From losing weight to looking younger to feeling fit, there are many reasons to focus on one’s health. Choosing the right way to maintain a healthy lifestyle can be a daunting task, but the Southwest Orlando Bulletin’s 14th annual Health & Fitness Guide provides advice from local experts to help residents achieve and maintain their varied health goals.
Preventing Sports Injuries
by Jeffrey N. Shebovsky, D.C. & Robert G. Ostheim, D.C.
West Orange Wellness & Injury Centerand SuperSlow Zone
407-877-7117
www.westorangewellness.com
www.superslowzone.com
What do all sports have in common? They all require proper conditioning and safety gear to prevent injuries.
One of the most important factors in preventing injuries is the development of an appropriate level of physical fitness. Certain sports require greater levels of fitness of different body parts. For example, a soccer player requires strong lower body development but usually has weaker upper body development.
A low level of fitness can lead to fatigue, which can lead to injury, and skill alone will not protect an athlete from overexertion. Following the basic components of physical fitness conditioning can help protect athletes from injuries.
During warm-ups and stretching, the entire body is put through stretching or flexibility exercises. Then the specific body parts vital to the sport and position are exercised. Warm-up is sufficient when perspiration arises.
For the development of muscular strength, slow cadence strength training is best.
Voluntary resistance exercises specifically designed for the sport and position involved help develop joint flexibility.
To develop cardio-respiratory endurance, aerobic exercise is best.
If athletes are just starting out in sports or exercising, they should progress gradually. New players should start at levels comfortably below that which may cause injury. As they progress, they can work to comfortable points that require moderate effort. Stress should be felt, but no pain.
Safety gear is another important aspect of preventing sports injuries.
Protective clothing or padding should always be worn, even if they hinder flexibility or speed.
Safety glasses or goggles should be worn while playing racquetball. They should be cushioned around the bridge of the nose to prevent trauma and stabilized around the head by an elastic band.
Mouth protectors and face guards should be worn to prevent tooth damage, which accounts for 45 percent to 55 percent of contact sports injuries. Football players should always wear mouthpieces, as should Little Leaguers, softball players and recreational athletes. Face guards should always be worn to deflect severe blows to the face, as the protective coverings can prevent jaw fractures and concussions.
Arm and hand protection is also vital to preventing injuries. Long sleeves and elbow and wrist guards should be worn when in-line skating, skateboarding, or playing hockey or volleyball.
Special gloves should also be worn to reduce blisters, add traction and prevent the effects of trauma. Gloves should always be worn when participating in baseball, fencing, bowling and gymnastics.
Helmets should be worn to avoid head injury and must be fitted and worn properly, especially in football.
Footwear and foot protection should possess three main features — good shock absorption, good traction and good side support under stress of impact.
If players are injured during a sport, they should never be allowed to play until injuries are fully healed. When an athlete takes a painkiller and returns to competition, the risk of injury aggravation and disability is extremely high.
The saying “Prevention is better than cure” is nowhere more important than in sports. All too many athletic injuries are unnecessary.
• • •
Healthy Legs
by John D. Horowitz, M.D.
Central Florida Vein & Vascular Center
407-293-5944
www.cfvein.com
Varicose veins and painful, tired, swollen and heavy legs are not part of the natural aging process. Many people have these symptoms and assume they happen because they are getting older. The root cause of these problems is frequently an abnormality in the vein system of the legs called venous reflux.
With venous reflux the legs have lost their natural ability to return venous blood to the heart, and as a result, allow blood to pool in the legs, causing pain, swelling and varicose veins. In healthy legs, there is a valve system in veins that is designed to support venous blood.
Venous reflux stems from a failure of this valve system, which allows blood to collect in the legs after standing for long periods.
The common causes of vein valve failure are pregnancy, prolonged standing, excess weight, aggressive physical exercise and familial inheritance. The affected veins usually need to be eliminated to improve the overall health of the legs and allow venous circulation to flow properly.
Modern vein care allows the elimination of these dysfunctional veins with minimal intervention. Surgical stripping is now obsolete and has been replaced by minimally invasive, needle and catheter-based techniques. EndoVenous Laser Treatment and ultrasound-guided sclerotherapy are combined to provide treatment for leg swelling and varicose veins of any size. These procedures result in no incisions to heal, require minimal downtime, and are highly successful in the right hands.
• • •
Painkillers — Friend or Foe?
by Harbinder Ghulldu, M.D.
Central Florida Recovery Centers Inc.
407-370-9783
www.iaddict.net
Opiate dependency on prescribed medications, such as OxyContin, Vicodin, Percodan and codeine, is an all-too-common occurrence that afflicts individuals of all ages, ethnicities and walks of life.
Through accidental or careless misuse, people with no history of opiate abuse often find themselves as physically and emotionally hooked on these drugs as heroine or methadone addicts. Opiates do not discriminate. Whether intentional or accidental, prolonged opiate abuse results in opiate dependency.
Opiate addiction symptoms include cravings, constant exhaustion, decreased sex drive, insomnia and weight loss. Signs of withdrawal include restlessness, muscle and bone pain, diarrhea, vomiting, cold-like symptoms, sweating, chills and more.
There is help for opiate addiction.
Buprenorphine is a medication that serves as a “partial agonist” for the treatment of opiate and narcotic abuse. It is a Schedule III opiate medication that is Food and Drug Administration-approved for the treatment of opiate dependence. It has no desirable high, even if taken in large doses, because it does not fully activate the body’s opiate receptors. This makes buprenorphine very safe because it is difficult to overdose. Buprenorphine is the first opiate medication approved under the Drug Addiction Treatment Act of 2000 for the treatment of opiate dependence in an office-based setting. Like most other medications, buprenorphine can be dispensed for take-home use.
• • •
Menopause: the Prime of Life or Life’s Cruel Joke?
by Lynda Balint, M.D., F.A.C.O.G.
A Place for Women Obstetrics & Gynecology
321-939-3553
www.placeforwomen.net
Menopause, which is defined as one full year without a period, is a natural biological process that is part of every woman’s life.
Perimenopause is the time before menopause when hormone levels vary; and symptoms, including hot flashes, vaginal dryness, decreased libido, insomnia, memory problems, palpitations, rapid mood swings and changes in menstrual cycles, may begin. Menstrual cycles may become shorter or longer, bleeding may be lighter or heavier, and sufferers may skip periods and experience more cramping. Changes in bleeding patterns can mean other things, and it should never be assumed that they are related to hormonal changes without a complete medical investigation.
Menopause marks the end of fertility, not sexuality. Women experiencing menopause may need more time and stimulation to become aroused, but the ability to reach orgasm does not necessarily change. Some women may be less interested because vaginal dryness can make intercourse painful, but lubrications or vaginal creams can help.
There are several treatment options for menopausal symptoms, which include not treating symptoms; lifestyle changes, including smoking cessation, regular exercise, weight control, stress reduction and diet management; nonprescription remedies, including vitamins, minerals, herbal remedies, vaginal lubricants and moisturizers; and prescription hormone therapies. Women experiencing menopause should talk to their doctors about their symptoms.
• • •
Migraine & TMJ, a Neuromuscular Approach
by Matilde F. Castellini, D.D.S.
Orlando Advanced Cosmetic Dentistry, TMJ & Associates
407-351-2245
www.orlandomigrainecenter.com
When the teeth and jaw are out of alignment, muscles in the neck and shoulders try to compensate, causing neck pain and headaches that cannot be relieved until the jaw is realigned.
Symptoms of a bad bite and jaw misalignment include frequent head, neck, back or shoulder aches; abnormal tooth wear; snoring; ringing in the ears; dizziness; and pain around the jaw and temporomandibular joint area. Patients may also suffer from earaches and ear “stuffiness,” and they may hear clicking and popping when chewing.
Thanks to the specialized field of neuromuscular dentistry, sufferers may no long have to endure unnecessary pain because of a bad bite, also called malocclusion. Neuromuscular dentistry addresses the muscles that control the jaw position, swallowing and chewing with the use of the most up-to-date electromyography (computerized mandibular scanning) software and hardware. Founded on the belief that a healthy smile begins with a healthy bite, neuromuscular dentistry strives to relocate the jaw to its optimal physiological position, thus relieving symptoms.
A proper diagnosis is critical to ensure patients receive the best treatment for their particular conditions. In most cases, symptoms related to jaw misalignment can be successfully treated to reduce or eliminate discomfort with no medication or surgery. Postponement of treatment can result in more damage to the joint, muscles or teeth.
• • •
The Integrated Screen — a Noninvasive Screening Test in Pregnancy
by Lori K. Lambert, M.D.
407-363-2000
As a woman ages, her risk of giving birth to a child with a chromosomal abnormality increases. Historically, pregnant women who are age 35 or older have been offered genetic testing. In the past few years, a new and noninvasive screening test for two chromosomal abnormalities — Trisomy 21 (Down syndrome) and Trisomy 18 (Edwards syndrome) — and open spina bifida has been developed.
The integrated screen involves two blood draws and a special ultrasound to measure the nuchal translucency of the baby. NT is a time-specific measurement of the fluid-filled space at the back of a developing baby’s neck. Babies with thickened NTs statistically have an increased risk of chromosomal abnormalities. The integrated screen can lead to the detection of 92 percent of babies with Down syndrome, 90 percent of babies with Edwards syndrome, and 80 percent of babies with open spina bifida.
It is important to remember that this test is a screening test only. If a screening test is positive or abnormal, it does not necessarily mean that the baby has an abnormality. Further testing, involving a very detailed fetal ultrasound and possibly amniocentesis, would be offered.
Screening tests are not perfect and will not identify 100 percent of patients affected.
The NT measurement has to be done by an ultrasonographer or physician trained and certified in NT measurements. Most hospitals and several doctors’ offices are now offering NT sonogram measurements.
• • •
Oropharyngeal Cancer
by Gerald M. Levine, D.M.D.
407-924-0067
Although most oral and throat cancers are associated with tobacco or alcohol use, studies have shown that about 31,000 annual cases of oropharyngeal cancers, about 20 percent to 23 percent, can be attributed to the human papillomavirus. Those infected with HPV are 32 times more likely to develop cancers of the tonsillar area or base of the tongue than those who do not demonstrate the virus. These cancers account for about 3,000 deaths annually.
Current data suggests that oral HPV infections are sexually acquired. In the last three decades, there has been a five-fold increase in the occurrence of tonsillar and base-of-the-tongue cancers in patients under 40.
Additionally, a 2002 survey demonstrated that more than 25 percent of 15-year-olds and 75 percent of 19-year-olds had already engaged in both intercourse and oral sexual activities. Providing young people with medical information and parental and medical guidance is increasingly important.
In 2006, a new HPV vaccine, Gardasil, received Food and Drug Administration approval. The vaccine is 98 percent effective, but protects only girls and women ages 9 to 26. There is no vaccine for men.
The conventional head and neck examination remains the standard for detection of these cancers. Early detection is critical, as more than one-half of these patients are diagnosed after the cancer has spread to other parts of the body.
• • •
What Is VelaShape?
by Elham Mirali Akbari, P.A.-C.
Breeze Laser Center
407-370-9142
www.breezelasercenter.com
VelaShape is the only Food and Drug Administration-approved device that effectively and safely contours, shapes and slims the body by reducing cellulite and firming problem areas in as little as four visits.
The virtually painless, nonsurgical and noninvasive treatment results in no downtime, and patients can return to their daily activities immediately following treatment. Effective on all skin types and skin colors, VelaShape contours, shapes and tightens the body, giving patients the opportunity to improve their lifestyles and boost their self-confidence.
Gradual improvement of the treated area can be seen following the first treatment, and the skin surface of the treated area will feel smoother, firmer and tighter. Results in circumference reduction can be seen from the first to second sessions, and cellulite improvement is noticed in as little as four sessions.
Regardless of weight or size, 80 percent of all women older than age 20 have cellulite, which is one of the most aesthetically troubling concerns. VelaShape’s noninvasive cellulite therapy can help remove the dimpling of cellulite and give women their pre-baby look back.
Results vary from person to person, depending on the body’s reaction to the laser.
• • •
The Mouth: Gateway to the Body
by Ryan L. Mendro, D.D.S., M.S.
Precision Periodontics & Dental Implants
407-905-6777
www.perioprecision.com
Most people know that healthy teeth and gums are the foundation for good oral health. However, recent evidence suggests that a healthy mouth may be important for a healthy body, too. Research has shown that gum (periodontal) disease may be associated with other conditions, including heart disease, diabetes, stroke and
Alzheimer’s disease.
Scientists and doctors are trying to better understand this connection, and many believe it is related to chronic inflammation. Inflammation plays a key role in the body’s defense against bacteria. Some of these bacteria are found in the development of periodontal disease. While it is often painless, symptoms of periodontal disease can include swollen, puffy or bleeding gums, or a receding gum line. Increased inflammation in the gums may lead to an increase in inflammation throughout the rest of the body. Any overall increase in inflammation may contribute to a variety of inflammatory conditions, including heart disease, diabetes and stroke.
In addition to providing a happier, healthier smile, treating gum disease and reducing the inflammation in the mouth may reduce inflammation found throughout the body and help with the management of these other inflammatory conditions.
Periodontists are dental specialists who are extensively trained to diagnose and treat gum disease. With meticulous oral hygiene and home care, and the help of a periodontist, many forms of gum disease can be controlled and possibly prevented.
• • •
Tooth Care & Children
by Jason J. Sotto, D.M.D.
