NSIDE Coastal Bend MD Aug/Sept 2012 by NSIDE Corpus Christi

COASTAL BEND

NSIDE

MD AUGUST.SEPTEMBER 2012

GOING THE EXTRA MILE DR. JOSE UGARTE

A LIFETIME OF CARE

DR. ROBERT R. RAMIREZ

Urgent Care for South Texas THE DOCTORS CENTER

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Celebrating

years of emergency medical service

Our mission is to provide medical

Hillary Reyna Membership Director 361.265.0509

transport for critically ill or injured persons requiring medical or trauma facilities within our South Texas service area. Emergency assistance is provided to all persons regardless of their ability to pay.

This is our mission...

This is our promise...

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Dear Doctor: Interim Homecare provides a comprehensive array of healthcare services in your patientsâ&#x20AC;&#x2122; home. Helping your patients with new medications, diabetes management, CHF and other related cardiac complications, COPD, wound care, helping regain strength and mobility or other services that will aid in your patientsâ&#x20AC;&#x2122; recovery process. We at Interim Healthcare look forward to serving all your needs.

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NSIDE Coastal Bend MD August/September 2012

PUBLIC ATIONS publisher / Eliot Garza

eliot@nsidesa.com

co-publisher / corpus christi / adrian Garza

adrian@getnside.com

co-publisher / san antonio / Janis Maxymof

janis@getnside.com

co-publisher / austin / angela strickland

angela@getnside.com

staff executive editor

contributing writers

Erin Oâ&#x20AC;&#x2122;Brien

Mandy Ashcraft Tracey D. Bauer Myles Cooper Tracy Ganske Brittany Hilliard Amanda Howeth Margo Hurdt Katy Kiser Jody Joseph Marmel Craig Myers Dr. Robert K. Thompson

creative director Elisa Giordano

graphic designer Cristina Villa Hazar

executive assistant Natalie Barton

Administrative assistant/ account executive Amanda Howeth

photography Dustin Ashcraft Edgar de la Garza

NSIDE Coastal Bend Advisory Board J u d y L a p ointe and d r . c h a r les cam p bell

www.getnside.com For advertising information, please call 361.548.1044 or email adrian@getnside.com. For editorial comments and suggestions, please email adrian@getnside.com.

PUBLIC ATIONS

18402 U.S. Highway 281 N, Ste. 201 San Antonio, Texas 78259 Phone: 210.298.1761

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nsidethisissue august/september 2012 cover story 18

The Doctors Center

With their philosophy of compassion, Drs. Keith Rose, Sergio Solorzano and Tom Nguyen; Robert Burkenbine, PA-C; and the rest of the excellent staff at these multiclinic urgent care centers in the Coastal Bend truly make the difference in medicine.

profiles

Dr. Robert R. Ramirez

Having lost both of his parents to kidney failure, this nephrologist uses his firsthand experiences with the disease and lifelong interest in the medical field to provide his patients with the highest quality of care possible at Bay Area Kidney Disease Physicians.

Dr. Jose Ugarte

cover story | the doctors center

Patients are never just a number at Ugarte Family Medical Clinic, the practice run by this seasoned physician of 40-plus years who always advocates for his patients and provides the highest level of care with unparalleled passion.

departments

12 14 28 34 38

Nonprofit Feature Health & Wellness Patient Enrichment

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Tribute速 Plan

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Saving eyesight...

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NSIDE nonprofit

The 20th Summer of Camp Sandcastle

In June, the American Diabetes Association celebrated two decades of the fun, free day camp for kids with Type 1 diabetes. By: [Brittany Hilliard]

The American Diabetes Association celebrated the 20th anniversary of Camp Sandcastle June 18 to 22. Camp Sandcastle is a day camp for Type 1 diabetic children ages 5 to 14. The camp has been held at Camp Aranzazu in Rockport for the last few summers, and the kids love it there. Activities at camp include archery, fishing, swimming, kayaking and so much more! The camp is completely free for the campers, and it is one of two remaining American Diabetes Association camps in the country that is still free. Camp medical supplies are donated by various medical companies, and the counselors and medical staff all donate their time, too. The staff consists of doctors, nurses and dieticians from around the Coastal Bend, along with counselors who were once campers at Camp Sandcastle when they were younger. The camp costs are covered by local sponsors, including Rabalais I&E Constructors, Mattress Firm and H-E-B. The camp was held at Camp Aranzazu Monday through Thursday, and then on Friday, the kids spent the day at the Texas State Aquarium. Passes

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to the aquarium were donated by the Port of Corpus Christi. The kids got to see all kinds of fun attractions, and one of the campers was even called up during the dolphin show to be a helper! They had a blast on their last day of camp, ending it drenched after playing in the water play area at the aquarium. One of the campers, Trevor Hazlewood, said he’s been going to Camp Sandcastle for the last eight summers because he “loves that he can be just a normal kid.” Most of these children are not able to go to other camps because there is not someone there who is knowledgeable of their disease. If the child’s blood sugars were to get low, there needs to be someone there who is trained and knows what to do. This is why Camp Sandcastle is such a special week for these kids. This year, 34 campers and nine staff members attended Camp Sandcastle. The majority of the campers were Type 1, but there were also a few siblings who experienced camp with their diabetic brothers and sisters for the week.

Online registration opens each spring, so look for it on the American Diabetes Association’s Corpus Christi website and Facebook in early 2013. The American Diabetes Association would like to thank the amazing staff members who help run this camp year after year. Patsy Reyes, who has been the camp director for more than 10 years, helps in so much of the preparation for Camp Sandcastle, from getting counselors and helping parents get their children registered to getting testing supplies donated for the campers to use at camp. Dr. Jennifer Amaral-Ramos has been the camp medical director for the last several years, and she closes her practice for the week in order to be at Camp Sandcastle.

For more information about Camp Sandcastle and other events put on by the American Diabetes Association, please call 361-850-8778.

Recovery Isn’t Simply a Goal, It’s Our Mission.

Kindred Healthcare understands that when people are discharged from a traditional hospital, they often need continued care in order to recover completely. That’s where we come in.

Doctors, case managers, social workers and family members don’t stop caring simply because their loved one or patient has changed location. Neither do we.

Kindred offers services including aggressive, medically complex care, intensive care and shortterm rehabilitation.

Come see how we care at www.continuethecare.com.

