florida health news- july 2010 issue

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PAIDWEST PALM BCH, FL

PERMIT NO. 1340

FLORIDA HEALTH NEWSP.O. Box 213424

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JULY ISSUE • 2010 www.floridahealthnews-online.com

S e r v i n g P a l m B e a c h G a r d e n s , R o y a l P a l m B e a c h , We l l i n g t o n , B e l l e G l a d e , L a k e Wo r t h , L a n t a n a , B o y n t o n a n d B o c a R a t o n

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Also in this issueThe Health Care Reform Bill

Does Not Solve Longstanding

Dangers. Five Physicians

Predict Continued Trouble....2

If Your Feet Could Talk

They Would Say… part II .....3

8 Do-It-Yourself Home

Facials ..................................4

Health overhaul first

provisions start to kick in......5

Red Yeast Rice Comparable

to Pravastatin for Statin-

Intolerant Patients ................6

Zach’s Eagle Project

Oyster Reef ..........................7

Center of Distinction awarded

to Center for Wound Care &

Hyperbaric Medicine.............8

National Home Safety Month

is Upon Us: Are You

Prepared?.............................9

The Chocolate Milk Diet .....10

Abdominal Pain ..................11

7 Secrets to Staying Fit on

the Road.............................12

Everything You Need to Know

About Vitamins ...................13

Beauty foods for younger-

looking skin.........................14

The Commercial Break

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Center of Distinction awarded tocenter for Wound Care &Hyperbaric Medicine. PAGE 8

8 Do-It-Yourself Home Facials.PAGE 4

Zach’s Eagle Project Oyster Reef. PAGE 7

The Commercial Break BeautyRoutine. PAGE 15

Health overhaul first

provisions start to kick in

Jay and Sheryl Raether of Oconomowoc, Wisc., with their triplets, from left, Vincent, Mira, and Luk, on Capitol Hillin Washington. The first stage of President Barack Obama 's health care overhaul is expected to provide coverageto about 1 million uninsured Americans by next year, according to government estimates. PAGE 5

2 JULY • 2010 FLORIDAHEALTHNEWS-ONLINE.COM

CONTACT USP.O. Box 213424

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Last March our government finally passed The Health Care Reform Billto their great relief. And now all Americans hope that health care in theUnited States will finally be fixed. Even if this reform bill does fix someproblems for patients, physicians have found this law does not reformseveral longstanding deep problems, such as:

1. Nothing to stop defensive medicine 2. Nothing to stop threats of Medicare cuts or increase in pay for primary

doctors3. Nothing to affect the rising cost of training new doctors4. Nothing to stop the red tape of insurers meddling in patient care5. No real solution to the shortage of doctors.

1. Nothing to stop defensive medicine

The legislation continues to leave physicians vulnerable to lawsuits. Thegovernment has estimated that cost of medical malpractice is less than2% of overall health care spending. However, industry experts say de-fensive medicine actually accounts for about 10% of health care costs,or more than $100 billion annually. Doctors' fear of multi-million dol-lar lawsuits is pushing them to practice defensive medicine which meansmore doctors are ordering additional tests and procedures not based onneed but fear of liability.

Dr. Andrew Morton a family physician in Corydon, IN says:

Tort reform is nowhere on the horizon, and malpractice insurance pre-miums are astronomical in most states. Unfortunately it only takes onemulti-million dollar lawsuit to eliminate my ability to provide for myfamily. We can be sued into oblivion. “What's in the Health Care Reform Bill: The legislation doesn't impose acap on damages from lawsuits. Instead, the law just authorizes the Sec-retary of Health & Human Services to award five-year grants to statesto test alternatives to lawsuits such as specialized health courts. Whatthe reform bill really needs to control costs is meaningful malpractice re-form.

2. Nothing to stop threats of Medicare cuts or increase in pay forprimary doctors

Every year, doctors say their cost of doing business is rising much fasterthan what Medicare pays them. In fact, they say, payments have beenfalling. According to law, a Federally mandated formula is used every year to de-termine payment rates based on the health of the economy. Payment rateshave been cut for the past 8 years, although Congress has stepped in eachyear except for one to block them. This year, a 21% pay cut has gone intoeffect and Congress has yet to block it.Faced with these cuts, doctors say they could stop accepting newMedicare patients or even drop existing ones.What's in the Health Care Reform Bill: The legislation does not providefor a permanent solution to the threat of yearly Medicare pay cuts. Be-ginning in 2011 and in effect until 2016, the law established a 10%Medicare bonus payment to care providers who bill at least 60% of theircharges for primary care services. General surgeons also get a 10%Medicare bonus payment beginning in 2011 until 2016 if they practicein underserved areas.

Also, beginning 2013 and through 2014, Medicaid payments for all pri-mary care service (which tend to be much less than what Medicare paysfor comparable services) will be brought up to equal Medicare paymentrates.“Pay raises are not enough”. said Dr. Brandon Essink, a primary carephysician “As a rural family physician in Nebraska, 10% appears to bea nice increase, but it hardly offsets the increasing amount of adminis-trative nightmares." Doctors such as Essink say new bonuses mandatedby the legislation are a welcome benefit but fear they could be offset byother measures.

Another doctor fears the removal of co-pays will hurt his income. Be-ginning in 2011, the Health Care Reform Bill eliminates co-paymentsand co-insurance for preventive services and exempts preventive serv-ices from deductibles under the Medicare program. "Co-pays for health-maintenance visits are sometimes the only cash flow a practice canhave," said Dr. Paul Willis, a primary care physician.

3. Nothing to affect the rising cost of training new doctors

Medical school debt ranges from $120,000 to $150,000, on average,leaving many young doctors still drowning in school debt. Faced withsuch a sizeable debt, more graduates are shunning low-paying special-ties such as primary care in favor of higher paying specialties.That trend has resulted in a shortage of primary care doctors in the UnitedStates.Stephen Carey, a student at the Philadelphia College of Osteopathic Med-

icine, isn't sure that the legislation does enough to help him out.The Health Care Reform Bill does not do enough to address thefact that debt still is one of the limiting factors in deciding what andwhere to practice as physicians," said Carey.What's in the Health Care Reform Bill : The legislation sets aside$125 million for scholarships and other financial assistance in2010. For 2011 through 2014 hospitals and other institutions willget money to boost their primary care training programs, but howmuch is unknown. Other measures include increasing medical andnursing student loans and loan forgiveness to new physicians whoagree to practice in health care shortage areas. While health reformtries to place doctors where they're needed and attract more med-ical students, industry insiders say that it has ignored a critical as-pect of medical training -- residency slots. Medicare currentlyfunds about one-third of the costs of all residency programs andfroze its funding in 1997. The number of medical students is in-creasing, and the concern is that unless Medicare lifts its cap on res-idency funding in the near future, there will be more students in thesystem than there are residency slots to train them to becomepracticing physicians, said Dr. Atul Grover, the Association ofAmerican Medical Colleges' chief advocacy officer.

4. Nothing to stop the red tape of insurers meddling in patientcare

Many insurers now require "prior authorization" from doctors forexpensive procedures such as MRIs and CAT scans. This meansthat your doctor has to call the insurance company in advance toexplain why the tests are needed. The insurer may or may not ap-prove the procedure, in which case the patient can either forego itor pay out of pocket.

What's in the Health Care Reform Bill : The legislation does notaddress prior authorizations. "The preauthorization issue was notout of the realm of issues that the legislation could have ad-dressed," said Dr. Lori Heim, president of the American Academyof Family Physicians. “Insurers are still meddling in my work.”"I would presume that it was insurers that did not want the gov-ernment to be involved in this issue because those insurer preau-thorizations are a way for them to keep their own costs down,"Heim said.

Family Physician Dr Sofia Fernandwz of Hackettstown, NJ says:“When I first started practicing, I spent several years working ingroup practices. At the time, I felt like a hamster on a wheel,working for my employers, the insurance industry and the gov-ernment instead of the real consumer, my patient. I felt pressuredto churn patient after patient in order for us to 'break even.' This ex-perience drove me to open my own practice. Being in solo prac-tice for three years, I feel that I provide excellent level of care.However, the 'hamster on a wheel concept has followed me. Thecurrent reimbursement rates and endless red tape force many pri-mary care physicians to hire more staff and see more patients in or-der to cover our costs. Our costs continue to rise, driven by risingmalpractice premiums and payroll and small business taxes andfees. I know of several physicians that have held their own pay-checks for several months in order to make payroll. The passageof this bill does not fundamentally change the flaws in this system.It has not changed the physician reimbursement formula. It has notchanged the need for preapprovals or referrals. To the contrary, weare forced into more bean counting. I can no longer sustain my practice in this current environment[even though the legislation benefits my patients] that is the bestfor my patients. I see no other choice than to force the middlemanout and drop Medicare and insurance”.

