues . Charl.:me Regional Medical
Center, 809 E. Marion A'·enuc. Punla Gorda,
Florida. www.CharlottcRegional.com.
_____________________
www.swfHe~lthandweliness.com
Myth or Fact:
You are safe from the effects of UV
rays when it is cloudy or overcast.
This is one of the most common
myths associated with UV protection.
UV rays easily penetrate clouds and
haze, making it possible for the sun
to damage your skin. Again, always
cover up and _ar your sunscreen.
Charlotte Regional
Medical Center
941-205-2150
Remem/H,r Ihal Ihis injorm{Jlj(m j. MI in/ended 10
,...plau Ih~ ad"iu of your docwr. bUI ralh~, 10 incnQj e
awo",neSJ and help equip JX1lienlS with injarmmion
and facilitate Nmve",,,,jonJ ...j,h Jour ,my# cian ,har
...iII Mnefil )'Our heallh.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Charlotte/South Sarasota Ed ition - August 2011
w,
9
YOUR "ARCH" ENEMY
By Myles Rubin Samotin, MO - Board Certified Orthopaedic Surgeon, fellowship Trained in foot and Ankle
The signs and symptoms of
flatfect problems can include
lower leg pain and weakness,
pain around Ihe inside ankle.
sometimes with swelling.
You may have weakness
in,'erting (pointing the toes
inward) the foot. You may
find that you have une"en
shoe wear and notice that
your regular shoes SttJ1l to be
collapsing. You may also find
that you have the inability 10
stand on your toes. Sometimes flatfeet can contribute Or exaCCTbate other
problems such as plamar fasciitis, posterior tibial
tcndonop,athy, achilles tendonitis, shin splints,
bunions. stress fractures and calluses.
I
However. frequently the only way 10 correct your
painful foot is through surgery. Surgical procedures
can help reduce or eliminate the pain and can
improve bony alignmem. They can include Arthrodesis. or welding (fusing) two bones logether.
Osteotomy Or cutting Or reshaping a bone to correct
alignment. Excision or removal of extra bone or
spurs. Synovectomy or cleaning the sheath of a
tendon, and/or Tendon Transfer, to replace a worn
or ruptured tendon.
I
ook down at your feet right now! [)Q
they SttJ1l different from ten years
ago? Docs your foot arch look the
same as it did, or arc roo imagining that it has changed'-'
Does your arch seem flatter 10 roo? Well, maybe it has
become flatter. And quite possibly that flatness may
~ult in a 101 of scvere foot problems for yoo
First. 11)' the wet lest Wet your feet, then go and
stand on a flat. dry surface that can leave an imprint
of your fool. A normal fOOtprinl has a wide band
connecting the ball of your foot 10 the heel, with an
indentation on the middle. inner side of your
imprint A fOOl wilh a high arch has a large indentalion and a very narrow connecling band. and convcrsely. a flatfoot leaves a nearly complete imprint
with almost no curve.
Then: are scveral I'C3SOns for having flatfe<:1. They
can be present al birth (congenital), caused by
ongoing stresses to your foot. obesity. diabetes.
Osteoarthritis. Rheumatoid anhritis. hypertension.
or traumatic injury to your foot or ankle.
You may have flatfe<:t and be pain fre<:. fiut you
must understand that the arch in your fOOl is there 10
help distribute your weight across your entire fool.
Painless flatfeet can deteriorate over the years and
bcoome painful. By that time. it may be too late 10
treat conservatively.
So how should you treat this?
Fint, you should be properly evaluated by a Foot
and Ankle Onhopaedic Specialist who will review
your medical history and examine your feet. and if
necessary, your gait.
Why an orthopaedist?
Simple!! The foot has twenty eight bones that need
and should be evaluated by a bone doctor!!! Be
Sure to bring your regular shoes so that these may
be examined. X-rays of both feel should be done
for comparison and to determine, if it exists, the
severity of the flatfoot. Musele and tendon
strength should be evaluated by your Orthopaedic
Foot and Ankle Specialist.
Treatment Can vary depending upon the CauSe.
Conservative treatment Can include shoe modifications, arch suppons and cuStOm orthotics. An
injection of corticosteroid may be used to calm an
inflammatory pain in your flatfoot. Resting and
icing the involved extremity Can help. Physical
therapy may be necessary to strengthen and stretch
the surrounding tissues, helping 10 alleviate the
stress placed On to your affected foot.
Having flat feet Can be a very serious matter. If you
are experiencing foot pain and think it may be
related to flatfeet, see an Orthopaedic Specialist as
soon as possible. This is a problem that often
worsens over time with treatment bttoming more
and more complicated. With 28 bones in your foot,
you need to be evaluated by a Board Certified
Orthopaedic Surgeon witb a Sub-specialty, Fellowship Trained in Foot & Ankle surgcry. In facl r am
the only surgeon with these qualifications in Our
area. r believe this makes me uniquely able to deal
with these problems in a state-of-the-art atmosphere
and method that will keep you in good hands and
provide you with the most desired result.
________________________ www.swfhealthandwellness.com ________________________
10
August 2:011
Charlotte/South Sarasota Edition
What's in a Name?
By Joseph MagnanI, MD, FACS
spe-clal'lsl
Pronunc iation: rspesh-(e-}lasV
FuncUon:noun
Date : 1855
, : one who spec;alizes in a particu larOCClJpation,
practioo. 0< branch of learning
I
n Ihis day of advan~cs in rncdi~al treat_
ments wilh improvement and refinement
in technology, patients have unlimited
access to health related informa1ion in print
media. television networks and through 'he
internet Although the information that is there
fw the general public appears 10 be virtually
unlimited. wilh access to educational and procedural videos, web Ie<:lurcs and galleries of pre
and post procedure photos, patien1S often may
find themselves lost in the
rna~e
of choices of
providers. The question of who the beS! or most
wdltraincd physicians arc for a facclift, bunion
~urgery. knee replacement Qr vein procedures
has become a morc challcnging one as thc lincs
have blurred a bit with physician groupS
e~panding Qut~ide their areas Qf spe<:ialty
lraining to increase revenue.
In general.
advancemcnts in medical technQlogy have
resulted in a natural migration of physicians
loward greater spe<:ialization within their areas
ofnaining to remain current in the most modem
treatmem technolQgies.
A Good Starting Point for Researching
Spec ialty Providers
Online resourees are available for patient educational materials as well as for the researeh of
credentials and training background of potential
medical providers. A good starting point when
researching specialty providers is a review of
their practice website and the depth Qf contem.
as well as the completeness of their training
recQrd. Try tQ detennine what percentage Qfthe
practice is dedicated to their area of spe<:ialty
lraining and whether this is what you are specifically interested in. Is the physician completely
dedicated to the area you are interested in? Are
they spe<:ifically trained in this area and what sort
of documentation can they provide to document
their dedication and
interest in quality of
care
and
patient
outcQmes?
WQuid
you feel more com·
fortable having your
procedure perfQrmed
by a physician who
spends only 5·10%
of his time perform_
ing the procedure in
question. or having it perfonned by one who
performs the procedure 100"10 of the time?
Feci fi"cc to ask qucstiOtts and cxpect open and clear
answcn regarding provider netY."OIk status with
insunmcc CQ'npanics and whether your planned pr0cedure will be oonsidcred medically noccssary.
Established patient refercnccs may be supportive,
but HlPAA CQIllpliance regulations make obtaining
pcnonal refcrcnccs. ocbcr than written or video
patient testimonials, difficult. I'riIn&y care physi·
cian refercnccs. even from physicians other than
your ov.n. such as your friends' prill1lU)' care physician. may prove helpful in making the right decision,
as physicians have a much broader cxposun: 10
paticnlS with problems similar to yours.
Take Advantage of a Free IIl-OIIice Saeetlittg
One other and pcffiaps most important determining piece of homework is the free in-office sereen·
Ing. If the opponunity presents itsd( take full
advantage of i1. At the vet)' least. you will get the
chance to "kick the tires" of the practice, meet the
doctor and staff. gather informatiort regarding the
treatments they ofTer and any literature regarding
the physician's training. Check out the cleanliness
Qf the facility and. at a minimum. leave with an
overall impressiort of the office. whether positive.
neutral Or negative. Any other infonnation you
glean while at the screening regarding your
specific condition and the treatment options available should be considered a bonus.
Oetennine if Veins are a Sideline Bus iness
or the Main Focus
Determine whether veins an: a sideline business or
the main focus of their altcntion and whethcr the
physicians haYe specific training in the ficld of
vellQUs or vascular diseases. Ask yourself if
anything secms out of place or "wrong with the
picture·· and do not allow anyone to convince you of
the need for a procedure in the ab$cnce of true
symploms.just because something might happen in
the future. listen to thatlinle voiec that often subcOlI$Ciously guides YQur decisions.
E:otpect a High Level of Specializati on
In summary, do YQur horncl>.·ori< when choosing a
me<lical specialist professional. Dedicate at least as
mllCh time to making this decision as you do when
you make a major decision like an autQ purcha$c.
You should expect a high level Qfspeciali7.3tion and
dediealion. professionalism and personal catC from
your hcalth care specialist and their stafT. Their
training credentials and practice focu~ should be
readily available and transparent. Full financial disclosure and honest answers to yOllr questions
regarding netwQrk status with your provider should
be offered upfront, either on the website or in the
form of a printed financial disclosure policy of the
practice. If you meet a roadblock when making
thesc types ofinquirics, consider this a red nag. If
you have internet acCCS/; the nctwori< status can also
be easily verified Qn yQur carrier's provider ~ite.
Established Patient, Physician and Word of
Mouth Referrals are a Powerful Tool
The last and probably most imponant piece of dala
which should be considered is established patient,
physician and word of mouth referral. These are
po",·crful tools and will provide you with an added
measure of reassurance that you have made the
correct decision. Our community is more interconnected than ",·e appreciate and a single inquiry will
Qften lead to a nctwori< of referral opinions and
cxpenences. The an~wer to the question "What
",·ould you do if this were your mother or wife?"
should be an easy Otte for your specialist to respond
tQ while looking at you sincerely in the eyes. "TIle
SlIme thing as I am suggesting to you. under similar
clinical cireumstances."
