Thursday, 26 June 2014 17:03

Doctors Who Walk the Walk

So your doctor tells you that it's time to lose some weight. You have to get your cholesterol under control and your blood pressure down. He wants you to eat better and exercise. He wants you to learn to manage stress more effectively. But as he's telling you this, you notice his own elevated BMI, and you begin to wonder if he practices what he's preaching. Do you take his advice seriously if it seems that he doesn't adhere to the healthy lifestyle he's suggesting for you?

It's a common problem in today's physicians' offices. While treating patients and advocating the adoption of healthy habits, many doctors are actually unhealthy themselves. Often exhausted from dealing with the pressures associated with their profession, they don't eat right or exercise and end up contending with a host of chronic diseases. It's a problem because research shows that patients are more likely to follow preventative health measures if their physicians do so as well. Fortunately, these Atlanta doctors do, in fact, lead by example, walking the walk and living healthy lifestyles that serve as inspiration to their patients.

 

Shealyn-Buck-MDShealynn Buck, MD
Making a Lifelong Health Investment

This past December, Dr. Shealynn Buck, executive director of DeKalb Medical Employee Health Solutions, wasn't feeling her best. The single mother of two daughters, ages 11 and 14, had just turned 41, and while she was in generally good shape, she decided that she had to do something to reset her health. So she gave herself a full lifestyle makeover, starting with a transition to a plant-based diet.

"I had to ask myself what would work for me, and I know that I feel better when I'm eating foods that are from plants. I've never been a big meat eater, so it wasn't that difficult to go to a full plant-based diet," explains Dr. Buck, who not only is a medical doctor, but also a certified professional health and wellness coach. "I actually started eating a plant-based diet in high school, but it's easier today than it was then. There are options today. I eat whole foods – nuts, grains, vegetables and fruits. I don't eat meat, and I don't do dairy. And by doing that, I lost five percent of my body fat."

Truth be told, Dr. Buck didn't have a lot of weight to lose. A fitness enthusiast who was inspired by her father, a long distance runner, Dr. Buck has always been physically fit. She began running as a stress reliever while attending Emory University School of Medicine in 1996. And today, in addition to her healthy diet, she enjoys everything from running and walking to dance classes and rock climbing. "Those are the two areas I am so passionate about – nutrition and fitness," she says. "It's about overall well-being. When you exercise and eat right, your mind works better. Your body works better. You sleep better. And I've been able to integrate that thinking into what I'm doing with DeKalb Medical."

Hired in 2012, Dr. Buck is charged with creating programs that promote the long-term physical, mental and social well-being of the hospital's employees, as well as employees throughout Atlanta. With her background, it's a perfect fit. And while she currently does not see patients one-on-one, she understands the role that physicians play in transforming patients' lives. "Health care providers are some of the unhealthiest people. It's ingrained in us that someone else comes first," she states. "But a drowning person can't save another drowning person. We have to be healthy. We're walking billboards. When health care professionals are healthy, they deliver better care and are more likely to convey healthy habits to their patients."

Yet, she adds, "Doctors are human beings too. We have our own health journeys. I'm not picture perfect. My biggest struggle is stress management. But that helps me be more understanding about what people are going through. That compassion and empathy, bringing that human factor back to medicine, is crucial. It's easy to write a prescription, but it's tough to influence lifestyle change and behavior. We can show patients that investing in your health is the greatest lifelong investment you can make."

 

Ralph-Lyons-MDRalph Lyons, MD
All Things are Possible

It's not unusual to see Dr. Ralph Lyons out on the road at 5 a.m. running. When he's out there, he's usually training for a 10K, a marathon or a Half Ironman event. "I know my schedule, and I don't mind getting up early," says the renowned physician, who has worked with Atlanta South Gastroenterology since 1989. "I've trained for marathons at 4:30 a.m. It isn't easy, but if you find your passion, you'll magically find time for it. If you have that passion, you'll get up earlier or go to bed later to pursue it."

Dr. Lyons discovered long distance running at Harvard University after a roommate said he thought the active med student could run three miles. Believing he could not, Dr. Lyons hit the road and easily cleared the distance – and loved it. In time, he decided to enter the Peachtree Road Race. During the event, he saw people smiling widely as they ran. "I realized that this is a celebration of life," he recalls. "I've been hooked now for a long time. It resonates with my being."

Seventeen years ago, Dr. Lyons joined the South Fulton Running Partners, the oldest black recreational running club in the country. He now runs six miles every Saturday and participates in a variety of races. "Running partners have more fun, and we take that to heart," he says. "The glue that binds us is the fellowship and fun. It's not about how fast one runs. Your value to the group depends upon passion and enthusiasm." And for Dr. Lyons, those elements are coupled with determination. At 58, he's fortunate to have avoided any major injuries and trains and competes whenever he can. "Sometimes I don't know how I do it, but I think it's about having a passion and a goal," he notes. "I'm a goal-oriented person, and that drives what I do in both medicine and my athletic pursuits."

In addition to keeping him healthy, Dr. Lyons believes that being a runner makes him a better physician. Not only can his body tolerate long days because of his endurance training, but he also is more alert and cheerful. Furthermore, his understanding of the psychology and physiology of exercise lets him connect with patients on a different, first-hand level. "You can help patients in a more realistic way instead of on a theoretical basis," he explains. "You understand that when you're an athlete, you're more tuned to eating healthier and making healthier decisions, especially if you want to pursue your passion with proficiency. I tell my patients that healthy behavior can follow the passion, and that's okay."

What's more, Dr. Lyons knows that his athletic success inspires his patients in many ways. "I hope it's a motivating factor," he concludes. "Running has shown me that happiness can be achieved independently of one's occupation or economic position in life. I think of myself as an ordinary person, but I know I can be an example and show my patients that they can unlock their own potential. It's never too late to start. Find what you're passionate about, and all things are possible."

 

Naima-Cheema-MDNaima Cheema, MD
It Becomes Second Nature

Dr. Naima Cheema, who joined North Roswell Internal Medicine six years ago, isn't a fan of fast workouts with loud music. As a busy physician and married mother of two, her life is already fast-paced enough. "I'm mentally exhausted after working all day, and I don't want to have to rush or have a lot of noise around me," she says. "I used to do cardio, but it doesn't help you relax. I enjoy yoga so much more, with the slow transitioning, the breathing exercises and the soothing music. I love the stretches, and at the end, there are always five to 10 minutes of meditation. It's the best part of my day. It's a great way for me to de-stress."

