Texoma Area Living Well Magazine September/October 2025

Charles Toulson, MD, MBA

Pioneering a New Era in Knee Replacement

Dr. Hannah Abigail, a fellowship-trained foot and ankle reconstruction podiatric surgeon, is dedicated to providing exceptional care to patients in North Texas. She is committed to providing top-tier care and innovative treatment solutions and is a strong proponent of minimally invasive surgery. Dr. Abigail brings expertise and confidence in handling all aspects of reconstructive foot and ankle procedures, including complex trauma, diabetic ulcer care, flaps, sports medicine, elective reconstruction, and complications.

Whether you are experiencing foot pain, a sports injury, or a chronic ankle condition, Dr. Abigail is available to help you achieve optimal health and get back to your daily activities with confidence. Contact her office today to schedule an appointment.

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!”

“ Certainly, we understand that you want the best from your investment in hearing well. You deserve personalized attention and a hearing aid customized to your needs. We’re here to answer your questions and provide the excellent customer service you’ve come to expect. Call us at 903-868-2650. We want you to hear well again! ”

the Joy!

Life is a constant flow of sounds, overlapping and ever-changing. Hearing loss can be overwhelming, causing you to withdraw from the world. WIDEX Allure™ provides crystal clear speech, so you can stay fully engaged, hearing with greater balance, vibrancy and authenticity. With its innovative technology and refined design, you can embrace life fully, balancing your focus, easily transitioning between soundscapes.

Rediscover the joy of every voice. Every sound. Everywhere life takes you.

• Powered by the new W1 chip that is 4X faster with 4X memory capacity

• Enhanced push button to answer your phone or change volume/programs easily

• Wind & touch-resistant microphone; a new level of precise sound processing

• App & accessories

Jill Sheppard, B.S., SLP/Audiology, Licensed Fitter and Dispenser of Hearing Instruments (LFDHI), and co-owner of HearCare & Associates in Sherman and Gainesville

• Available in 10 stylish colors The Difference is Clear

Jill Sheppard, B.S., SLP/Audiology, Kenneth Sheppard, Jr., LFDHI

Living Well Living

LIFE IN FULL MOTION

This issue of LIVING WELL Magazine highlights the power of skill, creativity, and perseverance—qualities that shine through in each of our features.

We begin with Charles Toulson, MD, MBA, a board-certifid, fellowship-trained orthopedic surgeon whose groundbreaking SURRE KNEE approach is redefinig what patients can expect from knee replacement surgery. By combining robotic-assisted precision with a minimally invasive, muscle-sparing technique, Dr. Toulson’s method prioritizes comfort, speeds recovery, and delivers exceptional long-term results—often allowing patients to walk unassisted within days.

His dedication to excellence ensures that every patient receives the highest level of care, with outcomes that restore not only mobility but quality of life. Learn more on page 8.

From there, we turn the spotlight on Alicia Keys, a Grammy-winning artist who’s spent her career breaking boundaries in music and in life. Starting on page 24, her reflctions on self-worth, balance, and creativity might just have you rethinking how you defie success.

In The Dopamine Menu, Abigail Shaw serves up a refreshingly practical tool for lifting your mood and motivation, one small joy at a time—fid it on page 20. It’s not about overhauling your life overnight; it’s about giving yourself a gentle nudge toward better days.

Meanwhile, the article Life After the Bell, on page 31, takes us into the quiet space that follows a cancer patient’s fial treatment. It’s a moving exploration of what it means to heal, rebuild, and rediscover yourself in the chapters that follow survival.

Here’s to new perspectives, quiet courage, and the small moments that make all the difference.

Enjoy the issue!

Live well,

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

ADVERTISING & SALES

TEXAS: Denton County, Dallas County, Collin County

TEXAS & OKLAHOMA: Texoma Area

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

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,

SPRING AND SAM HOUSTON

SAM AND SPRING HOUSTON

Charles Toulson,

Expert Orthopedic Surgeons Close to

Left to right

John S. Early, MD

Terry K. Gemas, MD

William F. Tucker, Jr., MD

Duncan L. McKellar, Jr., MD

J. Conner Ryan, MD

Brian I. Nwannunu, MD

Florian F. Dibra, MD

Charles E. Toulson, MD

Cyrus E. Abbaschian, MD

Donald W. Hohman, MD

J. Stephen Appleton, MD

Alexander S. Greenstein, MD

Kwame A. Ennin, MD

Samuel K. Stephenson, MD

Raj Yalamanchili, MD

Emmanuel D. Eisenstein, MD

Innovation. Ingenuity. Integrity.

With a clear focus on quality, reliability and timely completion, Plyler Construction works with owners of such diverse commercial, institutional and industrial projects as manufacturing, warehousing, educational, retail, support and religious facilities to provide the most appropriate delivery method. Plyler offers pre-construction services, experienced construction management, a variety of delivery methods, equipment setting and in-plant maintenance services.

We work with our clients, not just for them. That’s just one of the reasons architects, designers, and industrial and commercial project owners from across the nation have looked to Plyler Construction for more than a half-century for solutions to their building needs. At Plyler Construction, we build relationships.

General Construction

Pre-Construction

Design-Build Capabilities

Construction Management

MEP Mechanical

Electrical

Plumbing

HVAC

Charles Toulson, MD, MBA

Founder of the SURRE KNEE–A New Era in Knee Replacement

Charles Toulson, MD, MBA, is an orthopedic surgeon who is committed to excellence. From a young age, he realized that his aptitude for medicine could help people living with chronic pain, and he dedicated his life to becoming a pioneer in the fild of orthopedic surgery.

Board-certifid and fellowship-trained, Dr. Toulson’s specialties and interests include adult hip and knee reconstruction, adult hip and knee revisions, and state-of-the-art robotic-assisted joint replacement. He is regarded by his patients and peers as one of the leading orthopedic surgeons in the country.

Exceptional Education and Training

Dr. Toulson’s impeccable educational pedigree includes a medical degree from the University of North Carolina at Chapel Hill, extensive training from Johns Hopkins Hospital, and sub-specialty training at the Hospital for Special Surgery in New York—the number-one ranked orthopedic hospital in the country.

The SURRE KNEE: Revolutionizing Knee Replacement

In keeping with his mission to deliver the best possible outcomes for his patients, Dr. Toulson is the founder of the SURRE KNEE—a groundbreaking approach to total knee replacement based on the Subvastus Rapid Recovery Experience (SURRE) technique. Ths innovative method combines the precision of robotic-assisted surgery with a minimally invasive, muscle-sparing approach that prioritizes patient comfort, quicker recovery, and exceptional long-term results.

Unlike traditional knee replacement methods, the SURRE KNEE spares the quadriceps tendon by working beneath the vastus medialis muscle. Ths reduces surgical trauma, which in turn minimizes post-operative pain, speeds up mobility, and allows many patients to walk unassisted within days of surgery.

When paired with robotic assistance, the SURRE KNEE ensures customized alignment and implant positioning, delivering a more natural feel and improved joint function.

Key Benefits of the SURRE KNEE Approach:

• Reduced pain and swelling compared to traditional knee replacement

• Faster recovery times, allowing patients to resume normal activities sooner

• Early mobility due to the muscle-sparing technique

• Highly precise implant placement using robotic technology

As the creator of the SURRE KNEE, Dr. Toulson has redefied what patients can expect from knee replacement surgery. His commitment to innovation, combined with compassionate, patient-focused care, ensures that each individual receives the highest level of treatment—with less downtime, better mobility, and superior results.

Outpatient Joint Replacement Program

Dr. Toulson is also a forerunner in same-day or next-day joint replacement surgery. The reason for his success is his minimally invasive, muscle-sparing surgical technique. His patients are returning to their active lifestyle quicker than ever before.

Because the SURRE KNEE technique minimizes softtissue disruption and signifiantly lowers pain levels after surgery, many patients are able to walk within hours of their procedure. Ths rapid recovery allows them to safely go home the same day, avoiding an overnight hospital stay.

Patients benefit from:

• Lower risk of hospital-acquired infections

• Recovery in the comfort of their own home

• Earlier return to daily activities and physical therapy

• Reduced overall healthcare costs

By combining advanced anesthesia protocols, precise surgical execution, and thorough pre- and post-operative care, Dr. Toulson has built one of the region’s most effective and patient-friendly outpatient joint replacement programs.

Successful Outcomes

“When patients come to see me with arthritis, we often try non-operative means of treatment before we talk about surgery,” says Dr. Toulson. Once non-operative options for hip or knee arthritis are exhausted, Dr. Toulson sits down with patients and details the benefits and the risks of a total joint replacement.

