Denton County Living Well Magazine May/June 2025

MAY/JUNE 2025

More Inside OLDER KIDS, WISER PARENTING THE COMPARISON TRAP FRIENDSHIP AFTER 40

DENTON COUNTY

PEDRO

Pascal IN HIS OWN TIME

Our Focus is

You

Denton Rehab is a locally owned and operated skilled nursing facility that is licensed by the State of Texas and certified to participate in both the Medicare and Medicaid programs. Our core management team has worked together for years and has decades of experience providing compassionate healthcare.

When you require professional, dependable, skilled nursing care to regain your health and strength, chose the expert team at Denton Rehab. We invite you to stop by and meet our friendly staff.

02 • MAY/JUNE 2025

Now Open!

We’re excited to show you our beautiful new community in Denton, located on six beautiful acres conveniently located next to Medical City Denton.

Our facility has 94 private beds with ensuite and shower. We have two suites that include ensuite, shower and a living area.

Our new community has three living areas, two dining areas, a private dining area for families, cultural center, sitting parlor, beauty shop, activities center, whirlpool room, therapy gym, and eight covered outdoor areas to relax and view nature and the beautiful, landscaped grounds.

Our state-of-the-art kitchen uses green technology to provide healthier, more delicious food.

Denton Rehab’s nurses and certified nurse aides provide around-theclock care. Doctors and nurse practitioners make rounds three times a week while our medical director makes rounds twice a week. Our number one goal is helping you recover and rebuild your life. Our Focus is You!

As always, Denton Rehab will expertly coordinate all aspects of your care: 24-Hour Nursing Care Wound Care Hospice/Respite Care Restorative Nursing Physical, Occupational, & Speech Therapies Assistance with Personal Care Laboratory and X-ray Services Skilled Nursing

dentonrehab.com | 940.387.8508 3345 Medpark Drive, Denton, TX 76210 DENTON COUNTY • 1

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 5450 Clearfork Main, Ste. 100, Fort Worth, TX 76109

Please call 817-433-8301 for an appointment.

2 • MAY/JUNE 2025

Don’t let hip or knee pain keep you from what you love.

Find a doctor who uses Mako, visit

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All surgery carries risk. Talk to your doctor to see if joint replacement is right for you. JR-MKOSYM-GRAP-681675

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Living Well

FROM THE PUBLISHER

A Health & Lifestyle Magazine for THRIVING ADULTS

WELLNESS, WISDOM, & THE BEAUTY OF BECOMING

W

MAY/JUNE 2025

PRESIDENT & CEO SAM HOUSTON VICE PRESIDENT & CFO SPRING HOUSTON EDITOR, FEATURE WRITER & SOCIAL MEDIA SONDRA BARR

e’re kicking off this LIVING WELL issue with none other than Pedro Pascal—Holly-

wood’s beloved “internet daddy.” From The Last of Us to

TM

SPRING AND SAM HOUSTON

The Mandalorian, Pascal has charmed audiences not just with his performances, but with his humanity. His rise speaks to the power of emotional complexity in an age of spectacle, and his story is a timely reminder that resilience, humor, and quiet authenticity never go out of style.

ART DIRECTOR VANESSA FRYER ACCOUNTS MANAGER JENNIFER BEAVERS WEBSITE LYDIA ROGERS

er into modern-day wellness. In “Older Kids, Wiser Parenting,” Sarah Collins captures

ADVERTISING & SALES TEXAS: Denton County, Dallas County, Collin County

the quiet, sometimes tender ache of parenting teens and young adults with remarkable

TEXAS & OKLAHOMA: Texoma Area

We’re also delighted to offer a rich mix of thoughtful, real-life reflections that dig deep-

grace. It’s a moving exploration of what it means to stay close while stepping back, to love fiercely without clinging. If you're in this stage of life—or approaching it—you’ll find comfort in its honesty and insight. Read it on page 18.

And for anyone who’s ever scrolled social media and felt that pang of “Why not me?”

Lauren Hayes' piece, “The Comparison Trap,” on page 46, offers a compassionate look at

WRITE TO US: Tell us who you would like to see featured on the cover, or what subjects you would like covered in upcoming editions of LIVING WELL MAGAZINE at info@livingwellmag.com

envy as a mirror, not a flaw. With nuance and care, she invites us to use comparison not to diminish ourselves, but to reconnect with what we truly value.

We’re also featuring, “The Quiet Evolution of Friendship After 40” by Andrew Miller, a moving and relatable piece about how our connections shift in midlife on page 28.

It explores what it means to nurture fewer, deeper relationships, to make peace with friendships that fade, and to recognize that real companionship is less about who’s always been there, and more about who sees you now. For anyone balancing the beautiful (and sometimes bewildering) stretch between middle age and meaningful connection, this one will resonate.

Wherever this season finds you—redefining your role, reclaiming your joy, or simply catching your breath—we hope these pages offer wisdom, perspective, and a little encouragement to keep living well.

Live well,

SAM AND SPRING HOUSTON

4 • MAY/JUNE 2025

SUBSCRIPTIONS & CUSTOMER INQUIRIES

Houstons of Dallas Publishing, Inc. 102 E. Broadway, #901 Prosper, TX 75078 www.LivingWellmag.com Phone: (214) 507-1000 Fax: (855) 248-2132 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.

All advertisements in this Magazine are placed by third parties. We do not control or endorse either the advertisements or their content.

Further, we do not manufacture, sell, distribute or provide any of the goods or services advertised herein. We hereby expressly disclaim any liability with respect to information or goods and services contained herein. We further disclaim any and all warranties or representations, express or implied, with respect to such information, goods or services, including any warranty of merchantability or fitness for a particular purpose (it being understood that we do not acknowledge that any such warranty exists). We are not liable or responsible for any loss, injury, damage, or harm that you may suffer as a result of the information contained in any advertisement or goods or services contained herein.

“We” refers to the name of this Magazine, and all versions of Living Well Magazine as well as Houstons of Dallas Publishing, Inc.

CONTENTS

AND MUCH MORE...

8

25

Sudden Hearing Loss

33

Quality Hospice Provider Concerns

37

Early Signs of Colon Cancer

39

You Had a Stroke…In Your Eye?!

40

Oops, Did I Just Say That?

43

Your Opinion Matters

18

FEATURES 8 18 28

Pedro Pascal In His Own Time

Older Kids, Wiser Parenting Parenting When the Nest Is Loosening

Friendship After 40 Why our connections change—and how to nurture the ones that truly matter

46

The Comparison Trap Finding Peace in a World of Perfect Lives

MAY/JUNE 2025

More Inside OLDER KIDS, WISER PARENTING THE COMPARISON TRAP FRIENDSHIP AFTER 40

DENTON COUNTY

28

FOLLOW US ON SOCIAL MEDIA

PEDRO

Pascal IN HIS OWN TIME

@ LivingWellmag @ LivingWellmags @ LivingWellmags @ LivingWellmagaz

Visit LivingWellMag.com for a free digital subscription.

46 DENTON COUNTY • 5

Spine Surgery FAQ Guide

From the experts at Texas Back Institute 45 years, Texas Back Institute (TBI) F orhasover been a leader in spine care, driven by a

commitment to collaboration, research, and innovation. These core values distinguish TBI, providing patients with personalized and innovative treatment plans for various spine conditions. Texas Back Institute offers access to a diverse team of spine specialists, including orthopedic spine surgeons, neurosurgeons, and conservative care physicians, ensuring that every patient receives the most appropriate care. Whether surgical or non-surgical treatments are needed, TBI’s comprehensive approach guarantees the highest level of care.

While a small percentage of TBI patients require surgery, when surgery is necessary, the specialists at TBI are equipped to address nearly every spine condition, treating everything from bulging discs to scoliosis and complex spinal deformities. A peer review process ensures the best outcomes, with surgeons collaborating to discuss and review complex cases before deciding on the appropriate course of action.

TBI’s strong commitment to research and training further solidifies its position as a leader in spine care, allowing Texas Back Institute to offer advanced treatments such as disc replacement, ultra-minimally invasive spine surgery, and robotic spine surgery.

6 • MAY/JUNE 2025

What is endoscopic spine surgery?

Endoscopic spine surgery is an ultra-minimally invasive spine surgery which allows the surgeon to use a small camera and micro-instruments to scope the spine through a dime sized incision. The camera allows the surgeon to clearly see the nerves, discs, and other structures in the spine. The surgeon then uses the micro-tools to relieve nerve compression from bone spurs and disc herniations.

This procedure allows for a smaller incision, quicker recovery, and patients getting back to life faster.

2. Why is disc replacement surgery revolutionizing the spine industry?

Disc replacement is a ground-breaking spine surgery which replaces a disc (or discs) in the spine with an artificial disc. Studies show patients are able to maintain motion in their neck or back long term, and there is less chance of needing additional surgery in the future.