Dedicated to Hope, Healing and Recovery

CONTINUE THE CARE 6226 Saratoga Blvd · Corpus Christi, Texas 78414 · 361-986-1600 www.khcorpuschristi.com N S I D E C O A S TA L B E N D M D

NSIDE feature

Left to right: Mari Escobar, CHRISTUS Spohn rehab patient; Barbara Dolce, “Paws Up”; Eloisa “Nena” Morin, CHRISTUS Spohn rehab patient; and Soveida Garcia, CHRISTUS Spohn rehab patient Opposite page: James Pittman, lead inpatient therapist

Rehab for Wellness and Well-Being

Patients with both physical and neurological conditions receive the best care and quality of life possible at CHRISTUS Spohn Hospital Corpus Christi-Shoreline’s inpatient rehabilitation unit. By: [katy kiser]

There are some changes that aren’t longed for, but come anyway. That’s what happened to the Escobar family. Just weeks ago, 42-year-old Mari Escobar was a working mother with two children, a husband and a dependable job. Then her husband started noticing something wasn’t right. Mari seemed to be losing her memory. A CAT scan would reveal a tumor on the left side of her brain. Surgery would leave her weak on the right side, requiring her to undergo three hours of physical rehabilitation a day. Part of that rehabilitation includes CHRISTUS Spohn Hospital Corpus Christi-Shoreline’s partnership with “Paws Up,” a pet therapy program of canine-assisted rehabilitation. As Mari pets Emmie with her right hand, the poodle mix makes her smile. Emmie also brings a smile to the faces of two other patients: Nena, who is re-

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covering from a stroke, and Soveida, who recently had her leg amputated because of diabetes. All three are doting on the rescue-turned-rehabilitation dog, trying to regain some lost strength. “The rehab will hopefully make Mari stronger so she can take the next step: chemotherapy and radiation,” said Mari’s husband, Joe. “Life changes so quickly. [A few] weeks ago, we wouldn’t have dreamed we would be in a hospital, but now we’re surrounded by such wonderful positive people.” Some of the people whom Mari’s husband is referring to are the dedicated associates you’ll find among the hospital hallways and on the fourth-floor inpatient rehab unit. They are the ones in burgundy hospital scrubs – the speech-language pathologists and the physical, recreational and occupational therapists of the CHRISTUS Spohn Hospital Corpus Christi-Shoreline’s inpatient rehab facility. “Each therapist is specialty-certified and dedicat-

ed to not only the patients’ medical and rehabilitative needs, but also their social, emotional and lifestyle well-being,” explained Cindy Carson, CHRISTUS Spohn’s Hospital Shoreline’s manager of rehabilitation services. CHRISTUS Spohn Hospital Shoreline’s inpatient rehab facility is internationally certified by the Commission on Accreditation of Rehabilitation Facilities (CARF). It stands out as an established premier facility for many of its patients. These patients are those who have been hospitalized for surgery or a serious medical illness that requires ongoing care before they can return to their homes and daily lives. Patients can be admitted from another facility or directly from home. Any physician may refer a patient. Patients are typically adults or geriatric patients. On average, therapists will work with their patients for two weeks, but if they are very involved cases such as spinal cord injuries, the therapists can

spend a more extended time working with a patient. “The focus here is not on compensation, but remediation of deficit,” said James Pittman, CHRISTUS Spohn Hospital Shoreline’s lead inpatient therapist. “So that means we want our patients to regain function rather than find ways to replace a less useful extremity.” CHRISTUS Spohn Hospital Shoreline’s inpatient rehabilitation unit is dedicated to providing individual attention to each patient’s condition and need, striving to help achieve the best quality of life possible. The inpatient rehab unit provides simulated real-life environments where patients perform daily activities such as getting around the kitchen and into and out of a car. These activities help patients relearn functional skills. The rehabilitation team even takes patients on a field trip to the grocery store. They start by making a grocery list, then shop, prepare a meal and finally put away dishes. What might seem like a simple chore to most of us can be-

come a rewarding challenge for patients. Areas of care The rehabilitation unit is equipped to care for patients with a variety of both neurological and physical conditions, including: • Stroke • Parkinson’s disease • Multiple sclerosis • Back and hip fractures • Joint replacement • Brain tumor and other craniotomy patients • Spinal cord or head injury • Amputations Once patients have completed their rehabilitation stay, they are evaluated for the need of follow-up services. A coordinated plan of care for life after discharge is developed. Rehabilitation therapy may be continued on an outpatient basis, which is also available through CHRISTUS Spohn.

For more information, call the CHRISTUS Spohn Health Line at 361-8813103 or the CHRISTUS Spohn Rehab Unit Referral Office at 361-881-3144. You may also visit www.christusspohn.org.

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Keep making memories.

We’ll take care of the rest.

Alice 361-664-4888 · Corpus Christi 361-882-5900 www.rivercityhospice.com N S I D E C O A S T A L B E N D M D 17

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Making the

Difference ✜ in Medicine

Drs. Keith Rose, Sergio Solorzano and Tom Nguyen; Robert Burkenbine, PA-C; and numerous other outstanding medical professionals at The Doctors Center provide top-quality urgent care 24/7 at three freestanding centers in our region. By: [Jody Joseph Marmel] Photography: [dustin ashcraft]

Being the CEO of The Doctors Center, multi-clinic urgent care centers on the Coastal Bend, Dr. Keith Rose and his team of excellent physicians make a difference in the medical care field. “I want medicine to be like medicine once was,” he says. Sharing this refreshing view has enabled the urgent care centers to provide the best quality of care to the large volume of patients they see on a daily basis. Having three freestanding urgent care centers in this region, Rose also has a private practice in plastic surgery and operates at the South Texas Surgical Hospital. The urgent care centers are unique; they are not the “doc in the box” clinics that started forming across the country more than a decade ago. In fact, the differences are infinite. “Our urgent caregivers are the difference because our staff puts the patients’ needs first.” When Rose was a fellow at the Shriners Burn Center in Galveston, he moonlighted in emergency rooms all over Texas. This was in 1995 and 1996. “I kept hearing complaints about emergency rooms from the staff all the way to the patients. I understood then what there was a tremen-

dous need for. I thought having centers such as the ones we made possible on the Coastal Bend would be the solution to many of these problematic issues.” And as Rose worked nights in the emergency rooms, he built his company during the day. Robert Burkenbine, PA-C (certified physician assistant), has been working at all three locations of The Doctors Center since 2008. Specializing in cosmetic surgery and dermatology from 2000 to 2008, he also attended many military medical schools, including nuclear, chemical and biological training. All of those interviewed agree with Burkenbine’s focus: “patient care and treatments are an integral part of what we do.” “You never know what is coming through the door,” he says. “You need to be able to triage all patients into the ones that you can treat now, delay treatment pending test results and the ones that need to be moved to the next higher echelon of treatment. It makes you think and stay on your ‘A’ game.” The urgent care centers cater to every patient’s needs and listen to what the patients say. “Compassion and empathy play a large role in how you treat patients and how they perN S I D E C O A S TA L B E N D M D

ceive you. Many of our patients use our facilities as their primary level of care, and when asked why, they almost always answer, ‘for the convenience and for the way they are treated.’ Our patients enjoy the convenience and care they receive at our clinics, and that’s what brings them back.” Rose, Burkenbine and Drs. Sergio Solorzano and Tom Nguyen detail their practice with factual information that enables patients and future patients to understand urgent care. “Urgent care is a solid vehicle to deliver timely medical care to the majority of patients. To know we could make the necessary actions to fix their problems by listening to them and taking the time to explain things that they do not understand is crucial to building patient rapport. In an urgent care setting, you touch all facets and specialties of medicine.” All physicians agree it is a testimonial to their urgent care centers that at least 50 percent of the patients are regulars and “they will not go anywhere else for treatment. We have many winter Texans here, and every year, certain ones will return for their annual checkups and tell us all about their adventures.” Solorzano, Nguyen and Burkenbine present the other side to their protocols of patient care. “We also have patients that see us instead of the emergency rooms because their wait time is only a fraction of