About Dr. Magnant
fH..ioHpIt Mog""'" M...d ~u ~ in M<dicNaoJ~,..
~~" &Mml SuIgt"PY",.w...cyat tM Medkal CciIWof
I1fJinu. i~ Rkilmond. Vi')!in;'. II~ """""..ed ~u VaK"Ijla,
Swg<ryftllo~~hip at Da"""",tIo·l/jtc/ococl M<dicai C..,,,, i.
II""""" IV"" lI""""hir< and it ct!rtifl<d /or tM " ....""'.
Ikard ofSuTfp!ry;" I'Q.f("U/o, s..1gt"PY. II~ u an acti,~-..Jy,
of 1M Sockty for 'a..c.lar Su~ 'M"~ CO/IW of
PM~. 1M Soot~",. AUOCu.,ioo\for I'....-.dar Swg<ryand
it aUo a F<lIo"'oflM A ....riam Cci~ofSwg<oN. II~ prac:tkd artMal "oJ ,~""'" """"la, ''''80)' <u part of"
",uI,i 'P"';;,lty If""Ii'for u
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hU f"'Xlj,y 10 .....,..,du<an>;"]()Qj and ~ 1M doonof
lfin s"..:u./uu ;" -",,,,, 2OQ6. INjuiriu .J"Jtj/d IH dim:t<d 10
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Charlotte/South Sarasota Edition - August 2011
w,
11
Stop Overlooking Signs of Incontinence
By Rolando Rivera, Board Certified M.D.
Urinary Incontinence is a
corrunon medical condition
lha( affec(s over 40 million
Americans, y<:( it often goes
untrca(ed Or unrecognized.
Rolando Rivera. MD
The reason for lhis lTend is
multifaclorial. spanning from embarrassment to
speak ab<M (his (opic 10 dealing Wilh more aCUle or
morbid condilions (hat require focused altcn(ion.
Nevenheless. il is a Healable condition (hat
frequently affe.:(s thc quality of life of patien(s.
Incontinence is classified as Slress, urge, mixed
and overflow.
In this article we will acIdt ess some particular
issues about urge incontinence.
Urinary urge inconlinenee (UUI) is defined as a
sudden uncontrollable urge to urinate with or
withou( frequent urina(ion and associated leakagc of
urine. With urge inconlinenee, the bladder coo(raets
and squee~es OUI urine involuntarily. Accidemal
urina(ion can be (riggcrcd by:
• sudden eh'",ge in posilion Or aeti ..iry
• hearing or louching running Woler
• drinking a smoll omoum of liquid
Patients with overactive bladder symptoms. such
00 can occur due to multiple conditions,
and many times as a sequelae of others;
frequently. il may be idiopathic. Dy~funelions of (he
dc1rusor muscle or nervc pa(hways are lhe culpri1S
for the bladder over-aclivily. Condition. that can
lead to 00 include:
• Bladder polyps and tumOf'!
• Urinary (rae( infections · Bladder calculi
• Bladder ouliel obstruction from BPH or
stricture disease
Medications, such as diuretics, increase the
urgency and frequency of urination in some
people, especially the elderty and bedridden.
Dosage modification may ameliorate the
bothersome symptoms. Dietary habils may
lead to significan( voiding symploms. Caffeine
(e.g .. in coffee, lea, chocolate), carbonated beverages,
spicy foods and tomalo-based foods can irrilale the
bladder and cause de(rusor instability. resuhing in
urge incominenee.
The treatment and management of lUge incontinence
indudes nonsurgical and SlUgieal modalities. An
imponanl factor. however. is idcn(ifying lhe
poten(ially morbid Or lifc-(hreatening condi(ions
(hat may lead to incontinence. such as bladder
cancer. re.:um:n( UTI or ncurogenic disorders.
as urinary urgency. frequency and nocluria, may
have associaled incontinence Over 60% ofthe time.
Though more common in women lhan men overall.
after (he age of 70 Ihe prevalence in both sexes is
about equal.
There are two bladder abnormalities that
are associated to UUI: neurogenic overactivily
and detrusor overactivity (00).
Neurogenic bladder OCC\ID; when there is interruption
in lhe normal nerve conduclion from the brain or
spinal cord above the sacrum (0 Ihe bladder. and
rcsuhs in loss of bladder sensation and motor
control. Conditions associaled Wilh neurogenic
bladder include (he following:
• Alzheimer'~ disease ' Muhiplc selerosi~
• Parkinson's disease ' In(ervenebral di~k disease
• Cerebrovaseular evcnlS ' Oiabeles
• Traumatic brain or upper spinal cord injury
• Brain or spinal cord tumors
Anticholinergics have been shown to be ''efY effective
in (he lreatment of both neurogenic and idiopathic
cause ofUUI. As a class. side effects include confusion,
dry mouth. oonslipa(ion. dizziness. visual changes
and urinruy rt1ention 10 name a few. Beyond medications
there arc simple yet effec!ivc trcaunen1S.
Advanced trea(ment modalilies for refractory patien1S
to conservative therapy and anticholincrgics are
available in Ihe urologic armamen(arium. Urological
evalua(ion of these patients will InOSl likely include a
cystoscopy. urine cultures and urine cytology 10 rule
ou( bladder pa(hology and bladder malignancies. As
well, a dC13.iled, computerized assessment smdy of
bladder function called urodynamics may help the
clinician in cSlablishing (he best lreatmcnt op1ioo.
Neuromodula(ion. eilher via sacral nerve p,uhway~
(In(ers(im) Or peripheral nerve pa(hways (Urgent
PC). have been shown 10 be very effec(ive in (he
(rea(menl of UU l in pa(ien(s wilh refraclory disease.
These modali(ies are safe, FDA approved, minimally
invasive and provide. lhrough neural pathways,
improvement in bladder function . Urgem PC is an
outpaliem. office-based. nonsurgical therapy that
affects the sacral nerve ple~us lhrough TCtrograde
pa(hways (posterior libial nerve). [nterstim ulilius
lhe sacral nerve S3 10 provide parasympathelic
inhibilion. thereby de.:reasing bladder over-ac(ivily.
It is based on paccmakcr lechnology. and effective
in abou( 70% of refrae(ory pa(ien(s.
Injec(ion of botulinum (oxin (Bolox) into Ihe
bladder muscle (intravesical injection) is an
experimental treatmenl for refractory urge
incominence. This treatmem has been shown !o
successfully reduce !he instabililY lhat leads !o
urgency in both idiopathic and ncurogenic patients.
Surgical urinary diversion ;s an invasive lherapy
used mos([y for severe pa(icnts refractory (0 all
other therapics.
Urinary inconlinence is a common but overlooked
problem. Urologic evaluation is warranted in
refraclOry patients. or in pa(ients in whom underlying
bladder pathology or anatomic abnormalities, such
as prolap:scd.. need to be addrc$sed as well. lmervcmi..,.,
beyond medical ions will significantly improve lhe
quality of life of these patients.
239-434-6300
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12
w,
August lOll - Charlotte/South Sarasota Edition
~",1!!folneous
T-Cell Lymphoma
Dear Dr. Cam;sa:
My uncle has had a rash for years (hal was recenlly
diagnosed as C"I~"e()"S T-cell lymphoma. The
doctors say it's a rare type of skin cancer. Iflhat's
true. how will he be treated?
Signed, Anthony E.
Dear Anthony:
A lymphoma i. a type of cancer which is deri,-cd
from white blood cells in circulating blood and in
lymph nodes called lyrnphocylc~. These cells,
known as B.eclls and T<clis, playa major role in
the body's immune defense mechanisms againST
infe<;lions and cancCI". However, some Iympho·
cyles may {hcmsel"cs undergo mUlali{ms and
become mahgnant.
When the
maljgnanllymphocytc~
accumulate in a
solid organ such as (he lymph nodes. liver. or
spleen. the disease is called a lymphoma. When
they are found prcdominanlly in the eireulating
blood, the disease is considered a I~ubmi", It is
possible to have lymphoma and leukemia at the
same time,
In the Case ofa lymphoma that stans with Iympho·
e)'les tha! reside in the skin, almost always T-cells,
the disease is called cutaneous. meaning skin,
T-cell lymphoma. The common abbreviation is
CTCL Because thc diseasc is rare, and has many
different appearances in the skin, it can be very
difficull to diagnose_
Stages of CTCL
I Or P~leh SI"ge: The earliest fonn ofCTCl
begins as pink to salmon-colored patches on the
skin tha! are flat, dry, and flaky. The rash may Of
may not be itchy. It may look like eczema, psoria·
sis. Or fungal infcction of the skin. O.'er time, it
may gmdually spread to mOre areas of the body and
begin to itch. You may hear older nameS still in use
for this stage of CTCl such as "parapsoriasis" Or
"mycoois fungoidcs."
SI~ge
Sr~ge /I or Plo"ue SlagI': As the patches spread
and enlargc, they may also become elevated to fOml
plaques_ Elevation is a sign of more advanced
disease_ II is common for the rash to affect areas
that are protccted from the sun, such as the
buttocks, groins. and female breasts. Unlike the
more common skin cancers, CTCl is actually
helped by sunlight.
Siage III or rumor Siage: Tumors of CTCl arc
nodules in the skin that arc higher than they arc wide
and may break down into ulcers and get infccted.
Tumors may arise from patches or plaqucs in slow
progression, or they may arise abruptly from
normal.appearing skin, indicating advanced
disease. These patients are more likely to also have
solid organ involvement,
SI"ge IV or £.ylhrodumalteuJ:emie Siage:
Erythrodcnna means that 90% or more of the skin
surface is red and sealy, usually not elevated. and
extremely itchy. The erythrodermic rash may have
developed over time from patehes and plaques, Or
it may have staned as erythroderma from the
onset These patients are also more lik ely to have
lymph node involvcment and malignant T·cclls
cireulating in their bloodstream.