3. What do I need to know about adult scoliosis?

Adult degenerative scoliosis is a progressive curvature of the spine which usually develops later in life. It can significantly impact a patient's quality of life. Over the last few years, advancements in medical technology and surgical techniques have provided new solutions for patients suuering from scoliosis. With a comprehensive approach and the right technology, doctors can navigate the curve of adult degenerative scoliosis and help patients regain their quality of life.

4. What are the beneets of my spine surgeon employing robotics?

Spine surgeons have real-time guidance, along with continuous computation and scan integration by the navigation system. This allows the surgeon to see a comprehensive three-dimensional picture of the patient’s neck or back. The benefits are a less invasive and higher precision surgery, which also decreases radiation exposure, complication rates, and operative and recovery time.

5. Why is it important to see spine specialists who offer multiple surgical options? Depending on your situation, there could be multiple solutions to help you with your neck or back pain. Make sure you know all your options.

6. Why is it important to me that my surgeon is involved in spine research and education?

Research and education allow your spine specialist to have access to innovation that continues to advance the world of spine.

7. What are three questions I should ask my spine surgeon about the surgery they are recommending? a. Are there alternatives to the surgery you are recommending? b. How many of these procedures have you done? c. What are my risks if I choose not to do surgery at this time?

Texas Back Institute remains a trusted leader in spine health. Whether you need non-surgical care or complex spine surgery, the experts at TBI can help prepare an individualized treatment plan to get you back to what you love.

Visit one of our many locations in North Texas, including: Alliance, Argyle, Dallas, Denton, Flower Mound, Fort Worth, Frisco, Lewisville, Mansfield, McKinney, Central Plano, Plano, Rockwall, Texoma, & Wichita Falls

Learn more at www.texasback.com or call to schedule your appointment at 972-608-5100.

DENTON COUNTY • 7

The actor we didn’t know we needed.

By SONDRA BARR

P

edro Pascal is now recognized around the globe—even when he’s hiding behind a Mandalorian helmet—but it’s the heart he brings to every role, an emotional range as rich as it is authentic, that has propelled him on a journey into the cultural zeitgeist. But now, at 50 years old, with two major blockbuster TV roles under his belt and a slate of upcoming projects as ambitious as they are high-profile, Pascal has become something more than a star. He’s become a cultural moment.

Born in Chile and raised between Texas and California after his parents fled the Pinochet regime as political refugees, Pascal’s path to stardom was neither smooth nor swift. As he told Vanity Fair, “I still awe at the opportunity that was handed to me by David Benioff, Dan Weiss, and Carolyn Strauss” when they cast him in Game of Thrones. “Without Thrones, I would not have had Narcos, The Mandalorian, or The Last of Us.” But before Westeros came years of lean times and near-misses. After graduating from NYU’s Tisch School of the Arts, Pascal scraped by with theater gigs and small TV parts, getting fired from more waitstaff jobs than he can count. He told Esquire, “I guess that, and this delusional self-determination, and no real skill at anything else, is what kept me going.”

It was during those lean years in New York that he formed lifelong friendships with fellow actors, including Sarah Paulson. She told Esquire that she sometimes gave him her per diem from acting jobs so he could eat. “You just want him to succeed,” Paulson said. “And that, to me, is the sign of a major movie star.”

Pascal’s breakout came in 2014 as Oberyn Martell, the Red Viper of Dorne, whose short but unforgettable arc in Game of Thrones showcased his magnetic screen presence. He followed it up with Netflix’s Narcos, where his turn as DEA agent Javier Peña proved he could hold a show’s center of gravity. But the real seismic shift came with two wildly different roles: masked bounty hunter Din Djarin in Disney+’s The Mandalorian, and rugged survivor Joel in HBO’s The Last of Us. “He’s a part of some spectacularly successful things,” Paulson said, “but sometimes in those situations, the show is the superstar. It’s really exciting to see that he is the thing that is becoming the superstar out of this.”

Both roles cemented Pascal as the go-to figure for complicated, emotionally armored father figures. But don’t let the paternal archetype fool you: Pascal is not formulaic. As Last of Us creator Craig Mazin noted, “There are actors you feel slightly intimidated by, and then there are actors you want to take home and hug and give some soup. And he’s both. Somehow he’s both.”

8 • MAY/JUNE 2025

PA S C A L

PEDRO

MY VISION OF IT WAS THAT IF I DIDN’T HAVE SOME MAJOR EXPOSURE BY THE TIME I WAS 29 YEARS OLD, IT WAS OVER.

DENTON COUNTY • 9

I GUESS THAT, AND THIS DELUSIONAL SELF-DETERMINATION, AND NO REAL SKILL AT ANYTHING ELSE, IS WHAT KEPT ME GOING.

10 • MAY/JUNE 2025

Yet with all this success, Pascal remains unmoored from the trappings of celebrity. “I had a moment of thinking; ‘You’re in your 40s and you don’t own a home? Grow up,’” he told Esquire. “But I’m relinquishing expectations around what it is to be middle-aged and what it means to be fully grown up.”

He speaks candidly about self-doubt and the many points when he almost gave up. “My vision of it was that if I didn’t have some major exposure by the time I was 29 years old, it was over,” he said. “So, I was constantly readjusting what it meant to commit my life to this profession.”

Part of what makes Pascal so magnetic is the tension between his vulnerability and strength. He’s someone who survived hardship not with cynicism, but with warmth. According to multiple interviewers, he laughs easily, often at himself, and tells stories with the enthusiasm of someone still surprised by his own trajectory.

His personal story is as remarkable as his professional one. As he shared on the Smartless podcast, his family’s flight from Chile involved hiding a wounded opposition member from Pinochet’s regime, going underground, and ultimately scaling the walls of the Venezuelan embassy to seek asylum. “And it worked,” Pascal said.

His mother, a child psychologist, and father, a fertility doctor, would eventually settle in the U.S. and raise Pedro and his siblings between Texas and California. When his mother died in 2000, he adopted her surname professionally. “I just always wanted to be like, I’m here,” he said of stepping in to help care for his younger siblings.

That same mix of loyalty and resilience defines his career. Asked by Vanity Fair about his process, Pascal said: “I think everyone has a method, and I admire, even envy, those that have more rigorous ones. It’s always important to read a room, but sometimes disrupting the room can help achieve something that serves the work.”

He doesn’t see himself as above the work, and in fact, often deflects praise.

While he was hailed for his 2023 Saturday Night Live hosting gig, Pascal demurred: “SNL was all of those challenges stuffed into one week of my life…I could not have had a better time.”

From indie plays to Marvel blockbusters (he’ll soon debut as Reed Richards in The Fantastic Four: First Steps), Pascal remains impossible to pin down. He can go toe-to-toe with Nicolas Cage in The Unbearable Weight of Massive Talent (2022), then turn around and voice a tender fox in The Wild Robot (2024). He weaves in and out of internet memes with the same ease he brings to monologues. Whether he’s leaning on furniture mid-panic attack in The Last of Us or munching a sandwich in a viral YouTube clip, there’s a rare relatability to his presence.

“It was really intimidating,” Pascal said to Men’s Journal this year. “I relied on the people that I was around to hold me to the experience and help get me through it. Stepping into something like Game of Thrones and then going into the early days of Netflix with Narcos and then Star Wars and the world of video games with The Last of Us, each time I’ve felt like I couldn’t top how intimidating the last one was.”

“They’re all scary because you really want to make people happy, especially if it’s something that’s widely known with particular expectations around it because you want those expectations to be met,” Pascal continued.

“You also want to be authentic to yourself so that it can be the best that it can be for anybody who wants to be entertained by a story and travel with us into this world.”

Hailed by Time as one of the 100 most influential people in the world in 2023, Pascal is proof that stardom doesn’t have to come at the cost of authenticity. He doesn’t posture. He doesn’t pretend. He simply keeps showing up, doing the work, and letting the world catch up.

In a landscape that often favors spectacle over soul, Pedro Pascal is a reminder that living well means showing up fully—heart, humor, and all. His rise may have taken time, but in a culture that craves truth and connection, he’s right on time.

Game of Thrones; HBO

Gladiator II; Paramount

Narcos; Netflix

The Last of Us; HBO

DENTON COUNTY 11 Wonder Woman 1984; Warner •Bros.

See Better.

Look Better.

Feel Better.

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Stephen P. Courtney, MD Fellowship-Trained Orthopedic Spine Surgeon Over 28 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!”

