Document 6750

November 2011
Living with
Alzheime 's
I Love
PhenTabz Rx·
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Urology prob1ems can have a huge impa<:1 on one's qu~lity of life.
OUf experts al Specialists in Urology offer leading-edge treatments.
inrxwative researt;h and the ~t ildvall(ed minimally inv.~e su'gkal
procedures. From urinary incontinence to pelvic disorders. sexual
dysfunction to cancer, OUr fellowship trained ~icians in female
urology are here to help.
Spedalists in Urology provides. comfonable, private. <;peei.lile<! pl3(e
for women logo where people whoc"re will liMen. evaluate their problem
and provide treatment thaI wililruly make a difference in their lives.
N. f ranco, M.D•
in Urology
239·434· 6300
C. Langford, 0.0,
R. Rivera, M.D.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHea lthand _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
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Contents November 201 1
6 Sacral Neuromodulation for
Urinary and Fecal Incontinence
Why Isn't My Thyroid
Medication Working?
8 Venous Insufficiency:
17 VAX-O: Non-Surgical Neck
& Back Pain Treatment
Care Reform Turn Back the
Ballroom Dance can $jew the
Progression 01 Alzheimer's
Will President Obama's Health
Clock on Vein Treatments?
Diabetes is Killing Your Heart
Why it is Silent Ischemia
Periodontal Disease and the
Diabetic Patfenl
Protect Your Skin:
Prevent Melanoma
10 What you can do now to
Conquer Aging in the Future
Finding a Health Coach to
Help You Meet Your Health
and Well-being Goals
Aging, Aching Booes
and Joints?
Why Diabetes can Result in
Hard to Heal Wounds
Uving with Alzheimer's
Resolving Erectile Dysfunction
I've Beoomea Warrior
for Health!
Regardless of Your
Age or Medical Condition!
Spiritual Wen ness
Seeking a Vibrant Prayer Ufe
Inflammatory Bowel Disease
(IBO) in Adults
Find us on
14 Taking Control With Inte!"-
mrttent Catheterization
Now m~n of all ag~s can find th~ solution 10 ~re<:tiJ~ dysfunclion and
premature ejaculation and start enjoying a great sex life.
We offer personalized treatment that s fast and easy, with no surgery
or pain. On~ appointm~nI will chanS" your life forevcr.
See Results In Just 1 Visit
and Get Your Sex Life Back!
Our Licensed Physicians Will Help You
South_s t
H~ lth'".., M.~zl,.. C<l1I be tound in (N8f 600 SO<JIt._ I Florida medical lacili!ies inck.>di"O, hospiIal's, CIO<:IOr's, chiroprllClOr" and
<:Ie<1tisl'S oIIioe,. Find a copy of your FREE SO<Jlhw1Ist Florid,', He/lItMW.,I_
Maoa;:ine in rrIO$I grooery and convorVel\Qt . _ as wei
To get your ertlcle publi shed and for ed rates, call 239.389.9449
[email protected]
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Call (239) 693-5200
12650 World Plaza
Building 72, Suite 2
Fort MyCT'S. FL 33907
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os November 2:011 - lee Edition
Sacral Neuromodulation for
Urinary and Fecal Incontinence
By Dr. Carolyn Langlord, of Specialists in Urology
Ilave yoo tried treatment for overactive bladder, urinary incontinence or
fecal incontinence and still suffer
from any of the symptoms below?
• Urgen.:.:y 10 gerlO the restroom in time
, [n.:.:reased frequency of urination
• Gelling up at night 2 ormore times to urinate
• Wearing adult protective undergarments or pads
• Inability 10 empty your bladder C()mpletely
• Curbing your usual ~ivities because you must be a restroom at all times
• Loss of bowel eontrol or fecal soiling
[fyou an: a man or woman who said yes 10 any of these
then yoo should know about an advancOO therapy that
can dmstically improve your quality Qf life.
Commonly used tllerapies such as behavi0T1l1 modification, bladder lnIining and medications an: a fi~tline of
therapy for Q\'eI"aC1ive bladder (DAB).UnfQltWlatcly in
many patients these do 001 wml< or don't worl< well
enough. Some patients may 001 be able tQ IOlerate the
common side effects Qf medications such as dry mouth.
dry eyes or constipation.
F«al incontinence (FI) ean occur alone or in rombination with DAB and can be a socially devastating
problem. After conservative measures such as fiber
therapy. biofeedback or medications have failed many
FI patients are left feeling hopeless. Fortunately, the
FDA has =ently approved the use of sacrnl neummodulation specifically for FI in the United Statcs. It
has been used successfully in Europe for yeaJS and
over 100,000 implants have been placed to date.
Studies have shown that 83% of patients with F! experienced a > 50% reduction in fecal incontinence
episodes per week.
Sacral neuromodulation (SNM) allows regulation
of the nerves that go to the bladder and bowel. This
works by sending mcssages baek to the brain to
regulate the "on-off' switch for bladder and bowel
function. A simple way tQ think of SNM is as a
pacemaker for the bladder and bowel. It can help
improve your pelvic (loor function and possibly
return it 10 nonnal function .
SNM is approved by the FDA for the treatment of
refractory DAB, urge inoonlinen.:.:e, urinary retention and now fecal incontinence. Currently One
rompany (Medtronics, Minneapolis) produces this
SNM device for international use under the name
lnterstim. 11 is also used successfully to treat bowel
dysfunction including severe constipation and fecal
urgency. frequency and fecal soiling. This is
possible because there are nerves in the pelvis that
work On both the bladder and bowel.
SNM is a very appealing option to patients due 10
its high success rate (up to 83%) and a unique trial
phase. This trial phase oD-7 days is called a percutaneous nerve evaluation (PNE) and is a simple procedure that places a thin temporary lead next tQ the
nerve that controls bladder and bowel function.
This can be placed using local anesthesia or with
light sedation, and takes only minutes to perform.
This gives the patient the ability to <"test drive" the
device without going through the full implant. It
also helps patients to gain insight on just how much
the lnterstim could help them. At the end of the trial
the leads are removed in the office without
damaging the nervc.
If the PNE is successful in reducing symptoms it is
likely that the full implant will work in these
patients. The lnte~tim uses an implantable Icad and
small battery that are placed for long tenn treatment
of DA B , urinary retcntion and or fccal incontinence. Once placed, thc [ntc~tim can last up 10
IOy~ depending QIl its use. The banery can be
easily changed under local anesthesia. After
implantation, the Inte~tim is vinually undC1ectable
even in a bathing suit.
[f you or someonc you know has refractory ovcr
active bladder or fecal iocQntinenee sacral neuromodulation may be the answer. Experienced physi_
cians can have success where others have failed.
A full range Qftreatments for DAB. urinary inoon_
tinence and sacral neuromodulation for fecal inrontinence are offered by Dr. LangfordofSpecialists in
Urology. If you would like mQre information
regarding these or any other urologic eoncerns
please contact Dr. Langford at 239-434-6300 or
Dr. Carolyn Langford.
of SpedalislS
unique dis/inc/ion
being the only """,j
cerlifiedftmale urologist in South ..·cst
Florido w h"" ,~.
pleted a 1 year fello .. , ,
ship in ,·aiding dY$_
II""'·' "''''1'';'/''''/''''' ."he
Cleveland Clinic.
,...m lawJe graduate
Universiry and gradrmte of the
Medicine and Dentislry of New Jersey
O$teopiJlhic Medicine
Or: Langford i.! a
Dr. IAngfotd completed her Urologic Sl.rgery
TrainIng 01 the UniVI'TSiry of Medicine and Dentistry
of New Jersey Scltool of O$teOpa1hic MedicUw.
Dun·ng her training she ..-as both Chief Intern and
Chief Urology Resident. She liwrI completed a 1 )'ear
foI11"1tt1hip atthe Cleveland Clinic Flon·da in the sfX'·
cw/ry of Female Urology. PeMc Floor Reconstruc·
tiOll and Male and Female l"caminellCe. Dun·ng her
fellu",ship she ...", imemational fJOP'iT ofthe ymrfar
Sockryfar Urodynamics and Female Urology. In
addition 10 Ihi.! she has been a guesl speaker at
n"""""", educational ,.,.nue$ including the Interna·
tional Urog;mwfogy muting in Atheru. GtUCe.
Among her specwl interulS is the treatment of the
(!Itti", fX'Mc floor a.s a ..·/raJe a.s many ofthe urologic
problems of illCQlttinence and prolapse coaist. TIle",
Mve beeII COWllless llI.Iwmces in ttdmique and male·
ri.lis IMI Dr. lAngfotd keeps herself uptklled (Nt by
ollendingfrequenl specialry meetinfJ$. She is. one ofa
jewdactors in Southwesl Flori(/(). chosen as a clinical
UIs/TuCl()rfar ather physicians by Bos/Ofl Scwmijic.
Dr. lAngford is Board Certified by the American
Board ofO$teopalhic SurgroM.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfhe a _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
lee Edition· November 201 He th & Welllll
Medication Wor
By Robert Gilliland, B.5" D,C.
allY people, especially women,
continue to suffer with hypothymid symptoms despite taking
medication. Is 1M still happening to you desp~e taking
thyroid hormone medication? Do )\lu continue to
struggle with )\lur weigllt despite diet and exercise? Is
)\lur $lUn dl) and ~ctr{? Do)\lu need 10 take a sweater
with)(lu when IW go to a restaurant? Are IW 100 tired
to play with )(Iur children or go out with )\lur friends?
Are you still tired even after S hours 01 sleep? Does hair
ktss continue to be a problem lor )(Iu1 Are )\lu
depressed? Do)OU lack motiVation?
Your thyroid medication was supposed to get rid of )\lur
symptoms, rigllt? So why isn1 IWr Itlyroid medlcabon
worlling? There are a number of things that can cause
)\lur thyroid medication to be ineffectiYe. However, the
first thing I think of whef1 someone tells me their medication isn't working is that they may hlMl an autoimmune tIrfroid , Wtr{?
Hashimoto's Is The Number One Cause Of
Hypothyroid Symptoms
Hashimoto's (an autoimmune diSOl'deo-) is the number
one cause of hypothyroid symptoms in the United
States. Interestingly, women account lor 75'11. of al l
autoimmune diseases,
Hashimoto's Is Often Missed During
Routine Thyroid Screenings.
Wtr{? Routine Itlyroid screening checks yourTSH {thyroid
stimu lating honnone) levels. With Hashimoto's )OUrTSH
level can all)'Wllere 00 the scale. It can be Jew,( normal or
high. ~ nucwil1l!S depending on Ymether)OUr immune
system is attad<ing or is in retreat The TSH level of
someone with Hashimoto's will go up and down with or
without medical intervention.
When JOU have an autoimmune thyroid )OUr immune
system attacks your thyroid tissue, Ymen this happens,
that tissue will release it's thyroid hormooe. causing your
TSH level to decrease. When )OUr immune system SlOpS
its attack. the remaining thyroid tissue doesn1 produce
enough thyroid hormone. causing )(IurTSH level to go
up. Can you see wtr,' routine thyroid testing - checking
your TSH level, can easily miss Hashimoto's,
Routine Thyroid Testing Does Not Include
Testing For Hashimoto's
Another reason to locus on an autOimmune thyroid is the
fact that. even ~ )(Iur doctor SUSpeCl$ Hashimoto's. lie or
she may not test IW for it wtr{! Secause it wil l IlOl change
the way they treat )\lu, Most docto~s idea 01 success is
keeping )OUr TSH level within a vel) broad lab range.
adJustmg and readjusting )\lur thyroid medication as
needed, Sut ~ the underlying autoimmune condition is not
addressed.)\lu will continue to have symptoms.
