NSIDE MEDICAL MAGAZINE
M AY | J U N E 2 014
DR. MAURICIO B.
TEIXEIRA OF SERVICE AND DEDICATION [ PG. 14 ]
MAMMOGRAMS: HARMFUL OR HELPFUL? THE RECENT CONTROVERSY
TIPS FOR HEALTHY EYES
UNITED ALLERGY SERVICE: A FRESH APPROACH TO ALLERGY RELIEF
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“MIND YOUR HEALTH”
NATIONAL MENTAL HEALTH AWARENESS MONTH
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SCOLIOSIS & SPINE DEFORMITY CENTER LEADERS IN THE CORRECTION OF PEDIATRIC & ADULT SPINE DEFORMITY Every scoliosis patient is different. Treatment for scoliosis and spine deformity varies with respect to the patient’s age, puberty level, degree of curvature, pain and growth. What we emphasize in our practice is conser vatism — surgery is always a last resort. While we are often successful with non-invasive measures, the average outcome for patients who do require surgery is a 90% correction.
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ENDOVASCULAR, CORONARY AND PERIPHERAL INTERVENTION
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We perform thorough, Rapid Diagnostics, Coronary and Peripheral Intervention and Carotid and Vertebral Intervention, all while providing a personal and professional touch with all of our patients. Dr. Kiesz and Dr. Bailey are experts in Interventional Cardiology and
Endovascular Interventions and are two of the few Physicians here in San Antonio and the world with unrivaled experience, skill and outcomes. Dr. Kiesz is also the author of over a hundred publications and is an inventor and an entrepreneur. He has pioneered many new coronary and endovascular techniques and devices.
PLEASE CALL FOR AN APPOINTMENT AND WE’LL HELP YOU LIVE YOUR LIFE THE BEST WAY POSSIBLE.
Heart Institute Charles E. Bailey, MD, FSCAI
R. Stefan Kiesz, MD, FACC, FSCAI, FESC Adjunct Professor of Medicine and Cardiology UTHSCSA
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NSIDETHISISSUE MAY.JUNE 2014
Page 10 10
PROFILE UNITED ALLERGY SERVICES
United Allergy Services brings a refreshing approach to allergy care as it increases patient access to allergy relief by working directly with physicians and health care systems.
PROFILE DR. MAURICIO B. TEIXEIRA
With 40 years of dedicated medical service to his country and his patients, Dr. Mauricio Teixeira has an inspirational story of a young Brazilian who comes to the United States and makes an important impact.
PROFILE HONORS FOR ST. LUKE'S BAPTIST HOSPITAL
Under the direction of Dr. John B. Metersky, this hospital becomes the first in the San Antonio area to receive the distinguished national Robotic Epicenter for General Surgery designation.
AUSTIN, DALLAS, HOUSTON AND SAN ANTONIO COVERS: PHOTO OF NICOLAS HOLLIS BY ALEXANDER ALEMAN; COVER DESIGN BY MICHAEL MANCHA CORPUS CHRISTI AND LAREDO/RIO GRANDE VALLEY COVERS: PHOTO OF DR. MAURICIO B. TEIXEIRA PROVIDED BY ERIKA TEIXEIRA; COVER DESIGN BY CRISTINA VILLA HAZAR
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PATIENT 30 » Athletes and ibuprofen 32 » My emergency room 34 » Summer is almost here
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- Hope for healthy living
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United Allergy Services (UAS) specializes in providing allergy testing and therapy centers as an additional service offering to medical practices. Take your patients’ allergy treatment into new territory.
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- It takes a village to combat obesity - The best defense against cervical cancer
SENIOR PROFILE BOB FARRAR
A lifetime filled with love for his family and career, Bob Farrar, reflects on following his dreams and finding love a second time around.
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NSIDE Texas MD Magazine - May/June 2014
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Michael A. Leonard, M.D.
ALAMO NEUROSURGICAL INSTITUTE
• Diagnosis and treatment of surgical disorders of the Brain and Spine • Board certified neurosurgeon by the American Board of Neurological Surgery • Conservative approach: Reserving surgery as the final option • Employing the least invasive procedures • Welcoming, personal, unrushed environment with knowledgeable, kind staff • Fellowship trained in Spine Surgery at one of America’s busiest trauma hospitals
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TEXAS • HOUSTON // PROFILE
NSIDE TEXAS MD / MAY.JUNE 2014
UNITED ALLERGY SERVICES PHOTO, THIS PAGE, BY ALEXANDER ALEMAN
By: NICOLAS HOLLIS
oo often allergy symptoms are ignored by patients or self-diagnosed causing a multitude of problems. Patients unnecessarily suffer while masking symptoms that can lead to allergy-induced asthma, an emergency room visit and an avoidable economic burden on patients and the overall healthcare system. Allergic rhinitis, commonly known as hay fever, is the third most common chronic medical disorder in individuals younger than 45, and the fifth most common chronic condition among all Americans. Hay fever costs the U.S. healthcare system approximately $18 billion annually. In addition, allergic asthma, a significant comorbidity of allergic rhinitis, accrues $56 billion yearly in healthcare expenditures. For patients, the diminished quality of life is often more debilitating than the economic burden. Months spent avoiding the outdoors and activities, suffering from watery eyes, itchy throats and constant sneezing all while uncertain of the exact cause of the symptoms; Am I allergic to my dog? Or the pollen my dog brings in from outside? It’s annoying at best; painful, depressing and even life-threatening at
worst. And it’s unnecessary. Diagnosis is simple. Effective treatment options exist that can eliminate symptoms restoring quality of life. So why are so many people still suffering from hay fever and other seasonal and perennial allergies? Until recently, the only real relief for allergies has remained primarily in the hands of allergists. This access to care challenge compromises the best interests of patients. With more than 60 million allergy sufferers, the small community of approximately 2,800 practicing allergists in the U.S. cannot effectively meet the needs of allergy suffers. Across the country there is approximately one allergist for every 21,428 patients suffering from allergies creating a supply and demand disparity that is causing patients to have to wait months for an appointment with an allergist. Many patients are also forced to travel great distances to reach the specialist. As a result, too many patients aren’t receiving the level of care they need. Patients deserve better. Patients need access to proven and long lasting treatment for allergies. The patient care approach that is exclusive to only allergists must end in order to ensure that the more than 60 million allergy suffers are properly diagnosed and treated.
MAY.JUNE 2014 / NSIDE TEXAS MD
NSIDE TEXAS MD / MAY.JUNE 2014
THE UAS MODEL FOR INCREASING PATIENT ACCESS TO ALLERGY CARE BEGINS WHEN PATIENTS DISCUSS THEIR ALLERGY SYMPTOMS WITH THEIR PRIMARY CARE PROVIDER. Access to care for these patients begins in primary care; it begins during a patient’s next visit with their family doctor. Primary care physicians are trained and certified to diagnose and treat allergies. Once a diagnosis is determined, a family doctor will recommend the best treatment approach. For those suffering from food allergies, an appointment with an allergist is the next step. For patients determined to be suffering from airborne allergies, treatment can be coordinated by the family doctor. United Allergy Services® (UAS) committed to broadening access to care for allergy suffers by helping family doctors, general practitioners, pediatricians and pulmonologists act as the first line of defense for allergy diagnosis and treatment. Based in San Antonio, UAS works with physicians and health systems to bring effective and convenient allergy testing and immunotherapy to the mass population of allergy sufferers. The UAS model for increasing patient access to allergy care begins when patients discuss their allergy symptoms with their primary care provider. It is important for patients to realize that lingering coldlike symptoms may in fact be allergies and should be discussed during a visit with their family doctor. If the physician determines that the patient is a candidate for allergy testing based upon his/her medi-
cal history and current condition, the physician will order a Skin Prick Test, the gold diagnostic standard for allergy testing. As every patient is uniquely reactive to different allergens, UAS partner physicians test patients for 48 geographically specific allergens, including products from dust mites, cockroach, proteins from pet hair and dander, trees, grass, weed pollen and molds. Based upon the test results, the physician can then order a customized immunotherapy treatment that correctly treats the patient’s specific allergies. UAS works with physician offices to support the entire process, from allergy testing to training, immunotherapy inventory, reimbursement and even patient compliance. Since the company’s founding in 2009, more than 95,600 patients have received skin prick tests and customized immunotherapy treatment from physicians contracted by UAS, and more than 4,470,000 allergens have been tested. UAS simplifies allergy testing and treatment by providing an in-office Allergy Center, staffing and training, reimbursement assistance, and technology services to support physicians and staff enabling them to spend more time with patients delivering personalized, quality care. Allergen immunotherapy, known by most patients simply as allergy shots, is based on a century old concept that the immune system can be desensitized to
specific allergens that trigger allergy symptoms. Immunotherapy induces tolerance by introducing the patient to safely increased doses of an allergen(s) through a series of customized single-injections that can often be administered by the patient at home. The purpose of immunotherapy allergy shots is to desensitize the patient to the allergen that triggers the symptoms. This approach is in stark contrast to over-the-counter and prescription drugs that only temporarily mask allergy symptoms without treating the actual disease. For patients, maximum benefits are achieved after three to five years of consistent immunotherapy administration. Ultimately, effective treatment allows the patient to be exposed to sensitizing allergens in everyday life without any reaction. Up to 85 percent of patients receive a significant long-term reduction in allergy symptoms using immunotherapy. Patients may one day be completely symptom free without the need for routine allergy treatment. Logically and ethically, such a treatment—one that not only effectively reduces symptoms, but also may prevent the development of new, related illnesses and can be conveniently administered at home—should be made widely available to patients as a first-line option. The world of allergy care is changing, for the better. This year, talk to your doctor during your next appointment about your symptoms. Don’t let another year of symptoms keep you from enjoying your life.
Nicolas Hollis is president and chief executive officer of United Allergy Services. For more information, call 210-265-3181 or visit www.unitedallergyservices. com. MAY.JUNE 2014 / NSIDE TEXAS MD
TEXAS â€˘ CORPUS CHRISTI // PROFILE
LIVING THE AMERICAN DREAM The Life Story of Mauricio B. Teixeira, M.D. By: ERIKA TEIXEIRA BOLLER
NSIDE TEXAS MD / MAY.JUNE 2014
AS WE WALK THROUGH THE ISLES of our local grocery store, several people stop and shake my fatherâ€™s hand thanking him for saving their lives. My father has touched the lives of so many families doing what he loves and what he knows best. His journey began long ago in a small town in Brazil named Iguatu in the state of Ceara. Francisco Mauricio Bandeira Teixeira was born on September 22nd to Elza and Jose Vicente Teixeira. At the time of his birth, in this northeastern region of Brazil, there were few if any doctors, no pharmacies and no formal educational institutions. When Mauricio turned eight, he was recruited by the Marista Brothers to attend their boarding school where all subjects were taught in French. It was in this strict learning environment, with the curriculum in a foreign language, that the first building block of his early education was laid. Mauricio returned to Iguatu at the age of 15, after being away from his family for seven years, and shortly after moved into the city of Fortaleza in order to continue his education. His days there
began early, working delivering eggs and chickens that his father had sent from Iguatu on the train. Once all his deliveries were completed he would attend his high school classes. He knew that in order to make a better life for him and his family one-day, he needed to dedicate himself to the books. With good grades and great testing skills, he was accepted into medical school and graduated in 1964 from Universidade Federal do Ceara. He finished at the top of his class and was asked by his professors to come to the United States to research new medical techniques. Mauricio was to bring back this knowledge and teach it to his colleagues, but when he reached the American Consulate, he was granted a permanent immigrant visa. Within three months of residing in Plainview, Texas and working at the local Hospital, he received a letter from the Selective Services to present himself for a physical. He then traveled to Oklahoma City and took the ECFMG examination to legalize his medical status in the United States and began his official training at Scott & White Hospital in Temple, Texas. In 1968, soon after he began at Scott & White, he received a formal invitation from the President of the United States to go to Vietnam. He had two choices, return home and end the opportunities that the US could offer him, or accept the Draft and ultimately become a US Citizen. Mauricio accepted the draft and reported to Fort Hood for basic training. Upon completion of this training he was then sent to Fort Benning , Georgia for preparation for a tour of duty in Vietnam. Mauricio was deployed to Vietnam in June of 1969. He served one full year and accepted an extension, serving six extra months, at the busiest hospital in all of Vietnam. The 12th Evacuation Hospital in Cu Chi, along the Ho Chi Min trail is where he spent 18 months getting some MAY.JUNE 2014 / NSIDE TEXAS MD
of the most extensive trauma and orthopedic training a Surgeon could acquire. At this hospital, Mauricio carried out a great number of amputations, extensive surgical trauma care, and even delivered babies via cesarean for the local Vietnamese women.
MY FATHER IS LIVING PROOF THAT HARD WORK DOES EQUAL SUCCESS YET HOW WE MEASURE OUR SUCCESS IS SUBJECTIVE. Dr. Teixeira conducted over 800 surgical procedures and is extremely proud that he never lost a single life that was under his care. Due to his knowledge of the French language, he was regularly assigned to train Vietnamese doctors in the practice of surgery. During his service in the Army he received many honors including the Bronze Star, and was discharged as a U.S. Army Major. When Mauricio finally returned home he was granted his U.S. Citizenship. The American dream continued as he returned to Scott & White, to finish his residency program in general surgery. He met his future wife, Ingrid Follak, a fellow Brazilian native, who was studying at Baylor University in Waco. Their relationship blossomed and upon completion of his residency program, they moved to Alice, Texas where they were married. The American dream went into full swing for Dr. Teixeira as he set up his practice in this small town, which served many surrounding areas. In the mid seventies, the Alice Physicians and Surgeons Hospital provided a broad range of care to the patients of the area, including trauma. With the experience that Dr. Teixeira possessed, he was able to care for many critical patients with extensive injuries that Trauma facilities focus on these days. Some of these major injuries were multiple bullet and stab wounds and the occasional tree branch stuck in a man’s chest. Being on call meant having to rush to the hospital in the middle of the night to help stabilize a critical patient and then take them into surgery shortly after. Hospitalists or ER docs were not available in Alice back then and the surgeon on call had to do it all. My father was always up for the challenge and had great success in keeping these patients alive. He never complained about being tired or feeling overworked, it was just what he did. His wife Ingrid was truly the pillar of Mauricio’s success, supporting him and the running the business side of his practice. In 1976 they had their first child, Fabian, and I followed soon after in 1978. As busy as
NSIDE TEXAS MD / MAY.JUNE 2014
he was with his work, Mauricio was always a present father. He always had his camera out as we participated in school functions and I must say he is a much better doctor than he was a photographer. In March of 2007, he was honored on the Texas Senate floor with a Senate Resolution #446 in appreciation for his service. Mauricio has dedicated the past 40 years of his life to his work and his family. He has often admitted that his work is his favorite hobby and when he is not busy with family he finds himself back at the hospital. Over the years, his wife graciously shared her husband’s time with the hospital and his patients, of which the majority was spent with the later. The same is still true today as he says he works to live and lives to work. The pleasure he finds in helping others is what satisfies him at the end of the day. He completes about 500 surgical cases a year still and admits that having made a difference is how he would like to be remembered one day. My father is living proof that hard work does equal success yet how we measure our success is subjective. He knew as a young boy that he was born into a family of little financial means and that it was up to him to create a brighter future for himself. He had great support from his family, but ultimately had to motivate himself to strive to achieve more. When he initially came to the United States his intentions were to return to Brazil, yet upon arrival he realized the realm of opportunity that this Country possessed and was committed to capitalizing on the opportunities. He came here wanting to better himself because his country of origin had many limitations and he embraced what it was to be an American. He served this country for 18 months, putting his life in danger, because he knew this was the gateway to his future.
Throughout his career in Alice, he served many people who did not have insurance because he has always shown true dedication to those in need of his service regardless of their situation. I admire my father’s drive and ambition but most of all his achievements. He has always exuded hard work and dedication and never felt sorry for himself or his situation. He had the extra hurdle of not speaking the English language or understanding the culture yet he overcame these obstacles and used them as fuel to continue to strive for his success. He took the opportunities we have in this country and maximized them even though it meant going to Vietnam first. This past June, he lost his loving wife Ingrid as her battle with breast cancer finally came to an end. She was the matriarch of the family, keeping everything and everyone together. She truly possessed a deep love and dedication not only to her family but also to those who had the pleasure of calling her a friend. Ingrid, like Dr. Teixeira, gave herself fully to those around her and was an extremely generous woman. They would have celebrated their 40th wedding anniversary in December and not a day goes by that she is not incredibly missed. The love and care that Dr. M.B. Teixeira has brought to Alice is to be admired and appreciated but even if it were never recognized, he would give it again all the same. He is a beautiful man, father and doctor and I am truly blessed to call him Dad.
Dr. Teixeira can be reached at 361-664-5535 and his office is located on 312 E. 2nd St., Alice, TX 78332.
TEXAS • SAN ANTONIO // PROFILE
LEADING THE WAY Thanks in part to the stellar skill and leadership of Dr. John B. Metersky, St. Luke’s Baptist Hospital becomes a national Robotic Epicenter for General Surgery. By: PAMELA MOOMAN
NSIDE TEXAS MD / MAY.JUNE 2014
• General surgery • Gynecological • Gynecologic oncology • Colorectal • Urological • ENT • Cardiothoracic
PORTRAIT PHOTO OF DR. METERSKY BY MARK HUMPHRIES
nder the guidance of Dr. John B. Metersky, St. Luke’s Baptist Hospital has received the designation as a national Robotic Epicenter for General Surgery, becoming the first San Antonio-area hospital to receive the recognition. As home to one of the nation’s most comprehensive multi-specialty robotic surgery programs, St. Luke’s Baptist Hospital now holds the distinction of being only one of the 10 hospitals in the United States with the designation by Intuitive Surgical, the maker of the da Vinci Robotic Surgical System, to serve as a teaching and training site for visiting surgeons from all over the nation. St. Luke’s Baptist Hospital was chosen due to the skill of Metersky, a general surgeon at St. Luke’s Surgical Care, who has performed more than 300 procedures utilizing robotic equipment since 2010. “Robotic surgery is such a wonderful innovation in medicine because the patients benefit so much from robotic procedures,” Metersky said. “I see patients healing faster and having less pain after surgical procedures when they are performed with robotic equipment. There also tends to be less risk of infection because incisions in robotic surgeries are much smaller than those in standard surgeries.” With the Robotic Epicenter for General Surgery designation, Metersky is entrusted with training surgeons on use of the equipment and sharing his best practices. The St. Luke’s Baptist Hospital multi-specialty robotic surgery program includes the following areas:
“It is indeed an honor to be chosen as a national Robotic Epicenter in the area of general surgery,” Metersky said. “As one of just a few hospitals in the country with such a designation, doctors from around the United States will look to us for training and leadership. I am proud to be part of the St. Luke’s Baptist team that broke new ground in robotic surgical procedures. Plus, there can be less drawbacks to the patient in using robotic surgical procedures. Limitations are typically determined only by surgeon experience and expertise.” According to Metersky, robotic surgery began with
the AESOP Endoscope Positioner in 1993, but it did not become widely used until 2000, with the introduction of the da Vinci Robotic Surgical System. Urologists were the first to recognize the distinct benefits of robotic surgery, with gynecologists being the next specialists to widely adopt robotic equipment for surgeries. Since 2006, nearly 10,000 robotic surgeries have been performed within Baptist Health System. More than half of these surgeries have been at St. Luke’s Baptist Hospital.