Livingwell TOP DOCS AND OTHER

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2004 Ventura Drive, Suite 200, Plano, Texas 75093 (972) 499-5457 • scheduling@advancedspinecenters.com advancedspinecenters.com DENTON COUNTY • 13

PREMIER SURGEON FOR HIP AND KNEE REPLACEMENT Livingwell VOTED TOP DOC IN DALLAS COUNTY AND COLLIN TOP DOCS AND OTHER

HEALTHCARE PROVIDERS

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COUNTY. DR. TOULSON IS PROUD TO SERVE LOCAL RESIDENTS AND SURROUNDING COMMUNITIES.

Dr. Charles Toulson specializes in: Robotic Joint Replacement Total Hip Replacement Total Knee Replacement Partial Knee Replacement Total Hip and Knee Revisions

TO LEARN MORE, VISIT

txjointinstitute.com ALLEN 1125 Raintree Cir., Ste. 201 Allen, TX 75013 (972) 566-5255 MCKINNEY 4201 Medical Center Dr., Ste. 100 McKinney, TX 75069 (469) 796-4295 SHERMAN 204 Medical Dr., Ste. 110 Sherman, TX 75092 (469) 796-4295 Please call to make an appointment.

14 • MAY/JUNE 2025

Left to right William F. Tucker, Jr., MD Duncan L. McKellar, Jr., MD Brian Nwannunu, MD Florian F. Dibra, MD Charles E. Toulson, MD Cyrus Abbaschian, MD Donald W. Hohman, MD J. Stephen Appleton, MD Alexander S. Greenstein, MD Raj Yalamanchili, MD Kwame A. Ennin, MD Samuel K. Stephenson, MD J. Conner Ryan, MD

Expert Orthopedic Surgeons Close to Home ALLEN | DALLAS | FRISCO | PLANO | MCKINNEY | SACHSE | SHERMAN At Texas Joint Institute, our growing team of highly skilled orthopedic surgeons and medical professionals are at the forefront of bone and joint health. From joint replacements and minimally invasive treatment options to complex joint reconstruction and treatment of bone and soft tissue sarcomas, our team offers a wide range of services to help you get back to your daily activities you enjoy.

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DENTON COUNTY • 15

At North Texas Orthopaedic & Spine (NTOS), patients of all ages are given the focused, individualized care they need in order to live fully and comfortably.

The team at NTOS has a high level of expertise in the diagnosis and treatment of conditions involving the spine, joints, and bones.

Patients appreciate the practice’s ability to educate them thoroughly about their conditions and give them the tools that they need to take control of their well-being. Whether the patient is an athlete with an injury or someone who has a long-term condition that affects their daily life, the NTOS team works alongside them to get them back to a full, active life. NTOS offers treatment for shoulder pain, tennis elbow, torn ACLs, sciatica, carpal tunnel, herniated disc, scoliosis and more. These and other conditions can get in the way of your work, hobbies, and general enjoyment of life.

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FRISCO 9990 Dallas Pkwy., Ste. 105 Frisco, TX 75033

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DA L L A S Lakewood Medical Center 6243 Retail Rd., Ste. 500 Dallas, TX 75231

C A R RO L LT O N 4333 N. Josey Ln. Professional Plaza II, Ste. 103 Carrollton, TX 75010

16 • MAY/JUNE 2025

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VUDHI SLABISAK, MD Orthopaedic Spine Surgeon

BRUCE MARKMAN, MD Orthopaedic Surgeon & Sports Medicine Specialist

JAMES STANLEY, MD Orthopaedic Spine Surgeon

STEVE HONG, MD Interventional Pain Management Specialist

RAHUL BANERJEE, MD Orthopaedic Surgeon

GEOFFREY G. GLIDDEN, MD Orthopaedic Surgeon

AMIR MALIK, MD Neurosurgeon

KHAWAJA IKRAM, DO Orthopaedic Surgeon

CHARLES MARDER, DPM Podiatrist, Foot & Ankle Surgeon

If you’re suffering from pain or an athletic injury, schedule an appointment with your preferred NTOS location for effective, compassionate treatment.

BRIANA HODGSON, PA-C Orthopaedic Surgery Physician Assistant DENTON COUNTY • 17

Older Kids, Wiser Parenting Parenting When the Nest Is Loosening

By SARAH COLLINS

T

here’s a moment—quiet, nearly invisible—when the hum of family life shifts. The backpacks are still tossed by the door, the shoes still multiply in corners, but something’s changed. Your child—once a small, constant presence—is now taller than you and soon creeping into their 20s. Their questions have grown more complex. Their silences, longer. They come and go in a rhythm that feels less like yours and more like their own. And without anyone saying so, parenting begins to feel like a practice in letting go.

Raising older kids—teenagers and young adults—is a different kind of love story. It’s less about guidance and more about grace and connection. Less about control and more about quiet presence.

You’re still needed, of course. But in ways that can be hard to recognize, and harder still to accept.

You used to be the sun around which their world revolved. Now, you are the steady warmth they orbit when they choose to, sometimes with long, silent stretches in between.

18 • MAY/JUNE 2025

The Shift No One Prepares You For There’s no celebration when your child no longer reaches for your hand. No party when they stop asking for bedtime stories or needing you at every practice. These shifts happen slowly, then all at once.

One day you’re making their lunch and reminding them to bring a jacket. The next, they’re driving themselves to school and leaving texts unread.

This can be jarring. For years, your days were structured around their needs. The logistics of raising children require you to be a constant manager, nurturer, and protector. But when those demands ease, what remains is less clear—and often less applauded.

You may find yourself wondering: Where do I fit now? What does good parenting look like when your child is pulling away? There’s no one answer. But perhaps the beginning lies in understanding that love at this stage is less about doing, and more about being.

Being a Steady Presence, Not a Constant One Older kids don’t always need answers. They don’t always want advice. What they need—though they may not say it—is the assurance that you’re there. That your love doesn’t hinge on their success, their choices, or how often they call home. They need to know they can fail in front of you and still be met with kindness.

This is the work now: to soften the edges of our expectations. To listen more than we lecture. To offer guidance like a lighthouse offers light—not chasing, not controlling, just shining steadily from the shore.

It requires restraint, especially when their decisions seem risky or strange. But it’s in that restraint that trust grows. The more we allow them to struggle, the more they learn their own strength.

The Courage to Evolve Alongside Them Parenting older kids often requires shedding old identities. You are no longer the fixer of scraped knees, the orchestrator of playdates, the keeper of schedules. And while that can feel like loss, it can also be an invitation: to evolve.

As your children grow, you’re offered the chance to rediscover parts of yourself that may have been paused. A creative spark. A dormant ambition. A version of you that exists beyond parenting. You’re allowed to change, too. And when you do, your kids notice. Not always with words, but with curiosity. They see that growth doesn’t stop at a certain age. That reinvention is always possible. In this way, you continue to parent—not by doing, but by being an example of a life still unfolding.

agree. What matters most is that they know they can come to you— and that they’ll be met with compassion.

Letting Them Struggle (and Still Sleeping at Night) Perhaps one of the hardest parts of parenting older kids is watching them suffer. Whether it’s a friendship breakup, academic pressure, heartbreak, or just the general confusion of growing up, their pain no longer lives under your roof in a way you can easily reach.

There’s no Band-Aid for existential dread. No quick fix for selfdoubt. And so we do the most radical thing: we stay close while doing less. We don’t swoop in. We don’t solve. We trust that they will find their way—because that’s the only way they’ll learn that they can.

This doesn’t mean disengaging. It means offering emotional safety while allowing for emotional risk. It means saying, “This is hard.

I’m here.” Not, “Here’s how to fix it.” That balance can feel impossible. But with practice, it becomes one of the greatest gifts you can give—a belief in their own resilience.

When the House Grows Quieter As older kids begin to build lives outside of your home, the quiet can feel deafening. You might walk past their empty room and feel an ache you can’t quite name. You might miss the chaos you once craved a break from.

This is a tender time. It’s okay to feel grief here. It’s okay to feel joy, too. To enjoy the new freedom. To miss the old messiness. Often, both exist at once. What helps is ritual. New ones. A Saturday morning walk. A standing dinner date. A shared show or book club, even if it’s over FaceTime. Connection looks different now, but it’s still possible. And in some ways, even more beautiful—because it’s chosen.

Trusting the Seeds You’ve Planted More than anything, this stage of parenting is a test of faith. You’ve spent years planting seeds: kindness, integrity, empathy, resilience.

You can’t control how they take root. But you can trust that they’re there.

When your child faces a challenge and handles it with grace, you see those seeds. When they apologize without prompting. When they stand up for someone. When they take responsibility for a mistake. And even when they don’t, you remember: this is still their story to write. You’re no longer the narrator. You’re the editor in the wings, ready to support—but not to rewrite.

Conversations That Matter

Parenting, Reimagined

One of the great gifts of this stage is the potential for deeper, richer conversations. When they were younger, communication often revolved around logistics and rules. But now, if you’re lucky—and if you create the space—there are glimpses of real dialogue. Opinions.

