February 2013 Health and Wellness

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January 2013 1

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January 2013

Women need to address heart disease risks how many women take care of The busy executive, the everyone in their lives: their husmultitasking wife and mother, bands, their kids, their moththe devoted sister and friend. ers, their fathers, their friends.

Chances are you or someBut they hardly ever stop to one you love fit one of these take care of themselves,” said descriptions—or maybe even Dr. Tobin. “The sad fact is that all of them. As women’s roles women are dying of heart dishave evolved to encompass ease at the rate of one per minever-increasing family, profesute, and most of us don’t even sional, and civic responsibilirealize we’re at risk.” ties, many women have taken Tobin says there are two on more than their health can Dr. Tobin important steps that a woman handle.

“A staggering one in three American can take to improve her odds. The first women suffers from heart disease, yet is knowing her “numbers”—vital cardioonly one in five believes she is person- vascular indicators like weight, blood ally at risk,” said Leah Tobin, M.D., fam- pressure, and cholesterol level.

Total blood cholesterol level should ily physician and staff member at North be less than 200. Anything higher than Fulton Hospital.

Tobin says that this disconnect can that can increase your risk for heart leave many women unaware or unmo- disease, especially if it is 240 or above, tivated to learn about risk factors or to which is considered high blood cholesmake heart-healthy changes to their terol. Your blood pressure should be in the 120/80 range. You have high blood lives.

“As a family physician, I see firsthand pressure if it is 140/90 or higher. If you

need to lose weight, lose it slowly at a rate of about one-half to one pound per week.

“You and your doctor can come up with a plan of action to reduce your risks through lifestyle changes and, if necessary, medication, but first, we need to know those numbers,” said Dr. Tobin.

The second critical piece of information is that women’s heart attack symptoms are not like men’s heart attack symptoms. What most people consider as the “typical” warning signs of heart attack—chest tightness, arm pain and

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ADHD – not just in children anymore Adult ADHD is associated with multiple comorbidities such as anxiety, depression, bipolar disorder and other personality disorders. Adult ADHD is a valid psychiatric disorder of adulthood distinct from these other conditions.

Adult attention deficit disorder differs from the childhood variant because the hyperactivity in adults may be replaced by other symptoms such as anxiety, impulsivity and inattentiveness. In fact, prior to 2002 there were no diagnostic guidelines, but there have been great advances since. Some of the symptoms that characterize Adult ADHD are:

ADHD is a relatively common psychiatric disorder among adults. The prevalence is thought to be 3.5%-5.3%, which accounts for more than 11 million cases in the United States alone. With increased public awareness, adult ADHD became a topic of great interest so clinicians should be able to diagnose, treat, and manage patients with this disorder.

Etiology is still uncertain. Genetics however is believed to play a prominent role, followed in importance by acquired injuries to the brain.

ADHD was widely thought to be strictly a disorder of childhood. Now there are numerous scientific papers and clinical trials that acknowledge the existence of an adult version of this disorder, which can be traced back to the younger years.

Before this time ADHD in adults was known as Minimal Brain Damage or Dysfunction (MBD).

1. Often fails to give close attention to details or makes careless mistakes in school-work, work or other activities.

2. Often has difficulty sustaining attention in tasks or play activities.

3. Often does not seem to listen when spoke to directly.

4. Often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace (not due to oppositional behavior or failure to understand directions) 5. Often has difficulty organizing tasks and activities.

6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)Often loses things necessary for tasks and activities (eg.

School assignments, pencils, keys) 7. Is often easily distracted by extraneous stimuli.

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8. Is often forgetful in daily activities.

Some children with ADHD continue to have it as adults. And many adults who have the disorder don’t know it. They may feel that it is impossible to get organized, keep a job, or remember and keep appointments. Daily tasks such as getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the job can be especially challenging for adults with ADHD. These adults may have a history of failure at school, problems at work, failed relationships and traffic accidents. Like teens, adults with ADHD may seem restless and may try to complete several tasks as once, most of them unsuccessfully. They also tend to prefer “quick fixes,” rather than taking the steps needed to achieve greater rewards.