John Metersky, M.D., practices general surgery with St. Luke’s Surgical Care, located at 7940 Floyd Curl, Ste. 620, Tower II, in San Antonio, Texas. For more information or to make an appointment, call 210-614-7300 or visit www.stlukessurgicalcare.com. For more information on the BHS Physicians Network, go to www.bhsphysiciansnetwork.com or email Julie Minnick at firstname.lastname@example.org.
“I AM PROUD TO BE PART OF THE ST. LUKE’S BAPTIST TEAM THAT BROKE NEW GROUND IN ROBOTIC SURGICAL PROCEDURES.”
MAY.JUNE 2014 / NSIDE TEXAS MD
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AUSTIN HEALTH & WELLNESS
[ DOCTALK ] HOPE THROUGH HEALTHY LIVING How changes in your diet and physical activity can help alleviate the symptoms of osteoarthritis.
MOST PEOPLE KNOW generally what “arthritis” is, but what specifically is “osteoarthritis”? Osteoarthritis is the “wear and tear” version of arthritis, in which the cartilage that covers or cushions the ends of bones in the joints wears or breaks down, causing the bones to rub very near or against each other. This is usually accompanied by pain, stiffness, reduced range of motion, and joint deformities as the disease progresses. This form of arthritis, which is sometimes called degenerative joint disease or degenerative arthri22
NSIDE TEXAS MD / MAY.JUNE 2014
tis, is the most common condition of the joints, affecting approximately 27 million Americans. Most of those suffering from osteoarthritis are over the age of 65.
HOW DO YOU CURE OSTEOARTHRITIS?
Every physician, including myself, wishes that he or she could give this good news to patients suffering from osteoarthritis – that medical researchers have finally found a cure for the debilitating disease and their painful symptoms will finally end. Unfortunately, we
can’t give them that news yet, as there is no known cure for osteoarthritis. While nothing will actually stop the progression of this disease, there is treatment to alleviate the symptoms. A common long-term management plan consists of a regiment of NSAIDs (non-steroidal antiinflammatory drugs) like ibuprofen or naproxen, heating or cold packs, physical therapy, corticosteroid injections into the joints, and other physical aids like braces and shoe insoles.
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By: DR. ALLEN MAUDLIN
A TREATMENT OPTION THAT IS EASY TO RECOMMEND, BUT HARD TO STICK TO, IS A HEALTHY CHANGE TO YOUR DIET.
New Year, New You!
HOW SERIOUS CAN OSTEOARTHRITIS GET?
When osteoarthritis has advanced to the point where mobility is severely affected, the next step is usually surgery to replace the affected joint. It’s pretty safe to say that almost everyone knows an older adult who has undergone knee or hip replacement surgery. Surgery at any age is risky, but especially for elderly adults, and recovery can be long and painful.
WHAT CAN BE DONE TO SLOW THE PROGRESSION OF OSTEOARTHRITIS?
A treatment option that is easy to recommend, but hard to stick to, is a healthy change to your diet (if it seems like this is a recommended treatment for every condition under the sun, it’s because it is!) Here’s why it’s especially helpful for people with osteoarthritis: new research suggests that osteoarthritis is a complex disease with several subtypes. A recent Duke University study found that while age has something to do with osteoarthritis, there are also secondary causes that come into play. The researcher found that one of those factors is an increased level of uric acid in the affected joints of the arthritic patients, but the increased uric acid produced no symptoms or history of gout (a type of arthritis triggered by uric acid). The first step in treatment for reducing uric acid levels in the body is changing your diet to include more antioxidant rich foods, like fruits and vegetables, and cutting out saturated fats, trans fats, sugar, and alcohol. Again, this treatment will not cure osteoarthritis, but it may help lower uric acid levels, and reduce the severity of symptoms and progression of the disease. And unlike some medications, there are no negative side effects to eating a healthier diet. It is also important to maintain healthy muscle tone with regular physical activity that doesn’t put undue stress on already-weakened joints, such as water aerobics or chair exercises. The added benefit to physical activity, combined with a healthy diet, is a reduction in body weight, which puts less stress on arthritic hips, knees, and feet.
IS THERE ANYTHING ELSE THAT CAN BE DONE TO TREAT THE SYMPTOMS OF OSTEOARTHRITIS? Finally, there are supplements that can support joint health by reinforcing the connective tissue in joints, like glucosamine and Omega-3. Please talk to your doctor before you take any vitamins or supplements, as some may have adverse reactions when taken with certain medications. As your physician, it pains me to tell you that there is nothing medicine can do to stop or reverse osteoarthritis, but I am hopeful that we can work together to slow the progression or severity so that you won’t need to undergo risky, expensive surgery. Please contact your primary care physician to get a complete diagnosis and individual treatment plan.
Dr. Allen Mauldin, Board Certified in Family Medicine, earned his undergraduate biology degree from McMurray University in 1977. He graduated from the University of Texas Health Science Center at San Antonio in 1982 and completed his residency at Texas Tech Regional Academic Health Science Center in Amarillo. Dr. Mauldin has been practicing medicine in Leander for a quarter century. As a WellMed physician, he and his staff utilize the nationally recognized WellMed Care Model, focusing on preventive medicine to help patients manage chronic disease and improve health outcomes.
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A wonderful mix of strength and conditioning skills and canine rehabilitation expertise By: HEATHER DANIELS
NSIDE TEXAS MD / MAY.JUNE 2014
EVERY NOW AND THEN, you are fortunate enough to meet talented people that use their knowledge and years of experience in an unusual field that touches your heart and reaches your soul. Deborah Carroll is one of those extraordinary woman. With her certification-CSCS-Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association (NSCA) she bases most of her functional rehab principles for companion animals on the science of exercise physiology and orthopedic injury recovery as it relates to athletes and “other active bodies, human or otherwise.”
PHOTO BY BILL BASTAS
AUSTIN // HEALTH & WELLNESS
Through the University of Tennessee College of Veterinary Medicine and the Department of Physical Therapy, Deborah obtained her Certified Canine Rehabilitation Practitioner-CCRP- designation. This certification is one of two prominent certifications for veterinary rehabilitation in small animal practices and the CCRP is the one most recognized by veterinarians across the board. Prior to her extensive training, Deborah graduated from The University of Texas at Austin within three years. “By that time, I had discovered cycling and began to ride to help rehabilitate my knees. When I first arrived at U.T., I walked onto the cross-country running team, but my knees wouldn’t comply with the training without a lot of pain. After a string of differing diagnoses, I decided I really didn’t care that much about running any longer and I moved to cycling.” After graduating, Deborah had been working with others on their sports nutrition and training programs for fitness. This continued for a number of years and included working with patients with incidents of mild to moderate injury. Having grown up with a mother who started educating herself and her family in progressive wellness nutrition in the mid 1970s, Deborah says, “Our family practiced wellness nutrition way before it hit mainstream America. We made many dishes from scratch and eliminated the chemicals and preservatives from our family diet. Having an organic garden almost everywhere we lived, my father took an active role in this. I was brought up in an atmosphere of education and finding out how things tick and if they can be improved.” By the time Deborah was 25, she had been toying with creating training programs for over 10 years and had been deeply educated in the world of progressive/ alternative nutrition, sports nutrition and nutritional supplements for sport improvement and wellness. She moved to Colorado to work in bicycle racing, enjoying the dynamics of team management and team support. “I worked for a number of seasons with a couple of different women’s racing teams during the most progressive women’s stage race in the world at that time, the Ore Ida Women’s Challenge, in Idaho. The international cycling powers that be were saying that women couldn’t ride that far, couldn’t put their bodies under that type of pressure and we were saying yes, they could!” She continues, “Stage racing is difficult and I didn’t have the will to train that hard, however I did have the scientific curiosity to pursue team support and management, working on diets where I could, doing recovery massage, working on team tactics, and all the while increasing hands-on knowledge of sport science and recovery from injury.” When Deborah worked on the level of world-class sports training and competition, there was a high degree of body knowledge and a lot of mutual participation between athletes, coaches, and trainers to overcome injury and improve recovery. While being a student of sport science, nutrition, and wellness for over 30 years, Deborah has accumulated a variety of training and coaching certifications along the way. On several occasions she intended to
return to academic study toward advanced science disciplines but after looking at the time and money it would cost to review entry subjects she had far surpassed in self-study, Deborah ended up going in another direction. Fast forward 2004; “I have been working to bring a high level of simple sport-science based recovery protocol and criteria into veterinary
Having read a lot of neuroscience and through a variety of experiences, Deborah started putting together drills and programs of action to get the animals with neurological problems to a stronger place and even walking again in most cases. “Because of my experience working in the field with athletes and other animals and working on my own body repairs,
DEBORAH’S MAIN MISSION IS TO EDUCATE AND EMPOWER PEOPLE TOWARD WELLNESS. functional rehabilitation.” Thus enters her Canine Rehabilitation Practice. “I was talking to my veterinary surgeon friend on the phone asking about the gaps and lamenting the trail I had traipsed, and her words to me were-‘Why don’t you leave me alone and come bother the dogs?’. I had no idea what she meant and when she explained it to me, I had no idea that this vocation I might never have discovered otherwise, a potential dream job, existed.” Deborah’s soul mate back then was a Great DaneGrace. She had knee surgery performed and then she tore her other CCL (ACL in humans) so Deborah went to the hospital for Grace’s surgery and stayed to build and run their rehab department. She took the coursework, both the veterinary courses and the physical therapy courses, and obtained her CCRP in 2005. She has since been able to successfully implement training programs that work sufficiently for most dogs to stabilize the knee joint without their going to surgery. “This is something that is often done in human sports medicine, however bringing principles and practice of this sort into the paradigm of veterinary small animal rehab is novel enough that I’m constantly and gladly educating veterinarians and the public.” After Deborah left the veterinary specialty hospital to serve a broader base of clientele, she became a sole- proprietor and sole-practitioner of Rehabilitation and Conditioning for Animals, a mobile rehabilitation practice that Deborah started in January of 2007. “In veterinary rehab many therapies are crossed over from human physical therapy and eager practitioners often haven’t had experience working previously with these therapies. I find practical reasons to substitute principle of exercise physiology for some of the human physical therapy activities that are complicated and even bothersome to the animals. I have a variety of experience that enables me to come up with recovery programs that utilize the animal’s nature and inclinations to encourage and activate healing.” In addition to the training recovery programs, Deborah also utilizes low-level laser therapy (LLLT). She has therapeutic ultrasound, which can be good for arthritic joints and contracted muscles. “However I have rarely used it and find it not as productive as LLLT, pharmaceuticals, Epsom salt baths, and appropriate exercise.”
I am able to work with people around the world via phone and mail consults. I get a substantial number of those and most of them are desperate for a plan of action.” Deborah publishes four-week rehab recovery booklets covering a variety of conditions to help people and guide them in caring for their pet companions. While the majority of Deborah’s time is working with companion animals, she is still involved in fitness and training for people. In 2007, she was diagnosed with breast cancer and has been actively participating in a couple of cancer groups in Austin; Team Survivor, which is a free program for fitness and training for any woman with any type of cancer diagnosis, and the Pink Ribbon Cowgirls, a social group of women diagnosed with breast cancer at age 45 or younger, overseen by the Breast Cancer Resource Center. “I am constantly working on surgical recovery and nutritional wellness with my friends in those groups. Not all of them are referred to physical therapy by their surgeons or another doctor post-surgery and a lot of people really don’t know what to do with their mild to moderate complications in movement. Bottom line-get massages, exercise, be happy and don’t overdo it.” Deborah helps her clients –both human and other animal- in rehabilitation, training, nutrition, and overall understanding of what they are dealing with and how to go about achieving wellness. In dealing with her pet client’s humans she says, “People tend to think that since it’s another species, it’s a foreign deal, and I wrangle them back down to practical earth, encouraging them to relate to their pet and use cautions based on how they think they would feel. A lot of what I do is educate others, and I take a lot of time to try to open new avenues of understanding.” Deborah’s main mission is to educate and empower people toward wellness and a better practical understanding of biological systems and their specific body function and that of their pets. Looking ahead, she would like to have a clinic open in an area of Austin that doesn’t have one and be able to implement her services that fill in the big gaps.
For More Information, call 512-970-5076 or visit www. rehabdeb.com, Facebook: AnimalRehabConditioning, or email at Deb@RehabDeb.com. MAY.JUNE 2014 / NSIDE TEXAS MD
AUSTIN // HEALTH & WELLNESS
A FUSION OF THE HEALING ARTS Dr. Rosanne Butera: Austin chiropractor par excellence
Dr. Rosanne Butera practices at 1803-A West 35th St. in Austin, Texas. For more information, call 512-323-6767 or visit www.drbutera.com.
DR. ROSANNE BUTERA received her B.S. in Dance and Psychology in New York City. She followed her heart and was a dancer, teacher and trainer in her 20s through her early 30s. Her path then led her to working for a short time for a chiropractor as a trainer and a receptionist. “I noted that although I could see many imbalances in the body, the chiropractor was able to affect her patients in a profound manner where I had no skills; I just had a vision of the problem,” Butera says. “She also had a profound effect on my health and wellness.” Butera interviewed other health professionals before she made the choice to become a chiropractor. “It seemed very apparent to me that those who chose chiropractic were the most satisfied with their choice and had the most expansive view of their work,” she 26
NSIDE TEXAS MD / MAY.JUNE 2014
says. Pursuing this career change, Butera moved to Austin immediately after graduation. She started by working as an associate for one-and-a-half years, and then she opened the doors to her private practice. And her practice has been thriving ever since. “My work is a fusion of the healing arts,” she says. “I have a strong Pilates-based rehab program that offers a functional rehab model in a tri-plane mode that addresses the individual patient’s needs in a comprehensive manner.” Her first response to a patient accepted into care is chiropractic; the technique Butera uses may vary, but the premise of structural integrity and clearing nerve interference is primary to good health. Chiropractic clears the body and corrects biomechanics while allowing the body to heal itself. This is of paramount importance for all patients to under-
stand on their journey to becoming holistic patients. Butera utilizes adjunct therapy to increase the desired results of treatment. Acupuncture, physical rehab, taping and nutrition will be applied as needed to patients’ individual concerns. Butera explains that acupuncture can be used to balance emotions and help decrease inflammation, resulting in an increase in healing time. She uses acupuncture to enhance the effects of chiropractic; examples cited include sinus congestion, digestive problems, lowered immunity, anxiety, nerve and joint pain and paresthesia, just to name a few conditions. Focusing on nutritional support decreases inflammation caused by external sources and increases the healing process. Butera looks for food allergies and sensitivities. She develops nutritional programs
CHIROPRACTIC SESSION, MYKEYRUNA/SHUTTERSTOCK.COM
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custom-tailored for each patient and eliminates foods that are causing the patient problems. She also works with patients on hormone fluctuation with adrenal support. “I work on the rehabilitation of the digestive system with nutritional builders,” she says. “I believe the most important factor in designing supplement plans is tracking the response of individual supplementation and variation of these protocols.” Sports injury prevention and Pilates-based prevention are highlights in Butera’s practice. She uses the rehab techniques as a basis to increase the strength and stretch of the patient in a way that expedites the body’s acceptance of the adjustment and increases the function of the patient. This also decreases the future occurrence of the injury, allows for returning to sports in a greater capacity and allows health-compromised adults to continue activities of daily living. Butera chose Pilates as a base for rehab because it is a comprehensive workout program. Additionally, she says, “it works most closely with the ideas of chiropractic. For example, the structure of Pilates focuses on the spine and the core.” Pilates also works with simple levers and pulleys and is therefore more organic in the shape and variation of muscle contraction and release. It also works on a tri-plane principle of supine, seated and prone. “Pilates works on the coronal/horizontal and sagittal planes and crosses these planes with arcs.” Butera groups exercises into three areas: ➊ Scapula stability ➋ Pelvic stability ➌ Abdominal strength
Each exercise is taken from one of these groups and varied from position and plane in accordance with the desired level of the patient and the need of correction. “We have had great success with our chiropractic adjustments and rehabilitation using the principles of Pilates core strengthening,” Butera says. “Adjustments are received in an easier fashion for the patient and last longer. Pain is decreased, and the patient has a home protocol for pain relief when they are injured. Most of all, the patient learns why they get injured and how to prevent the cycle from reoccurring.” Understanding Butera’s history is integral in understanding her treatments in chiropractic. First, she was a dancer. When she went into chiropractic, she had to put aside all that she knew to learn a new way of thinking. “Painful as it was to do, this action proved to be intelligent,” she says. “When I received my degree, I went back to use the tools I once knew to form the basis of the clinical understanding that has led to the development of a comprehensive program. As you learn the healing arts, we begin to see how all techniques have their merit. It is with this understanding that the practitioner will begin to draw from the knowledge of the many disciplines to form a belief system that one can utilize for the greater good of all their patients.” Explaining that while activities such as bike riding are rote and become “patterned” motions, Butera says, “Dancing is a series of related motions or unrelated motions that are created by the intention and initiation of the dancer to create equality and image.
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CHIROPRACTIC CLEARS THE BODY AND CORRECTS BIOMECHANICS WHILE ALLOWING THE BODY TO HEAL ITSELF.
It is in this way I could view the human body to create a system that would encompass both kinds of movement.” Butera looks at how that system defines its function, what it needs, what it lacks and what it overuses. “It is here that I can add a variety of techniques which blend together to create a healing way of treatment.” Seeing patients from 1 week old to 90-plus years old, Butera also treats pregnant women, as well as a smaller group of handicapped and stroke patients. Looking ahead, she wants to write a manual for chiropractic functional rehab. With her successful history in doing what she sets out to accomplish, Butera’s manual is a work in progress. As she concludes, “I am not alone in my work in functional medicine. There are many others besides myself. I believe this is the way of future holistic medicine.”
