Dallas County Living Well Magazine January-February 2024

Stephen P. Courtney, MD

Fellowship-Trained Orthopedic Spine Surgeon

Over 26 Years of Experience

Dr. Courtney is a board-certified orthopedic spine surgeon located in Plano, Texas. A Louisiana native, he attended Louisiana State University for medical school, and completed residency at Texas A&M followed by a fellowship at the Florida Neck and Back Institute.

SPECIALTIES:

• Back Pain

• Neck Pain

• Spine Pain

• Disc Replacement

• Microdiscectomy

• Spinal Fusion

• Minimally Invasive Surgery

• Steroid Injections

• Physical Therapy

“I believe in treating each of my patients with honesty, dignity, and respect. My patients come away from our shared interactions feeling confident, assured that they are truly in the best hands. Throughout my career, I have remained laser-focused on providing world-class care and innovation to the patients I treat on a daily basis. I look forward to getting to know you!”

Expert Orthopedic Surgeons Close

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J. Stephen Appleton, MD

Alexander S. Greenstein, MD

Kwame A. Ennin, MD

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STAND OUT WITH THE EMINENT CHOICE IN HEALTHCARE

Pain Management • Sports Medicine • General Surgery • Spine Surgery

Orthopedic Surgery • Neurosurgery • Minimally Invasive Spine Surgery

Total Joint Surgery • Foot & Ankle Surgery • Hand Surgery

Gynecological Surgery • Plastic Surgery

ROBOTIC TECHNOLOGY

PIONEERING PATHS WITH DR. COURTNEY

Welcome to the latest edition of LIVING WELL Magazine, where our pursuit of health extends beyond the physical, where we explore health not just in body, but in every part of everyday life.

In this issue’s cover story, we delve into the life and ethos of Dr. Stephen P. Courtney, a board-certifid, fellowship-trained orthopedic spine surgeon whose commitment to patient care shines as brightly as his distinguished reputation. His journey from a hardworking orderly to an innovative force in spine surgery reveals a relentless dedication to medical excellence and compassionate care. With a hands-on approach at the Advanced Spine Center, Dr. Courtney and his team embody the pinnacle of “high tech and high touch,” ensuring patients are not only treated with the latest advancements in minimally invasive procedures but also with the utmost respect and empathy. His story is a testament to the idea that true wellness begins when patients feel valued and understood.

Switching gears, we step into the world of cinema with our celebrity spotlight on Ryan Gosling. From his early days on the Mickey Mouse Club to his transformative role as Ken in the hit Barbie movie, Gosling’s career is a remarkable narrative of evolution and reinvention. We explore the depths of his multifaceted talent and how his personal journey of discovery has made him one of Hollywood’s most enduring stars.

In an essential read by Leu, Peirce & Olson PLLC, we’re reminded that the New Year is a perfect time to reassess and recommit. Their article, New Year’s Checklist, offers an invaluable guide to getting your affirs in order. The piece underscores the importance of a comprehensive approach to estate planning, which is crucial in these times of uncertainty.

We also share a poignant piece that touches the hearts of pet lovers. A Giftof Love for Your Pet delves into the benefits of spaying and neutering, not just for our beloved companions but also for the broader community. Ths article is a beautiful reminder of the responsibility and love we owe to our furry family members.

Lastly, in Unusual Symptoms of Anxiety, we shine a light on the often-overlooked signs of anxiety disorders. With expert insights and practical tips, this article encourages us to listen to our bodies and minds, seeking harmony and health.

We hope this edition inspires you to live well in every aspect of your life, reminding you that wellness is a comprehensive journey. Each story, each individual, each discovery is a step towards a fuller understanding of what it means to truly thrive.

Thank you for joining us on this journey. Here’s to living well, in knowledge, in health, and in spirit.

Happy reading!

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LIVING WELL MAGAZINE is a source for quality educational articles on living a healthy, vibrant life. Our focus is on connecting our readers with the latest information on a host of topics relevant to their evolving life. From cutting edge medical news and procedures to top–tier financial, legal and lifestyle information. Connecting readers to leading medical and business professionals in their community in Texas and Oklahoma.

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Stephen P. Courtney, MD

For board-certifid, fellowship trained orthopedic spine surgeon

Dr. Stephen P. Courtney, patients come fist. It’s an ethos that developed early on in his life and one that has helped guide him in his journey to earn a distinguished reputation among his professional colleagues, medical peers and, most importantly, his patients.

Dr. Courtney began his medicine career from the ground up. While a teenager, he spent summers working in a rural north Louisiana hospital. As an orderly, he was an integral part of the hospital environment. While not a glorifid job, cleaning bed pans, changing bed sheets, cleaning patient rooms, helping medical practitioners, and assisting patients, offered him an invaluable glimpse into the hard work and dedication necessary to succeed in the medical fild. The job also served as the catalyst for his decision to pursue medical school.

Inspired by the patients he’s cared for there, Dr. Courtney made education a priority. He was salutatorian of his high school class and went on to graduate summa cum laude from Northeast Louisiana University. While at Louisiana State University Medical School, he utilized his summer to perform spine biomechanical tests on human spine cadavers utilizing pedicle screws. Considered cutting edge biomechanics and technology at that time, most spine surgeons didn’t even know they existed yet. However, Dr. Courtney performed one of the fist biomechanical tests on those implants. It was a feat that earned him the Howmedica Biomechanic Award and the Louisiana Orthopedic Association Award. He also placed fourth in the World Congress for Student Research Competition.

Dr. Courtney’s residency at Texas A&M University Medical Center and further specialty training through a fellowship at Florida Neck & Back Institute in Gainesville, Florida, additionally cemented his strong medical foundation. From there, he continued to gain more knowledge and insight on how to help his patients with useful tools, while recognizing there was room for much improvement in the tools at hand.

Ths realization inspired Dr. Courtney to design, develop, biomechanically test, complete FDA testing and oversee quality control and validation on a host of tools he created. To date, Dr. Courtney has developed nine spinal product lines and obtained nine patents and 14 trademarks on spine related products.

When he’s not traveling the country training other physicians on how to utilize his products, Dr. Courtney dedicates himself to the patients of his own medical practice, Advanced Spine Center.

Led by Dr. Courtney, the skilled team at Advanced Spine Center cares for patients with neck and back pain using a wide array of the most state-of-the-art tools and techniques—from conservative physical therapy and injection therapy—to advanced pain manage-

SPINE SURGEON PRACTICING FOR 28 YEARS.

ment, as well as surgical intervention. We employ the latest in minimally invasive spine surgeries, in addition to cutting-edge replacement technology. Incorporating both high tech and high touch, we get our valued patients back to their lives so they can enjoy all the activities they love.

The medical fild is not the only arena in which Dr. Courtney excels. He approaches fitness with the same dedication and vigor he applies to medicine. In 2005, Dr. Courtney was in the top 10 of his age group in mountain biking in Texas. He also completed one of the largest cycling events in the country multiple times: the “Hotter’N Hell” race. Always up for a new challenge, from there, he began training to compete in triathlons.

