nside texas md july/august 2013

1JULY.AUGUST 2013 / NSIDE TEXAS MD

MDNSIDE MEDICAL MAGAZINEJULY.AUGUST 2013

7th Anniversary

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JULY/AUGUST 2013

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16PROFILEWELLMED AT ST. JOHNSDue to patientdemand, WellMedexpands its presencein North Austin to thecity's St. Johnsneighborhood with a newstate-of-the-art healthcare facility.

PATIENT1 8 » Not your average physician20 » Pioneers for innovation22 » A wellness care destination24 » Filling the niche

HEALTH & WELLNESS26 » A state of wellness

15Austin

29Dallas

FEATURE30 » Top-notch training

HEALTH & WELLNESS32 » Building kitchen con!dence

PATIENT34 » Leader of the pack

Page 26

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38PROFILEWELLMED EXPANDSIN EL PASOThis leading provider of senior health care opens two Extended Hours Clinics in El Paso, making e"ective, patient-centered care more available to the Sun City community.

37El Paso


Page44

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PATIENT42 » Passion for preemies44 » Driving force

MD NSIDER46 » Pain matters

48PROFILEDR. DENNIS SLAVINAs this anesthesiologist brings the latest in interventional pain management to the Rio Grande Valley, area patients no longer have to travel to larger cities to get out of pain and back into motion.

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74PROFILEBAPTIST HEART AND RHYTHM

CENTERNortheast Baptist Hospital reshapes the standard for cardiac care and research in South Texas with its

new#electrophysi-ology lab, led by#Drs.

Stephen Scott Reich, Stephen Allen May and Gregory Buser.

78PROFILEORTHOPAEDIC & SPINE INSTITUTE OFSAN ANTONIODrs. Steven Cyr, Hongbo Liu and John T. Friedland of this renowned practice prove they have the right combination of training and personality to transform both the patient experience and the landscape of spinal surgery.

82PROFILEDR. ROBERT L. OCHSSan Antonio's preferred dermatologist and his dedicated sta" at Alamo Dermatology work with all age ranges to help them maintain healthy skin and healthy lives.

HEALTH &WELLNESS84 » Ask the experts

PATIENT90 » Lasik vs. PRK92 » Slim down to shape up

MD94 » Top risks in o"oce practices identi!ed in national survey96 » Modulating the process of aging

59San

Antonio


NSIDE Texas MD Magazine - July/August 2013

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For advertising information, please call 210.373.2599 oremail [email protected]. For editorial comments and

suggestions, email [email protected].

Copyright © NSIDE Media Productions. All rights reserved. Reproduction without the expressed written permission of the publisher is prohibited.

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WELLMED RESPONDS TO PATIENT DEMAND AND MOVES ON TO BIGGER AND BETTER THINGS IN NORTH

AUSTIN WITH ITS NEW STATE-OF-THE-ART SENIOR CLINIC IN THE CITY’S ST. JOHNS NEIGHBORHOOD.

By JODY JOSEPH MARMELPhotography by RON AARON EISENBERG

MaximizingEFFICIENCY

Dr. Daniel Oyiriaru, WellMed St. Johns Clinic, waits for a patient in an exam room.

AUSTIN // PROFILE


Committed to changing the face of health care delivery for seniors by em-ploying a rigorous and disciplined dis-ease prevention program, the WellMed care model is setting new precedents in

disease management for senior patients throughout the states of Texas and Florida, and it has become a recognized leader in preventive health care. One of WellMed’s expanding clinics in the North Austin area recently outgrew its former facility and, as of Janu-ary 2013, has moved into a much larger suite across from Highland Mall o" of Interstate 35.

The WellMed Senior Clinic at St. Johns medi-cal sta" is proud to announce their migration into a new state-of-the-art clinic in Austin’s St. Johns neighborhood. Complete with an onsite laboratory, X-ray facility and top-caliber medical sta", WellMed of St. Johns provides Central Texas seniors with the best resources in preventive care of chronic illness-es. The beautiful new facility boasts a 4,200-square-foot $oor plan, a"ectionately called by sta" the “Taj Mahal Austin.” Procedures include wellness checks, onsite specialist referrals and WellMed’s signature patient education initiative.

Previously, the St. Johns clinic sta" occupied a cramped o%ce suite in a building on the other side of Interstate 35. The clinic opened as one of the !rst four WellMed clinics in the Austin area (today, WellMed has 10 clinics across Central Texas) and quickly outgrew its old home thanks in part to a growing demand for health care services focused on Medicare patients.

On June 22, 2013, WellMed at St. Johns played host to a health fair from 10 a.m. to 2 p.m. to further inform existing and future patients. “We want to ed-ucate as many people as we possibly can,” says clinic administrator Roxanne Salazar.

From the doctors and nurses to the medical as-sistants and front o%ce sta", the entire medical sta" plays a part in facilitating a patient-centered and goal-oriented clinic. “Our team is phenomenal!” claims Sue Ellen Gondran, APRN, FNP.

Each morning before seeing patients, the WellMed at St. Johns medical sta" forms a huddle to review each patient on their schedule, utilizing qual-ity metrics to ascertain that all patients are receiv-ing the exact screenings and tests appropriate for their individual disease prevention regiments. While preparing a daily health agenda that allows them to maximize health care e%ciency, the St. Johns sta" can adapt to any patient’s foremost needs, putting the patient’s concerns to ease by addressing all com-plaints. “The foundation of our encounters with pa-tients is built on the premise of prevention,” Gondran explains. “This model of care is dynamic!”

A native Texan and board-certi!ed nurse prac-titioner, Gondran received a Bachelor of Science in Nursing and a Master of Science in Nursing from

the University of Texas at Austin. She is also the co-founder of the nonpro!t Round Rock Health Clinic in Williamson County, which provides much-needed health care services to individuals who cannot qual-ify for Medicare or a"ord private health insurance.

Accompanying Gondran, Drs. David Bui and Dan-iel Oyiriaru compromise the resident physicians of WellMed at St. Johns. Board certi!ed in internal med-icine, Bui received his medical degree from Chicago Medical School and completed his internal medicine residency program through Mercy Medical Center in San Diego, Calif.

After receiving his medical degree at the Univer-sity of Nigeria, Oyiriaru completed his internship and residency in family and community medicine at Howard University Hospital in Washington, D.C. “I grew up in a country where there was a great need

for family physicians,” Oyiriaru explains. “I have al-ways wanted to be of service to my community, and this was a way of accomplishing that. I came to the United States and saw that there was a great need for geriatricians.”

As a geriatrician, Oyiriaru (a"ectionately referred to as “Dr. O”) specializes in the unique and often challenging health care needs of seniors. He was a geriatric medicine fellow at George Washington University Medical Center, and he became board certi!ed by the American Board of Family Medicine before joining WellMed in 2011. “I was fascinated by

WellMed’s goal of changing the face of health care delivery for seniors and wanted to be a part of it,” Oyiriaru claims.

WellMed at St. Johns provides patients with the proactive and preventive care of a primary care phy-sician, while maintaining a !rm continuity of care through teams of health coaches, social workers and onsite referrals to a multitude of specialists. “A great deal of our work consists of coordination of care, re-source linkage and assisting patients and their fami-lies navigate through a complex health care system,” Gondran says. “We are more focused on quality than quantity.”

Gondran continues to explain the WellMed team dynamic, which consists of both the patient and the family. Together, barriers are identi!ed and a plan of action to overcome these barriers is constructed in

order to facilitate interventions and provide health education.

“At WellMed, our patients see us as their medical home,” Oyiriaru explains. “We provide quality, pro-active, compassionate patient care in collaboration with our patients.”

WellMed at St. Johns is located at 6937 IH 35 North, Ste. 120, in Austin, Texas. For more information, call 512-465-4800 or visit www.wellmedmedicalgroup.com.

"WE ARE MORE FOCUSED ON QUALITY THAN QUANTITY."

Radiology technologist Cindy Moran, WellMed St. Johns Clinic.


By JODY JOSEPH MARMEL

NOT YOURAVERAGE PHYSICIAN

With a background in the performing arts, an impressive career in physical medicine and a unique focus on leg

length discrepancies, Dr. Michelle Paris of Whole Family Chiropractors proves she is anything but ordinary.

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Dr. Michelle Paris is not your or-dinary physician. Her background is in opera, and because of her diverse career choices, she has become a well-respected and well-known expert in leg length discrepancy (LLD). Practic-ing since she graduated from Life West as the valedictorian in 1994, most of those years were spent in San Francis-co until she moved to Austin in 2008.

With a performing arts degree and

the talent to become an opera singer, she worked on staging and ergonom-ics for several theatrical productions. Her passion to learn more about phys-ical biomechanics (the integration of structure and function) grew into her pursuit of a medical career.

Paris was a primary care physician in California, and she is well versed in most all aspects of physical medicine. However, she has become the leading authority on leg length inequalities.

“This is an under-evaluated and under-managed aspect of structural integrity of the spine that without appropriate treatment, not only pre-vents long-term stability, but may also lead to permanent curvatures and contribute to scoliosis,” Paris ex-plains.

The following highlights the ana-tomical short leg and what can be done to help patients who su"er from the condition. Often, one leg simply stops growing before the other one does and is called “congenital.” While it is not to-tally understood, it seems to account for 25 percent of the population dem-onstrating a true LLD. Other causes of a true LLD include trauma, broken bones, surgical repair, joint replacement, radia-tion exposure, tumors and Legg-Calve-Perthes disease.

Many times, there are few or no symptoms prior to the age of 25 to 35. The most common symptom is chron-ic lower back pain, but there is also fre-quently middle and upper back pain. Repeated injuries or pain to the hip, knee and/or ankle are also attributed to longstanding untreated LLD.

While physicians used to evaluate LLDs using only a tape measure to assess various distances between the hip and the ankle, current research suggests valid evaluation of a true LLD requires a weight-bearing radiograph with the central ray focusing through the heads of the femur. This weight-bearing X-ray has proven to be just as reliable as any other more expensive radiation-intensive test.

Evaluation of certain foot condi-tions such as excessive pronation can also be a crucial piece of the puzzle. Although it is still misunder-

stood, positive family history of LLD is also a significant factor, as it ap-pears LLD is congenital.

The use of customized heel lifts is the most e%cient treatment option available to patients with a true LLD. However, the orthotic treatment must be applied incrementally to lift the patient’s short leg, as the body would rebel such increased compensations of curvature and muscle length. Physi-cians have found that a non-compres-sive silicone heel can be used to lift a shoe in increments of 3 to 4 millime-ters maximum per week.

As the patient’s balanced length is reached, another gait analysis and fol-low-up X-ray are performed so that a !nalized prescription for the patient’s heel lift can be written. If the !nal prescription is greater than 7 mm, the patient’s whole shoe typically needs to be modi!ed. This type of service is easily conducted by a pedorthist (a highly skilled modern cobbler), and many insurance companies will reim-burse patients for this service if it is deemed medically necessary.

The doctors at Whole Family Chiro-practors (WFC) are full spinal adjustors who are interested in restoring proper biomechanics, structure and func-tion. “A working body in the absence of nervous system compromise tends to not only heal itself, but also goes far into maintaining optimal homeosta-sis,” Paris says.

“Our goal is to ultimately pro-vide wellness care similar to a dental cleaning, rather than merely pain re-lief and late intervention strategies. Early intervention can help prevent or minimize ongoing degeneration, especially when combined with soft tissue therapies and home stretching and strengthening techniques.”

Although WFC works with many ath-letes and children, their particular brand of biomechanical evaluation works well for any candidate. They have created a network of carefully selected medical specialists with whom they feel con!-dent referring their patients. The critical subspecialty that sets WFC apart from other chiropractic practices is the evalu-ation management of structural leg

length inequalities. Due to Paris’ performing arts back-

ground and her ongoing interest in the unique stresses performers and musicians place upon the body, WFC has partnered with the Health Alliance for Austin Musicians (HAAM). By doing so, WFC o"ers lower-cost services to uninsured and under-insured musi-cians working in Austin.

In addition to this magnanimous service, WFC supports many chari-table organizations and typically se-lects one speci!c organization each quarter to pro!le and to focus fund-raising e"orts. The highly trained and experienced doctors, massage thera-pists and sta" make the practice run smoothly and e%ciently to ensure that the focus is always on the pa-tients’ needs.

The state-of-the-art clinic is out!t-ted with the best that technology has to o"er. From EHR software that allows the o%ce to easily transfer notes, !les, reports and X-rays to other health providers to touch-screen check-ins, online forms, in-o%ce iPad patient and doctor notes and the latest digital X-ray equipment, WFC has welcomed the 21st century, and the patients and medical community are reaping the bene!ts.

As Paris explains, “the tremen-dous upside is that an anatomical leg length discrepancy is not only easily managed, but the correction of it of-ten has signi!cant positive e"ects on quality of life and an individual’s abil-ity to fully participate in the activities they love.”

Whole Family Chiropractors is located at 4600 Mueller Blvd., Ste. 1009, in Aus-tin, Texas. For more information, visit www.facebook.com/wholefamilychiro-practors or call 512-505-8500.

AT WHOLE FAMILY CHIROPRACTORS, THE FOCUS IS ALWAYS ON

THE PATIENTS’ NEEDS.

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With more than 60 million Americans expe-riencing heartburn and acid re$ux at least once a month and more than 15 million Americans ex-periencing symptoms every day, Dr. Paul Buckley III performed a “!rst” in Central Texas on April 10, 2013.

Utilizing the LINX Re$ux Management System, Buckley has treated four patients to date who suf-fer from gastroesophageal re$ux disease (GERD), a chronic disease. Both doctor and patients are pleased with the results so far. With several more patients scheduled, Buckley says, “we are the busiest center in Texas.”

At the Scott & White Heartburn and Acid Re-$ux Center (HARC), innovation is an integral com-ponent of the physician’s philosophy. Buckley, a highly experienced surgeon in the treatment of acid re$ux, serves as the director of the division of general surgery and the surgical director of HARC.

Shedding light on the LINX procedure, Buck-ley informs Texans, “the reason people re$ux is that the normal barrier or sphincter between the stomach and the esophagus does not work; this allows for the reverse $ow of stomach contents into the esophagus.

“Traditional anti-re$ux surgical procedures use the top part of the stomach and wrap it around the bottom of the esophagus to ‘recreate’ an esophageal sphincter. These types of opera-tions are known as fundoplications, with the Nis-sen fundoplication being the most popular.”

While the traditional procedures work very well and have excellent results when performed correctly on the right candidate, the LINX device acts in a similar manner, but it has two main ad-vantages. First, surgical implantation of the LINX device is much less invasive than the traditional fundoplication surgery.

“There is no need to disconnect the stomach from its many attachments in order to make it useful as a ‘wrap,’” Buckley says. “With the LINX procedure, a small tunnel is made around the esophagus and the device is then deployed. This maintains much of the normal anatomy and de-creases scar tissue.”

Secondly, the LINX device is dynamic. It actu-ally opens and closes in response to swallowing. The traditional fundoplications are not able to do this. This bene!ts patients in several ways.

“With traditional surgery, there can be long-term issues with swallowing known as dyspha-gia. With the LINX device, this is virtually eliminat-ed,” Buckley says. “There are also fewer reports of long-term bloating. Best of all, with both surger-ies, the quality of life that patients enjoy is mark-edly better than with medication, and over 87 percent of patients can expect to be completely o" of their GERD medications long-term.”

Scott & White Healthcare – Round Rock is one of only a few centers performing this procedure on a national scale. Approved by the FDA in March 2012, the LINX device is being o"ered for

Scott & White Hospital – Round Rock brings a breakthrough

By HEATHER DANIELS

PIONEERS FOR INNOVATION

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UP TO 40 PERCENT OF THE POPULATION SUFFERS FROM MONTHLY

HEARTBURN-TYPE SYMPTOMS.the !rst time in Central Texas. Patients now have access to relief from their re$ux disease through a minimally invasive laparoscopic procedure. A mag-netic beaded bracelet is placed around the esoph-agus, where it meets the stomach at the lower esophageal sphincter.

According to a study that was published in the February issue of the New England Journal of Medicine, 87 percent of patients who underwent the LINX procedure reported complete cessation of heartburn medications; 100 percent reported the elimination of severe regurgitation; and 92 percent reported a signi!cant increase in quality of life. With such remarkable statistics, this less invasive surgical option is gaining recognition and patients are go-ing to Scott & White to learn more about LINX.

It is estimated that up to 40 percent of the popu-lation su"ers from monthly heartburn-type symp-toms and 20 percent su"ers weekly symptoms. These symptoms include chest pain (heartburn), a bitter taste in the mouth, voice changes, coughing, asthma trigger, tooth erosions and frequent lung infections.

Complications from GERD may include tempo-rary or permanent damage to the esophagus (with or without medications), esophageal strictures and even cancer of the esophagus, which is now the

fastest-growing cancer in the United States. The best candidates for this procedure are those

who take daily PPI medications (Prilosec, Nexium, Dexilant, Aciphex and Protonix) and who had an initial good response to them. Up to 40 percent of patients only get a “partial response” to medication or experience a loss of its e"ectiveness over time. People in this category are excellent surgical can-didates.

If a hiatal hernia is present and it is relatively small, these patients are candidates for the LINX anti-re$ux system. If there is a larger hiatal hernia indicating a larger structural problem, the more tra-ditional surgery would be of greatest bene!t.

“It is important to note that even patients that have good relief of their symptoms on medications have a better quality of life after surgical correction when compared to those who stay on medications long-term,” Buckley says. “Patients that cannot af-ford their medications do not want to take medi-cations for the rest of their life or are having side e"ects from them are excellent surgical candidates, as well.

“We know that GERD is actually a mechanical problem and not one of over acid production. The medications that millions of people take every day are designed to eliminate the acid from their stom-

achs. Unfortunately, they do not eliminate re$ux; they only change its composition. When you stop the re$ux and repair the underlying problem, the patients bene!t. Their quality of life improves be-cause the problem has been !xed.”

GERD is reaching epidemic proportions in the United States. Some people are su"ering from GERD-related symptoms that are di%cult to diag-nose. At HARC, they have brought together all of the specialists and specialized equipment to ac-curately diagnose and treat their patients in one location.

The communication between specialists allows them to treat each patient as an individual. For pa-tients from out of town, arrangements can be made to see more than one specialist in the same day if needed.

Scott & White is a multi-specialty group model and one of the largest of its kind in Texas. With their expertise and advanced technology, it is easy to see why many patients throughout the state opt to be-come part of the Scott & White Healthcare System.

For more information, visit www.sw.org/rr-harc/harc-rr-landing or call 512-509-GERD (4373).

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Dr. Robert W. Hausman uses

at Hausman Chiropractic & Acupuncture.

By HEATHER DANIELSPhotography by TRESAL PHOTOGRAPHY

A WELLNESS CARE DESTINATION

Dr. Robert W. Hausman has a unique approach when dealing with his patients – an approach that seems to be gaining momentum throughout the country. And with good reason, as modern medicine appears to be centered on “sickness care” instead of what Hausman believes should be called “wellness care.”

“I am happy to be part of a health profession that seeks to !nd and !x the cause of a patient’s pain or condition,” Hausman said, “and then aims to prevent future problems without the use of drugs, chemicals or surgery.” Being very passionate about chiropractic and spinal adjustments, Hausman promotes this as the primary treatment modality at his practice.