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AUSTIN // FEATURE
The ultimate tanning experience in central Texas By: HEATHER DANIELS
OWNED AND FAMILY OPERATED by Dallas Ross and business partner Brandon Scott, X-TREME Tan opened on June 1, 2011 and officiated the grand opening with the Cedar Park Chamber of Commerce Ribbon Cutting Ceremony. Since that day, Ross and Scott have learned a great deal and provide the ultimate experience in tanning for their clients. “As we prepare to cel28
NSIDE TEXAS MD / MAY.JUNE 2014
ebrate our 3 year anniversary, we have realized that our true partners are our clients, the community and the Indoor Tanning Industry,” explains Ross. While their journey to success began on a “rocky road” when Dallas Ross bought into a local chain of tanning salons, the business started to experience financial problems and the owner gave Dallas 100 percent ownership of his store while the other locations shut down. Instead of fighting against the current of a business built on policies that they didn’t believe in, Ross and Scott decided to strike out on their own. “It is a perfect partnership for Brandon and myself to keep the business thriving logistically and creatively.” X-Treme Tan believes that responsible UV exposure from a tanning salon or outdoors is natural, intended and a necessary function for human life. “We believe that SPF or sunscreen should only be used when sun-burning is possible and not used all day, every day as per the lack of long-term studies on the human body. Tanning salons are the best avenue of achieving your base tan before going outdoors. The base tan acts as your body’s natural defense to the sun.” X-Treme Tan houses the highest
certified staff under one roof for Central Texas; all of the team members have achieved Smart Tan Masters certifications. The team is trained to detect your skin type and determine your exposure schedule according to the Medical Tanning Device which will eliminate the risks that come with over-exposure.” While repeated over-exposure does have its associated risks, X-Treme salon does not practice over-exposure. Since salons are regulated and licensed, the X-Treme team advises that you choose salons that can prove the last time their bulbs were changed since old bulbs output high amounts of UVB. UVB over long periods of time are not suggested, unless prescribed by your physician or cosmetic dermatologist for medical needs. X-Treme Tan provides five levels of UV equipment including the only machines to exist of their kind in Central Texas-the i. So Italia collection of high-pressure UVA tanning. An open-air-lay-down and stand-up are available at X-Treme Tan. They are the exclusive owners of the Matrix L33 UVA high-pressure tanning beds, the Matrix V28 UVA high-pressure stand-up & the Matrix L58 open-air tanning equipment. “We have
been noted for having two open-air tanning beds in both level 4 and 5. No other salon has these!” Everyone’s skin type is based upon the Fitzpatrick Scale. The scale ranges from Skin type 1 to 6. Skin type 1 tends to be red hair and blue eyes with freckles. Whereas, skin type 6 are those with the most pigmentation by heredity. This skin typing determines your potential to burn and potential to tan. If you are able to tan outdoors, you are able to achieve a tan indoors. The Fitzpatrick Scale is also based upon your skins reaction to the
TANNING SALONS ARE THE BEST AVENUE OF ACHIEVING YOUR BASE TAN BEFORE GOING OUTDOORS. first 10 to 45 minutes of sun exposure after the winter months. There is an alternative for skin type 1 or those who would rather have a quicker tan-spray tanning. Ross and Scott explain, “There is no safe alternatives to tanning. It is as though bottled water is not labeled “safe” yet we drink it. Do so with precautions the FDA has set out, such as wearing lip balm, undergarments and protective eyewear for your spray tanning sessions. DHA (Dihydroxyacetone) is the chemical in which your skin’s sebum reacts to, thus creating an artificial tan. Spray tanning is not an SPF.” Spa services available at X-Treme Tan include, The NEW VersaPRO Heated spray tanning with a no-orange and streakfree experience, Far-Infrared Thermo-Body wraps for detox and weight loss, custom sunless tanning by Central Texas’ only Norvell Masters certified airbrush technicians, teeth-whitening with guaranteed results, plus five Levels of UV tanning-at the best prices. Brandon Scott is the creator of the first known
promotion that offers clients discounts on single month packages and to offer non-members membership advantages. “We are a family owned business dedicated to providing giving more back to our clients and the community. We are honored to have donated over $7,400 back to the Cedar Park community in 2013 alone. There is no secret recipe for what our salon is. We offer the most giveaways over any salon. We offer monthly X-Treme giveaways such as lotion raffles on the 15th, sample giveaways on the 20th and spray tanning raffles on the 25th. Quarterly customer appreciation days reward visitors with free upgrades, lotions and body wraps. We offer the perfect mix of education, charitable giving and marketing.” That perfect mix has earned X-Treme Tan several awards and rightly so. Voted #1 for having the best equipment, the lowest prices and for providing the best customer service in Central Texas is certainly something to be proud of and one of the many reasons their customers continue their tanning/spa experiences at X-Treme Tan. They were also voted Best of The BEST by Hill Country News readers two years in a row-2013 and 2014. Other noteworthy awards are- voted Best of Austin for the one time voting awards hosted by KVUE News in 2013, voted Best Tanning Salon by The Austin Business Network and they are the only salon in Central Texas to be nominated by a Chamber of Commerce, as the Small Business of The Year. Some more helpful advice given by Ross and Scott“The reason you should tan indoors is because we regulate the time and with outdoor tanning you can burn easily. You should tan indoors since tanning beds emit only UVA and UVB, whereas the sun emits harmful rays such as UVC plus other invisible rays and infrared heat. Tanning at professional salons means you tan quicker, are on clean surfaces and can relax in the air conditioned rooms.” X-Treme Tan suggests patrons seeking to worship the sun this summer, do so with ease. Seek out your local Smart Tan Masters certified salons, make sure to check certifications and health department licenses. Ask your salon professional to assist you with un-
derstanding your Fitzpatrick skin type, trust in low amounts of time to reach your tanning desires and understand that tanning is a process. “Clients generally take 3-7 session to achieve a base tan. Please be aware the law in Texas; you may only tan once every 24 hours. If you have a family history or have had a history with skin cancer, you should consult your physician. You cannot exceed the Medical Tanning Device time and you must be 18 years of age or older to UV Tan. Know that you should not tan indoors and outdoors in the same day and use a tanning lotion from a tanning salon to reduce the signs of photo-aging when tanning for long periods of time.” The promise of X-Treme Tan may seem too good to be true. After all, it is tough to live up to a name like that. They are totally dedicated to providing clients with the best tanning experience possible. “Our owner operated salon ensures each client receives red carpet celebrity service with the quickest tan known in the land. Our philosophy is a combination of trust, results and determination. The back of our tshirts say ‘I LOVE X-Treme Tan, Sun, Spray, Spa, Faith, Life, Award-Winning, Community, Certified, VersaPRO, Volunteer, Relaxing, Fun, Faith & Life!’ Our clients love sporting these shirts and it makes us feel that we are succeeding at providing the best services to our clients and the community at large.” Enjoy your summer and listen to the advice of the X-Treme Team experts. Have a happy and healthy tanning 2014.
X-Treme Tan is located at 1420 Cypress Creek Rd. #800, Cedar Park, TX. 78613. For more information, 512-8325850 or visit www.X-TremeTan.com, Facebook: EXTREMETANAUSTIN, Twitter: Xreme TanAustin. MAY.JUNE 2014 / NSIDE TEXAS MD
AUSTIN // PATIENT
ATHLETES AND IBUPROFEN Can too much be hazardous to your health? SPECIAL TO TEXAS MD
NSIDE TEXAS MD / MAY.JUNE 2014
explains, but there are circumstances where they have no use: - Do not use prior to exercise. You do not want to mask how your body feels, as pain is a way of telling you something is not right. Additionally, there is a risk of kidney damage if you take them and get dehydrated. - Do not use during exercise. If you must take something, take Tylenol, especially during longdistance events where dehydration is an issue. After an endurance event, to make sure your kidney function resumes, go to the bathroom prior to taking an NSAID. While the most common side effects of Ibuprofen are minor, improper use can cause major health problems. NSAIDs reduce the ability of blood to clot and, therefore, increase bleeding after an injury. Ibuprofen may cause ulceration of the stomach or intestine, and the ulcers may bleed. NSAIDs can also reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients who already have impaired function of the kidney or congestive heart failure, and use of NSAIDs in these patients should be cautious. Fluid retention, blood clots, heart attacks, hypertension and heart failure have also been associated with the use of NSAIDs. Rodriguez went on to say that instead of just popping an Ibuprofen or another NSAID while playing a sport, here are a few things to do instead:
FLUID RETENTION, BLOOD CLOTS, HEART ATTACKS, HYPERTENSION AND HEART FAILURE HAVE BEEN ASSOCIATED WITH THE USE OF NSAIDS. - See a doctor to treat the underlying injury, rather than running through pain. - Ice the painful area before and after running for 10 to 15 minutes at a time. - Talk to your doctor about a topical pain reliever that will not impact the stomach or kidneys. Coping with injuries is tough, both mentally and physically, so it is critical to make sure that long-term health and longevity goals are always ahead of your short-term goals. Taking time off to rehabilitate an injury may seem hard at the time, but it could make the difference in avoiding permanent damage that could stop you from running or exercising altogether.
For more information, contact the Scott & WhiteRound Rock Pain Clinic at 512-509-0200.
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EVERY DAY, people across the country take Ibuprofen to help ease the aches and pains of daily life. Many athletes, typically those in long high-endurance events, take Ibuprofen during the course of a race or even several times a day during long training sessions. But with the possibility of health risks, is this necessarily a good idea? Ibuprofen, most commonly known as Advil or Motrin, is an over-the-counter non-steroidal anti-inflammatory drug (NSAID). NSAIDs are typically used for the management of mild to moderate pain, fever and inflammation, which are promoted by the release of chemicals called prostaglandins. Ibuprofen blocks the enzyme that makes prostaglandins, resulting in lower levels. As a consequence, pain, fever and inflammation are reduced. So, according to Dr. Jesus Guillermo Rodriquez, a pain medicine physician at the Scott & White - Round Rock Pain Medicine Clinic, while there is a place for NSAIDs in athletics, it is important for athletes to remember that NSAIDs are not without risk. For those taking these medications for general aches and pains and occasional use, the risks are minimal. However, those who take them for inflammation (things like tendonitis, bursitis and overuse injuries) need to use higher amounts, which can cause intestinal bleeding and raise that risk. Physicians recommend only using high doses for a limited amount of time and then to decrease to as needed. For example, someone with ankle tendonitis might take four Advil three times a day (always with food) for 10 days and then scale down to two a day if needed. NSAIDs can be helpful if used properly, Rodriguez
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MY EMERGENCY ROOM
An important addition to the medical community in San Marcos
MY EMERGENCY ROOM is a licensed freestanding emergency room that is always open, 24/7. By providing emergency medical treatment to the communities they serve, the physicians will meet the highest level of standards that the patients and staff expect. Patients will be treated by experienced emergency medicine physicians and nurses. “We provide a comfortable and pleasant experience that is unsurpassed. Striving to continue our education to be able to provide the current treatments for medical conditions is always on the agenda. The work environment will be supportive and inclusive for all employees. Ultimately, this is an emergency room experience that is wonderfully unforgettable for all involved,” explains the three physicians and partners of My Emergency Room, Dr. Ryan Cradeur, Dr. John Turner and Dr. Brad Sloan. Meeting with these three stellar physicians, the emergency medical care that those in San Marcos and surrounding communities will have available by this summer, 2014 should make the residents in Central Texas feel a whole lot safer; high quality emergency care is one of those aspects of life that you never know when you are going to need the help. Having Dr. Cradeur, Dr. Turner and Dr. Sloan and their well trained staff within minutes of several cities surrounding San 32
NSIDE TEXAS MD / MAY.JUNE 2014
Marcos, will most certainly meet the medical concerns of many residents throughout Central Texas. Dr. Ryan Cradeur grew up in Branch, Louisiana, a small town of 400 just 20 miles west of Lafayette. Dr. Cradeur went to college at Louisiana State University and received his BS in biology in 1999. He then attended LSU Health Sciences Center in Shreveport graduating in 2003 with his medical degree. “I was planning on doing my residency in Louisiana, but I figured if I did that I would never leave Louisiana. So I explored Texas. I heard about a nice town, Austin and decided to schedule an interview for residency just to get to visit. Within the first 24 hours I was there, it felt like home. I accepted a position in the family medicine program at Brackenridge with plans to move back home when I completed the program in 2006. That never happened. I loved Central Texas too much. Everyone is friendly and hardworking but at the same time, laid back. I fit right in.” While doing his family medicine residency at Brackenridge, Dr. Cradeur “fell in love” with the ER. He remembers the day well. “The patient was brought into the trauma room by EMS. The ER crew was prepped and ready to go. Once the patient arrived, things just started to happen with very little communication about what each one was doing. It seemed like a sym-
phony to me with the doctor leading the team. Within minutes, the patient was stabilized and sent off for testing. At that point, the doctor said ‘Good job, team.’ That was the moment I knew ER was for me.” After his first year of residency in Family Medicine, Dr. Cradeur did all of his electives in ER and started moonlighting in outside facilities in small towns around Texas such as Rockdale, Weimer, Martin, Glen Rose, Brenham, and Crockett. The smaller towns were a good fit for him since he grew up in a smaller town. “The challenge of working in smaller ERs is the lack of specialty back up. You are the cardiologist, orthopedics, radiologist, neurologist, and any other type of hat you have to wear. Since family medicine has a broad background, I was well suited for this type of ER work.” Free Standing ERs can sometimes be the same type of scenario aforementioned and Dr. Cradeur is well prepared for this type of ER practice. Once completing his residency in 2006, he has been working full-time in ER. Dr. Cradeur was the medical director of ETMC Crockett from 2008 through 2012. It was a Level III Trauma Center at the time. Dr. Cradeur, Dr. Turner and Dr. Sloan truly enjoy the interaction with patients and time well spent taking care of them. Working in hospital based ERs, they all felt that there was too much bureaucracy getting
EMERGENCY HOSPITAL SIGN, STEVE DESIGN/SHUTTERSTOCK.COM
By: HEATHER DANIELS
in the way of patient care. My Emergency Room is owned by these physicians and staffed with people that care about patient care. This will be a completely new experience for the people seeking emergency health care in San Marcos. There will be little to no wait time to see a physician. Most patients will be in and out in less than an hour unless they have a complicated medical condition that requires extra attention. And the customer service will be excellent. Dr. John Turner grew up in Cedar Hill, a small town south of Dallas. He played all the sports he could while he was there because he knew he wasn’t going to play for any of the big schools once he entered college. He had his heart set on going to his parent’s
the sciences and mathematics. I graduated from W.T. White High School in 1983 as Salutatorian.” He received his undergraduate degree at The University of Texas at Austin in electrical engineering. Dr. Sloan was accepted into medical school before completing this degree. Attending medical school at The University of Texas Health Science Center at San Antonio, Dr. Sloan did his residency training in Dallas at the University of Texas Southwestern residency program. After completion, he became assistant professor and trained the incoming residents. “I have been in medical practice for over 20 years with almost all of that time in emergency medicine. The reason for opening an emergency room with my
PATIENTS CAN GET IN QUICKLY AND BE TREATED QUICKLY WITH CLOSE PARKING, LITTLE TO NO WAIT TIMES AND SHORT VISITS. alma mater, The University of Texas. While attending U.T., Dr. Turner studied biology and tried teaching for a year but decided he wanted to go to medical school. “I had a friend about to attend Ross Medical School in the Caribbean so I decided that sounded like a nice way to spend a few years while studying for my degree. I got my dive-master’s license during my first 2 years of medical school while on the island of Dominica. I spent the last 2 years of school mostly in Manhattan, Boston and Washington DC and some time at Parkland in Dallas. I was jogging one day in my hometown and a neighbor stopped me to chat. She asked if I might like to study at U.T. Southwestern for my residency and of course I was interested. She was the mental health director and a resident supervisor. Ultimately, she helped me get connected with the family medicine residency program in Austin at Brackenridge Hospital. I owe her a lot for helping me with my medical career and I think of her often.” Trained and board certified in family medicine, Dr. Turner’s original goal was to become a small town doctor. He started as a faculty physician at a residency program in New Mexico. Along the way, he discovered that he liked the fast paced medicine of the emergency department. He followed his desires and has now been a full time emergency physician since 2006. “I have worked in both small rural and large urban emergency departments. I found myself wanting things I couldn’t have while working for a hospital. The most glaring want was to have more control over how the ER functioned. I felt like my voice often fell on deaf ears. ER physicians never really get to feel like they are part of the hospital medical staff. By opening our own center, we have stability and some control. I look forward to earning the trust and respect of the patients we soon will be serving in San Marcos.” Dr. Brad Sloan grew up in Dallas; his father was an attorney and educator and his mother was a school teacher and counselor. “Growing up, I remember my parents put a lot of emphasis on education. I went to Dallas public schools and excelled, especially in
partners is to provide the community with high quality care without the impediments that a hospital provides. My Emergency Room is owned and run by physicians. We will provide the high quality care that you deserve including getting you into seeing a specialist.” Through all his years spent between Austin and San Antonio, Dr. Sloan saw the community’s need for more accessible and affordable ER services. “I have learned a lot about the people of Central Texas and I have gained a cultural awareness that is indispensable when providing cultural competent care to these communities.” Dr. Sloan sums it up well; “I have learned through my medical career of 20 years that medicine requires compassion and caring and that will be what our patients are going to receive when they come to visit My Emergency Room. As the name says, My Emergency Room, we will be open for everybody, 24/7 and will provide the highest quality of care. I am excited and look forward to being part of this community and as a physician, I look forward to experiencing the satisfaction of helping people and improving their lives.” My Emergency Room is the perfect name that these three fine physicians have named the ER. “We naturally want people to understand that we are an emergency room and we want them to know that we are there for them. When they think of the name, they can make a connection that it is a place for them to go and feel comfortable while getting outstanding emergency medical care that puts the patients first.” Dr. Cradeur explains, “My Emergency Room is a place for patients to feel comfortable because they know it is their place to go for ‘my medical care.’ And, My Emergency Room is a place where the physicians and nurses can get back to basics to provide caring, patient-centered service because it is ‘my place to do great work’.” The 6,000 square foot facility provides CT scans, ultrasound, lab work including blood, urine, and rapid screens for strep throat and flu, IV’s to give fluids and medications and more. My Emergency Room will be
able to provide any care needed to stabilize any emergency medical condition. “We can handle anything that walks through the door.” This includes minor emergencies such as sore throats and earaches to heart attacks and broken bones. Most patients that are treated in any ER, approximately 70 to 90% of the total volume, are treated and discharged without admission to a hospital room. “That is what makes our facility so convenient. Patients can get in quickly and be treated quickly with close parking, little to no wait times and short visits. Frequently ER visits at hospital based ERs have long wait times and the visits last several hours. For patients that do need to be treated in the hospital for observation, ongoing treatment or surgery, we can arrange a transfer directly to a hospital room and bypass the hospital emergency room. We have a transfer agreement with Central Texas Medical Center, which is the local hospital in San Marcos.” These three remarkable ER physicians are providing a new experience in emergency medicine for the San Marcos area. “We want to get involved with the community to prove our commitment to being there for years to come such as participating with health fairs and getting involved with the local schools and Texas State University. We hope to develop relationships with patients, their families, and the medical community in San Marcos,” says Dr. Cradeur. “We plan on growing old with the community and serving the medical needs of the people in this great town and surrounding towns for a very long time,” adds Dr. Turner. Stay tuned, My Emergency Room will be opening their doors within weeks and with these three physicians and their concepts and expertise in ER medicine, residents are awaiting the news and already welcoming My Emergency Room to their city. Or should I say my city?
My Emergency Room is located at 2810 South IH-35, San Marcos, TX 78666 (in front of Target). For more information, call 512-392-7800 or visit www.myemergencyroom.com.
MAY.JUNE 2014 / NSIDE TEXAS MD
AUSTIN // PATIENT
SUMMER IS ALMOST HERE Are you putting yourself at risk for skin cancer? SPECIAL TO TEXAS MD
BASAL CELL CARCINOMA
Basal cell carcinoma (BCC) is the most common form of skin cancer, affecting one million Americans each year – in fact, it is the most common of all cancers. The average age of onset of the disease has steadily decreased and more women are getting it than in the past. Those with fair skin, light hair and blue, green or gray eyes are at the highest risk for BCC, in addition to those whose occupations require long hours outdoors or who spend extensive leisure time in the sun. Almost all BCCs are caused by chronic exposure to sunlight. They occur most frequently on exposed parts of the body – the face, ears, neck, scalp, shoulders, legs and back.
NSIDE TEXAS MD / MAY.JUNE 2014
SOME OF THE WARNING SIGNS OF BCC INCLUDE: •
An open sore that bleeds, oozes or crusts and remains open for three or more weeks A reddish patch or irritated area, frequently occurring on the chest, shoulders, arms or legs A shiny bump or nodule that is pearly or translucent and is often pink, red or white; the bump can also be tan, black or brown, especially in dark-haired people, and can be confused with a mole A pink growth with a slightly elevated rolled border and a crusted indentation in the center A scar-like area that is white, yellow or waxy, and often has poorly defined borders
SQUAMOUS CELL CARCINOMA
Squamous cell carcinoma (SCC), the second most common skin cancer, afflicts more than 200,000 Americans each year. SCC is similar to BCC in that chronic exposure to sunlight causes most of its cases and many tumors appear on sun-exposed parts of the body. However, SCC may also occur where skin has suffered certain kinds of injury such as burns, scars, long-standing sores and sites previously exposed to X-rays or certain chemicals. In addition, chronic skin inflammation or medical conditions that suppress the immune system over an extended period of time may encourage the development of SCC. Although SCCs usually remain confined to the epidermis for some time, they eventually penetrate the underlying tissues if not treated. In a small percentage of cases, they spread to distant tissues and organs and can be fatal.