Dr. Courtney trains for triathlons with the same focus he uses as a surgeon. Waking up at 4 a.m. six days per week to work out in his home gym, he never waivers from the goal at hand—exceeding his personal best. After successfully completing multiple triathlons, Dr. Courtney shows no signs of slowing down. He continues to train and looks forward to competing in many more triathlons.

“I think if you can survive a triathlon you are absolutely living well,” he says.

Paying attention to fitness is something he encourages his patients to consider, too. “People don’t have to be a tri-athlete to be healthy. I like to tell people you need to start small. Do something to be active. It can even be yard work—that’s a great workout too. As you get older especially, you need to be in tune with your body, monitor your calorie intake and be active. I encourage people to change slowly, start small, and fid out what you like to do,” he says.

Sharing his wellness journey is part of the straight-forward, honest approach that puts his patients at ease and creates a trusting bond, an important element for the highly technical operations Dr. Courtney performs to help restore patients’ quality of life. As he learned early on, the single most important person in the treatment process is the patient and well-informed patients are more successful in following through on their rehabilitation and have better outcomes.

It’s a sentiment that his patients echo. “You don’t want to trust (your back) to just somebody that has his name on a door. You have to go to people that you trust. I talked to people and everybody trusted Dr. Stephen Courtney and I do too and I’d highly recommend him,” says Judy Jones, a lumbar fusion patient of Dr. Courtney’s.

“Above all, I believe in treating each and every patient I have with honesty, dignity, and respect. My patients come away from our shared interactions feeling confidet, assured that they are truly in the best hands,” says Dr. Courtney, who always brings his A-game.

Incorporating both high tech and high touch, we get our valued patients back to their lives so they can enjoy all the activities they love.

SEE WHAT DR. COURTNEY’S PATIENTS HAVE TO SAY.

Natasha Hernandez

SURGERY: L5/S1 360° LUMBAR FUSION

“After having back surgery twice and being frustrated with the lack of care from my previous doctor, I made an appointment to see Dr. Courtney. He is one of the most humble, funny, laid back and coolest surgeons I’ve met. He makes you feel like family. His office staff is amazing. His clinic Eminent Medical Center, where he performs the procedures, is also a 5-star facility. Every staff member I have encountered there has been so caring and professional. I am so glad I decided to change doctors and meet Dr. Courtney. I can see his attention to detail and his caring personality every time I see him. Before my injections he took some time to chat and made me feel at ease since it’s always nerve wrecking to have any spinal procedure. I will be having surgery soon and even though I am nervous and scared I know I am in good hands, and I know Dr. Courtney and all his staff will take great care of me. Thanks, Dr. Courtney and thanks to all his staff.”

Irene Shelby

SURGERY: LEFT L5/S1 MICRODISCECTOMY

“My husband and I have been coming to Dr. Courtney for years. We trust him for all of our back issues here recently. I had a spinal condition and had no doubt that Dr. Courtney would be able to take care of this and make me fully normal again. He and his staff were amazing! From the moment I decided to move forward with the surgery option to the very last post-op appointment, Dr. Courtney and his staff have been nothing but pleasant, courteous, professional and extremely friendly and helpful. I encourage anyone who has any type of back pain to come to Dr. Courtney’s office He is the BEST!”

Deanna Noyes

SURGERY: C4/C5, C5/C6, C6/C7 ACF (ANTERIOR CERVICAL FUSION)

“Great medicine coupled with great care. Dr. Courtney takes the time to listen to your medical needs. He put me at ease regarding my condition.”

Holly Coffman

SURGERY: L5/S1 360° LUMBAR FUSION

“After struggling for 11 years with severe back pain, I found Dr. Courtney through a mutual friend. After the first visit, Dr. Courtney said he could fix my problem back pain and let me tell you HE DID! This 360° fusion has saved my life. Thank you, Doctor Courtney.”

Lori Juarez

SURGERY: L4/5, L5/S1 360° LUMBAR FUSION

“After years of learning to “live with the pain” I made an appointment with Dr. Courtney, expecting a drawn out wait time. I was shocked at the quick, friendly and professional attention I received from Dr. Courtney and his staff. After 5 years of life altering pain, I am able to keep up with twin toddlers and a 3-yearold grandbaby without a problem. From office to operating room, Dr. Courtney and his staff are the best at what they do.”

Bilal Mahmood, MD

ORTHOPEDIC SURGEON

Dr. Bilal Mahmood is a Cleveland Clinic trained orthopedic surgeon with fellowship training in adult hip and knee reconstruction and joint replacement. He specializes in anterior hip replacement, robotic joint replacement, hip resurfacing, total knee replacement, partial knee replacement, minimally invasive joint replacement, same-day joint replacement, complex hip and knee deformity, revision joint replacement, hip and knee arthritis, osteonecrosis, hip dysplasia, and femoroacetabular impingement (FAI).

Outside of work, Dr. Mahmood enjoys spending time with his wife and children. His hobbies include alpine skiing, baseball, hockey, biking, and travel.

He is involved with local outreach organizations for medically underserved populations. He is also involved in research and innovation to advance hip and knee joint replacement.

TOP LAWYERS 2023

Livingwell

NEW YEAR’S CHECKLIST

By LEU, PEIRCE & OLSON, PLLC

Throughout history, the New Year has always been representative of a new beginning. Every January 1st presents us all with the opportunity to take an inventory of last year’s resolutions and recommit ourselves to a new set of goals. Due to the lingering effects of the Covid-19 pandemic, many will add “getting affirs in order” to their list of aspirations for 2024. Many people think only of a Will when contemplating the legal documents necessary to protect their future. However, there are more documents and considerations in developing a well-rounded estate plan. Every estate plan ought to include the following:

q Durable Power of Attorney

q Medical Power of Attorney

q Directive to Physicians and Family or Surrogates (Living Will)

q Authorization to Release Medical Information (HIPAA Authorization)

q Declaration of Guardian

q Will

q Long-term Care Insurance

Although often overlooked, a Durable Power of Attorney and a Medical Power of Attorney are critical parts of long-term care planning, since they designate the person or persons who will be acting for you in the event you are unable to handle your own fiancial and health care decisions. Without these documents, no one, not even your spouse, is legally authorized to handle your fiances or make medical decisions for you.

Your estate planning documents are extremely powerful and should be executed after great contemplation. The people you appoint to act on your behalf as your agents should be those you trust fully to handle your affirs now, as well as when you cannot handle them on your own. If you do not trust the person you have named to act for you right now, be careful about naming that person to act for you when you are incapacitated. Often people appoint spouses, adult children, or other family members as agents to keep affirs private and to avoid hurting feelings. However, appointing a family member may not always be the best option. In all cases, signing estate planning documents should be done only after deep reflction as to the abilities and trustworthiness of each candidate.