Once Dr. Cheema found a physical activity that she enjoyed, making it part of her lifestyle was easy. Today, she does yoga twice a week at Women's Premier Fitness and adds in a third day of another type of exercise, such as tennis. "We are such creatures of habit," she explains. "By doing something regularly, it can become second nature." It's a principle that she shares with her patients often, especially those struggling with their weight.

That principle is also something she understands personally. When she entered medical school, Dr. Cheema was overweight. In school, she says, "I learned more about chronic health issues like diabetes, hypertension and hyperlipemia, and I realized that there is a strong association between these health conditions and obesity." From that point on, she started making healthier choices like controlling her portions and exercising regularly. Through those changes, she managed to lose nearly 50 pounds.

Dr. Cheema's personal insight allows her to better guide her patients as the director of a medically supervised weight loss program. She says, "I understand the dynamics of weight loss. I understand that it's hard." Because she's been there herself, Dr. Cheema knows a realistic approach can work wonders. She advocates healthy additions to your plate, rather than counting calories or cutting out food groups. "You have to eat what you need to survive. You need protein, fat and carbohydrates," she asserts. "Counting calories is not practical," she adds. "Instead, just cut back on the calories with portion control." She recommends gauging an appropriate portion size by putting it on a quarter of a plate and eating just one serving.

These healthy practices that Dr. Cheema recommends to her patients are the same ones that are now second nature for her. Her easy rules of thumb are tried and true and have helped her maintain her weight loss over the years. "Drink plenty of water to stay hydrated," she says. "Eat more fruits and vegetables, have desserts on weekends only, minimize fried foods and try to eat more grilled and baked foods."

Since Dr. Cheema has been in her patients' shoes, she is proof that simple lifestyle changes can work. "You can only preach what you practice," she says. "If I'm 300 pounds, my patients won't listen to me. You have to own your behavior. When you do, you can make the greatest difference in others' lives."

 

 

Thursday, 26 June 2014 16:47

Eating Disorders Explained

"When I was 14 years old, I was told that I was 'too big.' I was extremely embarrassed and ashamed of myself and how I looked." Even at such a tender age, Dr. Genie Burnett's negative feelings about her body prompted a change in how she ate. "I began to engage in anorexic and bulimic behaviors in order to 'prove' that I was okay." At age 16, Dr. Burnett spent seven weeks hospitalized for treatment. Now a psychologist and executive director of the nonprofit Manna Fund, Dr. Burnett has long since returned to healthier eating behaviors, but increasing numbers of men and women of all ages are still struggling.

Eating Disorders Defined
At its most basic, an eating disorder is a disturbance in someone's eating patterns and behaviors that affects both their physical and mental health. These behaviors take many forms: severely limiting food intake, binge eating, purging, eating when not hungry, exercising obsessively to prevent weight gain, and the list goes on. According to the National Eating Disorders Association (NEDA), the most common ways these behaviors manifest are known as anorexia nervosa, bulimia nervosa and binge eating disorder.

 


 

 

Anorexia Nervosa

  • Inadequate food intake leading to a weight that is clearly too low
  • Intense fear of weight gain and persistent behavior to prevent weight gain
  • Self-esteem overly related to body image

Bulimia Nervosa

  • Frequent episodes of consuming very large amounts of food followed by behaviors to prevent weight gain, such as self-induced vomiting
  • A feeling of being out of control during the binge eating episodes
  • Self-esteem overly related to body image

Binge Eating Disorder

  • Frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain, such as self-induced vomiting
  • A feeling of being out of control during the binge eating episodes
  • Eating when not hungry, eating to the point of discomfort, or eating alone because of strong shame or guilt about the behavior

— Information courtesy of the National Eating Disorders Association

 


 

Sometimes a person's eating behaviors do not fit into any of those three categories, which may result in a diagnosis of EDNOS, or Eating Disorder Not Otherwise Specified. This basically means someone exhibits behaviors typical of disordered eating but perhaps not to an extreme.

Not only do multiple conditions fall under the eating disorder umbrella, but also an increasing number of people struggle with them. A 2011 National Institutes of Health study estimated the number of Americans with eating disorders at 30 million, and that number is on the rise.

Digging Deeper
As the variety and prevalence of conditions shows, eating disorders are complex. The underlying reasons for the disorders are, if possible, even more complex because they are mental, rather than physical. Jessie Alexander, clinical coordinator for women's services at Ridgeview Institute, explains, "Often, clients will express that they can remember being cognizant of their bodies in a destructive way as early as three to five years of age. Other times, clients became critical of their bodies after experiencing a traumatic event that felt unmanageable to them."

Dr. Burnett adds that the disordered eating patterns can often stem from relatively common behaviors or desires. For example, many people diet regularly, sometimes lose their appetite due to nerves or stress, or have occasional negative feelings about their body. For some people, though, emotional factors cause these habits to escalate to unhealthy levels. "They use food to cope with their negative (often unconscious) beliefs and emotions," Dr. Burnett says. "At later stages, it is difficult for them to manage their intense feelings in any other way than by using food." Alexander agrees, saying, "Patients feel that their eating disorder provides them with a sense of control and serves as a distraction from unwanted feelings of shame, disempowerment, loneliness, emptiness and grief."

Get the Facts
Because eating disorders are a mental health issue as much as a physical one, misconceptions about these conditions are rampant. Make sure you know the truth.

Myth #1: Eating disorders are a choice. Many people make the mistaken assumption that recovery is as easy as just "eating more." In reality, "Developing an eating disorder is at least 50 percent biologically/genetically determined," says Dr. Linda Buchanan, the founder and clinical co-director of the Atlanta Center for Eating Disorders. Recent research shows measurable differences in the brains of those who suffer from eating disorders. "Differences in their brain chemistry increase their sensitivity to stimuli," Dr. Buchanan explains. This sensitivity makes them overly aware of – and often worried about – their own and other people's perceptions of them. According to Dr. Buchanan, "This generally leads to harm-avoidant strategies such as perfectionism, obsessive-compulsive behaviors, social avoidance, shyness and ultimately eating disorders." So rather than it being a simple choice, physiological differences and the resulting coping mechanisms are major factors in these conditions.