BASAL CELL CARCINOMA IS THE MOST COMMON OF ALL CANCERS.
SOME OF THE WARNING SIGNS OF SCC INCLUDE: •
A wart-like growth that crusts and occasionally bleeds A persistent, scaly red patch with irregular borders that sometimes crusts or bleeds An open sore that bleeds and crusts and persists for weeks An elevated growth with a central depression that occasionally bleeds; a growth of this type may rapidly increase in size
• • •
Once patients have been diagnosed with skin cancer, they should be well informed about the treatment options, as there are a variety of both non-surgical and surgical treatments. It is important to discuss all options with a physician, as treatments vary from case to case.
For more information, contact Scott & White Round Rock Cosmetic Surgery Center at 512-509-8550 or visit www.cosmeticsurgery.sw.org.
WOMAN SUNBATHING, BALAZS KOVACS IMAGES/SHUTTERSTOCK.COM
SUMMER IS UPON US. For most of us in Central Texas, that means spending more time outdoors and exposing our skin to the sun while out on the lake and by the pool. And for more than one million Americans this year, that sun exposure could mean skin cancer. The incidence and mortality rates of basal cell carcinoma and squamous cell carcinoma – the two most common forms of skin cancer – have increased exponentially over the last several years, and every year, cases continue to increase. Prevention is best, but for those who are already at risk, early identification and treatment could save your life. According to Drs. Susan Pike and Staci Hix-Hernandez, plastic surgeons at Scott & White Round Rock Cosmetic Surgery Center, sunscreen is critical in helping prevent sun damage and skin cancers, while generally an SPF of 50 or higher and using a physical blocker sunscreen is best. If you’re out in the sun for more than two hours, reapply that SPF at least every two hours.
MD // AUSTIN
COUNTERFEIT DRUGS If the cost of a medication is too good to be true, the drug may be counterfeit By: THOMAS T. KUBIC AND SUSAN SHEPARD
• • • • • •
PRESCRIPTION PILLS, BURLINGHAM/SHUTTERSTOCK.COM
IN THE PAST FEW YEARS, a number of developments have occurred, including drug shortages and patients having trouble affording their prescriptions, that might seem to justify importing medications from overseas. The world outside of U.S. borders appears to offer a ready supply of cheaper medications easily obtained through unlicensed distributors, trips across the border, or online pharmacies. The laws that prohibit importing non-FDA-approved medicines are designed to ensure that patients receive medications that meet the FDA’s requirements for safety, purity, and potency. Under the Federal Food, Drug, and Cosmetic Act, it is illegal to import unapproved, misbranded, adulterated, or foreign versions of U.S.-approved medications into the country. The law also applies to medical devices such as intrauterine devices, which, along with oncology drugs and cosmetic injectables, are commonly involved in legal actions against physicians concerning counterfeit items. Every healthcare professional who purchases medications is familiar with daily price-list faxes from persistent direct sales companies. Regardless of the supplier, purchasing or using non-FDA-approved drug products exposes the physician to criminal and civil liability. Medical malpractice insurance may not cover
any errors in this area – making physicians personally liable for claims that they provided counterfeit drugs. The medication doesn’t even have to be counterfeit for the physician to suffer legal consequences: Medications that have the correct ingredients but haven’t been FDA-approved are still illegal to use. Physicians and their office staff may inadvertently order counterfeit drugs or devices. Follow these tips to protect yourself and your patients from the risks of illegal medications and devices: • •
Require training for everyone involved in purchasing medications. Be wary of fax or e-mail blast offers from an unauthorized distributor selling “discounted” foreign medications or devices. Have clear policies that dictate how to verify the license of a wholesaler providing medications. For example, require that your staff verify all vendors by checking wholesaler accreditation and licensing at http://safedr.ug/VAWDaccredited and http:// safedr.ug/fdalicense. Obtain medications only from secure sources Know the warning signs that a product may be counterfeit:
Are prices or deals too good to be true? Was the fax/e-mail offer unsolicited and from an unknown seller? Is the labeling in a foreign language when it’s normally in English? Is the package damaged or soiled? Are all tamper seals present and intact? If in doubt, call the manufacturer to check if the lot number is still valid and matches the expiration date. Educate patients about avoiding counterfeit drugs with free resources like the S.A.F.E.D.R.U.G. checklist at www.safemedicines.org/safedrugs.html. Identify at-risk patients who may be purchasing medicines online and discuss with them the risks and challenges of buying medications over the Internet. Dispense free samples of brand name drugs so that patients can establish a baseline of the medicine’s characteristics, including appearance, taste, texture, reactions, and packaging.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.
For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety. For more information on counterfeit medicines, go to www. safemedicines.org. This article has been reprinted with the permission of ©2014 The Doctors Company. MAY.JUNE 2014 / NSIDE TEXAS MD
AUSTIN // NONPROFIT
HONORED WITH PHILANTHROPY AWARD AGE of Central Texas recognizes senior-focused healthcare company and non-profit, WellMed Charitable Foundation.
WELLMED AND ITS EMPLOYEES HAVE MADE AN IMPACT ON THE LIVES OF OLDER ADULTS AND THEIR CAREGIVERS IN OUR COMMUNITY.
By: DAN CALDERÓN
IN SOUTH AUSTIN, what was once 8,000-squarefeet of non-descript office space is today a senior center bustling with activity. Older adults come here to take part in exercise classes, to learn how to use the computer and access the Internet, to play Wii and line dance. They, and their family caregivers, take classes on how to better manage diabetes, heart disease and dementia. They play table tennis and bingo, dance Zumba, and socialize – all at no cost. As it marks its two-year anniversary, the WellMed Charitable Foundation Senior Community Center (706 W. Ben White, Ste. 125-A) is fulfilling the mission of its namesake by providing a nurturing space where seniors and caregivers can practice wellness and health, while also learn to live better with chronic illness. The WCF Senior Community Center is one of the reasons that the WellMed Charitable Foundation and WellMed Medical Management have been named winners of the 2014 AGE Awards in the Philanthropy category. AGE of Central Texas (formerly Austin Groups for the 36
NSIDE TEXAS MD / MAY.JUNE 2014
Elderly) honored WellMed and the WellMed Charitable Foundation at the 20th annual AGE Awards Dinner on Thursday, April 10 at the Driskill Hotel in Austin. AGE of Central Texas is a non-profit organization dedicated to serving older adults and those who care for them. Among its many services, the agency operates the only two state-licensed adult day care centers serving Travis and Williamson counties. “We are proud to honor WellMed and the WellMed Charitable Foundation with the AGE Philanthropy Award,” said Joyce Lauck, executive director of AGE. “Through their generosity, WellMed and its employees have made an impact on the lives of older adults and their caregivers in our community.” AGE officials noted WellMed’s commitment to giving back to the communities it serves through its annual employee contribution program called GIVE (Generous Individuals Value Everyone). WellMed operates more than 70 senior-focused primary care clinics in Texas and Florida, including 11 in the Austin area. Through GIVE, WellMed employees choose to donate
to national and/or market-specific charities, often using payroll deduction. WellMed matches these donations dollar-for-dollar. Additionally, the Rapier Family Foundation has in years past also matched WellMed employee donations, tripling the impact of the employee gift. The Rapier Family Foundation is the personal charity of WellMed Chairman and CEO Dr. George Rapier and his wife Kymberly. In 2013, the GIVE campaign raised more than $780,000 for 25 charities, including AGE. Since its inception in 2008, the campaign has raised more than $1.7 million for charities. The non-profit WellMed Charitable Foundation, the philanthropic partner of WellMed, serves older adults in Austin through the WCF Senior Community Center at 706 Ben White in South Austin. The center offers complimentary services for seniors including exercise and nutrition classes, a computer lab, access to workout equipment, social programs and more. The WCF Senior Community Center, which opened March 2012, has become one of the most popular se-
nior destinations in South Austin, with more than 800 registered members at the close of 2013. The center is open Monday-Friday from 8 am to 4 pm. More information about WCF senior center programs in Austin, the Rio Grande Valley and San Antonio is available at www.WellmedGives.org. The WCF is a partner with the Capital Area Agency on Aging to support family caregivers through two Foundationbased initiatives - the Stress-Busting Program for Family Caregivers and the Caregiver Teleconnection. The Stress-Busting Program is an evidence-based program that provides support for family caregivers of those with Alzheimer’s disease and related dementia. These free classes are offered over a nine-week period using a curriculum developed by researchers at the UT Health Science Center in San Antonio. The Caregiver Teleconnection is a complimentary telelearning program, a confidential service connecting caregivers and family members to information and support using the most common tool available to caregivers – the telephone. More information about these initiatives is available at www. CaregiverSOS.org. Also honored at the AGE Awards dinner were Anna Gatti (Willie Kocurek Vital Aging Award), a 91-year-old volunteer at the non-profit group; Samantha Young (Bert Kruger Smith Vision Award), who started a company assigning social workers to work with seniors; registered nurse Patricia Ward (Rose Professional Spirit Award), who spearheaded an innovative project to improve health outcomes for hundreds of diabetes patients; and Susie Lightfoot Scherr (Community Service Award), past president of the Capital Area Parkinson’s Society.
The WellMed Charitable Foundation (www.wellmedgives.org) is a non-profit 501(C)3 organization that supports seniors and their caregivers with special emphasis on wellness, prevention and living with chronic illness. Established in 2006 by Dr. George M. Rapier III, a noted physician and the Chairman of the Board, the Foundation has contributed more than $3 million to Texas-based non-profit groups. The Foundation oversees several initiatives benefiting seniors and caregivers, including Caregiver SOS resource centers, the Caregiver Teleconnection, and senior center health and wellness programs.
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HEALTH OR MONEY? Here’s how you can save both with wellness plans By: STEWART BEASLEY
NSIDE TEXAS MD / MAY.JUNE 2014
number of health issues, including cancers. As a personal trainer, I have discovered that the majority of people who come to me for training or nutritional advice as a result of an abnormal biometric screening or company wellness program have never heard the term, “metabolic syndrome.” Their screening came back abnormally high for X, Y and Z, and to qualify for the insurance reduction, they need to improve their numbers. Once it’s explained how these risk factors can potentially affect their lives sooner rather than later, their motivation tends to turn from saving a few dollars to saving their health. Many wellness programs offer valuable resources for their employees. Activities and seminars aimed at educating employees in healthy lifestyle and behavioral modifications such as cooking classes, exercise clinics, support groups and health coaching are among the most popular. Sadly, the majority of people do not use these resources. The wellness programs are simply seen as an avenue to savings, which is only one consideration, rather than as a way to become healthier and save money. Wellness programs are meant to drive people to health care or behavioral change. However, getting people to truly make long-term behavioral changes is very difficult without the proper motivation. The issues faced by employers regarding wellness programs mirror the health issues we face in America as a whole. This nation is the fattest it has ever been. Obesity is at an all-time high. This is primarily because of the poor dietary choices people make every day despite countless resources made available to them. If you are fortunate enough to have an employer who provides a wellness plan, I encourage you to participate. Have a biometric screening and find out if you are at risk for metabolic syndrome. The suc-
WELLNESS PROGRAMS ARE MEANT TO DRIVE PEOPLE TO HEALTH CARE OR BEHAVIORAL CHANGE. cess or failure of your health and/or fitness goals is 80 percent nutrition. Eat like your life depends on it – because it does.
Stewart Beasley has been a personal trainer since 1992, and he is a 20-year veteran of the Baytown Police Department, where he is assigned to the crime prevention and training divisions. He has a fitness column for the City of Baytown Police Department, where he addresses fitness and health concerns for city employees. Beasley is a competitive powerlifter who has set several Texas state powerlifting records; he was also International Powerlifting National Champion in 2003.
RUNNER'S FEET, WARREN GOLDSWAIN/SHUTTERSTOCK.COM
FOR MANY YEARS, businesses, regardless of size, have recognized the value of healthy employees and sought ways to encourage and often subsidize healthy lifestyles. Over the last 30 years, this initiative has evolved from the simplicity of a company paying for an employee’s gym membership to a much more systematic approach. In the wake of rising health care costs and uncertainty within the medical community as to the direction of health care in general, employers are taking employee wellness more seriously than ever. Many employers are implementing wellness programs to combat health issues and rising health care costs. These programs often include discounts on the employee’s monthly or yearly insurance premiums if they meet certain health criteria each year. One of the more popular facets among wellness plans is the biometric screening. A biometric screening typically measures blood pressure, HDL cholesterol levels, triglyceride levels, body mass index (more specifically belly fat) and blood sugar levels. Any combination of these risk factors being elevated is known as metabolic syndrome, which is the intermediate step on the way to heart disease. Furthermore, both obesity and diabetes are considered symptoms of metabolic syndrome, both of which are epidemics in the United States. The sooner a person learns they have one or more of the risk factors associated with metabolic syndrome, the sooner that condition can be addressed and corrected through behavioral change or medication. Employee wellness programs are playing a vital role in bringing this information to the younger generation. Employees who may not have otherwise had blood work or health screenings done are discovering they are at risk for heart disease, diabetes or any
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NORMA’S TOUCH Norma's Touch Spa: superior skin care services By: HEATHER DANIELS
WITH MORE THAN 30 YEARS in the skin care industry, Norma Garza opened the doors of her skin care spa in 1985. Due to her knowledge, insight and skin care expertise, NORMA’S TOUCH is a novel spa, ensuring that each client gets the personalized care they deserve. Norma explains, “I give my clients my undivided attention and customize a treatment plan depending on their skin care needs. My goal is to pro42
NSIDE TEXAS MD / MAY.JUNE 2014
vide worry free skin and arm my clients with solutions to help them look and feel better.” NORMA’S TOUCH is a well-known establishment in Houston that customers discovered many years ago, back in the late 1980s and her secret to success is still proving to be a rewarding skin care option for Houstonians. Providing quality services and top quality products, Norma Garza’s corrective skin care treat-
ments and long term results are sought after by both women and men throughout the area. Born and raised in Houston, Norma started her career at the age of 15 as a make-up artist in the beauty industry at Revlon and Elizabeth Arden. She attended the Long Point Beauty Academy and on a yearly basis, she continues to get certifications and training on new products that she knows will help her clients achieve their goals. Norma details her history in the skin care industry. “I love cosmetics but unfortunately make-up can only do so much on acne prone skin, which I had through my early teens and early adult years. To obtain a make-up license at that time, three quarters of the certification was esthetics and one quarter was make-up application. I was so intrigued on what I gathered by researching and studying skincare that I was determined to help others with the same problem.” Back then, there were no acne line products available and Norma knew she was not the only one suffering with this problem. “I made it a goal and a priority to bring awareness and find solutions to not only acne problematic skin but all types of skin challenges.” Norma was so impressed on the positive changes that were occurring on her own skin due to the products she was using and quickly realized that there was more to healing acne than just drying up the skin. “I made it my quest to research the skincare products in more depth to fully understand how to find solutions in order to continue to help myself and others that faced the same problems.” And thus, she began to create what would become NORMA’S TOUCH in Houston to help others for all their skin care needs. From facials, herbal and chemical peels, microdermabrasion, anti-aging treatments, acne and noninvasive skin care treatments, NORMA’S TOUCH has been treating fellow Houstonians for nearly three decades. “By combining nature and science, Norma’s Touch Skin Specialty Spa brings to our clients a combination of awareness, education and exceptional results with the finest skincare products and non-invasive techniques to create a new and beautiful you.” She continues, “It starts with a relationship, a complete understanding of your treatment needs, goals and a precise regime of products and treatments to reach these goals.” Speaking with several of the clients, it is apparent that when you walk out of NORMA’S TOUCH, your whole state of being is better with radiant, youthful skin. What sets them apart from other similar establishments is that the focus is on quality over quantity. “As I analyze the skin, I also ask the right questions which include lifestyle, career, physical health and other areas of everyday life. This allows me to create the appropriate skin care treatments and products for that individual.” According to one client, Pamela Pedrosa, NORMA’S TOUCH is the solution to all of her skin care needs. She states, “I travel a lot and have been all over the globe and visited many spa establishments but nothing compares to NORMA’S TOUCH. Every time I leave the spa, my skin automatically has a gorgeous glow. My pores are significantly smaller and by the next day, my skin is 100% flawless. Norma analyzes your skin
SPA PHOTOS BY NICK GUILLEN
HOUSTON // HEALTH & WELLNESS
in detail and gives you her full expertise on skincare. I continuously receive compliments on my skin and I have Norma to thank for that. You just can’t go wrong with NORMA’S TOUCH.” Results-oriented is the philosophy that NORMA’S TOUCH follows. “When somebody comes in and does not know what they want, I decide on what treatment is best for them.” People want to see the results almost immediately and Norma strives to achieve the best results possible via her treatments and line of skin care products. Having both local and international clients, ages ranging from 8 years old to 86 years old-women and men, NORMA’S TOUCH is continuously getting rave reviews. Another client, Gaye Lynn Boyer shares her experiences. “I have been a monthly client of Norma’s for 23 years. Norma does not have a standard ‘menu’ of services that she utilizes for her skin care treatments, but rather she takes the time to understand what my skin requires each visit. She tailors my facials to the needs of my skin
at that time, so my facials are different at each appointment. Norma is knowledgeable regarding the latest skin care techniques and is constantly seeking improvements in her services to provide the best results possible for each client. I am never disappointed; I leave her spa with glowing, radiant skin. I am asked many times how I manage to have such beautiful skin. My secret is monthly facials with Norma and following her skin care regime. We all want younger looking skin without surgery or medical procedures. NORMA’S TOUCH is the answer.” 29 years ago, people did not care about their skin like they do now. Great skin was just not high on the priority list. “As a matter of fact, I couldn’t even give away a facial back then. Now, people look for the latest and greatest treatments. I always expect results from my skin treatments and products that I proudly support,” states Norma. “What I provide for my clients are Cosmoceautical grade products which do a fantastic job and leave my customers with flawless, glowing skin.”
“I AM ASKED MANY TIMES HOW I MANAGE TO HAVE SUCH BEAUTIFUL SKIN. MY SECRET IS MONTHLY FACIALS WITH NORMA, AND FOLLOWING HER SKIN CARE REGIME.”
NORMA’S TOUCH is located at 14359 Misty Meadow Lane, Houston, TX 77079. For More Information, call281-912-6039 or visit www. normastouchhouston.com. MAY.JUNE 2014 / NSIDE TEXAS MD
HOUSTON // PATIENT
PAIN THAT’S HARD TO FIND Dr. Richard Francis talks low back pain and the sacroiliac joint.
By: JODY PLUMB-GONZALEZ
RICHARD R. M. FRANCIS, M.D., MBA, is a leading orthopedic and spine surgeon offering innovative treatments for low back pain. Four out of five people will suffer from back pain in their lifetime. For many, it’s debilitating and it impacts their quality of life. Their pain can go on for years without relief. One common cause of low back pain originates from the sacroiliac (SI) joint. The SI joint is located in the pelvis and links the iliac bone (pelvis) to the sacrum (the lowest part of the spine above the tailbone). This joint transfers weight and forces between your upper body and legs. It is an essential component for shock absorption to prevent impact forces during walking from reaching the spine. 44
NSIDE TEXAS MD / MAY.JUNE 2014
SI joint disorders are commonly misdiagnosed in patients with low back pain due to the similarity of symptoms with other spinal conditions such as herniated discs and sciatica. Pain generated from SI joint disorders occurs in varying degrees on one or both sides of the low back. The pain can also be felt in the groin, the hip, the thigh and the buttocks, as well as down the back of the leg. Certain movements or positions can provoke pain in the SI joint. Many people experience pain when sitting and will shift their weight to the opposite side. Moving from a seated position to standing, twisting, climbing stairs, crossing legs, rolling over in bed, getting in or out of the car or lifting may also cause pain.
