MD Monthly- May 2017 Regional

May 2017

mdmonthly.com

50 EMERGENCY MEDICINE

REVOLUTIONIZED ALONG

THE COASTAL BEND Dr. Lonnie Schwirtlich, with Physician’s PremiER, recognized the growing need for emergency medical attention and opted in.

38 OFFERING COMPASSIONATE CARE With a 20-plus-year focus in women’s health, Dr. Jose Ruiz with Institute for Women’s Health, strives to provide a welcoming environment for expecting mothers.

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BREAKING GROUND IN

Trauma Treatment Dr. Kasi Howard brings new innovation to her practice, Innova Recovery through her treatment program, Telehealth.

BOERNE, TEXAS

NOW OPEN

Lounge on the broad, breezy wraparound porch, cocktail in hand. Step into a lovingly restored 19th century dining room to savor contemporary interpretations of Southern heritage foods and classic American dishes. Sit down to a familiar, casual, satisfying menu influenced by seasonal bounty from “As a kid growing up in Jourdanton, I watched my Mother and Grandma make everything from scratch every day. My Father and Grandfather were the Kings of Barbeque. I cooked some, too, but I did a lot more watching, tasting, and learning.”

area farms and the affinity of beef and mesquite smoke that is the soul of the Hill Country.

CHEF MARK BOHANAN

KENDALL INN

128 WEST BLANCO ROAD BOERNE TX 78006

t el 830.572.5000

w e b PEGGYSONTHEGREEN.COM

Back to Normal S p i n e A s s o c i at e s

Comprehensive Spine Center Adult & Pediatric Orthopaedic Spine Specialists Spine Associates’ Comprehensive Spine Center creates a direct link between your primary care provider and the management of your spine injuries. Our Comprehensive Spine Center provides a full scope of spinal services including the evaluation, treatment of the cervical, thoracic and lumbar spine by a nationally recognized orthopedic spine specialist. Working together with referring physicians, our team ensures that each patient receives a personalized treatment plan specific to his or her circumstance and lifestyle. Spine Associates is equipped with the most state-of-the-art imaging and diagnostic technology which enables our spine specialists to effectively and accurately

THE SMARTER CHOICE FOR SPINE CARE Comprehensive Spine Care that follows you from diagnosis to treatment to recovery - and even follows you home AREAS OF EXPERTISE - Robotic Assisted Spine Surgery - Minimally Invasive Spine Surgery - Adult & Pediatric Scoliosis Correction - Reconstructive Spine Surgery - Physical Therapy - Interventional Pain Management

diagnose and treat you. We also offer a full range of leading-

STOP LIVING WITH PAIN

edge, non-surgical and surgical treatment options including

Call or email today and begin your personal treatment plan 800-9-SPINAL (800-977-4625) or info@myspineassociates.com

robotic assisted spine surgery and minimally invasive treatments to get you back to normal.

SPINE ASSOCIATES LOCATIONS: 9301 Southwest Freeway, Suite 600 | Houston, TX 77074 | 713-383-7100 3820 Pointe Parkway | Beaumont, TX 77706 | 409.767.8221 myspineassociates.com

THE HUNT OF A LIFETIME If you are looking for the ultimate hunting experience, then look no further then DEA Ranch. The diverse selection of wildlife will create a lasting impression and make you the envy of your family and friends. For the discriminating whitetail, elk or exotic hunter, DEA Ranch is a paradise.

Skeet shooting, nature walks, bird watching or just relaxing under the 100-year-old oak trees, will make your trip a complete Texas retreat.

• Customized hunting packages for groups of all sizes.

• one-on-one guided, all day hunts that can include different types of game.

• Year-round hunting for axis, blackbucks, hogs, elk and several species of trophy rams.

• Introducing quail hunts and organic meat such as elk, axis and Kobe beef.

• Corporate dove hunts and spring turkey hunting.

• Wedding and party packages including skeet shooting and quail hunting.

We look forward to helping you plan the hunt of a lifetime or a oneof-a-kind event. Contact us today for additional information.

311 CR 351, Mathis, TX 78368 361.249.1157 www.dearanch.com

Stop the Pain Visit Us At AmericanSinus.com or SouthTexasSinusInstitute.com

Honrubia Technique™ for Balloon Sinuplasty

Patient Comfort and Safety Come First

The Honrubia Technique™ for Balloon Sinuplasty is a revolutionary, minimally invasive procedure for treating chronic sinusitis.

The primary symptoms of chronic sinusitis are headaches, trouble sleeping, snoring, fatigue, facial pressure, ear discomfort, and post nasal drip. The Honrubia Technique™ addresses many of the primary symptoms of chronic sinusitis while maximizing the comfort and safety of the patient. It is recommended by our team of board certified ENT Physicians. This technique involves less pain than a traditional sinus surgery and therefore contributes to a quicker recovery.

The Honrubia Technique™ for Balloon Sinuplasty is done under anesthesia. This ensures that patients have a more relaxing and positive experience than when the procedure is performed under a local anesthetic. It also allows us to address several other sinus related complaints. An anesthesia provider administers intravenous medications to keep patients lightly sedated and comfortable.

Our American Sinus Institute team of specialists have performed thousands of procedures using the Honrubia Technique™ for Balloon Sinuplasty. Come see us at the American Sinus Institute. We Solve Sinus Problems.

Vincent F. Honrubia, M.D., F.A.C.S., Director

6363 De Zavala Road, Suite 200 San Antonio, TX 78249 (210) 225-5666 • (210) BALLOON 1801 Binz Street, Suite 400 Houston, TX 77004 (713) 225-5666 • (713) BALLOON

2821 2821Michaelangelo MichaelangeloDrive, Drive,Suite Suite201 201 Edinburg, Edinburg,TX TX78539 78539 (956) (956)661.8200 661.8200• (855) • (855)99SINUS 99SINUS

ANGELICA JACKSON Angelica Jackson is a Board Certified Dermatology Physician Assistant who specializes in Aesthetic Medicine. Originally from Southern California, she received her Bachelor’s of Science from Azusa Pacific University. She then received her Master’s of Physician Assistant Sciences from St. Francis University. She recently moved to Corpus Christi for her husband’s career as a Military Pilot. They are now settling in Corpus as he teaches flight school here.

Working as a team to provide the patient with the highest quality of care is her constant goal. Through her extensive training in Dermatology and years of handson experience in this field, she has developed the capability to effectively serve patients and provide natural looking results. Her positive personality is a reflection of her passion for what she does. In her spare time, she enjoys swimming, working out and spending time with Family.

1752 Santa Fe Corpus Christi, TX 78404 HalcyonMedSpa.com 361.452.2637

Specializing In: •

Non-Surgical Intervention

•

Artificial Disc

•

Minimally Invasive Surgery

•

Degenerative Disc Disease

•

Sacroiliac Joint Fusion

•

Spinal Stenosis

• •

Cervical and Lumbar Fusion • • Spinal Decompressions

•

Robotic Surgery

Anthony Owusu M.D. Orthopedic Spine Surgeon

Sciatica Back and Neck Pain

13409 NW Military Hwy | San Antonio, TX 78231 nxgosi.com | 210.763.7149

PRACTICAL APPROACH SERVICES

Pediatrics, Pediatric Dentistry & Pediatric Urgent Care

Pediatric Care You can find the best pediatrician San Antonio has to offer right here at Practical Approach. From day one, Practical Approach Pediatrics helps children lead healthy and happy lives through a comprehensive approach to healthcare.

Pediatric Dentistry From the first tooth to wisdom teeth, the pediatric dentists at Practical Approach are committed to providing beautiful and healthy smiles. When should your child have their first trip to the dentist? We provide all general pediatric dentist services.

9480 Huebner Road, Suite 400 | San Antonio, TX 78240 210.697.3900 | practicalapproachpediatrics.com

Pediatric Urgent Care San Antonio’s only Pediatric Medical and Pediatric Dental Urgent Care! Our practitioners at Practical Approach are fully trained to handle pediatric emergencies.

Your child’s safety is very important to us and we take great pride in ensuring the quality of our pediatric emergency services!

May 2017 Production Media Digital Source Designer Meghan Goettl Project Manager Miranda Paredes Writers Rudy Arispe Edmond Ortiz Contributing Writers Monica Brant Fiona Cunningham Dr. Michael Fuentes Susan Peirce Thompson Mary J Berkman Chad Gunter Sonya Roemisch, B.S. CPT Kristy Aleman Rachel Lagaly, PA-C Dr. Sabhash Reddy

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Breaking Ground in Trauma Treatment Dr. Kasi Howard brings new innovation to her practice, Innova Recovery through her treatment program, Telehealth.

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50

Emergency Medicine Revolutionized Along the Coastal Bend

Dr. Lonnie Schwirtlich recognized the growing need for emergency medical attention and opted in.

Contributing Photographers Paul Marshall Marc Arevalo FOR ADVERTISING INFORMATION, PLEASE CALL 210.373.2599 OR EMAIL HELLO@MDMONTHLY.COM. FOR EDITORIAL COMMENTS AND SUGGESTIONS, EMAIL EDITOR@MDMONTHLY.COM.

Offering Compassionate Care With a 20-plus-year focus in women’s health, Dr. Jose Ruiz, strives to provide a welcoming environment for expecting mothers.

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MDMonthly.com Cover Photo Dr. Kasi Howard – Marc Arevalo Cover Photo Dr. Jose Ruiz – Marc Arevalo Cover Photo Dr. Lonnie Schwirtlich – Paul Marshall

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Medical Business

Having a Tenant Representative can alleviate stress when opening a new practice, relocating an existing practice, or renegotiating an existing lease.

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Preparation for a Change in Your Medical Practice

"

Informed Patient

Managing A Diabetes Diagnosis Founder and owner of Younique Physique, believes overall wellness begins when commitment to a lifestyle change is achieved.