Following the methodology of chiropractic care, Hausman believes that mobilization of the spine is a chiropractor’s best tool. “It is what much of our edu-cation and training is geared toward,” Hausman said. “Additionally, in order for a person to be truly well, they might need some guidance with regard to pos-tural correction, nutrition and exercise. Our bodies are meant to move and be active; I try to give my patients the tools to live healthier, pain-free lives, instead of al-ways reacting only to the symptoms.”

Pain is a message from your body telling you that

something is wrong. Not only can chiropractic care help treat the pain – regular chiropractic adjustments can prevent future pain and exacerbations from occur-ring.

As an athlete and a runner, Hausman recognizes the importance of maintaining your body’s proper func-tion in order to be active and healthy. Chiropractic care is an essential part of helping our bodies express their future potential.

While Hausman grew up in Iowa, he considers himself lucky to call Austin his home. Attending the University of Iowa, majoring in psychology while com-pleting pre-med requirements, he then received his Doctor of Chiropractic from Cleveland Chiropractic College in Kansas City, Magna Cum Laude.

Upon graduation, Hausman became an associate doctor in a large clinic in Minnesota, but Austin was calling him. Hausman truly loves the Capitol City he calls home. His patients appreciate and respect him for his knowledge and positive approach.

Hausman practices the “whole person approach.” This means that every patient is truly treated di"er-ently when they become part of the practice. Many of the techniques used are similar, but what works really well for one person may not be as e"ective for another.

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“I try to tailor each treatment to the particular per-son I am treating,” Hausman said. “It is in my nature to get to know people on a personal basis, and that enables me to treat more than just their bones and muscles.” Through getting to know his patients and asking the proper questions, Hausman can also pro-vide guidance about other aspects of their health, including diet and exercise.

Performing a comprehensive health history in-cludes discussions of a patient’s lifestyle, previous injuries and surgeries and current pain/symptoms. Hausman performs a physical exam, which includes X-rays, orthopedic tests and palpation in order to as-sess the musculoskeletal system, as well as the ner-vous system.

Knowing what an average day is like for his patients helps Hausman understand the etiology and sources of their pain. This also enables him to give advice for changes that can be made to help with the healing process and help prevent future occurrences.

Patients are then given a custom treatment plan based on all of these elements. The treatment plan explains the frequency of care that is anticipated to reduce and eliminate pain and increase function and mobility. Further visits help stabilize the spine until a point is reached in the treatment where the physician works with the patient to strive for regular wellness care.

Chiropractic care is incredibly successful for treat-ing neck and back pain, which explains why chiro-practors are most commonly thought of as treating these problems. Sports injuries are treated with soft-tissue techniques, as well as maintaining proper mo-tion throughout the musculoskeletal system to help relieve injury and wear and tear.

Other than chiropractic adjustments, Hausman Chiropractic & Acupuncture o"ers massage therapy and acupuncture. Hausman received post-graduate training and certi!cation in order to perform acu-puncture because he strongly believes it’s a terri!c conservative treatment modality.

“I have training that helps me treat acupuncture points associated with pains, and I most often use acupuncture in conjunction with chiropractic care,”

Hausman said. “I !nd that acupuncture works great in my o%ce when I have a patient who is in acute, severe pain. For patients who are interested in receiving acu-puncture for anything other than pain relief and sinus congestion, I gladly refer them to other acupunctur-ists who are trained to treat other concerns and con-ditions.”

With a diverse patient population that includes in-fants to the elderly, Hausman feels it is important to provide a form of health care that keeps his patients moving and feeling well. His short-term goals are to treat more children. When treating children, the re-sults chiropractors see are amazing, to say the least.

“It is important to do my part to help parents un-derstand that chiropractic isn’t just about back pain,” Hausman said. “It is about maintaining the proper function of the nervous system, which controls every-thing that our bodies do from day one.”

He also wants to foster solid relationships with more medical doctors in his area. “I would love to con-vey the message that we can work together to help the people in our community live healthier lives.”

For more information, call 512-419-1000 or visit www.hcaustin.com.

CHIROPRACTIC CARE IS AN ESSENTIAL PART OF HELPING OUR BODIES EXPRESS THEIR FUTURE POTENTIAL.


Jeffrey Fry

By JODY JOSEPH MARMEL

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Sometimes throughout our life experienc-es, an idea emerges because we !nd ourselves caught up in a system that leaves few options. Je"rey Fry, CEO of Help Find Care (HFC), had such a personal experience when having to take care of his mother, Gladys S. Fry, at !rst remotely and then eventually moving her to Austin, where he resides.

It became apparent that something was wrong with the system when he was getting charged $20 an hour for in-home care and the caregiver was only receiving $8.25 an hour in wages.

Fry decided to take action and founded HFC in December 2011. After developing the imple-mentation strategies, blueprinting the feature set and building a team of experts to $esh out the company prior to starting, HFC launched its Web search in June 2012.

With more than 10 years of startup experi-ence with over half a dozen companies, Fry also has expertise in marketing, operations, branding, positioning and sales. And his personality exudes warmth, charisma and class. His experience and style combined make Fry the “go to” expert in all aspects of business – especially businesses that have an unserved need.

The health care !eld has always been one of his main interests, so he formed HFC with two ob-jectives in mind. Most important is increasing the quality of the care and simplifying the experience for the care-seeker, while saving them money. The other highlight is to help caregivers work more independently and earn more money.

Add these two together, and it is easy to see how both parties are the winners, which in es-sence is what Fry wants to emphasize to the ever-growing home health care market.

“By empowering both parties to better man-age the care-giving relationship, HFC !lls a much-needed niche,” Fry explains. “With our superior customer experience and services, HFC will adapt quickly and provide a customer-centric Web por-

tal to make both care-seekers’ and caregivers’ lives easier.”

In order to di"erentiate itself in the market-place, HFC has to constantly re!ne its service to make it easy to understand, simple to use and a true convenience in a person’s life. HFC realizes they need to be far more e%cient in gaining new clients (those looking for care) and as such, have focused the company’s marketing e"orts on part-nering with home health agencies (skilled medi-cal, private health insurance, Medicare) and in some cases, with homecare agencies (non-med-ical, private pay, long-term care insurance).

“By deploying a plan of partnerships with these types of organizations,” Fry says, “this will allow us to grow quickly on a national scale and better help us attract quali!ed, superior caregiv-ers.”

The No. 1 competitive advantage on the care-seeker side is what HFC likes to call the “high touch without the high cost” ability. “We recog-nized that in-home agencies had an advantage over strictly online homecare matching compa-nies in that they provided a local person to come and visit the home of the care recipient. For that service, they charge $12 to $15 more per hour over the salary they pay the caregiver.”

This is also known as “overhead.” HFC o"ers “hands-on” service with their nurse network, which uses local nurses and care managers to help both the care-seekers and caregivers with safety and oversight.

“We also empower the care-seeker to better manage their care by making sure they get the perfect match in a caregiver and negotiate a wage that is both more a"ordable and equitable. In doing this, Help Find Care attracts the best caregivers, o"ering them a better salary, with the assistance of a nationwide, locally administered nurse network.”

HFC is active in the Austin, Dallas, San Antonio, Houston, Killeen, Fort Worth and Corpus Christi MSAs (metropolitan statistical areas), and they account for 90 percent of their business. HFC has just started expanding outside of Texas to Michi-gan, New York, Florida and California.

“Our short-term goal is to complete the rollout of our nurse network service in all MSAs in Texas by the end of 2013, and be in at least 10 other MSAs outside of Texas,” Fry says. “We hope to be in every major MSA in the United States by the end of 2014.”

For nurse, caregiver and care-seeker information, contact managing part-ner Lauren Tarrant, R.N., at [email protected]. For all other information or inquiries, contact Je!rey Fry, CEO, at [email protected]. You may also call 855-HF1-CARE (855-431-

2273) or visit Help Find Care at 6300 Bridge Point Parkway, Building 1, Ste. 575, Austin, Texas 78730.

WITH HFC, FRY AIMS TO MAKE BOTH CARE-SEEKERS’ AND CAREGIVERS’ LIVES EASIER.

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When Derrick Amoriko needed to !nd relief for his chronic back pain that started when he was a child, he became very interested in massage therapy as an alternative route to take to help him with his pain. As a result of this, Amoriko founded Massage Harmony, which rep-resents a new concept in the massage industry.

After he studied at the Lauterstein-Conway School of Massage, Amoriko worked as a therapist for 15 years. With a great educational background and years of treating others, he decided to strike out on his own with a new type of spa. Deter-mined to make massage a luxury avail-able to everyone, he removed many of the “frivolous extras” that were not mak-ing an impact on the clients.

Instead of the frivolous fuzzy slippers and steam rooms, guests are treated to a tranquil waiting area, state-of-the-art treatment rooms, heated tables and the !nest-quality massage therapists. The added bonus is that all of this comes with a price that everyone can a"ord.

Opening the !rst Massage Harmony spa in 2006 in the West Gate Center in Austin was just the beginning. Amor-iko’s concepts gained popularity, and he opened two more spas in the Capitol City.

“We have been carefully growing throughout Austin ever since,” he ex-plains. “Often, clients come to us after having tried other methods such as chi-ropractors or acupuncture as an added element to support their recovery. Regu-lar bodywork has made a huge impact on my life, which is why I am so passionate about giving others a low-cost way to ex-perience the healing bene!ts of massage for themselves.”

Deep-tissue massage is what most people want for chronic pain, but tech-niques such as ashiatsu and sports mas-sages are more e"ective. Massage Har-mony !rst brought the 3,000-year-old ashiatsu bar therapy practice to Austin residents in 2008. From the Japanese words “ashi” (foot) and “atsu” (pressure), this type of barefoot bodywork o"ers cli-ents the deepest massage available.

“We have out!tted 10 of our massage rooms with the practice’s signature par-allel bars, suspended from the ceiling, to enable the specialists to apply their body-weight in varying degrees on the client’s back, legs and shoulders.” This type of therapy has been heralded as an e"ective

Massage Harmony owner Derrick Amoriko and his

By JODY JOSEPH MARMELPhotography by JONATHAN

GARZA PHOTOGRAPHY

A STATE OF WELLNESS

HEALTH & WELLNESSAUSTIN


treatment for reducing back pain, espe-cially for those su"ering scoliosis and disc problems.

The sports massage is for the “serious” athlete. It focuses on the muscles used for a particular activity. This type of massage enhances endurance and performance, lessens the chances for injury and reduces recovery time. Acupressure, or shiatsu, is related to the Chinese system of acupunc-ture. By stimulating the body’s energy pathways, it provides a wonderful sense of relaxation, consciousness and wellness.

Another o"ering is re$exology mas-sage. This eases pain, reduces stress, promotes relaxation and improves cir-culation. A re$exology practitioner ma-nipulates the feet of the patient. Di"er-ent parts of the body can be treated by manipulating di"erent parts of the foot. With more than 7,000 nerve endings, the foot is suited to this sensitive manipula-tion.

For pregnant women, Massage Har-mony has the pregnancy massage. This has been proven to be helpful in treating the back muscles that become sore and tense as they counterbalance the extra weight in the abdominal area.

The most preferred of all the massage types is the Swedish massage. The sooth-ing stroke and manipulations are de-signed to relax muscles, relieve tension, improve the $ow of blood and stimulate the lymphatic system.

Last, but not least, there is the deep-tissue massage. In breaking the stress,

tension and pain cycle by relaxing the muscles, this causes an increase of cir-culation and thus, brings the body to a neuromuscular balance. Designed to re-lieve muscular pain, address soft-tissue injuries and increase range of motion, the techniques consist of slower strokes with more direct pressure across the grain of the muscles.

“Massage therapists of today are the ones bringing their skills to the doctors and chiropractic o%ces to round out their practices,” Amoriko says. “We have a lot of regular clients, and more to the point, over 90 massage therapists. It’s about caring enough about your clients to help them heal themselves, which is what our entire team strives for.”

Reaching a point of wellness is the op-timal goal for Massage Harmony’s sta" and clientele. And by the looks of their success rate, they are very close, if not already there. As Amoriko concludes, “We can’t cure disease. What we can do is help people keep their bodies as healthy as they can to help prevent illness to begin with.”

Massage Harmony has three locations: 1206 W. 38th St., 3300 Bee Caves Road and 4477 S. Lamar Blvd. For more information, visit www.massageharmony.com. And you can call the 26 Doors Spa at 512-276-2481, the Westlake Spa at 512-306-0900 or the Westgate Spa at 512-358-9300.

REACHING A POINT OF WELLNESS IS THE OPTIMAL GOAL FOR MASSAGE HARMONY’S STAFF AND CLIENTELE.


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DALLAS

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FEATUREDALLAS

The National Laser Institute and its onsite medical spa provide a network of learning for

health practitioners and aestheticians.BY HEATHER DANIELS

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The ever-increasing demand in both the medical and cosmetic in-dustries for a “look good-feel good” !x may not be headline news. But the course o"erings for medical profes-sionals, aestheticians, cosmetologists and career-changers at the National Laser Institute (NLI) in Dallas, as well as their onsite med spa, are newsworthy, to say the least.

With campuses in Dallas and Scott-sdale, Ariz., NLI travels the country for “destination courses.” These courses have been held in New York City, Chi-cago, Boston, Philadelphia, Beverly Hills, Las Vegas, San Francisco, Denver, Honolulu and Toronto. “These courses give physicians, nurses, aestheticians and other students the ability to train for a medical aesthetics career with-out traveling far from home,” explains Ami Montague, an LVN in Dallas.

With two plastic surgeons on sta" and a plethora of other specialists who frequent NLI to share their ex-pertise with others who are learn-ing, courses o"ered for medical professionals include a 10-day CE/CME:Botox/Dysport, dermal !llers,

laser, sclerotherapy, skin rejuvenation and chemical peels; this is the most popular of all. Getting 85 CME hours and learning a great deal at the most innovative location in the country is quite remarkable.

While 40 percent of NLI students are medical professionals, Montague has noted an increasing trend: “There is an increasing interest amongst phy-sicians. I have seen several family prac-titioners, pain specialists and even some neurosurgeons attend NLI. I be-lieve that many doctors want to learn more about lasers either because they want to supplement their earnings or they are looking for a career change within the medical !eld.”

Since NLI partners with the biggest companies in the industry, the laser manufacturers can have their prod-ucts seen by people who plan to get into the business. And with thousands of students training at NLI every year, the exposure is a natural one. “Be-cause we receive the equipment for free, we are able to pass the savings along to NLI’s clients.”

Clients? Look a bit further, and there is the NLI Medical Spa, which is getting rave reviews from fellow Dal-lasites. Two options are given for med spa guests. There is the intimate train-ing environment (three to !ve stu-dents and an instructor). The instruc-tor works with one student to guide the process while the others observe.

The deep discounts o"ered are a

tempting treat, and many clients pur-chase a membership card for the NLI Medical Spa for $25. These VIP mem-bers can access deals like laser hair re-moval for less than $8 per treatment. And the dazzling deals are endless.

The private, one-on-one treat-ments give clients the opportunity to be treated by NLI’s expert instructors on non-school days. These are the same practitioners who teach plastic surgeons, dermatologists, general physicians, nurses and aestheticians from around the world how to per-form these procedures. The prices NLI charges for these treatments are still 30 to 50 percent less than the average retail prices.

The story behind NLI starts in 2002 when Louis Silberman (NLI’s presi-dent) and his business partner, Mat-thew Gould, opened a med spa in Scottsdale. They soon realized that there wasn’t any standardized train-ing provided for the people who per-formed laser hair removal and other procedures. Education was limited to a four-hour training session from the

laser manufacturers. “It was like the Wild West. Basically, anyone could pick up a laser and begin treating clients.”

Silberman and Gould wanted to make sure clients were treated in a way that was safe and e"ective, so they created the country’s !rst struc-tured curriculum for cosmetic lasers. Nine years later, in June 2011, the Dal-las location opened its doors.

NLI has received a great response from the community. While NLI has a lot of in-state students, the majority of students travel from across the coun-try and internationally, as well. NLI Medical Spa clients are mostly from the Dallas area.

“We are a top-notch training facil-ity,” Montague concludes, “and our services that we o"er to the clients are high-tech with results that are superb.”

The National Laser Institute is located at 3850 W. Northwest Highway, Ste. 1100, in Dallas, Texas. For more information, call 1-800-982-6817 or visit www.nlion-line.com.

“THE SERVICES WE OFFER TO OUR CLIENTS ARE HIGH-TECH WITH RESULTS THAT ARE SUPERB.”

Ami Montague, LVN, LE, LSO, LHRP

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HEALTH & WELLNESSDALLAS

Robin Plotkin, CEO and founder of Robinsbite Inc., had the marketing knowhow and experience working with successful “big name” corpora-tions, but in 2003, she decided to let her entrepreneurial spirit reign and opened the doors to her company.

“I decided to go back to school to

become a dietitian after my father su"ered a heart attack in his early 50s,” Plotkin says. “I realized that diet and health were directly related and wanted to learn more about how food can dictate better health.”

Being fortunate to work with busi-ness and industry, as well as consum-

ers, Plotkin will not be found in an of-!ce discussing diets with individuals. Rather, you will !nd this registered dietician and culinary nutritionist chatting at cooking classes that focus on healthy foods or leading a Face-book or Twitter chat for a client about healthy ways to feed the family. You

will also !nd her leading a seminar or social media platform on how to re-vamp your diet for heart health.

Providing strategies on market-ing and public relations for many well-known brands, as well as acting as their spokesperson, Plotkin also works with restaurants and chefs. One of her clients is the well-known and respected M Crowd Restaurant Group in Dallas. “I help them identify gluten-free menu items, train the sta" and create accurate nutrition information for their guests.”

Welch’s is one of her clients, and she is a member of the Health and Wellness Advisory Panel. She also develops recipes for them and helps execute their overall nutrition com-munications strategy.

Also being actively involved with Dallas Independent School District, she helped implement the district’s Chef’s Move to Schools program, a derivative of First Lady Michelle Obama’s Let’s Move campaign. This past spring, 12 local chefs shared their time and expertise in 12 schools – primary schools, middle schools and high schools – in an e"ort to in$u-ence students on a host of nutritional aspects.

“Our hope is that the chefs will con-tinue on with this program and there will be a regular presence within all the schools.” Plotkin is making sure the younger generation in Dallas is being educated exactly the way the !rst lady wants so many others to do. She is a true pioneer in all aspects of her business. And this is just an over-view of what Plotkin is currently in-volved with.

Having been in the business of food for 25 years, Plotkin is a nation-ally acclaimed culinary and nutrition expert. She appears on TV and radio and in print on a national level, and she has a very strong social media presence. Spending her “free time” cooking and volunteering for Minnie’s Food Pantry, the North Texas Food Bank and Duck Team 6 (a dog rescue organization), to name a few, she is

BUILDING KITCHEN CONFIDENCE

Nationally acclaimed culinary and nutrition expert Robin Plotkin, R.D., L.D., helps clients revamp their diets for better health, serving as a true pioneer in her business.BY HEATHER DANIELS

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sharing her knowledge and making a di"erence in living a quality life via nutrition and diet.

Teaching Americans about food and food choice is not an easy job, yet somehow, with Plotkin’s amazing personality and sense of humor, she makes learning and changing the way we eat enjoyable.

The lost art of cooking is an art that Plotkin strongly believes needs to be reintroduced for liv-

ing a healthy life. We have all heard that we are what we eat; Plotkin strongly advocates this.