Fears. Dreams. Ideas that surprise you.

These conversations don’t always arrive on your schedule. They tend to emerge late at night, on long drives, or in the middle of folding laundry. The key is to be available without hovering, interested without interrogating. Curiosity, without control.

It’s okay if they don’t tell you everything. In fact, it’s healthy. But when they do open up, honor it. Even if it’s hard. Even if you don’t

This chapter asks us to reimagine what it means to parent. To move from doing to being. From directing to witnessing. From holding tightly to holding space. It’s not always easy. But it can be deeply fulfilling. Because if we’re lucky, our children will continue to return— not out of obligation, but out of love. Not because they need us to solve things, but because they know we’ll listen. Not because they’re still our babies, but because we’ve become something even more enduring: a steady, loving presence in the unfolding of their lives. And in doing so, we realize that parenting doesn’t end when the house grows quiet. It just takes on a new, quieter power—one built not on control, but on connection.

DENTON COUNTY • 19

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WITH THE EMINENT CHOICE IN HEALTHCARE

20 • MAY/JUNE 2025

Eminent Medical Center is the premier treatment destination in the Dallas/Fort Worth area with three operating suites and five private patient rooms.

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Eminent Medical Center is a premier, boutique treatment destination in the DFW area. We are an In-Network provider with Aetna, Blue Cross Blue Shield, Cigna, and United Healthcare.

ROBOTIC TECHNOLOGY Orthopedic surgeons and the medical staff at Eminent Medical Center are excited to offer Zimmer Biomet’s ROSA Knee System, which helps surgeons personalize surgical procedures for their patients.

PROVIDING SPECIALTY CARE We provide surgical services for pain management,

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Eminent Medical Center is a proudly certified Center of Excellence Designation for Advanced Spine Surgery and Advanced Hip & Knee Replacement

www.eminentmedicalcenter.com • (469) 910-8800 1351 W. President George Bush Highway, Richardson, Texas 75080 DENTON COUNTY • 21

Let your feet guide your way to

Comfort 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.

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22 • MAY/JUNE 2025

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See what KoonsFuller can do for your family.Working together, as a fully integrated team, there is no case too large or complex for us to manage. To learn more about KoonsFuller, visit koonsfuller.com.

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www.koonsfuller.com DENTON COUNTY • 23

Better Hearing KEEPS YOU

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Livingwell

Sudden Hearing Loss What You Need to Know Courtesy HEARING SERVICES OF McKINNEY

I

magine waking up one morning and realizing the world sounds quieter—on one side. There’s no pain, no clear cause. Just a strange silence in one ear. You might assume it’s earwax or a sinus issue. You might wait for it to pass.

But that wait could cost you your hearing.

Every year, thousands of adults experience a condition called sudden sensorineural hearing loss, or SSNHL. It’s often mistaken for something minor, yet it should be treated as a medical emergency. When it comes to preserving your hearing, time matters.

SSNHL is defined as a rapid, unexplained loss of hearing—usually in one ear—that occurs over a span of a few hours or up to three days. In many cases, the first sign is subtle: sounds feel muted on one side, or the phone suddenly sounds muffled in one ear. Some people notice it when they wake up. Others hear a sudden “pop” followed by a sensation of fullness, ringing, or even dizziness. It can be disorienting. And because there’s often no pain, it’s easy to brush off or misdiagnose.

In fact, one of the most common assumptions is that the ear is simply blocked with wax. That leads many people to delay seeking care. But unlike common blockages, SSNHL isn’t something that clears up on its own. It requires swift medical attention—ideally within the first two weeks—for the best chance of recovery.

Doctors still don’t fully understand what causes SSNHL in most cases. In fact, a specific cause is identified in only about 10 to 15 percent of patients. When a cause can be pinpointed, it’s often linked to viral infections, autoimmune disorders, or problems with blood flow to the inner ear. However, most cases are considered idiopathic, meaning there’s no obvious explanation.

What’s clear, though, is the need for quick treatment. The most common therapy involves corticosteroids, which help reduce inflammation and swelling in the inner ear or auditory nerve. These medications can be taken orally or injected directly into the ear. When given promptly, they may improve the odds of restoring at least partial hearing. Without treatment, the chances of permanent hearing loss may increase.

SSNHL typically affects just one ear, and it impacts both men and women equally. While it can happen at almost any age, the most common time for first occurrence tends to be ages mid-40s to mid60s. And while SSNHL is relatively rare—affecting about one in every 5,000 adults annually—many experts believe it’s underreported due to misdiagnosis or delayed recognition.

The key challenge is that SSNHL doesn’t look like a typical medical emergency. There’s no bleeding, no trauma, and no visible symptoms.

As a result, many people assume it’s safe to wait it out. But when it comes to your hearing, time really is of the essence.

If you experience sudden hearing loss, the first step is to contact a hearing professional or ENT specialist right away. A simple hearing test can determine whether the loss is due to a blockage (conductive hearing loss) or nerve damage (sensorineural). From there, your doctor can recommend a treatment plan. In some cases, additional tests may be needed to rule out underlying conditions such as autoimmune issues, infections, or even small tumors on the auditory nerve (though these are rare).

While not every case leads to full recovery, many patients who receive prompt treatment may see a significant return of hearing. Others may need ongoing support, including hearing aids or rehabilitation therapy.

The important thing is that early intervention provides the best possible chance for improvement. Early intervention may also help prevent or assist in managing complications such as dizziness, tinnitus, and balance problems. The outcome of SSNHL may vary depending on the cause, severity, and individual response to different treatment plans.

Living with hearing loss can be isolating, especially when it happens suddenly. It can affect communication, confidence, and quality of life.

But knowing the signs of SSNHL—and acting quickly—can make all the difference.

So, if you ever notice a sudden change in your hearing, especially in one ear, don’t ignore it. Don’t wait and see. Seek medical help as soon as possible.

Your hearing may depend on it.

DENTON COUNTY • 25

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Subscribe now to our free digital magazine and get expert advice from local professionals, catch up with your favorite celebrities, and discover wellness tips to improve your life. Enjoy inspiring content, health insights, the latest lifestyle trends, and our annual Top Docs and Top Laywers issues—all delivered straight to you electronically!

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26 • MAY/JUNE 2025

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DENTON COUNTY • 27

THE QUIET EVOLUTION OF

Friendship After 40

Why our connections change—and how to nurture the ones that truly matter

By ANDREW MILLER

28 • MAY/JUNE 2025

This chapter of life holds the quiet wisdom of knowing who you are—and the quiet courage of seeking out those who can hold that truth with you.

S

omewhere between juggling careers, caring for aging parents, raising kids (or launching them into the world), and managing the steady rhythm of adult life, something happens quietly—but undeniably—to our friendships. The late-night calls grow fewer.

The spontaneous brunches become rare. And sometimes, without realizing it, the people we once considered closest begin to drift just a little out of reach.

This isn’t always a sad thing. In fact, for many of us, midlife becomes a turning point—not just in how we view ourselves, but in how we relate to others. The friendships that stay, deepen. The ones that fade, often do so for good reason. And what we begin to crave in this chapter is less about quantity, more about soul-level quality.

The Shifting Shape of Connection When we’re younger, friendship often feels effortless. We’re thrown together in classrooms, dormitories, or the chaotic blur of young parenthood. We bond over shared circumstances, spontaneous adventures, or the thrill of new beginnings. But by the time we hit our 40s, life has moved into a different gear. We’re more aware of our energy, our time, and our emotional bandwidth.

We begin to notice that we don’t want the same kind of conversations anymore. We want fewer surface-level updates and more depth. We want friends who can sit with us in our contradictions—those who can celebrate our wins without jealousy and hold space for our losses without flinching. We want to laugh, yes, but we also want to be seen.

For many, this means redefining what friendship even looks like.

It might mean letting go of relationships that no longer align. Or choosing to reconnect with someone who’s drifted, simply because your heart remembers how safe it once felt. It means recognizing that friendship, like any living thing, evolves—and sometimes requires pruning in order to thrive.

The Grief of Growing Apart There’s a subtle kind of heartbreak that can come with midlife friendships—the kind where no one fights, but the silence grows anyway. You find yourself scrolling past their social media updates instead of commenting. You text less, not out of anger, but because the spark has dimmed. And it hurts, quietly.

This grief often goes unnamed. It doesn’t have the clean edges of a breakup or the rituals of mourning, but it’s real. The friend who once knew every detail of your day now barely knows the rhythm of your life. And even if it ended gently, there’s a sadness in recognizing that something once precious has run its course.

It’s important to allow space for that grief. To acknowledge that even as we grow, we also lose. And to remind ourselves that the end of a friendship doesn’t mean it wasn’t meaningful. It simply means it served its season.