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Informed Patient

Empowerment Tools to Combat Skin Disease Mary J. Berkman shares eight tools to remedy the emotional trauma and the decline in self-esteem resulting from skin disease.

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58

Environmental Factors Collide with Weight Loss

Being Chronically Ill in America

Op-Ed

Informed Patient

Dr. Subhash Reddy agrees, healthy lifestyle change may not be enough to insure weight loss.

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Informed Patient

Be Kind to Your Skin With summer quickly approaching, it is imperative to learn new ways protect our skin against sun damage.

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Houston-based Celltex Therapeutics finds the answer to save a young girl’s life.

Melissa Y. Macias, MD, PhD Neurosurgery Dr. Macias treats a spectrum of adult degernative spine and brain pathologies and conditions: • Complex Degenerative Spine Disease, Disc Herniations, Spinal Stenosis, Acquired Adult Scoliosis • Infections • Tumors • Stroke • Trauma Through compassionate and individualized care, Dr. Macias uses minimally destructive techniques, as well as stem cell technologies in her procedures. She also offers treatment of chronic pain and compressive peripheral nerve disorders.

A Healthy Spinal Axis is fundamental to an active and healthy lifestyle.

SouthTexasBrainAndSpineCenter.com Corpus Christi Location: 361.883.4323 Fax: 361.883.4324

Hospice is a journey and we’re here to hold your hand every step of the way.

Alice | Austin | Bandera | Boerne Corpus Christi | Hondo | San Antonio

River City Hospice has earned The Joint Commission’s Gold Seal of Approval

compassionate Wecareprovide for our patients and

those who love them most. Our experienced team of professionals are here to support you during the challenges that come with a terminal illness.

Because Every Moment Counts rivercityhospice.com | 1.877.537.4837

MEDICAL BUSINESS/SAN ANTONIO

THINGS TO CONSIDER WHEN

Opening or Re-locating YOUR PRACTICE By: Chad Gunter

O

pening a new practice, relocating an existing practice, or renegotiating an existing lease can be a lengthy process that requires commercial real estate knowledge specific to medical office space, and attention to every step, which impacts your Practice. Having a Tenant Representative working on your behalf, providing guidance and market expertise will undoubtedly alleviate much of the stress associated with the decision-making process.

plan and a corresponding preliminary construction budget is important.

Finish-out expenses that exceed your allowance are, paid by the Tenant either in cash, or the Landlord may amortize the outstanding cost over the term of the lease.

It is a common misconception that tenant representation is too expensive, Tenant Rep services are actually provided at no cost to your Practice. Before you begin the task of looking for medical office space, consult a Tenant Representative.

Following, are a few important items to consider when choosing the best space for your Practice.

Multi-tenant medical office buildings that have imaging, dialysis, or other high power utility uses should be separately metered or submetered.

Ask the Landlord if these users have separate meters or are sub-meters, if not, ask how this impacts the operating expense budget.

A Landlord’s contribution to interior finish is largely dictated by the lease term. A finish-out allowance or Tenant Improvement Allowance is the amount per square foot allocated to a Tenant to customize lease space. The amount quoted by the Landlord may not be at market value, and possibly will not cover basic (standard) building improvements.

Finish-out cost currently runs $50 to $100 per square foot for a shellcondition medical office space.

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Operating expenses will increase year to year. Inserting language in a lease that caps controllable expenses is important as Practices budget for future overhead.

It has been a trend to sign longterm medical leases due to medicalspecific build out expenses. However, Landlords are attempting to limit terms on leases to 3 years or less, giving them the opportunity to raise rents in line with market trends, which have been greater than longterm rent increases.

of the property’s permitted use. Don’t waste time if there is a conflict.

Most importantly, addressing your Practice’s office-space needs too close to your lease expiration can be a costly decision. If your lease expires within the year, you need to begin doing your homework now.

How many square feet do you need?

What part of the city do you want to serve? What are your Practice growth objectives? How will your parking needs be addressed? What is the cost to finish-out the space to meet your Practice needs? What is the current payer mix for this area?

Whether this is your first office, or you want to explore alternate lease options, these tips and a Tenant Representative to help you along the way will make the process much easier.

Chad Gunter, Senior Vice President of Peloton Commercial Real Estate.

Commercial ground leases differ significantly from the traditional medical office or retail space lease. Ask to review the restrictions on a building that has a ground lease up front.

Typically, the Landlord retains control

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MDMONTHLY.COM

ST CE R RT OK IFI E E D

Quality Rehabilitative Care - It Matters!

When looking for rehabilitative care, quality matters.

At Corpus Christi Rehabilitation Hospital, we treat patients recovering from disabilities caused by injuries, illnesses and chronic medical conditions such as: • Strokes • Brain injuries • Spinal Cord injuries

• Amputations • Parkinson’s disease • Multiple sclerosis

• And more…

We are accredited by The Joint Commission and have earned the organization’s Gold Seal of Approval for our Advanced Stroke Rehabilitation Program.

Our goal is to help our patients return home with as much physical and cognitive independence as possible.

We are passionate about patient care and consider it a privilege to provide our community with quality rehabilitative care.

It matters.

CCRH.ERNESTHEALTH.COM

Follow Us

5726 Esplanade Drive • Corpus Christi, TX 78414 • ph: 361.906.3700

HEALTHY LIVING/SAN ANTONIO

The Body & Soul Retreat INSPIRES WOMEN TO ACHIEVE

Physical & Personal Goals By: Monica Brant

O

ften people forget to make time to take care of themselves, especially women. I wanted to create an inspirational weekend for women - away from all the hustle and bustle of everyday life. The Body & Soul Retreat is an opportunity to do just that.

This is not your average boot camp, instead I prefer to refer to it as a retreat. All women, no matter age or skill level, are welcome. We leave nobody behind. It’s not a competition, but a fun opportunity to experience new things.

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The Body & Soul Retreat is a dynamic compilation of all the things I love and practice myself.

It is an opportunity to get to know one another and develop lasting relationships. The retreat starts at the 40-acre ranch in Spring Branch (right outside of San Antonio) called Power Park Fitness owned by one of my personal trainers and American Ninja Warrior competitor, David Yarter.

We will walk and jog the outside of a two-mile course, lovingly called the 'Green Mile', that includes nearly 30 obstacles. Completing this course will challenge not only their bodies,

but their minds as well. After a short break from the outside course we will conquer the American Ninja Warrior training facility inside.

Something unique about the Body & Soul Retreat is the opportunity to partake in a Women's Gun Safety & Handling two-hour session. The 2nd Amendment of the U.S. Constitution has caused quite a stir, and it is my opinion that women should take the initiative to learn the basics of gun safety. Together, we will practice safe gun handling and spend some time on a privately owned shooting range,

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off their own skills. I’ve also invited my good friend and motivational speaker, Melissa Weathersby, to the retreat. She will conduct a nutritional body and soul connection session where each of us will speak on the benefits of having a healthy body and soul. Over the years, it has become evident to me that we can’t gain strength in our bodies without spiritual growth. Melissa uses biblical principles to teach practical life skills for women in every area of life.

Garrison Arms, owned by Jeff and Holly Martin.

Through many years of competitive running I have developed a passion for sprinting that I love to share through this retreat. As part of the weekend, I go over fundamentals and give the ladies a chance to show

My goal is that the attending women will leave the retreat with refreshed souls and full hearts, and they will be motivated to tackle their next endeavors head on with some newly-gained ammunition.

Military, Student & Group discounts are available. 12 and older are welcome to attend with a guardian.

Sponsored by my good friends at: EggWhites International www.eggwhitesint.com/likes/ monicabrant Play Again Now www.playagainnow.com Paleo Zone Food Service https://www.eatology.co/

My next retreat will be June 10th-11th and I will host another sometime in August. For more details please see www.monicabrant.com/ bodysoulretreat.

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HEALTHY LIVING/SAN ANTONIO

ENRICH

Your Life Strength training: A vital part of a fitness program you cannot skip to preserve your body and improve your overall health and fitness performance By: Dr. Marta Dahiya

M

any people I know, including myself, consistently have a negative attitude toward weightlifting and strength training. Most do not enjoy it, and even I did not understand the importance of it until recently.

Strength training enriches daily life by enhancing endurance, assisting in proper weight management and improving overall fitness performance.

By definition, strength training is a concerted effort to use resistance or weights to work a muscle group.

Many have been misled into believing that maintaining an active job or doing housework is enough to keep muscles healthy and strong. An active lifestyle is beneficial to the body, but it takes a focused effort to work muscles by either using weights or personal body weight.

Many women accept a false representation of strength training and fear a muscular and bulky body.

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However, women do not produce as much androgen hormones – a hormone essential to muscle development – as men, and women must engage in heavy weightlifting to build this amount of muscle. A regular strength-training program can reduce body fat, increase lean muscle mass and burn calories more efficiently.

Muscle mass naturally diminishes with age, and as the saying goes, if you don’t use your muscles, you will lose them! Humans are a naturally active species; therefore, exercise

Research has shown that strengthening exercises are both safe and effective for women and men of all ages, including those who are not in perfect health. You don’t have to spend hours a day lifting weights to benefit from strength training.

must be a vital part of preserving our bodies. Starting as early as 25, people who do not exercise lose about 0.5 to 1.0 percent (or about a pound) of muscle per year. This leads to tasks as simple as standing up from a chair, going up and down stairs and picking up something from the floor becoming more difficult with age. Strength training has been shown to mitigate this gradual deterioration of the body.

Strength training is necessary for all of the following reasons. It helps: •

Develop and maintain bones.

Strength training increases bone density and reduces the risk of osteoporosis and fractures.

•

Control your weight. As you gain muscle, your body burns more calories, which can result in weight loss and decreased body fat. If you don’t initially rebuild muscle through exercise, every 10 years, you will need to eat 150 to 450

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is because people feel more self-confident when they are stronger or if strength training produces a helpful biochemical change in the brain.

fewer calories each day to maintain your current weight.