“My advice is always centered on food – un-derstanding it, appreciating it and knowing how to prepare it. Without this basic knowledge, it is a challenge to understand the nutrition behind it and why it is important to our health. I love building kitchen con!dence in people. It can be how to chop

an onion correctly or how to create !ve easy meals based on a rotisserie chicken. I’m not a chef; I’m self-taught. If I can do it, anyone can!”

For more information, visit www.robinplotkin.com or www.robinsbite.com. You can also follow Robin Plot-kin on Twitter (@robinsbite).

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Dr. Craig Schwimmerplace as the leading national provider of minimally invasive

treatment methods for snoring and sleep apnea.BY JODY JOSEPH MARMEL

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“OUR MISSION IS TO IMPROVE PEOPLE’S LIVES BY IMPROVING THEIR SLEEP.”

Is snoring really the laughable and harm-less midnight mannerism we all think it is? It just so happens that snoring and sleep apnea are the most volatile variables a"ecting couples and indi-viduals in the bedroom today, depriving them of the restorative sleep and intimacy they require for a vital life and relationship. It might surprise some to know that 25 percent of married couples regu-larly sleep apart due to a partner’s snoring habit.

Snoring can also cause embarrassment and frustration, as no one wants to be “that guy” on the airplane or the family member no one can sleep near on a campout or vacation. People with un-treated sleep apnea are consistently deprived of sleep. And even more concerning: Sleep apnea is a comorbidity associated with a plethora of other health risks.

“Snoring and sleep apnea are di"erent points on a continuum,” explains Dr. Craig Schwimmer, founder and medical director of The Snoring Cen-ter. “They result from vibration of soft tissue in the mouth and throat. Lesser degrees of vibration cause snoring, while greater vibration can lead to repeated episodes of actual collapse of the airway, which is called sleep apnea.”

Schwimmer spent the !rst 15 years of his ca-reer as a board-certi!ed ENT specialist using tra-ditional surgical methods, but in the early 2000s, several new technology-based procedures were introduced to treat snoring and sleep apnea with minimally invasive techniques.

These new state-of-the-art procedures inspired him to found The Snoring Center in 2004, a na-tional outgrowth of his traditional ENT practice, which is exclusively devoted to using these new minimally invasive methods to enhance the sleep, and even the intimate frequency, of his patients’ lives. Since opening their !rst o%ce in Dallas, The Snoring Center has expanded to include o%ces in Houston and Austin.

As they are the leading national provider of the newest treatment methods, patients from all over the nation $y to The Snoring Center’s Texas o%c-es to undergo the safest and most cost-e"ective snoring and sleep apnea treatment available.

Invasive surgical treatment of snoring and sleep

apnea works by operating on and manipulat-ing the appropriate anatomic sites – typically the soft palate, nose, tonsils and tongue. The newer minimally invasive methods target the exact same sites, but in a much less invasive and painful man-ner. This allows practitioners to treat patients in the o%ce with the use of only local anesthesia, negating the risks and costs associated with in-patient hospitalized surgery.

“Unlike traditional surgical treatments, which typically have prolonged, painful recovery periods, these techniques allow our patients to return im-mediately to normal activities,” Schwimmer says.

Each person’s individual anatomy can vary sig-ni!cantly, requiring di"erent target procedures to attain the desired results. The Snoring Center specializes in a variety of minimally invasive proce-dures that can be used to remedy any individual’s personal snoring situation – the most common be-ing the pillar procedure and turbinate coblation.

The pillar procedure consists of tiny woven im-plants that are inserted into the soft palate in order to sti"en it and decrease vibration potential. Tur-binate coblation is treatment that utilizes a radio-frequency-emitting wand to shrink the turbinate walls inside the nose, providing immediate nasal allergy relief and reducing sinus-related snoring.

Other services include home sleep studies to help patients diagnose their particular situations. Oral appliances can also be custom fabricated for a patient. They are to be worn while sleeping to change the position of the jaw and pull the tongue forward in order to open the airway, serving as a helpful addition to other procedures.

“Our mission is to improve people’s lives by improving their sleep,” Schwimmer says. “Snoring and sleep apnea are two of the most common im-pediments to good sleep. We are the nation’s lead-ing provider of minimally invasive, o%ce-based treatment for snoring and sleep apnea. We hope to help as many people as possible to get better sleep so that they can be healthier and happier.”

For more information, call 855-DR-SNORE or visit www.snoringcenter.com.

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IT STARTS WITH THE MIND.

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El Paso

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WellMed makes patient-centered primary care more available to the residents of Sun City by opening two new Extended Hours Clinics in East and West El Paso.

"SPECIAL TO NSIDE#

ADDINGOPTIONS

EL PASO // PROFILE


l Paso patients who thought the hospital emergency room was their only after-hours option for health care now can see a quali!ed primary care provider in the east and west sides of Sun City.

Physicians at two WellMed clinics are now seeing adult patients and o"ering some pediatric care after hours on weekdays and on Saturdays in an ex-panded space at their facilities.

These WellMed Extended Hours Clinics are a !rst for WellMed, a primary care provider focused on the care of

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Medicare-eligible patients in several Texas markets. Introduced in May 2013 (from an idea pioneered by WellMed sta" support-ing a physician in Harlingen), the Extended Hours concept has since spread to certain WellMed clinics in the Austin market and will be introduced soon in Corpus Christi and San Antonio.

“Inadequate access to health care is a ma-jor problem across the country, !lling hospi-tal emergency rooms and urgent-care clinics with patients whose needs often can be ad-dressed by a highly quali!ed primary care physician,” said Dr. George M. Rapier III, chair-man and CEO of WellMed. “By introducing the WellMed Extended Hours Clinics concept in El Paso, we will make e"ective, patient-centered health care more available to the Sun City community.”

WellMed at Trawood Extended Hours Clin-ic (2260 Trawood) is open Monday through Friday from 8 a.m. to 8 p.m., and Saturdays from 8 a.m. to 5 p.m. Dr. Jie Wu will be the lead physician, serving patients with nurse practitioners Maria Gomez, Linda Ozuna and Maria Rojas.

WellMed at Remcon Extended Hours Clin-ic (7430 Remcon Circle, Building A) is open Monday through Friday from 7 a.m. to 7 p.m., and Saturdays from 7 a.m. to noon. Drs. Ver-noy Walker and William Pitchford will be the providers, assisted by nurse practitioners Mabel Martinez, Lisa Wookee and Cerena Suarez.

WellMed operates more than 70 other WellMed clinics in Texas and Florida dedi-

cated to primary care for Medicare-eligible patients. The El Paso Extended Hours Clinics, however, will accept multiple commercial insurance lines, along with Medicare, as pay-ment for treatment of adult patients.

The Extended Hours Clinics are attached to existing WellMed clinics at Trawood and Remcom. WellMed announced a major ex-pansion in El Paso earlier this year. As part of that expansion, the health care delivery com-pany took over large adjacent space at those locations, setting up the Extended Hours concept.

The expansion also included the opening of a primary care clinic, WellMed at Murchi-son (1810 Murchison), which opened May 1. That clinic is open to Medicare patients on a regular 8 a.m.-5 p.m. schedule Monday through Friday. Dr. Jamie Midez, board cer-ti!ed in internal medicine, is the lead physi-cian.

In all, WellMed has added 10 fulltime health care providers and nearly 30 addi-tional support sta" to the El Paso market in the past few months. WellMed expects to an-nounce further expansion plans for El Paso before the end of 2013.

As part of the expansion, WellMed also an-nounced that Walker is joining the provider group as its fulltime medical director for the El Paso market. Walker had been working part-time in that capacity for WellMed.

To learn more about WellMed Medical Group, visit www.wellmedmedicalgroup.com.

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WELLMED HAS ADDED 10 FULLTIME HEALTH CARE PROVIDERS AND NEARLY 30 SUPPORT STAFF TO THE EL PASO MARKET IN THE PAST FEW MONTHS.


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PATIENTHOUSTON

After studying medicine abroad, Dr. Amir Khan graced the University of Texas – Houston Medical School with his presence and passion as he attained his residency in pediatrics, followed by a fellowship in neonatol-ogy. Joining the faculty at UT Hous-ton in 1998, Khan was determined to make a di"erence in the complex care of preemies. Over the years, he has taken on additional administra-tive roles besides seeing his patients. His desire to help the “little ones” continued to grow as he became more engrossed in this specialized !eld of neonatology.

He is currently an associate pro-fessor of pediatrics and the medical director of the Neonatal ICU, Neona-tal Transport and Respiratory Care at Children’s Memorial Hermann Hos-pital. “I am actively involved in resi-dent education,” Khan explains. “In addition to seeing the patients and directing the clinical enterprise, I am involved in both basic science and clinical research.”

His research interests include re-spiratory diseases and treatment of patients with birth asphyxia us-ing whole-body cooling, to men-tion a few. He is also involved with the Extracorporeal Membrane Oxy-genation (ECMO) program. Khan describes this as heart lung bypass therapy for patients with very sick lungs. While his credentials are quite impressive, the medical care and the additional research he provides to the community are awe-inspiring to those who receive his expert care and their families, as well as the med-ical community at large.

Khan’s mother and father are biol-ogists – “Biology was a natural to me because of the environment I grew up in,” Khan says. “However, I loved physics, as well. What swayed me to become a physician was the pros-pect of dealing with people and their problems and helping them improve their quality of life.”

During his residency, one of his professors suggested that he was a natural at taking care of sick babies and that he should consider fur-ther training in this !eld. “Initially I laughed at the idea, but somehow, I found myself more and more at-tracted to this specialty. I discovered that I was happier when working in the NICU than any other place during my training. As a result, I decided to

do my fellowship in neonatology.”Rather than focusing on speci!cs,

neonatologists focus on the quality of care of premature births. “Inten-sive care, unlike surgery, involves tak-ing care of the whole patient rather than a speci!c area,” Khan explains. “All of us are trained to take care of everything, but some of us develop expertise over time in a speci!c area. For instance, I am one of a handful of people that take care of neonates who are placed on ECMO because they are unable to survive without such extensive help. I also have some expertise in providing respiratory care to sick infants and have been in-volved with various initiatives in the nursery to improve the care of our patients.”

As premature births have in-creased over time, there are a host of reasons that have been postulated. The key word here is “postulated”; nobody knows all the facts as to why, but many physicians in the !eld say nutrition and lifestyle attribute to the rise in premature births. Khan is one of those physicians who feel that regardless of the reasons, premature birth, especially those that happen very early, are very traumatic for the parents by virtue of the fact that they are unexpected.

“There is a tendency for the par-ents to question themselves about what they could have done to pre-vent this, and in most cases, there is nothing that they could have done,”

BY: HEATHER DANIELS

PASSION FORPREEMIESSpecializing in pediatrics and neonatology, Dr. Amir Khan has a passion for improving the complex care and the lives of even his tiniest patients.

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Khan says. “It is very hard to prepare for something that one wishes never happened. I think if a parent is at risk for delivering prematurely, especially those that have delivered prematurely in the past, they should have a thor-ough follow-up with their obstetricians so if there is anything that can be done, it will be done.”

Putting a great deal of emphasis on parental involvement after the in-fant is born allows the parents some sense of control over the lives of their babies who may be very sick and need help with all sorts of machines and medications.

Khan further explains that being a tertiary care hospital means patients are referred to their nursery because they need a level of care and expertise that is not available everywhere else. It requires a dedicated, well-trained group of nurses, respiratory therapists, pharmacists, dieticians, physicians and surgeons to take care of such patients.

“The way I see it is that every patient that goes home from our nurs-ery after having been admitted for being very sick is a success story. There have been instances whereby patients have survived and have gone home after being so sick that the chances of their surviving were deemed to be near impossible. Yet they de!ed the odds with a lot of hard work.” Because of these health care professionals who provide intensive care to neonates, the probability of going home is increasing every day.

The philosophy Khan follows is to provide the best possible care for his patients, and most importantly, to learn from each individual patient so that the care of the next patient is even better. Nowadays, it is not enough to just be able to take care of the patient; it is important to continually improve the quality of care.

“This is known as the learning health care system,” Khan says. “It is ex-tremely important that we do research because without research, we can-not improve the care of the patient. People view research as experimenta-tion. I view it as a way of learning to make the lives of patients better by learning from other patients.”

Because of Khan’s views and devotion to his patients, this family-cen-tered care has made the world brighter for neonates and their families both now and looking ahead toward the future.

For more information on the department of pediatrics at UT Houston, visit http://ped1.med.uth.tmc.edu. To learn more about Children’s Memorial Her-mann Hospital, visit http://childrens.memorialhermann.org.

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AM Healthcare Capital has spent years forming relationships with physician practices across Texas. These relationships provide our clients with access to best healthcare business resources in the lone star state. Headquartered in Houston, Texas with presence in San Antonio, Austin & Dallas, our network has over 15 years of roots embedded in the Texas medical community. We believe in innovation through collaboration and evidence based business practices.

INNOVATON THROUGHCOLLABORATION

OF EVIDENCEBUSINESS PRACTICES

BASED

CALL NOW FOR A FREE CONSULTATION(713) 574-1149

www.amhealthcap.com


PATIENTHOUSTON

Dr. Ravi Somayazula has been servicing East Texans as a board-certi!ed plastic and reconstructive surgeon since 2011. With more than a decade of pro-fessional experience, Somayazula founded Body by Ravi, a subset practice of the established Azul Plastic Surgery clinic in Sugarland, Texas. Since opening his new practice, Somayazula has become a driving force in the education and demysti!cation of plastic surgery myth and misunderstanding, providing pro-fessional consultation and superior surgical prowess.

Somayazula graduated from Rutgers University in New Jersey with a Bach-elor of Science in Biology before heading to Long Island to attend the New York College of Osteopathic Medicine. After completing medical school, he pursued his residency in general surgery at the University of Massachusetts in Pitts!eld.

Unlike a multitude of other cosmetic surgeons, Somayazula took his edu-cation even further, pursuing his plastic surgery fellowship while working at a combination of institutions, including the prestigious Lahey Foundation,

BY: JODY JOSEPH MARMEL

Dr. Ravi Somayazula remains committed to the art of reconstructive surgery and works to establish Body by Ravi as the

premier plastic surgery clinic and med-spa in East Texas.

DRIVING FORCE


Brigham and Women’s Hos-pital and the Boston Children’s Hospital at Harvard.

It was while sojourning on a medi-cal mission to Ecuador, reconstructing cleft lips and treating burn victims, that Somayazula became committed to the art of reconstructive surgery. The Latin root of the word “plastic” means” to change,” and Somayazula has gained the skills necessary to change people’s lives, whether it be for functional or aesthetic pur-poses.

One of the most important variables a surgical candidate should consider when choosing a physi-cian is the doctor’s quali!cations and operational training. “Choosing a board-certi!ed plastic surgeon is important because it means that there is a large ele-ment of safety and honesty that goes into the thought process, which eventually leads to happier patients and better outcomes,” Somayazula explains.

At Body by Ravi, it all starts with the free initial con-sultation, where patient concerns and expectations are carefully considered. Regardless of the complexity of the transformation, Somayazula has the ability to ex-plain all treatment and procedure options thoroughly and in way that is comprehensive to any patient.

“There have been numerous times that patients have chosen me as their plastic surgeon based on the fact that they went to other surgeons who did not spend enough time with them,” he says. “I go over all the risks and bene!ts of each procedure with the pa-tient, and they appreciate that.”

With all the hype and misleading information out there about plastic surgery, Somayazula can consult patients on the truths and fallacies of some of the contemporary myths and help patients safely achieve realistic goals. “I strongly believe that a well-educated patient ultimately leads to a happy patient,” he says.

Body by Ravi o"ers a variety of in-demand surgical procedures, including (but not limited to) breast aug-mentation, breast lifts, breast reconstruction after can-cer surgery, tummy tucks and liposuction. Somayazula uses the most state-of-the-art breast implants avail-able, including Mentor implants made in Texas and anatomic breast implants, which can provide a more natural shape than their rounder counterparts. Also o"ered is a diverse menu of non-invasive procedures such as the ever-popular !llers and Botox.

“Cosmetic surgery truly is a combination of sci-ence, art and safety,” Somayazula says, summing up his professional philosophy. With an impressive list of credentials and superior surgical training, So-mayazula’s practice is establishing itself as one of the best choices for cosmetic surgery in the state of Texas.

For more information or to reserve a free consul-tation, please contact Body by Ravi at 281-242-1061. You can also visit Dr. Ravi Somayazula online via Facebook, Twitter (@bodybyravi) or www.bodybyravi.com.

“I STRONGLY BELIEVE THAT A WELL-‐EDUCATED PATIENT ULTIMATELY LEADS TO A HAPPY PATIENT.”

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MD NSIDERHOUSTON

Chronic pain is a syndrome with multiple dis-ease processes, and it a"ects the lives of more than eight million Texans today. In order to help both the patient and the doctor obtain their desired end re-sult, understanding that pain is key.

In this article, the !rst entry in our new MD NSID-

ER section, we speak with pain management spe-cialist Dr. Teody Aves about what he and his team at Houston’s Pain Relief Associates do to improve the lives of their patients.

Although the treatment of pain is as old as the practice of medicine itself, pain management is

relativity new as a subspecialty. As a board-certi!ed anesthesiologist, Aves has been practicing pain management medicine since 1993. He and his team take a conscientious approach to their pain prac-tice, but they also have the following strategy for treatment that sets them apart from other practices:

“Patients experience pain in various times in their lives. We at Pain Relief Associates take our time in getting to know each and every new patient so that we can truly understand the source and devise the best treatment for pain. Our hope is if we can treat your lower back pain and give you an exceptional patient experience, you will come back to us if you develop a migraine, for example.”

Like so many other specialty practices, success-ful pain management practices rely on new patient referrals. Aves and his team at Pain Relief Associates create an environment that cultivates patient refer-rals.

“Compassionate care begins with clinical expe-rience and is conducive to relationship building,” Aves says. “The best referral a physician can receive is from a patient that he treated successfully. That’s what we hope for at Pain Relief Associates. We try to focus on the problem at hand and !nd out what is causing it.”

When it comes to treating patients, Aves uses what he refers to as the “sniper approach,” which encompasses diagnostic imaging, along with physi-cal medicine and muscle therapy. Physical medicine such as physical and occupational therapy is an in-tegral component of treating more than 50 percent of pain. When those options have been exhausted, therapeutic blocks such as epidural steroid injec-tions (ESIs) and spinal cord stimulators (STIM trials) are then considered.

While the o%ce experience is a crucial compo-nent, Pain Relief Associates partners with treatment facilities and surgery centers that they consider equally important. According to Aves, “our surgical procedures are performed at the best facilities in Houston with the highest patient satisfaction I have experienced since I opened my doors in the 1990s.”

Pain really does matter, and unfortunately, its occurrence worsens over time. But Aves and Pain Relief Associates seem to have both the expertise to help patients !nd relief from pain and the special recipe for creating lasting relationships with their patients and delivering quality outcomes.

To learn more about Pain Relief Associates, go to www.livewithrelief.com.

Amir Mortazavi is a physician development professional at Healthcare Capital, a physi-cian practice management firm that partners with physi-cians and creates opportuni-ties to optimize practices. For more information, visit www.amhealthcap.com.

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Dr. Teody Aves and his team at Pain Relief Associates take a compassionate approach to pain management medicine.