Choosing Intention Over Obligation One of the most empowering parts of friendship after 40 is the shift toward intentionality. We begin to realize that we don’t owe anyone constant access to our time or energy. And yet, the people who light us up—who see us in our mess and our magic—are worth protecting fiercely.

This might look like fewer friends but stronger bonds. It might mean planning that monthly lunch and refusing to cancel it, even when life gets chaotic. It might mean sending a voice memo instead of a perfectly crafted message, just to say, “Hey, I’m thinking about you.”

Intentional friendship doesn’t always look grand. Often, it’s found in the small gestures. A text on a hard day. A shared joke after months of silence. A willingness to listen without fixing. These acts become sacred in a world that moves so quickly.

Making Peace with Who We’ve Become By midlife, we’ve all accumulated layers—stories, scars, regrets, resilience. We’ve changed. Sometimes in ways we didn’t expect. And sometimes that change means we no longer fit the molds our old friendships were built around.

It’s not unusual to reconnect with an old friend and feel like you’re speaking different languages. That used to feel like failure. Now, it can feel like growth. Not everyone is meant to walk the entire path with you, and that’s okay. Letting go of the pressure to maintain every friendship from every chapter is a form of self-compassion.

But equally, it’s never too late to find your people. Some of the richest, most soul-nourishing friendships begin after 40—born not of circumstance, but of shared values, life experience, and a hunger for authenticity. You might meet them through volunteering, community classes, mutual interests—or sometimes just a chance conversation that clicks in a way you didn’t expect.

Holding Space for What Matters If there’s one truth that midlife teaches us, it’s this: energy is precious.

We begin to protect our peace the way we once protected our schedules. We don’t have time for relationships that are performative or draining. We crave realness, and we’re willing to wait for it.

But that doesn’t mean closing ourselves off. It means staying open to connection while being discerning about where we invest. It means understanding that friendship isn’t just about who’s known you the longest—it’s about who shows up, sees you, and meets you where you are. This chapter of life holds the quiet wisdom of knowing who you are—and the quiet courage of seeking out those who can hold that truth with you. Friendship after 40 isn’t always flashy. Sometimes it’s a checkin during a hard week. Sometimes it’s sitting in silence next to someone who knows your story without needing the footnotes. Sometimes, it’s letting go of what was in order to make space for what could be. And in the stillness of midlife, we may find that the best friendships aren’t the loudest—they’re the ones that simply stay. Let them.

DENTON COUNTY • 29

“Where we are committed to excellence” RECOGNIZED BY U.S. NEWS AND WORLD REPORT AS BEST NURSING HOME AND SHORT-TERM REHABILITATION FACILITY

Experience The Cantex Advantage Cantex Continuing Care Network has been performing the highest standards of transitional healthcare and long-term residential services for more than 30 years. Ask anyone who knows. Cantex stands for quality.

AMENITIES:

CLINICAL SERVICES

• Private and semi-private studios, some with kitchen elements and/or Frenchdoor courtyard patios

• Library with computer stations and complimentary internet access

• Flat-Screen televisions • 32 channels of satellite television service

• Neighborhood cafes with complimentary premium beverages and snacks

• Wi-Fi internet access

• Restaurant-Style dining room

• Electric beds for easy comfort adjustments

• Beauty/barber shop with full-time beautician

• Living room with fireplace and player piano

• Sedan and van for resident transportation

• Chapel

• Activity program with community outings

• • • • • •

Around-the-clock skilled nursing Physical, Occupational, and Speech Therapies Wound Management Intravenous Therapy Tracheotomy Care Physician Services

• Medication Administration • Enteral/Parenteral Therapy • X-Ray Services • Laboratory Services

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TRANSITIONAL HEALTHCARE IN A LUXURY SETTING Cantex Continuing Care Network is committed to providing the highest level of services to promote recovery and restore independence.

We are passionate about patient safety and well-being, devoted in innovation, and dedicated to values of compassion and service.

30 • MAY/JUNE 2025

#1 WOUND CARE CENTER IN DFW!

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.

JOSHUA WORLEY, DPM | REZA MOBARAK, DPM, FACFAS, FAPWCA, FAPWHC | ROSE MARY WILSON, DPM

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

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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. DeSoto, TX 75115

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www.dfwWoundCareCenter.com DENTON COUNTY • 31

JOSH CREEL, DC Josh Creel, DC is a chiropractor with Airrosti, a healthcare group that specializes in rapid recovery for soft tissue injuries by utilizing manual therapy—a hands-on treatment used to alleviate pain, improve mobility, and promote overall physical well-being.

In nearly all cases, this allows for rapid recovery, complete injury resolution, and lasting results. In-clinic patients should expect to see dramatic improvement after the first visit, and most patients experience complete injury resolution in as few as three visits (based on in-clinic and Remote Recovery patientreported outcomes).

Dr. Creel has been serving the McKinney/Prosper area for 10 years and provides patients with an individualized treatment plan, and uses a variety of techniques, including joint mobilization, soft tissue manipulation, and muscle energy techniques to address specific musculoskeletal issues and promote recovery.

Dr. Creel graduated with honors from Mississippi State University. Soon after, he received his Doctor of Chiropractic degree from Parker University in Dallas, Texas. In Dr. Creel’s free time, he enjoys all types of fitness activities and spending time with his wife and three children. Dr. Creel is an active member Lighthouse Church in Prosper, TX.

1400 N. Coit Road, Bldg. 4, Ste. 401 McKinney, TX 75071 1-800-404-6050 www.airrosti.com 32 • MAY/JUNE 2025

of

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, We are considering hospice care for our mother and want to ensure she receives the best care possible. How can we compare the quality of different hospice organizations to make the best choice? ~Concerned About Quality Dear Concerned About Quality, There are several ways to evaluate the quality of hospice providers you are considering for your loved one. First, remember that you have the right to choose among different hospice providers. It can be helpful to interview several before making your decision.

The Centers for Medicare and Medicaid Services (CMS) offers a website called Care Compare, which allows you to compare various hospices and their quality scores. These scores, when available, help families select the right hospice provider. VNA of Texas participates in the CMS quality program.

On Care Compare, you can find measures such as family perception survey results, which are expressed in a star rating. There is also a score called the Hospice Care Index (HCI) that evaluates a hospice based on ten different factors related to the delivery and frequency of care. A score of 10 represents the highest quality of care. VNA Hospice has maintained a perfect score of 10 out of 10 since this data has been collected, and we are also proud to be rated as a 4-star hospice.

This information is available for you to review as you navigate these challenging decisions for your loved one. We are dedicated to providing high-quality, patient-centered care to all the patients and families we have the honor of serving. ~Olivia Care Compare’s website: www.medicare.gov/care-compare/

Hospice & Palliative Care

Ann’s Haven vnatexas.org Livingwell TOP DOCS AND OTHER

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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 DENTON COUNTY • 33

Livingwell TOP DOCS AND OTHER

HEALTHCARE PROVIDERS

Left to Right Caetano J. Coimbra, MD; Joseph Beshay, MD

2024

Providing modern, minimally invasive procedures to patients with neurological conditions Dallas Brain, Spine and Skull Base Surgery is a neurosurgical practice that offers over 40 years of experience providing an innovative and collaborative state of the art approach to the care of patients with challenging neurological problems from around the world. Dr. Beshay and Dr. Coimbra have developed unique expertise in the treatment of brain tumors becoming the referral destination for the treatment of patients, especially those with complex or difficult to access tumors. They have also shown a commitment to the development of minimally invasive neurosurgical procedures including the most modern expanded trans–nasal endoscopic skull base surgical techniques and focused extradural approaches to skull base tumors.

Dr. Beshay’s interests include tumors of the brain and spine, minimally invasive spine surgery, complex spinal reconstruction, and epilepsy surgery. In addition to surgical treatment of intracranial and spinal disease, he has an interest in neurological bleeding and its reversal. Dr. Beshay’s clinical interests include: benign and malignant brain tumors, neuroendoscopy, epilepsy surgery, intracranial hemorrhage, cranial/ spinal trauma, minimally invasive spine surgery, complex spinal reconstruction with an interest in C1–C2 and occipito–cervical junction disease.

Dr. Coimbra restricts his practice mostly to intracranial neurosurgery. This selective tertiary practice has fostered the opportunity to develop unique expertise and commitment to the treatment of malignant and benign brain tumors. He is an expert in the minimally invasive resection of the most complex skull base tumors, including meningiomas, acoustic neuromas, and pituitary tumors. He employs CyberKnife radiation therapy, endoscopic endonasal techniques, and an array of focused skull base approaches to create a customized treatment plan for each patient in his practice. These innovative approaches allow resection of deep, difficult, and complex tumors with minimal brain tissue manipulation and maximal preservation of function.