•

Reduce your risk of injury and falls. Building muscle helps protect your joints from injury and contributes to better balance, which can help you maintain independence as you age.

•

Fight fatigue. As you get stronger, you will have more endurance.

•

Sharpen your focus. Research suggests that regular strength training helps improve attention and concentration in older adults.

•

Sleep better. It is easier to fall asleep quickly, enter a deeper sleep, awaken less often and sleep longer.

•

Improve cardiac health. The risk of heart disease is lower when the body is leaner. Studies have prompted the American Heart Association to recommend strength training as a therapy for patients in cardiac rehabilitation programs.

•

Improve glucose control.

Lifestyle changes such as strength training have a profound impact on helping adults manage their diabetes.

In a recent study, 16 weeks of strength training produced dramatic improvements in glucose control that were comparable to taking diabetes medication.

•

Control depression and boost mood. Strength training provides similar improvements in depression as antidepressant medications.

Currently, it is not known if this

•

Manage other chronic conditions. Strength training can reduce the signs and symptoms of arthritis and back pain. It will increase muscle strength and general physical performance, improve the clinical signs and symptoms of the disease and decrease disability. It is also an integral part of rehabilitation for neurological conditions like Parkinson’s disease, multiple sclerosis and stroke, to name a few.

Research has shown that strengthening exercises are both safe and effective for women and men of all ages, including those who are not in perfect health. You don’t have to spend hours a day lifting weights to benefit from strength training. Two to three 20to 30-minute strength-training sessions a week are sufficient for most people.

Finally, don’t be intimidated.

Strength training is not as intense as bodybuilding or heavy lifting, and it does not require equipment or expensive gym memberships. It can be done at home or in the gym. Don’t wait anymore! It is not too late to add strength training to your New Year’s resolutions.

Marta Dahiya, M.D., specializes in oncology, but is increasingly active in fitness and nutrition. For more information, please go to www.oncologysa.com or call Oncology San Antonio at 210-299-8000. If you are interested in reviewing a list of references, please contact us at NFit magazine.

HERE ARE SOME OPTIONS IF YOU WOULD LIKE TO TRY STRENGTH TRAINING:

PERSONAL BODY WEIGHT Try pushups, pull-ups, abdominal crunches and leg squats.

RESISTANCE BANDS Resistance bands are inexpensive, and you can fine them at any sporting goods store.

FREE WEIGHTS Barbells and dumbbells are classic strength-training tools, and home items can substitute until you can purchase a set.

WEIGHT MACHINES Find an affordable gym or save up to purchase your own for home.

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IN THE COMMUNITY/SAN ANTONIO

REHOME BY ADOPT-A-PET.COM AND PETCO FOUNDATION LAUNCH NEW INNOVATIVE TECHNOLOGY FOR

PEOPLE WHO NEED TO FIND NEW HOMES FOR THEIR PETS San Antonio is the first market for state-of-the-art peer to peer pet rehoming service Special to MD Monthly

S

an Antonio pet owners who find themselves faced with the difficult decision to find a new home for their beloved pets now have a caring helping hand thanks to Rehome, a new and free online pet adoption program

by Adopt-a-Pet.com and the Petco Foundation.

Rehome, an innovative and ground-breaking service developed

by Adopt-a-Pet.com, North America’s largest non-profit adoptable pet search engine, and its collaborator, the Petco Foundation, will make its first public introduction in the Alamo City before being rolled out nationally, officials announced recently.

Adopt-a-Pet.com is a charity on a mission to help homeless pets 22

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find loving homes. The organization has, for many years, been focused on providing support to its network of over 17,000 animal shelters and rescues across the US and Canada— getting the pets in their care seen by the millions of adopters who search for their new best friend on Adopt-aPet.com each month. Thanks to the Petco Foundation, Adopt-a-Pet.com is now able to extend that support directly to pet owners who can no longer keep their pets. The service is free to owners seeking to rehome their pets, and adopters pay a small adoption fee with 100 percent donated to an animal shelter or rescue of the original owner’s choosing.

“Rehoming a beloved companion animal can be an extremely stressful, and emotionally devastating,

experience,” says Abbie Moore, executive director of Adopt-a-Pet. com. “Our first priority is to help the owner keep their pet. If that’s out of the question, we’re here to hold the owner’s hand throughout the process and make sure that they have every tool available to them to help find their pet a new loving family.”

Rehome by Adopt-a-Pet.com and the Petco Foundation provides those people needing to find their pet a new home with an easy way to directly connect with the millions of potential adopters each month. A pet going from one home directly to its new home is definitely the right thing for that pet, plus it lessens the burden on the animal shelters throughout the country reducing the number of animals in their care, and

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IN THE COMMUNITY/SAN ANTONIO

allowing them to focus their precious resources on saving lives.

“This new innovative technology is a win for everyone involved, owners needing help, pets, adopters and animal shelters throughout the country; and we are proud to join forces with Adopt-a-Pet.com to make this happen,” said Susanne Kogut, Petco Foundation’s executive director.

“At the Petco Foundation we believe that when we develop solutions and empower communities to participate and help, we will create lifesaving communities everywhere and assure every that pet has a loving home.”

Through Rehome, pet owners can visit Adopt-a-Pet.com and create a profile for their pet with photos, video, and information about the pet’s personality, behavior, and health. “When pet owners use the Rehome tool, their pets appear on Adopt-a-Pet.com, where they can be seen by millions of people looking

to adopt pets,” Moore said. “Our goal is to prevent pets from being relinquished to shelters. Rehome

by Adopt-a-Pet.com and Petco Foundation directly addresses an actual need faced by the millions of pet owners who must find new homes for their beloved animals.”

Pet owners who need to place their pet up for adoption can visit rehome.adoptapet.com to create a profile and learn more.

Adopt-a-Pet.com (formerly 1-800-Save-A-Pet.com) is North America's largest non-profit pet adoption website. We help over 17,000 animal shelters, humane societies, SPCAs, pet rescue groups, and pet adoption agencies advertise their homeless pets to millions of adopters a month, for free. We're all about getting homeless pets into homes. We use the power of TV, the Internet, and a toll-free phone number to connect adopters with

shelter pets and help pets go from alone to adopted.

At the Petco Foundation, we believe that every animal deserves to live its best life. Since 1999, we’ve invested more than $175 million in lifesaving animal welfare work to make that happen. With our more than 4,000 animal welfare partners, we inspire and empower communities to make a difference by investing in adoption and medical care programs, spay and neuter services, pet cancer research, service and therapy animals, and numerous other lifesaving initiatives. Through our Think Adoption First program, we partner with Petco stores and animal welfare organizations across the country to increase pet adoptions. So far, we’ve helped more than 5 million pets find their new loving families, and we’re just getting started. Visit petcofoundation.org to learn more about how you can get involved.

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Breaking New Ground in Trauma Treatment

via Telehealth By: Rudy Arispe

or PTSD (post-traumatic stress disorder). “People usually associate PTSD with war veterans, but individuals who have been sexually or physically abused also have PTSD,” Dr. Howard explained.

“So we have two tracks. One for veterans with PTSD and one for females, who have had what we call ‘relationship trauma.’ They were sexually abused as children or sexually abused or raped as an adult,” she said.

Dr. Howard is proud to share that Innova is a leader in providing mental health treatment through its telehealth services.

W

hen Megan sought professional assistance at Innova Recovery, a telehealth trauma treatment program, for her mental health issues, she was skeptical at first at the idea of receiving counseling via her computer and the internet.

But because she lives outside the San Antonio city limits, she decided to give it a try. Now, after five months into the telehealth program, she has given her assessment.

“I think it’s a great program, and it really has made a phenomenal difference,” said Megan, 32, who works in the juvenile justice field. “It’s convenient since I work full time. I don’t know if I would have been able

to do in-person, intensive outpatient treatment three times a week. I was out of town for training for work (recently), and I was still able to log in and participate in group sessions.”

Innova Recovery was founded in December 2016 by Dr. Kasi Howard, a psychologist who specializes in trauma, insomnia, anxiety, depression and eating disorders, among other mental illnesses.

“The beauty of Innova is everything we do is done through telehealth, so people can be treated from the comfort of their home,” Dr. Howard said. “A lot of people, especially after they have experienced trauma, are anxious and don’t like leaving the house, or they have hectic work schedules, so now they can receive live treatment through something similar to a secure version of Skype.”

“We’re the first program like this in the entire state and the second program like this in the country,” she said. “We’re forging new ground.”

In 2015, Medicare, she added, created an initiative to increase telehealth. “It’s not often used because it’s so new. But they did pass laws saying insurance has to cover live services at the same rate as telehealth. I think mental health is a little behind everything. We want to catch up and get ahead of the curve.”

Moreover, Innova Recovery is a treatment program for people suffering from trauma

STYLIST Juanita Gonzalez

MAKE-UP ARTIST Danielle Cunningham – The ONE Cosmetics

PHOTOGRAPHS BY Marc Arevalo

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Dr. Howard has patients throughout Texas, including one in Laredo, so traveling to San Antonio would not be convenient for her. Another has chronic pain and struggles to leave her house.

family members, Dr. Howard said that “a lot of them are rejected by their families and have no support.”

“Life or distance and other factors can prevent people from getting treatment,” she said. “Telehealth fills that gap, so those things don’t get in the way.”

She also treats many veterans, such as soldiers who served in Afghanistan and Iraq and experienced the horrors of war.

And she wants them to know she and her staff are eager to help them, so they can lead normal, healthy lives again.

“Many have never had treatment,” Dr. Howard said. “Most of them are humble. They’ll said, ‘The other guy had it worse than me.’

They are divorced, they can’t keep a job, they can’t sleep, and they can’t do crowds.”

