Healthy Living June 2018

Things I’ll never understand

Some things leave me shrugging my shoulders in disbelief.

There are some things in life that simply do not make sense and leave me shrugging my shoulders. Here’s a quick list:

TAKING A BABY TO A CONCERT

ABSTRACT ART

I really cannot see the messages, emotions, or symbols being represented. To me, it looks like someone splashed several colors of paint onto a canvas.

First, there’s nothing more annoying than the sound of your favorite musician being drowned out by incessant whining. Second, I doubt the singer will want to autograph your child’s poop-filled diaper. Third, breastfeeding your baby in a mosh pit probably isn’t a great idea. Fourth, when other children receive bikes for their fifth birthday, yours will be getting hearing aids.

PEOPLE WHO DON’T FLUSH TOILETS IN PUBLIC RESTROOMS.

It’s absolutely sickening to walk into a public restroom and see someone has left you a little “present.” How hard is it to push the little lever? If it’s brown, please flush it down.

VEGETARIANISM

Sorry, but for me, no meal is complete without some form of dead animal on my plate. Is being a vegetarian a mistake or a missed steak?

of Superior Heart Care 20 Years

DREAMS

MOTORISTS WHO DRIVE 15 MPH OR MORE UNDER THE SPEED LIMIT.

I understand that we all want to be cautious while driving. That said, if you’re driving 35 mph in a 55 mph zone, you are impeding traffic flow. And why on God’s green earth do you insist on STAYING in the fast lane?

Our board-certified heart and vascular surgeons, supported by an advanced team of cardiac care professionals, perform open heart surgeries daily—totaling more than 740 per year.

There’s no limit to what my mind can conceive while I’m asleep. I’ve been late to important appointments, ran in slow motion while being chased by scary people and monsters, and stood in public places completely naked. Sleep isn’t always what it’s cracked up to be.

With 15,000 open heart surgeries performed in the past 20 years alone, no other heart program in our area has more experience in cardiac care.

WOMEN WHO CLAIM THEY DON’T UNDERSTAND MEN. We’re actually very simple. Just remember the basics: recliner, beer, and sports.

What does that mean for you and your family? That you can trust your heart to us.

PASTORS WHO HANDLE RATTLESNAKES DURING CHURCH SERVICES

Some people call it a test of faith. I call it a hiss of death.

Story: James Combs Illustrations: Josh Clark

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TINY CELLS MAKE A BIG DIFFERENCE.

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Orthopedic Surgeon

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Orthopedic Surgeon

Are stem cells a miracle? Not exactly. However, stem cells are a highly e ective means of repairing damaged tissue. Stem cell therapy is a non-surgical procedure that gives the body the tools it needs to heal itself naturally. Stem cells repair damaged tissue and regenerate bone, ligaments, tendons, cartilage and muscle. Pain lessens and range of motion increases after a simple injection—without risk of infection.

Schedule a consult today to see if you are eligible for this cutting edge therapy.

Rosacea? Psoriasis? Thinning Hair? Worrisome Moles or Growths?

We can help clear up your questions

The nation’s largest dermatology practice has three locations in The Villages ® community. We now accept UnitedHealthcare Medicare Advantage.

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Dr. Michael Bond (Retiring January 2018)

Dr. Michael Wangia

Dr. Christine Moorhead

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Dr. Michael Bond (Retiring January 2018)

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Dr. Michael Wangia

After graduating with Honors from Howard University College of Medicine, Dr. Wangia attended University of Florida where he completed his dermatology residency serving as a chief resident. He also completed his dermatopathology fellowship training at UF where he served as an Assistant Professor of Dermatology. He was awarded “The Arnold P. Gold Humanism in Medicine Award”. Today, he is committed to providing compassionate, comprehensive and individualized dermatologic therapies.

Following a storied career, marked by excellence in patient care, Dr. Bond is retiring. Please join us in wishing him well.

DEPARTMENTS

45

46. Worth the weight. Important updates to the Atkins diet.

48. Two men, different lifestyles. Who’s more likely to live longer?

50. Comfortable in your skin. Foods and supplements for superior skin health.

53.

54. A ray of hope. How to overcome summertime blues.

56. Head in the right direction. Use accelerated resolution therapy to help post-traumatic stress.

59.

60. Flower power. The healing benefits of nature.

64. Forming consciousness. Let’s re-examine what children are learning.

67.

68. Dave Says. Cash in on the expert’s advice.

70. The cost of health care. Direct primary care may be a viable solution.

COLUMNS 10. Publisher’s letter 11. At your service

It’s not just shocking, it’s scary!

Typically, each June we focus on issues pertaining to men’s health. However, an issue came to light that I felt we needed to share with our readers. Recent studies show that men are in a state of decline in their mental, spiritual, physical, and financial health. For example, did you know there are more women than men who graduate from high school, have more advanced degrees, and make more money? Did you know women have more driver’s licenses than men?

It’s been proved that men commit more crimes, are more likely to become addicted to an illegal substance and have a much higher suicide rate than woman.

I was certainly shocked when I heard these statistics, mainly because media coverage focuses on how women struggle and make less money, and so on. I am sure you’ve heard all the reports. That is why I felt it necessary to share our findings with you in this month’s issue of Healthy Living

While at my daughter’s college graduation this year, I saw fi the number of female graduates compared to the number of

thy hile at my uation this I saw firsthand d number of female pared to the number of

male graduates. There were 10 females to every male receiving a bachelor’s degrees. There is something happening with our guys.

If this is news to you, I invite you to read our feature story titled, “The Decline of Men.” The results from our research are shocking, and scary to say the least.

I think it is time to shift the conversation away from the women marching and the struggles women face and take a deeper look at what is happening with men. Cater to our sons, who appear to not be as needy as our daughters and realize they may not be as eager to express their feelings and share their challenges, but they are most certainly having them.

Let’s not make our men feel less masculine because they may be dealing with emotional issues. Instead, let’s be a soft place to land, and let them know we are here to help and here to listen.

We must start somewhere.

Until next month,

Kendra KendraAkerAkers

Doug Akers / President doug@akersmediagroup.com

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NEW HELP FOR PROSTATE CANCER PATIENTS

Florida Hospital Waterman Cancer Institute recently announced it has a new tool proven to protect prostate cancer patients from the side effects of radiation therapy. A press release offered these statistics from the American Cancer Society

• Prostate cancer is second only to skin cancer as most frequently diagnosed in men.

• Worldwide, prostate cancer growth is expected to reach 1.7 million new cases by 2030.

Recently, FHW injected a patient for the first time with SpaceOAR hydrogel, the first FDA-cleared spacing device to protect the rectum during radiation therapy for prostate cancer. This system temporarily positions the anterior rectal wall away from the prostate during radiotherapy, thus creating the space to protect the rectum. Florida Hospital Waterman Cancer Institute is the first cancer center in Lake County to offer this advance technology.

“The SpaceOAR hydrogel placement is tolerated well, and we have level 1 clinical evidence to show that it decreases side effects and improves quality of life after radiation therapy to the prostate. We are excited to offer SpaceOAR and extend this benefit to our prostate cancer patients,” says Dr. Anudh Jain, radiation oncologist at

Sleep deprivation may play a part in Alzheimer’s disease, according to a study by the National Institutes of Health. Just one night of lost sleep leads to the immediate increase in beta-amyloid, a protein in the brain associated with the disease, a press release states. Beta-amyloid proteins clump together to form amyloid plaques, which are a hallmark of the disease. This is the first study that demonstrates sleep may play an important role in human beta-amyloid clearance. Beta-amyloid is a metabolic waste product

demonstrated the negative effect of sleep deprivation on beta-amyloid burden in the human brain. Future studies are needed to assess the generalizability to a larger and more diverse population,” Dr. Ehsan Shokri-Kojori says. It is also important to note that the link between sleep disorders and Alzheimer’s risk is considered by many scientists to be “bidirectional,” since elevated beta-amyloid may also lead to

Prostate cancer develops mainly in older men and in AfricanAmerican men. About six cases in ten are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66.

Source: American Cancer Society

IT DISSOLVES IN YOUR MOUTH

Taking medication orally is sometimes a challenge for children and adults alike. Meroven Pharmaceuticals has developed a new way to administer drugs, according to its website. Called Spee-D Oral Films, these are like the familiar mouthwash films that melt on your tongue. They’re fast-dissolving films and are gaining interest as an alternative to oral tablets, capsules, or effervescent dosage forms. Because the films quickly become liquid, there’s no need to have liquid to take them. Right now, the company offers Tadalafil, Ondansetron, and vitamin D3 in oral films.

PARTNERSHIP MEANS BETTER HEALTH

The University of Florida Shands Hospital system and Central Florida Health have agreed to collaborate on new health initiatives to expand access to leading-edge patient care programs and clinical studies for residents of Lake, Sumter, and Marion counties, according to a press release. Hospital officials will work together to explore the creation of primary care physician training opportunities at Central Florida Health’s Leesburg Regional Medical Center and The Villages Regional Hospital. With demand for primary care physicians increasing due to the population growth in this area, growing the physician workforce will provide two benefits: physicians tend to stay near where they complete their training, and there will be economic benefits throughout the area.

A DRIVE TO HELP

Comprehensive stroke care already is in place with the two agencies, allowing UF Health physicians to accept transfer patients 24/7 and provide around-the-clock access to consultations with vascular neurologists for treatment plans and decisions related to the administration of the clot-busting drug tPA.

“This affiliation is an acknowledgment of the great care we already offer, and a means to find ways of coordinating care for patients from our local community who have especially complex medical problems we don’t typically treat,” says Don Henderson, president and CEO of Central Florida Health. “It is important for us to work with a comprehensive academic health center like UF Health because it affords us the ability to continually offer our patients the latest medical breakthroughs.”

If you’d like to help someone on the road to recovery, be a driver for the American Cancer Society. This group needs volunteers to provide transportation for patients. Volunteers like you can offer free rides to cancer patients to and from treatments. Visit cancer.org/drive to sign up and give your neighbor a nice lift.

A way up, a way out

Forward Paths helps children find a new path to a bright future.

Story: Leigh Neely Photo: Fred Lopez

Denise Burry loves children—her own eight, and the additional hundreds of children she and her volunteers help every year through Forward Paths Foundation. The organization helps homeless youth and children aging out of foster care create a path to independence.

“We take each kid as an individual and work on their needs,” Denise says. “We recently had a girl who needed a car. She lives with her indigent grandmother and had been saving for a long time. This grandmother had sacrificed everything for these kids. We got a car donated and told [the young woman] to use her money for insurance.”

These big events don’t happen every day, but a variety of young people receive help from Forward Paths daily. The organization’s offices at Morrison United Methodist Church in Leesburg have a stock of nonperishable food, health and hygiene products, and various other items that can be supplied quickly.

“Right now, the big concern is transitional housing so the kids can qualify for school,” Denise says. “We have two house moms who do inspections in the apartments we have to ensure they’re keeping them clean and safe. At first, the boys were messy, but now they look forward to the house moms’ visits, so they can show her how clean their apartment is.”

Boundaries and accountability are an important aspect of what Forward Paths does.

“When somebody is in charge, everything is not on the kids,” Denise says, allowing the young people time to learn and grow and think about the possibilities for a future that is not bleak but hopeful.

Forward Paths is opening a second office at First United Methodist Church in Eustis to widen its scope of care, and Denise is very excited about the tiny housing community planned. Homes are vital because the kids can’t stay in or get into school without a place to live. Forward Paths operates on small grants from Lake County, family trusts, and private donations.

