Thursday, 27 October 2016 19:30

Unhinged

Often, we don't thoroughly appreciate the role our joints play in our body until they hurt. Suddenly, it's harder to climb stairs or a shoulder aches too much to blow-dry hair. Joint pain can not only take some of the fun out of life, but it can also make it harder just to get through the day. From running races to running errands, joint function impacts the daily quality of life. When is the pain a problem?

Basically Bent

A joint is a meeting place of bone and muscle, tendons and ligaments. Cartilage is also present and, depending on the joint, there may also be synovial fluid for lubrication. There are six different types of synovial joints in the body that move in different ways. One type can hinge, for example, like the elbow, while another fits together like a ball and socket, like in the shoulder.

The knee is your largest joint and the most complex, with three bones, two types of cartilage and ligaments, and tendons. According to Spero G. Karas, MD, director of Emory's Orthopaedic Sports Medicine Fellowship Program, the joints that are most problematic are the weight-bearing joints such as the knee, hip and ankle. When walking up and down stairs, for example, the knee bears three times one's body weight—so, a 150-pound person exerts 450 pounds of weight on the patella. A squat, like a lunge on the tennis court, can exert five to seven times your body weight on the same joint. The hip joint withstands similar forces, according to Stanley H. Dysart, MD, of Pinnacle Orthopaedics. Rising from a seated position to standing burdens the hip with three to five times your body's weight.

Joints are work horses, made for wear and tear and constant usage. But they weren't made to last forever, to endure severe or recurring trauma or to withstand certain diseases.

image-1Inflamed

All musculoskeletal pain is inflammatory in nature; joint pain falls into this category. When the body "diagnoses" itself as damaged or ill, it activates blood vessels, blood cells and hormones to initiate its own "treatment." That's what causes swelling and subsequent pain. This inflammation can be short-term, related to, say, a sprained ankle, or it could be chronic, as in conditions like osteoarthritis or lupus. For you to choose a correct course of treatment, the exact cause of the inflammation must be assessed.

Julia Kao, MD, a hip- and knee-replacement surgeon with Resurgens Orthopaedics, emphasizes the importance of getting a correct diagnosis and when to intervene. "If joint pain is affecting your life, figure out what it is. Don't self-treat for too long." She often sees patients who have waited until their problems are quite serious—a man who came in after his knee buckled to find out that he had severe arthritis, an older woman who had been seeing a chiropractor who actually had a broken hip. Pain that doesn't resolve itself is a clear indicator that it's time to make an appointment with a physician.

SB-1Some general practitioners are willing to take the first steps to diagnosis, while others prefer to direct a patient to an orthopaedist immediately. A provider will take a family history, inquire about your health habits and do a hands-on physical exam. They will usually schedule an X-ray and sometimes do lab tests as well.

Painful Truth

So when something goes wrong, what's the culprit?

Conditions like "tennis elbow," which is a type of tendinitis, muscle strains and bursitis are easily treated. Many autoimmune diseases that are tougher to treat cause joint pain, from lupus to fibromyalgia to rheumatoid arthritis (RA). Very often, the cause of joint pain is osteoarthritis (OA), a degenerative disease of the joints that breaks down the cartilage that keeps them moving smoothly and pain-free. When people talk about arthritis, they are usually talking about OA.

"Arthritis is caused by a mix of factors. If everyone in your family has terrible knees, you'll probably have terrible knees," says Dr. Kao. "If you were a college athlete and had terrible injuries, the effects will show up when you're older. If it's a factor we can't change, like genetics, we'll just deal with it. But if it's a modifiable risk factor, like weight or smoking or drinking or steroid use, let's change it." Nearly one in two people have knee arthritis by the time they're 85, and one in four have hip arthritis.
Obesity can make arthritis worse, much earlier. "The weight conversation is a tough one," says Dr. Kao. "Sometimes I see a patient in their thirties with terrible arthritis. The good news is that one pound lost [equals] four pounds of stress taken off your knee, for example. Losing even a little bit of weight helps with all joint pain." She recommends putting together a plan with your general practitioner or investigating medical weight-loss programs.

An important thing to remember about OA is that it's "persistent and progressive," says Dr. Dysart. It can, and will, get worse if you don't protect your joints.

The RICE Way

The first step of joint-pain treatment is always RICE: rest, ice, compression, elevation.

"Rest means relative rest, not the complete cessation of activities," says Dr. Karas. "The body needs movement. If you're completely sedentary, you're doing yourself more harm than good. An injured joint needs a gentle range of motion. Synovial fluid, the fluid that lubricates a joint, needs to bathe the joint, and the muscles need to activate or they atrophy. Keep moving or get stiff—and then you have two problems instead of one."

Anti-inflammatories, like ibuprofen, aspirin and naproxen, are also key. They're not like pain pills, which just mask the problem, although they do help with pain; they treat the cause of your pain as well. But anti-inflammatories are meant to be a short-term therapy. For chronic conditions, there are other options: steroid injections in the joint, or viscosupplementation, an injection of lubricating fluid in the knee. Physical therapy may be needed to strengthen the muscles around a joint. "The biggest misconception people have is thinking that because they do aerobic activity, they're strengthening all of their muscles," says Dr. Dysart. "Aerobic activities are good for the heart, but they don't necessarily strengthen the shock absorbers around the hip, for example." The exercises you learn in physical therapy can help with both strength and balance, warding against falls and instability.

Drs. Karas, Kao and Dysart, along with other experienced orthopaedists, recommend exhausting conservative therapies before moving on to surgical ones. "When the patient has failed non-operative treatments, they are functionally disabled, and the pain is unacceptable to them, then it's time to consider joint-replacement surgery," says Dr. Dysart. "Joint replacement is very much elective. It's always the patient's choice."

