Denton County Living Well Magazine November-December 2023

NOVEMBER/DECEMBER 2023

More Inside

AVOIDING AND MANIPULATING A DOWAGER’S HUMP

OVERCOMING AQUAPHOBIA: ADULTS LEARNING TO SWIM BOOMERITIS: PREVENTING INJURIES AS YOU AGE

Sharon Stone RISING

FROM RUBBLE

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.

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

Our new facility will have 94 private beds with ensuite and shower. We will 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 aroundthe-clock 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!

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.

Living Well Living

EMBRACING THE FULLNESS OF LIVING WELL

The many facets of living well can often be obscured by the mundane, the daily rituals, or the hurdles we encounter. Yet, it’s stories like that of Sharon Stone, revealed in this issue, that illuminate the profound depths of what it truly means to ‘live well.’

SPRING AND SAM HOUSTON

Sharon’s story is a mirror that reflects not only Hollywood glamour but also the raw, unvarnished truth of human vulnerability. Despite experiencing moments that would bring many to their knees, she emerges triumphant, turning tragedy into resilience, loss into wisdom. Her journey, from the dizzying heights of stardom to the quiet introspection of self-discovery, reminds us that it’s not just about surviving; it’s about thriving.

But living well isn’t solely confined to the realms of personal endurance and growth. It touches upon our physical health as well, something we dive into with our segment on dodging the ‘dowager’s hump’—that dreaded curvature of the spine that sneaks up with age. While seemingly minor, addressing such physical concerns can mean the difference between aging gracefully or falling victim to avoidable ailments.

Speaking of facing fears, our piece on aquaphobia doesn’t just dive into the depths of an often-debilitating fear but also celebrates the jubilation of overcoming it. Learning to swim isn’t just about staying afloat in water but serves as a metaphor for life itself—learning to stay buoyant amidst life’s turbulent waves.

Tying all these narratives together is the underlying theme: the essence of living well is about embracing life holistically. It’s about confronting the challenges, both mental and physical, celebrating our triumphs, and finding joy in the smallest moments. It’s about learning, growing, and continuously evolving.

This issue is a testament to all of that and more. Through Stone’s narrative and our exploration of physical and mental well-being, we hope to inspire, empower, and remind our readers that living well is a journey, not a destination. It’s about the choices we make, the battles we fight, and most importantly, the stories we tell.

Thank you for joining us on this enlightening voyage. Here’s to living well, in every sense of the word.

Happy reading!

PRESIDENT & CEO SAM HOUSTON

VICE PRESIDENT & CFO SPRING HOUSTON

EDITOR, FEATURE WRITER & SOCIAL MEDIA SONDRA BARR

ART DIRECTOR VANESSA FRYER

ACCOUNTS MANAGER JENNIFER BEAVERS

WEBSITE LYDIA ROGERS

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SAM AND SPRING HOUSTON

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!”

FROM THE Rising Rubble

SHARON STONE’S QUEST FOR AUTHENTICITY, WELLNESS, AND CONTENTMENT.

BY SONDRA BARR

“

I

lost everything.

I LOST ALL MY MONEY. I LOST CUSTODY OF MY CHILD. I LOST MY CAREER. I LOST ALL THOSE THINGS THAT YOU FEEL ARE YOUR REAL IDENTITY AND YOUR LIFE.

In the chaotic world of Hollywood, where stars often flicker and fade, Sharon Stone, 65, exemplifies an unusual durability, showcasing a narrative that triumphs over adversities. Beneath the deceptive allure of fame, she’s emerged not as a victim but as a symbol of perseverance.

At the peak of her career, prior to a cascade of devastating health issues, Stone enraptured global audiences with her sensual and commanding performance in “Basic Instinct,” and later garnered critical acclaim for her role in “Casino.” Her trajectory was steeped in a kind of success story that many only dreamed of—she was an undisputed movie star, embodying both charisma and mystique, offering the world a seductive yet empowered picture of femininity.

Yet, beneath this glamorous exterior, a storm was brewing. In 2001, a ruptured vertebral artery bled into her brain for days, leaving her with a 1% chance of survival, throwing her life into disarray. It wasn’t mere chance that allowed Stone to identify the onslaught of her stroke; it was a piercing headache and numbness in her leg, which became an omen of the cerebral hemorrhage that could have ended her life. Stone’s awareness of her own physicality in that dire moment paved the way for the medical intervention that ultimately saved her.

“The pain was still so wildly intense that I was put on a 24/7 drip of Dilaudid, which is a kind of synthetic heroin. I was in and out of consciousness,” she writes in her memoir. “… We were now on day five of my brain bleed and I had been coming and going. I had been ‘sleeping’ more than waking. I had not eaten since the initial incident…After a couple more days, I was unable to get up, stand up, or think clearly and function. I had lost 18 percent of my body mass…The general consensus was that I should go on home and stop faking it.”