BY: AMIR MORTAZAVI

PAINMATTERS


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R. DENNIS SLAVIN may be a New Yorker,

but he came to Texas and stayed for a reason. And he’s

been relieving people of their pain and putting them back to work and into motion ever since.

Slavin was a chemistry major in col-lege, fascinated by the pharmacology associated with anesthesia. Intrigued by the physiology of what receptor was being blocked to the dynamics of patients’ heart rates, the !eld of an-esthesia was like exercise training in physiology. Slavin completed medical school and a residency in anesthesia in New York City. While completing his residency, he saw the potential in interventional pain management. During his training in the early ‘90s, in-terventional pain management hardly existed, but he realized he was on the brink of something big.

Slavin wanted to see what op-portunities existed throughout the United States, so he enrolled as a trav-eling doctor with a few locum tenens programs. One of those companies brought him to the Rio Grande Val-ley in 1994. The Valley in 1994 was on the brink of a substantial health care growth spurt. With new technologies, the mid- to late ‘90s brought tremen-dous growth to the bourgeoning !eld of interventional pain management, and Slavin knew he was situated in a prime position to advance with it. Slavin worked in a growing hospital practicing anesthesiology and some interventional pain management.

“It was a good climate to stay,” Slavin says. In the ‘90s, it wasn’t un-common for patients in the Valley to have to go to San Antonio or Houston for pain management procedures. “There was a need here. Patients don’t have to travel long distances because the expertise is here now. I’m doing anything and everything that they’re doing in the major cities.”

Shortly after his locum tenens as-signments, he set up his own practice in McAllen and Weslaco doing both an-esthesiology and pain management. As an anesthesiologist, his expertise in targeting injections and tailoring nerve blocks for surgical procedures gave him leverage in the growing !eld. He says interventional pain manage-ment physicians became the answer to the requirement that both patients

DR. DENNIS SLAVIN: CHAMPIONING INTERVENTIONAL PAIN MANAGEMENT IN THE RIO GRANDE VALLEY

By SHANA HAMIDPhotography by JOSEF ARMENDARIZ

OF RELIEFKING

DRIO GRANDE VALLEY // PROFILE


and insurers wanted good out-comes without side e"ects. His pain management division soon grew to the point where he invested fulltime as an interventional pain manage-ment specialist.

Slavin treats a range of pain conditions, including very common cases like lower back pain, shoulder pain, hip bursitis and degenerative joint disease of the knees. His practice o"ers a number of treatments, which always include a detailed phys-ical exam, MRI imaging and a focus treatment, and he does all treatments in the o%ce as outpatient visits. About half of his patients su"er from lower back pain, many times caused by a bulging or herniated disc in the lumbar spine.

Slavin says most patients with minor disc problems don’t require surgery, but en-dure enough pain that it in-terferes with their sleep, their daily activities and their jobs. Slavin emphasizes that di"er-ent pain structures cause dif-ferent pain patterns. He treats a lot of facet joint problems, herniated discs and muscle spasms, all of which have spe-ci!c treatments.

He explains that many pain structures that a"ect the lower back can also a"ect the thorac-ic and cervical spine; therefore, many low-back treatments can treat di"erent spinal areas of pain. “It’s about a detailed history and physical exam, di-agnosing what the pain gen-erator is and doing speci!c treatment that alleviates that pain. We’re really trying to get patients better with the least amount of interventions.”

He’s constantly asked, “How long will the pain be gone?” Slavin regularly educates his patients on outcomes, designs home exercise pro-grams speci!c to their problem and encourages all of his patients to be earnestly involved in their treatments. “It all depends how the patient presents. The thing that I tell patients is that they have to be actively involved in their treatments. All the patients who we do treatments on the lumbar spine – we give them a speci!c home exercise program. We en-courage them to pursue that program.”

Slavin coaches patients in ways to strengthen the structures around the pain generator. He treats many people with sedentary jobs and says most people don’t realize sitting for long periods of time is stress on the lumbar spine. Walking – one of the

best exercises for strengthening the muscles in the lower back – is often recommended. “The way you were made is to be standing. The lumbar and tho-racic spine was made to be standing upright, not sit-ting or lying down.”

Inevitably, patients do !nd relief and are able to resume a normal life through interventional pain management techniques. Seeing those restorations is exciting. For example, an elderly woman couldn’t brush her hair because she couldn’t lift her arm above her shoulder. “After her injection, she comes in and is waving to me down the hall like, ‘Look, I can wave my arm.’ That’s awesome!” Slavin says. He treats many workman comp injuries – many work

with the border patrol, at H-E-B, as 18-wheeler truck drivers and as police o%cers. “Getting them back to work and having them feel con!dent they can do their job – huge!”

He’s witnessed 90-year-olds who couldn’t get up out of a chair jump out of their chair after treatment. He’s watched people who’ve been told they’d have to have a total knee replacement come o" their pain medications and no longer entertain the option of surgery.

Slavin stays fairly close to new research and continues to be certi!ed by some of the best boards of certi!cation in his !eld. He is board certi!ed through the American Board of Pain Medicine and the American Board of Anesthesi-ology, and most recognizably, he became a diplomat of the rigorous American Board of Interventional Pain Physicians.

“There were speci!c rea-sons why I wanted to get these other certi!cations. I thought it would set the bar the high-est out of all the certs I have. I feel committed to the patients here to provide the highest quality of care possible. It makes them very con!dent in the care I deliver because I’ve met the criteria of very strin-gent board certi!cation pro-cesses.”

Slavin wants people to know if they have chronic pain, there are very good medicines and interventions that work. People have the ability to seek out a pain management specialist. There are many minimally invasive treatment options and some highly so-phisticated devices used to control pain. Medicines have gotten better, interventional

techniques have improved and cutting-edge tech-nology is making treatment even more speci!c.

Interventional pain management is the solution to many conditions when surgery isn’t an option or necessary. Neurosurgeons may be!ttingly treat pa-tients where the condition requires surgery, but as Slavin points out, “we’re not putting neurosurgeons out of business. We’re addressing a need that wasn’t met 15 years ago.”

For more information on Dr. Dennis Slavin’s practice, visit www.riograndepainteam.com.

“WE’RE TRYING TO GET PATIENTS BETTER WITH

THE LEAST AMOUNT OF INTERVENTIONS.”

HEALTH & WELLNESSRIO GRANDE VALLEY

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The low down on low T: what to do if you suspect your testosterone levels could use a boost

By AARON I. GARZA

KEEPING THE“KING” IN CHECK



Meet Bob. He’s in his mid-40s, hard-working and at the peak of his business career. He has a beautiful wife, and two daughters who think the world of him. Bob tries to take care of himself; he goes to the gym three times a week and makes decent decisions when it comes to his diet. But lately, something’s been missing. He just doesn’t seem to have the pep in his step he used to. By the time 2 p.m. rolls around, he !nds himself dragging, tired and needing a nap.

Bob’s also noticing a slight decrease in strength and muscle, not to mention his pants just don’t seem to !t the same. Now, Bob can deal with the strength and energy decline, but the one thing that seems to really be getting him down is his love life. Things are changing, and Bob doesn’t like it. But there is good

news: What Bob is experiencing is ex-tremely common in men over 40, and it can be reversed.

If Bob’s scenario sounds familiar and you can relate, chances are you could be su"ering from low testosterone lev-els, otherwise known as “low T.” Testos-terone, as we all know, is the “king” of male hormones. It is responsible for a host of functions, including strength, energy, mental clarity, fat loss, sex drive and overall wellness. As men age, testos-terone levels can drop and cause a host of sometimes serious problems such as weight gain, depression, lack of energy, diabetes, high blood pressure and most strikingly for some, erectile dysfunction.

That last one seems to really get most men on edge, but it’s the truth, and to-day, more and more men are beginning to ask the question, “What can I do to in-crease my testosterone levels?” First, it’s

important to understand what’s consid-ered low. The bottom of a man’s normal testosterone range is around 300 nano-grams per deciliter, and the upper limits are between 1,000 and 1,200 ng/dl.

Low T can be caused by a number of conditions, including testicle damage, obesity, hormonal disorders, kidney or liver disease, diabetes and medications, as well as age. Blood tests can determine your testosterone levels and open the door for discussion with your doctor.

Today, many options are available that will help replace testosterone if and when needed. These include patches, implants, gels and injections, but they may have drawbacks and of course, side e"ects, which could a"ect other areas of your health. So what’s a man to do?

Although sound nutrition, diet and

exercise play a role in optimizing any man’s testosterone levels, there is more and more scienti!c validation showing the bene!t of using certain supplements to naturally increase existing testoster-one levels. When I encounter a client with low T (which has been validated with blood tests), he usually has come to me as a last resort. He has visited with his physicians and understands his issue, but he wants an alternative to pharma-ceuticals.

As a supplement formulator by trade, I immediately pursue a direction that can promote the body’s natural ability to heal or restore its normal balance natu-rally. Up until recently, there were very few e"ective natural products to help restore and improve testosterone levels in men.

This changed a few short years ago with the introduction of D-Aspartic Acid

(a naturally occurring amino acid found in the neuroendocrine tissues of hu-mans.) D-Aspartic Acid has valid scientif-ic studies establishing its e"ectiveness. In fact, an Italian study recently demon-strated that giving 3 grams (3,000 mg) of D-Aspartic Acid to individuals daily for 12 days increased serum testosterone by 35 to 45 percent. This is the most signi!-cant e"ect on testosterone that has ever been documented through the use of a natural supplement.

Until recently, D-Aspartic Acid wasn’t available as a supplement because it was only sold as an Aspartate (this version is not e"ective.) The D-Aspartic form is what actually was used in the study, and it shows the most promise. D-Aspartic Acid was originally only available in Italy (where the study was completed), but

it has now slowly made its way to U.S. soil through a novel new supplement called T-Drive.

T-Drive, which uses a patented form of D-Aspartic, releases quick-ly into the blood stream and el-evates testosterone levels within 48 to 72 hours. My advice is to compound this product with oth-er natural products, including one called TestoPlex, which combines other well-studied testosterone elevators such as magnesium, zinc and Bulgarian tribulus.

Although not as e"ective as true pharmaceutical testosterone, D-Aspartic Acid o"ers a complete-ly natural and side e"ect-free way of enhancing the body’s natural testosterone-producing abilities. The initial results have been very positive, and I’ve personally wit-nessed several men (who have done blood work pre- and post-D-Aspartic Acid supplementa-

tion) experience increased testosterone levels, improved wellness and of course, enhanced sexual performance.

If you feel like you could be su"er-ing from low T, you owe it to yourself to get your testosterone levels checked and perhaps give a product like T-Drive a go. It may be your answer to improv-ing those certain aspects of life that truly count. T-Drive can be purchased at www.thepureline.com or at any Pureline Nutri-tion Store in Texas.

Aaron Garza is the founder of Pureline Nu-trition and a nationally recognized author-ity on nutrition and supplementation. He’s been featured in Muscle & Fitness, Mus-cular Development, FLEX and Iron Man magazines. He can be contacted through email at [email protected].

D-ASPARTIC ACID OFFERS A NATURAL AND SIDE EFFECT-FREE WAY OF ENHANCING THE BODY’S NATURAL TESTOSTERONE-PRODUCING ABILITIES.


HEALTH & WELLNESSRIO GRANDE VALLEY

he occurrence of overweight in children has tripled in the past 30 years, and it is now estimated that one in !ve children in the United States is overweight. There has also been an increase in overweight children, including preschoolers.

Dr. Ambrosio Hernandez is a board-certi!ed general and pe-diatric surgeon. He is passionate about combating adult and

childhood obesity rates in South Texas. The prevalence of overweight individuals is especially higher among certain

populations such as Hispanic, African American, Mexican American and Native American. Studies show that 35 to 40 percent of individuals in these populations are over the 85th percentile on the body mass index (BMI) chart.

Also, while more children are becoming overweight, the heaviest children are getting even heavier. As a result, childhood overweight is regarded as the most common prevalent nutritional disorder of children and adolescents in the United States, and one of the most common problems seen by pediatricians.

Hernandez answers a few common questions regarding the problem.

Summer is the season of ice cream, barbecues, cold sodas and raspas, coupled with lazy days by the pool, on the sofa and at the beach. But don’t let the leisure of

summer affect your child’s weight.

SPECIAL TO NSIDE

BEAT THE TREATS

THIS SUMMER

THE EXPERTS

"Expert advice from the physicians at Doctors Hospital at Renaissance.”

T Q/EXPLAIN THE DIFFERENCE BETWEEN AN OVERWEIGHT CHILD AND AN OBESE CHILD.

A/Obesity is an excess percentage of body weight due to fat that puts people at risk for many health problems. In children older

than 2 years of age, obesity is assessed by a measure called the BMI.The BMI is calculated from a child’s weight and height. It is a reliable

indicator of body fat for most children and teens. Your child’s pediatrician should assess BMI at each well visit beginning at age 2. For children and adolescents, BMI is age- and sex-speci!c, and it is often referred to as BMI-for-age. After BMI is calculated for children and teens, it is plotted on the CDC BMI-for-age growth charts (for girls or boys) to obtain a percentile ranking.

Children and adolescents with a BMI over the 85th, but less than 95th, percentile are considered overweight. Children with a BMI greater than the 95th percentile are considered obese.

ASKHEALTH & WELLNESSRIO GRANDE VALLEY


Q/ PARENTS USUALLY HAVE TO LEAVE KIDS ALONE DURING THE

SUMMER. HOW DO WE CONTROL WHAT AND HOW MUCH THEY EAT?

A/It’s extremely important that you, as the parent, be a nutritional and physical role

model for your children. The !rst thing you must do is keep nutritious food around the house. Focus on creating a home environment that encourages and supports healthy choices. Here are some things you and your children can do beat the treats this sum-mer:

Eat !ve fruits and vegetables per day. Sum-mer fruits like melons are very refreshing after fun, outdoor activities. So reach for a slice of fruit and

some water as opposed to a sugary sports drink or soft drink.

Eat breakfast daily. Research shows that peo-ple who eat breakfast on average weigh less than those who don’t. A high-protein breakfast such as eggs will curb hunger longer than sugary cereals and pastries.

Eat a diet rich in calcium, but switch to low-fat dairy products such as soymilk, fat-free Greek yogurt and low-fat cheese.

Limit your consumption of fast food and take-out, and reduce the frequency of eating out. Instead, prepare meals at home as a family and reg-ularly eat family meals together.

All families should strive to live healthy, active lives. Creating a healthy home environment where physical activity is encouraged, nutritious, low-fat food options are readily available and sugary drinks and sodas are limited is an achievable goal.

Q/WHAT ARE SOME THINGS WE CAN DO TO ENCOURAGE

PHYSICAL ACTIVITY IN THE SUMMER?

A/Parents can play a key role in helping their children become more physically active. It

is important to talk with your pediatrician. Your pe-diatrician can help your children understand why physical activity is important and suggest a sport or activity that is best for them. Help your children !nd fun activities they enjoy. The more children enjoy the activity, the more likely it is that they will con-tinue with it. And get the entire family involved – it

is a great way to spend time together!It’s also imperative to choose an activity that is

developmentally appropriate. For example, a 7- or 8-year-old child is not ready for weightlifting or a three-mile run. But soccer, bicycle riding and swim-ming are appropriate activities for most ages.

Plan ahead. Make sure your children have a con-venient time and place to exercise. As a parent, you should provide a safe environment. Make sure your children’s equipment and chosen sites for sports and activities are safe, and make sure their clothing is comfortable and appropriate.

One of the most e"ective things we can do to en-courage more activity by our children is turn o" the TV. Limit television watching and computer use and encourage kids to go outside to play. The American

Academy of Pediatrics recommends no more than one to two hours of total screen time, including TV, videos and computer and video games, each day. Use the abundance of free time in the summer for more physical activities.

Q/MANY OF US HAD A FEW EXTRA POUNDS AS ADOLESCENTS;

WHY IS IT SUCH A BIG DEAL NOW?

A/Our society has become more sedentary over time, especially with the continued

development of technology. With participation in all types of physical activity declining dramatically as a child’s age and grade in school increase, it is important that physical activity be a regular part of family life. Studies have shown that lifestyles learned as children are much more likely to stay with a person into adulthood. If sports and physi-cal activities are a family priority, they will provide children and parents with a strong foundation for a lifetime of health.

Overweight or obese children and adolescents are at risk for many health problems. Some of the negative health outcomes that may be more obvi-ous to children and their parents are asthma, sleep apnea, skin infections and complaints of joint pain. All of these are signi!cant health problems and need the attention of a doctor.

However, in addition to these, there are other se-rious health risks associated with obesity that may be less obvious to the child or parent such as high blood pressure (hypertension) and Type 2 diabetes. These conditions can have serious long-term health

e"ects and may require ongoing medical treatment and management. The bottom line is that obesity can cause immediate health problems, as well as a number of very serious chronic health conditions.

Q/ IF A TEEN IS SEVERELY OVERWEIGHT AND HAS TRIED

UNSUCCESSFULLY TO LOSE WEIGHT, WHAT ARE HIS OR HER OPTIONS OTHER THAN GOING OFF TO A WEIGHT-LOSS CAMP THIS SUMMER?

A/We have to remember that losing weight and making better nutritional choices are

not the acts of the children alone. They must be encouraged and supported by the family. There

are many reasons a child may not be able to lose weight. Again, it’s important to discuss this with your pediatrician. When dieting and exercise fail, there are other options that a doctor can provide such as weight-management programs, nutritionist visits and even in extreme cases, bariatric surgery.

Q/ HOW CAN EXTRA WEIGHT AFFECT CHILDREN WHEN THEY

GO BACK TO SCHOOL?

A/Current research indicates that obese chil-dren have lower self-esteem and self-con!-

dence than their thinner peers. Low self-esteem and self-con!dence have been linked to poor academic performance, fewer friends and depression. For all of these reasons, it is important to try to prevent childhood obesity and identify overweight and obese children quickly so they can begin treatment and attain and maintain a healthy weight. It is also noted that overweight children are confronted in school with:

• Shame• Teasing and bullying• Negative stereotyping• Discrimination• Social marginalization

For more information about obesity or bariatric sur-gery options, or to schedule an appointment, call the Renaissance Bariatric & Metabolic Institute (RBMI) at 956-362-LOSE or visit www.dhr-rgv.com.

WHILE MORE CHILDREN ARE BECOMING OVERWEIGHT,THE HEAVIEST CHILDREN ARE GETTING EVEN HEAVIER.

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ASK THE EXPERTS

Protection, that is. In the summer, we enjoy more sun. Most of us remember to protect our skin, but we often forget about protecting our eyes. By DR. R. PENA

MAKE SURE THE EYES HAVE IT!

Q/WHAT ARE UV RAYS, AND HOW DO THEY AFFECT

OUR EYES?

A/Ultraviolet (UV) light is electro-magnetic radiation from the sun.

UV light can cause varying degrees of dam-age to the eye based on the amount of ex-posure. Exposure to excessive amounts of UV radiation over a short period of time is likely to lead to photokeratitis. Photokera-titis is referred to as “sunburn” of the eye. It is usually temporary, and it rarely causes permanent damage to the eyes. Symptoms include discomfort involving red eyes, hazy vision, sensitivity to light and a gritty feel-ing in the eyes. Exposure to UV radiation over a longer period of time can increase the chance of developing a cataract and/or damage to the retina, a nerve-rich lining of the eye used for seeing.