New surgical techniques, such as the anterior approach to hip replacement that spares the tendons, have vastly improved the patient experience. "It's quite remarkable," says Dr. Dysart. "Today, we can do outpatient, same-day joint-replacement surgeries with minimal pain afterward."

Mix the Risk

Often, changing activities offers a respite to the impacted joints while working a different set of muscles. Doctors recommend thinking of it as adding variety, not limiting your activity.

SB-2"A singles tennis player who's feeling stiff and finding it strenuous to cover the entire court can switch to doubles tennis," says Dr. Karas. "It's about finding reasonable modification. If running five miles a day has become uncomfortable, switch to doing it three times a week and take a good long walk, bike or go to the pool. One of the best exercises for cardiovascular health that's low impact on joints is a good long walk. The difference between calories burned running and walking a mile is only about 20 percent."

Dr. Kao finds that her older patients understand that the body gets creakier as they age, but her patients who are 40 to 60 are often in denial about their bodies getting older. "They're shocked when they see their X-ray and it shows arthritis. They want to get back to what they were doing when they were 20, but the body is saying to take it easy."

"Not everybody is born an opera singer, not everybody is born a comedian and not everybody is born a long-distance runner or a tennis player," says Dr. Karas. The trick to living a long and healthy life that doesn't hurt? Treating your joints with care, keeping an eye on the scale, seeing a doctor when you're in pain and trading in a few tough workouts for ones with gentle
motions.

 

Sources:

American Academy of Orthopaedic Surgeons, aaos.org
Centers for Disease Control and Prevention, cdc.gov
Emory Healthcare, emoryhealthcare.org
Pinnacle Orthopaedics, pinnacle-ortho.com
Resurgens Orthopaedics, resurgens.com

Thursday, 27 October 2016 19:05

The Pet Life

A wagging tail. The happy little flip of an ear. Soft purring and warm nuzzling. A reassuring chirp, twitch or shake. Maybe even a zen-like calming splash or slither. Pets add a special level of meaning to the lives of their owners.

The deep connection between humans and their pets has been evident for centuries, with domesticated creatures offering protection, companionship and comfort. Contact with animals can have hugely positive effects on those facing significant health issues, whether physical, emotional or psychological. Animal companions can help just about anyone—from homeless youth to house-bound seniors, from adult stress to childhood insecurities. The unconditional love of a pet boosts the physical and mental health of humans.

image-1Leader of the Pack

Studies by the American Psychological Association (APA) show that pet ownership not only improves the quality of life for those who are ill, but also for the average healthy individual. According to the APA, many pet owners feel as attached to their creatures as they do to the significant humans in their lives. Survey respondents said that during periods of emotional difficulty for them, conjuring up the image of their pet instantly eased some of their anxiety.

Can the key to happiness be as simple as developing a relationship with an animal? Emory University researchers, among others, report that interacting with animals, specifically cats and dogs, increases levels of endorphins—the brain chemicals released by the body that create a sense of happiness, pleasure and euphoria.

"I see it all the time—a former depressed couch potato is reformed by the dog they adopt," says Kathy Swank, former owner of an Atlanta area pet-sitting business. "When they have a cute dog looking at them and hoping to get out for a walk, it's hard to say no. I've seen people undergo huge lifestyle changes just because they adopted a dog or cat." And, by adopting animals through rescue groups, people can also gain the satisfaction of knowing that they may actually be saving the life of an otherwise wayward stray. "People who adopt from the Atlanta Humane Society can be assured that we will use our best efforts and resources to facilitate a lifelong relationship between people and animals," says Dr. Gloria J. Dorsey, DVM, MPH, vice president of community education and advocacy for the Atlanta Humane Society.

image-2Pick of the Litter

The reality is that those more traditional pet choices of adorable kittens and puppies may not always be the best choice. Perhaps there are significant animal-dander allergies in the household or limitations on the amount of time available to spend with your pet. Before selecting any type of pet, evaluate living arrangements, schedule commitments and the costs involved.

Choosing the perfect pet takes some thought and planning. It's not wise to make an impulsive decision, no matter how much those sweet eyes plead. In the movie "What About Bob," Richard Dreyfus's character, a psychiatrist, explains to his patient, played by Bill Murray, "A journey begins with baby steps. ... Baby step out the door, baby step down the hall, baby step into the elevator." If you aren't sure that you can handle the responsibility as a pet parent, follow Dreyfus's advice and take a baby step—maybe bring home a goldfish.

SB-1Fish are great for first-time pet owners or kids because they are inexpensive, fit in a confined space and won't chew your favorite pair of Manolo Blahniks. Skip the small fishbowl to house your new pet and splurge on a five- or ten-gallon tank to ensure they have room to grow and good water-to-air surface ratio to thrive. The bonus for the investment? You will likely find that watching goldfish go about their business is a tranquil, soothing experience. As members of groups like the Atlanta Area Aquarium Association (AAAA) can attest, a new pet might also connect you with like-minded pet owners in your area, sharing your interests. Chuck Grisp of Marietta's Splendor Koi & Pond says his shop even offers a "Kids' Guppy Club" to reach out to budding aquarium enthusiasts. "Fish are fascinating pets," he asserts. "They are really responsive to humans and it's fun to watch them interact with each other."

SB-2If you hope to find a pet that provides more touchy-feely, one-on-one interaction, but that is still relatively budget-friendly and low-maintenance, baby step your way to a hamster, mouse, gerbil or guinea pig. They are easy on the checkbook, fun to play with and don't require constant attention if you provide them amusement in their cage. For the most part, rodents can live their life without costly visits to the vet—you will mainly shell out for food and bedding supplies. Domestic rodents are a good first pet to teach kids some responsibility.