Myth #2: Eating disorders only affect young, white girls. "This is absolutely not true," Dr. Burnett says. According to recent studies, Dr. Buchanan explains, "The prevalence of eating disorders is similar among non-Hispanic whites, Hispanics, African Americans and Asians in the United States." And when it comes to age? At The Renfrew Center, a national eating disorder treatment center with a location in Atlanta, the number of midlife patients is on the rise. According to their website, "Over the past decade there has been a 42 percent increase in the number of women over the age of 35 who sought treatment at Renfrew." Dr. Burnett's private practice has treated men and women from age 7 to 67, and at Ridgeview Institute, clients range from age 13 to 65.

Myth #3: Eating disorders aren't a serious medical condition. Not so, according to Dr. Jay Faber of the Amen Clinics. He explains, "Eating disorders can lead to cardiac arrhythmias, renal problems and multiple system organ failure. Often, these problems are very serious and come on quite suddenly." If you are a parent and suspect that your child may be struggling with disordered eating behaviors, Dr. Burnett recommends a medical evaluation that includes blood panels. These will reveal how the child is being affected by their change in eating and help address the health repercussions as early as possible.

How to Help
Whether you're a parent, a family member or friend, if you see general warning signs of an eating disorder, take note. Is your child making excuses to skip meals or eat alone? Does your friend make self-critical statements about her body and seem increasingly concerned with perfection? Does a family member seem preoccupied with discussing food or food-related subjects? Do you yourself feel like you have some strange behaviors around mealtimes? And of course, keep an eye out for significant weight loss or gain, though these may not always occur.
If you are concerned about someone's unhealthy eating habits, don't try to control the behavior by trying to force them to act a different way.

Dr. Burnett recommends simply asking about the symptoms you've noticed, being sure to steer clear of specific comments about weight, and then listening to their response.

After opening up the conversation, you may want to seek out someone who has a specialty in dealing with eating disorders, like a counselor, physician or inpatient treatment facility like Atlanta's Ridgeview Institute."Ridgeview has an access center that is open 24 hours a day and provides free assessments for anyone concerned about issues associated with emotional distress," Alexander says. In addition to treatment facilities, support systems like Manna Fund's online space Talk It Out encourage people to talk out their emotions rather than acting them out with food. Manna Fund also helps families with the cost of inpatient treatment, which is often a necessary but expensive step in the recovery process. Even organizations like the Atlanta National Hypnotherapy Institute can help address weight and food issues with people of all ages.Ultimately, the goal of treatment is two-fold: to stop the disordered eating behaviors and to learn to process emotions safely. Even once the disordered eating behaviors stop, treatment for the underlying issues can continue for years. Dr. Burnett recalls her own years of recovery, saying, "I spent many years in outpatient therapy to work through and deal with the shame and pain of other issues from my childhood." Ultimately, she was able to come through the experience with a healthier mind and attitude as well as a nourished body.

 

Editorial Resources
Jessie Alexander, LPC, NCC, Ridgeview Institute – www.ridgeviewinstitute.com
Linda Buchanan, PhD, Atlanta Center for Eating Disorders – www.eatingdisorders.cc
Genie Burnett, PsyD, Manna Fund – www.mannafund.org
Jay Faber, MD, Amen Clinics – www.amenclinics.com
Laura LaRain, Atlanta National Hypnotherapy Institute – www.anhi.com
National Eating Disorders Association – www.nationaleatingdisorders.org
The Renfrew Center – www.renfrewcenter.com

 

Thursday, 26 June 2014 16:33

Evaluating Your Home Health Care Options

When a loved one needs extra care, you may consider arranging care for them at home. Care at home offers the comfort of familiar surroundings, including continued support, interaction with pets and neighbors and other positives that help ease what can be a difficult time of transition for aging parents or others who need care assistance. But how do you know when home care is appropriate for your loved one? Factors like type of care required, qualifications of the providers and cost are all worth examining before taking the next step.

Know Your Needs
It is important first to establish the difference between "home care" and "home health care," as they are not the same service. Home health care means receiving skilled medical care from registered nurses, licensed practical nurses or certified nursing assistants, who are often affiliated with home health care agencies. Home care, on the other hand, is provided by a non-medical caregiver such as a personal care aide and tends to focus on companionship and assistance with daily activities.

"Both home care and home health care have the same goal: to keep your loved ones safe and as healthy as possible," says Ed Ukaonu, Certified Senior Advisor and CEO of FirstLight HomeCare's Atlanta locations. "Often, they work in tandem. A home health care nurse or physician's assistant will visit the home and potentially adjust prescriptions, while a non-medical caregiver will make sure these medications are taken on time. A physical or occupational therapist may design an exercise plan; a non-medical caregiver will help with these exercises throughout the day. A physician usually prescribes home health care when someone needs skilled care in the home. Both services require specific licensing and both assist with activities of daily living (ADL)."

Kinds of Service
The great benefit to home care is that it is truly customizable to each individual person and situation. "Our home care services are available to people of all ages wherever and whenever they need it," Ukaonu says. "This includes seniors that need some assistance to stay in their homes, care for the elderly who have chronic illnesses, families with members who have special needs or disabilities, people recovering from illness or surgery, new moms and families of deployed military personnel. We can even serve people who just need someone to talk to."

Some of the most common services provided include activities of daily living like bathing, dressing, eating, transferring (from a bed to a wheelchair, for example), toileting and walking. A home care provider may also address companionship and social needs by providing transportation to shopping, errands, medical appointments, social events, church, playing cards or board games and watching movies or television. In some arrangements, the provider may even do some light housekeeping or cooking to make life easier on everyone in the family.

Broaching the Subject
Discussing the topic of in-home care is often difficult for families, but having an open dialogue is key in identifying and providing the best care solutions. When you first bring up the topic to your loved ones, they may be resistant to accepting additional care. Try to speak candidly to the person about the issues holding them back from accepting assistance. Is it fear of losing their privacy and independence? Are they worried they are being a burden? Are they concerned about the cost? Once you identify the real issues behind someone's resistance, you are better equipped to rectify their fears or misconceptions.