Q/WHAT IS THE UV INDEX, AND HOW DOES IT AFFECT

US HERE IN THE RIO GRANDE VALLEY?

A/The UV Index is the measurement of the strength of the UV radiation

from the sun at a particular place on a par-ticular day. UV levels are greater when the sun is high in the sky, typically from 10 a.m. to 2 p.m. In addition, UV levels are greater in wide-open spaces, especially when highly

re$ective surfaces like snow and sand are present. With much of the Valley traveling to and from South Padre this summer, it is even more important to use quality eye protection.

Q/WE ARE OFTEN OUT IN THE SUN A LOT DURING

THE SUMMER DOING PROJECTS AROUND THE HOUSE. SOME WEAR HATS TO BLOCK THE SUN. SHOULD THEY WEAR SUNGLASSES, TOO?

A/It is extremely important when selecting sunglasses that they

provide 99 percent or higher UV protec-tion. Proper sunglasses are key to protect-ing your eyes from sun-related damage, and they should be worn anytime you are outdoors, especially in the summer when UV radiation is at least three times higher than in the winter, when at the beach or in the water and when using medications that cause sensitivity to light. The best sun-glasses o"er 100 percent UV absorption, are of the best optical quality and are impact resistant.

Q/DO I HAVE TO WEAR SUN-GLASSES IF IT’S CLOUDY?

A/Surprisingly, cloud cover doesn’t af-fect UV levels signi!cantly. Your risk

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of UV exposure can be quite high even on hazy or overcast days. This is because UV is invisible radiation, not visible light, and it can penetrate clouds.

Q/DO THE POPULAR, STYLISH SUNGLASSES REALLY PROTECT OUR EYES AND PROVIDE PROTECTION FROM

UV RAYS (ESPECIALLY THE ONES WITH A LIGHT TINT)?

A/Tint and color do not provide insight into the ability of the sunglasses to block UV rays. It is important to check the UV protection they o"er.

In fact, darker tinted glasses with no UV protection may cause even more dam-age because your pupils may be larger, allowing more UV light in. It is always best to choose wraparound styles and/or close-!tting sunglasses.

Q/WILL MY CONTACT LENSES PROTECT MY EYES FROM UV LIGHT?

A/There are contact lenses available with UV protection. If you do not have contact lenses that absorb UV light, you need to protect your

eyes with sunglasses.

Q/WILL I NEED TO TAKE EXTRA PRECAUTIONS AFTER HAVING CATARACT SURGERY?

A/It is important to know that we all get cataracts if we live long enough. It is not a question of if, but when. People who spend more time out-

doors without protection will be a"ected sooner. More than two million Ameri-cans have cataract surgery each year. During the procedure, I remove the eye’s natural lens and replace it with an intraocular lens (IOL). The newer IOLs absorb UV light, but it is always important to use sunglasses as added protection.

Q/WILL I NEED TO TAKE EXTRA PRECAUTIONS AFTER HAVING LASIK SURGERY?

A/Sunglasses after LASIK surgery are absolutely essential. Although LASIK allows the freedom to be more active outdoors without the

need of contacts or glasses, it is still important to protect your eyes with sun-glasses. In fact, this is an excellent time to purchase those stylish glasses with-out worrying about a prescription! LASIK eye surgery is life changing, and many of my patients wonder why they waited so long in the !rst place. You don’t have to decide between being able to see and getting wet next time you travel to the beach. Just make sure you have the proper goggles when swimming and the proper sunglasses when outside.

For more information, contact Shea Joyner Prevost of Doctors Hospital at Renaissance at 956-827-6211.

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ASK THE EXPERTS

Simple steps occasional athletes can take to avoid common injuries and increase their ath-letic performance By DR. KIP OWEN

PREVENTING STRESS ANDEXERTION

Q/WHAT ARE THE MOST COMMON INJURIES YOU SEE AMONG

OCCASIONAL ATHLETES?

A/Most of the injuries I encounter among occasional or aspiring athletes can be

classi!ed as “overuse” or “stress” injuries.# In other words, the athlete’s activities have exceeded their body’s capacity to repair or keep up with the ex-ercise stress they have applied to their body.# Our bodies can adapt and refurbish themselves when given the opportunity.# Common ailments include knee pain, leg pain and foot pain (where the rubber meets the road).

Q/WHAT SIMPLE STEPS CAN SOME TAKE TO PREVENT COMMON

INJURIES?

A/A dedicated pre-stretch and post-stretch can help prevent# exertion injuries. Five

minutes pre and post should be a minimum at ev-ery workout. Progressive training and cross train-ing are also essential.#An occasional athlete should pick a training goal and then drop that goal to less than half for starters.#They should cross train on al-ternate days (stretch, bike, swim, gym).#A progres-sion of 25 percent per week for the chosen activity should#be#safe and allow the body an opportunity to compensate and strengthen for the activity.

Q/WHAT ROLE DO PROPER FORM AND TECHNIQUE PLAY IN THE

PREVENTION OF COMMON INJURIES?

A/Form and technique are important for performance at the highest levels of

competition.# Occasional athletes should focus more on frequency, recovery and intensity.#As oc-casional# athletes graduate to more competitive levels, they can focus more intensely on form and technique.

Q/ HOW DO PROPER GEAR/ATTIRE AFFECT INJURY PREVENTION?

A/Proper gear and apparel make a di"er-ence.#Well-cushioned running gear with ex-

cellent arch support and impact cushioning can help alleviate running impact injuries. Appropriate cloth-ing can decrease heat overload while exercising.

Q/ARE THERE CERTAIN FOODS I CAN EAT TO INCREASE DEXTER-

ITY OR PHYSICAL PERFORMANCE?

A/A balanced diet of fruit, vegetables, nuts, meat and dairy products is the safest

and most recommended prescription.# The addi-tion of a multivitamin with C and zinc helps with bodily repair after exercise.# And the addition of a vitamin D supplement usually makes sense. Hydra-

tion is essential!# Preload with 20 ounces of $uids pre-exercise.# I recommend 15 ounces of $uid per 15 minutes of exercise. If#your exercise exceeds 60 minutes, supplementation with carbohydrates and electrolytes is recommended (for example, sports drinks such as Gatorade or Powerade).

Q/ IF I HAVE BEEN HURT DURING AN ATHLETIC ACTIVITY, WHAT

SHOULD I DO (ASSUMING I DON’T NEED TO GO TO THE ER)?

A/In addition to anti-in$ammatory medica-tions as needed, most athletic injuries re-

spond well to RICE:

R: restI: iceC: compressionE: elevation"

When injuries persist beyond seven to 10 days despite conservative management as previously listed, evaluation by a medical professional is rec-ommended.

Dr. Kip Owen is a board certified-orthopaedic surgery sports medicine doctor, and he is board certified by the American Board of Orthopaedic Surgeons in both general orthopaedics and sports medicine. Owen has hospital privileges at Doctors Hospital at Renaissance. For more information, contact Doctors Hospital at Re-naissance at 956-DOCTORS or visit us online at www.dhr-rgv.com.

Note: Doctors Hospital at Renaissance proudly meets the federal definition of a “physician-owned hospital” (42 CFR §489.3). The physicians on our outstanding medical sta! are not employees or agents of the hos-pital, but are independent contractors whose profes-sional relationship is directly with the patient.

APPROPRIATE CLOTHING CAN HELP

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The Rio Grande Valley Diabetes Association (RGVDA) is a not-for-pro!t organization founded in 2007 by a group of local doctors and business pro-fessionals who were concerned about the health and well-being of the Hidalgo County residents. In an e"ort to educate and service the fast-growing community of the Rio Grande Valley, they worked in coalition to form a localized and independent diabetes association.

The RGVDA mission is dedicated to the preven-tion of diabetes and its complications through edu-cational services, early detection and awareness for residents of the Rio Grande Valley. The RGVDA o"ers an array of services tailored speci!cally to this area such as diabetes management, meal planning, out-reach programs, cooking classes, insulin injection training, preventive in-school programs and diabe-tes camps for children and adults.

In order to provide these services free of charge, the RGVDA must host several events throughout the year to raise funds. Annually, the RGVDA hosts its very own “Dancing with the Stars” gala, the most pro!table fundraiser of the year. At this memorable fundraiser, trusted community leaders in the Rio Grande Valley volunteer their time to participate as the “stars” and pair up with professional dancers who choreograph a dance routine that will hope-fully be snappy enough to grab the attention of the audience. A live and silent auction also takes place throughout the course of the gala; all proceeds of this event go to the RGVDA.

Walkerz Against Diabetes is another annual fundraiser for the RGVDA. At this event, teams of walkers and runners are organized to participate in a three-mile walk/run that creates diabetes aware-

ness throughout the Hidalgo County and San Beni-to area. Citizens, as well as universities and busi-nesses, rally a large group of teams that proudly sport Walkerz Against Diabetes T-shirts. Every year, the “Diabetic Walkerz” are accompanied by their family members and friends to show their support in the !ght against diabetes.

Just recently, the McAllen-Edinburg-Mission met-ropolitan area was ranked the most obese metro in the United States. Obesity is a leading factor con-tributing to diabetes and diabetes-related complica-tions. Events such as Walkerz Against Diabetes not only help raise awareness of this epidemic in the Rio Grande Valley, but also encourage a healthy lifestyle through physical activity.

We currently live in an age where daily home-cooked meals are almost entirely extinct and fast-food franchises and restaurants have replaced “din-ner time at the table,” as well as our food portions. Home cooking is not always the healthiest, but if we take into consideration the amount of oils, fats, sugars and carbohydrates we use in our meals and learn to balance them, we come to !nd that home cooking can be delicious, as well as nutritious.

The RGVDA o"ers healthy cooking classes that are designed speci!cally for the diabetic person. In each class, participants are given a step-by-step guide to follow that shows them how to cook and teaches them the portion size to use for each rec-ipe. After the cooking class, participants mingle, sample the meal that was prepared and then en-gage in a session of Q-and-As.

The RGVDA hosts two camps year-round – one in the summer and one in the fall. Now that school is out for summer, the RGVDA held Summer Camp

ENERGY from June 6 through 8. Camp ENERGY is free to kids ages 6 to 15 who have been diagnosed with Type 1 or Type 2 diabetes. The camp was !lled with# fun activities and games geared toward the

education of the children to better understand their role while living with diabetes. Camp activi-ties included canoeing, hiking, archery, horseback riding, dancing, arts and crafts and swimming.

With diabetes a"ecting a great number of our youth and adults in the Rio Grande Valley, the RGV-DA believes education is the !rst step in combating this preventable disease.

For more information about the Rio Grande Valley Diabe-tes Association, go to www.rgvdiabetesassociation.org or contact us at 956-782-1900. Ask for Diana Ramirez, executive director.

THE RGVDA BELIEVES EDUCATION IS THE FIRST STEP IN COMBATING DIABETES.

The Rio Grande Valley Diabetes Association takes on the diabetes epidemic in South Texas.

By JOE GARZA

EDUCATION FORA CAUSE

NONPROFITRIO GRANDE VALLEY

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SAN ANTONIOmedical

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Dustin Deemer, PA Family Medicine

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YOUR HEALTH IS IMPORTANTWe are committed to providing quality compassionate primary care to our patients including services such as physicals, sick visits and disease prevention.

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Lewis Greenberg, MD Internal Medicine


05/2013


210.549.0388www.SouthTexasOrthodontics.com

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WellMed is proud to announce two new clinics to the San Antonio area.

Doctors in the WellMed network focus on the health and well-being of Medicare Beneficiaries. We believe preventive care is the key to keeping patients healthy and out of the hospital. Through the WellMed Care Model, primary care physicians coordinate patient care with specialists, hospitalists, and other healthcare providers ensuring our patients receive the care they deserve.

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COMMUNITYSAN ANTONIO

San Antonio Christian Dental Clinic (SACDC) honors Dr. Ken Krueger’s 26 years of service and leadership in the community ministry. Krueger began his service as a volunteer with the birth of the ministry in 1986, and he went on to serve as a board member and then as president in 1998.

His most signi!cant accomplishments include

the clinic’s transition to the Haven for Hope cam-pus in 2009 and the partnership with UTHSC Dental School, which allows the clinic to serve as a com-munity health rotation site and a dental assistant training program. He has attracted essential sup-porters like Methodist Healthcare Ministries, Bap-tist Health Foundation of San Antonio, the William

Greehey Foundation and the Kronkosky Charitable Foundation.

Unique to Bexar County, SACDC o"ers a full range of dental services and health education to thousands of impoverished and homeless San Antonio adults at no cost. The clinic now operates a state-of-the-art facility at the Haven for Hope

REACHINGAND TEACHING

San Antonio Christian Dental Clinic honors Dr. Ken Krueger’s 26 years of service.

By: [SHANA HAMID#Photography: [PAOLA LONGORIA#


homeless campus, serving both community patients and the homeless. In 2012, SACDC delivered a retail service value of nearly $3 million across 55,000 procedures.

“We have this unique position of being able to assist adults in San Antonio who cannot a"ord care to get out of pain and to have the opportunity to become employable,” Krueger said. “And we have the opportunity here at the clinic to help those people who want to be helped and need help to become productive members of society.”

Executive Director Gloria Canseco came to SACDC from the UTHSC, and she works to e"ectively brandish SACDC as a !rst-class caretaking and teach-ing facility that cultivates both patients and practitioners to become success-fully pro!cient.

“We’re helping them become free of infection and free of pain, but then we help them toward self-su%ciency,” Canseco said. “What’s helped us be-come predictable with our delivery of service is our partnership with the health science center. We train dental assistants and purposely attract them from disadvantaged backgrounds. The kind of care that they are able to de-liver is on the caliber of the academic science center – as high as it can get.”

For more information on SACDC, visit www.sachristiandental.org or contact Glo-ria Canseco at 210-220-2325.

SACDC OFFERS A FULL RANGE OF DENTAL SERVICES AND HEALTH EDUCATION TO IMPOVERISHED AND HOMELESS ADULTS AT NO COST.


NONPROFITSAN ANTONIO

Through the support of LYND and H-E-B, A Taste of the Northside again proves it is one of the best Fiesta events! A year of planning and prepara-tions across the city culminated over two weeks for San Antonio’s biggest and most anticipated party. Fiesta 2013 ended just as fast as it started. Unlike many San Antonians who feel a sense of loss with the !nale of Fiesta 2013, the Brighton Center sees this time not as the end, but as the beginning of something great for the year to come.

The Brighton Center hosted its 14th annual A Taste of the Northside, an o%cial Fiesta event, on Wednesday, April 24, at the Club at Sonterra. The largest food and wine/beer tasting event in San Antonio, A Taste of the Northside raised more than $550,000 for the nonpro!t.

Named “Best Fiesta Event” by WOAI for the third year in a row, A Taste of the Northside is the Brigh-ton Center’s largest fundraiser, with all proceeds from the event going directly back to the center to help cover the cost of providing therapy services, early childhood education, parent training and advocacy to children with developmental delays and/or disabilities and their families right here in Bexar County.

This year’s event featured more than 60 res-taurants from all over the city serving samples of their !nest menu selections (including seven food trucks), !ve live bands, margaritas by Dulce Vida Organic Tequila, more than 15 varieties of !ne wine provided by Glazer’s and a wide selection of beer from the vast Silver Eagle Distributors product line.

Brighton Center sta" members pour countless hours of work and energy into planning, prepping and coordinating A Taste of the Northside. How-ever, if it weren’t for the immeasurable support and gracious contributions from our co-presenting partners, LYND and H-E-B, as well as the Queen of the Vine Court (Queen April Ancira, Princess Dr. Karen Hasty and Duchess Gina Cruz), the success of this event would not be possible.

For the past 11 years, Brighton Center has orga-nized the Queen of the Vine campaign, an eight-month venture for candidates to compete and raise funds and awareness for the nonpro!t. Queen of the Vine culminates at the Queen’s Ball when the candidate who raised the most funds for the Brigh-ton Center is crowned Queen of the Vine. Ancira

reigns as the 2013 Queen of the Vine, raising more than $77,000 during her campaign with a collec-tive total of more than $180,000. The queen and her court serve as o%cial Fiesta royalty, represent-ing the Brighton Center at its o%cial Fiesta event, A Taste of the Northside.

Fiesta is unique in that while its events encom-pass 11 days of partying, it truly is more than just a party. Fiesta is a time when the members of our community come together, boundaries are erased and support is extended to the multitude of or-ganizations, like the Brighton Center, that work to make the lives of people living in our city better.

The Brighton Center extends a warm “thank you” to all who came out to the 14th annual A Taste of the Northside to support our mission. When you look in the eyes of children with developmental

The 14th annual A Taste of the Northside raises more than $550,000 for the Brighton Center and lives up to its reputation as one of the best Fiesta events.[SPECIAL TO NSIDE#

MORE THAN JUST A PARTY


HELP OTHERSBY DONATING

YOUR USED MEDICAL

EQUIPMENT

TO DROP OFF EQUIPMENT, CONTACT:Project MEND Warehouse

1201 Austin Street | San Antonio, TX 78208P: 210.223.7283 | F: 210.223.6441

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A TASTE OF THE NORTH-SIDE IS

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FUND-RAISER.

delays and/or disabilities, it is our hope that you see them as chil-dren, sisters, brothers, friends, athletes, sons and daughters. They are just like you. They have hopes and dreams, and your support demonstrates to us that you also believe in them.

The Brighton Center has been serving the community for more

than 40 years. The center serves more than 2,700 children with developmental delays and dis-abilities and their families each year through four distinct initia-tives: an inclusive child devel-opment center, early childhood intervention, parent education and advocacy training. The Brighton Center continues to

ful!ll its vision to create a soci-ety where all children are valued and included.

For more information, contact Ka-trina Campbell, development di-rector, at 210-826-4492 or [email protected].


We accomplish this through: Peer to Peer Networks for children and their parents to create a sense of “normalcy” and acceptance, and to keep families together

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We are just like you. We have hopes. We have dreams.Believe in our abilities. Support Brighton.

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FEATURESAN ANTONIO

Talented and determined, Texas Olympic swimming hopeful Raquel Grays has been a consistently domi-nant force in Alamo Area Aquatic and 5A Texas high school swimming for the past two years, and this sum-mer, she’s set her gaze far beyond a senior year repeat performance.

Grays was already swimming at 2 years old, and by 10 years old, she was swimming competitively. Her parents encouraged her to par-ticipate in a plethora of sports and activities when she was younger, including – but not limited to – bas-ketball, volleyball, cheerleading and dance.

It wasn’t until her freshman year in high school that, after being exposed to a taste of every sport, Grays realized competitive swim-ming was “the one” for her. She has been swimming for the Alamo Area Aquatic Association’s club swim team in San Antonio since 2006, and she is Johnson High School’s only state champion in the school’s four-year 5A history.

On Feb. 23, 2013, with a time of 23.37 seconds (a Johnson High School record time), Grays secured a 0.06 second advantage over her opposition to claim the state gold in the 50-meter freestyle event. “There are no words to describe the way I felt,” Grays recalls. “It was so close” and a “weight o" my shoulders.”

Later that day, she placed silver in the 100-meter freestyle, setting another school record as the only Johnson athlete to place twice at a state event. Grays’ strongest compe-tition at state came from her peers on her club swimming team, which created a dynamic competitive envi-ronment that pushed all participat-ing swimmers to exert their fullest e"ort.