Helping others, or rather lending an ear or a shoulder to cry on, appears to have been a calling for Dr. Howard since childhood. She remembers being 8-years-old, when she knew she wanted to be a psychologist.

Regarding those who have been sexually abused, often times from

“I had an elderly neighbor who I used to go visit. She was a nurse,”

she recalled. “I told her one day I liked listening to people’s problems. She said, ‘You should be a psychologist.’ ” After learning to spell “psychologist,” the young Kasi made up her mind about her future career. “I was in a gifted and talented program, and I made a Dear Abby sign with big, glittering letters. Kids could ask me a question, and I would give my second grade ‘expert’ answers to all of them,” she said, laughing.

Incidentally, Innova is Latin for “renewal” and the program’s logo includes an image of the lehua flower native to Hawaii. “They grow best in volcanic ash,” she said. “It’s the idea of beauty from ashes. Horrible things can happen, and then you regrow.”

Innova Recovery treats men and women, 18 and older. For more information, visit www.innovarecoverycenter.com or call (210) 254-3618.

Get to Know Dr. Kasi Howard •Education: I went to Baylor for my undergrad and received my doctorate from Regent University in Virginia Beach, Va. •Work Experience: I worked in a Sexual Trauma Unit at a Virginia VA. •If you weren’t a psychologist: I would own a bakery.

•First job: I worked at Baskin Robbins. I swear my right forearm is still bigger than my left from years of scooping.

•Something about you nobody knows: I have climbed 28 of the 50 high points in each state.

•Guilty pleasure: Freddy's brownie sundaes with my son.

•Hobbies: Running and DIY projects around my house.

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STYLIST Juanita Gonzalez

MAKE-UP ARTIST Danielle Cunningham – The ONE Cosmetics

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INFORMED PATIENT/SAN ANTONIO

Does modifying just

Environmental Factors help with weight loss?

T

By: Subhash Reddy, MD

he simple and short answer for this is “probably, but not sure”. Body weight is the product of genetic effects (DNA), epigenetic effects (heritable traits that do not involve changes in DNA), and the environment.

The majority of the obese population who are intending to lose weight will agree. One may lose a few pounds by diet modification, exercise, or adding some healthy lifestyle changes. But over a period of time, they regain their lost weight or sometimes even more. It does not mean that they did not follow healthy rules, it just means their body found a way to slow their metabolism (save energy). This is the inbuilt mechanism in human beings developed over generations to adapt the body for periods of starvation.

A study done by University of 30

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Exeter Medical School in the UK evaluated a bio bank of 120,000 people, and found that many weight-producing aspects of the environment, lifestyle and behavior interact with a person's genes to influence his or her waistline - and that the strongest influence is from poverty. Poverty and weight gain is related to dietary pattern, activity level, and most importantly, genes.

The conclusion of the article was that policies to fight obesity can’t be done just by focusing on environmental/ dietary or activity level in those who are genetically susceptible. A similar study was done by University of San Francisco that was published in JAMA 2016, which looked into 29 obese genetic variants of around 7000 Caucasian and 1300 African American people born between 1900 and 1958 and their influence on weight gain. The number of genetic variants each person had did not increase

in the population over time, while their effects on people did, pointing to environmental influences. The analysis found that average BMI (body mass index) increased over time for everyone in the study, even those with quite low genetic risk for obesity.

But, people with high genetic risk were affected the most. The study points out that genes that had little or no influence in the past now play a significant role in gaining weight with the changing environment. One possible hypothesis of these obesity genes is that they may increase hunger and make people to look for a high calorie diet, which is readily available in well-developed countries.

The situation is made worse when the population overall is less active.

This hypothesis was tested by Uppasala University, where they collected blood samples of the people with the obesity gene variant after overnight fasting, and compared to

MAY - 2017

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INFORMED PATIENT/SAN ANTONIO

normal population. People with the obesity variant gene had 8% higher levels of ghrelin (hunger hormone) and 9 % low levels of Leptin (satiety hormone) compared to the normal population, which helped them gain weight easily. Leptin, a naturally occurring hormone, is known for its hunger-blocking effect on a region in the brain called the hypothalamus.

Food intake is influenced by signals that travel from the body to the brain.

Leptin is one of the molecules that signals the brain to modulate food intake. It is produced in fat cells and informs the brain of the metabolic state. If animals are missing leptin, or the leptin receptor, they eat too much and become severely obese.

People have looked to the concept of starvation to lose weight, which is one of the environmental factors.

Multiple studies have looked into this and found out that it’s not quite helpful in the long run. In the Minnesota starvation study, the subjects lost 66% of their initial fat mass in response to 24 weeks of semi-starvation (i.e., at 50% reduced energy intake), but re-feeding (normal calories) resulted in a regain of fat mass reaching 145% of the pre-

A study done by University of Exeter Medical School in the UK evaluated a bio bank of 120,000 people, and found that many weight-producing aspects of the environment, lifestyle and behavior interact with a person's genes to influence his or her waistline - and that the strongest influence is from poverty. starvation values (i.e., there was an overshooting of fat mass, known as the catch-up fat phenomenon).

Further simulation of the Minnesota starvation experimental data suggested that after re-feeding, it may take more than a year for the fat mass to decrease to within 5% of the initial value. These data reflect a transient loss in appetite control (and thus body weight regulation) during the first months of re- and overfeeding. Returning to a prestarvation (and presumably healthy) lifestyle may take longer time periods as the body reconstitutes or resets its body weight regulatory system. This finding might lead to the more general hypothesis that the

biology of body weight regulation is camouflaged by hyperphagia (and presumably a Western lifestyle). The other observation from prior studies was that diet-induced weight loss in overweight subjects does not affect adipose tissue distribution, implying that the different depots (e.g., visceral and subcutaneous) are reduced with weight loss. However, there are preferential losses of visceral adipose tissue and ectopic fat in the liver and these are disproportionately depleted with weight loss.

The biological control (genes) of weight gain is lost or camouflaged

by Western diets, suggesting that the failure of biological control is due mainly to external factors. Biological control, i.e. genes, have a significant role to play in weight gain or control, but are overtly suppressed by the current environmental situation. All the multiple studies looking at the genetic aspect of weight gain have one thing in common: These genes existed hundreds of years ago, but what has changed to trigger weight gain is the biggest mystery. This will be the answer to control the obesity epidemic. Lucky were the older generations who carried these genes, but did not have exposure to the many calorie-dense, processed foods available today.

For more information, visit texasbariatricspecialists.com or call 877.538.6909. The corporate headquarters for Texas Bariatric Specialists is located at 14603 Huebner, Building 2 in San Antonio, Texas 78230.

2017 - MAY MD Monthly

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INFORMED PATIENT/CORPUS CHRISTI

Summer SKIN TIPS By: Kristy Aleman

Did You Know?

•

•

•

•

•

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Sunburn happens when your skin is burned by ultraviolet (UV) radiation.

UV light can go through clouds.

That means you can get a sunburn, even on a cloudy day.

Within a year, sunburn affects more than 70% of children and 30% of adults.

Even though most sunburns are not severe, frequent sunburns significantly increase your risk of developing wrinkles, skin cancer, cataracts, and other cosmetic concerns.

People with fair skin and light colored hair often can develop a

MD Monthly

•

sunburn in less than 15 minutes.

Sunscreen can expire! If it doesn’t have an expiration date, then don’t keep it for more than 3 years.

•

What Can I Do To Prevent a Sunburn?

•

•

Wear sunscreen. It protects the skin by absorbing or reflecting UV light. The Sun Protection Factor (SPF) is how much protection the sunscreen offers against UVB (sunburn) rays. Look for broad-spectrum sunscreen because it protects against UVA and UVB rays.

Use at least a sunscreen with SPF greater than 30.

•

•

•

Remember, if you have fair skin or know you will be in the sun for a long time, the greater the SPF the better!

Apply your sunscreen at least 15 minutes before going outside and reapply around every 2-3 hours.

Don’t forget about your lips!

Protect them with lip balm of SPF 30 or more and don’t forget to reapply just like your sunscreen.

Try to stay out of the sun between 10am-4pm, when UV rays are strongest.

Look for shade. Trees, tents, and umbrellas help to block some of the UV rays.

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INFORMED PATIENT/CORPUS CHRISTI

•

•

•

In Texas, the bigger, the better.

So in the Texas sun, the bigger the hat the better! It will protect your face, neck, and ears.

Same goes for sunglasses, but make sure your sunglasses have UV protection.

Cover up! Some clothes are sun-protective with SPF.

What If I Get A Sunburn?

•

•

•

It can take 3-5 hours after being out in the sun before the redness appears. Then, the burn will worsen after 12-24 hours.

You can treat a mild sunburn on your own by taking a pain-relieving medicine (like Ibuprofen or Acetaminophen).

Use a cool soak or compress, or a lotion containing aloe vera.

Stay out of the sun until the redness and pain goes away.

Have fun outside, but be kind to your skin. Always protect against the sun!

2017 - MAY MD Monthly

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INFORMED PATIENT/SAN ANTONIO

10 Lifestyle Recommendations THAT CAN PREVENT OR MANAGE A

Diabetes Diagnosis By: Sonya Roemisch

I

am constantly teaching and reminding my clients that they have to commit to a lifestyle change and get out of the “diet� mentality. I work with them to make changes and adjustments in their habits and choices and am always so impressed at how quickly they improve when they incorporate these changes into their lifestyle: 1. Move more. Get out and take a walk around the neighborhood, take the stairs, and choose to park in parking spots farther away when you are out. This can help lower your blood sugar and help you lose excess weight.

Make sure to have a pair of wellfitting shoes, especially if you are diabetic.

2. Resistance training. Strength training is one of the best things you can do for your body. For

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those who are at risk or have diabetes, resistance training also helps your body respond better to insulin and helps lower and stabilize the blood sugar. It helps you build and maintain lean weight, which is important in keeping your metabolism going.