Diagnosis of CTCL
Just as CTCl can be difficull to diagnose by e~ami.
nation because the disease mimics other common
skin diseases, skin biopsies arl: olkn oot definitive
in the early stages. The pathologist may rcpon
some abnonnal T-cells in the skin and suspect early
CTCl, but their quantity anddegrcc ofabnonnality
may not be sufficient to contiml the diagnosis.
Another test that can be run On the skin biopsy
tissue is called gene analysis. lJecausc the malig·
nant T-cells arose from mutations in their DNA,
DNA analysis can show a difference between
normal DNA and DNA in thc cancer cclls. Unfortunately, this test is not "ery sensitive in early
disease and leads to many false_negati"e results_
Any persistently enlarged or swollen lymph gland
should be biopsied In erythrodermic or Stage IV
patients, the blood smear may show the larger
malignant T·eells. In addition. other T·ccll immu·
nologic mar~crs and genes of circulating lymphocytes can be studied to continn the leukemic
phase ofCTCL.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandwellness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
h '" W~ne
13
Treatment of CTCL
The treatment of crCL depends on the staging oflhe
disease and whether thcre exists any internal
in"olvement such as lymph nodes or blood in
addition to the skin rash. Therefore. I won·t be able
to comment On Anlhony·s unclc·s case unless I have
all his "",ords and can examine his skin,
The
disease is so unique and variable in its behavior that
treatment must be tailored to each individual case.
In general. crCL is c<msidered incurable. but hmg·
tenn remissions can be achieved with a variety of
medicines. ultraviolet light lreatment&. and radiation.
such that patients do oot die from this disease. Our
goal Ihcn is to maintain remission or reduce activity
of the disease so that patients live a normal lifespan
and die from natural causes.
Examples of Patient Treatment
II<:re arc some examples of how a patient may be
treated at the different stages ofcreL. As a derma·
tologist. thoc majority ofthe patients I sec wilh crCL
ha,·c the patch/plaque rash, If the skin in,·olvemcnl is
limited to less (han 10% of body surface area. I may
tty a potent topical steroid ointment or a chel11Otherapy gel called T;ugretin. Iflhe rash does not clear
after a few months of treatment, or if it invol"es more
than 10% of the body surface area. full body ultraviolet liglll thernpy is delivered by an in-oftice narrow
band UVB cabinet. \>"c can expect remission in
70-80'1'. of cases.
If thoc disease does not respond well to aggressive
narrow band UVB treatment given three times weekly
for months. then we may select photochc:mo\hcrapy.
also kno"'ll as PUVA. which is the combination ofa pill
called Psoralcn plus UVA light in a full body cabinet.
A pill form ofTargrelin may also be prescribed.
If the skin shows crCL tumor nodules, then we
must consult our colleagues in the specialties of
oncology to givc radiation therapy to thc nodules
and to sean thc body for internal involvement, For_
tunately. the tumors a~ c~quisi te\y sensitive to
radiation and resolvc relati,'ely quickly, If there is
no internal invoh'ement at this point. ",·c can
maintain that patient in remission with narrow
band UVB phototherapy. particularly if the tumor
arose from a patch Or plaque. If the oncologist docs
find intemallymphoma. then certain pill or injectable chemotherapies may be selected.
If the skin shows erythroderma, that is, nearly tOlal
body red. Kaly. itchy skin. sometimes called cxfoliali,·c dennatitis. the oncologist will need to be
involved as well, The skin-dirccted therapies such
as topical steroids and ultraviolet light impro,'c thc
symptoms but do not help the lymph node and
blood invoh'ement, a condition also known as the
Sezary syndrome. A combination of chemotherapy
including alpha·interferon and a blood-cleansing
treatment called photopheresis available locally
havc improved quality of life and eXlended
survival. Stem cell transplantation for cure of the
leukemic phase is under study at MD AndcT$On
Cancer Center.
00............. _._
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'-1......
1-800-561-0ERM
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Parkinson's Disease or treatment?
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The prognosis of crCL is directly correlated to
the Stage at diagnosis . It is also fair to say lhat the
more extensive the skin involvement is. then the
higher the risk of internal involvement. Therefore. early Slage I and
patients have the best
prognosis such that thcir long-tenn survival may
not be reduced al all by having Ihe disease. while
Stage III and IV patients statistically have the
poorest survival measured in ycars after the diagnosis is made.
II
IOI~~a., t5C N,COO ... ' ...... 3QJ
• Newborns to AdoIe$Cents
- Well & Sick WaIting A.r9a
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OBSTETRICS AND GYNECOLOGY
Jeffrey M.
Greenberg, MD
Please Call for Appointment
941.979.5153
2811 Tamiami Trail , Suite 1
Port Charlotte, FL 339 52
Ponce School of Medicine Ponce, Puerto Rico
Residency: University Hospital San juan, Puerto Rico
Office Hours: Tues-Thurs-Sat
9am - 3pm
Languages Spoken: English and Spanish
Accepting Medicaid - Obstetrics and Gynaecology
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16
Haiti & We
August 2011 - Charlotte/South Sarasota Edition
~,2~mon in High School Athletics
A
s kids head back to school. they
will also head back to team sports.
Parents, gCI ready for Ihe inj uries
lha\ can come with athletics. Before Ihe football
team takes the field. countless hours are spent On the
field practicing. Proper training and conditioning is
Ihc key 10 preventing injuries; however, no rnaucr
how prepared Ihe athletes are when they take the
field, injuries are 10 Ix: expected.
Research on Spor1S that Produce Severe Injuries
An OhiQ Stale University study gives some insight
inlo which sports arc more likely to produce severe
injuri~
that can prohibit athletic participation for
weeks. Trn;ncn; submitted injury information on
nine spon s between 2005 and 2007 from 100 high
schools nationwide. Researchers from the Ohio
State Univcnity College Qf Medicine and the Center
fQr Injury Research and PQlicy in the Research Insti_
tute at Nationwide Children's Hospital. both in
Columbus. Ohio compiled and analyzed the data
collceted. A severe injury was defined as Qne that
=ulted in losing three ""ccks or more ofspons participation. During that time, 1,37g severe injuries
werc noted. CQmprising 14.9"10 of all high school
spons-related injuries. Severe injury rates ",'cre
higher in competitions than during practices.
High School Football Ranks as Having
Highest Injury Rate
Football ranked as having the highest injury rate.
fono""ed by w=tling, then girls' baskctball, and then
girls' soccer. While the injUJ)' rate was higher in all
boys' sports versus all girls' sports, when injuries in
certain sports (soccer. basketball, basebailisoflball)
were directly compared, the results were different:
girls had a higher scvere injury rate overall than boys.
and girls basketball ranked higher in injuries than
boys basketbalL
Which Parts of the Body Take the Most Hits?
The smdy also described which parts of the body
took the!TIQSt hits. Knees were on
followed by
the III1kle and shoulder. The most oommon diagnoses
were fractures, complete ligament sprains. and
inoomplete ligament sprains. Among all the severe
injuries, 28.3% needed surgery.
"'p.
Prompt Medical Care and Diagnostics
is Critical
n.c injuries were COSIly in other ways. Athletes CIII1
IQSC valuable time off the field and may even require
surgery. This can result in the student missing out on a
college scholarship. potentially losing Over S I00,000.
Charlone/South Sarasota Edition - August 2011
th &
W~lne
17
With this being the ca!;C, it is critically important
for the student to receive prompt medical care and
diagnostics. Most of the schools in CharlOlle and
Sarasota County have a team trainer. This trainer
allends practices and games, and helps to pre"cnt
and treat student injuries . When the student com_
plains of an injury. whether it be an acute injury
that happened during an athletic competition Or a
chronic injury that is caused by overuse, the
trainer works with the team's O rthopedic Physician to determine the extcnt of the injury and the
course of treatment.
Selection of Imaging Facility and Radiologist
is Imperative to Accurate Diagnosis
With an acute injury, the student will ollen be
referred fora diagnostic exam such as an x-ray, CAT
Sl:an or MRL Parents need to be aware that the
choice of the imaging facility and the qualifications
of the radiologists reading the cUm arc imperative
to the aoxurate diagnosis and the ability to begin
treatment and gC1the athlete back into oompc1ition
as SOOn as possible.
Tampa Bay Rays Imaging Center of Choice
Fortunately, Advanced Imaging of Port Charloue
has both the toxhnology and the highly trained radiologists to treat athletes from Charlotte, Sarasola,
Hardy and Lee Counties. Advanced Imaging has
been chosen as the imaging facility for the Tampa
Bay Rays and the Charlotte SlOne Crabs. Advanced
Imaging not only possesses the most advanced
equipment, but also has the good fonune of having
Dr. Thomas Fabian, who has been involved in the
Port Charlotte community for many years. Last
year. Dr Roy RicejQinoo the practice as a MusculQskclC1a1 Radiologist Dr. Rice comes with a varied
background having served in the Marinesand is reiIQwship trained in musculoskeletal radiology. Both
physicians are highly qualified and combined have
read thousands of tests for professional athletc;S,
The Most Advanced Equipment and Highly
Trained Radiologists lor Your Athlete
Advanced Imaging is prepared to handle student
athletes and has Saturday hours which is pcrfoxt for
diagnosing Friday night footb.all injuries. When it
comes 10 choosing a facility for your injured athlete,
choose Advanced Imaging. the Clear Choieen ".
With the most advanced equipment, highly trained
radiologists and STAT results. you owe it to your
child to choose Advanced Imaging. To learn more,
please call us at 941·235-4648 Of I'isit om website at
-.ad'tlmagln.g.eom.
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I h...."" E<oIoJy
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18
The Seven Steps to Natural
Immune Sufficiency
By Dr. David Martin, D. O. M., Lie. Dipl. Acupuncltire & Katie Romano Gliffin,
R
igh! now, {here are
!rillion~
Cert~ied
Hypnotist, Lije Coach, LPN
of cells
in your body husHing and bustling
10 fulfill their mission: To replicate
and create health and homeostasis-maintaining
the stability of your body_ Isn'\ it arnll7.ing that they
arc able {O do this every single day?
Back-to-school time ;s approaching which means
many people are already concerned about increased
opportunities for infocti{)ll, flu, colds and the like.
