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By Jill M. Golsen, DMD

You just came from your dental appointment. We spoke to you in what seemed to be another language. You nodded your head as if you understood— but did you?

We said, “You have occlusal decay on tooth #30, a MO lesion on #29, and a buccal Class V on #21.”

Wait, what? OK. So, here is the decoding.

There are several types of decay. They are based on location in the mouth.

Screen Shot 2018-11-28 at 7.22.42 PMThe occlusal surface is the biting, chewing surface of the tooth. This surface has the pits and fissures that require dentists to use the explorer (that instrument) to see if they can find a “catch” in the pit. These grooves are like little fissures that collect bacteria, but some are developmental defects that never really closed when the tooth was formed—allowing bacteria to dig easily into that groove of the tooth. This decay is usually more of a poor closing of the grooves caused by genetics. In my practice, we use a Spectra camera to detect the level of decay, so it takes the guesswork out of using the explorer. If you don’t know what a Spectra camera is, see my article “Dental Care: Have You Seen The Inside Of Your Mouth Lately?” on BestSelfAtlanta.com.

The second type of decay is smooth surface decay. This one IS your fault!

If you are not flossing and brushing, well, guess what? This is the decay that happens between your teeth when you don’t floss! So, MO is Mesial, toward your nose, so to speak, and DO is Distal, away from the nose on either side of the tooth. The O stands for occlusal. Unfortunately, we have to access the tooth from the top to get in between it and get the decay out.

The third type of decay is root decay or root caries (the Class V).

This decay is usually at the gumline in recessed areas under the junction of the enamel, where the cementum starts. That area is considered the root of the tooth and the surface is softer than enamel. Once penetrated, it’s closer to the nerve and decay can grow fast there. You must brush effectively at the gumlines of your teeth to prevent this type of decay!

The final type of decay is redecay.

You will hear us say this when there is decay at the edge of the artificial material of a restoration like under a crown margin or filling margin. This type of decay is usually from not brushing and flossing those areas as well.

Here is the bottom line. Get your Sonicare toothbrush and use it at least twice a day. Floss all of your teeth at least once, if not twice, a day. Concentrate on it and do a good job getting this plaque out of your mouth.

Watch your sugar intake and don’t snack all the time. If you need instructions on how to brush, ask your hygienist or come to our office. We will be happy to decode this and teach you how to take better care of your teeth so you can keep them from getting these types of decay!

Golsen Family Dentistry • Jill M. Golsen, DMD • (770) 667-0669 • GolsenDental.com 

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By Robert Hyslop, MD

Screen Shot 2018-11-28 at 6.53.41 PMThese days, one would be hard-pressed to find someone who has been untouched by the scourge of lung cancer. As the most common cause of cancer deaths in America, lung cancer strikes both the young and the old, and men and women from all walks of life. Although heavily associated with smoking, this terrible disease can even strike nonsmokers up to 15% of the time. Fortunately, smoking education and cessation campaigns have been successful and smoking rates are on the decline. However, lung cancer can strike even those who have successfully quit the habit and medical science has been working hard for decades to fight this epidemic. Unfortunately, it is often too late to
successfully intervene once the cancer has shown its face by way of a nagging cough, weight loss, fatigue, or myriad other symptoms. Beginning in only a single cell, this deadly group of tumors grows often undetected for years before clinical symptoms occur and, in many cases, the tumor has spread to other organs—rendering treatment options only palliative. Early detection is, therefore, the best, and currently only, hope for a cure in most cases.

Recently, after years of hard work and many trials, it has been shown that annual low-dose screening CT scans could be used to find and follow tiny possible early cancers of the lung and allow for early treatments.

In the past, CT scans were too slow, costly, and of poor resolution to allow early detection while keeping radiation doses low. However, rapid technological advancements in recent years have allowed for low dose but highly detailed scans to be made, often in just seconds, that allow doctors to nd possible cancers as early as possible.