It also assists in weight and body fat loss.

requires insulin for metabolism, it has minimal effect on blood glucose levels.

3. Eat small, frequent meals. Aim to eat every 2.5 to 3 hours, with your first meal within 45 minutes of waking up. Again, this will help stabilize your blood sugar and kick start that metabolism to help lose those unwanted pounds.

5. Increase good fats. Good fats help keep you full longer, curb sugar cravings, and are vital for the production of healthy cells, hormones and energy. Include in small amounts a variety of Essential Fatty Acids also known as EFAs such as avocado, nuts, nut butters, seeds and olive oil. Coconut oil or Butter, a Medium Chain Triglyceride or MCT, is a great fat source and has many health benefits including combating insulin resistance.

4. Eat protein with each meal.

Protein stabilizes blood sugar levels and helps build and maintain lean muscle. Incorporating protein in each meal will also keep you full for longer. Although protein

6. Decrease sugar intake. Limiting your sugar intake can help control weight gain, which can increase chances of type 2 Diabetes. It can also help control your blood sugar levels.

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7. Limit the carbs, and take out white carbs altogether. We need carbohydrates for energy, but too many raises blood sugar and causes weight gain, which leads to a greater risk of Type II Diabetes. White carbs have higher glycemic index which releases glucose quickly into the bloodstream. Choose complex carbs like, oatmeal, sweet potato, brown rice and black beans over simple carbs such as white potatoes, bread and rice.

Limit your fruit to small servings and choose berries which are high in fiber, antioxidants and lower glycemic.

8. Eat more veggies and fibrous foods. Vegetables contain vitamins, minerals, fiber, and phytonutrients, which are all integral to your health. Fiber helps stabilize blood sugar levels by slowing down the rate that your body absorbs sugar, so you should try to eat 20-30 grams of fiber daily.

9. Increase water intake, drink low calorie drinks and limit alcohol.

Not only will watching your calorie intake from your liquids help keep the blood sugars stable, but will save calories as well, helping you lose those unwanted pounds. I recommend trying to shoot for 2-3 liters of water and drinking unsweetened tea, coffee and zero-calorie flavored drinks occasionally to help keep you hydrated. You can sweeten your tea or coffee with stevia, truvia or something similar and use unsweetened Almond or Coconut Milk as creamer for coffee. Alcohol not only affects your ability to lose unwanted pounds but can affect

your blood sugar by causing it to go too high or extremely low, depending on how much you consume. Although I don’t recommend it to my clients, if you do drink alcohol, try to limit to occasionally; drink plenty of water when consuming, make sure you eat before and don’t replace alcohol for regular meals.

10. Rest and de-stress. Not getting enough rest can cause insulin resistance. It is recommended to get 6-8 hours of sleep each night. You can manage stress levels through exercise, meditation, walking, yoga, and/or massage therapy.

Some exercise tips to follow if you are diabetic:● •

•

•

•

•

Always check your blood sugar before exercising. You may also need to check during exercise if exercising for a long period of time.

Eat a healthy snack 30 minutes to an hour before working out, such as: a ½ cup to 1 cup of low-fat yogurt or cottage cheese, ½ cup blueberries, and 2Tbs chopped nuts or a Protein bar with low sugar.

Keep something nearby that can raise your blood sugar quickly in case it drops. 3 or 4 glucose tablets, 1 tablespoon of honey, or 3 or 4 hard candies will generally be enough to raise your sugar.

If you get shaky, light headed, dizzy or nauseous those can all be of initial signs your blood sugar may be getting low.

If you use insulin, check with your doctor to find out how to adjust your dose when you exercise.

•

Don’t inject the body part you are going to be focusing on.

Whether it be lack of knowledge or self-care, my goal is to educate, motivate, and inspire each person at their own level to reach success, which empowers them to continue their journey and in many cases inspire others.

Because each person is different, my job as a coach is to help introduce these changes in small doses so that it is less overwhelming. You can’t expect overnight results, but with patience, persistence, and consistency, these guidelines can change your life whether you are prone to, or suffer from diabetes, or are just trying to live a healthier lifestyle. I am a firm believer that by taking charge of your lifestyle, you can control your health!

Sonya Roemisch, B.S. CPT, has been in the Fitness & Wellness industry for over 20 years and is the founder and owner of Younique Physique and Younique Fitness and Wellness LLC. She is a fitness model, writer, WBFF Bikini Athlete, and 2015 Ms. Fit American Beauty. Since opening Younique Physique in 2005, Sonya has helped thousands of clients transform their bodies and their health. She has a passion for educating, motivating, and inspiring others to reach their potential with her down-to-earth approach.

For more information, please visit www.youniquephysique.com and connect with Sonya on Facebook and Instagram (@youniquephysique) and Twitter (@sonyaroemisch). You can also subscribe to her Youtube channel TheYouniquePhysique.

2017 - MAY MD Monthly

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INFORMED PATIENT/SAN ANTONIO

8

EMPOWERMENT TOOLS

P

FOR PSORIASIS

soriasis is a non-contagious skin disease that affects about 4.5 million people in the US. It is characterized by red, dry plaques, or scaling, of skin. Doctors will tell you that if you are diagnosed with psoriasis that it is incurable.

over 20 years and I cleared it using holistic means and adding these empowerment tools into my life.

Those that have psoriasis can suffer from much emotional trauma.

This includes consistent feelings of shame, embarrassment, sadness, and low self-esteem.

This tool can help you raise your frequency and find your way back to a calm, centered state after a challenging emotion, such as shame.

There are 8 Empowerment Tools that have been extremely helpful to help in dealing with the day-to-day when you have psoriasis. You may feel frustrated, angry, disconnected, embarrassed, and one of these tools may help you shift your vibration, refocus your energy, handle stress and/or accept that you feel out of balance or irritable. I had psoriasis for

When I developed psoriasis, my nervous system was in deep need of relaxation and nourishment. I began to infuse myself with emotions and feelings, in the form of words similar to charging myself with healthy, nourishing foods and supplements.

It recharges me, uplifting me to a higher frequency very quickly. I often think of the word EASE and then I say to myself ease, ease and feel

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By: Mary J. Berkman

the resonance of this word surging through my body. This is fulfilling and one of my favorite ways to reset my system when it is overwhelmed.

8 EMPOWERMENT TOOLS • •

INFUSING SELF WITH FEELINGS AND WORDS

EVERYTHING IS AN OPPORTUNITY

This is a powerful tool to change a pattern and redirect your focus.

If you find yourself in a challenging situation, try this; say to yourself, “Wow, this is a great opportunity to… grow, forgive, transform, expand, learn, empathize, love myself more, accept someone for who they are, see an unhealthy pattern, or choose a new way of doing something."

Opportunity is a powerful, transforming word. If you are feeling uncomfortable because your psoriasis is exposed, maybe this is an opportunity to love yourself through this challenge.

MAY - 2017

MDMONTHLY.COM

INFORMED PATIENT/SAN ANTONIO

•

DEEP, DEEP PRESENCE

Tapping into your deep state of presence is a great tool for moving through life with greater ease.

Find yourself immersed in the moment. Close your eyes and feel the aliveness of your body: your breath, your cells, your muscles, and spirit.

Doing so can support you in letting go of the constant stream of thoughts. It encourages a calm feeling to emerge.

Then, allow yourself to meet the spirit within. Feel its presence. Relax into it with your body by letting go of any stresses, or concerns.

•

RE-PATTERNING

Re-patterning – changing a pattern that you've been repeating for a long time - can be a big contributor to clearing skin.

Re-patterning can be accomplished by continually doing something differently, therefore creating a fresh way of moving through life. I had eczema on my hands for a period, and it was painfully itchy. I remember once I was in so much discomfort I started to cry, and my dear friend gave me some ice. Immediately I began creating a new pattern. I began using ice to ease the discomfort instead of scratching. It took me continually choosing this to begin to change my pattern. Now, I do not itch very often and, when I catch myself scratching, I return to new ways of handling it.

Repatterning can be accomplished by focusing on what beliefs resonate with you, and what beliefs are the basis for creating and manifesting your life. If I believed what my skin doctor believed, that psoriasis is incurable, then I would live by this premise. I would think this thought regularly, and the result would likely show up for me in my life. I knew

thinking that psoriasis was incurable would not work. So, what would I have to lose by thinking the thought, psoriasis is curable?

•

VISUALIZATIONS

Visualizing clear skin regularly has been a helpful tool for me in clearing my skin.

I do a regular visualization when I am in sitting meditation: I see myself with clear skin all over my body. See it and then feel what it feels like to have clear skin, to feel your knees, your scalp, wherever psoriasis is, totally free of psoriasis. Relief and contentment will probably be the feelings you will experience. I sink into the feeling that comes up, allow it to really settle in, and continue to meditate on the feeling for as long as possible. I take note of this sensation in my body and conjure it up going forward when I remember to do so.

As I do this visualization, the tension in my body begins to dissolve.

Eventually, this helped me gain serenity in my life, and clear my skin.

•

LISTENING

Listening to the spirit within is a great tool to develop.

Here, you tap into your inner voice and let it guide you. You can ask it questions or simply pay attention to your inner body. A place that is deep in your body, beyond your body, will communicate with you; it is your spirit, which is always dwelling in and about you.

It is guiding you, based upon the questions, visions, wishes, and dreams you have and the energy you are emitting. It might be the questions you write in your journal. If your focus is to clear your skin, then you will likely be led in that direction.

We are powerful creators, continually

creating the world around us from the world within us.

•

FOCUSING ON THE GOOD

In adding this daily practice into my life, I have watched the unfolding of a more serene, quality of life.

Focus on the good in your life regularly, and as often as you can.