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the wait time compared to the ER, and we feel they get as good, if not better treatment. Those patients that have true emergencies are stabilized and referred to the emergency room for care.” Services include family medical care, occupational health, minor surgery, physicals, immunizations, vaccines and corporate health care. But the centers are not limited to these services. With the vast array of services offered, Rose would like to expand on the development of his

medical care. A glimpse into the past of Rose’s involvement in the medical community paints a picture that aligns with the urgent care center philosophy of compassion. Since 1997, Rose has worked with Smile Train and other surgeons affiliated with this charitable organization. Being involved in training others in Afghanistan, Africa and South America, he does this because “that is where the greatest need was.

The urgent care centers are not the “doc in the box” clinics that started forming around the country more than a decade ago. In fact, the differences are infinite. private urgent care system. And with his excellent team of physicians, certified PAs, nurses and the entire medical staff, this expansion is a goal that benefits all of those in need of an affordable quality of

While cleft surgery has been around for decades, a family living off less than $2 a day could not begin to dream of affording this type of surgery for their child.

“Yet, every child born with cleft palate, anywhere in the world, should have the opportunity to live complete lives.” Smile Train provides free cleft palate surgery for thousands of poor children in developing countries. While this shows the levels of medical and emotional care Rose believes in, other stories were shared about voluntary work by some of the other physicians at The Doctors Center. And there are more tales told about being in the military and helping thousands of people. Burkenbine explains how serving as a PA in the military is similar to working in the urgent care setting: “When deployed, I would find myself as the sole medical officer of 2,000-plus soldiers, and the nearest major medical support would be a twohour flight away. This separation and isolation from medical support and the knowledge that the lives of so many depended on you and your abilities has been burned into my soul.” Evidently, the other physicians feel the same way. Being a cohesive unit, The Doctors Center staff members truly care about the patients first. “We see the urgent care clinics as the mainstay for the normal populous where they can go and get their everyday needs taken care of without spending hours upon hours in the primary care setting.” The number of patients they have helped over

the years gives them “a heartwarming feeling just knowing that we have made a difference in their lives. You cannot help but feel good when a patient comes in and tells you they were waiting for your shift to come see you. Patient satisfaction and their well-being are at the heart of the urgent care center, and it has become our way of life and theirs.” Looking ahead, Rose would like to expand on the development of his private urgent care system. “Within the next five years, I would like to expand urgent care centers into a franchise model.” He would also like to help develop a cranial facial center in South Texas. “The delivery of health care in America is the best there is. It is the process that needs to be changed. We need to see decreasing regulations in order to provide and deliver the best quality of medical care in the world.”

For more information, please call The Doctors Center at any of the following urgent care clinics: South Padre Island Drive (361-852-6824), Northwest Corpus Christi (361-241-1116) or Southside Corpus Christi (361-992-0227). You may also visit www. urgentcarecc.com or look for the practice on Facebook or Twitter. N S I D E C O A S TA L B E N D M D

Committed to Providing Quality Care After practicing medicine in South Texas for nearly 20 years, Dr. Robert R. Ramirez continues furthering his career and returns to his roots. By: [amanda howeth] Photography: [edgar de la garza]

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Dr. Robert R. Ramirez is just one doctor out of eight others at Bay Area Kidney Disease Physicians who has devoted his life to providing the best possible care for his patients. It’s a commitment that stemmed from some of his more personal experiences in life, and it’s one he strives to uphold today. Ramirez was born and raised in Alice, Texas, and as long as he can remember, he’s known he wanted to become a doctor. “I was really young and wanted to pursue a career in medicine at a very young age,” he said. It’s always been my ambition my whole life to go down that path.” It wasn’t until his father became very ill during his high school years that he would determine what part of medicine he wanted to focus on. He decided on nephrology as his specialty. Nephrology is a branch of internal medicine that focuses on the study of the function and diseases of the kidney. “Part of the reason that my interest remained very intense to pursue a career in medicine is because my father was a dialysis patient,” Ramirez said. “I had a chance to observe what kidney failure can do ... And I took care of him in his later years.” Ramirez’s father was diagnosed with kidney failure while Ramirez was in high school. During this time, Ramirez was able to see firsthand the kind of symptoms patients with kidney disease have to endure. “I think my father was probably my motivation to step up and take care of patients that were afflicted with his illness,” he said. Ramirez’s father passed away from kidney failure in 1988. Two years later, Ramirez would lose his mother to the same disease. After graduating from Alice High School in 1972, Ramirez began his career in medicine at the Universidad Autónoma de Guadalajara in Mexico. After obtaining a Bachelor of Science in Pharmacy, he entered medical school in 1980. Upon finishing his education there, he completed an internship in Baltimore, Md., and then moved to Houston to continue his training. While Ramirez was working on completing his internal medicine residency, his mother moved from Texas to Virginia to live with his sister. According to Ramirez, his mother suffered from diabetes,

heart failure and kidney failure, and she did not want to undergo dialysis treatments. He said she had already made up her mind: It was her time to go. “She said, ‘Bobby it’s time for me to go be with dad, and you need to go back to Houston to take care of your patients that need you.’ I flew back and never saw her again.” She died just hours afterward. “She sent me back to Houston to continue my training so I could turn around and dedicate my life to what I do.” Ramirez listened to his mother’s words. He completed his fellowship in nephrology in 1992 and then finished his residency at the University of Texas Medical School in Houston. Two years later, Ramirez made the decision to move to Corpus Christi in 1995. That year, he joined Bay Area Kidney Disease Physicians as a partner. When Ramirez thinks about his past, he doesn’t look at his parents’ illnesses as a hindrance to obtaining his career or his success. He says they were his inspiration. “They weren’t obstacles; they were motivations. They kept me focused on what I had always wanted to do, and once I knew the area of medicine that I wanted to practice, it became very easy for me to decide. This is what I want to do for the rest of my life.”