SB-3Cats are naturally tidy, requiring only that you clean their litter box and give them a good brushing to keep hairballs from developing as well as to reduce the amount of fluff coating everything in the house. Generally speaking, cats can be left home alone for extended periods of time and entertain themselves without getting into too much mischief. They're fairly quiet and don't need much in the way of discipline, training or exercise space. However, they can also be somewhat selective with their affection and attention.

Dogs, by contrast, practically invented the words "unconditional love." Most want to spend every second they can by your side or underfoot, which can get a little tiresome when you simply want to go to the bathroom by yourself. Before bringing home a pooch, take a minute to think about your outdoor space, the size of the dog, the thickness/shedding of its coat and the average life expectancy of the breed.

When you decide on the type of animal you wish to bring home, remember that adopting a cat or dog from an animal shelter is not only cheaper than purchasing one from a breeder, but your pet will also be spayed or neutered with no cost to you. Neutering males can keep them from "spraying," or marking their territory; spaying females, of course, is a crucial step in controlling the overpopulation of unwanted animals. "Spend lots of time with the animal before you commit to take him home; returning a pet to a shelter can place a black mark on his record, which will count against him in the future," Traci DeWan of the Atlanta Humane Society warns.

Sniff Out the Pedigree

For all animals, finding a good veterinarian will be crucial for the pet's health and a necessary resource for the owner. Trust friends and neighbors for recommendations or approach humane societies and adoption centers for their input. A vet can assist you with locating boarding facilities and daycare options, grooming and training professionals, or even reputable breeders for specific animals.

If you do decide to buy from a breeder, thoroughly research every detail of their business. Check national organizations, such as the American Kennel Club (AKC) and the Continental Kennel Club (CKC) to see if they're registered. The deplorable conditions in puppy mills and the sketchy practices of some hobby breeders make it imperative to keep a watchful eye on the origin of your pet. Look at their kennels and the conditions for both dams and sires. Ask questions: "How often are the animals bred per year? How many dogs are housed together? Are they exercised frequently? Do they receive regular health evaluations? Are records available for the parents and littermates?"

SB-4Need More Snuggle Time? Volunteer!

Fostering an animal for a pet-rescue group or volunteering at an animal shelter is a great way to learn more about a variety of animals and research different breeds. Becky Banner of the Greater Atlanta Veterinary Medical Group explains that the Angels Among Us Pet Rescue in north metro Atlanta "provides a network of volunteers that help find abandoned dogs and cats a 'forever home.' The rescue works with Atlanta residents to foster animals ... before they find their new adoptive family." Megan Bowman, a representative of Angels Among Us, describes the group's mission: "We take unwanted animals from a cage to a couch, not a cage to a cage." Fostering a needy animal can be a way to connect you with your perfect pet.

Sharing the joy of your pets with others might also be a rewarding way to spend quality time with animals while supporting the community. For many years, nonprofit organizations such as the Happy Tails Pet Therapy group in Roswell have brought therapy animals to nursing homes, VA clinics, schools and hospitals in the hopes of encouraging healing. The group matches volunteers and their pets with patients in need of a dose of TLC. Arlene Sinanian, president of Happy Tails Pet Therapy in Atlanta, says, "We find that most people who are visited by a volunteer with a pet don't focus on the therapeutic benefits of the visit—they just end up having fun!"

image-3Talk to the Animals

Maybe it's the simple act of caring for an innocent, vulnerable creature or perhaps there's a true symbiosis between man and beast — whatever the reason, developing some kind of relationship with an animal enriches life for both of you. Some pets require much more of a commitment than others, but most reward "their humans" with unconditional love and a heaping dose of low-tech TLC, much-needed in our high-tech lives.

 

Sources:

American Psychological Association, apa.org
Angels Among Us Pet Rescue, angelsrescue.org
Arlene Sinanian, president of Happy Tails Pet Therapy, happytailspets.org
Atlanta Area Aquarium Association (AAAA), atlantaaquarium.com
Becky Banner, DVM, Greater Atlanta Veterinary Medical Group, gavmg.vetstreet.com
BluePearl GVS, bluepearlvet.com
Chuck Grisp, Splendor Koi and Pond, splendorkoi.com
Dr. Gloria J. Dorsey, DVM, MPH, vice president of community education and advocacy for the Atlanta Humane Society, atlantahumane.org
Emory University, emory.edu
For Pet's Sake (avian, reptile, small animal vet), forpetssake.com
Greater Atlanta Veterinary Medical Group, gavmg.vetstreet.com
Petco, petco.com
Veterinary Center of Buckhead, vetcenterofbuckhead.com

Thursday, 27 October 2016 18:57

The fab’rik of a Full Life

Whether it's her customers, franchise owners, women in need or her own children, Dana Spinola is all about inspiring others to live in ways they don't think are possible—to go far beyond the limitations they may perceive.

Spinola's own life is her greatest inspirational tool. After all, she formed her incredibly successful, one-of-a-kind company, fab'rik, the same day she began her family: August 1, 2001.

"The night I got incorporated, I went out to celebrate and saw this man and was sure he was my husband," she remembers. "I walked across the room and told him, 'I know this is going to sound crazy, but I'm going to marry you.' Pretty productive day: Started my dream career and met my husband!"

image-1"Productive" is a bit of an understatement when describing Spinola's no-holds-barred lifestyle.

Since that fateful day one of both her courtship of her future husband and founding of her company, the wildly popular fab'rik series of affordable upscale clothing boutiques, her business empire has grown exponentially and her family has expanded to include four children, ranging in age from two to nine. For good measure, she's even added to the mix a nonprofit that comes to the aid of victimized women and girls. She attributes her success to the focus, drive and organization she says is essential to getting it all done.