“Sometimes you feel like you’re on an island, but there are a lot of people out there trying to do something, too,” Denise says. “What hurts is the kids I lose or kids who don’t get where I want them to be.”

• More than 23,000 children age out of foster care every year.

• 20 percent of these children become instantly homeless.

• A child aged out of foster care has less than a 3 percent chance of earning a college degree.

• 25 percent of children aged out of foster care suffer posttraumatic stress disorder.

Source: Florida Department of Children and Families

Dr. Kimberly Besuden

Dr. Lauren Cooper

The steak is OK— you’re the problem

Aging can be tasteless when your buds fade away.

Story: Fred Hilton

You just spent big bucks for a luscious-looking filet at that fancy-schmancy restaurant you go to on special occasions. Sadly, the steak didn’t taste all that good. You’ve noticed that lots of things don’t taste as good as they used to. You’re not cursed. The fault is not in the stars but in yourself—you’re getting older.

The effects of growing older are all too apparent. You know that your knees, eyesight, and hearing have declined over the years, along with various other parts of your tired old body. Sadly, you can now add your sense of taste to that growing list.

When we’re born, we each have around 10,000 taste buds. They are replaced every 10 days or so, but after age 50, they don’t regenerate as quickly. An older person may have only about 5,000 taste buds.

Contrary to what many of us think, those little bumps on your tongue aren’t taste buds. Those are called papillae, and your taste buds are located deep inside them. Taste buds are little clusters of 50 to 100 cells. They pick up sensory information and send it to the brain, letting you know if something is sweet, sour, bitter, or salty. Taste buds aren’t all located on your tongue. Some are on the insides of your cheeks and some are on the roof of your mouth.

Compounding the problem caused by the loss of taste buds is a diminished sense of smell that accompanies aging. When your ability to detect particular aromas declines, you’re limited to basic taste sensations picked up by your tongue and they won’t be as strong or as complex.

“As you chew food, the flavor is released, and you smell it through the back of the nose,” says Dr. Erin O’Brien, a rhinologist at the Mayo Clinic. “If you’re eating strawberry ice cream, your tongue will tell you it’s sweet, but it won’t know the flavor. The nose tells you it’s strawberry. That’s the difference between taste and flavor.”

Loss of your sense of taste can have serious consequences for your health. Of your four taste sensations—sweet, salty, sour, and bitter—sweet and salty are often the first to go, so you might be tempted to over-salt your food, which could cause your blood pressure to rise and put your heart health at risk.

Aging isn’t the only thing that threatens your taste buds. Smoking, pesticides, other chemicals or additives, some drugs, poor nutrition, and eating processed junk foods also can damage them.

Sources

“When Aging Steals Your Sense of Taste,” by Beth W. Orenstein, medically reviewed by Dr. Lindsey Marcellin, Senior Health Center, Everyday Health. // everydayhealth.com/senior-health/when-agingsteals-your-sense-of-taste.aspxa

“Do Your Taste Buds Change as You Age?” by Dr. Brent Ridge, Care2, April 15, 2009.// care2.com/ greenliving/do-your-taste-buds-change-as-you-get-older.html

“Loss of Taste and Smell, How to Revive Taste Buds on the Tongue,” Growing Raw. // growingraw.com/ loss-of-taste-and-smell.html

“Aging Gracefully: Changes in the Taste Buds and Sense of Smell,” Comfort Keepers, July 2, 2014. // comfortkeepers.com/home/info-center/senior-health-wellbeing/aging-gracefully-changes-in-the-taste-

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Who is a Cancer Survivor?

The National Coalition for Cancer Survivorship says you are a cancer survivor from the time of your diagnosis through the rest of your life. Survivors also include family, friends and caregivers.

NED, Remission or Cure?

Dancing with NED may sound fun at a disco. But when it comes to cancer survivorship, NED stands for No Evidence of Disease, also called complete remission. It means that the signs and symptoms of cancer are no longer found.

But that doesn’t necessarily mean one is cured. Cancer cells might still be present at a level that can’t be detected. A complete absence of cancer cells means one is in complete remission (NED). In near-complete remission, some abnormalities exist even if tests show no clear evidence of disease and the person is symptomfree. In partial remission, cancer is still present but is greatly reduced.

Some doctors may say you are cured if you remain in complete remission for at least five years. But even then, some cancer cells may exist in your body and may return years later. The chance of recurrence depends on the kind of cancer. For example, breast cancer might return decades after complete remission, but some leukemias are considered cured after five years. A survivorship care plan tells the best ways to monitor for any cancer recurrence.

Five-year cancer survival rates were introduced in the 1930s, when living beyond that benchmark was considered near-impossible. In 2014, the five-year survival rate for all cancers taken together was 66.9 percent.

What is a Survivorship Care Plan?

A survivorship care plan (SCP) is a blueprint tailored to each individual. It takes effect after active cancer treatment ends and can be used by your full medical team. An SCP organizes the following:

1. Medical information about cancer treatments;

2. Recommended follow-up care, including tests and physical exams;

3. Ways to maintain your health and wellbeing;

4. All of your support needs

by the numbers

5 million

The estimated number of cancer survivors in the U.S. in 1986.

15 million

The estimated number of cancer survivors in the U.S. in 2017.

Financial Survival

Cancer is expensive, not only for treatment but for related costs like transportation, lodging, child care, home care and respite care. As more people survive cancer for longer periods of time, those costs can create financial hardship. That hardship can impact survivorship, especially if one skips medication or appointments just to get by.

Resources are available at the local, regional and national level. They include H.U.G.S. in Marion County and the Citrus Aid Cancer Foundation in Citrus County. You can also get help through the American Cancer Society, Cancer Care, Cancer Support Community, National Cancer Institute, National Coalition for Cancer Survivorship, NeedyMeds and elsewhere.

From Victim to Survivor

The term “Cancer survivor” was controversial when Harold Benjamin coined it in 1986, the year he co-founded the National Coalition for Cancer Survivorship. Before then, people were “cancer victims.” After lobbying by NCCS and other advocates, the National Cancer Institute established its Office of Cancer Survivorship in 1996. The office spearheads survivorship research and supports patients and caregivers, often partnering with groups like the American Cancer Society, LiveSTRONG, Living Beyond Breast Cancer and NCCS.

1,735,350

The estimated number of new cancer cases that will be diagnosed in the U.S. in 2018

$35 billion

The cost of cancer treatment within Medicare.

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“Cancer didn’t bring me to my knees. It brought me to my feet.”

— Michael Douglas

of

The DECLINE MEN

It may be premature to say, but if trends continue, the American male will be a gender in decline.

Story: James Combs

There was a time when men sought to conquer the most difficult of challenges, like building the tallest buildings or climbing the highest mountains. These days, the male species is teetering on the edge of those rooftops and mountaintops as American manhood appears to be in a sad state of affairs.

After decades and decades of social dominance, men are now entering adulthood with less education, less money, less ambition, and fewer achievements than their female counterparts.

eventually graduate to opioids. Others experience a decrease in testosterone and start becoming depressed. They turn to drugs and alcohol to cope with that depression. Some may feel that because they’re older and more mature, they have control over their addiction. However, it’s important to remember that if you drive a car and let go of the wheel, you go straight for a while before you crash.”

Retiring from a career can also leave men vulnerable to substance addiction. While it seems unfathomable that retirees would spend their Social Security checks and pensions on illegal drugs, there are 2.5 million American seniors with alcohol and drug problems, says the Substance Abuse and Mental Health Services Administration.

After retiring, men may feel a loss of purpose, a loss of status, and a loss of social support formerly derived from coworkers.

“We live near numerous retirement communities and have retired males come into our treatment center,” says Diane Peterson, supervisor of adult outpatient substance abuse services at LifeStream. “Many of them don’t have a retirement plan, and I’m not talking about finances. I’m talking about they no longer know what to do with themselves. When you retire and your lifestyle changes, if you don’t have a plan mapped out for what you’re going to do, depression may set in. They feel worthless. They feel less than a man. They turn to alcohol or drugs. They have lots of downtime, and I always say idle time has the potential to be your biggest enemy, especially when you’re dealing with addiction.”

One obstacle men of all ages face in overcoming substance abuse is the tendency to bottle up their feelings.

“There’s a lack of instruction in our society in how males are supposed to express their feelings,” Jorge says. “They have a hard day at work and assume drinking is the best coping mechanism. Nobody has ever instructed them to talk to someone about that hard day of work or figure out why they’re feeling angry about that hard day of work. As a result, when they continue enduring difficult times, they keep turning to the one thing they know. That’s when occasional drinking turns to a full-blown addiction. In my experience treating men, emotional health and the lack of expressing emotions has been the biggest factor why men become addicted to alcohol and drugs.”

Men’s testosterone levels have been declining since the 1980s, a 2007 study in the Journal of Clinical Endocrinology and Metabolism states. A 60-year-old man in 2004 had 17 percent lower testosterone levels than a 60-year-old man in 1987.

SPIRIT

ABSENCE OF FATHERS

On O e

bi b ollog o ical father in the home, to o U.S Census Bureau. father in the hoomme are more prone to be suuffer and endure low self-esteem.

One in three children live without their biological father in the home, according to the U.S. Census Bureau. Children—and boys in particular—with no father in the home are more prone to be aggressive, suffer depression, perform poorly in school, and endure low self-esteem.

In the Centers for Disease Control a annd all ch coomme from fatherless homes. booyys without fathers are twice as to d drop p out of school and four times as a likkely to need treatment for behavioral problleems, to the National Center f for Chhildren in d’thgdll

In fact, the Centers for Disease Control and Prevention CDC says 85 percent of all children who exhibit behavior disorders come from fatherless homes. Moreover, boys without fathers are twice as likely to drop out of high school and four times as likely to need treatment for behavioral problems, according to the National Center for Children in Poverty.

“If you don’t have a good male role model, then you don’t have a model to determine what it means to be masculine,” says Dr. W. Steven Saunders, a licensed psychologist and owner of Central Florida Psychological Consultants in Clermont.

“If you don’t have a male role model, then you don’t have a model to determmine what it means to be sayys Drr. W. Steven Saunders, a licensed ps Central Florida Pssychollogical Consultants in Clermont.

“Boys need father role models to learn what to do with all their energy. Masculinity is a natural force just like femininity is. If you use it in a positive way, then you can achieve a lot. It’s a conquering kind of energy and an energy to help you act in the world. Without role models, then what do you do with all this energy? You will create an internal self-concept that makes you begin to hate yourself.”

No matter how great a single mother may be, she cannot replace what fathers provide their children. While mothers are nurturing and comforting, fathers teach children how to be risk-takers and challenge themselves. Boys need that balance of protection and reasonable risk-taking.

“BBoyys need father role models to learn what to do with all energy. is a na n tural force just like is. y you use you can a achieve of energy and an energy to you act in the w woorld. Without role then what do yo y u do with all You will create a an you beegi g n to hate No be, s she cannot what fathers their children. While mothers are nurturing an a d fathers teach children how to be risk-takers and Booys need that balance of reaasonable risk-taking

The number of young adult men saying that having a successful marriage is one of the most important things in life decreased from 35 percent in 1997 to 29 percent in 2012.