5. No real solution to the shortage of doctors.

Dr. Brian Krakover, an Emergency Physician says “ I am anemergency medicine physician and an active duty army officer. Myopinion is my own and in no way represents the government or themilitary. I have worked in private practice in both busy inner citytrauma centers, suburban settings, and both urban and remote lo-cations in Iraq.

People [in the U.S.] choose where they want to seek care. That free-dom to choose is what guarantees people get the care they need.They come to the ER because they get comprehensive service andthey generally get their complaints addressed in a timely manner. The new health care legislation may increase the number of peo-ple with health insurance. But unless there are more doctors beingcreated in the United States, and the numbers of medical schoolgraduates start increasing for things like primary care and emer-gency medicine, there won't be anywhere for these people to go ex-cept where they're already going - the ER.

What in the Health Care Reform Bill: Emergency room doctorshave to see everyone regardless of their ability to pay.

Dr. Krakover goes on: “Sure, the amount of care that is not reim-bursed may go down some. But the real problem is shortage ofproviders, not a shortage of insurance.

The new health care law does nothing to address this. They whiffedcompletely. In the end, we have always had a safety net mandatedbut not funded by the Emergency Medical Treatment and ActiveLabor Act, which guarantees stabilizing medical treatment for a pa-tient or for an unborn baby without respect to ability to pay. Thatmeans I have to see you without asking how you plan to pay. How-ever, it costs money in the form of materials, facility costs, salaries,and malpractice coverage to see patients. Just because I can't closemy doors to you doesn't mean you don't have the responsibility topay for the care you get.”

Please recycle this newspaper.

By Dr. Mark Schor

Board Certified in Internal Medicine

and works for U.S. Hospitalists

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The Health Care Reform Bill does not solve longstanding dangersFive physicians predict continued trouble

FLORIDAHEALTHNEWS-ONLINE.COM JULY • 2010 3

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**I am painful and swollen.Why are you walking on me?Pain and swelling are serioussymptoms and are not to beignored. There is never aninstance where pain and swellingis normal. For example, stressfractures are one common causeof pain and swelling in the foot.Unlike traumatic fractures, stressfractures are due to repetitive,normal force. Trauma to thebone is often not involved. Ifsymptoms are ignored, and thebone continues to be put understress, the break can worsen. Insevere cases, displacement of thebone may occur, requiringpossible surgical intervention.Although there are many causesof pain and swelling in the feet,other common etiologies includearthritis, infections, andmuscle/ligament tears. Consultyour foot and ankle specialistimmediately if pain and swellingdevelop.

**Why is my big toe under mysecond toe?!This is commonly seen withsevere bunion deformities.Bunion deformities, also calledHallux Abducto Valgus (HAV),occur when the big toe “drifts” in

the direction of second toe. Insevere cases the big toe canunder lap the second toe, thuspushing the second toe up.Genetics, inadequate archsupport, and improper shoe gearare potential etiologies. Buniondeformities can be very painfuland should be evaluated by afoot and ankle specialist. Thereare conservative and surgicaltreatment options that are veryeffective. Depending on thecharacteristics of the bunionconservative treatment in theform of orthotics,padding/accommodation, andsymptom management can help.In severe cases, whereconservative treatment has failedsurgical intervention may benecessary to re-align the jointsand straighten the toe.

**I am a diabetic foot! I haverights! I demand a podiatrist!Diabetes is a systemic diseasethat can potentially affect manyregions of the body. Diabeticneuropathy is a serious conditionthat can lead to lack of protectivesensation. Use the example of asewing pin. For most of us, withnormal sensation, if we step on apin, we will retract our foot andeither remove the pin or seekhelp. For a diabetic with lack ofsensation, they may not feel theneedle stick. They may walk onthe pin, driving it further intotheir foot, without knowing it.

This leads to infection, abscessformation, and potentialamputation. Diabetics are alsoprone to circulatory problemsand fungal conditions thatrequire monitoring. For thisreason, a comprehensive footexam that evaluates thecirculation, nervous system, skin,and musculoskeletal systemshould be added to every diabetichealth care regimen.

**I have had an open sore onmy toe for months…Don’t youthink this is a problem?Open wounds can be veryserious. Nonhealing woundsmay be the sign of an underlyingsystemic disorder. Circulatorydisorders, infection, pressure,systemic disorders, cancerousconditions are just a few of thereasons why an open wound isslow to heal. If a foot wound is

noticed and has not responded totraditional first aid, consultationwith a specialist isrecommended. There are manytypes of specialists trained totreat nonhealing wounds.Throughout the United Statesthere are many wound carecenters which specialize indifficult to heal wounds. Thesecenters general have physiciansof different specialties on stafftrained to provide state of the art,comprehensive care for difficultto treat wounds.

**If you take care of me, I willtake care of you!Words to live by. If your feet arehappy, you are happy. Take timeout to pamper your feet. Anoccasional foot spa, pedicure, ormassage will give you the energyto walk that extra mile. Don’tignore warning signals.

If your feet could talk they would say…

Dr. Shelley D. Plumb

PART II

**OWW! A bolt of lightningjust shot between my toes!Sharp shooting pains thatradiates between the toes may bethe sign of serious footpathology. A Neuroma is acondition where a nerve at thebase of the toes becomesentrapped, irritated, andinflamed. The resultingsymptoms may include sharpshooting pain that radiatesbetween the toes. In some casespatients may complain ofswelling, limited toe mobility,and the feeling of a “marble”between the toes. In advancedcases, as the Neuroma enlargesthe effected toes may graduallyspread apart. This splay of thetoes may be accentuated withweight bearing. It is important toseek treatment promptly. In mildcases this condition can bemanaged conservatively withalterations in shoe gear. Ifignored, symptoms can escalate

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8 Do-it-yourself home facialsDiscover simplebeauty recipesthat’ll help youput your best faceforward

Facials are a great way tokeep your skin glowing,but they can be pricey.We asked Louisa Macan-

Graves, author of HollywoodBeauty Secrets: Remedies to theRescue, and Elda Argenti, ownerof the Plantogen skincare line, fortheir favorite make-at-home facemasks crafted from commonhousehold ingredients.

For All Skin Types

Brighten: Cut a slice of ripe pa-paya and remove the seeds andpulp (save the pulp for a snacklater—it’s great for digestion).Rub the inside of the papaya peelon your cleansed face, focusingon lines around the mouth andeyes, crow’s feet, thinning tem-ples, neck and hands. Let it dryfor 15 to 20 minutes, then rinsewith tepid water. This mask can bedone twice a week. “The enzymesin papaya exfoliate, repair sundamage, diminish age spots andsmooth skin. Your skin will lookbrighter, with a more polished fin-ish,” says Macan-Graves.

Exfoliate: Combine 1 tsp honeyand 1 tsp olive oil. Separately, pre-pare a packet of plain oatmeal, us-ing less water than called for so itforms a thick paste. Next, add thehoney and olive oil mixture to thecooked oatmeal. Apply as a scrub,

gently rubbing it in small circlesover your skin, avoiding the eyearea. Rinse off with warm waterand pat dry. This mask can be donetwice weekly. “The oatmeal in thisscrub exfoliates, while the honeyand olive oil moisturize,” says Ar-genti.

Cleanse: “Believe it or not, I loveto cleanse with oil,” says Argenti.For this facial, she combines 1Tbsp plain Greek yogurt with 2tsp olive oil and 1/2 tsp lemon oil(not to be confused with lemonjuice; lemon oil is an essential oilthat can be found at health foodstores). The mixture should be alittle bit runny but not easilypoured out. Massage it over skin,then immediately wipe it off witha washcloth soaked in tepid water.This can be done daily. “You wantto use good-quality oil and you’llbe surprised at how clean yourskin will feel,” says Argenti. “Youdon’t need a harsher product, evenfor skin with acne. Just be carefularound the eye area…[the mix-ture] tends to be very sticky.”

For Oil- and Blemish-ProneSkin

Lift & Tighten: Combine 2 Tbspplain yogurt with 1 Tbsp freshlemon juice (the juice of onelemon) and apply to your cleansedface and neck. Let it dry for 20 to30 minutes. You’ll feel the masktighten on your face and neck,which creates a lifting and firmingeffect. Leave it on longer (up toone hour) for even more face-lift-ing effects. Once done, rinse with

Tone: This toning eye treatmenthelps to “de-puff, relax, refreshand energize your skin,” says Ar-genti. “It’s much more coolingthan the traditional cucumberslices.” After cleansing your skin,brew a cup of chamomile or greentea and allow it to cool. Then soaktwo clean, round makeup spongesin the tea and squeeze out any ex-cess liquid. Place one on each ofyour eyes for 15 minutes. Do thisdaily. “You need to use an alcohol-free toner on your skin to cleanseand tighten pores. Alcohol is verydetrimental, and tea works just aswell,” adds Argenti.