Treatment is very rewarding. The first medications to be approved by the FDA belonged to a non-stimulant group of medications: Atomoxetine. The FDA later approved stimulants such as methylphenidate and mixed amphetamine salts. Group delivered cognitive behavioral therapy is recommended in some cases as a supportive treatment.

If you or someone you know may have Adult ADHD, call Johns Creek Family Medicine at 770-771-6591 and schedule an appointment with Dr. Zack Charkawi.

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New Study Shows Testosterone Tx Helps Men Trim Waistline

By Dr. Averel Snyder Co-Founder of AgeWell Men’s Institute

I have been following with great interest studies that look at the long term effects of Testosterone Replacement Therapy. A new report has revealed that men who recently participated in a long term study of Testosterone Replacement Therapy lost an average of 36lbs and shed 3.5 inches from their waistline while on the program as reported at the ENDO 2012 annual meeting. Overall, 95% of the 255 men in the study lost weight during TRT for as long as 5 years, and 97% had reduction in waist circumference.

According to Farid Saad, PhD, “The interesting part is that these changes were unintended and also unexpected.

We think that this may be the result of a combined increase in vitality, improved lifestyle behavior, and increased energy expenditure, which is triggered by normalization of testosterone levels,” he added.

According to the study, more than half of the men (53%) lost at least 33 lbs., and almost a third lost 44 lbs. or more weight. Similarly, 86% of the men had a least a 2-inch reduction in waist circumference, and 46% dropped 6 inches or more. “This is an amazing response,” said Saad. “I don’t know many treatments where more than 90% of patients respond in a positive way to the treatment.”

The results of this study are in line with the kind of results we are seeing with our patients at AgeWell Men’s Institute.

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Dr. Snyder is a Board certified Cardiothoracic surgeon and Certified in Age Management Medicine. He Co-founded AgeWell Men’s Institute to help men better manage aging with bio-identical hormone replacement and diet.

See their ad for more information or visit their website at www.agewellmensinstitute. com.

January 2013 3

4 January 2013

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Make a Resolution to Get More Sleep

By Larry Lindberg RN, BSN, CPHQ Director Northside Hospital’s Sleep Disorders Centers

Sleep deprivation is becoming an increasing problem in the U.S. Today, about 20% of Americans report that they get less than 6 hours of sleep on average, and the number of Americans that report that they get 8 hours of more has decreased.

Lack of sleep is linked with poor work performance, driving accidents, relationship problems, and mood problems like anger and depression. A number of health problems, such as heart disease,

diabetes, and obesity, are linked as well.

There are several ways sleep deprivation can cause health problems: Obstructive Sleep Apnea is a common disorder occurring when the muscles at the back of the throat relax up to the point of obstructing the upper airway. You don’t receive enough oxygen, causing “mini-awakenings” (gasping for breath) several hundred times in a night. These awakenings can cause heart rate and blood pressure to rise, straining the heart and leading to permanent high blood pressure or, ultimately, heart disease.

Sleep imbalance can upset or confuse the release of hunger regulating hormones.

Research shows that when we don’t get enough sleep, our leptin (internal appetite-suppressing hormone) levels fall and ghrelin (internal hungerpromoting hormone) levels increase. Thus, when you’re feeling sleepy, you might feel like you need to head to the fridge, instead of bed. Even with exercise, our metabolism slows down if we don’t get

enough sleep. This can potentially lead to obesity and diabetes, two of the primary causes of heart disease.

Cortisol levels can rise due to lack of sleep, causing inflammation around your heart, raising blood pressure and disrupting sleep. Inflammation also can cause plaque in your arteries to break loose, lodging in vessels in the heart or brain and leading to a heart attack.

Tips for a Good Night’s Sleep The human body needs sleep to maintain a healthy balance. The Northside Hospital Sleep Disorders Centers offer these tips to help you get a good night’s sleep.

• Go to bed at the same time each night and wake up at the same time each morning, including weekends • Exercise regularly, but finish at least three hours before bedtime.

• Eat healthy, but finish eating at least 2-3 hours before bedtime.

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• Avoid caffeine, nicotine and alcohol close to bedtime • Replace sugar and caffeine with healthy snacks such as carrots or granola.