One of Dr. Toulson’s recent patients was suffering with severe arthritis in her knees. “I was having severe pain in my knees, I had difficulty going up and down stairs, steps, even the curb. It hurt so bad to walk, even short distances,” she says. The results of her bilateral (both) knee replacement procedure have been life changing. “ The surgery went wonderfully. I haven’t had any problems and every day it gets better and better. I can walk up the steps now getting into my home,” she says.

Highlights of success stories and the joy his patients express at the outcome of their hip or knee replacement surgeries—and how it’s changed their lives—are documented on his website, drcharlestoulson.com, with videos and moving testimonials.

Awards and Accolades

It’s no surprise that Dr. Toulson has been named among the Best Doctors in Dallas for orthopedic surgery by D Magazine nine times and among the Best Orthopedic Surgeons in Collin County by D Magazine six times. He has also been awarded Best Orthopedic Surgeon for nine consecutive years by Living Magazine, along with being named Best Orthopedic Surgeon for the past five years by Living Well Magazine

SURRE KNEE

Choosing the Right Attorney

By CRAIG WATSON

Our story begins with Paul, a 78-year-old divorced man who passed away in late 2013. He had two children: a son named Rip and a daughter named Kelly. Paul told Kelly that he chose her to serve as Executrix in his Will because she was responsible as compared to his son Rip who had an abusive personality and was often unemployed. Rip was hard for everyone to get along with and seemed to reserve his most intense wrath for his sister. Paul’s Will lefthis estate to his two children in equal shares.

When Paul died, Kelly acted quickly to probate her father’s Will. She hired her father’s long-time general practice attorney, Max, to probate the Will. Max and Paul had been golfig buddies for a long time. Kelly figued that Max drafted the Will so he would be the best choice to probate it. Max had helped Paul with his divorce and had defended him when he was arrested for driving under the influence.

Max got Kelly appointed Independent Executrix before the end of the year. Several creditors unexpectedly filed claims in the estate. Unfortunately, Max didn’t specialize in probate law and so he didn’t know how to handle the creditor’s claims. In fact, there are many general practice attorneys that will accept a probate case, thinking that it’s easy. The progress of probating Paul’s estate slowed to a crawl because Max didn’t know what to do about the creditor’s claims. The problems cascaded because the slow progress angered Rip. He began calling and emailing Kelly and Max daily, sometimes multiple times per day. His communications were very abusive. Rip even filed a large creditor’s claim of his own. Rip’s claim was frivolous but Max didn’t know how to dispose of it. Max had to charge the estate for the time he spent responding to Rip’s emails and talking to Kelly and Rip on the phone so his legal fees began to add up.

Kelly was able to sell her father’s house and land, which brought in enough money to enable Kelly to pay Max’s legal fees and make a large preliminary distribution to herself and Rip. The money didn’t placate Rip one bit and he continued to badger everyone involved. After over two years of ineffective representation, Max withdrew as the estate’s at-

torney. Ths forced Kelly to do what she should have done in the fist place: research and fid an elder law attorney who had expertise in probate.

Kelly made an appointment with her new elder law attorney and brought him the thick file of documents to review. After reviewing the thick file of documents, the elder law attorney realized that Max had failed to perform several procedures and give several notices required by the law. The requirements that Max had missed were only recently passed by the legislature. Since Max’s general law practice included mostly divorce, personal injury and criminal defense, he didn’t have enough volume in the probate area to justify the time it takes to keep current on all the new laws. The elder law attorney realized that in order to protect Kelly from potential personal liability, the case would have to be delayed even further to give the required notices and allow the required time periods to expire so that known and unknown potential and actual creditors, including Rip, would not be able to file claims against Kelly individually after the estate was closed. Ths delay infuriated Rip even more. However, the elder law attorney was experienced in dealing with difficult estate beneficaries and was able to shut down Rip’s abusive communications to his sister.

The delays, frustration, extra expense, and exposure to liability that Kelly experienced could have been avoided if she had hired an elder law attorney instead of her father’s general practice attorney. Probate law is a complicated fild. The legislature and the courts are constantly making new laws, adding to the complexity. The sheer volume of all this change is forcing more and more attorneys to choose to specialize or limit their practice.

When Kelly fist called her father’s attorney, before telling him who she was or why she was calling, she should have asked him to tell her specifially which two or three areas of the law accounted for the majority of his practice. If his answer didn’t include probate or estate law, she would have been able to deduce that she should hire a different attorney who had expertise in the fild of law that she needed.

STAND OUT WITH THE EMINENT CHOICE IN HEALTHCARE

Total

Headache

ROBOTIC

Seeds of Change

The Promise and Perils of GMOs

By GEORGE YULANI

When it comes to food, there are few topics that generate as much curiosity as GMOs. Some call GMOs the future of farming, while others worry about what they mean for our health and the environment. With so many voices in the conversation, it can be hard to separate fact from fear.

Ths article takes a straightforward look at the pros and cons of GMOs, drawing from current evidence and research. It isn’t about persuading you one way or the other—it’s about giving you the tools to understand what GMOs are, why they exist, and what scientists are learning about their impact.

Let’s start with a little history: the buzz around “GMOs” began as much with curiosity as controversy. GMOs—genetically modifid organisms—are simply plants whose DNA has been adjusted in a lab to give them helpful traits like pest resistance, improved nutrition, or longer shelf life. The idea of GMOs can sound futuristic, but in reality it’s just a more precise version of plant breeding that’s been happening for centuries. As  Time Magazine explains, selective breeding laid the groundwork for modern gene editing.

So what’s the upside? Many GMO crops, like corn or soy, are engineered to resist insects or tolerate herbicides. That means farmers can cut pesticide use, and environmental studies suggest overall chemical applications drop signifiantly. In fact, a meta-analysis of 147 studies found that adoption of GMO technology reduced pesticide use by about 37 percent. At the same time, crop yields increased roughly 22 percent. That suggests farmers—and consumers—could benefit from more food with fewer chemical interventions.

GMOs can also be tailored for nutrition. Take Golden Rice: it’s enriched with beta-carotene, a vitamin A precursor, to help prevent childhood blindness in regions where diets are deficiet in this nutrient. Ths isn’t hypothetical—in places where vitamin A deficiecy is common, Golden Rice can deliver meaningful nutritional support.

But GMOs aren’t without their critics. Concerns include the potential for allergens when genes from known allergens are introduced into new plant varieties. For example, an experimental GMO soybean that included a Brazil-nut protein triggered allergic responses, leading researchers to halt that effort. So while no current approved GMO foods have caused allergic reactions, the potential is taken seriously—and safety assessments are part of the approval process. Likewise, environmental concerns like “superweeds”—plants that evolve resistance after repeated herbicide use—signal that GMO success can ripple beyond the farm.

What about safety for everyday eating? Here’s where scientists and regulators mostly agree: available GMO foods have passed rigorous safety assessments, and there is no evidence linking them to health problems like cancer, allergies, or organ damage. The World Health

Organization affirms that no proven risks have emerged, though each GMO product is evaluated individually. Still, public skepticism lingers. A 2020 poll reported by  Time Magazine found that only 27 percent of Americans consider GMOs safe to eat—a perception gap that shows how trust is hard to win, even when science leans toward reassurance.

Globally, GMO adoption varies—most U.S. soy, corn, and cotton crops are GMO, but that’s not the case everywhere. In Europe, regulations are stricter, and consumer attitudes tend to be more cautious. Part of the debate revolves around transparency and labeling, yet research suggests health risks remain negligible—a sentiment echoed in a 2016 National Academies report that didn’t fid additional hazards from GMO compared to conventional crops.

Talk of GMOs also loops into bigger conversations about sustainability. Genetic engineering can help crops thrive in drought, heat, or poor soil, which is especially relevant in a changing climate. Plus, engineering faster-growing species—like some types of GMO salmon— could eventually help feed more people using fewer natural resources.

At the end of the day, GMOs are not evil—and they’re not miracle cures. They’re tools, and like any tool, their value depends on how we use them. If they help reduce chemical exposures, improve nutrition, and boost harvests in challenging conditions, that’s a win. But careful regulation, ongoing research, and open labeling remain important.

Here’s something to keep in mind: if you’re walking through your grocery store, very few items will wear a “GMO” sign. Often, genetically engineered corn, soy, or canola are hidden inside familiar foods—think cooking oils, cereal ingredients, and snacks. If you’re choosing organic or non-GMO-labeled products, you’ll likely avoid most of it.

