Friday, 22 April 2016 16:06

Changing Lives Inside and Out

The 2016 Over 40 & Fabulous! Advisory Board members share memorable client and patient success stories.


Crown of Glory

Steve Hightower is proud to serve all types and ages of clients, including those with fine and thinning hair. He tells us: "I'm happy to be known for special cutting and styling techniques and products designed for fine and thinning hair. Also, my salon is the only salon in Atlanta that offers Laser Hair Regrowth Therapy. Clients have actually cried with joy when I finished their hair because it looks better than they dreamed possible."

"Hair is your crown of glory. I've seen women lose breasts to cancer and they were more upset about losing their hair than their breast—I've seen them so excited when I showed them how to style their problem hair. The products, the growth treatments, I've studied it all so I can help people. "

Steve has had clients that are loyal to him for decades. Sometimes when one passes away, the last thing he can do for her is her hair at the funeral home. Steve says, "These women aren't just clients---they're family. It's sad that younger stylists can think that kind of work is 'dated.' Only five salons in Atlanta do roller sets, and I'm one of them. I'm proud of that—these are grand ladies, they're someone's grandmother and they like to look a certain way. I give them a cup of tea, fix their hair and they feel beautiful. It's so special that I can show someone of any age how beautiful they are and make them feel beautiful."




4-AlexanderUse Your Natural Strength

TaraHammPlatelet-Rich Plasma Therapy (PRP) is a game-changer for facial rejuvenation. Tara Hamm, clinical and PRP coordinator at Artisan Plastic Surgery says, "What I love about this technique is that the PRP stimulates new collagen and blood vessels, thereby helping to repair and regenerate damaged skin and reverse the signs of aging. The growth factors and platelet gel help rejuvenate the skin from the outside in and the inside out with a totally natural, soft, beautiful result. Over the last 12 years of using PRP, I have seen hundreds of fresh faces and happy patients!" Tara goes on to say, "I have used PRP to treat patients for varying cosmetic issues, including facial rejuvenation, collagen volumizing, acne-scar removal, improvement of scars and stretch marks and even hair loss." PRP is a natural approach—using your own natural tissues and growth factors to rejuvenate and heal your body. Artisan Plastic Surgery is very excited to offer this program to enhance patient anti-aging programs.




AnnaPareMDBest Face Forward

Does your chin have you seeing double? This isn't the case anymore for Leslie Avery, who struggled with her double chin for years. This area had become increasingly bothersome for Leslie and it was all she could think about when speaking with friends, family and coworkers. Her self-esteem was dwindling, but her solution was right around the corner.

LeslieAveryIn February of this year, Leslie came to Dermatology Consultants for her annual skin exam with Dr. Anna Paré. While in the waiting room, she saw a brochure for a new injectable treatment called Kybella that is used to reduce submental chin fat. Leslie explains, "I started reading the brochure and learned that Kybella was a permanent solution to my double chin! As soon as Dr. Paré walked through the exam-room door, I asked her how I sign up. Dr. Paré explained to me that fat under the chin sometimes is influenced by genetics and is unrelated to a person's weight. I am active and not heavy and could not understand why this part of my body would not decrease with diet and exercise. I am three weeks out of my second injection and my results are incredible! I couldn't be happier."

"Leslie was a perfect Kybella candidate," says Dr. Paré. "We are thrilled with her results and are so happy to have been able to make a difference."




2-WhitemanA Healing Journey

DeniseWithHerSonKenneyDr. David M. Whiteman recalls a patient, Denise, who first came to Southern Plastic Surgery (SPS) after successfully battling breast cancer. "She had undergone a double mastectomy and was ready to take on reconstruction to restore her breasts," he says. "As a mother of three adult children and with a zest for life, Denise knew that she had much for which to be thankful. With a passion for triathlons, Denise led an active lifestyle and wanted to improve her overall health well beyond her procedure. Denise's SPS experience didn't end after breast reconstruction, but continued as she chose to refine her thighs with liposuction, rejuvenate her face with laser treatments and facials, and partner with our in-house NESTA Weight Management Specialist during her recovery. Today, Denise is feeling great and continues to focus on healthy eating and regular exercise—enjoying life and refusing to take anything for granted."