For Dry Skin

Soothe: Combine 2 Tbsp honeywith 1 Tbsp apple cider vinegaror lemon juice. Apply to yourclean face and leave on for 20minutes. Rinse with tepid waterfollowed by a cool rinse. This canbe done three times a week. “Thismask heals, moisturizes and bal-ances the pH of the skin,” saysMacan-Graves. “Honey is ahumectant and natural antibioticthat heals and moisturizes. Applecider vinegar helps balance the pHof skin and soothes damagedskin.”

Moisturize: Macan-Graves rec-ommends oatmeal and fennel tohelp moisturize dry skin. Grind 1Tbsp oatmeal in a blender and setaside. Add 1 Tbsp fennel seeds to1/2 cup boiling water to make atea. Allow the seeds to steep for 10minutes; strain the seeds and dis-card. Let it cool down to roomtemperature and then combine 1Tbsp of the fennel tea with 1 Tbspground oatmeal and 1 Tbsp honey.Apply the mixture to your cleanface and leave on for 20 minutes.Rinse with tepid water followedby a cool rinse. This mask can bedone twice weekly.

tepid water followed by a coolrinse. This mask can be done twoto three times a week or wheneveryou need a face lift. “This instantface-lifting mask helps fade age-spots, acne scars and even helpskeep blemishes and acne in check.It also gets rid of uneven-lookingskin tone,” says Macan-Graves.

Brighten: Combine 2 Tbsp sourcream with 2 Tbsp honey and 1Tbsp apple cider vinegar or lemonjuice. Apply to your cleansed faceand leave on for 20 minutes. Rinsewith tepid water followed by acool (not cold) rinse. This maskcan be done twice a week. “Thismask heals, exfoliates, brightensand moisturizes skin. It refinespores, fades acne marks and pre-vents blemishes from coming up,”says Macan-Graves.


WASHINGTON (AP) -The first stage ofPresident BarackObama's health careoverhaul is expected toprovide coverage toabout 1 millionuninsured Americansby next year, accordingto governmentestimates.

That's a small share of the unin-sured, but in a shaky economy, ex-perts say it's notable. Many others- more than 100 million people -

are getting new benefits that improve theirexisting coverage.

Overall costs appear modest at this point,split among taxpayers, employers and indi-viduals who directly benefit, although thebiggest part of the health care expansion isstill four years away. For weeks, the WhiteHouse has been touting the new law's initialbenefit changes, even as Obama dares Re-publicans to make good on their threat to re-peal his signature social policy achieve-ment. Now, a clearer picture isstarting to emerge from the patch-work of press releases.

In 2014, government tax credits willhelp uninsured workers and theirfamilies pay premiums, and Medi-caid will take in many more low-in-come people. Eventually, more than30 million will gain coverage,sharply reducing the number ofuninsured and putting the nation ona path to coverage for all citizensand legal immigrants. Political sales-manship and an attempt to addresssome glaring health insurance prob-lems are key elements of the strategy to ex-plain the initial changes resulting from thelaw. After battling for a year to pass thelegislation, Democrats desperately wantedto have tangible accomplishments to pointto in high-stakes congressional electionsthis fall. But they also have to deflect lin-gering questions, often stirred up by oppo-sition candidates, and doubts about the ef-fectiveness of the overhaul and its costs.

Four-year-old daughter Mira, who was bornprematurely and has kidney problems, ex-hausted the lifetime limit on her parents'policy earlier this year. Mira now has tem-porary Medicare coverage because of a kid-ney transplant, but her parents were worriedabout what would happen when they haveto get her back on private insurance.

"A huge weight has been lifted," said SherylRaether, the mother. "She has ongoinghealth care needs, and I was afraid she'd hitanother lifetime limit." Medicare not onlycovers seniors, but people of any age withpermanent kidney failure.

The major early coverage benefits in-clude:

- Allowing young adults to stay on theirparents' coverage until they turn 26. In 2011,an estimated 650,000 young people whowould otherwise have been uninsured willgain coverage. Another 600,000 will bene-fit by switching from individually pur-chased policies to less costly, more com-

prehensive employer plans. The numberwith coverage will grow in 2012 and 2013.

-A health plan for uninsured people withpre-existing health conditions. From200,000 to 400,000 could benefit in 2011,according to the Congressional Budget Of-fice. The government may limit enrollmentif $5 billion allocated through 2013 starts torun out, as projected. Beginning in 2014, in-surers will be required to accept all appli-cants, regardless of medical history.

-Ending lifetime limits on coverage, and re-stricting annual limits. As many as 20,400people a year hit lifetime limits, as did MiraRaether. Many more - an estimated 102 mil-lion - are in plans that impose such limitsand will no longer be able to do so.

- Requiring insurers to cover children withmedical problems. An estimated 51,000uninsured children are expected to gain cov-erage. Another 90,000 children who havebeen excluded for coverage for a particularcondition - asthma, for example - will alsobenefit.

Many Americans covered through employ-ers won't see the changes until Jan. 1, thestart of their next health plan year. Thatmeans 2011 will be the first year that theearly benefits are fully in place. What thatentails for costs is a matter of intense spec-ulation. A recent survey of employers by

Mercer, a major benefits consultant, foundthat 42 percent expect an increase of 2 per-cent or less, while one-fourth expect an in-crease of 3 percent or more. Government es-timates are generally lower.

Beth Umland, research director for Mercer,said employers were expecting health costincreases averaging about 6 percent a yearbefore the law. "Now they are looking at anadditional 2 or 3 points, so that 6 percentcan become a 9 percent, and that seems tobe above their comfort level," she said.Dave Osterndorf, chief health actuary forthe Towers Watson consulting firm, saidlarge employers will respond by passing oncosts to their workers. "These first fewchanges, in and of themselves, will not dra-matically change the way employers look atthe provision of health benefits," he said."Employers will feel part of the impact, andemployees will feel part."

Some coverage gains may take a while toadd up. For example, Blue Cross BlueShield Kansas City reports brisk sales tosmall businesses by advertising Obama'snew tax credit for those who offer coverage.CEO Tom Bowser said more than 60 of the227 small firms signed up so far did not pre-viously offer health benefits.

"Small groups are one of the toughest mar-kets we have," said Bowser. "Because of theeconomy, more and more were droppingcoverage entirely, and we've able to reversethat."

Health overhaul first provisions start to kick in

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Red Yeast Rice Comparable to Pravastatinfor Statin-Intolerant PatientsRed-yeast-rice extract is as welltolerated as pravastatin inpatients who previously developeda statin-associated myalgia andwithdrew from therapy, researchshows [1]. Withdrawals from thered-yeast-rice and pravastatintreatment arms were low; andboth groups achieved comparablereductions in LDL-cholesterollevels, report researchers.

"Statin-associated myalgia is an im-portant clinical problem that willlikely become more prevalent owingto the ever-expanding indications for

statin use," write lead author Dr Steven Hal-bert (University of Pennsylvania School ofMedicine, Philadelphia, PA) and colleaguesin the January 15, 2010 issue of the Amer-ican Journal of Cardiology. "Although nodefinitive conclusions could be drawn, ourdata showed that red yeast rice was as welltolerated as pravastatin and achieved clini-cally significant levels of LDL-cholesterolreduction in a population with previousstatin intolerance."

Halbert, along with senior author Dr DavidBecker (University of Pennsylvania HealthSystem, Philadelphia, PA), previouslyshowed that red yeast rice and a therapeuticlifestyle change significantly reduced LDL-cholesterol levels in statin-intolerant pa-tients with dyslipidemia. As Becker toldheartwire at the time, red yeast rice, if prop-erly regulated to control for potential con-taminants and regulate consistency betweendifferent manufacturers, might represent anoption for these difficult-to-treat patients.

Dr Richard Karas (Tufts Medical Center,Boston, MA), who was not part of the study,said that in the real world, statin-associatedmyopathy is a common and difficult pro-blem for clinicians.

"One of the reasons is that having achesand pains is extremely common in olderpeople," Karas told heartwire . "That circlethen intersects with the circle of a lot ofolder people treated with statins. We don'thave a specific test to identify whether a pa-tient is achy because of their statin or be-cause they're older. It's often very difficultfor a physician to determine whether thatstatin should be stopped."