Dr. Coimbra and Dr. Beshay believe in customized patient care and a team approach to medicine with attention to careful selection of the least invasive and most effective treatment for each patient. Their commitment to this philosophy has resulted in maximum preservation of function, less discomfort, shorter hospital stays and durable favorable outcomes for their patients.

7777 Forest Ln., Ste. A307, Dallas, TX 75230 (972) 566–5200 • dallasbrainandspine.com 34 • MAY/JUNE 2025

Diane S. Litke, MD

Diplomate American Board of Orthopaedic Surgery Dr. Litke is a passionate artist, both in her spare time and as an orthopaedic surgeon. At L&W Orthopaedics, she approaches every orthopaedic problem with an eye toward restoration of function and mobility. With a deep knowledge of the inner workings of the body’s most active and important joints, Dr. Litke is able to repair most hip, knee, and shoulder problems, giving her patients the freedom to move again. Assisting her skilled hands, she uses the latest state-of-the-art robotic equipment for accuracy and precision, delivering a powerful combination of experience and technology to all of her patients.

Dr. Litke earned her medical degree at the University of North Carolina Chapel Hill. She went on to complete her orthopaedic residency at the University of South Carolina in Columbia South Carolina. She is certified by the American Board of Orthopaedic Surgery, and is a Fellow of American Academy of Orthopaedic Surgery and a Fellow of the American Associaion of Hip and Knee Surgeons. Dr. Litke is the medical director of the Orthopedic Department for Methodist Health System and is affiliated with the Methodist Richardson Medical Center, where she is the director of the joint program. When she’s not working, Dr. Litke enjoys photography and cycling.

Dr. Diane S. Litke, MD

Please call 972.498.4791 to schedule an appointment.

L&W Orthopaedic Associates

Orthopaedic Surgeons located in Richardson, TX Livingwell TOP DOCS AND OTHER

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2821 E. President George Bush Highway Suite 201 Richardson, TX 75082 www.LWOrthopaedics.com

(972) 498-4791 DENTON COUNTY • 35

T E X A S O N C O L O G Y. C O M

EXPERT COLON CANCER CARE RIGHT WHERE YOU LIVE.

Carly, Colon Cancer Survivor

When you’re diagnosed with colon cancer, you need comprehensive care from renowned physicians, advanced treatment options, leading edge technology, and clinical trials. But you also need to keep being Mom. With more than 280 locations across the state, Texas Oncology provides expert cancer care and keeps you close to those you love. Because we understand that hugs from your six-year-old are an important part of your treatment plan.

36 • MAY/JUNE 2025

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EARLY SIGNS OF COLON CANCER AND TIPS FOR PREVENTION

By CARRIE UMSTEAD

C

olon cancer, or colorectal cancer, is a type of cancer that starts in the colon or rectum. It is one of the most common types of cancer, but when detected early, it can be treated effectively. The disease often begins as non-cancerous growths known as polyps, which can develop into cancer over time if left untreated. Understanding the signs and symptoms play a crucial role in early detection and prevention.

In its early stages, colon cancer may not cause noticeable symptoms, which is why regular screening is essential, especially for those over the age of 50 or with risk factors. However, as the cancer progresses, it can produce a range of symptoms that affect digestion and bowel habits.

One of the most common signs is a change in bowel habits that lasts for several weeks. This could include persistent diarrhea or constipation, or a noticeable difference in the consistency of stools. These changes often occur without any apparent cause and may be accompanied by a feeling that the bowel does not completely empty.

Another potential sign is the presence of blood in the stool, which may appear bright red or dark, making the stool look almost black.

Blood in the stool may be accompanied by rectal bleeding. While not always indicative of colon cancer—conditions such as hemorrhoids or anal fissures can also cause bleeding—persistent or unexplained bleeding should always be checked by a healthcare professional.

Unexplained weight loss and fatigue can also be early signs of colon cancer. Weight loss occurs as the body uses more energy to fight the cancer, and fatigue may develop due to anemia from blood loss in the digestive tract. This can leave individuals feeling unusually tired even after adequate rest.

Abdominal discomfort, such as cramping, bloating, or pain, may develop as the tumor grows, obstructing the passage of stool. This can lead to a feeling of fullness, even after a small meal. In some cases, advanced colon cancer can cause nausea or vomiting if a bowel obstruction occurs.

While the exact cause of colon cancer is not fully understood, several risk factors can increase the likelihood of developing the disease. Age is a significant factor, with most cases occurring in people over 50. A family history of colon cancer or certain genetic conditions, such as Lynch syndrome or familial adenomatous polyposis, further elevates the risk.

Lifestyle choices also play a role. A diet high in red or processed meats has been linked to an increased risk of colon cancer, as has a sedentary lifestyle. Obesity, smoking, and heavy alcohol use are addi-

tional modifiable risk factors that can elevate the likelihood of developing colorectal cancer.

Preventing colon cancer involves a combination of regular screening, healthy lifestyle choices, and sometimes medical interventions for those at high risk. Screening is the most effective way to detect colon cancer early or even prevent it by identifying and removing precancerous polyps. The American Cancer Society recommends that individuals at average risk start screening at age 45, while those with a family history or other risk factors may need to begin earlier.

Colonoscopy is the most commonly recommended screening test because it allows for the direct visualization and removal of polyps during the procedure. Other screening options include stool-based tests, which check for hidden blood or abnormal DNA in the stool, and flexible sigmoidoscopy, which examines the lower part of the colon.

Diet plays an essential role in reducing the risk of colon cancer. A diet rich in fruits, vegetables, and whole grains provides fiber, vitamins, and antioxidants, which help protect against cancer. Fiber, in particular, promotes healthy digestion and helps reduce the time that waste spends in the digestive tract, potentially limiting exposure to harmful substances. Consuming less red and processed meat, along with avoiding excessive alcohol, further contributes to a lower risk. Incorporating fish, lean poultry, and plant-based protein sources can be beneficial.

Regular physical activity has been shown to decrease the risk of cancer as exercise helps maintain a healthy weight and regulate hormone levels that may contribute to cancer growth. Even moderate activities such as walking can make a significant difference in overall health.

Smoking cessation is another crucial preventive measure. Tobacco use is not only linked to lung cancer but also increases the risk of many other cancers, including colon cancer.

For individuals with a high genetic risk of colon cancer, medical interventions may be necessary. Preventive surgeries may be considered in those with inherited conditions like Lynch syndrome. Genetic counseling can help assess risk and guide these decisions.

Colon cancer is highly treatable when detected early, with survival rates significantly higher for cancers caught before they spread. That’s why it’s important to not ignore symptoms or delay routine screenings. Seeking medical advice without hesitation can be life-saving.

DENTON COUNTY • 37

We Preserve, Enhance, and Protect your vision.

OUR SERVICES: Macular Degeneration Diabetic Eye Disease Retinal Vein & Artery Occlusions Flashes & Floaters Retinal Tears & Detachments Macular Pucker/Epiretinal Membrane Macular Holes Uveitis

MATTHEW K. ADAMS, MD, MBA At Texas Macula & Retina, our mission is to provide exceptional eye care with a focus on the diagnosis, treatment, and management of retinal disorders.

Dr. Adams is a board-certified Ophthalmologist and Ophthalmic Surgeon specializing in Vitreoretinal Surgery. His principal areas of interest include age-related macular degeneration, diabetic retinopathy, retinal detachment repair, macular surgery, retinal lasers, and secondary intraocular lens implantation.

Dr. Adams and his team are committed to preserving and improving the vision and overall quality of life for our patients by offering the most advanced and personalized retina care available.

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You Had a Stroke…In Your Eye?!

Understanding the Connection Between Blood Pressure and Your Eye Health

By MATTHEW K. ADAMS, MD, MBA

A

s a retina specialist, I have seen firsthand how systemic conditions like high blood pressure can lead to serious, sometimes irreversible vision problems. Two of the most common eye conditions related to uncontrolled blood pressure are hypertensive retinopathy and retinal vein occlusions. These conditions can sneak up silently, often without symptoms at first—but they can ultimately threaten your sight if not caught and managed in time. In this article, I will discuss how these conditions develop, why high blood pressure plays such an important role, and what you can do to protect both your eyes and your overall health.

What is Hypertensive Retinopathy?

Hypertensive retinopathy is a condition where high blood pressure damages the small blood vessels in your eye. Over time, this damage can reduce the flow of oxygen and nutrients to the retina, resulting in the following findings on your eye exam: • Narrowing of retinal arteries • Flame hemorrhages (bleeding) • Cotton wool spots (small areas that swell due to lack of blood flow) • Swelling of the optic nerve (in severe cases) These changes might not affect your vision right away, but they’re a warning sign that your blood pressure is high enough to harm the delicate tissues in your eyes—and likely, other organs in your body like your brain, heart, and kidneys.