The U.S. Preventive Services Task Force released recommendations advising adults with at least 30 pack-years of smoking history (1 pack per day for 30 years, or 2 packs per day for 15 years, etc.) between the ages of 55 to 74 to undergo an annual low-dose screening. Depending on multiple factors, lung cancer mortality could be reduced as much as 20%! Of course, quitting is the best medicine and all smokers are encouraged to kick the habit as soon as possible.

The scan itself couldn’t be easier and involves no needles or pain. One simply lays on his or her back on the comfortable CT table and is scanned while holding a short breath. Radiation exposure is minimal. The detailed images are reviewed by a specially trained board-certi ed radiologist.

At OutPatient Imaging’s (OPI) brand-new, state-of-the-art facility in Buckhead, a screening CT exam can be performed in just minutes. Conveniently located off Peachtree Road in the Peachtree Square Shopping Center, OPI can perform your scan quickly and ef ciently. OPI offers screenings not just for lung cancer, but for cardiac disease (calcium scoring CT scans), breast cancer (mammography and breast ultrasound), stroke (carotid ultrasound), aortic aneurysms (aortic ultrasound), and others.

OutPatient Imaging • 2284 Peachtree Road N.W., Atlanta, GA 30309 • (404) 225-5674 • outpatientimaging.net

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By Scott A. Kelly, MD 

Suffering from low back pain? You’re not alone! It might begin as an ache after a round of golf or working in the yard. On the other hand, it can begin as a sudden, intense pain that can affect your function and alter your quality of life. Epidemiological statistics indicate that there is an 80% chance that you will experience significant low back pain at some point in your life. In the majority of cases, pain relief is accomplished by simple conservative measures such as physical therapy, activity modification, and oral medications. When conservative therapy fails, there is still hope of avoiding surgery. Epidural steroid injections (ESI) can provide both diagnostic and therapeutic benefits and serve as an integral part of a comprehensive spinal-rehabilitation program.

Screen Shot 2018-11-28 at 6.44.13 PMWhat is an Epidural Steroid Injection?

An ESI is the administration of a long-lasting steroid solution into the epidural space (the area which surrounds the spinal cord and the spinal nerves). ESIs work by delivering steroid, the most potent anti-inflammatory in modern medicine, to the exact area of inflammation. Fluoroscopic or live X-ray guidance is used by interventionally-trained physicians to deliver the steroid to the precise location in the spine. By injecting directly into the spine, we can avoid many of the systemic adverse effects common to oral steroid medications. In addition to the obvious therapeutic benefits of ESIs, due to the precise nature of fluoroscopic guided injection, it frequently enables the physician to determine the exact pain-generator in the spine.

The History of Epidural Steroid Injections

ESIs are not a new concept. The first documented ESI to treat low back pain was reported in 1901. The first ESI for the treatment of a lumbar disc herniation occurred in 1952. As medicine and technology advanced in the 1980s and 1990s, the addition of fluoroscopy became more commonplace. Now, this procedure is significantly more effective and most importantly, safer.

How Many Injections Will Be Needed?

The interval between and the number of injections given to a patient varies from individual to individual depending upon the clinical response. However, it is not uncommon for the treating spine physician to administer up to three epidural injections per year. Clinical judgment and communication between the physician and the patient are what determines the appropriate number of injections and scheduling variations.

In Summary

Epidural steroid injections play an integral role in the nonsurgical management of low back pain that is unresponsive to conservative management including rest, activity modification, physical therapy, and oral medications. They can serve both a therapeutic and diagnostic role in the nonsurgical management of low back pain. Benefi  ts of the treatment include decreasing back and sciatica (radicular) pain, improving quality of life, decreasing use of oral analgesics, improving return to work statistics and helping to avoid surgery in some patients.