A crucial element in addressing those fears and misconceptions is education, both for the family members and especially the person in need of care. David Solie, author of "How to Say It to Seniors: Closing the Communication Gap With Our Elders," shares, "In 20 years of working with seniors, I've come to know how deep the need for control is in that age group." He points out that, though they desire a reasonable measure of control over their lives and circumstances, seniors often wind up with very little control. That can be confusing at least and frightening at worst, but education about home care options can help significantly. Often, once patients understand their options, they feel more active in their care and appreciate the independence home care can offer.

Find the Right Care Provider
Once you and your family member agree that some sort of home care is needed, it's important to know what to look for from care providers. Whether you work with an agency or a private professional, knowing the right questions to ask can be a huge help in identifying the best person or group of people to provide the necessary care. Your starting place should include:

  • Speaking with former and/or current patients and their families
  • Confirming the agency or private professional's licensing
  • Running background checks
  • Ensuring there is a backup person available in the case that the individual you hired is unable to perform their job due to scheduling issues, emergency or illness

"You should have good communication with the agency," says Nancy Bour, co-owner of Synergy HomeCare of Metro Atlanta. "Are the owners accessible? Can you speak with the nurse if you have questions?" Accessibility can make all the difference in your experience as you select the right provider and move forward with care for your loved one.

Your primary care physician may be able to assist in providing names of qualified caregivers. Check with your local church or senior center; they may know qualified people looking for employment. You can also access the Eldercare Locator at www.eldercare.gov or at 1-800-677-1116.

 


 

13 Questions to Ask

  1. Does my state license home care? If so, is the agency licensed? If not, does the agency follow policies and procedures similar to those in a licensed state?
  2. Is the agency locally owned and operated? Are the owners on site actively managing the agency? If the agency is part of a franchise, what "watchdog" organizations is the franchise a member of?
  3. Are the agency's caregivers employees or independent contractors? (You might want an agency that knows its employees, not one that just acts as an employment agency.)
  4. Are caregivers bonded and insured? (They should be.)
  5. What criminal screening and background checks does the agency run on its caregivers?
  6. What sort of training do the employees receive? Is training ongoing?
  7. Will an agency supervisor evaluate the quality of care you receive? How often?
  8. How is billing handled? If private insurance will pay for some of the costs, will the agency bill them directly?
  9. If you have a family member who is involved in your care, how does the agency ensure they stay informed and included?
  10. What provisions are there for backup care? Who do you call if no one shows up? Does the agency have someone on call? After hours? What provisions are there for care during a disaster?
  11. Who can you call to discuss any issues and be sure to have them resolved?
  12. Are you committed to a long contract with the agency?
  13. Once you decide to work with the agency, how long will it take to get a caregiver?

—Information provided by Synergy HomeCare

 


 

Costs of Care
When it comes to costs, home health care is usually paid by Medicare, Medigap, Managed Care, Medicaid, Veterans Benefits and private pay, Ukaonu says. He says home care clients are generally private pay, although Medigap, Long Term Care Insurance (LTCI) and veteran benefits are available. Some health insurance plans can offer limited respite care coverage. "Home health care services are usually temporary (generally a short period of time) and with limited frequency (one to two hours per week), whereas non-medical home care can go on indefinitely."

HHC-PHOTODepending on the type of care provider you choose, you may also need to be prepared to deal with taxes and speak with your insurance company to insure your employee in case of an accident. You may want to consult an attorney to ensure you have all the bases covered when it comes to hiring an independent home care worker.

Quality of Care
No matter how thoroughly you've vetted the care providers, it's still important to be an advocate for your loved one and continue participating in their care. Keep an eye out for any changes in your loved one, such as a personality change that may be due to medications or a change in conditions like dementia, according to Bour. "Did the agency raise the issue to you? If not, you should have a discussion with them and ask what their caregivers have observed," Bour recommends. "When was the last nurse visit, and what were her observations? What do the caregiver notes show?"

Bour says communication and participation are key to the success of any caregiving situation. "I tell anyone who is managing someone's care not to abdicate your involvement. You still need to go visit Mom on a regular basis, whether she's still at home with home care services, in a skilled nursing facility or in assisted living."

So when it comes time to call in some professional backup, rest assured that you will still be involved in the care process. From starting the conversation in a respectful, loving way, to selecting and working with the right care providers, your advocacy for your loved one can make all the difference in their enjoyment of their years at home.

Editorial Resources
Nancy Bour, Synergy HomeCare of Metro Atlanta – www.synergyhomecare.com
David Solie, "How to Say it to Seniors: Closing the Communication Gap with Our Elders" – www.davidsolie.com
Ed Ukaonu, CSA, FirstLight HomeCare – www.firstlighthomecare.com

Is your menstrual cycle heavier, more painful and longer than it should be? Should that discomfort you feel during intercourse be happening? Many women overlook the symptoms of uterine fibroids because to them, their abnormalities seem normal. After all, you've never had someone else's period, right? Surprisingly, up to half of all women may develop fibroids in their lifetime. For African American women, the numbers are even more alarming, estimated at 80 percent. Because uterine fibroids are so common, it's important for all women to understand the implications and symptoms of this condition as well as the various treatment options.

What is a Uterine Fibroid?
A fibroid is a smooth, abnormal growth of uterine tissue muscle, and 99.7 percent of fibroids are benign. Dr. Nathan Mordel at Gwinnett Medical Center explains, "For all practical purposes, if you have any disease or medical condition that is 99.7 percent benign, you don't have to address it as possible cancer." While most fibroids are benign, they do vary in size, location and number. A woman can have a single fibroid or multiple fibroids, and their size and location play a major role in the characteristics and severity of a woman's symptoms.