Even if everything looks bleak and feels challenging, you can begin to just let it be. Then, choose something great in your life. It could be the delicious lunch you made or that you love your dog. Just dwell on that. It takes your focus off your skin and the possible difficult emotions and you allow in some easier emotions.

I am grateful for something every day, no matter what.

•

SELF-OBSERVATION

Self-observation is a tool to use daily to help shift patterns in your life. It can be used to help in many circumstances, including when feeling frustrated at your situation of having psoriasis.

Having skin challenges helped me clear up my inner game. It helped me to see that there is an opportunity to release negativity by seeing where my thoughts go when I am focusing on a skin breakout.

I scratch my skin when I feel anxious and fearful and am thinking thoughts that feel uncomfortable.

So, when I catch myself scratching, I can almost always match it with a challenging thought or emotion.

Then I take a deep breath, stop any activity I am doing, and just stay in deep openness and observation.

The pain will usually transform. The more you can watch what comes up non-judgmentally, the more you are shifting the pattern.

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DR. JOSE RUIZ

OFFERS COMPASSION AS OB/GYN By: Edmond Ortiz

nearly 7,000 babies.

“Any medical student knows, really, when they deliver babies — it’s an incredible feeling,” he says.

“For me, knowing as a kid that’s what I’ve wanted to do, being able to do that, it was a thrill. Even to this day, I love doing it. There’s nothing better in medicine.”

Ruiz’s resume grew and earned accolades. He found his way to San Antonio. He has developed affiliations with several hospitals, including Methodist Hospital.

Becoming a partner at the Institute for Women’s Health was his biggest professional move. Several local practices merged to become the IFWH about 23 years ago.

I

Ruiz has been with IFWH for 20 years. The institute is San Antonio’s largest OB/GYN clinic, involving more than 30 physicians with over eight locations who offer services in all areas of women’s health, including management of menopause and fertility treatment. t’s a rainy day, but in his office, Dr. Jose Ruiz is cool, calm and collected, going in between appointments.

The Baton Rouge, Louisiana native is an obstetrician/gynecologist at the Institute For Women’s Health in the South Texas Medical Center. He’s been practicing medicine for more than 30 years, with a 20-plus-year focus on women’s health.

“My best friend’s dad was an OB/ GYN. He was kind of my mentor,” Ruiz says. “Ever since I was a kid, I

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MAY - 2017

knew that was what I wanted to do.”

Ruiz graduated from Louisiana State University with a bachelor’s degree in science. He earned his medical degree from LSU’s School of Medicine in New Orleans.

He completed his residency at St. Luke’s Women’s Hospital, part of Columbia University, in New York City.

Ruiz said helping a mother with the birth of a child, bringing him/ her safely into the world, is an aweinspiring moment. And he’s delivered

“What sets us apart here is that personal touch — that you matter, that we give you the time and that we’re here for you,” he says of IFWH. “I also think we provide great prenatal care. We’ve been doing it for a long time,” Ruiz adds.

Over the years, Ruiz has seen many changes in OB/GYN regarding treatment. The use of robotics for minimally invasive surgery is perhaps the biggest evolution.

“With the robotic instruments we’re seeing, that’s probably one of the PHOTOGRAPHS BY Marc Arevalo

MDMONTHLY.COM

biggest advances in surgery,” he says.

“Before, we used to cut open people with large, open incisions.

Now, we’re able to do these complex surgeries through very small incisions. Patients recover faster.

They’re in less pain.”

Ruiz says he and other OB/GYNs give their all because they understand how crucial and special the day is the birth of someone’s child.

“One of the most important days in someone’s life is the birth of their child,” explains Ruiz, a husband and father to three children.

“It’s like your wedding and the birth of your child. That’s as high as it gets. Anything we can do to make that day special, which you’ll always remember, that’s as good as it gets.”

He continues: “It’s about making that a safe, happy day for the whole family, because it affects the whole family. That keeps me going and saying, ‘I love what I do.’”

Whereupon prescribing preventative care, Ruiz says he strives to keep things simple.

“Just good clean living…you eat healthy, exercise, take the best care of yourself because you’re not only doing it for yourself but you’re doing it for your unborn child,” Ruiz says.

we tell them to do their normal things because you have to remember pregnancy is not an illness,” he notes.

“Listen to your mind, take good care of yourself. Just a lot of good common sense goes into this.”

Ruiz says he and his colleagues are seeing a lot more instances of expectant mothers who cope with diabetes and other afflictions of which there are high rates in San Antonio and South Texas.

“Our diets play a big role, so we try to educate mothers and mothersto-be on good eating habits and how to prevent these diseases,” he adds.

RUIZ SAID HELPING A MOTHER WITH THE BIRTH OF A CHILD, BRINGING HIM/HER SAFELY INTO THE WORLD, IS AN AWE-INSPIRING MOMENT. AND HE’S DELIVERED NEARLY 7,000 BABIES.

“We’re professionals trained to treat pregnancy with hypertension, manage these conditions — things that put patients in high risk.”

Ruiz and his colleagues are also seeing more women in their late 30s and 40s having children.

IFWH has ways of providing care to those patients with specific acute or chronic conditions that could affect a pregnancy.

“They have special concerns that we have to pay attention to, but we have much better techniques to identify problems — ultrasound, blood tests — much better than we did several years ago,” he says.

“But in most cases, the baby is born healthy, the mother is healthy, so

“We’re here to help parents prepare the best we can.”

According to Ruiz, another thing that has improved in recent years is how hospitals want to be seen as a more warm, welcoming environment for expectant mothers.

He acknowledges that, for decades, a mother about to give birth would typically enter a hospital and face relatively sterile, drab surroundings.

Mainly working with Methodist Hospital, Ruiz says that institution and others have sought to enhance aesthetics and services for a mother about to give birth.

“They’re involved in making it a family setting. That brings a lot of comfort to the moms, especially firsttime moms,” he adds.

Ruiz points to the site across the street, where Methodist Hospital is in the final months of its three-month expansion project. The new building will have large-scale upgrades in an array of areas, including obstetrics and pediatric services.

“It’s going to be a comforting place. One of the things that makes it unique is that it’ll have systems where we can communicate with each other,” Ruiz says of different medical departments.

“It’ll be a place where we can refer to each other.”

For more information on Dr. Jose Ruiz and the Institute for Women's Health in The South Texas Medical Center visit ifwh.org. Please note the location in the photograph is not currently open for patients.

2017 - MAY MD Monthly

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INFORMED PATIENT/HOUSTON

Busting the myth of the

Big Yellow

Pollen Monster By: Rachel Lagaly, PA-C, Allevia Allergy Center

S

neezing, itchy eyes, scratchy throat and a runny nose can make the springtime a miserable time. The first culprit mistakenly blamed, is the yellow dust seen covering cars and anything else it comes in to contact with. This ugly monster that forces us to wash our cars countless times a month is pine pollen. But, surprisingly, it’s not the cause of our itchy, watery eyes.

Pine pollen particles are too large to affect our sinuses. Although you want to blame what you can see, it is what you cannot see that is causing your misery. Tree pollens, such as Oak, Cypress, Birch, Pecan, and Elm, 44

MD Monthly

are commonly high in the Greater Houston area and cause the annoying upper airway symptoms.

But how do you avoid something you cannot see? On beautiful spring days, we tend to leave the windows and doors open, but this may be doing more harm than good. By “letting the fresh air in” we are allowing pollen to infiltrate our homes. Houstonians should utilize air conditioners and avoid inward directed fans to avoid pesky pollen.

Additionally, change clothes and wash hair after being outdoors for long periods of time. Be sure to bathe animals frequently as well to keep

them from carrying outdoor pollen on their fur indoors.

Spring passes, and the yellow pine monster disappears, yet the symptoms persist. Now what could be the culprit? Living in the humid, hot city of Houston opens the door to many possible allergens. It is important to know when the different pollen seasons occur including: • • •

Spring: prime-time for tree pollen allergens Summer: grass season comes with very potent allergens Fall: weeds, such as the infamous ragweed, pollenate

MAY - 2017

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INFORMED PATIENT/HOUSTON

Outdoor allergens may not be the only thing making Houstonians miserable during peak allergy seasons. Some allergens are always around and live in our homes; animal dander is a common cause of symptoms. These allergens are small and can affect the airways of a person; often leading to asthma, runny nose and nasal congestion.

Even if you give “Fluffy the Cat” to your neighbor, cat dander will stay around for a while as it is very sticky and robust. We also live with dust mites, which are the most prevalent allergen found in house dust. Environmental controls such as mattress and pillow encasings, removing as much carpet from the home as possible, removing curtains and washing sheets once every one to two weeks in hot water may

ALTHOUGH YOU WANT TO BLAME WHAT YOU CAN SEE, IT IS WHAT YOU CANNOT SEE THAT IS CAUSING YOUR MISERY. help reduce exposure, but complete avoidance is not possible. Blaming what we can see for irritating allergy symptoms is the easy solution.

However, when you are washing your car for the hundredth time this spring, keep in mind that the allergens you cannot see are what truly making you miserable. Remember the tips shared above for a sniffle-free spring, and enjoy the wonderful weather.

Author byline: Texas Ears, Nose and Throat Specialist is Houston’s premier ENT professionals servicing Southeast Texas. Texas ENT’s specialized service is dedicated to offering the highest level of care for all ear, nose and throat issues, diseases and disorders. With more than 34 board-certified otolaryngologists in 16 location, Texas ENT brings together the very best physicians and support staff committed to providing an exceptional experience. The state of the art facilities allow for Texas ENT’s professionals to create individualized treatment plans based on patient’s needs and symptoms. Learn more about Texas ENT’s superb services at http://texasent.com/ or follow them at https://www.facebook.com/ TexasENTSpecialists or https://twitter. com/Tx_ENT_Spec

2017 - MAY MD Monthly

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INFORMED PATIENT/SAN ANTONIO

FED UP WITH

FOOD CRAVINGS? HOW TO BEAT THEM By: Susan Peirce Thompson

W

ith dreaded swimsuit season just around the corner, people everywhere are making a commitment to get rid of those extra pounds that piled on during the Winter season.