Resurgens Spine Center • Non-surgical & Surgical Spine Care • 24 Convenient Atlanta Locations • ResurgensSpine.com 

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By David Martin, RN

For Lesa Kagan, an audiologist and active mother of three (she takes care of her 95-year-old mom, volunteers with several organizations, and plays ALTA tennis)—loving her legs is a new thing.

“I have had problems with my legs since I was in my 20s. Varicose veins run in my family. We have a very strong history of it,” Kagan says of her diagnosis of Chronic Venous Insufficiency, or CVI. She adds, “I’d asked my dermatologist, my internist, and my OB-GYN about what to do about my varicose veins. None of them had any strong recommendations, or were that knowledgeable about them.”

Screen Shot 2018-11-28 at 3.54.37 PMWhen one-way valves in leg veins fail, blood that is supposed to travel upward to be reoxygenated by the heart and lungs flows backward instead. This can cause the blood to pool, and create pressure in the legs, extending veins and causing a host of problems, including pain and swelling. These problems do not correct themselves; CVI is a progressive disease, which develops most often due to heredity, pregnancy, lifestyle (standing or sitting for long periods of time), or injury.

“It makes sense that I would have tired and achy legs. I am up and down a lot at work, but on my feet a good bit. When I was active, playing tennis, my legs would be sore and tired the next day. Also, flying and riding in a car for a long time was a problem. I always felt as though my legs needed to move. They ached. I just felt as though I needed to walk around more,” she says.

Kagan’s symptoms were classic. With the calf muscle being the heartbeat of the lower body, CVI sufferers are often compelled to jump out of bed and walk around in the middle of the night, or need to get up during a flight and move around to relieve the pain and get the blood traveling in the right direction. Many patients complain of leg pain, thinking they have arthritis or muscle cramps, when in fact their problem is CVI.

About 30 million people in America suffer from CVI, yet many physicians don’t know to tell patients that varicose veins and spider veins are oftentimes much more than a cosmetic problem. This is due to the relative newness of in-office, minimally invasive treatments, which were not available until the last 15 to 20 years.

Advances in vein disease treatment have made the process of having your legs treated much less complicated and painful. Treatments can be done in less than an hour with local anesthetic, and with little pain or downtime. Patients are encouraged to walk and resume normal activity immediately following procedures.

Kagan says, “Nothing is standing in my way now that I have had my legs done. My life is better. I would like to say my tennis game is way better!” she laughs. “I am definitely less tired. I have always been a runner on the court. Now, I am more energetic. And I definitely feel better in my skirt because my legs look better.”

VEININNOVATIONS • (678) 731-9815 • veininnovations.com 

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By Scott D. Miller, MD

As we come to the end of another year, we look forward to the holidays, good food, and resolutions. We also buy gifts for ourselves and others, sometimes using that beloved credit card that we will pay off next year. All is good.

Screen Shot 2018-11-27 at 11.30.58 AMUnfortunately, “health debts” are not as easily reconciled. At the top of the list is balancing food and exercise. Let’s just think in terms of calories. A bagel and cream cheese for breakfast will provide 300 calories to start your day. If you chose to eat an egg and sausage biscuit, it would set you back 500 calories. That’s an extra 200 calories without any additional time commitment. In order to burn off those 200 calories, you will need to sweat for 20 to 30 minutes. Now repeat the calculation for all of the other dietary choices you make during the week. Balancing the budget can quickly become a challenge.

Now let’s talk sleep deficit. Sleep is not a luxury, it is a requirement. Although we often talk about “catching up” on our sleep over the weekend, the lost sleep creates a lot of other deficits along the way. Here are some examples: Increased cortisol levels leading to higher stress and weight gain

  • Increased appetite
  • Becoming accident prone
  • Decreased cognitive ability
  • Poor memory creation and recallTo make matters worse, the more sleep- deprived we become, the less we recognize the problem. Unlike calories and body weight, there is no good way to track sleep debt.