“Being the !rst athlete in any sport at Johnson to win a gold med-al, to have that title forever ... It’s the best feeling,” she says.

The Johnson state champion’s training schedule is extremely de-manding, as she trains both in and out of the water for four hours a day, six days a week. She is a sprint-focused swimmer who depends much more on aggressive accelera-tion and overall velocity than a dis-tance swimmer does, so her training is adapted to suit the development of this tempo.

But when it comes time to man-

age her academic priorities, Grays is de!nitely not a !sh out of water. Even with her hectic and disciplined swimming schedule, she is still able to do all of her homework and study for every test.

Grays plans to enroll in a physical therapy program after completing her undergraduate degree, and of course, she plans on becoming a Division I NCAA swimmer. You can

most likely expect Grays to be com-mitted to swim for a speci!c NCAA school by November.

Besides preparing for a senior year repeat of her junior year cham-pionship performance, Grays has loftier goals in focus. “Although I won state, I haven’t reached the goals I’ve set for myself,” she says. “I anticipate working twice as hard to make a run for the gold my senior year, and this time, I will be more fo-cused on my personal times.”

With passion and focus, Grays continues to train and push herself to new levels, and like most swim-mers of her ability, she has big dreams of Olympic gold. “The thing that helps me the most is being con!dent,” Grays says. “I believe in myself and have great support from my coach, my teammates and my parents.”

With this type of self-discipline, ambition and parental support, it would appear Grays is more on track than ever to reach her goals.

Talented Texas state swimming champion Raquel Grays is on track to turn her dreams of Olympic gold into reality.By: [JODY JOSEPH MARMEL#Photography: [MARIA HEY PHOTOGRAPHY#

STARDOM IN SIGHT

GRAYS’ TRAINING SCHEDULE IS VERY DEMANDING. SHE TRAINS BOTH IN AND OUT OF THE WATER FOR FOUR HOURS A DAY, SIX DAYSA WEEK.


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SAN ANTONIO // PROFILE


By: [JODY JOSEPH MARMEL#Photography: [ALEXANDER ALEMAN#

Northeast Baptist Hospital establishes the Baptist Heart and Rhythm Center, an electrophysiology lab that brings cutting-edge technology to South Texas heart patients under the guidance of Drs. Stephen Scott

Reich, Stephen Allen May and Gregory Buser.

Northeast Baptist Hospital, an af-!liate hospital of Baptist Health System, is proud to announce the establishment of a brand-new elec-trophysiology lab featuring Stereo-taxis robotic technology, reshaping the standard for cardiac care and research in the South Texas area.

With heart disease as the leading cause of death in the United States, Baptist Health System places spe-cial emphasis on cardiovascular care and services, becoming the !rst health system in San Antonio to o"er !ve accredited chest pain centers.

Known as innovators in the health care indus-

try, the Baptist Heart and Rhythm Center, located inside Northeast Baptist Hospital, is the !rst in San Antonio to o"er the Stereotaxis Robotic Navigation System to heart patients. Previously, South Texans seeking this type of cardiovascular procedure had to travel to Austin, Dallas or Houston.

With this relatively new technology to correct heart rhythm disorders (arrhythmias), there are sev-eral bene!ts to patients. The !rst noted advantage of the system is that it o"ers 10 times less risk for major complications during the procedure, com-pared to other available methods. This fact alone makes the Stereotaxis Robotic Navigation System a procedure worthy of further investigation, not only

INNOVATORSFOR Heart

Health


for the patients themselves, but for their families and loved ones.

The heart is a re!ned and complex pump. It de-pends on an intrinsic electrical system to initiate and coordinate heartbeats, and when this system breaks down or malfunctions, the heart rhythm pumps less e%ciently, leading to palpitations, shortness of breath, mild chest discomfort and even sudden death.

Stephen Scott Reich, M.D., FHRS, and Stephen Allen May, M.D., both board certi!ed in clinical car-diac electrophysiology and cardiovascular disease,

are South Texas pioneers with specialized training in diagnosing and treating electrical problems and the heart rhythm disorders they cause.

“As I explain to my patients, a cardiologist is a plumber for the heart. I am the electrician,” Reich says. May and Reich are partners who constitute Arrhythmia Associates of South Texas, a practice that focuses on providing the full array of cardiac electrophysiology services, including complex ab-lations for the treatment of disorders such as atrial !brillation and ventricular tachycardia.

The doctors at Arrhythmia Associates of South Texas and Baptist Health System are the !rst team in San Antonio to perform cardiac ablations using the state-of-the-art Stereotaxis Robotic Navigation System, an innovative and safer approach to per-forming arrhythmia treatment.

With an impressive list of experience and ac-complishments, Reich, an Air Force veteran, com-pleted both his internal medicine residency and his cardiology fellowship at Wilford Hall Medical

Center on Lackland Air Force Base after graduating from the Wayne State

University School of Medicine in Detroit.

He was deployed to multiple missions in Iraq and Afghani-

stan and served as Lackland Air Force Base’s chief of cardiology his last year in service. Reich attained his board certi!cation

in clinical cardiac elec-trophysiology dur-

ing his fellowship at the University of

Michigan, and he is committed to the continuity of cardiac care of his patients.

A native Texan, May g r a d u a t e d !rst in his class from the Univer-sity of Texas at Austin before at-t e n d i n g B a y l o r C o l l e g e

of Medicine. Serving as a chief resident of internal medicine at Emory University, May went on to be a chief cardiology fellow and chief cardiac electro-physiology fellow at the Texas Heart Institute.

At Arrhythmia Associates of South Texas, they leverage the most advanced technology and tech-niques available to provide their patients with the best standard of care and continue to be one of Baptist Health System’s most valuable allies in pro-viding specialized cardiac arrhythmia treatment to South Texans.

The Stereotaxis Robotic Navigation System is a trusted, low-risk and minimally invasive innova-tion in cardiac ablation that was !rst used in 2003 to treat heart arrhythmia disorders. Traditional and manual catheter ablation of arrhythmias, while hav-ing very e%cient success rates, requires a sti" cath-eter with a limited range of motion that can make navigating in the heart challenging and sometimes dangerous, especially in procedures that require manipulation throughout the left atrium.

Traditional ablation also requires the provider to manually manipulate the catheter into the correct position, which at times can require another indi-vidual to assist the physician. With an integrated computer and three-dimensional mapping system, the Stereotaxis machinery creates a weak magnetic !eld around the body of the patient in order to manipulate a magnet-tipped catheter through the chambers of the heart.

“This requires a precise knowledge of three-dimensional cardiac anatomy, as well as particular expertise with computer systems and remote cath-eter ablation,” explain the professionals at Arrhyth-mia Associates of South Texas.

The amount of pressure emitted on heart tissue by the catheter during the procedure is as light as four or !ve paperclips resting in the palm of one’s hand, while the technology’s one-millimeter preci-sion a"ords physicians better stability and control, enabling them to navigate the catheter with re-markable accuracy while decreasing the chances of catheter perforation.

Ablation in elderly patients can be challenging, as the heart walls tend to be thinner in this demo-graphic, increasing the chances of the catheter damaging fragile heart tissue. The Stereotaxis cath-eter’s malleability and gentler phalanx decreases the risk associated with catheter perforation, while the precise navigation allows for decreased radia-tion exposure.

“Stereotaxis could facilitate improving on stan-dard care by allowing procedures to be performed

“WE ARE COMMITTED TO THE CARE OF OUR PATIENTS.”


potentially more quickly, with less radiation exposure and equal or bet-ter long-term results,” says Gregory Buser, M.D., an a%liate physician of the Baptist Heart and Rhythm Center and a physician of the Heart & Vascu-lar Institute of Texas.

After graduating from the Johns Hopkins School of Medicine in 1986, Buser is considered the patron physi-cian of clinical cardiac electrophysiol-ogy in the South Texas region and a pro!cient master of traditional cath-eter ablation.

As Buser explains, most ablation strategies are simple enough as not to require the use of Stereotaxis robotic navigation, but some com-plex strategies may require its use to be performed safely. Regardless of the procedure’s complexity, both patients and doctors bene!t signi!-cantly from the decreased radiation required to navigate the superior catheter.

“An operator of the Stereotaxis system should be a board-certi!ed clinical cardiac electrophysiologist who has been specially trained in magnetic catheter manipulation,” May says. “This training includes

viewing several cases by experienced providers, as well as going through several hours of guided hands-on ex-perience in a practice lab.”

Training begins with a glass heart, in which practitioners practice ma-neuvering the magnet-tipped cath-eter under Stereotaxis control. Once a physician becomes acclimated with the navigation of the catheter and oriented with the imaging and control software, he or she can begin implementing the procedure in rela-

tively simple cases with a trainer still present and eventually progress into more complicated procedures with less counsel.

The practitioners at the Baptist Heart and Rhythm Center have al-ready performed more than 100 dynamic Stereotaxis ablation proce-dures in Northeast Baptist Hospital’s new electrophysiology installation, symbolizing a signi!cant advance-ment in aptitude for the participat-ing physicians and the South Texas

medical community as a whole. The center’s team also recently

performed an atrial !brillation pro-cedure that was reported the third of its kind in the world and the !rst in North America, which was achieved by the Stereotaxis technology that would not have otherwise been pos-sible by a manual or conventional approach.

“We are committed to the care of our patients,” Reich says. “With the Stereotaxis technology in place, we are building a new level of dedi-cation and trust for focused, safer heart rhythm care in San Antonio and South Texas that helps patients return quickly to a normal and ac-tive life. The Baptist Health System has shown great commitment to the care of the city’s patients by building a state-of-the-art electrophysiology lab at Northeast Baptist to include a Stereotaxis system.”

To learn more about Sereotaxis and the Baptist Heart and Rhythm Center, call 210-297-7005 or visit www.baptis-thealthsystem.com.


&

the country, there are very few fellowship-trained and acces-sible spine and orthopedic sur-geons. The Orthopaedic & Spine Institute of San Antonio (OSI) has

seven of those surgeons. In fact, two of OSI’s or-thopedic and spine specialists are graduates from the renowned Mayo Clinic, a training program that has ranked No. 1 in the country for orthopedic and neurosurgical training for the last 20 years, an ex-ceptional credential to come by.

This distinction is one of many that brings people across the state and even around the world to seek the care and solutions OSI’s team of physicians are known for. Patients go to the institute after years of su"ering, after nerves have been damaged, af-ter undergoing multiple failed surgeries and pain management attempts and moreover, after being told there’s nothing that can be done for them.

It’s a very common problem, and the doctors are discovering that fewer and fewer people are receiv-ing a real examination, if any, before they receive a diagnosis or have the surgery trigger pulled. OSI

battles this neglect with a diligent approach to an individualized discovery process, treatment and recovery, and ensures its surgeons are hands-on through the whole course.

“There has been a stigma attached to spine sur-gery,” says Dr. Steven Cyr, founder and visionary of OSI. “People are afraid of spine surgery. They see one after the next failure. They automatically as-sume if you have a back problem, you’ll never be functional. And that’s not even close to the truth.”

Cyr is a Mayo Clinic-trained surgeon and former chief of orthopedic spine surgery for the U.S. Air Force, and he was recently recognized by America Top 10 as one of San Antonio’s top orthopedic sur-geons. Cyr has become known as an acclaimed re-vision specialist, treating and surgically revising the conditions people are in after undergoing failed surgeries – those who are often in more pain than when they !rst received treatment. He has treated patients who have undergone up to 11 failed sur-geries, who are on all kinds of narcotics, who can’t speak clearly and who can’t function.

Drs. Steven Cyr, Hongbo Liu and John T. Friedland carefully invest in each patient and bring the right combination of training and personality to the renowned Orthopaedic & Spine Institute of San Antonio.By: [SHANA HAMID#Photography: [CHRIS PICHADO#

DISTINCTION TRAINING

IN

IN


e attributes his training at the Mayo Clinic for the tech-niques to understand how to rework failed surgeries and identify the subtleties on why someone is still having pain after multiple surgeries. He sees endless accounts of people who’ve

had multiple surgeries in multiple places and were told by doctors that there isn’t anything that can be done to !x them. He says there are two choices: “You either leave them in the system to do chronic pain management the rest of their lives or !gure out if there’s a !xable problem.”

Cyr personally only does one surgery a day and only about 15 to 20 surgeries a month out of the hundreds of patients they see. He’s known to spend hours with that patient, getting the patient comfortable, and he says a very small percentage of their patients end up going to the operating room. Surgery is not an option for everyone.

Cyr insists that optimal outcomes are the result of great doctors, and great doctors are the right combination of both training and personality, a formula he admits is not the easiest to come by. He has invested substantial time in shaping the in-stitute’s manifest, scouring for fellowship-trained doctors and making sure the care patients receive re$ects both aspects of the formula.

“Finding the right mix of personalities and train-ing is not so easy,” Cyr says. “What I was looking for were people that had the background and the cre-dentials to do a good job, but also the personality

and the bedside manner to separate them from the norm.”

And !nd he did. Cyr wanted to expand OSI with well-trained physicians who could versatilely treat a spectrum of conditions and ages. Dr. Hongbo Liu came recommended to Cyr from the Mayo Clinic with adult spine training, but he also came equipped with fellowships in orthopedic pediat-

rics from Cincinnati Children’s Hospital. With the expansion of the new, independent pediatric or-thopedic division, Liu was an ideal !t and an asset who supports both OSI’s adult and pediatric clin-ics.

“That training and level of expertise is almost impossible to !nd outside of academic institu-tions,” Cyr says. While supporting the adult and pediatric divisions, Liu specializes particularly in

scoliosis. He also veri!es that the academic train-ing his team is equipped with sets OSI apart.

“The di"erence between OSI and other ortho-pedic institutes is that we carefully use academic ideas to treat patients,” Liu says. “We don’t just use surgical intervention to treat each patient. We use research-based evidence to guide our practice.”

OSI o"ers a number of treatment options to

patients upfront before surgery is entertained, including medication, physical therapy, injections and even alternative medical options like acu-puncture. It’s after those approaches have been appropriately tapped that surgery is introduced. Their individualized approach to each patient’s treatment considers their condition, age and even preferences. “This is the Mayo Clinic approach,” Liu says.

H

W

“WE DON’T JUST USE SURGICAL INTERVENTION TO TREAT EACH PATIENT. WE USE RESEARCH-BASED EVIDENCE TO GUIDE OUR PRACTICE.”


hile Cyr was chief of spine surgery

for the Air Force, Dr. John T. Friedland was

serving as chief of or-thopedic spinal surgery

at BAMC. Friedland com-pleted a spine fellowship

in Denver with the former president of the Sco-liosis Research Society, served as the orthopedic consultant to the U.S. Army in Europe, and served as chief of surgery for allied forces at Camp Bucca, Iraq. Friedland looked to expand his practice in his San Antonio home, and Cyr eagerly took him on board.

Like his OSI teammates, Friedland can treat everything, but he has his own specialty and one that has been transforming the landscape of spinal surgery. His focus is on minimally invasive surgery and surgically approaching the spine in a manner that yields the most stability possible. Friedland explains that over the past 20 years, traditional approaches to the surgical incision in spine surgery have shifted, with the last 10 years ordaining a lateral surgical approach and smaller incisions to decrease instability caused by tradi-tional methods.

Friedland insists that the right diagnosis is imperative. “For the spine, it’s much more of a

diagnostic specialty as it is a treatment specialty. Either you have a surgical problem or you don’t, and there are a lot of ways to approach the spine surgically.”

Friedland endorses a conservative, non-opera-tive approach and advocates the course OSI takes by investing carefully in every patient. “The whole focus of OSI medical center is looking at the pa-tient as a whole person,” he says. “There really is a focus on spending time with the patient.”

Looming doubts in surgery and doctors are usually the result of lack of proper diagnosis and failed surgical outcomes by doctors who aren’t trained well enough or have become comfort-able in routine surgical !xes. Cyr’s team has built an entire practice on non-operative care. Their conservative approach with surgery and the time they invest in their patients has brought them substantial success to treatment outcomes and recognition in their !eld.

“We’ve created a practice that takes care of the person, not just focuses on surgery,” Cyr says. “Those things from the academic world help us learn better how to take care of patients without thinking surgery is the solution for everything.”

Proper diagnosis is making sure you’ve found the right indicators for surgery, and even mini-mally invasive surgery has to avoid tissue dam-age as much as possible. “We don’t always o"er it

because it’s cutting-edge – we have to solve the problem,” Liu says.

Many practices see up to 30 patients a day, with the nurse practitioner seeing the patient !rst and being their in-person contact. The doctor may come in for !ve minutes and then leave. The doctors at OSI see a handful of patients a day, and they plan to keep it that way.

“Trust in spine surgery is huge,” Friedland says. “Other orthopedic groups tend to focus on only the immediate clinical needs of patients, which is a narrow focus. The idea with OSI is to focus on the whole person, giving the patients options to maintaining healthy lifestyles that they wouldn’t get in their 10-15 minute doctor visit elsewhere.”

One thing is certain: If there is a solution that can !x your problem and transform your experi-ence, these doctors have it, and Cyr a%rms his team has the experience to prove it.

“If you go to a person who’s been trained well, there’s a pedigree – a spectrum of training. My personal opinion is if you get a spine surgery, it should be done by a fellowship-trained surgeon.”

For more information on OSI, visit www.saspine.com.

W



’ve known since second grade that I wanted to be a doctor,” quipped Dr. Robert L. Ochs when asked what got him interested in medicine. “Being a doctor was always my goal. When I was in sixth

grade, my mother had a hysterectomy, so I spent time in the hospital watching the doctors and nurs-es, and I was hooked. All through school, I worked and studied hard. And in high school, I was in the Latin and science clubs and all the honor societies.”

Ochs (pronounced “Oaks”) is a native Texan, Amarillo born. Right after high school, he attended West Texas State University (now West Texas A&M University) in Canyon, where he majored in biology and chemistry, earning a Bachelor of Science. He spent some time conducting cardiology research in Houston, and in 1986, he enrolled in medical school at the University of Texas Health Science Center – San Antonio.

Next he completed a six-year residency at the New York Hospital – Cornell Medical Center in Man-hattan; the !rst half was in pediatrics, followed by a three-year residency for special training in derma-tology.

Subsequently, Ochs came back to San Antonio and opened Alamo Dermatology, now located on Blanco Road at Bitters. “At !rst I thought I’d focus on pediatrics, but soon realized that I really like be-ing able to see all age ranges,” he clari!ed. “In fact, I’m seeing a 9-day-old baby this morning and a 90-year-old this afternoon. Every day is fun, is dif-ferent, and I never feel stuck in a rut.”

The dedicated sta" at Alamo Dermatology in-cludes nurse Susie Anderson, medical assistants

Irma Grohmann and Amy Cowboy and Ochs’ long-time o%ce manager, Roxanne Jiminez, who has been with him since he went into private practice 17 years ago. Together, the team provides patients with excellent cosmetic treatment, as well as gen-eral medical and surgical dermatological care.

In addition to routine skin checkups and acne treatments, procedures for adults include chemical peels, microdermabrasion to help keep skin supple and Botox Cosmetic injections to reduce signs of aging.

Also, some patients sign up for Foto facials that utilize an intense light treatment with radio fre-quency to tighten skin, or the Excimer laser pro-cess, which involves a narrow band UVB ray to treat psoriasis patches and vitiligo, the condition of lost pigment around the eyes and/or hands.

