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Our focus on proactive wellness helps you manage your own healthcare.

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TABLE OF CONTENTS MAY/JUNE 2014

17

Cover Story: Dr. Jennifer L. Walden

Fitness: De-stress Through Golf

An Austin girl comes home

0IEVREFSYXXLIQIRXEPLIEPXLFIRI½XW of golf

Medical: A History of Women in Medicine

8

Business: Summer Real Estate

& 20 women who have helped shape our health & wellness

94

38 83

Buying a home in one of the hottest real estate markets

Dining: The Bonneville Austin MD speaks with co-owner and co-chef, Jennifer Costello

69

Books: The Journeys of The Horse Boy The story of how far two parents go to help their son

Mental Health: NAMI Austin

56

Changing the face of mental illness

Beauty: Med Spas How to choose the right one

29

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!!!"#$%&'()*+,-,.'(/"01+ For advertising and/or editorial information, please call Rachel Escobar (512) 963-5544 or email info@AustinMDmagazine com. Copyright Š by Green Iceberg Publications LLC. All rights reserved. Reproduction without the expressed written permission of the publisher is prohibited.

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ustin MD Magazine's First Annual Health and Wellness Fair was a huge success even with the crazy Austin weather. We had a couple hundred people come out and participate in the free fitness classes, free health screenings/exams and to support the magazine. We predict that next year's event will be twice as large.

Austin MD is so proud that this issue is highlighting some of the top women in medicine. I would like to dedicate our May/June issue to the top woman I know: my mother Maudie Strickland. You are truly an inspiration in everything you do!

This spring/early summer brings out the best of the Austin community. Fashion Week and the X-Games are just a few of the events that Austin MD Magazine will be covering over the next few months. The excitement for all these new endeavors will be an amazing way to show how Austin MD Magazine will creatively include these local events in every issue. As the magazine progresses the partnerships that are being forged will continue to grow as will the Austin MD family. We are proud of our contributors, clients and employees for making this year really successful. Our goal this summer will be to continue expanding our Austin MD family and the people who make us relevant. Please keep an eye out for how the magazine continues to grow and change with local and global pieces for our Austin readers!

Photo: Jessica Sikes Timeless Images

Angela Strickland

MEET OUR TEAM

ANGELA STRICKLAND CO-OWNER

AMAN BANDALI INVESTOR

RACHEL ESCOBAR ACCOUNT EXECUTIVE

KATHLEEN DELGRANDE EDITORIAL MANAGER

angela@austinmdmagazine.com

aman@austinmdmagazine.com

rachel@austinmdmagazine.com

kat@austinmdmagazine.com

STEVE DEMENT PHOTOGRAPHER

LESLIE HANCOCK ASSOCIATE EDITOR

CHRIS JACKSON EDITORIAL INTERN

GRACE SINGSTAD PR INTERN

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CONFIDENCE IS BEAUTIFUL.

Look your best. Feel your best. Live your best.

THE COSMETIC SURGERY CENTER OF SCOTT & WHITE IN ROUND ROCK

Meet our board certified plastic surgeons: Susan M. Pike, MD (left) and Staci J. Hix-Hernandez, MD

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1422: Costanza Calenda Calenda was the first university-trained female doctor. She attended the University of Naples in Italy.

1098-1178: Saint Hildegard Von Bingen This German nun followed the Greek teachings that the body was controlled by different humours. She believed that imbalance of humours in the body caused illness. One of the favorite treatments for imbalanced humours was the practice of bleeding the patient.

1854: Florence Nightingale The founder of modern nursing, Nightingale used her experiences tending to wounded soldiers during the Crimean War as a springboard for revolutionizing nursing. She is responsible for turning it into the vital, respected profession that it is today.

Ancient Times to Present: Midwives Midwives played a vital role in birthing children long before modern medicine was developed. One early reference to midwives comes from the Bible, Genesis 35:17, “Rachel began to give birth and had great difficulty. And as she was having great difficulty in childbirth, the midwife said to her, ‘Don’t be afraid, for you shall have another son.’”

11th Century: School of Salerno At the world’s first medical school, many women were trained as physicians and acted as instructors, even as they were banned from other medical schools throughout Europe. Trotula di Ruggerio was an instructor at the medical college and is considered to be the world’s first gynecologist.

1812: Margaret Ann Bulkley A brilliant British doctor, Bulkley lived and worked for her entire career under the alias of Dr. James Barry. Bulkley served in the British Army as a doctor in South Africa, India and Canada. She was the first doctor in South Africa to perform a successful caesarian section in which both the mother and child survived. She also fought in several duels and was accused of having an affair with the Governor of India. Only upon her death in 1865 was it revealed that Bulkley was in fact a woman.

1849: Elizabeth Blackwell Blackwell was the first woman to earn a medical degree in modern times. Blackwell attended Geneva Medical College in upstate New York. In order to be accepted there, the dean of the school told her that the male students would have to vote unanimously for her to attend. The male students thought it was a joke and voted to admit her. The joke was on them as Blackwell graduated first in her class and in 1868 started a women’s medical college.

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1900 By the end of the 19th century, over 7,000 doctors in the United States were women, making up five percent of the total number of doctors.

1952: Dr Virginia Apgar Apgar developed the APGAR score, which is a way to evaluate the health of a newborn and is still in use today.

1896: Marie Curie Marie Curie pioneered studies in radioactivity that led to the development of cancer treatments and X-rays as medical tools. Curie later died from overexposure to radiation due to lack of protection while handling radioactive materials. Curie won two Nobel Prizes during her lifetime.

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WOMEN IN MEDICINE

1990: Antonia Novella Antonia Novella becomes the first female Surgeon General of the United States.

1992: Roberta Bonder Roberta Bonder becomes Canadaâ&#x20AC;&#x2122;s first female astronaut and the first neurologist in space.

1960 Women had trouble making inroads as doctors. By 1960, only six percent of doctors were women, up one percent from the turn of the century.

1936: Dr. Maude Abbott Dr. Abbott published the Atlas of Congenital Heart Disease, which became the foundation of modern heart surgery.

Today In 2012, twenty-nine percent of doctors were women, up from just six percent in 1960. Now nearly fifty percent of students enrolled in medical school are women. Women are making huge contributions in medicine, and it is safe to say that this is only the beginning.

1881: Clara Barton Barton founded the American Red Cross.

2009: Elizabeth Blackburn Elizabeth Blackburn wins the Nobel Prize in medicine for her work in genetics, which she shares with Carol Greider, the Director of Molecular Biology and Genetics at Johns Hopkins.

1947: Dorothy Crowfoot Hodgkin Hodgkin published the structure of penicillin, and later insulin. She was a passionate advocate for the use of insulin to treat diabetes and was awarded the Nobel Prize for Chemistry in 1964.

1970 Women were making advances in the medical field, but they were still held back due to discrimination. This did not begin to change until 1972.

1915 Women were admitted to the American Medical Association.

1972: Title IX Title IX was a true game changer, as it prevented women from being denied entrance to educational programs because of their sex. This opened the doors for women to go to medical school in ever-increasing numbers.


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!"#$%&'(#$)%#*+,'#-)+.'/#012#*'+34)#+(/#$'33('55 omen have always been an essential part of healthcare and medicine. As doctors, nurses, family caregiZIVW TYFPMG SJ½GMEPW supporters of charities and more, women are forging an ever-increasing role in shaping our health and wellness. On a national level, there are many women, both famous and less well known, who have made important contributions to the public conversation about health care.

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The First Lady of the United States has been an enthusiastic advocate of healthy eating in her fight against childhood obesity. “Lets Move,” her initiative to review current programs and create a national plan towards changing young children’s activities and exercise, has been her focus since she has been a political figure. She has also focused her time on healthy eating and alternative choices for children in school. Though the smaller offerings on school lunch trays are not pleasing to some of the children who receive them, Mrs. Obama has certainly gotten them thinking about (and tweeting about) what they eat. Michelle has stated that her goal was to make changing childhood obesity her legacy, long after she leaves the White House.

&8D>5339',31356E4 The former Governor of Kansas was appointed to be the U.S. Secretary of Health and Human Services (HHS) under President Barack Obama. While in office, Secretary Sebelius led many efforts to improve America’s health through the enhancement of humans services to the nation’s most affected populations like the elderly, the nations youth and those with disabilities. Though she recently stepped down from that role, she was an integral part of the implementation of the Patient Protection and Affordable Care Act (also known as Obamacare). Some say she was the most powerful woman in the U.S. during that time because of her influence with politicians and her relationship with the medical community. She continues to change and influence the policies for everyone regarding health care and services needed.

!9C35698'0;563 The award-winning actress underwent a preventive double mastectomy after finding out that she carries a mutation of the BRCA1 gene. This increased her risk of developing breast cancer to 87 percent. Since her mother died of ovarian cancer at the age of 56, Jolie decided to take no chances. She announced her surgery after the fact in a frank and open New York Times op-ed, starting a public conversation about proactive cancer prevention measures. Angelina Jolie has been considered one of the most beautiful women in the world, and with the announcement of her choice of preventative health care, she has created an alternative option for women today.

03992'A:F8@D>2 Jenny McCarthy: Best known as a model and actress, Jenny McCarthy has also, for better or for worse, shaped many people’s beliefs and decisions regarding vaccinations. Though she has recently claimed that she was never anti-vaccine, she was perceived for many years to be an activist who believed that vaccinations cause autism. Many parents chose not to vaccinate their children, even though studies have shown that there was no link. The debate continues as long-eradicated diseases begin to make a comeback.

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/@G'"8:>835'";44 Dr. Rachael, a regular co-host on the television show The Doctors, is a family medicine physician and sexologist from Gary, Indiana. She says she became a doctor because she is a “product of brainwashing.” Though she laughs, she shares the story of how her mother would tell her at bath time every night, “You’re going to be a doctor, just like your daddy.” Her father was a wellloved and highly respected family doctor, and Rachael did want to be just like him. She was one of nine children, and three of them became doctors. As an African-American female, she had her setbacks along the way. But she was determined to put in the hard work and earn her dream. She and her late sister Rebekkah built an outreach program for young women; they taught girls proper etiquette, self-respect, how to avoid abusive relationships and sex. Now, as a co-host on The Doctors, Dr. Rachael hopes that young women of all races and ethnicities who watch her on the show see from her example that they can be classy and fearless, and they can make a positive difference in people’s lives.

&8D>2'&3552 As founder and CEO of HysterSisters.com, Kathy Kelly has touched the lives of hundreds of thousands of women over the years. When she had her hysterectomy in 1998, she discovered that there was little information or support for patients available, and practically none online. So she founded an online community to provide woman-towoman support for GYN medical and emotional issues surrounding the hysterectomy experience. Today, HysterSisters.com has more than 330,000 registered members and over 28,000 unique visits per day. She has created a safe place for women to discuss their health and emotional concerns frankly and supportively, a huge contribution to the public conversation about health and wellness.

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#@64>8'#;@@32 After experiencing a frightening and expensive cancer misdiagnosis, Trisha Torrey decided to use her communication skills to become a patient advocate. She built a national organization for patient advocates, the Alliance for Professional Health Advocates, and she has written three books. She was named CNN’s Hero of Patient Empowerment in 2008, and today her work helps thousands of patients, caregivers, providers and advocates nationwide.

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She helped break through the glass ceiling when she became the first female president of the American Medical Association. Her dedication to education, science and compassion for Texans has been a life-long goal for Dickey. She has devoted her time and effort to this cause by becoming the chancellor to A&M System Health Affairs along with setting an example for her family especially her children. Nancy has always loved science, but she chose a career in medicine because of her love for people!

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A8@2HF586@3'&69CI'J>/ King is a world-renowned human geneticist known for major accomplishments in the field, including the identification of the BRCA1 gene, which shows inherited susceptibility to breast cancer. King studied genetics and the interaction of genetics and environmental influences of human conditions, such as HIV, lupus, inherited deafness and many types of cancer. She has many accomplishments, along with identifying the breast cancer genes, like demonstrating that humans and chimpanzees are 99 percent genetically identical and applying genomic sequencing to identify victims of human rights abuses.

+98'A82'.84<69 Dubbed the “mother of authentic midwifery,” Ina May Gaskin founded one of the first out-of-hospital birthing centers in Tennessee in 1971. With the publication of her book Spiritual Midwifery in 1977, Gaskin became a household name in home birthing and midwifery circles. She is still a very active leader in safe natural childbirth practices; she publishes, maintains a web site and speaks. She gave a TED talk in 2013 about reducing fear of birth in U.S. culture.

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here are women making a difference in health and medicine at both the state and local levels as well. Here in Austin, we have women in government, media, charities and private practice leading the way.

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!96D8'J3@@2 The First Lady of Texas is a former nurse and the daughter of a physician. As such, she advocates for the nursing profession and for women and children’s health education. Her passion for nurses and the nursing education has been recognized by Texas Tech University, and as a result, they renamed the nursing school in her honor in 2008. Anita also has two endowments set up in her name helping aid the nursing shortage, The Anita Thigpen Perry Nursing Excellence Scholarship at West Texas A&M University and the Anita Thigpen Perry Endowment at the University of Texas at San Antonio. Though some Texans take issue with her husband’s health policy decisions, Mrs. Perry strives to find common ground in politics using her power to create change.

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*;@6898'73@989=3L A beloved former anchor on Austin’s FOX 7 News, Loriana Hernandez is now a role model and inspiration to many as she fights leukemia. She believes strongly in sharing her story honestly and openly, stating, “If I can help even one person to detect cancer earlier, cope with their emotions, survive their treatment, it’s worth it. There’s no shame in crying, being depressed, missing your child. People follow my Facebook page and thank me.” Loriana has four missions now, aside from beating leukemia and going home to her husband and son: First, she wants people to get fit and eat clean before they become sick. Cancer can strike anyone at anytime. If you are healthy and strong, both mentally and physically, going into the fight you will have a much better chance of winning. Second, she wants everyone to get regular complete blood counts (CBC); that is how she found out she had fast-moving leukemia. Her third mission is to raise bone marrow donorship among minorities; it is currently extremely difficult to find matches. Finally, she wants to help her fellow warriors to “Armor Up,” which is her slogan for staying strong and getting moving. Leukemia is cancer of the blood, so it affects the entire body. It takes emotional and physical armor to survive.

F8@;529',:>K8@L The current Executive Director of Ronald McDonald House Charities (RMHC) of Central Texas and a founder of Health Alliance for Austin Musicians (HAAM), Carolyn Schwarz truly makes a difference in people’s lives. “While my professional journey has taken twists over the years, the one thing that has remained constant is my drive to support and help others with their healthcare needs,” she says. HAAM is the first nonprofit organization in the nation to provide low-income, uninsured working musicians access to affordable health care. At RMHC Central Texas, they provide a “home-away-from-home” for families with hospitalized children. “I continue to see how providing support to families dealing with medical crises can have long-lasting positive impacts. Most often, families come to RMHC Central Texas in the middle of a completely unexpected pediatric crisis. Their worlds are unraveling, and while we cannot remedy their child’s medical condition, we can provide support and stability in a home-like environment that allows them to concentrate on the most important thing – getting and keeping their children healthy and happy.” Carolyn’s advocacy for those whose difficulties are often overlooked helps steer public awareness and funding for those in greatest need.

*3D6:68'M89'=3'JEDD3 As a Texas State Senator and currently a Democratic nominee for Lieutenant Governor, Leticia is making a name for herself in politics and health care. Van de Putte comes from a long line of medical professionals, working in her grandfather’s pharmacy before buying her own business in San Antonio. She gained recognition for her famous one-liner after an 11-hour filibuster along side state Sen. Wendy Davis in 2013, “At what point must a female senator raise her hand or her voice to be recognized over the male colleagues in the room?” Van de Putte said. Van de Putte stands for good policy and good outcomes, including her preventative health care initiative. She is taking steps to change the immunization protocol for children with a program named the Texas Two Step, encouraging and enforcing full immunizations for children by their second birthday. She has future plans to address issues with childhood obesity, newborn screenings, lead registry and standards for ambulatory care services.

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/@G'/31;@8>'A;@@64'78@@64 As Chief Medical Officer of CommUnityCare, Dr. Morris Harris has the opportunity to help those in our community who are most in need. CommUnityCare started out as the Travis County Health Center, but it now encompasses 21 sites that can serve 70,000 people with everything from primary care to psychiatry. Funded by both federal grants and county funds, CommUnityCare serves the underserved with an integrated approach to the whole person. Dr. Morris Harris started her career in a federally-qualified health facility in Boston as a National Health Service Corps participant, followed by a trip to Africa as an Albert Schweitzer Fellow. Her time in Africa was a formative experience for her; seeing health care in far less fortunate circumstances gave her a deep appreciation for modern medical care and a passion for improving public health systems. She explains, “You can make a world of difference by doing the simple things well. If we address the basics, from housing to obesity to diabetes – if we can make an impact there, we will make quite a difference.”

F>@64D2'F8432HA;;@3 Though she was a 2013 nominee for the Austin Business Journal’s Profiles in Power – Central Texas Women of Influence, Christy CaseyMoore is humble and grateful for the opportunity to lead Susan G. Komen Austin as its Executive Director. “It’s the organization that inspires me, not the other way around. What motivates me are the fantastic people I get to work with at Komen Austin.” Christy was asked to help with Komen Austin’s first Race for the Cure back in 1996. She did it, of course, and she did it again and again and again, all the way until 2010, when she was tapped to become Executive Director. All told, Christy has been raising money and awareness as well as helping to fund research for breast cancer for 18 years. Komen Austin has raised $13.9 million over the years, and 75 percent of that has gone to local organizations. The other 25 percent goes to research to find a cure.

/@G',6B;93',:EBN68 Born in Romania under a communist regime, Dr. Simone Scumpia had a formative experience watching her grandfather die of congestive heart failure, being treated with nothing but cough medicine, while the politically connected elite were treated well. She became a doctor in Romania but wanted to practice medicine in a society that has more freedom. She escaped communism and fled to Canada, and later to the United States. She dove deeply into her endocrinology specialization, establishing Austin Thyroid and Endocrinology, conducting research, publishing, speaking and teaching over the course of her 35-year career. She is particularly vocal about clinics prescribing hormones to treat headaches or weight gain without consulting an endocrinologist. She reminds us that the endocrine system is extremely sophisticated and responds in a fraction of a second to changes. So if you have a hormone deficiency, you should get it treated. But if you do not, don’t throw hormones at symptoms. For Dr. Scumpia, it comes down to doing the right thing, no matter who the patient is. “I want to look in the mirror and ask myself if I did the best I could. It’s a moral issue. We have a big challenge in the future for generations to come to provide better care for everyone.”

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/@G'#@8:32'7884 In her current role as Co-founder and Chief Medical Officer of DocbookMD, Dr. Haas is helping to solve healthcare communication problems with the HIPAA-secure DocbookMD messaging application for the web, smartphones and tablet devices. She and her husband/business partner, Dr. Tim Gueramy, recognized that it would save time, money and perhaps even lives if doctors had a secure way to send case photos to each other for triage or second opinions. In addition to running a successful technology company, Dr. Haas, an award-winning family physician, is extremely active in leadership roles in the medical community of central Texas. Dr. Haas was drawn to medicine as a way to combine her love of adventure, science and care for the underserved around the world. Always with a focus on international medicine and global health, she served as the Medical Director of an Austin-based nonprofit, The Miracle Foundation, for six years and is currently on their advisory board for a second year. She is also on the advisory board of Libyan Hearts and is serving a second year on the Seton Fund’s “The Fifty.” She is the executive director of a physician-only incubator, Walters Physician Incubator, of which she is also a founding board member. She received a Certificate in Global Mental Health from Harvard in 2011. She has used this training to work in India, Haiti, Libya and all over Texas. Dr. Haas is a person who makes a difference in the world around her.

&6B'*82D;9 After serving as President of Harden Leadership Development Institute at Harden Healthcare, Kim Layton struck out on her own, establishing Treeline Leadership, LLC. She explains that a holistic healing environment is created through a collective and interdisciplinary leadership culture. With the ever-increasing regulatory and reimbursement challenges facing our healthcare delivery system, interdisciplinary leadership skills are even more critical. “My passion has been to serve health care organizations to enact their missions, visions and values through the training and development of their team members and leaders in addition to facilitating our current and future health care team members becoming even better through professional and leadership development.”

/@G'F>@64D698',3134D239 Owner of OBGYN North and recognized three times as Austin’s Best OBGYN by the Austin Birth Awards Committee, Dr. Christina Sebestyen worked tirelessly to give women more birth options within the hospital environment. She believes strongly in certified nurse midwives (CNMs) practicing side-byside with physicians to give women the choice of a variety of natural birth options. She chose to give birth to her two sons with a CNM in a hospital, using hypnobirthing for strength and focus. Her efforts have expanded women’s choices and changed the way many women give birth at NAMC.

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r. Jennifer Walden, named one of the 24 best beauty surgeons in the !443@D6O3'89=',D@;9CP'$8@B'89='F8@69C United States by Harperâ&#x20AC;&#x2122;s Bazaar magazine last month, is a woman who Dr. Walden is brilliant, beautiful and successful â&#x20AC;&#x201C; the kind of woman you might think arguably â&#x20AC;&#x153;has it all.â&#x20AC;? would be intimidating or cold. Sheâ&#x20AC;&#x2122;s anything but that.

An acknowledged leader in her field, she trained with the best cosmetic surgeons in New York City, establishing a successful practice in Manhattan before returning to her hometown of Austin to do the same here. Sheâ&#x20AC;&#x2122;s one of the only women to have ever been on the board of directors of the American Society for Aesthetic Plastic Surgery (ASAPS), a board on which she currently serves. Sheâ&#x20AC;&#x2122;s a published author and award-winning surgeon. Sheâ&#x20AC;&#x2122;s even a media darling, regularly appearing on many national television programs and in prominent magazines. She has two beautiful children, several siblings who are highly successful in their own fields, and a mother Dr. Walden says inspires her on a daily basis.

Dr. Walden is brilliant, beautiful and successful â&#x20AC;&#x201C; the kind of woman you might think would be intimidating or cold. Sheâ&#x20AC;&#x2122;s anything but that. %) %)

A U S T I N MD M A G A Z I N E . C O M A U S T I N MD M A G A Z I N E . C O M

Jennifer Walden is in fact warm and friendly, putting people at ease with her calm confidence and relaxed manner. Though sheâ&#x20AC;&#x2122;s always busy, she doesnâ&#x20AC;&#x2122;t come across as rushed. Though she firmly controls every aspect of the environment in her office and OR, no one would call her harsh. And though sheâ&#x20AC;&#x2122;s a powerful woman with a waiting list of patients eager to receive her elite services, her eyes shine softly with a motherâ&#x20AC;&#x2122;s love when she shows off pictures of her young twin sons, Houston and Rex. Sheâ&#x20AC;&#x2122;s a very grounded person with an easy smile who empathizes with her patientsâ&#x20AC;&#x2122; desire to improve their looks and feel better about themselves. How did Jennifer Walden get to where she is today? It may seem like a clichĂŠ, but it was quite simply hard work â&#x20AC;&#x201C; lots and lots of hard work, backed by keen intelligence, talent and a drive to be one of the best.

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Dr. Walden’s guiding philosophy in life is her desire to make things happen. “I’m a doer,” she explains. “I wake up each morning, and the first thing I want is for my children to be happy and healthy. I want to do the right thing for them so they have a fulfilling life. So I’m proactive. I’m achievement-oriented, and I thrive on challenges. I never let anyone tell me I can’t do something if it’s in the best interest of my patients or my family.” She wants to pass that internal drive on to her sons, who are her reasons for doing everything she does.

Jennifer Walden was born in Austin and grew up in the Northwest Hills neighborhood. Her late father was a dentist, and her mother was a surgical nurse. One of five children, young Jennifer grew up in an environment where education and achievement were valued. She calls her mother her hero and a role model in raising her own two sons. “I honestly don’t know how my mother did it with five kids. I can barely get through HEB with two!” Dr. Walden laughs. She claims that in some ways being a plastic surgeon is easier than being a mom. She can control the environment at work, but kids are totally unpredictable. “I have great respect for at-home moms,” she says. “Seriously, it’s the most selfless and challenging job you can do.”