Treatment of hypertensive retinopathy usually involves simply controlling the blood pressure. Flame hemorrhages, cotton wool spots, and swelling of the optic nerve can all be reversed with better control of hypertension.

What is a Retinal Vein Occlusion?

A retinal vein occlusion occurs when one of the veins that drains blood from your retina becomes blocked. This leads to a backup of blood and fluid, causing swelling, bleeding, and in many cases, loss of vision.

High blood pressure increases the risk of retinal vein occlusions because it damages the blood vessel walls and contributes to blockages.

The higher and more uncontrolled your blood pressure is, the greater your risk.

Treatment of retinal vein occlusions often require injections in your eye and sometimes laser treatment as well. Vein occlusions are known to progress rapidly, so time-to-treatment is of paramount importance to preserving your vision.

Controlling Your Blood Pressure: The First Line of Defense The good news is that you can reduce your risk of hypertensive retinopathy and retinal vein occlusions by managing your blood pressure. Here are some practical steps: • Monitor your blood pressure regularly. Know your numbers and aim for your target range, usually around 120/80mmHg unless otherwise advised by your doctor.

• Take medications as prescribed. Don’t skip doses or stop medications without discussing it with your healthcare provider first.

• Limit salt intake. Sodium can raise blood pressure—try to stay under 1,500– 2,000mg per day.

• Stay physically active. Aim for at least 30 minutes of moderate exercise 3-5 days of the week.

• Eat a heart-healthy diet. Plenty of vegetables, whole grains, healthy proteins (lean meat and fish), and avoiding trans and unsaturated fats.

• Maintain a healthy weight. Losing even 5–10 pounds can make a significant difference.

• Avoid tobacco and limit alcohol. Both can raise blood pressure and damage blood vessels.

When to See a Retina Specialist If you have high blood pressure—especially if it’s been uncontrolled for some time—it is crucial to get regular eye exams, including a dilated fundus exam by a retina specialist.

A retina specialist can: • Monitor the health of your retinal blood vessels more closely • Use specialized imaging to assess for damage • Provide treatments such as injections or laser therapy if needed • Coordinate with your primary care doctor or cardiologist to help manage your overall health Remember: vision loss from these conditions can be sudden and permanent—early detection and management are your best defenses.

Final Thoughts High blood pressure affects more than just your heart—it can silently damage your eyes and steal your vision if you’re not careful. However, with good blood pressure control and regular monitoring by your eye care team, including a retina specialist, you can preserve your sight and maintain a high quality of life.

If you have high blood pressure, don’t wait until you notice a problem. Make an appointment for a comprehensive eye exam—and take the steps today that your future self will thank you for.

DENTON COUNTY • 39

t a h T y a S I Oops, Did

? d u o l A u That Thing Yo g in y a S t o N rt of

The Fine A

40 • MAY/JUNE 2025

By BENJAMIN

ADAMS

Just Thought

W

e’ve all had the experience: the words are barely out of your mouth when you wish, with every cell in your body, that you could snatch them back. But there they are, floating in the air like an uninvited party guest—awkward, overconfident, possibly offensive, and definitely not what you meant. You might try to laugh it off. You might backpedal with the elegance of a flamingo on roller skates. Or you might just change the subject and pray everyone forgets.

Spoiler: they won’t.

Whether it’s blurting out an inappropriate comment at dinner, misjudging a joke in a meeting, or offering unsolicited advice that lands with the grace of a brick, we’ve all put our proverbial foot in our mouth. It’s part of being human. But somewhere along the way, most of us start craving a little more verbal grace. A little less cleanup in aisle conversation. A little more… thinking before speaking.

At this point in life, we’ve learned that not every thought needs a microphone. And yet, the temptation to let something slip— whether it’s a spicy opinion, an outdated joke, or a “harmless” observation—is as present as ever. Maybe more so, given how many decades of opinions we’ve been quietly accumulating. The challenge, of course, is figuring out which of those thoughts are actually worth releasing into the wild.

Thinking before you speak isn’t about stifling personality or walking on eggshells. It’s about discernment. It’s about understanding that words have weight, and that tossing them around carelessly can damage relationships, reputations, and even the way we see ourselves.

Take, for example, the casual question lobbed at someone you haven’t seen in a while: “So, are you seeing anyone yet?” It may seem friendly enough, but for someone navigating a breakup, divorce, or simply enjoying solitude, it can land like a slap. Or that moment when someone shares a big accomplishment and you respond with a lukewarm, “Must be nice,” instead of a genuine congratulations. We don’t always mean to be thoughtless—it just kind of...happens. Often with good intentions. Occasionally with caffeine deficiency.

The good news is, a little self-awareness goes a long way.

Thinking before you speak doesn’t require monk-like silence or a vow of eternal tact. It’s more like installing a mental speed bump.

A brief pause. A quiet, internal moment to ask, “Is this helpful?

Is it kind? Is it necessary? Will I regret this in seven seconds?”

That pause can be a lifesaver. It can stop you from asking a woman who’s not pregnant when she’s due. It can keep you from telling your friend that you never liked their spouse (who, by the way, is still very much their spouse). It can rescue you from launching into a long-winded story that ends with “...guess you had to be there.” Most importantly, it can give you time to redirect a thoughtless comment into a more thoughtful one.

Humor can be especially tricky. What you find hilarious may hit someone else like a punchline with a side of insult. That zinger you’ve used for years might have aged like milk, not wine.

And while sarcasm is practically a second language for many of us, it can easily be misunderstood—especially in emotionally charged conversations or when typed into group texts at 11 p.m.

Then there are those moments when we’re not trying to be funny—we’re trying to be helpful. But advice, even the wellmeaning kind, can backfire spectacularly when it’s not asked

for. Telling someone how to handle their health, their money, or their children without being invited into the conversation is the verbal equivalent of rearranging someone else’s furniture. It may come from a good place, but it tends to cause bruised shins and bruised egos.

One particularly effective strategy is to listen longer than you normally would. Not the kind of listening where you’re just waiting for your turn to speak, but the real, honest-to-goodness kind where you let the silence hang and let the other person finish their thought. In those quiet moments, we often realize our witty retort or well-meaning correction isn’t necessary at all.

Sometimes the best response is a nod, a smile, or a simple, “Tell me more.”

There’s also value in giving your inner voice a filter. That inner voice can be a bit unfiltered at times—equal parts snarky aunt and overconfident game show host. It chimes in with opinions, judgments, and observations at lightning speed. But just because the thought appears doesn’t mean it needs to be spoken aloud.

It’s perfectly okay to think something and keep it in the vault. As they say, discretion is the better part of valor. It’s also the better part of not getting uninvited to family events.

Of course, no one gets it right all the time. We’ll all have moments when we speak too quickly, laugh too loudly, or say something that lands poorly. The goal isn’t perfection—it’s mindfulness. When we mess up, a sincere apology can go a long way. Owning your words, even the clumsy ones, shows character.

And that, in turn, makes people more likely to give you grace.

Over time, the art of thinking before speaking becomes less about restraint and more about connection.

Words chosen with care have power—the power to comfort, to support, to lift someone up at just the right moment.

And just as importantly, the choice to hold back a few of them, when necessary, can be its own kind of kindness.

So the next time you feel a zinger rising, a correction forming, or a comment that might not land quite right edging toward your lips, pause. Breathe. Picture the moment ten seconds from now—how do you want it to feel? Sometimes silence truly is golden. Other times, it’s platinum with a diamond setting.

Either way, your future self will thank you. Probably right after everyone else does.

We’ll all have moments when we speak too quickly, laugh too loudly, or say something that lands poorly.

The goal isn’t perfection—it’s mindfulness.

DENTON COUNTY • 41

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Your Opinion P Matters When It Comes to Funeral Planning

By RICK ALLEN

lanning has many benefits. Planning a vacation or a joyous occasion such as a wedding or baby shower often result in months of discussion and attention to details. Much effort goes into making certain that everything goes smoothly, and no stone is left unturned. If you are fortunate enough to not worry about expenses, the planning is even more fun. The result is gratifying and the stories told recounting the amazing event will go on for years.

Naturally, an event that will not be pleasant to attend or even think about, for that matter, is not something that anyone wants to discuss or certainly plan for. However, while we plan for retirement, college, weddings, and vacations, many people fail to plan for the one thing we all, without exception, have in front of us. Over the course of my career, I have met with many families who have lost a loved one. Not a single family whose loved one planned has expressed regret or displeasure. On the other hand, I talk with families who are completely caught off guard and have no idea what the person who has died would have wanted for their final arrangements.