407-347-5956
www.drsotto.com
Most children lose their first primary teeth at 6.5 years old. The lower front teeth are usually the first to be lost.
It is important to prevent decay on all the biting surfaces of children’s back teeth. This can be done with sealants. The biting surfaces of teeth are the most common areas of decay. A sealant is a plastic material that can be “painted” on these surfaces to prevent decay from developing. Applying sealants is completely comfortable and quick. There are two keys to sealants. They must be applied before decay is present, and they must be checked regularly. It is also important to note that all teeth do not need sealants.
In order to maintain a healthy smile, children must regularly brush their teeth. Studies reveal that the average child needs parental help with brushing until about age 6 and help with flossing until about age 8.
Seeing a pediatric dentist is the last key to keeping children’s teeth healthy. One-year-olds who sleep with a bottle and 2-year-olds should see a dentist for a quick look. Cleaning is not always attempted at this age. Age 3 is a good time for a child’s first cleaning appointment.
These early appointments should provide a pleasant, positive experience.
• • •
Removing Physical Limitations to Golf Swings
by Richard Cleary, TPI-certified golf fitness instructor
Gold’s Gym
407-226-9996
www.goldsgym.com
When it comes to achieving a better swing, removing physical limitations is important, but virtually all golfers are lacking the knowledge of where to start.
Golf fitness instructors have physical screens available to identify limitations in the golf swing. Many golfers know that removing flexibility limitations has to be prioritized, but there are other important limitations that must be addressed.
One limitation is not being able to separate the upper body from the lower body. Flexibility can be emphasized so much that different limitations are left unspoken or not understood, such as this upper and lower body separation.
However, it is important to stress that flexibility is very important and not very well understood. Stretching should start at the feet, and golfers should then work up the ankles, calves, thighs, hips, glutes, lumbar and thoracic spine areas, lats, shoulders, arms, and cervical spine.
Working from the bottom up is important, as energy is transferred up the body, and keeping each part flexible and mobile along the body is essential to efficient movement, which includes the golf swing.
While flexibility is paramount to a successful swing, the inability to separate the upper and lower body is also very important.
PGA, LPGA and elite players have a discernible ability to dissociate, or separate, their upper and lower body. There is a stunning, direct and obvious correlation between a person’s level of golf to their ability to perform this movement. The physical ability to rotate the pelvis and stabilize the upper body within a golf posture is directly correlated to the level of play.
Visual representation of this is evident when watching the pelvis of PGA or LPGA professionals starting their downswing in slow motion. Before their hands have fully set in the backswing, their lower body is driving, and their pelvis is rotating. These professionals have a distinguished ability to separate the upper body from the lower body and pelvis. This maximizes their stretch in the swing and creates a whipping action. It also enables a golfer to have proper sequencing on the downswing, transferring energy from the pelvis, trunk and arms into the golf club, which is essential for consistent accuracy. Flexibility is involved, but it takes coordination, mobility and stability to work the pelvis and lower body independent of the upper body.
This skill can be practiced by standing in a golf posture and crossing one’s hands over the shoulders, stabilizing the upper body, and rotating the pelvis back and forth 10 times, without lateral movement. Torso rotation is practiced by standing in a golf posture, crossing hands over shoulders, stabilizing the lower body, and rotating the torso back and forth 10 times. The original golf posture must be maintained throughout movement, and practicing two sets of 10, three times per week, can help develop this skill.
• • •
Address Stress — the Link Between Anxiety & Obesity
by Damon Tanton, M.D., endocrinologist, obesity specialist
Florida Hospital Celebration Health Weight Management Program
407-443-5989
www.celebrationweightmanagement.com
Body composition can improve with better management of stress if a person eats in response to emotions, eats to feel better, or gains weight during periods of high anxiety.
A crucial step in the prevention of fat gain and regain is learning to cope with life’s stressors. It is known that emotional stress can increase body fat by adversely affecting regulation of appetite and fat metabolism.
Stress is the body’s response to upsetting psychological or physical stimuli. The body responds to anxiety by producing stress hormones along two different pathways. One of these pathways involves activation of the sympathetic nervous system, often called the “fight-or-flight” response to stress. When sensing danger, the activation of this system triggers the release of stress hormones. These hormones, in turn, increase heart rate, mobilize fuel and divert blood flow to the large muscles. This stress response equips a person’s muscles to either flee or attack the perceived stressor.
Another response to stress involves the hypothalamic-pituitary-adrenal axis. Anxiety causes the hypothalamus gland within the brain to stimulate the pituitary gland. This process sends a hormonal signal to the adrenal glands, which are on top of the kidneys, and promotes the release of cortisol. Cortisol is a pro-obesity stress hormone that stimulates the production and mobilization of sugar from the liver, which is essential for the brain and muscles in the midst of a stressful event. Ongoing stress can lead to a chronic elevation in cortisol, which can manifest as fat accumulation and weight gain.
Increased stimulation of the HPA axis is also often associated with a reduction in the actions of serotonin. A decrease in the effectiveness of serotonin often manifests as weight gain due to increased food cravings and decreased feelings of fullness.
In addition to changes in serotonin actions, stress-induced HPA stimulation is also believed to contribute to a decrease in dopamine, an important mediator of food consumption. Dopamine provides feelings of satisfaction and reward when eating. If the dopamine response to food is diminished under chronic stress, some may feel the need to eat more in order to feel satisfied.
Chronic distress can contribute significantly to fat gain and regain.
Learning how to reduce the effects of stress on the body is important for successful, long-term weight management. In addition to eating healthy foods and exercising regularly, those who are overweight should seek out activities that assist them with their daily battles against stress.
• • •
THD Offers New Relief for Hemorrhoid Sufferers
by Jay Redan, M.D., F.A.C.S., A.S.C.R.S.
Advanced Laparoscopic Surgeons at Celebration Health
407-303-4602
www.adhesionscenter.com
It is estimated that 50 percent of all Americans have suffered from hemorrhoids at some point in their lives. Many people simply tolerate the problem and often do not proceed with surgical treatment because of pain associated with the surgery.
However, the transanal hemorrhoidal dearterialization, or THD, procedure offers a minimally invasive surgical approach to treating the source of hemorrhoids. Because there is no surgical removal of tissue, and the surgery is performed using intraluminal devices above where the pain fibers that innervate the rectum are located, patients have minimal postoperative discomfort.
This option is offered as an outpatient procedure, which can get patients back to normal as quickly as possible. Clinical results have shown that patients who have THD may encounter less pain, less risk of complications, and a return to activity in about 24 to 48 hours — much less than the traditional three to four weeks associated with a traditional hemorrhoidectomy.
The procedure is performed using Doppler technology, where the arteries supplying the hemorrhoidal vessels are able to be localized and ligated. By eliminating the Doppler flow to the hemorrhoids, there is immediate confirmation that the procedure was successful. This is evident by the absence of an audible Doppler signal at the completion of the surgery. Patients seeking relief from hemorrhoids should ask their doctors if THD is an option in their treatment plans.
• • •
Premenopause & Menopause: the Holistic Approach
by Stephen Renick, D.C., M.S.
Renick Family Chiropractic
407-877-2400
In light of the side effects caused by hormone replacement therapy, many women can benefit from using natural, holistic products that do not cause any of the problems associated with allopathic hormonal replacement therapy.
At first, all women should assess factors that influence menopause and premenopause, such as smoking, alcohol use, caffeine consumption, poor eating habits, and lack of exercise. Vitamins and minerals that are important are calcium; magnesium; vitamins C, D, B6, E and K; boron; folic acid; chromium; silicon; zinc; copper; and manganese.
Phytotherapy, which uses plants for healing, may also be beneficial.
Plants that may help are dong quai, licorice, alfalfa, black cohosh, Siberian ginseng, uva ursi, damiana, soy, rice bran, corn, barley oil, wild yam and red clover.
Glands, which can be treated with protomorphogen therapy, that may need support are the thyroid, pituitary, ovary and adrenal glands. The adrenal glands should be given special attention because of excess stress.
A woman’s spinal alignment is also important for maintaining proper nerve function and will keep the body at its optimum health potential to utilize nutrients.
When using holistic products, one must be patient, as it will take time for the practitioner to put together a specific program utilizing diet history, blood chemistry, health appraisal forms, kinesiology and other diagnostic tools.
• • •
Oral Allergy Syndrome
by Ximena Aldea, D.M.D.
Windermere Center for Dentistry
407-909-1097
www.windermeresmiles.com
Up to 70 percent of people with pollen allergies can have oral allergy syndrome. OAS is caused by cross-reactivity between proteins found in fresh vegetables and fruits and pollens. People with OAS can experience burning, itching, tingling, and occasionally, swelling of the lips, mouth, tongue and throat where the fresh fruit or vegetable touched. These symptoms can last from a few seconds to minutes, and it is rare for the reaction to progress to anything more serious.
A small percentage of people with OAS may experience more severe symptoms of food allergy, including anaphylaxis. For this reason, the particular fresh fruit or vegetable that causes a reaction should be avoided.
Usually, the fruits and vegetables are tolerated in cooked, baked and processed forms, because the proteins that cause the allergic reactions are easily broken down by these processes. OAS is diagnosed through positive skin testing by a licensed physician.
OAS patients may be prescribed antihistamines or other medications year-round or at the height of pollen season. Many people find that their OAS symptoms are worst when the corresponding pollens are in the air, and these people should be careful to avoid the offending foods during these times. There are a few studies that show that allergy shots to the cross-reacting pollens can reduce and even eliminate OAS symptoms. Those experiencing any of the symptoms described above should notify their primary-care physicians and dentists.
• • •
Endocrine Disease Prevention
by Jose Mandry, M.D.
Endocrine Associates of Florida
407-331-1117
An endocrinologist is a physician who treats patients with diseases like diabetes, thyroid disorders, osteoporosis, calcium disorders and other conditions caused by hormonal dysfunction. Experts in the field of endocrinology believe in the power of prevention and importance of patients becoming integral parts of their disease management. Too often patients do not seek the advice of an endocrinologist until they experience complications.
Many endocrine disorders can be prevented or delayed with regular physical activity and proper nutrition. These two important lifestyle habits can lower the risk of heart disease, as well as prevent obesity, high cholesterol and Type 2 diabetes. Increasing physical activity does not always mean going to the gym. Simply changing habits, like parking far away, taking the stairs, or taking a walk after dinner, can help.
Healthy eating habits include the correct food choices and proper portion sizes, with three to four small meals per day. One should never skip meals to lose weight, as this will lower the metabolism and make it difficult to control appetite.
Discontinuing the use of all tobacco products and limiting alcohol consumption can also greatly improve the health of a person and lessen the risk of disease. As a nation, Americans need to change their lifestyle habits by incorporating healthier eating and increased physical activities. In doing so, people will feel better and stronger, and they will help delay or prevent diseases.
• • •
Transforming the Metabolism to Get Healthy
by Richard Bragg, M.D.
Svelte Medical Weight Management
407-352-9877
www.sveltemd.com
Ideal body weight is the most critical health advantage one can possess. However, it is estimated that more than 67 percent of Americans are clinically overweight. One of the key contributors to obesity is wide ranging insulin levels. The constant hunger, feed, crash, hunger cycle is facilitated by insulin level swings in the bloodstream.
To remain healthy, people must transform a sugar-burning metabolism to a fat burning, resulting in permanent weight loss, ideal body fat and an incredibly healthy lifestyle.
Understanding the metabolism is key, since many of the pitfalls of weight management are related to habits, myths or unscientific beliefs.
To transform the metabolism from sugar to fat burning, people should start by drinking a gallon of water per day. The liver breaks down fat into sugar, and fat needs water to travel to the liver.
To jump start gluconeogenesis, those looking to lose weight can undertake a sugar and carbohydrate fast. Gluconeogenesis happens in the liver, and this function of turning fat back into sugar will not happen in the presence of high blood sugar levels. Carbohydrates, sugar and alcohol must be avoided for two to five days.
Once the body is burning fat, one can introduce small, manageable amounts of sugar into the bloodstream.
Increasing activity will up the caloric demand on the metabolism, causing the body to burn more fat. Eating smaller meals that are high in protein and low in sugar and carbohydrates aids in the metabolism-changing process.
Snacks also should be healthy, which will help one eat right at mealtime.
• • •
Painful Bunions in the Healthy Adult
by E. Corry Maguire, D.P.M.
Orlando Foot & Ankle Clinic
407-423-1234
www.orlandofootandankle.com
Painful bunions are deformities of the big toe, or hallux, and the first metatarsal bone, involving a lateral or rotational deviation of the great toe, with or without the development of a large bump to the joint. The cause of bunions has been the subject of some debate.
The most common cause of the condition is a complex of biomechanical abnormalities that lead to the development of bunions. There is a consensus that shoes can aggravate or cause symptoms associated with bunions, but there is controversy over whether footgear can actually initiate the disorder. Shoes may only be a causative factor insofar as they develop instability of the hallux.
Development of symptoms may include bursitis, capsulitis, pain and tenosynovitis.
The goal of treatment of bunions is to provide a reduction of symptoms in order to allow the patient to maintain or return to a normal activity level. Some patients will have self-limiting conditions that, after a consultation with a podiatrist, may need no further professional care.
The management of bunions has both nonsurgical and possible surgical components. Nonsurgical care includes patient education, shoe modifications, padding, orthoses, physical therapy, anti-inflammatory medications and corticosteroid injections. When conservative therapy is either impractical or fails to reduce the patient’s pain to a tolerable level, surgical intervention is indicated. The goal of surgical treatment is to relieve symptoms, restore function and correct the bunion deformity.