Source: Pew Research Center

“I think our society in general is over-mothered and under-fathered,” Dr. Saunders says. “When I think of what the positive side of men are, I think of my two heroes, Mr. Rogers and Captain America. Mr. Rogers exemplified the kind, nurturing, compassionate part of masculinity that I think men should aspire to. Captain America represented masculinity in the sense of its heroism and the ability of a man to want to face danger and conquer evil.”

SUICIDE

A statistic from CDC: 77 percent of U.S. suicides are men. However, it is important to put this number in perspective. One big reason for gender disparity in suicide rates is that men choose more lethal means to kill themselves.

“Men have a higher completion rate of suicide,” Dr. Saunders says. “Women actually have more attempts, but their means of suicide is often overdosing with pills, which is not as lethal. When a man decides to kill himself, he’s usually going to use a firearm or hang himself. Surviving a self-inflicted gunshot wound to the head is extremely rare.”

Often, family members and friends are naïve about a male contemplating suicide. That’s because men tend to bottle up their feelings and suffer in silence.

“Women will often cry out for help and make suicidal gestures,” Dr. Saunders says. “Men have an inner world that’s very private and can be very difficult for others to access. Men need to understand it’s OK to reach out for help and vent their frustrations and problems.”

MIND

INCARCERATION

Looking at incarceration rates by gender, there is no escaping the fact that men are imprisoned more than women—and it’s not even close. According to data released by the Federal Bureau of Prisons in March 2018, 93.1 percent of inmates are male, while only 6.9 percent are female.

There are several reasons for that, says Dr. Steven Saunders.

The genders process their inner worlds differently. Men often act out, while women shut down.

“There’s a private part of men that is only accessible by ourselves—it’s our own subjective understanding of who we are,” he says. “A man’s inner world is a collection of thoughts, good memories, and traumatic events of what has happened to him in his lifetime. They all connect and create a sense of self-concept. A man’s inner world can be extremely tortuous. They may have a series of traumas that nobody knows about, and they’re struggling with that or carrying it with them. It can be really difficult to manage and may force men to lash out.”

Men also commit a higher percentage of serious and violent crimes, such as murder, aggravated assault, and robbery. Moreover, he says, women often receive shorter sentences for the same crimes. “Men receive 63 percent longer sentences on average than women do, and women are twice as likely to avoid incarceration if convicted,” Sonja Starr, a University of Michigan Law School professor, writes in a research paper titled, “Estimating Gender Disparities in Federal Criminal Cases.”

“Even in a situation where you have a man and a woman who commit the same crime together, it’s the man who takes the fall for it,” Dr. Saunders says. “This is especially true if they have children together. The justice

system takes it easy on the mother because they want her to remain in her children’s lives rather than have them orphaned. I used to work for the Federal Bureau of Prisons and saw this type of gender disparity all the time.”

EDUCATION

Men lagged behind women seeking higher education for four decades, and the gap widens each year, according to data from the National Center for Education Statistics (NCES).

Females outnumbered males in U.S. college enrollment every year since 1979. NCES estimates for this fall show that about 11.7 million women will enroll in college compared to just fewer than 9 million men. Projections through 2026 indicate the number of women enrollees will rise at a faster rate than the men’s.

Locally, the University of Central Florida has the highest public college enrollment in the country. Current enrollment breaks down to 36,324 women and 29,859 men, including more women than men in graduate studies (5,163 to 3,563); the numbers in medical school are split about evenly, according to the school’s website.

International studies by the Organization of Economic Cooperation and Development examined gender differences in education. One study suggests girls get an early advantage over boys in reading, and boys never catch up, leading to a general “anti-education” attitude that’s embedded well before college age.

Some male teens see college as a high-cost, low-benefit risk, and prefer to jump into the workforce and make money immediately. Many male-dominated vocations, such as electrician, mechanic, and plumber, are high-paying and don’t require college.

When they do attend college, men graduate at a lower rate (56 percent) than women (62 percent), the NCES reports as of 2015-16. Overall, about 34.6 percent of the female population in the United States had a four-year degree as of 2017, compared to 33.7 percent for males, according to statista.com.

During 2015-16, women also received 59 percent of all master’s degrees, and 53 percent of all doctor’s degrees,

which include doctoral, medical, dental, and law degrees in the NCES classification.

MASS SHOOTINGS

Mass shootings have infiltrated American culture like toxic sewage. Mental health is often fingered as the main culprit. Interestingly, a 2013 Oxford University study found that women are 40 percent more likely than men to develop a mental health condition. Yet, between 1982 and April 2018, females initiated only three mass shootings.

So, why are most mass shooters male? One big problem stems from societal expectations of how men are supposed to react to stress. Men are trapped in an outdated model of masculinity, and they don’t know how to express how they feel being trapped.

“Our society has never been good at giving men a place to feel and express their emotions and the range of those emotions,” Dr. Saunders says. “Men are taught to suck it up and walk it off. I have an emotion chart that I give to men to help them identify how they’re feeling and name what these different feelings are.

The more you’re able to name your different emotions and feelings, the more access you have to them, the easier they are to control, and the more likely you are to express them. If you’re able to express those emotions, you are healthier psychologically.”

IQ TEST RESULTS

Historically, men have scored higher than women on IQ tests, but yet again, this is another changing trend. Women are scoring higher than men on IQ tests, according to data from New Zealand researcher James Flynn.

Based on a “substantial and long-sustained increase in both fluid and crystallized intelligence test scores” from various parts of the world since 1930, everyone has been getting higher IQ points, but women are gaining faster than men. Evidence indicates it’s the result of modern living and women assuming larger roles in all parts of professional and home life.

In the 25-34 age group, 37.5 percent of women have a bachelor’s degree or higher, compared to 29.5 percent of men.

Source: Census Bureau

FINANCE

WAGE DIFFERENCES

Median weekly earnings for men were $965 while women received $783, according to an April report from the Bureau of Labor Statistics.

However, indications in professional areas and white-collar jobs are women do make more money. Statistics say there are more women in managerial positions than men.

YOUNG ADULTS LIVING AT HOME

Since 2007, the number of young men living at home increased significantly—from 14.2 percent to 18.6 percent, according to the Population Reference Bureau. However, young women still living with parents remained steady at 10 percent. This is the highest level of young men living at home since the Census Bureau began tracking this measure in 1960.

SHE’S PASSING THE GUYS

There are more female drivers on the road than men for the first time since the automobile was invented, according to a study by Edmunds, an auto information service. The University of Michigan

Transportation Research Institute found this after a study of driver’s license statistics. The assumption is this will affect everything from highway fatalities to car design, as more women than men tend to buy smaller, safer, fuel-efficient cars. These statistics are consistent for age groups from 25 to 55 and rise even more for women over 70, a Frost & Sullivan marketing report indicates.

CONCLUSION

While women seem to have surpassed men in educational pursuit, communication skills, social skills, and emotional recognition, it would be inaccurate to say a man’s worth in society is endangered.

There are still plenty—plenty—of men who financially support their family, raise their children properly, and treat their wives like royalty.

Unfortunately, it seems these men are largely ignored by society.

“I teach at a university and we did a study one time on how commercials during prime time television portray men,” Dr. Saunders says. “One of them had a man tied to the porch with a leash and collar on him. A car goes by and he starts running toward it before getting snapped back. His wife laughs at him. Whenever a commercial or sitcom depicts a father, he’s always inept, like a Homer Simpson or Al Bundy. Those kinds of stereotypical negative images about what fatherhood is, in and of itself, to me, are part of the decline of men in America and how the culture views men.”

State-of-theart treatment

Urologist Dr. Dinesh Rao uses robotic surgery and the latest techniques to treat men and women.

Over the course of 15 years of practicing at Advanced Urology Institute, Dr. Dinesh Rao has firmly established himself in the medical community in the tri-county area of Sumter, Lake, and Marion.

The highly educated doctor offers full-service urology care and the most advanced surgical techniques available as one of nine urologists on staff at Advanced Urology Insti-

tute in Oxford, on the western edge of The Villages.

Dr. Rao focuses on state-of-the-art robotic surgery and solving issues with erectile dysfunction, or ED, incontinence, and kidney stones.

“We offer the latest minimally invasive techniques for prostate and kidney surgery,” he says. “The robotic surgery is laparoscopic—minimally invasive—so it has less pain, less healing time, and shorter hospital stays, usually overnight stays for those types of surgery.”

For incontinence, Dr. Rao offers minimally invasive sling surgery and injection therapies, including Botox, which is injected into the bladder.

“Botox works on the skin because it relaxes those muscles and gets rid of those wrinkles,” Dr. Rao says. “We inject Botox in the bladder muscle and it relaxes it so that people don’t have that frequency and urgency (to urinate). Same drug in a different spot.”

PAID PROMOTIONAL FEATURE

For ED, Dr. Rao uses the full range of current medications and surgical options, such as implants, though medications are much more common.

“It’s interesting how many men are interested in treating their ED until they get to the surgical part, and then they back off and say, ‘Well, I was interested but maybe not quite that much,” the doctor jokes.

Dr. Rao also treats kidney stones with every current treatment, such as lithotripsy and other minimally invasive stone management techniques. Lithotripsy is a procedure that uses ultrasound shock waves to break up kidney stones so they can pass through the body.

Both men and women share similar ailments such as incontinence and bladder problems, kidney stones and kidney cancer, Dr. Rao says. But urologists naturally treat more men than women because men also seek care for ED and prostate cancer, while women generally go to gynecologists for many women’s health issues.

Dr. Rao started on his path toward the medical field while growing up in North Carolina, where he attended the North Carolina School of Science and Mathematics, a public school in Durham. He received his undergraduate degree from the University of Pennsylvania and then returned to North Carolina for medical school and urology training. He earned his medical degree at Duke University, then completed his residency at Duke University Medical Center.

“I’ve trained at one of the best urology programs in the country,” he says.

In 2003, Dr. Rao moved to Ocala and has been practicing at Advanced Urology Institute ever since, splitting his time between the Ocala and Oxford offices.

He does manage to find time for one of his passions, racing Spec Miata cars in amateur races of the Sports Car Club of America. He has driven the Mazda-made vehicles in events at Sebring,

Daytona, Atlanta, and elsewhere. He’s also a pilot and hopes to buy his own plane so he can devote more time to that passion as well.

Life on the job will get a little easier for doctors and patients when the Advanced Urology Institute completes construction of a new surgery center directly across from its offices on County Road 103. The center will allow most surgical procedures to be done onsite, making arrangements much more convenient for patients. Dr. Rao estimates that the building will be finished in six to 12 months.

In the meantime, Dr. Rao continues to accept new patients, and appointments usually are available promptly. He emphasizes that the patients come first at his practice.

“I try to offer the best available up-to-date care,” Dr. Rao says. “I offer high-quality care at a reasonable cost, and I don’t try to drive up costs or do unnecessary testing. I try to promote the best practices.”

We offer the latest minimally invasive techniques for prostate and kidney surgery. The robotic surgery is laparoscopic—minimally invasive—so it has less pain, less healing time, and shorter hospital stays, usually overnight stays for those types of surgery.

— Dr. Dinesh Rao

Regain the FREEDOM to Explore!

There’s a big, wide world out there, but if sagging lids are keeping you from experiencing it fully, it might be time to consider blepharoplasty, a safe, quick surgery to gently lift sagging eyelids that can block peripheral vision, and make you look more tired than you feel.

Shelby Terpstra, DO is a leading provider of upper and lower corrective and cosmetic eyelid surgery designed to promote better vision and a more refreshed and vital appearance.