Lovastatin in Certain Types of RedYeast Rice

In this latest study, Halbert and colleagueswanted to test the tolerability of red yeastrice 2400 mg twice daily in patients whopreviously discontinued at least one statin,other than pravastatin, because of musclepain. Extracts of red yeast rice have beenwidely used in China for therapy in patientswith circulatory and digestive disorders forcenturies, and preparations of red yeast ricehave been shown to lower plasma LDL lev-els. Lovastatin occurs naturally in certainforms of red yeast rice that are made whenthe rice is cultivated with the moldMonascus purpureus.

In total, 43 adults with dyslipidemia and ahistory of discontinuing statins were ran-domized to red yeast rice or pravastatin 20mg twice daily for 12 weeks.

Daily consumption of commer-cially available wild blueberryjuice improves neurocognitivefunction in older adults with

early memory decline, new research sug-gests.

In the first human trial to assess blueberrysupplementation on neurocognitive func-tion in older adults, investigators at the Uni-versity of Cincinnati Academic Health Cen-ter in Ohio found that after 12 weeks ofconsuming 2 to 2½ cups of wild blueberryjuice daily, study subjects showed signifi-cant improvement on memory and learningtests compared with their matched counter-parts who consumed a placebo beverage.

"The findings of this preliminary study sug-gest that moderate-term blueberry supple-mentation can confer neurocognitive bene-fit and establish a basis for morecomprehensive human trials to study pre-ventive potential and neuronal mecha-nisms," the study authors, led by RobertKrikorian, PhD, write.

Antidepressant Effect AssessedThe investigators point out that previousstudies in laboratory animals suggest thateating blueberries may help boost memoryin elderly individuals. Until now, however,there has been little scientific work aimed attesting the effect of blueberry supplemen-tation in humans.

To assess the hypothesis that blueberry con-sumption may have a beneficial effect onmemory in older adults, the investigatorsconducted the 12-week trial, which involveddaily supplementation with wild blueberryjuice in 9 subjects (5 men and 4 women) 70years and older who had mild, acquiredmemory decline.

The study's primary outcomes were meas-ures of memory function, including the Ver-bal Paired Associate Learning Test and theCalifornia Verbal Learning Test.

Alternate forms of these memory tests wereused at baseline and at the final 12-weekvisit to mitigate practice effects associatedwith using the same test twice.

The investigators also assessed the potentialimpact of blueberry juice on mood using theGeriatric Depression Scale and also meas-ured weight and waist circumference andassessed serum glucose and insulin valuesby obtaining fasting blood samples.

Blueberry Juice May BoostMemory in Older Adults

At South Florida Radiation Oncology, you’ll find the area’s most accomplished and respected radiation oncologists and a full rangeof state-of-the-art cancer treatments. This is the team you want.

Dr. Kishore Dass and Dr. Ben Han spearhead a team of eighthighly trained radiation oncologists practicing advanced cancertreatment techniques. We deliver inspired, compassionate care.Our physicians have been trained at esteemed institutions includingCleveland Clinic, National Cancer Institute, MD Anderson, MountSinai, Beth Israel, University of Washington, and Stanford. We combine compassionate care and state-of-the-art technology to give you confidence to move on.

Isn’t it time you got back to living your life? Don’t wait—contact one of five convenient locations in Palm Beach County today.

Boynton Beach | Palm Beach Gardens | Stuart | Wellington | West Palm Beach

(561) 795-9845www.SFROLLC.com

Get Back to Living Your Life.

Cancer care begins with us.When you’re facing cancer, you want the latest treatment techniques and the best physicians available so you can getback to living your life.

At South Florida Radiation Oncology, you’ll find the area’s most accomplished and respected radiation oncologists and a full rangeof state-of-the-art cancer treatments. This is the team you want.

Dr. Kishore Dass and Dr. Ben Han spearhead a team of eighthighly trained radiation oncologists practicing advanced cancertreatment techniques. We deliver inspired, compassionate care.Our physicians have been trained at esteemed institutions includingCleveland Clinic, National Cancer Institute, MD Anderson, MountSinai, Beth Israel, University of Washington, and Stanford. We combine compassionate care and state-of-the-art technology to give you confidence to move on.

Isn’t it time you got back to living your life? Don’t wait—contact one of five convenient locations in Palm Beach County today.

Boynton Beach | Palm Beach Gardens | Stuart | Wellington | West Palm Beach

(561) 795-9845www.SFROLLC.com

S O U T H F L O R I D ARADIATION ONCOLOGY

Get Back to Living Your Life.

Cancer care begins with us.When you’re facing cancer, you want the latest treatment techniques and the best physicians available so you can getback to living your life.


Cardiology Partners, PL

• Dr. Chandra Venugopal • Dr. Jean Foucauld• Dr. Amarnath Vedere • Dr. Neerav Shah• Dr. Mauricio Melhado • Dr. Elizier Hernandez

3347 State Rd. 7 Suite 203 Wellington, FL 33449

(561) 793-6100 • Fax (561) 793-1974

941 S.E. First Street Belle Glade, FL 33430

(561) 996-8799 • Fax (561) 996-8805

BOARD CERTIFIED CARDIOLOGISTS

LISTEN TO CONCERNS OF YOUR HEART

Ablutophobia

Fear of washing or bathing

Alektorophobia

Fear of chickens

Anuptaphobia

Fear of staying single

Atychiphobia

Fear of failure

Caligynephobia

Fear of beautiful women

Coulrophobia

Fear of clowns

Mysophobia

Fear or germs or dirt

Phasmophobia

Fear of ghosts

Pupaphobia

Fear of puppets

Xanthophobia

Fear of the color yellow

Top 10 Unusual Phobias

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Zach’s Eagle Project Oyster Reef

Zach Bishop of Troop 132 com-pleted an Eagle Scout Project onJune 12th 2010. He was helpedby 25 Scouts and family members

who embarked on a project to restore theLake Worth Lagoon. The project consistedof building an Oyster Reef at Palm BeachCounty's Environmental Resources Ma-nagement Nursery. Fossilized shells wereput into mesh bags. A total of 250 bags eachweighing 25 pounds were loaded into atrailer and hauled to the Bicentennial Parkin the town of Lantana. The bags were de-ployed in the Lake Worth Lagoon in the in-tertidal zone, which is between high andlow tide. The bags were placed parallel tothe seawall to make reef pods.This project was done to help the waterquality of the Lake Worth Lagoon and

create a habitat for oysters and fisheriessince one oyster can filter up to 50 gallonsof water per day. Congratulations ZachBishop and the rest of the Eagle Scouts foryour hard work in saving the environment.

Zach Bishop.

Zachary was accompanied by his father Dr. Jeffrey Bishop and wife Charlene and his motherJulie Bishop and his brother Ryan Bishop, to help along with the Scouts and other volunteersto help make this a very successful project.


ALL FOR ONEHome Health Care, Inc.

“Helping Hands for Your Wellness”

w w w . A l l F o r O n e H H C . c o m

PALM BEACH COUNTY

Phone: (561) 433-5677Fax: (561) 433-8191

ST. LUCIE COUNTY

Phone: (772) 403-2563Fax: (772) 403-2564

OKEECHOBEE COUNTY

Phone: (863) 393-0004Fax: (863) 393-0600

CORPORATE OFFICE

2326 S. Congress Ave. Suite 2-E West Palm Beach, FL 33406Phone: (561) 433-5677 • Fax: (561) 433-8191

We are a team of healthcare professionals who make your own home an alternative to hospital or nursing home stays. But, moreover, All For One focuses on your health

and your ability to live at home safe, happy and independent.

Our team of highly qualified healthcare professionals we can send to your home includes:• Skilled Nursing • Physical Therapy • Home Health Aides• Occupational Therapy • Speech Therapy • Medical Social Work

Wellington, FL– WellingtonRegional Medical Centerphysicians, leaders and cli-nicians gathered today to cel-

ebrate the Center of Distinction Awardwhich was presented to the Center forWound Care & Hyperbaric Medicine atWellington in recognition of its high pa-tient satisfaction rates, exceptional healingresults, and outstanding clinical outcomesover the past twelve months.

This prestigious honor was awarded by theCenter’s partner in wound healing, Diversi-fied Clinical Services (DCS), the nation’sleading wound care management company.DCS’ Area Vice President, Michael J.Markey, travelled in from the company’sJacksonville, FL headquarters to present theaward in person to the Center staff.

Carole DiFlorio, Wellington Regional’sChief Nursing Officer, commented on theaward, “DCS brings our hospital’s WoundCare Center enormous resources and ex-pertise, enabling us to meet the increasingneed for specialized wound care. We arethrilled to accept these awards and proud tooffer this quality of care to our commu-nity.”