9-FrixRenewed Hope

HowardKristler"I often hear from patients who are grateful to find relief from their pain," says chiropractor Dr. Tara Frix. "Recently, I heard from Howard Kristler, a patient who had suffered from the lingering effects of a whiplash injury he sustained in a car accident. He told me he felt so fortunate to have come across Total HealthCare, explaining,'Everyone in the practice is a compassionate, caring and knowledgeable professional; they are there to help. The staff takes pride in watching me get better.' He told me he was impressed that we listened to him and reacted to his concerns. He was no longer frustrated and was feeling better than he had since the accident—actually, better than he had ever expected to feel again. He trusted our process and his attitude is so positive. Providing that level of care and helping to change a patient's life is truly rewarding work."




7-HrobowskiCheck the Stress

Cardiologist Dr. Tara N. Hrobowski remembers her patient, Ana Browning: "She came to us with a history of fatigue and shortness of breath. She was stressed, worked long hours and couldn't spend much time with her husband and son. We diagnosed her with cardiomyopathy (where pumping of the heart is severely reduced). I felt it could've been the result of a flu-like illness she'd had earlier, compounded by the enormous stress in her life. I told her that she should invest in herself and her family, not just her work.

AnaBrowningWhen I saw her later, she told me, 'I feel so much better with the medications you prescribed. I walk in the evenings with my husband now and we feel more connected as a couple.' She said that while she was recovering and off work, they replaced her and moved her to a different department. She smiled, though. 'I'm sorry this had to happen for me to see what I was doing to myself and my family, but it made me realize what's important. I feel like I have a story to tell!' She stated that she wanted to counsel women in the workplace about the importance of maintaining a healthy work-life balance. She added 'I want this experience to mean something.'"




5-FoleyDaily Rewards

Karen Foley, general manager of Windy Hill Athletic Club, loves her job. She says:"When I come to work each day, it's a joy to talk to some of our members who have been with us for over 25 years. Don Rooks is one of those members. Every day, I ask him, 'How are you doing today?' And he responds with, 'Great today, but I'll be better tomorrow!' When asked about his personal motivation, he says that working out is about being positive both physically and mentally. He wants to keep moving every day.

DonRooksOne of the most touching encounters I've had was when I was teaching swim lessons and there was a lady who was 83 years old. She came to me and said, 'I don't know how to swim, and I want to be able to swim with my grandchildren.' So every week she took a swim lesson with me and went from not being able to blow bubbles in the water to being able to swim across the pool. That was such a rewarding experience for me—to be able to help someone in that way."




3-KingA Bright New Future

BeforeAndAfter"We're fortunate to be in a field where our work has a powerful impact on a person's life," says Dr. Debra King. One of her favorite patient success stories involves a patient's unique family trait—a gap between their two front teeth. Three generations in the family shared this trait and embraced it as their "special quirk." As she advanced in her career, she discovered her gap was holding her back. When the opportunity arose for a high-level promotion at work, she was overlooked because her appearance was described as "unprofessional and unintelligent." Motivated to overcome this, she booked a consultation at the Atlanta Center for Cosmetic Dentistry. She was shown her custom imaging and was brought to tears by the potential of her new smile. After completing the recommended treatment, she was thrilled with the results. She then headed to her family reunion, nervous about how they would receive her new smile. They commented on how beautiful she looked. It was as if her smile was always meant to be this way! Her story has two happy endings: not only did this young lady land the next promotion, she also met her future husband a few months later!




6-Madison-JamesEmpower Each Other

AtlantaBeltLineJamboree2015"As we grow, more things become important to us," says Madison James. "For me, it was giving back—the positive effects are so rewarding. When I'm advising 40-somethings about ways to get inspired and to find meaning in life, I suggest starting with looking at the world around them. A lot of them don't know where to start. I tell people, 'Look at your children's school, your place of worship or research an issue that has impacted your life and the lives of those you care about.' It is so rewarding to help people find ways to volunteer and get behind a cause. I tell people to make it a group event and invite friends and family—it's a good tool to teach selflessness. The BeltLine has great opportunities for everyone to connect with the community and has partnered with Hands On Atlanta. Volunteer with different charitable organizations in your community to feel really connected. The BeltLine is committed to connecting communities!"