Unlike sleep, we have an abundant supply of water. However, dehydration is one of the most common health deficits. Unfortunately, once we are thirsty, we are already dehydrated. Good hydration leads to the following health benefits:

  • Better kidney and intestinal function Higher energy level
  • Appetite and weight control
  • Improved thought processing

Many men are weekend warriors. We workout or compete athletically as time permits. Sometimes the days between workouts turn into weeks, so we tend to compensate by increasing the difficulty of our training. Since cardiovascular and strength gains can quickly decline between exercise routines, intensity on an infrequent basis can be a recipe for injury.

A sensible person will minimize their financial debt to a modest mortgage, affordable car payment, and maybe a small credit card balance. When it comes to health maintenance, pay a little now or pay more later. After all, isn’t cardiac bypass surgery the health equivalent of ling bankruptcy?

Look for my article on “Listen to Your Heart” in the next issue.

Scott D. Miller, MD, is the Medical Director of Robotic Surgery at WellStar North Fulton Hospital. He is a urologist with WellStar Urology in Roswell and has practiced in Atlanta for over 20 years.

WellStar North Fulton Hospital offers the Know Your Heart Screening that can determine your risk of heart disease, stroke and other serious conditions. Call 770-956- STAR (7827) to learn more or schedule an appointment.

Scott D. Miller, MD • WellStar North Fulton Hospital 470-956-4230 • ScottDMillerMD.com

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By Karen Foley 

Elizabeth Pietrusza

Screen Shot 2018-11-27 at 10.54.59 AMWhat made you choose Windy Hill Athletic Club as your fitness club?

Windy Hill has always felt like a safe place. There are smiling faces everywhere you look. The equipment is clean and the spaces are well lit. The staff at KidTown are kind and well qualified. The trainers are knowledgeable. The general manager Karen Foley’s door is always open. It was important for me and my family to choose a place that made us feel valued. It was also important for us to feel welcome, at all stages of our fitness journey. The club continues to exceed our expectations.

What do you like to do when you’re at Windy Hill Athletic Club?

I like to think that I spend just as much time using the amenities at the club as I do participate in the classes. We love the pool when it is warm outside. We are regulars at the café. My husband and I both enjoy massages at the spa. That’s just the tip of the iceberg.

What example do you want to give to your children and other moms about fitness?

I hope to show my family and friends that a healthy lifestyle is about maintaining
a balance. I am grateful the club offers more than exercise so I can practice what I preach.

Our promise to members is to inspire you through movement, community, and personal attention. Do you believe that we do that?

Without a doubt! It is not ironic that the most active and enthusiastic I have ever been in my life began once I joined the club. It feels like home. It is home.

Audrey Schemer 

Screen Shot 2018-11-27 at 10.55.09 AMWhen did you become a member?

I joined in 1989.

What is your favorite way to stay active?

My favorite ways to stay active are varied but I enjoy swimming, spinning, and tennis the most.

You are a busy lady. Do you give yourself a moment just for you here at Windy Hill. If so, how?

I enjoy the days I don’t have to be on a tight schedule, where I can work out and have conversations with fellow members during my time spent at the club. I also enjoy watching my teammates play in tennis matches.

Being active is a big part of who you are. How do you set an example for your family and friends to live this kind of lifestyle?

I joined Windy Hill for the nursery and during this time, my family has seen that working out is a priority and is primary to my well-being.

If you were helping a person start their fitness journey, what advice would you give to them?

I would suggest they always keep in mind the goal of progress, not the finish line. Fitness is always evolving and a work in progress. I hope to keep on keeping on till I cannot anymore.

Windy Hill Athletic Clubwindyhillclub.com 

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By H. Sooki Hon, MD, PhD

It’s that busy time of year when those well-balanced, Pinterest-inspired meals just don’t make it on your family’s weekly menu. But that’s OK. Nutritious meals don’t always have to be complex.