SI joint disorders affect both males and females, but they are more common in women. Many women experience low back pain during pregnancy when hormones are released to relax and enlarge the ligaments in preparation for childbirth. The growing uterus may stretch or weaken muscles around the pelvis. Added weight and compensatory changes in walking patterns during pregnancy can also place strain on the SI joints resulting in inflammation and pain. For most women postpartum, the SI joints revert to their normal, tightened and locked position. For 20 percent of women, full tightening does not occur and they develop varying degrees of chronic low back pain. Pain in the SI joints can also be caused by age-related degenerative changes, trauma, previous lumbar fusion or degenerative sacroiliitis; they also may be caused by another condition like ankylosing spondylitis. Most people respond to conservative treatments including physical therapy, SI joint injections, chiropractic manipulations and radiofrequency ablations. If conservative therapy fails to provide lasting relief, your doctor may consider surgical options. A new surgical option for the treatment of some causes of SI joint pain is the iFuse Implant System. “The procedure is minimally invasive and only needs a one-and-a-half-inch incision,” Francis explains. “We stabilize the SI joint by surgically inserting three small, titanium implants across the joint to eliminate motion. The iFuse Implant System is intended for sacroiliac fusion for conditions including sacroiliac joint disruptions and degenerative sacroiliitis. The procedure typically takes about an hour and requires one overnight stay in the hospital. Recent published studies have reported promising results for pain relief and a high level of patient satisfaction.”
Richard R. M. Francis, M.D., MBA, offers the iFuse Implant System. To learn more or schedule an appointment, call Spine Associates at 888-977-4625 or visit www.myspineassociates.com. Francis’ Houston office is located at 5420 West Loop, Ste. 2500, South Freeway, in Bellaire, Texas; and his Beaumont office is located at 3820 Pointe Parkway at Folsom Drive in Beaumont, Texas. Note: References are available upon request.
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BENEFITS FOR HEAVY SMOKERS?
After two decades of research, the U.S. Preventive Services Task Force issues recommendation approving lung cancer screening for those most at risk. By: JOHN LYNCH
LUNG CANCER is the leading cause of cancer-related death in the United States. Doctors say it kills more patients every year than breast, prostate and colon cancer combined. With public opinion turning against smoking, smoking banned in public places and a 46
NSIDE TEXAS MD / MAY.JUNE 2014
growing number of companies refusing to hire smokers, many people have been able to kick the habit. However, they may still worry about how much damage all those years of smoking did to their bodies. Lung cancer typically does not cause
symptoms in its early stages. The cancer is often advanced when symptoms do occur. Symptoms such as persistent cough, coughing up blood, wheezing or shortness of breath, recurrent pneumonia or bronchitis, chest pain, hoarseness, weight loss and loss of appetite,
bloody or rust-colored spit or phlegm and fever without a known cause may also be signs of many other lung problems. “After two decades of research, the United States Preventive Services Task Force recently issued its final recommendation approving screening for those at risk for lung cancer,” said Dr. John Rea, a cardiothoracic and vascular surgeon at Memorial Hermann Southwest Hospital. “This recommendation sets the stage for screening and is expected to save tens of thousands of lives.” The Lung Cancer Screening Program at Memorial Hermann Southwest uses an open computed tomography (CT) to help individuals at high risk for lung cancer receive a diagnosis and treatment plan at an early stage when the disease is more treatable and curable. CT lung screening is a noninvasive, painless procedure that uses low-dose X-rays to screen the lungs for cancer. CT lung screening is more sensitive than standard chest X-rays or sputum cytology in detecting lung cancer. Unlike standard chest X-rays, CT lung screening takes cross-sectional images of the lungs. This allows a radiologist to see the lungs from top to bottom. Chest X-rays only show views of the lungs from the front and sides. According to Rea, “the CT lung screening radiation dose from this procedure is less than the average person receives from background radiation in six months.” Screenings at Memorial Hermann Southwest are offered to current and former smokers 50 years of age or older who have smoked the equivalent of one pack of cigarettes a day, and individuals with exposure or family history that increases their risk.
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UP TO 90 PERCENT OF ALL LUNG CANCERS ARE THOUGHT TO RESULT FROM SMOKING.
Up to 90 percent of all lung cancers are thought to result from smoking. In addition to cigarette smoking, daily cigar smoking greatly increases risk. Nonsmokers who have been exposed to secondhand smoke also face an increased risk. Other risk factors include exposure to asbestos, radon or ionizing radiation; lung scarring from chronic infections; and family history of lung cancer. “The most significant risk factor for lung cancer is smoking,” said Dr. J. Georges Youssef, a pulmonologist at Memorial Hermann Southwest. “Even if you have smoked for decades, stopping now can reduce your risk of developing lung cancer. As with other types of cancer, early detection increases a patient’s chance of survival.”
Individuals who are interested in a lung screening should talk with their primary care physician, call Memorial Hermann Southwest at 713-456-4028 or visit www. memorialhermann.org/southwestlung.
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ONE FIGHT, ONE STAND The Life Support Project helps cancer survivors in the Houston area with supportive care, working to ensure that no one has to face the battle against cancer alone. By: JODY JOSEPH MARMEL
NSIDE TEXAS MD / MAY.JUNE 2014
MISTY KELLY IS A YOUNG, energetic woman with a bright future ahead of her. And she is on a mission that is close to home and will help cancer survivors who are fighting for their lives in Houston. During her journey facing cancer with her father, she began to realize that there isn’t always a straight answer to a diagnosis, the treatments available, completing treatments and how the bills inevitably are going to get paid. “I began to realize that the treatments were difficult enough – feeling weak, fatigued, pain, nausea, anemia, infections and the list goes on,” she says. “Those are only a few of the physical side effects, and there is a laundry list of emotional side effects of the diagnosis that range from distress, anxiety, fear, depression, intimacy issues and self-esteem. “It’s extremely difficult for many to maintain the strength through all of these side effects and to have a secondary burden to take care of the daily aspects of life such as working, providing for the family, caring for children or other family members, maintaining their prior lifestyle of sports, hobbies and other activities.
The journey becomes rugged and winding, and it’s not always easy to maneuver alone. I established the Life Support Project to assist with the journey.” The Life Support Project is Kelly’s passion, and at times, she admits that it almost seems to be an infatuation. She explains that cancer is 24 hours a day, 365 days a year – “It never stops, so why should I? I learned from my journey with my dad that so many times, people let time just pass them by and it takes a true crisis to make people realize what is important in life. I realized that what was once coined important no longer mattered, and it was amazing how much extra time became available to spend time helping others.” The Life Support Project’s mission is to assist the community with supportive care. Kelly would like to expand this mission beyond Houston’s boundaries. Ideally, she wants to take it nationwide with partnerships across the United States. One of her main goals is to establish a network of professionals in many fields. These include physicians, nurses, counselors, social workers, patient advocates, financial planners
THE LIFE SUPPORT PROJECT IS THERE FOR THE JOURNEY THE PATIENT MUST FACE UPON DIAGNOSIS.
and lawyers to join in the effort to educate patients about their options regarding treatments, end-of-life planning and financial planning. “I would like to see the medical community provide resources and referrals for many different treatment plans that are available,” she says. “I want holistic providers to show alternative treatments to help build the immune system to be coupled with traditional treatments. There is an endless list, but I am just beginning to get the Life Support Project growing strength here in Houston. Once that is established, I can venture further into Texas.” According to the Data Modeling Branch of the Division of Cancer Control and Population Sciences, at the National Cancer Institute, as of Jan. 1, 2012, nearly 14 million people in the United States alone will become a cancer survivor. “There is no use in fighting for your life if you survive only to find that you lost your house or car and will now be living under a bridge,” Kelly says. “The Life Support Project was established to try to ease that burden and allow the patient and their family to focus on beating cancer.” In late 2013, Kelly officially filed for the Life Support Project; while it was a work in progress, it is now a vision that has turned into a reality that will help hundreds of those diagnosed with cancer. Kelly still has a lot of work to do, and she is developing the project in Houston first, ensuring to establish a system to allow her ideologies to be replicated by other cities. She wants to set up teams in several large cities in Texas, including Amarillo, Lubbock, Dallas, Austin, El Paso, Arlington, Plano and Garland, San Antonio, Corpus Christi and Harlingen. To date, past events include the Third Annual Darkside Extravaganza, an annual anniversary party for popular Houston tattoo shop, Darkside Body Art. Ac-
cording to Kelly, “They allow the Life Support Project to set up a booth to accept donations and promotion of the resources and benefits provided through the organization, as well as future events.” The Rock Out for Kids Toy Drive was a huge hit in December 2013. The Life Support Project, along with Mike Kehoe, host of “On the Road with Old School Mike” with Dead Dave’s Radio and magazine, and Destany Ramirez of Houston Rock TV, hosted the drive. “This was an amazing opportunity to give back to the children that are fighting just to stay alive,” Kelly says. The event, along with interviews with the bands and attendees, was photographed and filmed for release on Dead Dave’s Radio and Houston Rock TV. The toys were distributed between two Texas Children’s Hospital locations: the main campus on Fannin Street and the west campus in Katy. Approximately $7,000 worth of toys was donated to the two locations. More events are planned, and more money is being raised to help patients and their families. Darkside Metal Madness was an amazing event on Nov. 2, 2013, hosted by John Janatsch of No Cover Houston and Gsptv Houston. The event featured raffles and silent auctions, and several metal and alternative bands from the Houston area came out to support the cause. Some of the bands included were Long Point, Havoc Wagon, EPIC, Born From Ruins, The Black 13 and Day of Reckoning with Rusty Cooley. Kelly says this year’s event is already being planned for Nov. 8, 2014. The Life Support Project is available for patients and their individual needs. “It is not set up solely for cancer awareness or even the cure of cancer,” Kelly says. “It is there for the journey the patient must face upon diagnosis. One fight, one stand! Nobody should have to battle this alone.”
For more information on the Life Support Project, visit www.thelifesupportproject.org or www.facebook. com/thelifesupportproject, or follow @LIFESUPPORTPROJ on Twitter. You can also email firstname.lastname@example.org or call 281-570-8664.
MAY.JUNE 2014 / NSIDE TEXAS MD
ROLL OUT THE RED CARPET A new kind of home care By: KARIE SPELL, RN, BSN
NSIDE TEXAS MD / MAY.JUNE 2014
STATISTICAL DATA demonstrates that 39.6 million people in the US are 65 years old or older. This number will increase to 72.1 million by 2030 according to Health and Human Services, Administration on Aging. With an aging population, comes the probable need for assistance in day to day non-medical activities. These needs may be as minimal as standby assistance while the client plays a game of golf or goes on a shopping excursion; or as maximal as 24 hour, around the clock care for patients that are unsafe to be alone or need constant assistance with activities of daily living and anything in between. This population and their families are more resourceful and educated on service options, than any other era of consumer. They demand a different type of a home care service organization, one that truly provides customer service and rolls out the red carpet for every client. What is home care? It is a service provided by a licensed organization that provides non-medical care to clients in a variety of settings. This care assists the client with activities of daily living as well as activities in general. These services are generally paid for out of pocket by the client or family. Occasionally there may be a long term care insurance policies that cover the cost of these services, but that is becoming less and less common. Currently, the types of services being provided by home care organizations are very standard and traditional convalescence care. The changing mindset of the consumer demands something different. The fact that the majority, if not all, of these services are paid for out of pocket by the client, changes the rules. The client has higher expectations of the type and quality of the services they are receiving. The client expects the red carpet treatment because they are important. Every client should feel and be treated as if they were the most important client to the home care organization. These expectations are requiring home care providers to change not only their menu of services but also the way in which they provide them. Today is a consumer’s market, and service providers must sell what the consumer is buying, not what they are selling. Having the information highway at their fingertips, in their pockets and on their desks, gives the consumer immediate data on home care organizations and helps them compare and choose which entity is the right fit for them. In the past, most home care services provided have been somewhat restrictive, generic, and otherwise status quo. Home care organizations have expected the client to adapt to their service model instead of creating a tailored, “VIP”, concierge or red carpet model for every client. Clients expect and are paying for a great customer service experience. What is customer service? It is a buzz phrase that consumers are inundated with at every turn. No matter what the product or service industry, customers are solicited to participate in surveys to report on their experience. The funny thing is all customers are
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asked to give the top score regardless of that experience. It seems that organizations just want to live with the facade that they are great customer service deliverers regardless of the real quality of service they provided. The definition of customer service includes ensuring customer satisfaction. Organizations need to work diligently from the beginning of the experience and make changes as necessary throughout the entire process, not just “talk” about customer service at the end of that experience, as an afterthought. Home care organizations must provide the service and experience that makes every client feel like they are the most important individual receiving their services. The client’s service plan must be tailored not only to meet their needs, but to meet their expectations. This experience will set them apart from the rest of the pack and ensure a lasting service product and true customer satisfaction. To quote Maya Angelou “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Home care organizations must roll out the red carpet and provide their clients with the care they are buying. Clients should “feel” the experience every single time.
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EVERY CLIENT SHOULD FEEL AND BE TREATED AS IF THEY WERE THE MOST IMPORTANT CLIENT TO THE HOME CARE ORGANIZATION.
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KEEPING IN MIND Dr. Jose Igoa speaks on behalf of National Mental Health Awareness Month SPECIAL TO TEXAS MD
EACH YEAR the month of May marks National Mental Health Awareness Month, a time to increase public awareness about mental illness and its related issues. In the United States, one in four adults and one in five teenagers (ages 13 to 18) experience mental illness. Healthcare professionals assert that half of mental illnesses begin by the age of 14, with three-quarters appearing by age 24. Unfortunately, many years pass between the first appearance of symptoms and when most people get help—less than one-third of adults with a diagnosed illness receive treatment! Dr. Jose Igoa, medical director of the Renaissance Behavioral Center, believes that everyone should know about the nature of mental illness and symptoms of different conditions. By observing Mental Health Awareness Month, we are given the opportunity to learn more about serious illnesses such as depression, bipolar disorder, schizophrenia, and ADHD. This year’s Mental Health Awareness Month theme is “Mind Your Health.” The aim is to build public recognition about the importance of mental health to overall health and wellness by informing people of the ways that the mind and body interact with each other. Dr. Igoa spoke with us about the positive actions people can take to protect mental health and promote whole health. WHAT DOES IT MEAN TO HAVE A MENTAL ILLNESS?
Mental illness is a handicapping, limiting condition. To have a mental illness is to have an affliction that causes distress or that impairs your ability to function. Mental illnesses affect a person’s thinking,
NSIDE TEXAS MD / MAY.JUNE 2014
feeling, behavior, mood, and daily functioning. Mental illnesses often result in the diminished capacity of coping with the demands of everyday life. Mental illnesses fall along a continuum of severity. Early identification and treatment of the illness is extremely important. By receiving treatment, further harm caused by the illness is minimized.
WHAT CAUSES MENTAL ILLNESS?
Through research we have found that mental illness is caused by a combination of factors—biological, psychological, and environment factors all play a part in mental illness. Many mental illnesses are genetic and passed down from family members. Environmental triggers also cause the onset or manifestation of mental illnesses—there is the combination of nature and nurture.
CAN MENTAL ILLNESS BE PREVENTED?
Many mental illnesses are caused by a combination of factors and cannot be prevented. But, the illness can often be minimized or suppressed by living a balanced lifestyle. I usually tell my patients that dealing with life is like sitting in a chair, the chair has four legs that hold you firmly. Those four legs represent the needs that we must address in our everyday life – physical needs, emotional needs, social needs, and spiritual needs. We must balance each of these needs and meet those needs as much as possible so that we are better able to handle stress.
HOW COMMON IS MENTAL ILLNESS?
Mental illness is more common than we like to think or believe. Mental illness can affect persons of any
age, gender, race, religion, or income/ social status. For example, the lifetime prevalence of depression is 15-20%, which means that 1 out of every 5 people you see on the street has had, does have, or will have depression. The U.S. Surgeon General estimates that 23% of American adults, or about 44 million people, suffer from a mental illness during any given year. But, only 6% of Americans suffer from a serious mental illness (one that significantly interferes with function). Unfortunately, there is a stigma attached to mental illness, which causes misinformation and misunderstanding. In reality, mental illness is a common illness, no different from heart disease or cancer. We are the stage where cancer was 60 years – people were afraid to talk about cancer or even say that word, we would call it “CA”. Now, there are walks and awareness campaigns for all forms of cancer. I hope that one day soon we can have such awareness and education for mental illnesses. We should be more open about discussing mental illness; it does not spare anyone, it can affect persons at any age, of any race, and of any socioeconomic status. Mental illness can affect anyone, and for that reason we should be more ac-
“MENTAL ILLNESS CAN AFFECT PERSONS OF ANY AGE, GENDER, RACE, RELIGION, OR INCOME/ SOCIAL STATUS.”
cepting of these diseases, willing to recognize them early on and receive treatment, and prevent suffering. What are some of the warning signs of mental illness? Early warning signs included distress, anxiety, inability to cope or function, confused thinking, inability to concentrate, memory lapses, and extreme highs and lows in mood. Other warning signs include social withdrawal, long-lasting irritability, dramatic changes in eating or sleeping habits, extreme anger, delusions or hallucinations, thoughts of suicide, denial, and the abuse of drugs and/or alcohol.
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WHAT TREATMENT OPTIONS ARE AVAILABLE FOR MENTAL ILLNESS?
There are various types of treatment options available for mental illness. Options include psychotherapy and behavioral therapy, such as office visits with a physician, counseling, support groups, and day treatment programs, medication alternatives, interventional treatment options, such as transcranial magnetic stimulation or electroconvulsive therapy, and hospitalization.
WHERE CAN I FIND HELP?
If you notice some of the early warning signs of mental illness, your first step should be to consult with your primary care physician. He/she can evaluate whether or not you need further treatment. You can also call the Renaissance Behavioral Center to speak with any one of our licensed professionals. They are available day and night at 956-362-HELP (4357). Describe the importance of mental health as it applies to a person’s day-to-day activities.Mental health is so important to a person’s day-to-day activities. Mental health strengthens us and supports our ability to create and maintain healthy relationships, make
good life choices, maintain physical health and wellbeing, handle the natural ups and downs of life, and discover and grow toward our potential.
EXPLAIN THE LINK BETWEEN MENTAL HEALTH AND OVERALL WELL-BEING (PHYSICAL HEALTH).
Mental health and emotional well-being is essential to your overall health. Positive mental health allows you to realize your full potential, cope with the stresses of everyday life, and be productive. Mental illness can have adverse effects on physical health as well as impair self-care and adherence to treatment for other medial illnesses. For example, people with both diabetes and depression have a greater chance of experiencing an increased number of complications as compared to those diabetics without depressions. Another example is that depression is common among people with coronary heart disease, which is especially dangerous because it nearly triples the risk of dying from heart disease. Left untreated, mental illness can cause unnecessary suffering and pain but effective treatment can prolong survival and increase quality of life.
WHAT ARE SOME TIPS FOR IMPROVING ONE’S MENTAL HEALTH?