"As a mom of four kids, I can get more done in an hour than I used to get done in a day—my to-do list is what some call a work of art," Spinola says. "But it really just means I like to be prepared. There is no way I could run a company, a nonprofit and have four kids if I wasn't always thinking ahead and anticipating what needs may come up. I get up early and prepare for my kids' day before they are up and I stay up late preparing for my fab'rik meetings."

Spinola never questioned that she could one day create the life of her dreams. Growing up, Spinola's parents taught her to reach beyond their means to achieve everything she wanted. Her mother made custom outfits for her, introducing her to fashion as a way to elevate everyday life.

SB-1"My mom made my clothes, so we would spend weekends at fabric stores picking out patterns and fabrics," she remembers. "While it was because we didn't have a lot of money, I felt like I had a personal stylist and loved every minute of it. I remember my mom with a pin in her mouth pinning together the fabric on me and feeling like I was a celebrity. I was in love from the first dress."

That first love quickly grew into a full-blown passion that continued throughout Spinola's youth and into adulthood. "Fashion has always been second nature to me. While I have never been a girly girl, I have always had this deep-rooted love for high fashion," she says. "My entire room was wallpapered head to toe with fashion magazines growing up."

Right out of college, Spinola entered the corporate world as a business consultant who helped companies streamline for maximum productivity and efficiency. But after a couple of years, she realized it was time to adjust her focus and redirect her path. She wanted a partner and a family, and something was going to have to give for her to get there.

"I wanted a husband, lots of kids, to stop traveling every week and, somehow, an incredible career doing what I loved—which was the fashion world. I wasn't sure how I was going to have it all, but I was going to try," she says.

Spinola's dreams were big, but at that time she had no idea just how big they would get. She opened the first fab'rik boutique on August 1, 2002, in Midtown Atlanta on West Peachtree (that store has since moved to Atlantic Station). That was monumental to her at the time, but since then she has watched many other women realize big dreams with their own fab'rik stores. The 45th fab'rik boutique just opened in Chicago.

"I never set out to franchise, but as women asked me to open fab'rik in their cities, it became clear that owning a boutique was not only my dream, but [was shared by] many others. Now that we have figured out the model, I can equip other women to do their own and follow their own dreams."
That central vision of making the seemingly out-of-reach attainable flows into and defines the customer experience at fab'rik as well.

"I believe fab'rik delivers an amazing combination of high-end customer service with affordable clothing," Spinola explains. "I think many would expect to have someone drive a dress to their house, serve them champagne or call their husband to remind them of their birthday at a high-end department store when spending $2,000, but we do this for a $60 dress. Our team has heart and cares more about the person than the sale. Wowing the customer is what inspires us!"

That heart and caring goes beyond fab'rik's customers to women who need a helping hand and a new start in life. Her nonprofit, free fab'rik, facilitates weekly visits to safe houses and spends time with girls and women who have been the victims of sex trafficking, homelessness and abuse. The team shops with them, organizes fashion shows for them and shares stories with them.

image-2"Giving and our business strategy are so closely woven together at this point they go hand and hand," Spinola says. "fab'rik really is the vehicle that God has given me to serve, whether it's our customers, my team and the girls in need. God always shows up in the sweetest way, reminding us all how similar we are. We truly all just want to feel beautiful about who we are. My vision is that each city that has a fab'rik boutique will also have the free fab'rik program. It's an awesome thing when you watch a community come around a group of girls and lift them up like free fab'rik does."

Spinola adds that the program also makes it possible for women who want to give back, but don't think they have the time or the means to do it in a meaningful way. "It's a beautiful way to serve and free fab'rik makes it very easy—the magic to it for me is that it's really easy to do. It's a beautiful, safe way to be there for these women."

At the center of Spinola's extremely full life is focusing on helping others do what she considers herself fortunate to be able to do each day: live her passion and her purpose.

"I hope I inspire women to dig deep to figure out what makes your heart beat, because that is your passion and what breaks your heart, because that is your purpose—then follow it relentlessly."

 

Photography by Catrina Maxwell of CatMax Photography, Hair and Makeup by The Green Room Agency

 

Wednesday, 26 October 2016 20:45

November 2016 Digital Issuu

Saturday, 24 September 2016 05:06

VEINAtlanta: Total Vein Care

Experience the Best Treatments for Unsightly Veins
At VEINatlanta's two locations, full-time surgeons redefine excellence when it comes to modern treatment of a variety of vein disorders.

 

Varicose Veins

Varicose veins are enlarged, twisted, blue veins that are close to the surface of the skin. Because valves in them are damaged, they hold more blood at higher pressure than normal.

Varicose veins can be treated using:

VEINAtlanta: Total Vein CareRadiofrequency (RF) Ablation
RF Ablation involves delivering radiofrequency (RF) energy to close the vein wall without any incisions. As the RF energy is delivered the vein wall is heated, causing the collagen in the wall to shrink, the vein to close and circulation to improve. Patients should be able to walk after the procedure and recovery time is quick.

Endovenous Laser Ablation (EVLA)
EVLA is a minimally invasive procedure used to correct venous reflux disease—the underlying cause of varicose veins and other venous disorders. Using ultrasound guidance, laser energy is delivered to close the vein permanently. The procedure takes just 30 minutes, and patients can drive afterwards.

VEINAtlanta: Total Vein CareAmbulatory Micro-Phlebectomy (AP)
AP is used to treat bulging and visible varicose veins. It is usually performed as part of a comprehensive vein treatment plan. The procedure is performed in the office with local anesthesia. Using specialized instruments, the vein is carefully removed in small sections.

VenaSeal™
VenaSeal™ is the first FDA approved "superglue" treatment to permanently treat venous insufficiency (reflux), which causes bulging varicose veins. Patients can return to their normal daily activities immediately with no pain or bruising after the procedure.