In addition to the essential legal documents listed above, another planning area that warrants early and informed consideration is preparing for the cost of funding long-term care. Long-term care differs from other types of healthcare, in that the goal of long-term care is not to cure an illness, but to provide an individual with support so they can maintain an optimal level of functioning. Some people want to stay in their homes as long as possible and bring in outside help to make that possible. Others want the freedom from home maintenance that a senior residence community offers. There is a wide range of living arrangements for seniors, from retirement communities to assisted living facilities to skilled nursing facilities. There exists a long-standing myth that Medicare will cover all our healthcare needs, including the cost of long-term care. The reality is that Medicare provides support only in limited situations. Notably, Medicare does not pay for assisted living, memory care, or long-term custodial care in skilled nursing facilities.

Some people are fortunate to have the ability to private pay for long-term care, which ranges from $4,000–$16,000/month in the Dallas-Fort Worth area. Others have long-term care insurance (an insurance policy designed to cover long-term healthcare expenses that are not covered by health insurance or Medicare). However, long-term care insurance may not be available if you have certain existing health problems, and the costs and premiums can rise as you age. Therefore, it is important to investigate the availability of long-term care insurance as early as possible. If you cannot qualify for long-term care insurance, there are fiancial options that may fit your circumstances and provide similar coverage. Professionals who work primarily with seniors, such as Elder Law attorneys, can often provide connections to a community of support agencies and other professionals who may be of assistance to you as you explore your options.

Ths year, resolve to take the time to crafta thoughtful, and thorough, estate plan. Educate yourself on your options, and seek qualifid professional advice on legal documents, healthcare, insurance, and fiancial planning. A little planning now goes a long way towards ensuring that you and your loved ones are protected, no matter what the future holds. Lori Leu, Erin Peirce, Lauren Olson, and James Sifford are Elder Law attorneys with Leu, Peirce & Olson, PLLC located in Plano, Texas. They can be reached at 972-996-2540.

At Orthopedic Institute of North Texas, your medical issues and concerns are our top priority. We demonstrate this by answering all questions, providing availability 24/7 during diagnosis, treatment and recovery, speaking in terms you can understand and discussing every step of your medical care to ensure you feel comfortable and confident that we will deliver the best surgical expertise with the best outcome. Now, two locations to better serve you.

Meet Our Doctors

Vikas Patel, MD

Surgery of the Upper Extremity

Christopher Kowalski, MD

Surgery of the Spine

Justin Kane, MD

Surgery of the Foot and Ankle

Leroy Butler, DO Surgery of the Foot and Ankle

Michael McHugh, MD

Surgery of the Hip and Knee

At the Orthopedic Institute of North Texas, our only goal is your return to normal activity. We provide surgical and non-surgical solutions designed to resolve your pain.

We are available 24/7

During diagnosis, treatment and recovery, any questions or concerns you have will be answered. We speak in terms you can understand, and discuss every step of your care to ensure you feel comfortable and confident with the recommended treatment plan.

Our promise to you

Using advanced, proven medical techniques, we will return you to the freedom of mobility you enjoyed before.

Introducing

Before, During, and After Cataract Surgery

Courtesy KEY-WHITMAN EYE CENTER

If cataract surgery has been recommended for your eyes, you are not alone. Truth is, we will all develop cataracts, reducing our quality of vision, as we age. Gratefully, cataract surgery procedures have become more advanced and is safe, painless and effective.

If you are thinking about having cataract surgery, you most likely have a lot of questions regarding when you should have it done, what you can expect, and how to prepare for surgery. Read on to see some helpful tips from Dr. Whitman at Key-Whitman.

What Are The Common Symptoms Of Cataracts?

The complaint we hear most from cataract patients is difficulties with their night vision. They begin to experience a lot of glare, halos and starburst symptoms, especially when driving. We also hear complaints of a haze or fog obstructing their vision and they’ll notice their vision gets blurrier over time.

How Do I Prepare For Cataract Surgery?

Before your procedure, our patients undergo a preoperative exam to gather measurements to determine the level of correction needed and review the types of intraocular lens options available. We will also schedule a visit to listen to your heart and lungs as well as review prior anesthesia and surgeries, medical history and medications to ensure they’re physically healthy enough to have cataract surgery.

Key-Whitman also has counselors who will walk our patients through the process, review insurance coverage and make sure the

lens option the patient selects best meets their goals. If there is an eye drop protocol associate with their surgery, the counselor will also go through the drop sequence involved—antibiotics and non-steroidal anti-inflammatories—well in advance of the procedure.

Be sure to have a friend or family member to accompany you to surgery, as you won’t be allowed to drive yourself home due to the twilight sedation.

How Do I Know It’s Time To Have Cataract Surgery?

When your cataracts have worsened to the point where they prevent you from performing day-to-day tasks and interfere with your quality of life, it is time to consider cataract surgery.

Cataracts worsen gradually, and we start to make a lot of accommodations for our vision as we get older. Essentially, we assume how well we see is normal. But if it gets to the point where you’re afraid to drive at night, can’t see well enough to safely take your medication or do household chores, and feel a loss of independence due to failing vision, cataract surgery can allow you to enjoy life again.

What Misconceptions Do People Have About Cataract Surgery?

In the past, cataract surgery was quite invasive, there were fewer lens options, and healing took much longer. Ths isn’t the case today. The biggest misconceptions people have is that the procedure is painful and complicated. That couldn’t be farther from the truth today.

What Can I Expect Following Cataract Surgery?

Following your surgery, your surgeon will review the procedure with you and answer any questions you may have at that time. Typically, patients leave with a protective eye patch, which will be removed at their follow-up visit the next day. Subsequent follow-up examinations will be scheduled approximately every two weeks until the eye is healed.

Healing post-surgery is also easier for most cataract patients today. “Key-Whitman uses the most advanced technology available, so healing occurs more quickly and with fewer complications. Even better, once the eyes have healed and adjusted, most patients are surprised by the improvement in their vision. They can see clearly again and notice how colors are much more vibrant than before with cataracts. Depending on the type of intraocular lenses patients choose, many become less dependent on glasses,” Dr. Whitman says.

You should also be aware that the surgeon won’t operate on both eyes during the same visit. Surgeries are typically scheduled one to two weeks apart. Ths allows plenty of time for the fist eye to heal and the patient to realize the full extent of correction in that eye.

From left to right: Larry A. Fish, M.D.; Leslie Pfeiffer, M.D.; Jeffrey Whitman, M.D.; Amanda Hoelscher, O.D.; Todd J. Agnew, O.D.