“Part of the reason my interest in pursuing a career in medicine remained so intense was that my father was a dialysis patient.” Continuing his commitment In addition to being a dedicated physician, Ramirez is a dedicated father, and a proud one at that. He has two sons who both are currently attending college – his youngest son, Richard, attends St. Mary’s University, and his eldest, Michael, is attending graduate school at Houston Baptist University. “I will admit, it was a difficult decision, but I’ve taken a position to return to Houston to go back where I started,” Ramirez said. “It’s a new challenge in my life, and it’s a new opportunity for me to help people. It’s time for me to go somewhere else where I can help people, and I am looking forward to it very much.” Ramirez will make the move in January. He says it was hard to come to the decision at first, but he wants to take advantage of a new opportunity to further his career, and he is glad he will be living

closer to his family. “It gives me a chance to be around my family ... It’s a new and exciting time for me. I’ll miss South Texas very much. Alice will always be home.” Ramirez, who was the fourth physician to join the Bay Area Kidney Disease Physicians practice, says he is grateful for his peers’ unwavering guidance. He says their leadership has helped mold him into the experienced physician he is today. “I was really so fortunate to have joined. I’ll always be grateful for that because they gave me such a wonderful opportunity to come to Corpus and participate and learn from them. I’ve learned so much ... It’s been a joy.”

Bay Area Kidney Disease Physicians is located at 614 Furman Ave., Corpus Christi, Texas 78404. For more information about Dr. Robert R. Ramirez or Bay Area Kidney Disease Physicians, call 361-882-9278. N S I D E C O A S TA L B E N D M D

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advocate

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Patient’s With his infinite passion, 40-plus years of experience and focus on total patient care, Dr. Jose Ugarte is the family physician we all want to have. By: [Jody Joseph Marmel] Photography: [edgar de la garza]

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physicians who goes that extra mile. With his everlasting commitment, which also includes weekly house calls, he makes us yearn for the type of doctors we once had – and most certainly, that our parents had, as well. Ugarte is a traditional doctor who was the norm back in the 1950s. Today, he is considered a rare breed. With a patient population ranging from 2 days old to a few patients who are 100 years old, this family doctor puts in a 12-hour day, but he is available 24/7. Having patients in the hospital, he can very easily get a 2 a.m. call from the medical staff if any questions need to be addressed that night. Ugarte expresses how this is the life of a doctor. He is the family physician we all want to have, but

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n Kingsville, 30 miles from the Coastal Bend, is a gentleman who became a physician more than four decades ago. Dr. Jose Ugarte has an extremely interesting history, and he brought his years of experience, knowledge and wisdom to Kingsville in 1992. Studying family medicine and having a well-established practice (Ugarte Family Medical Clinic here in Texas), he has brought a foundation of medical knowhow to this community. And by the looks of his patient population, he is a busy physician for all ages. His inspiration to become a medical doctor came from his male role models as he was growing up in Cuba. Having diphtheria at the age of 9, Ugarte’s father’s cousin, who was a physician in Cuba at that time, saved his life. Remembering the details, he vividly explains “that our cousin came to our house every day for at least 10 days to take care of me. He kept coming to visit me as a patient with strong family ties. He had an outstanding medical background and an excellent quality of care.” This near-death experience sparked a passion that became Ugarte’s destiny to be a family physician with the highest level of patient care and moral values. From Camagüey, Cuba, to his internal medicine residency at St. Luke’s Hospital in Bethlehem, Penn., Ugarte formed his first private practice in Giddings, Texas, from April 1974 to May 1977. Moving onward to Eagle Lake, Texas, this remarkable physician continued to have a private practice in his new hometown for more than 15 years. Making what he describes as his last move, Ugarte has had a private practice in Kingsville for 21 years. Wanting to be a physician who was involved in “complete patient care,” internal medicine was the route Ugarte chose. With his personality, patience, intellect and perseverance, he has created a family practice that is busy from dawn to dusk. His secret is his desire to “listen to what the patient is saying. If you just take that extra time to do this, you are showing the patient how much you truly care about their well-being. They are not just a number to me. They are my patients, and they are people that deserve respect. I would not have it any other way.” His patient population can vouch for his philosophy on total patient care and being one of the few

others in the field. He needed extensive surgery on his brain. This man is still my patient today. And he is an example of saving a life because I took the time to listen. Patients can explain their symptoms, but if you delve a bit deeper, have a conversation that explains more and listen to everything the patient tells you, it makes all the difference.” Just about a year ago, Ugarte saw one of his patients because he was having many problems. Using the medical formula he discussed, Ugarte heard what the patient was saying. Discovering that the patient had a brain aneurism, the doctor sent him to a friend in Houston to have a procedure that is relatively new in the field. Once again, this led to an excellent outcome for the patient. “It is not just about getting better, but it is about improving the quality of life.” To be able to witness the many technological changes in medicine throughout the decades and know where to direct the patient so the results not only save a life, but enhance the life ahead for the patients is a big part of who Ugarte has always been. As an advocate for all of his patients, the doctor is fully aware of the many challenges within the system. “How are we going to deliver care? With the government telling us what to do, the insurance companies telling us what we can and cannot do and all the other parties involved in this cycle, I want to know what happened to the American way. Where is the freedom of choice that our country prides itself on?” Elaborating on the upcoming presidential election, Ugarte says, “I do not think many of the American people realize what is going on here. Having lived in seven countries, they are rationing medical care in certain parts of Europe. Denying medical care is not what doctors want to do. In fact, it is just the opposite.” His concern is most admirable. “I am worried about the government taking over. It seems that it is coming to the level of, ‘this many people will live and this many people will die.’ This is not their decision.” Leaving all of these important issues to the medical community will solve most of them. “I am here not just to prolong life, but to make it as enjoyable as I can for each patient that walks through my doors.”

“They are not just numbers to me.

They are my patients,

and they are people

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who deserve my respect.” unfortunately, times have changed in the medical arena. Ugarte refuses to let this get in his way. The more you get to know this unique doctor, the more you want to help change what is going on with the government, insurance companies and pharmaceutical giants that Ugarte has been trying to defeat with his valiant efforts every day. Regardless of these obstacles, he believes helping people “get diagnosed properly and following through with the best treatments available is the cornerstone of being a physician that cares about their patients. “Twenty years ago, I diagnosed a patient with severe cranial problems that were not discovered by

Ugarte Family Medical Clinic is located at 1311 General Cavazos Blvd., No. L, Kingsville, Texas 78363. For more information on Dr. Jose Ugarte, call 361-592-5101.

REGIONAL ECONOMIC D E V E L O P M E N T C O R P O R AT I O N N S I D E C O A S TA L B E N D M D

NSIDE health & wellness

Don’t Drive-Thru. Drive Home!