• • •
Minimally Invasive Spine Surgery
by Richard C. Smith, M.D., F.A.C.S.
Florida Center for Orthopaedics
407-292-2156
www.fl-ortho.com
As technology improves, doctors’ abilities to treat various disorders continue to evolve. Minimally invasive spine surgery encompasses a variety of procedures, including percutaneous fusions for instability to microdecompressions for neurologic compression. Perhaps the least invasive form of spine surgery is plasma disk decompression, or PDD.
PDD is a procedure used to treat patients with back and radicular complaints due to disk herniations. This minimally invasive technique is performed under local anesthesia on an outpatient basis. PDD uses a unique form of plasma technology called Coblation to remove disk material from the center of the invertebral disk. During the procedure, the SpineWand is introduced through a needle placed within the disk. A series of channels are created to remove tissue from the nucleus. This removed tissue acts to decompress the disk and relieve the pressure exerted by the disk on the adjacent nerve root.
Since the procedure was first introduced in July, more than 100,000 surgeries have been done worldwide. Multiple peer-reviewed articles have demonstrated the safety and efficacy of PDD.
The ideal candidate for PDD is someone who has back and radicular pain; MRI evidence of a contained disk herniation; and a failed course of conservative treatment consisting of a period of rest, physical therapy and injection therapy.
PDD is the least invasive form of minimally invasive surgery. While it is not appropriate for everyone, it does allow properly selected patients a safe and effective form of treatment with minimal morbidity.
• • •
Understanding & Treating Menorrhagia
by John Kim, M.D.
The Center for Pelvic Health
407-303-4190
Menorrhagia is defined as a menstrual blood loss of greater than 80 milliliters per cycle or bleeding that lasts longer than seven days. Heavy periods can cause absence from school or work and adversely affect a woman’s quality of life. Depending on the severity of the condition, it also may cause anemia.
Menstrual bleeding occurs in women when they shed the endometrium, or lining of the uterus. In women of reproductive age, the ovaries produce estrogen and progesterone that influence the endometrium.
The average interval between periods is about 28 days. Ovulation usually occurs about two weeks before the onset of the next period.
Estrogen stimulates the lining of the uterus prior to ovulation. If pregnancy does not occur, the falling level of progesterone causes the stimulated lining to shed, inducing menstrual bleeding.
Heavy periods are usually the result of a uterine abnormality or conditions that cause skipped periods. A patient history and physical exam, paired with blood tests and ultrasound, are important initial steps in the evaluation and should lead to an accurate diagnosis.
Uterine fibroids and polyps are common physical causes of menorrhagia. These conditions are usually treated with surgery. In addition, polycystic ovarian syndrome and hypothyroidism are common endocrine causes of heavy periods. Contraceptive hormonal methods can be used to regulate periods in women with polycystic ovaries, and correction of the thyroid condition often restores regular menstrual cycles.
• • •
New Anti-Aging Treatments Offer Major Improvements for a Minor Investment
by George H. Pope, M.D., F.A.C.S.
Orlando Plastic Surgery Center
407-857-6261
www.orlandoplasticsurgerycenter.com
In today’s economy, the focus has turned to nonsurgical methods to help people look their best. New laser treatments, skin-care products and injectables bring a world of possibilities within everyone’s reach.
Radiesse is used to fill in the nasolabial folds and lines on the cheeks and chin. It creates volume and stimulates new collagen production around the injection area. Effects typically last a year or more.
Botox Cosmetic temporarily smooths moderate to severe lines between the brows and around the eyes. Results last about four months. Botox Cosmetic does not radically change facial appearance or make patients look as if they “had work done.” The muscle activity that causes lines is simply reduced, so patients can still frown or look surprised without wrinkles and creases.
Restylane, Perlane and Juvéderm are hyaluronic acid filler treatments designed to plump up fine lines and wrinkles on the face. Results are immediate and typically last six months to a year.
No pain, no downtime, no anesthesia and quick results have made laser treatments popular. They often are used in conjunction with injectables and fillers for maximum effect.
A laser can treat fine lines on the face and neck; improve uneven skin texture; reduce scars and large pores; and reduce redness caused by rosacea, tiny veins, and sun or age spots. Hands, arms and chests also can be treated.
Some treatments actually remove a portion of the skin surface to reveal new, healthy, vibrant skin.
Sagging skin on the face, jaw line, neck and abdomen also can be tightened with laser treatments.
• • •
The Dangers of Obstructive Sleep Apnea
by C.J. Liebsch, respiratory therapist
Florida Home Health Equipment & Supplies
407-843-2777
More than 12 million people in the U.S. have obstructive sleep apnea. OSA is a serious sleep disorder in which breathing repeatedly stops and starts during sleep. OSA occurs when the throat muscles relax and block the airway. The most noticeable signs of OSA are snoring, excessive daytime sleepiness, periods of no breathing, abrupt awakenings with shortness of breath, morning headaches and insomnia.
OSA occurs when muscles in the back of the throat relax. When relaxed, the airway narrows or closes when breathing in, causing inadequate breathing, which lowers the amount of oxygen in the blood. The brain senses this inability to breathe and wakes up, forcing a reopening of the airway.
Risk factors for OSA include a large neck circumference; being overweight, male, black or Hispanic; hypertension; narrowed airway; nasal congestion; diabetes; a family history of the disorder; use of alcohol and/or sedatives; and smoking.
Untreated sleep apnea can cause high blood pressure, heart failure, sudden death, stroke, Type 2 diabetes, depression, daytime fatigue, poor memory, and sleep deprivation. Reflux disease also may worsen.
Lifestyle changes, losing weight and quitting smoking may be recommended. Usually, a continuous positive airway pressure machine, a device designed to open a blocked airway, is used. In some cases, surgery also may be necessary.
• • •
Breathing for Well-Being
by Marina Lombardo, L.C.S.W., P.A.
407-578-4566
www.marinalombardo.com
In this fast-paced world, many people struggle with managing stress. Proposed solutions include finding time to exercise, taking up a relaxing hobby, or modifying one’s diet. These are good suggestions, but the extra effort required to make the changes may create more stress.
The simplest and most powerful technique is free, always available and right under one’s nose. Remarkably, proper breathing is the key to vibrant well-being.
A person can begin by trying an experiment that includes closing the eyes and placing one hand on the chest and the other on the stomach. Then, one should breath normally. Most people will notice that the hand on the chest moves more. This “upside down” breathing is the opposite of how the body is designed to breath. A stress response is being unknowingly triggered, and it can take a physical and emotional toll, including developing feelings of fatigue, anxiety and depression.
Proper breathing can help with this dilemma, and it can be learned by taking time every day to breathe properly. When people notice any stress, they can inhale slowly to a count of four, while expanding the belly and arching the small of the back. They can then exhale slowly to a count of four, gently relaxing the belly and flattening the small of the back. This should be repeated for four cycles.
When a person commits to proper breathing it becomes possible to experience the benefits of more energy, increased focus and enhanced well-being.
• • •
Stuffy Nose
by Wade W. Han, M.D., F.A.C.S.
Florida Ear Nose Throat & Facial Plastic Surgery
407-944-3340
www.floridaent.com
Nasal congestion, stuffiness or obstruction to nasal breathing is one of the oldest and most common complaints. For some, nasal congestion can be a source of considerable discomfort.
Medical writers have established four causes of nasal obstruction — infection; structural abnormalities; and allergic or nonallergic (vasomotor) rhinitis, also known as runny nose. Patients often have a combination of these factors.
The average adult suffers a common cold two to three times per year. Antihistamines and decongestants help relieve the symptoms of a cold, but no medication can cure it. Ultimately, time is what is needed to get rid of the infection.
Acute sinus infections produce nasal congestion and discharge. Pain may occur in the cheeks and upper teeth, between and behind the eyes, or above the eyes and in the forehead. Chronic sinus infections may or may not cause pain, but usually involve nasal obstruction and nasal or postnasal discharge. Some people develop fleshy growths in the nose from sinus infections, and the infection can spread to the lower airways, leading to a chronic cough, bronchitis or asthma. Acute sinus infections generally respond to antibiotic treatment, and chronic sinusitis may require surgery.
Structural abnormalities include deformities of the nose and nasal septum — the flat cartilage and bone that divides the two sides of the nose. These deformities are usually the result of an injury. Seven percent of newborn babies suffer significant nasal injury in the birth process. Nasal injuries are common, and if they obstruct breathing, surgical correction may be helpful.
• • •
Why Straighten Teeth?
by Nelson Diaz, D.M.D.
Diaz Orthodontics
407-233-2920
www.diazorthodontics.com
A smile is one of a person’s most important assets. It reflects one’s personality and health.
The smile is also one of the first features that people notice, and it can provide self-confidence and emotional well-being.
Unfortunately, not everyone is born with beautiful, straight teeth. Often people’s teeth and jaws do not align properly, and this can be detrimental to their smiles. Crooked teeth can be a source of dental and social problems.
For most people, a beautiful smile is the most obvious benefit of orthodontics, but there are other very important benefits of straight teeth.
Straight teeth help people to effectively bite, chew and speak, and a straight smile contributes to healthy teeth and gums.
Straight teeth function better and are easier to clean. Crooked teeth can be hard to clean and contribute to gum disease and decay.
Straight teeth contribute to self-confidence and self-esteem, and they are less prone to decay and injuries.
Untreated orthodontic problems may become worse and lead to tooth decay, gum disease and chewing difficulties, among other problems.
Orthodontic treatment is usually successful at almost any age. Children and adults can benefit from braces since the basic process involved in moving teeth is the same.
The American Association of Orthodontists recommends that children get an orthodontic checkup no later than age 7.
Adults can also benefit from today’s smaller, attractive, less visible orthodontic appliances.
• • •
Becoming a Medical Hero
by Linda Harper, M.D.
CNS Healthcare
407-425-5100
www.cnshealthcare.com
For most people, the idea of becoming a medical hero is something they can only read about. However, more and more heroes are emerging in the field of clinical research.
Clinical research is not a popular topic of conversation. Yet, it arguably touches everyone’s life regularly. According to the U.S. Census Bureau, more than one-half of all Americans are taking at least one prescription medication. And most Americans report routinely using over-the-counter medications.
The public simply does not realize that all medicines, and many behavioral interventions, have gone through clinical testing with people just like them. Although the majority of people believe that clinical research helps advance medical knowledge, less than 15 percent believe they have even a rudimentary understanding of how clinical research affects them directly. However, it is those medical heroes who make our current medicines and medications on the horizon possible.
Those people made it possible for everyone to have access to advanced medicine and treatments.
• • •
Strength Training for Everyone
by John Young, owner
Exercise Systems Inc.
407-996-8890
www.exercisesystems.com
Strength training has numerous benefits, not the least of which is helping exercisers to lose weight and keep their bodies strong. When properly performed, strength training can provide significant functional benefits and improvement in overall health and well-being, including increased bone, muscle, tendon and ligament strength; improved joint function; reduced potential for injury; increased bone density; a temporary increase in metabolism; improved cardiac function; and elevated good cholesterol.
No matter one’s goals, strength training is an important component of an exercise program, and it is never too late to start. Older people who take up weight training can prevent some of the muscle tissue loss that normally accompanies aging. Weight-bearing exercises also can help to prevent osteoporosis.
There are many options for strength training. Free weights involve plate-loaded barbells, machines and dumbbells, with multiple repetitions and sets of exercises targeting specific body parts. Free weights are versatile and inexpensive. They also simulate real-life lifting situations and promote whole-body stabilization.
Machine weights adjust to varying body dimensions and allow a full range of joint motion. Circuit training uses a series of exercise machines, each of which target a different muscle group. Resistance can be adjusted through a weight stack attached to each circuit machine.
There are also functional trainers — machines that allow multiple muscle groups to work through various strength exercises on the same machine. Functional training uses multiple muscle groups that cross several joints in one exercise. Today’s functional trainers incorporate cables, instead of fixed arms, and have hand grips that move around on the end of a cable, rather than a welded-on lever for the exerciser to hold.
This improvement allows one to stand, sit and lie down using a bench, the floor or other accessories and grab the handles on the cables and pull them against resistance to strengthen and tone muscles. This means one must use several muscle groups, including the legs and core, to do most exercises. Exercisers will never outgrow a functional trainer, no matter their needs.
One piece can be used comfortably by a beginner, as well as advanced athletes in training. A functional trainer can fit almost any body size or exercise preference, since the pulleys can be moved low or high and anywhere in between. Routines will not get as monotonous because there are an infinite number of exercise possibilities.
A functional trainer can be a superior choice for injury prevention or rehabilitation. It focuses on all muscles, including smaller ones, and uses many different angles for a more thorough and balanced workout.
Those with medical conditions, injuries or illnesses should check with a doctor before starting a weightlifting program.
• • •
Invisalign & the Benefits of Straight Teeth for Adults
by Maria A. Kashlak, D.M.D. & Anthony F. Oswick, D.M.D.
Bay Hill Dental Associates
407-345-5620
www.oswickkashlakdmd.com
When most people hear the word “braces,” the first thoughts that come to mind are the straightening of crooked teeth or closing gaps between teeth. While straighter teeth can lead to a more beautiful smile, there are other important benefits of straight teeth that adults should consider.
It is much easier to keep well-positioned teeth clean. Crooked and crowded teeth or teeth with gaps between them present challenges for brushing and flossing. Excessive buildup of plaque and calculus, or tartar, can lead to periodontal disease and tooth decay, as well as the need for more frequent dental hygiene visits.
