Englewood Hospital & Medical Center: Family Wellness Handbook

Family Wellness

HANDBOOK

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We hope you were able to join us

at BERGEN magazine’s BergenFest earlier this fall. But in case you missed it, we’ve put together this special issue with information and news about what’s happening at Englewood Hospital and Medical Center, one of New Jersey’s and the nation’s leading community teaching hospitals. As healthcare professionals, our entire staff is committed to providing the best experience to everyone who comes through our doors by doing the right thing, every time, without exception.

Wellness and disease prevention is a big part of what we’re doing. In this issue, you will read about our newest services and programs in integrative medicine and executive health, as well as information on how to stay healthy during the upcoming winter and spring seasons from experts here at the medical center.

This past year has been very exciting for us as we continue to invest in a newly designed medical center of the future, create and expand areas of care devoted to specialty medical services, and engage the community in events and wellness initiatives. Our beautiful and technologically enhanced spaces offer an ideal setting for leading-edge screening, assessment, and treatment.

Our nationally recognized medical, surgical, and nursing teams are working together seamlessly with a specific focus on treating the “whole” patient, including your family.

As one of only 59 hospitals in the United States, and the only hospital in Bergen County, to achieve straight A’s in patient safety, our hope is to create a climate of health and wellbeing in our community and be your lifelong partner in wellness.

Thank you for allowing us to be your hospital for life.

Michael T. Harris, MD Senior Vice President, Chief Medical Officer Englewood Hospital and Medical Center

Mary Ann Donohue-Ryan, PhD, RN, APN, NEA-BC Vice President for Patient Care Services Chief Nursing Officer Englewood Hospital and Medical Center

2012-2017

AMONG THE BEST HOSPITALS IN NJ AND NY METRO AREA

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12 CONSECUTIVE TIMES

2 EXCELLENCE AWARDS, 5 STARS IN MULTIPLE SERVICES

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TOP 10% IN NATION FOR OVERALL SURGICAL CARE AND HOSPITAL CARE, HONORS IN MULTIPLE SPECIALTIES

NURSING EXCELLENCE 4 CONSECUTIVE TIMES SINCE 2002

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65 TIPS A HEAD-TO-TOE HEALTH GUIDE

With a new year almost upon us, we asked our panel of experts at Englewood Hospital and Medical Center for their very best advice on how you can sail through 2018 (and beyond!) in your best health ever.

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A Better You

Know Your Body

What’s the number-one reason people get sick? Surprise: It’s not legions of germs. Discover the most probable cause of that winter bug—and how to avoid it.

Are you sure those symptoms are just a cold? Read on to find out what’s really ailing you…and much more.

5. Know the difference between having the flu and having a cold. The flu comes on suddenly, typically with a fever, cough, sore throat, muscle or body aches, runny nose, and headaches. A cold comes on gradually and symptoms are not as severe.

If you think you have the flu, call your doctor as soon as possible. Medication can help you recover more quickly but is only effective if started within 48 hours of symptom onset.

6. Stay hydrated during the winter. Make sure you’re drinking enough water throughout the day—at least eight 8-ounce glasses daily.

7. Eat foods that boost your immune system, including those rich in vitamin A (sweet potatoes, carrots, kale, spinach, red bell peppers, apricots, and eggs), vitamin C (oranges, grapefruits, tangerines, papayas, and strawberries), and vitamin E (sunflower seeds, almonds, hazelnuts, and peanut butter).

8. Devote a day solely to your health and well-being. The Braverman Family Executive Wellness Program provides a comprehensive head-to-toe assessment and wellness evaluation, all in a single visit directed by a dedicated concierge. Attention to detail will go far beyond a routine physical exam with extensive tests, lab work, deep tissue massage, and creation of a health action plan with one of the Braverman program’s medical directors.

And when you give us your time, we’ll give you ours—you will be the only person going through the preventive program that day. Be proactive and consider giving the gift of health this holiday season.