What Causes An Autoimmune Thyroid?
We still don1 know exactly Ymat causes ~, but most
researchers awee ~'s a mi>ture of genetic susceptibihty
and environmental factors such as iodine (excess). infection, pregnancy, diet and intestinal permeability.
Signs That You May HaYe An Autoimmune Thyroid
• You have other autoimmune disease like
rheumatoid arthrttis or cel iac disease,
• You doctor has to constantly &djust your
tIrfroid medicatioo.
• You are taking a boatload 01 supplements.
• II Iodine makes )\lu r symptoms worse.
How Is Hashimoto's Diagnosed?
A blood test forlPO andjorTBG antibodies will confirm an
autoimmune thyroid. With Hashimoto's, )(Iur immune
system can attack the enzyme lPO (Itlyroid pelOlidase)
Ymich h~ps package iodine into cluster of 3 (T3) or 4 (T4),
13 and 14 are you tIrfroid hormones. Or rt can attack the
pmtein that transportS your thyroid hormone throughout
)\lur 00dv. thyroid binding globulin.
Treating An Autoimmune Thyroid Medically
TI'r(roid hormones are an impOrtalll part of treating Hashimoto's· especially \\tIen TSH is consistently e4eYated and14 an
13 are consistently low. Sut th)'rok:I medication is ooly ooe
piece of the puzzle. and ~ won't be effectiye on its own unless
the autoimmunity and inflammation are addressed.
SWF Natural Health Center
444-3106 ·
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;s November 2:011 - Lee Edition
Venous Insufficiency:
Will President Obama's Health Care Reform
Turn Back the Clock on Vein Treatments?
By Joseph MagnanI, M,o., FAC.s,
f the estimated 35 million adults in the
U.s. ..w suffef /!Om supedicial venous
insufficiency, 0( YeOOllS reftUl disease,
symptoms and signs which cause sigi and disabmty. Until 2000. 1M only treat·
ments ava ilable for patients with significant saphenous
vein Insufficiency were compteSSion hose, high ligation
OJ lig,ltion and stripping. The latter two treatments were
too invasive for patients with
symptoms other than bleeding veins or non-Ilealing leg
OJ ankle venous ulcers. The laodscape 01 venous insufflcieocy treatment was transformed dramaticalf)' by the
introduction of endoYellOUS thermal ablation (seal ing
veins rather than stripping) io 2000. Tl1e radiofrequency
catheter system was the fifSt system apprOYed by the
FDA in 1999 and the LASER system for endovenous
ablation received FDA approval in 2001,
Advances In Venous Insuflldency Treatment
'fides Relief for Millions
Over the past decade, our urKlerstanding of I'!!IIOUS insuffl·
eiency has been ~a\!)' impro.oed as endoYeno\Is ablation
has I:leen applied to pabent:s with a<MInced stageS of
I'!!IIOUS insuflideocy with acelleot results. Supertidal veins
other than the ~t saphenous lein. such as the small
saphenous lein. inle!saphenous lein. anterior aa:essory
saphenous lein and perforating leins are now treatable
with ~ ablation. MOOem ultTasolJnd e'o'aluation
of the lower e4remit)' >enoIIS ~ by experienced
..ascular tedl~ can accurately identify v.tId1 leins
are insufficiellt leaking and the severity of refha Urtra·
sound directed sealing of the abnormall'eins under local
anesthesia has yielded far superior results
than lein ligation or stl'ipplng. The net resu~
has been relief for miHions of patients 'Ml!kIwide and for I'IJndreds of thousands 01 pate'ts., !he lISA.lbs are ~heaIed .,
fflC(W'\I tme. SUISIs derma1itis cI\a,,*,
are being re\'eI'Sed and leg S¥IeIling
and pain is recedng in thousands
of patients 0IICe thou!tlt to be
How wII Pleslde.1t Obama's Health CIftI Program
AHed T110se with Vflnous Disease?
What does the Mure hold for patients with l'enous
insufficiency in the USA? How will President Obama's
health care reform act affect the treatment of patients
with venous disease? H the Canadian Health care
program. wIlich the President has touted as one v.tIicll
sI10uld be emulated. is our window into the fuwre of
health care. the prospeets for patients with venous
insufficiency may oot be so favorable. Uke most other
plrfslcians in southwest Rorida. I often see patients
from Other states and countries during their winter
I'lIcations. In the past 5 )ears. I have seoo a number of
Canadians v.tIo have presented with severe venous
insufficiency. One patient was a 65 )ear old active
woman with terrible leg pain and swelling and was confirmed to have severe great saphenous insufficiency.
Another Canad ian patienL 84 )ears old and active.
presented with a 2 year history of severe stasis dermatitis (~chy alld scaly skin) and 2 months of severe pa in
and muttiple ulcers. Both patients had been treated
with compression hose and had seen their Canad ian
primary care physicians for e'o'aluation. The only treatment for these patients covered under the Canad ian
Health plan was either lig<ltion or ligation and stripping
of the great saphenous vein. They both decided to
obt!\in a second opin ion and sul)sequently underwent
endovenous ablation rather than stripping. at their
personal expense. Both patients were treated successfully with outpatient endovenous closure. under loca l
anesthesia and recovered with minima l to no down
time. Geroera l anesthesia is no longer required. no incisions reqUired. no fasting or lab WO<k needed. no more
I'enollS insufficiency or I'enollS hypertension. The first
patient rewmed for her 3 week follow-up appointment
without leg pain for the first time in )ears. The second
patient's leg ulcers dried up and the stasis dermatitis
alld ulcers healed without incident
To learn more about Venous IllSIJfficiency aod our
amanced. minima lly invasive treatment options.
please oont&ct Vein Specialists at 239·694·VEIN
{8346). or visit lIS online at
The treatment 01 these 2 pat,ents ""th venous insuN,
ciency represents a m,crocosm of the direct,on ,n whic h
med,eal care ,n the Uni ted States ,s head,nlt as we tran
sotJon ,nto the proposed government run health care
system 01 Pres,dent Obama 11 cost conta ,n ment efforts
are locused on restrict,ng access to more modern tec h
nology. ano pat,ents are oHered "hat are perce,veo to t>e
-le55 expensrve- procedures , wh,c h may rn lacl be more
anloquated ~nd rnvasrve treatments. they "rll Irkely opt
nol to see k treatmemlor Iherr med rcal problems . Only
when they df'\lelop severe complrCill ions 01 the d,sease
" rll they seek ~nentJon . In [he case 01 venous rn suH,·
cieney, these camp li cahon5 are leg ul ce rot ion s or
varrcose ,,100 bleed rng. As in Canada and OlM r coun trres
" ith nationa lized hea lth ca re. prrvate and para llel hea lth
care delrvery systems 01 medrcal care wrll Irkely t>e
spa"ned. The olfload ing 01 patrent care responsibi l'ty to
tnese private cl ini cs oNerin g more modern techno logy.
and the shott 01 Ihe I,nancial burden Irom the National
Health care system to the indi",dual patient will serve to
create t\\'O very d,sparate classes of medica l care, Cana
dians ... ,11 likely still come south to the USA fortheor more
modern and readol, ""a ola ble treatments. i)j' prr,ate
cl rnr cs . The questron ,s ...hether Amenca ns " rll tolerate
the rat,onrng 01 healthcare Ilrm'ted numt>er 01 tota l h,p
replacements per month or seve rrty 01 compl ,catrons of
venous drsease ) or accept rng lulllrnanc ral responsrb rl rty
for the mo re ad\'anced , mon,ma lly rnvaSNe treatments
wh,eh have. up untJI nQllo. been covered i)j' most payers
fo ll owrng rs a Irnk to ne'/l' medrca l code~ whICh are p~rt
of the ne'/l' health care system (ICO 10 Cod rn g System),
,"clu d,nlt codes for ,nMY Irom ducks. t u~jes , macaws
and e"en burnrng wate' sk rs: http://onlrne .''Sj .com!
article ema 'l! SB 1000 14240~31119041 03404 5 765
6() 7427 46()211 05 IMrQjAAMTA>:MDI",NjEyNDYjWl.htm l?
mod - wSJ share ema ,1
Changes ,n our hea lth ca re system are el eil~y needed A
mu lbdrse'plrnal)" appmach to address the many aspects
01 our hea ~h care dehvery system rs ,mperatrve to any
mean,ngfu l eHorI at ,mprQllrng the currenl system We
cannot aHord to rgnore thrs probl~m , nor can ....e ~fford to
m~ke ha5ty ~nd rnr;omplete reforms whrch 510nd to
undermr ne the doctor·patient relation5llrp , restroct pabent
access tD modern. m,n,ma lly r....· treatments, stifie
medical and tech nologic ,nn(}\"atJon. and eqland and
extend the l('(feral gG"Iernment's ro le rn determ,nrng who
gets what treatments, .....hen and lor hoI" lo ng. Tori reform.
senous erackoo",n on M('(f,ea,d and Medocare flaud.
portable hea~h ,nsurance across state Irn es wrth consolr
dation of redundant and top heavy ,nsurance admin,stra
toon. ,ncenbves to physic-ans and hea lthcare prw1ders
....t>o care for un, nsured or ind itent patients and block
IJOnlS to states to CO'o'€r Medoca1d and SPilrlo. ,nnovat,on
lIa\'e all t>een pruposed but are not currentl, rneluded rn
Presrdent Obama's hea lth care reform act
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Lee Edition - November 2011 Hf Ith & WelinE
Protect Your Skin: Prevent Melanoma
Riverchase Dermatology and Cosmetic Surgery
Melanoma doesn't always begin as a mole.
It can also occur on otherwise normal-appearing skin.
such as
Nonnal moles are generally
brown or black. wilh a diSlinct border separaling
the mole from your $IIrTOUIIding skin. They're oval or
round and usually smaller than 1/4 inch in diameter
- the size of a pencil eraser.
Mosl people have bel»'Ct" 10 a~d 40 moles. Many
of these develop by age 40. ahhough moles may
change in appearance over time - some may even
disappear wilh age.
elanoma. the most serious type
of skin cancer, develops in the
cells that produce melanin the pigment that gives your skin its color. Melanoma
can also fonn in your eyes and. rarely, in internal
organs. such as your intestines.
lbc exact cause of all melanomas isn't clear. but
e~posure to ultraviolet (UV) radiation from sunlight
or tanning beds increases your risk of developing
melanoma. Other factOTS, such as your genetic
makeup. likely also playa role.
Limiting your sun exposUJC and avoiding tanning
beds can help reduce your risk of melanoma.
Knowing the warning signs of skin cancer can help
ensun.: that cancerous changes arc detected and
treated before the cancer has a chance to spread.
Melanoma can be lrealOO successfully if il is
dclectcd early,
Melanomas can develop anywhere on your body.
but they mosl often develop in areas thai have had
e~posure to the sun. such as your back. legs, arms
and face. Melanomas can also occur in areas lhal
don'l receive much sun exposure, such as the soles
of your feet. palms of your hands and on fingernail
beds. These hidden melanomas are more common in
people with darker skin.