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!'Q63@:352'/3D3@B693='89='76C>52' ,E::344RE5'$;B89 She attended The University of Texas at Austin for her bachelor’s degree and was accepted to medical school on a waiting list. She would not be sidelined, though, and made it into the program. Determined to show that she was not a second-choice candidate, she ended up graduating as Salutatorian of her class. She decided to go into plastic surgery because she loved the artistry and creativity of it combined with the immediacy of surgical outcomes. She also felt an affinity for the primarily female patients who want to look better. She was matched into the plastic surgery program at UT Galveston, and then she was accepted to an exclusive post-residency aesthetic surgery fellowship program at the Manhattan Eye, Ear, and Throat Hospital. She was one of only two fellows accepted that year. She found she loved Manhattan and stayed there for eight years, starting her own practice in association with her mentor Sherrell Aston, an experienced plastic surgeon with an international clientele who has been in practice for over 30 years. She learned the business side of things and built a thriving practice there from 2004 until 2011. She might still be in Manhattan today if not for what she calls the “game changer” – the arrival of her twin sons Rex and Houston.

“You need the personality and internal drive to sustain your education, career, and wellbeing of your family and yourself over the long haul, not just over months or a few years.” ,D8@D69C'%O3@'89='?T:33=69C' ?TN3:D8D6;94

She had to start all over again with her practice when she arrived back in Austin. But with the support of her mother, who still lives in Dr. Walden’s childhood home, and the help of nannies and other family members, Dr. Walden was able to move effectively to reestablish her business. In less than three years, the practice has grown beyond her expectations. She takes great pride in what she has built here. “Westlake Medical Center is a surgeon’s dream,” she explains. “I do 99% of my surgeries in my own operating room, which is just 15 feet away from my private office.” She maintains the highest standards for her operating room, which is fully accredited by AAAASF, the premiere program for office OR accreditation. Although she rarely ever has to admit anyone to the hospital on an urgent basis, she has an arrangement with Westlake Medical Center to admit patients for overnight nursing if needed. “The Hospital at Westlake Medical Center feels like a five-star hotel,” she says. “If a patient needs to stay overnight, it’s a fantastic facility.” 90% of her patients, though, are outpatients and go home the same day with family members after surgery in her office operating room.

She also hopes she inspires other young women to pursue careers in medicine and business with confidence and determination, and as such female premed students often seek her advice and mentorship. If other women decide, as she did, to have a family and a demanding career, she wants them to understand that it’s not at all easy. “Be a well thought-out, organized woman,” she advises. “It’s a marathon, not a sprint. You need the personality and internal drive to sustain your education, career, and well-being of your family and yourself over the long haul, not just over months or a few years.” She adds, “You must be prepared to make difficult decisions about your own priorities in life.” She also wants other women to understand that, in order to “have it all,” they’ll need a support system. Whether it’s a flexible spouse, professional nannies or nearby family members, a woman with a demanding career and children can’t do it all by herself. Dr. Walden considers herself incredibly fortunate to have such a wonderful and supportive family surrounding her and her sons right here in Austin.

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,>6RD69C'J@6;@6D634S'&6=4'F>89C3' ?O3@2D>69C Dr. Walden says that dating, marriage and children weren’t really on her radar in her twenties and early thirties. But in her late thirties, she found that she did want to be a mother, and that maternal instinct was growing stronger. “I think I had about one egg left,” she laughs. “Well, I guess two.” Since there was not a man in her life she wanted to marry, she opted for in-vitro fertilization (IVF). Her boys were born in November of 2010, much to her entire family’s great joy. She decided to return to Texas so that her sons could grow up surrounded by family like she did. A U S T I N MD M A G A Z I N E . C O M

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EVENTS

!U,#+-'A/'7?!*#7' !-/'$?**-?,,'Q!+" This was the first year for Austin MD Magazine’s Health and Wellness Fair and it was a huge success. The community came out in full force to support all the doctors, physicians, non-profits, fitness instructors, and everyone involved in this event. Many medical facilities gave free exams and health screenings to help Autinites gain knowledge, information and tips for living healthy life. Hosted at the Long Center on a warm Saturday afternoon Austin MD Magazine’s Health Fair featured fun activities for children, delicious foods to sample and great music to listen to amongst Austin’s finest medical professionals. by Rachel Escobar Photo Credits: Steve DeMent

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!-/)'"%//+F&' Q%U-/!#+%-'.!*! This years event was spent swinging to the 20’s with the Andy Roddick Foundation. The evening included dancing to the big band tunes of Vintage 15, a silent auction, hor’s d’oeuvres, drinks and casino entertainment! All proceeds went directly to the Andy Roddick Foundation that works to ensure that youth in low-income communities have abundant opportunities to reach their full potential through education and sports-based mentoring. As always it was a fun and fabulous night supporting a great cause. by Rachel Escobar Photograhy: Taylor Schmitt

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7+,J!-+F'J7),+F+!-' !,,%F+!#+%-'.!*! The 6th Annual HPA Gala was the biggest event of the year for the association and its members. It was a night of celebration with great food, Salero playing classic Latin tropical music, dancing, and the theme was Puerto Rican Pride. This years keynote speaker was a great friend of the magazine Dr. Sergio Escobar from Rose Dental Group and he was wonderful! This was the largest gathering of all the members and people who have been involved with helping the Hispanic community through service, education and scholarships. by Rachel Escobar Photography: the Pelican Man

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#7?'VW'U-/?"'VW' !$!"/, The 16th Annual Austin Under 40 Awards honored the best and brightest young professionals in Austin! Nominees were recognized for their professional achievements as well as their contributions to the community. The evening included a plated dinner, cocktails, a huge silent auction, and of course our amazing awards presentation! The event was a great opportunity to mingle with Austinâ&#x20AC;&#x2122;s brightest young minds. by Rachel Escobar photograhy: Ginny B and Jonathan Garza

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Homemade products with all-natural ingredients are healthier for your body and your wallet than name brand products. Making DIY spa and beauty products at home is very simple and can be a fun project. Springtime in Austin brings tank tops and shorts, making skin care a necessity. Sugar scrubs can be used on the face, body and feet for silky soft skin. The recipe is very easy to personalize, based on ingredients you enjoy most, so tweak the recipe until you find your favorite mixture. The shelf life on the scrubs is about two months give or take, so only create enough at a time that you will use to avoid wasting your ingredients. We found these sweet sugar scrub recipes on the Wellness Mama blog.

#7?'(!,+F'"?F+J? Mix 2 parts sugar (regular white or brown sugar will work) with 1 part oil (almond, olive or coconut are great), and then add 1/2 tsp Vitamin E oil (or the gel from a few capsules). Add your favorite oils, scents and spices, or even coffee grounds, to create exciting and new sugar scrubs.

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P E R F E C T LY

PA R T Y SATURDAY, MAY 31

Brazos Hall • Downtown Austin BENEFITING

PRESENTING:

CO-CHAIRS: DEB DAVIS GROVES & MARTHA COONS

INVEST SPONSORS: 97 Degrees West Cabin 21 Films

Red Fan Communications Sterling Affairs


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Restoring outer beauty is my business…and so is restoring inner beauty. “So, how does one restore inner beauty?” one asks…for it is with inner beauty that outer beauty can truly manifest itself. How can we replicate the glow that someone has when they are in love…the translucent skin of a pregnant woman…the smooth, poreless skin of a child?

All beauty starts from within, down to the teeny tiny cells that comprise us -- no, actually, down to the genes contained within

those cells. It is the cellular environment we create that determines which genes – the good or the bad – express themselves. Just search for the twin studies on wrinkles caused by smoke, stress, alcohol, sun damage. Identical genes, different expressions…so you are not doomed to your genes. What can you do to improve your inner beauty? They say garbage in, garbage out…so modify your intake…eat real food, drink real water, use real sweetener (or forego the addition). Shop the perimeter of the grocery story… where the fresh fruits and vegetables and other products that don’t require ingredient labels lie…or help out your local growers by going to the farmer’s market, and get produce picked in season, when they have the most nutrients. Or, better yet, build your own little garden, where you can monitor what does and does not go into your food. Eat organic, so your cells do not accumulate the neurotoxic pesticides, and avoid GMO’s. Eat organic or natural grass-fed

beef, wild-caught fish, free-roaming chickens, to reduce the hormones, and concentrated pesticides and herbicides from the ground. Inflammation on a cellular level also shows on your skin, and your insides (diabetes, heart disease, Alzheimer’s, Parkinson’s are all inflammatory diseases). Avoid inflammatory foods, like red meat and charred foods. Eat more anti-inflammatory foods, such as blueberries, cantaloupe, salmon. Just make sure you have a colorful plate consisting of ¾ vegetables, ¼ meat. Food intolerances can also play a part in the inflammation that can show on your face. As for beverages, keep your cells hydrated not only for the best appearance, but also for cellular efficiency. Drink half of your bodyweight in ounces daily (50 ounces if you weigh 100 lbs) as a baseline, if you do not have much activity. Drink more if you exercise, drink caffeinated or alcoholic beverages (add two cups of water for every cup of these). Diet beverages and artificial sweeteners are especially bad, since these your body responds to these chemicals as if you consumed 100 times more sugar…your insulin response will spike, and that can lead to all sorts of mayhem. If you’re trying to avoid the calories, just drink water…it’s what you’re made of. And, remember, many people mistake thirst for hunger, so try drinking a glass of water before you reach for an unnecessary snack. Exercise is quite crucial to maintaining and regaining your beauty. Regular exercise is good for not only building muscle and bone, but it is also good for

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&)%98= the mind…you release endorphins, the happy hormones, when you exercise… which helps reduce stress…which helps reduce stress-induced wrinkles. The foundation for the skin is bone, muscle, and fat. After 30, you start losing bone; after 40, muscle. You may notice some sagging of skin because of the loss of muscle, especially on the arms and legs. I encourage you to lift weights (including your own weight) to build muscle and bone, and rebuild the foundation for your face and body.

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Women are particularly susceptible to the ill effects of sleep deprivation. This is the time when your body remodels, when your body produces growth hormone. Sleep disruption also affects your cortisol and leptin levels…both of which can affect your reaction to stress, deposition of fat, and hunger. Fortunately, you can improve sleep by exercising, avoiding caffeinated beverages at night, and having good sleep hygiene.

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Environmental stressors, emotional strevssors. Stress does not kill us…it is how we react to stress that does. UV radiation causes wrinkles, sun spots, worsening of rosacea, and genetic damage that can lead to cancers. Wear sunblock with an SPF of at least 30 daily, reapplying every 80 minutes while exposed to the sun…apply 30 minutes before going back out into the sun (before you leave work). Seasonal allergens can lead to chronic inflammation in the sinuses, which will show on your face.

Now that you have restored your inner beauty, let us discuss restoring your outer beauty. Structural changes in the face occur with age. Bone is reabsorbed, leaving smaller jaw bones (leading to jowls and wrinkles around the mouth), larger eye sockets (more sunken eyes), flatter cheekbones. Muscles also atrophy, fat pads migrate downward and inward, making nasolabial folds more prominent. These fat pads are also worn down by sleeping on them.

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Skin tightening procedures with the IPL or lasers may temporarily improve collagen tighten the skin. When it is severe enough, a face lift or partial face lift can help.

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As we age, our skin does not turn over as fast as it used to, so it accumulates on the surface, clogging pores, leaving a layer of dull, dry flakes. Daily exfoliation techniques, such as using a facial brush to cleanse with, helps to flick dirt and makeup out the pores. Other exfoliating procedures, such as microdermabrasion, enzyme masks, and chemical peels remove deeper layers of skin on a monthly basis. Retinals also improve skin turnover. Other products containing epidermal growth factors also aid in rejuvenating the skin.

There are many daily habits to incorporate into your life that can restore your youth, both internally and externally. Try a couple out and see if you start turning a few heads. If you need a little extra help to see your former self in the mirror, trust your rejuvenation to an artful eye to recreate what you lost over time. Rediscover your youth. Rediscover your self.

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Microdermabrasion, chemical peels help to whittle down the skin to reduce the appearance of these and wrinkles. CO2 fractional resurfacing stimulates your own body’s collagen production to fill in the depressions. Loss of volume. Usually due to migration or just plain loss of fat pads, this can be rectified by the use of dermal fillers, fat transplant, or silicone implants. Dermal fillers last a few months to years. Implants have the risk of some migration.

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Usually caused by UV radiation or hormones (melasma). You must use SPF 30 for the rest of your life. Photofacials are the quickest way to reduce the appearance of brown spots, and are typically performed in a series. The darkest spots respond the quickest, because they absorb the most light to get destroyed in toto. When the spots get too light to absorb enough light to be destroyed, lightening creams should be used. Melasma is the most difficult to treat, since the pigment comes from below the skin surface. Hormone balancing is important prior to addressing melasma by these means.

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These are worsened by UV radiation, alcohol, exercise, hot showers and saunas. Sometimes, rosacea can be caused by microscopic parasites that defecate and irritate the blood vessels, so may respond to antibacterials. IPL or laser is also great to quickly remove unwanted blood vessels. Judicious use of SPF is also warranted to prevent further damage.

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Microdermabrasion and chemical peels remove the top layer of skin to minimize the appearance of wrinkles. Botulinum toxins help relax the muscles that create wrinkles. Once the skin is not constantly bombarded with folding, it has a chance to fill in to some degree. Dermal fillers are used to fill the deeper wrinkles that remain.

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D.O., with Innate Beauty, personally performs all medical cosmetic procedures in her office on South First St. and has performed more than 7,000 ablative laser treatments. She has been in medical practice for 13 years; nine of which she has spent performing medical cosmetic procedures.


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Dr. Avinash Ramchandani is a Medical Director Pain Care 4L]WMGMER,IMW&SEVH'IVXM½IHMR4EMR1IHMGMRIERH Physical Medicine and Rehabilitation.

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n honor of self-discovery month, I am writing about something that I discovered about myself a few years ago. Since I was young, I had episodes of cramping pain in my legs, but these episodes were not associated with any excessive exercise or food consumption. However, I noticed that when I was out in the sun for long periods of time, I did not experience this odd pain. Many times I passed it off as normal growing pains; however, I was in my twenties, past the point of typical growth. Eventually, I started supplementing with Vitamin D, and my pain disappeared. After checking my levels, I was like many other people I know: significantly Vitamin D deficient. What is considered a low Vitamin D level has typically been controversial, but the current normal levels of Vitamin D include anything greater than 30 ng/mL (nanograms per milliliter), while 20 to 30 ng/ mL is considered insufficient and less than 20 ng/mL is considered deficient. Anything greater than 100 ng/ mL is considered hypervitaminosis D (or too much Vitamin D). In my career, I have never encountered a hypervitaminosis D patient, although some detrimental effects, including neurogenic diabetes insipidus and increased calcium levels, can be found in these patients. What foods have Vitamin D? Surprisingly, not many. Egg yolks, fish—including salmon and mackerel— intrinsically have Vitamin D. Milk, yogurt, bread and some juices are fortified with Vitamin D. The best place to get Vitamin D is from exposure to beta ultraviolet light from the sun. This is likely why dark skinned people have a harder time with maintaining a normal Vitamin D level. In the United States, 36 percent of the population of

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A U S T I N MD M A G A Z I N E . C O M

otherwise healthy people and 57 percent of admitted patients to the general medicine ward are lacking in Vitamin D. Overall, it is estimated that one billion people in the world have low Vitamin D levels. People that are obese, dark skinned and anyone having difficulties with Vitamin D absorption are all at higher risk of having low levels. Some diseases that affect absorption may decrease Vitamin D levels as well – such as celiac disease or irritable bowel syndrome.

Does this mean that you should go take a bunch of Vitamin D supplements right now? No. There are potential health risks with not only a low level of Vitamin D, but also with high levels of Vitamin D, which could be even worse than low levels (think of high calcium levels as leading to weak bones and kidney stones). Get your levels checked, talk to your doctor and discuss a strategy to normalize your Vitamin D levels.

Some of the diseases with low Vitamin D levels have been associated with bone fractures, heart disease, some cancers, rheumatoid arthritis and even depression

These low Vitamin D levels have been associated with many diseases, and even featured on television shows by famous physicians, like Dr. Oz. Some of the diseases with low Vitamin D levels have been associated with bone fractures, heart disease, some cancers, rheumatoid arthritis and even depression. Vitamin D levels are particularly important in elderly people, and even more important in elderly people with a history of diabetes. There is evidence that low Vitamin D levels may increase the risk of osteoporotic fractures. Osteoporotic fractures, including hip and spine fractures, can in turn increase the rate of mortality. Furthermore, Vitamin D can also increase chances of falling, likely due to an unknown mechanism due to diabetic neuropathy causing peripheral neuropathy symptoms that increase the risk for fractures in the elderly.

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acular degeneration of the eyes mostly occurs as part of the aging process, hence its full name, Age Related Macular Degeneration (AMD). AMD is a leading cause of vision loss in the aging population. The disease affects the macula, a small spot near the center of the eye where our sharpest central vision occurs. The macula allows us to read, identify faces, watch television, safely navigate stairs, drive, and perform countless daily tasks. A person suffering from AMD would see dim images or black holes at the center of vision and be left with only their surrounding or peripheral vision. In the United State today, about 15 million people suffer from AMD. Out of this 15 million, about one quarter are 65 years of age or older.

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Currently, there are not many successful treatments for AMD. However, Chinese medicine has an excellent success rate in dealing with this issue. Chinese medicine looks at the body as a whole rather than as isolated parts. All the organs, both internal and external, are interconnected though a network of energy pathways called meridians or channels. As a result, Chinese medicine does not focus solely on specific parts of the body but on the entire system. For example, eye problems are regarded as directly connected to the kidney and liver organs and their related meridians. Therefore, macular degeneration is not treated by focusing on the eyes, but by addressing problems in these organs and meridians. For example, people who are farsighted and who have had to wear reading glasses since they were young are usually considered in Chinese

medicine to have a kidney â&#x20AC;&#x153;deficiency,â&#x20AC;? or weakness. Often, they show other symptoms of kidney deficiency as well as far sightedness.

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Chinese medicine considers that the blood and chi (life force) are important to the health of the eyes. Chinese medicine has known for thousands of years how the internal organs can affect other organs in the body. For example, the liver provides the blood that brings nourishment to the eyes. When we start to age, usually our chi and blood start to get weak or deficient. If we donâ&#x20AC;&#x2122;t get the same nutritional supply to our eyes as before, we can develop eye problems. This information has been known to Chinese practitioners for millennia and can be found in the ancient Chinese medicine text, The Yellow Emperorâ&#x20AC;&#x2122;s Classic (Huangdi Neijing).

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To treat AMD, Chinese medicine begins by tonifying (bringing energy to) the liver, kidney, blood, and chi. To do this, we use mainly Chinese acupuncture and herbal formulas. The best way to re-open the bodyâ&#x20AC;&#x2122;s closed meridians and collaterals and to improve the flow of blood and chi is through acupuncture. As we get older, our eyes can get damaged in various -1%+)*6317,988)6783'/

waysâ&#x20AC;&#x201D;e.g., if we work in a very strong light or in bluish light (emitted by electronics) for too long, it can weaken the supply of chi to the eyes and slow down its flow. This can result in damage to the meridians and the eyes. Chinese medicine also has a great many herbs to treat AMD. These herbs are designed to strengthen weakened kidneys, liver, blood, and chi so they can support the eyes. The liver, kidneys and eyes are connected through the meridians or energy channels or collaterals. The collaterals send the chi to the eyes and ensure that the blood vessels work properly and stay healthy and strong.

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In the past ten years, through research and practice, Austin Natural Healing Center (ANHC) has developed a unique set of treatments for AMD, including herbal formulas designed to treat the wet form of AMD. The wet form of AMD can get worse very quickly and can cause blindness. We use both traditional acupuncture methods, combined with the Zhang MicroAcupuncture System, to increase chi flow to specific points on the eyes. We have found this method to be very successful and usually see results very quickly. Within several courses of treatment, the patientâ&#x20AC;&#x2122;s vision is usually restored. For example, one 64-year-old patient had lost his driverâ&#x20AC;&#x2122;s license due to AMD. After several courses of treatment, his vision improved so much that he was able to get his license back and drive again. Even if AMD runs in your family, you can prevent this type of vision loss from happening to you. If you already have symptoms of AMD, you can look to Chinese medicine to help you find the solution.

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Removing the barriers and limiting beliefs from your life

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n 1987 I found myself a year out of college, still pondering what I wanted to do with my life. By default, I had re-enrolled in some education courses and was biding my time, thinking that I might ultimately consider a career in teaching.

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On the other hand, I had always dreamed of one day going to medical school, but still had some unresolved coursework that I would need to complete to even consider sending an application anywhere. I was well aware of how competitive getting into medical school could be. On some level, deep down in my heart, I also knew that I might not get in, no matter how hard I tried. It was around this same time that my brother was on a trip to Hawaii, and, while running on the beach, he had a chance encounter with a young, but rapidly rising motivational star by the name of Tony Robbins. Not long after that, my brother began working for Mr. Robbins on his security team, traveling all over the country to his three-day seminars, which famously concluded with participants literally walking over hot burning coals to show what human beings are capable of when the mind is in a committed state.

and mindset to guide and direct our outcome. Over the years, I have come to realize what many of you may intuitively already know: that our thoughts and words are powerful predictors of where we are heading and what we are likely to achieve. As human beings, we are endowed with the ability, based on our dreams and goals, to move our lives in any conceivable direction. Right now, you may have long-held dreams and goals, which you may have set on the backburner. Maybe you have always wanted to paint, learn to play a musical instrument or learn to speak Spanish, but for whatever reason, you have set those desires aside because you are too busy or overburdened with responsibility. You simply cannot seem to justify lending time to the pursuit of that one thing you really want to accomplish.

a significant portion of their time focusing on negative chatter reported in the news and doing a lot of â&#x20AC;&#x153;what if â&#x20AC;? type of thinking. â&#x20AC;&#x153;What if I fail?â&#x20AC;? â&#x20AC;&#x153;What if my girlfriend leaves me?â&#x20AC;? â&#x20AC;&#x153;The economy is horribleâ&#x20AC;Śwhat if I cannot find a job?â&#x20AC;? As we move into summerâ&#x20AC;&#x201D;the brightest, warmest season of the yearâ&#x20AC;&#x201D;I want to challenge and encourage you to guard the door of your mind. Be vigilant about the information and messages that you allow to cross the threshold of your eyes and ears. Resolve to focus on the positive things that surround you. Actively read and listen to the words and wisdom of those who have achieved success, in any area that may be of interest to you.

For many individuals, it may be a nagging sense of self-doubt that makes you believe you are not qualified to pursue a particular outcome, develop a talent or master a particular skill.

Decide that you are going to begin taking some daily steps to lead you in the direction of your desired outcome. Visualize yourself becoming, and ultimately being, successful as you walk step-bystep along the road to your ultimate destination. Do not give up on your dreams! Do whatever you must to reignite that flame that once burned so bright within you. Find your drive again.

Because of my brotherâ&#x20AC;&#x2122;s new alliance, I became captivated with the study of human potential, and I began to realize how much innate ability that we, as human beings, have been given to direct the outcome in almost any area of our lives.

Tony Robbins is fond of saying, â&#x20AC;&#x153;The past doesnâ&#x20AC;&#x2122;t equal the future,â&#x20AC;? and I think he is right. Just because you failed last year, last month or even yesterday, it does not mean that you cannot be successful moving forward with something that you strongly desire to achieve.

This is your season to blossom. You have every right and all of the ability you need to do so. Success is written into your DNA. Become the person you know is inside you; as you do, the world around you will watch with wonder and ask exactly how you did it.

I began to study and listen to anything I could get my hands on regarding goal-setting and optimizing human potential. It was after spending weeks absorbed in various audio programs that I distinctly recall telling my parents, over dinner, that the following year I would be accepted into medical school.

Before long, someone you know may be moved to â&#x20AC;&#x2DC;modelâ&#x20AC;&#x2122; the success that you have taken the time to create. You have the ability to make your life a masterpiece. Let go of the limiting beliefs that may be holding you back. Go forth, live your dreams and succeed!