Spider Veins

VEINAtlanta: Total Vein CareSpider veins are caused when blood backs up into smaller veins, enlarging them as they fill with stagnant blood and become visible to the eye. Spider veins can be an isolated cosmetic issue, or they can be the "tip of the iceberg," indicating deeper, more significant venous disorders such as chronic venous insufficiency.

Sclerotherapy
Screen Shot 2016-09-23 at 5.54.28 PMSclerotherapy is a method for treating spider veins and small varicose veins. An FDA-approved medicine called Asclera™ (polidocanol) is injected into the vein using a fine needle. This causes chemical irritation to the inside lining of the vein and the vein closes down.

Ultrasound-Guided Foam Sclerotherapy
Ultrasound guided foam sclerotherapy involves using an ultrasound machine to help deliver polidoconol foam in the deeper larger "feeder" veins, causing the vein to
close down.

VEINAtlanta: Total Vein CareSurface Laser Therapy
At VEINatlanta, we use the most state of the art Cutera laser with both 532nm and 1064nm for surface laser therapy. The laser energy is absorbed by the blood in the vein causing the vein to close. This treatment is often combined with sclerotherapy.

Facial Veins

VEINAtlanta: Total Vein CareFacial veins are dilated blood vessels found on the nose, cheeks, and chin and around the eyes. They can be thin, red spider veins or blue reticular veins. These tiny, painless and harmless veins can occur in both men and women.

Surface laser therapy can be used to treat facial veins. The laser energy causes the vessels to close down. Over the next several weeks, the body absorbs the unwanted veins and they disappear. Surface laser treatment can also be an option for small spider veins.

Periorbital Veins
These are the blue veins under the eye, side of the eye and sometimes on the forehead.

VEINAtlanta: Total Vein CareSpider Veins
Spider veins can appear on your face typically around your nose, cheeks and chin. They can occur in both men and women.

VEINAtlanta: Total Vein CareRosacea
Rosacea is redness of on the cheeks, nose, chin or forehead.

Hand Veins

VEINAtlanta: Total Vein CareBulging veins on the back of the hands can develop over time as we age. The elastic fibers in vein walls lose their elasticity, causing the veins to dilate. Most dilated hand veins do not signify any serious vascular condition; the concern is primarily cosmetic. Hand veins can be treated with Sclerotherapy and Ambulatory micro-phlebectomy (AP), which involves using specialized instruments to remove the vein in small sections via small nicks made along the skin.

FOOT VEINS

Just as in hand veins, unsightly veins can result in the feet. As the skin becomes thinner, veins show more prominently. Foot veins can also be treated with sclerotherapy and Ambulatory micro-phlebectomy, both done in the office.

VULVAR VEINS

Vulvar veins occur in approximately 10% of pregnant women. They can become uncomfortable with prolonged standing and can grow larger and more painful during premenstrual and menstrual cycles. Vulvar veins can be treated in the office with foam sclerotherapy.

Pelvic Congestion Syndrome

Symptoms of pelvic congestion syndrome include a dull, aching pain and discomfort in the lower pelvis, vulva, lower back and abdomen. This condition is caused by venous insufficiency of veins located in the pelvis. VEINatlanta helps diagnose this condition and manage its treatment.

 

VEINatlanta | TWO LOCATIONS:

1100 Johnson Ferry Road NE, Suite 165 | Atlanta, GA 30342
601-A Professional Drive, Suite 170 | Lawrenceville, GA 30046

Phone: (404) 662-3407 | VEINatlanta.com

VEINAtlanta: Total Vein Care

 

 

 

Screen Shot 2016-09-23 at 5.57.06 PM

 

Saturday, 24 September 2016 01:41

Beyond the Pink

All too often, the opening lines of a breast cancer story echo similarities—"I felt a weird lump" or "I finally went in for my mammogram" or "They saw something on the scan and asked me to come back in" or "It's in my family, so I knew I should get checked." And yet each journey through treatment remains completely unique to the patient. For years, medical experts have advocated breast self-exams and regular mammograms, reporting the benefits of early detection. And genetic testing advancements continue to increase rapidly.

There are volumes of clinical studies and research and an incredibly active, devoted network of foundations and fundraisers determined to speed the efforts to find a cure. But until that cure is found, the comprehensive care available in Atlanta honors the person beyond the patient, strengthening life in the present tense.

breast cancer awarenessAt First Blush

Hearing that diagnosis, watching the physician's lips move as they pronounce the C-word, lingers as a surreal moment, with time standing still. There's no way to accurately anticipate the reaction to such news. Will the words be heard? Will the brain even process the information? When it's time to get the test results from the doctor, don't go at it alone.

breast cancer awareness"The impact is big from day one," acknowledges Anita Johnson, MD, FACS, Breast Surgical Oncologist at Cancer Treatment Centers of America® (CTCA) in Newnan, and she addresses that impact at her initial meeting with the patient after their diagnosis. "The first thing I ask is: Who helps take care of you? Immediately I address that. We go through the entire breast cancer talk and then we talk about real life. If they have somebody in the room with them, I tell that person that it's time to step up. Now!" Johnson says.

breast cancer awareness"Bringing a trusted family member or friend to appointments when patients are first diagnosed is very helpful," says Mylin Torres, MD, director of the Glenn Family Breast Center at Emory University's Winship Cancer Institute. "Understandably, this is a time that can be unsettling and overwhelming. Having a strong, calm individual in your corner is invaluable. This person can help record and recall conversations with providers."