— Alexandra Gottdiener, MD, Internal Medicine/Executive Wellness Program

1. Be sure you’re getting enough sleep, despite how busy your schedule may be. Lack of sleep compromises the immune system— that’s the biggest reason we get sick.

2. Clean surfaces in your home or office that many people touch. This includes refrigerator doors, microwave and faucet handles, and water fountain and vending machine buttons. Never touch your eyes, nose, mouth, or face after handling objects such as handrails, doorknobs, or shopping carts in public places. The nose and mouth are the main portals of entry into our bodies for bacteria and viruses. Use antiseptic wipes or hand sanitizer while out and about.

3. Don’t overindulge too often. When attending frequent seasonal gatherings, it’s easy to do. But before your next party, try having a cup of soup—you won’t be so hungry and will eat less overall. If you do overdo it, don’t be too hard on yourself; just make a greater effort at the next event.

4. Give yourself a break. Remember, you can’t do everything perfectly. Whether you’re a young professional, a working parent, or a homemaker, this expectation is unrealistic. Practice delegating chores or let something go if it’s causing you stress. The house can be messy; the laundry can wait a few days.

— Diane Schwartz, MD, Internal Medicine

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A Quiet Place We know you’ve been busy shopping for the holidays, but amid all the hubbub, don’t forget one very important person: you!

9. Give yourself the gift of kindness this season. Parties, events, and festive activities will soon dominate our schedules until the New Year.

Reserve time for quiet moments, meditation, yoga, exercise classes, and meaningful exchanges with loved ones.

10. Have your physician check your vitamin D levels. As the days shorten, we have less exposure to the sun and the UVB rays that help us produce vitamin D. Taking 800-1000 IU per day of vitamin D3 will help keep your levels normal throughout the winter months.

11. Don’t let the colder weather keep you under a blanket! Dress in layers and go for a brisk walk or take an indoor class to keep your body moving. If you don’t want to venture outside, follow exercise videos in the comfort of your own home to keep your energy and your spirits up.

12. Do a simple hydration check. When you use the bathroom, check to ensure that your urine remains a pale yellow throughout the day. If you see a darker color, increase your water intake.

—Tracy Scheller, MD, Gynecology 13. Pay attention to your body. Note any changes such as persistent abdominal pain, postmenopausal bleeding, and bloating. Record when you experienced these feelings, and for how long.

14. Talk openly with your doctor. Report any changes you’ve noted when you go for your next visit, or call ahead if pain or discomfort is persisting and disrupting your daily life. It’s important to provide your care team with as much detail as possible.

15. Get tested regularly. Be sure to see your OB/GYN annually and stay up to date with screenings, including mammograms and Pap smears.

—Nimesh Nagarsheth, MD, Gynecologic Oncology

The Breast Advice Attention, ladies: Breast screenings are imperative—both at home and at Englewood Hospital and Medical Center, where our staff will welcome you with open arms.

16. Always go for your annual 3D mammogram, when you’re at the appropriate age. If you have dense breast tissue, schedule a breast ultrasound.

17. Have a clinical breast examination at least once a year with your OB/GYN or primary care physician, and get in the habit of performing breast self-exams at least once every month.

18. Beware of the risk factors for developing breast cancer: obesity, smoking, alcohol consumption, supplemental hormones and family history. Communicate honestly with your doctor.

19. Increase fruit and vegetable consumption for their protective nutrients, as a preventive measure.

—Patricia LoPinto, NP, Breast Surgery

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Integrative Medicine at Englewood Hospital and Medical Center The Graf Center for Integrative Medicine offers evidence-based services to promote prevention, recovery, and support in a safe, comfortable environment. We offer services to help minimize nausea, reduce pain, lower blood pressure, and relieve stress and anxiety, working closely with your physicians. Services and events are also open to family members and the public.