So what should a thoughtful shopper do? Start with curiosity, not fear. Learn what ingredients go into your food, ask questions, and trust trusted sources—like the WHO or national science bodies—that assess each GMO with care.

In plain terms: GMOs are tools that can do good—but only if wielded wisely, transparently, and thoughtfully. And for your family’s table, the most important step is informed choices, not blind acceptance or rejection.

Veterans, We’re Here for You Hospice and Palliative Care Support

By TAMERA WHITLOW, LVN, USAF

“Ithought hospice meant the end. What I didn’t know is that it gave me more life, more comfort, and time with my family.”

– James R., U.S. Army Veteran

Every Veteran deserves comfort, dignity, and support—especially during life’s most challenging moments. Unfortunately, many Veterans don’t have access to the full range of care available to those living with a serious illness.

Hospice care does not mean giving up hope or accepting a six-month life expectancy. It means focusing on comfort, managing symptoms, and improving quality of life while providing emotional and spiritual support for both the Veteran and their loved ones. That’s why the Department of Veterans Affirs (VA) partners with local hospices to create Hospice-Veteran Partnerships (HVPs) like the “We Honor Veterans” program. These partnerships are committed to ensuring that no Veteran faces serious illness alone.

“Serving my country was my greatest honor,” says James R. “But when cancer hit, I didn’t know where to turn. Hospice didn’t just

help me—it helped my whole family. They understood what I needed as a Veteran, from my military history to my emotional struggles. They made sure I was never alone.”

Though HVP programs, Veterans receive care from teams who understand their unique challenges—whether related to combat experience, PTSD, or the need for military-specificsupport. Ths includes assistance with VA benefits, respectful recognition of military service, and access to resources tailored for Veterans and their families.

As one hospice nurse shared, “When we care for a Veteran, we honor their service every day. It’s more than medical care—it’s about dignity, respect, and gratitude.”

If you or a loved one are a Veteran facing a serious illness, you are not alone. Home Hospice of Grayson, Cooke and Fannin Counties is a member of the “We Honor Veterans” program, and our commitment is to provide the support our Veterans deserve. Give us a call to learn more about our Hospice and Palliative Care at (903) 868-9315.

Caring for patients. Supporting their families.

JUST BECAUSE DAYS ARE LIMITED, QUALITY OF LIFE SHOULDN’T BE.

We are your neighborhood hospice helping patients and families find loving care with unparalleled skill. Surprisingly, perhaps, there are still opportunities to experience joy. Governed by community leaders, funded by grants and gifts, we are an award-winning hospice, providing end-of-life care for you and support for those you love. Let us be of assistance during this time when every moment is more precious than ever.

USAF Veteran, Tamera Whitlow

Texas Back Institute

Texas Back Institute (TBI) has served the North Texas area in spine care for over 45 years. An uncompromising desire to put patients first and provide individualized spine care has helped change the treatment options available to patients for neck and back pain.

Today, TBI is a leader in artificial disc replacement, minimally invasive spine surgery, complex revision surgery, and treatment of spinal deformity. TBI has trained hundreds of surgeons, scientists, and allied health professionals now practicing worldwide. Its research institute employs state-of-the-art technology and is actively involved in many clinical trials, including artificial disc replacement, minimally invasive technologies, and robotic spine surgery. Texas Back Institute has remained one of the most academic practices in spine care. It is one of the largest multidisciplinary spine centers in the world, providing comprehensive care for neck and back pain. With a fully dedicated staff of board-certified orthopedic spine surgeons, neurosurgeons, physiatrists, and physical therapists, the TBI team works together to support its mission of helping patients get back to life. The 26 physicians at Texas Back Institute are leaders in the surgical

and nonsurgical treatment options for back and neck pain, from the most common outpatient procedures to the most complex cases. Thanks to the unmatched expertise of the medical staff, the advanced diagnostic testing, and an unparalleled commitment to patient care, the Texas Back Institute physicians can identify the potential cause of your pain and create a treatment plan specific to your needs.

Texas Back Institute has developed several spine specialty programs. These include the Minimally Invasive Spine Surgery Center, Center for Disc Replacement, Scoliosis and Spine Tumor Center, and Complex Back Surgery Center. These programs give patients access to highly-trained care teams who focus specifically on these areas of spine care, allowing patients in the North Texas area access to treatment options for their individual problems from physicians with extensive experience in these areas.

“At Texas Back Institute, finding the right solution for each patient and offering the least invasive treatment is core to our belief and the foundation for all treatment plans.” Dr. Michael Duffy.

ALLIANCE

3025 N. Tarrant Pkwy., Ste. 220 Fort Worth (Alliance), TX 76177

ARGYLE

310 FM 407E, Ste. 100 Argyle, TX 76226

DALLAS

12222 N. Central Expy. Pavilion II, Ste. 310 Dallas, TX 75243

DENTON

3537 S. Interstate 35, Ste. 308 Denton, TX 76210

FLOWER MOUND

4370 Medical Arts Dr. River Walk Bldg. III, Ste. 230 Flower Mound, TX 75028

FORT WORTH

1650 W. Rosedale St. Ste. 301 Fort Worth, TX 76104

FRISCO

5575 Frisco Square Blvd. Ste. 400 Frisco, TX 75034

LEWISVILLE

500 W. Main St., Ste. 380 Lewisville, TX 75057

MCKINNEY

4510 Medical Center Dr., Ste. 106 McKinney, TX 75069

NORTH RICHLAND HILLS

4351 Booth Calloway Dr., Ste. 404 Fort Worth, TX 76180

CENTRAL PLANO

4001 W. 15th St. Ste. 455 Medical Office Bldg. III Plano, TX 75093

PLANO

6020 W. Parker Rd. Ste. 200 Plano, TX 75093

ROCKWALL

3164 Horizon Rd. Ste. 100 Rockwall, TX 75032

SASCHE

4650 President George Bush Turnpike, Ste. 100 Sachse, TX 75048

TOP ROW:

Sheena Bhuva, MD; Michael Duffy, MD; Peter Derman, MD; Brian Braaksma, MD; Shashank Gandhi, MD; Stephen Tolhurst, MD; Blake Staub, MD; Alexander Satin, MD; Chun Lin, MD; Kevin Ju, MD; Akwasi Boah, MD; Junyoung “Jon” Ahn, MD

BOTTOM ROW:

Adewale Adeniran, MD; Thomas Kosztowski, MD; Rey Bosita, MD, MBA; Rajesh Arakal, MD; Jessica Shellock, MD; Isador Lieberman, MD, MBA, FRCSC; Richard Guyer, MD; Jack Zigler, MD, FACS; Scott Blumenthal, MD; Theodore Belanger, MD; Nayan Patel, MD; Craig Lankford, MD; Michael Hisey, MD; Uche Davidson, MD

The Dopamine Menu

A Delicious Way to Boost Your Mood and Motivation

By ABIGAIL SHAW

I’ve had those days—the ones where I stare at my to-do list like it’s written in a foreign language. The coffee isn’t kicking in. The house is quiet, but my brain feels anything but calm. I want to get things done, but the motivation just isn’t there. And when I fially do something, even that feels like too much. Sound familiar?

A while ago, I stumbled across the concept of a “dopamine menu.” The idea made sense immediately. It’s basically a curated list of things that bring you joy, calm, or energy—small actions that help nudge your brain into doing the next thing. I liked the metaphor: a menu for your mood, your energy, your motivation. A little emotional room service.

So, I made one.

Not on a fancy app or color-coded spreadsheet. Just a page in my journal, scribbled during one of those afternoons where I felt low-key stuck. I grouped the things I love into rough categories—quick things, bigger things, and a few guilty pleasures that I decided to stop feeling guilty about. And here’s what happened: It worked.

I didn’t become wildly productive or start waking up with superhero energy. But on days when I felt that heavy sense of “blah,” I didn’t have to think so hard. I’d glance at my list and pick something that felt doable. And slowly—ten minutes at a time—my energy returned. Not always fast, but reliably. Here’s what I’ve learned since creating that fist dopamine menu, and why I think it’s worth making one for yourself.

Why a Dopamine

Menu Works

Dopamine is often called the brain’s “reward” chemical, but it’s more nuanced than that. It helps regulate things like motivation, attention, and movement. When you anticipate or experience something pleasant—hearing a favorite song, seeing a loved one’s face, even finshing a puzzle—your brain releases dopamine as a kind of “Yes, more of that, please.”