Many families stock up on costly cold medicines.
saniti:rers, IOxic chemicals, [<:>lions and potions to
fighllhc sccmingly inevitable infections that arc tm:d
in schools and offices. What most people fwgct to
put in their metaphorical pantries arc the vel}' basics
their cells need in ordcrto remain healthy in the first
place. By following these 7·steps you will do more
than save money, you can enjoy a healthier life.
Back to Basics
Mind Your Business
Clean water and fresh air are essential for a
hcalthy immunc system. and the very first place
any health plan should start. Your body is mostly
water, and oxygen is essential to life, Think of
these two basics a> the gas your engine needs to
ron. So, put the good SlUff in! Get out in nature
each day for 20·minutes or so and tah nice deep
breaths as you walk
Exercise increases your
capacity to usc oxygen efficiently, helps you build
blood vessels and strengthens your Iynlphalic
system, and therefore your immunity! With regard
10 water, the average healthy adult should drink al
least half of their body weight in ounces of pure
water each day. So, a 100 pound wOman would
need 50 ounces of water, each day, Keep in mind
fancy vitamin waters and l!ollled promises are nOI
only more expensive than filtered water: they may
also contain additives thaI are more hannful than
good. So reach for Ihc fillered waler instead.
RighI now, I'm sure my mother is smiling . Her
advice was good when I was seven and works even
belter nOw. U's SO easy to get caught up in office
drama, horrible events that are splashed across the
newspapers, and 10 feel angry when someone cuts
uS off in traffic, Our reaclions and participation in
thoughts, words and actions wilh regard to this
type of stimuli activates our sympathetic nervous
system. which is responsible for Our fight Or night
response_ When this response is active, our
immune system begins to break down over time,
Try to minimize your exposure to environmental
drama, focusing on your health and positive goals,
and then use the nextte.:hnique 10 take your life to
the next level.
This simple practices forces your breathing to slow
and deepen, initiating a relaxation response that
can last fOf hours, can help you sleep belter, and
will help you have more focus throughoulthe day,
When thoughts like laundry lislS and tasks intrude,
n:tuming your thoUghts \0 your breath will begin to
teach your mind to function more intentionally and
in a less reactionary manner. The end result is
feeling less stressed in everyday life, increased
coping skills, a less active sympathetic nervous
system and a healthier immune system. If you find
that you struggle with this technique initially, a
couple of hypnosis sessions or even a good guided
meditation at night can help you find your way to
greater relaxation.
Just Breathe
Sleep On It
Dr, Andrew Weil, a forerunner in Integrative
Working on your bn:athing each morning, evening
and afternoon can help you to sleep better, and
cutling out the substances that can keep you up will
Medicine, recommends that you pay attention \0
your breathing for 3·5 minutes 3·5 times a day,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWellness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Charlone/South Sarasota Edition - August 2011
hclp cven more! The human body needs about 7 or
8 hour.! of quaiity ~Iecp each nisht Caffeine, sugar
and alcohol consumption can all di~ropt the sleep
cyclc. which can predispose you to infections , Be
careful what you watch bcfore bed as well. The la~t
half hour before you go to bed is most "rocial
because all that you take in ""ill bc thc first bit of
information to drop into your subconseious innuencing your dreams. Things like the news. crime shows
and reality TV are beucr suited for daytimc viewin8.
Try reading a self-help book or joumaling on your
goal~. You may find yourself ~leeping bener and
waking up smiling by dc>'eloping this simple habi!.
before rinsing.
Hand
sanitizers should bc used
only in a pinch. The high
akohol contents can
actually break down your
skin, SO use them only
once in a while. Keep in
mind also that productS
we put on our skin like
100ions,
cleansers.
shampoo~, gels and cos-metics may contain substances, which hann our
immune systems. Aim to
purchase prodUcts thaI
are devoid of these sub·
stances or look for home
alternatives which can
fill the needs for kss.
fo r instance, olive oil or
even pure watcr can work
as a facial cleanser for some skin typeS.
Go with Your Gut
The Standard American Diet (SAD) i~ chock full of
foods which damage our intcstit\CS' ability to
function and absorb nutrients, while also killing our
beneficial natural intestinal flora. When our nalUral
intestinal nora is lost. imbalances can occur and pr0liferate leading to gastroenteritis, fatigue, irritability
and illnes~. The simplest solution is to avoid sugars
and processed foods while dining on enzyme-rich
fresh froits and vegetables, to the tunc ofbctw""n 7
and II servings daily. Leafy greens are best because
their natural components help to sweep thc intestines
clean of the sludge and innammation other foods can
create. Foods like raw yogurts can replace lost
bacteria to aid in digestion and immune prot""tion .
The next line of intestinal defense is enzymes and
oral probiotic supplemenuuion.
Acupuncture and Herbs
for mon: than 4000 years Acupuncture has been
utilized to help people maintain their health as well
as combat disease. Ultra fine needl es (smaller than
the width ofa single hair) are inserted into various
"points" on '·meridians" in the body to balance the
system and activate the body's ability to heal. [n
the case of more severe imbalances, an Acupuncture Physician will recommend high-quality herbs
(often in pill fonn) and supplements to help the
body return to full health. Dr, Martin's favorite for
cold and n u season is an herb called Gan Mao
Ling, which is taken at the first &ign of immune
deficiency or can even be used as a preventive if
you know you have just been Or will be exposed to
The Skinny on Health
Our skin is actually the largest organ in our body
and one of our first lines of defense against disease.
Good hand washing is the best way to fight infection. Wet your hands, use one pump of soap and
strob your hands together for a good 10-30 seconds
th & Weilne
19
somcone who is ill , The herb actS quickly to
initiate a hcaling response in the body. A visit
with an acupuncturist can be covered by insurance
because acupuncturists are Primary Care Physi_
cians , Also. at our clinic. we offer a sliding seale
option for clients who are self_pay, making visits
as low as S39.
Good bealth year round is affordable and attainable.
The COSt is more education and time in decisionmaking. but it is well worth it when you experience
the payoff! for mon: tips and information, call our
office fOf a free consultation at 239-277-1399 or
visit our website at www. LotusBlossomClinic.com.
We are located in South f ort Myers
Lu/us Rluggum Clin;lC
"Tlrt pillct ...here htilith blooms. ~
Acupuncture - Hypnosis - Herbs
Homeopathy - Point Injection for :
PORT CHARLOnE
CAPE CORAL
941.629.1600
239.242.0541
www, inlinitytiC,CQm
0. 1.
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me.
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• Well Bei ng
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20
H
tt '"
WE
August 2:011 • Charlotte/South Sarasota Edition
10 Tips
For Losing Weight After Pregnancy
By Marlena Cecil, PA-C
T
he joy of pregnancy (forget the
morning sickness for a moment) can
last a lifetime. As up to 80"10 of moms
have found out - sa Can the SOme of the extra
weight gained during pregnancy_ Ves - maybe it's
only five pounds; bUllhc desire 10 gel back 10 your
starting weight (if nOt less) is a standard goal
desired by most mothers.
1. Don't slart trying to lose weight too soon
Your body needs time 10 recover from labor and
delivery. Give yourself unlil your six-week postpanum checkup before you start watching your
calorie intake and actively trying to slim down.
And if you're breastfeeding, expens recommend
that you wait until your baby is at leas! 2 momhs
old before you try 10 lose weight
2. Don't diet
It may sound strange, but starting an official "diet"
could derail your post-pregnancy weight loss
goals, Feeling deprived of your favorite foods
while you're already stressed out can actually
cause you to gain weight..
Keep different healthy snacks in the house to keep
you from feeling hungry and give you energy
throughout the day_ No matter how much you
want to lose weight, try not to drop below 1,800
calories a day, particularly if you arc breast feeding.
3, Load up on · super foods·
When you're a new mother, your body needs
maximum nutrition (es]Jecially if you're nursing).
Choose foods thai arc heavy in the nutrients you
need and light in calories and fat. Fish is one of
these "su]Jer foods" because ii's paeked with DHA,
an essential omega-) fatty acid that helps your
newborn develop a healthy brain & nervOuS
syslem. The best SOUrces of DHA arc cold-water
fish such as salmon, sardines, and tuna (stick to
canned light tuna because albacore tends to be high
in mercury). Organic milk and yogurt arc also
super foods because they're high in the calcium
you need to keep your bones strong.
________________________ www.swfHealthandWeliness.com - - - - - - - - - - - - - - - - - - - - - - - -
4. Breastfeed
Some studies find that breastfceding exelusively can
help you return to your pro-baby " 'eight faster. " 'hile
others find 00 difference in weight loss between
ho breastfcedand those ..... ho bottle feed.
"'omen . . .
What is for SUJe is that breast feeding is good for
your baby. boosting immunity atld providing a
number of other important health benefits. Just
make sure that if you do breastfeed, you don~ usc it
as atl excuse to cat ..... hatever you .....atlt.
5. Drink up
Drinking plenty of ..... ater throughQut the day
prevents you from gening dehydrated. It fills you up
so that you don~ cat as much, and research has
found that it may speed up your metabolism.
Try to drink at least 8 - Soz. glasses of pure water
each day - tea. soft drinks atld non·dear liquids do
not count.
Bul before you slart any exercise program. get
your doctor's approval, especially if you had a
C-section.
1. Get some sleep
In a recent sludy. new moms who slepl five hours
or less a night were more likely 10 hold onlO Iheir
extra pregnancy weighl than women who slept
seven hours. When you're tired, your body
releases cortisol and olher Siress honnones Ihat
can promote weight gain. Also when you're
e~hausted. you don't feel like taking good care of
yourself.
w,
21
10. Appetite suppressants/weight
loss medication
If you arc not breaslfccding or once you arc
ftni.hed breaSlfeeding you can tum to a safe and
cffeclive appc1itc suppressant/weight loss recom·
mended by your physician. The current gold
standard in Ihis regard is PhcnTabz from Gcmeeh
Pharmaceutical. Do your n:seareh and make suTl: it
is right for you and your goals.