Somehow by verbalizing my intended goalâ&#x20AC;&#x201D;in that momentâ&#x20AC;&#x201D;a spark was ignited, which created momentum in my life and ultimately led to the outcome I desired.

One of the defining characteristics of any successful person is that they rarely give up or quit. It is a well known axiom that success or victory does not always go to the smartest, the most highly educated or the one with the most degrees. There are countless examples of individuals who, endowed with nothing more than their dreams and desires, have started successful businesses, become entrepreneurs, developed a product that solves a problem or overcome a disability that would stop a lesser motivated person in his or her tracks.

This phenomenon is far from unique; in fact, I believe that the ability to pursue and achieve oneâ&#x20AC;&#x2122;s dreams and goals is a gift we all possess. Often, we simply need the right strategies, approach

At least once a week I see someone in the emergency department who is struggling with anxiety. Often, as I probe into what may be going on in their lives, I will find that a particular individual is spending

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rimary care settings are a gateway for many individuals with behavioral health and primary care needs. To address these needs, many primary care providers are integrating behavioral health care services into their settings. CommUnityCare, one of the largest Federally Qualified Health Centers in Texas, is doing just that. They provide integrated behavioral health care through the E-Merge program, a collaboration between CommUnityCare and Austin Travis County Integral Care (ATCIC). The E-Merge program embeds behavioral health providers into primary health care teams to provide timely, culturally and linguistically responsive, seamless and comprehensive health care. The goal of the program is to help patients achieve improved physical and mental health by addressing these needs together. The behavioral health team uses brief therapy to assist patients challenged by mild to moderate behavioral disorders. This team includes:

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During initial visits primary care providers ask patients to complete a behavioral health screening. At discharge, the patient is scheduled for the next available appointment with a behavioral health consultant. For more acute needs, the behavioral health consultant will see the patient on the same day receiving a â&#x20AC;&#x153;warm-handoff â&#x20AC;? from the primary care provider.

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30-minute initial assessments and follow-up sessions Treatment ranging from six to eight sessions Coordination with the primary care provider to ensure continuity of care Cognitive-behavioral and interpersonal therapy Enhancement of self-management, personal care skills, psycho-education, referral to community resources and consultation Referral and coordination with specialty behavioral health services or psychiatric emergency services through ATCIC Psychiatric consultation provided in the primary care clinics

The goal of the program is to help patients achieve improved physical and mental health by addressing these needs together.

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Behavioral health consultants complete a bio-psychosocial evaluation and mental status exam with each patient. The behavioral health consultant and patient establish a plan of care to enhance self-management skills for their behavioral and medical health conditions. Additionally, the behavioral health consultant provides supportive counseling without placing limits on the frequency or number of sessions provided. If the behavioral health consultant determines that the patient may benefit from a psychiatric consultation, the behavioral health consultant will confer with the primary care provider and receive medical authorization for a psychiatric consult; then the behavioral health consultant will schedule the psychiatric appointment.

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primary care provider. Responsibility for ongoing psychiatric medication management rests with the primary care provider. The psychiatrist remains available to the primary care provider and behavioral health consultant to consult the patientâ&#x20AC;&#x2122;s progress. If the psychiatrist determines that the patientâ&#x20AC;&#x2122;s psychiatric needs require specialized behavioral health care, a referral to Austin Travis County Integral Care (ATCIC) is recommended. If the patient consents, the psychiatrist completes this referral via ATCICâ&#x20AC;&#x2122;s electronic health record.

The psychiatrist completes a psychiatric evaluation. If the psychiatrist deems that the person may benefit from psychiatric medication, then therapy is initiated. The psychiatrist communicates the plan of psychiatric care to the

Individual, group and family sessions are provided in twelve clinics throughout Austin. The behavioral health providers deliver services to adults and children. Behavioral health consultants are bilingual in Spanish, hold a Masterâ&#x20AC;&#x2122;s degree or higher, are licensed in the State of Texas as a Licensed Clinical Social Worker, Licensed Professional Counselor or a Licensed Marriage and Family Counselor.

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o you have stress in your life? Like most of us, the answer is probably “yes.” Stress can come at us from many different angles. Work, finances, health, family and the economy are just a few examples of what can make us feel worried and tied up in knots. How we handle this stress can reveal a lot about us. Some people prefer running, the gym or medication. A growing number of people, however, are choosing a way to relieve stress in a way that actually causes stress for some...golf. Sound confusing? Let us take a look at some of the ways golf can help you untie the knots that come from the everyday issues most of us face, and simultaneously improve your mental health.

exercise is one of the best medications for the mind. And finally, if you just do not have the time to play a round of golf, hitting balls on the driving range can be very therapeutic and a great way to get your mind off the everyday issues causing you stress. This works much the same way lifting weights in a gym does for some people. You are by yourself, alone with your thoughts, exercising in a quiet place outdoors. Again, do not worry about how you are hitting your shots. Oftentimes, the answer to your problems will come to you once your mind has had a chance to be more calm and relaxed.

“Fulfill yourself by being outdoors in a beautiful setting”

By nature, golf is a quiet game. How many places can you think of that are as quiet and peaceful as a golf course? Whether you are playing a relaxing round with friends or family, or spending a few quiet hours alone with your thoughts, golf can be very therapeutic. However, some people take the game, and their score, very seriously. For these players, golf is the opposite of relaxing. For golf to be a stress reliever, do not keep score when you play; do not worry about how you are playing. Fulfill yourself by being outdoors in a beautiful setting. Enjoy the good shots you hit and forget the bad ones. Selective memory works well in this situation! If you do not keep score, golf as a stress reliever will be easier than you think. Another way golf can help you become more mentally healthy is to walk when you play. Yes, this takes more time, but look at it this way: is an extra hour walking a few holes worth it if it helps you decompress mentally? Of course it is. Make a list of all of the things you make time for during the week that you could do without, and put that time towards an enjoyable experience at the golf course. Not only are you taking steps (no pun intended) to relieve stress, but

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So the next time you are feeling overwhelmed with what life is throwing at you, set some time aside for the golf course. Your mind and overall mental well-being will forever be grateful!

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!"#$%&'()#%'*"*"+)&,-),#$'./0,#'#$)1'%.*2 Special Contribution to Austin MD by Stephanie Flores with Body by FRAME When it comes to exercise, we typically seek out immediate gratification from the best way to get the quickest desired results. There has been an increase in popularity for interval training recently, and you may find yourself wondering what it is, how it works, and if it will work for you and your body type. Traditional cardiovascular exercise has typically been defined as lengthy periods of aerobic activity lasting anywhere from 20 to 60 minutes. Such activity usually consists of running, walking, biking, swimming, elliptical or all of these. While doing steady state cardio, you would need to not only maintain a heart rate that is challenging, but also maintain a manageable pace typically between 60 to 70 percent of your resting heart rate. It is standard to increase the intensity by time, frequency or distance to improve cardiovascular endurance and strength. One well known type of interval training is HIIT: high intensity interval training. This type of workout consists of short, quick bursts of high energy, followed by short, low-intensity rest intervals. Work intervals range approximately from 90 seconds to two minutes, at 80 to 100 percent of one’s intensity level. The rest intervals range between 10 seconds to two minutes, where heart rate is brought down to a lower intensity level. You would repeat the cycle as many times necessary during a 15- to 30-minute time span. The two different types of cardio — aerobic (steady state) and anaerobic (HIIT) — employ two different types of energy sources, each having different but equally as effective mechanisms on improving the heart. Steady state cardio requires more oxygen and immediately utilizes carbohydrates for fuel.

Exercising at a steady state over the course of 45 minutes or longer will only then begin to burn through fat reserves after the carbohydrate resources are exhausted. The downside to this is that post-workout, your body stops burning calories. Interval training requires no oxygen and immediately employs fats and proteins for fuel. However, interval training makes your body work harder by building up more lactic acid (which the heart in turn utilizes as an energy source), burning more calories both during and after the workout. Of those calories, a higher amount of fat calories are utilized. Thus, you would need to do a longer period of steady state cardio to equal the caloric burn of interval training. If you are an athlete and compete, you can use both, but you should use periodization. In season it is wise to do activity that your sport calls for. For example, if you are a marathon runner focusing on building endurance and distance both in-season and in off-season, try switching to more explosive activity or shorter distance in the off-season. Both forms of cardio are beneficial and effective in their own ways. They both can increase your cardiovascular endurance, fat oxidation, heart strength, cardiac muscle mass, blood flow and oxygen supply. However, if you are pressed for time, you may consider high intensity interval training. It is best to implement both forms to provide your body with a balance between pushing yourself and allowing muscle recovery from HIIT.

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Want to try Interval Training? Here is an alternative to steady state running that can be done on a treadmill, track or trail. Warm up at a low to moderate intensity for about 5-10 minutes. Then sprint for 30 seconds and walk for 30 seconds. Repeat for approximately 15 20 minutes, followed by a 10-minute cooldown and stretch.

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hronic pain generally refers to persistent, non-acute, sometimes disabling pain in the spine, extremities or other areas of the body. This pain can be associated with a known cause such as an injury, or it can be a symptom of other chronic painful conditions such as fibromyalgia or migraine headaches. Naturally, a person experiencing persistent pain may begin to struggle with depression and various other mental health conditions. It is estimated that about 35 percent of the American population has some degree of chronic pain, and up to 50 million Americans have some form of disability due to chronic pain. Many individuals suffering from chronic pain may also have mental health disorders, like depression or anxiety, that can significantly impact the underlying chronic pain condition. The convergence of depression and pain is reflected in the pathways of the central nervous system. These pathways (which control the transmission of pain signals to the brain,) use some of the same neurotransmitters involved in the regulation of mood and emotion, such as serotonin and norepinephrine. When the regulation of mood and emotion fails, the existing pain is often intensified, along with feelings of sadness, hopelessness and anxiety. Like depression, chronic pain can alter the optimum functioning of the nervous system and perpetuate itself.

to identify risk factors for depression and anxiety, and they are treated accordingly. Sometimes antidepressants that work on neurotransmitters, such as serotonin and norepinephrine, are more beneficial than traditional painkillers in treating certain pain conditions. Furthermore, Advanced Pain Careâ&#x20AC;&#x2122;s ancillary services like cognitive behavioral therapy may help patients cope with depression and anxiety, while medical doctors treat the ongoing pain. Functional Restoration, a program available through Advanced Pain Care, is a concept specifically designed to help workers compensation patients return to day-to-day activities. This program utilizes physical therapy, neuromuscular re-education and, equally as important, treatment of psychological distress to help patients get back to a functioning lifestyle. With the support structure in place to build a patientâ&#x20AC;&#x2122;s confidence, many of the psychological barriers that accompany chronic pain can be eliminated, resulting in a whole new life, both phy s i c a l ly and mentally.

A classic example of overlapping depression and pain is seen in fibromyalgia, a condition marked by widespread muscle pain and tenderness at certain pressure points with no evidence of tissue damage. Because there may be no physical explanation for the pain they are experiencing, fibromyalgia patients are typically frustrated, discouraged and depressed. Fibromyalgia is more closely associated with depression than most other medical conditions. Functional MRI studies of people with this condition show heightened pain processing in cortical and subcortical regions of the brain, leading to the hypothesis that this condition could be caused by a brain malfunction that compounds sensitivity to both physical discomfort and mood changes.

There are strong links between anxiety and chronic pain conditions, with some studies showing that

nearly 45 percent of chronic pain sufferers reported having symptoms of at least one or more of the common anxiety disorders. Chronic pain can inevitably cause mental distress, and without treatment keep a person from being able take the necessary actions to return to a normal, productive and desired lifestyle. Numerous guidelines on evaluating and managing chronic pain conditions, like lower back pain, recommend that clinicians assess patients for psychological factors that may contribute to a poorer prognosis and address them with appropriate treatments. Because chronic pain and mental health can be cyclical, it is imperative for patients to feel that their healthcare providers listen, understand and support them in their healing process. It is also important for caregivers to advocate for psychological treatment plans that correlate with the physical treatment plan for chronic pain sufferers. Advanced Pain Care offers a comprehensive, multidisciplinary approach to treating chronic pain disorders and their associated psychological conditions. Our providers recognize the strong overlap between mental health and how it affects oneâ&#x20AC;&#x2122;s pain symptoms. Each patient is screened

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Sri Mandyam, M.D. of Advanced Pain Care is a board certified anesthesiologist and fellowship trained pain management doctor.

*36136)-2*361%8-32 Visit austinpaindoctor.com or call (512) 244-4272


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Special Contribution to Austin MD by the Regional Director of Texas Physical Therapy David Browder, PT, DPT, OCS Measure, (Mercer, 2004) was chosen as the method of assessing the impact of Called to Care in determining the shift in behavior of the participating physical therapists. It was selected because it incorporates key constructs of positive psychology that are part of the curriculum, including empathy, quality connections and positivity. CARE also has a normative database that allowed comparison of our results to various databases, including a publicly available dataset of 62,357 questionnaires from 1,520 different professionals, including physiotherapists from the UK. Over 1,300 new patients of trained physical therapists from five physical therapy clinics in Texas were given a confidential TexPTS begin implementing the Called to Care training in January 2013. Since space and mobile platform to enter their response to the ten questions after their then, the practice has been collecting data to demonstrate whether there is a initial visit (exhibit 1). The questions reflect the following on a five-part likert “shift” of behavior in therapists who have undergone Called to Care training and scale from fair to excellent: how it impacts patient care. The results are staggering and show that patients are responding to the compassionate treatment. A survey of more than 1000 TexPTS patients shows that TexPTS Called to Care therapists are performing well above the baseline averages*. The results show that there is a shift in behavior that patients take note of in their ability to show empathy, listen well and exhibit a positive attitude among other traits. Texas Physical Therapy Specialists (TexPTS), the preeminent provider of outpatient physical therapy in the region, is leading the charge on a new compassionate care training initiative aimed at improving patient care, results and overall recovery process. The Called to Care training program gives therapists the tools they need to focus more on personalized patient care with compassion at its core. TexPTS is one of two practices in the United States taking part in this training while actively monitoring the results with a validated instrument, the Consultation and Relational Empathy (CARE) Measure.

“The results have been eye opening and reaffirmed our team’s belief in the program. Called to Care has truly changed the way our PTs treat and interact with patients,” states TexPTS co-owner Dr. Rob Wainner, PT, PhD. “In today’s regulatory, paperwork-driven healthcare environment, the patient and his or her specific needs can be totally ignored. This training, based on research findings emphasizing empathy, listening and compassion, is more important than ever.” “The training has shifted the way our therapists think about approaching and treating patients,” Dr. Wainner continues. “We are focusing more on connecting with people, learning more about their lifestyle and goals to create a treatment plan customized to reflect those goals. We’re thrilled with the results and believe this will have a huge impact on the patients in our community.” Developed by PT Development and Evidence In Motion, the Called to Care training focuses on the non-clinical factors that impact successful clinical outcomes. The program is designed to bring humanity and personal care back to healthcare, thereby energizing both the medical professional and the patient. TexPTS has implemented the program in its clinics throughout Texas.

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Founded in 2005, Texas Physical Therapy Specialists (TexPTS) is a private physical therapy practice with locations throughout San Antonio, Austin, Georgetown, Dallas and Jourdanton. Known for teaching and training physical therapists all over the United States, TexPTS physical therapists take pride in delivering comprehensive and compassionate care with the best results to their patients. Our clinicians have a wide range of clinical expertise in manual physical therapy, spine care and rehabilitation, general orthopaedic conditions and rehabilitation, sports-specific injuries, workplace injuries and much more. TexPTS was voted one of the Top 50 Places to Work in San Antonio in 2011 and 2013 by their own employees, the Best Private Physical Therapy Practice in the U.S. in 2009 by their peers in the American Physical Therapy Association and has been recognized on the Inc. 500/5000 lists for the past three years.

1IEWYVMRK'EPPIHXS'EVI-QTEGX The validated instrument, Consultation and Relational Empathy (CARE)

How was the physical therapist at… 1. Making you feel at ease 2. Letting you tell your story 3. Really listening 4. Being interested in you as a whole person 5. Fully understanding your concerns

6. Showing care and compassion 7. Being positive 8. Explaining things clearly 9. Helping you to take control 10. Making a plan of action with you

*SV1SVI-RJSVQEXMSR Learn more about Texas Physical Therapy Specialists at texpts.com or call them at (888) 658-8483 A U S T I N MD M A G A Z I N E . C O M

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@061$*"+,%*'%4)+"'(%4*/*1$ #>3':;BN586489:3'D;'4E@@39=3@ Special Contribution to Austin MD by Carol Zernial with WellMed Medical Group My mother-in-law never knew my name. She already had Alzheimer’s disease when my husband and I first started dating. Whenever she saw me, she would say, “You’re that sweet, young thing.” And I would reply, “Yes, I am.” She had difficulty distinguishing between what she saw on TV and reality. She would tell us that Queen Elizabeth drove by her house that day in a carriage. And you wouldn’t believe it, but the Queen actually leaned out of the carriage window and waved.

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Show” at the time. To my mother-in-law, however, Johnny was the President of the United States, and he was picking her up to take her to the White House. Every night, she packed her pale blue overnight case and sat near the front door waiting for him to call for her. She would gradually get tired and go to bed, sleeping late into the next morning. When we set our wedding date, my father-in-law told us that they would not be coming. We were both shocked and saddened. We finally figured out that he was afraid that my future mother-in-law would do something to embarrass us or “ruin” our day. We told him that it did not matter what she did, that we wanted them at the wedding and we would just deal with whatever happened. At the wedding rehearsal dinner, the food was slow getting out. I looked over, and my mother-in-law was eating the small square butter pats off of the table one after the other. The waitress was staring at her - horrified. I smiled and asked if we could go ahead and get some bread to go with that butter. At the wedding, an amazing thing happened. My mother-inlaw thought all of the people had come to see her. They got in a line to her to congratulate her, and she was gracious in her thanks, shaking each hand. She smiled and waved from the front of the church like she was the Queen on that day. She had a wonderful time. Normally, I am what my loved ones might affectionately call “a control freak.” But studies have shown that people who age the best, through better health and a good quality of life, are people who are flexible. The species that have survived the longest throughout evolution

are those who learn to adapt. Flexibility is the key. I have never forgotten what I learned that day. I did not have to be in control of everything. It was okay to let go a bit, maybe even a lot. It did not really matter that much. Perhaps it was the motherly advice she would have given me, if she could have. And so, my mother-in-law, who had Alzheimer’s, who had lost all but the smallest words, and who never really knew who I was, gave me the greatest wedding gift of all.

Carol Zernial is Vice President of Community Relations for WellMed Medical Management and Executive Director of the non-profit WellMed Charitable Foundation. A noted gerontologist, Ms. Zernial is incoming Chair of the National Council on Aging Board of Directors.

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For More Information Visit wellmedmedicalgroup.com or call (888)781-WELL (9355)


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women in dentistry unlimited potential for leadership & influence in the field Special Contribution to Austin MD by Dr. Winnelle Bonilla of Rose Dental Group

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eing a dentist has historically been considered a man’s job. The increased number of women in medicine is cited as one of the leading causes of the changing face of medical practices. Currently, women comprise 50 to 60 percent of medical and dental students in Canada and the United States today. Our profession is on the road to becoming less gender-focused and more oriented to the individual’s ability and performance. What this means for women is that we have an unlimited potential for leadership and influence in dentistry. Women have a qualitative and quantitative advantage for leadership considerations. Concurrent with the increasing enrollment of women in dental schools, the attitudes of society have changed. As a consequence, medical students of today prefer to work for a living rather than living only to work. This is equally true for both men and women. They have demanded and obtained a better balance to life. They want reasonable hours of work, more sharing of responsibility, and time for family and recreation. Many female dentists strive to balance their personal lives with their professional careers, as well as the needs of individual patients and entire communities. They are promoting reforms to eradicate the professional barriers that many of them faced in their own careers and are working to change the way dentistry is taught and practiced. U.S. Department of Health and Human Services has

suggested that increased numbers of women in leadership roles in the healthcare fields can have the power to change the current system. Such changes in healthcare might result in a reorientation of our focus on diagnosis and treatment to a “more humanistic” approach to healthcare, including greater emphasis on primary prevention and health promotion. Female dentists are serving in the highest ranks of the medical profession, caring for whole communities and responding to new challenges in healthcare around the world. As high-profile leaders they offer new examples of roles for women today, and they institute strategies to help more women reach the very top of the profession. As leaders, they make choices that benefit communities across the country and around the world. As healers, they identify and respond to many of the most urgent crises in modern medicine, from the needs of underserved communities. Drawing on their own interests and experiences, women are instituting changes that have far-reaching benefits for the health and happiness of families, communities and medical practitioners themselves. I am proud to be a part of a growing female presence

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in dentistry. It is very exciting to practice in this time of growth and change in the dental field. I enjoy treating my patients and providing them with compassion and a gentle touch.

3+-'%+-0'"&4+-%$#"+& To contact Dr. Bonilla or Rose Dental Group please go to rosedentalgroup.net or call the South Location at (512) 288-4447

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Breaking the Stereotypes: Women Dentists Leading the Way

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The medical field has traditionally been known as a male-dominated profession. Dentistry is no different. Although more women have enrolled in dental school within the past few years, the general population still holds the traditional view of male doctors with female assistants. Prior to the 1970s, only three percent of all practicing dentists were women. According to a study done by The University of Michigan School of Dentistry, women now make up over 25 percent of all practicing dentists. An even more astonishing number, nearly half of all dental students today are women. My 2013 graduating class at The University of Louisville School of Dentistry was the first time there were more females than males. Due to this misconceived stereotype of genders within dentistry, there are several struggles that I encounter on a daily basis, both with patients and the general public. Often, women are stereotyped to be hygienists or dental assistants rather than dentists themselves. I cannot tell you how many times I have told people that I am a dentist, and their immediate response is, “Oh, that’s interesting; how long have you been a

hygienist?” Although I believe they mean no disrespect, I find myself continually educating the public about this common misconception. Even more disheartening is the patient who requests to be seen by a male doctor before I have the opportunity to provide them with treatment. I hope in the near future this currently standard perception changes. Although there may be a few obstacles to overcome as a female dentist, there are several positive aspects about it as well. Organizations, such as the American Association of Women Dentists (AAWD), provide a foundation for women to establish themselves within our field. Foundations such as this often give back to the community, in the form of charity or scholarships, to promote the growth of women in dentistry. Women-focused groups, such as AAWD and other study clubs, offer an avenue for females to gather and discuss our role and contribution to the field of dentistry. One of the more rewarding aspects of being a female dentist is the feedback that I receive on how nurturing we can be. Often, patients come to us scared or nervous. I have found that setting aside an extra minute to talk and relate to my patients about their daily life during appointments, rather

than only about the planned procedure, is an aspect that I believe my patients appreciate. Based on patient feedback, it seems like families with children love having the option of having a female dentist available to treat their kids. Having a positive firsttime experience for children can go a long way for not only the preventative dental health, but also instills confidence in going to the dentist for future checkups. Many of the children I see now will be great patients for life. I enjoy the thought of getting to see them grow up over the years. All in all, I am proud to be a part of a rapidly evolving industry for women. Although I am in the beginning of my career, I plan to be an integral part in not only the lives of my patients, but also change the standard perception that a visit to the dentist has to be an uncomfortable experience. My hope is for people to become more open to seeing female dentists if the opportunity presents itself. I definitely think that as time passes we will be seeing more and more female dentists. I am grateful to work in an environment where the team members and other dentists respect my knowledge and contribution to the industry.