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Gastroenterologist

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Steve Gadol

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Marley Lites

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General Surgeon

Robert Hagood

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Brian Long

Nicholson Clinic

Sandra Moore

Texas Health Center for Diagnostics & Surgery

Nick Nicholson

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Thomas Roshek

Nicholson Clinic

Hematologist/Oncologist –Cancer Care Specialist

Chad Amosson

Genesis Care

Alison Barron

Texas Oncology

Sharon Gregorcyk

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Margarita Johnston

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Mitchell Moskowitz

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Gerardo Trillo

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Internal Medicine Doctor

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Julie Kennedy

Baylor Scott and White

Susan McKinney

HealthCore Physicians Group

Gary Tigges

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Hospice Care Providers

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Visiting Nurse Association of Texas

Lasik Surgeon

Dain Brooks

Brooks Eye Care

Harvey Carter Carter Eye Center

Wallace Ryne

Clear View Lasik Center

Jeffrey Whitman

Key-Whitman Eye Center

Mohs Surgeon

Pooyan Rohani

McGuiness Dermatology

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Ahmed Ata

Neurocare of TX

Charise Barta

Texas Neurology Consultants

Rajat Gupta

Headache and Pain Center

Jennifer Takesaka

Neurology Consultants of Dallas

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Joseph Beshay

Dallas Brain, Spine, and Skull

Base Surgery

Akwasi Boah

Texas Back Institute

Caetano Coimbra

Dallas Brain, Spine, and Skull Base Surgery

Rob Dickerman

North Texas Brain and Spine Institute

Shashank Gandhi

Texas Back Institute

Thomas Kosztowski

Texas Back Institute

Jefferson Miley

Jefferson T. Miley, MD

Blake Staub

Texas Back Institute

Opthalmologist

Norman Slusher

Slusher Eye Center

Kim Warren

Key-Whitman Eye Center

Jeffrey Whitman

Key-Whitman Eye Center

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Carey Brooks

Eye Source

Amanda Hoelscher

Key-Whitman Eye Center

Jeffrey Hollingsworth

Hollingsworth Family Eye

Clint Meyer

Dallas Eyeworks

Oral Surgeon

James Bates

Texas Oral and Maxillo Facial

Surgery

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DFWOMS

John Wallace

Dallas Oral Surgery

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George Dula

Dula Orthodontics

Jeffrey Johnson

Woodhill Dental Specialties

Mark Ozier

Ozier Orthodontics

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Ericka Sample Orthodontics

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OINT

Andrew Chambers

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Stephen Courtney

Advanced Spine Centers

Florian Dibra

Texas Joint Institute

Richard Evanson

Plano Orthopedic & Sports

Medicine Center

Justin Kane

Orthopedic Institute of North Texas

Diane Litke

L&W Orthopaedic Associates

Bilal Mahmood

Baylor Scott & Whtite

Brian Nwannunu

Texas Joint Institute

Vikas Patel

Orthopedic Institute of North Texas

James Stanley

North Texas Orthopaedic & Spine

Charles Toulson

Texas Joint Institute

Pain Management

Brent Belvin

American Pain & Wellness

Don Enty

American Pain & Wellness

Gregory Powell

American Pain & Wellness

Steven Remer

American Pain & Wellness

Kamlesh Sisodya

American Pain & Wellness

Periodontist

Jonathan Pajouh

Neighborhood Medical Center

Amit Patel

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Pediatric Dentist

Paul Rubin

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Aleco Tujios

Woodhill Dental Specialties

Pediatrician

Halley Hogan

Cook Childrens

Julio Len

McArthur Pediatrics

George Nail

Centennial Pediatrics

Christopher Straughn

Forest Lane Pediatrics

Jason Terk

Cook Childrens

Physical Medicine & Rehabilitation

Sheena Bhuva

Texas Back Institute

Craig Lankford

Texas Back Institute

Chun Lin

Texas Back Institute

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Texas Back Institute

Physical Therapist

Michelle Pietrowski

Edge Physical Therapy

Hayden Taylor

Greater Physical Therapy

Laura Yeatts

Results Physiotherapy

Podiatrists

Justin Kane

Orthopedic Institute of North Texas

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SouthWest Foot and Ankle Center

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Neighborhood Foot and Ankle

Binoy Sheth

Premiere Foot & Ankle

Psychiatrist

Mark Cartwright

Carewright Clinical Services

Stephen Vobach

Vobach and Brennan Medical Group

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Southwest Pulmonary Assoc.

Taylor Long

Southwest Pulmonary Assoc.

Anthony Nebor

FiveStar Pulmonary Associates

Rheumatologist

Margarita Fallena

Rheumatology Associates

Jyuin Fan

Dallas Rheumatology

Swathi Gonnalagadda

Texas Rheumatology

Megha Patel-Banker

Arthritis & Rheumatology Institute

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Rajesh Arakal

Texas Back Institute

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Texas Back Institute

Sheena Bhuva

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Ray Bosita

Texas Back Institute

Scott Blumenthal

Texas Back Institute

Stephen Courtney

Advanced Spine Centers

Peter Derman

Texas Back Institute

Rob Dickerman

North Texas Brain and Spine

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Texas Back Institute

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Texas Back Institute

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Texas Back Institute

Isador Lieberman

Texas Back Institute

A.J. Rush

Texas Back Institute

Alexander Satin

Texas Back Institute

Jessica Shellock

Texas Back Institute

Vudhi Slabisak

North Texas Orthopaedic and Spine

Jack Zigler

Texas Back Institute

Urologist

Zeeshan Danawala

Dr. Zeeshan Danawala

Michael Gross

Urology Clinics of NT

Vascular Surgeon

Dev Batra

Dallas Vein Institute

Tony Das

Connected Cardiovascular Care

Wound Care Specialist

David Godat

Godat Plastic Surgery

Tram Hill

Hill Wound Care

Reza Mobarak

DFW Wound Care

Matthew Pompeo

Promise Wound Care Clinic

Kwame A. Ennin, MD

Orthopaedic Surgeon

Kwame Ennin, MD, is a fellowship-trained board-certified orthopedic surgeon at Texas Joint Institute in McKinney and Plano, Texas who is an expert in hip and knee replacement procedures, adult reconstructive surgery, and nonoperative osteoarthritis care.

Dr. Ennin earned his undergraduate degree in biochemistry from the State University of New York in Stony Brook. He then went on to receive his medical education at the University of Cincinnati College of Medicine, before completing his general internship and orthopedic surgery residency at The University of Texas Southwestern Medical Center in Dallas. He is fellowship-trained in adult reconstructive surgery from William Beaumont Hospital in Michigan.

Dr. Ennin has a keen desire to educate. He is a presenter and educator to his colleagues regarding direct anterior total hip arthroplasty, total knee arthroplasty, revision total knee arthroplasty, partial knee replacement, and robotic surgery. He is committed to ensuring that the best understandings and techniques are available to all surgeons in the orthopedic community. Dr. Ennin is passionate about research. He has, throughout his career, been involved in and published numerous peer-reviewed studies.

Dr. Ennin has been a leader in the North Texas orthopedic community since 2015. He delivers personalized, patient-centered, evidence-based care for his patients. He is committed to taking care of his patient’s joints for their lifetime.

Dr. Ennin specializes in:

• Hip Replacement Surgery

• Joint Replacement

• Knee Replacement Surgery

• Orthopedic Surgery

• Osteoarthritis

DFW Wound Care Center is a group of wound care specialists in all of the DFW area. They are fellow trained surgeons, and board certified in wound care and reconstructive surgery. All physicians have also completed an intense residency and fellowship in the area of limb salvage, and foot and ankle surgery. When it comes to wound care and limb salvage, DFW Wound Care Center has the knowledge and experience to successfully treat your condition. As a result, patients from all over the country seek to be treated by DFW Wound Care Center.