Sharon Stone further shared with The New Yorker: “I didn’t know until I got home and read People magazine that I had to wait 30 days to see if I was even going to live. Nobody was communicating with me. Even 20 years ago, women’s rights were so much less than they are now, and nobody was listening to me, which is why I still scream to be heard. I still fight with doctors because I panic when people don’t listen to me.”

The cataclysmic ripple effect of the event reverberated far beyond the physical realm for Stone, laying waste to not just her health, but dismantling her once-sturdy life in shattering ways. Prior to the debilitating event, Stone was basking in both professional and personal luminescence. An Oscar nod for Casino had already etched her name into the annals of Hollywood’s recognized talents, and on the home front, she and then-husband, newspaper editor Phil Bronstein, had recently welcomed their adopted son Roan into their lives.

However, the stroke heralded a cruel and unforgiving storm that left no aspect of her life untouched—career, finances, and even motherhood were unceremoniously wrested from her. Her marriage crumbled in its wake, ending in divorce from Bronstein in 2004, and the once-buzzing phone, linking her to Hollywood’s bustling opportunities, fell eerily silent.

“I lost everything,” she openly confided to journalist Nigel Smith, her words bearing the weight of every stripped-away piece of her past self. “I lost all my money. I lost custody of my child. I lost my career. I lost all those things that you feel are your real identity and your life.” Stone’s narrative unearths more than mere personal pain and loss; it stands as a haunting epitaph to the often underestimated fragility of what we perceive to be steadfast and enduring in our lives.

The pain WAS STILL SO WILDLY INTENSE THAT I WAS PUT ON A 24/7 DRIP OF DILAUDID, WHICH IS A KIND OF SYNTHETIC HEROIN. I WAS IN AND OUT OF CONSCIOUSNESS. “

When Stone speaks about the demise of her once-thriving career in Hollywood, the lost custody of her child, and her financial ruin, there is an evident tranquility in her acceptance of that period as a mere chapter, not the entire narrative of her life. Sharon’s unapologetic embrace of her life’s calamities and her aptitude to turn them into opportunities for transformation makes her more relatable, and in many ways, inspirational.

Stone’s journey through trauma, recovery, and self-discovery took a turn when she chose to no longer be governed by fear, fighting for over a decade for custody of her son Roan.

“I fought for my son, put him ahead of getting anything at all back in my life. I did that for 13 years; I played a very long, very difficult game of custody chess in an effort to get him everything I could for his health and well-being,” she pens in her memoir. Her endeavors demonstrate not just a commitment to family above all, but an unwavering dedication to the well-being and future of her children.

Subsequently, Stone expanded her family, adopting biological brothers Laird and Quinn.

It was her 2021 memoir, “The Beauty of Living Twice,” that delved into Stone’s deeply human and relatable story. In it, she addresses her Hollywood career’s collapse, lost custody, and financial ruin with a tranquil acceptance, viewing it as a chapter, not the entirety, of her life. Her unreserved acceptance of life’s adversities and her ability to convert them into transformative opportunities lend relatability and inspiration.

Stone’s wisdom extends to wellness and contentment, both physically and mentally. Post-turmoil, she found peace in the arts, painting, and pickleball, not merely as hobbies but as mediums of recovery and expressions of joy.

In April 2023, Stone unveiled her first-ever art exhibit, Shedding, an intimate exploration of her multifaceted self through abstract and landscape paintings. Art, it seems, has been an ever-present force in Stone’s life. She studied in the discipline at Edinboro University of Pennsylvania before her studies were cut short by the advent of her modeling and acting careers. “All of those paintings I sold to other students to eat and live,” Stone recalls in a chat with Maxim. “And then, you know, this acting thing—that took up quite a bit of my time, and I didn’t paint anymore.”

The return to painting occurred when the world locked down, a friend’s gift of a paint by numbers kit reigniting a subdued flame. Stone, thereafter, invested in brushes, paint, canvases, and boards, progressively crafting over a dozen paintings before allowing herself the luxury of prepared canvases.

Giving back through her work with the Barrow Neurological Foundation and ensuring others battling neurological conditions have a fighting chance is also important to Stone. Her lived experiences, once shrouded in layers of Hollywood glamor and superficiality, now serve as the foundation of her advocacy, focusing on education and research to light the path for others navigating similar dark tunnels.

In a universe that often reduces individuals to their pain, Stone redefines what it means to be a survivor, to reclaim, rediscover, and revel in one’s identity beyond trauma. Stone encapsulates a wellness that is not solely built upon the absence of disease but the continuous and intentional act of crafting one’s wellness every day. Today, Stone is not just a movie star – she is a beacon of relentless authenticity, a testament to harnessing one’s past to forge a future with unwavering determination, a journey where living well means valuing oneself.