Friday, 22 April 2016 14:42

Y’all, Set the Table!

For over a decade, Atlanta Food & Wine Festival (AFWF) founders Elizabeth Feichter and Dominique Love have built a partnership that supports charitable giving, nourishes community, celebrates Southern cuisine and, now, even plants a vineyard ... right smack in the middle of Midtown Atlanta.

The two met years ago, when Love worked at The Coca-Cola Company and Feichter at Hands On Atlanta; they were part of a team that connected those organizations for community action initiatives. In 2003, Love started the company Corporate Community Outsourcing (CCO) to continue such efforts on a wider scale, helping corporations and nonprofits maximize their impact on the community at large. Feichter joined CCO and, together, they developed projects with a wide range of clients from Fortune 500 companies to small nonprofits, from NASCAR to Food & Wine magazine.

PHOTO-1Sowing Seeds

Their work with Food & Wine magazine planted the seeds for the Atlanta event. Love recalls their initial consultation about nine years ago: "They said, 'Your timing is perfect! We're about to celebrate the 25th anniversary of the Food & Wine Classic in Aspen and the 30th anniversary of the magazine and we want to give back to the community.' We came up with a concept that focused on increasing consumer access to locally and sustainably grown foods—the Grow For Good campaign. We launched that and it propelled us into this world of food and drink."

Once immersed in that world, they felt compelled to create a festival based in Atlanta that would celebrate and educate people about Southern cuisine. Love admits, "We pushed ourselves to limits I didn't even know were possible."

In May 2011, the table was set, the linens pressed, the dishes piled high and the first Atlanta Food & Wine Festival launched ... with Feichter watching from the production office as she nursed her three-month old son. She says, "I remember looking out the window [at the festival activity below] and thinking, 'We DID this! All of that out there! We brought it together.' It's a legacy we want to leave."

Photo-2Plating Courses

The applause and accolades rained down immediately as the Festival was greeted with a sort of "where-have-you-been-all-my-life" enthusiasm by presenters and attendees alike. Love and Feichter had tapped into something special—exploring the richness of Southern culture through its food and drink with some of the most talented chefs in the region educating people about methods and motivation.

"The Festival is about the South," Love explains. "We are, in many ways, marketing this region through the narrative of its food and drink. It is a rich story. If you go every year, you are deep into the novel. You can't talk about [all] Southern food in one weekend. We're really working to shine an international spotlight on what's going on here. There is a ripple effect to that. When a small business says to us, 'I'm about to open a store in Atlanta, thanks to you and thanks to the Festival, now we are in a place where we can actually expand,' we know that this is really important."

Photo-3Feichter agrees, "We have such talent in the South. They've been here for years, if not hundreds of years. We've got pitmasters that have handed down generations of knowledge.They've always been here and we've always known those magical little places where you can get something to eat that you can't get anywhere else."
And they've brought that magic and legend and history to Festival-goers through their collaboration with those sharing that same passion. Chefs join restauranteurs, sommeliers, vintners, mixologists, brewers, distillers and epicureans to form the AFWF Advisory Board, which designs the programming for each year's event. Presenters bring their knowledge and expertise into the classroom and workshops of the Festival's Learning Experiences, teaching everything from grilling techniques to pairing tips to food history. And the tents ... oh, the Tasting Tents. Rows upon rows, table after table, bar after bar—laden with decadence for an endless gastronomic adventure. Special dinners, parties and the ultimate package, the Connoisseur's Experience, combine for a three-day sensory bonanza with a Southern drawl.

Photo-3Family Recipes

This is conscious-eating at its most elevated level, pulling every principle of "eating well" into sharp focus. Feichter and Love advocate culinary awareness far beyond festival planning. "For us, food carries such meaning," Love shares. Her mother had a catering business when she was growing up; she and her husband have always been avid cooks and entertainers, and those interests became a family focus after adopting their son seven years ago. Now the family sets new intentions and heads to the farm later this year. "We're moving down to Serenbe and raising pigs, among other things. We'll have our garden and have been working on the garden plans together. My son flips through cookbooks and gets totally psyched about it. He is NOT a picky-eater!"