Work to find a balance between your emotional, physical, social, and spiritual needs. Taking care of your body is a powerful step toward improved mental health. Tips for improvement include: get enough rest, practice good nutrition, drink plenty of water, exercise, spend time outdoors, and avoid alcohol, nicotine, and other drugs. Also, pay attention to your needs and feelings, don’t let stress and negative emotions build up. Pursue ac-
tivities that naturally release endorphins and contribute to feeling good, such as doing things for others or volunteering, practicing self-discipline, taking a new class or starting a new hobby, and spending time with others (in person, away from the computer or phone). When you become stressed or worried, try meditating or other relaxation exercises, or try connecting spiritually through prayer. Counteract stress by setting realistic goals—aim high but be realistic and don’t spread yourself too thin. You will enjoy a great sense of accomplishment and self-worth as you progress toward your goal if you set smaller goals along the way. Finally, do not be afraid to ask for help. Seeking help is a sign of strength, not of weakness.
WHAT IS THE MOST IMPORTANT TIP YOU WOULD LIKE TO PROVIDE FOR OUR READERS?
Do not suffer in silence. There are so many support and treatment options available; all you have to do is ask for help. Mental illness is not something to be ashamed or scared of. There are numerous tools at your disposal and we are here to help. Dr. Jose Igoa is a licensed psychiatrist in four different countries and currently serves as medical director of the Renaissance Behavioral Center. Dr. Igoa is also a distinguished Fellow of the American Psychiatric Association, a Member of the Royal College of Psychiatrists of England and a Fellow of the Royal College of Physicians and Surgeons of Canada.
For more information about mental health awareness, or to schedule an appointment, call the Renaissance Behavioral Center at 956-362-HELP or visit www.dhr-rgv.com. MAY.JUNE 2014 / NSIDE TEXAS MD
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IT TAKES A VILLAGE TO COMBAT OBESITY According to Dr. Sveta Singh, physicians, patients and even politicians play important roles in dealing with the obesity epidemic.
WHAT IS OBESITY, AND HOW COMMON IS IT?
Obesity is defined as being more than 30 percent over an ideal weight based on gender, height, age and build, and it is an epidemic in American society. Obesity can increase some health risks. No one person can combat obesity. As the epidemic spreads, there are projections of 50 percent of Americans being obese by 2030. Obesity is a vicious cycle in American society. It is a symptom of problems in our society. With today’s extremely fast-paced lifestyles, and with both parents often required to work to make ends meet, the result is that people get no exercise, eat out three or more times per week for convenience, maintain intense stress levels with no outlet for that energy, develop irregular sleep patterns and often fail to do the simplest things such as drink enough water. The inevitable result of this cycle is the creation of a lifestyle that makes it easy for people to gain weight, and in turn, for our children to learn these behaviors from us. The discord between learned/lived
behaviors and the popular media depiction of the ideal man/woman only further the negative psychosocial impact, adding to the cycle. The epidemic calls for participation at every level to break this cycle.
HOW CAN PHYSICIANS HELP THEIR PATIENTS LIVE HEALTHIER LIVES?
We, as physicians, can take a leadership role in helping people take an active role in their own health because they are worth it, and because their lives – and their children’s lives – may ultimately depend upon their attitudes about themselves and their levels of self-esteem. We are in the position to guide our patients to make self-care a priority, and to encourage them to boost their children’s self-esteem and take a hands-on approach to teaching their children proper self-care (i.e. modeling behavior known most effective). This does not necessarily mean lecturing them on losing weight. Just five minutes of stretching can have extremely positive mental and psychological effects that equal or override the physical effects of the
activity. But it does mean we can encourage them to feel good about themselves now, as they are, and educate them on developing a healthy lifestyle that may help them lose weight, and that will improve the quality of their lives even more. I think so often of what grandfather said: “Healthy mind, healthy body.” A healthy mindset will do a great deal in determining overall body health; conversely, a healthy body will do wonders to improve mental health. Many times, obese patients present with fatigue and depression. Depressed patients are less likely to eat healthy, exercise and engage in life. It is often difficult to know which came first. We can guide them and begin to educate them on simple, healthy habits they can work into their lives. As they see the impact in their lives, they will search further, too. It is our job to start the spark. As physicians, it is our role to encourage our overweight and obese patients, and even to get them excited, about proper self-care and healthier lifestyles. As physicians, we can work together with our
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OBESE PATIENTS OFTEN PRESENT WITH FATIGUE AND DEPRESSION.
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patients to help them first think in a more healthy way, to counsel them on the impact these changes will have on their lives and to guide them toward a healthy lifestyle that will allow them to lose weight and make good choices. Remember Richard Simmons? His pure sense of joy at losing a large amount of weight was contagious as he transformed himself into a fit celebrity. And what about his energy level?
OBESE SEINOR WOMAN, JAN MIKA/SHUTTERSTOCK.COM PHOTO OF DR. SVETA SINGH BY MARK HUMPHRIES
HOW IMPORTANT IS EDUCATION IN COMBATING OBESITY?
Education for overweight and obese people goes a long way. For example, first-time mothers must be educated that large amounts of weight gain are not the norm for pregnancies. Also, the elderly population should be taught that weight gain is not an inevitable condition of growing older. Fitness can be maintained at any life stage and during any life event such as pregnancy. The Centers for Disease Control has a plethora of public information on its website, links to related websites and statistics to help educate us, as physicians, as well as our patients. In addition, we, as physicians, can help educate and encourage patients to initiate simple changes in family lifestyles such as deleting fruit juice from the diet (a move that will also improve dental health, especially among children) and sitting at the dinner table to eat meals. Just sharing meals together as families can help change the general cultural mindset about food and eating.
HOW DO WE, AS DOCTORS, DEFINE AND HELP PATIENTS FIND A HEALTHY LIFESTYLE THAT WORKS FOR THEM?
I am a vegetarian, but I am not advocating that everyone rush out and become vegetarian or vegan. I choose this way of eating because it is best for me. But people have to know themselves. Not every program of exercise or type of diet is right for every person.
But if people keep looking and keep trying to learn about themselves and their habits and preferences, with their physiciansâ€™ guidance and encouragement, they will find a solution to help them improve their health. A huge initial financial investment is not necessary to begin a fitness program once patients are approved to exercise by their physician. Each of us must find an exercise routine to which we are committed. Then people can think about joining a gym or buying a piece of fitness equipment, once they have established their commitment to fitness. The biggest initial investment all of us must make to combat obesity is showing interest in our own health.
DO YOU HAVE ANY FINAL THOUGHTS ON OBESITY?
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Obesity does not have to be a permanent state. I have seen lovely cases of people losing weight in a healthy way and keeping it off. A healthy lifestyle does not have to be extreme. We can all begin by making small changes, then fine-tuning these changes to fit our lifestyles and preferences. With physicians taking the lead, we can help obese patients find their own road, find what works for them and begin to improve their lives, starting with a healthy attitude and mind, which is ultimately the source of a healthy body. Sveta Singh, D.O., M.S., is a board-certified family practice physician at Westover Hills Clinic, located at 3903 Wiseman Blvd., Ste. 100, San Antonio, Texas 78251. For more information or to make an appointment, call 210-681-0126.
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CERVICAL CANCER IS THE THIRD MOST COMMON TYPE OF CANCER IN WOMEN WORLDWIDE.
WHAT IS CERVICAL CANCER?
Cervical cancer is a cancer that forms in the tissue of the cervix, which is found where the uterus and vagina meet. Cervical cancer is the third most common type of cancer in women worldwide, with an estimated 300,000 deaths annually. In 2011, the United States saw more than 12,000 new cases of invasive cervical cancer and more than 4,000 cervical cancer-related deaths. Human papillomavirus (HPV) is the most common cause of cervical cancer. HPV is a group of viruses, some of which are associated with changes in or cancer of the cervix.
WHAT ARE RISK FACTORS FOR CERVICAL CANCER?
Infection with HPV is the most common risk factor for cervical cancer. Other risk factors include: • Early onset of sexual activity • Multiple sexual partners • Cigarette smoking • Poor nutrition • Oral contraceptive use • Immunosuppression • Low socioeconomic status
THE BEST DEFENSE AGAINST CERVICAL CANCER For women, proactive testing for cervical cancer is an important part of regular wellness checkups. A few minutes in the office of your primary care physician or OB/GYN can prolong your life. By: DR. DAISY RAMIREZ-ESTRADA
NSIDE TEXAS MD / MAY.JUNE 2014
With early stages of this cancer, you most likely will not have any signs or symptoms. That is why it is so important to screen for cervical cancer with Pap tests, which can detect changes in cervix cells. Locally advanced disease may present with abnormal vaginal bleeding, discharge, pelvic pain and bladder, renal or bowel obstruction.
WHEN SHOULD A WOMAN SEE HER DOCTOR AFTER SHE BEGINS TO NOTICE ONE OR MORE OF THESE SIGNS?
If a woman is having any of the signs or symptoms previously described, she should see her doctor immediately. Most women should start getting a Pap test when they turn 21. Frequency will depend on age and previous Pap test results. In general: • Women ages 21 to 29 should have a Pap test every one to two years. • Women can switch to every two to three years between Pap tests after they turn 30 and have three normal Pap tests in a row and a normal HPV test.
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WHAT ARE SIGNS OR SYMPTOMS OF CERVICAL CANCER?
PHOTO OF DR. DAISY RAMIREZ-ESTRADA BY MARK HUMPHRIES
It is very important that all women 21 and older who have a cervix get cervical cancer screening at their primary care or OB/GYN clinic regularly, based on their physician’s recommendation. This is the only way for your doctor to detect and treat early stages of cervical cancer. I offer screenings every year to all my patients who meet the criteria for a Pap test.
Depending on the results, your doctor might order an HPV test, do another Pap test six to 12 months later or do a test called colposcopy, which allows your doctor to look at the cervix with a microscope and take tiny samples of tissue from the cervix.
SHOULD A WOMAN VISIT HER GP FIRST OR GO DIRECTLY TO SEE HER OB/GYN?
Cervical cancer is usually a slow-growing cancer, but it is important to get regular cervical cancer screenings as recommended by your doctor. With regular screenings, your doctor will be able to detect abnormal cells early, so she or he can perform surveillance or treatment before the disease progresses to an advanced stage.
Patients may get a Pap test at either their primary care physician’s clinic or at their OB/GYN’s office. The important thing is that a woman gets it done.
HOW IS CERVICAL CANCER DETECTED?
Every woman over 21 should start getting a cervical cancer screening. We do this by performing a Pap test, sometimes called a Pap smear. The purpose of this test is to collect cells from the cervix and send the specimen to a pathology lab, where it will be examined for the presence of any abnormal cells. Pap tests can find cancer cells or precancer cells. Precancer cells that are not treated may turn into cancer over time.
WHAT DO YOU DO IF YOU HAVE AN ABNORMAL PAP TEST?
Pap tests are an initial screening test, and most women with abnormal Pap tests do not have cancer.
States for children 9 and older and adults 26 years old or younger.
For more information on the BHS Physicians Network, go to www.bhsphysiciansnetwork.com or email Julie Minnick email@example.com.
HOW QUICKLY DOES CERVICAL CANCER DEVELOP?
HOW IS CERVICAL CANCER TREATED?
If there is cervical cancer or precancerous cells present, the treatment depends on the staging of the disease.
WHAT ARE PREVENTATIVE MEASURES TO PROTECT AGAINST CERVICAL CANCER, IF ANY?
Cervical cancer can be caused by HPV infection. Getting an HPV vaccination reduces your chances of contracting cervical cancer, but it does not completely protect you. Therefore, you still need the Pap test. The HPV vaccine is currently recommended in the United
Daisy Ramirez-Estrada, M.D., is board certified in family medicine. She can be reached at Medfirst-Northeast Primary Care, located at 2130 NE Loop 410, Ste. 325, San Antonio, Texas 78217. The phone number is 210-653-2693.
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We have clinics downtown and in the medical center, and we accept most major health plans. Go to www.UTKids.org to find the information you need to refer a patient or schedule a consultation.
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loving AGAIN ROBERT FARRAR'S HEARTWARMING JOURNEY By: KELLY HAMILTON Photography: ROBIN JERSTAD
NSIDE TEXAS MD / MAY.JUNE 2014
ith moist eyes, Robert Farrar shares a love story that started in childhood. The little girl next door unknowingly stole his heart when he was 10 years old. They lived an alley apart but from the day he saw “the prettiest little girl ever”, he knew she would be his. Time passed, they lost each other but a teenage party brought them back together and from that day they were a couple. Married six months after they reunited, 56 years together and four children later, their earthly story came to an end in 2006 but his love for her lives on. Farrar joined the Marine Corps Reserves in January 1949 prior to marrying his wife, Joann Young, and in June of the
same year, weeks after their wedding, he was called to move from their home state of Missouri to California where they would live for the next 25 years. Serving three years as a radar operator for the Reserves, Farrar began his lifelong career as a meat cutter. In 1960, the Farrars moved to the San Pedro area of California, just south of Los Angeles and went into business for themselves running Farrar & Sons meat markets in grocery stores. Farrar would take over an existing meat market, build it up then sell it to someone else. Being in business for 25 years honed Farrar’s keen ability to remember his customers’ names. To this day, it is still a talent for which he is known in his community at Independence Hill Retirement Community.
As the owner of his own business, Farrar’s dedication to his business and his clients reached an all-time high on a day when two employees were out sick and he was managing things alone. On this particular morning, he suffered an unfortunate mishap with the meat cutting machine. Unable to leave work, Farrar securely wrapped and gloved his severed finger and continued on with his work day until late evening when he could go to the doctor for medical attention. Fortunately, the doctor was able to reattach the digit and Farrar has full use of it to this day. Farrar acknowledges that he got lucky on a couple fronts. First, his wife had no idea how severe the injury was so she couldn’t interject, and second, the doctor was able to sew him back together with no further complication. Farrar laughs as he tells the story and carries on explaining that after decades in the business, that was his only major mishap with the saw. His oldest boy wouldn’t stay away from the saw, ultimately cutting his thumb off when he was 14. Farrar wrapped up the thumb, took his boy to the hospital and next thing he knew he woke up on a gurney. He could handle seeing any number of mishaps with his employees over the years but couldn’t deal with the trauma when it was his own child. Because of that experience, his son became fascinated with emergency rooms, volunteered a day a week in hospitals, went into a medic position in the military and is now a lab administrator for VA Hospitals in San Antonio. It seems the saw redeemed itself as it facilitated Farrar’s son finding his life’s passion from that unfortunate blade.
“THE HEART THAT LOVES IS ALWAYS YOUNG.” After 25 years in business, the Farrars packed up and moved back home to Missouri in 1984 where they lived out their marriage together until Joann’s passing in 2006. With his eldest son residing in San Antonio, Farrar left Missouri in 2009 to be close to his son. He settled into town on a
Saturday and met his new bride Marie that next day at church services. Seemingly given a second chance at love, Robert and Marie married in Hawaii nine months after they met. Both having grown children, no one could agree on how the ceremony should proceed, so the Farrars decided for everyone that they would spend their ceremony and honeymoon together in the islands and celebrate with family and friends upon their return home. Much ado was made about the “quick” dating and “why so soon” engagement timeline to which both Robert and Marie laughed and said, “It’s not like we’re getting any younger!” The Farrars have resided at Independence Hill Retirement Community for two years now and are active Bridge players and dinner socialites with their family of neighbors. His humble spirit is a joy to be around and is bolstered by Marie’s love and support. They both enjoy social time at dinner with their new “family” where Farrar’s name recall amazes people daily. He smiles broadly when announcing that he knows over 200 of his Independence Hill family member’s names. As dedicated to their faith as two people can be, they attend church regularly at Park Hills Baptist and proclaim their love for Jesus Christ. Farrar enthusiastically states that “God is good all the time and all the time God is good.” Together, they enjoy their cozy cottage at Independence Hill where they love to sit together to read such books as O’Reilly’s “Killing Jesus.” An impressive feat, Farrar read through his Bible twice last year and knows at least 200 verses by heart. The book of John speaks most strongly to him in that John was the last one to see Jesus and was the last one to write about Him. “The closeness that they shared just speaks to me and there’s just something about him and the love he had for our Christ.” There’s a palpable spirit of love that lives inside the home of Robert and Marie Farrar – the joy of friendship and the blessing of having another day together with family and friends.
For more information on Independence Hill Retirement Community please visit www.independencehill.com or call 210-6154000. MAY.JUNE 2014 / NSIDE TEXAS MD
SAN ANTONIO // PATIENT
IN PERFECT HARMONY Inside the world of rhinoplasty
RHINOPLASTY, or surgery of the nose, is considered one of the most demanding and exacting plastic surgery procedures. There is really only one opportunity to achieve an outstanding result. Secondary procedures to correct a previous rhinoplasty are much more difficult. Rhinoplasty deals with surgery of the nose to enhance the appearance of the nose, to improve the function of the nose or both. The world of rhinoplasty deals in millimeters. A 1-millimeter elevation of a tip or a 2-millimeter deviation of the bridge can dramatically change the appearance of the nose. Add to that the variables of too thick or too thin skin and the firmness – or lack thereof – of the underlying cartilage, and you can have a For more information lot of unpredictability in terms of healing. on Jaime R. Garza, M.D., DDS, P.A., or rhinoplasty, Rhinoplasty surgery is not only an operation of the nose, please visit www.garbut also the artistic and surgical ability of the surgeon zaplasticsurgery.com or to bring the entire face together in harmony. The call 210-616-0301. outside of the nose is divided into the bridge, the tip and the base of the nose. The nose should be designed to fit the individual face of each patient. There is no “cookie cutter” operation that will give an outstanding result on each and every patient. I tell all of my patients that I believe the function of the nose is to “sit quietly in the middle of the face and not draw attention to it,” but to allow the viewer to focus on the patient’s eyes. The nose is just one component of the face, and it is important that it is in balance with the rest of the face. Often, patients will complain that their nose is “too big.” Sometimes it is a small chin that gives the illusion that the nose is too big. The treatment is usually a simple chin implant, followed by a more conservative rhinoplasty than originally planned. The chin in proper anatomic position and a nose that blends in brings balance to the entire face. The surgeon must have not only a mastery of the aesthetics of the nose, but also a mastery of its functional aspects. One of the dangers of performing a rhinoplasty for aesthetic purposes and not taking into consideration the functional needs of the nose is that the surgeon may create a nasal “cripple.” That is when the nose looks better, but the patient is unable to breathe through it properly. Function should always trump aesthetics in rhinoplasty surgery. Nasal surgery takes about one or two hours to perform; recovery is within two to eight weeks. By two weeks, most patients have a very pleasing appearance to their nose; by three months, it’s even better. I tell my patients they will probably not see the final result until 12 months after surgery. Choose your surgeon carefully, and always make sure you see a multitude of the surgeon’s one-year postoperative results to get a sense of his or her artistic abilities. Rhinoplasty is an incredibly rewarding experience for a surgeon who is dedicated to the art of nasal surgery, and it is truly a lifelong pursuit.
ABOUT DR. JAIME GARZA
Jaime R. Garza, M.D., DDS, P.A., is an active member of the Rhinoplasty Society, which consists of the top surgeons throughout the world who specialize in rhinoplasty. Surgeons must undergo an extensive screening process and be voted in by their peers in order to be part of this nonprofit organization. As the most respected nasal surgeons in the world, they are considered innovators in their field who are deeply committed to aesthetic and reconstructive nasal surgery.
NSIDE TEXAS MD / MAY.JUNE 2014
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WHY THE CONTROVERSY?