Maybe someone in the support network could assume a designated administrative role, managing notes, reports and schedules. "Staying organized seems to help patients cope," comments Sara Owens, BSN, RN, OCN, breast health nurse navigator with WellStar Kennestone Hospital. "They tend to feel more in control, can better communicate with their treatment team and are better able to advocate for themselves." Owens explains that when patients are first diagnosed, they are in the acute phase of their treatment and her team acts as a guide. "During this phase, they learn about their disease and treatment options—physical components such as surgery, medical procedures, radiation."

Concurring, Kathleen Gamblin, RN, BSN, OCN, coordinator of oncology patient navigation at Northside Hospital Cancer Institute, also advises designating a spokesperson for the patient.

"They can be the one to disseminate information, field phone calls and be the point person for meals and other services." Delegating as many tasks as possible gives the patient the space needed to adjust to a new reality.

A Hint of Tint

Allow time to absorb information. Don't hesitate to get a second opinion or third—whatever necessary to fully understand what's happening in the body and what the road to recovery might look like. Trust that the best decisions will be made by evaluating all the different opinions. Go ahead and shop it around. This is hard. Talk about it. Ask questions.

"Build clear and consistent communication with your healthcare team," Gamblin says. "Know who you can call and when ... the healthcare team is there for you; you are not a bother!"

Developing a partnership is a crucial part of the approach, as Torres describes. "Having honest conversations about prognosis, the potential benefits and risks of treatment, helps patients make informed decisions about their care. It also helps patients to align their priorities so that they and their families are prepared for any outcome."

breast cancer awareness"Cancer research continues to progress on a day-to-day basis," says Shefali Shah, MD, chief of medical oncology and hematology at Kaiser Permanente Georgia. "Therapy is becoming increasingly individualized."

Part of that individualization begins with the team assembled for each case. "Developing a personalized plan always involves a multidisciplinary approach," confirms April L. Speed, MD, oncological breast surgeon and member of the Komen Atlanta Board of Directors, requiring an entire care team to collaborate and form a plan. For some patients, this can mean combining a traditional medical approach with a variety of alternative therapies, and their treatment teams will have resources for all the options. At CTCA, each patient receives a plan that includes a variety of modalities with oncologists, radiologists and surgeons, joined by specialists in physical therapy, mind/body therapy, naturopathy, chiropractic care, acupuncture and nutrition.

Asaf Yalif, MD, FACS, of Y Plastic and Reconstructive Surgery, agrees, "By having open communication and transparency, we can make sure that we put the patient's personal journey at the forefront. One of the most rewarding parts of my job is the opportunity to be in the initial meeting where a hard diagnosis is delivered and be able to offer hope with regard to reconstruction and a focus on recovery right from the beginning."

Such focus benefits both patient and provider, as Johnson mentions when talking about the Breast Center at CTCA approach. "All of our providers are dedicated to breast care. All are located in one area [of the hospital] and stay on top of the latest advancements. Every case is completely different. Even within the same family."

Saturation Point

Be realistic about lifestyle and expectations during treatment, accepting that there are vast unknowns. The primary focus for the patient should be striking back against cancer cells.

Torres reiterates the need to seek assistance to deter additional stress: "A network of family, friends and neighbors who will help with childcare, eldercare and other home responsibilities is key. Being able to turn to different individuals from your network for advice, help at home or emotional support is important, as each one will have a unique perspective on your journey and will help provide you with the energy and encouragement needed to successfully complete treatment."

breast cancer awarenessFrom keeping health notes and nutrition guides, to running errands and scheduling meals, or even gardening and pet care—help is needed in a myriad of ways. Perhaps a friend that's a born leader or an organizing genius could serve as the patient's personal volunteer coordinator, using computer apps to keep everyone updated on the tasks at hand.

Puzzled Pale

When thoughts and feelings get too overwhelming, writing them down can help cope with confusion. In addition to taking notes on medical information, consider having a diary of the entire experience.

"We have found that journaling is a good strategy for [patients], because it helps them keep track of what they are going through physically and emotionally," advises Owens. "A small company called CanPlan has created an organizer and journal that has calendars, an address book, and a detailed daily chart that the patient can fill out about how she is doing on any particular day. Similar organizers can also be obtained from the LiveStrong foundation as well as the American Cancer Society®. Also, there are amazing computer applications specifically geared toward keeping track of medical information and cancer treatments, many of which are free. Chemo Brain Doc Notes is one that can help patients keep track of information, appointments and side effects related to their chemo treatments."

breast cancer awarenessWhen it comes to emotional support, some feel that's harder to quantify. Owens sees this as a pivotal role, influencing the patient's ability to cope emotionally. "Having a support person who can act as a 'safe place' for the patient to express their worries and as a sounding board for decisions is important to their outcomes."

Shah suggests that patients and caregivers consider reaching beyond immediate friends and family, "Some find that joining a support group where they can talk to others going through a similar experience is very comforting. If the idea of speaking to strangers does not appeal to you, social media and other online forums are also a great way to build a network of support and connect with others."

A Rose by Any Other Name

The doctors, nurses, technicians, therapists and experts that are part of the treatment team have dedicated their lives to this battle. But they also count on patients to teach them new things along the way. Knowledge about the disease is constantly developing. Communicate with your team every step of the way.

Torres looks to her patients for cues on how she can enhance their care. She says, "My research on quality of life and side effects of breast cancer treatment has been largely driven by conversations with my patients. I like being asked, 'Why?' by my patients because, if I don't know the answer, I view it as an opportunity to conduct research to figure it out."