Whether caused by diabetes, infection or disease, any wound that will not heal can be very serious. If you are experiencing a wound or ulcer that will not properly heal, our wound care center can provide a range of expert treatment options best in each case. We offer non-surgical and surgical treatments for:

Diabetic Wounds & Ulcers

Arterial Ulcers

Infected Wounds

Open Wounds

Pressure Ulcers

Vascular Wounds

Acute Wounds

Non-Healing Wounds

Chronic Wounds

Surgical Wounds

Traumatic Wounds

PLANO CLINIC 5804 Coit Road, Ste. 100 Plano, TX 75023

LEWISVILLE CLINIC 502 N. Valley Pkwy., #2 Lewisville, TX 75067

IRVING CLINIC

6161 N. State Hwy. 161, Ste. 320 Irving, TX 75038

DESOTO CLINIC 714 N. Hampton Rd. De Soto, TX 75115

JOSHUA WORLEY, DPM | REZA MOBARAK, DPM, FACFAS, FAPWCA, FAPWHC | MARK MASHNI, DPM, AACFAS | MITCH WILLIAMS, DPM

HOLLYWOOD’S

RENAISSANCE MAN AND DEVOTED FAMILY GUY

BY SONDRA BARR

YAN

YAN

Ryan Gosling’s life is a captivating story, one that could easily be the plot of a movie you can’t stop watching. Starting out as a young, hopeful artist in the world of Disney to becoming a Hollywood heartthrob, his journey has been nothing short of cinematic. His latest role transforming into Ken for the Barbie movie, has not only gone viral but also positioned him as a potential Oscar nominee. Ths unexpected and bold role choice highlights his ability to reinvent himself and take risks. Yet, while it’s been quite the ride for Gosling, surprisingly, his story isn’t just about climbing the ladder of fame; it’s a journey filled with genuine passion, a quest for artistic expression, and those precious, down-to-earth times he cherishes with his loved ones.

Gosling’s entry into the world of showbiz was not a tale of instant stardom. At the age of 12, after a series of auditions, Gosling found himself amidst the talented ensemble of Disney’s The All-New Mickey Mouse Club, joining the ranks of future stars like Justin Timberlake, Christina Aguilera, and Britney Spears. However, unlike his prodigiously talented peers, Gosling’s presence in the show was more understated. He told GQ magazine’s Zach Baron, “Everybody was at, like, prodigy level. I certainly wasn’t a child prodigy. I didn’t know why I was there. And I think that was the consensus.”

His experience in the show was less about shining in the limelight and more about figuing out his place in the world of entertainment. Gosling has often recounted how he often felt out of place, sometimes being dressed up as a hamster or relegated to the background. Yet, he recognized the value in these experiences, noting, “It was all a great experience in a way because it helped me figue out what I wasn’t going to be good at. Which is important to learn too.”

The ascent to stardom can be signifiantly attributed to his role in The Notebook. It was a pivotal moment in his career, marking his transition from a relatively unknown actor to a leading man in Hollywood. The path to landing this role was as unique as Gosling’s talent. During the audition process in 2002, director Nick Cassavetes made a remark that would become a definig moment for Gosling. Cassavetes said to him, “The fact that you have no natural leading man qualities is why I want you to be my leading man.” Ths unconventional perspective on Gosling’s appeal was a gamble that paid off imensely.

Casting Gosling in The Notebook was also influenced by a somewhat surprising reason. According to Nicholas Sparks, the author of the novel on which the film is based, Gosling was chosen for the role partly because nobody else was particularly keen on it. Sparks humorously noted that Gosling’s selection might have been because he “looks a bit nuts.”

Gosling’s performance won the hearts of audiences worldwide but also elevated his career. Prior to this, he was recognized for roles like the young Hercules, but The Notebook changed his public image dramatically, catapulting him to the status of a heartthrob and a respected actor in romantic dramas. Ths role laid the foundation for a career characterized by versatility and depth, allowing Gosling to showcase his ability to embody complex and emotionally rich characters.

His journey in the arts extends beyond Gosling’s accolades as an actor; he has also made signifiant strides in the world of music. His involvement in the indie rock band Dead Man’s Bones showcased a different side of his creative persona. The band, known for its hauntingly beautiful and evocative melodies, allowed Gosling to explore a musical landscape.

It was his part in Damien Chazelle’s La La Land that brought Gosling’s musical talent to a wider audience. Ths modern musical is both a grand musical spectacle and an intimate love story. Gosling’s character, Sebastian, a passionate jazz pianist, intertwines his life with Mia (played by Emma Stone), an aspiring actress. Their love story unfolds in a series of beautifully crafted musical and dance sequences that capture the essence of classic Hollywood musicals.

Drawn to the project by Chazelle’s “infectious love of movies” and the communal experience of film-watching, for Gosling, it was not only a foray into screen musicals but also an intensive dive into both music and dance. He took jazz piano lessons to

The Notebook

Photo courtesy New Line Cinema

Crazy Stupid Love

Photo courtesy Warner Bros. Gangster Squad

Photo courtesy Sony Pictures

authentically portray his character’s skills (it’s actually him playing the piano in the film) and engaged in rigorous dance rehearsals with Stone.

Gosling went on to showcase his range with a variety of roles. In 2017, he appeared in Song to Song and Blade Runner 2049, delving into both romantic drama and science fition. Then, in 2018, he portrayed Neil Armstrong in the biographical drama First Man, before appearing in The Gray Man

The decision to take on the role of Ken in the Barbie movie has been perhaps the most intriguing shiftin Gosling’s career trajectory. He’s said he was drawn to the role of Ken due to its resonance with his experiences as a father. He mentioned how his daughters play with Barbies and Ken, and seeing the doll, once face down in the mud next to a squished lemon, sparked his interest in bringing Ken’s story to life.

“There’s something about this Ken that really, I think, relates to that version of myself. Just, like, the guy that was putting on Hammer pants and dancing at the mall and smelling like Drakkar Noir and Aqua Neting bangs. I owe that kid a lot. I feel like I was very quick to distance myself from him when I started making more serious films. But the reality is that, like, he’s the reason I have everything I have,” Gosling told GQ.

Following his unique take on Ken, Gosling is set to continue his trend of diverse roles with The Fall Guy, scheduled for release this year. Directed by David Leitch, this action-comedy film, inspired by the 1980s TV series, will see Gosling portraying Colt Seavers, an experienced stuntman. The film delves into an intriguing scenario where Colt investigates the disappearance of a movie star from a film directed by his ex-girlfriend. Ths role represents another facet of Gosling’s versatile career, seamlessly moving from a whimsical character like Ken to the more action-oriented character of Colt Seavers.

Gosling’s dynamic acting career is balanced with his family life. Residing in a quiet Californian town, he brings his family to his film locations, aiming to work on just one movie per year. At home, Gosling and Eva Mendes, whom he met on Th Place Beyond the Pines, embrace a hands-on approach to parenting their daughters, Esmeralda and Amada, without a nanny. Ths harmonious blend of a professional life and a deeply fulfilling personal life reflcts Gosling’s commitment to living well, cherishing the simple, loving moments with his family.