Poorly positioned teeth lead to an unbalanced bite. This puts uneven pressure on teeth, which can cause discomfort, as well as excessive wearing down of the natural tooth structure. As people age, improperly aligned teeth are much more susceptible to wear. Teeth may look like they are getting shorter, or tooth edges will wear unevenly.
Invisalign is an orthodontic technique that can straighten teeth without traditional braces. The system uses a series of aligners. These are designed and fabricated utilizing computer imaging technology. They are clear, comfortable and removable. The aligners are custom-fit to teeth and progressively changed at two-week intervals, as the teeth are gradually repositioned. Because the aligners are removable, patients can continue to brush and floss normally.
Invisalign also is very effective in adult patients who may have had traditional braces earlier in life and notice their teeth have relapsed.
• • •
Skin-Cancer Myth Busters
by John L. Meisenheimer, M.D.
The Meisenheimer Clinic and Day Spa
407-352-2444
www.orlandoskindoc.com
Many articles on skin cancer review the medical signs of skin cancer, but they rarely address conventional wisdom that circulates about skin cancer.
Conventional wisdom arises from many sources. This advice may come from a friend, co-worker or family member, but they are common myths that need to be busted.
People often believe that if the growth does not hurt, it is not skin cancer. The truth is, most skin cancers do not hurt. Some may be symptomatic, but a painless spot is definitely not a sign of a growth being harmless.
Another common myth states that if a mole or growth has not bled, it is not cancer. Although a bleeding growth may be a cancer, the reverse is often not true.
Many think that skin cancer growths must be black. However, the majority of nonmelanoma skin cancers are not black. There is even a variety of melanoma called an amelanotic melanoma that may not have any dark colors at all.
Conventional wisdom also states that skin cancers only appear in sun-exposed areas. Even though the majority of skin cancers do appear in sun-exposed areas, including the face, scalp, arms, hands and neck, dermatologists routinely remove cancers from all areas of the body. If a growth has suspicious changes, it should be checked, no matter its location.
Others may think that a nonhealing spot was caused by an injury. Frequently, patients will show dermatologists nonhealing spots and tell stories of how they cut themselves shaving, got scraped doing yardwork, or hurt themselves during various activities. They are certain it is not cancer because they can identify specific injuries to the sites.
Unfortunately, sites that have skin cancer are much more prone to injury and nonhealing than healthy skin. The “injury” may have traumatized an inconspicuous skin cancer that may not have been noticed. Any spot that is not healing, whether it is due to an injury, should be evaluated.
Many feel they are safe from cancer because their marks do not look like pictures of skin cancers on the Internet or in other media. But if all skin cancers and diseases had textbook appearances, there would be no need for dermatologists. There are hundreds of variations in the appearance of skin cancer. And dermatologists are trained in these variations. If a spot has some of the warning signs of skin cancer, it should be checked by an expert.
Many believe that a bump must be raised to be cancerous. However, skin cancers can be flat. Some can make a depression in the skin. Occasionally, skin cancers can even look like a rash.
If one has a growth or spot that is bleeding, changing or not healing, he should see a dermatologist. Patients should not rely on conventional wisdom about what is and what is not cancer.
• • •
Hormones — the Balancing Act for Anti-Aging, Health & Vitality
by Kirti M. Kalidas, M.D., N.D.
The Center for Natural& Integrative Medicine
407-355-9246
www.drkalidas.com
With so much news on bioidentical hormones and their anti-aging effects, does everyone need replacement? Hormones allow bodies to function optimally. While it is true that hormones naturally decline with age, everyone is unique in their hormonal needs, and one pill does not fit all.
Hormonal imbalance can generate multiple complaints, including foggy thinking, fatigue, insomnia, hot flashes, weight gain or loss, irritability, mood swings, low sexual drive or depression. The interplay of all the hormones — thyroid hormones, estrogen, progesterone, testosterone, cortisol and melatonin — is intricate. Only after appropriate testing using blood or saliva should hormones be prescribed. It is important to monitor symptoms and retest at intervals.
Sometimes even appropriate hormone replacement does not achieve the expected results. Toxins such as lead, mercury, cadmium, pesticides or even environmental toxins can block hormones. Medically supervised detoxification programs that safely and effectively remove these toxins using oral and intravenous protocols can make a huge impact on health. Food allergies can present as foggy thinking and fatigue, whereas an imbalance in neurotransmitters can lead to insomnia and depression. An imbalance in the gut flora leading to candida, or yeast, can also be a stumbling block to health.
There is more to achieving health and vitality. A truly integrative approach looks at the whole person. Good nutrition, vitamin supplementation, exercise, fitness, stress reduction and lifestyle choices are integral components to improved energy and wellness. Hormone replacement that is done judiciously and safely adds vitality and vigor and leads to better health and healing.
• • •
Emotional Well-Being & Exercise
by Jennifer Ferrell-Hanington, Psy.D., licensed psychologist
Associates in Psychology and Counseling
407-523-1213
www.apc-orlando.com
Exercise is not only a healthy behavior for physical well-being, but research provides evidence of it producing mental health benefits. Exercise can decrease symptoms of depression, anxiety and stress, as well as prevent relapse after therapeutic intervention.
It is now understood that exercise does not improve mood through a rush of endorphins in the brain. Instead, the improvements appear to be from an increase in other neurochemicals, including norepinephrine and serotonin, which are the same neurochemicals increased by antidepressants.
Research also has shown that exercise does not only affect neurochemicals that improve mood, but it also conditions the body’s response to stress and helps it work more efficiently.
There is no particular form of exercise that is prescribed to improve mood or reduce stress. However, research has shown that longer exercise programs with more sessions are more likely to make a greater improvement.
Waiting for motivation is unlikely to lead to success, especially with the low energy associated with depression. Instead, those looking to start exercising should start gradually and set realistic goals. They should identify their strengths and skills and pursue activities that are enjoyable. Social contact can also improve mood and serve as a means of finding a workout buddy to sustain motivation. Everyone should check with their physicians before starting exercise regimes.
People should make exercise a regular component of their health and wellness programs. Psychology and physiology interact with one another, and exercise is an easily accessible approach for maintaining mental and physical well-being.
• • •
Thank the Plank
by Fran Johnson, A.C.E.-certified personal trainer
Fit4Ever Lifestyle, LLC
407-617-9632
www.fit4everlifestyle.com
What is it exactly that makes a person noticeable? A person’s posture and gait emphasize core strength and give a younger, more noticeable appearance.
So what exactly does the plank have to do with core strength, posture and gait? The plank is an exercise performed by floating or hovering the body in a face-down or side position. There are forward planks and side planks, as well as a variety of options for different training levels.
Proper plank training develops the core, or entire girdle, of the body, which includes back, abdominal and stabilizer muscles. This core strength is what allows everyone to push, pull and lift things in order to be able to functionally perform daily routines. According to the American Council on Exercise, the plank is one of the 10 best core exercises.
• • •
Choosing the Right Family Fitness Program
by J. Restrepo
Victory Martial Arts
877-758-0061
www.victoryma.com
Modern medicine suggests that prevention is perhaps the most effective way of staying in good health. What better way to prevent ailments than to keep the body strong and fit? But, out of so many options, how does one choose the right physical activity?
In making the right choice, the essential criterion must be: Will it be effective for the individual?
Exercise should be fun and something to look forward to. This attitude will promote consistency, which is a quintessential prerequisite for success in any fitness program.
The ideal activity will also offer constant challenges, which keep motivation high. If people do not exercise consistently, or if they quit, nothing relevant has been achieved.
Team sports can be very effective. They provide the fun of the game, challenge of competition and commitment to team members. These factors can facilitate that all-important consistency.
For those who do not enjoy team activities, there is golf, tennis and other sports. Training at a health club is also a popular option that can be very effective, but only if exercisers have the discipline to train consistently on their own.
An alternative that offers perhaps the best of both worlds is martial arts. Students are constantly challenged as they learn new skills. There are techniques to be practiced individually and others that require teamwork. Tournaments provide a great source of motivation, and the belt system offers students clear goals.
Whatever the choice, exercise should work for the individual. Participating in a fitness program with consistency will surely improve the health of any child or adult.
• • •
Massage Therapy: Part of a Wellness Lifestyle
by Nicole Manvel, L.M.T. & Jacque D. Dunegan, Ph.D.
Welltrax
407-654-9355
www.welltrax.com
For anyone interested in maintaining a healthy lifestyle, massage therapy offers several health benefits that help round out the wellness routine.
Massage therapy not only helps alleviate pain and stress, it also improves circulation by bringing oxygen and other nutrients to body tissues, increases flexibility and mobility, helps clear waste and boosts the immune system.
There are three key types of massage. Swedish, or relaxation, massage is the most common and well-known form of massage. It feels good and is relaxing and invigorating. It affects the nerves, muscles, glands and circulation, while promoting health and well-being.
Therapeutic massage is a type of massage therapy that focuses on realigning deeper layers of muscles and connective tissues. It is especially helpful for chronically tense and contracted areas, such as stiff necks, tight lower backs and sore shoulders. Some of the same strokes of classic Swedish massage are used, but the pressure is deeper and concentrated on areas of tension and pain.
Sports massage is specifically designed for people who are involved in physical activities. But one does not have to be a professional athlete to have the service. Sports massage also is used by people who are active and work out often. The focus is not on relaxation, but on preventing and treating injury and enhancing athletic performance. The strokes are generally faster than those used in Swedish massage.
Facilitated stretching is a common technique that helps to loosen muscles and increase flexibility.
• • •
The Benefits of Boutique Gyms
by Lani Llanes
Zero Gravity Fitness
407-654-2600
www.zerogravityfitness.net
Summer is quickly approaching, but before people dig through their drawers for bathing suits, they might consider hitting the gym.
But instead of piling into a room where there is no space to move, let alone see what the instructor is doing, those looking to get in summer shape should think of trying something a little less mainstream.
Boutique gyms are the best-kept secret among those who confidently hit Florida’s beaches. Smaller class sizes allow for a more personalized workout, putting focus on the clients, rather than the dollar.
Riskier and more specialized techniques like Pilates, yoga and Russian kettlebell can be safely executed under a watchful eye when training in a more intimate atmosphere.
Trainers will know their clients’ names, whether working one-on-one or in group settings. This holds clients accountable for showing up because they are no longer just another face in the crowd. Results can be seen more quickly due to the smaller nature of the gym, as opposed to larger group classes.
Joining a boutique gym will have clients seeing changes in their bodies quickly, all while delivering exercise services in a unique, intimate setting.
• • •
Why Do People Have Noses?
by Carlos M. Jacinto, M.D.
Allergy & Asthma Associates of Central Florida
407-370-3705
www.aaacfonline.com
The nose is a prominent feature on everyone’s face. But it is only the tip of a large nasal cavity that extends another three quarters into the skull. It is a simple structure, but it has amazing features that serve various important functions.
The air-filled nasal cavity acts as a sound amplifier that provides resonance to our voices. The roof of this cavity contains the olfactory nerve cells, which are easily accessible to airflow and provide the sense of smell.
The major function of the nasal cavity is to act as an air-conditioning system. It has to filter, purify, humidify and control the temperature of the air during its brief passage through the nasal cavity.
The inside of the nose has wing projections from the side walls called turbinates, which provide turbulence to air flow. Whereas major impurities are filtered by nasal hairs found in the front of the cavity, smaller particles impact and deposit onto the turbinates. These turbinates also have a rich array of blood vessels that provide the proper temperature to the air. Even very cold air is warmed to body temperature in the milliseconds it takes to pass through the nose.
The nose also has a very important role in the frontline of the body’s defense system. The lining of the turbinates has goblet cells that form a mucus blanket, which covers the lining of the nasal cavity and is rich in antibodies. The lining is composed of cells that have bristle-like projections that beat in unison to sweep the mucus blanket toward the back of the throat. It takes 10 minutes for particles impacted in the front of the nasal cavity to be swept and swallowed for elimination.
• • •
The Convenience of Intense Pulsed-Light Therapy
by Danielle Beck, Medical, Spa Manager
Nova Cosmetic Centers
407-226-0609
www.novacosmeticcenter.com
The most powerful and versatile aesthetic system available for the treatment of permanent hair reduction is the intense pulsed-light therapy approach. IPL therapy provides the most effective treatment solution for those wanting to eliminate unwanted hair.
The heat generated during treatment targets, damages and destroys the hair and its potential for regrowth. When the procedure is complete, most of the hair will fall out during a period of one or two weeks. Hair of any color can be treated, and the treatment is effective on all skin types. A series of treatments are administered at four- to eight-week intervals, depending upon the location of the hair. IPL hair removal has been very helpful in reducing or eliminating hair growth and diminishing or stopping recurrent folliculitis.
Not only does laser hair removal stop folliculitis and subsequent skin darkening, but it also is beneficial in reducing hyperpigmentation and persistent skin redness. This treatment will leave skin smooth and eliminate razor burn.
• • •
Just Add Water
by Maureen McGinty
SouthWest Aquatics
407-905-0999
www.southwestaquatics.com
Swimming is the quintessential summer sport. Life in Florida involves endless pool parties, beach activities, boating and snorkeling, as the state is surrounded by opportunities to enjoy the water. Regardless of one’s age or skill level, there is a myriad of ways to reap the benefits of swimming.
Swimming offers a low-impact, full-body exercise that can span a lifetime. It leads to better physical development and coordination, and it promotes health and fitness. Even those who cannot partake in other high-impact sports can enjoy swimming. The sport is easy on the joints and provides phenomenal use of aerobic and anaerobic energy systems. Swimmers have healthy, strong bodies and higher grade-point averages.