Many people in our local communities suf-fer from chronic or non-healing wounds-aserious disorder that can lead to amputationof limbs and dramatically impaired qualityof life. Associated with inadequate circula-tion, poorly functioning veins, and immo-bility, non-healing wounds occur most fre-quently in the elderly and in people withdiabetes and other diseases--populationsthat are sharply rising as the nation agesand chronic disease increase.

The outpatient center works with referringphysicians to determine the most effectivecourse of treatment, offering advanced heal-ing therapies often unavailable in primarycare offices. The interdisciplinary approachto treatment involves a variety of therapiesand techniques, including debridement, hy-perbaric oxygen therapy, dressing selection,special shoes and patient education.

“We’re honored,” said Susan Gauthier, pro-gram director. “It’s a privilege to be part ofa great collaborative effort betweenWellington Regional Medical Center andDiversified Clinical Services. Together, weare able to heal patients in our community,getting them back to living happy, healthylives.”

Carole A. DiFlorio, RN,MSN,NEA-BC, Chief Nursing Officer for Wellington Regional MedicalCenter received the award from Michael J. Markey, Jr. - Area Vice President from DiversifiedClinical Services.

Front, Left to right: Carole A. DiFlorio, Dr. Jeffrey Bishop, Dr. Steven Golf, M.D., Susan Gauthier, Center Director of Wound Care & HyperbaricMedicine. Back Row: Dr. Arthur Hansen, D.P.M., M.S. and Dr. Thomas Scott.

Center of Distinction awarded to Center for Wound Care & Hyperbaric Medicine


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National Home Safety Month is Upon Us:

Are You Prepared?The National SafetyCouncil annuallypromotes June asNational Safety Month,an initiative thatfocuses on heighteningawareness of importantsafety issues.

Each year, more than 1.8 millionpeople over age 65 are treated inhospital emergency rooms for in-juries associated with the home:

stairs, bathtubs, furniture, carpeting andother products seniors live with and useevery day. As your family members or lovedones age, their homes have aged, as well. Itis good practice to take a step back and ex-amine the home to see how well the livingarrangement supports your loved ones’ dailyneeds and activities. As we age, our mobil-ity decreases. Even if aging people aren't us-ing an assistive mobility device (i.e. walkeror wheelchair), they move more slowly,have less strength, reduced stamina, weakervision, reduced sense of smell and hearingis not as sharp.

Recognizing and promoting National HomeSafety month is important to really make animpact to increase awareness of the haz-ards around them and change their behav-iors. Among older adults, falls are the lead-ing cause of injury deaths and the mostcommon cause of hospital admissions dueto injury. There are numerous factors thatshould be taken into consideration whenplanning home safety for seniors. “Many in-juries result from hazards that are easy tooverlook, but also easy to fix,” explains Sh-eryl Policastro, Apogee Home Health Di-rector of Nursing. “By spotting these haz-ards and taking some simple steps to correctthem, many injuries could be prevented.”

There are a considerable amount of recom-mendations you can use to ensure that yourfamily members stay safe and comfortablein their homes. Apogee Home Health hasprovided you with a Home Safety checklistbelow:

CHECK FLOORS, STAIRS &STEPS:3 Move furniture around to give you clear

pathways3 Remove throw rugs in your pathway (or

use non-slip backing)3 Always keep objects off the floor and

out of your pathway3 Be sure to fix any loose or uneven steps3 Be sure to fix or replace loose handrails

& loose carpeting3 Consider installing an overhead light at

the top and bottom of the stairs3 Have a light switch at the top & bottom

of the stairs

CHECK KITCHEN:3 mmediately clean up any liquid, grease,

or food spilled on the floor3 Store food, dishes, and cooking equip-

ment at easy-to-reach waist-high level3 Don't stand on chairs or boxes to reach

upper cabinets; use only a step stool withan attached handrail so you are supported

3 Repair loose flooring3 Use non-skid floor wax

CHECK BATHROOMS:3 Install grab bars on the bathroom walls

near the toilet and along the bathtub orshower

3 Place a slip-resistant rug adjacent to thebathtub for safe exit and entry

3 Place nonskid adhesive textured stripson the bathtub/shower floor

3 Use a sturdy, plastic seat in the bathtub ifyou are unsteady or if you cannot loweryourself to the floor of the tub

3 Stabilize yourself on the toilet by usingeither a raised seat or a special toilet seatwith armrests

CHECK BEDROOM & LIVINGAREA:3 Place a lamp and flashlight near your bed3 Install night-lights along the route be-

tween the bedroom and the bathroom.3 Keep a telephone near your bed and sofa 3 Keep electric, appliance, and telephone

cords out of your pathways, but don't putcords under a rug

3 Do not sit in a chair or on a sofa that is solow it is difficult to stand up

CHECK WITH YOUR HEALTHCARE PROVIDER:3 Ask your health care provider about the

best type of exercise program for you 3 Have your health care provider review

your medicines (including over-the-counter), as some may cause dizziness orsleepiness and increase chances of a fall

3 Check your vision once a year to pre-vent falls

APOGEE HOME HEALTHPROVIDES:3 Home Assessment3 Medication Review3 Home Health Therapy- balance & neu-

ropathy programs3 Medical Nutrition Therapy3 Physical Therapy3 Low Vision Program

In addition to the suggestions listed above,always remember to have a properly ratedfire extinguisher in the kitchen area, andfire and carbon monoxide detectors on allfloors of the house.

The Apogee Family offers home safetyevaluation and medication managementalong with their home health services, in-cluding the balance and vestibular rehabil-itation program. Patients undergo a com-prehensive evaluation by a vestibulartherapist to determine what may be causingtheir balance and dizziness problems. Eachpatient is provided with a Medical Braceletto ensure extra safety. This Medical Braceletis a fast and efficient communication toolthat prevents medical errors between healthcare providers, patients and caretakers. Thepatient’s bracelet includes emergency con-tact information, list of attending physiciansand their contact information, their med-ication list, links to important health relatedwebsites and physicians websites. Shouldthere ever be an emergency, this braceletwill certainly help prepare you for a safetreatment and recovery.

Join Apogee Home Health and the NationalSafety Council (www.NSC.org) as we pas-sionately promote home safety, from ourfamily to yours. To learn more and get yourquestions answered, please contact SherylPolicastro, Director of Nursing at ApogeeHome Health: 561.278.3272 or visit us on-line at www.Apogeehc.com.


ChocolateT

urns out this childhoodstaple may be the idealvehicle for your body’smost neglected nutri-

tional needs. Each bottle delivers apackage of micro- and macronu-trients that can help you shake offbody flab and replace it with firmmuscle. And when you served itice-cold, the creamy sweetnessflows across your tongue with allthe pleasure of a milk shake. Yum.

That’s the crux of what I'm calling"The Chocolate Milk Diet," whichisn’t a diet at all. It’s essentiallythree eight-ounce servings ofchocolate milk consumed at keypoints throughout your day: onewhen you wake up, a second be-fore you exercise, and a third di-rectly after your workout. Or, ifit's your day off, just pattern themfor morning, afternoon, and night.Sounds good, right? It is, andthat’s why it’s so easy. But is thisa free ticket to eat as much friedchicken as you want throughoutthe rest of the day? Unfortunatelynot, but alongside a healthy diet, itcan help you drop lots of belly fatfast. Here are the four reasonswhy:

Secret #1: The CalciumEffectResearchers have known for yearsabout the role that calcium plays inbuilding strong bones, but a morerecent development deals withthey way it affects your belly. Aseries of studies have shown thatcalcium can actually impede your

body’s ability to absorb fat, andwhen researchers in Nebraska an-alyzed five of these studies, theywere able to estimate that con-suming 1,000 mg more calciumcan translate to losing nearly 18pounds of flab. What’s more, otherstudies have shown that dairyfoods offer the most readily ab-sorbable calcium you can find.Knock back three servings ofbrown cow and you’ll reach thatcrucial 1,000 mg threshold. At thatpoint, any other calcium that youeat or drink is a bonus.

Secret #2: The Vitamin DFactorAll the calcium in the world isn’tgoing to help you if you don’t geta good dose of vitamin D to gowith it. That’s because vitamin Dis responsible for moving calciumfrom your food to your body,which means if you’re runninglow on D, you’re probably alsomissing the calcium you need tostay slim. Other symptoms of theD deficiency are weak muscles,easily breakable bones, and de-pression—not a great combo for

success. Now here’s why this issignificant: Most experts agreethat the average American isn’tgetting enough D. Some estimatethat only half the population ismeeting the requirement and onestudy published in the journal Pe-diatrics found that 70 percent ofAmerican children had low levelsof D in their diet. The thing is,your body makes vitamin D natu-rally when you expose your skin tosunlight, but most people spend toomuch time indoors to benefit. Andintentionally spending more timein the sun could put you at risk forskin cancer. The solution? Drinkup. Chocolate milk, like most milk,is fortified with vitamin D.