BEFORE AFTER PICS

PATIENT STORY:

“Sagging lids [impacted] my peripheral vision, especially when I was driving. Then a friend recommended Lake Eye. Dr. Terpstra was very informative. After surgery I immediately noticed an amazing improvement. I could see out of the sides of my eyes. A wonderful side-effect is how much better I look. I love it!” – Decemma Bensyl

READ

Shelby Terpstra, DO

Board-certified Comprehensive Ophthalmologist

and on top of the changes in the medical industry.

June Lew: Sitting on Top of the World

Whether pursuing her dream to help doctors build successful medical practices, shooting wildlife on a Serengeti photo Safari, or climbing to the summit of a mountain range in China, June Lew approaches every new opportunity with passion and the drive to positively impact lives.

Twin Medical Consultants

Twinning the ‘art and science’ of medicine with the ‘business’ of medicine helps make practices perfect. And no one understands that better than June Lew.

She and business partner Gary Blakely are the principals in Twin Medical Consultants, a company which makes

it easier for physicians to take care of businessrelated and IT issues within their practices so they, their physician assistants and nurses, and their administrative teams can focus on a much greater priority… diagnosing, treating and caring for patients.

“Above all, a physician’s commitment and obligation is to his or her patients—to doing what’s

in their best interest,” said June. “Gary and I help doctors solve some of their most complex business and technology problems, so they have more time to be doctors and care for their patients,” she added. Whether a doctor or practice needs turnkey assistance to open an office, assistance with billing, a fully integrated information technology system, or help merging with, or acquiring, new practices, Twin Medical Consultants is here to help.

“We help practices run smoothly by providing as much or as little help as they need. Our clients include physicians who are opening or restarting medical practices and want to establish best practices right from the start, practices that are successful, but want to make improvements to encourage growth, and those that need to implement changes to see improvements quickly.

“After 25 years of experience working with

a medical practice, I have become something of an efficiency expert,” said June. “I use the practice’s own staff to fix their particular problems, helping them to perform better and cut inefficiencies. I provide spreadsheets, so they get the proper reports on everything, including inventory and where it’s going. This is also an important step in helping them keep up with patient satisfaction.”

“Gary and I bring fresh, new insight and advice to a situation to solve problems or to identify any obstacles in the way of the growth and productivity of a practice,” June added.

A Passion for Caring for Doctors…and Their Patients

“We’re not just their consultants, but their friends,” said Gary about the clients he and June work with. “We get joy out of taking a problem and coming up with a solution for it. For

example, we don’t just handle billing. We’re right here, locally, so patients can call us directly with billing questions. So often, a doctors’ office will take a call from a patient with a billing question, call the billing company, call the patient back, and then find out the patient has an additional question. We invite that patient to call us directly, instead. We can answer every billing question until that patient has the information he or she needs, and is satisfied that every question has been answered.

“I’ve seen how many doctors can use our help,” said June, who in 1991, was instrumental in helping to establish a cardiology practice that has now grown to one of the largest and most successful multi-specialty groups in Central Florida. That practice now has more than 25 physicians and 10 offices. She retired in 2017 in order to move ahead full speed with her newest venture.

“This is where my passion is. I see many doctors who are simply burned out after years of struggling with regulations and the demands of an ever-changing healthcare environment—a key reason many small doctors’ offices have been gobbled up by large practices or hospitals. We work sideby-side with these doctors

to help them regain their passion by allowing them to do what they do best and enjoy the most.

Great TranslatesSupport to ResultsSuperior

Services provided by Twin Medical Consultants run the gamut from billing and coding, help with location selection and buildout, office expansion, Insurances, risk management, purchasing of equipment, marketing, monitoring office flow, analyzing finance and overhead, overseeing accounting and bookkeeping, assisting CPAs on tax planning, inventory control, front office, physician recruiting, strategic planning, and compliance.

“Billing correctly is a critical issue for physicians. Often, a physician’s staff does not have time to follow up with insurances on medical billing issues and this causes money to go uncollected. We offer a fully customizable billing service that helps to increase revenue throughout a medical facility.

If Twin Medical handles a practice’s billing, June’s other medical consulting services are included in the fee.

Gary is equally passionate about handling a practice’s

medical IT and tech support needs. With over 20 years of experience in the medical field, he is ready to assist practices with a wide array of services to help them run smoothly and efficiently, creating IT systems from the ground up, or providing whatever a practice may need.

“Doctors today are being compensated based on the quality and value of their services, not the quantity. They’re being held accountable for giving better care instead

of more service. We thoroughly understand what it takes to capture the information they need for the merit-based reporting of performance information that Medicare and insurance agencies require today,” said Gary.

Medical Knowledge Boosts IT Productivity

“When a practice calls in just a traditional computer company— most don’t understand the complexities of the

“Gary and I bring fresh, new insight and advice to a situation to solve problems or to identify any obstacles in the way of the growth and productivity of a practice.”

medical field. MIPS and MACRA (quality measures), EHR and EMR (electronic health records and electronic medical records), we completely understand them. We have used many of the software products doctors use like eClinical®, MicroMD®, and Amazing Charts™, and can provide all the hardware and software needed to fully integrate their systems.

“I believe computers should work for us, and helped design a personal health package. A lot of companies sell EHR

packages to doctors and then train them to use them. Instead, I look at the doctor’s workflow and create an EHR package that works for them.”

“In 2017, if everything was not done correctly, such as billing and coding, a practice could lose on average four percent of their revenue. In 2018, it will be more,” Gary says.

“Technological innovations are deeply changing everything around us. Our team at Twin Medical Consultants is driven to succeed in

providing healthcare IT solutions for today and tomorrow,” he added.

“It’s exciting to help doctors get back to what they love—practicing medicine and having the time to enjoy their doctorpatient interactions,” said June. We help doctors be doctors, give nurses more time to take care of patients and provide office staffs with the administrational skills they need to operate like a well-oiled machine.

“We want them to enjoy the time they spend in the practice, and we

want to give them more time to spend with their families and friends.”

The Dream is Alive

June and Gary work very hard and are very passionate about what they are doing together. Their passion spills over into other aspects of their lives.

For June, who came to the US as a high school sophomore from Seoul, South Korea, the field of medicine has always been a passion. She earned a pharmacy degree from the University of Georgia and worked as a practicing pharmacist in Gainesville for seven years before moving to Leesburg.

While raising her family, June dreamt of becoming a wildlife

photographer. Seven years ago, she began realizing her dream, setting out on her first photography safari. For her, this was a pictureperfect second calling.

Since then, June has begun raising awareness of the beauty and fragility of the natural world with a portfolio of captivating wildlife photographs which includes mischievous baby pandas playing together in China, and an awardwinning photograph of a lion balanced majestically on a rock in the Serengeti in Tanzania.

She has been privileged to visit numerous countries to photograph rare and exotic animals, becoming an advocate for the preservation of wildlife in their natural habitats.

Other passions she pursues with much the same gusto and drive include tennis, biking, ballroom dancing, scuba diving, cooking and spending time with her family.

Doubling Down on a Great Life

After moving to Florida from Radcliff, Kentucky, in 1987, Gary married the love of his life and soul mate Diane in 1988. Raised in a small town, Gary was attracted to Lake County life.

Today, Gary and Diane have twin daughters who mean the world to them. In fact, keeping them close to his heart was the impetus for the creation of the Twin Medical Consulting company name and logo. When not working, Gary enjoys riding his Harley, scuba diving and exploring the underwater world, playing video games, going to movies, and reading comics.

Twin Medical Consultants is prepared to help doctors focus on the health of their patients. Call them today.

“It’s exciting to help doctors get back to what they love—practicing medicine and having the time to enjoy their doctorpatient interactions.”

—GARY BLAKELY

Michael A. Freedman, DO Board Certified, Otolaryngology

S. Dwight Vaught, MD Board Certified, Otolaryngology

Judith Milstead, MD Board Certified, Otolaryngology Dino Madonna, MD Board Certified, Facial Plastic Surgery, Otolaryngology

Pamper Your Man With A Peel

Great skincare isn’t just for women. Men who want to maintain a youthful, healthy look should start with a skin peel. With several options to choose from, a peel provides visible results with little downtime.

Peels treat brown age spots, fine lines, wrinkles, ingrown hairs and large pores. Peels also improve skin texture, leading to a closer shave, as well as brighter, healthier looking skin.

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352.259.5126

About 350 million people suffer from depression, the leading cause of disability, according to the World Health Organization.

Story: Leigh Neely Photo: Fred Lopez

Grief and sadness are normal human emotions you will experience at some point in your life. However, if you find yourself feeling an overwhelming sadness to the point of losing interest in your favorite activities, noticing a lack of concentration and focus, or even experiencing physical symptoms like aches and pains in joints and muscles, you may be suffering from depression.

Fortunately, a variety of pharmaceutical medications can treat depression. However, for those who suffer long-term issues or those who have excessive side effects from medication, there finally is another solution: transcranial magnetic stimulation (TMS). It’s a new medical technology available in Lake and Sumter counties only from Dr. Pritha R. Dhungana, who has an office in Lady Lake. She also is a psychiatrist with Serenity Health Center, with offices in Clermont, Leesburg, and Windemere treating children, adolescents, and adults.

“I practice what is called neuropsychiatry, which involves much more,” she says.

Dr. Pritha R. Dhungana

By definition, neuropsychiatry treats mental disorders that come from the nervous system. It combines the disciplines of psychiatry and neurology.

“The mental, the brain health, is the most important, though most medicine focuses on the other organs—the heart, the liver—and not on the organ that controls all of them,” Dr. Dhungana says. “Now we work on the biological part, which is the body; the psychological part; and the social.”

The doctor uses diabetes as an example. “You have a physical condition—the nutrition, hydration, weight, stress—which makes the condition worse and causes depression, which also makes the condition worse,” she says. “It’s the same in psychiatry. I have so many patients who suffer from depression, but after using three or four medications, they find it no longer works.”

According to Mental Health America, in 2018, one in five adults have a mental health condition.

However, as many as 56 percent of adults with mental health issues do not receive treatment. Add to that the shortage of mental health professionals, and it makes the problem much worse.

Among the many mental health issues is post-traumatic stress syndrome, common among veterans, first responders, and trauma victims. It can be debilitating, and Dr. Dhungana believes TMS can offer help for this that medication cannot.

“TMS is a breakthrough, and it was approved by the FDA (Food and Drug Administration) in 2008 for recurrent depression disorder and recurrent

depression,” she says. “At Duke University, when they did a PET scan, they realized they could recognize a depressed brain. There is very little activity in a depressed brain. When they started doing the TMS treatment, the activity increased.”

This noninvasive procedure uses magnetic fields to stimulate nerve cells in the brain, which improves symptoms of depression. An electromagnetic pulse is painlessly delivered to the part of the brain that controls moods and depression, sometimes activating parts of the brain that had decreased activity due to the depression.

It is nothing like electroconvulsive therapy (ECT), which is generally used for the most severely depressed or suicidal patients.

This caused researchers to rethink their treatments, and now, Dr. Dhungana says, TMS has become the norm for treatment of depression. “It is 100 percent safe, and the fastest, most effective treatment so far,” she says.

By the time Dr. Dhungana sees most patients, they are totally frustrated. They’ve been to multiple doctors, tried multiple medications, therapy, and still have no relief. “Even though they’re trying their best and trying to use coping skills, they’re not feeling any better,” she says.