It turns out, many of the things we have to do every day (answering emails, folding laundry, paying bills) don’t generate much dopamine at all. And when we’re tired or stressed or mentally foggy, our brains need even more coaxing to get into gear.

The beauty of a dopamine menu is that it gives you a small hit of pleasure or satisfaction fist—or lets you pair it with something more mundane. It’s like warming up your brain before a workout.

How

I Built Mine

My fist version had four sections: Quick Hits, Every Day Joys, Paired Pleasures, and Treats. That’s what worked for me. You can call your categories whatever you want.

My Quick Hits list includes things like:

• Stepping outside barefoot for a few deep breaths

• Putting on a song that makes me nostalgic

• Sending a funny meme to a friend

They’re easy, almost effort-free, and they remind me what feeling good feels like.

Every Day Joys are the things I love but sometimes forget about:

• Watering my plants and checking on their new growth

• Journaling for ten minutes with no filter

• Making a fancy version of my afternoon tea (complete with lemon or honey or a cute cup)

Paired Pleasures are things I use to make boring tasks less boring:

• Listening to a podcast while folding towels

• Burning a favorite candle while answering emails

• Watching the birds out the window while doing leg stretches

Treats are exactly what they sound like. A square of dark chocolate. Rewatching a favorite movie scene. A long bath with good music. Thigs I used to label as “unproductive,” but now see as valuable tools. Once I had it all down, I taped it to the inside of my planner. It’s not always beautiful, but it’s mine—and when I need it, I don’t have to overthink. I just pick something.

It’s Not Just for Lazy

Days

Some days, I’m already in a groove. I don’t need a dopamine jumpstart. But the menu still helps me maintain balance. I’ll choose something from it when I feel my mood dipping, when I hit a wall mid-afternoon, or even as a way to reward myself for finshing a tough project. What surprised me most is how this approach softened the way I talk to myself. Instead of “What is wrong with me?” I ask, “What would help right now?” That shiftalone is worth a lot. And it’s flexble. As the seasons change, so does my list. In the fall, I add things like baking or switching out the porch cushions. In summer, I might put “early morning walk before it gets hot” or “ice water in a pretty glass.”

This Is Not About Toxic Positivity

Let me be clear: a dopamine menu isn’t a magic cure. If you’re dealing with grief, burnout, depression, or deep fatigue, no list will fixthat. And there are days when the best I can do is one small thing—and

that’s okay. Ths tool isn’t about being endlessly happy or squeezing productivity out of every moment. It’s about offering your brain a lifeline when it feels stuck. It’s permission to say, “I can’t do everything, but I can do something.” It’s a nudge toward the light.

Where to Start

Don’t overthink it. Grab a piece of paper, and write down 10 things that make you feel:

• Peaceful

• Energized

• Cheerful

• Clear-headed

• Capable

Then sort them into categories that feel right to you. Make a pretty version if that’s your style, or keep it scrappy and real. Post it somewhere you’ll see it. You don’t have to use it every day. You don’t have to “earn” the items on it. Just give yourself the option. That alone helps rewire the belief that you’re stuck. And if it starts feeling stale? Rewrite it. Refresh it every month. I often do a new version when I notice I’m stuck in a scrollandsnack spiral that isn’t really making me feel better.

A Dopamine Menu for Real Life

Here’s a peek at some of the items that have lived on mine lately, in case you want ideas:

• A walk to the end of the block with my camera, just to see what’s blooming

• Thee yoga poses I know by heart

• Sending an old photo to a sibling

• Coloring in a tiny corner of an adult coloring book

• Reading a few pages of a favorite memoir

• Lighting a lemon candle while working

• Watering the plants with music playing

• Dancing around the kitchen (no witnesses allowed)

Some days, I do one. Some days, I forget. But the menu is always there— waiting quietly, like a friendly nudge. Start small. Pick one thing. Let it shiftthe next few minutes. Sometimes, that’s all you need to begin again.

It’s basically a curated list of things that bring you joy, calm, or energy— small actions that help nudge your brain into doing the next thing.

Alicia Keys

When Alicia Keys steps onto a stage, there’s an unmistakable shiftin the air. It’s not just the velvet-rich tone of her voice or the way her figers dance across the piano keys—it’s the gravity of a woman who has spent her life mastering not only her craft,but also herself. Over two decades into a career that has redefied R&B and soul, Keys continues to expand her artistry, her activism, and her influence—all while living life on her own terms. Keys has long been a cultural touchstone. From her 2001 breakout hit “Fallin’” to anthems like “No One” and “Empire State of Mind,” her songs have served as soundtracks for love stories, heartbreaks, and moments of triumph. Her career may be defied by chart-topping hits and armfuls of Grammys, but the heart of her journey is rooted in resilience, staying true to herself, and an unshakable drive to keep evolving.

Soulcare, selfworth, and the rituals that keep the Grammy-winning artist grounded.

By SONDRA BARR

Alicia Keys

From Hell’s Kitchen to the World Stage

Born Alicia Augello Cook on January 25, 1981, in New York City, Keys grew up in the vibrant but gritty neighborhood of Hell’s Kitchen. Raised primarily by her mother, Terria Joseph, she was surrounded by a mix of cultures, music, and street energy that would later infuse her art. At age 4, she appeared on The Cosby Show as Rudy Huxtable’s friend, but her true calling emerged when she began piano lessons at 7.

“I was drawn to the piano like it was a long-lost friend,” she’s recalled. Classical training dominated her early years, but by her teens, she was blending Chopin with jazz, soul, and the hip-hop beats of her city. By 14, she was composing her own songs; at 16, she graduated as valedictorian from Manhattan’s Professional Performing Arts School.

It didn’t take long for the industry to notice. Legendary music executive Clive Davis signed her to Arista Records in 1998, later bringing her to his new label, J Records. Her 2001 debut album, Songs in A Minor, was a revelation—a fusion of raw emotion and sophisticated musicianship. The record sold over 10 million copies worldwide and earned Keys five Grammy Awards, including Best New Artist and Song of the Year.

Here (2016), and Alicia (2020) reflcted both personal and creative evolution. “Every time I write a song, I never know how it happens,” she told NPR. “It happens, and then I’m on my knees thanking God.”

Her most recent musical chapter includes Keys (2021), the holiday album Santa Baby (2022), and an entirely new frontier—Broadway.

Hell’s Kitchen: A Full-Circle Moment

After more than a decade in development, Keys’s semi-autobiographical jukebox musical Hell’s Kitchen debuted Off-roadway in 2023 before moving to Broadway in 2024, earning 13 Tony nominations. Inspired by her teenage years, the show tells the story of Ali, a spirited 17-year-old navigating life with her single mother in ’90s New York.

“It’s intentionally not autobiographical,” Keys told Sunday TODAY’s Willie Geist. “Ali is a more gullible, naive version of myself. At its heart, it’s a love story between a mother and a daughter.”

The production blends her chart-topping hits with new compositions, reimagining songs like “Fallin’” in fresh contexts. Seeing icons like Oprah Winfrey and Michelle Obama in the audience was, she admitted, surreal. “It’s a new experience, a new challenge,” she told Today. “I’m a newbie in this world.”

Building a Legacy, Album by Album

Following her debut, Keys proved she was no one-hit wonder. Th Diary of Alicia Keys (2003) delivered classics like “If I Ain’t Got You” and “You Don’t Know My Name,” winning her four more Grammys. A collaboration with Usher, “My Boo,” dominated the charts in 2004, and in 2005, her MTV Unplugged album showcased her in stripped-down, soulful form.

In 2007, As I Am brought us “No One,” another Grammy-winning anthem. That same year, she and Jack White recorded “Another Way to Die” for the James Bond film Quantum of Solace. Her 2009 collaboration with Jay-Z on “Empire State of Mind” became a love letter to her hometown and a global hit.

Albums like The Element of Freedom (2009), Girl on Fire (2012),

Activism with Heart

For Keys, art and activism are inseparable. In 2003, she co-founded Keep a Child Alive, which provides treatment and support for families affected by HIV/AIDS in Africa and India. She has been a vocal advocate for racial justice, launching her Moonshot initiative to push for systemic reforms in underserved communities.

She’s also committed to empowering women and girls, often speaking about self-worth and self-expression. “Beauty is individuality and wisdom,” she told Glamour. “It’s a deep-down knowing of yourself.”

Her activism has a personal dimension, too. Songs like “Blended Family” reflct her role as stepmother to her husband Swizz Beatz’s children, offering a rare, empathetic portrayal of modern family life.