3+-'%+-0'"&4+-%$#"+& To contact Dr. Whitehouse or Rose Dental Group please go to rosedentalgroup.net or call the Round Rock Location at (512) 310-9374

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r. Sherry Neyman has provided care for the women of Central Texas since 1996 when she joined Renaissance Womenâ&#x20AC;&#x2122;s Group. She focuses on convenient and compassionate well woman care by providing easy access to services such as mammograms, bone density screening for osteoporosis, urodynamic testing for incontinence and lab work available onsite during a single visit. Patients can get all their yearly screenings, including blood work, done at one time in one place. Dr. Neyman customizes care as patients move through different phases in life. She enjoys working with her patients as they transition through the teen years, childbearing, middle age and beyond. Dr. Neyman transitioned her practice to focus on gynecology exclusively in 2013. One aspect of her practice that she particularly enjoys is providing preconception counseling and fertility testing. â&#x20AC;&#x153;Since I personally did fertility treatments, I understand how stressful this can be and love to help my patients with advice from someone who has â&#x20AC;&#x2DC;been there.â&#x20AC;&#x2122;â&#x20AC;? A very popular part of her growing practice includes evaluation, counseling and treatment for menopausal issues, including hormonal treatment options. â&#x20AC;&#x153;There are so many changes during this time of your life, you want a caregiver who is interested in learning about you and working with you to achieve the vitality and good health practices that will last a lifetime.â&#x20AC;? Other services offered by her practice include birth control, HPV vaccination, medical and surgical treatment of incontinence, STD testing, evaluation of abnormal pap smears and treatment of menstrual disorders. Dr. Neyman is particularly interested in screening and treatment for Polycystic Ovarian Syndrome (PCOS). In-office surgeries provided by Dr. Neyman include hysteroscopy, endometrial

ablation to eliminate heavy menses, Essure for permanent sterility, and LEEP for abnormal Pap smears. Dr. Neyman is a strong advocate for utilizing cuttingedge technology when medically necessary. She uses daVinci robotically assisted, minimally invasive surgery for endometriosis, uterine fibroids and hysterectomies. â&#x20AC;&#x153;This allows me to perform complex surgeries with minimum discomfort and tiny scars to meet the needs of the active women who donâ&#x20AC;&#x2122;t have weeks to recover from treatment,â&#x20AC;? she explains. . She is a founding member of the Texas Institute of Robotic Surgery and one of the few gynecologists in the Austin area certified to perform the daVinci single-incision hysterectomy. One particular aspect of Dr. Neymanâ&#x20AC;&#x2122;s work stirs personal passions. Both her mother and maternal grandmother died of breast cancer and she feels a strong connection with breast cancer patients and survivors. â&#x20AC;&#x153;It is a special honor to care for these women,â&#x20AC;? she says. â&#x20AC;&#x153;I work closely with general surgeons and medical oncologists as part of a team approach during this time.â&#x20AC;? She also provides BRAC gene testing in her office to help women learn more about their risk factors and be proactive in breast cancer prevention. Dr. Neyman received her MD from the University of Texas Southwestern Medical School where she was the outstanding senior student in obstetrics and gynecology. She completed her internship and residency in obstetrics and gynecology at Parkland Memorial Hospital in Dallas. She holds an MS in biology from Southern Methodist University and a BS in biology from Christian Brothers University in Memphis, Tennessee.

found an opportunity to expand compassion and care-giving beyond her human patients. â&#x20AC;&#x153;Around Easter that year, I found an abandoned bunny by the side of the road, which led me to become involved with animal rescue.â&#x20AC;? A decade later, she cares for eight bossy yet adorable rabbits at her home. Additionally, she is president of House Rabbit Resource Network, an Austin-based non-profit which rescues rabbits and finds them forever homes. For more information on this aspect of Dr. Neymanâ&#x20AC;&#x2122;s work, visit www. rabbitresource.org. Dr. Neyman takes pride in providing personal attention to patients. In addition to a relaxing, comfortable surrounding and friendly staff, she makes a point to greet each of her patients with a hug. â&#x20AC;&#x153;I want to let them know I genuinely care about them and their health.â&#x20AC;?

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r. Marci Roy, an adult neurology practitioner, wanted to create a different experience for her patients. “It was our desire to create a softer, less clinical environment,” she explains. “We wanted it to reinforce how we feel about our patients and set expectations for receiving the highest level care available.” Initially a solo practice, Dr. Roy’s operation evolved to encompass the NeuroDiagnostic Clinic, Austin Headache Clinic, and Carpal Tunnel Clinic, with each providing focused services. The latest evolution of her practice is a partnership with Arise Austin Medical Center. “We are looking forward to being the neurology arm of Arise,” Dr. Roy says. As part of the partnership, she anticipates expanding her practice to include satellite offices throughout Central Texas. Dr. Roy diagnoses and treats neurological disorders of the nervous system, brain, spinal cord, muscles and nerves, including peripheral nerve disorders. Peripheral neuropathy describes damage to the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body. More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development and prognosis. Impaired function and symptoms depend on the type of nerves—motor, sensory, or autonomic—that are affected. Treatments are individualized, utilizing a combination of medicine, orthotics, physical/rehabilitative therapy, surgery and lifestyle changes.

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F].SR&PEGO 4LSXSKVETL]F]7XIZI(I1IRX Other conditions she focuses on include muscle disease and headache disorders. Most of the time Dr. Roy functions as a consultant to referring physicians. In this consulting role, she diagnoses and treats a neurological disorder and then advises the referring physician managing the patient's overall health. “We know that speed, accuracy and communication are of the utmost importance to our referring physicians and patients,” she explains. “That’s why we take the time to get to know our referring clinics’ unique needs and support the common goals of the best patient experience possible with the highest standard of care. We strive to make a positive contribution to each patient’s well being. I want to make a difference in my patient’s lives.” Dr. Roy has a reputation as an accomplished diagnostician who can diagnose tough cases, becoming one of Texas’s “go to” neurologists for other professionals. Additionally, she frequently lectures and conducts continuing education programs on a variety of topics such as headache disorders and neuropathic pain. One of the key elements Dr. Roy cites in the success of her practice is her staff. “We all share the same vision and mission to attend to patients with compassion and dignity,” she says. Many of Dr. Roy’s staff have been with her since the beginning of her practice, fostering the attitude that providing for patients is a collaborative process of diagnosis, treatment and education. “The staff constantly work to give patients the best clinical experience and highest quality of life

possible. Each member of the team is essential for providing optimal care for patients,” Dr. Roy says. “We want our patients to feel like family.” For many years, Dr. Roy has been named one of Austin Monthly Magazine’s Austin Top Doctors, and she has been a peer-selected Texas Monthly Texas Super Doctor for the past decade. Certified by the American Board of Psychiatry and Neurology, Dr. Roy received her MD at the University of Texas Medical Branch (UTMB) in Galveston. She completed her internship in internal medicine at Baylor College of Medicine and returned to UTMB where she served as Chief Resident of Neurology. She received her master’s degree from Texas A&M University College Station and a bachelor’s degree, summa cum laude, from the University of Texas at Austin, both in education.

Q%"'A%"?'+-Q%"A!#+%To learn more about Dr. Marci Roy and The Austin Headache Clinic, Carpal Tunnel Clinic and NeuroDiagnostic Clinic call (512) 467-7770.


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reating patients with movement disorders is very demanding, requiring continuing and comprehensive medical care. Another challenging aspect of these disorders, says movement disorder specialist Dr. Georgeta Varga is that they take a psychological as well as physical toll on patients. â&#x20AC;&#x153;Patients need to feel that they are not alone in their battle and Parkinson Disease Movement Disorders Clinic is here to be the ally they need.â&#x20AC;? Dr. Varga specializes in the diagnosis and comprehensive treatment of movement disorders using multiple techniques and therapies. She also employs clinical research as an avenue to contribute to this rapidly expanding field of medicine, with the intent of providing cutting-edge treatment for her patients. The complexity of movement disorders requires PDMDC to foster close cooperation with a team of specialists to address the full range of a patientâ&#x20AC;&#x2122;s needs. Depending on a particular patientâ&#x20AC;&#x2122;s requirements, this team may include neurosurgeons, neuropsychologists, psychologists, neurobehavioral specialists, physical therapists, occupational therapists, speech pathologists and others. Among the conditions treated by PDMDC are Parkinsonâ&#x20AC;&#x2122;s disease, Parkinsonâ&#x20AC;&#x2122;s plus syndrome, dystonia, tremor, gait disorders, Huntingtonâ&#x20AC;&#x2122;s disease and other choreiform movements, ataxia, myoclonus, restless leg syndrome, tics and Tourette syndrome and psychogenic movement disorder. Dr. Varga treats patients with a variety of therapies optimized for a patientâ&#x20AC;&#x2122;s unique condition, beginning with medical visits for diagnosis and medication management. Other treatments include botulinum

toxin injections for treatment of dystonia or spasticity; deep brain stimulation (DBS) screening evaluation for treatment of Parkinsonâ&#x20AC;&#x2122;s disease, dystonia or essential tremor; DBS programming for Parkinsonâ&#x20AC;&#x2122;s disease, dystonia or essential tremor as well as baclofen pump management for treatment of spasticity. While movement disorders are challenging and frustrating for patients, Dr. Varga says this is a time of great promise for their treatment, â&#x20AC;&#x153;In a time when our understanding of these disorders is accumulating faster and faster and the practice of medicine is undergoing dramatic changes, physicians need to make every effort in the best interests of their patients.â&#x20AC;?

fellowship in movement disorders at the Cleveland Clinic in Cleveland, Ohio. Her work on deep brain stimulation for movement disorders has been published in the Oxford American Neurology Library. Given the complex needs of the patients under her care, Dr. Varga has worked to ensure that every position at PDMDC is staffed by qualified and compassionate individuals. â&#x20AC;&#x153;I am very grateful to have a very professional and dedicated team in my office that allows me to focus on the most important part of my work â&#x20AC;&#x201C; taking care of patients.â&#x20AC;?

Dr. Varga feels strongly that part of providing the best service to her patients comes from constantly advancing research in the field of movement disorders. â&#x20AC;&#x153;I pursue clinical research as an avenue to learn more and contribute to the rapidly expanding knowledge base in this field,â&#x20AC;? she explains. Currently, one of PDMDCâ&#x20AC;&#x2122;s major research projects involves collaborating with the University of Tennessee as an investigative site to develop a genetic repository for movement disorders. In addition to her clinical and research work, Dr. Varga conducts educational programs on movement disorders both for her patients and for the community at large. Dr. Varga is a board certified neurologist and a Medical Diplomat of the American Board of Psychiatry and Neurology. She received her MD from the University of Medicine and Pharmacy in Cluj-Napoca, Romania, where she also completed a residency in radiology. Dr. Varga completed a second residency, in neurology, at the University of Oklahoma Health Sciences Center as well as

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ustin Pain Associates is unique from other pain practices in that we focus on treating chronic pain from a multidisciplinary approach,” explains Dr. Christine Anderson, a physician with APA. The practice’s multidisciplinary approach is rooted in an understanding that the impact of chronic pain goes beyond physical symptoms and can negatively impact many aspects of a patient’s life, including their interaction with family and friends as well as the ability to work or even perform routine tasks. As Dr. Anderson explains, APA’s approach is solidly endorsed by the latest data. “Recent neurobiological research shows the importance of addressing the biopsychosocial aspects of pain and emphasizing how emotion, anxiety and stress can further sensitize a patient to pain.”

With that in mind, in addition to targeting the source of pain through injection-based therapy, medication management and infusion therapy, APA offers patients a variety of other therapies and services. These include physical therapy to rehabilitate the body, behavioral health services such as meditative techniques and yoga to address chronic pain as well as cognitive behavior therapy and tools to improve coping mechanisms. APA’s office setting is designed to provide each client with an inviting and comfortable environment. “We recognize the patients coming to see us are in pain and

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we do our best to cater to their needs,” Dr. Anderson says. Members of the APA team, including physicians, physician’s assistants, nurse practitioners and medical assistants, work as a team to make a patient’s experience the best it can be. Dr. Anderson says that going into chronic pain management is one of the best decisions she’s ever made. “It is very rewarding when I am able to offer a treatment plan that enables patients to return to their lives, families and work. We give patients the tools to take control of their pain and ways to manage their pain instead of letting their pain control them.” She takes special pride in her work with soldiers, both active duty and veterans, who have been injured on deployment or in training. Her commitment to the military is personal as well as patriotic. “I’m part of that community. My husband, who was on active duty as a general surgeon, was deployed to Afghanistan on two separate tours.” Dr. Anderson is also involved with supporting charities such as the Susan G. Komen Foundation and The Georgetown Project, an initiative which supports and empowers that city’s children and youth. Dr. Anderson is double board certified in both anesthesiology and pain management by the American Board of Anesthesiology. She received her MD from the University of Nebraska Medical Center and completed her internship and anesthesiology residency training at Virginia Mason Medical Center in Seattle. She remained at Virginia Mason to complete

a fellowship in interventional pain. Dr. Anderson credits her time at Virginia Mason, an institution with an international reputation in regional anesthesia and pain management, with her decision to continue her training in chronic pain management. She received her undergraduate degree at St. Olaf College in Northfield, Minnesota. For Dr. Anderson, one of the most rewarding aspects of her work is seeing patients begin to make wise choices for their general health, such as beginning an exercise regimen, improving their diets and focusing on a healthier lifestyle. “That’s going to continue positively serving them in the future,” she says.

Q%"'A%"?'+-Q%"A!#+%Austin Pain Associates has offices in Georgetown, Cedar Park, Round Rock, North Austin, Central Austin, South Austin, Kyle , Westlake and Riverplace. Dr. Anderson sees patients at both the Cedar Park and Georgetown locations. To schedule a new patient appointment, you can reach us at (512) 416-7246, or schedule a new appointment online via our patient portal at austinpainassociates.com.


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or Dr. Lisa Jukes, one of the most rewarding aspects of practicing gynecology is the ability to build long term relationships with her patients. “I have the opportunity to get to know my patients through the

It also allows her to look after her patients from both a medical and surgical side. While most specialties divide these roles, as a dedicated gynecologist Dr. Jukes has the opportunity to be both to her patients. “This allows for a genuinely close and trusting relationship between patient and doctor for now and into the future,” she explains. In 2004, Dr. Jukes made the decision to stop providing obstetric services in order to better focus on the many needs of her gynecological patients. “I truly want to investigate female problems to find the most appropriate treatment and collaborate with other experts as needed.” Dr. Jukes is their primary care provider for many of her patients. With this in mind, her practice offers a wide range of gynecological, urinary and wellness treatments, products and services. In every aspect of her practice, she places a strong emphasis on preventative medicine. “We want to help patients navigate their treatment options with a variety of evidence-based remedies,” Dr. Jukes says. Gynecological services provided include annual wellness exams from adolescence onward, birth control consultation, urinary testing, cancer gene testing and an individualized approach to managing menopause. Dr. Jukes specializes in gynecological problems such as heavy and abnormal bleeding, pelvic pain, fibroids, ovarian cysts, endometriosis and abnormal PAP results.

In-office procedures and services available include uterine ablations, Essure permanent sterilization procedures, LEEP, colposcopies to treat cervical disease as well as sonograms. The practice also offers pelvic floor therapy for urinary incontinence, pelvic organ prolapse and pelvic pain. Dr. Jukes is a skilled daVinci Robotic Surgeon, having performed more than 400 such procedures, and performs numerous other minimally invasive surgical interventions. “I was one of the first physicians nationally to perform single-site daVinci robotic surgery,” she says, “It’s all done through the belly button. Patients who have had the procedure are very pleased with it.” In the coming weeks, Dr. Jukes will become the first physician in Austin to offer the Acessa procedure, an outpatient laparoscopic fibroid ablation for premenopausal women suffering from fibroids that allows them to return to normal activities quickly.

has appeared as an expert on gynecological issues in media outlets including FOX News Austin and Austin Woman Magazine. She is a national proctor for Intuitive Surgical for robotic gynecological procedures and was formerly a speaker for Warner Chicott pharmaceutical company. She is a member of both the Strategic Planning Committee and Robotic Steering Committee for the South Austin Medical Center. Dr. Jukes says her practice allows her to be surrounded be good people, patients, staff, family and friends. In putting together her team, she has strived to find staff members who care about patients and take pride in the job they do and the service they provide. For patients, the practice has created a peaceful and beautiful medical office environment to help them feel comfortable and at ease. “Every patient matters,” Dr. Jukes says, “Every day we operate with that as our directive.”

Her wellness center is an authorized clinic for Ideal Protein, an FDA approved and physician-supervised weight loss plan. Additionally, her practice is certified for BioTE® bio-identical hormone pellet therapy, which identifies and corrects hormone imbalance for both men and women. Dr. Jukes is board certified by the American Board of Obstetrics & Gynecology. She received her MD from the University of Texas Southwestern Medical Center where she also completed her residency in obstetrics and gynecology. She holds a B.S. in Zoology from Texas A&M University College Station. She also expresses her commitment to women’s health through a variety of outreach activities. Dr. Jukes

Q%"'A%"?'+-Q%"A!#+%To learn more or to schedule an appointment with Dr. Jukes, go to lisamjukesmd.com, call (512) 301-6767 or visit her practice at 5656 Bee Cave Rd., Suite B101.

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or Dr. Christina Sheely, practicing medicine meant coming back home. “I grew up in Buda and graduated from Hays High School,” says Dr. Sheely, now chief of surgery at Seton Medical Center Hays and a physician with Seton Orthopedic and Sports Medicine. “When Seton Medical Center Hays opened, I decided it was time to move back. It’s enormously satisfying to be back here practicing medicine and serving the people of Hays County and the Greater Austin Area.” Seton Orthopedic and Sports Medicine treats patients of all ages for a variety of orthopedic conditions and sports injuries such as bone fractures, degenerative joint disease and joint pain. Clinical services provided include injections, anterior cruciate ligament (ACL) reconstruction, as well as arthroscopic and joint replacement surgeries. In addition to Dr. Sheely’s location in Kyle, Seton Orthopedic and Sports Medicine has an office in Lockhart. Just as relocating to Hays County was inspired by growing up in the area, her decision to become an orthopedic surgeon is also rooted in personal experience. “I always knew I wanted to be a doctor,” she says, “but after having surgery to treat a high school athletics injury, I was hooked on orthopedics as a specialty.” A special area of interest for Dr. Sheely is regenerative medicine. “Throughout my medical career, I’ve used many different regenerative medicine procedures, evolving my procedures as the knowledge of regenerative medicine has grown. I’m always striving to stay on the leading edge,” she says. Her work with regenerative medicine has included using platelet rich plasma for tendonitis, tendon

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growth and bone growth. She was also a practitioner of Carticel, an early stem cell procedure used to repair articular cartilage injuries.

Kinesiology and Biology. Previously, she served as chief of orthopedics at the Community Health Center of Branch Country in Coldwater, Michigan.

Today, Dr. Sheely is a passionate advocate for the use of adult stem cells and often incorporates them into her practice for cartilage, bone and soft tissue repair as well as in the treatment of arthritis. She places great emphasis on keeping current on the latest developments in adult stem cell therapies and incorporating them into her practice.

Dr. Sheely is a member of the American Osteopathic Association, American Academy of Orthopedic Surgeons, American Osteopathic Academy of Orthopedic Surgeons, Arthroscopy Association of North America, Texas Osteopathic Medical Association and Texas Orthopedic Association.

“Few areas of medicine are growing as rapidly as the use of adult stem cells,” Sheely explains, “It’s less invasive than conventional surgical procedures and offers an extremely high rate of success.”

“No matter how small a patient’s injury may appear, it’s a big deal for them and you need to respect that,” Sheely says. “I love the instant gratification of being able to help patients with that, to see them come in hurting and go away feeling better and happy.”

In addition to her practice, Dr. Sheely is extensively published and a regular presenter on leading-edge topics in the field of orthopedics. “Part of ensuring that I’m providing my patients with the very best care possible is working to expand our understanding of orthopedic conditions and innovative therapies to manage those conditions,” she explains. Dr. Sheely is a board certified orthopedic surgeon. She received her Doctor of Osteopathy from the University of North Texas Health Science Center. She completed her internship and residency in orthopedic surgery at St. Joseph’s Health Center in Warren, Ohio. Dr. Sheely trained at a number of highly regarded institutions including Cincinnati Children’s Medical Center, Shriner’s Hospital, Cleveland Clinic, Ohio University of Osteopathic Medicine, University of Pittsburgh Medical Center and Steadmen Hawkin’s Sports Medicine Clinic. She has a BS from the University of North Texas in

Q%"'A%"?'+-Q%"A!#+%To learn more or to schedule an appointment visit setonfamilyofdoctors.com/institutes-and-specialtypractices-name/Seton-Orthopedic-&-SportsMedicine, call (512) 504-0866 or visit the practice at 1180 Seton Parkway #220 in Kyle.


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(210) 545-3147


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!"#$%&'($)%(*"+%,($'-%.(-#)%/(012'3% 2'454'))4&% ()% 2'$% 3(#*20'$% 6'*(-% 0"% 1"44(5)'7% “On the surface, she looked like she had it all together,” Ranus said, as she pensively lowered her eyes to the desk in front of her, in her office on the fourth floor of Building 781, the Austin Medical Center. She reflected on the endless cycle of treatment specialists, therapy sessions and support groups that she and her daughter endured together — all of the terrifying, life-changing moments that led her to eventually find herself in this very room. Indeed, Karen’s daughter did seem to have it all together. Sara Ranus, at the time a bright and ambitious 18-year-old, was the picture of college success. She was attending a small, private liberal arts university in Austin, Texas, where she was actively involved in leadership organizations, community service projects and study tours to Washington, D.C. But beneath the surface, Sara was secretly struggling with the onset of mental illness. Shortly after her arrival to college, she was diagnosed with depression, and she soon developed an eating disorder to cope with her anxiety. “I felt like I was losing her,” says Ranus. “And I just felt so protective. There are so many misconceptions and stigmas associated to mental illness. I didn’t want people looking at my daughter differently or thinking badly about her because of her illness.”

But Karen and Sara found help in the Austin chapter of an organization called NAMI, the National Alliance for Mental Illness. This non-profit organization, which has been in Austin for thirty years, is dedicated to offering individuals affected by mental illness the help and support they need throughout their treatment process. They offer a variety of counseling sessions and support groups, completely free of charge. One particular program, Family to Family, had a profound impact on Karen’s and Sara’s lives as they sought to understand how they could move forward now that the diagnosis of mental illness had changed everything. “Family to Family is a class that’s made for family members: sons, daughters, parents, spouses, siblings, partners of someone who lives with a mental illness; it’s everyone coming together to help those they love,” says Ranus. “The class really covers the full spectrum of all of the different types of mental illness, what the medications and treatments need to be, and what the signs and symptoms are. It really made a huge difference in the way we addressed [Sara’s] illness.” After completing the 12-program, Karen and Sara felt empowered to face the mental health issues that they previously had not known how to address. They left the program with a binder full of resources, phone numbers and information, all provided at no cost from NAMI, and they were able to develop a greater understanding of the illness that once caused them so much pain and uncertainty. Sara, now 22, is attending a local community college and is considering transferring back to a private university next year. “NAMI taught me that there is hope,” says Ranus. “There is recovery.”

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Although Karenâ&#x20AC;&#x2122;s and Saraâ&#x20AC;&#x2122;s story is empowering, it is not unique. They are just one of the hundreds of families whose lives have been changed by the programs offered by the Austin chapter of NAMI. This grassroots organization is committed to providing help and hope for individuals and families affected by mental illness through advocacy, education and support. The Austin chapter is growing rapidly, both in numbers and in esteem. It was named both the National NAMI Affiliate of the Year and the NAMI Texas Affiliate of the Year for 2013. Although NAMI Austin had been entirely grassroots and volunteer-based up to that point, its growth inspired the organization to begin hiring staff at the beginning of this year, including its first-ever Executive Director: Karen Ranus.

in students and how to best address the needs of these individuals in a way that is supportive and productive. It is also currently launching a program called â&#x20AC;&#x153;End the Silence,â&#x20AC;? which is presented in high schools and middle schools to educate teenagers and young adults about mental health disorders in adolescents.

After her positive and life-affirming experience with NAMI Austin, Ranus decided to use her previous experience with non-profit management (mainly involving work with supplemental housing and homelessness) to help NAMI reach as many families as possible with educational resources and support groups.

â&#x20AC;&#x153;We want people to start talking about what mental illnesses really are. Theyâ&#x20AC;&#x2122;re like physical illnesses. They require treatment and medication and a support system,â&#x20AC;? says Ranus. People can live and function well with mental illnesses. And then we invite them to help us. We can reduce the stigma associated with mental illness by beginning to talk about mental health with each other and with other people.â&#x20AC;?