Acupuncture • Aromatherapy • Functional medicine • Manual lymphatic drainage Massage therapy • Meditation, including pre/post-surgery • Nutritional counseling Reflexology • Reiki • Stress management • Wellness programs • Yoga

201-608-2377

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All in the Family

Have you made your New Year’s resolution yet? Here’s one suggestion: Spend more time with loved ones—your body (and mind) will thank you!

20. Get outdoors and enjoy the seasonal weather. Go for a long walk with your brood, make time to appreciate the colors and sounds of falling leaves, and take deep breaths of the cool, crisp air to relax yourself.

21. Remember to make healthy choices as the holidays approach. Set goals and avoid temptation whenever possible.

Choose a New Year’s resolution you can keep—start small and only work on changing one unhealthy behavior at a time.

22. Stay active. Doing so will strengthen your immune system and is the best way to keep your heart and mind healthy.

23. Don’t forget the flu shot! To give your body adequate time to build immunity to the virus, you should see your primary care physician to get vaccinated by mid-November.

Those older than 64 should get the high-dose flu shot, if possible. If you’re traveling, especially internationally, try to get vaccinated two weeks before your trip for maximum protection.

—Nicole Tully, MD, Family Medicine

The Food Factor Eating the right foods has never been so easy thanks to these tips—plus a smartphone app that can help you make the very best choices.

24. Eat the rainbow. Consume unprocessed, healthy foods rich in nutrients and vitamins like green leafy vegetables, fresh berries and fruits, fish, lean meats, and whole grains.

Strive for five colors daily—red, orangeyellow, green, blue-violet, and white-tanbrown. For fall, try pomegranate and beet salad, pumpkin soup, citrus roasted Brussels

sprouts, ginger and honey-glazed purple carrots, and pear-parsnip puree. A great app to get you out of a fruit-and-veggie rut is Perfect Produce by SparkPeople, an A-to-Z of fruits and vegetables with nutrition facts, purchase and storage tips, and recipes.

25. Boost your energy, beat the afternoon slump, and stay hydrated with a mid-day, nutrient-dense drink. Try vegetable juice, coconut water, kombucha, nut milk, or a caffeine-free herbal tea with a tablespoon of a sulfite-free dried fruit boost (dried apricots, currants, cherries, goji berries, gooseberries, mango, mulberries, or pineapple).

26. De-stress with daily meditation breaks. Set an alarm for a mid-morning and mid-afternoon. Find a quiet spot to meditate for three to five minutes. Studies show meditation has short- and long-term benefits for energy metabolism, insulin secretion, inflammation, blood pressure, insomnia, pain, and response to stress. Great apps for meditation beginners are The Mindfulness App, Headspace, and Calm.

27. Laugh hard, and laugh often. Laughter is great medicine. It improves depression, anxiety, pain, stress, blood vessel health, immunity, insomnia,

coping and resilience. Laughter is free, can be done anywhere, and it’s contagious! Studies show that one person’s moods, emotions, and behaviors can directly trigger similar ones in other people. So tell some jokes and look for humor in everyday situations.

28. Don’t forget the z-z-z-z’s. Sleep quality and duration directly impact your daily wellbeing and your long-term disease risk. Sleep experts recommend seven to nine hours of uninterrupted sleep per night. Poor quality sleep, sleep deprivation, and oversleeping are linked to obesity, inflammation, heart disease, poor blood sugar control and diabetes, increased bone loss, and impaired memory and Alzheimer’s. Sleep in a dark and quiet room, at a comfortable temperature (not too hot, not too cold), and meet with a sleep expert if you or a sleeping partner snore (which limits deep sleep). A great app to track your sleep is Sleep Cycle. It uses your phone accelerometer and microphone to track movements and noise. After five nights of tracking sleep, Sleep Cycle analyzes sleep quality, time in bed, snoring time, trends associated with weather and air pressure, moon phase, and activity/steps.