Redefining Beauty on Her Own Terms

In 2016, Keys made headlines by stepping away from makeup for public appearances, a decision she described as a rebellion against societal expectations. “It’s not about makeup or no makeup,” she explained to InStyle. “It’s about how you want to express yourself, and what boundaries you want to set for yourself.”

Ths philosophy inspired Keys Soulcare, her skincare and lifestyle brand launched in 2020. The line promotes rituals of self-care, pairing clean beauty products with affirmations printed on each package. “Soulcare and beauty are connected,” she told Forbes. “When you are true to yourself, your authentic voice pours out.”

Balancing Roles, Finding Peace

These days, Keys moves fluidly between her roles as artist, businesswoman, and mother, weaving them together into a life that feels entirely her own. She and Swizz Beatz, whom she married in 2010, are raising two sons, Egypt and Genesis. She encourages them to listen to their own voices—advice that took her years to embrace herself.

“I used to ask 75 people for validation before deciding what I wanted,” she admitted. “Now, I’m learning to be comfortable with my own opinion.”

She credits meditation and intentional stillness for helping her stay grounded. “It’s noisy as hell out there,” she says. “Ritual creates space so you can hear yourself.”

Living Well, Alicia Keys Style

When asked what’s next, Keys doesn’t rattle offcareer milestones. Instead, she talks about cultivating space— being “just as productive by not moving as much.” It’s a lesson in living well that she’s earned through years of both triumph and self-interrogation.

“I want to be comfortable with the non-work, the non-movement,” she reflcts. “Sometimes I’m killing it, sometimes I fall off. And that’s okay. It’s about giving myself grace.”

From a young pianist in Hell’s Kitchen to a global icon rewriting the rules of beauty, artistry, and activism, Alicia Keys has built a life that harmonizes ambition with authenticity. Her journey is a reminder that true success isn’t just measured in awards or accolades—it’s in the ability to live fully, love deeply, and stay true to yourself, no matter how loud the world gets.

In other words, Alicia Keys is still—and always will be—a girl on fie.

Macular Degeneration

Diabetic Eye Disease

Retinal Vein & Artery Occlusions

Flashes & Floaters

Retinal Tears & Detachments

Macular Pucker/Epiretinal

Membrane

Macular Holes

Uveitis

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.

Are All People With Blue Eyes Crazy?

What determines your eye color and what it says about you.

By MATTHEW K. ADAMS, MD, MBA

They say your eyes are the windows to your soul. While that sounds poetic, as an ophthalmologist, I’ll tell you they’re actually windows to your genetics—and occasionally to your health. Let’s talk about what really determines eye color, whether that hazel sparkle says anything about your personality, how your iris shade might influence your risk for certain medical conditions, and whether you can, or should, change it.

What

Determines Eye Color?

Eye color is primarily determined by genetics, specifically the amount and distribution of melanin (pigment) in your iris. Thik of melanin as nature’s paint. A lot of melanin gives you brown eyes; very little results in blue eyes; somewhere in the middle yields green, hazel, or gray. Multiple genes (at least 16 we know of) influence eye color, but the two main players—OCA2 and HERC2—are the main contributors.

And yes, your parents’ eye colors can influence yours, but it’s not as simple as “Mom’s eyes + Dad’s eyes = Yours.” While brown is generally dominant over blue and green, and green often trumps blue, eye color inheritance is a mix of dominant and recessive genes from both parents (and sometimes grandparents). That’s why two brown-eyed parents can have a blue-eyed child, or two blue-eyed parents can almost never have a brown-eyed child, unless there’s a rare genetic twist in the family tree.

Is Personality Reflected in Your Eye Color?

Ths is where science and folklore part ways. For centuries, people have claimed that blue-eyed folks are more “dreamy,” brown-eyed people are “trustworthy,” and green-eyed individuals have a “mischievous” streak. Fun to imagine, yes. Scientifially proven? Not so much.

Eye color comes down to biology, not behavioral wiring. Your iris shade doesn’t dictate whether you’re bold or shy—it’s your environment, upbringing, and life experiences that shape personality.

Does Eye Color Predispose You to Illnesses or Diseases?

Here’s where things get interesting—and a little serious. While personality isn’t determined by your eye color, some health risks are.

• Lighter eyes (blue, gray, green) have less melanin, which means less natural protection from UV light. Ths increases the risk for conditions like macular degeneration and ocular melanoma. If you have light-colored eyes, sunglasses aren’t optional—they’re a survival tool for your retinas.

• Darker eyes (brown) have more melanin, which

offers better UV protection. However, some studies suggest that people with darker irises may have a slightly higher risk for certain types of cataracts.

• Eye color can also be linked to rare genetic conditions, such as albinism, but for the vast majority of us, it’s just a pigment variation, not a red flag for disease.

Can You Change Your Eye Color?

Yes, sort of, but not without some caveats.

• Temporary changes: Colored contact lenses can give you an instant transformation from brown to blue or green to violet. Safe when fitted and prescribed by an eye care professional, dangerous when purchased from questionable online shops.

• Surgical options: A few experimental procedures claim to permanently change eye color, usually by implanting an artifical iris or using lasers to strip pigment. These carry serious risks, including glaucoma, inflammation, and permanent vision loss. Most Ophthalmologists (myself included) strongly advise against them.

• Natural changes: Your eye color can shift subtly over time due to aging, injury, certain medications, or medical conditions affecting the iris.

The safest “eye color change” is lighting, makeup, or wardrobe choices that make your natural eye color pop, without risking your vision.

The Takeaway

Your eye color is the product of complex genetic interactions and pigment chemistry, not a mystical personality decoder ring. While certain iris shades come with unique considerations for UV protection or disease risk, the best defense for any eye color is proactive eye care.

• Wearing sunglasses with 100% UVA/UVB protection

• Eating a diet rich in leafy greens, omega-3s, and antioxidants

• Keeping systemic health (blood pressure, blood sugar) in check

• Getting a routine eye exam every year, even if your vision seems perfect

Thik of it this way: your eye color is beautiful and unique, but it’s also just one small feature in an incredibly complex visual system. Protect it well, and those windows to your soul, whatever their color, will keep showing you the world in high defintion for years to come.

FUN EYE COLOR FACTS

1. Rarest Eye Color?

Green eyes are the unicorns of the iris world—only about 2% of people have them.

2. Two-Tone Eyes Exist

Called heterochromia, it can be complete (two different eyes) or sectoral (one eye with two colors). Causes range from genetics to injury.

3. Eye Color Can “Bloom” in Babies

Many newborns have blue-gray eyes that darken over their first year as melanin develops.

4. Hazel Eyes = Light Show

Hazel eyes aren’t just brown or green—they shift color in different lighting due to scattered light and varying pigment.

5. Red Eyes Aren’t Just in Vampires

In rare cases of albinism, very little pigment makes blood vessels in the retina visible, giving eyes a reddish or pink hue.

6. Amber Eyes Are Not “Light Brown”

True amber eyes have a golden or coppery tone caused by a pigment called lipochrome.

7. Not All Blue Eyes Are the Same Blue

The shade depends on how the iris scatters light—just like the sky.

8. Eye Color and Night Vision

Darker eyes have a slight edge in bright sunlight; lighter eyes may be more sensitive in low light.

Carly, Colon Cancer Survivor

Life After the Bell

By CHRISTOPHER EVANS

There’s a moment many patients look forward to during treatment—the ringing of the bell. It signals the end of chemotherapy or radiation, and the beginning of something new. Friends cheer, nurses smile, and photos are taken to mark the victory. But what happens after the bell? What does life look like when the appointments slow down, the medications taper off, and the rhythm of survival gives way to silence?

For many, the end of treatment isn’t as neat as it sounds. It is both a milestone and a mystery. Survivors step into a chapter with no map, no clear timeline, and often, no one checking in daily. The support that once felt constant may fade as routines return to “normal.”

But what is normal, really? The truth is, life after cancer isn’t a return to what was. It’s the beginning of something entirely different. The American Cancer Society acknowledges that survivors can face lingering physical and emotional side effects that may not go away just because treatment has ended. Fatigue, anxiety, sleep disturbances, and fear of recurrence are all common experiences. According to the National Cancer Institute, nearly 60 percent of survivors report experiencing anxiety and uncertainty in the months following their fial treatment.

Ths new normal can feel like walking a tightrope between relief and vulnerability. On one hand, you’re thankful. On the other, you might feel a bit lost. You’re supposed to feel triumphant, and you do— but not all the time. Sometimes you feel guilty for not feeling more grateful. Sometimes you wonder why it still hurts when the hardest part is supposedly over.