Photo-4Feichter concurs, "I feel like it's influenced our families and our appreciation for food—how it's brought to the table, how it's raised, how it's grown, the care that's taken to feed people, feed families. We have a garden at our house and [my son] plants it with me. So, why does he love lima beans out of the garden? Because he grew them. Why is he fascinated with peaches? Because he picks them off a tree and brings them into the kitchen. To blow his mind even further, I can introduce him to a chef and say, 'Watch that chef take that bean and turn it into something fabulous that you are going to love!' We're proud of what we've done and when people come together around the table—and I think of AFWF as a big table—for my family to see that I was even a small part of it makes me proud."

Love goes on to say, "The bigger thing for our kids is growing up with entrepreneurs. I want my son to see that we had a passion and an idea and took the chances. We took the risk. We believed in ourselves enough to make it happen. It's not an entitlement. You don't wake up and have your dreams delivered to you. You make it a reality through hard work and falling down and detours."

"And, it's okay for them to see you with your head in your hands sometimes," Feichter reassures. "This is hard. It's okay if you need someone to pat you on the back every once in awhile. For us, the strong friendship, having each other ... we've been able to hold each other up, to grab hands and say, 'We've got this!'"

Photo-5Test Kitchen

Those hands have clutched tighter recently as Love conquered two different of types cancer in a little over a year. With a very prominent history of breast cancer in her family, Love was already vigilant about regular mammograms. She confesses that her July 2014 early-stage diagnosis did not totally shock her. She underwent a bilateral mastectomy and soldiered forth, attending crucial corporate planning meetings only three weeks after surgery—"I got my hair and makeup done, took some pain pills, wore layered outfits and sat through the whole thing.The second cancer, thyroid cancer, however, was a surprise." But, again, her doctor caught it early and she was able to tackle it. "I was extremely fortunate to get two treatable types and because I didn't require chemo or radiation." She armed herself with positive thoughts, a team of supporters and doctors and, then, she says, "fought through every poke, prod, exam, surgery and treatment to get to victory!"

It's been a rollercoaster ride ... for both of them. But these two let no obstacles get in their way; they are armed with supportive husbands and a yin-yang friendship that functions at an intuitive level. From raising babies to raising funds to contracting talent to kicking cancer, they've been by each other's side through it all.

New Menu

This year, AFWF celebrates its sixth anniversary and adds some new people to the mix—their team is now part of the London-based IWSC Group, Ltd., which originated as the International Whiskey & Spirit Competition and then expanded to include several other prestigious beverage events. With the acquisition of the Festival, IWSC now forays into the culinary realm and establishes their North American office with Love as CEO and Feichter as COO.

Photo-6Feichter explains, "They said, 'We're interested in moving into the U.S. marketplace. Are you interested in selling AFWF? We've been watching you for the last couple of years.' We said that we're not interested in selling it outright, but through a series of conversations we found the perfect meeting of what we do, and [also] how to do these other larger initiatives. I think we are at a different chapter. The Festival has grown up, we've passed the five-year mark, we put a stake in the ground with a successful event that has a long-lasting opportunity behind it. So, what does the next five years look like? How does IWSC take shape here in North America? How are we helping to guide that? We really are in partnership with the group in London, setting the course for what the food and beverage entertainment industry looks like in North America.We thrive off of what comes next! Finding the next big thing drives us, and going big drives us and never settling drives us. Quiet doesn't work for us."

No, quiet does not work for them. And the delicious noise they make echoes once again through Atlanta when AFWF serves up its fare from June 2 to 5. The Learning Experiences will be presented at Loews Atlanta Hotel and the Tasting Tents this year move over to Piedmont Park Promenade—including the brand-new experience of the pop-up Vineyard in the City, which is an actual vineyard planted just for AFWF and remaining in place through July 30 for community enjoyment. The roots of the Festival continue to spread deeper and further as its influence grows, nourishing new ventures and inspiring the next generation. Visit for full event details and to purchase tickets.