Sharon found peace in painting

Photo: @sharonstone

Casino

Photo: Universal Studios

Total Recall

Photo: Carolco Pictures

Basic Instinct

Photo: Sony Pictures

Basic Instinct 2

Photo: Metro-Goldwyn-Mayer

The Quick and the Dead

Photo: Sony Pictures

Oculoplastic Surgery

Courtesy KEY-WHITMAN EYE CENTER

The first signs of aging usually take place around the eyes. With injectables such as Botox and dermal fillers, subtle changes can be corrected quickly. A patient may be considering the long-term benefits of oculoplastic surgery for concerns related to loose, sagging skin. We perform oculoplastic procedures for functional or cosmetic improvement at the Key-Whitman Cosmetic Center.

The term oculoplastic surgery describes the different procedures involving the eyelids and area around the eyes, the orbit of the eye, or the tear ducts. Eyelid surgery is popular and conducted more than 100,000 times a year. This surgery can not only rejuvenate a patient’s appearance but also improve their vision.

At Key-Whitman Cosmetic Center, Dr. Leslie Pfeiffer consults with her patients to discuss their goals and the way in which a particular oculoplastic procedure can enhance the structure of the eyelid. She has confidence in adopting a customized strategy to fit every patient’s individual needs while adhering to high quality, evidence-based standards of medical and surgical care.

Patients may be a good candidate for the oculoplastic surgery if they are in good general health and would like to enhance the looks of their eyes. During your consultation, Dr. Pfeiffer performs an intensive examination to verify that your objectives can be achieved with eyelid surgery.

Types of Oculoplastic Surgeries:

BLEPHAROPLASTY: Upper and lower blepharoplasty procedures are some of the most common oculoplastic procedures performed today. Upper blepharoplasty may be done for functional or cosmetic reasons. This procedure removes the extra or loose skin of the upper eyelid to restore the crease of the natural lid. Upper blepharoplasty may also be performed to remove tissue that has dropped into the field of vision. Lower blepharoplasty repositions fat and skin in a manner that decreases or eliminates the appearance of under-eye puffiness and dark circles.

PTOSIS REPAIR: Ptosis repair is performed to correct a droopy eyelid. This surgery is different than upper blepharoplasty because it shortens or otherwise repairs a stretched or elongated levator muscle, the muscle of eyelid opening.

ECTROPION REPAIR: Ectropion is an eyelid condition that affects the lower eyelid, making it roll outward away from the eye. The affected eyelid might also sag, exposing the eye and resulting in dryness. Untreated ectropion can cause chronic redness, pain, irritation, and tearing. Prolonged exposure may also wear down the corneal surface.

ENTROPION REPAIR: Entropion is an eyelid condition that affects the upper or lower eyelid, making it roll inward. This condition may be related to the eyelid’s natural aging or breakdown in the strength of certain eyelid muscles. When the eyelid turns inward, the eyelashes rub the surface of the eye, causing redness, discomfort, and sensitivity to wind and light. Untreated entropion could trigger excessive tearing or mucous discharge. The cornea might also be scratched and scarred over time.

EYELID GROWTHS AND SKIN CANCERS: The fragility of the skin around the eyes makes this area particularly susceptible to sun damage. Exposure to UV light through sunshine and tanning beds can degrade the looks of the eyelids and might also cause skin cancer. Growths on the eyelid, especially those that bleed or become inflamed, should be evaluated immediately. Skin cancer may be identified by taking a biopsy of tissue from the growth. Then, the lesion can then be removed using a precise surgical technique that attempts to restore as much as possible of the eyelids’ natural contours. In some instances, growth or skin cancer removal is followed by reconstruction of the eyelid.

TEARING DISORDERS: Tears are important for the eye’s function and health. The lacrimal gland and meibomian glands are involved in producing the necessary layers of fluid to keep a healthy tear film. Patients may experience tearing due to a variety of conditions, including blockage of the natural ear drain, eye irritation or dryness, or eyelid ectropion. An oculoplastic surgeon can investigate these causes, and some may require surgery to correct.

Benefits of Going to an Oculoplastic Surgeon:

An oculoplastic surgeon, such as Dr. Pfeiffer, has obtained extensive training after completing medical school. This includes a residency in ophthalmology and a fellowship in oculoplastic surgery. The clinical training that an oculoplastic surgeon undergoes leads to a thorough understanding of the intricate details of the eyelids, eye structure, and the area of the face that surrounds the eyes. The amount of training an oculoplastic surgeon undergoes enables Dr. Pfeiffer to perform delicate procedures with a great deal of precision.

Patients undergoing an oculoplastic procedure with Dr. Pfeiffer, an experienced oculoplastic surgeon, personally appreciate the natural-looking results achieved with their eyelid procedure. In general, the eyes look more open, more vibrant, and all-around more youthful after surgery.