— Mary Beth Augustine, RD, CDN, Nutrition

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Building A Better Body

Exercise is key to maintaining good health, but did you know that sticking to the same workout plan can do more harm than good? Here’s how you can avoid injury while you’re sweating it out—and more.

29. Switch up your exercise routine and train appropriately. We see a lot of people repeating the same workout over and over, which can actually be harmful and cause further injury. You should change your exercise routine every three months or so. And remember not to overdo it—it’s a matter of pacing yourself. Spartan Races and Tough Mudders are great, but you can’t just show up and do that kind of a run. You’ve got to train for it appropriately, especially when temperatures drop.

Allow time for extra stretching, as winter weather can reduce flexibility and make you more prone to injury.

Sudden activity puts stress on your muscles, tendons, ligaments, and bones. A tight or infrequently used muscle can easily become strained, pulled, and even torn. The same goes for ligaments and tendons abruptly called upon to work beyond what they’re used to.

30. Work with a physical therapist to heal injuries. There’s a common misconception that if you go to the gym on a regular basis, you won’t benefit from physical therapy. But many people aren’t exercising properly at the gym, which only makes injuries worse. And stretching some parts of the body, like the hip or shoulder, requires help from a therapist. Physical therapists play a more important role than most people realize.

31. When in doubt, get checked, particularly if pain is disrupting your life or an injury is impacting your function. We always look to treat patients with the least invasive approach possible, using noninvasive or minimally invasive techniques to help them safely get back to enjoying normal activities.

32. Safety-proof your home and seasonal activities. We see a tremendous increase in fractures when families bring elderly loved ones home for the holidays, taking them out of their controlled environments. Make the home environment safe—remove loose rugs from the bathroom, fix unstable handles or balusters on the railings. We also see wrist fractures and ankle sprains from people falling on snow and ice, so wear appropriate footwear for the weather. Lifting and moving heavy objects, like boxes of holiday decorations, also takes a toll. Always bend at your knees and hips, rather than your spine, and lift with your legs.

—Asit Shah, MD, PhD, Orthopedics

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A DAY DEVOTED SOLELY TO YOUR HEALTH AND WELL-BEING Nothing affects the quality of your life more than the quality of your health. All around you, at home and at work, people are depending on you to be at your best – and that requires good health and wellness.

At the end of the day, you and one of the program’s co-medical directors create an action plan to address any challenges and position you for better health. You leave with the confidence that you’re in command of your total well-being.

The Braverman Family Executive Wellness Program is designed to provide a comprehensive head-to-toe assessment and wellness evaluation, all in a single visit directed by a dedicated concierge.

IT’S TIME TO PROTECT YOUR MOST IMPORTANT ASSETS Good health is a win-win proposition. Your six-hour investment in yourself will empower you to make important decisions that can directly impact your future. And people depending on you will have peace of mind knowing that you’re taking good care of yourself.

From the moment you enter Englewood Hospital and Medical Center, your health is our center of attention. You are the sole focus of select physicians, nurses, therapists, and technicians.

Your personalized itinerary of exams, lab tests, and consultations is arranged for the most efficient use of your time.

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For more information on The Braverman Family Executive Wellness Program at Englewood Hospital and Medical Center, please call 201-608-2355 or email bravermanwellness@ehmchealth.org.

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Take It To Heart What are the warning signs of heart disease? And how much exercise should you be doing to keep your ticker in tip-top shape? Find out…

33. Know your numbers. Regularly follow up with your doctor to check your blood pressure, lipid profile, and glucose level. If elevated, taking steps to reduce these levels can significantly decrease the risk of developing heart disease.

34. Monitor your progress. Ask for printouts of your lab work or make use of your physician network’s online portal.

Take note of your activity and behavior changes between visits, and any resulting changes in your levels.

35. Build exercise into your weekly schedule so it becomes a habit. Aim for at least 30 minutes of moderate intensity aerobic activity, five days per week.