One caveat here: Drink 1% choco-late milk. Vitamin D won't workwithout a little fat to help break itdown. You want to skip the wholemilk, too, as it has too many calo-ries to make it a regular habit. Thebest option is 1%, or low-fatchocolate milk. It has the fat youneed to absorb crucial vitamins,yet at three cups a day, it will saveyou 120 calories over whole milk.

Secret #3: The EnduranceBoostIf you want to lose the gut, you’vegot to exercise—no surprise there.But here’s a fact that’s not so ob-vious: Drinking chocolate milkcan improve your gains. In a studypublished in The InternationalJournal of Sport Nutrition and Ex-ercise Metabolism, subjects givenchocolate milk before hopping onthe stationary bikes were able toride 49 percent longer than sub-jects given a generic carbohydrate-replacement beverage. And on topof that, they pedaled even harder.Total work performed by thechocolate-milk group was greaterthan the work performed by sub-jects drinking carbohydrate-re-placement drinks or electrolyte-fortified sports drinks. The reason?Milk has naturally occurring elec-trolytes that keep you hydrated—more hydrated then water, in fact,which I revealed recently on myTwitter account—and its naturalsweetness helps push more energyinto your muscles. Another studyfrom 2009 found similar results,but it went one step further by ask-

ing participants which beveragethey thought tasted better. Not sur-prisingly, 100% chose chocolatemilk.

Secret #4: The Protein-Body-Weight ConnectionWant to know the secret to stayingthin? You need more muscle.That’s because muscle burns morecalories than fat, so for every newmuscle fiber you create, your rest-ing metabolism receives anothersurge of fat-torching energy. Andchocolate milk can help you dothat. Researchers have determinedthat the ideal protein load for build-ing muscle is 10 to 20 grams, halfbefore and half after your workout.How much protein will you find inlow-fat chocolate milk? Eightgrams per cup. (That means oneserving before your workout andone serving after will give you a to-tal of 16 grams of highly effectivewhey protein—a perfect serving.)Add that to the extra cup you drankfirst thing in the morning andyou’re looking at a turbochargedmetabolism that keeps you burningcalories all day long.

Imagine if everything you needed toknow about weight loss, you learned inkindergarten. Well, if your teacher gaveyou chocolate milk as a lunchtimetreat, she was (unknowingly) givingyou one of the most powerful weight-loss tools in the nutritional universe.

Ways to Soothe SunburnMaybe youskipped thesunscreen becauseyou didn’t thinkyou’d be outsidefor very long, orperhaps you forgotto reapply after adip in the pool.Whatever thereason, your skinis red-hot to thetouch andseriously painful.

Now what? You can popan aspirin and apply astandard drugstoretreatment that contains

a numbing agent like Lidocaine, oryou can try one of the followingnatural remedies.

To Stop the Pain:1. Slather on aloe. If you’re goingto buy it in a bottle, the best choiceis one that contains no added col-ors or fragrances. (A good optionis Aubrey Organics Pure AloeVera.) But aloe straight from theplant may be even better and pos-sibly more effective, says LynneC. David, ND, a naturopathic doc-tor at the Center for IntegrativeMedicine at the George Washing-

ton University Medical Center inWashington, D.C. Purchase a plantat a garden store or florist, andthen just split open a spear and rubthe gel on your skin.

MORE FROM WOMAN'S DAY

Skincare Advice DoctorsWish You’d Follow

How to Detect Skin Cancer

2. Milk it. Soak a clean cloth incool milk and apply it to theburned area for 20 minutes, saysHadley C. King, MD, a clinicalinstructor of dermatology at WeillCornell Medical College in NewYork. Make sure you use wholemilk; the fat content is what’ssoothing. Reapply every two tofour hours.

3. Soothe with baking soda. Youuse it to deodorize your fridge,clean your house and bake

bread…but did you know that youcan use baking soda to treat sun-burns, too? Just dissolve a spoon-ful in water to make a coolingcompress, or add 1/2-cup to a tepidbath that you can soak in, says Dr.King.

4. Try vinegar. According to Dr.King, a popular folk remedy is touse white distilled vinegar or applecider vinegar to relieve sunburnpain. She admits there’s no sci-ence proving it works, but saysthat it can’t hurt to try it. Just soaka cloth or towel in a solution ofhalf vinegar, half water and applyit to the affected area.

5. Heal with herbs. The herbscomfrey and calendula promotetissue healing and have anti-in-flammatory properties, says Dr.David. Ask at your local healthfoods store for a cream that con-tains this combo, or try CountryComfort Herbal Savvy, which

contains both of these herbs aswell as aloe vera. Or you can buycalendula tea bags, wet them andapply them to sensitive areas ofyour skin, leaving them on untilyou feel better. Mint tea bags arealso a good pick, as mint has cool-ing, pain-relieving properties. Ifyou don’t want to apply tea bagsdirectly to the skin, you can brewthe tea, let it cool and then dip cot-ton balls into it to dab onto the af-fected area.

To Help Repair theDamage:

6. Drink up. “Dehydration is a se-rious side effect of sunburn,” saysAndrea Donsky, co-founder ofNaturallySavvy.com, a website fornatural, organic and green living.She recommends drinking plentyof water (your healthiest option)and other fluids to help re-hydratethe skin and fight dryness.

7. Let honey help. A thin layer ofraw honey (the unprocessed kind;it should say “raw” on the label)spread on the affected area can re-duce inflammation and help fightfree radical damage incurred bythe burn, says Donsky.

8. Lock in moisture. Dr. Davidrecommends Burt’s Bees Aloe &Linden After Sun Soother, acreamy lotion containing beepollen, coconut oil, aloe and lin-den extract to calm and moisturize

inflamed skin. Dr. King is a fan ofBach Rescue Cream, a homeo-pathic moisturizer with floweressences that hydrates and soothesthe skin while fighting inflamma-tion. She recommends applyingthe lotion right after a cool to luke-warm shower, when your skin isstill a little damp.

9. Get more vitamins. It won’tdull the sting of a sunburn, but anextra helping of antioxidants canhelp your body repair itself faster,says Dr. King. For a few days af-ter getting sunburned, she recom-mends taking 1,000 mg of vita-min C, 400 IU vitamin E, 15 mgbeta carotene and one to two ta-blespoons (or three to six cap-sules) of liquid flaxseed oil. Don-sky also recommends loading upon vitamins, but she prefers to getextra A, C and E from food. “Car-rots, spinach and red bell peppersare rich in vitamin A; citrus fruitsand dark leafy greens offer plentyof vitamin C; and avocado, al-monds and wheat germ are packedwith vitamin E,” she says.

10. Go fish. Donsky says omega-3 fatty acids, which are found insalmon, sardines, herring and an-chovies, can help reduce inflam-mation and promote tissue heal-ing from the inside out. Not a fishfan? You can also get these healthyfatty acids from walnuts, pecans,hazelnuts, chia seeds and hempseeds.

10

Palm BeacH Primary care aSSOciaTeS, iNc.

3347 State Road 7 Suite 200 Wellington, FL 33449

Tel: (561) 795-9087 • Fax: (561) 753-8730

1200 South Main Street Suite 101 Belle Glade FL 33430

Tel: (561) 996-7742 • Fax: (561) 753-8730

State of the Art Office Building with Imaging Center, Sleep Lab Coming Up

ACCEPTING NEW PATIENTS

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9 AM - 5 PM MONDAY - FRIDAYSAME DAY APPOINTMENTS AVAILABLE

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Shekhar V. Sharma, M.D.

Board Certified in Internal Medicine

Dr. Sharma has relocated his office in Belle Glade to 1200 South Main Street,

Suite 101 (opposite the Old Glades GeneralHospital). Dr. Sharma will be seeing patients

at this location along with his nurse practitioner Grace VanDyk.

He is currently accepting New Patients and the office accepts most insurances

Please call 561-996-7742for an appointment.

Abdominal Pain

Abdominal pain is a con-dition that I comeacross in my office al-most everyday. Pa-

tients who present themselves withthe above condition often do notrealize that they may have some-thing brewing inside their ab-domen that could be dangerous.Below are cases I have seen in re-cent years and I shall simplifythese case histories.

Patient comes to my office withcomplaints of “stomach pains”which are mild in nature. He wantsme to prescribe something for painnot wanting to know what the rootof the problem is. As a physicianin practice for many years my ex-perience in clinical practice

prompted me to ask the patientspecific questions pertaining to hisailment. I come to a diagnosis af-ter much questioning, history ta-king and examination that he hadan ulcer of the stomach which wasproven to be so by an upper en-doscopy that was done later.