If you’re interested in oculoplastic surgery, consider visiting with Dr. Leslie Pfeiffer. She sees patients in Key Whitman’s Frisco, Dallas, North Arlington, and Rockwall locations.

M. Barke, MD; Chian-Huey (Amy) Hong, MD; Rosemary Sanchez, OD

Dr. Leslie Pfeiffer, MD is board certified by the American Board of Ophthalmology and is a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery, American Academy of Ophthalmology, the Texas Ophthalmology Association and the medical honor society, Alpha Omega Alpha. She completed a full 2-year surgical training at the largest oculoplastics-only private practice in Los Angeles, Eyesthetica and the University of Southern California Rossi Eye Institute. She has advanced training in eyelid, orbit, tear duct system and facial cosmetic and reconstructive surgery. She sees patients in Dallas, Frisco and Rockwall.

Dr. Lauren May, MD is a board-certified, fellowship trained Oculofacial Plastic Surgeon specializing in both reconstructive and aesthetic surgery of the eye and face. She is dedicated to providing patient-centered medical care using the most sophisticated techniques to address her patient’s medical and cosmetic concerns. Dr. May completed two intensive years of fellowship in Oculoplastic Surgery at Duke University in Durham, North Carolina Where she received the “Fellow of the Year” award for teaching. Here, she developed an expertise in both cosmetic and reconstructive surgery with a focus on eyelids, forehead, and the lacrimal system. She sees patients in Dallas, Arlington and Colleyville.

Ronald

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

Expert Orthopedic Surgeons Close

Left to right

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

Kwame A. Ennin, MD

Samuel K. Stephenson, MD

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

True Compassion

A HOLIDAY Heart-to-Heart

By LEU & PEIRCE ELDER LAW ATTORNEYS

During the holiday season, we are reminded that the gifts we cherish the most do not come wrapped in a box. Rather, it is the time we spend with loved ones that makes the greatest present of all. As you celebrate the holidays with family and friends, we encourage you to sit down with the seniors in your life to discuss their plans for the future. There is more to planning for the future than just signing documents as part of an estate plan. Discussing Elder Law issues with your loved ones will give them options so they can have control over decisions about their own care, thus giving them peace of mind. After all, Elder Law is first and foremost about empowering seniors. Elder Law is not a type of law, but a relatively new way to bring

• LIVING ARRANGEMENTS—No one knows exactly what the future holds, but the key to feeling secure is to keep all of your options open. There are a wide range of living arrangements for seniors, from retirement communities to assisted living facilities to memory care to skilled nursing facilities. Some people want to stay in their own 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. Elder Law services can help you weigh all the options and make sure you have the right plans in place for the future.

• FINANCIAL WELLBEING—Money matters can be especially complex for seniors. It is important to plan carefully and preserve your assets for when you need them most. Will your Social Security, pension, or other retirement fund be enough to pay your monthly expenses? Will you be eligible for public benefits such as Medicaid or Veterans benefits? Do you have long-term care insurance? Have you designated individuals to act on your behalf in financial and legal matters through a proper Durable Power of Attorney so your finances can be protected if you cannot act for yourself? Elder Law encompasses all of these decisions within the context of planning for long-term care.

several areas of law together to benefit a particular group of people— older adults. Elder Law services enable you to make your own choices and decisions about managing life as you age. Everyone wants to have some control over the future, and Elder Law helps people do just that. The main areas of Elder Law include planning for your living arrangements, financial wellbeing, healthcare options, and the ultimate disposition of assets. Helping seniors learn about these Elder Law issues may be the most valuable gift you give this year.

Starting the conversation about aging and planning for care can be overwhelming. Consider opening the discussion with these important topics:

• HEALTHCARE OPTIONS—Healthcare in the United States has become one of the most confusing and uncertain issues we face. If you have private insurance that covers medical expenses or long-term care, you need to be sure that changing laws and regulations will not affect your coverage. If you rely on Medicare and a Medicare Supplement or, alternatively, a Medicare Advantage Plan to pay your healthcare costs, do you know what your benefits those plans will cover when you need them? Elder Law includes these issues, and can help you outline your wishes for health decisions through a Medical Power of Attorney and Advance Directives.

• DISPOSITION OF ASSETS—Elder Law includes estate planning issues such as wills, trusts, special needs trusts, and property transfers. As time passes and circumstances change, it is often necessary to make changes to your plans to control the disposition of your assets during your lifetime and after you pass. Further, depending upon the government benefits for which you may be eligible, changes may be needed to ensure your long-term desires are met. Elder Law considers the importance of planning to preserve assets and maintain eligibility for public benefits.

As this holiday season approaches, consider having a heart-to-heart with your loved ones about these important Elder Law issues. The peace of mind for your family will be the gift that keeps giving for years to come.