I spoke with a woman recently who described it best: “I rang the bell and went home. I stood in my kitchen and thought, now what? I didn’t recognize my body or my emotions. I wasn’t the person I used to be, but I wasn’t sure who I was becoming either.”

That identity shiftis very real. It’s a rebirth in a way. And just like anything newly born, it takes time to grow into the world. For some, life after treatment is a season of reflction. For others, it’s a slow journey of rebuilding—physically, emotionally, and spiritually.

Ths is where faith can be a lifeline. Not necessarily the loud, bold kind of faith that demands certainty, but the quieter kind that whispers in the dark, “You’re not alone.” The kind of faith that doesn’t need all the answers to feel at peace. In the Bible, we see countless examples of people navigating the in-between: the wilderness before the Promised Land, the waiting between Good Friday and Easter morning.

Continued on page 32

The truth is, life after cancer isn’t a return to what was. It’s the beginning of something entirely different.

These stories remind us that uncertainty is not the absence of God— it’s often the space where grace takes root.

One of the hardest parts of this new chapter is learning how to trust your body again. During treatment, every ache had a meaning, every symptom needed a response. After treatment, the vigilance doesn’t just disappear. You may still scan for signs, wondering if something is coming back. You may hesitate before planning too far into the future. And that’s okay. It takes time to reestablish a sense of safety.

Mental health professionals often refer to this phase as “post-treatment transition.” According to the Dana-Farber Cancer Institute, this stage is commonly marked by an emotional dip. During treatment, people often feel they have a clear purpose and a team of professionals rallying around them. Afterward, they may feel like that structure has vanished, leaving them to rebuild it on their own.

Ths is why connection is so important. Talking to others who have walked the same road can offer immense comfort. Whether it’s a formal support group, a casual coffee with a friend, or a shared moment at church, human connection grounds us. It reminds us that we don’t have to figue this out alone.

Spiritual practices can also bring rhythm to this new reality. Whether it’s daily prayer, journaling, or simply taking a quiet walk to reflct, these practices help tether us to something steady. For some, returning to church or exploring Scripture becomes a way to make sense of the journey. For others, listening to worship music or writing gratitude notes is a way of connecting to peace. There’s no right or wrong here—just whatever brings light into the room.

It’s important to acknowledge the grief that comes with survivorship. You may grieve the loss of who you were before the illness. You may grieve the time, energy, or relationships that changed along the way. That grief is valid. Naming it doesn’t mean you’re ungrateful—it means you’re human.

One helpful perspective I’ve heard is to approach this time like recovery from a long journey. You wouldn’t run a marathon and then expect yourself to hop on a bike the next day. You would rest. You would hydrate. You would slowly return to your routines, honoring your body’s limits. The same grace should apply now. Give yourself permission to heal beyond the hospital. Healing is not linear. It’s layered, unpredictable, and deeply personal.

You might also fid that your values shift.Thigs that once seemed urgent may now feel less import-

ant. You may crave deeper connections, quieter days, or more meaningful work. You may start to ask bigger questions, or seek more intentional ways to spend your time. These shiftsare not something to fear. They’re part of the transformation. They’re signs of life taking root in a new way.

If you are in this season now, I want you to know this: you are still healing, and healing deserves as much tenderness as treatment did. The world may expect you to move on, to bounce back, to act like everything is okay. But it’s okay if you’re not there yet. It’s okay if you never return to “before.”

Because life after the bell is not about going back. It’s about learning how to go forward. With a new sense of self. With a heart that knows how to hold sorrow and joy at the same time. With a spirit that still believes, even in the quiet.

Let this chapter be slow. Let it be sacred. Let it be whatever you need it to be.

And if your faith feels shaky or your strength feels thin, remember: even mustard seed faith can move mountains. Even small steps count. Even silence can hold healing.

You rang the bell. And that was brave.

Now comes the rest of your story—and it matters just as much.

• Comprehensive Adult Eye Care

• Light Adjustable Lens, Odyssey™, Symfony®, PanOptix, Vivity® and the Eyhance IOL

• Management of Dry Eye, Glaucoma & Corneal Disease

• Eyelid Surgery & Botox®

• Laser Vision Correction, EVO ICL™ Convenient locations to serve you in Allen, Arlington, Dallas, Frisco, Greenville, McKinney, Mesquite, North Fort Worth, Plano, Richardson, and Rockwall.

Left to Right: Leslie Pfeiffer, MD; Anita Jacob, OD; Kimberly Warren, MD; Sadaf Razi ElHaffar, OD; Faisal Haq, MD

VUDHI SLABISAK, MD OrthopaedicSpineSurgeon

BRUCE MARKMAN, MD

OrthopaedicSurgeon&Sports MedicineSpecialist

JAMES STANLEY, MD OrthopaedicSpineSurgeon

STEVE HONG, MD

Interventional Pain ManagementSpecialist

AMIR MALIK, MD Neurosurgeon

KHAWAJA IKRAM, DO OrthopaedicSurgeon

RAHUL BANERJEE, MD OrthopaedicSurgeon

BRIANA HODGSON, PA-C OrthopaedicSurgery PhysicianAssistant

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

CROSSROADS MEDICAL

Jelsma Orthopedics & Sports

Richard D. Jelsma, MD

Texas Joint Institute.............................................Suite

➠ Duncan L. McKellar, Jr., MD

➠ Charles E. Toulson, MD, MBA

Helix

➠ Jon Poe, PT, LAT ENT

➠ Hunter Richmond, MD

➠ Peter Selz, MD

➠ McDonald Arnot, DO

➠ Benarji Tegala, MD

➠ Jeremy Urbanczyk, DO

➠ Jermaine G. Clarke, DO, MBA

➠ Joseph Kim, MD Texoma

➠ Ikram Kureshi, MD

Why Am I Burping?

By WILLIAM PARKER

Studies show that consciously retraining the habits around air intake can sharply reduce the frequency of belching.

On more than one occasion, I have found myself excusing a sudden, unexpected belch—with more embarrassment than alarm. They can come from seemingly nowhere, right in the middle of a conversation. If you’ve experienced similar moments—or bloating, discomfort, or that mysterious feeling of air needing to escape—know that you’re far from alone. Belching is simply your body’s way of releasing trapped air in the upper digestive tract, but when it becomes frequent or disruptive, it may point to underlying habits or health concerns.

I’ve learned from medical professionals and trusted resources like the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) that most people burp up to thirty times a day—anything more can feel distressing or socially awkward. Often, those extra belches are linked to swallowed air, which commonly happens when eating too fast, talking while chewing, sipping through a straw, chewing gum, or even when stress encourages rapid breathing or gulping. These are all habits that invite too much air into the stomach.

Chronic belching may also be connected to acid reflux—or GERD (gastroesophageal reflux disease)—where stomach acid escapes back into the esophagus because the lower esophageal sphincter relaxes too often. Medical News Today reports that GERD affects about one in five adults, and reflux can trigger more burping as the body tries to force air upward to relieve the discomfort.

Another pattern sometimes overlooked is supragastric belching—a learned behavior where someone frequently draws air into the esophagus and immediately expels it, without letting it reach the stomach. According to UCLA Health, this type of belching often accompanies stress or habit, and speech therapy with behavioral retraining can offer substantial relief.

Gastritis—sometimes due to an H. pylori infection— can inflame the stomach lining and lead to increased belching, especially when digestion slows or becomes uncomfortable. Stomach inflammation frequently triggers gas release as your body reacts to irritation.

When belching becomes frequent, noticeable, or is paired with symptoms like heartburn, regurgitation, nausea, chest tightness, or bloating, it’s time to dig deeper. I recommend starting with your primary care physician— they can evaluate your symptoms and, if needed, refer you for an endoscopy or acid monitoring to pinpoint the cause.

If GERD is suspected, a gastroenterologist is the right specialist. Together with lifestyle guidance—like weight management, avoiding caffeine, spicy or fatty foods, not lying down after meals, and modifying medication—doctors can often help restore comfort. Many patients experience lasting improvement when dietary and behavioral changes combine with therapies such as antacids, H2 blockers, or proton-pump inhibitors, as described in resources like Verywell Health.

In cases involving supragastric belching or aerophagia, many people benefit from working with a speech-language pathologist or a behavioral therapist. Studies show that consciously retraining the habits around air intake can sharply reduce the frequency of belching.