What's Normal, Anyway?90-fibroids-removed,-cred-Michael-D
Dr. Boyd Byrd, a radiologist with Roswell Radiology Associates at North Fulton Hospital and Roswell Imaging Center, says, "Only approximately 10 to 20 percent of women with fibroids are symptomatic." If you are in that group, it is common to experience disruptive symptoms like heavy menstrual bleeding, clotting and pain. Dr. John C. Lipman at Emory-Adventist Hospital points out, "Sometimes the woman has been bleeding heavily for so long, she does not realize that it is abnormal." A woman's period should last three to four days without clotting or pain. Dr. Lipman continues, "If you change pads more frequently than every three hours or use more than eight total pads or tampons a day, it is abnormal and needs to be evaluated." Frequent urination is another possible sign. If you're running to the bathroom more than usual during the day and multiple times at night, make a note to tell your doctor. Also, any physical discomfort during intercourse isn't considered normal. If you're experiencing discomfort, talk to your doctor. Frequent constipation is another symptom and is often the most commonly disregarded.

Because fibroids are very hard, their location and weight can inflict pressure on different parts of the body. If located near the center of the uterus, the fibroid can stretch the lining. If stretched too far, the lining isn't able to heal properly, which causes heavy menstrual bleeding and clotting. Some fibroids block the bladder and disrupt the flow of urine, which – you guessed it – causes frequent urination. Fibroids located near the cervix are responsible for causing sexual discomfort. Those located near the back of the cervix press against the colon, causing constipation.

Fibroids and Menopause
While most affected women experience these symptoms in their 20s and early 30s, many other women don't become symptomatic until they reach their 40s. Dr. Thomas Murphy from Quantum Radiology explains, "Fibroids usually shrink in size or involute after menopause, but fibroids can continue to be a problem for post-menopausal women if symptoms persist."
Dr. Byrd adds, "Most commonly, fibroids will become asymptomatic since hormonal stimulation will decrease with menopause. However, women who receive hormonal replacement therapy (HRT) may have fibroids which will not decrease in size or disappear."

Sometimes, Dr. Byrd continues, they may even increase in size. In that case, another consideration is the rare chance that the growths are cancerous. "If a fibroid grows post-menopause or there is excessive bleeding, a condition called leiomysarcoma must be considered," Dr. Byrd says. Thankfully, this cancerous condition is exceedingly rare. Dr. Byrd says there are more likely causes for post-menopausal bleeding, such as break-through bleeding from HRT, endometrial hyperplasia or endometrial cancer. So whether or not fibroids are the culprit, if you notice unusual symptoms during or after menopause, have a consultation with a physician familiar with these conditions.

Causes and Prevention
It's not completely understood what causes uterine fibroids, but it's generally accepted that genetics are to blame. The gene responsible hasn't been isolated; however, as the topic is researched further, doctors are able to suggest possible preventative measures. Dr. Lara Hart from Georgia Elite Obstetrics and Gynecology explains, "Some risk factors and associations with fibroids are diets high in red meat and low in vegetables, higher consumption rate of alcohol and early onset periods." Dr. Thomas Murphy from Quantum Radiology adds, "There are studies showing that women who get more exercise do have a lower incidence of fibroids." Basically, many practices that benefit your overall health could potentially help with fibroids too. Another of those practices is maintaining a healthy weight. "As fibroids are estrogen sensitive, keeping oneself at a normal weight may help with the condition," says Dr. Melissa Seely-Morgan at Radiology Associates of DeKalb. "But it is genetic," she continues, "and the best measure is to know your body and follow your fibroids for life-altering symptoms."

Diagnosis and Treatment
Because fibroids are genetic, the low possibility of prevention can be discouraging. Fortunately, diagnosis is relatively quick. During your annual gynecologic exam, your doctor may actually be able to feel or see the fibroids upon examination. If the fibroids are too small, however, an ultrasound or X-ray may be used to verify their presence, size and location.

If you do end up with a diagnosis of fibroids, treatment may not be necessary, especially if you don't show any symptoms. "Most women are unaware that they have these growths and will go their whole lives without an issue," explains Dr. Hart. However, for many women, fibroids can be extremely inconvenient and sometimes life-altering. It varies from case to case. This is also true for the various treatment options. Dr. Hart continues, "Fibroids can be treated many different ways, depending on the patient's individual situation and what her desire for the ultimate outcome is."

For a woman who no longer desires to become pregnant, the two most common treatments are hysterectomy or embolization. A hysterectomy is the complete removal of the uterus and will trigger menopause, whereas embolization carries a lower risk of menopause. Embolization works by injecting the uterus with small particles, blocking the blood supply to the fibroids, causing them to shrink and die. This option is minimally invasive and carries a low risk of triggering early menopause. However, because its effects on fertility aren't completely understood, patients are advised to avoid pregnancy following this treatment.

For others, there are options that have fewer implications on fertility, such as a myomectomy. "During a myomectomy, the fibroids are removed from the uterus," Dr. Hart says. "This may require cutting them from the outside, inside or both sides of the uterus. Women are then encouraged to allow a few months of healing before attempting pregnancy." Despite the recovery period, this procedure can ultimately leave the patient's fertility unaffected, meaning that uterine fibroids do not have to be a sentence of infertility.

These days, the removal of fibroids, whether through hysterectomy or myomectomy, may be performed using a minimally invasive laparoscopic surgery. Small incisions are made and, using a camera and operating instruments, the surgeon can completely and safely remove the fibroids. Embolization is even less invasive than surgical routes. Whichever treatment you choose, know that all of your options will likely be much less of an ordeal than in years past.
With as many as half of all women being affected by this condition, it's extremely important for women to understand their bodies and recognize abnormalities. This knowledge enables women to communicate effectively with their doctors and ensure the successful diagnosis and management of uterine fibroids. But as Dr. Lipman says, it's important to remember, "If a patient has no symptoms, no treatment is usually necessary."

Tania-Leah-Davis-showing-phone-picReal-Life Recovery
Local woman Tania Leah Davis’ story began when she first noticed some unusual symptoms. She experienced everything from extreme cramps and heavier than normal menstrual bleeding to pelvic pressure, frequent urination, blood clots and even iron deficiency anemia. Upon talking with her OB/GYN, she was told that fibroids were causing her symptoms and that a hysterectomy was basically her only option. “I was devastated,” Davis remembers, because she still wanted to have children. “I decided to get a second opinion.”