Now let’s discuss about what arethe other potential diagnoses thatthe above patient could have hadafter he walked into my office. As

means inflammation of the pan-creas. Then again, he could behaving hiatal hernia with acid re-flux which in the long term if leftuntreated could lead in some to acondition called Barretts Esopha-gus.

This patient could be having hepa-titis whch is inflammation of theliver. Rare instances like stomachcancer, pancreatic cancer, enlargedspleen can all cause upper abdomi-nal pain.

Now you can probably understandthat a ‘simple complaint’ such asabdominal pain can pose to bequite a complex situation for thephysician. One must understandwhy a “simple visit” to my officecan sometimes take more timethan predicted. I cannot shut off avisit like shutting off a computer.Practicing Internal Medicine is notas easy as it seems, because I haveto take care of a myriad of pro-blems everyday so much so that Ican go home with a clear mind,that I have not missed something.

Coming to a final conclusion inthe above example gives me asense of well being that I havedone something similar to playinga tough chess game and check-mating my opponent.

a physician of good training I haveto think about other issues that cancause pain in the abdomen andcone down to the correct diagno-sis. I could be thinking that hecould have pancreatitis which

Daily Calcium Plus Vitamin DSupplements May Reduce Fracture Risk

Daily supplements of cal-cium plus vitamin D, butnot of vitamin D alone, are

associated with significantly re-duced fracture risk, according tothe results of a patient level-pooledanalysis reported in the issue ofthe BMJ.

"A large randomised controlledtrial in women in French nursinghomes or apartments for olderpeople showed that calcium andvitamin D supplementation in-creased serum 25-hydroxyvitaminD, decreased parathyroid hor-mone, improved bone density, anddecreased hip fractures and othernon-vertebral fractures," write B.Abrahamsen, from CopenhagenUniversity Hospital Gentofte, in

Copenhagen, Denmark, andcolleagues from the DIPART(vitamin D Individual PatientAnalysis of Randomized Tri-als) Group.

"Subsequent randomised trialsexamining the effect of vitaminD supplementation — with orwithout calcium — on the inci-dence of fractures have pro-duced conflicting results....

We used individual patient datamethods to do a meta-analysisof randomised controlled trialsof vitamin D — with or withoutcalcium — in preventing frac-tures and investigated if treat-ment effects are influenced bypatients' characteristics."


7 Secrets to Staying Fit on the Roadwhy not schedule your workoutlike you do a meeting? Put it onyour calendar and e-mail yourselfa reminder so you don't forget.

If possible, exercise in the morn-ing. When you travel, the days canbe long and last-minute client din-ners can interfere with your evening workout. Exercisingin the morning helps ensure suc-cess.

2. Determine How You WillExercise on Your TripBefore You LeaveMost hotels have gyms. Call be-fore you travel to determine thegym's hours and range of equip-ment. Once you know what thehotel offers, you can decidewhether you will need to bring ad-ditional equipment, like exercisebands or a swimsuit if there's apool.

In addition, DVD players are read-ily accessible in hotel rooms or onlaptops. If you have a favorite ex-ercise DVD, bring it along and dothe routine in your hotel room.

3. Don't Forget Your Tennis ShoesWhen you travel for business, youwould never think of leaving yourlaptop or cell phone behind. Thesame should hold true for yourtennis shoes and workout gear.Just as your computer provides thetools you need for your work, yourtennis shoes offer a wealth of ex-ercise possibilities.

4. Don't Be Rigid When itComes to Your FitnessRoutineWhen you travel, even the best-laid plans can be disrupted byflight delays, traffic snarls andscheduling changes. If you missyour "scheduled" workout, a shortexercise routine is better thannothing. Consider doing sit-ups oryoga stretches in your room, orrunning up and down the stairs inthe hotel a few times. Even 10minutes of activity can make a dif-ference.

Another good place to get exerciseis in the airport. If your plane isboarding at the farthest end of theconcourse, you can skip the elec-tronic walkways and power walkto the gate (just remember to wear

comfortable shoes). And if youhate layovers, make the most ofyour time by taking a power walkaround the airport. Again, everylittle bit helps.

5. Pack Healthy SnacksWhen you make a list of things totake while you travel, make sure toinclude granola bars, apples, orbetter yet, make your own trailmix that you can enjoy on theplane or in your hotel room.

Not only will the snacks tide youover until your next meal, theyalso will ensure that you don'tmake a late-night trip to the vend-ing machine or an afternoon jauntto the coffee shop for a pastry.And, always, ALWAYS carry wa-ter. Traveling dehydrates the body.

Water satisfies hunger and helpsyou stay alert.

6. Have it Your WayRemember that restaurants arethere to serve you. In addition toordering your salad dressing onthe side, ask that your meal be pre-pared to your specifications. Re-place potatoes with steamed veg-etables, ask for sauces on the side,and request a "to-go" box for halfyour meal. Or consider eatingsoup and a salad instead of a largeentrée.

Also, if you are required to attendcocktail parties, order a glass ofwater between each beverage.Whether you drink alcohol, soda,or coffee, water decreases thecalories that you consume andcounteracts the effects of alcoholand caffeine.

7. At the Very Least, TryNot to Lose GroundIf you know that you are going toeat more when you travel, makesure that you institute some type ofdaily exercise so that you balancethe increase in calories with phys-ical activity. While it may not berealistic to think that you will loseweight while traveling, you willfeel better if you maintain somehealthy habits.While traveling for business of-fers some challenges to your exer-cise routine, a little creativity cango a long way to helping you stayfit at home and on the road.

Finding the timeand energy on adaily basis toexercise and eatright can bedifficult. Throw infrequent businesstravel, and thetask can seemalmostimpossible.

To ensure that your hardwork at home doesn't goby the wayside on theroad, there are a few sim-

ple steps that you can take to keepyour waistline and calorie intakein check.

1. Include Workouts inYour Travel ItineraryExercising on the road is just likeworking out at home — it requiresplanning and commitment. If youdon't plan to exercise on a regularbasis, it's not going to happen.

When we travel, we schedule.From airline reservations andrental cars to hotel reservationsand itineraries, every detail of thetrip is planned well in advance. So

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Before you pop yournext multivitamin orconsider a newsupplement, considerthese 10 little-knownfacts:

1. TemperatureRefrigerate supplements that contain oils(such as fish oil or omega-3 fatty acids) orprobiotics. “Heat, light and oxygen are theelements that make oils go rancid and killprobiotics,” says Rashmi Gulati, MD, med-ical director at Patients Medical in NewYork. “If your pills are exposed to any ofthese for long, they will be completely use-less.”

2. Drug InteractionsIf you take aspirin or are on birth control,you may need to boost your vitamin C in-take. “People who frequently take moder-ate-to-large doses of aspirin lose vitamin Cin the urine and may need higher doses tomaintain their blood levels,” says Kathi J.Kemper, MD, author of Mental Health, Nat-urally: The Family Guide to Holistic Carefor a Healthy Mind and Body. Contracep-tives that contain estrogen can also lower Clevels.

3. Synthetic vs. NaturalGo synthetic when it comes to folate, a typeof B vitamin that’s especially important forwomen of childbearing age. Kerry Neville,RD, spokesperson for the American DieteticAssociation, says that synthetic-based sup-plements are actually easier for the body toabsorb than those made from naturalsources.

4. B12 BenefitsYou might want to consider taking a B12supplement if you don’t eat much meat. Vi-tamin B12, an important vitamin that helpsmetabolize folate as well as protect the nerv-ous system, is found mainly in animal prod-ucts. “Vegans definitely need a B12 sup-plement because the kind found in someplant foods is in a form the body cannotuse,” says Elisa Zied, RD, CDN and authorof Nutrition at Your Fingertips.

5. VolumeEven though vitamins are good for you,more is not necessarily better. For example,“huge doses of vitamin C or magnesiumcan cause diarrhea,” says Dr. Kemper. Othervitamins pose even greater risk when over-used, including vitamin A and niacin, whichcan cause liver damage and other issues.

6. Iron AwarenessIf you’re using a multivitamin that containsiron, be sure to take only the suggestedamount per day or week. Most people don’tneed extra iron unless they’re pregnant, ane-mic or have a poor diet; if you ingest toomuch, it’s possible to overload your sys-tem, says Dr. Gulati. An excess of iron canbe damaging—especially in men—to theliver, heart and pancreas.

7. Food PairingFat-soluble vitamins, which include vita-mins A, D, E and K (water-soluble vita-mins are B-complex and C), should be takenwith food that has a little bit of fat in it, saysBonnie Taub-Dix, RD, spokesperson for theAmerican Dietetic Association. This willhelp your body maximize its benefits.