Now that school is back in session, maintain nutrition for the whole family by involving your kids in meal planning and introducing them to new vegetables and health foods. By: [mandy ashcraft]

The summer sun has set on late bedtimes, weeknight barbecues and family vacations. As homework and activities consume schedules for parents and kids alike, the hope for a nutritious family dinner becomes just a mirage in the desert of obligations. Getting your children involved in meal planning may be the answer to maintaining health and nutrition for your whole family during the school year. Before you microwave a frozen burrito (this is South Texas, so actually, you should not ever microwave a frozen burrito), consider finding quick and easy recipes that would also allow you a chance to talk to your kids about their day. Spark creativity by letting your children choose a vegetable at the store to be your “secret ingredient” and then find a way to utilize it. If children feel they have actively participated in creating their meal, food becomes a source of artistic inspiration. What should they pick next time? Do they have any ideas for what you could make? Deciding between chicken nuggets and a cheeseburger in the drive-thru doesn’t have the same effect on the mind or on the body, and there’s rarely bonding time between “I’ll have a No. 6 with cheese” and “Pull up to the second window.” Most children have an almost Zen-like acceptance of new vegetables and health foods. In fairy tales. If your children are of the human variety, you may have more difficulty with the implementation of green things in their diets on busy school nights (or any nights). You might find it easier to introduce a new food when it’s served with a well-liked food such as serving edamame as a snack with a few cheese cubes and pretzels. Children may find a pile of fuzzy pods intimidating until it’s presented as part of a mini snack platter. By gaining familiarity with a food in a more casual “snack time” manner, such ingredients are more accepted on a dinner plate – for example, an edamame salad as a side dish. However demanding the family schedule is, the truth is that daily tasks are more easily completed when alive and well. (Surely a valid argument?) A sacrifice of nutrition is an unfortunate corner that’s often cut, and the drive-thru windows are beckoning toward all of those who are glancing at their watches. Moments in the kitchen may also be what your kids will later recall to their own kids, so don’t be afraid to give them some memories so that they don’t have to make up “the good old days.” Freeze time in your kitchen by making it count in more ways than one – and keep in mind that in the desert, you may also find an oasis.

For more information or healthy recipe ideas, email mandyashcraft314@gmail.com or visit www.mandyashcraft.com.

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NSIDE health & wellness

Workouts Not Working Out? To build lean muscle and burn fat faster, try switching to high levels of intensity with short breaks in your workouts. By: [Margo Hurdt and Craig Myers]

Thirty-minute workout: Warm-up: 10 minutes

Three sets of 10 reps each:

There are so many ways to work out nowadays. There are workout videos, StairMasters, treadmills, ellipticals, classes you can join, extreme sports Squats / Jumping Jacks / Seal Jacks and much more. But how do you know if they are working or not? So many people think running mile after mile or spending 60 minutes on the elliptical is going to give them that killer body. What if I told you there is a better way? The truth is, if you do the same thing over and over again, your body gets Glute Bridges / Single Leg Bridges used to it. It evolves and adapts to your workouts, and eventually you don’t shed Hip Circles / Arm Circles the pounds you are looking to shed. Plus, your metabolism is only increased durReverse Crunches ing the workout, followed by a rapid decline – not an ideal situation for burning fat. The best way to lose weight, along with eating a balanced diet, is high levels of intensity with short breaks. This type of exercise keeps your body guessing so it can’t adapt. You also increase your metabolism for a much longer period time after your workout is over, so the fat burning continues! With these workouts, you are not only getting in cardio and increasing your heart rate, but also using light dumbbell weights to help firm up your body and build muscle. To give you a visual, picture a long-distance runner compared to a sprinter. There certainly isn’t anything wrong with distance running, but you can see the effect of steady, long duration versus short, intense intervals. Most people would rather have lean muscle definition, which happens much faster with weighted interval training. With workouts like the one on this page, you will be able to turn that flab into a fabulously toned body.

Two sets of 10 reps each:

If you are interested in hearing more about workouts like this, please contact Pro Performance Training Center at 361-806-2085.

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If you do the same thing over and over again, your body gets used to it, and eventually you don’t shed the pounds you want to shed.

When you think of physical therapy... you most likely think of our ability to

treat the standard musculoskeletal injuries or conditions such as strains, sprains, low back pain, neck, shoulder, elbow, hand, hip, knee, ankle, and foot pain, etc.,

...but did you know Humpal P.T. also has programs for:

• Pregnancy (Pre/Post Natal Care) • Diabetes • Fall Prevention • Neuropathy

• Cardiovascular Therapy • Osteoarthritis • Vertigo (dizziness) • Osteoporosis

• Athletic Rehab (Sport Specific) • Thoracic-Outlet Syndrome • Orthotic Evaluation/Fabrication • Pre-Op/Post-Operative Therapy

We have a program for you if you are unable to perform your activities of daily living due to pain or limited range of motion.

We will put you back in the Game of Life!

4500 sq.ft.Gym - Corpus Christi location

46’x 20’Indoor Pool - Corpus Christi location

All 6 locations offer carefully designed and supervised exercise programs in State of the Art gyms and Large Indoor Heated Pools.

Medicare, Medicaid, Workers Compensation, and most insurances accepted.

If you have a condition that is causing you pain or concern, ask your Doctor for a prescription to Humpal P.T., or stop by any of our locations to request a FREE physical therapy Screening to determine if your condition can benefit from physical therapy.

Humpal Physical Therapy & Sports Medicine Centers

w w w. H u m p a l P h y s i c a l T h e r a p y. c o m w w w. F a c e b o o k . c o m / H u m pa l P T

Corpus Christi, 5026 Deepwood Cir., 361-854-2278 Calallen, 4040 Five Points Rd., 361-241-7399 Alice, 1302 E. 5th St., 361-664-9675 Portland, 114 Lang Rd. 361-643-8243 Aransas Pass, 2150 W. Wheeler Ave., 361-758-5199 Rockport, 1811 Broadway (aka Fulton Beach Rd.), 361-729-8777

6 Locations • 120 Employees • One Philosophy- Provide the Best Ncare! S I D E C O A S TA L B E N D M D

Celebrities: Bad for Your Health? Forget the fad diets and get science on your side by addressing the underlying issues in order to meet your weight-loss goals in a healthy and effective way. By: [Myles Cooper & tracy ganske]

NSIDE health & wellness

Want to lose 20 pounds? Easy! Just ask Britney Spears how. Wait, what? Ask the pop diva how she lost weight while drinking a Grande Frappuccino and eating Cheetos? The reality is celebrities aren’t great role models when it comes to weight loss. The tabloids might lead us to believe that all it took was elimination of carbs and intense yoga sessions, but if we “real people” try that, we are lucky to lose one pound, not 10. Last year, one of the most popular search terms on both Google and Yahoo was Kim Kardashian. A quick review of the top 500 searches for last year reveals inquiries on other celebrities, too, including Spears, Jennifer Aniston, Jennifer Lopez and Katy Perry. Why are we, as a country, so fascinated with celebrities? When considering what is universally accepted as an ideal shape and structure for the human body, we typically refer to the grinning, gleaming celebrities who always make looking great so easy. While these attractive folks have achieved extraordinary fame for their figures in both film and photographs, they possess no extraordinary secret power for weight loss that the rest of the ordinary human populace does not. Stars try to make it seem like the light emitted from the interminable camera flashes they’re subjected to every day endows them with a mysterious secret for weight loss that will only work for them. Don’t be fooled! Most celebrities have achieved a level of financial security that enables them to take advantage of some of the most expensive, over-publicized, overglamorized weight-loss techniques. They have the luxury of personal chefs and private trainers, as well as an obnoxious amount of time to work out while they’re waiting around to be photographed. “As celebrities continue to exert their influence on the perceptions and beliefs of Americans, physicians are finding that we have to spend more and more time with our patients correcting misinformation,” said Dr. Anthony Youn in his article, “Celebrities Can be Bad for Your Health.” One thing is certain: Diets do not work. Of all the diets people embark on, only 2 to 6 percent are successful. Why? Because successful weight loss isn’t always about “calorie math” – you take in fewer calories, while also exercising to burn off extra calories to create that deficit, and poof: Like magic, the weight will fall off. This isn’t the case for many of us. We all know people who eat next to nothing and never lose a pound. If we let the unreal advantages celebrities enjoy overwhelm us and get us low, it will distract us from the real answer to our own personal weightloss goals. This elusive blueprint for achieving and maintaining a healthy weight that makes you look and feel great resides purely in the science of human biology. There is unfortunately no “one size fits all” approach to weight loss. Each person needs to be seen as an individual and carefully studied to understand the root cause of the weight gain. There is no magic pill or diet that works for everyone. To truly lose

weight in a way that is healthy and effective, the following issues must be addressed:

Hormone imbalances

We rarely pay attention to the importance of hormones, but when you wake up one day in your mid40s and have gained 20 pounds seemingly overnight, you will want to start paying closer attention to your hormones. Hormones are extremely potent; very small amounts can pack a punch. Too much or too little, or an imbalance, can upset your metabolism and cause you to gain weight.

Of all the diets people embark on, only 2 to 6 percent are successful. Hormones function best, like the instruments in a well-tuned orchestra, when they are correctly balanced. If any instrument is missing, overpowering or out of tune, it can throw off an entire performance. Similarly, an alteration of a hormone’s structure can upset your metabolism and cause you to gain weight. Understanding if you have a hormonal imbalance is an important first step.

Reduce inflammation

Inflammation is a response of tissue to injury, often injury caused by invading pathogens. When you receive an injury that causes tissue to inflame, the inflammation of that injury causes insulin resistance. The reverse of this sequence is true, as well; insulin resistance also causes inflammation. Many of the illnesses we are experiencing in the 21st century stem from our diets containing an overabundance of sugar, refined carbohydrates, trans fat, omega-6 fats from processed plant oils and artificial sweeteners. To go along with a poor diet, we also tend to lead rather sedentary lifestyles that put us into contact with environmental toxins. All of these factors contribute to inflammation, and for every person, it is a different path to diffusing the health risks by reducing inflammation.

Improve digestion

It’s really all about a healthy gut. Recent research has shown that composition of gut flora differs in people who are obese and diabetic, versus people who are normal weight with no metabolic abnormalities. Here is another disturbing piece of research: Changes in gut flora can increase the rate at

which we absorb fatty acids and carbohydrates and increase the storage of those calories to fat. What does this all mean, exactly? It means that someone with bad gut flora could eat the same amount of food as a person with healthy gut flora, but extract more calories from it and gain weight! The key is to work on what is known in functional medicine as the four Rs: Remove the bad bugs, drugs and food allergens; replace needed enzymes, fiber and prebiotics; reinoculate your gut with good bacteria or probiotics; and finally, repair the gut lining with omega-3 fats, zinc, glutamine, quercetin and other healing nutrients.

Maximize detoxification

Environmental toxins interfere with blood sugar and cholesterol metabolism, as well as block the function of receptors on the nuclei of your cells. Scientists have realized that these toxins can increase glucose levels, cause cholesterol buildup, contribute to a fatty liver and slow down your thyroid function. On top of everything, environmental toxins can trick your brain into thinking your body is hungry when it really is not. All of these factors spur weight gain that can be easily avoided by deducing the toxic environmental factors that affect you and eliminating them from your life.

Genetics

Believe it or not, your genetics play a role in your weight. Those who come from a family of overweight family members have a higher risk of becoming obese themselves. But all is not lost – we can change this destiny. By understanding our genetic makeup, we can influence our body weight. We each have a different genetic makeup. As they say, no two people are created the same. Some of us have genes that tell our body to absorb fat in excessive amounts and store it as body fat. Other people may have genes that say absorb carbohydrates and store them as fat. Just like some people can digest milk and some people cannot. When you know which foods your genes say you should store as fat, you can better manage your weight. According to research at Stanford University, you can lose two to three times more weight when you match your diet to your genes.

Adrenal fatigue and cortisol imbalances

Cortisol is sometimes known as the “stress hormone.” It comes from the adrenal gland located on top of the kidney. Cortisol is released as a response to stress and anxiety, and it directs the breakdown of the various tissues such as fat. When cortisol is elevated for a long period of time, it stimulates the deposit of a specific kind of fat called visceral fat. This is the source of fat that is around your stomach. Celebrities might be helpful when it comes to fake tans and styling tips. But when it comes to weight loss, you need science on your side.

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NSIDE patieNT

Busting the Myths Whatever the cause of your varicose – or “very-gross” – veins, today’s minimally invasive outpatient procedures make yesterday’s painful, bloody procedures a thing of the past.

Before

After

Before

After

By: [Dr. Robert K. Thompson]

Everyone seems to know the reason – fact or fiction – for their varicose veins: “I cross my legs a lot” (fiction); “I spend my day walking on concrete floors” (fiction); “I wear high heels every day” (maybe); ”I got them from my mother … or my children” (fact … fact). Unfortunately, few people seem to know that significant improvements have been made in the last decade in the treatment of this common medical problem.

Painful past Until recently, treatment of varicose veins was limited to a painful, bloody procedure called veinstripping, which was exactly that: The large saphenous vein located on the inside of your thigh and calf, along with all of its branches, was simply pulled out through multiple incisions throughout the leg. The procedure required general anesthesia, several days in the hospital at bed rest and a week or more off work at home wearing a bulky compressive bandage with restricted activity. Even the smaller spider veins were treated with painful saline injections, often leaving behind unsightly spots and blisters. Recent advances in technology now enable doctors, trained specifically in the management of vein disease, to treat all stages of varicose and spider veins using minimally invasive outpatient procedures performed in specialized vein clinics.

Science behind the symptoms Diseases of the venous system can be explained most simply as a defect in the hydraulic system our bodies use to transport used blood from our extremities back to the heart and lungs to be resupplied with oxygen. The blood leaving our legs and feet must climb several feet uphill through our veins to our heart and lungs using only the push of the heartbeat, the contraction of the calf muscles and a series of one-way valves inside the veins opening and closing with each beat, all working in concert to prevent the venous blood from falling back downhill. Gravity is a constant enemy of this process, in addition to excess weight, a pregnant uterus, prolonged standing or an inherited weakness of the veins’ integrity. This constant downward pressure eventually overcomes the ability of the weak, thinwalled veins and valves to perform their task, resulting in an overstretched, enlarged, bulging network

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of veins in our legs – varicose veins. Complications of these stagnant, blood-filled veins can include pain, bleeding, blood clots (phlebitis), skin thickening and discoloration and in severe cases, large open skin sores around the ankles called venous stasis ulcers.