Characteristics of unusual moles that may
indicate melanomas or other skin cancers
follow the A-B-C-D-E guide developed by
the American Academy of Dermatology:
A is 10/ asymmetrical shape. Look for moles with
irregular shapes, such as two very different-looking
B is 10/ in'eg-ular border. Look for moles with irregular,
notched or scalloped bo!ders - characteristics 01
• C is lor chMges in 0010/. Look lor growths that have
many colors 0/ an uneven distribution of color.
• D is for diameter. Look for new growth in a mole
larger than about 1/4 inch.
• E is for evolving. Look 10/ changes over ~ me, such
as a mole that grows in size 0/ that changes color 0/
shape. Moles may also evolve to develop new signs
and SymplomS, such as new itch iness or bleeding.
Other suspicious changes In a mole
may include;
Spreading of pigmem from lhe mole into 1he
surrounding skin
Oozil1g or bl«'ding
Factors that may increase your risk of
melanoma include:
- ski" . Having less pigment (melanin) in
your skin means you have less prolcclion from
damaging UV radialion. If you have blond or red
hair.lighl-colored eyes. and you freckle or sunburn
easily, you're more likely to develop melanoma
than is someone with a darker comple~ion. But
melanoma can devclop in people Wilh darker comple~ions as well.
• A his/f1ry f1[su"bu, ,,. One or more severe. blistering sunburns as a child or leenager can increase
your risk of melanoma as an adult
• Excessive
ul/ra~iolefl/ (U J? light exposure.
UV radiation. which comes from the
sun and from lanning beds, can increase the risk of
skin cancer. including melanoma.
- lIa".;"g ma"y moles M u""s" M moles. Having
more than SO ordinary moles on your body indicates
an increased risk of melanoma. Also. having an
unusual lype of mole increases lhe risk of
E~posure 10
• A[amily hi$tory o[ meianomiL lfa close
relative. such as a parent. child. or sibling
has had melanoma you have a greater chance
of developing il as well.
, Weakened immu"e system, People with
weak immune syslems have an increases risk
of skin cancer This includes people who
have H[VIAI DS and those who have undergone organ lransplanlS.
If you notice any skin changes !hat concern you
visil your family doctor or general prac1ilioncr
right away_ Depending on your situation and the
OUleome of any teslS, you may be referred 10 a
doctor who specializes in skin diseases
(dcnnatologiSl) or to a doctor who specializes in
caocer treatment (onoologisl).
With fOOt convenient locations throughout
Southwes1 Florida, the skilled providers and
staff of Riverchase Dermatology and Cosmetic
Surgery arc happy to answer any ~tions you
may have about melanoma Of ather skin issues.
Contact the office nearest you today if you are
concerned about any changes you notice on your skin.
00 ......
"""" ......
Il10 ... I.....
f50N,COO ... ' ...... iIOJ
F.r1 MJc_ Coni
The first melanoma symptoms often are;
Cancerous (malignant) moles vary greally in
IllIG_o., 1.2S¥Isu7o....,.. 'I02
• A change in an exiSling mole
appearance. Same may show all of the changes
• lbc development ofa new, unUSWII-looking
lislOO above, while others may have only one ortwo
unusual cha.-aclerislics.
groWlh on your skin
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
& We
S$ November 201 1 - lee Edition
'¢' What you can do now to Conquer
Aging in the Future
new trend on the anti-aging front
is having facial procedures done
at an earlier age than ever before.
Staning early has some real benefits. Patients used
to wail until lines and wrinkles became creases
and sagging skin and the only solution was an
invasive face lift or some type of plastic surgery.
Today, doing certain OOII-invasive treatments in
your 30$. 4Os. and 50s may preserve the stn,Jctun:
of your face hailing orevrn slOpping the hands of
time for a younger, more rejuvenated look.
I. Unes &Wrinkles
2. Under Eye$
3.VoIOO1e Loss
In Your 30s
The very first lines and wrinkles fonn around the
eyes and mouth and on the forehead. Slight bags
under the eyes may also become noticeable. With
the use of Ik>to~ and fillers yOll are less likely 10
develop lines and wrinkles. Staning Botox in your
early 30' s is now cormnon practice. Patients now
use 801'1:< for p~tative purposes and 10
reshape the jawline and lift Ihe brows. In your 30's
lines and wrinkles start to develop bul you can
inhibit their progression with injections as a pre_
ventative measure. You can also USC the same
approach to treat and correct any of nature's
, Brow.
2. Crow's Feet
l.l.ower nee
In Your 40s
50 S
Botox is becoming better known for being a " b,ow
iJlaper" in addition to its association as a wrinkle
freezcr. An ideal treatment for those with relatively
low brows, BolOx works by weakening the mu""lc in
the forehead that pulls on the browline. lifting and
cievating it back to a I1'I01"e desirable position. To
reduce the appearance of Cr(IW'S fe<.:t and prevent new
ones from fonning Dr. Stanciu injects the area with
Bo!o~. In your 20s and 30s, you should usc Boto~ as a
way to prevent crow's feel and soften any lines. As
you age. BotOlt Cosmetic!! can be used 10 tn:at these
lines and ntake them less visible.
Fillers in your 40 '5
With age oomes changes in facial fat, and this loss of
volume results in nasolabial folds: the lines that stretch
from your nose 10 your mQUth. The I1'I01"e fat that'S lost,
the I1'I01"e prominent they are. Hyaluronic acid filleTS
like Juvcdcnn and Restylane arc best used 10 correct
and smooth out the5\: lines. f or patients that complain
of somewhat deeper folds. Dr. Stanciu may inject the
cheeks with a bit of filler 100, 10 lift the fold. To
augment thin lipS Dr. Stanciu uses the same acid based
filleTS to add volume and plump youthful lipS.
D iscover your Foun tain of
Augmenting the cheeks can delay aging due to
enhanced suppa". Adding volume to the ehe<.:k
You,h by ca ll;ng 239.9"9.2020
to scht'<l ul c your FREE consultation or
";Sil Our we bsite www.stani to
see some tile ama •.in g Irnnsfomlations of
some of our patients.
!!a~Sta~,~~1f~Fc;.0~,';C~i~0~1. ~~;~E~~;,,~~re~.:~1.asef COOter
is a facial rejwenation specialist and inject·
able treatment ~rt..oo has been perlonning these procedures for Ole( 10 rears With excel lent results. She specializes
In aest!letic procedures such as the European Face Uft. BotoIC CosmetJol), and all dermal fillers. lip augmentation and
Ble?haroplasty or eye lid lifts cosmetic and functional. Of. Stanciu is a memtler of the American Academy of Cosmetic
Surgery and frequently attends aesthetic meeting<; nationally and internationally.
Lower Face
Euro~.n Face Lift
& Beyond
Get on Eleva ted Look:
Fillers in your 30'5
area, fills in hollows and folds. gives fullness and
prevents gravity from pulling on the muscles so the
cheeks woo't deflale. Both hyaluronic injectables
and collagen slimulating fillers can reinstate definition to the cheeks, giving a more defined profile.
In Your 50S and Beyond
Ikcau,c thc '~IIl ,urnnmd ing lil~ cyc, " thc
til innc·,t anJ ",,,,I lk li cat~ III ",,' h""Ji~,. ;t',
t,pICally til" rLN pb"c 10 ,h,,,, "~r" of ,,~m ~
\\'h,1t.- n",,.,nV"'''l· p"'''·l·dur ..·, help put <llf
",,~cry. Ii" m",,,. ,,,,,,.,ur~ICal option, '''c
J"'t n"t <lu"e e""ugh
L,d,d ,urge"
(tc<h",<aliv <alb] Bl~pha"'I'Ia't\ t"" P"'''c,
durc I" "''''''''' ,"cC" ,~'" ,,,,,I I,,, Ii-om thc
~ychd" It i, ""~ "f thl' n""t """,,,,,,n ,·",m~tI"
p"""c,lu",, p.:rli>nnc,1 '" rhc I'S. CTC'''ITl~ "
,<luthru I 10'" hy "'"'''' I ng I'll. 'k m. and
()r mLJ,,'k Iro'" th~ ~,'did" I'" ~hd ,,"~~rv "m
"o",d d,oopmg uP!"" 1id, Ihat ",a~c ,0" I "o~
tlrl·d. "Idl" '" ;mgr, In "'''". l·'tr~m~ C;"l', it
lMY mtcrICrc" itil yo,,,, "'011
D,5cover Your Fountain af youth
IO"TO!",an Face l. 11t " a IlIlL<llI, ,-., .... ,,1 'qu, ~na·
t,,,,, trcatm~nt that Ilr. SI,," " ou dc, d"l"'d ,,,.,,,
" ltcm'UlI" t" 'ur~",y II, S"lnC"", I""hn ,<!"c
"f n"id tac~ ,,:lL lptmg "nd litimg c'<,,,,hinc,
d"n",,1 r,lk" ","h '''icc(ahk, "",h 'IS Boto,"
CO'lllelle In ",dcc t<l ,'nnw\" ,mkle, m d,]fer·
~nl "ay'
I'h~", "O"TI~tlC
f,llc" ",,'h '"
Ju"cdcr",". R"tybn~'. and R"d ic"e.
r~plal'~ 1,,,( \"Iu",~ and ,~,t"rc' '''''lhi'u l
conto\'" 10 Ih, ,km. "'H~,tlll Tl~ '''''';
"'rinkit.-, In wllt .. ,,1 Il"t"~ ("'Illl·tle.
Te la,,·, rhc """d~, 110,,1 ,"Ll'~ fro"" bnc'
ixt"ecn thc eych"",,> I'hc c'<,mbmalwn or
the," I'mdUch in thc h,,,,d, "I' a ,ki ll fu l
IL'" II, S"lnC'" ",,,,Id g"" rc,,,lh
In or 1x·1t,·, tha" an il1\ ,,, i\ t' tlC'~ 11ft " ilh
m inlTl\,,1 r"lT'. rHl rc-.;m cry IlTnc. ,",,(a,,1 rc,,, Irand "gllllicallt linanelal ,," lng,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
th & Wellno,
lee Edition - November 2011 H
Finding a Health Coach to Help You
Meet Your Health and Well-being Goals
By Deborah Lee, PhD, AN
n the last edition of Healtll & Wellness
Magazine, we explored tile topic of [email protected]
healtll coach ing, Mlat it is and Mlat it isn't As
a review, integrative health coaches worll witll individuals
who seek to im pKM! any area of healtll and well-being in
their life sllCh as nutrition and p/lySJcal activity, wor\<
isstJes. relationshipS isstJes and worll-Iffe ba lance.
Healtll is seen as more than pl'tfSical healtll and encompasses every aspect of 11 person's life incll/ding prole$-sJoJlllI and personal developmenL mind-bolly-Spirit
connection, environment. etc.
What is the Coach's Background
and Tl-aining?
WOrl<ing wltll a healtll coach. individua ls develop their
health and weliness!'PIIls and the health coach assists
them in development and execution of 11 plan to achieve
their !'PIlls and provides the suppOrt motivation and
acaJuntably so the cl ient is more likely to achieve their
!'PIlls for long.term sllSta inable behavior change. The
process is based in the relationship between the client
and the health coach. Unlike uaditional models of care
where the health care pro-;ider tells the patient/client
what they need to do. the agenda in a hea lth coaching
relationsh ip is set by tile cI ienL not by the heatth coach.
, Did they complete the entire training ~m?