NAMI Austin has grown tremendously over the past couple of years. Through fundraising efforts and stories like the Ranus familyâ&#x20AC;&#x2122;s, it has reached hundreds of families and individuals across the Austin community, providing help, hope and advocacy for individuals who need a place to turn, and changing the face of mental illness one presentation at a time.

â&#x20AC;&#x153;NAMI taught me that there is hope. There is recovery.â&#x20AC;?

â&#x20AC;&#x153;What weâ&#x20AC;&#x2122;re really trying to do is help family members and families feel empowered to do two things,â&#x20AC;? says Ranus. â&#x20AC;&#x153;One is to be good advocates for the person in their family living with a mental illness, and the other is to help them develop the skills to help take good care of themselves as well.â&#x20AC;? In addition to the Family to Family program, NAMI Austin provides other workshops and classes that help advocate for and support the 25 percent of people in the United States living with mental illness. Another class offered is Peer to Peer, which is a support group and educational workshop for people suffering from mental illness. It teaches participants how to recognize the signs and symptoms of depression, how to develop coping mechanisms and how to both care for themselves and prevent relapse. Both Family to Family and Peer to Peer are 12-week courses that are taught not by professionals or health care specialists, but are instead guided by what Ranus calls the â&#x20AC;&#x153;lived experience.â&#x20AC;? They are taught by individuals and family members who have either suffered from mental illness themselves or have a loved one who has or is suffering from mental illnessâ&#x20AC;&#x201D;individuals like Ranus and her daughter Sara.

Q%"'A%"?'+-Q%"A!#+%NAMI Austin also works to educate the community about advocacy and support. It currently works with local schools to provide school professionals with educational presentations that teach what mental illness can look like

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entire person operate with more ease, efficiency and confidence.

As an alternative medicine doctor who relies equally on intuition and science, I focus on the neurologic conditions that can inhibit effectiveness and success in people’s lives. Conditions that people have been told are irreversible and unchangeable, such as dyslexia, ADHD, head injuries, allergies and many chronic health conditions, are often reversible – much to patients’ amazement and relief. Neural Freedom is the umbrella term used in this approach. One of the main therapies developed over three decades of study, research and action is Books Neural Therapy™, a gentle, hands-on, drug-free and whole-body approach to healing.

A very thorough case history begins the process, which I follow up with neurological, structural and cognitive testing, as well as allergy and brain chemistry panels. Goals vary widely from wanting to read better or think more clearly to wanting to uncover blocks in emotional or business effectiveness.

This approach includes a comprehensive view of what might be contributing to the communication breakdowns going on within an individual’s body, or among various brain functions, belief systems or even interactions within the work environment or home environment. It incorporates the latest advances in neuroscience to find communication breakdowns in the circuitry (the nervous system) and “rewires” and “upgrades” the neurology via particular tracts (e.g. spinothalamic tract), to help the

When the treatment succeeds, as it does four out of five times, my patients’ lives change in ways they could not even begin to imagine. Even the family dynamic changes. Here is a peek into a day in my office. Allow me to share with you the stories of my patients, and though their names have been changed to preserve their privacy, the specifics of their situations are very real.

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For Victoria, mother of three young boys, a layoff was a blessing in disguise. Victoria had suspected, since Kindergarten, that her eight-yearold son, Israel, had Attention Deficit Disorder (ADD). “Getting him diagnosed took a long time,” she told me recently. “My son’s teachers had the wait-and-see attitude. That’s easier said than done; kids know when they’re different.” Being forced to stay home gave Victoria the chance to observe Israel’s behavior for longer stretches of time – and convinced her that ADD was the cause. “We had a couple years of high-stress evenings – Thursdays were the worst because homework was due on Fridays – and not understanding his behavior,” she said. “I wondered: Was he smart enough to understand the school work? Why was it taking him a long time to complete assignments?” Victoria knew that she and her husband were making concessions for Israel’s behavior. If he did not finish his chores or took too long a shower, instead of scolding, Victoria and her husband would assume he had gotten distracted and looked the other way – but when Victoria discovered teachers were also making concessions, she knew it was time to act.

unsure boy who wanted to behave differently, and a sincere but skeptical mother who wanted Books Neural Therapy™ to work. I spent time talking with them both. I needed a clear and comprehensive understanding of what was happening at home (anger issues) and at school (behavior issues). Once I had that, I was able to suggest a treatment plan, which we began immediately. Victoria noticed an improvement in Israel’s behavior after just a couple weeks of therapy. “I couldn’t explain to my friends exactly what was happening, but I knew the therapy was working,” Victoria said. “I took him off sugar, and his appetite increased. He was hungry all the time, which was good because he was underweight. I noticed he was able to get his assignments done, and Thursday nights were not nightmarish anymore.” Israel’s improvement continued. In time, he was able to do his homework independently (that was simply not an option before) and follow multistep directions. Even his stutter went away. Israel is not yet off the meds his pediatrician prescribed, but his dosage has not increased (it typically does as a child grows), and his parents are optimistic that one day, the meds will be a thing of the past.

That is when Victoria came to see me. At our first meeting, I saw a shy and

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The pressure that comes with running a successful business is intense, even without the added stress of chronic health issues. Grace is the CEO of a multi-generational family business who first heard me speak on a radio program about how dyslexia can rear its discombobulating head at different points in a personâ&#x20AC;&#x2122;s life and wear down other bodily systems in the process. When we met, I learned that Grace suffered from chronic fatigue, allergies and an old head injury, and that she felt like she had the flu all the time. All of that, compounded by â&#x20AC;&#x153;the buck stops

hereâ&#x20AC;? reality that every business owner experiences, left her too exhausted to fight back when employees took advantage of her weakened condition. After six weeks, Grace felt like a new person. Her face looked younger and rested, and her voice sounded happier and lighter. She began joking more; now she jokes all the time! She decided on a new direction for the business, announced rules to curb employeesâ&#x20AC;&#x2122; ability to take advantage, and feels that our work together allowed her to take her life back.

'EWI7XYH]2S .S]GI¯XLI')3[LSLEHXS WRIEOSYXSJXLISJ½GIIZIV]EJXIVRSSR Joyce, founder of a 20-year old company, found herself sneaking out of her office around 3:00 every afternoon so she would not meet employees in the restroom during her attacks of diarrhea. Blood tests revealed that she could eat only four foods (onions and sardines were two) without becoming ill. Over time, the effects of the allergies contributed to a thyroid condition, which resulted in unwanted weight, a generalized inflammation that was affecting her eyesight as well as other bodily functions. In short, it was affecting her ability to run a successful business. We worked together on eliminating the allergies, one

by one. Twelve years later, Joyce is still totally allergy free. She told me once that undergoing treatment with me was the best investment she ever made in herself. Books Neural Therapyâ&#x201E;˘ has changed the lives of thousands of people â&#x20AC;&#x201C; people like Victoria, Israel, Grace and Joyce â&#x20AC;&#x201C; all around the world. If you see yourself or a loved one in any of these descriptions, I would love to hear from you. I have learned that to give hope, it takes looking at a problem in a way the traditional world does not see. Do you have issues that could benefit from an alternative approach?

Are You A Candidate for Books Neural Therapyâ&#x201E;˘? 2IEVP]ER]SRIGERFIRI½XJVSQXLI XVIEXQIRXFYXXLIIJJIGXMWTEVXMGYPEVP] HVEQEXMGJSVTISTPI[MXLPIEVRMRKERH FILEZMSVMWWYIWERHLIEHMRNYVMIW -J]SYSVEPSZIHSRIGERERW[IVÂł]IW´ XSER]SJXLIWIUYIWXMSRW]SYQE]FIE GERHMHEXIJSV&SSOW2IYVEP8LIVET] ,EZI]SYIZIVJEPPIRSR]SYVLIEHSV ]SYVXEMPFSRI# %VI]SYVLMTWWPMKLXP]YRIZIR MW]SYV FIPXFYGOPILMKLIVSRSRIWMHI# (S]SYLEZIERYRIZIRKEMX RSR žYMHSVYRKVEGIJYP[EPO # (S]SYLEZI81.TVSFPIQW KVMRHMRK ]SYVXIIXLEXRMKLXFVEGIWTSTTMRK NE[ # ,EZI]SYIZIVFIIRORSGOIH YRGSRWGMSYW# (S]SYLEZIWGSPMSWMW WMHI[E]W GYVZIMRXLIFEGOFSRI # (S]SYWXVYKKPI[MXLPIEVRMRK HMJ½GYPXMIWSVWIUYIRGMRKMWWYIW#

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North Office (512) 219-8600 Tues/Thurs NorthWest area: Peoples Pharmacy Wellness Center Northwest 183/620.

Q%"'A%"?'+-Q%"A!#+%:MWMX(V4L]PPMW&SSOW´WSJ½GI&SSOW*EQMP],IEPXL'IRXIVPSGEXIH at 13740 U.S. 183 M-1, Austin, TX 78750 or call (512)331-0668 to book an appointment. Dr. Books also offers professional training courses. Learn more about upcoming classes at drphyllisbooks. com/upcoming-classes.

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SIGNS OF MENTAL HEALTH IN CHILDREN Using the potential of the mind...

Special Contribution to Austin MD by Renee Hanson, Director of Development - Austin Child Guidance Center

MAY 8th

is the national holiday for Children’s Mental Health Awareness Day. Every year around this time, the Austin Child Guidance Center, a local leading non-profit in serving children’s mental health conducts community outreach and events to raise awareness and funds for children’s mental health. The mental and emotional health of children continues to be an important local and national topic of discussion. As time goes on, more and more parents are accessing mental health services for their children in times of crisis, stress, transition and concern. When a child breaks his arm, you take him to the doctor. When a child is experiencing emotional issues, seeking out a trained professional who understands behavioral health can strengthen the child and family’s ability to navigate through difficult times. Making sure our children are reaching appropriate developmental milestones has long-term impacts on a child’s ability learn and create positive relationships with peers and family members. Child development research links children’s mental health to a child’s overall health and well-being, as well as their ability to learn, focus and succeed in social learning environments.

“FOR INSTANCE, MOST CHILDREN SHOW INTEREST IN PEERS AND DERIVE ENJOYMENT FROM INTERACTING WITH OTHERS.”

Julia Hoke, Ph.D., Licensed Psychologist and Director of Psychological Services at Austin Child Guidance Center said, “Early signs of mental health challenges can include atypical social development. For instance, most young children show interest in peers and derive enjoyment from interacting with others. When, these patterns are absent, it is concerning. Extreme difficulties regulating emotions can also be a red flag for emerging mental health difficulties. Most children have tantrums in the early years but when tantrums persist after ages 3 or 4, and are very intense and difficult to interrupt, children should be screened for developmental or social-emotional problems. Finally, frequent or very intense aggression can also be a clue to parents or professionals that additional evaluation is warranted.” As children transition into adolescence, their resiliency and coping skills to stress are important factors that contribute to their emotional wellbeing. Results from the Austin Independent School District Student Substance Use and Safety Surveys from 2011 show that 16% of middle and high school students report that their ability to cope with stress or negative emotions is “poor” or “very poor.” The Indicator Improvement Project (2011) stated that 9 out of 10 students classified as having an emotional disturbance in a Texas public school were suspended or expelled on a discretionary basis. School disciplinary referrals are the greatest predictor of future juvenile justice involvement in Texas. Not surprisingly, one-third of all youth referred to the Texas Youth Commission (now the Texas Juvenile Justice Department) have been diagnosed with mental illness, and 60% of those incarcerated

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at Commission facilities have been identified as needing mental health services. Travis County’s 2012 Community Impact Report on Behavioral Health stated, “Participants in the 2012 Austin Travis County Community Health Assessment (CHA) and the 2011-2012 Central Health Connection Leader Dialogue Series cited mental health as a critical issue facing the community.” Now more than ever, the need for quality, local mental health services for children and families is monumental. For over 63 years, the Austin Child Guidance Center has been the leading provider of affordable mental health care for central Texas children and families. The agency annually serves over 3,500 children and family members. Services are provided by a multidisciplinary team of social workers, counselors, psychologists, and psychiatrists from a central location on 45th and Lamar. Services are also delivered at the juvenile justice center, community health clinics, schools, and eight at-risk childcare centers. The Center provides affordable, comprehensive mental health treatment services to children and families on a sliding fee scale or at no cost. No child is turned away for inability to pay for services. The agency has also served as a recognized, premiere center of training for future mental health care professionals and youth service providers.

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Innovative Tool Helps Diagnose and Track ADHD Cedar Park West Clinic First in Central Texas to offer computerized testing 7TIGMEP'SRXVMFYXMSRXS%YWXMR1(F]7GSXX ;LMXI,IEPXLGEVI

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ttention Deficit Hyperactivity Disorder (ADHD) is a common childhood condition characterized by more than normal difficulty with focus, behavior control, impulsivity and hyperactivity. It affects nine percent of children younger than 18 and approximately four percent of American adults, according to the National Institute of Mental Health. Boys are four times more likely to be diagnosed with the condition as girls, but after adolescence, males and females are diagnosed in equal numbers. Some kids grow out of it, and some never do.

relationships, self-esteem, and addictions.

ADHD is a common condition that affects children and adolescents and can continue into adulthood for some. The National Institute of Mental Health (NIMH) estimates that three percent to five percent of children have ADHD. Some experts, though, say ADHD may occur in eight percent to ten percent of school-aged children. Experts also question whether kids really outgrow ADHD. What that means is that this disorder may be more common in adults than previously thought.

“Since ADHD shares traits with other mental health conditions, it can be difficult to diagnose. So a thorough assessment by a trained professional is critical. The test is a more objective test than previous methods of diagnosis and will serve as an additional tool for us as clinicians,” Dr. Lal said. “Testing can be done from age six to 55 years of age.” The test can also be used to quantify severity of deficits in brain function associated with controlling motion and sustaining attention. The results are objective and allow the patient, parent and physician to see the progress when treatment is working and help to guide decisions about how to optimize the treatment plan for each individual.

Children with ADHD generally have problems paying attention or concentrating. They cannot seem to follow directions and are easily bored or frustrated with tasks. They also tend to move constantly and are impulsive, not stopping to think before they act. These behaviors are generally common in children. But they occur more often than usual and are more severe in a child with ADHD. The behaviors that are common with ADHD interfere with a child’s ability to function at school and at home. Adults with ADHD may have difficulty with time management, organizational skills, goal setting and employment. They may also have problems with

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Arti Lal, M.D., a pediatrician who specializes in treating patients at the ADHD Clinic at Scott & White in North Austin, is currently utilizing a new technology on patients, called the Quotient® ADHD Test. It is FDA-cleared for the objective measurement of hyperactivity, impulsivity and inattention, as an aid in the assessment of ADHD. The test measures motion and analyzes shifts in attention state to give an assessment of the core symptom areas of ADHD: hyperactivity, impulsivity and inattention.

Bradley R. Berg, M.D., Ph.D, Medical Director at Scott & White Clinic – Round Rock Pediatrics says treatment for ADHD varies with age. For very young children, he explained that, “After age six, medications in combination with therapy generally work best.” The test takes 15 minutes for children aged 6 to 12, or 20 minutes for adolescents and adults. The clinician can present a treatment plan to the patient/ parent. Dr. Lal added, “The test also has a 94 percent negative predictive value, which means it can say

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with 94 percent certainty that you do not have ADHD, which is a very powerful statistic.” Berg added, “We’re also able to see patients from other pediatric or family medicine, neurology, psychiatry offices in and around the Central Texas area to help the primary care physician with a diagnosis.”

Q%"'A%"?'+-Q%"A!#+%Visit the Scott & White Cedar Park West Clinic, which is located in North Austin at 12129 FM 620, Austin TX 78750, or call (512) 336-3400. Patients will need a referral from their primary care physician and prior authorization from their insurance carrier for the test. The test is covered by most major insurance plans.


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ama, where are you? I can hear you but I canâ&#x20AC;&#x2122;t see you!â&#x20AC;? These are the anxious words I heard one recent Sunday as I left my churchâ&#x20AC;&#x2122;s sanctuary. I looked down to see a school-age girl frantically make her way against the flow of traffic of all the grown-ups in search of her mother. Her face and tone of voice said it allâ&#x20AC;&#x201D;â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;m scared!â&#x20AC;? Young or old, I think we can all identify with this girlâ&#x20AC;&#x2122;s immediate feeling of fear. Anxiety is a normal part of life. Speaking in front of an audience, a job interview, a first date, flyingâ&#x20AC;&#x201D;all of these normal, everyday experiences can certainly produce anxiety or what is known as acute anxiety. Acute anxiety is fueled by the immediate situation. The good thing is that the stressful situation that produces the anxious feeling is usually short-lived. When the situation is over, such as when the young girl reunites with her mother, the anxious feeling goes away and the person feels better. Anxiety, however, can also be long lasting and sustained and more generalized. This type of anxiety is more chronic and could be the result of an anxiety disorder. According to the Anxiety and Depression Association of America, anxiety disorders are the most common behavioral health issue in the country, affecting 40 million adults, or 18 percent of the adult population. And people struggling with an anxiety disorder are also three to five times more likely to visit their doctor. Chronic and generalized anxiety not only affects how we feel emotionally, but also how we feel physically. Our bodies take a direct hit from prolonged anxiety and stress. When stressed, we experience a physiological reaction as our brain quickly moves us into a â&#x20AC;&#x153;fight or flightâ&#x20AC;? mode and dumps stress hormones into our bloodstream. The longer the anxiety lasts, the longer we remain on heightened alert. The longer we are on high alert, the more stress hormones remain in our bodies, which can lead to a decrease in bone density and muscle

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tissue, lowered immunity and fatigue. More mental tension can lead to more physical tension resulting in upset stomachs, tightened chests and headaches. What causes an anxiety disorder? It is usually a mix of risk factors, including genetics, brain chemistry, certain personality traits and stressful life events all coming together to put these disorders in motion. But there are things you can do to help ease your mind and regain control of your anxiety:

â&#x20AC;&#x153;Chronic and generalized anxiety not only affects how we feel emotionally, but also how we feel physically.â&#x20AC;? ¡ Exercise: With your doctorâ&#x20AC;&#x2122;s permission, develop a regular regime consisting of moderate aerobic and strengthening exercises. This can help boost your immune system and energy levels while limiting the effects of stress. Remaining sedentary allows the stress hormones to pile up in our bodiesâ&#x20AC;&#x201D;so move! ¡ Eating habits: Make sure you are eating healthy, balanced meals and snacks. It is not uncommon for people to eat too little or eat too much, or to load up on sugars and carbohydrates when stressed. Also, monitor your caffeine intakeâ&#x20AC;&#x201D;too much can certainly add to your anxious jitters. ¡ Relationships: Chronic anxiety and excessive worrying can negatively impact important relationships and engender feelings of loneliness and isolation. Stay connected with others, especially those who can be empathic and supportive. And talk openly with your partner about what you are experiencing and needing. ¡ Relaxation: There is something to be said about meditation and practicing mindfulness. Spend 10-15 minutes each day paying close attention to what you are experiencing in that moment. Notice your thoughts and feelings without judgment or analysis. And practice breathing slowly and deeply. Distracting yourself with a funny movie or book, or doing something playful can also help you relax.

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Laughter really is good medicine! ¡ Therapy: Having a trained professional helps you identify your particular triggers, and developing healthy coping mechanisms can help you manage your feelings and worries. ¡ Medication: If the feelings of being overwhelmed are getting in the way day in and day out, you can always consult a psychiatrist about medications. Although medications will not â&#x20AC;&#x153;cureâ&#x20AC;? the anxiety, they can help you feel more in control so you can function. Chronic anxiety can make you feel out of balance. Taking the time to take care of yourself physically, mentally and emotionally can help you feel calmer while inoculating yourself against additional stress. It is crucial to remember that prolonged anxiety and stress can potentially lead to serious medical conditions, so always consult your physician first if you develop symptoms you are unsure about.

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# Civil Rights Struggle

The Employment Pickle for Disabled Adults

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by Hannah Thornby

ike many students, Tasha Smith spends upwards of 20 hours every week on the campus of St. Edward’s University in south Austin. She can be seen across campus doing a wide variety of things (from watercolor to lunch dates with people from the Student Leadership office) but never attending an actual class. She is in fact in no way affiliated with the university and never has been. A disabled adult living in Austin, Texas, Tasha was a recruit of the Go Project. Tasha was enrolled in the Go Project, an alternative education program run through AISD, in 2005 after years of being bullied in high school. A community-based effort, the Go Project offers life-skills classes for adults with significant disabilities. These classes are designed to combat that fraught transition for the developmentally disabled after school, when there are inevitably fewer government services and programs available. They run the gamut of job training to biology and use some of the classrooms available on St. Edwards’ campus. Those classes ended in 2008. But Tasha never left St. Edward’s. “I just like being out of my house,” Tasha told me while in Ragsdale Student Union Center at St. Edward’s. Since she is a frequent flyer at Ragsdale, a number of cafeteria workers, students and professors greeted her while we were there. She is at St. Edward’s Monday through Friday because she wants to be; she likes the campus and the friendly people. And though she has dreams—she would love to work with kids like her mother, a pediatrician—those dreams far surpass her options. Under U.S. law, Tasha Smith is categorized as developmentally disabled. She has a severe and chronic intellectual disability that started before she was 22 and will continue throughout her life. As a resident of Austin, Tasha has some help. Because she is disabled, and because she earns less than $1,040 every month, she is one of over 640,400 people that receive Supplemental Security Income in Texas. So far, that $600 check is one of the reasons that Tasha is not working: she has yet to find an employment option that will make giving up that check worthwhile. In 2008, Tasha was aged out of the GO Project. Federal law only standardizes education for the developmentally disabled until the age of 22. Despite the GO Project’s best intentions to help her transition on to bigger and better things, her disability has held her largely in place. Now 30, Tasha is still coming to St. Edward’s

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every day. She is among the 62.6 percent of those living in Texas with a disability who are unemployed. Despite the Texas Labor Code and the American Disabilities Act of 1990’s best efforts to curb discrimination (they made it illegal), discrimination against those with disabilities is alive and well. Lack of understanding, lack of support and the threat of lawsuit under the ADA’s own accommodation mandate continues to put barriers in front of the hiring of disabled workers. In Texas, 29.5 percent of those with a cognitive disability in 2012 lived in poverty. One of Tasha’s options is to return to work at a Goodwill in Austin where she worked in a sheltered workshop. Sheltered workshops are an alternative work option for an estimated 450,000 Americans with disabilities, a supposed answer to the question of what to do after losing the infrastructure of services and programs available for disabled youth. Touted as opportunities for those with disabilities to find the type of dignity those without disabilities find in their jobs, sheltered workshops are an attempt to find “a safe place” for those with disabilities. Yet in menial jobs like stuffing envelopes, sorting buttons and pushing in screws, those employed by sheltered workshops are still being closed off from the rest of the world, laboring out of the public’s eye. In these roles, there is little in the way of education, further job training or interaction with peers. They are a form of both segregation and discrimination. Last year, an NBC news investigation aired a segment uncovering how widespread it is for charities to pay people with disabilities a sub-minimum wage in sheltered workshops. They highlighted Goodwill, a nonprofit well known for employing the disabled—they advertise on billboards around the country. Yet while some of their top executives earn as much as six figures, loopholes in a federal law allow them to legally pay some of their disabled workers as low as $0.22/hour. That federal law is the Fair Labor Standards Act, which was originally passed in 1938 to combat discrimination.

In the world 75 years later, its legacy is one of enduring discrimination as people with disabilities are legally allowed to be paid less than everyone else because of their disability. Tasha is one of many who understand sheltered workshops as places that reinforce what she cannot do as opposed to what she can. At the Goodwill, she was paid $2.00/hour to sort baby clothes. She was told to keep to herself and not talk to others. She quit after a week and promised herself she would never go back.