Friday, 22 April 2016 14:22

Sweet Slumber

by Morgan A. McLaughlin McFarland

Sleep is as strong a biological need as food, water and shelter. Without adequate sleep, physical health degrades and mental health suffers. Sleep deprivation wreaks such profound havoc on the mind and body that it's used in some cultures as an enhanced interrogation technique for prisoners. Achieving adequate sleep can be a challenge, however, as variances in work and school schedules, medical conditions like insomnia or lifestyle choices can all interfere with the ability to fall into a deep, restorative sleep. What does the ideal sleep cycle look like and how can we achieve it?

The Clinical Need for Sleep

One cause for sleep difficulties may be your work schedule, particularly shift work that involves late or irregular hours. Inconsistency in bedtime and waking time or attempting to sleep during daylight hours can make achieving an adequate amount of sleep difficult.

sweet slumber"Humans are best suited to sleeping when it is dark outside. We release melatonin when it gets dark and when our bodies are cooling down," says Nancy Collop, MD, director of the Emory Sleep Center and professor of Medicine and Neurology at the Emory University School of Medicine. The National Sleep Foundation suggests a melatonin supplement can replicate the body's natural melatonin production in certain cases, such as jet lag and shift work, by resetting the body's internal clock. Melatonin supplements are not a substitute for the proper amount of sleep, however, and have not been adequately studied for use in treating sleep disorders.

Taz Bhatia, MD, of CentreSpringMD stresses the importance a consistent sleep schedule. "​Most people sleep an average of seven hours per night, falling asleep and waking up at the same times," says Bhatia. "Professions that demand otherwise accelerate aging and disease."

When should those seven hours of sleep fall? While sleep time may vary, most people's ideal sleep schedule falls within a specific window of time.

"Most people go to sleep between around 10 p.m. to 12 a.m. and rise around 6 a.m. to 8 a.m.," says Hitendra Patel, MD, Medical Director of the WellStar Sleep Program. "A very small percentage of folks have Advanced Sleep Phase Disorder (ASPD), where they naturally fall asleep around 5 p.m. to 8 p.m. and rise around 1 a.m. to 4 a.m. The opposite condition is Delayed Sleep Phase Disorder (DSPD), where the sleep time is around 2 a.m. to 6 p.m. until about 10 a.m. to 2 p.m. Of the two, DSPD is more common, and patients with this are often misdiagnosed as having insomnia since they cannot fall asleep during the 'conventional' sleep period. They have great difficulty waking up and functioning in the early part of the day (when their brain is still wanting to be in sleep mode). ASPD is more common in the elderly, and these patients often complain of early morning awakening and being unable to return to sleep."

Sleep Cycles: REM and Non-REM

Not all sleep is created equal. Our bodies go through different stages in the sleep cycle, with different physiological effects from REM (rapid eye movement) and non-REM sleep. Both stages of sleep affect the nervous, endocrine and cardiopulmonary systems. During sleep, core body temperature drops. Heart rate and diastolic blood pressure decrease by as much as 10 percent. Growth hormones, testosterone and prolactin increase, while cortisol and hormones that affect insulin and thyroid production decrease. During non-REM sleep, respiratory rate slows and blood oxygen levels decrease.

"[Non-REM sleep] is typically seen after falling asleep and initially going into non-REM sleep. About 90 minutes later, we go into REM sleep and cycle between non-REM and REM sleep every 90 minutes or so. REM sleep is where we typically dream." says Vijay M. Patel, MD, pulmonologist and sleep medicine specialist with Piedmont Newnan Hospital. "We usually spend more time in non-REM sleep during the first part of the night and more time in REM sleep in the later part of sleep. We may have two to five cycles between non-REM and REM sleep."

How important is it to experience full, uninterrupted sleep cycles, particularly REM sleep? While REM's full effects on the body are still being explored, we do know that REM plays a vital role in our physical and mental health.

"In general, a good night's sleep is very important in our overall body functions, including learning new information and consolidating that information into memories," Dr. Vijay Patel says.