How to Find a Reputable Health Coach
00 ~u know there is no standardized training, no lega l
requ irement and no specific level of edvcation to be a
heatth coach (or any other type of coach SlJch as a life
coach or executive coach ' )? Health coaches do not
need a license to call themselves coaches or to po-actice
their trade. Anyone can hang out a shingle as a health
coach (or any other type of coach) and pro-;ide services
with no formal degree or training. There are Qvestions
~u can ask wilen selecting a health coach to help ~u
select a coach who best meets )OUr needs.
"'t""Odeos ,,,,.",'oacmg
• 00 tIley haYe a professioJlllI degree to augment
their heatth coachin(r'
, Which health coach training program did
they atterld?
, How many Ilours of training did they rece~?
, How was the training deI~red (oo-site. distance
leaming, or a combination)?
, Are they a certified health coach? certification
means the person has completed extensive training
and has at least 100 hours of coaching time as part
of the certification process. certifICation should
take seYef(ll months arid depending on the level of
certilieation, seYef(ll years. certification should
require completion of an el\ilm, either oral or
written, and in some cases both .
For health coaChing, ~u most likely want to select a
person with a backgound in a health profession or allied
health profession, such as nursing, nutrition (registered
dietician). health education, medical social worlc. etc. An
irldi'lidual with a degree in a health profession , depending on the profession, was required to pass 11 licensing
ellilm. wIlich means they meet the minimum standard to
practice in their field. Why is this imponam? Because
there is no educational or training requirement for
coaches. ~u should haw some level of comfort that the
person has an understanding through their professiona l
train ing of health and wellness and WO<1\ing with people
who hltYe health chal lenges.
A good e.xample of the importance of ~ur health coaell 's
qualifications comes into play for those wIlo have a
chronic health condition or are dealing with an isstJe that
impacts their health. Oiabetes is a comple>; cond i~on
that requires a muttifaceted approach to mitigate complications that can arise. While the health coac!l does
nOI need to be an expert in diabetes, they do need to
hltYe an understanding of the cond ition. Your health
coach needs to know how to wor\< with !he regimen the
pl'tfSician has identified and how to complement the
other resources that may be 8Vl'Iilable, such as a
diabetes educator and/or a registered dietician. These
pmYiders will give jou information on how to check ;our
blood sugar, how to recognire the symptoms il ~ur
glucose level is too high or too low. and counsel ~u on
what to eat to manage ;our blood sugar. This information
is invaluable. The integrative health coach does not
replace these proyiders. The integratiYe health coaell
works with )OU to figure out how to reduce the challenges
of living with diabetes by helpOng jOO develop a plan for
how to keep ~urself healthy and focus on ~ur wellbeing. What is different is that the integrative healtll
coach's approach is centered on what the person wants,
and by being centered on the person and their desires
for their Iffe, behill'ior change is more likely to result
' SpoIls coechlnC ..... Illness _
to 110
In II1Is . _ .
and not Intended
DebGnlh 1M, PhD. RN is an
Integrative Health Coach and
President of Better Choices
Keaith Coaching based in
Naples. She received her
train ing at Duke Integrative
Medicine's Integrative Health
Coach Professional Traini ng
Program wIlere she is currently working towards certifICation as an Integrative Health Coach. She 30 years
of professional and personal e>:perience to her integrative health coaching practice. After working as a
hospital and home care nurse, researcher. university
professor, public health professional and health care
administrator in the U.S. and Canada. she decided to
retum to the root of why she became a nurse; to help
people feel better and stay healthy, Oebo rah can be
reached at Deborah.
or _.BettertholcesHealthCoar;
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
S5 November 201 1 - lee Edition
Aging, aching bones and joints?
Take three steps to better health
By John C. Kagan, M.D.
Bone and joint pain is one of the 101' reported
health problen1S and a leading cause of severe
long·\C"nTt pain and disability. Given the aging
baby boom population. changes in risk factors and
increasing life cxpcctancy. bone and joint
problems are predieted to increase greatly. As an
orthopedic surgeon, my goal is 10 empower
patients to panieipate in decisions about their f,;arc
and treatment.
any people consider aching
bones and joints as cQmmOn
signs ofaging. While the aging
process docs result in loss of muscle mass and
bone tissue, which Can contribute to bone and
joinl problems. there
steps you can take 10
remain active and healthy as you age.
What happens to our bodies as we age?
As we age. our mU!iCles begin to shrink and lose
maSS. While Ihis is a natural process, a sedentary
lifestyle csn accelerate it. In addition. muscle
fibers and tendon lissues also decrease as we
age, resulting in stifTer muscles. As Our muscle
mass decreases. we lose strength. making il dif_
ficult to perfonn everyday tasks such as opening
jars. The heart muscle is also impacted and the
decrease in blood flow tan CIUse people to tire
as they age. As the body slows, a person's
metabolism begins 10 slow down and un lead 10
obesity and high f,;holesteroL In addition to
changcs in our musele lOne. the aging process
also resulls in loss of bone tissue. As we age. Our
bones lose mass and be<.:ome more fragile. This
can cause osteoporosis. which affects both men
and wOmen and Can result in bone fractures. In
additi.;,". the cushioning cartilage between bones
breaks down and can cause painful, inflamed
joints leading to osteoarthritis.
What steps can I take to Improve bones
and joint health?
Allhough the fragility of bones and joints
increases as we get older. many of the changcs in
muscles. joints and bones are due to lack of use,
rather than simply getting older.
There are things you Can do to help prevent
injury and anhritis. Below are three steps to help
maintain optimal bone density and heallh:
• Get your recommended value of Calcium and
Vitamin D - Calcium is essential 10 maintain
strong bones and teeth. however, your body does
not produce calcium naturally. Instead, calcium must
be absorbed from your dietary intake. There are
many sourees of calcium: green leafy vegetables.
mi lk and other dairy products.. salmon, almonds. tofu
and any food products. fortified with calcium.
Vitamin D is important for bone health be<.:ause it
aids the body in absorbing calcium. Talk with your
doctor to make sure that you are gening your daily
requirement of vitamin O.
As always, consult a physician befo,,", taking any
medications, vitamin supplements or beginning
an exercise regime. For more infonnation on
ways to maintain healthy joints and bones or to
dis<:= trcannenl oprions, call 239-936-6778 or
visit For more useful
tips on your bone and joint health and updates
practice. visit my bing al
on Facebook and on Twiner.
• Know your body - If you have had fractures in
the past. you're more likely to have them in the
future. Be aware of your body's limitations and pain
threshold. Reduce your risk of falls and fractures by
having your physidan f,;hock your eyesight. prescription medications and balance to assess your risk of
falls and tips for preventing falls that can lead to
broken bones and aching joints.
• Exercise - Less than 10 pereent of Americans
participate in regular exercise. It·s crucial to
maintain an exereise regimen al any age. To
maximize bone heallh, try weight bearing exercises
lih running. walking or yoga. Stretching is also an
excellent way to help maintain flexible joints..
Walking, dancing, bicycling and swimming are also
good options. Regular ph~ical activity f,;an slow
loss of mUs<:le mass and reduce your risk of developing high blood pressure, heart disease, and some
forms ofcanf,;er.
l\ "t
10..0(""'''00",""''''''' ,UI.'""
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
lee Edition - November 2011
n 3<
Inflammatory Bowel Disease
(IBD) in Adults
By Michael H. Weiss, MD, FACG
nflammalory bowel disease is an autoim·
mune «mdition where the body 's immune
defense systems sees something foreign in
the gastrointCSlinal tract, and causes white blood cells
10 go and attack the intestines. Many different1heories
as 10 what causes the inflammation to stan have been
investigated. but 10 dale none have been proven.
The two types of [nflammatory Bowel Disease are
Ulcerative Colitis and Crohn's disease. The distinction hetween the two are based upon where the
GJ tract is involved with the inflammation. and
whether the inflammation can penetrate all the
way through the howel wall Or is confined to the
interior surface or lining of the howeL
Both forms of IBD can cause diarrhea which may
be bloody, frequent howel movements or diarrhea.
and abdominal cramps or pain. In addition.
patients may lose weight, have fevers, mouth
uleers, or develop symptoms outside the intestinal
tract such as anhritis, swollen joints, skin lesions.
Or visual symptoms and eye redness.
~Gastroenterology Associates
• 01 S.W. Florida. P.".
For the diagnosis of lBO, usually a patient would
have stool tests done to rule out infections, and
then likely be referred to a gastrointestinal specialist for a sigmoidoscopy Or colonoscopy, procedures thaI allow the doctor to look inside the colon
(large intestinc) to get biopsies which help them
come up with the proper diagnosis . ColonOs<':opies
are usually done with the patient completely
asleep, and therefore are painless.
After a diagnosis is established, treatment consists
of medications to decrease or stop the inflammation of the intestines. These include anti-inflammatory medications that work like aspirin inside
the intestinal lining, and sometimes strongcr medication that alters the bodies immune system to stop
the white blood cells from allacking the inlestines
in the first place.
Some people find that altering their diet helps to
contro l the symptoms, but no specific diet has
been proven to heal the inflammation. Avoiding
aspirin medications such as motrin or advil can
help the bowel recover from the inflammation .
Stopping smoking also plays a large role in
healing the disease .
Treatment for severe inflammation docs occasionally require surgery, but the goal of medical
therapy is to prevent surgery and preserve normal
howel function. Unfonunatcly, IBD is a lifelong
disea!iC and requires monitoring and treatment by a
well trained physician. Most patients with either of
the inflammalOry howel diseases live long and
productive lives.
Michael H. Weiss, M .D.
Board-Nrli/iM GIlS' nH'nler%giJl
Dr. Weiss joined Gastroenterology Associates of S. W. Florida,
P.A. In [995 . Dr.
Weiss received his
Medical Degree from
the University of South
Florida College of Medicine. Tampa, Florida. He
completed his Post-graduate training in Internal
Medicine and his Gastroenterology Fellowship at
Wilford Hall USAF Medical Genler, Lackland Air
Foree Base. TX. Dr. Weiss is a fellow of the
Ame-rican College of Gastroenterology.
Free Seminar
--_.""-,._- ___
Thursday, November 10th - 5:30pm
..."'.' ....
""-'- '-
_ ~_"" ' _ ' _'-"""'>a_ '
Learn about a DRUG FREE altema1lve iliaC will dlaoge your life!
Limited Seating ... call Now! 239-444-3106
SWF Katural Health Center
Riverview Center Blvd., Bonita
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
S$ November 201 1 - lee Edition
By Urological Supplies, Inc.
Taking Control with Intemaittent
SeIf·Catheterization (ISC)
It is important 10 ask your health<;= provider
which method for managing neurological bladder
dysfunction is best for you. Intermittent self_
catheterization (lSC) may be rcrommendcd. II is
the regular, temporary insertion ofa catheter into
Ihe bladder to drain urine. Many consider ;110 be
the preferred method for bladder control because
of convenience and discretion compared to other
collection devices or absorbent products. Additionally, many benefit frQrn a reduction in urinary
lracl infections with [SC. However. 10 ensure Ihal
Catheter Eyelets
Eyelets an: the small holes at the tip ofa cathctcr. To
assure passage through the urethra to the bladder
without trawna, it is critical to consider the eyelet
quality when selecting a catheter. Thcy fall inlO two
main categones:
• Cold Punched eyelets are produced using a lesser
expensive manufacturing method which results in
ragged, sharp edges that can cause irritalion.