8. Eat when you are hungry.
Don't skip meals, hunger is a natural instinct and
will always win! Plan your meals atld cat a
sensible amount of calories for each meal. You
need 10 learn the difference belween actual
hunger and emotional hunger.
9. Remember your goals
6. Move it!
Aerobic and strength training eXCTCiscs after pregnancy helps to bum calories and keep your muscles
and bones strong. EXC1'Cise. beyond helping you
lose " 'eight, provides many benefits to a new morn
- it helps with depression, il helps with the sleep
issues. it helps in relieving stress - and having a new
baby in Ihe house can definitely be stressful.
Yoo don't have to hit the gym to get back in shape
after pregnancy - taking a brisk walk wilh your baby
in the stroller is enough to get your heart pumping
and muscles wor1<ing. With a new baby. finding 30
minutes in a row might be impossible. SO try bn::aking
up the time into IO-minule increments. TI>cn tty 10
wor\:: your way up to 20- or JO-minute sessions.
WI LLIAM
T. EDY
Set a realistic weight loss goal and remember to
focus on it daily. Small steps equal big losses and
reaching your goal! Having a pre·pregnancy
picturc on Ihe refrigerator (or a picture of someone
else that motivates you) is an easy way to stay
focused!
•
For more information or to order PhenTabz:
PIIenTabl.com I 888-666-1714
HEIDI M. BROWN
MftlIlAIIl PI ~""(; .lo'l'" T tR\! CARr Am I>OR . AI}\A'l m ESTATf PI ~''''''
TRLsrs ~'D WIll S . TR~sr Aoltt'tSIRATlD' . PRO~AH
The Law Office Of William T. Edy Offers ...
Medicaid Planning and Elder Law
FREE
INITIAL
CONSULTATION
.,. .
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INTERESTED IN REDUCING
YOUR STRESS?
TRY A PROVEN METHOD
Mindfulness-Based Stress
Reduction
1025 Santa Barbara Blvd. Suite 9
Cape Coral FL 33991
239,772.5800 or 888.772.5801
WW1."'I"wy~",.ro ... f~dyl"w
22
w
Relief From Depression ~':;:'::'~~:~"';'" MS ARNP
The Best Treatment For You
F
rOm time to lime everyone experiences
feelings of sadness, but when these
Does it really work? How does it work? Who does
it work for? Does my insurance pay for this?
fcclings hnger or intensify or arc com-
bined with other cmo\iQns thaI negatively affecl
Onr productivity or abi lity \0 enjo y life we caillhis
depression.
Other features often but not always
associated with depression are:
• Decreased interest or pleasure in activities
• Change in appetite
• Change in sleep pancms
• Anxiety or worry
• Anger. Frustration. or Agitation, Restlessness
• Fatigue, or Loss of Energy
• Decreased Concentration
How do you know if you have depression?
lltakcs a careful interview by a mental health profes-
sional. F"'<iucnt1y when an individual is feeling
depressed it is "cry difficult to illicit feelings in a
quick office visit Specific questions must be asked
in the correct manner for an aceurnte evalualion.
Much like any specialist asks in tbcir field of specialty. Feelings are not described too easily by any
individual. Forexample ifasked how you arc feeling
and you ans ....'<:re<I·· depressed:' that is not sufficicnt
enough for an accurate account of your feeling. Try
this, describe your feeling after viewing a beautiful
sunsct. or your firs( experience with loss and see how
long it takes you to describe that. It was more Ihat a
few seconds, right? Well, this is why the mental
health into:rview is specialized. Emotion takcs lime to
describe, whether it is positive or negative. especially
when it is negative. The interview pn:.x:ess should
take appro~imately one hour.
Let s talk about treatma nt
Antidcpressants? What will they do? Are Ihcy all
the same? Which one. ifany, is right for you? How
long should you Slay on them? Docs your insur_
anCe pay for them? What about co st ? T hcrapy?
Antidepressants do work but they are not
all the same. These differences can make you
feci better or worse.
A careful psychiatric and
medical history as well as psychiatric family history
should be taken if this is your first time. There arc
numerous factors to wcigh when prescribing amidepressants. therefore. the samples in your Doctor 's
medicine closet might n01 always be the best choice.
Remember. the psychiatrist and psychiatric nurse
practitioners have a medical background with a psychiatric specialty, much like any specialist. Therefore. they are most qualified to evaluate for and
prescribe antidepressants. Frequently when an individual is depressed they have utili~ed all of their
resourees on the precipitating event which brought
about the depression Or On the depression itself
therefore they have lost all resiliency. Sometimes an
individual is utilizing all their energy on the depression so they have nothing left over. therefore they
cannot work, go to school . or interact with others.
Thi s is where an antidepressant can ass ist. An
antidepressant
can supplement
the resiliency
to begin treat·
ment, and once
treatment begins assist until remi ssion. Once you
have b«n prcSl'ribed an antidepressant close
follow up is imponant to measure side effects and
treatmenl goals. These treatment goals should be
continuously reviewed with your preSl'riber.
Insurance docs pay for antidepressants, many arc
offered generic .
The American Psychiatric Association (APA) recommends Antidepressants and Psychotherapy
combined as the preferred treatment for depression.
Therapy d oes work for those appropriate
fo r therapy. 1I0w does it work? Let's lalk about
Cogniti\'c Behavioral Therapy (CBT). C BTutilizes
the principle Ihat feelings follow thought, Iherefore
if a person has negative thoughts. they will experi_
ence negative emotions. and if that person can learn
to create positive thoughts they will experience
positive emotions . This might sound very simple.
but it can be quite challenging for some without a
therapist. People frequently think in habitual ways.
learned early in life, CBT helps break these old dysfunctional habits and offers new pos itive
ways of thinking. When a person is experi encing depression they are plagued with
negative thoughts which in tum invoke
negative emotions.
Thcrapi5ts as sist
depressed individuals to rcframe some of
their negative thoughts.
We now understand that the brain is plastic:
not concrete. When we learn something new
it callSC5 a wrinkling in the eonex and i1
becomes easier 10 repeat what was learned.
We can contin...: 10 do this as we age. This
can be compared to a learned activity such as
tennis or golf. The same can be applied to our
thoughts. If we can reframe our thoughts to a
poSitive way of thinking it is a new learned
behavior, and if we continue to exercise this
way of thinking our emotions will follow. In
fact according to recent rescarch in Archives
of General Psy<:hiatry 2010 it is suggested
that C BT prevents relapse of depression.
Charlotte/South Sarasota Edition· August 2011
Yes therapy is covered by Medicare and
most insurance plans
Not another pill! MOlit rtten!ly phannaceutical
companies have been advertising the prncticc of
boosting antidepressants with antipsychotics whcn
depresliion is not completely resolved. This practice
has been well supported in psychiatry, and in SOme
cases necessary. but in othcrs might be avoided if
therapy were initiated,
Treatment should be individuali~ for each person
experiencing depression. A mental health profess ional is most qualified to evaluate the best treatment for each individual.
Beacon Clinic provides the most qualified staff of
experienced mental health providers offering evalu_
ation and treatment of dC'pression and other mental
health concerns.
Dr. rho/N/lS Willingham 1/1, a Board Certified Psychiatrist has been practicing in Charlotte County for
over seventecn years. Dr. Willingham believes in
giving his patients the time needed to express thcir
concerns in a relaxed aunosphere. He sees no more
than eight patients per day. SQ he can devote time
needed toward each patient.
Two Board Cenified Nurse Practitioners special_
izing in Psychiatry arc at the Beacon Clinic.
Ch"rlene Rosenfield, MS ARN /' specializing in
children. adolescents. and young adults. and
Kathleen Kalos.i, ,liS ARNP, specializing in
adults and geriatrics (senior adults). ARNP is an
acronym for Advanced Registered Nurse Practi_
tioner. The ARNP can preseribe medication and
offer brief therapy. The ARNP also has a role as
teacher. Uistorically nurses have been educators.
th&WI~
23
in addition to medication management and brief
therapy teaching is another benefit offered. For
example, the APA (American Psychialric Association) recommends diet and cxcreise in addition
to mcdications and therapy as treatment objectives for dC'pression . The ARNP will teach proper
diet and exercise to complement treatment.
Beacon c linic has a variety of experienced therapi sts:
0 ,. Jerry Ross, Ed..D, Psychologist. Depression,
Post Traumatic Stress Disorder, Crisis Manage.
ment, Anxiety Disorders. Brain Disorders, Alcohol
and Substance Abuse, Stress management
Ch"nI~lle Grant. MSW LCS W (Licensed
C linical Social Worker) Children and Adults·
Parenting. Children and Infant Mental heahh,
Play Therapy,
De>'elopmental
Di sorders,
(Autistic Spectrum Disorders) DepressionChildren, Adoleseents. Aduhs. Military Issues.
DO" flg Chi",,,/O, ,liS, LMIIC (Licensed Mental
Ueahh Counselor) Depression, Individual and
couples counseling, Adults and teenagers.
Di vorce and blended family issues. American
Association ofOristian Counselors
S .. :j Desio, MA , LMIIC (Licensed Mental
Uealth Counselor) Depression , Chronic Mental
Health Disorders, Rehabilitation Counseling
Port Charlotte Office
3782 Tam iami Trail. Port Charlotte, FL
Phone: 941-629-7855 in between Gatorz bar
and grill and The Port Charlotte Post Office
Christintl Rooney, MA (Licensed Mental Health
Counselor) Depression, Child Therapy, Individual Therapy, Family Therapy
Beacon Clinic accepts Mcdicare and a variety of
insurance plans, The Beacon Clinic is located in
IWO convenient locations to serve you . Why not
give The Beacon Clink a call to help refocus
your life in a positive direction .
Englewood Office
356 Indiana Avenue, Englewood. FL
Phone: 94 t -681-34OO Across from Stefano's
Restaurant, near Dearborn St.
f---- BEACON CLINIC
Children ' Teens · Adults
"E~'ening fJour~'
In stitute
Cesar B. Yepes, M,D __
4161 T.miami Trail, Suite 701
POrt Charlott., FL 33952
•
•
•
•
•
•
•
---::-cc:---:-=-~
Available"
f's)'<hlatrH: Enl"atlon.