There’s something about this Ken that really, I think, relates to that version of myself. Just, like, the guy that was putting on Hammer pants and dancing at the mall and smelling like Drakkar Noir and Aqua Net-ing bangs. I owe that kid a lot.

Barbie

Photo courtesy Warner Bros.

Blue Valentine

Photo courtesy Silverwood Films

VUDHI SLABISAK, MD OrthopaedicSpineSurgeon

BRUCE MARKMAN, MD OrthopaedicSurgeon&Sports MedicineSpecialist

JAMES STANLEY, MD OrthopaedicSpineSurgeon

STEVE HONG, MD Interventional Pain ManagementSpecialist

RAHUL BANERJEE, MD OrthopaedicSurgeon

GEOFFREY G. GLADDEN, MD OrthopaedicSurgeon

AMIR MALIK, MD Neurosurgeon

KHAWAJA IKRAM, DO OrthopaedicSurgeon

CHARLES MARDER, DPM Podiatrist,Foot&AnkleSurgeon

KELLVAN CHENG, DPM Podiatrist,Foot&AnkleSurgeon

AMIR AHMED, MD Gastroenterologist

BRIANA HODGSON, PA-C OrthopaedicSurgery PhysicianAssistant

Unusual Symptoms of anxiety

By KIMBERLY BLAKER

Imagine, out of the blue, you feel your brain spin 180 degrees at lightning speed as if fueled by an electrical current. Ths bizarre feeling isn’t lightheadedness, dizziness, or anything you’ve ever experienced. You panic and wonder, ‘Am I going crazy?’ Or worse, ‘Am I going to die?’ You try to brush it offwhen suddenly, it happens again.

According to the National Institute of Mental Health, nearly one in five Americans will experience an anxiety disorder in a given year. What’s more, there are over 100 possible symptoms, many of which you’d never expect to be caused by anxiety. For that reason, when they occur, they often exacerbate anxiety because of the worry caused by the symptoms.

Distressing Anxiety Symptoms

The following are some of the more bizarre symptoms of anxiety, though most are not uncommon. If you experience symptoms that persist, seek medical attention to rule out a medical cause since all the symptoms of anxiety can also be associated with various medical conditions.

Indigestion. Anxiety can cause temporary or even chronic indigestion. Burping, passing gas, diarrhea, and heartburn can all be symptoms.

Phantom ringing. Tinnitus, which is a ringing in the ears, can be a sign of stress or anxiety and can be experienced in several ways. According to anxietycentre.com, you may hear buzzing, ringing, humming, whizzing, chirping, roaring, swooshing, or any number of other sounds.

Burning sensation. This unusual anxiety symptom can be felt on your skin, lips, tongue, and even in your eyes. It can feel like a sunburn despite no sunburn being present, a prickling sensation, or even shooting sparks.

You may feel disconnected from the world and people around you, sort of like being in a dream state.

Heart irregularities. Skipped heartbeats, palpitations, or a racing heart can all be symptoms of anxiety. What’s so troublesome is that it can be difficult to tell the difference between heart irregularities caused by anxiety versus a heart attack. When in doubt, seek medical treatment right away.

Physical numbness or tingling. These feelings can occur in your hands, feet, arms, legs, or face. It may also feel like physical weakness.

Excessive yawning. During anxiety attacks, hyperventilation is a common response leading your body to feel it isn’t getting enough oxygen. As a result, you might experience frequent yawning.

Phantom smell. Phantosmia, an olfactory hallucination, sometimes occurs with anxiety. It can cause you to smell something that isn’t there, or rather, a neutral smell becomes unpleasant.

Brain shivers or zaps. Most often, this bizarre sensation is caused by antidepressants or withdrawal from them. However, sometimes it’s associated with anxiety. Brain shivers can range from mild to severe and feel different from person-to-person, though they usually last only a brief time. Brain shivers or zaps, explains anxietycentre.com, can feel like an electrical jolt or a shaking, vibration, or tremor in the brain,

Phantom vibrations. If you’ve ever felt your phone vibrate, only to discover it didn’t, attachment anxiety may be the cause. Ths is a genuine phenomenon, according to a study reported by the University of Michigan in 2016.

Tremors. Anxiety can cause numerous types of tremors. In addition to shaking or trembling, other typical forms, according to calmclinic.com, include arm or leg spasms, cramping, or longer or slower shaking than usual.

Derealization. This experience feels like not being in reality. Anxietybc.com says it can be experienced in several ways. You may feel disconnected from the world and people around you, sort of like being in a dream state. You may have a distorted perception of space, time, and the size of things. Everything might feel foggy or fuzzy or that you’re very ill or going crazy.

Globus hystericus. With this anxiety symptom, it feels like a lump in your throat, or you might have difficulty swallowing. Some people also feel a tightness in their throat.

Eye problems. Blurred vision, dilated pupils, watery eyes, and shapes that flat in front of the eyes can all be a result of anxiety.

Skin rashes. Stress can cause hives, itching, and rashes. If you already have rosacea or psoriasis, anxiety and stress can exaggerate it.

Shooting pains. You may experience these in several areas of your body, including your face, abdomen, arms, and chest during episodes of anxiety.

Freezing hands and feet. Stress and anxiety can decrease circulation. As a result, your hands and feet may feel icy.

How to Alleviate Anxiety

Depending on whether you have an actual anxiety disorder or the severity of the symptoms, anti-anxiety or antidepressant medication may be the solution. But there are other things you can do as well to reduce anxiety and alleviate symptoms.

During periods of high stress, get plenty of rest. Ths will help keep anxiety under control and result in fewer or less severe symptoms.

Also, practice slow breathing. Alice Boyes Ph.D., in her article, “Breathing Techniques for Anxiety,” says the key is to focus only on breathing out. While concentrating on slowly, steadily, and gently breathing out, allow the tension to flw out of your body and relaxation to flw in.

Mindfulness meditation is another useful technique for reducing anxiety according to a growing body of research. You can start by meditating for just a few minutes each day and gradually increase it to more extended periods. For complete instructions, visit https:// www.mindful.org/mindfulness-how-to-do-it/

Get some exercise. It doesn’t have to be a lengthy, hardcore workout. Even a 10-minute brisk walk can provide several hours of anxiety relief, according to psychologists, says the Anxiety and Depression Association of America.

Finally, if your doctor has told you your symptoms are anxiety-related, remind yourself of this when symptoms strike. Try not to worry about the symptoms, which only serves to exacerbate anxiety and cause the symptoms to persist.

David Shau, MD/MBA

Texas Hip and Knee Center Fellowship Co-Director and Faculty at the Anne Burnett Marion School of Medicine at Texas Christian University

Dr. David Shau is a native Texan, born in Fort Worth, TX. He graduated high school in Flower Mound, TX, and attended the University of Texas at Austin, where he studied biomedical engineering. Dr. Shau then ventured out-of-state to work at leading academic orthopedic surgery centers, including Vanderbilt University, Emory University, and University of California, San Francisco, before being recruited to return home to practice at the premier DFW joint replacement group, the Texas Hip and Knee Center (THK).