“There are no lifestyle changes, no down time (with TMS). All we ask is that the patient do it every day to increase effectiveness,” she says. “TMS has improved to the point where it used to take more than 45 minutes for treatments, but now it is reduced to about 18 minutes.”

After a designated period of time, treatments are tapered until they end.

Thirty-three studies were reviewed and provided scientific evidence that there is strong benefit of using TMS to treat post-traumatic stress, an article from the National Institutes of Health states.

“In my practice, almost 75 percent of the people who received treatment have gone into remission and 80 percent have a reduction of symptoms, and we have graphs to show that,” Dr. Dhungana says. “The way we track it is by the patient’s self-report. The human being is the best judge of how they are feeling.”

The doctor says her patients are improving to the point where they’re getting off opioids for pain, their lifestyles are improving, and she has seen a variety of other changes in a large number of patients.

“Most of them found us by Googling ‘What’s best for depression?’” she says. “They come to us on their own, not by referral.”

The treatment is done in a chair, and the important part is patients are relaxed. They can watch television and go back to work or other duties when treatment is complete.

Though TMS is not recommended for those under 18, approval for adolescents is very close, the doctor says. Another positive note is that insurance and Medicare cover treatments now.

The doctor takes the patient’s history and determines if they qualify for the treatment. “The first treatment is the mapping session to determine what’s needed, and the information is fed into

“With treatment, it’s like night and day for me. I told the doctor I was afraid I was dreaming and would wake up and be back the way I was.”

— Cheryl Monaco

the computer to ascertain what the patient currently needs,” she says.

Dr. Dhungana does the first treatment and after that, it is done by a certified TMS treater, overseen by the doctor. After treatment ends, if the patient feels a relapse, Medicare will pay for maintenance.

“They may need one or two boosters, but it’s less and less,” Dr. Dhungana says. “With ECT, there was memory loss. With TMS, the patients find their memory becomes sharper. So now they’re looking at Parkinson’s, cognitive enhancement, and even migraine headaches (for treatment with TMS).”

Cheryl Monaco was diagnosed with chronic fatigue syndrome in 1998 at the age of 68. “I was wrecked with illness and terrible depression,” Cheryl says. “I didn’t want to get out of bed, didn’t want to live.”

When Cheryl heard about Dr. Dhungana and TMS, she was eager to see if it would help. The results were stunning. She feels physically and mentally healthier than she has in years.

“With treatment, it’s like night and day for me. I told the doctor I was afraid I was dreaming and would wake up and be back the way I was,” Cheryl

says. “It’s life-changing, extraordinary. If I hadn’t experienced it myself, I wouldn’t have believed it. God has really smiled on me.”

“The brain is the only organ that continues to grow throughout your life. That’s neuroplasticity, which is the brain’s way of forming new neural connections throughout your life,” Dr. Dhungana says. “That why we do all this cognitive therapy. That’s why the brain needs continuous stimulation, and patients doing their part with nutrition and psychological therapy. That’s why it’s so important to keep the brain healthy.”

What if your Back pain is a Spine Compression Fracture?

PAID PROMOTIONAL FEATURE

What if you develop sudden onset severe back pain, more unbearable than you ever imagined? If your pain is new or feels different from the chronic back pain you may already be experiencingwhich is currently being treated with exercise, pain medicines, and injections - it is recommended that you should visit your doctor or urgent care center immediately, because you may have a vertebral compression fracture in your spine. If you are able to pinpoint your pain with the touch of a finger to a specific vertebra, it is important to act quickly or it may become too late to repair it.

What is a compression fracture and why is time of the essence? A compression fracture is when a vertebrae cracks and becomes compressed or somewhat flatter than it was before the fracture. Think of an elderly person with a hunchback or curved spine. A hunchback, medically known as kyphosis, is often caused when the bones become frail and brittle from osteoporosis (loss of bone density) and the vertebrae begin to fracture one by one. As these vertebrae fracture, they become misshapen. The rectangular vertebrae become triangular or wedge-shaped, eventually creating a curve in the spine.

Once a vertebrae fractures it will heal on its own, but it takes several weeks or even months to do so, during which time the pain is often unbearable. In the past, doctors would put patients in a brace and prescribe medication, often in the form of narcotics, to help ease this pain. When

the compressed vertebrae heals on its own, it heals in its compressed state or compresses even further, sometimes flattening completely and reducing the height of the individual. At this point, nothing can be done to restore its integrity since the bone has hardened or scarred, making it impossible to fix.

Compression fractures can also be caused by an impact such as a fall, or from cancer which has metastasized to the spine. Unfortunately for many, a compression fracture can be a first indication of cancer, so do not ignore this sign - get a consultation immediately. If you had an X-ray, CT, or MRI indicating a compression fracture, insist that your physician acts quickly to refer you to a specialist for a kyphoplasty or vertebroplasty.

With a procedure called kyphoplasty, kyphosis can be a thing of the past! A Kyphoplasty procedure can stop pain instantly in over 95% of patients, as well as prevent further collapse of the vertebrae.

During the procedure, the physician uses image-guidance in the form of a C-ARM (which is a live X-ray) to obtain access and inject a plastic cement into the vertebrae to restore the integrity of the bone, often stopping pain completely and preventing further damage. The procedure is performed under conscious sedation and takes approximately 30 minutes under the expertise of an experienced specialist, such as an Interventional Radiologist. Although other specialists are now performing this procedure, an Interventional Radiologist should be your first choice, since they pioneered this procedure, and any imageguided procedure should always require a person trained in radiation safety.

often overlooked by other physicians. An Interventional Radiologist such as Dr. Mark Jacobson, uses a mere fraction of the typical radiation exposure used by other specialists, including other radiologists. An Interventional Radiologist also uses minimally invasive surgical techniques with the least number of punctures (usually one per vertebra) and the smallest needles possible, thereby enhancing safety and reducing healing and recovery times.

In the case where a compression fracture is caused by a cancerous lesion, an Interventional Radiologist can also biopsy the bone and perform a radiofrequency ablation to alleviate pain prior to the kyphoplasty (this is not a replacement for, but complimentary to radiation treatments, because if a patient is in less pain, the treatments can be tolerated better).

This is why it is imperative to understand that not just anyone should perform your kyphoplasty, but someone trained in identifying the difference between a simple fracture caused by osteoporosis, and a fracture caused from a possible cancerous lesion. A trained expert will be able to offer to you the best options available.

ABOUT DR. MARK JACOBSON Dr. Jacobson has performed nearly 1000 kyphoplasties in his Lady Lake office and is the “go-to provider” for this procedure, not only because of the number of procedures performed and numerous happy patients, but also because of his participation in the research of radio-frequency ablation of cancerous spine tumors. Local, as well as out of town physicians entrust Medical Imaging & Therapeutics for treatment of their patients’ spine fractures. MIT is affiliated with the University of Florida College of Medicine as an Interventional Radiology training center for physicians in the interventional radiology residency and fellowship program.

Interventional Radiologists believe that limiting X-ray exposure to patients is crucial, which is something 352.261.5502 | mitflorida.com facebook.com/mitflorida

Interventional Radiology procedures performed in a nurturing, safe, state-certified outpatient center

Is Your Knee Pain a Torn Meniscus?

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Leave the fear behind

believes many people have to fear. With all the calorie certain food groups, and worrying about what to eat for your next meal, it’s no wonder people develop stress and fear. Nicola is a nutritionist and intuitive eating counselor. In her book, “Fear-Free Food,” she provides the compassionate advice, mindset techniques, and practical ways to trust your body and enjoy food freely. “Fear-Free Food” has more than 80 nutritious recipes that are not only delicious and beautify your plate, you can eat them with no guilt. Nicola believes it’s possible to replace dieting and deprivation with nutrition and nourishment—freely!

What’s new about the Atkins Diet?

Six new updates to the Atkins Diet, plus why it’s so easy to lose weight on a low-carb diet.

Story: Colette Heimowitz

In its almost 40-year evolution, the Atkins Diet has undergone a number of changes that keep up with emerging nutritional science, and it has truly evolved into a low-carb lifestyle, not a short-term quick fix. The New Atkins is easy to follow, more versatile, and sustainable for a lifetime of healthy eating.

Here are some of the major changes:

• You eat more veggies. On Atkins, you’re eating more veggies each day than the average American eats. Right from the start, you’ll eat five servings of high-fiber “foundation vegetables,” which include leafy greens, other salad vegetables, and additional low-carb vegetables that are usually cooked. The list of foundation vegetables includes more than 50 vegetables.

• You can do Atkins on your terms. You have your choice of three levels: Atkins 20, 40, or 100, which means you can decide how many grams of carbs you’d like to consume, depending on your personal carb tolerance. You can also easily move between each level, and you’ll learn how you can make this transition in the latest Atkins book, “Eat Right, Not Less.”

• You can go meatless on Atkins. If you’re vegetarian or vegan, you’ll receive detailed advice on how to follow a low-carb lifestyle that accommodates your dietary needs.

• You learn how to do Atkins anywhere. Whether you’re on the road, stuck at the office, on vacation, or out to eat, you’ll learn all the tips and tricks for sticking with Atkins at airports, in fast-food places, and any restaurant.

• You learn about the hidden sugar effect. Did you know your bloodstream can process only 1 to 2 teaspoons of sugar at a time? There are foods, such as whole-wheat bagels, which may contain carbohydrates that convert to more sugar in your bloodstream than your body can process. And that excess sugar can be stored as fat. This is called the hidden sugar effect. Once you learn how to identify foods containing hidden sugars, you’ll be able to make the right food choices.

WHY YOU LOSE WEIGHT WITH ATKINS

Whether you have a little or a lot of weight to lose, you will usually find you can lose weight quickly, especially with Atkins 20. And you can do so without being plagued by hunger and cravings once your body makes the switch to a fat-burning metabolism, which usually takes about a week. After this, you usually experience a surge of energy because you have gotten off the blood sugar roller coaster that results from eating a diet high in sugar, white flour, and other refined carbohydrates.

SCIENCE SUPPORTS ATKINS

There are more than 80 studies that prove Atkins is a safe and effective way to lose weight, but it also can help you overcome diabetes, hypertension, and metabolic syndrome.

ATKINS 20, 40, AND 100: HOW TO GET STARTED

For many, Atkins 20 is a brief jump-start phase that will start you off on the right foot before moving on. Or you can stick with Atkins 20 longer and lose more weight before transitioning to Atkins 40 or Atkins 100. If you have more weight to lose or certain health issues, start in Atkins 20, but otherwise, you can start on Atkins 40. It’s up to you. If you want to reduce your carbs gradually by making smart lifestyle choices, and you do not have a lot of weight to lose, Atkins 100 is right for you. Regardless of where you start, you’ll be eating optimal protein, healthy fats, and high-fiber carbs, which means you’ll be enjoying a wide variety of delicious food while staying satisfied and never hungry.

As Lake County continues to grow, so does our need for high-quality health care. We are excited to announce our new facility – Orlando Health South Lake Hospital Emergency Room and Medical Pavilion at Blue Cedar – which will enhance your access to healthcare when you need it most.

A tale of two men

One of these men is not like the other.

Story: Dr. Richard T. Bosshardt

They live in Everytown, U.S.A. You almost certainly know one of them, most likely both. Either could be your father, brother, best friend, boss, rabbi, or priest. They could be your doctor. They could be you. We’ll call them Clew and Les.