As soon as children start crawling, which is typically around 6 months, they are able to learn swim survival skills. Any healthy child, including most with special needs, can be taught to swim and float. This life-saving technique is the most efficient way to swim, as it ensures proper posture and allows a seamless progression into stroke development.
Local swim teams train competitors of all ages year-round. The sport allows a level of individual competition, as it is just as important to race against personal-best times as the swimmer in the adjacent lane. Swimming offers a lower chance of injury than other sports, which is a relief to many parents. Psychologically, swim teams instill valuable self-confidence and build lasting friendships.
• • •
Health, Fitness & No Pain
by Diego Guerrero, M.D.
Center for Pain Medicine at Celebration Health
407-303-4020
www.centerforpain.com
Chronic and acute neck, back and joint pain are very common symptoms that affect people of all ages. These conditions interfere with the ability to exercise and maintain a healthy lifestyle. However, there are treatments that do not require surgery that can help.
For many, symptoms will resolve within a week or two with the use of conservative treatments, such as anti-inflammatory medications, physical therapy and rest. But there are a significant number of individuals who suffer from continued spine or joint pain in spite of conservative treatments.
In these cases, it is recommended to have a complete evaluation by a pain medicine doctor. The evaluation may include MRIs or X-rays to rule out the presence of herniated discs in the neck or lower back, or arthritis in major joints.
If a complete physical exam and radiological data confirms the presence of any of these pathologies, a pain medicine specialist will be able to treat these conditions by using a multidisciplinary approach that may include medication therapy in combination with physical modalities and X-ray-guided, minimally invasive nonsurgical procedures that address the pain trigger area by blocking specific nerves or joints. These treatments can also be effective for patients who have already undergone surgery of the spine or joints but have not responded to the treatments.
Ignoring and not treating these chronic painful conditions with a pain medicine doctor may complicate a mild back or neck condition to a point where surgery may be the only option.
All of these therapies are performed in an outpatient basis. Usually, procedures are no longer than 15 minutes to 30 minutes. Individuals can return to their normal activities the next day. Once their pain is controlled, patients will be able to gradually return to healthy and fit lifestyles.
• • •
Being Proactive About Colon Cancer May Save Lives
by Shams S.M. Tabrez, M.D.
Four Corners Digestive Disease Institute
407-303-4829
Cancer of the colon or rectum is the third leading cause of cancer-related deaths in the U.S. In 2005, more than 141,000 Americans were diagnosed with colorectal cancer, making it the third most common cancer.
Colorectal cancer symptoms are usually very few and nonspecific. Symptoms may include blood in the stool, a change in bowel habits, stools that are narrower than usual, unexplained stomach discomfort and unexplained weight loss.
The risk of developing colorectal cancer increases in people older than age 50. Nearly 90 percent of cases are in this age group. Other risk factors include inflammatory bowel disease; family history of colorectal cancer or colorectal polyps; and genetic syndromes, such as familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer.
Environmental and lifestyle factors may play roles in increasing the risk of colorectal cancer. These factors include lack of regular physical activity, low fruit and vegetable intake, a low-fiber and high-fat diet, alcohol consumption, tobacco use and obesity.
Studies have shown that colorectal cancers almost always arise from polyps, which are finger-like, sometimes flat growths. These can be present in any part of the colon or rectum.
There are several ways to screen patients who are at-risk for forming colorectal cancer. These screening tests include a stool test for occult blood, flexible sigmoidoscopy, double contrast barium enema, and colonoscopy. Virtual colonoscopy or CT scan colography also are available to detect polyps and other colonic diseases.
Colonoscopy is the standard test because of its high sensitivity and specificity. It is not only a diagnostic tool, but also a therapeutic tool. If a gastroenterologist finds any polyp or growth, it can be removed and biopsied. The follow-up to any screening test is determined by the findings. If a colonoscopy comes back negative and the patient has no family history of colorectal cancer, then he may not need another screening for up to 10 years.
When colorectal cancer is found early and treated, the five-year relative survival rate is 90 percent. It is estimated that at least 50 to 60 percent of colorectal cancer deaths could be prevented if all men and women age 50 or older were screened routinely. Some studies suggest that people may reduce their risk of developing colorectal cancer by increasing physical activity, eating fruits and vegetables, limiting alcohol consumption and avoiding tobacco.
Colorectal cancer screening saves lives. Awareness about this preventable disease is needed.
• • •
Sunblock Labeling
by James G. Scelfo, M.D., F.A.A.F.P.
Personalized Primary Care
407-566-2545
www.personalizedprimarycare.com
The Food and Drug Administration has proposed new regulations to ensure that consumers are better informed when selecting a sunscreen product. This system, which will be used in conjunction with the sun-protection factor designation, involves a four-star rating scale for the amount of protection from ultraviolet A rays. UVA and ultraviolet B rays are two major types of ultraviolet light that are emitted by the sun.
The SPF value that is currently listed on sunscreen labels only applies to UVB light. In order to obtain the best protection possible, it is important that consumers choose a product that blocks both types of UV light, as both are known to increase the risk of skin damage. Within this new four-star rating scale, one star represents low UVA protection, two stars represent medium UVA protection, three stars represent high UVA protection, and fours stars represent the highest UVA protection available. Sunscreen products that do not meet a one-star rating will bear a label reading “no UVA protection.”
In addition, sunscreen labels will also require a new warning that states “UV exposure from the sun increases the risk of skin cancer, premature skin aging and other skin damage. It is important to decrease UV exposure by limiting time in the sun, wearing protective clothing and using a sunscreen.”
FDA officials hope this warning will make consumers aware that wearing sunscreen is just one way to help decrease the risk of skin damage from the sun’s harmful rays.
• • •
Performance Camps Give Athletes an Edge
by Brad Homan, D.O., director of sports medicine
Florida Hospital Celebration Health
407-303-4204
www.celebrationhealth.com
Athletes today are not what they used to be — they are better. Today, emphasis is on performance. To excel at a sport, it helps to be bigger, faster and stronger than one’s opponents.
This transformation has been seen in professional sports in recent decades, and the trend is trickling down to collegiate, high school and recreational athletes. Through years of research, the science of exercise has been developed, and these principles are being used to optimize athletic performance. Once utilized only by professional organizations, these techniques are now taught in sports performance camps for all.
Sports performance camps promise to improve athletic ability by using proven training techniques focused on improving various skills. Many camps will tailor training programs for participants, with special focus on particular sports. These camps teach techniques that have been clinically proven to improve the skills needed for specific sports. Running speed, power, strength, vertical jump height and agility are all skills that can be enhanced.
These camps also offer an athlete additional training outside of the regular practice schedule, which can translate to improved execution on the field.
There are many sports performance camps, and choosing the right one may be difficult. Some camps target specific types of athletes, and others may use diverse training regimens and techniques. It is important for athletes to find a camp or training center that will identify specific needs and create programs that will help them achieve their goals.
Performance camps are here to stay. Advanced training exercises and instruction have helped thousands of athletes improve their skills and abilities. Learning proper form and training principles is also important to prevent injuries. Athletes who are interested in getting an edge on the competition can find a fun and effective way to achieve this goal at sports performance camps.
• • •
The Art of Transforming Stress Into Peace
by Edely L. Wallace, E.-R.Y.T., C.Y.T., master yoga teacher
Yogamatrix Studio
407-354-0909
www.yogamatrixstudio.com
Stress is simply a blockage that prevents clear thinking, optimal health and harmonious relationships. Today, people can choose to react, resist or scream toward stressors, such as the current financial crisis, or one can simply respond in a more conscious way.
Even though it is considered a form of exercise, yoga actually goes beyond the physiological level. Yoga is defined as “settling down the restlessness of the mind.” The ultimate purpose of yoga is for one to become established in a state of peaceful mind and total awareness. Over time, the inevitable pressures of life will have less impact, and people can respond more effectively.
Yoga cultivates an inner state of conscious awareness and reinforces the saying “this, too, shall pass.” This allows people to move more calmly through life. By choosing to practice yoga, one learns the art of transforming stress into peace at any time.
• • •
What Is Wrong With Conventional Diets?
by Debbie Gryniewicz, certified metabolic balance coach
Metabolic Balance All Natural Weight Loss
321-559-1213
www.balanceyourmetabolism.com
A healthy metabolism depends on the body producing all the hormones and enzymes it needs. To support this function, bodies must be supplied with the right nutrients through healthy foods. Consuming ready-to-eat foods often cheats the body out of the substances it needs. For example, strawberries contain iron, manganese and copper, all important nutrients. In order to get these substances, people may crave strawberries, and they may choose to satisfy that need with strawberry yogurt from the grocery store.
Typically, this type of product contains anything but strawberries. Instead, it is loaded with strawberry aroma and flavoring. In reality, the body has been cheated out of needed nutrients because the food choice was based on external stimuli, such as TV commercials and positioning in the supermarket.
Everyone seems to be on a diet, but people continue to choose foods full of additives and sugar. These foods do not supply the body with what it needs, and cravings to get these nutrients push them to eat more and more.
It is imperative that people get past the concept of dieting and learn the skills of shopping, preparing and eating real, not processed, foods. Supplying the body with the right foods will balance the hormones that contribute to a healthy metabolism and, ultimately, good health.
• • •
Looking Good & Feeling Good
submitted by Elase Medical Spas
407-370-3100
www.elase.com
Many may have read about SmartLipo in magazines or seen it on TV. It is the new buzz in Hollywood, as celebrities return to their pre-baby bodies and shed unwanted fat deposits. But SmartLipo is available for everyone.
With all the different diet options and ways to slim down, it can be very confusing to select the right plan. However, there is only one way to permanently eliminate fat, and this is by taking it out of the body. All other modalities can work temporarily, but just like so-called “yo-yo” diets, the fat can come back. SmartLipo is permanent fat removal for any area of the body.
SmartLipo is an in-office procedure with little to no downtime. No general anesthesia is needed, and the laser provides added skin tightening benefits in the treatment area. SmartLipo offers instant and permanent fat removal in the arms, chin, abdomen, flanks, thighs, knees, back and men’s chests.
SmartLipo works through an incision the size of a ballpoint pen. The laser liquefies the fat, making permanent elimination easy, without the downtime or recovery of traditional liposuction. The laser also coagulates the blood vessels to lessen any bruising and stimulates collagen and elastin for added skin-tightening benefits.
Another treatment to help one look and feel great is VelaShape, which aides in cellulite and fat reduction. VelaShape treatments help smooth out cellulite and reshape the body, removing the cottage-cheese look of cellulite, dimples or pockets of fat.
VelaShape can also be the perfect companion to SmartLipo. The purpose of this safe and effective treatment is to slim the figure, without the downtime of surgery. It also can help to improve circulation in the treatment area. VelaShape treatments ultimately result in a more firm, smooth and tight treatment area.
VelaShape is four times as powerful as any other type of cellulite reduction treatment on the market, and it is the first Food and Drug Administration-approved, noninvasive medical solution for circumferential reduction and first FDA Class II cleared platform for cellulite reduction. The VelaShape platform has also received the CE mark for noninvasive body contouring with temporary circumferential reduction and temporary reduction of cellulite.
Professional weight-loss programs can offer a simple way to lose weight in conjunction with SmartLipo and VelaShape. The ups and downs of dieting and losing weight make it difficult for people to stick to programs, and it is important to find a program that has been proven to work. Consumers should pick a program that provides them with the right amount of vitamins and nutrients and ensures that they do not deplete the good fat storage that surrounds the organs.
• • •
The Value of Orthodontists
by Maria C. Mendez, D.M.D.
All About Smiles
407-855-6305
aas@allaboutsmilesortho.com
An orthodontist is to the teeth what a cardiologist is to the heart. Orthodontists are highly trained specialists who partner with dentists to provide the best oral health care.
Orthodontists are qualified dentists who have an additional full-time university-based education in an accredited orthodontic residency program supervised by orthodontists. Training lasts two to three academic years.
By learning about tooth movement, or orthodontics, and the guidance of facial development, called dentofacial orthopedics, orthodontists are uniquely trained as experts in straightening teeth and aligning jaws.
Orthodontists diagnose, prevent and treat dental and facial irregularities. They limit their practices to orthodontics and dentofacial orthopedics. Orthodontists treat a wide variety of improperly aligned teeth and jaws, known as malocclusions. They regularly treat young children, teens and adults.
• • •
The Best Father’s Day Gift
by Ricardo A. Perez, M.D.
Southwest Internal Medicine Specialists
407-345-0005
www.southwestinternalmedicine.com
By encouraging dads to undergo health screenings, families can give the gift of health this Father’s Day. Fathers can benefit from early detection and prevention of serious diseases. When caught early, many of these diseases can be treated, and even cured. Disease prevention and early detection of certain medical conditions through screenings help people live longer. Even though these benefits are well-known, many people still avoid health screenings.
There is some indication that male patients seem to wait longer than female patients to schedule appointments after getting sick. Some men choose to “tough it out,” as they do not have the time to deal with an illness and go to the doctor.
Many times, these male patients have additional complications and may end up in the hospital. Other patients see a doctor only after encouragement from a family member, usually a wife. Although consistent screening remains a challenge for both sexes, health screening is more challenging in men.
Family and friends can encourage the important males in their lives to undergo screenings by having frank conversations with them about the benefits of getting screened.