OLIVIA ROGERS , RN, BSN, CHPN, CHPO, MBA,

senior services and the Vice President, Chief Nursing Officer of VNA Texas.

Dear Olivia,

I have so many questions about hospice care, and I have heard different things from the medical community and family members. Can you help clarify a few things?

~Wanting to Learn More

Dear Wanting to Learn More, You are not alone! Navigating health care can be confusing when it comes to talking about end-of-life care, which is hard to discuss for anyone facing these difficult decisions. I hope the below questions can help!

1. Is hospice a place? No, hospice is a type of health care provided primarily in the home. Many people associate hospice with inpatient facilities, but most hospice care (more than 90 percent) is actually provided in the patient’s own home, or wherever they call home (nursing facility, assisted living facility, memory care, etc).

2. Is hospice care expensive? The services are meant to be accessible and affordable for patients. Hospice is covered by Medicare, Medicaid, and most private insurance plans. The Visiting Nurse Association (VNA) also provides charitable care for those with no means to pay.

3. Do most hospice patients have cancer? Hospice is not just for cancer patients. Though many associate it with cancer, hospice can be used for any terminal diagnosis. These included Alzheimer’s, other forms of dementia, heart disease, lung disease, liver disease, and many other diagnoses. The doctor certifies that a patient meets the criteria for hospice care, and then care can begin.

4. Does hospice stop all of my medications once I sign up for hospice care? No, hospice works with your doctor and the hospice doctor to establish a plan of care to meet the goals of the patient and family. Also, hospice care is about more than medical needs. Hospice aims to treat the whole person by providing emotional, social, and spiritual support.

5. What about personal needs for those who cannot care for themselves with activities of daily living? Hospice support includes a home health aide who can assist in personal care such as bathing, dressing and light meal preparation. They are part of the interdisciplinary team, along with volunteers. Hospice organizations have many trained volunteers who visit patients, provide respite for caregivers, help with errands, and offer companionship.

~Olivia

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 confidet 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 confidet 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

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.

Avoiding and Manipulating a Dowager’s Hump

Dowager’s hump, neck hump, text hump, hunchback, or round back area all names for the same condition. There are a few different labels for the excessive bend in your spine. There are a number of difference causes of dowager’s humps, the most prevalent of which are postural, congenital, and Scheuermann’s.

The term “dowager’s hump” refers to the slightly rounded hump that can sometimes be seen at the base of an elderly woman’s neck, however the condition can occur in people of either sex.

What is a dowager’s hump?

Considered a spinal condition, the chronic forward-leaning posture that is all too frequent in our world of computer screens and other devices is the cause of this ailment, is named “kyphosis” in the medical community. If you have a propensity of slouching all the time, it’s possible that your top vertebrae will develop an unnatural bend over time. Your spine has natural curves to it, which helps you stand straight and supports your posture, but kyphosis can affect your posture and make standing a challenge.

In addition to having a hump in your upper back, you may also experience:

• Rounded shoulders.

• Tight hamstrings.

• Pain or stiffness in your back and shoulder blades.

• Extreme fatigue.

• Headaches or migraines

Oftentimes, a dowager’s hump is frequently confused with the condition known as a buffalo hump, which has a similar look. The development of a buffalo hump is frequently seen in patients who suffer from Cushing’s disease where an excessive amount of cortisol is produced, resulting in an increase in the formation of fat. This excess fat often deposits behind the neck forming what is often referred to as the buffalo hump. Both conditions can occur together or independently.

What causes it?

Poor posture is the leading contributor to the development of a dowager’s hump. Because of this, a dowager’s hump most commonly appears between the ages of 40 and 60. This forward-leaning and humped posture is frequently the result of tight muscles in the chest and neck, as well as weak muscles in the upper back and neck. Other possible causes include:

• Osteoporosis. A compression fracture causes an increased forward curve. This causes your upper back to curve more, which forces you to lift your neck into more extension to be able to see forward. It’s those two factors that cause the bump in the upper back. Women are more likely to develop a Dowager’s hump, as hormone changes during menopause can increase their risk of osteoporosis.Degenerative changes in your spine. This is a slow, progressive loss of the normal structure and function of your spine. Degenerative changes range from mild to severe and most often occur as a result of the normal aging process. Arthritis, tumors and infections can also cause these changes.

The hump at the base of your neck may be caused by osteoporosis or poor posture.

• Underlying bony or ligamentous pathologies. Spinal infections, fractures, tumors, calcifications of spinal ligaments and other bony or ligamentous pathologies can also change the shape of your spine.

• Excess weight. It’s not the fat that is choosing to go to the back of your neck, but as you put on weight on your body, it can also get worse in this area.

• Congenital problem. Less frequently, the spine doesn’t form properly before birth.

• Scheuermann’s kyphosis. This shows up in teenagers, when their spine develops into a wedge shape instead of a rectangle.