Dr. Shau has quickly built his practice through connecting with his community, committing to quality service, and delivering excellent patient care. He utilizes a variety of techniques and approaches for hip and knee care, including direct anterior hip replacements, and offers technology-assisted surgeries, such as Mako Technology for partial and total joint replacements. He also specializes in revision joint surgeries and enjoys complex, challenging cases. As a result of dedicating himself to his craft, his partners at THK promoted him to Fellowship Co-Director early in his practice. Dr. Shau also serves as a Physician Development Coach and is an Assistant Professor at the Burnett School of Medicine at TCU, where he enjoys his roles as a teacher, mentor, and coach.

In his free time, he enjoys food, sports, music, and spending time with his wife and daughter. For more information on Dr. Shau’s care philosophy and the techniques/approaches offered for hip and knee care, please visit DavidShauMD.com.

Dr. Shau has three office locations: 10900 Founders Way, Ste. 201, Fort Worth, TX 76244 6301 Harris Parkway, Ste. 300, Fort Worth, TX 76132

Should I Be Screened for Lung Cancer?

Courtesy TEXAS ONCOLOGY

Although  lung cancer  is often preventable, this cancer type has the highest rate of cancer-related deaths nationwide. In fact, it claims almost as many lives annually as colon, breast, and prostate cancers combined. In 2023, an estimated 14,510 Texans are expected to be diagnosed with lung cancer, with 80 to 90% of all lung cancer deaths attributed to smoking.

Like with all cancer types, knowing your risk of developing lung cancer is crucial in early detection. Understanding what preventable measures you should take, such as lung cancer screenings, can reduce your risk and protect your body against lung cancer.

The Importance of Getting Screened

Men and women who smoke are approximately 25 times more likely to develop lung cancer. Lung cancer screenings (LCS) are key for early detection and lowering the risk of mortality, especially in those who smoke. People ages 50 to 80 who have smoked, on average, one pack of cigarettes daily for 20 or more years and who currently smoke or have quit within the past 15 years are at a higher risk of lung cancer and qualify for screening with annual low-dose non-contrast computed tomography (CT) of the chest.

A  recent study  found despite 70% of at-risk women being diligent in getting their annual mammogram, the screening rate for lung cancer among eligible women was low by comparison. Researchers discovered a 20% reduction in lung cancer deaths among at-risk women who received a low-dose screening CT of the chest.

By encouraging women to become educated on their risk factors, as well as consider getting an annual LCS in addition to their  mammogram, the hope is to  reduce deaths from both common types of cancer.

If I Do Not Smoke, Am I Still at Risk?

If you are a non-smoker, there are still other genetic and environmental factors that may play a role in your risk of lung cancer.

• Age: Most people diagnosed with lung cancer are 65 or older.

• Family and/or Personal History: People with a parent or sibling who had lung cancer may have a higherthan-average risk, even if they do not smoke. People who have already had one episode of lung cancer are at an increased risk of developing a second lung cancer.

• Carcinogen Exposure: People who live or work in certain conditions with exposure to radioactive gas, asbestos, arsenic, radon, diesel exhaust, air pollution, and other substances have an increased risk of developing lung cancer.

Preventive Measures to Lower Your Risk of Lung Cancer

Do not smoke or quit as soon as possible. Smoking is the number one risk factor for lung cancer. Other steps you can take to lower your risk of lung cancer include:

• Take precautions at work: Exposure to certain types of fumes, dust, and chemicals can cause lung cancer. Make sure to wear appropriate safety gear.

• Test your home for radon: Radon, a radioactive gas, can increase your risk of lung cancer with long-term exposure. Most of Texas has low levels; however, some homes that are built on soil with natural occurring deposits like uranium can have high levels of radon that may seep into the home. To test your home, you can buy a radon detection kit or seek an EPA-suggested professional.

• Avoid secondhand smoke: More than 7,300 people in the U.S. die annually from lung cancer as a result of exposure to secondhand smoke.

Men and women are encouraged to consult with their physician to learn about the impact of lung cancer, including what they can do to lower their risk and protect their body, as well as consider getting screened.

FLORIAN DIBRA, MD

Florian Dibra, MD is an Orthopaedic Surgeon who provides extensive knowledge in hip and knee orthopedics. He treats operative and non-operative hip and knee arthritis. He specializes in minimally invasive muscle-sparing total hip and knee replacement, anterior hip replacement, partial knee replacement, robotic joint replacement, and complex revision hip and knee replacement.

Dr. Dibra graduated with honors from Villanova University in Pennsylvania. Soon after, he received his medical degree, with cum laude honors from the esteemed Jefferson Medical College in Philadelphia, Pennsylvania. He completed his orthopedic surgery training at the University of Florida. He continued at the University of Florida Health Hospital to complete his fellowship in Adult Arthroplasty with an emphasis in hip and knee reconstruction. During Dr. Dibra’s surgical training, he accomplished several publications, book chapters, and poster presentations.

Dr. Dibra’s family consists of his wife and two children. In addition to English, he is fluent in Albanian, Italian, and proficient in Spanish.

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Experienced DWI Defense THE LAWYER LAWYERS CALL

Deandra M. Grant

JD, GC, MS

Attorney Deandra M. Grant leads Hamilton Grant’s North, East and Central Texas offices. She is an international speaker on DWI law, science and trial skills. As the author of the annually updated Texas DWI Manual, she is viewed by her peers as being a leader in her field. Deandra understands the science behind alcohol absorption and elimination rates and can use this knowledge to competently defend you.

Deandra formerly was an assistant district attorney. Her tenure as a prosecutor focused on DWI prosecutions which has given her firsthand knowledge on how to counter the prosecutor’s evidence and strategy. Deandra has spent hundreds of hours in training courses and programs related to DWI defense and has completed the certification course to administer standard field sobriety testing (SFST), the same training course taught to police officers nationwide on how to identify drunk drivers during traffic stops. As a certified SFST Instructor, Deandra has taught the course to other attorneys. She’s also completed the coursework on DWI forensic blood and urine testing.

“I have a masters degree in pharmaceutical science and a graduate certificate in forensic toxicology. I am able to take apart evidence in ways a lot of other attorneys are not able to do. The most important part of my job is being the barrier between the government and my client. Standing between them. Making sure their rights are protected.”

–DEANDRA GRANT

Co-Author of the Texas DWI Manual

Radiant Imaging is a locally owned and operated diagnostic imaging center that offers their patients full-body scans with optimum patient comfort. Our team aims to make the diagnostic process as comfortable and safe as possible because we recognize the tension and anxiety that are frequently associated with it.

Radiant Imaging’s cutting-edge technology provides our patients the most reliable results possible. Our imaging center offers:

• Arthrograms

• Bone Density Scans (DEXA)

• Computed Tomography (CT) Scans

• PET/CT Combined Imaging

• Digital X-Rays

• Magnetic Resonance Imaging (MRI)

• Myelograms

Southwest Foot & Ankle Center is a respected group of board certified foot and ankle surgeons. They are fellow trained surgeons, and board certified in wound care and reconstructive surgery. All physicians have also completed an intense residency and fellowship in the area of limb salvage, and foot and ankle surgery. The team at Southwest Foot & Ankle Center strive to make each patient’s experience personable. Our outcomes are of perfection and meticulous in surgery. As a result, patients from all over the country seek to be treated by DFW Wound Care Center.