The doc also likes to sculpt with various !llers. For example, he said, “I like to use RADIESSE for a liquid face lift; it adds nice volume to decrease wrinkles around the jaw without surgery. I also use it to rejuvenate hands and minimize the appear-ance of veins.”

Alamo Dermatology is one of the only places in town that o"ers the new CoolSculpting procedure that “works predictably well to get rid of the ‘love handle,’ ‘mu%n top’ and ‘bra fat’ areas that seem to be exercise-resistant,” Ochs said.

He went on to explain the simple non-invasive procedure that removes fat cells from $abby spots around the abdomen, inner thighs, upper back and underarms by freezing the fat cells. Patients see re-sults within four to eight weeks after the treatment as the immune system naturally clears out the fro-zen fat cells.

The group does not do scar revision or acute

trauma care, but will refer patients with such needs to other specialists. However, they do see pediatric patients who may need a congenital mole evalu-ated or have a neonatal rash for which their pedia-trician wants con!rmation – but “mostly it’s hand-holding to help the parents,” the doctor explained.

Even before entering medical school, Ochs ad-mitted, he thought about specializing in dermatol-ogy. “The only doctor I saw growing up was my der-matologist for acne problems. He was a member of

YOURSKIN

DR. ROBERT L. OCHS helps his patients maintain both healthy skin and healthy lives at ALAMO DERMATOLOGY.

SAVINGBy: [DEBORAH M. MARTIN#Photography: [ROBIN JERSTAD#

I“


I can recognize patterns and diagnose things

our church, and provided the reference letter for me to get into medical school. There I had to learn all aspects of medicine, but it was dermatology that clicked. I’m very academic, but I can recognize pat-terns and diagnose things visually. That’s a big part of what I do, and I’m good at it.”

And that’s exactly what he did for Dawn Kraus-kopf, 38, a mother, wife and nurse in San Antonio. Krauskopf understands the value of keeping her skin healthy, and has been seeing Ochs routinely

for more than nine years. But last year, Ochs no-ticed a change in a shoulder mole and immediately removed it to send for biopsy. It turned out to be malignant melanoma.

“He’s my angel!” Krauskopf exclaimed. “Seriously, Dr. Ochs saved my life. He saw the cancer and acted right away. Thank goodness because the surgeon said it was almost Stage 2, and if we’d waited, the cancer most likely would have moved into my blood stream.”

Humbled, Ochs said, “At the end of the day, our goal is to help all of our patients achieve and main-tain healthy skin and live a healthy life.”

Now that summer is here, Alamo Dermatology re-minds everyone to wear sunscreen! To learn more about how Dr. Robert L. Ochs’ team can help your skin, visit www.ochsdermatology.com or call 210-493-1568.


HEALTH & WELLNESSSAN ANTONIO

SUCCESSFULLY TREATING AND MANAGING DEPRESSION SO YOU CAN FEEL BETTER AND LIVE BETTER

The Good Life

BHSPHYSICIANSNETWORK

Q: HOW PREVALENT IS DEPRESSION?

A: It is very common and often undiagnosed. I usually screen my patients when they are at the clinic for their annual physical exam or when I suspect depression

is present and they have some symptoms. Depression is a major public health prob-lem and a leading predictor of functional disability and mortality. The annual economic consequences of depression have been estimated at $83 billion in the United States. Optimal depression treatment improves outcomes for most patients.

Q: WHAT CAUSES DEPRESSION?

A: The etiologic perspective requires considering whether the depressive episode is caused by a speci!c physical agent or condition or represents a unipolar

primary (“idiopathic/unknown”) depressive disorder. Depressive syndromes may be caused by a wide range of systemic or neurologic medical illnesses (mood disorders due to a general medical condition) or substance intoxication or withdrawal (substance-in-duced mood disorder). These are often referred to as secondary depression.

By: [DR. CESAR GEREZ#

ASK“Expert advice from your trusted BHS Physicians Network.”

THE EXPERTS

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Q: HOW CAN I KNOW IF I SUFFER FROM DEPRESSION?

A: This can be quite simple. A major depressive syndrome or episode manifests with !ve or more of the following symptoms, present most

of the day nearly every day for a minimum of two consecutive weeks. At least one symptom is either depressed mood or loss of interest or pleasure.

• Depressed mood• Loss of interest or pleasure in most or all activities• Insomnia or hypersomnia• Change in appetite or weight• Psychomotor retardation or agitation• Low energy• Poor concentration• Thoughts of worthlessness or guilt• Recurrent thoughts about death or suicide

Q: HOW DO I KNOW IF GRANDPA OR GRANDMA HAS DEPRESSION?

A: The Five-Item Geriatric Depression Scale: Are you basically satis!ed with your life?Do you often get bored?Do you often feel helpless?Do you prefer to stay at home rather than going out and doing new things?Do you feel generally worthless the way you are now?

Q: HOW DO YOU TREAT DEPRESSION?

A: Cognitive behavioral therapy (CBT)• Relaxation techniques#• Breathing techniques• Yoga• Exercise

Medications• Antidepressants called SSRIs, a class of medication used as !rst-

line therapy because of fewer side e"ects, and SNRIsCombined therapy

• CBT and medication have the highest success rates for treating depression.

Q: WHAT IS THE PROGNOSIS FOR DEPRESSION?

A: An initial therapeutic response typically occurs within two to six weeks of beginning antidepressant therapy.I recommend that patients who have been on an antidepressant for eight weeks without response should be switched to another antidepressant.Frequent and quick#follow-up care is very important in patients diagnosed with depression.

Depression is a treatable condition that must be diagnosed and treated properly. With proper treatment for depression, you can feel better, live bet-ter and enjoy life as it is to the maximum.

Cesar Gerez, M.D., is board certified in family practice. His o$ce is at MedFirst Westover Hills (3903 Wiseman Blvd., Ste. 100) in San Antonio. For an appoint-ment, call 210-681-0126.

ASKTHE ANNUAL

ECONOMIC CONSEQUENCES OF DEPRESSION

HAVE BEEN ESTIMATED AT

$83 BILLIONIN THE UNITED

STATES.

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HORMONE REPLACEMENT THERAPY SAFELY RELIEVES MENOPAUSALSYMPTOMS FOR MANY WOMEN. By: [DR. CARLOS ENRIQUE QUEZADA#

Healing HormonesQ: WHAT IS HORMONE REPLACEMENT THERAPY USED FOR?

A: Hormone replacement therapy (HRT) is a type of treatment where the body

is given hormones to prevent or treat certain medical conditions (such as treating symp-toms of menopause in women and preventing osteoporosis). The hormones used in HRT are synthetic hormones, which means they are cre-ated in a laboratory (rather than by the body), but they act like natural hormones once inside the body. #At menopause, your body begins making less estrogen and progesterone hormones. This causes the body to stop having menstrual peri-ods. This is because estrogen and progesterone hormones control your periods and menstrual cycle. A lack of estrogen may cause symptoms such as:

• Hot #ushes (or hot #ashes)• Vaginal dryness • Dry skin• Loss of sex drive • Risk of bone loss (osteoporosis)

When these symptoms occur, you may

choose to take hormone therapy (HT) to get back the estrogen lost during menopause. When the hormone estrogen is given alone, it is usually referred to as estrogen therapy (ET). When the hormone progestin is combined with estrogen, it is generally called HT or combina-tion therapy. This was formerly known as HRT.

Your caregiver can help you make a decision on what will be best for you. The decision to use HT seems to change often as new studies are done. Many studies do not agree on the ben-e!ts of HRT.

Q: WHAT ARE THE BENEFITS OF HRT?

A: HT can alleviate many of the climacteric (menopausal) symptoms and protect

against osteoporosis.# # HOT FLUSHES (ALSO CALLED HOT FLASH-

ES): A hot $ush is a sudden feeling of heat that spreads over the face and body. The skin may redden like a blush. It is connected with sweats and sleep disturbance. Women going through menopause may have hot $ushes a few times a month or several times per day, depending on their individual bodies.

OSTEOPOROSIS (BONE LOSS): Estrogen helps guard against bone loss. After meno-pause, a woman’s bones slowly lose calcium and become weak and brittle. As a result, bones are more likely to break. The hip, wrist and spine are a"ected most often. HT may help slow bone loss after menopause. Per-forming weight-bearing exercises and taking calcium with vitamin D also may help prevent bone loss. There are also medications your caregiver can prescribe that may help prevent osteoporosis.

VAGINAL DRYNESS: Loss of estrogen causes changes in the vagina. Its lining may become thin and dry. These changes can cause pain and bleeding during sexual intercourse. Dryness also can lead to infections that cause burning and itching. Vaginal ET can help relieve pain, itching and dryness.

URINARY TRACT INFECTIONS are more common after menopause because of lack of estrogen. Some women also develop urinary incontinence because of low estrogen levels in the vagina and bladder.

Possible other bene!ts of estrogen include a positive e"ect on mood and short-term mem-ory in women.

Q: ARE THERE RISKS? IF SO, WHAT ARE THEY?

A: There are several potential risks with the use of HT, as with any medication.#

Using estrogen alone without progester-one causes the lining of the uterus to grow. This may increase your risk of cancer of# the lining of the uterus (endometrial cancer). Your caregiver should give another hormone called progestin if you still have your uterus to coun-teract this e"ect.

There is a slight increased risk of# breast

HORMONE THERAPY MAY

HELP SLOW BONE LOSS AFTER

MENOPAUSE.

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cancer. The risk appears to be small, but it increases during the period that HT is taken.

Combination# therapy makes the breast tissue slightly denser, which may make it harder to read mammograms (breast X-rays).

Combination or continuous# therapy can# in-crease risk#of spotting. HT can be taken cyclically, in which case you will have menstrual periods. Cyclical hormone therapy means HT is taken for a set amount of days, then not taken. This process is then repeated.

The estrogen in HT may increase the risk of stroke, heart attack, breast cancer and blood clots in the legs.

Transdermal estrogen (estrogen that is ab-sorbed through the skin with a patch or a cream) may have more positive results with:

• Cholesterol• Blood pressure• Blood clots

Patients with# endometrial cancer, liver disease, breast cancer, heart disease or a history of blood clots or stroke#should not take#HT. Researchers aren’t sure, but it is possible that women who use HRT drugs other than those previously mentioned that have been studied also may be at higher risk for breast cancer, blood clots, heart attacks and strokes.

Even so, many doctors consider that short-term use of HRT to control menopausal symptoms is still safe for most women. Women who have a history of heart disease or blood clots are at the highest risk and most likely should not receive HRT.

Q: ARE THERE DIFFERENT TYPES OF HRT?

A: HT can come in many di"erent forms. The traditional way to take HT is with a pill. There

are also applications#that use transdermal dosing (a patch that administers the medication across the skin).#

Newer formats now include vaginal pills or sup-positories that are comparable to oral pill form.#There also are medications produced by pharmaceutical companies, some forms of which can be created by local pharmacies or by compounding. This method allows for a greater variety of methods to receive the medication such as injections, suppositories and topical creams.#Other di"erences in medication for-mats include estrogens derived from synthetic ver-sus natural sources (plants versus animals).#

Naturally occurring compounds that mimic es-trogen in the body are known as phytoestrogens, and they can come from yam extracts or black co-hash.# These types of medications are considered supplements, and they vary in e"ectiveness in treating menopausal symptoms. Varying degrees of

concentration make this type of HT less reliable.

Q: WHO SHOULD CONSIDER DISCUSSING HRT WITH A DOCTOR?

A: Any woman who is starting to experience menopausal

symptoms either sporadically but still with a menstrual cycle (perimenopausal) or on a fulltime daily basis without men-strual cycles.

Women who may undergo procedures that involve removing the ovaries should also discuss taking HT with their caregivers.

Ideally, women who start HT as they start meno-pause have the greatest improvement in symptoms with lower risks.#

Q: HOW IS HRT ADMINISTERED?

A: If you choose to take HT and still have your uterus, estrogen and progestin are usually

prescribed.#Your caregiver will help you decide the best way to take the medications. Possible ways to take estrogen include:

• Pills• Patches• Gels • Sprays • Vaginal estrogen cream, rings and tablets#It is best to take the lowest dose possible to al-

leviate your symptoms and use HT for the shortest period of time possible. Current guidelines recom-mend limiting use of hormone therapy to !ve years, but with proper counseling#on the risks, HT can be extended beyond that.#

HT can help relieve some of the problems (symp-toms) that a"ect women at menopause. Before mak-ing a decision about HT, talk to your caregiver about what is best for you. Be well informed and comfort-able with your decisions.

Q: WHAT IS A SURPRISING FACT ABOUT HRT THAT MANY WOMEN MAY NOT KNOW?

A: The Premarin brand was originally derived by collecting and processing urine from

pregnant horses in Canada, hence the name “Pre-mar-in” (mare).#

The Women’s Health Initiative recently reversed concerns about the safety of HT.# In 2001, the initial !ndings made signi!cant news concerning the dan-

gers of HT, but when considered in context, those risks eventually were considered less risky than pre-viously thought.

Earlier large studies such as the Nurses’ Health Ini-tiative and the Postmenopausal Estrogen/Progestin Interventions (PEPI) study showed a good safety pro-!le and bene!ts for relief of menopausal symptoms, osteoporosis and heart disease.

Q: ARE THERE OTHER OPTIONS BESIDES HRT FOR TREATING MENOPAUSAL SYMPTOMS AND FOR LOWERING MY RISK OF OTHER DISEASES?

A: For some women, vaginal estrogen creams, antidepressants, soy products and certain

herbal supplements may o"er relief from menopaus-al symptoms. Speci!c medications are available to help prevent and treat osteoporosis. Your doctor can help you decide which of these treatments might be most helpful for you.

Finally, remember that eating a healthy diet, main-taining a healthy weight, exercising regularly and, if you smoke, quitting can help protect against heart disease, osteoporosis and some types of cancer.

Carlos Enrique Quezada, M.D., is board-certified in ob-stetrics and gynecology. Quezada and his colleagues, Drs. Jose Garcia and Susan Rivera, practice at Acacia OB/GYN, located at 8715 Village Drive, Ste. 305, San An-tonio, Texas 78217 and 3327 Research Plaza, Ste. 303, San Antonio, Texas 78235. For more information or to make an appointment, call 210-226-7827 or visit www.acacia-obgyn.com.

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Q: WHAT IS PAD?

A: Peripheral arterial disease (PAD) is a disease in which plaque (ath-

erosclerosis) builds up in the arteries that carry blood to your head, organs and limbs. Plaque is made up of fat, cholesterol, calcium, !brous tissue and other substanc-es in the blood. Over time, plaque can harden and narrow the arteries. This limits the $ow of oxygen-rich blood to your or-gans and other parts of your body.

PAD usually a"ects the arteries in the legs, but it also can a"ect the arteries that carry blood from your heart to your head, arms, kidneys and stomach. PAD a"ect-ing the legs is very common, and it is the most common cause of amputations in the United States. Therefore, it is a major cause for concern.

Q: WHAT ARE THE SYMPTOMS OF PAD?

A: The classic symptom of PAD is pain in the legs with exertion such as

walking, which is relieved by resting. How-ever, up to 40 percent of individuals with PAD have no leg pain. Symptoms of pain, ache or cramping with walking (claudica-tion) can occur in the buttock, hip, thigh or calf.

Physical signs in the leg that may indi-cate PAD include muscle atrophy, hair loss, smooth and shiny skin, skin that is cool to the touch (especially if accompanied by pain while walking that is relieved by stop-ping walking), decreased or absent pulses in the feet, non-healing ulcers or sores on the legs or feet and cold or numb toes.

Q: WHAT ARE SOME CAUSES OF PAD?

A: The most common cause of PAD is atherosclerosis. Some rare causes

include in$ammation of the arteries to the legs, unusual anatomy of ligaments and muscles causing compression and radia-tion injury to the arteries.

Q: ARE THERE RISK FACTORS FOR PAD?

A: The main risk factors for PAD include:

• Smoking • Diabetes• Older age (65 years old and older)• Hypertension• High cholesterol

Q: WHO NEEDS TO BE SCREENED FOR PAD?

A: The American College of Cardiol-ogy and the American Heart Asso-

ciation have given screening recommen-dations for PAD. Screening tests should be used to establish the lower-extremity PAD diagnosis in patients with suspected lower-extremity PAD, de!ned as individu-als with one or more of the following:

• Exertional leg symptoms• Non-healing wounds• Age 65 years and older • Age 50 years and older with a history

of smoking or diabetes

ASK

ARTERIAL HEALTH AND CARE AND TREATMENT OPTIONS FOR

PERIPHERAL ARTERIAL DISEASE

By: [DR. KIRAN K. CHERUKU#

PAD 101

PAD AFFECTING THE LEGS IS THE MOST COMMON

CAUSE OF AMPUTATIONS IN THE UNITED STATES.

THE EXPERTS

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Q: WHAT SCREENING TEST IS USED TO DETECT PAD?

A: A simple test called an ankle-brachial index (ABI) often is used to diag-nose PAD. The ABI compares blood pressure in your ankle to blood pres-

sure in your arm. This test shows how well blood is $owing in your limbs. ABI can show whether PAD is a"ecting your limbs, but it won’t show which blood vessels are narrowed or blocked.

A normal ABI result is 1.0 or greater (with a range of 0.90 to 1.30). The test takes about 10 to 15 minutes to measure both arms and both ankles. This test may be done yearly to see whether PAD is getting worse. A modi!ed test where blood pressures cu"s are used at di"erent levels in your legs can be done to perform ABI, and this can also localize which arteries are blocked.

Q: WHAT LIFESTYLE CHANGES SHOULD A PERSON WITH PAD MAKE, OR MAY BE REQUIRED TO MAKE?

A: The key to treating PAD is risk factor modi!cation. Treatment often in-cludes making long-lasting lifestyle changes such as:

Quitting smoking: Your risk of PAD increases four times if you smoke. Smoking also raises your risk for other diseases such as coronary heart disease (CHD).

Lowering blood pressure: This lifestyle change can help you avoid the risk of stroke, heart attack and heart failure.

Lowering cholesterol: Lowering cholesterol can delay or even reverse the buildup of plaque in your arteries.

Lowering blood glucose (sugar) levels if you have diabetes.Being physically active: Talk with your doctor about taking part in a su-

pervised exercise program. This type of program has been shown to reduce PAD symptoms.

Following a healthy eating plan that’s low in total fat, saturated fat, trans fat, cholesterol and sodium (salt): Include fruits, vegetables and low-fat dairy products in your diet. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan.

Q: WHAT HAPPENS IF A PATIENT IS DIAGNOSED WITH PAD?

A: Treatment primarily consists of aggressive control of blood pressure, dia-betes and cholesterol. Complete cessation of smoking is essential, with-

out which PAD will invariably get worse and can lead to amputations.Further treatment options depend on patients’ symptoms. If a patient is as-

ymptomatic, risk factor control is all that is needed. If a patient is symptomatic, a supervised exercise regimen, along with medical therapy with medications like Cilostazol, is recommended.

Patients with PAD and limb ischemia or non-healing ulcers need further stud-ies like arterial dopplers, CT angiograms, MR angiograms and peripheral angio-grams. Based on the extent of the disease, angioplasty with or without stenting or bypass surgery could be recommended.