MAMMOGRAMS: MORE HARMFUL THAN HELPFUL? A new study questions the benefits of the annual mammogram. By: DR. EVANGELINE K. RAMOS-GONZALES
WITH NEW MEDICAL STUDIES
and findings being published every day, it can be challenging to cipher through all of the information to determine what is best for you. One recent study addressing the necessity of annual mammograms challenged what physicians traditionally recommended for women’s wellness management. On Feb. 2, 2014, the Swiss Medical Board released a report to the public stating that regular screening mammograms reduce the mortality rate from breast cancer slightly while significantly increasing the rate of psychological stress, additional exams and potentially unnecessary treatments associated with false positive readings and detection of “non-life threatening” breast cancers. Based on their findings from data collected from 1963 to 1991, the board recommended that all current mammogram screening programs in their country be given a time limit for existence after which no new mammogram programs should be created. I caution women to be careful when
NSIDE TEXAS MD / MAY.JUNE 2014
they read articles like this on the Internet or see stories in the media that make such controversial statements. Not all research studies are created equal, and few people know how to determine if a study’s findings are statistically significant. The reality is that the combined data from all previous clinical trials on screening mammograms show that the death rate for breast cancer is reduced by 15 to 20 percent when regular screening mammograms are performed. Not only does early detection of breast cancer via screening mammograms save lives, but it also allows less invasive, toxic and disfiguring treatments. Like any screening test, mammograms are not diagnostic. They are designed to be sensitive enough that they detect the majority of cancerous breast lesions present and specific enough to minimize false results. Additional imaging or biopsies may be recommended based on abnormal screening results. A mammogram is currently the standard of care for breast cancer screening, and the technological advances
The debate over the benefit of having screening mammograms done is one that will likely go on for decades to come. The Swiss Medical Board feels that the increase in additional studies and needle biopsies associated with screening mammograms is not worth the extra one or two lives saved per 1,000 from breast cancer, but the pain and suffering endured for a breast biopsy is nothing compared to the pain, suffering and loss of quality of life a woman goes through if breast cancer is allowed to progress until it is so large that it has metastasized and is causing severe pain. Many women convince themselves they are at low risk for breast cancer because they do not have a family history of it. The reality is that the majority of breast cancer diagnoses are made in women who have no family history. Obesity and diets poor in fruits and vegetables are some of the biggest risk factors for developing breast cancer. Women with a BMI of 30 or higher are also in that category.
HOW OFTEN ARE MAMMOGRAMS NECESSARY?
The American College of Obstetrics and Gynecology (ACOG) recommends women begin having annual screening mammograms at age 40. Between mammograms, women should practice breast self-awareness, which is understanding the normal appearance and feel of their breasts. With improved selfawareness, women can report abnormal changes to their physicians.
SO HOW DO YOU PERFORM A SELF-EXAM?
A breast self-exam is performed in a
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systematic way so all of the breast tissue is evaluated on a regular basis (usually monthly). The best time to perform this exam is immediately after a menstrual cycle or on the same date of the month for a menopausal woman. Women can examine themselves while in the shower or lying in bed. One arm needs to be elevated above the head to stretch the breast tissue against the chest wall. The pads of the fingers from the opposite hand then examine the breast tissue in a circular pattern making smaller circles until the nipple is reached and gently squeezed to check for discharge. The fingers are not to be lifted while performing the exam so as not to miss an underlying mass. If a mass is present, it will stop the smooth movement of the fingers once it is encountered. The axillary area also needs to be examined for enlarged lymph nodes, which would feel like marbles.
WHAT SHOULD WOMEN DO FIRST?
While it is undeniable that early detection from breast screenings reduces the mortality rate from breast cancer, the decision is ultimately up to each individual woman. The first step a woman should take to decide if she needs a mammogram is to make an appointment with her physician for her annual exam. Her physician will then review her family and personal history, perform a breast exam and work with her to determine if an annual mammogram is recommended. At the Institute for Women’s Health, we hear concerns about women’s health studies from patients frequently. The best response to these is to take them with a grain of salt and visit with your physician for counseling on recommendations for annual clinical breast exams, instructions on self-exams and education on breast self-awareness.
Dr. Evangeline K. Ramos-Gonzales, Obstetrics and Gynecology, Institute for Women’s Health, received her medical degree from the University of Texas Southwestern Medical Center in Dallas. She completed her residency training at Texas Tech University Health Science Center in El Paso. Ramos-Gonzales is board certified by the American Board of Obstetrics and Gynecology, and she is a member of the Texas Medical Association and a fellow of the American Academy of Obstetrics and Gynecology. She is married and has three children.
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being made in mammography are amazing. Those advances are making reading the films much easier and improving detection of smaller masses.
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ARTERIAL MOVEMENT Expert guidance on heart health SPECIAL TO TEXAS MD
DR. TERESA A. CRUTCHLEY graduated with honors from the University of Nevada where she received a Bachelor of Science in biology. From there, she received her medical degree from the University of Nevada School of Medicine. She completed both her internship and general surgery residency at the University of Texas Health Science Center at San Antonio. She then completed her fellowship in vascular surgery at Wake Forest University Medical Center in North Carolina. Dr. Crutchley has many professional affiliations including the American Medical Association, Southern Association for Vascular Surgery. She is board certified in both vascular and general surgery and is a fellow of the American College of Surgeons. She is also the AngioScreen medical director at Southwest General Hospital and chief of surgery at Methodist Texsan Hospital, a campus of Methodist Hospital. Dr. Crutchley specializes in vascular surgery and uses both open and minimally invasive techniques. This has allowed her to develop relationships with the patients she serves, as well as help them tremendously with their healthcare needs. She believes in educating her patients about preventive care and managing existing conditions in order for them to make informed decisions about their health. One specific method Dr. Crutchley stands behind is the AngioScreen. The AngioScreen is a mobile carotid artery ultrasound screening for artery blockage, which includes tests of ankle brachial index, blood pressure, heart rate, heart rhythm and body mass index. The screening process requires two medical assistants to accompany the screening van and assist participants, while a registered vascular technologist (RVT) perform the screenings. “RVTs have national credentialing,” said Dr. Crutchley. “They are highly specialized in what they do. When screenings are performed by people without a sound understanding of the blood vessels, they can have significantly altered results leading to missing a disease the patient has or ‘finding’ a disease that the patient actually does not have.” While not diagnostic in nature, these screenings can indicate risk factors for a variety of cardiovascular conditions, such as stroke, heart attack and peripheral arterial disease (PAD). “They check the carotid arteries for plaque buildup and test the legs for peripheral arterial disease,” said Dr. Crutchley. “Even patients who do not have blockages in their arteries may be surprised to learn how high their blood pressure and BMI are. It’s a good program for raising people’s level of understanding about 68
NSIDE TEXAS MD / MAY.JUNE 2014
“WHEN SCREENINGS ARE PERFORMED BY PEOPLE WITHOUT A SOUND UNDERSTANDING OF THE BLOOD VESSELS, THEY CAN HAVE SIGNIFICANTLY ALTERED RESULTS.” PAD, aneurysmal disease and health in general.” Numerous factors make the mobile vascular screening program an excellent option for individuals and organizations. AngioScreen is non-invasive and requires very little time, so it is a convenient way for people to learn more about their vascular health. If the van comes to a workplace, coordinators can work with the employer to schedule screenings during workers’ breaks. The entire appointment takes 20 to 30 minutes, and, by the time the screening participant is ready to leave the van, his or her images are ready. Techni-
cians take time to explain results. If any areas come back positive, they recommend the screening participant follow up with a primary care physician and can refer them to a list of local providers if they do not have one. Dr. Crutchley believes it is important to expand health awareness to the people across south Texas. She has seen the risk factors for cardiovascular disease, with the exception of smoking, increasing among Texans. With blood pressure rates on the rise coupled with high cholesterol and obesity, it is more important now than ever to educate the public about the importance of heart health. Many people in south Texas lack health insurance and access to health care, meaning they have few opportunities to discuss their health with a provider or take steps to reduce their risk. “Patients with severe heart and vascular problems are transferred to me from all over South Texas,” said Dr. Crutchley. “For example, a patient may be brought in with a ruptured aneurysm, yet not have been previously aware there was anything wrong.” Health awareness, rather than diagnosing specific illnesses, is the main benefit of the mobile vascular screening program. People who are screened get to speak one-on-one with an RVT and take a digital DVD of their results with them to study and share with their personal physician, bringing home the message that they may need to follow. “PAD is an unrecognized, under diagnosed problem,” said Dr. Crutchley. “The public doesn’t understand what causes artery blockages in the legs or neck, which correspond to blockages in the coronary arteries. This helps them understand the connection between these conditions and diabetes, smoking, high blood pressure and high cholesterol. We let them know that now is the time to work on their modifiable risk factors.” Prevention is the best strategy. The mobile vascular screening program is only one of Southwest General’s initiatives to take health care out of the hospital and directly to people who need it most. Many people get wrapped up with work and caring for others. They don’t take time, or lack the resources, to care of their own health. Armed with knowledge about their health status, patients of Dr. Crutchley are encouraged to discuss their concerns and learn the best ways to control their risk factors.
For more information, please visit http://www.swgeneralhospital.com.
SAN ANTONIO // PATIENT
SOLUTIONS FOR PATIENTS Kirk Simendinger and the team at Bulow Orthotic & Prosthetic Solutions help patients get back to living healthy, happy lives.
SPECIAL TO TEXAS MD
IN COLLEGE, Kirk Simendinger’s passion for racing bikes competitively led him to take a job as a physical therapist’s aide at a North Texas clinic. He figured that a career in sports rehabilitation after graduation would combine all of his key interests: physiology, biomechanics and kinesiology. That all changed, however, when a patient in his mid-20s began visiting the clinic for 70
NSIDE TEXAS MD / MAY.JUNE 2014
treatment of a shoulder injury. “He liked to run and hike. He was very active,” Simendinger recalled. “One day, he wore shorts, and he was wearing a prosthesis. I had no idea. So I asked where he had it made. I had so many questions.” Fascinated, Simendinger went to the prosthetic company where his young patient had his prosthesis molded and
fitted. “When I walked in and saw the tools they used and the methodology,” he said, “I knew right then and there: This is for me.” Today, Simendinger, chief prosthetist for Bulow Orthotic & Prosthetic Solutions (OPS), is helping countless individuals from here and throughout the country live normal, active lives by fitting his patients with high-tech, comfortable prostheses made especially for them. Founded in 2011, the Bulow OPS San Antonio location provides innovative prosthetic technology, one-on-one attention and guidance to its patients. When a patient comes to be fitted for a prosthesis, Simendinger starts with an in-depth conversation and then makes an evaluation and educates the individual on the next steps. “If you’re 65 or 70 and you’ve had a limb taken because of diabetes or a vascular disease, all you might know about prostheses is what your father or grandfather might have worn in the ‘40 and ‘50s,” he said. “They might think of a prosthesis as always being uncomfortable with calluses or pressure points like a parent had. We let them know what the field of prosthetics is like today, and we come up with a plan to fit them with the right device. We want everyone to be on the same page.” In March 2013, Mike Jacobs, 48, had his left leg below the knee amputated as a result of a life-threatening septic infection that spread throughout his body. He was fitted with a prosthesis at Bulow OPS several months ago, and he is back playing golf at least once a week and coaching his 10-year-old twin boys in baseball and basketball. “When this happened, I knew I had to remain active and be strong for my boys,” said Jacobs, senior vice president of a financial management firm. “So just laying down and feeling sorry for myself was not an option. Kirk is a great guy and so passionate about
what he does. They have helped me get right back to what I was doing before I had an amputation.” Bulow’s Medical Center office allows patients to be fitted for a mold and then have their prosthesis made in its inhouse lab. When patients return to try on the new device, Simendinger assists them every step of the way, ensuring that the prosthesis fits properly, making any necessary adjustments and overseeing their physical therapy as they get used to the new prosthesis. “We do everything by hand,” he said. “I’ll outline bony prominences like the knee cap or fibular head and take lots of measurements. Then we wrap the limb in wet plaster bandages and get an accurate negative impression of a person’s limb. Then we fill it with plaster in the lab. That’s how the process starts.” Simendinger, who was a prosthetist at the Center for the Intrepid working with wounded warriors for four-anda-half years, has been in the industry since 1996. He has seen the advances in prosthetic technology over the years. These advances include new techniques for fitting people, the development of lightweight, yet strong titanium materials and new ways to support body weight. “When I got out of college, methods of support were concentrated in specific areas,” he said. “Now they’re more global, and there’s total contact because these new materials allow us to disperse pressure better. Prostheses are more comfortable, and people are doing all the things they want to do if they’re capable.” Walking into a back therapy room, Simendinger points to a prosthesis made in 1936 that was given to him as a gift and marvels over its craftsmanship. “Prosthetists who made artificial limbs in the 1930s were true artists,” he said. “That’s hand-carved bass wood, and an enormous amount of hours went
“Equipping, encouraging, and mobilizing Christian women to unite in their workplaces and neighborhoods to pray for their city and nation”
ONE in the SPIRIT 17th Annual Celebration
To be held at the beautiful downtown Marriott Riverwalk Hotel Limited number of Special WPI Room Rates for September 18-20. Call (210) 224-4555.
Friday, September 19 7:00-9:30 PM Event Sponsor Displays open at 6:15 PM Featuring: Charles Flowers Senior Pastor, Faith Outreach International Open to Men & Women – “after five” or “business attire” $60 per person, or reserve a table for 10 at $600
Women’s Prayer Breakfast Saturday, September 20 at 9:00-11:30 AM: $25 per person
“AT BULOW OPS, THEY HAVE HELPED ME GET RIGHT BACK TO WHAT I WAS DOING BEFORE I HAD AN AMPUTATION.” into making prostheses. The body weight was taken in the thigh fastened by strings. It has a single-axis foot and a toe break that moved up and down.” Reflecting upon his work at Bulow, Simendinger said he and his three-person team have an opportunity each day to impact someone’s life. “That’s our goal,” he said. “Besides, you never know who’s going to walk through the door. It could be the most interesting case you’ve even seen.”
For more information, visit www.bulowops.com or call 210-614-4077.
Featuring: Joan Courtney President & Founder Women’s Prayer International Make Your Reservations Early!
For the Gala or the Women’s Prayer Breakfast You may pay online at: www.womensprayer.org or mail checks payable to “WPI” (along with a list of attendees for the event you are attending) to: 11103 San Pedro, Ste. 221, San Antonio, TX 78216
Limited Sponsorships Available!
For more information call: (210) 349-PRAY (7729) or email: firstname.lastname@example.org Ladies! Visit a WPI group or start one in your workplace or neighborhood. Contact us at the info above.
SAN ANTONIO // FEATURE
BIHL HAUS ARTS’ GO! ARTS PROGRAM National Programs of Excellence winner SPECIAL TO TEXAS MD
THE GO! ARTS PROGRAM at the Alicia Treviño López Senior One-Stop Center, cited by UT Health Science Center researchers as having a positive impact on hundreds of budding senior artists and writers, is among six newly named national Programs of Excellence award winners by the National Institute of Senior Centers (NISC). Led by experienced professional artists/educators with advanced degrees, GO! Arts at the López Center teaches seniors to explore and hone their artistic abilities. It was named the 2013 Expressive & Creative Arts winner by the NISC, an initiative of the non-profit National Council on Aging with a mission to highlight effective and replicable programs at nation’s 11,000 senior centers. The López Senior One-Stop Center opened in 2011 as a partnership of the WellMed Charitable Foundation and the City of San Antonio. It has become one of the most active senior centers in the Southwest, surpassing 6,000 registered members today. Soon after opening, the non-profit Bihl Haus Arts program was invited to bring its successful GO! Arts program to the López Center. GO! Arts started in 2007 when a Bihl Haus Arts docent, who noticed many of her aging peers had a reduced interest in engaging in social life, shared her newfound enthusiasm for taking art classes. Today, participants called “Goldens” attend regular classes at five locations (Bihl Haus 72
NSIDE TEXAS MD / MAY.JUNE 2014
Arts, the López and Cisneros Senior Centers, Granada Homes and Casitas de Villa Corona). They exhibit artwork, write, read and publish prose and poetry. Bihl Haus Arts publishes catalogs of Goldens artwork and chapbooks of their writings. Their work also appears at micro-galleries in neighborhood businesses and at area senior centers. For Goldens like Mary Baker, the art classes have been a self-revelation. “Never in a million years did I think I’d be doing this. I just never thought I had the natural talent to do it,” said Baker, a 67-year-old grandmother who also volunteers at the López center. “It made me feel like, hey, if I apply myself I can paint. Not only that, it made me more aware of nature and how to look at it. When
I see something, I view it in a different way: Is this something I would want to draw?” This year, a total of 38 two-hour classes will be offered including: Advanced and Basic Painting; Basic Ceramics, Drawing and Printmaking; Collage Journal; Creative Writing; Mixed-Media; Crafts and Yoga. GO! Arts teachers rotate among five locations each fall, spring, and summer semester. The National Institute of Senior Centers noted that the López Center serves a large population of socioeconomically minority seniors, a group often ignored by the professional art world. The program is an especially important voice for seniors and women of color. Independent research by the UT Health Science Center also has validated the value of the Bihl Haus’ program at the Lopez Center. A UT Health Science Center study cited in the 2012 issue of Arts & Health noted that 100 percent of the Goldens who participated in the GO! Arts Program experienced positive changes in their health – emotional, physical, mental, spiritual—and maintained or increased their level of independence. This is critical to help reduce risk factors for the aging that drive the need for long-term care. “With our first study, although it was very small, we did see that in fact there was a growth in their sense of well-being. That will translate into more seniors aging in place, more seniors being able to control their health conditions,” said Adelita Gonzales Cantu, the lead researcher of the study and an assistant professor at the UT Health Science Center’s School of Nursing. “It’s not necessarily that they don’t get diabetes or other chronic conditions. They have more of an ability to manage those; they feel more empowered.” Part two of the UT Health Science Center study is now being conducted at the Lopez Center. Results are expected to be available in Summer 2014.
For more information, www.bihlhausarts.org.
TransitionCare Health, Inc. “Delivering Quality, Targeted and Focused Care”
See the receptionist or call our office today to schedule (this is not a physical exam).
225 E. SONTERRA, STE.201, SAN ANTONIO, TX 78258 • (210) 499-0060
‘SEEING ONE PATIENT, HELPING MILLIONS’ Discovery Clinical Trials fulfills its mission of bringing progressive medical treatments to families and to those they love.
MANY OF OUR CLINICAL TRIALS HAVE IMPACTED PEOPLE’S LIVES BY OFFERING THE KIND OF CARE THAT THEY OTHERWISE COULD NOT AFFORD.
By: MEGAN PEREZ
DISCOVERY CLINICAL TRIALS’ mission is “seeing one patient, helping millions.” This statement extends beyond the aspect of just seeing patients because that is not all that we do. We aim to enrich the communities we are part of by educating families about health and the progressive medical treatments available to them and to those they love. Many of our clinical trials, such as the pain study, have impacted people’s lives by offering the kind of care that they otherwise could not afford. Our patients express their appreciation of how relieving it is to finally address a complicated medical issue and not 74
NSIDE TEXAS MD / MAY.JUNE 2014
have to worry that medical bills are piling up in their mailbox from medical exams, labs and medications. When we receive this kind of acknowledgement from our patients, it verifies that we are really fulfilling the entirety of our mission. We sincerely appreciate each and every one of our patients for making this process possible. If you are interested in a clinical trial for yourself or a family member, we would be happy to help you learn about how you can be part of fulfilling the mission, “seeing one patient, helping millions” – because it all starts with you.