• Create a quiet, dark, comfortable sleep environment.

• Relax. Take a warm bath, drink a cup of warm milk, or read a book.

• Leave worries at the bedroom door. If you’re concerned about something, make a list of the steps you’ll take to solve the problem.

• Don’t nap during the day for more than 30 minutes or on a regular basis and never after 3 p.m.

• Don’t read, watch TV, or do work in bed for an extended time.

For more information about Northside Sleep Disorders Center---in Atlanta, Forsyth, and Cherokee---or about how you can get a better night’s sleep, visit www.northside. com/sleep.

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6 January 2013

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February is Children’s Dental Health Month

By Dr. Ushma Patel Center for Advanced Dentistry

In February, for over sixty years, dentists, parents, and children all across America observe National Children’s Dental Health Month. This all began as a one-day event in Cleveland, Ohio on February 3rd, 1941, and the first national observance of Children’s Dental Health Day was held on February 8th, 1949. It has since grown into a monthlong celebration. Our mes-

sage of the importance of oral health goes out to millions of children and adults in communities across the country, and includes such events as health fairs, dental office tours, and visits to the classroom by dentists and hygienists. Dr. Ushma Patel has volunteered at local schools giving educational programs to several children’s classes on how to take care of their teeth and talking to them about nutrition to keep them healthy.

One of the reasons for this special annual event is that many people are still unaware of the important role early dental care plays in our children’s overall health. We strongly recommend that parents take

action early to ensure the health of their children’s teeth because attitudes and habits established at an early age are critical in maintaining good oral health throughout life.

Children’s teeth are meant to last a lifetime, and a healthy smile is important to a child’s self-esteem. With proper care, a balanced diet and regular dental visits, their teeth can remain healthy and strong.

Please make sure that we see your child within six months of the eruption of the first tooth, and certainly no later than the child’s first birthday.

Preventive care such as cleanings and fluoride treatments provide your child with “smile insurance” for a lifetime!

If you wish for any further information on any aspect of your child’s dental and oral

Dr. Ushma Patel

health, please call us at 678894-7926 or visit us on the web at www.HiTechSmiles. com. We’d be happy to help in any way we can!

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One Week to a Happier Heart: Tips from Gwinnett Medical Center-Duluth One in three American adults is estimated to have at least one form of cardiovascular disease.

That’s a staggering statistic, but by adding these five tasks to your workweek to-do list, you can help your heart on its way to a lifetime of good health.

Monday: Starch Your Shirt, Not Your Diet

Eating starchy food regularly can lead to high blood glucose levels, which have a negative effect on your heart health. The American Heart Association (AHA) considers blood glucose levels of 126 mg/dL a warning sign for potential heart trouble.

“Consuming starchy foods and full-calorie soda is the equivalent of sucking on sugar packets,” says Manfred Sandler, M.D., medical director of cardiologist at Gwinnett Medical Center.

Try this: Replace your breakfast bagel with a banana.

Potassium plays a critical role in heart health, plus the fiber will

keep you fuller longer.

while whole milk is high in both fat and cholesterol.

Tuesday: Give Smoking a Pink Slip

If you’ve never smoked, or you quit more than 12 months ago, give yourself a pat on the back. “On average, it takes a person eight tries to quit smoking for more than a year,” Dr. Sandler says. “Simply stopping is one of the best things you can do for your heart.”

Try this: Identify your smoking triggers. Stress? Hunger?

Swap them for something healthier, like a brisk walk or a piece of fruit. Of course, quitting is a commitment, so seek social support—every day and attend a Smoking Cessation class at Gwinnett Medical Center. You can register online at gwinnettmedicalcenter.org/classes or call 678-312-5000.

Wednesday: Take a Hump-Day Hike

“Being skinny isn’t associated with survival, but not be-

Friday: Phone a Friend

ing overweight is,” Dr. Sandler says. The AHA recommends at least 2½ hours of moderate activity each week to maintain ideal heart health, and for most people, that means integrating activity into their daily routines.

Try this: Walk to work. Or, if that’s not an option, enjoy a brisk walk at lunchtime (get your heart beating strongly), and nix eating at your desk.