Inside and Out

Healthy sleep gives the body and the mind a period of restoration. According to the National Sleep Foundation, while we rest in deep sleep, the brain builds and strengthens neuropathways, glands release and rebalance hormones, the blood supply increases and tissue growth and repair occurs. Therefore, sacrificing sleep affects mental acuity, reflexes, mood, stamina, immunity and even appearance.

"​Lack of sleep is aging your body in many ways and can leave you with a dull, sallow skin look, early wrinkling and hair loss," says Dr. Bhatia. "Mentally, lack of sleep worsens anxiety, depression and attention or the ability to focus." The body needs that regular rejuvenation to maintain health and combat stresses from lifestyle and environment.

Without this downtime, David Westerman, MD, medical director of Northside Hospital Sleep Disorders Center, cautions there's "a negative impact on memory and thinking processes, mood changes, irritability, increased risk for depression and substance abuse and a negative impact on interpersonal relationships." Dr. Collop agrees, stating that "the biggest effects of sleep deprivation in studies is that on mood—more depressed and labile. Reaction time is reduced as well. Chronic sleep deprivation also seems to affect the immune system, so one may be more susceptible to infections."

The Dos and Don'ts of Good Sleep

For those without a chronic sleep disorder, a few changes to lifestyle and behaviors may greatly improve sleep. Here are some Dos and Don'ts to help you achieve the best possible night's sleep:

Do: Be consistent with bedtime and waking time.

Do: Get regular exercise, which is shown to reduce insomnia and lead to deeper, more regular sleep.

Do: Develop a bedtime routine, with 30 to 60 minutes of unwinding activities before bed—such as yoga, meditation or prayer, even a warm bath or shower to help relax.

Do: Keep the room cool, dark, quiet and uncluttered.

Do: Limit screentime for one to two hours prior to bedtime; light from TV and devices (smartphones or tablets) stimulates the pineal gland, interfering with the sleep/wake cycle.

Do: Use the bed for sleeping and sex only, not for other activities such as work or spreading out projects.


Don't: Use tobacco or other nicotine-containing products.

Don't: Have caffeine within four hours of bedtime (this includes chocolate).

Don't: Drink alcohol within one to two hours of bedtime (particularly for women).

Don't: Eat heavy or fatty late-night snacks.

Don't: Nap in the late afternoon or early evening.

Don't: Let sleep be shortchanged. Prioritize it!

And the Most Important Don't? "Don't think you can catch up on your sleep—you can only catch up on slowing down the aging process," says Dr. Bhatia. "We all need consistent, regular nightly sleep for our bodies to function optimally."


Editorial Resources
Taz Bhatia, MD, CentreSpringMD —
Nancy Collop, MD, Director of Emory Sleep Center and Professor of Medicine and Neurology, Emory University School of Medicine —
National Sleep Foundation —
Hitendra Patel, MD, Medical Director of WellStar Sleep Program —
Vijay M. Patel, MD, FCCP, Pulmonologist and Sleep Medicine Specialist, Piedmont Newnan Hospital —
David E. Westerman, MD, FCCP, FAASM, Medical Director of Northside Hospital Sleep Disorders Center —


Friday, 22 April 2016 14:08

Loosening the Stroke Belt

By Katie Lambert

Southerners live in what the Centers for Disease Control calls the "Stroke Belt," an area made up of people who are both more likely to suffer a stroke and more likely to die from one.

The one thing doctors who treat stroke victims wish you knew? How much control you have over that risk. As part of National Stroke Awareness Month, we're providing information necessary to help you recognize how to lower your risk of having a stroke.

An average of about 795,000 people per year have a stroke. For more than 140,000 of them—roughly the population of the city of Savannah—their stroke is fatal. Yet most of us have only a superficial understanding of what a stroke looks like, how to prevent it and what the outcomes can be.

"Eighty percent of strokes are preventable," says Dr. Aaron Anderson, a vascular neurologist at the Marcus Stroke & Neuroscience Center at Grady Memorial Hospital. "There are some risk factors that you can't change, like age, but there are plenty that we can treat and control."


Those factors are what the American Heart Association calls the Simple 7: manage blood pressure, control cholesterol, reduce blood sugar, get active, eat better, lose weight and quit smoking.