Better, brighter and more beautiful future The mainstay of prevention and conservative management of vein disease has been compression stockings, which help prevent overstretching of the veins by squeezing the leg in conjunction with calf muscle contraction, helping propel the blood up the vein even in the presence of weakened veins. Newer fabrics and elastic materials have made today’s compression stockings more effective and provide a comfortable uniform fit and color choice, thereby improving patient satisfaction and compliance. Once vein disease has advanced to the more severe stages of pain, bleeding or ulceration, more aggressive intervention is medically indicated. The diseased vein segments must be removed, diverting the blood to stronger and healthier veins found deeper in the leg. Laser or radiofrequency ablation of the long, straight diseased saphenous vein segments, in combination with ambulatory phlebectomy of the short, tortuous segments, has replaced vein-stripping with better long-term outcomes, significantly fewer complications and a quick return to work or play. With these new techniques, the diseased vein segment is identified with ultrasound and then surrounded by the infiltration of large amounts of dilute local anesthetic. A catheter is inserted into the vein through a tiny needle puncture, and intense heat generated by either laser light or radiofrequency energy is then passed through the catheter into the vein wall itself. The high temperature causes the vein to swell, collapse and ultimately obliterate itself without having to be removed through any incisions in the skin. The local anesthesia infiltrated around the vein allows for a painless and bloodless procedure, and the patient is able to walk and drive home immediately afterward using only a compression stocking for a week. Smaller, more tortuous veins can then be removed later with similar local anesthetic using

small needle punctures and a vein “hook,” since their blood supply has already been removed by obliteration of the larger “feeder vein.” Spider veins, those unsightly thread-like veins in the skin surface, can now be treated much more effectively with the injection of newer, less painful solutions developed and tested in Europe, but now available to patients in the United States. These chemicals are injected directly into the spider vein cluster using a tiny needle. Contact between the solution and the vein wall causes the vein to swell and obliterate itself within a matter of days, providing an optimal cosmetic result. So no matter the cause of your “very-gross” veins, no one should have to suffer from the complications or cosmetic embarrassment of vein disease. Innovation in the treatment of venous disease over the last decade has revolutionized our ability to care for patients suffering from this common problem. Newer treatments have proven safer and more effective, and can be performed in the comfort and privacy of a specialized vein clinic.

Robert K. Thompson, M.D., is a vascular surgeon for Veintec Varicose Vein Clinics of San Antonio (owned and operated by Peripheral Vascular Associates). For more information or a list of locations, visit www.veintec.com.

2008, 2009, 2010, 2011

Skilled Home Health Care Services

Anodyne Therapy, Assessment & Evaluation, Blood Pressure Monitoring, Central Line and PICC Line Management, Certified Diabetes Educator, Certified Nurses Aide, Disease Process Teaching and Management, Enteral Nutrition, Foley Catheter Care, Insulin Administration, IV Therapy, Medical Social Services, Medication Management, Occupational Therapy, Parenteral Nutrition, Physical Therapy, Speech Therapy, Venipuncture/Lab Work, Wound Care Certified Nurses, Wound Care Management, Wound Vac

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Your Home. Your Health. Your Choice. BENAVIDES

119 W. Railroad Ave. Benavides, Texas 78341 Ph: (361) 256-3980 Fax: (361) 256-3981

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6262 Weber Rd. Ste. 302 Corpus Christi, Texas 78413 Ph: (361) 853-3971 Fax: (361) 853-4309

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NSIDE patient

skin care 101

Serenity Creek Med Spa answers some common questions about sunscreens, SPF factors and UV radiation. [SPECIAL TO NSIDE] Intellishade® SPF 45, an anti-aging tinted moisturizer, is now available in Original Radiant or NEW Matte formulas.

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act as an SPF 10, while for someone else, the same product may act like an SPF 60.

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What kind of ingredients should you look for in a sunscreen? Are chemicals in sunscreens safe? When searching for the right sunscreen, make sure the sunscreen contains zinc oxide and/or titanium dioxide. Both zinc oxide and titanium dioxide work by sitting on top of the skin and providing a barrier against UV rays. Zinc oxide provides protection over the broad spectrum of UVA and UVB. Titanium dioxide protects against UVB rays and short UVA rays, but unfortunately, not against longer UVA rays. All of our sunscreens have zinc oxide or titanium oxide in them.

What are sunscreens? Sunscreens are topical products combining several ingredients that will help prevent the sun’s ultraviolet (UV) radiation from reaching the skin. There are two types of UV radiation: UVA and UVB. These increase your chance of skin cancer and can damage the skin. All sunscreens are different and vary in their ability to protect against UVA and UVB. The sun protection factor (SPF) is what measures the ability to prevent UVB from damaging the skin in sunscreens. Broad-spectrum sunscreens help protect the skin from both UVA and UVB rays. UVB rays are quicker to produce sunburn, are more powerful and have been linked to melanoma. Aging of the skin is associated with UVA rays, and although milder, UVA rays may increase the risk of melanoma. What does the SPF number on the sunscreen mean? The SPF number on sunscreens measures the protection against UVB. This radiation is what causes the burning of the skin. The number is a derived ratio that measures the increased amount of radiation that causes redness in the skin when the sunscreen is applied, compared to when it is not used at all. For example, if it takes 10 minutes for unprotected skin to show redness, then an SPF 15 sunscreen applied correctly will take 15 times as long to burn, or 150 minutes.

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How protective are sunscreens? Do sunscreens offer everyone the same protection? And how much SPF do you really need? According to the American Academy of Dermatology, sunscreens should protect against UVA and UVB, and the SPF should be 30 or greater and water resistant. Both adults and children should use an SPF 30. Creams are best for dry skin; we recommend the Treatment Sunscreen, SPF 25, by iS Clinical ($36). The protection of sunscreens is not the same for everyone. For someone who is more prone to burning, a sunscreen labeled SPF 30 may

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When should I use sunscreen? Everyone should use sunscreen every day. The sun releases harmful UV rays year-round. Harmful UV rays can penetrate your skin even on a cloudy day. Snow and sand increase the need for sunscreen because the sun’s rays reflect off the snow and sand. Apply sunscreen 15 minutes before going out into the sun. Reapply sunscreen every two hours or after swimming or sweating. For easy application, we recommend Powder Sunscreen, SPF 20, by iS Clinical ($43) or gloMinerals Protecting Powder (bronze or translucent), SPF 30 ($40).

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What are the side effects of not using sunscreen? Without sunscreen, you are more prone to melanoma, fine lines and wrinkles and melasma. To help prevent melanoma, fine lines and wrinkles, we suggest our tinted moisturizer and anti-aging sunscreen, Revision Skin Care Intellishade (original or matte), SPF 45 ($48), or iS Clinical’s Tinted Treatment

Perfect Tint® SPF 25, hydrating, protective tinted moisturizer offers antioxidant-rich protective seal and soothes inflammation.