Yet, as we all know, even the best intentions can be easily derailed.

Especially when we can’t kick the urge to sink our teeth into a chocolate glazed donut or down a 1,000 calorie mochaccino. Sometimes it feels like no matter how hard we try to push those urges aside, they always win out in the end.

Meet food cravings: a powerful weight loss enemy.

As a brain and cognitive scientist specializing in the psychology of eating, I’ve devoted a lot of time to 46

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the study of cravings. Historically, the mechanism of cravings served us.

In lean times, being able to activate a drive to eat that was so powerful we’d literally swallow bugs, kept us alive. But now that same part of the brain is telling us we’ll die without a moccachino. What happened?

Today’s packed, processed, refined foods are received by the body as drugs, not as fuel. In fact, brains scans have shown that the brains of obese people have sustained more damage to their pleasure receptors than the brains of drug addicts.

What happened is the food we eat. The current global diet is excessively high in sugar and flour.

And what most people don’t know is that consuming that much sugar and flour actually changes the brain, rewiring it to ensure that it will continue demanding more and more of them.

The problem is, our brains and bodies evolved to survive crop-fails and droughts, not process the steady fix of empty calories we’re getting.

Today’s packed, processed, refined foods are received by the body as drugs, not as fuel. In fact, brains scans have shown that the brains of obese people have sustained more damage to their pleasure receptors than the brains of drug addicts. This damage is the root of cravings.

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When the brain is overstimulated it turns off pleasure receptors in a process called “downregulation” so they won’t respond as strongly next time. Meaning that to feel the same level of pleasure, you need more of the stimulus next time. That’s addiction. And it only takes three weeks of consuming the average American’s daily load of sugar, 22 teaspoons, for the brain to start making these adjustments. So when you start to try to lose weight and take your brain off its drug of choice, it’s going to demand a fix.

reminder alone can help us rise above the cravings.

Yes, brain science has proven that food addiction is very real, and likely hundreds of millions of people are affected. But swimsuit season is still lurking. What can we do to resist those cravings when they start to tug? The good news is that science has some answers for us.

We could see some “food porn” that might trigger our brains past the point where we can resist.

We can: Remind ourselves why the cravings happen It’s not real hunger, it’s your brain in the grips of downregulation. This

to our brains as cocaine and other powdered drugs. The more we eat, the more we’ll crave.

Smell peppermint oil I’ll sometimes brush my teeth, because that flavor or scent of peppermint has been clinically proven to kill hunger that isn’t rooted in the body’s genuine need for fuel.

Reach for distractions Go for a walk, do laundry, read a book. Even healthy food prep can be a good distraction until it passes.

Avoid commercial television

Practice an attitude of gratitude When I take sixty seconds to run through everything I am grateful for it shifts my brain away from what I want to what I have.

There are also ways to help prevent cravings from setting in: Eliminate sugar and flour They are as addictive and harmful

Eat regular meals A steady schedule of three meals a day at regular mealtimes—breakfast, lunch, and dinner —trains the brain to eat the right things at the right times and to pass up those wrong things we might crave in between.

Above all, cravings are an important thing to look at, because they are a symptom of a hijacked brain. One of the many joys of cutting those foods out of my life fourteen years ago is that I went from having daily cravings, to weekly cravings, to monthly cravings, to rare cravings.

So, if you feel like cravings are a daily part of your life, that is a sign that big changes, along the lines of eliminating sugar and flour, might be in order.

Finally, if you’re in a weightloss phase now, and your brain is demanding the foods you are trying to wean off of, just be patient. Treat your craving brain like a tantruming toddler.

Distract, deflect, but don’t give in.

Susan Peirce Thompson, Ph.D. is the New York Times bestselling author of Bright Line Eating: The Science of Living Happy, Thin and Free. An Adjunct Associate Professor of Brain and Cognitive Sciences at the University of Rochester, Susan is an expert in the psychology of eating.

She is President of the Institute for Sustainable Weight Loss and CEO of Bright Line Eating Solutions, a company dedicated to sharing the psychology and neuroscience of sustainable weight loss and helping people achieve it.

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INFORMED PATIENT/CORPUS CHRISTI

Controlling Your

Stroke Risks By: Dr. Michael Fuentes

W

hen you think of celebrities such as Dick Clark, Sharon Stone or Rick James, you probably think of their many talents. What you might not realize is that each of them at one point suffered a stroke.

Strokes—or brain attacks—can happen to anyone at any time.

Strokes are the leading cause of adult disability in the United States, and the fifth leading cause of death.

“Strokes occur when blood flow and oxygen are cut off to an area of the brain,” says Dr. Michael Fuentes, Medical Director of Corpus Christi Rehabilitation Hospital. “This causes brain cells to die, which in turn affects the abilities controlled by that part of the brain.”

According to the National Stroke Association, about 800,000 people suffer from strokes every year. What’s notable, however, is that nearly 80 percent of strokes can be avoided.

“Certain traits, conditions and habits can raise an individual’s risk of having a stroke,” Fuentes says. “Some of these factors, 48

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such as age, family history, gender and race, can’t be controlled. But many lifestyle risk factors can be controlled, which can actually help prevent a stroke from occurring.”

Some of the major risk factors associated with stroke that can be controlled include: • • • • • • • • •

High blood pressure Smoking Diabetes Poor diet High blood cholesterol Physical inactivity Obesity Heart disease Alcohol consumption

“If you’re aware of lifestyle risk factors that you have, you can control, treat and improve them to lessen your chances of having a stroke,” Fuentes says.

For example, Fuentes recommends getting regular checkups and following physician recommendations to treat any risk factors. “A healthy diet and regular exercise can go a long way toward preventing a stroke,” he says, “as can minimizing alcohol

consumption and eliminating smoking.”

Fuentes does recognize, however, that changing behaviors or habits is not always easy—especially when there haven’t yet been any negative consequences.

“Changing your diet or activity level is a long-term commitment that requires a lifestyle change, so it can be somewhat difficult,” he says.

“But if you have any stroke risk factors, the time to change is now, before something negative happens.

Remember, the changes you make now can affect what happens—or doesn’t happen—later.”

Corpus Christi Rehabilitation Hospital provides specialized physical rehabilitation services to patients recovering from disabilities caused by injuries, illnesses or chronic medical conditions. The hospital has earned The Joint Commission’s Gold Seal of Approval for its Stroke Rehabilitation program. For more information, visit CCRH.ernesthealth.com.

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REVOLUTIONIZES EMERGENCY MEDICINE

ALONG THE COASTAL BEND By: Edmond Ortiz

compassion, tending to a wounded bird here and there around the home.

But outside of his family, Schwirtlich as a child was especially impressed by one specific person — his pediatrician, Dr. James Simpson.

Schwirtlich, as a teenager, reconnected with Simpson while working at an H-E-B grocery store. “(Simpson) was an awesome guy, simply the most fantastic guy,” Schwirtlich recalls, enthusiastically.

P

hysicians de-stress in many different ways. Golfing, basketball, tennis, racquetball, mountain climbing, reading — they’re all just some of the methods healthcare professionals use to take their minds off long, sometimes chaotic hours on the job.

Dr. Lonnie Schwirtlich, it just so happens, likes fishing, cycling, swimming, backpacking, among other activities.

He also enjoys surfing.

Sometimes, it’s in exotic places like the Maldives. He and a group of friends, longtime professionals in their career fields, go away a few days each year to locales such as Mexico or Fiji to catch up and literally get away from it all.

“I’m having fun, but it strengthens my mind,” Schwirtlich says by phone from his surfing excursion in the Maldives. “It’s a stressful job where you have to take long breaks. To survive long term, you’ve got to completely get away.”

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Schwirtlich’s has spent more than 30 years as an emergency medicine doctor, with many of those years in the Corpus Christi area.

He is affiliated with numerous hospitals in the region, including Christus Spohn Hospital Corpus Christi-Memorial, and Dubuis Hospital of Corpus Christi.

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He and five other physicians, as a group, oversee Physicians Premier Emergency Room, a freestanding ER in Corpus Christi.

Schwirtlich grew up in the Calallen/ Corpus Christi area. As a child, Schwirtlich had formed his brand of

Saving up money earned at the H-E-B job, Schwirtlich was offered an opportunity to follow Simpson at his pediatric practice, becoming a student of sorts there.

Schwirtlich remembers helping to document cardiological examinations of Simpson’s patients. Those and other findings would then be used in a study of pediatric cardiology. “(Simpson) really took me under his wing,” says Schwirtlich.

After working his way through high school, Schwirtlich earned an associate’s degree at Del Mar College, and a bachelor’s degree in chemistry from the University of Texas at Austin.

He continued to help Simpson with research. When it came time to head for medical school, Schwirtlich applied with several such institutions around Texas.

Baylor College of Medicine was the first institution to contact Schwirtlich, and they agreed to an interview.

Baylor College was impressed PHOTOGRAPHS BY Paul Marshall

MDMONTHLY.COM

enough with Schwirtlich’s academic performance, and his work at Simpson’s practice, that he got to enroll in an accelerated program.

Schwirtlich finished medical school in three years, by 1980. He knew then emergency medicine was a way to go.

Recognizing the growth of the Rio Grande Valley and the Texas Coastal Bend, Schwirtlich was familiar with the plight of people needing emergency medical attention.

He saw the gamut of afflictions — from the typical illness and waterrelated accidents, to gunshot wounds and emergencies arising from chronic diseases such as diabetes.

Regardless, Schwirtlich opted to proceed with a busy residency schedule.