36. Don’t ignore the warnings signs. If you develop new chest discomfort, difficulty breathing, palpitations, lightheadedness, or a tendency to pass out, be sure to discuss with you doctor as these could be signs of heart disease.

—Andrew Weissman, MD, Cardiology 37. Limit alcohol: Have only drink per day.

38. Stop the salt: Prepare foods with little or no salt.

39. Cut out smoking: If you smoke, even casually, QUIT. 40. Keep sweet in your love life, not in your food: Read labels and minimize the amount of sugar you consume in beverages and prepared foods.

—Sam Suede, MD, Cardiology

Best Foot Forward

Winter’s arrival—and the inevitable chilly temps—don’t have to wreak havoc on your feet. Read on: 41. Stick to a winter foot care routine. Skin tends to dry out during the cold months when dry air and heaters draw moisture away from the body. Dry skin can lead to splits, bleeding, and painful fissures that open your feet to bacteria. Start by moisturizing in the morning to keep skin supple and smooth. Use a heavier moisturizer at night—especially in difficult areas like your heels, toes, and the ball of your foot— and wear warm socks so it can work overnight while you sleep.

42. Invest in a good pair of all-weather boots to prepare for rain, snow, and ice. Look for a waterproof exterior and a comfortable, breathable interior. Boots are better than high-quality sneakers because they usually have a high upper portion to properly stabilize your ankle and tendons when trekking through unstable terrain. If you wear dress shoes to work, carry them in a bag and change when you arrive, or consider wearing shoe covers with rubber gripping on the soles that you can slip over what you’re already wearing. These covers act similarly to snow chains on automobile tires—providing immediate traction for slippery surfaces.

43. Minimize the use of heating elements and accessories. Patients often ask why their feet are affected by neuropathy, but their hands aren’t. The feet are the furthest away from the heart and the cardiovascular core—therefore, the nerves in the foot and ankle are usually the ones to be damaged first. Some sensory nerves are comprised of small diameter fibers that are very sensitive to blood sugar and diabetic pathology. Due to neuropathy and the decreased ability to feel hot temperatures on your feet, I advise avoiding hot water bottles, heat packs, and electric blankets.

Try warm wool socks or polypropylene compression socks instead. And to prevent burns when bathing, always check the temperature of the bath with your hand before putting your feet in the water.

44. Don’t let the cold keep you on the couch. Sitting around all day can lead to lower extremity swelling. If you must stay inside, then be sure to do a few basic leg exercises to keep your blood flowing.

—Kirten Parekh, DPM, Podiatry

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Leg Work Let’s get pumping! Healthy veins will ensure you stay on your toes—and improve your overall health.

Sidestepping Cancer

The good news: According to the National Cancer Institute, the number of people living beyond a cancer diagnosis will rise to almost 19 million by 2024. The even-better news: With our doctor-approved tips, you’ll be on the road to avoiding the disease.

49. Avoid standing for long periods of time, when possible. Doing so can cause vein problems such as varicose veins. If you have a job that requires you to stand for most of the day, take breaks to sit as often as you can.

50. Work to maintain a normal weight.

This will aid not only overall wellness, but also vein wellness.

51. Develop an exercise routine to maintain good muscle function. As the calf muscle pump carries blood from the legs back to the heart, every time you walk your muscles pump blood in that direction. A common myth is that exercising (or lack thereof) can cause vein disease; this is not true.

52. Wear compression stockings to prevent blood clots in the veins or deep vein thrombosis when taking long car rides or flying. While wearing compression stockings will not prevent the progression of vein disease, studies show it can help relieve existing vein problem symptoms, including heaviness, aching, throbbing, and swelling, which get worse at the end of the day.

—Steve Elias, MD, Vein Disease and Vascular Services

45. Consider risk assessment. Based on guidelines from the National Comprehensive Cancer Network, a cancer risk assessment is recommended for individuals with the following personal and/or family history of cancer: a personal diagnosis of cancer younger than age 50; multiple close family members diagnosed with cancer younger than age 50; more than one cancer diagnosed in the same person; or three or more close family members with different types of cancer.