1)28%0,)%08, She may not have something to do every day of the five days a week she is on campus—she goes on many lunch dates —but she feels more valued in her ambiguous role at St. Edwards’ community than she ever did with a contract at the Goodwill. When summer arrives and people talk to leave St. Edward’s for vacation, Tasha will not be coming to campus as much. Her goal is to spend the summer babysitting, earning money and working with kids. She is currently working on getting her babysitting certification. Her options for work in the public sphere might be changing soon. A ruling by the U.S. Department of Justice in April is being called a “blueprint” for facing the big questions and big gaps in equalivty employment for Americans with disabilities. The core tenets of their “landmark” decision involve community integration and preparation education, not unlike Tasha’s GO Project experience. The ruling came out of a harsh condemnation of Rhode Island’s reliance on sheltered workplaces in lieu of other options for disabled adults. The plans for reform in Rhode Island are being given a 10year deadline. Their success hinges on a comprehensive understanding of the vast spectrum of disabilities currently included under the Americans with Disabilities Act. The Texas Council for Developmental Disabilities has yet to take an official position on sheltered workshops. Yet their position on employment reads: “Through employment, people with disabilities gain an important point of entry into their community, a sense of being valued, wages and job benefits.” The TCDD insists on opportunity without “segregation or discrimination.” A funneling of disabled adults into sheltered workshops is a far cry from these values. With luck, change will come down from Rhode Island to Texas, and inequalities that have marred Tasha’s adult life will finally be addressed. There may be no complete resolution for how to best serve and address the various living and working challenges faced by disabled adults, but recognizing the lack of a one-fit-all solution and the need for an array of services and options is a good first step.

of St. Edward’s now, and earn competitive enough wages that she will not have to rely on her SSI check. She will be able to share her smile and charm with the people she loves to talk to without settling for a job that will keep her in the back of some building, shut away from the rest of the world for non-livable wages. Last month, four presidents and dozens of leaders from all over the country came to the LBJ library in Austin for a Civil Rights Summit honoring the 50th anniversary of President Johnson’s Civil Rights Act. Speakers and panels honored the continuing civil rights struggle and raised awareness for civil rights issues today, including equality in education, gender, income and race. Up until the week prior to the event, there were no panels recognizing the disabled inequality struggle. Only after a statement released the week prior by the National Council on Disability, about how their exclusion from the summit boiled down to discrimination, did the organizers of the LBJ Civil Rights Summit include a panel on disability. If things are to change for Tasha and other disabled adults in America looking for equal rights and employment, we have to start acknowledging how our culture and our institutions address disability discrimination and segregation, and how they do not. We have to think of the reason behind the many questions, such as: Why is Tasha on a college campus she does not belong to everyday? How can people like Tasha be included in society, have meaningful work and support themselves?

One day, Tasha will perhaps be able to further integrate into a community in a setting that will also allow her meaningful work. She will be able to show off her work as proudly as she does her watercolors to the students

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n the United States, about 15 to 20 million people are alcoholics. According to The American Medical Association, alcoholism is a primary, chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestations. Experts understand the disease to be progressive and fatal. It is characterized by continuous or periodic impaired control over drinking, preoccupation with alcohol, use of alcohol despite adverse consequences, and distortions in thinking—most notably denial. The term “disease” has entered America’s popular lexicon when identifying alcoholism; however, society has not yet evolved to take significant combative action against recovery, which hinders any progress in treating this disease. Science has revolutionized our understanding of alcoholism as a disease. Alcohol is connected to the incarceration of 57 percent of inmates in the United States. More often than not, offenders are sent to jail rather than receiving treatment for the problem that perpetuates criminal activity. When individuals are released from prison with untreated alcoholism, they will almost certainly return to their previous behavior. There is a 90 percent chance of relapse—a vicious cycle.

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Currently there is not a standard system for offering treatment to offenders—it is up to the discretion of each jurisdiction. In most cases, the judge will ignore the option of treatment altogether and give the offender a standard form of punishment, which is often outdated and not consistent with the current science. Once the alcohol has entered the body, the individual loses the ability to choose the amount consumed. This disease is defined by a physical craving that causes the individual to experience a strong urge to drink alcohol. It is unethical to punish those suffering from alcoholism because they do not have the ability to control their alcohol consumption. Alcoholism is a disease that affects the brain and, in turn, affects behavior. Excessive alcohol consumption can change how the brain works by disrupting delicate mechanisms through which nerve cells transmit, receive and process information critical to daily living. When alcohol travels through the cerebral cortex, the results can include poor judgment, unreasonable confidence and a dulling of the senses.

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1)28%0,)%08, Alcohol is a depressant of the central nervous system, which can negatively influence one’s ability to speak, alertness and emotions. Alcoholics lacking impulse control also tend to exhibit novelty seeking, aggressive and antisocial behaviors.

the justice system sent alcohol-related offenders to treatment, they would learn how to create a healthier environment for themselves and learn coping skills when they do not have control over their surroundings.

If a person commits a crime as a result of their disease, society and the individual would benefit more from treatment than punishment. Alcoholics’ brains are wired in a way that favors alcohol use—merely removing them from society for a period of time is not a proactive method for treating the disease.

Alcoholism is a powerful and complex disease characterized by genetic, neurological and environmental factors. The opportunity to receive treatment should be equal. The justice system ought to regulate a treatment plan for all alcohol-related offenders. Society has accepted the disease model pertaining to alcoholism; now social systems and institutions should follow up with appropriate action to change the way society responds to alcoholism.

Today, scientists understand that alcoholism has a genetic component. Studies of identical twins indicate that as much as half of an individual’s risk of becoming addicted to nicotine, alcohol or other drugs depends on their genes. This is just one of many studies that suggest people with certain genetic traits are more susceptible to the disease of alcoholism. There are many diseases linked to just one gene, but addiction has been linked to several; there is not just one “addiction gene.” There are various genes that make some individuals predisposed to alcoholism. Of course, one’s genetic makeup is not the only factor that leads to alcoholism. The use of alcohol is certainly a learned behavior, and several environmental factors contribute to development of the disease. Children raised in a home with the disease are much more likely to become alcoholics themselves. Furthermore, children raised in abusive environments are more likely to use alcohol as a way to cope with the trauma. Alcoholism is an extremely complex disease that cannot be assumed is caused by one factor. If

Q%"'A%"?'+-Q%"A!#+%If you are struggling with addiction, or think you need help, visit Austin Recovery at austinrecovery.org or call them at (512) 697-8600

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The Journeys of The Horse Boy F].SR&PEGO

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Every parent says they would go the ends of the earth for their child. The Horse Boy is the story of two parents who actually did, for their extraordinary son, Rowan. In seeking to manage R o w a n’s autism, Kristin Neff and Rupert Isaacson took their family to Mongolia for a visit with the s t e p p e ’s nomadic shamans w h o perform traditional healing practices. When Rowan was diagnosed with autism at age three, he was non-verbal, prone to massive tantrums, incontinent and socially incompetent. His parents explored a variety of treatments and therapies for their son, including discrete trial format of Applied Behavioral Analysis, medication

“Witnessing the impact it had on Rowan was absolutely humbling. It shows how little we know about the human body and mind, let alone the spirit.” (Valtrex) and chelation therapy—all of which were either ineffective or had only minimal impact. The family’s experiences with speech therapy were particularly disheartening, with two different therapists giving up on Rowan. Fortunately, Neff and Isaacson had unique skills and resources to bring to the table that would be used in treating their son. Neff is a professor of educational psychology at UT Austin. Isaacson is a

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journalist and writer who has extensive experience in training horses. The family’s first breakthrough came by adapting speech therapy techniques to work with Rowan in one of the few places he was happy: on horseback. Suddenly, techniques that had failed in a clinical setting began working very well. “Intrinsic motivation almost always got results,” Isaacson says. “The key is to go where the kid goes rather than trying to reward the kid with playtime after completing a task they don’t really want to do.” When his son was three, Isaacson brought a group of Kalahari Bushmen to the United Nations. The group included traditional healers who expressed a desire to work with Rowan. “We felt that a bit of dance and prayer wouldn’t do him any harm,” Isaacson explains. The Bushmen worked with

“The family’s experiences with speech therapy were particularly disheartening, with two different therapists giving up on Rowan.” Rowan for five days, during which many of his obsessive tendencies disappeared and he began speaking. Rowan’s obsessive tendencies returned after the Bushmen left, but a seed had been planted. “Two things really helped Rowan—being with horses and shamanic healing. I wondered how we could combine them. I was familiar with the shamans of Mongolia, for whom the horse was a healing totem. My gut said ‘go there and something good will happen.’” Their experiences in Mongolia validated that intuition. During the first ceremony, Rowan hugged a Mongolian boy, calling him “Mongolian Brother.” It was the first time he had reached out to another child. Over the next month, that child and his father were the family’s constant companions as they traveled from shaman to shaman. Their final visit took the family to the mountains of South Siberia and to an encounter with the reindeer-herding Dukha culture. Following his encounter with the Dukha, Rowan had ceased throwing tantrums and appeared content. “There were a lot of stresses during this trip,” Isaacson says, “but it was the most magical and profound journey we have ever made. Witnessing the impact it had on Rowan was absolutely humbling. It shows how little we know about the human body and mind, let alone the spirit.” This time, the effects on Rowan were lasting. He remained continent and his tantrums ceased. Just as dramatically, he became extremely sociable and started making friends with other children. After their experiences in Mongolia and Rowan’s dramatic transformation, the family knew they had a very special story that could help others.

Isaacson turned the family’s experience into a book. The Horse Boy: A Father’s Quest to Heal His Son was published in 2008 and became a New York Times bestseller. They also produced a documentary film, The Horse Boy, which was an official selection at the 2009 Sundance Film Festival and won the Audience Award at the 2009 South by Southwest Film Festival. “We wanted to share our story and let people in our position know they can view autism as a grand adventure rather than a problem to be fixed and, when you take that approach, you will go so much farther,” Isaacson says. The family also established The Horse Boy Foundation, which provides equine and other animal-based therapy to autistic children. It also offers games to enforce discipline and perspectivetaking exercises in a natural environment to catalyze communication, enhance brain function and teach academics. The foundation has a homeschooling program called Horse Boy Learning, which does not involve horses but uses play equipment and the utilization of imagination to achieve the same goals. In the years following the family’s Mongolian adventure, Rowan’s remarkable development has continued. Now twelve, Rowan runs his own small zoo. He has also experienced owning and training several exotic animals. He has just pitched the idea of a reality TV show, which would feature Rowan encountering animals in exotic locations around the globe. Academically, Rowan uses the national curriculum and excels in almost every area. For families still struggling with their child’s autism, Isaacson has some advice, “Don’t believe people who tell you autism is a catastrophe; it isn’t. Lots of autistics grow up to have careers and love lives, but only if their family and natural environment are right. Let your child lead you. Observe what your child likes and follow that. If you try to impose stuff from the outside, you’ll break your heart. But if you follow intrinsic motivation and go from there, you might be surprised where it leads.”

Q%"'A%"?'+-Q%"A!#+%To learn more about The Horse Boy and Horse Boy Foundation, visit horseboyfoundation.org


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What it Means to be a Woman

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his business of being a woman in the 21st Century is hard. This business of balancing motherhood, marriage and a career with an airbrushed smile. The anxiety of it all makes us wallow in a carton of ice cream. “To be a woman is to have a body image problem,” writes Mary Pipher, Ph.D. As females, we are born people pleasers, who, along with giving birth to children, give birth to enormous bouts of self-doubt. We take pride in this “mother guilt,” which keeps us up all hours of the night and tears at the fabric of our marriages. It makes us jealous of each other, unable to connect with our children, fearful of the future and paranoid of rejection. To deal with our tormented souls, we take comfort in fast food and Twinkies, or we starve ourselves in an attempt to feel like we are in control. We spend hours on the treadmill chasing our guilt. But guilt always runs faster, and ultimately, leaves us spent and exhausted.

ourselves? The parts that make us, us? “A woman’s happiness is in throwing everything away to live for love,” says Ai Yazawa in Paradise Kiss, Volume 5. But this living for love does not mean throwing away our dreams and desires. No, it means fully entering oneself, while ridding of any pre-conceived notions about beauty and value and worth. It means embracing our crooked noses, snorting laughter, the stretch marks, saggy boobs, tea-bag eyes and warty feet. It means accepting our humanness, but more than that. It means approaching ourselves like author Anne Lamott does: with kindness and laughter. “Age has given me what I was looking for my entire life,” she writes. “It has given me me. It has provided time and experience, and failures and triumphs and time-tested friends who have helped me step into the shape that was waiting for me. I fit into me now.” We each have a shape. It may not be perfect, but it is ours. A unique space in history to fill. But it is up to us to take care of this shape; to respect and honor the role we have been given. We need to remember that we were born for more than this world, to see food as just this: a gift. Our bodies, as tents of skin, which house the soul. As psychiatrist and author Elizabeth Kubler Ross said, “People are like stained-glass windows. They sparkle and shine when the sun is out, but when the darkness sets in, their true beauty is revealed only if there is a light from within.” And so, dear friends, let us shine.

We each have a shape. It may not be perfect, but it is ours. A unique space in history to fill.

“Most women will do anything, including becoming mental patients, to help their families,” Pipher says. So we bear the brunt of the world in an attempt to save it, but this is not, in fact, doing anyone any good, because we cannot save the world. And we cannot save ourselves. We can only learn to love. Our husbands, our sons, our daughters, know the truth. They see the way we pinch our stomachs in disgust, the way we spend hours at the gym, the way we put other women down and throw up our dinner. “It’s not very easy to grow up into a woman,” says C. JoyBell C, author of The Sun is Snowing: Poetry and Prose by C. JoyBell C. “We are always taught, almost bombarded, with ideals of what we should be at every age in our lives… I want to be able to say that there are four things admirable for a woman to be, at any age! Whether you are four or 45, or 19! It is always wonderful to be elegant, it is always fashionable to have grace, it is always glamorous to be brave and it is always important to own a delectable perfume! Yes, wearing a beautiful fragrance is in style at any age!” It is also admirable, sometimes, to put yourself first. Now, this goes against everything that tradition, and most religions, tell us. As mothers, as women, we are meant to be barefoot and silent in the kitchen. But tradition—like religion—is not always right. How can we serve our families—how can we love on our husbands, our children—if we do not first love ourselves? And how many of us can say we love ourselves? Most of us can admit to loving things about ourselves, but do we love

Q%"'A%"?'+-Q%"A!#+%To learn more or speak with someone please call (800) 845-2211 or go to their website at rosewoodranch.com A U S T I N MD M A G A Z I N E . C O M

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F;BBU96D2F8@3 A safety net for Austinâ&#x20AC;&#x2122;s uninsured F]0EYVIR&SPEHS

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eople with treatable illnesses often do not get the care they need because the cost is high, restrictively so for those without health insurance coverage. CommUnityCare provides Travis County residents with the care they need in order to be healthy. CommUnityCare is a Federally Qualified Health Center or FQHC. In order to be designated a FQHC, a practice must meet strict guidelines established by the Federal Bureau of Primary Health Care. These guidelines require that the practice offer specific services and provide care for those without health insurance. Providing quality care to all is a key mission of CommUnityCare, making them a vital safety net in the nationâ&#x20AC;&#x2122;s health care delivery system. Services at CommUnityCare are available to anyone in Travis County who needs care, regardless of their ability to pay or whether or not they have health insurance. Most recently CommUnityCare has begun accepting many commercial insurance plans. Three of the locations, Hancock, Rosewood/Zaragoza and William Cannon, were designed to expand access by providing walk-in services to patients. These health centers offer extended hours and weekend care. In addition to the ability to accept patients with no guaranteed payment, CommUnityCare ensure that all patients are able get the care they need and a full understanding of their health concerns. Many of the providers speak several languages and the health system also utilizes a telephone medical translation service for less common foreign languages. CommUnityCare provides a wide range of health services. The care system partners with the Austin Travis County Integral Care in an E-merge program which works together to improve mental and physical health. The behavioral health services are intended for those with mild to moderate behavioral disorders as well as substance abuse. These services include private appointments, group counseling, cognitive-behavioral and/or interpersonal therapy models to address functional needs, patient education such as teaching self-management and personal care skills, referral and coordination with specialty behavioral health services or psychiatric emergency services is provided through

Austin Travis County Integral Care (ATCIC), and psychiatric services provided on-site in the primary care clinics by contracted psychiatrists who are members of ATCIC.

the County that provide patients with routine and emergency dental exams along with services such as fillings, extractions, and dentures and partials as deemed necessary.

The David Powell Clinic in the CommUnityCare system provides primary medical care on an outpatient basis to adult HIV-positive residents of the Austin Health Services Delivery Area (HSDA), which includes Travis, Bastrop, Blanco, Burnet, Caldwell, Fayette, Hays, Lee, Llano, and Williamson Counties. The David Powell health center is the largest provider of HIV medical services in the Austin area. Approximately 75 percent of the clinicâ&#x20AC;&#x2122;s funding is provided by federal and state grants, making it the largest HIV services grantee in Central Texas. The clinic accepts Medicare, Medicaid, and some private insurance plans; however, no one is refused services based on inability to pay. This clinic focuses on the prevention of illness and the management of chronic illnesses, providing patients with respect and confidentiality.

The most recent addition of services to the CommUnityCare system has been key in providing specialty services that, traditionally, low income residents have not been able to access. These services include the latest Hepatitis C treatment, cardiology, pulmonology and tele-psychiatry for patients that are in need of immediate behavioral health assistance and cannot return at a later date. Together these services help provide patients with comprehensive health care that addresses the needs of Travis County residents. Social workers, case managers, dieticians, on site pharmacists and eligibility counselors are also key to the provision of comprehensive health care at almost every location.

CommUnityCare also provides care for the homeless at the ARCH location. From bumps and bruises to serious illness and health screenings, the ARCH location has been crucial in providing lifesaving care for the homeless population in Austin. The clinic runs 40 hours a week to provide care, and includes two case managers from the Salvation Army who are on hand to assist in connecting patients to the services they need most. Lastly, the ARCH Clinic works in conjunction with a mobile dental clinic and the Right to Sight Clinic (RTS) in which services are provided on a weekly basis. A special high risk OB/GYN clinic is included in the CommUnityCare system, which aims to provide patients that are considered high risk such as patients with gestational diabetes or prior pregnancy complications, in addition to pap smears, breast exams, mammogram referrals, help with menstrual problems, diagnosis of cervical and uterine cancer, hormone therapy and treatment for osteoporosis.

Today, CommUnityCare provides services at 23 locations in Travis County. Each year, the health centers provide approximately 220,000 medical and dental patient appointments. This number represents more than 68,000 individual patients. Each patient appointment represents a step forward in quality healthcare for all.

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Texas Sleep Medicine The “one-stop-shop” for sleep medicine in Austin F]0IWPMI,ERGSGO EVX[SVOF].MPP8MXS Sleep problems can really disrupt a person’s life. It’s more than just snoring or having a little trouble getting to sleep; sleep disorders can negatively affect job performance, relationships, mental health and more. In addition, people who don’t get enough sleep are more likely to suffer from chronic diseases such as hypertension, diabetes, depression, migraines and obesity, as well as from cancer, increased mortality, and reduced quality of life and productivity. So identifying and getting treatment for a chronic sleep issue can be critically important to one’s health and wellbeing. Sleep disorders are also much more common than many people think. According to the Centers for Disease Control and Prevention (CDC), more than 40 million people in the United States have a chronic sleep disorder such as sleep apnea, insomnia, narcolepsy or restless leg syndrome. Many people have sleep disorders and don’t even realize it, or they think they can manage their sleep issues without medical assistance. However, most will see a marked improvement in the quality of their lives after getting proper treatment for their sleep disorders.

Improving Quality of Life with Comprehensive Care Dr. Ashwin Gowda, board certified in Sleep Medicine and Psychiatry, has been providing care to those with sleep disorders in Austin since 2002. As the Medical Director of Texas Sleep Medicine, he strives to improve his patients’ quality of life by managing and treating their sleep disorders in a dedicated full-service sleep clinic offering comprehensive services: · Consultations and evaluation—determining the best method of diagnosing and treating each patient’s sleep disorder · Sleep studies—performing overnight studies in an in-house sleep lab[SG1] , administered by qualified technicians and analyzed[SG2] by Dr. Gowda · Diagnosis and treatment—explaining the diagnosis thoroughly, along with recommended treatment options · Ongoing care—continuing evaluation of progress with adjustments to treatment as needed · Medical equipment provisioning—offering top-of-the-line equipment for obstructive sleep apnea This “one-stop-shop” approach to addressing patients’ sleep problems allows Texas Sleep Medicine to centrally manage all aspects of diagnosis, treatment and ongoing care under the supervision of Dr. Gowda. This keeps the quality of care extremely high, and it makes patient visits convenient and quick. Types of Sleep Disorders Treated at Texas Sleep Medicine At Texas Sleep Medicine, patients are provided clear and detailed information on sleep disorders and treatments. Through consultations, sleep studies and literature provided by expert staff, patients can rest easy knowing that education is a major component of treating sleep disorders. Below are the most common sleep disorders among American adults. Texas Sleep Medicine treats all of these, plus other, less-common sleep issues. · Obstructive Sleep Apnea is a condition that occurs in sleep and is characterized by repetitive episodes of obstruction to airflow into the lungs. The level of obstruction is usually at the level of the soft palate, however the obstruction can be at different levels in the throat.

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· Restless Legs Syndrome (RLS) is an uncomfortable sensation in the legs, which is relieved by moving or stimulating the legs. This sensation has been described as tingling, insects crawling, electric current, and water moving. The symptoms often occur at night and when at rest. Symptoms often occur while riding in a car, watching TV, reading, and lying in bed. · Insomnia is the perception of inadequate or poor-quality sleep because of one or more of the following: difficulty falling asleep, waking up during the night with difficulty returning to sleep, and/or waking up too early in the morning. Insomnia may cause problems during the day, including tiredness, difficulty concentrating, and irritability. · Narcolepsy is a neurological disorder that causes excessive sleepiness. This condition usually develops in younger individuals and is life-long. It is also associated with cataplexy (sudden attacks of muscle weakness when the person has a strong emotion), sleep paralysis, and hypnagognic hallucinations (vivid dreams that occur as the person falls asleep). · Parasomnias are a variety of abnormal movements and behaviors that occur during sleep. These can include sleepwalking, sleepwalking and sleep eating. If you or someone in your life is suffering from sleep problems and side effects of insufficient sleep, consider consulting with Dr. Gowda at Texas Sleep Medicine.

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txsleepmedicine.com (512) 440-5757


H E L P I N G Y O U R B U S I N E S S M A K E I T S M A R K.

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GIVE US A CALL: 512 719 9999


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Mann Eye Institute and Laser !D'D>3'R;@3R@;9D';R'O646;9':;@@3:D6;9 12'*34563'789:;:<

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or over 35 years, Mann Eye Institute and Laser Center has been providing exceptional vision correction services.They currently have nine locations in Austin and the Houston area, staffed by a full team SJFSEVHGIVXM½IHSTLXLEPQSPSKMWXWERHI]IHSGXSVW 'SQTVILIRWMZI services include blade-free LASIK, laser cataract surgery, Active Life Lenses™, ocular allergy testing and more.

State-of-the-Art Laser Cataract Surgery

Did you know that everyone gets cataracts? Assuming one lives long enough, cataracts are unavoidable. It is normal for natural lenses to harden and become less flexible over time. Most people begin to notice this in their 40s, when they develop presbyopia and need reading glasses. When the lens hardens further and begins to cloud, usually in one’s 60s or so, it means cataracts have formed. There is no cure except to remove the cataractous lens and replace it with a synthetic lens. The good news is that technological advancements in ophthalmic laser systems and implantable lenses have made cataract surgery very quick, precise and safe in the hands of an experienced surgeon. The procedure itself can take just minutes, and the recovery time is usually brief. With refractive cataract surgery, many patients even come out with better vision than they have had in decades and no longer need glasses.

who uses top-of-the-line technologies. At Mann Eye Institute and Laser Center, LASIK surgery is performed using the fastest and most-advanced FDA-approved laser system in the nation, the WaveLight® Refractive Laser Suite.

Exceptional Patient Experience

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Mann Eye Institute and Laser Center offers state-of-the-art laser cataract surgery and a variety of intraocular lens (IOL) options to suit each patient’s vision correction needs. IOLs, which are permanently implanted in the eye, now allow the eye to focus on objects near, far or in between, much like a natural lens is able to do. There are even toric IOLs that can correct astigmatism. Mann Eye Institute’s highly trained and experienced surgeons consult with patients personally to get to know them, educate them about their options, and set their expectations about the outcomes of their procedures. They make it a priority to personalize every procedure and take pride in making every patient feel like a VIP.