Clew and Les are both 60 years old. They’re boomers, the generation that grew up in the shadow of World War II and Korea. They have lived through the greatest advances of medical science in the history

of mankind. Both are college educated and have had successful careers. The resemblance ends there.

Clew has a body mass index (BMI) of 23. Not quite a beanpole, but close. BMI is a function of height and weight. It is used as an estimate of health risk; 19 to 25 is ideal. Over 25 is overweight. Over 30 is obese. Les’ BMI is 34. He has the usual adult male “beer belly.” Just for fun, let’s compare Clew and Les in several areas of their respective lives.

FAMILY HISTORY

Strokes and heart disease run in Clew’s family. Clew’s father died of a heart attack, as did his father and his grandfather. Les’ father was obese and suffered from arthritis and diabetes. He died of complications of the latter.

HABITS

Neither of them has ever smoked. Clew drinks moderately, rarely more than a single beer, glass of wine, or mixed drink in a single evening. Les is what most would call a heavy social drinker, although he hardly ever gets drunk. He enjoys a couple of highballs most nights. When he drinks beer, he will have several at a time.

EXERCISE

Clew exercises four to five days per week. His workouts last 30 to 60 minutes; half are moderate—he can hold a conversation while doing it. Half are intense—he can’t complete a sentence between gasps. Les plays softball once a week and golfs twice a week. He rides the course in a golf cart. After both, he heads out to a local bar for some beers with the guys.

MEDICAL

Clew is not on any prescription medications. His blood pressure is normal. Cholesterol is high-normal but not high enough to be treated. His triglycerides are very low—a very good thing. His HDL/LDL ratio is good but not great. This is a measure of risk of heart disease. Clew dislikes seeing doctors and hates taking pills. Les is on five prescription meds. Two are for his high blood pressure, one for his rapid heartbeat, one is a statin for his cholesterol, and one is because he is “pre-diabetic.” As long as he is on these, his blood pressure is normal, cholesterol levels are good, his heartbeat is controlled, and his blood sugar is normal. Les believes in better living through pharmaceuticals and modern medicine.

DIET

Knowing his family history, Clew eats a plant-based diet 95 percent of the time. Breakfast is whole grain cereal with fruit, juice, and a cup of coffee with cream, no sugar. Les skips breakfast most days and grabs a big gulp coffee on the way to work, the first of several cups each day. Both men eat lunch on the go. Clew sticks with fruit smoothies with no added sugar, containing assorted fruit, yogurt, almond milk, and a large spoonful of flax, chia, or other seeds. Les grabs a deli sub or heats up a prepackaged meal in the microwave. Clew’s idea of a great dinner is a big salad or roasted vegetables over quinoa, brown rice, or couscous that he prepares at home. Les likes to eat out and a favorite meal is a large steak, pink in the middle, with potatoes swimming in gravy, and a salad with creamy ranch dressing. Clew doesn’t snack. Les does, mostly pretzels, chips, or Cheese-Its. Dessert for Clew is a square of dark chocolate. Les loves cookies.

There you have it. Clew and Les, both living an arguably pretty good life. Both are pretty happy. Neither feels deprived. Clew thinks Les is on a fast track to disaster. Les thinks Clew is too uptight and missing out on the good things of life. Who is right?

Here’s the thing. As a doctor, I know that both Clew and Les are going to experience physical decline as they get older. Both will eventually die. These circumstances are inevitable. I think the late George Sheehan, runner, philosopher, author, and cardiologist, said it best. He was at a post-run party reflecting, as he often did, on why he and all these people around him ran. He knew that regardless of how fit and healthy they were, none would outrun death.

“It is beyond our control,” he said. “What is possible, however, is what is technically called ‘compression of morbidity.’ This means limiting the disability and

SOCIAL

Both are good family men, happily married for many years, and with several children and grandchildren who they dearly love and who love them back. Clew is more introverted. He has a few good friends of many years. He eschews large gatherings. Les is “Mr. Social.” He is funny, smart, and witty, and people gravitate to him. His circle of friends is huge and expanding steadily.

dependence of our final years to a minimum.” George went on to say, “I dread to join the thousands who, as Graham (Wilfred Graham, a professor of religion at Michigan State University) points out, ‘languish in homes for the aged, their minds and spirits exhausted, but their bodies helpless to die.’”

Medical science has advanced to the point where we can keep people alive long after any meaningful quality of life is gone. George died in 1993, at the age of 74, after a seven-year battle with prostate cancer. He remained active and still was running races until a year before he died.

I am not a betting man, but if I were, I would bet the farm that Clew will have a better quality of life in his final years, however long they may be, than Les, even if he dies sooner. The question is, who would you rather be? Clew or Les. The choice is yours.

ABOUT THE WRITER → Dr. Richard T. Bosshardt graduated in 1978 from the University of Miami School of Medicine. In 1989, he founded Bosshardt & Marzek Plastic Surgery Associates, Lake County’s first practice to provide full-time cosmetic and reconstructive plastic surgery services.

Your most visible organ

Diet, supplements can improve skin health

Story: Hannah Braye

Skin is considered the largest organ in the body, accounting for around one-sixth of total body weight. It is the only organ with continual visual access—we can see it all the time—and its appearance can give useful insights into other aspects of health. Research indicates that diet and the health of the gut microbiome (the composition of bacteria in the gut) is particularly important for skin health, with many skin conditions giving particular clues to internal digestive health.

Atopic dermatitis (AD) is the most common skin condition in infants, affecting 15 percent to 30 percent of children. It is caused by disregulation

of the immune system, causing increased reaction to irritants and allergens. Skin becomes inflamed, often leading to crusty scales or blisters. The lining of the gut houses approximately 70 percent of the body’s immune cells, and is lined and influenced by diverse bacteria that play an important role in the development of the immune system. Studies suggest supplementation with a multi-strain probiotic is beneficial in helping to regulate the immune system and has been shown to significantly reduce AD symptoms in infants and young children within just eight weeks.

Acne, the bane of many a teenager, affects an estimated 85 percent of

adolescents. It can also stubbornly persist into adulthood. It causes oily skin and unsightly, sometimes painful blemishes on the face and body.

Gastrointestinal symptoms such as bloating, reflux, and constipation, are more common in acne sufferers, and studies indicate they may have marked differences in the composition of their gut bacteria. Probiotic supplements are showing promise in the management of acne due to their ability to reduce inflammation in the skin.

One potential contributing factor to AD, acne, and many other skin conditions is intestinal permeability, also known as “leaky gut.” Leaky gut occurs when the lining of the digestive

tract becomes damaged, usually by pathogens such as yeast overgrowth, low beneficial bacteria levels, antibiotics, or unhealthy diet and lifestyle practices. This leads to inflammation that can be reflected in the skin. Certain strains of beneficial bacteria have been shown to help support the lining of the gut, reducing leaky gut, thereby improving skin symptoms.

Research also indicates that gut bacteria are important as we age in the battle against wrinkles. Probiotic supplements taken orally are showing promise for delaying skin-aging due to their ability to help increase skin hydration, protect against UV damage, and produce nutrients needed for collagen formation. One study found that after 12 weeks of supplementation, there was a significant reduction in wrinkle depth, improved skin gloss, and skin elasticity increased by 13 percent.

When it comes to food, many people report substantial improvements in skin symptoms when certain aggravating ingredients are removed from the diet. Acne has been associated with milk consumption,

and it’s thought that hormones found in milk potentially could influence sebum and hormone production. Low glycemic index diets also have shown improvements in symptoms, and acne remains rare in non-Westernized societies that eat diets low in sugar, refined carbohydrates, and processed foods. Sensitivities and intolerances to certain foods also are identified by many as a contributing factor to AD, and elimination of specific foods may improve symptoms in some people. Common culprits include cow’s milk, eggs, gluten, and solanaceous vegetables such as tomatoes.

A variety of nutrients are important for skin health and many work together synergistically, so it’s important to

eat a varied whole-food diet, rich in colorful fruit and vegetables, and healthy sources of fat and protein. Nutrients of particular importance to skin health include anti-inflammatory omega 3 fatty acids (found in oily fish), zinc, vitamin A, and vitamin E. Eating lots of cruciferous vegetables such as broccoli, cauliflower, kale, and Brussels sprouts also may help increase levels of the antioxidant glutathione, which may help combat the signs of aging.

Traditionally fermented foods such as sauerkraut, kimchi, live yogurt, and kefir are a great way to support both gut and skin health as they provide live beneficial bacteria and have been shown to have positive effects in skin conditions. For additional support, taking a probiotic supplement, such as Bio-Kult Advanced Multi-Strain Formula, containing 14 different bacterial strains, can help.

Skin cells are continuously being rubbed off, renewed, and completely replaced around every 40 days. So when changing eating habits and supplements, it may take at least this amount of time before the benefits are reflected in the skin.

ABOUT THE WRITER → Hannah Braye is a qualified nutritional therapist and a technical advisor at Protexin, manufacturer of Bio-Kult, an awardwinning innovative research-based probiotic product. She studied at the College of Naturopathic Medicine in Bristol, England, and is a member of the British Association of Applied Nutrition and Nutritional Therapy.

Atopic dermatitis (AD) is the most common skin condition in infants, affecting 15 percent to 30 percent of children. It is caused by disregulation of the immune system, causing increased reaction to irritants and allergens.

ABOUT OUR PRACTICE:

The focus of our practice is to provide the very best surgical care available to patients. We are committed to achieving this goal through continuing education and training in most current robotic and laparoscopic techniques. It is our belief that all patients deserve the best medical care available. We provide the most advanced, compassionate surgical care that has helped thousands live longer, healthier, happier lives.

For more information:

OUR STAFF: FROM LEFT TO RIGHT

JASON BOARDMAN M.D., F.A.C.S.

CHRISTOPHER JOHNSON D.O.,F.A.C.O.S., F.A.C.S.

JOSEPH M. ARMOTRADING II M.D., F.A.C.S

LUISANGEL A. RONDON, M.D.,FACS

COURTNEY E. COLLARD PA-C

AMY E. DIEHL PA-C

BENJAMIN V. CHU PA-C

JORGE FLORIN M.D., F.A.C.S.

Serving Lake, Sumter, and Orange Counties since 1991

Anxiety and children

Know the of disorder in child or teen

Know the signs of anxiety disorder in your child or teen

• Recognize and praise your child’s small accomplishments and help build a strong support network.

• child’s small and help build a strong network.

ing a positive support network helps, too.

• Don’t punish mistakes or lack of progress.

• A normal routine but flexible routine is necessary. Modify expectations during any high-stress periods.

• is a normal of adolescence; however, teens nosed with an disorder more sympchild or teen

• Anxiety is a normal part of adolescence; however, teens diagnosed with an anxiety disorder experience more ongoing symptoms. Effective and consistent parenting helps your child or teen feel less anxious. Build-

• Building a teen’s self-esteem is always important, but for children with anxiety, building interpersonal strength is necessary If your child shows conencourage involvement and praise frequently.

• Be consistent but flexible when needed to help your child be more comfortable with change. Have transparent conversations allowing discussion and feedback so the teen feels empowered.

Source: Bethany Kassar, licensed clinical social worker and executive director of outpatient services at Summit Behavioral Health. Used with permission.

Source: Kassar, licensed clinical social worker and executive director of services at Summit Behavioral Health. Used with

Fighting the summertime blues

Summer doesn’t sizzle with excitement for everybody.