Thursday: Learn Your Numbers

High blood pressure and

So Big Deal, a Little Inflammation

By Leslie Gaskill, M.D.

Exactly,….. BIG DEAL! Inflammation is not something to take lightly. Let’s put it this way, if you came across a smoldering fire in your house, you wouldn’t just walk away...would you? I suspect that you would consider this an important matter to tend to, because you know that even a small smoldering fire could quickly become a big rip roaring fire that could burn your house down. Your though process might be something like, “don’t panic, just put the fire out; and put the fire out fast.!” You might even say “Whew, I am glad I caught that fire while it was small, and thank God that I just happened to walk in here and see this.” Yeh, it would be an emotional and financial disaster to lose your home. So what if we were talking about your life? All it takes is ONE fire to cause an event i.e heart attack and stroke.

There are many causes of inflammation that can ul-

Leslie S. Gaskill, M.D., LLC

timately cause your arteries to be fragile. The arteries can suddenly rupture as plaque pushes through the wall like a volcano. A clot is formed, blocking the flow and BOOM. You have a heart attack or stroke. What causes inflammation?

Great question.

Stress, bad diet, migraines, autoimmune diseases( like lupus and psoriasis), smok-

ing, cholesterol, insulin resistance, prediabetes, diabetes, PCOS, liver disease, sleep disorders, and, periodontal disease to just name a few.

Don’t get a false sense of security if you are a marathon runner, passed your stress test, calcium score, and even have a phenomenal cholesterol profile. Stay tuned to hear more from us and Plaque Busters in the national arena.

If you are serious about your life, and your life is a priority, we can help you before it is too late. We are very experienced in a prevention strategy that works! It is tailored to YOU, your body and your genetics!

www.drlesliegaskill.com and www.plaquebusters.net Leslie S. Gaskill, M.D., LLC 6290 Abbotts Bridge Road, Ste 201 Johns Creek, Georgia 30097 770-495-9995

cholesterol levels are two key components in heart disease.

Blood pressure of 140/90 and cholesterol levels greater than 240 mg/dL equate to a much greater risk for heart attack, according to the AHA. Try this: Say “no thanks” to extra salt and swap whole milk for skim. Salt has a known negative effect on blood pressure,

If you experience chronic stress, so does your heart.

“Acute stress is associated with events like heart attacks,” Dr. Sandler says. “But chronic stress is associated with high blood pressure and cholesterol, which can lead to a variety of heart problems.”

Try this: People who have a strong support system deal with stress much better. So, call a friend and plan an outing. It is Friday, after all.

In a food slump? One of the most important factors in a heart-healthy lifestyle is eating wholesome meals. So visit pinterest.org/gwinnettmedical for some heart-healthy meal ideas.

8 January 2013

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Perimeter North Family Medicine Perimeter North Family Medicine has been serving the Johns Creek area since 2004.

Prior to that, our office was located in Duluth. We are part of a large practice that has 4 offices in the Atlanta area, with another scheduled to open in the spring/summer of 2012.

Our hospital affiliations are with Northside Hospital and Emory Johns Creek Hospital.

We offer all of the services needed to keep you and your family in perfect health. We believe that it is important to have a family physician who knows you, your family, your history, and all of your current medications. Once you choose your personal primary care physician, you will be starting a relationship that will provide you with specialized care, whether it is a sore throat, or an emergency.

All of our physicians are board certified in Family Medicine, and adhere to the highest standards of medical care.

We treat both genders and all age groups, including children and geriatrics with or without Medicare. We have Doctors on call 24 hours a day to answer your after hours needs.

Our office is open on

weekdays from 7:30 until 5:00 pm, and two Saturdays each month. We don’t believe anyone should call and be sent directly a nurse’s voice mail, so we have friendly, knowledgeable patient care representatives on staff to direct your call and help you with your immediate needs. We know that our patients lead busy lives, so we do our part by calling you with a reminder when you are due for a follow up visit or your annual physical.

Our central scheduling office is open from 8 am to 5 pm for appointments. They will schedule or change appointments and call you a day or two in advance with a reminder. Central scheduling can be reached at 770-395-1130.