8. AbsorptionSome medications affect the absorption ofsupplements, and may even deplete vita-mins already stored in your body. “If youtake prescription meds, ask your doctor orpharmacist if there are any vitamin interac-tions you should be aware of,” says Neville.

9. LabelingThe FDA regulates vitamins more like foodthan drugs, explains Dr. Kemper. Thismeans that they can vary in quality and thelabel may not accurately reflect the con-tents. Visit ConsumerLab.com, a websitethat independently tests nutritional prod-ucts, to see if your vitamins are fit for con-sumption.

10. Your DietAlways remember that vitamins are not aninsurance policy. “Too many people thinkthat popping a pill and not caring aboutwhat they eat is fine,” says Neville. Whilevitamins can help keep you healthy, theyaren’t a complete replacement for wholefoods that naturally provide an assortmentof vitamins and minerals.

Everything You Need to Know About Vitamins


Beauty foods foryounger-looking skinBy Brierley Wright, M.S., R.D.

When I was in highschool and college, Igot a summer job as

a lifeguard. Allthose hours in thesun gave mewhat I thought

then was a beautiful,bronzy tan.

Today I realize the sun exposurejust accelerated my skin’s agingprocess. Truth be told, I did wearsunscreen, but not always as much

as a dermatologist would recommend.

Turns out, the vast majority of UV lightthat I was soaking up was UVA. UVA is amajor contributor to premature skin aging(think: fine lines and wrinkles) because itpenetrates deeper than UVB light and dam-ages skin cells before there’s any visiblesunburn.

Even worse, collagen—the fibrous proteinthat keeps skin firm, youthful-looking andwrinkle-free—begins to decline starting in

your twenties!

Now that I’m older and wiser—and not anx-ious to look the part—I’m wearing moresunscreen to protect my skin from the out-side in. And because I’m a registered dieti-tian and nutrition editor, I’ve seen the sci-ence that shows eating more of these foodswill protect my skin from the inside out.

Keep your skin looking younger—for therest of your life—with these 4 foods:

Strawberries: Eating more vitamin C-richfoods, such as strawberries, may help toward off wrinkles and age-related dryness,suggests research from 2007 in the Ameri-can Journal of Clinical Nutrition. VitaminC’s skin-smoothing effects may be due to itsability to mop up free radicals producedfrom ultraviolet rays and also its role in col-lagen synthesis. (Vitamin C is essential forcollagen production.) You can find vitaminC in a multitude of cosmetics—of whichsome have been shown to be effective in

protecting skin—

but why not go straight to the source for atasty boost of C: red bell peppers, papaya,broccoli and oranges are other excellentsources. (Try these sweet strawberry recipesfor better skin.)

Tomatoes: Tomatoes get their red hue fromlycopene, a carotenoid that may help tokeep your skin smooth. In a study publishedin 2008 in the European Journal of Phar-maceutics and Biopharmaceutics, re-searchers found that of the 20 individualsstudied, those who had higher skin concen-trations of lycopene had smoother skin.Boost your lycopene intake with fresh sum-mer produce like watermelon and carrotstoo.

Tofu: Tofu and other soyfoods, such asedamame and soymilk, may help to pre-serve skin-firming collagen because theyare rich in isoflavones. In a study publishedin the Journal of the American College ofNutrition, mice fed isoflavones and exposedto ultraviolet radiation had fewer wrinklesand smoother skin than mice that were ex-posed to UV light but didn’t get isoflavones.The researchers believe that isoflavoneshelp prevent collagen breakdown.

Tuna: Eating tuna—and other omega-3-richfish, such as salmon, sardines and trout—may help keep your skin looking youthfulthanks to the omega-3 fat EPA (eicosapen-taenoic acid). EPA has been shown to pre-serve collagen.

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Create your ownrelaxing mini-spaduring ad breaks foryour favorite show

Ordinarily, we’d never dream ofgetting between you and yourbeloved DVR, but here’s onereason to put it on pause for a

night: You can treat yourself to a mini–spaday in the span of your favorite one-hourTV show. Simply follow our step-by-stepplan during the commercial breaks (which,believe it or not, tally up to nearly 25 min-utes) and you’ll be feeling much moreZen—and likely glowing—by the time thecredits roll.

Mario Badescu Skin Care Salon in NewYork City. Hold your face about 12 inchesfrom the steam for five minutes. While yourface is still damp, apply a Bioré Ultra DeepCleansing Pore Strip ($7.99;Drugstore.com) to your nose—it’s still oneof the best ways to declog and minimizethose problematic pores. As your showcomes back on, bring your large and smallbowls of water over to the couch with you.Place the bigger one on a towel on the floorand dunk your feet in (but first make surethe temperature is comfortable; you cancool it a bit with ice cubes if you want). Thesmaller one is for soaking your fingertips;keep soaking your hands and feet until thenext commercial.

Commercial Break 2Remove your hands and feet from the wa-ter and pat dry. Push back dead cuticles us-ing the towel for gentle pressure. Then mas-sage in a rich cream, focusing on dry nailedges and hand and foot calluses. TryH&M’s new organic Raspberry & MelonLotion ($5; HM.com for store locations),which contains sunflower oil and applejuice for deep hydration. To really get aspa-like experience, pull on a pair of heat-activated gloves or socks, which help mois-turizer penetrate the skin much moredeeply—and are the next best thing to amassage. Try Earth Therapeutics Moistur-izing Hand Gloves ($8; Drugstore.com) orAloe Socks ($8; Drugstore.com). Leavethem on until the next commercial break.

Commercial Break 3Remove the gloves, if you used them,and take off your nose strip. Rinseyour face clean and apply your fa-vorite face mask. A great maskfor brightening up a dull, tiredcomplexion is Mario Bade-scu’s Enzyme Revitaliz-ing Mask ($20; Mari-oBadescu. com), whichcontains exfoliating al-pha-hydroxy acids derived from papaya andgrapefruit. (For a DIY option, you couldwhip up an all-natural mask in the kitchenusing the recipe at the end of this article,provided by the lead aesthetician at BlissHollywood.) Once you’re cozily back onthe couch, swipe your nails with astringentor rubbing alcohol to remove any lotion

residue, then paint them with clear polishand let dry until the next commercial.

Commercial Break 4Use a soft, natural-bristled bath brush, likethe Bamboo Bristle Bath Brush from Eco-Tools ($5.99; Drugstore.com), to gentlymassage the skin on your body in a circularmotion, concentrating on very dry zoneslike your calves, forearms and elbows. Thistechnique, called “dry brushing,” is oftenused in spas to efficiently remove dead, dull

skin flakes and boost cir-culation. “Dry brushing isalso believed to aid indetoxification and boostingimmune function,” Ar-

boleda adds. After, massageyour skin with some scented

body moisturizer and let it soak in.Sit back and relax until the next com-

mercial.

Commercial Break 5Rinse off your face mask and apply anovernight moisturizer. Then treat yourtresses to similar nighttime nourishment,working in a hair treatment such as Red-ken’s Real Control Overnight Treat HairRecovery Treatment ($12.67; Amazon.com). When you wash it out with yourmorning shower, your hair will be smoother,shinier and more manageable.

A Quick Mix-It-Yourself Face MaskThis face mask only uses two commonkitchen ingredients and is beneficial for all

skin types, says Kenneth, the lead aestheti-cian at Bliss Hollywood. “The enzymes andminerals in banana exfoliate and ‘feed’ theskin; the natural fat in whole milk hydrates,”he adds. What you need:

1. 1 large ripe banana (or a cooked sweetpotato)

2. 1 Tbsp whole milk (oily skin types canskip this)

3. A food processor or small blender Gentlyblend the ingredients to a thickness sim-ilar to molasses, being careful not tooverblend. Apply the mask to your skinand leave it on for up to 15 minutes, thenrinse. Feel free to eat any leftovers!

The Commercial Break Beauty Routine

Right Before the Show StartsTo make your couch area a bit more spa-like, light a candle in a scent that’s soothingand refreshing, like Banana Republic’sspicy, citrus-scented Golden Orchard Can-dle ($24; BananaRepublic.com) or the newsoy Lemon Verbena Candle from Mrs.Meyer’s ($9.99; MrsMeyers.com). Next,put a small saucepan of water on the stoveto boil and get out a large glass bowl, asmall bowl and a few clean towels.

Commercial Break 1Turn the burner off and care-fully pour the boiling water

into the large bowl so you canuse it to steam your face (andwhile you’re at it, fill yoursmaller bowl about halfway,too). “This way, the steam willrise over a large area and beable to come into contact withthe entire face,” says Elena Ar-boleda, head aesthetician for

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Beauty foods foryounger-looking skin

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florida health news- july 2010 issue

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