Initially, I thought burping was just a minor annoyance. Until a gastroenterologist friend reframed it for me: “It becomes a problem when belching becomes your body’s default response to stress or discomfort, instead of a reaction to fullness.” That shifted everything.

I started making incremental changes—slowing down at meals, favoring water over soda or coffee, giving up gum and mints—and I noticed a signifiant decline in belching. I slept better, digestion felt lighter. When I felt bloated at night, I would lie on my side or pull my knees in toward my chest until relief came. Mount Sinai recommends such positions for easing trapped gas.

At the end of the day, burping is usually normal—but if belching seems to be increasing—or feels more than just quirky—don’t let embarrassment keep you from seeking answers. Reach out to your physician. Consider asking for a gastroenterology consultation. You don’t have to navigate it on your own; expert support is available, and you deserve relief and the comfort of meals you can enjoy without worry.

Burping doesn’t have to be a source of shame; it can be a source of insight—a message your body sends when something feels off. Whether it’s placing pause on meals, tweaking habits, or reaching out for medical help, there's nothing wrong with honoring that signal.

So when the question echoes within—“Why am I burping?”—let it become an invitation to listen, not panic. Notice the patterns. Make a shift.Seek support. It’s perfectly fie to ask for answers—or to take one small step forward to feel more at ease again. And that’s an answer worth exploring.

» Staffed by 2 Licensed, Doctors of Audiology

» Hearing Aid Fittings, Maintenance and Repairs

» Invisible Fittings/Open Fittings

» Evaluation Period On All Hearing Aids

» Hearing Evaluations For All Ages

» Wireless/Connectivity Hearing Solutions

» Battery Purchase Programs

» Custom Ear Protection

» Assistive Devices

Your Ears Protect Your Brain

Courtesy HEARING SERVICES OF McKINNEY

Hearing is about so much more than catching the punchline in a conversation or hearing a favorite song clearly. The tiny structures inside your ears connect directly to the health of your brain, influencing how sharp you feel, how steady you walk, and even how connected you feel to the world around you.

Research is showing that untreated hearing loss doesn’t just make communication harder—it’s linked to faster cognitive decline, dementia, depression, and anxiety. In fact, a long-term Johns Hopkins study found that people with mild hearing loss had about twice the risk of developing dementia, moderate loss tripled the risk, and severe loss increased it fivefold. That’s not just a small correlation; it’s a clear signal that the brain and ears are working together in ways we can’t afford to ignore.

When hearing starts to fade, the brain has to work harder to fill in the blanks. Ths extra mental strain can leave fewer resources for memory and problem-solving. Over time, that constant effort can contribute to cognitive decline. It’s called the “cognitive load” effect, and it’s one of several ways hearing loss impacts brain health. Another is auditory deprivation—when the brain receives less sound input, it can lead to changes in brain structure, particularly in areas responsible for memory and language.

There’s also the human side. Struggling to hear often leads to pulling back from conversations, social gatherings, and community life. That isolation has its own risks. Studies have shown loneliness can raise the risk of dementia by about 40%. Add in the frustration of missed conversations, and it’s no surprise that untreated hearing loss is also associated with higher rates of depression and anxiety.

Here’s the encouraging news: treating hearing loss can help lower those risks. A major study published in The Lancet  in 2023 found that older adults at high risk for dementia who used hearing aids, along with audiologist-guided support, slowed their rate of cognitive decline by nearly 50% over three years compared to a control group. Other large reviews of research have found that hearing-aid or

cochlear implant use can cut the long-term risk of cognitive decline by almost 20% while also improving day-to-day mental sharpness.

The benefits don’t stop at brain health. Wearing hearing aids can reduce the chances of developing depression or anxiety and even lower the risk of serious falls. That’s because your hearing plays a key role in spatial awareness—helping you know where you are in relation to your surroundings.

The decision to get your hearing checked isn’t just about improving how well you hear the TV or the phone. It’s about protecting your overall well-being. Early detection is especially important because hearing loss often develops gradually. Many people don’t realize how much they’ve adapted—turning up the volume, avoiding noisy places, leaning on lip reading—until the change in hearing is undeniable. By then, the brain may have already been compensating for years.

Modern hearing aids are far from the bulky, squealing devices of decades past. Today’s models are discreet, comfortable, and smart— able to filter background noise, stream calls and music, and adapt automatically to different environments. More importantly, they can restore the clear, effortless hearing that allows the brain to focus on what matters: understanding, remembering, and connecting.

If you’ve been noticing changes in your hearing—needing to ask people to repeat themselves, missing parts of conversations, or feeling exhausted after social interactions—it may be time to make an appointment with an audiologist and have your hearing tested. Even if you’re not sure there’s a problem, a professional evaluation from an audiologist can give you a clear picture of your hearing health and whether hearing aids could help.

The sooner hearing loss is addressed, the more you can protect not just your ability to hear, but also your cognitive health, mood, and quality of life. Your ears may be the entry point for sound, but they’re also guardians of your mind. Schedule your hearing check-up today with Hearing Services of McKinney and take the fist step toward protecting both your hearing and your brain health.

Tonsil Stones

What They Are and How to Manage Them

By GEORGE YULANI

If you’ve ever noticed a strange sensation in your throat, a persistent cough, or an unexpected bout of bad breath, you might be dealing with tonsil stones. These small, often overlooked formations can cause discomfort and raise questions about their origin and how to handle them.

Understanding Tonsil Stones

Tonsil stones, medically known as tonsilloliths, are calcifid deposits that form in the crevices of your tonsils. They consist of food particles, dead cells, bacteria, and other debris that become trapped in the tonsillar crypts. Over time, these materials harden into small, often white or yellowish lumps. While they are generally harmless, they can lead to unpleasant symptoms.

Common Symptoms

Many individuals with tonsil stones experience minimal or no symptoms. However, when symptoms do occur, they may include:

• Persistent bad breath (halitosis)

• A sensation of something being stuck in the throat

• Sore throat or discomfort when swallowing

• Coughing

• Earache

In some cases, visible white or yellowish lumps may be seen on the tonsils. It’s important to note that these symptoms can overlap with other conditions, so it’s advisable to consult a healthcare professional for an accurate diagnosis.

Prevalence and Risk Factors

Tonsil stones are relatively common, affecting up to 10% of the population. They are more frequently observed in adults, especially those who have experienced recurrent throat infections. Factors that may increase the likelihood of developing tonsil stones include:

• Deep tonsillar crypts

• Poor oral hygiene

• Chronic inflammation of the tonsils

• Smoking Maintaining good oral hygiene practices, such as regular brushing and flosing, can help reduce the risk of developing tonsil stones.

Treatment Options

In many cases, tonsil stones can be managed at home. Here are some methods that may help:

• Saltwater Gargles: Gargling with warm saltwater can help dislodge smaller stones and alleviate discomfort.

• Oral Irrigation: Using a water floser on a low setting can gently flush out debris from the tonsils.

• Manual Removal: With clean hands or a cotton swab, some individuals can gently remove visible stones. However, this should be done cautiously to avoid injury.

• Antiseptic Mouthwash: Rinsing with an antimicrobial mouthwash can help reduce bacteria and prevent new stones from forming.

If these home remedies don’t provide relief or if tonsil stones become a recurring issue, it’s advisable to consult an ear, nose, and throat (ENT) specialist. In some cases, medical procedures may be necessary to remove the stones or address underlying causes.

When to Seek Medical Attention

While tonsil stones are typically benign, certain signs may indicate the need for professional evaluation:

• Persistent or worsening symptoms

• Difficulty swallowing or breathing

• Frequent throat infections

• Swelling or bleeding of the tonsils

An ENT specialist can perform a thorough examination and recommend appropriate treatment options, which may include surgical removal of the tonsils in severe or recurrent cases.

Preventive Measures

To minimize the risk of developing tonsil stones, consider the following preventive measures:

• Maintain excellent oral hygiene by brushing and flosing regularly.

• Stay hydrated to promote healthy saliva flw.

• Avoid smoking and other irritants that can contribute to throat inflammation.

• Gargle with saltwater periodically to keep the tonsils clean.

Understanding tonsil stones and their management can help alleviate discomfort and prevent complications. If you suspect you have tonsil stones or experience related symptoms, consult a healthcare professional for personalized advice and treatment options.

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,

As a family, we believe it is time for hospice services, but there are many hospices to choose from! How do we start to decide which hospice is right for us?