“People told me ‘you’re gonna be on call everyday, no breaks, but you’ll be done in a few years, a shorter period of time and you’ll be making money’,” he recalls.

Schwirtlich worked 5,000 hours

in his residency. He became a boardcertified emergency room physician in 1987 with a focus on service in a rural setting, or outside of one of the mayor Texas metro areas.

Schwirtlich worked in emergency rooms around the state, but mainly along or near the coast. He then moved to South Padre Island.

Then, he went on to practice in the Valley Baptist Health System, working in the system’s Harlingen and Brownsville facilities.

He continued to receive acclaim for his work, and was being appointed to positions such as ER director in some places. He was medical director at Valley Baptist’s Harlingen and Brownsville medical centers.

From the mid-1990s to the mid-2000s, Schwirtlich practiced emergency medicine in Corpus Christi.

Over the last 20 years, Schwirtlich has seen plenty of evolution in techniques, best practices and technology in ERs. He also has seen first-hand

the challenges that many people, especially the uninsured and underinsured, have had in getting proper emergency care in a timely manner and being able to pay for it.

In some cases, patients would rather drive to an emergency room in another town than wait hours and hours in the ER closest to them.

Schwirtlich also laments the stressful work conditions and long hours that tend to make some physicians, nurses and other support ER staff work elsewhere or completely leave emergency medicine altogether.

“Conditions are challenging,” he says. “We had a hard time attracting specialists or keeping them.”

So, Schwirtlich gathered with other like-minded physicians in the Corpus Christi area and set about to improve the provision of emergency medical service for the region.

That’s how Physicians Premier ER came to be. It quickly became a

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successful model for freestanding ERs that offer the Coastal Bend an array of emergency medical services and technology. On the company’s website, long waits for patients are a “thing of the past.”

Physicians Premier has four Corpus Christi locations, one in Portland, one in Houston, and others spread out to even San Antonio, Austin and Bastrop.

More locations are planned for around the Houston, Austin and San Antonio areas. Physicians Premier is equipped enough that, if needed, it can quickly refer a patient to the closest hospital for more comprehensive care.

Schwirtlich, and a few other physicians also have had the resources to invest in another endeavor, Halcyon Medspa and Wellness Center.

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He serves as medical director for the Corpus Christi-based Halcyon, which offers multiple cosmetic and spa services, and massage therapy.

But Schwirtlich’s first professional passion is for improving emergency medicine. The American College of Emergency Physicians’ grades emergency medical services state by state every few years.

In 2014, Texas got a D+ overall, and an F in access to emergency care.

Schwirtlich says that must change: “People get sick. They need to be seen as quickly as possible.”

Schwirtlich says, in his opinion, health insurance companies do not think highly of freestanding ERs, whose numbers have increased in recent years.

“(Insurers) think patients are spending too much money,” he adds.

Schwirtlich is on the board of directors for the Texas Association of Freestanding Emergency Centers.

That group has been lobbying the Texas Department of Insurance for patient-friendly reforms.

Quality emergency care continues to inspire Schwirtlich.

“We’ll win this battle (with the insurers) because we do these things more efficiently, faster and for a lesser amount of money,” he adds.

“We’re right there in the trenches, seeing our patients. All you have to do is look into their eyes, and that does it.”

PHOTOGRAPHS BY Paul Marshall

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INFORMED PATIENT/AUSTIN

AGE-RELATED

Infertility Why it happens, and what you can do to prevent it Special to MD Monthly

M

ost women realize that the older you get, the more difficult it is to get pregnant. However, that statistic hasn’t stopped the growing number of couples in their late 30s and early 40s from becoming firsttime parents.

From marrying later in life to establishing a career, many couples are waiting longer to conceive, and this can pose a challenge 56

MD Monthly

when it comes time to start a family.

“Of the six million people in the U.S. affected by infertility, one of the leading causes is advanced age,” says Dr. Jose Pliego, a reproductive endocrinologist at Scott & White Healthcare. “The good news is that this is one of the most easily treated forms – if you don’t wait until you are 40.

“The message is that women need to start thinking about their fertility sooner and take a more proactive approach with their reproductive health.”

The Female Factor To many women, the word, “infertile,” is about as appealing as a scarlet letter, but infertility can be avoided and treated.

“Infertility is typically defined as a couple who

have not conceived after 12 months of unsuccessful, unprotected, well-timed intercourse,” Pliego says.

However, a patient over age 35 or with obvious reasons (for example, irregular cycles) should not wait 12 months, but should get evaluated after six months of trying to conceive.

The major reason for women being unable to conceive is the result of a

MAY - 2017

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INFORMED PATIENT/AUSTIN

declining “ovarian reserve.”

Monthly ovulation further reduces the ovarian reserve, and by the time a woman is between 50 and 60, she will have naturally depleted all of her eggs (also known as menopause).

Aging can also impact the quality of a woman's eggs. Present from the time of birth, eggs are some of the oldest living cells in the female body.

This is also caused by chromosomal damage, and it increases a woman’s chances of birth defects and miscarriage. As a result, they may not be viable at a later stage in a woman's life.

The Male Factor Thirty percent of infertility problems come from the male.

“Men are capable of producing sperm continually throughout their life,” Pliego says.

“However, age can affect a man's testicular function and cause a reduction in hormonal levels.”

Lower levels of testosterone can lead to diminished interest in sex and lower levels of sperm production. The quality of a man's sperm may also be

impaired over time.

All couples having difficulty getting pregnant should have a semen analysis performed to rule out male factor infertility.

Protecting Your Fertility First and foremost, women need to think ahead. If you are in your 20s and not planning to have children until later in life, you need to know that pregnancy rates begin to decline in your 30s and drop drastically after age 40.

If you are over 35 and have been unable to conceive after six months, it is recommended that you visit an infertility specialist and undergo a series of tests to rule out any existing medical conditions and find the proper treatment.

Dr. Jose F. Pliego sees patients at Scott & White Healthcare – Round Rock and Temple. He is also a professor of obstetrics and gynecology at Texas A&M Health Science Center College of Medicine. Pliego is boardcertified by the American Board of Obstetrics and Gynecology: Reproductive Endocrinology, Infertility.

For more information, call 512-509-0200.

2017 - MAY MD Monthly

57

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THE COST OF BEING

Chronically Ill IN AMERICA By: Fiona Cunningham

W

hen we consider that 117 million Americans with serious or chronic illness may not have access to effective treatments, we need take a step back and realize that a downturn in health can happen in a blink of an eye. When traditional methods of treatment fail us, what are we left to do? As a mother of a chronically ill child, I am familiar with the struggles, the difficult decisions and the real cost of being chronically ill in America, because this was the life my daughter lived from birth.

On average, it costs millions of dollars each year just to keep my daughter alive. She spent most of her life in hospitals due to systemic juvenile idiopathic arthritis (SJIA).

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She received world-class medical care from her team of eight medical specialists in Houston, Texas and the National Institutes of Health (NIH) in Maryland.

By age 19, Sarah was taking 23 maintenance medications daily, plus high-dose chemotherapy. But the medications kept her alive, though her quality of life was greatly diminished and she was bed-bound and hospitalized. Her doctors predicted she would not live to see age 25. Because her body could not absorb nutrients, she received longterm TPN (Total Parenteral Nutrition) & lipids intravenously for many years.

Due to the life-threatening side effects associated with receiving long-term nutrition intravenously, by

2012, her only option was 24/7 tube feeding directly into her stomach.

She weighed only 82 pounds and the tube feedings could not sustain her weight. It cost approximately $1,200 per day, or almost half a million dollars each year, to feed her. She was continually hospitalized in the ICU, or the critical care unit. From birth, her health insurance deductible was usually met by mid-January each year.

In 2014, both of our lives changed thanks to Celltex Therapeutics, a Houston-based biotechnology firm, whose adult stem cell technology proved to be a lifesaver for Sarah.

After extensive research, we decided to work with Celltex’s team of scientists, who grew my

MAY - 2017

MDMONTHLY.COM

OP-ED/HOUSTON

daughter’s own stem cells in their Houston laboratory and expanded them to the hundreds of millions, and then cryogenically banked for future use. While Celltex’s lab is registered with the FDA, adult stem cell therapy is not approved by the FDA to treat my daughter; therefore, no doctor in the United States is permitted to administer her cells back into her body.

Though her cells were processed and banked in Houston, her cells would have to be shipped to a private hospital in Cancun, and we would need to travel by plane, for therapy.

For anyone living with chronic or terminal illness, travel is very difficult, if not impossible. Sarah made the decision to travel to Cancun, where her adult stem cells were infused into her blood stream through a simple IV. It was a major trip for Sarah to take for such a simple procedure.

doctors in the Texas Medical Center.

Her quality of life has changed dramatically for the better, and living in hospitals is a thing of the past.

She has a life now – and better yet, she has a future. She has not been hospitalized since receiving her own stem cells and lives a healthy life, which includes showjumping her horse and attending college. She turned 25 this past October and is planning a May 2017 wedding to a wonderful young man.

daughter’s journey, our country will begin to see how Celltex’s procedure of using our own stem cells can help our medical community in their daily effort to save lives.

Fiona Cunningham is a Houston resident and mother of an autologous stem cell recipient. She and her daughter Sarah will attend the State of the Union as a special guest of Texas Congressman Pete Olson (R).

For the first time ever, we had not met Sarah’s health insurance deductible at the end of the year in December 2016. Instead of taking 23 daily medications, she now takes eight medications at lowered doses and is no longer immune suppressed.

If one looks at the option of stem cell therapy just from an economic standpoint, no longer is Sarah subject to the stress and fear of crippling medical expenses.

But that was three years ago.

The changes she has experienced since then cannot be measured in words, and she has astounded her

This month, Sarah will be Texas Congressman Pete Olson’s guest of honor at the upcoming State of the Union. My hope is that through my

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