Medlcatl.,., Management
f's)'<hotl>e<'. py
Indloldual" Group Counseling
M."ilge t Co...ple. t f amily
SeouIII .. u...
Wo,k Pla-ce Sire.. Counseling
TIl",.,,,, WollingAom III, MD
Ka/hiun A. Koloski, M.S.. A,R.N.P. , B.C
Clrarl~n~ RO$,nfi,'J, M S , A.R.N.P. , B.C
Ge.."ld N, Ross, FA/,D" PsycAologis/
{)()nna 1.. Chim% , M.S.. L.M,nc.
CIMn/dle Grant. M S.. LCS W
--------------------------Christina ROQJIO)', M.A" L,M.II.C.
3'1l T. ....IT~ .....
3~' H. M ''''" ..
!iuzl Dcsio, M.A .. L.M,II.C.
I'ort C/OO".... fl 33'$2
fl3. 223
en,,_. A"_I
(941) 629·1855
(941) 681·3400
----------------------------------------------- www.swfHealthandWeliness.com ______________________________________________
24
August lOll - Charlotte/South Sa rasota EdItion
ELDER LAW ANSWERS
BV Wt!iam Edy
When I 'old my only grand<laugh!!:.. tllal J was going 10
withdraw 5100,000 (rum my IRA
10 prm'idc: her with a little security
when I re,ire in November, ~he
lold me Iha! Ihe additional funds would disqualify
her from ,antinuing to receive her public
i)cncfits. which include SS lfSSD I Medicaid,
A
Absolutely not. If $he
has. 04A
special needs IrUSt, ;, was presumably funlkd wilh assets she
""ned. like her sa";na:s and in\'CSi-
menlS she acquired before her disability, or ilSsets
she re(f:i..w from a 5elllemcnt for personal
injury, Funher, if she became cnl;,lcd to assets
she inherited from a relative or friend who died
leaving her money or propeny in his OTher w;lI or
those assets " 'ould vest
truSt, on the dale of death
the txtn:mcly oomplicaled half-loaf Slr1ltegy, a lillie
Ihal II h\:r dealh. the firsl beneficiary must be Ihe
Stall' Medicaid rttOvery fund before any remaining funds are distributed 10 any person .
over SO 10 60 pcn:cnt of the applicants funds is giRed
10 t~ e-',ildn:n, tax free, with lhe balance of the: funds
used 10 purchase a Medicaid qualifying annuily 10
make payments for the: n~ of monlhs the transfer
10 the children TC$lllted in • period of disqualifll'ation.
To obtain the period of disqualifll'ation calculation
from OCF. an appliealion for benefits muSI be fil<:d
with OCF, al the time of the firsl gift and then again
after the IUlnuily has ended and the: Ilpplicllnt booomcs
qualified for bcndilS.
By eonmst. if you set up a lifetime giftingirusi.
10 which the fulKb an: ""ill. Ihc:rc: is no "Stalc
pay-back clausc· and the remaining funds can be
paid 10 hcr children, if any, or 10 her siblings. or
10 whoover you designate in the \rUSI document.
Ol her relalives can be advised 10 makl' their gifts
for her benefit to your giftingllUst, as well.
Although Ole M<:dicaid rc:covcry must be nanxd
first bcnefll'iary 10 the extent medic.l expenses were
paid by M<:dicaid, the annuily " 'ould bave paid 0111
all funds prior 10 lhe granling of benefits 10 the
palienl, resulting in 00 pay-back. The children
would lose Ihe fu nds paid for the annuily if the
patient out·livC$ the annuity.
in your granddaughter. This mca.ns your disabled
granddlQghlo:F O"TIS lhem e.'en though 1M
probate process may take two )'(:aI'S unlil she
actually rc:«ives the funds.
When. "proper party" sets up a 04A trust for her.
it mIlS! con lain, among other clauses, a provision
I have beard of the lIalf-loaf
$IJlItcgy for Medicaid QualiflC1llion. Can you explain how this
could benefit my husband who
was rc<;cntly admil1ed 10 a skilled
nursing home.
A
Actually, 11 would probably not be
applicable in your situation
Iw:a, .... iI is a SIJatCiY more appr0priate 10 an unmarried person. In
l"O"'(\'er, if the paticnt dies after, say, thn:c months.
the remaining funds in the annuity would also be
transfami 10 the chi1drc:n. Wbether this is better
than usina I pcnonal care oontract. paying _ of the
chi1drc:n his funds for providina Ole ("tra can: flOI
co\lCrcd by Medicaid, on which the child must pay
income taxes, d"PCnds on several consideralions, one
of which is the actuallifc C" l'«uney, as dClcnnincd
by the family membm; and the patients doctor. and
anoIhcr is the tax bra.ckel of Ole chi1drc:n. Da:isions of
which Mooicaid $IJlItcgy should be used should not
be made " 'ithout the ad\.icc of." elder law attorney.
1"hcrc an: se',CTaI stralegics ITIQr\: appropriate for a
married person becausc M<:dicaid rules and income:
wr. law 1CfI"'l1ly allow tnmsfcrs of assets to • spouse
or disloblcd child withow penalty or any period of disqualiflCllion. The applicant is scilllimitcd 10 own no
l1'I()ft than S2.000. HO"·C'o'er. the SpOUSe. in Florida
may have countable assets of 5109.000 and asse\S
OVer Ihat limit can be convened to oon-counrnble
income. 11>c well spouse can have unlimited income.
unlike the ""tient. 111esc calculations can be made
"ming with your cIder law attomey. The al10mcy
can also ~ • Medicaid wi]] to pm'COI assets
fi-om ""Uling 10 the patient, TC$lllting in loss of
Ixno=fits for excceding the: S2.000 assct limit.
1I 'j1l/"". tidy is a ctrlified finanr;al planntr. uu
,,"orney, and a cenified elder law allarney jn Lu
CaUtlly. lie is a member a/lhe HarMa Academy
ofHorma tilder Law At/orMyJ and Iht Academy
of VA Pension Planners. lie ma), be contacted On
/int for arlicle ideas and 'IutsticmJ. Since t·mail
is nO/ Jteu,.... do nO/ include confidenlial in/orma_
licm in t-mail. This arlicle sllQUld nO/ be a sllbsti·
lute for ..d,·ice from ),our o ...n allornf!)'. Mrul
tlder la", allornt)'s offu f,...t literature and a fret
initial consultaNon.
1025 Santa Samara Blvd , Suite 9
c..pcCoral FL )J991
239.772.5800 or 888.772.5801
www. •• ~...jnl.l •• w
- - - - -- - - -- - - - - -- - -- - - www.swfHealt ha nd Wellneu.com _ __ _ _ _ _ __ _ _ __ _ _ _ _ __ __
25
h&Welne
"Snakes on a Plane OR ...
PARKINSON'S DISEASE PSYCHOSIS"
By Ramon A. Gil, M.D.
and they pereeive il as a person or a different
object). Another feature of PDP <:>flen expericn~
by patients is delusions or false beliefs Ihat are
maintained despite evidence IQ the eonlrary.
Paraooid delusions can be quite distressing.
CommQn examples include thQSC of dc1usiQns of
jealousy, or Ihat of '"people trying tQ hun or steal
from the palient.'·
I
n the summer of 2006, the blockbuster
"'Snakes On a Plane" depicted Samuel L.
Jackson as a courageous and sma rt FBI
agent dealing with a true nightmare for the passengers of a plane from Honolulu to Los Angeles·
snakes on a plane.
It is perhaps difficult for most Qf us tQ think that
some paticntsaffected by Parkinson·s Disease (PO)
Or similar disordCTS. such as Lewy Bodies Di sease
(LBO), may fm[uently e~perience similar ·'night_
mares:· with the difference being this time, Samuel
L. Jackson won·t be there tQ save them, and The
snakes, oontrary to those represented in the movie.
are not real. but they are the product of ",·hat is
known as "'Parkinson·s Disease Psyehoois" (PDP).
What is Par1tinson's Disease Psychosis
(PDP)?
Psychosis is defoned as a state or illness character_
ized by major alterations in mental function. se,·ere
disturbances in cognitive and pereeptual processes
(e.g. hallucinations. delusions). inability TO distin_
guish reality from fantasy. changes in behavior, etc.
I'sychoois may be aCUte Or chronic and in The case
of PO patients, iT is estimated tQoccur in up to 50%
of the e3SCS. PDP is primarily characterized by hallucin3liQns (moot often visual, but all sensory
oomains have been reponed). The images are well
defined and moot of the time involve people in Ihe
hQuse. children playing outside Or inside Ihe house.
or animals. One must distinguish halludnations
from illusions. The latter are mispereeptiQns of a
real stimuli, often visual (e.g. a person sees a lamp
PDP is Leading Calise of Nursing Home
Placement in PO Patients
PDP is more often secn in paticms receiving <lopamincrgie dnJgs (especially Dopamine Agonists
(OA) such as Pramipexole or Ropinimle): however
il has been reponed in up IQ 10% of patients who
are 001 receiving oopaminergie drugs. Dementia.
depression, earlier monality, and greater caregiver
strain have all been associated with PDP. As a
maller of fact, PDP is CQnsidCTCd the leading cause
of nursing home placement in PO patients. Once
prcscnt, PDP lends to be persistent and progressive.
Fortunalely. all hough SQmewhal limiled, effective
treatment is available.
Adjustments in Medication Can Help
Eliminate HallUCinations
Despite the fre<Juency of this problem, PDP is often
under reported by patients and family membcn
afraid of the ··consequences·· of telling their physicians QJ others that ·"their loved one is hallucinaTing.'·
It is disappointing tQ sec palicnts ooming tQ their
initial oonsultation with us. after being treated elsewhere and having PDP for months and even ye~,
and simply having been told ·"there is nothing ....'e can
do·· QJ thaI ··this is a side effect of the treatment:' as
if there is noIhing They oould have done to minimize
or resoh'e Ihese problems. It appears that patients
have to endure the presence of this rather distressful
problem. This was recently the case fQJ a 12 year old
man who had reponed (fQJ over 2 years) reeurrent.
well defined, vivid visual hallucinalions: seeing
snakes on his bed alntost e\"Cry nigh1. Adjustment in
the doses Qf his medications eliminated the hallucinations within a couple of .... eeks.