Her search led her to Dr. Randell, who recommended an abdominal myomectomy. Through that process, he was able to remove 90 fibroids and successfully repair Davis’ uterus. “I went into surgery weighing in at 130 pounds and came out weighing 117 pounds!” Davis recalls. After two weeks, Davis was up and about, and after four weeks, her menstrual cycle returned. “It was not heavy at all, with no cramping or blood clots,” she says. Though she did still need a few weeks to recover fully from the anemia, today Davis experiences no symptoms or remaining negative effects.

She says, “My advice to other women who are experiencing issues with fibroids is definitely to see a physician.” Doing so helped Davis change her day-to-day life. “The pain [of the fibroids] was awful, but not knowing if I would experience spotting or bleeding from day to day was horrible! I no longer have any of the symptoms I had before the surgery. I can honestly say that I am happier than I have been in a long time.”


Editorial Resources
Boyd Byrd, MD, Roswell Radiology Associates at North Fulton Hospital – www.roswellradiology.com
Lara Hart, MD, Georgia Elite Obstetrics and Gynecology, LLC – www.georgiaeliteobgyn.com
John C. Lipman, MD, Emory-Adventist Hospital – www.emoryadventist.org
Nathan Mordel, MD, Gwinnett Medical Center – www.gwinnettmedicalcenter.org
Melissa Seely-Morgan, MD, Radiology Associates of DeKalb – www.radadpc.com
Thomas Murphy, MD, Quantum Radiology – www.quantumradiology.com
Michael D. Randell, MD, PC – www.obgynatlanta.com

Fat is beautiful!!! In today's exercise and diet-conscious world, this statement probably makes most people cringe. However, to plastic surgeons, fat is beautiful! While today's media buzz focuses on fat use for breast and buttocks enhancement, fat is a tool that has been used for years to restore youthful, full cheeks, smooth jaw lines, brighten eyes, and restore plump, fuller lips. It's possible to revitalize a tired face using one's own fat.

But why fat? The answer is that most of us have extra fat somewhere like love handles, saddle bags, inner thighs, and the back of the arms, to name a few.  While most fillers come in one cc increments, fat transfer generally involves 80-120cc of volume for facial rejuvenation. As a result, fat becomes a cost-effective means of restoring youthful volume to the desired body area.

BeforeAandAfterFat transfer has not always been successful. Twenty years ago, fat transfer was very unpredictable. Doctors would tell patients that they would require four to five treatments with little long-term benefit. Over the years, research began to shed light on new techniques which have resulted in much more consistent results. Today, the majority of patients will retain most of the transplanted fat. No filler (fat or otherwise) is ever 100 percent effective, however the improved consistency of fat has resulted in it becoming one of the most popular fillers used throughout both the face and body.

Patients often ask if they should eat more before undergoing fat transfer in order to increase the number of fat cells for harvest. The answer is a resounding "NO!" As adults we do not "grow" more fat cells if we weigh more. Fat cells increase in size when we are heavier, and decrease in size when we lose weight. If a patient's weight fluctuates, I will generally harvest fat from the outer thigh area as the fat cells in the saddle bag and tummy areas seem to change more with shifts in weight.

Depending on the areas to be filled, the fat transfer procedure can be performed under a twilight or general anesthesia. When I perform fat transfer, the process generally takes less than ten minutes. First the fat is collected and then the intact fat cells are isolated. These fat cells are then placed in the desired areas. We recommend that patients lightly cool the transplanted fat areas during the first 48 hours to reduce swelling and bruising.  Because the fat cells need to reconnect to the surrounding tissue to survive, resting the enhanced areas by limiting movement may help to increase the success of the procedure. Most patients do not have much discomfort following fat transfer.

Fat transfer techniques can vary from doctor to doctor. In our practice, I do not over-correct (use a greater quantity of fat than needed in case a percentage does not "take"). My approach is based on the fact that if 100% of the fat cells survive the transfer, a second procedure would be required in order to eliminate the excess. I prefer to fill the targeted area to the optimal level. Results are evaluated three to six months after the procedure. If some settling occurs, patients may elect to "top off" the area with a filler such as Juvaderm. If a patient began with significant volume loss, I will often recommend that he/she would benefit by having a second fat transfer procedure three to six months after the initial one.

Fat is beautiful, it has become a mainstay filler for achieving a more youthful look- especially when a large volume of filler is needed for optimum results.

Brian Maloney, M.D., F.A.C.S.

The Maloney Center for Facial Plastic Surgery
www.MaloneyCenter.com  |  (770) 804-0007

Dr. Maloney is an award-winning, double board-certified facial plastic and reconstructive surgeon. He is a National Trainer for Allergan. He is a fellow of the American College of Surgeons and a Diplomat of the National Board of Medical Examiners. Dr. Maloney's artistry and specialized approach has resulted in regular features on MSNBC.com, ABC News, Discovery Health, TLC, and CNN Headline News. He can be reached at (770) 804-0007 or online at www.MaloneyCenter.com.

Friday, 23 May 2014 11:02

Neck and Back Pain: Facet Joints

Facet joints connect the vertebrae in your neck and low back to one another. Facet joints are like any other joint in your body. They have cartilage that line the joint, (allowing bones to glide smoothly), and a capsule surrounding the joint.

back-painFacet joint problems are located in the cervical, thoracic and lumbar spine areas. When the facet joints are affected, a person can experience lower back or neck pain.

Diagnosing facet joint disease in the neck or low back begins with a medical history, physical examination and imaging. Symptoms are treated with medications and physical therapy. Patients not improving with those treatments may benefit from a cervical or lumbar facet joint nerve block. This injection "blocks" the pain the same way a dentist uses an anesthetic to block pain in your jaw before working on your teeth. Successful facet injections indicate that you could benefit from a facet joint nerve radiofrequency ablation. This is an injection with a needle that uses heat to destroy the nerve fibers in your low back or neck that carry pain signals to the brain. This injection can relieve the pain. Midtown Neurology is fully equipped for the above procedures and is happy to assist you should you have these symptoms.

Aashish Bharara, MD
Midtown Neurology, P.C.
(404) 653-0039
www.MidtownNeurology.com


Aashish Bharara, MD is a Board Certified Physical Medicine and Rehabilitation physician with a fellowship in interventional spine management.