We offer: Complete Physicals, Annual Wellness Visits for Medicare patients, Immigration Physicals, Sports Physicals, Well Child Checks, Paps, Immunizations, Travel Immunizations, and Routine Sick Visits.

We are located at 4375 Johns Creek Parkway, Suite 320, Suwanee, Georgia 30024, 770-623-7576, www. pnfm.com

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Jump Start your Beach Body at Title Boxing Club Author Matt Smith Assistant Manager Title Boxing Club

Life is constantly changing from moment to moment. One day it is 30 degrees and rainy while the next is 70 degrees and sunny. It’s almost impossible to make plans that are long standing with the changes we face on a daily basis. But, we can always be certain that the summer will be inching closer and closer with each passing day.

Do you look forward to going to the beach and catching a few admiring glances from your peers? Or do you dread how you’ll look in last year’s bathing suit? Don’t be caught unpre-

pared and let summer creep up on you. Start working on that beach body today! All over the country, women have discovered a hidden gem in the world of fitness, Cardio Boxing. It has helped thousands of women shed pounds while relieving stress and having fun. Now, women of Atlanta have the opportunity to experience this previously hidden secret for themselves!

Title Boxing Club will not only help you to lose weight and tone up, but also kick unhealthy habits and improve your overall health. They offer boxing/kickboxing classes, appropriately branded the Power Hour. The

See BOXING, Page 9

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I got my botox at my dentist Do you suffer from Migranes or Tension Headaches? Have you been diagnosed with TMJ? Do you wear a NightGuard? Do you suffer from Bruxism?

Many people suffer from undiagnosed facial pain and seek help from many different avenues. Often times only the symptoms are treated and not the cause.

Botox® is widely known

Boxing:

Continued from Page 8 Power Hour is an intense 1-Hour Cardio fitness class developed to burn 1000 calories and provide a total body workout. Title Boxing Club has two locations that each

for its use as a cosmetic treatment for facial wrinkles. What many people don’t know, however, is how effective Botox® is for the wide range of painful, limiting and sometimes embarrassing facial and dental issues associated with severe or chronic muscle contraction.

Because Botox® Therapeutic is delivered right to the affected muscles, it is a targeted treatment, limited to the specific areas involved. This means that Botox® Therapeutic can often deliver more

offer over 30 classes per week Monday through Sunday. Your first class is free so be sure to jump start your Beach Body today. Don’t let the hustle and bustle of daily life allow you to postpone your fitness dreams. If a bikini body is what you want then Title Boxing Club is the perfect fit for you.

direct and effective relief than general muscle relaxants Consider all these ways that Botox® Therapeutic can help you feel better, look better, and heal sooner: • Migraine headaches • Tension-Type Headaches • Temporomandibular Joint Dysfunction • Myofascial Pain Syndrome • Bruxism (grinding) or Clenching • “Gummy” or “Off Center”

smiles So If you suffer or have been diagnosed with any of these conditions, and you are seeking relief, Please call our office @678-436-1300 and allow our staff to explain the procedures and check with your medical insurance for possible coverage.

10 January 2013

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Renew Your Health in 2013 Comfortable dental

care in Johns Creek

-Dr. Lisa Cattarulla

Can you believe it’s February already! Sadly, many of you that started off January 1st with the best of intentions have already fallen back into your old ways. Your resolutions for improved health and weight loss have either already gone out the window or have become increasingly more difficult to keep.

For many people it’s the same routine at the start of every year. They are sick and tired of being sick and tired and being overweight and out of shape. Why is it that you are totally committed to making changes and within only a few weeks or sometimes even days you are back to square one.

If you haven’t figured it out by now, willpower does not work! Also, not all diets are right for every person. The reason our patients get such phenomenal results is that we are able to customize a diet based on their own body

When you walk into Dr. Shackelford’s office in Johns Creek, you immediately feel at home. Their goal is to make their patients feel calm and comfortable while providing the highest standard of personalized dental care and establishing long-lasting relationships.

lisa tabick cattarulla

brian ouellette

chemistry. Success, whether it be losing weight, or improved health and well-being, becomes not only easy but sustainable when you have a plan specifically designed for you.