Talk with your Primary Care Physician or
Neurologist
What can you do ifYQU QT a loved one is experienc_
ing PDP? The vcry forsllhing should be IQ discuss
il WiTh your Primary Carc Physician (PCP) or the
treating NeurolQgist.
The treatment involves
adjustment of the anti Parkinson's drugs and
careful review of concomitant medications, some
of which could be the culprit. Medical problems
(in panicular infectious processes, such as urinary
tract infecliQnS) must be nJled out. Any acuTe
medical problem. hoopitalizations or surgical interventions may trigger PDP.
Which Drugs are Considered for Treatment
of POP?
Once these interventions have taken place. if the
psychosis persists, the use Qf anti psychotic drugs
should be considered. The so called ·"non cOnven·
tional neumleptic'· agents include several drugs.
but Qnly Quetiapinc (Seroqucl) and Clozapinc
(Clozaril) are safe to use in PDP. All the other
medicatiQns in this family arc cQntraindieated, due
to Ihc high incidence Qf worsening the parkinsonism. Quetiapine could aggravate Or trigger low
blood pressure upon standing (onhosTatic h)lpOten.
sion). and not infm[uenlly. the 00sc is limited by
excessive sedation. Clozapine. although effective,
m[uircs fm[uent blood tests, as it could 10wC1" the
white blood cell count.
Participation in a Phase III Trial
We arc currently panicipating in a phase !II lrial to
demonstrate the safety and efficacy ofa no\·el drug
(Pimavanserin) in the treatment of PDP. $I) far the
drug seems to be vcry well toleraTed and prelimirwy data suggests that it is effective in reducing the
psychotic symptoms, improving slecp pallcm and
decreasing burden on caregivers. For those panicipants who complete the 6 weeks blinded therapy
phase, an open label safety extension is offered.
This is a great Q]lponunity to continue treatment at
no cost for the study drug, testing, and all visits COn·
nected TQ the trial until the medical ion is approved.
Feel free to contact uS at 941-143-4981 with any
questions or if you are interested in panicipating in
a ··free screening visit.'·
Ramon A. Gi l, M.D.
Medicat Dinxtor. Parkinson'$ Disease
P",i,·TIS"" 's Di<"".~ rU"I"'~'"
C~nl~' of s
w Flo,id"
(all 941.743.4987
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHea lth andweliness.com - - - - - - - - - - - - - - - - - - - - - - - -
26
• w,
August is National Immunization
Awareness Month
By Lois Ruth - Assistant Admin istrator
Infinity HomeCare, F1. Myers Branch
F
or the upcoming flu season you
~hould be prepared by gcuing
your immunization. The influenza
virus can be hazardous to aduhs ovcrthc
age of 65, cSpc<:ially those with a unde.ly.
ing illness such as asthma, diab<:tcs. or
hean disease. According to the CDC
anywhere between 5% [0 20";' of Ameri-
cans come down with the flu each year.
More than 200,00 people arc hospitalized
and around 35,000 people die annually
from the influenza virus. These numbers
WQuid significantlydl'Crcasc ifmwc people
took advantage of properly gening vacci-
naled for the coming season. These arc
usually available beginning in September
each year.
The influenza virus is highly conillgious and
could greatly be avoided by washing your
hands frequemly and avoiding
overly
crowded areas. In the cider population or
lhose peop1c that may be immune suppressed Ihe virus could casily lum ;nlo
pneumonia if nOllaken care of al Ihe earliesl
signs. Comacl your physician loday 10
schedule your immunizalion.
PORT CHARLOTTE
P: 941,629.161Xl
CAPE CORAL
P: 239.242.0541
www. infinityhc.com
Charlon e /South Sar a sota Edition - August 2011
WE lness
27
Facts on Colon Cancer
,
Is the number of cases of Colon Cancer that will be diagnosed this year!
C
olo=tal tanccrs attount for about
eight pereent of new cancer diagnoses. In recent years death rates have
deelined due to increased wlQlloscopy screening,
polyp removal (preventing the progression of
polyps into invasive cancer) and improved treatment methods.
Q : What is the colo n?
A: The colon and rectum fonn a muscular tube
called the large intestine or large bowel. Through a
process called peristalsis. digested food moves
from the stomach and small intestine into the colon.
Once in the colon, all remaining water is absorbed
into the body. fonning solid waste(stool) which
leaves the body through the anus .
Q: Am I at ris k?
A: Colorectal cancer occurs most fi"equently in
peoplc over the age of 50. Colonic polyps, inflammatory bowel disease and a family history of col ·
oreCial cancer are factors of increased risk of
developing colorectal cancer.
Q: What are the symptoms?
A: Common symptoms of wlQll cancer:
• Diarrhea Or constipation
• Blood in or on the stool
• Frequent gas p<lins
• General stomach discomfort
• A change in bowel habits
• A feeling that the bowel docs not empty
completely
• Unexplained weight loss
Because these symptoms may be caused by other
problems consult your Dr. for proper diagnosing
and treatment.
Q: How is c ol on cancer d etected ?
T REAT M ENT OPTIONS
A: There are many symptoms that your doctor
will consider during your initial office visit. He
may ask you about your pcroonal and family
history. perfonn a physical exam and other laboratory tests.
Q: Do I have a choice of
treatment?
Patients should take an active role in the early
detection of colorectal cancer.
GUIDELINES
• HAVE REGU LAR CHECKUPS BEG INNING
AT AGE SO:
• Have an annual fecal occult blood test.
• Have an initial sigmoidoscopy (exam of the
rectum and lower colon) and QIle every three to
five years thereafter.
A: There are several options for
the treatment of colon cancer.
depending on your age. the size
and location of the tumor, the stage
_
R. 8a:III. t.lD
of the disease (i .e .• whether it has
spread to other organs) and your general health. You
may also have wncems regarding the treatment
process and potcntial side effccts: therefore, it is
essential for )lOu and your doctor to discuss all available options leading to thc development of a treat·
ment plan that i~ specifically tailored to your needs
and cireumstances.
Dr. Bada doesn't mEAT symptoms, he CURES them!
CALL NOW! (941) 255.0069
www.badamd.com • www.refluxbadamd ,com
1s n M..o"dock Q '101, Port Charlotte . Sa!eite Officesil North Port
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www. swfHealth a ndWeliness.eom - - - - - - - - - - - - - - - - - - - - -
28
nQ reawn al alL Aneurysm can be there fQr years
before they rupture. Smoking seems to increase
the chance of bleeding from One of them. Different types of stro kes require different types of treat·
ments, however in most cases the lreatment is
urgenl or emergent 10 prevent further damage.
There fQre. it is imp<>rtant in these silualions be
taken to the emergency room immediately. In
some types Qf strokes the window Qf <:>ppc>rt unily
is only of twO to six hours.
•
By ..1000 I. Cab<era, MD
raIn
ttac
refer 10 strokes. They arc also
known as cerebrovascular accidents
or eVA's. Strokes are a common
brain itself This blockage ean happen because of
fonnation ofa bl<><.>li clOI in the artery or bc\:ause a
bl<><.>li clOI fonned in another part oflhe body (i.e.
heart) ends up in the artery.
cause of death and disability among
Americans. Usually il is associated with older pc<Jplc
but young people can also be victims of a stroke. The
causes for strokes in ywngc. pcT1lO11S an,: slightly
difTcrent\han in older fol ks. A stroke is basically an
event in which the blood circulation in the brain is
imcrruplcd and nQl enough blood circulates there or
in which there is bleeding inlO the brain tissue or
oolh. Younger persons can get them because of
anomalies in the blood itself, blood vessels and the
hea" Ihal Ihey were born wilh. or because of drug
abuse such as cocaine. Typically, older people get
strokes secondary 10 having diabetes, hypcncnsion,
Sometimes Ihe e,'enl consisls of bleeding into the
brain substance or into the surface of the brain.
What happens in this siluation is that there is a
weakness in the wall of the bl<><.>li "essel that
allows the blood vessel to rupture and leak bl<><.>li
into the brain , Such case is the one secn in brain
aneurysm which is li ke a small bleb Or bubble in
the bl<><.>li vessel that will burst and cause bleeding
Some of the symptoms are Ihose of seVere sudden
onset headache (worst e,'er), maybe fainting,
nausea, vomiting and weakness . Somelimes this
happens during exertion such as during sex or for
rain anaek is the lay term used to
The medical treatment can consist of inject ing
medication that will disrolve the blockage in the
bl<><.>li vessel. The diagnosis of a stro!.:e is deter.
mined by the patient 's history and a physical
examinatiQn using MRI s. Cal scans and other
modalities , The treatment of some patient s
requires surgery. Such is the case with a rupturox!
brain aneurysm and the goal is to prevent further
bleeding from happening; this involves occluding
the aneurysm with a clip Qr a coil. The placement
of Ihe clip involves opening of the skull. This is
usually is perfonned when the aneurysm cannot
be <Qiled , The placement of the coil is done mini mally invasively thru a catheter placox! in the groin
and treaded all the way into the aneurysm location
in the brain. Wh en there is a bl<><.>li clot in the brain
tissue surgery can be done to remove and de<:rease
the elevated pressure in the brain.
As you can sec from this article, a stroke arises
from complieatox! issues with mOre than One
solution. We suggesl that ifit happens to you or a
loved one, seek medical help immediately. In
town there are several stroke centers such as the
one located at Fawcett Memorial HQSpital thaI
counts on a team of neurologist. neurosurgeons.
radiolQgisl and nurses with expertise in treating
stroke patients.
hean disease or incn:ascd cholcsterol.