Few things are more motivating than a parent's love for their child, but a child's love for their parents is powerful too. When siblings Dean and Lauren Judson lost their parents, Jim and Beth Judson, in a 2010 plane crash, they knew they had to do something to commemorate them. Lauren, an avid collegiate golfer at the University of Southern Mississippi, wanted to honor her parents with a golf event. Jim and Beth had tirelessly supported Lauren's golfing aspirations, so it seemed like the perfect choice. With the help of family friend Jackie Cannizzo, the JCI Foundation was formed to house the golf event Lauren dreamed of.

"Sports help young girls to have a sense of belonging, build confidence and self-esteem," Cannizzo says. "Sports also teach us so many life lessons, like team work, collaboration, discipline, hard work, attitude, leadership and empathy. There is no down side to getting young girls into sports." Keeping these ideas in mind, they formed the Judson Collegiate and Legends Pro-Am Challenge, for which Cannizzo now serves as tournament director.

Now in its third year, the annual event features three components: the Pro-Am Scramble on June 27, the Legends Tour 1-Day Tournament on June 28, and the Collegiate 3-Day Competition from June 28 to 30. This third competition invites collegiate female golfers like Lauren herself a chance to compete with their peers and play one round alongside a professional female golfer – some of the best LPGA Legends players and a few Hall of Fame members will be in attendance. This inspiring pairing motivates girls to keep working toward their goals in sports, both so they can earn their spot in the world-class tournament and so they can meet their role models. Maribel Lopez Porras, the 2013 Judson Collegiate champion, says, "Playing the Judson Collegiate has been one of the most amazing experiences of my life. It was the perfect combination of golf, experience and talent." Not only that, but it also raises money for Children's Healthcare of Atlanta and the JCI foundation to support young women through positive mentorship and further education.

The event also includes a leadership conference to complement the sporting events. Last year a two-hour workshop brought women like author and speaker Becky Blalock, golfer Kathy Whitworth, entrepreneur LeeAnn Maxwell, Dr. Lisa Perez and others together to teach young women how to take control of their careers. This year, the leadership conference has grown to a half-day program. Canizzo says, "Ideally we hope that these young people walk away knowing about the business culture in 2014, business etiquette and communication. We hope they leave with the thought that the C-suite is reachable if they want it." Young women in high school and college, whether they're golfers or not, can attend this conference for free with a student ID.

Whether it's keeping girls active in sports or inspiring them to go for their career goals, no doubt the JCI Foundation is a fitting way to remember Jim and Beth Judson. The wonderful work they do is no less than they did for their own daughter, who carries on their legacy today. To get involved, visit www.judsongolf.com for more details.

Judson Collegiate & Legends Pro-Am Challenge
Country Club of Roswell

June 26 - 28 | www.judsongolf.com

Schedule of Events

June 26

11:30 a.m. – Judson Women's Leadership Workshop at the DoubleTree by Hilton Hotel

June 27

11:00 a.m. – Pro-Am Scramble

June 28

8:30 a.m. – Legends 1-Day

Tournament

1:30 p.m. – Kids' Day

Evening – Concert in the Park

June 28-30

8:30 a.m. Sat., 8:00 a.m. Sun. and Mon. – Collegiate 3-Day Competition

jackieMeet the Tournament Director

Jackie Cannizzo

As a skilled golfer, one of Golf Digest's Top Ten Teachers in Georgia and a dedicated mentor of all ages and skill levels, Jackie Cannizzo was a natural choice to lead this event. The event's other leaders recognize her unique ability to help varied groups work well together, as well as her fearless support of causes she believes in.

Bemvenuti,-LucianaLuciana Bemvenuti

Since moving from Brazil, Luciana has played on the LPGA Tour for 12 years, recording several Top 10 finishes. Holes-in-One: 4

Bradley,-PatPat Bradley

Pat started playing at age 11 under head pro John Wirbal and is now a member of Florida International University Hall of Fame. Holes-in-One: 6

Dibos,-AliciaAlicia Dibos

Alicia finished fourth in the 1994 U.S. Women's Open and won the 2006 BC Consulting Cup. Holes-in-One: 4

Figg-Currier,-CindyCindy Figg-Currier

Cindy has played golf since age 7 and joined the Michigan Golf Hall of Fame in 2003. Holes-in-One: 2

Jones,-RosieRosie Jones

Rosie served as co-vice president of the LPGA Tour Player Executive Committee in 2003. She is also an Atlanta resident. Holes-in-One: 5

Lopez,-NancyNancy Lopez

Nancy joined the PGA World Golf Hall of Fame in November 1989 and was named GOLF Magazine's "Golfer of the Decade" for 1978 to 1987. Holes-in-One: 3

Moxness,-BarbBarb Moxness

In conjunction with her 10-year LPGA Tour membership, Barb supports non-profit organizations like "Family Hope Services." Holes-in-One: 4

Mucha,-BarbBarb Mucha

Barb joined the LPGA in 1987 and has served as spokesperson for the Ohio Girls Golf Foundation. Holes-in-One: 3

Neumann,-LisoletteLiselotte Neumann

Liselotte represented Sweden in the European Team Championship in 1984 and the World Team Championship in 1982 and 1984. Holes-in-One: 4

Rarick,-CindyCindy Rarick

Cindy won the Most Improved Player in 1987 after joining the LPGA in 1985. Holes-in-One: 6

Scranton,-NancyNancy Scranton

A 21-year LPGA member, Nancy achieved three tournament victories on the 1985 LPGA Tour. Holes-in-One: 2

Skinner,-ValVal Skinner

Val was named GOLF Magazine's 1982 Collegiate Player of the Year and is currently the chairwoman of "LIFE" – LPGA professionals In the Fight to Eradicate breast cancer. Holes-in-One: 4

Steinhauer,-SherriSherri Steinhauer

Sherri won eight tournaments on the 1986 LPGA Tour as well as the 1992 du Maurier Classic and the 2006 Women's British Open. Holes-in-One: 2

Stephenson,-JanJan Stephenson

Jan began her pro career on the Australian LPGA circuit and was honored among GOLF Magazine's "100 Heroes" in 1988.