How do I get rid of a dowager’s hump?

You may often improve or reverse a dowager’s hump by manipulating it with exercises that strengthen the muscles in your upper back and neck. Your age and the severity of the condition will determine whether or not this is possible. Building up the strength in these muscles can assist you in pulling your shoulders and head up.

Try doing the following exercises:

• Chin tucks. To do a chin tuck, pull your chin straight back. This is good for the disks in your neck and strengthens your neck muscles. Do three sets of 10 daily.

• Scapular squeezes. For these, squeeze your shoulder blades together, which helps improve your upper back muscles. Do three sets of 10 daily.

• Release your suboccipital muscles, the muscles located at the base of your neck which are responsible for pulling your head into an incorrect forward posture. Lay on our back and place a tennis ball to where it’s pressing on this area. Gently rock your head from side-to-side in order to feel a release in the muscles. Do this a couple of minutes each day.

• Doorway pectoral stretches. Stand in an open doorway, raising your arms like a goalpost with your palms forward. Place your palms on the door frame and step forward with one foot to feel the stretch across your chest. Hold for 20 to 30 seconds. Do two to three times daily.

Your primary care physician may recommend physical therapy, which can teach you how to perform these exercises in the correct manner. You won’t have to spend a lot of time performing these exercises,

but if you do them frequently, you’ll notice a reduction in discomfort, an increase in energy, and an overall improvement in your quality of life. The most significant advantage, though, is that it encourages a more upright posture, which in turn helps lessen or eliminate the appearance of the hump. However, a dowager’s hump is not something that can be eliminated quickly. It can even take a few months for everything to get back to normal after such a long period of time.

How do I prevent a dowager’s hump?

The most effective method for avoiding the problem is to keep up a healthy posture. How is your posture while reading this article? It is recommended that you hold your cell phone at eye level so that you do not have to crane your neck in order to see the display. Repeat the process when at your computer in the same way. If you have a habit of constantly bending forward, you are putting unnecessary strain on your back and neck, which can lead to pain. Because of the increased strain placed on the muscles and the increased pressure placed on the discs, this forward curve raises the likelihood of experiencing disk problems as well as neck tiredness. This occurs as a result of the fact that the neck, rather of balancing with gravity, needs to fight against it in order to support the weight of the head. Our bodies aren’t made for that kind of curve. It can cause neck, upper back and lower back pain and even reduced lung capacity.

Hyperkyphosis is when the curve of your spine is extreme, is associated with impaired lung function, reduced functional capacity and increased higher risk for death.

You should also make an effort to stop the progression of osteoporosis in order to reduce the risk of your spine having compression fractures. These fractures can cause the upper back to arch forward more dramatically.

Symptoms of dowager’s hump might vary from person to person, but depending on the degree to which nerves are involved, radicular pain, tingling, and/or numbness that can be felt throughout the body. The severity of symptoms, such as troubles with the bowel or bladder, problems with balance and coordination, and impaired lung function, can increase if the condition is either allowed to go untreated or is not addressed aggressively.

If you suspect you may have a dowager’s hump, the first step of treating a neck hump is to determine the cause. Talk to your primary care physician to rule out any underlying issues.

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BOOMERITIS PREVENTING INJURIES AS YOU AGE

By LINDY SIMS

Baby boomers are the first generation to make a concerted effort to keep healthy and to stay active as their body ages. They have made it a point to redefine aging. There were of course exceptions in previous generations who kept active; however, prior generations were more likely to take up gardening or lawn bowls. My parents and their friends rarely, if ever, did planned exercise as we know it today, and their parents even less so.

The term boomeritis was coined by an orthopaedic surgeon at the Hospital of the University of Pennsylvania. He noted that while these fitness intentions were admirable, they led to a significant increase in the number of overuse injuries in the baby boomer generation. He thus used the term boomeritis to describe the growing number of sports injuries in this demographic. These injuries range from tendonitis to bursitis and arthritis. The suffix “-itis” refers to inflammation.

Most injuries are related to overuse. Listen to your body and learn ways to prevent injuries. Several factors contribute to the rise of Boomeritis:

» OVERZEALOUS TRAINING: Many older adults may try to perform exercises or activities at the same intensity as when they were younger, pushing their bodies beyond their current capabilities.

» LACK OF PROPER WARM-UP AND COOL-DOWN: Neglecting warm-up and cool-down routines can significantly increase the risk of injury.

» POOR TECHNIQUE: Incorrect form and technique during exercise or sports can lead to muscle and joint strain.

» INADEQUATE RECOVERY: Older bodies require more time to recover. Pushing too hard without allowing for sufficient recovery can result in injuries.

» NEGLECT OF NUTRITION AND HYDRATION: Proper nutrition and hydration are crucial for maintaining muscle and bone health. Neglecting these aspects can increase the risk of injury.