Foot and Ankle Surgery

Bunion and Hammer Toe Correction

MIS—Minimally Invasive Surgery

Heel Pain (Plantar Fasciitis) Stem Cell Therapy

Neuropathy

Ingrown Toenails

PLANO CLINIC 5804 Coit Rd., Ste. 100 Plano, TX 75023

LEWISVILLE CLINIC 502 N. Valley Pkwy., #2 Lewisville, TX 750067

Tarsal Tunnel Syndrome Diabetic Foot Care Flat Feet Trauma Wound Care

Custom Orthotics & Braces

Laser Therapy for Pain, Swelling, Arthritis, and Wounds

CLINIC 6161 N. State Hwy. 161, Ste. 320 Irving, TX 75038 DESOTO CLINIC 714 N. Hampton Rd. De Soto, TX 75115

By KIMBERLY BLAKER

Whether you’re considering welcoming a new furry friend into your home or have a dog or cat already, the decision to spay or neuter can be a difficult choice. You may feel uncomfortable deciding this or worry that it’s unnatural or harmful to your pet. In reality, spaying or neutering your pet is a giftof love, both to your own pet and to other cats or dogs.

What are spaying and neutering?

Spaying is the removal of a female pet’s reproductive organs, and neutering is the removal of a male pet’s testicles to prevent them from reproducing. These surgical procedures have a short recovery time. But they should be done only by a professional, licensed veterinarian under general anesthesia.

How does spaying or neutering help my pet?

Spayed and neutered pets reap many benefits, both physically and behaviorally. These procedures can signifiantly increase pets’ life spans and the quality of their lives. Here’s how

• Reduces cancer risk: Animals can be stricken with cancer, just like humans, which is devastating to their health and very costly to treat (when treatable). Spaying or neutering lowers a pet’s risk of developing breast, uterine, prostate, testicular, and ovarian cancer

• Reduces the chance of uterine infections: These infections are particularly dangerous for pets. But spaying or neutering decreases the risk of contracting one of these infections for both males and females.

• Females won’t go into heat: During the breeding season, female cats as young as four or five months old spend four to five days in heat every three weeks. Female dogs generally go into heat twice a year, lasting two to four weeks each time, depending on their breed. Dogs in heat may yowl or wail. They also urinate more often, and all over, in their search for a mate. Then they feel frustrated when they don’t fid one. Females may even bleed and have a swollen vulva during this period. Also, males are likely to be attracted to females in heat and may show unwanted attention or aggression.

• Males won’t have negative mating behaviors: Unneutered male pets are more likely to be distracted and aggressive. They also feel frustrated at not being able to fid a female to mate with. They’re more likely to try to escape and roam in search of a female in heat. Ths puts them at risk of getting lost, stolen, injured, or killed. Frustrated males may also mark their territory or make inappropriate sexual advances on people or objects they encounter

How does spaying or neutering help the community?

There are currently millions of unwanted, homeless pets living on the streets. Dogs and cats are not wild animals with the ability to survive and thrive in the wilderness (or on city streets). Some of these animals are captured and taken to shelters. Unfortunately, shelters are often overrun because there are so many stray dogs and cats. So when they don’t get adopted, they’re either euthanized or live out tragic lives in small cages with little exercise, affection, and interaction.

Stray animals can also injure people, destroy property, cause car accidents, kill wildlife, and disrupt the ecosystem. They also continue to mate, leading to even more homeless animals. Trying to manage this problem costs local governments large amounts of tax-payer money

SO WHEN THEY DON’T GET ADOPTED, THEY’RE EITHER EUTHANIZED OR LIVE OUT TRAGIC LIVES IN SMALL CAGES WITH LITTLE EXERCISE, AFFECTION, AND INTERACTION.

So spaying or neutering your pet reduces your pet’s potential to produce more unwanted litters that would otherwise increase the homeless animal problem. If you’re holding back on spaying or neutering because you may want to breed your pet to sell its offpring, realize this takes away a shelter pet’s chance of being adopted by a potential pet parent.

What if I can’t afford to spay or neuter my pet?

If you don’t already have a pet, keep in mind that part of deciding to adopt a pet is making sure you’re fiancially able to care for it. Pets require at least food and medical expenses, including regular checkups, vaccinations, and spaying or neutering. So you should be in a fiancial position to manage your pet’s expenses before adopting one.

If you decide to get a pet but choose not to spay or neuter for financial reasons, you risk incurring much higher costs down the road. Ths can result from having an unwanted litter or if your pet develops medical problems or behavioral issues that spaying or neutering would have protected against.

If you already have a pet or you’re considering getting one, many resources are available to help low-income individuals and families get their pets spayed or neutered. Check with your local veterinarian or shelters for affordable services or aid near you. The  ASPCA  and  Humane Society both have resources on where to fid services for lowcost procedures. Just make sure if you do fid an inexpensive option, the procedure is done by a reputable, licensed veterinarian to ensure your pet’s safety and health.

So remember, when you make the decision to spay or neuter your pet, you’re helping both your pet and the entire community of dogs or cats to live happier and healthier lives.

OLIVIA ROGERS , RN, BSN, CHPN, CHPO, MBA, is a leading voice in health care and senior services and the Vice President, Chief Nursing Officer of VNA Texas.

Dear Olivia,

What is the benefit of choosing hospice care for my loved one? How does someone determine that it is the right time for hospice? We don’t want to give up hope. That is the hard part about making this decision.

~Not Ready to Give Up

Dear Not Ready to Give Up, I understand how difficult and emotional it can be to make decisions about end-of-life care for a loved one. It is completely understandable to feel conflicted and unsure about what the best choice is. You want to ensure your loved one receives the best care possible while keeping hope alive. It is a challenging balancing act.

Fortunately, hospice care is designed to promote quality of life and control any symptoms that may present themselves. It is not the absence of care, but rather, it is intense care provided wherever the patient calls home. It focuses on ensuring the patient and family can enjoy their time together

and have the support system they need to make that possible. Please know that you are not alone in this. Many families face similar struggles, and it’s okay to ask for help.

I recently met a former patient’s daughter at a restaurant where she was our server, and she expressed how grateful she was to have that support at the end of her father’s life journey. She said, “Taking him home from the hospital would not have been possible without hospice. We just did not know what we did not know!” That is what the hospice team can do— help you and your family with questions, fears, and concerns and help to make your goals possible while offering hope and peace that is so needed at that time.

I hope this helps you as you navigate this challenging time. You can find more resources on our website at vnatexas.org. Remember, you are doing your best, and your loved one is lucky to have such a caring and compassionate family.

~Olivia

VNA Hospice & Supportive Palliative Care

Focuses on quality of life for the patient and family at a time when comfort, compassion and clinical expertise matter most.

To schedule your free in-home informational visit please call (214) 689-0000 or email gethelp@vnatexas.org For volunteer opportunities please call (214) 689-2271 or email volunteer@vnatexas.org