Turner,-SherriSherri Turner

Sherri joined the LPGA in 1984 and won 3 LPGA Tournaments, including the 1988 LPGA Championship. Holes-in-One: 7

West,-LoriLori West

Lori joined the LPGA Tour in 1983 and her best finish on the LPGA Tour was second in Hershey, PA. Holes-in-One: 2

Thursday, 22 May 2014 12:51

Worried About Hair Loss?

BrushHair loss in women is more common than you think. Did you know that more than a majority of men, and over 40% of women experience significant hair loss during their lives? Now, with recent advances in technology, women and men with thinning hair or hair loss have more options available to them than ever before.

There's no reason for your self-esteem to suffer because of embarrassing, thinning hair.

Dr. Ken Anderson, M.D. offers surgical treatment for thinning hair, including Georgia's first and only ARTAS Hair Transplant Robot, which under the guidance of Dr. Anderson, provides safe and permanent hair restoration results. In addition, there are several non-surgical treatments now available, and include cool-laser therapy, scalp therapy, and Platelet-Rich Plasma (PRP) procedures to help thicken existing hair.

Please see page 11 for more information.

The Anderson Hair Sciences Center

The Medical Quarters
5555 Peachtree Dunwoody Rd., Ste. 135
Atlanta, GA 30342

(404) 256-4247 | www.AtlantaHairSurgeon.com

Dr. Ken Anderson, M.D., Founder and Chief of Surgery at the Anderson Hair Sciences Center, is a double-board certified Facial Plastic Surgeon who has confined his practice exclusively to the treatment of hair loss in men and women for over 10 years. Call us to schedule your complimentary consultation. During your appointment, Dr. Anderson will analyze your scalp, and review all of the options available to you.

You've dealt with your thinning hair long enough. Call Dr. Anderson today! 404.256.4247

A poor night's sleep is associated with a variety of habits, medications, inactivity, and foods.  However, very commonly having a decrease in airflow to the lungs can also cause the brain and heart to overwork decreasing the ability to get a good night's rest.  A decrease in airflow can occur as a result of an obstruction in the nasal airway or the oral airway, or both.  Seeing a physician who specializes in the medical and surgical treatment of sleep disorders can open a dialogue that can diagnose the problem.

Snoring from a nasal obstruction generally involves deviations of existing structures, overgrowth of nasal tissues, or collapse of nasal cartilages.  If you are diagnosed with a sleep disorder, addressing one or all of the above with a rhinoplasty improve breathing and the amount of air your body receives on a daily basis which is a good thing.  You will want to find a rhinoplasty specialist that has expertise in not only form but also function.  Typically, a surgeon who is an Otolaryngologist and a Facial Plastic Surgeon is ideal.

rhinoplasticVery frequently, a functional rhinoplasty can address the collapse of cartilages, septal deviations, a large hanging tip, previous nasal fractures, a crooked or twisted nose, or damage from a previous rhinoplasty all of which can interfere with normal airflow through the nose and cause sleep issues.  If you already wear an airway pressure device, such as CPAP, then this procedure can make wearing the associated mask more comfortable and tolerable.  The functional rhinoplasty procedure takes generally two hours with a 7-10 day light recovery and an improvement you will notice in 2 weeks and for the rest of your life.  In our practice, we perform the procedure in our own fully accredited surgery center with a board certified anesthesiologist which is more convenient for the patient and, usually, less expensive.  Can the rhinoplasty improve breathing immediately?  Generally not, as the most common complaint is nasal congestion and not pain for the first week.  Unlike many other surgeons, we do not use packing inside the nose in the immediate postoperative period.  Because it is performed for functional reasons, it can be covered by your health insurance.  If you wish to have a cosmetic change at the same time, this is the best time to talk with your rhinoplasty specialist about this and generally there is a considerable savings over a purely cosmetic rhinoplasty.  In the end, we hope you'll have a nose that not only breathes better, but looks better too.

Northside Plastic Surgery
(770) 475-3146
www.NorthsidePlasticSurgery.com

Mike Majmundar, M.D. is a double board certified facial plastic and reconstructive surgeon. He is the principal of Northside Plastic Surgery.

What are some common digestive problems you see in your patients?

Some common digestive problems we see in patients include:

  • Gastritis: an inflammation of gastric mucosa
  • Food Allergies: an adverse reaction to common foods such as nuts, wheat and soy, causing many problems such as constipation, eczema, nose stuffiness and weight gain.
  • Leaky gut syndrome: defects in the integrity of the gut lining cells due to inflammation of the cells, causing Candida yeast and waste products to leak out into the blood stream and promote an inflammatory reaction in the body.

What role do hormones play in the digestion process?

The major hormones that are involved in the digestive process are gastrin, secretin and cholecystokinin.

Stomach-painHow can digestive problem prevent weight loss?

Quality of calories consumed, stress level, sleep, metabolic disturbances, emotional imbalances, food intolerances and toxic burden can all cause individuals to gain weight and have difficulty losing weight. Among these, gut health plays a significant role in obesity.

Is it possible to remedy and/or cure a digestive problem and ultimately achieve weight loss?

Changing gut flora from bad bacteria to good improves metabolic irregularity, and decreases storage of calories as fat in the body.

Are there any foods, vitamins or supplements that can jumpstart weight loss in people with digestive problems?

A high quality probiotic, magnesium, vitamin D, antioxidants, B vitamins (especially B12) and vitamin E have significant role in maintaining metabolism. Overall, along with healing of the digestive system, a successful long-term weight loss program demands permanent changes in life style, healthy calorie controlled diet combined with exercise.

Call Natural Health Atlanta to learn more about achieving a healthy gut naturally at (678) 892-6865. Most major insurance plans are accepted.

Azam Banaian, NMD
Natural Health Atlanta
Phone: 678-892-6865
www.naturalhealthatlanta.com

Most Major Insurance Plans Accepted

"Dr. Az" (Azam Banaian, NMD) received her medical doctorate degree from Tehran Medical College and her doctor of naturopathic medicine degree from the Southwest College of Naturopathic Medicine. She specializes in nutrition, weight loss, fasting, dermatology, immunology, allergy, adrenal fatigue, metabolic disorders, acupuncture, and botanical/herbal medicine.