• Poli$h~ eyelets ""luire additional manufacturing
steps to finish the edges for a smooth transition
between the eyelets and the catheter surface for
maximum comfon.
the full benefit of ISC is experien,,;d, use of a
quality calheter is essential.
What You Should Know
Catheter features can have a significant immediate
and long-term physical impact 10 safety and
comfort. Heallhcare providers and medical
product suppliers an: excellent resources fw
understanding catheter options. Another means for
selecting a catheter is to oonsider distinct features
such as material oontrnt and eyelet quality.
Material Content
• L"tu: is a COmmOn material used by many
calheler manufacturers. [t can be an irritant to
many individuals and for some, even the s[ightest e~posul"<' to it can cause an immediate, life_
threatening allergic reaction. The amount of
[ate~ e~posure needed to produce sensiti,vnion
or an allergic reaction is unknown however, it
has been shown that incl"<'asing Ihe e~posure to
late~ proteins increases the risk of developing
allergic symptoms.
• DEJlP, Di(2-ethy[he~yl) phtha[ate·, is a
chemical additive used to make plastic (such as
PVC) flexible. 11 has been banned from
children's ure anicles and toys because it can
pose a scrious health risk however, up to 28% of
the PVC used my most catheter manufacturers
contains DEH P.
• For infomunion OIl DEHP, "'" CA EPA Off",. orEnv. Heatth
Huard A>senmen, liS! of ~ Known 10 the Stole 10
c..... Cone« or R<prodUCIi •• T",icity. Dec. 8. 2006.
Cure Medical Catheters - Proven Function
& PromiSing Furunl
Cure Medical cathelers function like olher SCI
products that you may all"<'ady be familiar with .
There is nothing new to learn. The big difference is
Ihal ONLY the Cure Calhi!l and Cure C",hi!l
Closed System. enable the advantages of ISC bladder
control with all these product-specific benefits:
• Always lalex_free fw safety
• Always DEHP-free
• Always feature smooth, polished eyelets for
maximum oornfon
• Plus, an e~clusive commitment to contribute to
research for a cure for SCI & CNSJD
CuI"<' Medical offers the sterile. single-use Cure
Ca/hef~ in pediatric. female, and male sizes with
a straight tip in 8-18 French size~. The male catheter
is also available with a coude tip.
Additionally. Cure Medical offers a sterile. unisex
Cure Cil/hete"" Closed System featuring a prelubricated straight tip catheter with integrated 1500
ml collection bag as Singles or in Kit configurations. Kits include a nonstaining BZK wipe. Ihree
povidone-iodine swabsticks, one pair of ambidextrous gloves. a sterile wipe. and an underpad.
_____________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Hearing For Life Since 1950
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1890 Soo'imer&1 Lakes Drive, Rlrt M~ Florida 33907 I 239·768-6396
2828 lamlamiTrajl~. Na~11orida
16251 N. Clevellind Ave. I S
(comer of LittlelOll Ad.)
341031 239-687-2165
North Fort Myers, FL 33903
Attend Dr. Kagan's
next Ask and
Answer Seminar:
December 10
10a.m. to Noon
From frequently asked Questions to the most complex
and unique orthopaedic cases, Dr. John C. Kagan has
been providing Southwest Florida patients w~h answers
HealthPark Medical Center
9981 S. HeeltbPark 0,.
Fort Myers, Rooms 201·202
and treatment options for more than 30 years.
Get answers to your questions about joint pain and
all your orthopaedic needs. For a consultation, call
Dr. Kagan today at 2J9·936-6778.
~ ~
(I.mao O"HOP. '""
For reservations. call
239-9J6...6778 eKt. 2221.
Visit to
register online and for more
information. Space is limited.
.A ,.
~ Tu m ph'lfi<:~n $I""" 2Q(}() lor
Blog: www.koog.onb o _IIb."""' . .....
. . ..
FORTM'fERS, 3210~andAve.. Suite l 00
~ Fl33901
CAPt CORAl.: 2nl Del Prado BIYd .. Su~e 260
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealth _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
r & We
November 201 1 - Lee Edition
By Eric D. Rosenkrantz MD
schcmia is a condition where Ihe flow of
oxygen-rich blood to a pan <>flhe body is
restricted. Cardiac ischemia refers to lack
of blood flow and oxygen \0 Ihe heart muscle.
Cardiac ischemia happens when an artery
bcromcs narrowed or blocked for a shon lime,
preventing oxygen-rich blood from reaching the
hean . If ischemia is severe '1r lasts too long, it
can cause a hean attack (myocardial infarction)
and can lead \0 heart tissue death. In most cases,
What are the symptoms of silent ischemia?
a temp<Jrary blood shortage to Ihe hean causes
Silent ischemia has no symptoms. But researchers
have found that if you have episodes of sweating, you
may also have episodes of silent iscbcmia.
Ihe pain of angina pectoris. BUI in olher cases,
there is nO pain. These cases are called silent
ischemia. It can be oommon wilh diabetes.
How Is siloot ischemia diagnosed?
Silent ischemia may also disturb the hean's
rhythm. Abnormal rhythms such as ventricular
\.aChycardia or ventricular fibrillation can inter-
fere wilh the heart's pumping ability and can
cause fainting '1r even sudden cardiac death.
How common is silent ischemia, and
who is at risk?
The American Hean Association estimates that 3
to 4 million Americans have episodes of silent
ischemia. People who have had previous hean
attacks or those who have diabetes are especially
at risk for developing silent ischemia.
The following teslS can be used 10 diagnose silent
• An exercise stress test can show blood flow
through your coronary aneries in responsc 10 exercise.
usually walking on a treadmill.
• Holter monitoring records your hean rate and
rhythm over a 24·hour period (or longer). You wear
a recording device (the Holter monitor), whieh is
connected to disks on your chest Doctors can Ihen
look at the printout of the recording to find out if
you have had episodes of silent ischemia while you
were wearing the HolTer monitor.
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lee Edition - Novembe r 2011
n'" We
" 17
VAX-D: Non-Surgical
Neck & Back Pain Treatment
By Physicians
hronic pain is one of tile most debilitating health conditions. Studies show thaI
back and neck paIn is often re<:urrent
even if the original problem 1l!SOIYes, many patients
suffer chronic symptoms at intervals. Chronic back and
neck pain SlJffere!S olten live a Ine of compromise in their
daily activities.
Back and neck pa in is frequently treated in an epjsodic
manner. Treatment options /0( both back and neck pain
irlClude drugs, heat and cold, bed·rest, chiropractiC!
manipulation. physical therapy. eJcen::ises, acupuncture.
local epidural injections, prolotherapy, ID£T (IntradisGal
Electrothermal Therapy or heat cauterilation with an
electrothermal catheter) and the various typeS of SlJrgery.
Before resoning to a SlJrgical approach, it makes
sense to fJY a conservatiVe procedure, VAX·D. It is
known that the many forms 01 'traction' and gravity
inversion have not demonstrated the ability to lower
the intradiscal pressure. Clinical study has now docu·
mented VAX·D's ability to lower intradiscal pressure
{Ramos G., Martin W. Journal of Neurosurgery).
Decompression of the discs and spinal structures is
achiel'ed under precisely controlled. mon~ored conditions with no invasion or disruption of the spine's
norma l biornec/1anOcs.
Many of these are simply aimed at providing temporary
reduction of symptoms without altering the underlying
disease process or addressing the pathophysiology
aSSOCiated with lumbar discogenic disorders.
Surgical decompression of intervertebral discs has been
established for the management of low back pain and
sciatic pain in selected cases. Surgery may disrupt the
natura l biomechanical functions essential to preserve
pain·free spina l mobility. The majority of LBP patients are
not idea l SlJrgical candidates, and SlJrgery in the pOOrly
selected patient can lead to 'failed back syndrome'.
VAX-O Genesis is a !leW computerized treatmeot for
chronic neck pain, low back pain and sciatica. The
treatment is safe and effective without the risks of
injections. anesthesia or surgery.
VAX·D treatmeot is designed to relieve the pressure on
the Slnlctures that may be causing chronic spinal
pain. It can relieve the pain associated with hefniated
discs, degenerative disc disease, and sciatica. VAX·D
is the only bacll treatment device that has been shown
to decrease tile disc pressure in dinical resean::h.
VAX-O distracts the spine. taking the pressure off of
the discs and spinal nerves, and allows the back to
heal itseH. Many patients experience a relief of their
pain and other symptoms during tile treatment
sessions, and theo a gradual reduction in symptoms
as treatment progresses.
Patients find the treatment to be comfortable and
relaxing. All treatments are administered with patients
fully clothed. Ooth ing thaI separates at tile waist and
that can be loosened at the wrists and neck is most
sna.wZlNG rN
& NECKf\\rN
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November 20 11 • l ee Ed,tion
Ballroom Dance Can Slow the
Progression of Alzheimer's
By Theo and Ganine DeI'IoIh
foI't Myers Fred AsIairv Dance Studio
oday, we face a real fear of oot
n:membering who we are, the
people around us and the prC<'ious
mo:mories o f our past could be lost forever.
fkca~ we live so much longer, Alzheimer's
di$USe has bcromc • legitimate thn:cal 10 all W(:
know. Recent studies show a few positive ways
10 slow its progression. A 21-year-old study in
the New England Journal of Medicine has
proven that frequent ballroom dance
leSSOlls reduces Alzheimer's disease: by an
amazing 76%. WOW!
Danelng Stimulates the Brain
Our bnin oonsuntly n:wi~ its neural palhways
as needed; and if il doesn~ need 10, il "''OfI~.
Which mearu iI's impot"Wll 10 involve yourself
in aclivilies Ihat require splil-KCOnd. rapid-fire
doeision· making. In partncr dancing, we are
cilher leading or following another ~rson and
Ihis requirn into:nsc: focu, of when: we are in
'pace and oonsunl adjustments in our balance.
weight clwtgcs. in poslure, in di~, simultaneously involving kinesthetic, rational, musital
and emoIional processes. We tan dance our way
10 bener health because daneing integrates
several brain functions at once and will stimulate
the connectivity of the brain by generating the
need for new pathways.
DancIng for Diabetes
Anolher ~weighly~ issue affecling millions of
Americans is Diabetes. We eU!Rntly have a
teenage dance studenl who becllm diabetic
after a virus infected herpancn:llI . She relies on
an insulin pump, constant moniloring and
cxcl"(;i se to achieve normalcy in her life. Her
parents, both in the medical field, have found
Ihal Ballroom and Latin Dancing lessons hold
her interest, challenge her mind and body and
provide the physical workout she: needs 10
maintain a healthy lifestyle.
Dsnelng Bums Cams and Promotes
weight l oss
Diet control, medicalion. and weigbt control will assist
I CQo1ipl0i1t.ised panctUS to have. near normal blood
supr level, Cells always need fuel and insulin is the:
body'. helper to 1I1CIabolizc carbohydrates inlO fuel.
Increasing the amount offuelthal the: ~ll$ use through
exercise will cut down the amount ofinsulin the body
roquirn. A higb aerobic-low impact activity. ballroom
dancing ine~ascs our metabolic rate and bums tons of
calories while improving circulation. In other wvrds,
danei", intn:ascs energy, whi<;h bums olt" caJbs and
promotes weight loss, tbermy taking the: burden orr
the: pancn:as to produo.:e.