46. Know the risk factors. Additional factors that may put you at high risk for cancer include obesity, a history of smoking, drinking five to seven alcoholic beverages per week, having dense breast tissue, pale complexion, or a large number of freckles or moles, abnormal findings in a breast exam or mammogram, unprotected occupational exposure to chemicals, a diet primarily consisting of red meats and processed foods, and low to moderate level of physical activity.

47. Look into genetic testing. If your individual risk assessment indicates that genetic testing is appropriate for you, our certified professionals will provide you with more information about various testing options, including how to interpret results, their limitations, and what your specific insurance will cover. As the field of cancer genetics continues to evolve, multiple genetic tests are available for cancer risk assessment. Testing is available for breast, colorectal, endometrial/ uterine, gastric (stomach), ovarian, lung, melanoma, and pancreatic cancers, as well as polyposis syndromes.

48. Make a change. Once you know your risks and genetic results, we can offer personalized recommendations for risk-reducing strategies you can use to stay healthy. This may include getting routine screening tests, enrolling in a smoking cessation program, or taking an exercise class.

—Pat Mazzola, APN, Cancer Services and Genetics

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Let’s Get Physical ’Tis the season—to rake leaves and shovel snow. Fortunately, you can perform all those chores without risking injury.

53. Before doing seasonal work outdoors such as raking leaves and shoveling snow, focus on specific stretches to increase your heart rate and promote blood flow, maintain flexibility and continue strength training, and ultimately prevent shoulder injuries and low back pain.

54. Warm up your lower and mid-back when preparing to shovel snow; this is important as the weight of snow is much greater than that of leaves. Place your shovel behind your neck, draping both hands over it; it should look like you are holding the shovel on your shoulders with your arms resting on the handle, which is now across your lower neck and upper shoulders. Begin gently rotating your spine slowly, first left and then right, slightly increasing the radius of the turn each time. Do this for six to 10 repetitions up to three times before you start shoveling. This will promote blood flow to the lower spinal disc region and muscles. If you feel any pain, stop this exercise and do not shovel the snow.

55. Remember to bend and lift from the knees when picking up bags of leaves and moving them to the curb. To stretch beforehand, sit on the floor with your legs straight in front of you. Using one leg at a time, gently push your knees straight down into the floor, holding this position for a count of three. This not only increases blood flow to the knee, but also strengthens the quadriceps muscles.

56. Find a corner in your home where the walls have empty space. As if you were doing a pushup, place each of your hands on the different walls, facing the corner at a diagonal but standing up straight. Take one step toward the corner so your hands are closer to you, but still up against the wall at shoulder height.

You should feel some tightening in the back of your wing bones or scapula. Now move your hands above your head and back down to a starting position, for six to 10 repetitions. This will stretch your latissimus dorsi muscle and the ends of your pectoral and shoulder capsule muscles.

57. Take a few steps back from the corner and stand up straight. Place your hands behind your hips and push firmly on the back and buttock region. Using your hands, gently bend backward so that you are looking up at the ceiling.

Do this gently and slowly for six to 10 repetitions, each time trying to extend a bit more than the last. This will stretch your iliopsoas muscle and some of the anterior abdominal muscles, while allowing your spine to move into a position not commonly used with the amount of sitting and driving we tend to do. If you feel pain in your legs or hips, discontinue this stretch.

—Jeff Pavell, DO, Physical Medicine and Rehabilitation

Combatting the Cold

Frostbite doesn’t just afflict mountain-climbers—you’re at risk any time the temps dip. Find out how you can avoid the wrath of Jack Frost: 58. Be conscious of the cold weather and bundle up. Prevent frostbite on your nose by covering your face with warm clothing, like a wool scarf. This will act as a barrier, allowing warm air to keep your nose from freezing. A common misconception is that you have to climb Mt. Everest or go to the Arctic Circle to get frostbite—in reality, it can happen anywhere.