"People feel like they're powerless when it comes to stroke prevention, that they're at the mercy of their genetics," says Dr. Lisa Billars, chief of the departments of neurology and sleep medicine at Kaiser Permanente Georgia. "But these modifiable risk factors matter a great deal."

A recent REGARDS (Reasons for Geographical and Racial Differences in Stroke) Project study, sponsored by the National Institutes of Health (NIH), showed that a Southern-style diet, characterized by fried foods and high in both saturated fat and added sugar, significantly increased the risk of acute coronary heart disease (and therefore stroke) more than any other diet pattern the researchers evaluated—including one full of pizza and takeout. (Note: We are not advocating switching to pizza and takeout.)

High blood pressure is the most important risk factor to watch—in fact, both Drs. Billars and Anderson call it "risk factors one, two and three." Billars points to aggressive treatment of high blood pressure as one of the most important advances in stroke prevention in the last few years. She notes that cardiologists and neurologists are often more aware of the importance of aggressive treatment of hypertension than primary care providers, so it's important to be vigilant about your own blood pressure levels and don't hesitate to ask about treatments for high blood pressure with your primary care doctor.

loosening-the-stroke-beltIf one side of a person's face droops, one of their arms can't raise as high as the other or their speech is slurred or confusing, the key is the "T"—time. Clinicians say, "Time is brain," meaning that the longer it takes to get treatment for a stroke, the more nervous tissue is lost. It's estimated that, during a stroke, each minute costs a patient 1.9 million neurons. The difference between arriving at the hospital in 45 minutes versus 65 can be critical.

The growing awareness of the importance of time to treatment, along with treatment advances, is changing outcomes for stroke survivors. A good outcome for a person who has suffered a stroke is a mild disability (the patient can still walk and perform daily living activities independently). An excellent outcome means full function returns to the patient, along with some side effects, such as headaches.

The American Heart and Stroke Association defines two distinct types of stroke—ischemic and hemorrhagic. An ischemic stroke results from a clot that obstructs blood flow to the brain. The hemorrhagic stroke occurs due to the rupture of a blood vessel leading to the brain.


For an ischemic stroke, the treatment champion is tissue plasminogen activator (tPA), a blood-clot busting medicine that allows blood to flow to the brain where it's needed. However, the catch is that it can only be administered up to three hours (in some cases, four and a half hours) after a stroke.

The most exciting ischemic treatment advancement, according to Dr. Fadi Nahab, medical director for the Stroke Program at Emory University Hospital and Emory University Hospital Midtown, is an endovascular procedure called a mechanical thrombectomy. A physician threads a device called a stent retriever through an artery in the groin to get to the blocked artery in the brain to grab the blood clot.

SB-2"We've learned through multiple studies that getting to ischemic stroke patients as quickly as possible results in significantly less disability from that stroke than with just clot-busting medicine alone." Dr. Nahab adds, "This is one of the most substantial improvements in any procedure in any specialty in medicine."

Dr. Nahab also feels encouraged by new medications showing promise in early studies as well as a new procedure for unruptured brain aneurysms that can prevent hemorrhagic stroke. What doctors really want to share with the public is that researchers are learning new things all the time, and ongoing studies reveal insights into innovations that can be put into place immediately.


Recent studies on stroke recovery found, for example, that patients with weakness resulting from a stroke on one side of their body can regain more mobility if their full-functioning arm is constrained and they are forced to use their disabled arm.

Physicians have also taken a more aggressive stance on early mobilization after research showed better physical function and a better rate of return to walking if patients move around in the first 24 to 48 hours after a stroke. "We used to think, 'Let them rest, they just had a stroke.' But now we know it's vitally important to get them moving unless there's a compelling reason they shouldn't be," says Dr. Billars. She points out that this is a tactic that can be used even in small communities that don't have access to a high-tech stroke center.

The role of family and friends in stroke recovery is vital, not only to share the psychological burden or practical tasks in caring for a patient, but also to provide encouragement through the physical-therapy process. It can be difficult for patients to continue pushing themselves to move when their body isn't cooperating like it did before a stroke. "Stroke recovery doesn't have to stop six months or a year after a stroke," says Dr. Anderson. "It's not static. And it doesn't happen without support."