All orthese arc risk factQrs urociatcd with having
a brain auac!.: or stro!.:e. Spedfieally a stro!.:e can
happen if a bloc kage happens in one of the arteries
that prQvidc bl<><.>li tQ the brain such as the earQtid
arlery in the nec k or in Qne oflhe arteries in the
For more information please visit:
www.charloueneuro.com
or www.neurosurgerytoday.org
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www. s wf Heal th an dW eliness . com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Charlotte/South Sarasota EditIon
August 2011 Health & Wellness
29
Proper treatment can help kids
witli ADHD thrive
By BeIkiS Cepero, M.D., Pediatrician - H&Igemo & Uou Pediatrics
"Pay attention!- Teat;ht:r$ and paren" hal'e been
dclil·t:!ing this admonition 10 children for ICIICTIItioll5. Unfommatciy, for tlK= SA million· boys and
girls wilb Attention Deficit Hypaactivity Disorder
(A DHO). "paying attention" is 1'10 simple task .
C
hildren with ADIID have diffieuhy
focusing and can appear to be
fidge'Y. d isorganized daydreamen.
It's no surprise Ibat this oflen causes academic and
diseipline issues. as well as frumllt ion for children.
parents and .eachen. Ho,,·e~cr. wi.h proper diagnosis and treatmcnt, children with ADHD can thrive
both inside and outside of.he classroom.
What Is AOHD?
A child has AOHO when he or she exhibits hypclOlC_
tivity, impulsivity. inal1cn.iveness or a combination
tlult's not within the norm.:ttl range for a child his or
hcr age.
Symptoms oftelr lire/fide the !oIIQ"'''ll'
• Poor o.ganizatiooal skills
• Rcqui"" the: same: instruc,ions repeatedly
• Fidgeti", and Mlui""i",
Makes cardess mislakes
Talks cxcasi\'ely
• Difficul1y focusing and remaining on lask
• Frequcnlly foractful and distracted
The 5e\'erity and sym~oms vary greatly. ho"'cI'cr
the condition typically manifC$l$ itself as primarily
inanentivc. primarily hypct:Ktive·impulsivc or with
a combination of inanentive and hyperactivc_
impulsive symptoms,
Does my child have ADHD?
A diagnosi5 is usually made by a pediatrician. behavioral pediatrician. l'5ychologist or psychiatrist who
uses specific tts,ing and obj<:<:tive criteria
dctcrminc your child's aUcntion span. Questionnaires
completed by a parent and a. 1(liSt twO ,cachets are
helpful in revealing behavior paucms and making a
diagnosis. For this reason. children are not evaluated
for AOHD until they reach school age.
,0
lnming disabili,j,es. depression. bipolar disorder
and ocher conditions can be Pl'C$Cllt along wilb
AOHD. so it's vital to diagnose and lfeat tbosecon·
ditions as wcll . If only ADHD is p~t. your
pediatrician can provide treatment.
Treating it seriously
Children with ADIID usually have a normal
abo~e average intelligence 1('I'd. Ho,,'(vcr. bcc:ausc
of Iheir challenges. they ollen suffer from poor
self-confidence. If lell untreated, ADIID increases
the risk for depression ano substance abuse.
,0
Treatment often includes medication. which is
very safe when elosely moni(Ol·ed. Uowever, medi.
cation is not a magie cure. Family counseling and
an ongoing focus on social and organizational
skills is vital. Maintaining a set routine is abo helpful.
Public schools a~ requi~ to provide classroom
KWmmodat;ons, such as additional time on tests,
forchiklml with ADIID.
As a parent. you are )'I')Ur child's best a,h-ocate. Yowinvolvement and per5C'l'crm>ce can make a substanlialoifference in his or her ability to suetted.
Helgemo and Liou
Pediatrics
204{)CTamiami Trait. Port Cha rlOlle. Fl l3948
941-629-6601
www.helgemopedialrics.com
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHea lthand Weline ss.tOm _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ __
30
-Iealth.\
w.' lne';s August
lOll - Charlotte/South Sarasota Edition
Condition Of The Heart
Spon s ored By
by Terry HoskO"ls, Director 01 Oasis
www. p rs /s efm.com
OS! people who rome fo r eoun-
The Heart Changer
~Ijng
In Biblical Counseling we recognize thai God is lhe
true answcr 10 all of our problems. lie alQI>C can
change our heans . In His Word. He says: "J will give
them an undivided heart and put a nCw spiril in lhem:
I will rcmovc from them their hean ofstone and give
them a hcan of flesh . Then they will follow my
decrees and he careful 10 kecp my laws. They will be
my people, and [ will be their (}Qd.'" ( E:rekicl
II :18-20. N!V) God is (he only one who can rescue
uS from ourselves.
are seeking a !;Oluti""
to a problem. Whether lhey
are dealing with addiction, bitterness. depression.
anger, or any other issue. the common goal is a
desire 10 uncover the mOl of the problem. Understanding the rool of Ihe problem is, of course . the
beS! way to apply an adequate solution.
The Voice of the Day
The average American believes lhat psychologists
31"(> in {he best position IQ provide advice on human
behavior and arc the {rue expcns at getting 10 {he
root (If a problem. As the experts. these psychol<>gists claim to be able to wive Ihe problems of man
using models developed by man. MOT<: often Ihan
no!, they link onc's currenl behavioral challenges
to their past experiences andlor chemical imbalances in lhc brain.
Chemical Imbalances
Onc of lhe mosl popular lrends loday is lhe roo!
issue being diagnosed as a chemical imbalance.
This theory suggests Ihal a person will have
problems if too much Or \00 linle of a certain substance flows in Ihe brain. II is suggesled thai Ihe
brain Can be blamed for a variely of disorders.
including Bipolar and ADD.
The Past
AnOlher thoory claims that abnormal behavior is
cau$Cd by a panicular event(s) from one's past. A
person who has experienced some typeQftra uma is
typically referred to as having a "wounded hean.··
According to this theory, the emotional pain of the
past has the ability to hinder a person from living a
"normal"" life in the present. Many times. the
person experiencing dysfunction is unawal"<' of the
fact that these wounds have had such a profound
impact in their life. Psyehoh;>gist argue these
wounds cause the person to function out ofa false
sense of self in order 10 protecl. and even hide
himself from any funhcr pain. Then it is said that
Ihe person will nC"erbe lruly free from the wounds
unlil they Sian pulling out the emotional arrows.
Jelling thc wounds heal, and as this happens Ihe
lrue self will begin 10 emerge.
The Problem
Should ....'C lUm 10 psychology. which is man's underslanding of man, or is there something more? Can we
always blame it on the brain. or the experiences of the
past? Thc Bible does nOI mention chemical imbalances. nor does il blame the pasl for OUr problems loday.
This is not to say that these things never affw us. but
God's Word says Ihal "''C have hean issues lhal run all
the way 10 the core of who we are. This problem spans
back 10 the Garden of Eden. Satan tempted Eve by
telling her that if she ale Ihe fruit lhcn she we would "be
LIKE God knowing good and evil." (Genesis 3:Se.
NIV) Si""" that time. humans ha\'C had a natural desirc
to be god instead of worshipping the lrue God. This
means we are now prone 10 live independenl of God's
ways. commands. and Truths. Tl\at is why God's Word
says. "A person Ihinla; cvaything he does is right, but
the LORD weighs hearts." ( Proverbs 21:2, GWT)
COlT\lption 01 the Heart
The queslion is. why do we think this way? God's
Word says that. "the human hean is the most deceitful
of all things, and desperately wicked. Who really
knows how bad il is? (Jeremiah 17:9. NLT) The Bible
tells us that our problems arise out from our OWN
hean. II .x.:eivcs, connives. manipulales. and is full of
darkness. Our heart is I"<'ferred 10 as the "inner man" or
the "control Cl.'ntcr of life." It is what drives us
inwardly. and affects what We Ihink. feci. and do. Why
do we argue wilh Our spouse? Why do we get irrilaled
when we don't get our way? Why do we struggle with
fear, wony, or anxiety? These are nol simply chemical
imbalances, Or symptoms of Our pasl. bul ralhcr lhe
natural state of our sin ful hearts.
HjO\I wt>IJ ld like to learn how to 1M! everyday in God's 1oYe.
please oomact Oasis for the steps)'Ou need to ta ke. We
CO\lnsel indMduals, marriages, and fam ilies. Please visit lIS
at www.OOsiscouRSeI.comOfcallus 239·389-0273.
•
Oa
Counseling C':,:~!"'"---1
Refresh your life
using God's WQf"d,
Call Today! 239.389.2073
Oasis Counseling Cenler wanls 10 refreSh you r hope. heart. and l~e wilh God's Word. We are localed 00 Marco Island and
OIIr phone #389·20 73. We are friendS of HOPE Counseling Genler Ioe/I(ed in Fo~ Myer$. and tIIeir phone #-(81-0777.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www. s w f Heal th and Weliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
This Spring say goodbye to your swollen, achy legs and
spider and varicose veins so you can get back in your
shorts. Dr. Magnant has your solu ti on. He offers state
of the art vein treatments in a spa-like setting. You 'll
find com fort in knowing that he is SWFl's premier Vein
Expert and is a Board Certified Vascular Surgeon.
Schedule An Appointment Today!
239.694.8346
weknowveins.com
Joseph Magnant,
MD,
FAa
Vejn Expert dOO 80ard Cerlified
,.~/.,,",,~
•
~ •~
SENIORextra
at CHARLOTTE
REGIONAL MEDICAL (ENTER
Wouldn't you know that Charlotte Regional Medical Cen ter would t hink of a program this exciting, this event-packed, this
benefit-filled. Senior E. tra is designed to help you get the most out of your lifestyle through active, independent, and
healthy living. Everything we do centers around your health and wellness - from education sessions to health screenings.
Here are just some of the extras available to you when you join Senior Extra at Charlotte Regional:
Attend Senior Extra programs & events
Access Senior Extra onl i ne i nformation
•
You're always on the guest list
•
•
Bring a friend or spouse
Visit www.SeniorExtr3.comforcurrent health information &
events calendar
Mon it or you r health wit h f ree screenings
•
News about medical breakthroughs and wellness trends
•
Check cholesterol, blood sugar, hearing, vision, bone
density, & more
Free senior Extra e-newsl etter
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August is

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