Like a car, which needs regular maintenance to keep parts from breaking or not performing as expected, men need age-appropriate health screenings at their doctors’ offices to help prevent serious problems.
Some male patients find out the benefit of early screenings when benign lesions on the colon are found and removed during a routine colonoscopy, preventing those lesions from becoming malignant.
Others, however, are diagnosed with metastatic colon cancer only after having an urgent colonoscopy at the hospital because of significant rectal bleeding caused by advanced disease.
Men ages 20 to 39 should be screened for high blood pressure, diabetes, elevated cholesterol, obesity and testicular cancer with self-exam teaching. Men up to age 26 should be checked for sexually transmitted diseases.
Men ages 40 to 50 should be checked for elevated blood pressure, diabetes, elevated cholesterol, colorectal cancer and prostate cancer. At theses ages, men should have a colonoscopy every five years, with more frequent exams if they have a history of abnormal rectal exams or occult blood screenings. They should also have a diabetes screen every three years
.
And men age 50 or older should be screened for elevated blood pressure, diabetes, elevated cholesterol, colorectal cancer and prostate cancer. Men should have a colonoscopy every five years, or more frequently if they have a history of abnormal rectal exams or occult blood screenings.
Men of all ages should have body mass indexes determination with counseling.
Health screenings provide important information that will give fathers and family members the best chances for long, healthy lives.
• • •
Sleep Apnea: Symptoms & Treatment
by Morris T. Bird, M.D., co-medical director & Robert S. Thornton, M.D., co-medical director
Florida Hospital Center for Sleep Disorders
407-303-1558
www.orlandosleep.com
In today’s 24/7 world, it is not surprising that people are finding it harder to sleep well. Most adults need seven to eight hours of sleep per night, and adolescents and children need more. Poor sleep impacts everything from job performance to playing sports. Creativity and critical thinking are difficult when sleep is impaired.
Recurring tiredness and fatigue may indicate a sleep problem, such as sleep apnea. Warning symptoms include heavy or loud snoring, interrupted breathing, restless sleep and excessive daytime sleepiness. There are other factors and symptoms often seen in sleep apnea patients. These include being overweight and having a large neck — 17 inches or more for men and 16 inches or more in women. Other indicators include depression, high blood pressure, smoking and decreased memory. Usually, large tonsils and adenoids are the main cause of apnea in children.
Sleep apnea can be extremely serious and cannot be ignored. If left untreated, sleep apnea will increase the risk of high blood pressure, heart disease and stroke.
Sleep apnea is usually diagnosed by an overnight sleep study, during which breathing time, oxygen concentration and quality of sleep are monitored. The most common treatment for sleep apnea is a nasal mask called a continuous positive airway pressure machine, or CPAP machine. This provides a constant flow of air under gentle pressure that keeps the airway open.
• • •
Colorectal Cancer Screening: When & Why to Get Screened
submitted by Digestive and Liver Center of Florida, P.A.
407-384-7388
www.dlcfl.com
Cancer of the colon or rectum is also called colorectal cancer. Those older than age 50 and with a family history of colon cancer, polyps and inflammatory bowel disorders should discuss colon cancer screening with their primary-care physicians or consult a gastroenterologist.
Patients with a family history should get a screening as part of the their preventive exam. Patients with symptoms should be screened as soon as possible. If detected early, colon cancer can be cured completely.
Patients usually do not have signs and symptoms of colorectal cancer, and screening is the key to detection and survival. When symptoms are present, patients might experience bleeding from the rectum, pain, constipation or anemia.
Colorectal cancer is the third leading cause of cancer-related deaths and third most common cancer in the U.S. for men and women.
• • •
Making the Most of Doctor Appointments
by Robert M. Meyer, M.D.
Meyer Internal Medicine
407-297-3626
www.meyerintmed.com
Recent research conducted by various national universities suggests patients now receive about 11 minutes of face time with their doctors. Fewer primary-care physicians, overwhelmed office schedules and more patients are leaving doctors scrambling, and the result is less patient time. Because of this, patients must make sure the time they get with their doctors is quality time.
When scheduling appointments, patients should be sure to explain why they are coming in and if the appointment is an annual checkup or for a specific health concern. This allows the proper amount of time to be set aside for the issue.
New patients should bring their medications and any documents involving their health histories. For those with chronic illness or issues, providing a detailed record of symptoms and where they occur narrows the time the doctor has to spend hunting for the precise location of the problem.
When beginning a conversation with a physician, patients should use specifics. Losing time can be avoided by being concise. However, patients should never shy away from stopping the doctor to ask questions when they need clarification. When patients want additional information, they can ask if the doctor has a handout to read or an Internet site to recommend.
To avoid further lost time with follow-up visits, patients must ask the most critical questions first. Many times patients will wait until the end of the appointment to inquire about the things bothering them most, but by that time, patients will not get the quality time they deserve.
• • •
What Wellness Means to the Individual
by Frank P. Campisi, M.D., F.A.C.S.
Campisi Health Centers, an affiliate of Dr. P. Phillips Hospital
407-354-2570
www.campisihc.com
Wellness is a broad term that has baffled health and fitness professionals for years. For different people, different types of wellness come to mind, including financial, emotional, physical and mental wellness. Individuals need to ask themselves what wellness really means to them.
Wellness stems from the base word “well.” To be well. To live well. Being well means to be whole. Being well means to be fit. From a health care perspective, being well means being healthy. Although every person may have a different definition for wellness, every definition comes down to good health.
There are many standards by which people measure themselves. Often, that measurement is based on what other people say or the perception of what others think. People may measure themselves by the grades they receive in school and performance reviews given at work. Many may even
measure themselves based on their financial status. Health care professionals measure wellness with physical components, such as cholesterol, blood pressure, body weight and body mass. Being “well” is an evolving process, and it is unclear if anyone can ever achieve overall personal wellness.
According to the National Wellness Institute, wellness is an active process through which people become aware of, and make choices toward, a more successful existence.
This takes focus with specific goals and a plan of action to achieve those goals. Recent research shows that engaging in 10-minute walks can be hugely beneficial to physical health and fitness. In addition, physical fitness through exercise will enhance health levels in a number of other positive ways. This helps to regulate and maintain weight; build and maintain healthy bones, joints and muscles; promote both physiological and emotional well-being; strengthen the immune system; increase energy levels; and increase pain thresholds.
Through lifestyle programming, a team of health care professionals, including medical doctors, dietitians, exercise physiologists and psychotherapists, combined with the latest technology, can work closely with individuals to tailor a plan of action that will help them define wellness for themselves.
• • •
Fractional CO2 Laser
submitted by Sand Lake Dermatology Center, P.A.
407-352-8553
www.sandlakedermatology.com
The natural aging process, together with exposure to sun and pollution, leads to a gradual deterioration of the skin structure.
Recently, the skin-care market has been oriented toward less invasive and less problematic systems. A new method has been developed that manages to combine the needs of dermatologists and patients. The fractional CO2 laser for resurfacing, or DOT laser, is one such product.
The DOT laser’s beam is focused and positioned on adjacent dots by means of a special scanner.
With this treatment, damage to the skin is less dramatic than that caused by other traditional laser techniques. A part of the skin remains intact during the treatment and acts like a natural bandage. The healing process is much faster. The areas treated are surrounded by intact skin that helps heal the damaged areas by providing new cells. The downtime after procedures is considerably reduced. Redness is moderate, and the patient can apply makeup immediately after the operation.
The DOT laser has proven to be an extremely important instrument in dermatology, and the results obtained are excellent. The laser can be used to treat acne scarring, pigment changes, sun-damaged skin and wrinkles.
• • •
Fire Ant Allergy
by Bernard S. Zeffren, M.D.
Allergy & Asthma Consultants of Central Florida
407-859-9099
www.orlandoallergy.com
Fire ants, which are found throughout Florida, are aggressive, defending their homes without mercy. They typically attack in groups, stinging several times and leaving clusters of lesions. The stings feel like burns and form pimple-like lesions the next day. These ususlly can be left alone, and they will heal by themselves. For most, this is the extent of the risk. But about 0.5 percent of children and 2 to 3 percent of adults are severely allergic to the venom in the stings, and the anaphylactic reaction they may suffer can be life-threatening.
Symptoms of a severe allergic reaction include spreading hives; itchy, reddening skin; trouble breathing; upset stomach; throat tightening; lightheadedness; or passing out. People with these warning signs need help immediately. Injectable epinephrine, such as an EpiPen or Twinject, should be used first, if available. Emergency treatment should then be sought. Quick use of this treatment can stop the reaction and save the person’s life.
If this type of reaction occurs, a visit with a board-certified allergy/immunology specialist is essential. Desensitization therapy, which is permanent about 98 percent of the time, is available.
• • •
Vaccine Refusal Puts Everyone at Risk
by Christine Chase, A.R.N.P.
Personal Pediatrics, P.A.
407-345-9929
www.personalpeds.com
The development of immunizations is one of the most important health interventions of modern medicine. Immunizations have been so successful that many parents have no memory of the devastation caused by vaccine-preventable diseases, or VPDs. Before vaccines, paralysis from polio, blindness from measles, deafness from mumps and even death were among the effects of VPDs.
Some parents wrongly assume it is unnecessary to completely immunize their children. Other parents refuse vaccinations because they have fears regarding safety, putting the entire community at risk.
If an unimmunized child contracts a VPD, that child poses a threat to immunized and unimmunized community members alike. Because no vaccine can be 100 percent effective, a small percentage will remain susceptible after immunization. These people have tried to protect themselves but remain at risk. Other people may not be able to receive vaccinations because of age, allergies, illness or weakened immune systems, and they rely on the immunized to keep them safeguarded. If community immunization rates decline, there would be epidemics of diseases that are now nearly eliminated. More children would get sick, and more would die.
Tourism in Central Florida increases the likelihood of VPD exposure because of varying vaccine schedules and the inability to ensure the health of travelers. The health of the community depends on complete immunization of children.
The Internet is a source that many parents rely on for health information, and Web sites critical of immunizations are easy to find.
Many of these Web sites contain inaccurate information and perpetuate myths about vaccines. Delayed or alternative vaccine schedules carry risks by increasing the time children are susceptible to VPDs.
Any concerns should be discussed with a qualified pediatrician. For more information, visit www.cdc.gov/vaccines on the Web.
• • •
The Importance of a Regular Dental Checkup
by Alan R. Heap, D.M.D., P.A.
MetroWest Village Family Dentistry
407-578-3734
In its early stages, dental disease often has no symptoms, and a person is unaware that a problem exists. When problems are detected early, treatment is usually cheaper and less complex. Dental professionals also can recommend preventive treatments such as fluoride and sealants that will reduce the risk of dental disease.
Regular dental checkups allow for the early detection of cavities, cracked or leaking fillings, gum disease, causes of bad breath, orthodontic or temporomandibular joint problems, and oral cancer. The dental plaque that grows on teeth, produced by bacteria and food debris, metabolizes the sugars in food for energy, producing plaque acids. These acids erode the enamel on the teeth, causing tooth decay. The bacteria in plaque causes infection and destruction of the tissues and bones that surround and support the teeth.
Regular thorough cleanings of the teeth to remove plaque buildup are the only way to prevent gum disease. If cracked or leaking fillings are caught early, they can usually be replaced with another filling. But if they go untreated, more invasive measures may be required.
Early detection of precancerous tissue can minimize or eliminate the potentially disfiguring effects of oral cancer and possibly save lives.
• • •
Pregnancy & Leg Health
by Samuel P. Martin, M.D., F.A.C.S., medical director
Vascular Vein Centers
877-244-8558
407-244-8559
www.vascularveincenters.com
Pregnancy is not only one of the most wonderful experiences, but it also is one of the most challenging. The changes in a woman’s body are phenomenal and often under-appreciated. Although there are other risk factors for the development of varicose veins, pregnancy is the most significant.
During pregnancy, there is an increase in total body water of about 40 to 50 percent. The expansion of blood volume begins shortly after conception, and there is significant salt retention. Secondary to veins leaking, swelling often occurs in the ankles and legs because fluid accumulates in the tissues of the lower leg. This occurs because of pressure from the uterus on the pelvic veins due to an increase in fluid within the venous system.
Veins weaken and stretch, causing leaking through the valves. Hormonal changes during pregnancy also play a part. These changes cannot be completely avoided, but they can be decreased.
Some tips for better leg health during pregnancy include elevation of the legs and low-impact exercise, including power walking, elliptical training, bicycling and swimming. These exercises activate the calf pump, which is responsible for pumping most of the blood from the legs. The use of elastic compression stockings also helps veins maintain their resiliency.
Vein damage caused by pregnancy can be more than a cosmetic problem. The vein walls are permanently stretched, and this frequently leads to varicose or spider veins. Leg discomfort can signal a more significant problem and should be evaluated.
• • •
Helping Players Stay in the Game
by Kiernan Wilkins
Health Central
407-296-1000
www.healthcentral.org
The number of sports activities available for children and adults seems to grow all the time. Participating in sports is not just fun — it can also help develop good fitness habits and coordination. But with any sport, there is a risk for injuries.
According to the American Academy of Orthopaedic Surgeons, more than 28 million Americans develop some kind of musculoskeletal problem every year. Orthopedic physical therapy deals with the evaluation and treatment of musculoskeletal injuries, or injuries to the bones, muscles and soft tissues that make up the body. Therapists work with patients to develop a treatment program that fits their patients’ needs. Physical therapy is aimed at the reduction of pain, if present, and increasing joint motion and strength. The process also includes conditioning exercises to increase activity level.