59. Use a humidifier to restore moisture to the dry winter air. Increasing humidity levels can significantly reduce the ability of airborne viruses to cause flu infections.

60. Properly treat nosebleeds. Often, nosebleeds originate from one side of the nose.

After assessing which side is bleeding, the next step is applying direct pressure. Pinch the front of the nose firmly for at least 10 minutes. Roll up a cotton ball and soak it in Afrin. Gently push it into the side of your nose that’s bleeding and apply pressure. The bleeding should subside significantly.

You can remove the cotton ball after 24 hours. If bleeding continues, contact your primary care doctor.

61. Always wear sunscreen. Even in the winter, your nose can be the number-one sunburn spot due to prolonged sun exposure, usually while skiing at high altitudes. When out and about, you should wear sunscreen with SPF coverage of at least 50.

—Geoffrey Tobias, MD, ENT/Plastic Surgery

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Skin Health 101 We’ve got the truth about your favorite moisturizer, along with tips on how to keep your skin—the body’s largest organ— gorgeously glowing.

62. Moisturize the right way. Despite what the cosmetics industry would like you to believe, dry skin is not wrinkly skin—using moisturizers unfortunately does not slow down the skin-aging process, but dryness does make skin look unhealthy. The trick is to remember that water—not grease—keeps your skin soft, supple and younger-looking, but it must be bound in the skin by lubricating moisturizers. It is wise to use moisturizer throughout the day, but the key time is immediately after bathing or showering when you can trap water in your skin.

63. Protect yourself from the sun, especially when heading for the hills.

Though sun-burning rays are much less intense in Bergen County in the winter and the relative risk of developing skin cancers is lower, using sunscreen is still important. The level of UVA rays does not drop much in the winter, and long-term effects on premature aging of the skin, or even development of melanomas, are not clear. Most important to remember is that reflections off winter snow may be intense, as is ultraviolet radiation at higher elevations. Similarly, if you escape somewhere warm, rent an umbrella when you are beaching. Never sunbathe—doing so is poisonous for your skin!

64. Beware: Fillers are forever. Fillers, such as hyaluronic acid, seem almost miraculous rejuvenators of wrinkly or sagging skin of the face, but bear the supposed disadvantage of non-permanence, lasting only months to a few years depending on type. However, gravity, motion, and natural loss of elasticity make your wrinkling process a dynamic—not static—process that will need repeated readjustment. Permanent fillers may not be removable if your face naturally changes its quality and shape.

65. Keep up with skin checks. Though you will show much less exposed skin in winter, don’t forget your routine skin self-exams, particularly right after bathing or showering. While it’s normal to develop new skin growths as you age, pay particular attention to your own or your partner’s brown spots that may be changing in shape or color— these are very often harmless, but can represent rapidly lethal melanomas. You should never wait to see if a changing brown spot bleeds or becomes painful.

Melanoma is a disease that affects both the old and young; it’s the number one cancer we see in women in their 20s.

Consult with your dermatologist if you are unsure.

—Gary Brauner, MD, Dermatology

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The Antonelli Family, Tuxedo, NY

Little Angelina saved her mom’s life.

Carolina and Matthew were living a fairy tale. Love at first sight, a baby on the way, dreams for their future.

Then, during a routine test fourteen weeks into her pregnancy, Carolina found out she had cervical cancer.

Facing the unthinkable, they turned to Englewood Hospital and Medical Center for answers and hope.

The cancer and maternity teams created a treatment plan grounded in the latest medical advances, partnership, and trust. Carolina is now cancer free, and Angelina – Dad’s “little angel who saved my wife’s life” – is happy and healthy. A team dedicated to fulfilling dreams – one more reason to make Englewood Hospital and Medical Center your hospital for life.

Watch Carolina’s story at englewoodhealth.org/carolina

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National leaders.

Local address.

To find a specialist call 866-980-3462

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