Blade-Free LASIK

Are you nearsighted or farsighted, or do you have astigmatism? Would you like to reduce or possibly eliminate your dependence on glasses or contact lenses? LASIK may be an option for you. LASIK stands for Laser in-situ keratomileusis. It is generally safe and effective, and it usually involves a relatively short recovery time with few complications. The key to getting the best outcome from a LASIK procedure is to select a surgeon who is very knowledgeable and experienced and

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The Story of Texas Physical Therapy Specialists Q@;B';93'B89!4'=@38B'D;'89'8K8@="K69969C'N@8:D6:3'D>8D'64'>35N69C'D;' :>89C3'D>3'K82'N>246:85'D>3@8N2'64'=;93 by Leslie Hancock Photography by Winston T. Lackey

One beautiful fall morning many years ago, Rob Wainner was kicking back in a hammock after a run, thinking about what he was going to do with his life after completing his service as a physical therapist in the U.S. Air Force. He had a passion for clinical research and evidence-based practice of physical therapy, but he knew that most PT clinics were not actually practicing that way. He began to get excited about the idea of establishing such a clinic, and the seed that would grow into Texas Physical Therapy Specialists was planted.

Though it is now a large and widespread business, TexPTS strives to attract the very best physical therapists and support staff, and they treat them all like family. TexPTS therapists have fun and make friends with their patients, getting to know them, their families, their employers, their pastimes, and maybe even their pets. This old-fashioned handson approach to care demonstrates a commitment to truly personalized care, backed by proven results and accomplished in the fewest visits possible.

Deep Roots and Rapid Growth Rob started looping in long-time friends from Air Force and Army therapy programs who shared his philosophy, consulting with a variety of trusted colleagues about the ideal private PT practice. By 2004, the idea had grown into a firm plan. Rob was joined by Larry Benz, who would lead the business side of the clinic, and Andrew Bennett, who would serve as Clinic Director. This initial group of doctors chose to establish their stand-alone start-up clinic in New Braunfels, Texas. Less than two years after seeing their first patient, though, TexPTS began to expand, opening clinics in San Marcos and Selma. They then acquired more clinics, including five in the Austin area in 2008, two in San Antonio in 2010, Georgetown and Liberty Hill in 2011 and Round Rock in 2012. Today, TexPTS includes 17 clinics and two business offices throughout Texas, stretching from San Antonio to Dallas.

What Is a Physical Therapist? A doctor of physical therapy is different than a physician. They are required to complete a three-year accredited graduate program and pass an extensive licensure examination. Programs are selective, and it’s hard to get in. Due to changes over the years in educational requirements, many physical therapists hold master’s degrees (MPT or MSPT), although almost all physical therapy schools are now granting doctoral degrees. Beyond their initial professional education, some PTs—about five percent—go on to become boardcertified clinical specialists through the American Board of Physical Therapy Specialties (ABPTS). Specialization involves deeper training and advanced practice and research in a specific area such as orthopedics, neurology, sports therapy, pediatrics, etc. Specialization requires another two years of clinical residency, and it is voluntary.

Award-Winning Physical Therapy Practice Named Best Private Physical Therapy Practice in the United States by the American Physical Therapy Association (APTA) in 2009 and recognized on the Inc. 5000 list of 2010, TexPTS is known for leading the way in evidence-based PT best practices and for teaching and training physical therapists all over the country. In 2014, TexPTS co-owner Dr. John Childs, PT, PhD, MBA, OCS, FAPTA, was named a Catherine Worthingham Fellow of the APTA, the highest honor among APTA’s membership categories. Dr. Childs received this designation for his contributions to the advancement of the profession over 15 years, including a highly active research agenda in collaboration with prominent universities around the country and contributing to the establishment of Evidence in Motion (EIM), an organization dedicated to training physical therapists in evidence-based practice both nationally and internationally. Dr. Childs’ philosophy and dedication to excellence in the field of physical therapy is shared by his co-owners and infuses the organization.

Texas Physical Therapy Specialists has more boardcertified specialists than any other provider in Texas. Common Conditions and Injuries that Physical Therapy Can Help The goal of physical therapy is to help patients recover the use of joints and muscles through non-surgical treatment of musculoskeletal conditions. Methods include manual (hands-on) physical therapy, active supervised exercise and education. Physical therapy can be used to treat a variety of

conditions and injuries in the neck, shoulder, back, elbow, hand/wrist, hip, knee, ankle and more. Causes of pain or reduced function might include injuries, muscle strains, worn joints, diseases, nerve compression, arthritis and spinal disk problems. The doctors at TexPTS are qualified and experienced in treating all of these types of conditions and injuries, and they are committed to using research-based methods to bring the best outcomes in the fewest visits possible. This saves patients time and money while improving their quality of life. Three Guiding Principles The “three-legged stool” of guiding principles that provide the sturdy foundation of the TexPTS organization are: · Clinical Excellence—Running an evidence-based practice staffed by board-certified physical therapists and proven leaders in the PT industry · AmaZing! Care—Delivering high-quality, outcomedriven care based on nationwide data and analysis ·“Called to Care” Culture—Providing the best patient experience possible Texas Physical Therapy Specialists has far exceeded that vague dream Rob Wainner had in his hammock more than 9 years ago. The practice and its doctors have helped to transform the PT profession and its practitioners on an international level.

!"#$%"#&$'(!"#%)*'"( Learn more about Texas Physical Therapy Specialists at texpts.com or call them at (888) 658-8483

TexPTS has also been voted one of the Top 50 Places to Work three times by its own employees, proving the effectiveness of the philosophy that happy employees make for improved patient experiences. A U S T I N MD M A G A Z I N E . C O M

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ROSEWOOD CENTERS FOR EATING DISORDERS F].SR&PEGO

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t is tremendous to see a client overcome what is one of the deadliest psychiatric disorders there are and start accepting their true self and starting to give themselves compassion, nurturing and love,” says Lee Neagle, Executive Director for Rosewood Centers for Eating Disorders.

Located in the Sonoran Desert of Arizona, Rosewood provides multiple levels of treatment for eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder as well as bariatric surgery patients. The facility also addresses addiction, psychiatric and psychological conditions that often accompany eating disorders. Rosewood provides a variety of treatments to address the symptoms, root causes and co-occurring complications of eating disorders, with intervention plans customized for each client. Medical stabilization is available for inpatient clients. Nutritional services, such as meal/nutrition planning and mindful eating groups are a core component of Rosewood’s offerings. Therapy is offered at the individual, group and family levels. Other treatments addressing the psychological and social aspects of eating disorders include motivational approaches, psychotherapy, dialectical behavior therapy, psychodrama, body image therapy, mind/body modalities, Twelve Step enhanced treatment, eye movement desensitization and reprocessing therapy, creative expression modalities and recreational therapies as well as canine and equine therapies. . Part of what makes Rosewood’s approach unique is its “Continuum of Care,” with facilities, treatments and services geared towards clients with eating disorders at all levels of severity.

environment.” Another unique aspect of Rosewood’s treatment approach is its emphasis on core work, which empowers clients to deal with the root of their disorder. “To truly help our clients overcome their disorder, it’s not enough just to treat symptoms such as binging-purging, selfharm and exercise addiction,” Neagle says. Rosewood goes deeper to help clients address the particular roots of their disorder with shame reduction, trauma recovery work and similar programs. Rosewood is places great emphasis on helping clients make progress on core work. Its centers create environments that are nurturing and safe while also empowering clients to directly confront the core issues of their disorder. “There’s no doubt that confronting these issues can be uncomfortable,” Neagle says, “but it’s also critical for people begin healing.” Eating disorders are among the most complicated

Once clients return home, Aftercare Support programs make a variety of programs and professional support to clients who have stepped-down from higher levels of care. Rosewood’s Aftercare Support programs currently serve clients both nationally and nationally. The Continuum of Care approach allows Rosewood to initiate treatment at a level appropriate to each patient and then enabling it to step-up or step-down treatment levels depending on progress. “For a patient to have to transition directly from an inpatient facility to, say, going home can be very traumatic.” Neagle explains. “Rosewood’s continuum of care is designed to protect clients from facing abrupt changes in their

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Rosewood’s inpatient and residential facilities are located on a 13-acre property set in the Sonoran Desert, offering breathtaking views of the Bradshaw Mountains and Hassayampa River. “You think of place that offers 24-hour medical supervision and you might think of some place very sterile,” Neagle says, “Rosewood is a tranquil, beautiful campus. It’s almost like being at ranch that functions as a modern medical facility.” Rosewood’s accreditations and professional affiliations include the Joint Commission, Residential Eating Disorders Consortium, Binge Eating Disorder Association, National Eating Disorder Association, Eating Disorders Coalition, The Alliance for Eating Disorders Awareness, C4 Recovery Solutions and the International Association of Eating Disorder Professionals. Neagle says one the greatest things about Rosewood is witnessing the growth and transformation of individuals, “Every day I get to see the human spirit and people healing, and that’s really incredible.”

For medically complicated cases or clients requiring medical stabilization, Rosewood is licensed as an inpatient hospital offering the latest in inpatienttreatment for eating disorders. Residential and Partial Hospital Programs (PHP) serve clients who are medically stable but still need the benefits of a 24-hour support team. Transitional Living programs provide services and support in a mixed residential and self-care environment. Outpatient, including Intensive Outpatient (IPO), services include access to a multidisciplinary care team as well as state-of-the-art therapies and treatments.

life choices. Equally important is facilitating clients’ development of a strong support network including family and friends as well as medical and psychiatric practitioners.

conditions to treat, requiring multiple, interconnected physiological and psychological factors. Rosewood believes that treating clients requires the close coordination and communication between of many different practitioners and specialists, including therapists, psychiatrists, internists, registered nutritionists, nurses and many others. “Engagement” is the key word for Rosewood’s staff at all levels. Its team balances empathy and compassion with the ability to meet the challenges of the serious of eating disorders and work with patients towards resolution. “It takes a whole team,” Neagle explains. “Everyone has to be en pointe and constantly communicate with the client and every member of the team.” In treating eating disorders, it is essential to help clients maintain healthy lifestyles after the conclusion of treatment. For this reason, Rosewood empowering clients with the knowledge and ability to make healthy

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Stranger Danger!

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Special Contribution to Austin MD by Dyezz Surveillance and Security Inc.

Dyezz Surveillance and Security has been providing the highest quality of installations and service for video surveillance systems, burglar and fire alarms, access control systems, covert surveillance, bug detection, intercom systems and home automation since 2001. Lock the Doors and Windows â&#x20AC;&#x201C; The basic level of all deterrence starts with a simple lock. Take the extra five minutes before you go to bed or leave the house. Most thieves are just looking for the easy way in, whether it be the back door that was left unlocked or the window in the kitchen that had been cracked open earlier in the day to alleviate the strong cooking odor you created! Make Some Noise! â&#x20AC;&#x201C; Alarms draw attention. The thieves know right off the bat that it alerts the authorities. Protect your home from break-ins. Loud sirens make people run. (Our monitoring service starts at $14.95/ month; ask about us!)

Trim the Bushes â&#x20AC;&#x201C; These are the perfect hiding places for someone to sightsee from. If you happen to hear suspicious noises outside and look out the window, the first place for someone to hide is where they canâ&#x20AC;&#x2122;t be seen. Hide Your Valuables â&#x20AC;&#x201C; If youâ&#x20AC;&#x2122;ve got a new 65-inch television on the wall across from the living room window, cover it up! Thieves are a lot less likely to take a chance if they donâ&#x20AC;&#x2122;t know what theyâ&#x20AC;&#x2122;re risking their lives for!

Stickers and Signs â&#x20AC;&#x201C; These items draw awareness. It screams, â&#x20AC;&#x153;Donâ&#x20AC;&#x2122;t even try!â&#x20AC;? Even something as simple as â&#x20AC;&#x153;24/7 monitoringâ&#x20AC;? or â&#x20AC;&#x153;Beware of dogâ&#x20AC;? can be good enough to scare someone away.

Surveillance Cameras â&#x20AC;&#x201C; Just seeing a camera makes you think twice about doing something bad. Catch a thief red handed! Cameras not only help keep another pair of eyes on things, it also helps prevent neighboring crime. (Ask about our camera systems too!)

Watch Your Social Media Activity â&#x20AC;&#x201C; With the mass evolution of technology, many people make the mistake of posting Facebook statuses and Twitter updates about their location. If you are going on vacation for two weeks and tell the whole world, thieves may think â&#x20AC;&#x153;empty house for two weeks.â&#x20AC;? Be wise!

Light it up! â&#x20AC;&#x201C; Motion detection lights are a great way to illuminate the dark areas of the house. It also serves as a spotlight when something or someone is creeping around outside. Leaving one interior light in the house when you leave home has been proven to be effective also. It gives off that sense that someone may be in the home.

KEEP IT SAFE, AUSTIN! *SV1SVI-RJSVQEXMSR )+

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Private Mortgage Banker (512) 344-7219 Sean.P.Condon@WellsFargo.com

LivingInAustinTX.com

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Broker, CIPS, CNE, GRI, CLHMS (512) 330-1031 Eric@LivingInAustinTX.com


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ThreeThings Austin Entrepreneurs Should Know Being competitive in a city brimming with start-ups !"#$%&'()*+,-%./,%*+(,*(0/1,%+(23(.4()%,4(*5(0/1,%+(!6&''(7/1%+#11(3#8#'*"6#+,(9-*:-&6

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y now, we have all heard about Austin’s unprecedented growth, ranking at the top of Forbes’ America’s Fastest Growing Cities List for four straight years and boasting an economy that expanded 5.88 percent in 2013 alone. Additionally, The Business Journals ranked Austin as the top city for small businesses for a fifth straight year. Starting a successful business in Austin should be a slam dunk, right? Think again. Between 2010 and 2011 (the most recent period covered by official data), the number of small businesses in Austin increased by 1.73 percent, the largest in the nation. Entrepreneurs are coming to Austin from all over the world, and it is important to understand how to gain a competitive advantage.

Entrepreneurs are coming to Austin from all over the world, and it is important to understand how to gain a competitive advantage. Utilize Local Business Resources Austin is home to a number of organizations that dedicate their resources to assisting small businesses and aspiring entrepreneurs. The City of Austin’s Small Business Development Program features a robust portfolio of services and resources for entrepreneurs, such as the Business Solutions Center, business education classes, one-on-one business coaching, entrepreneurial events and a low-interest-loan program for qualifying businesses, called The Family Business Loan Program. Additional organizations dedicating their resources to entrepreneurs include: The local Chambers of Commerce (Greater Austin, Hispanic, Black, Young, Asian and Gay & Lesbian), Austin SCORE (Service Corps of Retired Executives) and the Texas State University Small Business Development Center. There are several community lenders dedicated to financial assistance for entrepreneurs, including: BiG Austin, BCL of Texas, Accion, PeopleFund and Capital CDC. Finally, since Austin has emerged as a technology hub, there are a host of business accelerators and incubators dedicated to advancing technology-based entrepreneurs (Austin Technology Incubator, Capital Factory, Tech Ranch Austin, DreamIt Ventures and

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The Incubation Station, among others). If you cannot afford your own office and want to work around likeminded individuals, consider one of Austin’s many coworking spaces: Capital Factory, Golab Austin, Conjunctured, Opportunity Space and Vuka, among others. Location, Location, Location As previously noted, Austin is growing at a very high pace, but where specifically within the city limits are they moving? It may be surprising to some but the primary population growth is outside of central Austin as the cost of living increases. It is vital to know where population increases are happening on a hyperlocal level, given that recent research by 8Coupons.com reveals that 80 percent of American consumers’ disposable income is spent within five miles of their home. With Austin’s traffic issues, do not plan on customers coming from across town. Take advantage of resources at the Small Business Development Program’s Business Solution Center, such as LoopNet and ReferenceUSA, to identify current commercial cost per square foot, as well as identifying where your competition is located. Maps and Apps It is vital that your business is technology friendly, -1%+)*6317,988)6783'/

as Austin’s population is dominated by the 20-34 year old age range. This age group features a high usage rate for smartphones, tablets and other innovative technologies. Make sure that your business is listed on Google Maps, as it is common for consumers to search for businesses near their current location via their smartphone. Also, ensure that your website is mobile-friendly so that potential customers can view your products and services from their smartphone. Finally, get your business listed for free on the LocallyAustin Mobile App because Austinites enjoy supporting local businesses.

For More Information Strategically planning how you will make your local business a stand-out can make a big difference in its viability. Get no-cost assistance for your startup or to further develop your current business by calling the Small Business Development Program at (512) 974-7800.


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How To Get That Raise #>3'6BN;@D89:3';R'C3DD69C'8'C;;='96C>D'4'4533N Special Contribution to Austin MD by Steven Galvan with Texas Sleep Medicine After a long day at work, most young professionals spend their nights glued to the screens of their iPads and TVs, not realizing that they are limiting their potential to be better people. With streaming programs becoming more available to the masses, sleep loss is at an all-time high. New trends in binge watching have contributed to an increase in sleep loss across the world. According to SleepRate, over 80 percent of people

who binge watch stay up later than normal and get less sleep. Now, do not get me wrong; I love marathoning shows on Netflix and Hulu Plus. And I am pretty sure that I have lost over 100 hours of sleep thanks to 208 streaming episodes of How I Met Your Mother. But there has to be a point at which we ask ourselves, “How is my nightly routine affecting my day at work?”

Here at Texas Sleep Medicine, we have comprised a list of benefits that come from a healthy sleep routine. Follow these steps and you will be on your way to a brighter future and career. 7PIITMRK;IPP'ER,IPT=SY Improve Your Performance Getting a good night’s rest has countless benefits. We sleep better, therefore we perform better. Whether it be in the office, in the kitchen or on the field, getting an appropriate amount of sleep every night is vital to success. The National Heart, Lung and Blood Institute (NHLBI) states that skimping on even one hour of sleep per night reduces our response time and makes us more likely to make bad decisions. Getting that extra hour can put you at the top of your game, so rest up! Deliver the Results According to the NHLBI, getting a proper amount of sleep can even boost creativity. Here in Austin, creativity is something we definitely have in surplus. So, how can you make yourself stand out in the crowd? Easy, get more sleep. Better sleep can help you complete harder tasks and solve difficult problems more easily. Now that is a competitive edge you can count on.

Become Really, Really, Really, Ridiculously Good Looking…and Get Paid Studies have shown that people who get a healthy amount of sleep have an easier time maintaining their body weight. When dieting, those who sleep better are even able to lose weight faster. In 2012, the Journal of Labor Research reported that physically fit individuals get paid around nine percent more than other employees. The study also showed that those tested were more disciplined than their colleagues. So, not only will you be looking better, you will be getting paid better, too. We realize that these rules do not necessarily apply to everyone; however, they can be tailored to the individual. With a better understanding of the importance of sleep in your life, you could be on your way to getting that raise you were promised months ago.

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For more information a healthy sleep routines, visit txsleepmedicine.com/articles. You can rest easy with us!

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If you do not want to compete with other offers or buyers you can always withdraw your offer. Many neighborhoods are experiencing multiple offer situations, especially in your more desirable communities where listing agents are seeing 10 or more offers in the first few days of being on the market. Preparation is key. Whether you are a seller trying to maximize your profit potential by properly staging your home and adding stainless steel appliances with granite countertops, or a buyer who is competing against multiple offers in that perfect neighborhood with exemplary schools. Take your time, do your homework and work with an experienced agent or broker who knows either the area or neighborhood. HINT - The more you get out and drive through neighborhoods, the higher the likelihood you will have of coming across a â&#x20AC;&#x153;Coming Soonâ&#x20AC;? sign or pocket listing that could be perfect for you and your family.

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8)',2303+= in surgery or in outpatient services. Such apps allow doctors to see all of their patients’ information in one place, updated in real time, which can eliminate time-consuming paperwork and miscommunication. Medical technology apps will continue to thrive in our data-driven economy. One such data-driven app is Epocrates. The more people who use Epocrates, the more people are able to benefit from public-patient testimonials. Apps such as these better help doctors diagnose diseases; the sooner the patient informs his or her doctor of symptoms, the earlier the doctor is able to diagnose the patient’s condition and appropriately treat the patient, possibly preventing disease. Some other apps allow either the patient or doctor to use them as a medical instrument with which to measure the patient’s vitals. AliveCor is an FDA approved application that allows users to determine their ECG (electrocardiogram) by pressing either a finger against the screen, or pressing the iPhone to the chest, right over the heart. The P, QRS and T complex waves are all visible and valid, but it is not recommended for determining coronary disease or complications such as atrial fibrillation or myocardial infarctions (heart attack). The main purpose of this app is to reassure patients that their heartbeat and heart rate are regular. Another app falling under this instrument and data-collecting category is Cellscope Oto. The phone transforms into an instrument with which to view the inside of a patient’s ear. This is most effective for ENT doctors, and it has the potential to reduce the quantity of antibiotics prescribed. Medical research and consumption of published scholarly journal articles still rank as number one in terms of usage for medical professionals. Pub Search Plus, the mobile version of PubMed, is an ideal app for doctors looking to read articles on the go. This app is also handy for those who have older family members suffering from degenerative diseases, such as Alzheimer’s. You can use Pub Search Plus to research the disease and how to help families, both individually and collectively, cope with this.

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Users who consume and utilize apps that collect data, such as Epocrates and Mobile MIM, are called digital omnivores. These digital omnivores are paving the way for medical apps in the future. By continually adding and uploading data to these apps, such as Mobile MIM and Pub Search Plus, doctors and nurses will be able to search for data not only locally, but also globally to help and improve living conditions in communities all over the world. The greater amount of people using these medical apps, the higher the likelihood of saving lives. Doctors who have not yet begun to utilize this incredible technology, jump on board! YouTube videos are great for explaining how to navigate apps if you do not have time. Although human error still exists, these medical applications are more beneficial with the increased amount of data uploaded and shared by making it user friendly in the medical community.

by Mary DelGrande Medical applications include more than just the apps we download on our smartphones. They also include applications used on our desktops, laptops and tablets. In 1977, Steve Jobs had an opportunity to help create the first userfriendly mobile app. He rejected this offer because he was paving the way for Apple hardware and software to be what we know it as today. As a result, Mobile MIM emerged as the first mobile application in this technological field. Similar to cloud-storage software programs, such as DropBox, medical apps have their own cloud server system. Mobile MIM is a FDA approved app that stores case studies in the cloud, based on title, not patient name. While this may initially cause some difficulties, the app otherwise has a smooth interface and is very user friendly. Found on both the iPhone and iPad, Mobile MIM not only functions as a cloud server, but it also works as a portable radiology device. One important function of this app is the ability to pull up X-Rays and MRIs on screen. One handy feature of this app is that it allows a doctor to tap and drag a finger across the screen. When looking at a torn ACL, the doctor can look at all three planes under the localization mode setting. This portion of the app allows the user to zoom in and assess the ACL, and then separate it from the MCL, PCL and other portions of the knee, enabling the physician to solely address the patient’s ACL.

Doctors who have not yet begun to utilize this incredible technology, jump on board!