Precautions should always be taken when starting a new sport activity. A physical exam can spot potential problems or weaknesses that may affect participation. Doctors or qualified therapists can provide information about exercises that can build the strength and flexibility needed for particular sports. Although most sports require a mix of strength, agility, endurance and coordination, the degree of development required in specific areas will vary.
Athletes should always warm up before participating in sports and work up to activities gradually.
When injuries occur, ice applied to the area for 15 to 20 minutes will reduce swelling.
• • •
New Eye Implants Help Patients Achieve Corrective Lens Freedom
by Mont J. Cartwright, M.D., F.A.A.C.S.
Medical Eye Associates
407-423-2400
www.medeyedoc.com
Modern eye surgery has made possible what was once merely a surgeon’s dream. Now, patients can experience liberation from dependency on corrective devices, such as glasses or contact lenses. Rapidly progressing lens-implant technology is responsible for this advancement in eye refractive surgery.
Until recently, implant lenses were “monofocal.” This meant that with the exception of “monovision,” where one eye is purposely focused for near vision and the other for far, the patient needed corrective lenses to assist in focusing at multiple distances.
Throughout the past few years, the Food and Drug Administration has approved several multifocal implant lenses, which allow the patient to focus at different distances with minimal or no dependence on external aids.
This technology is applicable in a wide variety of circumstances. An elderly individual may have a multifocal lens implanted at the time of cataract surgery, and a nearsighted or farsighted 35-year-old may also want to consider these implants.
Many are under the false impression that corneal-based refractive surgeries such as Lasik can achieve freedom from corrective lenses, but this is not usually the case, depending on the patient’s age. While this may be possible in the very young, as people age and lose their ability to focus on near objects, Lasik’s deficiencies manifest, and unhappy patients may require reading glasses.
The three approved implants, Crystalens, ReStor and ReZoom, are similar, and the best lens or combination of lenses for each individual is determined at a surgical consultation. Tecnis, the newest multifocal lens, takes this technology a step further by providing even higher quality vision.
Although these lenses are more advanced than the traditional monofocal implant lenses, technology will never be perfect, and some patients still find external aids essential for focusing. The goal, however, is to achieve less dependence on aids for the activities of daily living. Some adaptive time may also be necessary as the visual centers of the brain adjust to the new situation. Glare and halos may also be noticed, especially in low-light conditions, but most patients overcome this. The new Tecnis implant has reduced these symptoms immensely.
Whether one is contemplating cataract surgery or simply wants less dependence on glasses, the results of multifocal implants may be beneficial to potential patients.
• • •
New Tennis Format Helps Children Get in the Game
by Marcelo Gouts, director of tennis
Lake Cane Tennis Center
407-254-9170
www.lakecanetennis.com
QuickStart Tennis is a new format that helps children age 10 and younger learn and play the game. To make it easier, the court size, racket size, balls, scoring system and net height are all modified.
Children can start playing tennis almost immediately, even if they have never picked up a racket.
Like other popular youth sports, QuickStart stresses the importance of play and team competition. It is also part of the U.S. Tennis Association Jr. Team Tennis league.
Children have the opportunity to experience this new format, have fun playing with their friends, and develop skills that will become the foundation of their tennis skills.
• • •
The Importance of Good Oral Hygiene While in Braces
by Yadira Ortega
Champion Orthodontics
407-656-0990
www.championorthodontics.com
While in orthodontic treatment, one of a patient’s priorities should be good oral hygiene. Wearing braces or orthodontic appliances is a great investment that will have a significant impact on patients’ overall health, and they should not jeopardize their new smiles with bad oral hygiene.
There are some steps that everyone can take to ensure the best care of their teeth while in braces. Patients should visit their dentist every three to six months for checkups. The dentist will check for possible cavities and perform periodic cleanings. Patients should also carry a toothbrush at school or work and brush after meals, whenever possible.
Patients must avoid certain foods that can cause cavities by accumulating under the braces and making it harder to keep the teeth clean.
Flossing should be done on a daily basis. Flossing is extremely beneficial for the health of the gums, as it helps prevent gum disease.
• • •
Keeping Families Safe in the Sun
by William A. Steele, M.D.
Associates in Dermatology
www.dermorlando.com
According to the American Cancer Society, skin cancer is the most common form of cancer in the U.S. More than 1 million skin cancers are diagnosed annually. Each year, there are more new cases of skin cancer than the combined incidence of breast, prostate, lung and colon cancers.
Melanoma is the most serious form of skin cancer. However, if it is recognized and treated early, it is nearly 100 percent curable. If it is not treated, the cancer can spread to other parts of the body, where it becomes harder to treat and can be fatal. There are many warning signs, and it is important to know one’s skin very well and recognize any changes in the moles on the body.
There are several melanoma warning signs people can look for on their skin.
If a line through the mole makes two uneven halves, the mole is asymmetrical and should be checked.
Borders on an early melanoma tend to be uneven, and having a variety of colors is a sign of disease. Various shades of brown, tan or black are possible colors.
Moles larger than the size of a pencil eraser should be seen by a doctor, and any evolution or change in size, shape, color or elevation of the mole is suspect.
According to ACS estimates, in 2008, there were 8,420 skin-cancer fatalities in the U.S. — 5,400 in men and 3,020 in women.
People should see a physician every year for a professional skin-cancer exam. In addition, pediatricians should examine children’s skin thoroughly as part of their yearly checkup.
According to the Skin Cancer Foundation, about 23 percent of a person’s lifetime ultraviolet exposure occurs by age 18, and about 47 percent by age 40, which is why it is important to teach children good habits early to aid in the prevention of skin cancer.
A broad-spectrum, water-resistant sunscreen with a sun protection factor of at least 15 should be applied to all exposed skin. The broad-spectrum designation provides protection from both UVA and UVB rays. Sunscreen must be reapplied about every two hours, even on cloudy days, and after swimming or sweating.
Direct sun exposure between 10 a.m. and 4 p.m. should be avoided, and people should cover up with clothing as much as possible when out in the sun. Sunglasses should also block both UVA and UVB rays.
• • •
Water Is Ideal for Exercising
by Kathy Steege
Select Physical Therapy
407-292-0073
www.selectphysicaltherapy.com
Water offers a greater resistance to movement than air. This resistance makes the muscles, including the heart, work harder, resulting in more burning of calories and allowing for greater potential for losing inches and pounds. Swimming is also a low-stress activity for the joints.
Swimming utilizes the entire body. New swimmers should choose a swimming program based on what feels most comfortable. There are many creative workouts for all ages that can be performed in water.
One can join a structured swim class or take a class at a local fitness club that offers a total body workout, while never immersing the head in water. Another option is to join a masters swim class, which focuses on mastering different stroke types. Simple movements, such as walking back and forth through the water or treading in four to five feet of water, will offer many benefits. People who have difficulties with land exercises tend to do very well in water because it puts less stress on the muscles and joints.
At least 20 minutes of exercise three times a week is the recommended minimum to enjoy the cardiovascular and weight-loss benefits of swimming. New swimmers should progress slowly and should not increase their total exercise time more than 10 percent per week.
It is recommended that individuals consult with a physician prior to initiating a swimming program.
Proper hydration is also important while swimming. Exercisers will sweat while swimming, and they need to make sure they are replacing the water lost.
• • •
Plantar Fasciitis
by Duane McRorie, D.P.M., F.A.C.F.A.S.
Celebration Orthopedic & Sports Medicine Institute
407-303-4270
www.celebrationorthopaedics.com
Plantar fasciitis is an inflammation of the band of tissue that extends from the heel to the toe. The symptoms of plantar fasciitis are pain when first getting out of bed or after long periods of rest, increased pain over a period of months, and pain in the bottom of the heel.
The most common cause of plantar fasciitis is due to foot structures. Flat feet, high-arched feet, going barefoot on hardwood floors, an increase in activities, and obesity can contribute to heel pain.
The diagnosis of plantar fasciitis is obtained through a medical history and examination of the foot. A foot and ankle surgeon also will rule out other causes of heel pain. Diagnostic studies such as X-rays, MRIs or bone scans will likely be performed.
Plantar fasciitis treatment options include cortisone injections, stretching exercises, avoiding going barefoot, icing, massage, a decrease in activities, shoe modifications, anti-inflammatory medicine, physical therapy and custom shoe inserts.
• • •
Free Fitness
by Lisa McKibben, certified fitness instructor
JazzFit Studios
407-353-9647
www.jazzfitstudios.com
Finding free fitness is easy, and there are many free ways to keep fit. In these difficult economic times, free fitness is a great way to get healthy and save money.
Those utilizing free fitness must first find an activity that they like. If people enjoy walking, hiking or biking, they should visit the library, post office or grocery store without a car. This burns calories instead of gasoline.
Washing a car in the driveway instead of using a carwash is a great way to increase the heart rate. Pulling weeds builds muscle in the legs, abs and back, and planting flowers is a great upper-body workout. Dancing also can be beneficial. These are forms of fitness that can easily become part of anyone’s lifestyle for free.
• • •
Wisdom Teeth
by Winston G. Bedford, D.M.D., M.D.
Oral & Facial Surgery Center
407-352-6301
www.oralfacsurg.com
Wisdom teeth, also known as third molars, are the last teeth to erupt in the mouth, and this generally occurs between the ages of 17 and 25. The modern diet and popularity of orthodontic straightening produce a fuller dental arch, which usually does not leave room for wisdom teeth to erupt, creating problems for the final four molars.
A tooth becomes impacted when there is a lack of space in the dental arch, and its growth and eruption are prevented by overlying gums, bone or another tooth. Impacted teeth can be painful or lead to infection and may crowd or damage adjacent teeth or roots. More serious problems occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. A study sponsored by the American Association of Oral and Maxillofacial Surgeons found that third molars that have erupted into the mouth in a normal, upright position may be as prone to disease as third molars that remain impacted.
Not all problems related to third molars are painful or visible. Damage can occur without a patient being aware of it. As wisdom teeth grow, their roots become longer; the teeth become more difficult to remove; and complications become more likely. Impacted wisdom teeth are more likely to cause problems as patients age. It is estimated that 85 percent of third molars will eventually need to be removed.
Patients should not wait until wisdom teeth start to bother them, as earlier removal generally results in a less complicated healing process. AAOMS recommends that wisdom teeth be removed by the time the patient is a young adult to help prevent future problems and ensure optimal healing.
Before surgery, a surgeon will discuss what should be expected. This is a good time for one to ask questions, express concerns and inform the doctor of a medical history and medications. The relative ease with which wisdom teeth may be removed depends on several conditions, including the position of the teeth and root development. Impacted wisdom teeth may require a more involved surgical procedure. An X-ray that shows the position of the tooth and root structure will be reviewed by the doctor. Most wisdom teeth extractions are performed in-office under local anesthesia or intravenous sedation.
An oral surgeon is a graduate of a four-year university, with four years of dental school and four or more years of training in a hospital-based oral and maxillofacial surgery residency. This advanced training includes at least one year of medical rotations and six months in anesthesiology.
Following surgery, patients may experience some swelling and discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by the oral surgeon can help manage the discomfort. Some may also be instructed to modify their diets following surgery.
• • •
Preventing Sports Injuries
by Ayman Daouk, M.D.
Orthopedic Institute of Central Florida
407-355-7478
www.orthocf.com
A sports injury is easy to get when one has not been active for a period of time. Muscle pulls and strains and twisted ankles are very common in newly active people.
But there are simple steps that greatly lessen the likelihood of these injuries.
It is critical for one to ease into the activity with a warm-up instead of jumping right in. Walking, riding a stationary bike, or jogging in place for a few minutes are all effective methods.
After warming up, each of the major muscle groups should be stretched. Flexible muscles are less likely to be injured than tight ones.
Taking it slow, being cautious and following the 10 percent rule, which is to never increase activity more than 10 percent per week, is the cautious way to prevent injuries.
Providing strength training for the core of the body, particularly the abdomen and back, helps with all types of activities. If working with weights, an exercise professional can show how to use each machine properly and determine which ones should be used.
New athletes should also meet with a physician. A doctor can evaluate any underlying medical issues that a specific exercise or sports program may worsen. Those with physical or medical limitations should also check with a doctor before beginning an exercise program.
Players must listen to their bodies. Dull aches are normal when starting out; however, some pains should not be ignored. Players should watch for any pains that are sharp or catching, associated with a limp or joint swelling, or limit the ability to exercise or function.
Cardio training with strength and flexibility programs should be mixed to create a balance.
Overuse syndrome is very common because people tend to take on much more than their bodies can handle.
The right equipment is key, and all players need comfortable, properly fitted shoes and protective gear for their sports.
It is also critical to drink enough fluids to prevent dehydration. Water is generally adequate for activities less than two hours in duration.
These steps minimize the likelihood of injury. And a good walking program, such as 30 minutes a day, is very safe and healthy for the body.
• • •
The Benefits of Wellness
by Cara Jakob, M.D.
Total Family Weight Loss Center
866-212-2943
www.totalfamilyweightloss.com
Wellness is defined as the state of being in good health, especially as an actively sought goal. In today’s environment of instant gratification, wellness is not truly an actively sought goal, but the benefits are definitely worth the effort.
Recent statistics show the rates of newly diagnosed cases of easily preventable diseases, particularly diabetes, high blood pressure, high cholesterol and arthritis, are higher than ever recorded.
Technology has progressed farther in the past 100 years than in all of human history, yet for the first time, life expectancy in the U.S. has declined as a result of the lack of wellness and sharp increase in preventable diseases.