~Overwhelmed with Options

Dear Overwhelmed with Options, Selecting the right hospice for your loved one is crucial, and you need to ensure that you choose a provider that aligns with your values and care goals. Ask the following important questions:

1. How often do staff members visit? You must ensure that nurses, chaplains, social workers, home health aides, and doctors are available to provide comprehensive support during and after business hours.

2. Do you offer all four levels of care? It’s essential that the hospice provides:

• Routine Care : The most common type of care, delivered in the patient’s home.

• Respit e Care : Temporary relief for caregivers, allowing them time to recharge.

• Continuous Care : A nurse on-site aroundthe-clock for managing difficult symptoms.

• General Inpatient Care : Higher-level support for severe symptoms when home care is insufficient.

3. Does your doctor make house calls? Confirm that the hospice offers home visits from doctors when necessary.

4. How can I assess your quality of care? Use Medicare.gov/care-compare to check the quality scores for Medicare-certified hospices.

These questions are vital in ensuring you choose the best hospice for your loved one. Don’t settle for anything less than the support and care your family deserves.

~Olivia

A Place Once Set for Us

By JULIA PORTER

There was a time when the dinner table was the heart of our homes—a place where daily stories were shared, connections were reinforced, and support was offered effortlessly. Now, in many American families, that ritual has quietly faded away.

In those early years, our dinner table wasn’t about fancy meals or perfect etiquette. It was about presence. We’d trade off—ne of us grabbing the ice for the glasses, another setting the table, someone always asking, “How much longer?” Mom would ask about my day, my dad shared stories, and my siblings and I, in turn, joined the conversation. Sometimes we laughed, sometimes we argued, but always, we processed the day together. Those conversations taught us to listen, to speak honestly, and to be seen in a family setting.

Today, so many of us move through evenings with individual routines: someone catches up on work, another scrolls their phone, after school events running long, and dinner becomes a solo or drive-thru affir. The family table becomes a catchall—unopened mail, lap-

That regular contact builds resilience, trust, and understanding over time.

tops, groceries—its original purpose buried beneath modern clutter. Meals are eaten on the go, conversations scattered, and the beautiful architecture of daily sharing often vanishes.

Growing up, I realized that simple mealtime dialogue matters. One nationally representative study of parents in the United States (Project EAT) found that families who eat together regularly report stronger emotional bonds and better awareness of what’s going on in each other’s lives. Teens, for example, who share meals with their parents are less likely to engage in risky behavior and more likely to feel heard and supported.

In my own household, that shifthappened gradually. As schedules grew complicated, evenings turned into fragments. My daughter recalled glimpses of our table—occasional shared plates, curt greetings, and silent meals. The space lost its meaning, and so did we, just a little bit. It didn’t seem like a big deal. It became our new routine.

It was only when I paused to think about what was missing that I noticed. I missed hearing about her day. I longed to share stories of small wins or quiet frustrations. My husband sometimes drifted upstairs after eating his dinner, and I found myself lingering in the kitchen with mine—longing for connection.

Reclaiming that ritual didn’t require elaborate dinners—just intention. One evening, I invited everyone over for supper without expectation or agenda. No phones, no background noise. Conversation felt awkward at fist. But slowly, the table began to hum again.

My daughter shared about projects at school. My husband talked about ups and downs at work. I shared bits of my world too. The shift wasn’t dramatic, but it was signifiant. We weren’t just eating; we were reconnecting.

Family therapists often describe mealtime as “talk therapy by stealth.” In that structured, predictable setting, children feel safe sharing fears and joys, and parents model emotional openness. That regular contact builds resilience, trust, and understanding over time.

We weren’t aiming for perfect meals—some nights were sandwiches, others were store-bought takeout, and occasionally cereal. What mattered was sitting down together, unplugged. “Dinner’s ready! I’d love to hear your day.” No corrections or life lessons—just conversation. Some moments were joyful, others awkward or thoughtful. The act itself created space to share, to question, to laugh, and occasionally to heal.

Not everyone has a formal dining room—and we didn’t always ei-

ther. At times, we gathered around the kitchen counter or nestled in folding chairs at a small table. What mattered was not the setting, but the consistency. Even twenty-minute meals offer emotional benefit, if the table holds presence.

I noticed how habits shifted over time. Our children grew older, some moved away, but I ensure the weekly table habit continues— sometimes for holiday dinners, sometimes even via video call. The ritual holds meaning, no matter the changes around us.

It’s not that family life becomes flawless. Conflits still arise. Tiredness still sets in. But returning to the dinner table models a valuable lesson: showing up matters. When we eat together, listen without judgement, and honor presence, we teach emotional intelligence by example. Those subtle lessons resonate far longer than any lecture.

Our table also became a place of celebration—graduations, promotions, holidays, even Monday nights. The stories we exchange, repeat and pass on become part of our shared family memory—our emotional legacy.

I want to be clear: restoring the table won’t fixeverything. It won’t soothe deep wounds overnight. But it revives opportunity. If the table is empty too often, it’s possible we’re losing more than meals—we’re losing shared experience, mutual understanding, and emotional intimacy.

When the table is cluttered or overlooked, maybe it’s time to reclaim it. Begin with a gentle invitation: “Can we all eat together tonight?” Even once a week sets rhythm. Escort meals with a question like: “What was today like?” or “What’s someone you’d like to thank this week?”

You don’t need perfect timing or fancy plates. You simply need presence and a genuine invitation to share—to speak and be heard. Over time I learned that our table symbolized more than food. It symbolized connection. Taking your seat—even when no one else does yet—is a way to bring possibility back into the room.

Families don’t unravel in crises—they driftapart amid the silences. The greatest courage can be found in bringing back shared conversation—one dinner, one story, one invitation at a time.

You simply need presence and a genuine invitation to share—to speak and be heard.

The Importance of Ceremony

By RICK ALLEN

There are few things in life that will affect us like the death of someone to whom we are close. People will attempt to prepare themselves mentally for the time when that death will occur, but until the reality of loss hits, exactly how you will respond or what you will need to move through the grief you will experience is hard to anticipate.

In times past, funerals were traditional in nature and a set protocol was expected and followed. People traveled to attend ceremonies, time was taken offwork and people stopped to honor the life that was lived and to offer support for the grieving family. As with everything in life, funerals, traditions, and schedules are different and the approach to how we as a community deal with death is different. For example, viewing of the body has become less common now compared to times past. Preferences for cremation has paralleled that of burial on a national average and with that trend, the type of ceremony has changed. While the “traditional” funeral may be less popular for a lot of people, the need to have a ceremony has not changed.

Some people attempt to deal with grief by ignoring it. While some things will go away on their own, grief is not one of those things. There are identifiable steps and a chartable cycle of grief we experience and failing to acknowledge each phase and reconcile it can lead to longterm problems. The best way to acknowledge and deal with grief is

to allow others to come around you to show their support. While this helps the one most impacted by loss, it also allows others who knew the person who died to be able to say their “good-bye” as well. Ths is often accomplished through ceremony.

Ceremonies should reflct the uniqueness and personality of the one being honored. Memorabilia displayed often helps people remember the good times shared with the one who has passed and allowing people to share those stories often lightens the burden of loss for everyone. Finally, after a ceremony of remembrance, establishing a permanent memorial to the one who is gone is also important. For those choosing burial, a marker on a grave is common. For cremation, a permanent memorial can be a bit more difficult if cremains are scattered, but burial or placement in a columbarium allows for marking the place of rest.

In summary, everyone is different and while the way we live will vary, the way we are remembered will also vary, but it should closely resemble the way we lived. If you have strong feelings about what your fial tribute should look like, write down those wishes and make them known to the one who will be responsible for those arrangements. Even though none of us want to be a burden and it has often been said, “I don’t even want a funeral,” do not deny those who are leftand grieving a chance to deal with that grief through ceremony.

CENTER FEATURES:

• Chair Yoga

• Adaptive Yoga

• Chair Volleyball

• Treadmills

• Stationary Bikes

• Fitness Classes

• Book Club

• Movie Matinee

• Pool Tournaments

• Art Classes

• ZUMBA (Coming Soon)

And so much more!

Home Health

TheraCare Home Health brings the expertise and resources of a hospital to the comfort of your home.

We offer individual care including nursing, rehabilitation and social services. In addition, our expert clinicians and therapists provide specialized care for a wide range of conditions.

Our care teams strive to make the transition to home as seamless as possible, so you can focus on what’s most important – your health.

TheraCare Home Health services are covered by Medicare and many commercial insurance plans.

Speak to a TheraCare Home Health representative for more information about insurance coverage and Medicare Eligibility.