Story: James Combs

For many people, summertime means fun in the sun. It’s a time to break out the pool floats and cool boats and enjoy sandy beaches and outdoor barbecues. Everyone seems happy and chipper.

Well, not quite everybody. For some, the scorching Florida summer sun and the draining humidity are big downers. These people rarely venture outside and spend most of their time in isolation.

This condition has a name: summeronset seasonal affective disorder.

It’s a mood disorder that easily can trigger depression, according to Dr. Chrisann Reid, a licensed psychotherapist with Lake Countybased Central Florida Counseling and Psychological Services.

“Many people associate seasonal affective disorder with winter, but some people actually experience it in the summer,” she says. “In the winter, these people feel happy, invigorated, and energized. In the summer, they feel manic and lethargic.”

Healthy Living recently sat down with Dr. Reid to learn more about this condition, which is diagnosed four times more often in women than men, according to the National Institute of Mental Health.

HL: The summer months are supposed to be about fun in the sun. That’s not true for everybody. Some might be agitated by disrupted summertime schedules, have body image issues, or worry about finances because of vacation. What is the main reason why people develop the summertime blues?

CR: With the clients I serve, it’s mostly because of the heat and humidity. Of course, you have to remember that the majority of clients I see are the older population. That said, heat and humidity can affect people of all ages because the bodies of some people simply do not cool well in the heat. They may be active and athletic, but in the summertime, they cannot handle the temperature and thus tend to limit their exercise and stay inside more. The minute you start doing that, you no longer feel very well. Not only are they no longer exercising, they are limiting their social connectedness because they are inside. And to make matters worse, the sun is out in the summertime from about 7am to 8pm. Therefore, the days seem longer, which can intensify sadness and depression.

HL: What if these people already suffer from sadness, anxiety, or depression?

CR: If they have a predisposition toward depression, then the more you isolate, the more likely you are to increase those depression symptoms. It can become a vicious cycle.

HL: What are the symptoms of the summertime blues?

CR: Sadness, hopelessness, guilt, change in sleeping habits, and weight gain. They also experience diminished interest or pleasure in all or most activities. You have to understand that they’ve changed their behavioral patterns and exercise patterns when they’re confined indoors. Exercise helps release endorphins, which naturally lift your mood. When you’ve suddenly cut that out, it can throw your body into a mild depressive state.

HL: When you look at Facebook during summertime, you see that everybody posts pictures of themselves at the beach, out on a boat, and so on. Should people experiencing summertime blues limit time spent on social media?

CR: I would recommend stopping any activity that increases your depression.

HL: For people who experience the summertime blues, is it intensified by knowing or thinking everyone else is having a great time?

CR: It could be. When you’re sitting in an airconditioned room when it’s sunny and you see people outside, you begin asking, ‘What’s wrong with me? It looks beautiful outside. I should be out there.’ But in actuality, they are staying inside, gaining weight, and becoming sluggish. They begin

beating themselves up a little bit. They need to remember that there are many people who do not exercise outdoors as much during summer. They’re not alone, and everybody feels a little better about themselves when they realize they are not alone.

HL: What can people do to overcome the summertime blues?

CR: Join a gym. Some gyms offer a three-month special, so you can join a gym just to get past the summer months. This allows them to be active again and release those endorphins. It also creates social connections because you’re out among other people. You can also go bowling, invite a friend to a movie, or meet someone for lunch. Don’t isolate yourself socially just because it’s hot outside. I also tell clients to visit their family members up north during the summertime. They may find themselves doing more outdoor activities up north because it gets cooler at night. Then they realize it’s the Florida heat that is slowing them down rather than old age.

HL: For those who stay in Florida, do you recommend going outside at all?

CR: Sure. If they want to try golfing, then go at about 6pm. You still have two hours of daylight left. Or you could go for a short walk during that same time because the heat isn’t as intense as it is earlier in the day.

→ CHRISANN REID is a licensed psychotherapist and clinical social worker with more than 20 years of experience in her field. She deals with a variety of issues, including depression, anxiety, trauma, grief, and life transitions. She earned two bachelor’s degrees in psychology and social work at James Madison University and later completed her master’s degree in social work at Florida International University.

Sometimes ART is vital to healing

Dealing with post-traumatic stress? Try accelerated resolution therapy.

Story: Kelly Breeding

Recent hurricanes and floods have created high levels of anxiety that have affected thousands in the state of Florida. Similar to experiences of returning war veterans, events of this magnitude, where livelihoods, homes, pets, and loved ones were lost, can leave enduring traumatic memories and cause ongoing symptoms, called post-traumatic stress, or PTS.

PTS is a serious issue that prevents thousands of people from completing their normal life activities because the traumatic memories keep repeating like a loop in their mind. It is a debilitating health issue that creates feelings of isolation, anger, depression, anxiety, and confusion.

Individuals living with PTS need to know that there is hope. For many, accelerated resolution therapy, or ART, founded by Laney Rosenzweig, a licensed mental health counselor, may be the answer.

This proven therapy offers patients an evidence-based treatment psychotherapy that has produced dramatic improvements in patients who are experiencing symptoms of trauma. The therapy, which continues to gain popularity nationwide, incorporates a combination of techniques from other evidence-based psychotherapies to reprogram how distressing memories and images are stored in an individual’s brain so these haunting memories no longer trigger strong physical and emotional reactions.

The treatment program incorporates specific visualization techniques enhanced through the use of relaxing eye

movements, similar to the rapid eye movement stage of sleep, and voluntary memory and image replacement. This treatment works in as few as one to five sessions with the average being four.

I became involved with ART International Training and Research through Chris T. Sullivan, co-founder of Outback Steakhouse and OSI Restaurant Partners. Through his philanthropic giving, he funded one of the first studies on ART through the University of South Florida and firmly believes that this therapy can and will save countless lives.

My background in social work and history in working with victims of trauma has been instrumental in my position as the executive director. At ART International, our mission is to provide education and training to mental health professionals nationwide and beyond in accelerated resolution therapy so this successful therapy is widely available to individuals suffering from mental health issues. Currently, there are more than 200 ART-trained therapists in Florida.

As we look to expand this treatment nationwide and increase the number of trained clinicians, I urge those who are suffering to visit artherapyinternational.org to see if ART is right for you. PTS has serious symptoms that can be treated effectively with the right care. Whether it’s through ART or another preferred treatment, there are options available to help you successfully overcome the trauma you have experienced.

ABOUT THE WRITER → Kelly Breeding is a licensed clinical social worker and executive director of ART International Training and Research, based in Tampa.

JOURNEY OF A LIFETIME

Over forty years ago, Dr. Saroj Tampira followed his heart and embarked upon a career journey that finally led him to the Village Heart and Vein Center. His arrival completed the vision of the Center founder Dr. Georg Couturier to provide total care for patients with heart and/or vascular diseases. Dr.Tampira’s journey literally began with a medical degree earned at Madihol University—the number one university in Thailand. Internship and residency at the University

of Louisville Hospital followed. In 1978 he completed a Fellowship with Tulane University in New Orleans. His specialty is interventional cardiology—clearing and repairing blocked veins and arteries—and he is one of a very select group of talented cardiologists skilled enough to pursue blockages below the knee in individuals who need help.Today, many patients and procedures later, all of us in Central Florida are fortunate indeed that his heart and his journey brought him here.

A Lazy Day

The trees bend down along the stream, Where anchored swings my tiny boat. The day is one to drowse and dream And list the thrush’s throttling note. When music from his bosom bleeds Among the river’s rustling reeds.

No ripple stirs the placid pool, When my adventurous line is cast, A truce to sport, while clear and cool, The mirrored clouds slide softly past. The sky gives back a blue divine, And all the world’s wide wealth is mine.

A pickerel leaps, a bow of light, The minnows shine from side to side. The first faint breeze comes up the tide— I pause with half uplifted oar, While night drifts down to claim the shore.

—Paul Laurence Dunbar (1872-1906)

BODY

Now let’s consider a bit about keeping our physical selves well. I begin with one quick and dramatic comment: the primary objective of exercise is not to get injured!

I began preparing physically for hiking more than a year in advance even though I was “in shape” but not “conditioned.” We can maintain our weight and be active but not realize the peak of physical performance, which we attain by doing exercises to help us with mobility, stability, balance, strength, and endurance, in that order. When considering exercise, especially if it has been years since any real, sustained, vigorous activity, the phrase to follow is: slow as she goes. The goal is to avoid injury that stops your exercise regimen. So, the trick is to learn enough about your physical structure and capabilities that you can continue your regimen by working around an injury. Never stop the habit of exercising. It is all about:

SIMPLICITY. Exercising need not be complex. Determine to really exercise five times per week with a variety of low-impact conditioning routines like supervised high-intensity interval training, or HITT, swimming, spinning, and yoga, for example.

SUITABILITY. Age appropriateness is very important. CrossFit is da bomb! But an older person or someone new to exercise does not have to do the CrossFit we see advertised. Take a step down to routines that focus on light weights and high repetitions usually with body weight only. I have been doing this for about 18 months now and have never had the same workout twice. There must be variety in good conditioning.

SUSTAINABILITY. Exercise is for the long haul. Exercise hard and determine to do it for a lifetime.

Know that there is a difference between physical activity and exercise. One can’t be conditioned by gardening three times a week. You know if you are exercising if you cannot carry on a conversation during the exertion. Big difference. I am living the observation that the best years of your life will be after you are 60. But you must be vigorous and capable to be ready for the blessings of being a senior.

MIND

Now consider the second part of the holistic lifestyle: mind. Read voraciously. Always carry a book with you; one can read shelves of books in stolen moments, like waiting for an appointment. Find someone you admire and study how they conducted a life worth living and do some of the things they did. Time management is one thing; another is never being idle.

Relaxing and recreating is OK if time is also spent improving the self and those around us.

Nearly every day, it seems, accomplished people include mindfulness in their personal study and growth. Yes, the titans of industry meditate; so do many of our neighbors. This is merely a few minutes of quiet time where one practices being in the moment. This quiet time is scientifically proved to improve health and perspective. And I can make the case that this state of just being present can easily be achieved by practicing the art of the walk.

The art of walking is when the footfalls are in cadence with a set of hiking poles to involve the upper body in hiking, which together are matched with rhythmic breathing and relaxing. Yes, you can relax when you are walking. With practice I am now able to feel the pull of gravity on my face. Guess what is happening—these are the elements of meditation. It is tough to fret about yesterday and how it could have been—it’s done. And one can’t really worry about tomorrow because so much is unpredictable. Furthermore, you are simply away from worries in another marvelous world. Being in the moment in nature is what matters. Here’s proof:

I was explaining the art of the walk to a woman who belongs to a walking club. She remarked, “Yeah! Often I realize I have just walked five miles and I don’t know where it went.” She was in a meditative state. Who knows what her mind was free to think about and imagine during those miles where time stood still. That is meditation. Furthermore, she had begun so out of shape that, “I could only last 3½ minutes on a treadmill.” She was not deterred. She kept at it. Now she does 30- to 50-mile days with the club—and she just turned 70. There is something to this nature business. Lastly, let’s consider minding our spirit.