It’s never too late to start an exercise program that can help you age in a more healthy manner but take preventative steps to prevent boomeritis.

» CONSULT A HEALTHCARE PROFESSIONAL: Before starting any exercise regimen, consult with a healthcare provider or a sports medicine specialist. They can assess your overall health and provide guidance on what types and intensities of physical activity are suitable for you.

» TAILOR YOUR ROUTINE: Customize your exercise routine to your current fitness level. Gradually increase the intensity over time, focusing on steady progress rather than immediate results.

» PROPER WARM-UP AND COOL-DOWN: Always begin and end your exercise sessions with a proper warm-up and cool-down. This will help prepare your muscles and joints for activity and prevent sudden stress.

» STRENGTH TRAINING: Include strength training in your routine to build muscle mass and maintain bone density. This can help protect against fractures and joint issues. Seek the help of a personal trainer who can design you a program.

» FLEXIBILITY EXERCISES: Regular stretching and flexibility exercises can improve joint mobility and reduce the risk of muscle and joint strains.

» BALANCE AND CORE TRAINING: Improving balance and core strength can help prevent falls and associated injuries.

» STAY HYDRATED AND EAT WELL: Proper nutrition and hydration are vital for muscle and bone health. Ensure you maintain a well-balanced diet and drink enough water.

» LISTEN TO YOUR BODY: Pay attention to your body’s signals. If you experience pain, discomfort, or fatigue, give yourself adequate time to rest and recover.

» USE PROPER EQUIPMENT: Make sure you have the right gear and equipment for your chosen activity. Ill-fitting shoes or sports equipment can contribute to injuries.

» REGULAR CHECK-UPS: Schedule regular check-ups with your healthcare provider to monitor your overall health and address any potential issues before they become serious.

» CROSS-TRAIN: Avoid repetitive movements by incorporating a variety of exercises into your routine. Cross-training can reduce the risk of overuse injuries.

» INCORPORATE LOW-IMPACT ACTIVITIES: Consider low-impact activities like swimming, cycling, or yoga, which can be easier on your joints while providing valuable health benefits.

With the right precautions, a well-designed fitness routine, and a focus on overall health, you can significantly reduce the risk of injuries as you age. Successful aging lies in the balance between physical activity and self-care.

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Difficulty Hearing in the Presence of Noise

By CASSANDRA WILSON, AU.D., CCC-A, FAAA

Hearing loss is a pervasive, often underestimated health issue in the United States, affecting millions across all age demographics. Despite its prevalence, hearing loss frequently goes unnoticed, resulting in a significant lack of awareness and understanding of its impact on individuals and society.

The Prevalence of Hearing Loss

Hearing loss is more common than most people realize. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), approximately 15% of American adults—37.5 million people aged 18 and over—report experiencing trouble with hearing.

Causes of Hearing Loss

Hearing loss can result from various factors, both genetic and environmental. Here are some primary causes:

• Aging: Presbycusis, or age-related hearing loss, is the most common form. It occurs gradually as individuals age and often reduces the ability to hear high-pitched sounds.

• Noise Exposure: Prolonged exposure to loud noises—from music, machinery, firearms, or everyday city noise—can permanently damage the delicate hair cells in the inner ear, resulting in noise-induced hearing loss.

• Genetics: Some forms of hearing loss are hereditary and can be passed down through families, with genetic factors significantly influencing susceptibility.

• Medical Conditions: Certain conditions, such as diabetes, cardiovascular disease, and infections like meningitis, can also contribute to hearing loss.

• Medications: Ototoxic drugs can harm the auditory system, potentially causing hearing loss or tinnitus (ringing in the ears).

Consequences of Hearing Loss

Difficulty understanding speech in noisy environments is the most commonly reported problem among individuals with hearing impairment. Clinical studies show that even mild hearing loss can hinder one’s ability to communicate against background noise.

How Do We Define Noise?

In simple terms, noise is any unwanted signal that interferes with what the hearing instrument user wants to hear at a given moment. This concept is known as the Signal-to-Noise Ratio (SNR). When background noise is present, the speech signal (what we want to hear) is relatively low compared to the noise level. People with hearing loss require a more favorable SNR (louder speech than noise) to comprehend speech compared to those with normal hearing.

Reducing Background Noise

How do hearing instruments improve the SNR? The optimal way to minimize background noise is to prevent it from entering the hearing system. This can be achieved with advanced directional microphone technology, which assumes that the primary signal for the listener is speech, positioning the desired signal at the forefront. To enhance the SNR, the signals from the front (speech) are amplified, while signals from other directions (background noise) are suppressed. This approach facilitates better speech understanding with reduced background noise interference.