Your opinion does matter because it may be the only time your family will hear you say what you prefer when it comes to your funeral, burial, or cremation. Sitting down with a pre-planning professional at your funeral home of choice will bring you peace of mind and allow you to guide the process as you want to, not leave all the important details to your family to struggle through after you are gone. Pre-planning also assures that the cost is what you are comfortable with and when pre-planning, you will have payment options that are typically not available after someone has died. Most plans today are fully transferable should you relocate and by prepaying, you lock in the cost at today’s price, thus protecting your family from inflation.

Talk about this subject with your family while you can express your feelings and desires. The peace of mind you will have, once the discussion is over and you have a plan in place, will be remarkable. Furthermore, your opinion will be heard because it does matter!

DENTON COUNTY • 43

Brian Nwannunu MD, MS Brian Nwannunu, MD, MS, is an orthopedic surgeon specializing in hip and knee replacement. He care for patients at Texas Joint Institute in McKinney, Texas.

Dr. Nwannunu, a native of Dallas, graduated Valedictorian from the High School for Health Professions at Townview Magnet Center in DISD. He then earned his bachelor’s degree in Biology at Morehouse College in Atlanta, Georgia, where he was part of the Morehouse College Honors Program.

Upon graduation, he completed his master’s degree in Physiology at Georgetown University in Washington, D.C., with a concentration on complementary and alternative medicine. Dr. Nwannunu then graduated with his medical degree from Howard University College of Medicine in Washington, D.C., where he was inducted into the Alpha Omega Alpha Honor Medical Society.

Dr. Nwannunu completed his residency in orthopedic surgery at the John Peter Smith Health Network in Fort Worth, Texas, before pursuing additional training with a fellowship in adult reconstruction at Baylor College of Medicine in Houston, Texas. In addition to his clinical training, Dr. Nwannunu enjoys mission work abroad, providing medical care and health education to populations in need.

He is a member of the American Medical Association, National Medical Association, American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons.

When not working, Dr. Nwannunu enjoys basketball, weight training, outdoor activities, attending art and music festivals, traveling, world news, and reading.

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DENTON COUNTY • 45

THE

COMPARISON TRAP Finding Peace in a World of Perfect Lives

By LAUREN HAYES

46 • MAY/JUNE 2025

I

t can happen in an instant. A photo scrolls by—someone you know, maybe not well, smiling against a backdrop of turquoise water. The caption is effortless. Their skin is glowing. Their joy, unmistakable. Or perhaps it’s a colleague celebrating a promotion, their success punctuated with humble-brag hashtags and a flood of congratulatory comments. Sometimes it doesn’t even take that much. A casual remark at dinner, a glimpse of someone’s new home, a passing conversation about early retirement plans. It doesn’t matter how it arrives. What matters is what it stirs.

That sharp tug in the chest. That quiet, unspoken Why not me?

Comparison and envy are deeply human feelings—universal, even.

But in the modern world, they’ve become constant companions, creeping into places that used to feel safe. They arise not only in moments of insecurity but also in moments of reflection, where life diverges from what we imagined it might be by now. The achievements we hoped for. The relationships we envisioned. The ease we thought we’d earned.

The irony is that we often compare ourselves most harshly during the seasons of life that are the most layered, the most transitional, the most unspoken.

There’s something uniquely disorienting about feeling envious at this stage of life. It can feel, on some level, like a failure—not only to have not “arrived” at some imagined destination, but to still care so deeply about where others have landed. We tell ourselves we should be above this. That maturity means immunity from jealousy. That wisdom automatically protects us from the ache of comparison.

But it doesn’t. Because envy, at its core, isn’t really about the other person. It’s about the gap between where we are and where we hoped we’d be. It touches something tender inside us. Sometimes it’s grief over what didn’t happen. Sometimes it’s fear that there’s not enough time left. Sometimes it’s shame about a choice we made—or didn’t make. Envy points less to what others have and more to what we feel we lack. And in that way, it’s not just a painful emotion. It’s a mirror. One that invites us to look more closely at our own longings.

Social media makes that invitation relentless. We are now constantly exposed to the curated lives of friends, acquaintances, colleagues, and even strangers. We see the highlight reels, the filtered vacations, the flawless kitchens, the joyful family photos. Rarely do we see the arguments before the snapshot. The lonely hotel room after the award ceremony. The late-night doubts that follow a big career win. We compare our full, flawed, behind-the-scenes lives to someone else’s glossy preview, and wonder why we come up short.

But the trouble with envy isn’t only digital. It shows up in conference rooms and neighborhood gatherings, at dinner parties and family reunions. Sometimes, it’s subtle—a tightness in the chest when a friend shares good news. Other times, it’s loud—a persistent self-judgment that echoes long after the conversation has ended.

And yet, as uncomfortable as it is, envy can be a useful teacher. If

we allow it, it can point us toward what we care about most. It can shine a light on values we’ve neglected, desires we’ve buried, or changes we’re ready to make. Envy doesn’t have to be a judgment—it can be a compass. If we’re willing to sit with it, gently and without shame, we can ask deeper questions. What is this really about? What part of me feels unseen or unfulfilled? What would it mean to honor that part now, in this season of life?

Sometimes the answer is surprising. We may not actually want the thing we envy. We may not want the job or the house or the lifestyle.

We may simply want the feeling we imagine it brings—freedom, joy, meaning, connection. Those are desires worth listening to. Not to compete with others, but to come home to ourselves.

There’s power in reframing envy as information, rather than indictment. When we meet it with compassion instead of criticism, we make space for clarity and choice. We can ask ourselves what’s truly ours to pursue—and what’s simply a reflection of someone else’s story. Because not all roads lead to fulfillment, even if they sparkle from afar.

In a culture that rewards visibility and performance, it takes quiet courage to live an unflashy life. To build meaning not on what others can see, but on what we feel when we wake up in the morning. To define success in terms that aren’t shareable. To choose depth over polish, purpose over applause.

Sometimes, that means narrowing our focus. Turning down the noise. Curating our inputs as deliberately as others curate their outputs. This might mean stepping back from certain apps. Setting firmer boundaries with energy-draining conversations. Spending more time with people who value presence over performance. Not out of avoidance, but out of care for our own inner landscape.

We can also learn to celebrate others without losing ourselves. This isn’t easy, and it doesn’t always come naturally. But with practice, we can separate someone else’s joy from our own worth. We can say, Good for them without it meaning Bad for me. We can honor someone else’s chapter without assuming we’re behind. This doesn’t mean we won’t feel the sting sometimes. We will. But the goal isn’t to eliminate comparison—it’s to relate to it differently. To notice it, name it, and gently redirect our gaze back toward what truly matters to us.

What matters might not be big or loud. It might not look impressive. It might be a quiet peace in our relationships. A sense of integrity in our work. A reclaimed morning walk. A long-awaited painting class. A phone call with someone who truly sees us. The truth is, we are always building something. Even when it doesn’t feel visible. Even when it doesn’t show up in photos. Our lives are being shaped not only by what we accomplish, but by how we live through the ordinary days. The ones filled with laundry and bills and small kindnesses. The ones we don’t post about but remember nonetheless.

There’s no race to win. No timeline to meet. There is only the invitation—each day—to live more honestly, more gently, more in alignment with who we are becoming. And that is enough.

There’s power in reframing envy as information, rather than indictment.

When we meet it with compassion instead of criticism, we make space for clarity and choice.

DENTON COUNTY • 47

FLORIAN DIBRA, MD Florian F. Dibra, MD is a board-certified, orthopedic surgeon located in Frisco, Texas who has extensive knowledge in hip and knee orthopedics and treats operative and non-operative hip and knee arthritis. He focuses on minimally invasive muscle-sparing total hip and knee replacement, anterior hip replacement, partial knee replacement, robotic joint replacement and complex hip and knee replacement revisions. Dr. Dibra is specialized in MagicKnee and MagicHip, muscle-sparing techniques with robotic technology.

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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DENTON COUNTY • 49

Left to right William F. Tucker, Jr., MD Duncan L. McKellar, Jr., MD Brian Nwannunu, MD Florian F. Dibra, MD Charles E. Toulson, MD Cyrus Abbaschian, MD Donald W. Hohman, MD J. Stephen Appleton, MD Alexander S. Greenstein, MD Raj Yalamanchili, MD Kwame A. Ennin, MD Samuel K. Stephenson, MD J. Conner Ryan, MD

Expert Orthopedic Surgeons Close to Home ALLEN | DALLAS | FRISCO | PLANO | MCKINNEY | SACHSE | SHERMAN At Texas Joint Institute, our growing team of highly skilled orthopedic surgeons and medical professionals are at the forefront of bone and joint health. From joint replacements and minimally invasive treatment options to complex joint reconstruction and treatment of bone and soft tissue sarcomas, our team offers a wide range of services to help you get back to your daily activities you enjoy.

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