Editorial Resources:
Dr. Aaron Anderson, Grady Health Systems—
Dr. Lisa Billars, Kaiser Permanente—
Dr. Fadi Nahab, Emory Healthcare—
American Heart and Stroke Association—
Centers for Disease Control and Prevention—
National Institutes of Health—
National Heart, Lung, and Blood Institute—

Friday, 22 April 2016 13:58

Healthy Nails

By Taylor Arnold

Handshakes have long been a universal greeting—so hands and nails are often the first gesture we present to others. But aside from the occasional trim or manicure, many people fail to properly care for their nails. While imperfections such as ridges, cracks or inflamed cuticles may seem insignificant, they can sometimes be a sign of deeper problems that can impact a person's overall health. Paying close attention to the nails on both hands and feet can help you keep tabs on the rest of your body.

Nails, like skin and hair, are made of specialized proteins called keratin. As we age, these keratin-based structures tend to thin, so some natural thinning of nails over time is normal. However, issues like cracks, inflamed cuticles and warts are not. "Some of these common problems can damage the part of the skin that makes up the nail, known as the nail matrix," explains Dr. Weston Waxweiler of North Atlanta Dermatology. "When the nail matrix is damaged, the nail may be permanently altered."

According to Dr. Stephanie Michael of Village Podiatry Centers, the most common concerns with toenails are in-grown nails, nail fungus and bruising of the nail. "It's important to really look at your nails for any discoloration or deformities," she says. "If you have a bruise under the nail, have the podiatrist take a look. Although rare, melanoma can present itself as a dark spot."

The good news is that growing and maintaining strong nails on a day-to-day basis involves some very basic practices. First and foremost, eating lots of protein and vegetables is key, because good nutrition helps strengthen the nails. Cut your fingernails straight across the top and properly trim the cuticles (filing with the more gentle friction of 240-grit files and buffers). "Filing the natural nail should be done in one direction—from the edge to the center of the nail plate," says Stephanie Allen, nailcare program director at the International School of Skin, Nailcare and Massage Therapy. She also recommends educating yourself about the products used on your nails, particularly those with harmful ingredients like formaldehyde, DPB, toluene and acetone.

To further protect your fingernails, wear gloves when washing dishes, as excessive contact with water or cleansing agents can lead to cracks, ridging and fungal infection. "When considering a manicure, give your nails a week or two between gel coats to allow them to recover," Dr. Waxweiler says. "Finally, consider asking your doctor about biotin, as this vitamin can help all keratin-based structures (including nails, hair and skin) in your body."

For healthy toenails, cut the nail straight across the top, but avoid rounding them off or cutting them too short because this can cause ingrown nails. Also, wear shoes that fit properly. "If they are too small or too tight in the toe box, this can cause ingrown toenails, bruising and nail fungus," Dr. Michael says. "For fungal toenails—think discolored and yellow toenails—topical or oral medications or laser therapy all are very effective treatments," she says. "The number one cause of fungal toenails is trauma. For example, when you are a runner or a soccer player, that trauma of the nail against the shoe is what causes the fungus."

SB-1If you enjoy a good mani/pedi, treat yourself, but be sure you're frequenting a quality nail salon. "Several red flags for nail salons include unlabeled products, an unusually strong 'chemical' smell, a price that is extremely low and lack of a ventilation system or fans blowing in the salon itself," Dr. Waxweiler says. Dr. Michael adds, "Make sure the place is clean, that they wear gloves and that they are cleaning out basins where you soak your feet. They should not be doing any medical procedures for you, using sharp instruments near your feet or cutting out ingrowns."

Most of all, keep in mind that the majority of nail issues tend to resolve on their own. Be patient—nail turnover is slow, so it may take many months for a damaged nail to replace itself entirely. Consistent care and attention will help you keep your best foot, and hand, forward at all times.

Editorial Resources
Village Podiatry Centers—
North Atlanta Dermatology—
International School of Skin, Nailcare & Massage Therapy—

Tuesday, 19 April 2016 14:53

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