Can everyone benefit from directional microphone technology in hearing instruments? Yes, but the question remains: which technology is most appropriate? The answer largely depends on lifestyle. The more active a person is, and the more diverse their listening environments, the harder the hearing instrument must work for them, thereby necessitating more advanced directional technology. Your audiologist can help you make an informed decision about the technology based on your hearing loss and lifestyle requirements.

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

RAMI BASATNEH, DPM Podiatrist,Foot& AnkleSurgeon

BRIANA HODGSON, PA-C OrthopaedicSurgery PhysicianAssistant

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.

L

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With more than thirty proven attorneys in four offices across North Texas, KoonsFuller is one of the largest family law firms in Texas and the Southwest. KoonsFuller Family Law offers clients a level of legal representation and range of resources unmatched by any other family law firm. Whether your case calls for informal negotiations, mediation, collaborative law or court proceedings, KoonsFuller is equipped to handle cases of all sizes and issues and has been doing so for over 40 years. The attorneys pride themselves on the compassion, skill, and thoughtfulness they bring to each case. They understand that every family is unique and every family’s concerns are different, especially when divorce, custody issues, and finances are involved.

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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*BOARD CERTIFIED IN FAMILY LAW BY THE TEXAS BOARD OF LEGAL SPECIALIZATION.

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

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

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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

OVERCOMING AQUAPHOBIA

Adults Learning to Swim

Learning to swim is often seen as a rite of passage in childhood, but what about adults who never had the opportunity or developed a fear of water? The fear of water, known as aquaphobia, can be daunting to overcome, but it’s never too late to learn.

Swimming is a life skill and for a good reason. It’s more than just splashing around. Knowing how to swim can be a matter of life or death. However, a Gallup survey published two years ago revealed that across the world, fifty percent of adults report feeling afraid in water that is over their heads, and that’s just in pools. One in three adults in the United States is terrified of even submerging their heads in water.

American Red Cross launched a campaign to cut drowning in half in fifty cities. They released a survey that found that while 80 percent of adults claim they could swim, 44 percent of them also admit they would fail a basic test. That’s almost half the adult population!

So why is it that the vast majority of adult nonswimmers have the impression that they are the only ones? The primary reason for this is that they are largely unaware of the fact that millions of other adults are in on their “little secret.” They are certain that they will never be able to learn how to swim because of the humiliation they feel, the terrifying and/or unpleasant experiences they have had with water, and the poor training techniques they have been exposed to.

Hollis Parker, age 90, enjoying a swim at his granddaughter’s in Allen, TX.

mental and emotional obstacles that keep people from learning to swim. Many adults have given up hope of ever learning to swim after numerous failed attempts at swimming instruction. They typically do not want to try again.

Meanwhile, many of these same people are seeing their children and grandchildren learn to swim and watching them swim like fish. In the meantime, they avoid joining them, not only because they are afraid of the water itself, but also because they are afraid of being “found out” and publicly embarrassed by their lack of competence. In other words, they are embarrassed by their inability to swim. The result is that they have little choice but to observe what appears to be the rest of the world having a good time, sometimes even in the pools that they themselves own. They are missing out on the enjoyment, the companionship, and what is likely one of the very best ways to work out in the area.

When appropriate educational methods and conditions are in place, all of this is entirely unnecessary. Even though there are many wonderful swim programs available, which do teach individuals how to swim, these programs frequently lack an awareness of the challenges that adults experience that most children do not. Even while there is a lot of attention paid to the physical concerns and “learning strokes,” the actual hurdles for adults tend to be psychological barriers. These are especially the kinds of barriers that are specific to people who have had a lot of years of poor experiences with traditional swim lessons and other similar activities.

WHAT’S NEEDED IS A FOOLPROOF SYSTEM:

• Find a supportive environment. Call and speak to the manager of your local swim school and inquire about adult only classes with swim instructors who specialize in water-related anxieties. The instructors are trained to handle fear and can provide reassurance.

• For shy and embarrassed swimmers, sign up for an early or late evening class when the swim school isn’t as busy or take a private class by yourself. Visit the school before your class so you can get comfortable in the environment prior to getting into the pool. You can also take a trusted friend or family member along.

• Take it slow. Don’t rush the process or be hard on yourself by pushing too hard. Small steps. Get comfortable in the water first until you become more confident.

• Use a flotation aid such as a life jacket, pool noodle, or kickboard to provide an added sense of security while you learn to swim.

“We’re asking every family to make sure that both adults and children can swim and that parents make water safety a priority this summer,” said Connie Harvey, director Centennial Initiatives at American Red Cross. Non-swimmers of any age, finding yourself in water over your head can be fatal. This is preventable.

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 certiÿed 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 a°liated 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.

Please call 972.498.4791 to schedule an appointment.

Orthopaedic Surgeons located in Richardson, TX

www.LWOrthopaedics.com

Dr. Diane S. Litke, MD

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.