For Johnson, constant learning fuels her passion for patient care. "For me, through my training, breast was the specialty that was always evolving," she remarks. "I love the science behind it, and I love taking care of other women." Which is why Johnson focuses heavily on reconstruction, asserting, "I want to help all my patients as they get over the thought that they had breast cancer. I'm a woman, too. It makes me feel good when you are looking good!"

breast cancer awarenessIn Bloom

Mindset plays a crucial part in the cancer battle. Mind and body work in tandem. If there's ever a time where the axiom "attitude is everything" holds true, it's when that attitude guards the arsenal of a cancer warrior.

breast cancer awarenessTorres says, "I try to get a sense of how enthused a patient is to pursue traditional treatments, how aggressive they want to be in their treatment plan, what are their competing responsibilities and how much they value their quality of life." Allowing for every decision to be intensely personal gives a patient an active role in this ongoing cancer drama and also gives them hope to achieve the life they want in recovery.

"One particular lady that I've been working with," reports Owens, "has every barrier you can think of when it comes to getting care—no family support, dangerous living situation, language barrier, cultural differences, inconsistent employment. I was able to work with my team, including the doctor's office, a social worker and a case manager with the YWCA of Northwest Georgia, to get her into a safe environment and started with treatment. She's been amazingly strong and resilient!"

breast cancer awarenessGlowing Forward

Many patients find the transition from oncology to general medical care with a primary care physician (PCP) confusing—especially if no prior relationship with a PCP had been established prior to their cancer journey. Kim Randolph, MSN, FNP-BC, spearheads the survivorship program at CTCA and recognizes the need to help patients find a new routine for regular medical care. "Our goal for survivorship is to be that bridge between active treatment and surveillance," Randolph explains. "We help with any side effects or residual problems patients may have, but we also examine the new things someone may be dealing with. There can be some emotional and psychological issues at that time."

A huge part of Randolph's mission is monitoring patients' overall health. "Some become so focused on the breast cancer that they ignore comorbidities," she reveals. "I strongly encourage them to find someone in their community for follow-ups." Once patients establish a relationship with that PCP, Randolph and her team send over their survivorship care plan, called Journey Forward, documenting all their providers and a brief summary of treatment.

breast cancer awareness"I am big on primary care," Randolph says. "I want everyone to have that PCP; someone who knows them when they are sick and when they are well!"

The Ribbon of Truth

Yalif greatly values the inspiration he's received from his patients. "I think the most profound thing I have learned is the importance of remaining positive in times of great duress. Sometimes, even if you can't see the light at the end of the tunnel, you must believe it's there."

breast cancer awareness"Each patient's journey is unique and their own," says Gamblin. "There is no right or wrong way to be a cancer patient. Take care of yourself, allow others to help you and know that you are not a statistic. You are you."

And remember that this is only one chapter of an incredible life story.

 

sources:

Cancer Treatment Centers of America® at Southeastern Regional Medical Center, cancercenter.com/southeastern

Ford Warriors in Pink, warriorsinpink.ford.com

Glenn Family Breast Center at Winship Cancer Institute of Emory University, winshipcancer.emory.edu

Kaiser Permanente Georgia, kp.org

Northside Hospital Cancer Institute, northside.com

Rebecca Walden Wig Studio, wigspertofatlanta.com

Susan G. Komen® Greater Atlanta, komenatlanta.org

The Dana Barrett Show, biz1190.com/danabarrett

The IWSC Group, iwscgroup.com

TurningPoint Breast Cancer Rehabilitation, myturningpoint.org

WellStar Kennestone Hospital, wellstar.org

Wigwam Wellness Festival, wigwamfest.com

Y Plastic and Reconstructive Surgery, yplasticsurgery.com

 

Friday, 23 September 2016 20:35

October 2016 Digital Issue

 

Acne, irregular periods and excessive hair growth—these are not only symptoms of puberty, they're also signs of a problem that affects 10-15% of reproductive age women. Polycystic Ovarian Syndrome (PCOS) is a metabolic condition that can be a precursor for more serious conditions like type 2 diabetes, obesity and cardiovascular disease.

PCOS can be diagnosed by checking for signs of ovary abnormalities such as cysts, irregular menstrual cycles, and elevated male hormones in blood tests. "If you have two of those symptoms you probably have PCOS," says Mark Perloe, MD, Georgia Reproductive Specialists (GRS) medical director.

Treatment options often depend on what goals the patient has in mind. Are they trying to get pregnant and understand the role PCOS can play in infertility? Are they trying to prevent diabetes later in life by managing insulin resistance, which is a major factor in PCOS? Or, do they just want to lose weight to ease symptoms?
GRS helps patients of all ages work closely with a dietician who is well-versed in PCOS, provides assistance with proper supplement and medicine dosage, and explains exercise strategies for PCOS management to help patients get back on track to health and happiness.

Polycystic Ovarian Syndrome (PCOS) Awareness MonthTo hear Dr. Perloe speak more about PCOS save the date for the PCOS Awareness Symposium September 24 - 25. Hosted by PCOS Challenge, Inc., the symposium is the largest event in the country dedicated to polycystic ovary syndrome and related conditions. To learn more about PCOS Awareness weekend, visit pcoschallenge.org/symposium/Atlanta.

Mark Perloe, MD

Dr. Perloe earned his medical degree from Pennsylvania State University, Hershey Medical Center, and served his residency in obstetrics and gynecology at the University of Wisconsin. Dr. Perloe completed his fellowship in reproductive endocrinology and infertility at the University of Minnesota and is board certified in Obstetrics and Gynecology.

As Medical Director of GRS, Dr. Perloe has more than twenty years' experience in in vitro fertilization, the use of donor eggs, donor sperm, gestational surrogacy, PCOS, fibroids and endometriosis. As the creator of the PCOS Awareness YouTube Channel, Dr. Perloe is passionate about PCOS awareness, diagnosis and treatment.