Ballroom Dancing: Elterclse for the
Body and Bralnl
Ballroom dancing is e~ereillC for both the body
and the brain. It's fun and I proven method for
improving our quality (If life. Isn't il time you
cQIIsidercd dancing your way through life? Not
only ((If the fun ofit, but for the health ofil. To
learn mon:, tall the Fort Myers Fred ASlain:
Dance Studio al 239-939-1517, or visit our
website at See
you at the studio!
call 239-939-1517 or viSit our website at
_ _ _ __ _ _ _ __ _ _ __ _ _ _ _ ___ www .swfHealthandWellness .com _ _ __ _ _ __ _ _ _ __ _ _ __ _ _ __
lee Edition - November 2011
lh & We
Hearing Loss Linked to Diabetes
and Alzheimer's
ByW.L - Hunter" Huntley, III, Be·HIS
" Proper" stimulation 10 the porti.;," of the brain that
interprets spee.:h is critical; othctwise it will lose
function, Studies at John's Hopkins indicated even
individuals with mild hearing loss arc twice as
likely to suffer from dementia and Alzheimer's,
Those with sevCTe hearing impairment arc five
times as likely to dcvelop these maladies_
he month of November. is designated
as Diabetes and AlzheImer's AwareneSS Month. This is designed 10 e.:Iucate and make the general public more aware of these
diseases that amict thousands of Americans everyday.
Free Hearing Eva luation
If you Qr a loved Qnc sus~ts that YQur hearing
may not be up to par, call us today for a FREE. no
obligation hearing evaluation. To learn more, .:all
leonardi Ilearing Center al 239-997-8288 Qr visit
our website at
Hearing Loss Co mmon Due t o Complications of Diabet es
Diabetes. aka: the silent killer. can WTCak havoc on
the human body on the inside. Sometimes victims
are not aware they have the disease until the advo:rse
effects show up later. Diabetes can cause poor circulation to extremities. sometimes requiring amputations. Ere<;tile dysfunction can be a problem due to
lack of proper circulation. In addition, vision and
hearing loss are also very COmmOn due 10 the COmplicaliQns of diabetes.
Untreat ed Hearing Loss linked to Dementia
and Alzheimer's
Hearing devices an: usually sueccssful if a hearing
loss is detected early enough. Untreated hearing loss
is linked to brain atrophy. dementia and Alzheimo:r's
according to John's Hopkins Medical University,
the University nf Pennsylvania and The National
Institute on Aging,
W.L. "Hunter" Hunlley, III, HAS, BC-HIS
W.L "Hunter" Huntley, III, HAS, BC 'HIS, went to Edinboro State College, Edinboro,
PA, and finished his edUCOfion or the University of Florida before entering
"oining with Belrone Electronics in Chicago, IL. He wos a Beltone heoring
instrument dispen~r from 1986 to 199], He has operated Leonardi
Hearing Center, Inc. since 1994.
16251 N, Cleveland Ave, #81 (Corner of Litlleton Rood) I N. Fort Myers, FL 33903
Swing into savings!
Come in for your
FREE Trial Lesson
YOU » £S }: R VE A C HANG}:
PrOl,jding Old Fa shion Cure
Vascular Diseases ' Heart & Artery Screening
Cardio Diabetic Program · IV Vitamins
Cape Coral Pkwy E. Su~e F
--------------------------------------------- contact us 239 - 389·9449 ---------------------------------------------
r & We
S$ November 201 1 - lee Edition
By Juan Teodoro, D.M.D.
Fa ctors Than Link Oiabetes to Peri odontal
Diabetes mellitus is a disonkr in which blood
(Gum) Disease
levels of glucose (a simple sugar) arc abnonnally
high because the body doesn't release Or use
insulin adequately,
Diabetes affects more than 18 million individuals
in the United States and more than 171 million
individuals worldwide and has reached epidemic
starus. Unwntrolled diabetes can impair white
blood cell function which increases susceptibility
to infection and poor wound healing. Diabetes is
also l'IXognized as an important risk faclOr for
more scvere and progressive periodontal disease.
an infection resuhing in the destruction of tissues
and supporting bone that form the allachment
around the tooth.
Periodontal Disease
Periodontal disease (or gum disease) inname and
destroy the suucturcs SurrQunding and supporting
the teeth. primarily the gums. bone and the OUICT
layer of the tooth root. Periodontal disease is
caused mainly by an accumulation of bacteria.
Pockets form between the teeth and gums and
extend downward between the root of the tooth
and the underlying bone. These pockets collect
plaque in an oxygen-free environment. which
promotes the growth ofhactcria.
• Studies show tbat people with insuffidcnt blood
sugar control secm to dcvelop gum diseasc more
frequently and more sevcrely than people who
have good management over their diabetes.
• Diabetcs reduces thc bod~'s resistance to infection, which increase the probability of the gums
becoming infected.
• High glucosc levels in saliva promote growth of
bacteria that can cause gum discase,
Diabetes and Periodontal Disease:
Making the Infection Connection
People with diabetes are more likely to have periodontal disease than prople without diabetes.
probably because diabetics are more suseeptib le to
contnlCting infections. [n fact. periodontal disease is
orlen considered the sixth complication of diabetes,
Those people who don't have their diabetes under
control are especially at risk.
A study in the Journal of Periodontology found that
poorly controlled type 2 diabetic patients are more
to develop periodontal disease than wellcontrolled diabetics are. Researeh suggests that the
relationsbip between periodontal disease and
diabetes goes both ways - periodontal disease may
make it more difficult for people who have diabetes
to control their blood sugar and diabetes may make
it more difficult for people to control their periodontal disease.
• People with diabetes who smoke arc much more
likely to develop gum diseasc than people who
smoke and do not have diabetes,
• Poor oral hygiene is a major factor in gum
diseasc for cveryonc. but it is evcn more so for a
person with diabetes,
\1aintenancc of a healthy dentition for the purpose
of "",thctics. dictary imake and nutrition, quality of
life. and overall general health is the ultimate goal of
dental health care. In addition to public awareness
and education efforts. much of dcmal care is focused
on effective and efficient preventive and therapeutic
management of periodontal disease.
Take Steps to Keep Your Mouth
Dr. Teodoro is a Board
[, Visit your dentist regularly.
Cerlified Periodontist.
He holds both Diplo2. Keep your diabetes in check -· watch your diet,
mate StatUS in the
kecp a regular excreise routine. take your preAmerican Academy 0
Seven: periodontal disease can increase blood sugar.
scribed medications and monilor your blood
Periodontology and the contributing to increased periods of lime when the
glucose levels.
Intrenational Congress body functions with high blood sugar levels. This
3, Ilnlsh and noss every day.
puts diabetics al an increased risk for diabetic comaJOrollmplanto/ogisu.
plications. Diabetcs slows circulation. Therefore,
Dr. Teodorourved afa Major in the U.S. Air Fo
4. Watch for any changes in your Qral health. such
who have periooontal disease should be
practicing periodontics. Throughout his Air Fore
as rore gums. bleeding gums. dry mouth. bad
trealed to eliminate the periodontal infection. This
Career he served 03 Chief of Periodontics. Directo
breath. loose tcetb or a changc in the way your
of the Implant Board &, Clinical Instructor. He'
recommendation is suppol1ed by a study reported in
dentures fit, and be sure to discuss these changes
the Journal of Periodontology in 1991 involving I i3
currently a clinical assistant professor at the Naple
with your dentist.
dental residency program for the University ~ Pima Indians with bolh diabetes and periodontal
Florida, Dr. Teodoro is still the only periodontist i
disease. The study found Ihal when their periodontal
5, Keep your dentist up 10 date about any medicainfections were treated, the management of their
both Lee .& Collier County trained in Admnc
tions yQU may be taking.
diabetes markedly improved.
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Lee Edition· November 2011 f
It! & We
Just because you have diabetes doesn't mean
you'll have ond health problems. But it's helpful
to understand how your diabetes may affect your
overall health - including the health of your
mouth. Ask your physician or dentist about any
other questions you may have about your
diabetes or oral care.
Minimally-Invasive, FDA Approved
Laser Treatment for Periodontitis
Treatment Options for Periodontal Disease
There's another procedure, however, that makes
treating periodontal disease easier and virtually
pain-free. It's known as the Laser Assisted New
Attachment Procedure (LANAP) and involves the
use of the PerioLase Laser. This is Ihe first and only
FDA approved laser method used to trea! periodontitis.
Traditionally. when dealing with advanced periodontal disease, paTientS have to undergo gum
surgery, an invasive procedure thaI involves
euning and folding back the gum tissue to gain
access to the rootS and SlllT(mnding bone. Then
the periodontist will clean the bacteria from the
roots, and trim and reshape the bone around the
teeth using a drill and sharp hand ins!ruments.
The gums are then placed back and stitched in
place. This traditional method is usually quite
painful and, more oftcn Ihan not, leaves patientS
in disoomfort for days.
How does it work?
Tartar, associated with innamed and bleeding gul1l$,
is removed from the root surface of the tooth using
an ultrasonic scaler and small instruments. Then, a
small amount of light energy from the PerioLase is
directed through a tiny fiber which is gently
placed between the gum and tooth. This laser light
energy removes a tiny amount of diseased tissue and
aids in reducing the bacteria associated with the
disease. After the area is thoroughly cleaned. the
body can heal the area naturally.
' " Bonito Periodontics
I ---..
ImpI~nu - M~i ntenance - LASERTher<!p)'
IV & O ral SedatIOn
• Gum Gnfu
~ www~."pk'"t
Mindfulness·Bosed Stress Reduction (MBSR)'M
Next MBSR cours
Next Fre ... _.
Nov. 17 .
2 - March 6
To rese'r' go 10
www.lntegrativeMinclfulnes-.netorcall (239) 390-1113
Spri""lls. Fl34135
_____________________ _____________________
r '" WI;'
'5 November 2011 • Lee Edition
Also, collagens with silver sterili:re the wound bed at
the same time, Tt'Suhing in infection free fast healing
wounds. S<x:ond, Lymphedema pumps (massaging
pressure slecves) can literally milk this fluid ITom the
limb by pushing it back to the torw where it is reabsorbed and urinated out. This combination is incredibly fast and effective. Most initial Lymphedema
pump treatments result in a 5-12% swelling reduction in the first hour of use!
Find a Doctor Who Understands
By Patrick Rich, Acute Wound Care
he constant ups and downs of
uncontrolled insulinlblood sugar
takesa tenible 1011 011 the human body.
Essentially. il will age you before your lime. This
results in poor circulation early in life and subsequent hard to heal wounds and/or limb swelling.
commonly referred 10 as Edema.
The Dangers of Lymphedema
The comxl function oflhe ancrial,lymphalic and
vascular system is critical in supplying limbs
healthy blood while at the same time removing
buildup of the bodies' waste products. Once these
bad fluids have reached critical mass, the Lymphatic system can be overwhelmed resulting in
swelling. Allhis slagc, the body can literally creale
sores from the inside out. Any bump Or bruise Can
tum inl0 a small open wound which quickly results
in a large open wound. Since linle circulation
exists and what fluid is there is loxic, infection
invariably ensues. Left untll'ated, both wounds and
swelling will worsen into cellulitis, perhaps
gangrene and then amputation. Diabetics have an
amputation rate 10 times greater than non diabetics
for this reason.