The majority of these medical technology apps on the market are very user friendly; they allow both doctors and nurses to use tablets with patients, either -1%+)*6317,988)6783'/

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by Danielle Rivera

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he biggest challenge for health care is ensuring that everyone has access to it. The people who cost the system the most money, the one percent, generally do not have a regular primary care physician. Frankly, seeing a primary care physician once a year simply is not effective enough to truly change patient behavior. To alleviate the problem, a few people across the country have begun implementing “hotspot teams.” These teams are not necessary for everyone. If hotspot teams could take responsibility for the healthcare of the top five percent of spenders in each urban area, healthcare costs would likely drop. In New Jersey, at the Camden Coalition, run by Jeffrey Brenner, they found that their hotspot team helped their first thirty-six patients to reduce emergency room visits by 40 percent and reduce their hospital bills from 1.2 million dollars to just over half a million after, cutting costs by 56 percent. While each model is different, they all employ a variety of people, who all work together with each patient. The hotspot team is comprised of primary care physicians, nurse practitioners, social workers, secretaries and health coaches who do not necessarily have a health background; in fact, they usually do not. These teams in most of these models meet every morning. Each patient is reviewed, and everyone is a part of the team. This part of the process is extremely important. Hotspot teams are built to foster communication among the entire team. Further, by discussing each patient each day, miscommunication becomes far less likely. When one member of the team has a concern, it is easy to share that information to everyone at once, which ensures that everyone on the team has the same information, and ensures that each patient is getting highly coordinated care. These teams are very cost prohibitive up front because they are very intensive and patient-centered, which generates new costs that most doctors, who operate on a standard pay-for-services model, do not have to worry about. The hotspot teams around the country provide services that do not directly correlate to medicine. One California-based Medicare program called CareMore, which uses the hot spotter model, provides a number of unusual services to their patients. They are also one of the most successful teams in the country, growing to A U S T I N MD M A G A Z I N E . C O M

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run twenty-six clinics in the West. Their chronic heart disease patients receive scales that wirelessly transmit their daily weight to the clinic. If their weight fluctuates by a few pounds in a day, a warning sign that there might be fluid buildup in the lungs, the clinic will call, set up an appointment for the same day, and provide transportation to and from the clinic. Elderly patients, who are at risk for falling, get their toenails clipped periodically and participate in muscle-training sessions to help mitigate their risk. Further, the clinic will send someone to check the elderly patient’s apartment to ensure that shag carpets are replaced, which also lowers the risk of a fall. They provide specialized services to each of their patients, based on their chronic condition. Diabetic patients who get cuts have their wounds cleaned and dressed every two days until the cut has healed, which reduces the risk of amputation. However, despite all of this care and added benefits, CareMore’s member costs are 18 percent below the industry average.

therapist who is either a physical or occupational therapist, and a child psychologist. The team only meets with two patients per day and evaluates them for four hours. Often, they will watch a child interact at home or at school to get a better idea of how they behave in their own environment. Further, because the team travels together, they know each other well and have developed a high level of communication and coordination, which makes their work as effective as possible. Hotspot teams could emulate this model by going in teams to make house visits, particularly when the patient first joins. Further, their team coordination is certainly worth modeling. These highly involved and intense teams have been effective at saving money, and more importantly, improving and saving lives.

One study found that their hotspot team helped reduce emergency room visits by 40 percent The idea is, by spending the money to provide good preventative care and helping patients to manage their chronic conditions, in the end, the group will save money because they are preventing cataclysmic events, such as a heart attack, that result in extensive hospital stays and surgery. In 2011, WellPoint, the largest healthcare insurer in the United States, bought CareMore for 800 million dollars, proving that this healthcare model is profitable. Hotspot teams can learn from many models that are already in place. New Mexico has a bigger rural population than most states, and ensuring that those in rural areas get care can be difficult. The University of New Mexico hospital has developed a similar model that is designed to reach patients who live in more remote areas. The program, The Early Childhood Evaluation Program, is based off referrals from primary care physicians, and meets with young children around the state to evaluate child development when primary care physicians have a concern regarding development delays. The team is comprised of a pediatrician, speech therapist, motor -1%+)*6317,988)6783'/

Q%"'A%"?'+-Q%"A!#+%For more information on hot spotting, visit rwjf.org


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What do Austin's top medical professionals do to unwind and stay healthy?

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1. What do you like to do in your free time?

3. What do you do to stay healthy?

Nahal: I love to watch documentaries. One of my favorite shows on TV right

Michael: We start each day with a green smoothie. Nahal: I love Bikram Yoga. It keeps my body, mind and soul in balance. On

now is Vice. This is an HBO documentary series that travels around the world shedding light on important issues. I love watching shows that give me knowledge on what matters. Additionally, I love learning new things about people, places and cultures.

4. What is your favorite restaurant in Austin?

2. What do you do to unwind?

Michael: After a long day at the office, I want nothing more than to get out of my scrubs and into some sweats.

Nahal: I love to turn on some music and cook. I love to cook; I find it very therapeutic, and Michael has fantastic chopping skills! Dinner is where we both unwind and tell each other about our day and share the ups and downs that we have encountered that day. We both encounter so many people in a day’s work that undoubtedly there are some interesting occurrences that make for interesting conversation. A U S T I N MD M A G A Z I N E . C O M

the weekends, we love eating and spending time with friends at the great restaurants here in town.

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Both: There are so many new really good restaurants in Austin, and to pin it

down to just one favorite is not easy. Having said that, we would have to go with Uchiko. We never leave without a sense of being “wowed,” not just by the food, but also by the service. We love the fresh ingredients and creativity that go into each dish. So many of these dishes are made with such complexity and flavor. We definitely have our favorite dishes, but we love trying something new every time. It really is a treat to get to eat there.


0-*)78=0) 5. What is your favorite thing about each other?

Michael: There are so many things on the list. She is so compassionate, intelligent and understanding. But most of all, I love the way she supports me and encourages me to be the best me I can be. I know it is so cliche, but she truly makes me a better person.

Nahal: His humility, his love for others, his dedication to his work, kindness and

his sense of humor. How much room do I have? I could go on and on... Michael makes me a better person, too. He can always make me laugh after a tough day. He has undeniably been my biggest support as I am finishing my doctorate in psychology. 6. What do you do to stay active?

Michael: For exercise, I work out with a personal trainer two to three times a week, and I also mountain bike any chance I get. Nahal: I love to run. Running is a crucial part of my self-care.

Michael: Nahal and I also try to be active members of the Austin community. We try to take part in local fundraisers, social affairs and benefits

7. What do young medical professionals do in Austin?

Nahal:

We find ourselves dining out in any of Austinâ&#x20AC;&#x2122;s many great restaurants, followed by drinks and socializing at any lounge-type atmosphere where we can actually have conversations and meet new people. We definitely frequent the W bar. We go to the theatre, comedy shows and concerts. We are so fortunate to live in a diverse, eclectic town that has so much to offer.

8. Whatâ&#x20AC;&#x2122;s it like having two healthcare/medical professionals in the same household?

Michael: Love it. We both are in the business of taking care of people, and that

common thread makes for genuine conversations when we exchange or share our days with each other at dinner. We can relate to each other when one of us says that they are worn out at the end of the day. Basically, we both see patients, deal with their issues, and move on to the next. We have very similar ways of spending the day, so that makes it easy to relate to each other or understand where the other person is coming from. 9. Where are your favorite places to exercise?

Nahal: Austin Boxing Babes. I have been working with the trainer and owner of Austin Boxing Babes, Julia Gschwind, for four years. Boxing has changed my life. Boxing is an incredible stress reliever because it demands tremendous focus and dedication. I am not only stronger physically, but also mentally. This is very crucial to my role as a mental health professional. It also has empowered me in so many ways as a woman. It is an exercise that demands tremendous focus and dedication. I feel the benefits of my boxing workout long after I leave the gym. Michael: My favorite place to exercise, without a doubt, is on any trail that has

rocks, drop-offs or any other obstacle that makes me have to ride my bike. It is great riding on the Greenbelt and, on occasion, a trip to Colorado to ride the ski resorts in the summer. 10. What is your favorite healthy snack?

Nahal: I love anything with a crunch. I love Trader Joeâ&#x20AC;&#x2122;s Snap Pea Chips!

Michael: So many snacks! But if we are going healthy, I am eating caprese salads quite a bit.

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A U S T I N MD M A G A Z I N E . C O M


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0-*)78=0)

#<&4F>>/<%4 K';%4,47/,6&:34 L/<%D/0&'M/ ;LIROMHWI\TVIWWXLIQWIPZIWXLI]VIETLIEPXL] VI[EVHW

7TIGMEP'SRXVMFYXMSRXS%YWXMR1(F]/EVMR1EGLYWMG[MXL%FVEOEHSSHPI 4LSXSKVETL]F]7XIZI(I1IRX Abrakadoodle Remarkable Art Education offers award-winning art classes, camps, parties and events for kids of all ages at schools and community sites throughout Austin. It was voted Best Place to Learn Art in Austin 2009, 2010 and 2011 (Austin Family Magazine) and was voted Best Party Entertainer in Austin 2010 (Parentsconnect.com). Summer Camp registration is open now.

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painting to creative art activities, Abrakadoodle makes Art is an activity that can benefit kids colorful fun and imagination-boosting art accessible to by creating healthy perspectives and contributing to their emotional well-being. Austin kids and families. Art connects us regardless of race, age, gender, Art enables kids to express emotions culture, education or socioeconomic status. Kids gain Given the freedom to create art from the heart, perspective in more than one sense of the word. In children will reveal their emotions, art, perspective is a technique used to represent a three- “When kids are removed which is a very healthy outlet. psychologists often use art to dimensional world of what from judgment and are not Child help children share their feelings. we see on a two-dimensional surface. Perspective is used to confined by constraints they Creating images that reflect fear, anger and other create an illusion of space and experience an exhilarating sadness, powerful emotions allows those depth on a flat surface; but feelings to be processed in a healthy make no mistake—the ability to sense of freedom” way. Abrakadoodle Director Jenny use perspective (better known as an individual point of view Fouilloud-Hofmann worked for many years as a licensed clinical social worker and or outlook) is a considerably healthy outlet for kids. understands the value of helping kids to express their 1SFMPIEVXFVMRKWFIRI½GMEP feelings through art. Art is therapeutic for all kids, creativity to kids offering an alternative to communicating with spoken Abrakadoodle Austin is a mobile art program that takes or written words. art to kids in schools and community sites. Not only does this creative company specialize in comprehensive classes that exceed the National Standards for Visual Arts Education, but they are also offered in schools as enrichment after-school classes and in a variety of innovative camps. Abrakadoodle offers amazing arty parties. You may have even experienced Abrakadoodle at some of Austin’s popular festivals, such as Austin Kiddie Limits, where Abrakadoodle pulls out the stops every year with its engaging and fun Jackson-Pollockstyle action painting. Abrakadoodle provides creative art activities at the Old Settler’s Music Festival in the Kids’ Zone. They volunteer their time, talent and materials at the Art City Austin event, offering kids hands-on art activities. Abrakadoodle’s face painting enlivens the annual Zilker Park Kite Festival. From face

Karin Machusic is blogmaster for Abrakadoodle. With a degree in journalism and over 15 years experience in the children’s education franchise industry, she has written numerous articles about children, learning, art and creativity. Read more at www. abrakadoodle.com/blog.

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A U S T I N MD M A G A Z I N E . C O M


0-*)78=0) Art helps kids deal with stress Engaging in art activities can change a childâ&#x20AC;&#x2122;s focus in a positive way. In the process of making art, kids take charge of their creations by using problemsolving and critical thinking skills to express ideas. Spending time producing original art builds kidsâ&#x20AC;&#x2122; confidence and offers them a sense of personal satisfaction and joy. When kids are removed from judgment and are not confined by constraints, they experience an exhilarating sense of freedom. As children learn to discover all that art has to offer, they develop both a tolerance and an appreciation that can only improve their life experiences.

â&#x20AC;&#x153;The visual arts give a voice to kidsâ&#x20AC;&#x2122; imaginations, enabling creativity to take flightâ&#x20AC;? Art helps kids to be imaginative The visual arts give a voice to kidsâ&#x20AC;&#x2122; imaginations, enabling creativity to take flight. Creativity is a word that is often thrown out but is sometimes misunderstood. Are we born creative? The truth is, creativity is not a completely natural phenomenon, which means that you can nurture imagination and help it to grow. While traditional education tends to focus on left-brain logic and order, art education helps kids to pull patterns formed by their right brain to see the big picture, imagine endless possibilities and draw upon feelings to express joy and meaning. Art offers intrinsic motivation because kids can selfselect what direction their creations take; it can also work toward increased mastery and craftsmanship, leading to a sense of purpose and meaning. Art education feeds kidsâ&#x20AC;&#x2122; brains. It helps them to build important connections between the left and right hemispheres, enabling them to use their whole brains to approach education and life experiences in an integrated way. The ability to visualize and innovate offers kids long-lasting, positive outcomes. Having motivation propels kids toward success in all they undertake.

FOR MORE INFORMATION 'EPP  SVIQEMPYWEXNLSJVERR$ NLSJQERR$EFVEOEHSSHPIGSQ

Visit us at facebook.com/AbrakadoodleAustin. A world of healthy creativity and artful adventures awaits your child at Abrakadoodle. A U S T I N MD M A G A Z I N E . C O M

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Photos were taken at Preescolarte Spanish Immersion School


!"#$%&''(")*+,-". /&01&%("2,034+5"6/,"!7864+"!0,&9 :,"&0,"($70"$+,;86$<"=7''"8,034%,"</&01&%(" 8<,%4&'4>4+5"4+? Traditional and hard to find medications Traditional Compounding: Pain Management Support, BHRT & more State of the art compounding facility Medication & Disease Management Consulting Accepting most insurances Free delivery on all compounds and traditional medications in the local area

Stonegate Pharmacy 2501 W William Cannon, suite 203 Austin, TX 78745 M-F 8:30a - 6:30p Saturday 10a-2p Sunday closed

For more information or to transfer your prescription, call us at 512.693.4222 or visit us at www.stonegaterx.com

Stonegate Pharmacy at the Village Located in the Southwest Medical Village 5625 Eiger Rd, #150 Austin, TX 78735 M-F 8:30a - 6:30p Saturday and Sunday closed


(-2-2+ DINING

Austin MD speaks with co-owner & co-chef, Jennifer Costello by Kat DelGrande Photography by Lindsey Cavanaugh

The Bonneville is simple and approachable, modern yet industrial. Taking inspirations from familial roots and classic French cuisine, husband and wife duo, owner and chef team, Jennifer Costello and Chris Hanley bring more than the tumbleweeds from the Bonneville Salt Flats to the walls of their restaurant in Austin’s warehouse district.

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When you find yourself on a treadmill—on a path that was not making you happy—would you have the courage to, after making a name for yourself in Toronto, Canada’s advertising industry, take a leap of faith and send yourself to culinary boot camp because you truly believe in what you are most passionate about? Fifteen years ago, after working as an advertising executive for over a decade, Jennifer Costello left her life in Ottawa, realizing she craved something new. So, she went to culinary school, The New England Culinary Institute, in Montpelier, VT. For Costello, this was a career changer. “I was going to learn as much as I could, as quickly as I could, the best way I could,” she says. For Jennifer, cooking was always a source of peace, “So, when I was really, really stressed out, you would find me in the kitchen.” Born in Seattle and raised in Canada, coming from a family of six kids—all pitching in and each having their own jobs—Jennifer’s role became known very quickly. Learning to cook with both her mother and grandmother, Jennifer feels that her roots were always in cooking. They taught her to bake bread and would sell it at Pike Place Market in Seattle, “It was always something I loved.” She learned a lot from her Irish grandmother, but it was Jennifer’s mother who taught her about precision. Culinary school teaches structure, which is immensely important in a kitchen. You learn the basics, technique and how to function in a kitchen—you learn the playing field just like you would in any other career. It was not until later, while working for some strong and prominent female chefs, such as Oleana Restaurant under James Beard Award Winner Ana Sortun and Caffe Umbra as Sous Chef for Laura Brennan, that Jennifer learned about delicacy, layering and balance. “To me, those are the functionalities, the basics,” says Costello. Technique can be learned by anyone, with enough practice. It is the subtleties of flavor combinations, the layering of depth, texture and flavors that are tough to learn. Jennifer Costello and Chris Hanley met while cooking together at The Blue Room, in Boston, under Steve Johnson. “There’s no one we’d rather be in the kitchen with,” says Jennifer. Both coming from other careers, they not only knew they wanted to cook, but also that they both had a desire to open

their own restaurant. “The Bonneville has always come from the idea that we wanted to put a little of ourselves out into the world and cook our food, our way,” says Costello. Both classically trained in French cuisine, Chris and Jennifer like to draw from those techniques, especially when incorporating ideas from Jennifer’s FrenchCanadian roots. “It usually starts with one ingredient, and then we begin to build a dish around it,” says Jennifer. By starting with one ingredient, Jennifer and Chris are able to layer and develop their dishes, drawing on inspirations from traditional ones, into what they refer to as New-American cuisine. It is classic cuisine with a contemporary twist, marrying both classic French and modern techniques. As they build around one ingredient, Jennifer and Chris take into account not only traditional dishes, but also what they enjoy eating as well. “The inspirations are taken from the flavors, not the formal contents of the dish itself.” Incorporating inspirations from a multitude of sources, people they meet and places they have traveled; Chris and Jennifer take all of that and put it into one simply complex dish—one layered in creativity, passion, time and technique. How they take one ingredient and truly make it shine is at the core of what Jennifer and Chris do at The Bonneville.

“You have likely driven right past The Bonneville on multiple occasions without any idea of the decadent dishes being served up inside the quaint establishment” Much like the food, The Bonneville’s cocktails are rooted in the classics, but with a twist. “Barrel aging is kind of hot right now,” says Jennifer, “It’s one of the interesting developments in the cocktail industry.” Currently, The Bonneville has a barrel-aged rum punch, but they change it up, going off of the flavors previously used in the barrels. Previously, they have done what Jennifer and Chris like to call the double-parked sidecar. “But we’re from Boston,” she says, “so it’s a ‘double pahked sahde cah’—you have to do it with an ‘a’ ‘h.’” Inspiration can be drawn from various sources. Jennifer and Chris actively seek out inspiration by being voracious readers, such as reading the food section every week and by traveling everywhere, like Venezuela, Ireland and Italy—where they hopped on a Vespa with all of their bags and just drove through the wine country; but if they are being honest, a lot of their inspiration comes from being in the markets, talking to the vendors, talking to ranchers and finding out what is available, coming available, new and interesting. “It really comes from them,” Jen says.

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A U S T I N MD M A G A Z I N E . C O M


(-2-2+ Always being careful with the products they bring in, The Bonneville is farm-to-table, and they source locally whenever possible, “but it’s really about finding the best product that we can to put on the plate at the freshest point of its lifecycle.” Jennifer and Chris are avid fans of The Sunset Valley Farmers Market, which is the sustainable food center. They also deal with John Lash from Farm-to-Table, who sources food from all over the Texas region. However, Jennifer and Chris’ favorite rancher is Jeff Roule from IO Ranch, located in northern Lampasas county, “He is our lamb guy,” says Jennifer. This beautiful product is 100 percent grass-fed on the property. “His lamb, in particular, he calls a super food because of what the lambs graze on,” Jennifer says. “It’s clover and some dry grasses—it just takes the lamb up an extra notch.” The Bonneville currently has three lamb dishes on their menu: the IO Ranch Lamb Pizza, the IO Ranch Lamb Loin Chop and—my personal favorite—the Korean BBQ Style IO Ranch Lamb Spareribs. “We are a little lamb-centric right now,” Jennifer says, “but it’s a beautiful product.”

“Technique can be learned by anyone, with enough practice. -XMWXLIWYFXPIXMIWSJ¾EZSV combinations, the layering of HITXLXI\XYVIERH¾EZSVWXLEX are tough to learn.” They bring in a lot of their fish from New England because it is important to them to buy their food from its naturally occurring region. Growing up French-Canadian by birth, Jennifer was immersed in a different style of shopping and cooking—a more European style. In Ottawa, Jennifer would frequently visit the markets. “There are outdoor markets; even in winter you can go,” Jennifer says. She has always been used to dealing with what is fresh and local. She believes the quality of food is just as good here in Austin as it is back home, solely because they are dealing directly with local farmers. Jennifer and Chris have worked rigorously to establish themselves in Austin. “We knew that we would have to work a little harder down here to tell people who we are and let people know what we’re about,” Jennifer says. You have likely driven right past The Bonneville on multiple occasions without any idea of the decadent dishes being served up inside the quaint establishment. They hope, as time goes on, traffic will start to pick up and people will begin noticing 202 W. Cesar Chavez as The Bonneville—warm and inviting, a small but open space filled with satisfaction, happiness, great food and wonderful service. “It’s like anything,” Jen says, “you know, eventually people will find you.”

,IVIEVIWSQISJ%YWXMR1(´WVIGSQQIRHIH MXIQWSR8LI&SRRIZMPPI´WQIRY Here are some of Austin MD’s recommended items on The Bonneville’s menu: Korean BBQ Style IO Ranch Lamb Spareribs - The only way for me to describe these is mouthwatering, fall-off-the-bone tender. The Bonneville - Their signature cocktail is a take on a paloma (tequila and grapefruit). They do tequila with fresh-squeezed, local farm ruby rios grapefruit—which is phenomenal. If there is one thing Jennifer can say, it is that the Texas grapefruit is just knock-your-doors-off good. “By adding a little cinnamon syrup, it takes it in a little woody, but interesting spice direction,” she says. Seared Diver Scallops - Brought in from New Bedford, the golden-brown sear on these scallops is impeccable. As you bite into one, it literally melts in your mouth. Even if you do not like scallops, get them here. You will thank me. Cold sea water makes for beautiful shell fish; it is sweeter, denser, and it is just a gorgeous product.

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$ $<   "8:>835'"82'4N38<4'K6D>'!E4D69'A/'8D'D>3']W^_'#3T84'F;9R3@39:3'R;@'$;B39 by Mary DelGrande Artwork by Alisa Longoria

Rachael Ray is an internationally known

celebrity chef, author and businesswoman who fully believes that the way to changing how anyone views food is through kids. At the 2013 Texas Conference for Women in Austin, Rachael Ray stated, â&#x20AC;&#x153;Kids themselves are the ones who change and empower and retrain the family.â&#x20AC;? While this statement is powerful, it is also true. Kids are the ones who come home and inform their parents what they want. Because of their youthful energy, parents follow in their childrenâ&#x20AC;&#x2122;s footsteps. Kids give us energy, and they are therefore the future of food. Growing up in a small town, Rachael Ray was surrounded by a hard-working mother who took Rachael into work with her every day on her hip because she did not want someone else raising her kids. Rachael learned her work ethic through observation, and she is not afraid of working hard. As a savvy businesswoman, Rachael appreciates the value of hard work not only in the kitchen, but also in building her personal brand. She recognizes that it is important to cultivate relationships because in any one of these relationships she might find her next opportunity. Rachael is constantly searching for ways to grow her brand and provide the best quality to her customers, whether that is in the kitchen through her food or in a new product that makes her customersâ&#x20AC;&#x2122; lives easier; she seeks to solve a problem, serve a purpose and make herself irreplaceable. Rachael works primarily in paper and pen, and her wish for kids these days is that they would be more outdoorsy, unplug and learn necessary life skills. This is not a difficult task to achieve in Austin. Although it is essential to build your personal brand online, putting yourself out there and having a conversation with people is most crucial to growing your brand and finding the next opportunity.

Her four pieces of advice for anyone, regardless of the career choice, are: take your work, but not yourself seriously; work harder than the next person and do it without complaining; and lastly, have enough self-worth to provide for yourself. First and foremost, seek out opportunities. Then come home and enjoy a glass of wine with family and friends. *

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Celebrity chef, author and businesswoman Rachael Ray speaks with Austin MD at the 2013 Texas Conference for Women in Austin, on November 19, 2014. Austin MD: What is the healthiest life change youâ&#x20AC;&#x2122;ve made in the last few years? Rachael Ray: At 40, I had vocal cord surgery and decided to make some life changes. One of those was meaningful exercise. I started running most days, which helps me with mental clarity. Iâ&#x20AC;&#x2122;ve found if I run first thing every morning, it helps keep me centered for the rest of the day; exercise helps with staying focused. Austin MD: What is the healthiest change youâ&#x20AC;&#x2122;ve made in your diet? Rachael Ray: I eat real food, just in moderation. I eat olive oil, lean meats and red meats once a week. Itâ&#x20AC;&#x2122;s very much a mediterranean-type diet, but I think you should eat real over processed foods any time you can. Eating real food over processed foods, any time you can, is going to be one of the most beneficial and healthiest changes you can make. Austin MD: What would you tell your 20-year-old self? Rachael Ray: I would do it all the same. Iâ&#x20AC;&#x2122;d go through with my mistakes because I think they are important to learn from. I also think humility is important. Even today, I still have a bossâ&#x20AC;&#x201D;everyone doesâ&#x20AC;&#x201D;and I know not to take myself too seriously.

A U S T I N MD M A G A Z I N E . C O M

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May / June 2014  
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