Sunscreen, SPF 25 ($38). Melasma is dark skin discoloration that appears on the face from overexposure to the sun and by hormones. To help treat and correct melasma and fine lines and wrinkles, getting on a pharmaceutical grade regimen will help dramatically. Also, doing in-office treatments such as Botox, JUVEDERM, microdermabrasion, IPL Photofacials and chemical peels periodically could help with the appearance of the skin. When doing microdermabrasion, IPL Photofacials and chemical peels during the summer, you must be careful not to have sun exposure before or after these treatments, and always use sunscreen. During the summer, we suggest the Fire and Ice Facial by iS Clinical ($50) to maintain a beautiful summer glow.

Serenity Creek Med Spa is located at 8900 Shoal Creek Blvd., Ste. 301, Austin, Texas 78757. For more information, call 512-419-0303 or visit www.serenitycreek. com.

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NSIDE enrichment

Communication is Key

When it comes to communicating with your partner, avoid John Gottman’s “four horsemen of the apocalypse,” four unhealthy communication patterns that can ruin your relationship. By: [Tracey D. Bauer]

As a marriage and relationship counselor, one complaint I hear from almost every couple I work with is, “We just can’t seem to communicate.” According to John Gottman, renowned author, marriage and relationship researcher, there are four unhealthy patterns of communication that will most certainly lead to doom and destruction in your relationship: criticism, defensiveness, contempt and stonewalling – what Gottman calls the “four horsemen of the apocalypse.” Gottman spent over 20 years researching more than 2,000 couples and discovered that these four major emotional reactions – the four horsemen – were predictive of whether a relationship would succeed or fail. These are ways of interacting that sabotage your efforts to communicate with your partner. The first step in eliminating the horsemen is for you and your partner to identify when these patterns are happening. Then you can learn to change them. So let’s talk about the horsemen so you can learn to recognize them.

d Horseman No. 1: Criticism (over-generalized complaints that attack your partner’s character). Unlike complaints, criticism tends to over-generalize and entails attacking your partner’s personality or character rather than focusing on specific behaviors you don’t like. We will always have some legitimate complaints, but criticism feels like a personal attack. For example, “I am disappointed that you didn’t build that shelf like you promised” is a complaint. “Well, I see that shelf didn’t get built. I guess you obviously don’t care anything about my feelings or me. Your precious time at the gym is much more important than me” is a criticism. Since the criticized person feels attacked, the next horseman is invited right on in defensiveness.

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Horseman No. 2: Defensiveness (shielding oneself from a perceived attack and seeing oneself as the victim). Of course, it is only natural for people to feel defensive when they are being insulted, called names or accused. Defensiveness involves blocking a verbal attack and seeing yourself as the victim. When you get defensive, you experience anxiety or a flooding of emotions, which makes it difficult for you to tune into what your partner is saying. Defensiveness also leads to escalation. It includes matching anger with anger or blame with blame, hardening your stance, making excuses or denying responsibility. For example, one partner says, “You never feed the dog,” and the other partner says, “You never feed the cat.” Instead of listening to what is being said, you toss it back to your partner, saying, “It’s your problem,” denying responsibility or playing the victim role. Verbal examples include “Yes – but,” “So,” “It’s not my fault” and “It wouldn’t have happened if you didn’t …” Defensiveness prevents you from solving the problem at hand and further impedes communication.

d Horseman No. 3: Contempt (hostile words and body language aimed at psychologically abusing your partner). Holding onto resentment inevitably leads to contempt, which is even more destructive than criticism. Contempt involves directing hostile words and body language at your partner on purpose. These hostile words and body language are meant to psychologically harm your partner and attack your partner’s sense of self. Contempt includes openly insulting your partner, disrespecting them and tearing down their self-esteem. Verbal examples of contempt include putdowns, insults and name-calling, yelling and screaming, mocking, sarcasm, ridiculing and hurtful teasing. Phrases like “You are such a piece of work,” “There’s something wrong with you” and

“You are so selfish,” are examples of contempt. Names like “lazy,” “fat” and “stupid” are also examples. Contempt hurts a person’s sense of self and is extremely detrimental, leaving partners feeling hurt and extremely negative toward each other.

d Horseman No. 4: Stonewalling (withdrawing from the relationship in order to avoid conflict). Stonewalling happens when one person withdraws from the other partner to avoid a fight. This can happen in the middle of a discussion, when one partner just shuts down and stops responding to the other. Stonewalling can also happen when you remove yourself physically without communicating with your partner. When people stonewall, they exit the relationship and avoid solving the problem at hand. They are also not listening, the conflicts become silent and withdrawing becomes a hostile act. So now that you know what NOT to do, what are healthy ways to communicate? Instead of criticizing, make an impersonal complaint without blame. Instead of being defensive, take responsibility. Instead of having contempt, foster an environment of fondness and admiration. Instead of stonewalling, learn psychological self-soothing. Until next time, keep on growing!

Tracey D. Bauer, M.A., LMFT, is a licensed marriage and family therapist and the founder of The Center for Personal & Relationship Growth. For more information about the four horsemen and other topics for creating your best relationship, visit Bauer’s blog at: www.cprgnet.com.

The first step in eliminating the horsemen is for you and your partner to identify when these patterns are happening.

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YOUR QUALITY OF LIFE An Important Conversation

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d, "At the en I would ve never hat made i without Legacy Hospice."

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Ray High School students expand their outdoor classroom, featuring various gardens, a greenhouse pond and an archeological dig site, through a grant program funded by 2011 State of the District sponsorships.

Wednesday, October 17, 2012 Featuring Keynote Presentation from D. Scott Elliff, CCISD Superintendent of Schools, “Hearts & Minds” Student Showcase, and performances from CCISD students. Proceeds benefit the Corpus Christi Education Foundation, which funds innovative classroom programs and scholarships not otherwise able to be funded through the school district. Sponsorship Levels:

Valedictorian ($10,000) Salutatorian ($5,000) Honor Roll ($2,500) Senior ($1,000) Junior ($500)

Windsor Park Elementary students test their critical thinking and problem-solving skills through daily activities as part of the “Think Tank ” program funded by 2011 State of the District sponsorships.

NEW this year: Sponsors at Honor Roll level and above will be recognized at a first - ever Donor Appreciation Reception Tuesday, October 16, 2012, from 6pm to 8pm at the Corpus Christi Yacht Club. Sponsorship packages and ticket information is available at www.ccef-ccisd.o rg under “State of the District,” or call the CCEF at (361) 695 - 7412.

Carroll High School students test and apply real-world problem solving techniques to “teach “ goldfish to swim through a maze through aNgrant program funded by 2011 I D E C O A S TA L B E N D M D 42of theS District State sponsorships.

Shaw Special Emphasis School students track and study weather at their campus and around the world through a grant funded by 2011 State of the District sponsorships.

Cunningham Middle School students track animal migrations using GPS navigation through a grant program funded by 2011 State of the District sponsorships.

Carroll High School students interview community leaders, including Councilwoman Nelda Martinez, as part of a grant program funded by 2011 State of the District sponsorships.

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