MSRA Resistant Roll
and Pads
Antibiotics are a traditional COUISC, however,
many strains today are antibiotic resistant strains
or MRSA (Methicillin Resistant Staphylococcus
Aureus). In 2005, MRSA deaths overtook
IIIV/AIDS deaths in the United Statcs. An excellent alternative is a Silver based dressing (Silver
is an inert sterilizer) which kills ofT h.arrnful
bacteria in the wound bed. Bener still, the body
likely has never seen silver so no immunity has
been developed. MSRA resistant roll gauze and
pads have also been created which further protect
the wound. This gauze contains PolyDADMAC,
a biocide that is 99.999"/. effective against
MRSA, yet won't disrupt wound healing.
Further Critical Advances in Healing
On healing, two fUMher mo-dalilies have resulted
in critical advances. First, collagen is now used
to shut down a naturally occurring destructivc
enzyme in the body, MMP's (Matrix Metalloproteinascs). Most wounds break OUt ofa static
phase with collagen since the MMP's literally
attack the collagen versus the human tissue
(rentembcr to change your dressing daily!!).
What to do? First, find a doctor that knows and
understands the benefits of collagen and silver On
static woundsIMRSA. Secure it with a MRSA resistant roll gauze and tape the gauze. NEVER put tape
on the skin as tape can create new wounds on fragile
tissue. Second, veritY helshe understands your
diabetic propensity for slow healing wO\lnds and
swellinglLymphedcma. Since ANY swelling is
indicative of an overloaded lymphatic s~tem, pump
this fluid away as quickly as possible with a Lymphedema pump.
"An Ounce of Prevention is Worth a Pound
of Cure"
Lymphedema is a degenerative condition that if left
untreated can bc<;ome im:versib1e. There is no cure,
only treatments. If treated early, wounds and Lymphedema are normally 100% controllable. If left
alone, the results can be infection, amputation, even
death. So act fast, heal fast and watch your insulin.
React to even the smallest open wound or swelling
quickly. "An ounce of prevention is worth a pound of
CUll'," has never been SO true.
Acute Wound Care, LLC is a local Bonita Springs,
Fl provider specializing exclusively in high end
wound products and Lymphedema equipment.
q;--'4i~;f4fd!np \it
For more information, contact the experts al
239-949-44 I2, or visit us online at
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Lee Edition - November 2011
n &
Living with Alzheimer's
hen: are many people in the world
who ~uffer from disabilities so
severe that most of uS can't imagine
living life in tIte manner as tltey do. One of such
extreme conditions is Alzheimer·s. a progressive
disease that affects each and every aspect of one's
daily existenCe. Not only docs it impact the one who
is actually suffering from it. even those near and
dear 10 him oftentimes are negatively impacted.
especially as the disease enters into Later stages.
Be it emotionally or in the form of helping a
patient take care of himself. relatives and mends
of one suffering from this disability find it
cxlJerncly hard 10 handle the situation. which is
why they take help of professionals to give proper
care 10 the patient. Needless to say. it is very hard
On the part of the loved ones to see the patient in
such a condition. Particularly in the lalCr stages of
Ihe disease. lhe patient tends 10 forget very basic
things. and it takes a lot of effOJ1 from trained individuals to ensure Ihat the patienl does not hann
himself or his family by IICtions that arc obviously
not under his control.
This disease is still controllable in Ihe initial
stages, but as time passes by, the condition of
the patient continues to get worse. and while one
can keep the patie!l1 at horne when the problem
starts, as it develops into more advanced stages,
professional help becomes more of a necessity
than a provision.
contrary, it means you recognize the imponance of providing proper care for dementia
patients. PToviding long term
qualily care is a daunting task
and One that requires a full
team of dedicated individuals.
The major help one can give to the patient is to
reduce his stress. and not make issues OUI of
things that the patient can nOI control are due to
the disability. For instance. it is common for
those wilh Alzheimer's to develop different
caling preferences; such that. one might nOllike
the foods he did earlier. or might nOt any longer
enjoy social activities even Ihough he used to be
quite the extrovert. These things need to be
nOled and considered to properly provide
special care for those with Alzheimer's or other
dementia illnesses. It is nOI uncommon for the
burden of caring for dementia patients to
become overwhelming. Seeking assistance does
nOI mean you failed your loved one, on the
yo u s ufferi ng from lymphedema and c hron ic s welling
of upper or lower extremities?
We Can Help!
Live the Moment.... Love the Moment""
w. IMnfI ob<_.not """"'ob<~p>liDgln o.oo:h ..udm!'.
joum<y.not prooidi.. "Superior. quo!iIy CU<.
W.lIpreocrvethrirdipity...ruJe - - ...... freedom
IOtmo.oo:hd.ywllh ~.not~
·Sp«W; .... I. Ahbe; ..... •,.'...... 0. ........
.o..-,u.-..ds..w.sStod'- ~.~ 7n.,..1*<IL
~yoo _$OO<I · t"""~
~ .. . ~ kIn'n Il'Mtr>Wrt plat\.
... _11>0
Superior Residences at Ilealth
Park is a special memory care
community for those with
Alzheimer's Disease and other
Dementia related illnesses.
The Memory Care Team al
Superior Residences is specially tnlined in providing a supportive and nurturing environmenl
while preserving capabilities and protecting the
dignity of each resident. Life Enrichmenl
Programs available to residents enhance independence and activities are designed 10 address
personal inlerest. It is clear thaI the Superior
Residences staff is commiucd to improving the
quality of life for all residents and restoring
peace of mind to family and friends. For more
infonnation about the amenities and services
availahle for families with a loved One affected
by Alzheimer's or other dementia related ill·
nesses, please call (239) 437-5511.
. Uk Enri<h_.t "'<1.ItI,
.notl.... more..
$00<1 ....
ti",.., 'IOU/ own tIomel
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Phone: (139) 437·5511 ' www$
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-s November 201 1 - lee Edition
Treatment Options
In addition to the popular phosphodiesterase
inhibitors. such as Viaga. Cialis. and U:vitra.
then: arc olher effective treatment options available for ED, which include vacuum pumps,
intraurcthral suppositories. inj ection therapy.
andlor penile implants. [\ is very important to
consult a specialist in the area of ED treatment,
noting that most or the men who corne into the
clinic have failed olher treatments offered by
their family physician, because the treatments
offcn.:d depend {)n the cxpenise of Ike physician_
Successfully Treatil'l9 Over 96%
of Patients
Erttlile dysfunction is NOT a pan of getting
older thai you have to accept. "ED is mOre than
just a sexual problem_ A fulfilling sex life can
lead to greater satisfaction in many olher aspects
of life. ED treatment is a subspecialty of
urolQgy. and that's OOf main focus here:' le<:
emphasizes. "We have a great deal of experience
and expertise in treating this condition. In fact,
we are abk to successfully treat over ninety_six
pm:ent of our patients.
Our Goal: Improving Your Oveflill Qualify
Dedicated to helping men improve and maintain
their health. our goal is to help improve our
patients' overall quality ofhfe. by enabling them
to have healthy. satisfying sex. Most importantly. we want men and women to understand
that sex is part of a nonnal. healthy life and
there's 00 reason why they can't have sex into
their seventies. eighties, and beyond'
For more infonnation or to schedule a consultation, please call: (239) 693-5200. Or. visit US
online at The US
Male Clinic is located at 12650 World Plaza
lan<:. Building 72, Suite 2. Fon Myers. Fl.
D. Lee Abbott, PA-C
The us Male Clinic
12650 World PI ... Lane, Suild ing
Suite 2,
Fort M~t'$, H
C _
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Lee Edition - November 201
Guide Offers Tips On Living
With Dementia
By George T. Leamon, CLTC - Lulgenlnsurance
::1~~:i~er'S tORepo~e andWo;~:
American Association for LongTerm Care Insurance (AALTCl) reports, over 35
million people worldwide suITer from Alzheimer's
disease and other forms of dementia.
Without a significant medical breakthrough related
to dementia care that number could double every
20 years, and by 2050 could affect over 115
million people, explains lesse Slome, executive
director of AALTCI.
"Sased On Our 30 years of caregiving experience
we know that when someone receives a diagnosis
of Alzheimer's or dementia that it suddenly
involves mOre than just the patient," said Leann
Reynolds. president of Homewalch CareGivers.
The Guide to Dementia was prepared to arm
families and caregivers with free information and
resources. whi,h might not otherwise be provided.
that can educate them and provide a roadmap for
the difficultjoumey they face.
The guide covers t he following:
• Definitions of dementia and what those definitions mean both clinically and personally
A free informational
guide Living with
Dementia is available
for free download from
Homewatch CareGivers.
;, 25
There arefour types of People in this
world Those who have been caregivers. Those who are caregivers. Those
who will need a caregiver. Those who
will be a caregiver.
- Roslyn Carter
• In-depth tips for communicating with loved
ones experiencing dementia
• Communication issues to watch out for as the
symptoms of dementia progress
George T. Leamon, CLTC - Lutgert Insurance
• In_depth tips for helping family members with
dementia around the house
• Practical tips for understanding and dealing
with behavior issues related to dementia
G~,..g~ L~" mo",
Life ~nd Long Term
i" with Lulga, brsuranu. h{J$ bun in Naplu far
• Self-help and wellness tips for family
"Our goal is to support families by providing
information and resourees," Reynolds added.
"We want {his guide to be one of the resources
that helps family members and caregivers deal
with the numerous issues that arise from living
with dementia."
rWer 15 Y"~rr~ helping senior. with their Life !nsuranc~. Long Term Care. Annuilies Qnd 'he ropidly
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November 201 1 - lee Edi t ion
By Marlena Cecil, PA-G
(PhenTabzRX"' ) in the UK where it has received
the greatest reviews from both the medical commu_
nity and more imponantly the patients. Gentech has
finally released PhenTabzRX'" to the US and the
results are the same - phenomenal. Now before we
talk about PhenTabzRX'"'" it is absolutely imperative to remember that nO matter how effective at
appetite suppression or increasing energy levels
something is - "·e still nm to remember that long
term success ultimately comes from altering some
nutritional patterns and irlOOlpOrating some level of
activity to our weekly regimen.
What is PhenTabzRXT"'?
PhenTabz RX'"" is a true pharmac:ological diet pill
like Phentennine, Xenical or Adipex. PhenTabz.RX
T" is NOT an herbal supplement but rather a
designer non-prescription pharmac:eutical analog
providing superior appetite suppression and weight
loss without the side effects. One pill is taken in the
morning before breakfast and another before lunch
- thafs it!
;thout the right lools losing
weight safely and keeping il Qff
arc nearly impossible. Fighting
genetics. hunger, lack of energy and motivation is
enough \0 make the strongest willed person quit or
nol even bother allcmpting to lose weight!
when it comes \0 Ihe batlle of Ihe bulge, you have
\0 put up a good fight. Bul in our eat-and-run, oversized porlinn world, maintaining a healthy weight
is hard enough, therefore weight loss can be a
genuine struggle.
Adding 10 the difficulty is Ihe abundance offad diets
Ih81 tempi and confuse us and ullimalely do not
work. So where is the silver lining and what can we
do 10 seriously increase our chance of success after all we all know people who have actually
rcached their goal weight AND maintained;!.
First things first, we need to lose weight safely and
CQfIsistendy. Consistent weight loss is the key to
keeping motivation levels high and staying focused
on your goal. For the past sever.ll decades the
medical community was able to gn:ady enhan<.:e o;;onsistent weight loss via the all-time top selling appetite
suppressant/weight loss medication Phentennine
(Adipex & IQnanlin). While these medications were
''CrY efTe<:tive at decreasing appetite and increasing
energy, they have a multitude of undesirable side
effects and demonstrate a strong addio;:tive nature.