Screen Shot 2018-11-27 at 10.49.23 AMAn easy way to make sure your family is getting a variety of nutrients is by simply creating a colorful plate. Different colored fruits and vegetables provide distinct, and equally important, vitamins and minerals that your body needs to be healthy. By incorporating the colors of the rainbow throughout your meals, you’ll have a huge impact on your family’s well-being, as well as encourage healthy eating habits.

The colorful foods listed below are nutrient powerhouses your family will be sure to love.

Green produce indicates antioxidant potential and may help promote healthy vision, lower blood pressure, regulate the digestive tract, and boost immune system activity.

• Fruits: avocado, apples, grapes, pears, honeydew, kiwi, and lime

• Vegetables: artichoke, asparagus, broccoli, green beans, green peppers, and leafy greens such as kale and spinach

Orange and deep yellow fruits and vegetables contain nutrients that promote healthy vision and immunity, collagen formation and healthy joints, work with calcium to build healthy bones, and reduce the risk of some cancers.

• Fruits: apricot, cantaloupe, grapefruit, mango, papaya, peach, oranges, and pineapple

• Vegetables: carrots, yellow peppers, yellow corn, and sweet potatoes loaded with antioxidants and can improve memory, mineral absorption, and urinary tract health, and may reduce cancer risks in the digestive tract.

• Fruits: blackberries, blueberries, plums, and raisins

• Vegetables: eggplant, purple cabbage, and purple-fleshed potatoes

Red indicates produce that may help maintain a healthy heart by lowering blood pressure and reducing LDL cholesterol levels, as well as improving vision and immunity.

• Fruits: cherries, cranberries, pomegranate, red/pink grapefruit, red grapes, strawberries, tomatoes, and watermelon

White, tan and brown foods sometimes contain nutrients that may promote heart health, reduce cancer risks, and stimulate a healthy digestive tract.

• Fruits: bananas, brown pears, dates, and white peaches

• Vegetables: cauliflower, mushrooms, onions, parsnips, turnips, white-fleshed potatoes, and white corn

• Probiotic: cultured buttermilk, kefir, and yogurt

For more than 40 years, Atlanta Gastroenterology Associates has been treating all types of digestive health issues, including nutritional concerns. We offer personalized nutrition counseling services at several of our of offices across Metro Atlanta.

Atlanta Gastroenterology Associateswww.atlantagastro.com 

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By Grattan Woodson, MD, FACP

Having a physician who is skilled in women’s health, understands gynecoendocrinology, and is comfortable prescribing compounded pharmaceuticals is a requirement for successful bioidentical hormone supplementation. It is this physician who will monitor your clinical response to treatment, evaluate you for any side effects, and adjust the dose of your compounded prescription to precisely meet your needs. The bene ts described below can only be obtained from a compounding pharmacy because pharmaceutical companies do not manufacture bioidenticals. All of these elements are necessary to ensure a successful outcome for a woman on balanced bioidentical hormone supplementation.

How the Hormones are Delivered

Hormone Replacement TherapyIn my opinion, the preferred way for a postmenopausal woman to supplement with bioidentical hormones is by using an elegant cream formulation of balanced hormones given vaginally at bedtime. This is done by using a simple applicator and has four bene ts. First, the dose required for topical administration is only 1/10 the dose if given orally. Second, topical use avoids these hormones passing through the liver first before going through the body, which eliminates the high risk of blood clotting seen with oral estrogen use. Third, giving the supplement as a nightly vaginal cream restores the health and function of the vagina lost at menopause, which improves intimacy. Lastly, the veins that drain the vagina are the same ones that drain the ovaries, meaning that over the six hours the hormones are absorbed from the vagina, the body receives the same bioidentical hormones the ovary would make in small doses, similar to what it would expect to receive from the same entry point nature intended.

My goal is to provide patients with as normal a hormonal background as possible, mimicking nature, to provide her with what she had before menopause.