Simple steps to help curb this trend begin with a checkup from a reputable doctor specializing in weight loss, weight maintenance and wellness. Eating a balanced diet of lean proteins, fruits and vegetables; limiting alcohol intake; and maintaining an active lifestyle can help patients keep weight within a healthy range. Not only will this prevent years of suffering and disease, but it will arm patients’ children with healthy habits that will last a lifetime.
• • •
Endovascular Repair of Abdominal & Thoracic Aortic Aneurysms
by Charles S. Thompson, M.D.
Vascular Specialists of Central Florida Inc.
407-648-4323
www.arteryandvein.com
Thoracic and abdominal aortic aneurysms represent a significant health concern for the elderly.
Public interest has been heightened by news of public figures having aneurysm repairs, including former Sen. Bob Dole and former Vice President Dick Cheney. Aneurysms are abnormal expansions of an arterial wall and are the 10th leading cause of death, with the number of new cases per 1,000 people increasing in the past decade.
Prevalence among hypertensive, elderly patients is now at 10 percent. With an increasing elderly population, the frequency that aneurysms are diagnosed in the U.S. is rising. The danger of aneurysms rests in the fact that they may expand and rupture, resulting in unexpected death.
The majority of aneurysms are found incidentally during routine physical examinations or during radiographic studies performed for other reasons. The goal of early detection is to find and treat aneurysms before they rupture.
Advances in anesthesiology, critical-care medicine and surgical techniques have made aneurysm repair safer and more accessible. Traditional surgical repair involves laparotomy, aneurysm resection and graft placement. Typical hospitalization lasts several days and includes intensive care. Patient recovery is measured in weeks to months.
The more tangible improvements in aneurysm repair involve the use of catheter-based procedures. These minimally invasive techniques have allowed for safer aneurysm repair with a more rapid recovery.
Preparation for endovascular stent graft repair involves preoperative angiography, computed tomography or MRIs. Not all patients are candidates for the procedure.
The resources needed for the maintenance of an endovascular program are extensive, but the benefit is substantial. Most patients avoid an intensive-care unit stay and spend only a few days in the hospital.
• • •
Avoiding Injury at Home
by Jacinth Jenkins Taylor, L.C.S.W.
Health Center of Windermere
407-420-2090
www.hcwrehab.com
Bill, 72, is playing with his dog, when the phone rings. He hurriedly crosses the room, and the dog darts in front of him.
Connie, 62, is getting out of bed, eager to get going to work. She jumps out of bed, becomes lightheaded, stumbles on her bedside rug, and falls.
The only thing these two have in common is that they have both ended up in rehab recovering from fractures.
Although 30 to 50 percent of falls result in minor soft tissue injury; 3 to 6 percent of them produce fractures. Just 1 percent of falls result in a hip fracture, with the possibility of inpatient rehab.
However, most falls can be prevented. An easy way to prevent a fall is to avoid throw rugs. If they must be used, they should have a nonslip backing and be secured around the edges. Wobbly furniture and unruly power cords should also be avoided.
People should take care to orient themselves to spaces as they move.
If getting up from laying down or sitting, a light should be turned on. People should get up slowly and move attentively in their surroundings. Preferably, stretching and taking a few deep breaths should be done before getting up. This tells the body that it is getting ready to move. These steps may prevent injury from a fall.
• • •
Understanding the Cause of Shoulder Pain
by Sabrina Atkins-Bathalter, D.C.
Orlando Sports Chiropractic
407-345-8686
www.orlandosportschiropractic.com
Shoulder pain may occur when working out, sitting at a computer, or all the time. Symptoms may include pain in the arm, numbness and tingling.
Friends and even doctors may assume the injury stems from a pinched nerve or rotator cuff problem.
Sometimes, X-rays and MRIs of the shoulder will be negative, but the pain will persist.
To understand the cause of shoulder pain, patients must first see the rest of the picture. This includes the spine and rib cage joints; spinal nerves; shoulder, spine and rib muscles; and the fascia and connective tissue. There are several things that can cause one or all of the symptoms of shoulder pain and dysfunction, and none of them are the shoulder joint itself. This is why X-rays are often negative.
Spinal nerves give sensation to the shoulder so the joint feels the pain.
The spinal nerves also innervate the muscles of the back, rib cage and shoulder region for function. The muscles connect back to the spine and rib cage. There is also connective tissue called fascia that connects everything.
All of these components must be addressed to truly target the cause of pain. Once the dysfunction is identified, it is only a short time before the pain can be eliminated.
• • •
Sports Nutrition for Beginners
by Michael S. Melton, M.D.
Meyer Internal Medicine
407-297-3626
www.meyerintmed.com
While skipping through cable channels searching for a favorite show, one may catch a triathlon on TV. Several minutes into this event, he may think that it looks easy. Many who exercise regularly and have a history of physical fitness often jump into strenuous activity too quickly. They can become overwhelmed with the requirements of endurance sports, like the running, swimming and biking required in triathlons.
Often, the need for strong nutrition is overlooked, and athletes are not prepared to fuel their bodies. For beginning endurance athletes, the following diet can help catalyze training and prevent physically bottoming out:
Hydration is by far the most important element of endurance athletic training. Water generally does not provide the body any caloric energy, but it is necessary in large amounts in endurance training. Water is especially important in order to prevent core body temperatures from rising to dangerous levels. Perspiration causes water loss and potential dehydration. Consistent hydration is needed to avoid getting thirsty, as by then the body is usually dehydrated.
The powerhouse in the endurance athlete’s diet is carbohydrates, which are the body’s main source of energy for aerobic exercise. The body absorbs virtually 100 percent of all carbs consumed, converting them into a simple sugar, known as glucose. Glucose is stored in muscles as glycogen and used immediately by the body for energy. Endurance athletes usually need to eat carbs on a continual basis, with 50 percent of their diets consisting of complex carbohydrates, such as cereals, pasta, bread, rice, potatoes and vegetables. This keeps the muscles properly fueled.
Most people believe protein is the paramount nutrient in endurance training and often eat three times their daily requirement. Protein is necessary for proper body function and to build muscle and tendons, while also repairing broken down muscles and regulating hormones. Athletes need only fifteen percent of their daily calories from protein. Lean meat, eggs, beans and nuts are common sources of protein.
Recent studies have shown supplementing with antioxidants to be of added benefit. Antioxidants can be found in vitamins. as well as fruit juices or supplements. Daily multivitamins with minerals usually accomplish the task of supplementing.
Overall, eating a well-balanced diet, including plenty of fruit and vegetables and devoid of processed food, is the best direction for endurance athletes of every level.
• • •
LPR: An Unrecognized & Under-Diagnosed Cause of Cough
by Fortune O. Alabi, M.D., F.C.C.P., A.B.S.M.
Florida Lung, Asthma & Sleep Specialists
407-303-4515
Laryngopharyngeal reflux, or LPR, is the retrograde flow of stomach content and acid through the esophagus and into the throat, resulting in irritation to the voice box. LPR accounts for almost 50 percent of patients who visit their primary-care physicians with hoarseness and a significant proportion of patients who visit a pulmonologist for evaluation of a cough.
The vast majority of LPR cases are not diagnosed in a timely fashion because the presentation is diverse and not straightforward, as with gastroesophageal reflux disease, or GERD. For the most part, many cases of GERD share a similar cause; however, the manifestations are different.
Delayed diagnosis of LPR is not completely without consequence.
Symptoms, such as a lingering, nagging cough and sore throat, can be very frustrating. Occasionally, cases that go undiagnosed may slowly evolve into contact ulcers, vocal cord problems and other symptoms.
For many years, the concept of reflux-induced laryngeal tissue damage without the classic symptoms of heartburn was difficult to fathom. LPR differs from GERD in that it is often not associated with heartburn and regurgitant symptoms. About 87 percent of people with LPR experience throat clearing, versus 3 percent of those with GERD. Only 20 percent of LPR sufferers complained of heartburn, versus 83 percent of GERD sufferers. Additionally, GERD sufferers tend to cough more at night, whereas those with LPR are more prone to cough during the daytime.
When patients experience hoarseness, they are most often given a diagnosis of laryngitis, a nonspecific diagnosis of laryngeal inflammation. It is imperative to remember that 50 percent of patients with hoarseness may actually be suffering from LPR.
Doctors should be able to diagnose most cases of LPR with proper history taking and confirm the diagnosis with a response to behavioral and empiric medical treatment. Occasionally, laryngoscopy is needed to document the telltale signs of reflux-induced laryngeal tissue damage.
Findings on laryngoscopy are not specific, and they may include laryngeal irritation and inflammation. The observation of redness, thickening and edema is a common finding that is highly suggestive of LPR.
LPR is a common medical disorder that is under-diagnosed because of the multiple forms of presentation, as well as the lack of awareness of this disease among some clinicians. Doctors can avoid this, ensuring an accurate and apt diagnosis, by diligently obtaining a good history and making timely referrals to specialists for cases that are not straightforward.
• • •
Chiropractic & Decompression Therapy
by Gerald R. Mattia, D.C., P.A.
Mattia Chiropractic Wellness Center
407-909-4788
www.mattiawellness.com
During daily life, people do several things to maintain good health. Good nutrition, exercise, proper rest and a positive mental attitude are all factors that maintain health.
Chiropractic promotes wellness by improving function of the nervous system. Chiropractic is based on the fact that the nervous system controls the function of every part of the body. The spinal cord is protected by 24 moving bones of the spine. Many everyday activities can cause the spinal bones to lose their normal positions or motions.
This can result in nervous system dysfunction and, eventually, ill health. Chiropractors remove pressure on the nervous system and increase joint function, promoting better health.
When spinal bones remain out of alignment for many years, degeneration of the spinal bones begins to set in. The disks between the vertebrae become thin, causing degenerative disk disease.
Decompression therapy is a tool that chiropractors use to treat and help prevent degeneration in the spine. Decompression therapy is also used for herniated and bulging disks in the low back and the neck.
Patients can avoid surgery with decompression therapy.
Chiropractic and decompression therapy provide healthy alternatives to drugs and other chemicals, which may address symptoms, but do not resolve the cause of the problem.
People are realizing that good health is gained and maintained when normal energy flow is maintained from the brain down the spinal cord and over the nerves that pass between the spinal vertebrae to organs and tissues.
• • •
Heart Disease: Knowing the Symptoms, Risks & Numbers
submitted by Dr. P. Phillips Hospital Chest Pain Program
407-351-8500
www.drpphillipshospital.com
Heart disease continues to be the leading cause of death in the U.S., particularly for women. Learning the warning signs of heart attack and seeking prompt treatment within one hour of the start of symptoms can mean the difference between life and death.
Symptoms include pain or discomfort in one or both arms, the back, neck or jaw; chest discomfort or backache; an uncomfortable pressure or squeezing in the middle of the chest that lasts a few minutes or goes away and comes back; shortness of breath with or without chest discomfort; general weakness or fatigue; and cold sweats, nausea or lightheadedness
If people experience these symptoms, they should not delay. Every minute matters, and no one should wait more than a few minutes to call 911.
Heart attacks occur when blood flow to the heart is inadequate, either from narrowed arteries or blockage. Coronary artery disease refers to the narrowing of arteries due to plaque, an accumulation of fat and cholesterol, along the inner walls of the arteries. As the arteries narrow, blood flow to the heart is decreased, and the heart muscle is damaged. Blood clots can also keep blood from flowing to the heart. If either type of blockage is not treated quickly, the heart muscle will be damaged.
Risk factors are conditions or habits that make it more likely for the development of a disease. There are several risk factors for heart disease — some that are controllable, such as weight, and some that cannot be controlled, such as age and family history. For controllable risk factors, people can take action now to address each and protect the heart. Some controllable risk factors include high blood pressure, high cholesterol, diabetes, smoking, being overweight and being physically inactive.
Each risk factor increases the chances of developing heart disease, and blood vessels gradually will worsen unless a change is made in daily habits. Changes can be made gradually, but the important thing is to start now.
Time should also be taken to talk with a doctor and learn the numbers that are important to heart health. Those numbers include weight; a blood pressure reading of 120/80; total cholesterol of less than 200; low-density lipoprotein, or “bad” cholesterol, of less than 100; and high-density lipoprotein, or “good” cholesterol, of more than 50. Thirty minutes of walking five times per week can benefit all of these numbers.
• • •
Shoulder Pain: When to See a Surgeon
by Bryan Reuss, M.D.
Orlando Orthopaedic Center
407-254-2500
www.orlandoortho.com
Shoulder pain affects many people at some point in their lives. Often it arises after a significant injury, such as an athletic trauma or after lifting a heavy object. Other times it comes on insidiously, with no known trauma.
Most patients recognize when it is urgent that they see an orthopedic surgeon who specializes in the care of shoulder injuries. Common indications include fractures near the shoulder and shoulder dislocations. But for more subtle presentations, it may be difficult for patients to determine when they should see a doctor.
Patients will often complain of pain in the shoulder with certain activities or positions. They might say it hurts when reaching overhead, or they cannot sleep comfortably at night.
This is the typical presentation of a patient with impingement, which is the most common cause of shoulder pain. It is caused by inflammation of the rotator cuff tendons or bursa above the tendons. It is also called bursitis.
Occasionally, a patient with impingement will also have a rotator cuff tear. A tear can often go unrecognized because of inconsistent symptoms; however, it is important to diagnose a rotator cuff tear, as patients do better with surgical management.
In general, when pain or loss of function starts to interfere with daily activities, patients should see a shoulder specialist.
|
|