Sponsored by: Georgia Reproductive Specialists
Atlanta/Northside | Decatur | Alpharetta | Buckhead/Piedmont | Phone: (404) 843-BABY | www.IVF.com

 

Thursday, 25 August 2016 19:50

The Truth About The Flu

As summer winds down, we begin to see an uptick in patients with influenza, a virus that infects the respiratory system, often causing a sudden onset of fever, cough, sore throat, and body aches. Fall is the best time of year to get vaccinated against the virus, which typically peaks during the winter months. Although the flu virus infects millions of Americans each year, resulting in nearly 200,000 hospitalizations and thousands of deaths, less than half of adults get a flu shot. Perhaps busy schedules and forgetfulness are partly to blame. But there is also a lot of misinformation circulating about the flu vaccine, leading some people to opt out of a valuable form of preventive care. As an infectious diseases specialist, I'll help you separate flu facts from fiction.

Q: What is the best way to protect yourself from the flu?

The flu vaccine is the most effective way to protect yourself from getting the flu, and it's recommended for anyone six months of age or older. Even if you are healthy and rarely get sick, getting the flu shot can protect others around you who may be at greater risk of becoming very sick from the flu, such as those with chronic illnesses, cancer, weakened immune systems and infants.

Q: If I get a flu shot, can I still get the flu?

Yes. It can take up to two weeks for the vaccine to build up your body's immunity to the virus, so getting a flu shot early in the fall—when the virus is not circulating at peak levels—gives you the best protection against the flu.

Each year, the vaccine is developed to protect against specific strains of influenza. If a different strain begins to circulate, the vaccine may not be as effective. Still, a flu shot can help reduce the severity of flu symptoms if you contract the virus.

Q: Can the flu vaccine cause you to get the flu?

No. The flu vaccine contains a killed virus, so it cannot give you the flu.

Q: Is there anyone who should not get a flu shot?

If you have severe allergies, especially to the ingredients in the flu shot, or a history of Guillain Barre Syndrome, talk to your doctor before getting vaccinated. There may be other options for vaccination.
With any vaccine, there can be side effects, such as soreness at the injection site or a mild skin reaction.

flu-shot-signQ: If I get the flu virus, what should I do?

If you are experiencing severe symptoms, make an appointment to see your doctor. We often prescribe antiviral medications, which can shorten the duration of your symptoms. It's most effective when started within 48 hours of symptom onset.

Stay at home for at least 24 hours after your fever subsides. While you're at home, isolate yourself from others and wash your hands often to avoid spreading the virus. It's possible to transmit the flu virus for up to eight days, starting from the day before you actually experience symptoms.

Q: Where can I find more information about flu prevention?

Just log on to kp.org and type "flu" in the search bar.

 

Scott Cutro, MD
Chief, Infectious Diseases

Dr. Scott Cutro practices at the Kaiser Permanente Cumberland Medical Center in Atlanta. He is dual board certified in internal medicine and infectious diseases. He completed internal medicine residency at Emory University and an infectious diseases fellowship at New York University. To learn more about his approach to care, visit kp.org.

 

Sponsored by: Scott Cutro, MD, Chief, Infectious Diseases | Kaiser Permanente of Georgia | www.kp.org

Thursday, 25 August 2016 19:42

Prostate Cancer

According to the American Cancer Society, about one in seven men will be diagnosed with prostate cancer during his lifetime. Staying aware of risk factors and symptoms and maintaining a regular checkup schedule with a primary care doctor are key to staying healthy.

Risk Factors

  • Age: Prostate cancer risk rises rapidly after the age of 50, and is most often diagnosed in men older than 65.
  • Race/Ethnicity: Prostate cancer is more common among men with an African heritage.
  • Family History: Men with a family history of prostate cancer are urged to begin screenings by the age of 45.

What are some of the symptoms?

Early prostate cancer: Usually causes no symptoms, but can be identified by testing the amount of prostate-specific antigen (PSA) in a man's blood or through a digital rectal exam (DRE).

Advanced cancer symptoms: Problems urinating, blood in urine or semen, trouble getting an erection, pain in hips, back, spine, chest, or other areas if the cancer has spread.

men-doctor-prostateWhat are some of the latest treatment options for prostate cancer?

Patients with moderate prostate cancer are treated with two temporary radiation implants. Also known as HDR or temporary implants, each procedure is done over the course of one morning/early afternoon. The patient leaves the clinic following the implant without any radiation remaining in their prostate (unlike permanent implants), so they recover more quickly and there is no radiation exposure to their families.

For more advanced disease, patients can be treated with external daily radiation and HDR/temporary implants in combination.

What services does Atlanta Oncology Associates provide for men with prostate cancer?

Atlanta Oncology Associates, a division of American Professional Associates, has been treating and curing men with prostate cancer for more than 40 years. We are a recognized leader in the Atlanta metro region in prostate cancer technology and expertise. This commitment to quality care benefits our patients through a range of innovative treatment options, not a "one size fits all" approach.

 

 

MARK W. MCCORD, MD
Founding Partner

Dr. McCord is a member of the American Society for Therapeutic Radiology and Oncology, the American College of Radiology, the American Medical Association, the American Society of Clinical Oncology, and the Gilbert Fletcher Society. Dr. McCord has been named as one of Atlanta Magazine Top Doctors for 2016. Physician selection to this honor is peer review.

He resides in Alpharetta with his wife, Rachel and sons, Jacob and Noah. He enjoys hiking and camping with his sons and retrievers, Sophie and Ariel. He is a fan of Vanderbilt (his college), sports. His wife is a children's librarian now active in support of the local library system, and they both are avid readers.

 

Sponsored by: Atlanta Oncology Associates | (770) 255-7500 | www.atlantaoncology.com
Alpharetta | Atlanta | Eastpoint | Greensboro | Hawkinsville | Macon | Over 15 Hospitals and Centers

 

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