The Importance of Staying Balanced

I advocate using four bioidentical hormones in appropriately selected postmenopausal women whether they have had a hysterectomy or not. By appropriately selected, I mean healthy women within 10 years of menopause who have not had breast cancer or cardiovascular disease. I evaluate every patient before I prescribe hormones to her to ensure I keep her safe and I monitor her regularly to ensure she stays that way.

It’s my opinion that nature intended women to have all these hormones rather than just one or two. My goal is to provide patients with as normal a hormonal background as possible, mimicking nature, to provide her with what she had before menopause. This means including bioidentical estradiol, testosterone, progesterone, and DHEA, the four principal regulatory steroid hormones that become deficient or insufficient with menopause and aging. We need all four of these hormones because they have mutually supportive, and in some instances, opposing, effects that are important for health and well-being. Incomplete replacement, which has been the traditional practice, results in less than optimal results.

Brookhaven Women’s Health and Wellness is a full-service facility dedicated to providing women in early menopause with a suite of services to help them obtain optimal health and wellness using nutrition, exercise, compounded balanced bioidentical hormone supplementation, minimally invasive cosmetic services, hair restoration, weight management, osteoporosis management, and stem cell therapy for arthritis and tendonitis. For more information, call Kim Teasley, our Director of Women’s Health Services at 404.574.2373 or visit FemeRegen.net. 

GC Woodson, MD, PC • 1418 Dresden Dr., Ste. 225, Brookhaven, GA 30319 • 404.574.2373 • FemeRegen.net 

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By Laura Janelle Downey

I’m always on the go. From 5 a.m. workouts to long days at the office and after-work events, the minute I start my day, I don’t stop. So when I do have a chance to sit down and relax, there’s no other place I’d rather be than at The Spa at Mandarin Oriental, Atlanta. I was drawn to the spa’s new Sapelo Advanced Restorative Facial for a variety of reasons but for your sake, I’ll keep my list to the top three.

(L-R) Cindy Edwards and Stephanie Duttenhaver

(L-R) Cindy Edwards and Stephanie Duttenhaver

• The founders, Stephanie Duttenhaver and Cindy Edwards, are two charming Southern belles who make beauty a top priority.

• When at The Spa at Mandarin Oriental, Atlanta, the Sapelo Advanced Restorative Facial can be had in just 50 minutes or in 80. I recommend using your time wisely and experiencing relaxation at its best in the 80-minute treatment. Book the service (only offered at Mandarin Oriental, Atlanta) with esthetician Angela Gorham—you won’t be disappointed.

• Like what you experienced? Purchase Sapelo Skin Care products after your experience. Who doesn’t love the brand’s soft green and gold packaging?!

The science behind Sapelo Skin Care is an eye-opener. “By replicating the skin’s natural peptide cascade seen in response to injury, Sapelo’s restorative skin care regimen rebuilds the skin’s natural collagen and elastin as a true antiaging process, as opposed to the dermatology dogma that skin-inflaming agents are antiaging,” says Dr. John Duttenhaver (Stephanie’s hubby!).

With just six steps, my face was cleaner, brighter, hydrated, and healthier. From the B5-infused Gentle Seaweed Cleanser to the Milk & Honey Hydrating Mask, which comes complete with healing ingredients (think milk peptides), I was in heaven! Angela also applied Sapelo’s water-based Renewing Serum and papaya-, pumpkin-, and yeast-packed Anti-Aging Enzyme Mask to my face. The all-natural products were just what I needed to get my skin back to its happy place—long story short, I used a hotel soap that didn’t treat my skin right at all!

When my service was just about finished, Angela made sure to apply Sapelo’s Spring Tide Serum, Restoring Eye Serum, a Rejuvenating Cream, and a Softening Emollient to my face. The Sapelo Advanced Restorative Facial is perfect for the woman who deserves a little pampering.

The Spa at Mandarin Oriental, Atlanta | 3376 Peachtree Rd. NE. | 404.995.7500 | MandarinOriental.com/Atlanta/Buckhead/Luxury-Hotel

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