Kiran K. Cheruku, M.D., is board certified in endovascular medicine and intervention-al cardiology. Her o$ce is at the Heart and Vascular Institute of Texas, with locations throughout San Antonio and South Texas. The main phone number is 210-804-6000.

For more information on the BHS Physicians Network, go to www.bhsphysiciansnet-work.com or email Julie Minnick at [email protected].

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PATIENTSAN ANTONIO

Each surgery has its bene!ts and risks. The de-cision for the doctor and the patient comes down to the individual risk factors and preferences of each patient.

WHAT IS THE DIFFERENCE BE-TWEEN THE LASIK AND PRK PROCEDURES?

With LASIK (laser-assisted in-situ keratomileusis), there is a $ap of tissue that is cut and lifted. The pre-scription is treated with ablation of tissue by the la-ser. In bladeless LASIK, one laser is used to create the incision for the $ap and a di"erent laser is used for the treatment of the prescription.

There is no $ap in PRK (photorefractive keratecto-my); instead, the tissue on the surface of the cornea

is scraped o" with a !ne blade (sometimes a brush or alcohol is used to remove the tissue). The second part of the surgery is the same in LASIK and PRK: The laser is used to ablate the tissue and reshape the cornea.

WHY HAVE ONE PROCEDURE OVER THE OTHER?

LASIK has certain contraindications, and when people don’t qualify for this procedure, PRK can still be done in certain cases.

HOW IS THE RECOVERY?Visual recovery is usually faster with LASIK. Pain

is con!ned to some burning a few hours after the procedure. Foreign body sensation and visual $uc-

tuation may last a few weeks. PRK heals slower. The recovery can last a period

of weeks to months in some cases. The worst vision occurring days after the procedure, $uctuation, light sensitivity and overall blurriness can last for weeks. Because the skin is scraped o" the surface, it has to grow back and this causes more in$ammation and swelling. There is more discomfort and $uctuation in the vision at !rst. Light sensitivity and discomfort subside, and the vision comes in slowly.

Eventually, around six weeks out from vision cor-rection surgery, vision is comparable in LASIK and PRK.

WHAT ARE THE RISKS OF LASIK AND PRK?

There is a risk of dry eye with LASIK. It can take up to six months for tear production to normalize. There is a small percentage of people who end up with dry eyes permanently. The other consideration with LASIK is the presence of a $ap. There is a very rare chance of dislodging the $ap. The $ap also slightly weakens the cornea, so patients with thin corneas and those who have a propensity to corneal disease should not have LASIK. There are also some surface corneal diseases that can be exacerbated by the creation of a $ap on the cornea, causing chronic problems with recurrent erosions of the cornea.

There is no $ap on the cornea, so some of the risk is decreased. One of the risks with PRK is scarring/haze. The deeper the treatment, the more prescrip-tion is removed and the higher the risk of haze. Oth-er risk factors for haze include not using prescribed drop regimen, exposure to UV light and fair skin. Sunglasses with UV protection are a must to reduce exposure to the cornea and the risk of scarring/haze. Dry eye is usually temporary with PRK.

Lisa Martén, M.D., is a board-certified ophthalmologist with South Texas Eye Institute, located at 2424 Babcock Road, Ste. 101, San Antonio, Texas 78229. For more in-formation, call 210-692-1388 or visit www.southtexas-eyeinstitute.com.

Which procedure is right for you?

By: [DR. LISA MARTÉN#

LASIK VS. PRK

VISUAL RECOVERY IS USUALLY FASTER WITH LASIK.

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It’s your turn to play!

Join us for Sunday Mimosa Brunch

by calling (210) 782-9892 and ask for Sherrill, Kathleen or Laura.

2 Bedroom Cottage models available.

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PATIENTSAN ANTONIO

For those looking to shape up this summer, i-Lipo Ultra treatments are a convenient and fast way to lose inches from pesky problem areas that are impervious to exercise. i-Lipo Ultra is perfect for circumferential fat reduction, and when used with the infrared vacuum massage, it improves the ap-pearance of cellulite.

i-Lipo Ultra uses low-level lasers to mimic the e"ect of ex-ercise on the body’s fat stores. Vigorous exercise places a de-mand on the body for extra energy, which the body derives from stored fat. While exercise does not allow you to choose which part of the body it uses the fat from, i-Lipo Ultra does. With i-Lipo, you can target speci!c pockets of fat that bother you most.

For some, their problem area is the stomach. For others, it could be the legs or butt. Whatever the area, i-Lipo Ultra can quickly deplete the fat storage and leave you looking and feeling your best.

The non-invasive body contouring system is one of the lat-est technologies from Chromogenex, a world leader in laser and light aesthetic treatments. Designed and manufactured in the United Kingdom, i-Lipo Ultra is quickly making its way across the United States and taking the fat-loss industry by storm!

While the name is suggestive of liposuction, i-Lipo is ac-tually non-invasive and completely di"erent from traditional liposuction and cool sculpting techniques. Using externally applied laser paddles, the machine delivers an extremely gentle method of ridding fat from the body.

The lasers work to break down stubborn triglycerides in-side fat cells, which then convert to glycerol and fatty acids. These molecules are then able to permeate through the fat cell walls, leaving the fat cells empty and able to collapse.

Picture taking grapes and turning them into raisins, and you’ve accurately visualized what i-Lipo Ultra does to your ad-ipose fat cells. After the stored fat is released, your lymphatic system will pick it up and “burn” the fat as energy for your body. The released fat is then eliminated naturally.

While i-Lipo Ultra may already sound too good to be true, we’re not done yet! These pain-free treatments take only about 20 to 30 minutes to complete. Yes, you read that cor-rectly. The i-Lipo Ultra treatments are incredibly fast and ef-fective. You can even do the treatments during your lunch break and go right back to work with no downtime or nasty side e"ects.

While brief post-treatment cardiovascular exercise is re-quired, there are no additional changes to diet and exercise on non-treatment days required to see results. However, slight changes may be suggested in order to keep results long-term. A standard of at least eight treatments total is rec-

ommended for drastic centimeter/inch loss. These treatments are usually completed in one month

if treatments are done twice per week, but a series of eight can be completed in as little as two-and-a-half weeks for pa-tients who are under a time crunch. For other fat reduction methods, results can take weeks or even months to show up.

Patients undergoing i-Lipo Ultra treatments enjoy results almost immediately after a treatment. It’s not uncommon for a patient to lose up to an inch or two measured over three points of the problem area during one treatment. These immediate results often encourage people who may otherwise not have been motivated to start or stick

to a healthy regimen of diet and exercise. With no pain, no needles and no down-

time, i-Lipo Ultra delivers an e"ortless body-contouring system that provides quick-!x results that can be maintained inde!nitely through proper diet and exercise. i-Lipo is perfect for !nally getting that toned swimsuit body you’ve always wanted, or for any other occasion. Enjoy being inches smaller in just four weeks with the help of i-Lipo Ultra.

Alterna Clinic is located at 18730 Stone Oak Parkway, Ste. 106, in San Antonio, Tex-as. For more information on i-Lipo Ultra+ treatments, please contact the clinic at 210-403-2552 or visit www.alternaclinic.com.

Give your “best body ever” a kick-start by targeting your problem areas with i-Lipo Ultra+ treatments.By: [MEGAN COLEMAN#

SLIM DOWN TO SHAPE UP

THE I-LIPO ULTRA TREATMENTS ARE INCREDIBLY FAST AND EFFECTIVE.

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With your family every step of the way.

Liz Whittaker // 210.621.7301 // [email protected]

San Antonio Parenting Magazine

july.august 2013

INPURSUITOF EXCELLENCETHE JACKSON FAMILY

How to help your FURRY FRIENDSbeat the

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MDSAN ANTONIO

A recent survey of a range of practice environ-ments around the country – including small o%ce practices, large integrated delivery systems, hospi-tals and outpatient facilities such as surgery cen-ters – found that o%ce practices most frequently face patient safety/risk management issues related to lab tests/referrals and scheduling/follow-up. Although these two categories were individually ranked third and sixth in the survey of 723 sites conducted by The Doctors Company, they are so closely related that a !nding in one category typi-cally leads to a !nding in the other.

A total of 386 surveys – more than half – had at least one issue related to this combined category. These !ndings included a failure by the practitio-ner to review and sign all test results; no follow-up for missed appointments; and no tracking system to ensure that the ordered test was performed, the report received, the patient informed, and appro-priate follow-up accomplished.

Medical record documentation came in a close second, with 341 of the survey respondents identi-fying it as an issue. Top !ndings within this catego-ry included the failure to document allergy status in the same location in each record and the lack of a problem list or a list of current medications.

Medication management was the third most common risk category, identi!ed as an issue in 334 of the surveys. The issues in this category included medications that were drawn up in unlabeled sy-ringes, absence of a system for storing and manag-ing sample medications, and failure to ask patients for an updated list of current medications.

Communication was pinpointed as the fourth most common problem, mentioned as an issue in 235 of the surveys. Examples of the top !ndings in this category are failing to document advice given to patients, including advice given during after-hours phone calls, ensuring written protocols are followed with patient telephone calls, and ensuring appropriate handling of care transitions.

MINIMIZING RISKS ASSOCIATED WITH LAB TESTS/REFERRALS AND SCHEDULING/FOLLOW$UP

O%ce practices can take the following steps to lessen problems caused by this number-one risk category, which was identi!ed as an issue by 53 percent of practices surveyed:

• Ensure that all members of your o%ce sta" know how to reconcile tests, referrals, and consult orders with the results when received.

Implement a process to remedy any discrep-ancies promptly, before an adverse event oc-curs.• Do not rely on a return appointment or a “hold” on the medical record to act as a re-minder that a test was not performed or the patient was not contacted about results.• Communicate all test results to patients, in-cluding those that are within normal limits.• Engage the patient in following up on test results. Tell the patient to contact your o%ce if he or she has not received results by a speci-!ed date.• Send letters to patients who fail to follow up and cannot be reached by phone; !le all documentation in the medical record.• If using an electronic medical record, utilize the test tracking capability as designed.

REDUCING RISKS ASSOCIATED WITH MEDICAL RECORD DOCUMENTATION

To assist in alleviating risks with medical record documentation, identi!ed by 47 percent of those surveyed as a problem area, o%ce practices can:

• Document allergy information in the same

By: [ROBIN DIAMOND#

TOP RISKS IN OFFICE PRACTICESIDENTIFIED IN NATIONAL SURVEY

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place on all medical records. If the patient has no allergies, document no known allergies.• Maintain a current list of medications, includ-ing herbal supplements and over-the-counter medications.• Maintain a current problem list with dates of problem identi!cation, reviews, and resolutions.• Use the patient’s own words when document-ing. This is more informative to other physicians or sta" and lends more credibility in the event of a legal proceeding.• Make sure all pages are organized and that all forms are completed. Do not use sticky notes or other loose papers for charting.• Always indicate in writing or electronically that all results of tests, consultants, and referrals were reviewed, and maintain the reports in the same place in all medical records.• Document all after-hours patient calls in the medical record.

LESSENING RISKS ASSOCIATED WITH MEDICATION MANAGEMENT

Medication management risks were identi!ed by 46 percent of practices surveyed. The following are some tips to reduce these risks:

• Ensure that the patient understands the rea-son for the medication, how to take it, and

when to contact your o%ce about side e"ects. Use repeat-

back or teach-back techniques to con!rm the patient’s under-

standing.• Store medication samples, syringes,

and prescription pads securely.• Do not maintain unlabeled syringes, and do not leave them unattended. The medi-cation should be immediately adminis-

tered by the person who prepared it.• If you prepare medications to be used later,

sign or initial the label and include the name of the medication, the dosage, and the date.

• Ensure that medications requiring refrigera-tion are maintained at the correct temperature by keeping a record of who performs the checks and what was discarded.• Ask the person receiving a verbal order to re-peat back the order.

• Identify all high-alert medications kept in your practice, and follow guidelines to ensure they are stored, ordered, dispensed, and adminis-tered correctly. Refer to the Institute for Safe Medication Practices Web site at www.ismp.org for more information.• Refer to your state law to determine which sta" members can call in new prescriptions or re!lls. For example, medical assistants should not call in new prescriptions.

MINIMIZING RISKS ASSOCIATED WITH INEFFECTIVE COMMUNICATION

Communication was identi!ed as a risk factor in 33 percent of the surveys. The following are tips to mini-mize communication risks:

• Document in the patient’s record all advice provided to patients, including advice given during after-hours phone calls.

• Implement a timely way for licensed provid-ers to respond patient phone calls and ques-tions that fall outside the scope of o%ce sta" knowledge. Verify that the patient understands the risks, bene!ts, and alternatives of the treat-ment by asking the patient to repeat back the information.• Document the patient’s level of understanding during the informed-consent process.• Use open-ended questions.• Use a standard communication protocol to en-hance the hando" process and reduce errors of omission.

The overall survey !ndings were not specialty-spe-ci!c. The risk of a failed or missed diagnosis increases when procedures for tests, referrals, scheduling/follow-up, documentation, medication management, and communication fail or are ine"ective.

Robin Diamond, J.D., R.N., is the senior vice president and chief patient safety o$cer for The Doctors Com-pany. For more information, visit www.thedoctors.com.

Note: This article was reprinted with the permission of ©2013 The Doctors Company.

TO HELP ALLEVIATE RISKS WITH MEDICAL RECORD DOCUMEN-TATION, USE THE PATIENT’S OWN WORDS WHEN DOCU-MENTING.

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MODULATINGTHE PROCESS OF AGING

Aging gracefully and maintaining a youthful appear-ance are common themes in modern day medicine. We all want to feel younger and avoid the negative health e"ects associated with aging.

While we cannot stop the aging process altogether, age management medicine ensures proper hormone levels, identi!es age-related genetic biomarkers and al-lows physicians to create individualized lifestyle plans that help us work with our age and maintain vibrant and active lives along life’s continuum.

I recently attended a conference sponsored by the Age Management Medicine Group and had an opportunity to speak with leaders in this evolving specialty. Initially referred to as anti-aging medicine, the term has evolved into age management medicine. This term provides a more accurate and comprehensive view of the specialty.

Age management medicine is a proactive, preventive approach focused on preserving optimum function and

Age management medicine: a proactive, preventive approach to aging gracefully

By: [DR. JAMES WEISS#

AGE MANAGEMENT MEDICINE FOCUSES ON PRESERVING OPTIMUM FUNCTION AND QUALITY OF LIFE.

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Dr. James Weiss is a board-certified physical medicine and rehabilitation physician with more than 25 years of experience. A pioneer in age manage-ment medicine, he is the founder of the Longevity Institute of Houston. He re-cently relocated to San Antonio and cur-rently practices at the Orthopedic Sports Institute. He is launching the group’s Health Crave Age Management practice, located at 21 Spurs Lane, Ste. 245.

quality of life. It focuses on modulating the process of aging prior to the development of degenerative processes.

Basic components of age management medicine are patient evaluation through an extensive medical history, lifestyle assessment and laboratory evaluation and analysis. From this data, personalized, proactive treatment plans are created, including dietary recommendations, exercise plans, stress management techniques and appropriate medical interventions.

In recent years, scienti!c studies and evidence have clearly identi!ed the role that genetic biomarkers play in aging. Proper identi!cation of these markers allows for a targeted and patient-centered approach to care based on proven scienti!c principles and practices.

Age management medicine o"ers patients the opportunity to work with their age, instead of against it, and provides medical oversight to ensure a safe and e"ective treatment plan.

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pediatric dentistryCarlen Palmer Blume

“Where smiles blossom ”


OUR SERVICES INCLUDE:

PHYS ICAL THERAPYPR M TI NO O

Your Premier Physical Therapy Provider

www.PromotionPT-SA.com

Recover. Restore. Revive. Results.

we achieve results!

MEDICAL CENTER

T 210.478.5486

Three clinic locations to better serve the San Antonio community:

NORTH CENTRAL

T 210.479.3334

WESTOVER HILLS

T 210.647.9970

CONVENIENT HOURS:Mon-Fri, 7am-6pmSaturdays by appt.

www.Facebook.com/PromotionPhysicalTherapy

RESULTS SO YOU CAN GET BACK TO LIVING LIFE AGAIN!

Schedule YourFREEScreening

A Professional Corporation

Providing effective, smart, and zealous representation to San Antonio families and businesses

• Family Law

• Business Litigation

• False Claims Act Litigation

Cyrus F. Rea II

210-‐223-‐9700 • email: [email protected] 110 Broadway #444 • San Antonio, Texas 78205 • www.cyrusrealawfirm.com

The Law Firm of Cyrus F. Rea II


New Patients Welcome!Like us on Facebook

PATRICK G. McCABE, D.D.SUTHSCSA Dental School Graduate

www.McCabeFamilyDentistry.com

210.492.8335

1150 N. LOOP 1604 W., SUITE #118 • SAN ANTONIO, TX 78248

• Mention this ad and receive FREE Whitening (some restrictions may apply)

McCabe & AssociatesFamily & Cosmetic Dentistry

www.gastroconsa.com Dedicated to Clinical Excellence.

Call (210) 614-1234

to schedule an appointment

Medical Center 8214 Wurzbach Road, San Antonio

Stone Oak 855 Proton Road, San Antonio

Northeast 11485 Toepperwein Road, Live Oak

Zarema Singson, M.D. Silvio Melo, M.D.Zarema Singson, M.D. Silvio Melo, M.D.

Learn more about Dr. Singson and Dr. Melo at

www.gastroconsa.com. Patient appointments will

be available starting in late July.

Gastroenterology Consultants of San Antonio is pleased

to announce the addition of two outstanding new


KingsvilleHOME REHAB

Serving South Texas, San Antonio and Austin.

Focused on restoring function and regaining

independence.

Kingsville Home Rehab Services, Inc. was established in 2004 and is a leader in home health rehabilitation. We provide to our patients quaility and evidence-based rehabilitaiton services. Integrity, excellence, trust and compassion are the core values in which Kingsville Home Rehab therapist’ and staff follow day to day, and from one home to the next.

KingsvilleKingsville Home Rehab’s primary goal is to enhance a patient’s quality of life with subtle changes. Whether teaching a fall prevetion program or making small postural changes to relief lower back pain, our goal is to maximize our patient’s potential.

P.O. Box 1205 Kingsville, Texas 78364

Ph: (888)-549-7462 Fax: (361) 221-0178www.kingsvillehomerehab.com

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• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •••••••••••


210.494.1069www.geminiamb.com

2897 NE Loop 410San Antonio, TX 78218

Gemini Ambulance Service, Inc.San Antonio-Corpus Christi-Brooks County

(Professionals Who Care)

• Locally Owned and Operated

• MICU Level Service

• 24/7 Coverage

• Emergency-Non Emergency-911

• New contract provider for Audi Murphy Hospital

• AAA BBB rating

To join our growing team log on to www.geminiamb.com

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FACEBOOK

210.698.6616 23651 IH 10W, San Antonio, TX 78257 Located in Leon Springs, Exit 551 Boerne Stage Rd fralos.com

NOW SELLING BEER & WINE!

LIVE MUSIC and FAMOUS PIZZA with a neighborhood atmosphere. Serving delicious fresh pizza, salads, and more. Plus, Take-N-Bake ready-to-heat pizzas.Takeout and Delivery available.

PROUDLY SERVING OUR CUSTOMERS SINCE 2004

follow us on

We now have our beer & wine license.

WOAIBEST OFSAN ANTONIO

2011


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