Register today for our Extreme Makeover 2013, held on February 23rd. Call (678) 688-9996 to find out more information or register on-line at ExtremeMakeoverAtlanta.com.

Dr. Shackelford always knew that he wanted to be a dentist. He grew up in Atlanta and went on to study Biology at Georgia State University, and then onto Emory University to receive the degree of Doctor of Dental Surgery (D.D.S.) in 1984. He has enjoyed practicing dentistry now for over 25 years.

He uses advanced technology to enhance the comfort of his patients. The Waterlase MD laser system is able to do many fillings pain-free and drill-free. “This has been one of the most well received tooth restoration procedures that we have ever introduced here at our practice” says Dr. Shackelford. Please feel free to call and schedule an appointment today at 770-442-8472 or visit their website at www.askaboutasmile.com.

Dr. Shackelford

Risks:

Continued from Page 2 shortness of breath—are more characteristic of what men experience.

When a woman has a heart attack, she may experience shortness of breath and chest tightness, but she may also have overwhelming fatigue, dizziness, vomiting and back or jaw pain. Because these latter symptoms are often blamed on stress or other issues that are not immediately life-threatening, women have a harder time recognizing these early warning signs. Women also wait longer before seeking medical care.

“We know so much about heart disease and its risks, and we know it can be prevented if we just take the time and action to address it,” said Dr. Tobin.

“Women really do have a lot of people depending on them, but we can’t be there for our loved ones if we succumb to heart disease. Talk to your doctor about what you can do to keep your heart strong—for your family, for yourself.”

For a free referral to Dr. Tobin or other physicians who can help you take the first step toward heart health, call 777-7512600.

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January 2013 11

Alternatives to Hysterectomy Dear Dr Picture this scenario. You are having issues with heavy bleeding at menstruation. You go to your gynecologist and are told you need a hysterectomy. This will require a major surgery, a prolonged recovery time and inability to get back to work and your daily life for quite a while. Is this the only solution? The answer is probably no. We now have many more alternatives to hysterectomy than ever before.

In the category of medical alternatives to hysterectomy there is the possibility of oral contraceptives and hormonal Depo-Provera infections.

These medications are traditionally used for contraception but are safe for women to use until menopause if no medical health issues exist. They can decrease monthly bleeding substantially and even be manipulated so that there are fewer menstrual cycles. Oral contraceptives can also decrease acne and perimenopausal side effects as well.

Another new alternative to

hysterectomy is the Mirena IUD. This devise recently received FDA approval for use in managing heavy menses. It can easily be placed in an office visit without anesthesia. After the first few months most patients will have either no menses or very light menses.

The device can be left in for 5 years and is very safe in all age groups.

If you prefer not to use a medication or are reluctant to use an IUD another alternative would be an endometrial ablation.

This is a procedure that in some cases can be done in an office setting or as an outpatient at the hospital. The lining of the uterine cavity is treated so there is either no menses or very light menses each month. The nice feature with this procedure is

Joan,

What is HPV? I

have heard that the HPV vaccine is recommended for teenagers. Is it true that both girls and boys are to receive this vaccine?

When are they supposed to be immunized against HPV? Why is the vaccine needed?

Wondering in Norcross

Dear Wondering in Norcross, that recovery time is very quick.

Most people are back to work within a 24-hour time period and the results last for years.

So the next time your doctor days you need a hysterectomy, be sure to discuss these options. While the need for hysterectomy still exists in some cases there are more alternatives than ever before.

Laura Tsakiris MD Chattahoochee Gynecology

HPV stands for Human Papilloma Virus.

It is the most common Sexually Transmitted Infection (STI) in the United States today. The HPV vaccine, as of 2 years ago, is recommended for both boys and girls. When HPV first came out, only girls were recommended to get it. Studies were initially based on females because it causes cervical cancer. Cervical cancer is one of the most common female cancers. After that, the studies

were then focused on males.

Boys are now getting this vaccine primarily for the prevention of genital warts. HPV is given as a set of 3 shots over 6 months. Generally, it is given between the ages of 11-12 years but it can be given as early as 9 years of age.

Sincerely, Dr. Joan