Megan Perez is a media analyst at Discovery Clinical Trials. For more information, call 210-591-1165 or visit www.discoverytrials. com.
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SAN ANTONIO // MD
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SAN ANTONIO // HEALTH & WELLNESS
NUTRITION AND YOUR EYES What foods help your eyes stay healthy?
NUTRITION is important to our daily routine, and it can help prevent certain conditions that affect our health. I had a patient tell me, “People eat for taste, not for nutrition.” That’s true most of the time, but some foods are nutritious and tasty. What nutrients are important to the eye?
Antioxidant vitamins (vitamins A, C, E and beta
THE HEALTHIEST THING YOU CAN DRINK FIRST THING IN THE MORNING IS A GLASS OF WATER. carotene) and other antioxidants (minerals such as selenium, lycopene and zeaxanthin) are important in battling free radicals and decreasing the risk of cancer and damage from smoking and sun exposure. Vitamin A deficiency can affect night vision and cause dry eyes.
NSIDE TEXAS MD / MAY.JUNE 2014
Lutein is one of two major carotenoids found as a color pigment in the human eye (macula and retina). It helps with visual contrast in low light conditions, and it has been studied for its preventative effects on macular degeneration and cataracts. Some sources of antioxidants include berries, green leafy vegetables, garlic, green tea and tomatoes.
OMEGA 3 FATTY ACIDS
Omega 3 fatty acids are essential fatty acids; they are not produced by our body naturally. Found in deepsea fish (e.g. salmon, herring and tuna), some nuts and oils (e.g. flaxseed oil), omega 3 fatty acids have been shown to naturally lower triglycerides and blood pressure. These fatty acids can reduce inflammation to improve symptoms of arthritis and asthma. They are beneficial for pregnant women, they are associated with lower rates of depression and they can be helpful in the prevention of dementia. Omega 3 fatty acids have been used as treatments for children with autism and ADHD.
OK, so there are no calories in water and it is not really a nutrient, but it is an essential part of our body and our diet. The healthiest thing you can drink first thing in the morning is a glass of water. Water helps
us stay hydrated and produce a healthy tear film to maintain our ocular surface. Under-eye circles and dry skin can be minimized with hydration. Your body needs water to produce lymph fluid (to fight disease), flush out toxins and lubricate your joints. Dehydration can lead to headaches, dry eye, depression, insomnia, etc. Get your eight to 10 glasses of water a day. These are only a few of the nutrients that are important in your daily intake, and chronic malnourishment can slowly lead to health problems.
Lisa Martén, M.D., is a board-certified ophthalmologist with South Texas Eye Institute, located at 2424 Babcock Road, Ste. 101, in San Antonio, Texas. For more information, call 210-692-1388 or visit www.southtexaseyeinstitute.com.
WOMAN DRINKING WATER, GOODLUZ/SHUTTERSTOCK.COM
By: DR. LISA MARTÉN
EXPERT PRIMARY CARE.
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Ami Kadakia, MD Internal Medicine Alamo Heights, Broadway (210) 824-5392
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SAN ANTONIO // HEALTH & WELLNESS
MORE THAN JUST STYLE UV protection for your eyes: What are your options? By: DR. LISA MARTÉN
WITH SUMMER COMING, it’s good to be reminded of the many perils of sun and ultraviolet rays. Exposure to UV light has been implicated in the formation of cataracts and age-related macular degeneration. Sun exposure can also damage the surface of the eye and induce the growth of pingueculae, pterygia and skin cancers on the eyelids (not to mention wrinkles). A pinguecula is a yellow bump of tissue on the white part of the eye. A pterygium occurs when the conjunctiva, the tissue over the white part of the eye, grows into the clear cornea. Free radicals are produced when biochemical
changes occur in cells exposed to UV light. The formation of cataracts and the destruction of macular cells in macular degeneration have been linked to free radicals, as well as other diseases like cancer. Sunlight that bounces off highly reflective surfaces such as snow, sand, water and concrete can be especially dangerous. UV protective eyewear can protect your eyes against the effects of damaging UV A and UV B wavelengths. A good pair of sunglasses should offer more than just style. Oversized and wraparound frames offer more coverage to protect the soft tissue around
your eyes and more visibility for sports and driving. Polarized lenses make it easier to see in very bright conditions by blocking out certain wavelengths. Look for tints that will provide the best clarity and contrast, as well as glare reduction. Rose, brown, yellow and orange tints are effective for this. For sports enthusiasts, anti-fog glasses are most effective to reduce the risk of injury from temporary blindness due to fogging. Aside from protection from UV light, there are antioxidants, like vitamins E and C, to fight the devastating effects of UV light. Antioxidants can help inhibit cell damage from free radicals – the common pathway for cancer, aging and a variety of diseases. A combination of vitamins and UV protective eyewear can help maintain the health of your eyes.
Lisa Martén, M.D., is a board-certified ophthalmologist with South Texas Eye Institute, located at 2424 Babcock Road, Ste. 101, in San Antonio, Texas. For more information, call 210-692-1388 or visit www. southtexaseyeinstitute.com.
WOMAN WEARING SUNGLASSES, AARON AMAT/SHUTTERSTOCK.COM
EXPOSURE TO UV LIGHT HAS BEEN IMPLICATED IN THE FORMATION OF CATARACTS AND AGE-RELATED MACULAR DEGENERATION.
NSIDE TEXAS MD / MAY.JUNE 2014
We wrote the book. Meet Dr. Charles Rockwood and his books. If youâ€™re an orthopaedic surgeon anywhere in the world, you no doubt have spent time with one or more of his editions. Due to their value in medical education, they have been updated and republished year after year - for more than 40 years. Dr. Rockwood is just one of the many experts and authors at UT Medicine Orthopaedics. UT Medicine is academic medicine. Itâ€™s a powerful combination with powerful doctors, like Dr. Rockwood. UT Medicine Orthopaedics treats all ages for all bone and joint conditions.
To refer your patient, call 210-450-9300 UTMOrtho.com Medical Arts & Research Center (MARC) 8300 Floyd Curl Drive - 3rd Floor San Antonio, TX 78229
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SAN ANTONIO // HEALTH & WELLNESS
Stretching the limits of wellness By: HOLLY COYLE
LYNDA SHERLAND felt her heart race when she looked at the medical report. She is a nurse practitioner, but the report wasn’t for one of her patients. It was her biopsy and the results showed she had breast cancer. “It was very overwhelming and I was scared,” Sherland says. “I had a friend who died of metastatic breast cancer.” Soon after, she went to see her trusted family practice doctor, Dr. Simone Norris who, who practices mind body medicine in a small, highly tailored practice in North Central San Antonio, emphasizing prevention over treatment. Nor82
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ris recommended yoga for Sherland after she healed from the mastectomy and reconstructive surgery. “It’s really about bringing your body into balance,” Norris says. When Sherland asked where she could start practicing yoga, she was pleasantly surprised to hear that Norris and her colleague Dr. Regina Lee, who co-runs a thriving family practice in Westover Hills and the Medical Center, alternate teaching weekly yoga classes at Nydia’s Yoga Therapy on Lockhill Selma Road in San Antonio. “Ninety-nine percent of the people
tion for everyone and having five minutes with a patient,” she says. Today, she can spend an average of a half hour to an hour with a patient, which can have its own challenges. Sometimes she does the pose headstand after seeing a patient with a difficult problem. She encourages her staff to practice yoga as well. Lee, even with her busy patient load in her more traditional, highly successful family practice clinic, also takes time out to teach the class, and to recom-
“YOGA CAN OFTEN HELP PEOPLE IN WAYS THAT MEDICINE CAN’T.” cierge medicine, emphasizing nutrition, botanical medicines and mind-body interventions to complement conventional drug and surgery protocols. “I became tired of writing a prescrip-
mend yoga and relaxation to her patients. “In modern society sitting more than three hours can lead to early death. I do yoga for selfish reasons some-
PHOTOS BY MANUEL SERRATA
THE YOGA DOCTOR
who walk through my door have a problem caused by stress,” says Norris. “In most conventional practices, advice to pursue relaxation therapies is just given lip service; we are just as stressed and busy as our patients.” Knowing that yoga can often help people in ways that medicine can’t, Norris and Lee vowed for the practice of yoga to not just be lip service for them: they would practice what they preach to their patients. Norris left a busy family practice to focus on con-
times too,” Lee says. “It reminds me that I need to take time for myself.” The two busy physicians have known each other for many years. Norris was Lee’s faculty adviser at Christus Santa Rosa family medicine residency. The two doctors feel lucky to be teaching the yoga class, and yes, to be standing on their heads together sometimes. The class began as an experiment, part of a study on the effects of relaxation for recovering breast cancer patients where researchers compared yoga to traditional exercise. That was two and a half years ago, and the class is still going strong and open to anyone. “The interest is there so we keep going,” says Lee, her blonde hair brushing past her shoulders while she nimbly leans forward in a pose called pigeon. “This teaches you how to pay attention to your body.” “My job is to help people help themselves,” she continues. ” It’s really neat to see people progress. “We enjoy teaching people how to prevent injury.” In addition to preventing injury, these doctors say yoga can prevent disease. The statuesque Norris, an air force veteran and mother of three, is used to working under pressure. She explains how deep breathing lowers heart rate and blood pressure. “The magical part of yoga practice to me is the breathing part.” Dr. Lee has treated patients before who have panic attacks with breathing exercises. “Oxygen is required to relax your muscles. Teaching someone how to breathe properly is profound.” She says yoga is proven to prevent depression and help with a number of diseases from hypertension and irritable bowel syndrome to diabetes. Twisting poses are good for digestion, inversion poses, where legs are up in the air, is good for the thyroid. Doctors Lee and Norris hope patients take what they learn on the mat into everyday life. They say they certainly do, and yoga helps them to be more focused, relaxed and patient doctors. Lee explains that early results from the breast cancer study show reduced cortisol levels, reflecting reduced stress in the yoga half of the participants. And they say that less stress is good medicine for anyone. For Sherland, the classes taught by these doctors have made a difference. “It increases my strength and flexibility. It is a great adjunct to health. I recommend it to my patients.”
For more information, visit www.nydiasyogatherapy.com. For more information on Dr. Simone Norris visit http://ifmofsa.com and Dr. Regina Lee at www.whfh.com.
SAN ANTONIO // NONPROFIT
Ronnie Pilgrim, Mandy PilgrimWoman of the Year Candidate, George Julian, and Cheryl Julian
A GREAT START Mandy Pilgrim kicks off her campaign for Leukemia & Lymphoma Society South Texas Chapter Woman of the Year 2014 with “Fire and Ice.” Pete Lewis, Steve Collins-Man of the Year Candidate, and Michael Jimenez
Steve Griffith, Daniel Edelen-2013 Man of the Year, Joan Edelen, and Chris Edelen
Deandra Villa, Lacie McDonald, Tim Stocks, Brooke Stocks, Courtney Haass, Miriam Mitchell, and Katie Delve
NSIDE TEXAS MD / MAY.JUNE 2014
SPECIAL TO TEXAS MD
MANDY PILGRIM is a candidate for the Leukemia & Lymphoma Society’s 2014 South Texas Chapter Woman of the Year campaign. Each year, six to eight women, six to eight men and a boy or a girl run for the title of Woman of the Year, Man of the Year and Boy or Girl of the Year, respectively. Once chosen by a committee, candidates become involved in other charitable organizations and serve as leaders in their fields and professions. This year’s 10-week campaign ends with a grand finale on May 30, 2014, at the Rosenberg Sky Room at UIW. Each dollar raised counts as one vote for the specified candidate. Pilgrim’s campaign kick-off event was the Fire and Ice event on April 3 at the personal estate of Darren Casey, who serves as chairman/founder of Casey Development, a commercial and multi-family development company in Terrell Hills. With more than 250 guests in attendance, the event had a hugely successful auction and created great momentum for the rest of Pilgrim’s campaign.
NONPROFIT // SAN ANTONIO
SETON HOME’S PROGRAM WORKS TO BREAK THE CYCLE OF POVERTY, ABUSE AND NEGLECT.
ANOTHER WAY OF LIFE
Seton Home: giving new hope to pregnant and parenting teen mothers and their children By: LAUREN WEISS
FOR 33 YEARS, Seton Home has been at the forefront of meeting the needs of homeless, abused and/or neglected pregnant and parenting teen mothers and their children in San Antonio. Seton Home’s comprehensive program supports teen mothers ages 12 to 22 who have chosen to keep and parent their children while transitioning from crisis to self-sufficiency. Seton Home’s program seeks to move clients from a lifetime of victimization and dependence toward self-determination and independence. The core services of safe shelter, education, health care and support services address the challenges faced by teen mothers and their children in our community. Seton Home emphasizes the importance of education for our young girls and their families to break the cycle of poverty and abuse. When arriving at Seton Home, most residents are at least two grade levels behind their peers. Within 72 hours, each resident is enrolled in an educational setting that provides the best opportunity for her to succeed in school. Seton Home’s job and career development planning allows the teens to attain higher education or career training to allow for setting and achieving realistic vocational and educational goals. In 2009, Seton Home introduced an eight-week on-campus summer school program in collaboration with San Antonio Independent School District (SAISD), as well as a year-round after-school tutoring program. Since its implementation, this program has been tremendously successful, with 54 residents having
earned their high school diploma or GED. For many of the moms, they are the first in their family to graduate from high school – a huge accomplishment! On May 1, 2014, Seton Home will host its Fifth Annual Dr. Leslie Parks Tribute to Motherhood Luncheon. The event celebrates the teens of Seton Home who, de-
spite their traumatic pasts, have created educational goals for themselves. With the help of Seton Home and our community, these young moms are working hard to reach them. The funds raised from the luncheon support Seton Home’s education program. Seton Home also has a separately licensed child development center for the babies while the moms are in school or attending on-campus classes and groups. Having childcare onsite is extremely beneficial because the childcare staff works very closely with the residential and program staff on parenting issues the moms might be facing. Together they make sure the babies are properly cared for and grow up in a loving environment that prepares them for pre-k schooling. Young and uneducated teen mothers and their children encounter a lifetime of challenges ahead, including poverty and reliance on public assistance beginning with the birth of their child. Without intervention, it will be hard for them to recover from their victimization and be able to lead normal and productive lives for themselves and their children. Seton Home’s program breaks the cycle of poverty, abuse and neglect through innovative approaches that equip these young families with the tools they need to overcome their troubled pasts and become strong, healthy families that contribute to society. Seton Home accomplishes this by offering clients another way of life based on education, which includes life skills, parenting and academic education and support services that encourage personal growth and development. Seton Home is proud of the progress it has made since its doors opened in 1981. With the help of San Antonians, it will continue to thrive and give new hope to homeless teen mothers and their children – breaking the cycle for two generations.
For more information about Seton Home, its services or upcoming events, please visit www.setonhomesa. org or call 210-533-3504, ext. 215.
SETON HOME’S MISSION
Seton Home fosters childbirth and parenting and works to break the cycle of abuse and poverty by providing a caring home, education and support services necessary to transform the lives of pregnant and parenting teen mothers and their children. MAY.JUNE 2014 / NSIDE TEXAS MD
SAN ANTONIO // NONPROFIT
RISE RECOVERY Home of the Palmer Drug Abuse Program
Mark Barr, is the executive director of Rise Recovery, home of PDAP. For more information, visit www.RiseRecovery. org to explore its core services.
By: MARK BARR
WHEN I EXPLAIN the significance of Rise Recovery and the Palmer Drug Abuse Program—sometimes known as PDAP—and what it can do for a family, nothing embodies its importance and depth of support as these testimonies we’ve received from grateful parents, teens and young adults: A parent recently told me: “Rise Recovery and PDAP have literally been lifesavers for my family. We heard about PDAP and visited a group meeting with parents talking about boundaries, faith, codependency, enabling, and the 12 Steps. When we learned both of our daughters were addicts, we desperately needed all of the critical services that PDAP provides.” Here is the perspective of a young adult: “I had buried myself in an excessive amount of trouble due to my 10-year addiction to pain medication. I knew if I
hadn’t voluntarily attended a drug abuse rehabilitation program, my life would have taken a turn for the worst. Upon arriving at PDAP, I was greeted with open arms. The staff actually empathizes with their members as opposed to sympathizing with them. They demonstrate the aphorism ‘it works if you work it.’ I am blessed to have found the Palmer Drug Abuse Program; even though I was a stranger to everyone, they
NSIDE TEXAS MD / MAY.JUNE 2014
made me feel like I was their own family member.” Testimonials like this exemplify why the Rise Recovery and PDAP team have been dedicated to successfully providing recovery services for teens, young adults and their families to overcome the effects of mind-changing chemicals since 1977. We maintains our focus on the most vulnerable—children and their families living in the greater San Antonio area and surrounding counties. As government budgets have been slashed, we have become, in many cases, the only organization that never turns down a family in need. A probation officer for adults told me: “You are the only game in town where people don’t have to wait. Please don’t go away.” We are not going anywhere. In fact, in the past decades, we have continually improved and added to the PDAP services. Therefore, we changed our name to Rise Recovery, which is now the home of PDAP along with Rise Education and Prevention; Rise Youth Leadership; and Rise Early Intervention. PDAP remains the vital leading program of Rise Recovery by continuing to offer recovery counseling, support group meetings, classes and drug-free activities to individuals and families. Since we now also include education, prevention, early intervention and youth leadership services to help prevent the cycle of addiction, we bring in nationally known speakers to enlighten, inspire and educate parents, teachers, counselors, church leaders, and all the communities we touch. This year we are bringing in Jeff Jay, a clinical interventionist, educator and nationally recognized author as the featured speaker at Rise Recovery’s annual fundraising breakfast at 8 a.m., Friday, May 16, 2014 at the Omni Hotel, The Colonnade. Talking on “Love First: A New Approach to Intervention,” Jay speaks from experience. “I am passionate about intervention for a very simple reason: it saved my life,” says Jay. “My story is somewhat unusual because I went further down the scale of addiction than many. But it is still a clear illustration of the power of intervention. Family intervention uses the power of love to break through addiction and denial. By organizing family and friends in a specific way, we are able to get results that were impossible before.” Jay, whose personal recovery from addiction began October 4, 1981, has appeared on many national shows including CNN, the Jane Pauley Show and PBS; his works have been featured in Forbes Online and
professional journals. He is co-author of the bestselling books “Love First: A Family’s Guide to Intervention” and “At Wit’s End: What You Need to Know When a Loved One Is Diagnosed with Addiction and Mental Illness.” A certified addiction professional, he has served as president of the Terry McGovern Foundation in Washington, D.C., and on the boards for several professional organizations. Those who attend this breakfast will not only be inspired by Jay’s story, but their attendance will support the programs of Rise Recovery. This fundraising and keeping our programs free of charge, at no expense to taxpayers, is integral because the scope of addiction is beyond the combined capacity of caregivers to address. Rise Recovery is a 501(c)3 non-profit, community-based agency and does not accept government money. Funding for our programs comes through donations from individuals, businesses, foundations, churches, and the United Way of San Antonio and Bexar County. As Executive Director, I have witnessed countless, truly incredible stories of lives saved; families rebuilt; and love, faith and sanity restored because of our faith-based services for those affected by adolescent addiction, a very real disease that is largely misunderstood.
Rise Recovery is expecting more than 500 business, military and civic leaders at the 14th annual fundraising breakfast, featuring nationally recognized author Jeff Jay to speak on “Love First: A New Approach to Intervention.” Friday, May 16, 2014 8 a.m.-9:30 a.m. Omni Hotel, The Collonade To make reservations please visit: www.riserecovery.org/special-events
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