SPIRIT

I turn to the ancients again. They defined happiness as freedom from big worries and persistent big pain. What great insight and truth. With that in mind, just about anyone can be or already is happy. Furthermore, we have nearly daily examples of people with truly big troubles and pain. They struggle mightily, yes, but return to living vital and accomplished lives while being examples to untold numbers of us. Remarkably so, there are people who are missing limbs and even one blind man and his dog who have hiked the entire Appalachian Trail. Happiness is real and attainable. So, as I say in “The Honest Backpacker”: find your way—take a hike.

ABOUT THE WRITERS → James Klopovic and Nicole Klopovic are a father and daughter who enjoy hiking in various places around the world.

Before speaking of raising our children, we need to define our terms. Children, specifically, share a universal language, the language of children. Children understand each other after mere minutes together, no matter their

differences. I believe that this merits our attention: anyone addressing children in the world is addressing the children of the world.

What are the sources that form children’s awareness: school, home, and family and friends? Out of the

24 hours that make up the day, there are still three or four hours left. What happens in these hours? This is the focus of this article.

Anywhere in the world, children spend their free time in front of a television, computer, tablet, or

smartphone, depending on the family’s financial resources. Mostly they watch animation. What is the content of these works? The subject matter of most of these works worldwide, in whatever language, revolve around the following: A bad guy oppresses a good guy. The bad guy wins at first, then the good guy defeats the bad guy in the end. This plot is repeated endlessly in all children’s fare throughout the globe.

Most of these plots do the following to our children’s minds:

• Reinforce the concept of Self/Us versus Other/Them.

• Reinforce the concept that violence is the rule and not the exception.

• Reinforce the concept of eternal competition: Us or Them, with no compromise.

• Reinforce the concept that a victory for the Self/Us is the only way to win in life.

• Reinforce the concept that We must win, while the Other must lose.

• Reinforce the concept of tribalism, in its unhealthiest sense.

This can be found in most films and games mass-produced worldwide. You don’t need to speak any foreign languages to make sense of what goes on in these works: the overwhelming majority revolve around similar concepts. Doubtless, there are others working towards creating healthy content for

children; however, they are a negligible minority facing fierce competition.

“What’s wrong with that?” you may say. Well, what is wrong with that is that we are addressing children, who by nature and due to their young age, have no ego, and we are filling them with not only individual and collective ego, but with a competitive, exterminatory instinct. The meanings of these works are confined to Other versus Us. Those who attack us are Other; those who protect us are Us. But there is no mention of divine intervention. Deus ex machina is a tired plot twist, no matter the religion of the societies that show these films.

What happens as a result? I believe the universal model is geared towards saturating the consciousness of the world’s children with the individual and collective ego, preparing them for boxing God into specific times and places. This occurs automatically under self-centeredness, presented as the only natural way of life.

The question is: If you agree with this diagnosis, what are you going to do? Our children—the world’s children—are being raised from birth before our very eyes, with our full consent at that, on a steady diet engineered to build an individual and collective ego. With our full consent, or our full ignorance, they are encouraged to view the Almighty as having no role in what happens in our lives, or at best a marginal and ineffectual one. Our children today are the youth of tomorrow: they are the future.

ABOUT THE WRITER → Waeil Borhan has studied architecture and, as an entrepreneur, he has built business ventures in real estate development and farming. His book, “I,” is available from Next Century Publishing.

DAVE SAYS

Advice for old debts and pre planning funerals.

QUIT JOB FOR SCHOOL?

Dear Dave,

My wife and I have $72,000 in debt from student loans and a car loan. We’re trying to pay off our debt using the debt snowball system, and we each make about $45,000 a year. She’s a teacher and she’s planning on going back to school for her master’s degree, but she’s thinking about quitting her job to do this. She’ll be able to make more money with the additional education, and she would only be unemployed for two years. The degree program will cost us $2,000 out of pocket per semester for two years. Does this sound like a good idea?

—Chris

Dear Chris, There’s no reason for your wife to quit her job to make this happen. Lots of people— especially teachers—hold down their jobs and go back to school to further their education. I’m not sure trying to make it on one income when you’re that deep in debt is a good idea.

Whatever you do, don’t borrow more money to make this happen. Cash flow it, or don’t do it. We’re talking about $8,000 total, and you’ve got $72,000 in debt hanging over your heads already. My advice would be to wait until you’ve got the other debt

knocked out, then save up and pay cash for school. You could slow down your debt snowball, and use some of that to pay for school, but I’d hate to see you lose the momentum you have when it comes to getting out of debt.

The choice is yours, but don’t tack on any more student loan debt. I know her income will go up with a master’s degree, so from that standpoint it’s a good thing to do. But if you do a good thing a dumb way, it ends up being dumb!

—Dave

PREPLANNING EXPLAINED

Dear Dave,

My grandmother passed away a week ago. She was 98, and I know both she and my grandfather had prepaid for their funerals in 2004. However, there were outstanding costs of $1,500 with the funeral services that we had to pay out of pocket, because she had outlived the insurance policy attached to the prepayment plan. I know you say it’s always better to preplan, not prepay, for a funeral. Can you refresh my understanding of this?

—Rebecca

Dear Rebecca, Let’s use a round figure—$10,000. What would that grow to 25 years from now if invested in a good mutual fund? Now, juxtapose that number with the increase in the cost of a funeral over that time. The average inflation rate of consumer-purchased items is around 4 percent. On average, funeral costs have risen about 4 percent a year. By comparison, invested money would grow at 10 or 12 percent in a good mutual fund.

Now understand, I’m not knocking the funeral business. But lots of businesses that provide these services realize more margin in selling prepaid policies than in caskets.

Do you understand my reasoning? If we knew the exact date she prepaid, and how much she prepaid, that figure invested in a good mutual fund would be a lot more than the cost of a reasonable funeral. It’s the same principle I advise folks to not prepay college, or just about anything else, that’s far into the future. The money you could’ve made on the investment is a lot more than the value of prepaying. Preplanning, on the other hand, is a great idea for many things— including funerals.

I’m truly sorry for your loss, Rebecca. God bless you all.

—Dave

ABOUT THE WRITER → Dave Ramsey is CEO of Ramsey Solutions. He has authored seven best-selling books, including “The Total Money Makeover.” “The Dave Ramsey Show” is heard by more than 13 million listeners each week on 585 radio stations and multiple digital platforms. Follow Dave on the web at daveramsey.com and on Twitter at @DaveRamsey.

In 2008, the cost of the average employer-sponsored family plan was $12,680, with an employee share of $3,354. The 2016 cost topped out at $18,142, with a $5,277 employee cost. In the individual market, the biggest losers are those who earn a little too much to qualify for federal premium subsidies, particularly the self-employed in their 50s and 60s. For a bronze-level plan with a health savings account, a three-person family can pay $15,000 a year in premiums and paid out-of-pocket for the first $6,550 of medical expenses for each family member.

Moreover, many insurers have requested—and will likely receive— double-digit premium increases for 2018. Nationally, the increases between 2017 and 2018 for unsubsidized premiums for the lowest-cost bronze plan averaged 17 percent, the lowest-cost silver plan averaged 32 percent, and the lowest-cost gold plan averaged18 percent.

“We’ll start by increasing competition in the insurance industry”: That was a colossal failure. Overall, the number of insurers in the individual market has decreased since 2014. In 2017, UnitedHealth Group eliminated ACA Exchange plans in 31 of 34 states, and Aetna remains in only four states.

Humana and Aetna plan to exit all ACA Exchanges in 2018.

Agreed, some Americans gained health coverage. Medicaid and the Children’s Health Insurance Program (CHIP) accounted for 14.5 million of the 20 million of newly covered. The 2014 cost per non-disabled adult and child enrollee was $3,955 and $2,602, respectively. Some 27.5 million people remain uninsured, with cost cited as the main problem.

Further, being “covered” was meant to keep emergency departments from being used as an alternative to primary care. But according to the federal Agency for Healthcare Research and Quality, the number of emergency department visits covered by Medicaid increased by 66.4 percent between 2006 and 2014, outpacing population growth by a factor of two, making Medicaid the leading payer for emergency department visits.

These data tell us we must have a serious conversation, not intellectually lazy political slogans, like “Repeal and Replace!” Instead of ruminating about how to modify the government’s involvement in medical care, Congress and policymakers should ask how can we take better care of more patients and be open to all suggestions.

One successful model is direct primary care, mainly seen in solo and small medical practices. Here, patients pay a monthly fee (generally ranging from $75 to $150) directly to the physician’s office for 24/7 access, and in many cases, basic labs and medications, and steep discounts on radiology and pathology services. Also growing are direct pay specialty and surgical practices where the fees for the operating room, surgeon, and anesthesiologist are included in one low price. And yes, many of these practices offer sliding scales and charity care without running afoul of rigid federal regulations.

With direct primary care, patients spend more quality time with their doctors and physicians, who can shed the administrative burdens of government programs and insurance companies and treat patients according to their best judgment. A testament to the success of this model is the University of Michigan offering such a program this spring. Hopefully, the big boys won’t ruin a good thing.

ObamaCare’s individual mandate is dead. It’s time to use our health-care dollars wisely and pay for the medical care, not the middlemen.

ABOUT THE WRITER → Dr. Marilyn M. Singleton is a board-certified anesthesiologist and Association of American Physicians and Surgeons board member. She graduated from Stanford and earned her medical degree at University of California at San Francisco Medical School, completed two years of surgery residency at UCSF, then her anesthesia residency at Harvard’s Beth Israel Hospital.

OPTIONS?

FACELIFT, TEMPORARY FILLERS, OR PERMANENT FACIAL FILLERS

Kathy had a Laser ImageLift. Results are typical and do vary.

Things I’ll never understand

Some things leave me shrugging my shoulders in disbelief.

Story: James Combs

Illustrations: Josh Clark

There are some things in life that simply do not make sense and leave me shrugging my shoulders. Here’s a quick list:

TAKING A BABY TO A CONCERT

ABSTRACT ART

I really cannot see the messages, emotions, or symbols being represented. To me, it looks like someone splashed several colors of paint onto a canvas.

First, there’s nothing more annoying than the sound of your favorite musician being drowned out by incessant whining. Second, I doubt the singer will want to autograph your child’s poop-filled diaper. Third, breastfeeding your baby in a mosh pit probably isn’t a great idea. Fourth, when other children receive bikes for their fifth birthday, yours will be getting hearing aids.

PEOPLE WHO DON’T FLUSH TOILETS IN PUBLIC RESTROOMS.

It’s absolutely sickening to walk into a public restroom and see someone has left you a little “present.” How hard is it to push the little lever? If it’s brown, please flush it down.

VEGETARIANISM

Sorry, but for me, no meal is complete without some form of dead animal on my plate. Is being a vegetarian a mistake or a missed steak?

DREAMS

MOTORISTS WHO DRIVE 15 MPH OR MORE UNDER THE SPEED LIMIT.

I understand that we all want to be cautious while driving. That said, if you’re driving 35 mph in a 55 mph zone, you are impeding traffic flow. And why on God’s green earth do you insist on STAYING in the fast lane?

WOMEN WHO CLAIM THEY DON’T UNDERSTAND MEN. We’re actually very simple. Just remember the basics: recliner, beer, and sports.

There’s no limit to what my mind can conceive while I’m asleep. I’ve been late to important appointments, ran in slow motion while being chased by scary people and monsters, and stood in public places completely naked. Sleep isn’t always what it’s cracked up to be.

PASTORS WHO HANDLE RATTLESNAKES DURING CHURCH SERVICES

Some people call it a test of faith. I call it a hiss of death.

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