Phannac:ological improvements in the past few
years are staning to provide us with gn:atly
advanced medications with far fewer side eff«ts
and improved effectiveness. Yes - this is where we
hear about the silver lining. Gentech Pharmaceuti_
cal released their replacement for Phentermine
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - -
Lee Edition· November 20 II
How does PhenTabzRXTM work?
Th, patented ingredients
perfonn two essential functions_ It increases the
body's mobility of fat (Sympathomimetic Amine)
while increasing metabolic rate (increases ey.:lie
AMP levels within the body). PhenTabzRXf>l then
greally reduces appetite to ensure patients have
control and motivation. The bottom line is Ehat
PhenTabO'.RX"" provides consistent significant
weight loss and increased energy.
required to make it through your day including.
plenty of energy for e~ercising. PhenTabzRXTM
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burning which means your genetic. will no longer
hold you back!
PhentabzRXTM means Fast, Safe and Consistent Weight Loss!
PhenTabz RJ(TM was clinically designed as the
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Appetite Control & ItlCl"eased Energy
PhenTabzRXTM seriously ,",oca yoo, hunger
levels allowing you 10 make the right choices Ehat
you want to when it comes to food and ponion size.
PhcnTabzRXTM provides you with the energy levels
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If you are serious about losing body fat (not just
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r&WEI .....
s 27
We have had many health care professionals upgrade
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18070 S Tamiami Ttl. 8, Ft Myers, Fl33908-4602
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1220 Business Way Su~e 1
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November 201 1 - lee Edi t ion
I've become a Warrior for Health!
by louAnn Good
ur world has become more complicated. Modern warfare and (CTTI,I'-
il nol be what
country and ducalens our way of life. What If our
country we,e threatened by an outSide force. One
lha\ had the potential to bankrupt our economy,
destroy our way of life and make our children so
sick that children dying before their parents became
commonplace. Whal if this threat was already
within our borders, living amongst us? Would we
surn:ndcr? Would we say we're too tired to fight?
Would we say we can'! change and deny the threat?
Our country's health and the skyrQCketing cost of
heahhcare is HIE biggcsllhreat 10 our e«>nomy, to
our way of life and 10 Ihe pursuit of happiness 1ha1 is
Our binhright. Our country spends twice as much On
heahhcare as most other industria1i:red countries in
Ihe world. Our healthcare syslem. according 10 lhe
World Health Organizalion in 200(1, ranked 311h in
lhe world (jUSl after Costa Rica). Since "'e spend SO
much, shouldn'l we be healthier?
II is eslimaled lhal 10% of our illnesses are the result
of our lifestyle and our habits. The Milken Inslitute
estimates that chronic disease cost the US economy
over one trillion dollars a year through healthcare
COSIS and lost productivity. an amounl thaI could rise
to six trillion dollars a year by 2050.
According to the Center for Disease Control:
Chronic Diseases are lhc uading Causes of Death
and Disability in the U.S.
0 7 out of 10 deaths among Americans each year an:
from chronic diseases. Hean disease, cancer and
slroke account for more than 50% of all deaths
each year.
o ln 2005, 133 million Americans - almost I oul
of every 2 adults - had at least one chronic illness.
o Obesity has become a major heahh concern. I in
every 3 adults is OOese and almost I in 5 youth
between lbe ages of 6 and 1'1 is obese (BMI ;::. '151h
percenlile of the CDC growlh chan).
• About one-(ounh of people with chronic conditions
have one or more daily activily limitations.
o Anhrilis is the most common cause of disability.
with nearly 19 million Americans reponing
activily limitations .
• Diabetes conlinues 10 be the leading cause of
kidney failure, non-lraumatic lower-extremity
amputations. and blindness among adults.
aged 20-14.1
The four most common causes of chronic disease
an: a lack of physical activily. poor nUlrilion.
tobacco usc, and excessive alcohol consumplion.
So fellow warriors. who is lhe enemy? Do we
blame Phillip Morris, McDonalds. 100 much TV ,
the beer industry? As Pogo said. "we have met the
enemy and he is us!"'
o •
Client 1 Trainer 1 Goal
Fitness Together Fort Myers
9671 Gladiolus Dr. # 108
Fort Myers, FL 33908
Forget expecting the government to rescue us.
(orget expecling our leachers 10 do (or our kids.
whal we haven'l done for ourselves. forgel denial
and forget hoping to just get "lucky'"! It·s time to
take aClion and lake responsibilily for our health.
our kid's health and Our country's health.
Gel off Ihe couch and go sweal somewhere!
Man up and StOP eating alllhat stuff you know
you shouldn't be eating' Take a look at the
habils Ihal you know, and we all know, are
killing uS and quill
Modem marketing has convinced us lhal we're
weak ("'bel you can't eat JUSt onel''). We are
strong. we are powerful! Vote with your feet, vote
wilh your dinner plale. and YOle for lhe future of
our country by becoming a Warrior for Health!
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
lee Edition· November 2011
n&WE .....
s 29
Shingles and Postherpetic Neuralgia
By Adam Shuster, 00
Pain Management ConSU~1S of SWFl
hinglcs is one of the most common
neuropathic pain syndromes affecting
adults in the United States. Roughly
20"A. of the population will experience shingles in
their lifetime. Shingles is cause by a viral infecti{)ll
(Herpes Zoster). Usually, pain may start five to
seven days prior to eruption of a rash. The typical
pain produced by shingles is neuropathic in natun:.
That meanS the pain involves the nervous system,
usually the dorsal root ganglion, but may also affect
other nerves as well.
Shingles pain is usually described as burning, lancinating, itching, and can be accompanied by
numbness or a tingling sensation.
"The most
conunonly affected area involves the thoracic dermatomes, but can also affect the 5th cnmiaJ nerve,
also known as the trigeminal nerve. The rash and
painful symploms tend to occur in the distribution of
the affected spinal nerve. Herpes is hallmari<ed by ilS
unilateral prcscnllttion, rash, and painful symptoms.
The acute herpes infecti{)ll is a result of an inflam_
matory reaction at the dorsal root ganglia and
peripheral nerves. Early treatment (within 72 hrs)
with an antiviral medicati(ln such as Acyclovir, can
not only shanco the course of shingles and decrease
painful episodes during the acute infection, but it
also decreases the chances of developing posther_
petic neuralgia.
Postherpetic neuralgia is classified as a patient
having herpetic pain which C{)llTinues 3-4 months
after the rash has disappeared. [t is more common
in the elderly and approximately SO"A. of adults
aged over 70 are at risk for developing posTher_
petic neuralgia.
There are many treatmenTS for posTherpetic neuralgia. Injections such as a thoracic or lumbar
epidural steroid injection can be helpful. There arc
a variety of medications which can be used as well.
Narcotics may be helpful in the acute setting, but
are often paired with antidepressants Or anticonvulsants. as narootics alone may be inadequate to control
paIn. Antidepressants and anticonvulsants are
used to decrease symptoms involving pain,
burning, numbness, or tingling.
ointment. or a lidocaine patch (Lidodcrm) may be
applied to the affected area. This is a very safe
and often helpful treatmenT. For postherpetic neu_
ralgia. a newer medication called Q utcnza can be
topically applied and can offer pain relief for
months at a time.
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Noyember 201 1 - Lee EdItIon
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www . - - - -- -- - - - - - - - - - - - - - -
lee Edition - November 201 f
Seeking A Vibrant
Prayer Life
0, T."y Ho,l. , [X.e,ro,clOo",
hat does it mean 10 have a prayer
life? Is it mon: than just an O<,:C3sional prayer going up before a
meal ? More than the occasional prayer for so and so
to get beneT? The differenc<!' of having a prayer life
or nol is this: Does your life depend on prayer or is
prayer sprinkled into your life occasionally? I fear
that most of uS live our Christian lives li ke cars OUI
of gas. without prayer we don't get very far. We
have said with our lips that We love God, and wc
want 10 follow Him, yet our lives often reflect a
pathetic image of true: Christianity. There are
various reasons for the lack of faithfulness 10 God,
but it starts with our prayer life. Leonard Ravenhill
says, "that no man is better than his prayer life."
without Ceasing "--1
Thessalonians 5:17
Why should we pray? [s il because Ihere is power
in prayer or that we see people healed from
prayer, or thai it slrengthens us? All these are
important aspects of prayer, but there is a far
greater reason why we should pray. and it is
simply this, God COMMANDS uS to pray. We
often overlook the fact that we MUST obey God.
We as humans look at the bendits ofwhat we can
get from God over obeying lIim. God is God and
He descT\lcs our livcs as He is the One who gives
us our very next breath. If our hean is following
God for Ihe blessings instead of Ihe faci Ihal He
is God, then we are self-centered and doing
things for Ihe wrong reasons. God's Word warns
uS when il says, "Do nOI be deceived: God cannOI
be mocked. A man reaps what he sows . The one
who sows 10 please his sinful nalure, from Ihal
nature will reap destrudion; the one who sows to
please the Spiril will reap elcmallifc." (Galalians
5:1-g, NIV) We can either please OUl'$elves which
will lead to destruclion or we can please God
which willicad to ctemallifc. A good gage 10 see
if we are pleasing God or ourselves is to lake a
close look at our prayer life.
th & We
Sponsored By
Praying When You Don't Feel L.ike It
Why is il Ihal mOSt Chrislians have a hard timc
developing and thriving in a prayer life that truly
depends On God? The truth of the matter is that
mOSI of Ihe time our flesh holds us back and we
dOn'1 desire to spend more Ihan 2 minules in
prayer. We must press on in prayer even when we
don't feel like it and discipline ourselves to pray.
The more we choose to pray and ask God 10 help us
desire to pray, then the more il will become Ihe
delight of our heans.
Relationship; " Jesus.,went off t o a solitary
place, where he prayed."--MaJ1< 1;35
Our rdationship with GOO is developed in our prayer
life. If no prayer life, then no depth of relationship.
How can we possibly say that we are building a relationship with God, and not be praying? Jesus prayed
continually because of His greallove and submission
10 Ihe Falher. Scripture is clear Ihal Chrisl prayed
often all night because of His love to the Father. Was
Christ more in need of prayer than us today? Of
COUI'$e not, but we are SO busy, righl? We are busy, but
busy isn't an excuse not to pray. We have SO much on
our plates Ihal only a Ihriving relalionship wilh Christ
will get us Ihrough it aiL '"Trust in the Lord with all
your heart and lean not on your own understanding;
in all your ways acknowledge Him, and He will make
your paths straight." (Proverbs 3:5-6, NIV) Who do
we truSt in today, oUl'$elvcs or GOO? Prayer places our
dependence on Christ instead of oUl'$elves. We say
we trust in Christ for everything, yet practically we
Ihink and acllike the world, as we accomplish everything in our own strength. We will never walk on the
straighl path Wilhoul God's guidance, we will
continue 10 fall by Ihe wayside because we are
HELPLESS without God.
Oasis Counseling iAlter wants to reJresl1
God, help uS 10 pray to be in obedience 10 your
word, to pray to be in relationship with you and
give uS the desire to pray during the many times we
honestly don't fo:ellike it, so that we may grow in
your Spirit and live to please you.
hope, heio1,
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