Monmouth County's Ask The Doctor July/August 2019

Monmouth County’s Ask The DOCTOR THE HEALTH &WELLNESS MAGAZINE F R YOU ANDYOUR FAMILY SUMMER ISSUE JULY/AUGUST 2019

Local Physicians Answer Your Health Questions

NEWS YOU CAN USE:

• Kids’ Health • Beauty • Eating Well • Fitness • Aging • ...and more : i ’ l i ll i i ...

Bellmawr, NJ

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Our state-of-the-art facility is beautifully designed and set against a backdrop of lush wooded acres. This modern, pristine therapeutic environment promotes accelerated healing and recovery in a tranquil, home-like atmosphere. Equally important is our uniquely personal, individualized approach to each resident, actively involving family members and caregivers in the healing process from admissions through recovery.

Expect the unexpected at Imperial Healthcare, with lovely accommodations, amenities and facilities that promote the healing process and create a pleasant environment for all. • Beautifully designed resident rooms • State-of-the-art therapy gym • Enclosed center courtyard with gazebo

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COMPREHENSIVE PERSONAL Care Touch

DR. KIRAN MEDASANI, MD MEDICAL DIRECTOR

A t King Manor Care and Rehabilitation Center, we are dedicated to providing professional quality health care in a warm environment. Our highly experienced and devoted sta of health care professionals treat each patient with respect, compassion and dignity. Centrally located on the Jersey Shore, King Manor Care and Rehabilitation Center has been servicing the community for over 25 years.

SERVICES INCLUDE: Sub Acute Rehabilitation Long Term Residency Alzheimer’s Care & Memory Enrichment Hospice & Comfort Care Respite Hospitality

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We understand that choosing a rehabilitative care center can be difficult. CareOne has the experience and know-how to help patients and their families receive the right care and information, and to ensure that patients return home stronger. Our physical, occupational and speech therapists help patients regain strength and independence. To that end, CareOne’s staff provides 48% more therapy per patient day than the statewide average, and 53% more than the national average.* Call today. You will have peace of mind knowing that your loved one’s care is in our hands. CAREONE REHABILITATION CENTERS

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Take a virtual tour at www.care-one.com Toll Free 877.99.CARE1

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OUR DEPARTMENTS Health Articles and Q&A Pages ............................ 8 Your questions answered from local physicians, medical news and information Men’s Health ..........................................................16 Expert tips for Men’s health and fitness As We Age ..............................................................19 Articles and physician information just for seniors Kids’ Health & Camp ............................................ 26 Information, news and expert advice to raising healthy children from pregnancy to 18 Healthy Home ....................................................... 32 Here you will find expert tips to make your home healthier, safe and fabulous The Healthy Palate ...............................................43 Recipes to enjoy and local dining options for eating out Healthy Mind & Soul ............................................48 Inspirational stories and advice on achieving mental balance and clarity Financial Health .................................................. 52 Information, resources and news related to the health and well-being of your financial future Diet & Fitness ........................................................ 58

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Monmouth County’s ASK THE DOCTOR The Greater Princeton Area ASK THE DOCTOR THE MILLSTONE TIMES

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Grav i ola Fru i t Can It Cure Cancer?

A recent study in South Korea finds that Graviola Fruit is up to 10,000 times more effective than chemotherapy at stopping the spread of cancerous cells. This fruit is not new. In 1997 a study was published in the Journal of Medicinal Chemistry found that it was more than 200 times as effective as chemotherapy when tested on breast cancer cells. Another study in 2015 published in the Univer- sal Medicina also found that the leaves, fruit and seeds of this plant were shown to inhibit the proliferation of breast cancer cells. Graviola also showed anticancer effects in lab studies but the human data are lacking. Extracts of Graviola have been shown to be effective against a number of viruses, bacteria, and parasites in test tubes. Labora- tory studies have also shown Graviola to be effective against some types of cancer cells. It contains chemicals called acetogenins, which are

thought to be the active ingredient. However, substances derived fromGraviola damaged nerve cells and caused neurological side effects similar to Parkinson’s disease in laboratory and animal experiments. In addition, some animal studies suggest long-term use may increase the risk of other neurological diseases. Graviola may also affect nuclear imaging because it has been shown to decrease the uptake of radiopharmaceuticals used in such procedures. If you are taking blood pressure medications or if you are taking diabetic medications, you should not eat or take Graviola in any form.

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Goat Yoga 101 By Pam Tee l

H E A L T H A R T I C L E S A N D Q & A Goat yoga was started in 2016 by Lainey Morse, an Oregon farm owner who was already orga- nizing a “goat happy hour,” an event where people spent time with her goats. When Lainey’s yoga instructor asked if she would like to throw some yoga into the happy-hour mix, a wonderful idea was born and the caprine vinyasa yoga classes turned out to be a hit. According to Lainey, goats are the ideal therapy animals. Unlike other animals that relieve stress in humans, goats don’t need to develop a special bond with a person before they start fully interacting with them. Both baby and adult goats will come right up to you asking to be pet, even if you’re a stranger who just walked into their barn. The trend is growing far beyond Oregon now, and yoga with baby goats is available in many locations. According to Morse’s website, goat yoga is a form of animal-assisted therapy. In stud- ies, interacting with therapy animals has been shown to boost feel-good neurotransmitters and lower cortisol levels. In a yoga class, the goats are left free to interact with yoga students, which essentially serve as a happy distraction that allows you to take your mind off whatever is stress- ing you out. The goats are also just really cute, cuddly, and won’t bite or head-butt you — but they may nibble and poop. Have you heard about the latest fad that has been taken Instagram and the world by storm? You’re hearing it right Baby, goat yoga, also known as caprine vinyasa. A caprine vinyasa session is meant to be a relaxed form of yoga, consisting of various asanas (poses) primarily at beginner level and intended to be open to yogis of every skill level but with a twist. Goats get to intermin- gle with you as you do your yoga stretches but the goat kids are likely to make the class more challenging than normal by climbing on you while you’re trying to keep a pose. With tremen- dous energy and playfulness, but also a short attention span, the baby goats will attempt to break your concentration and get you to play with them instead. In spite of all their cuddly cuteness, you are supposed to carry on with your class while doing your best to also accommodate the little guys. Trying to concentrate on your yoga moves can be a little tough with a goat on your back, but you can view it as a fun way to interact with another life force. It’s pretty hard to take yourself or life too seriously when there are baby goats involved, so it’s a great way to break from your normal mindset and relieve stress.

Actress, Lisa Rhinna, of the real housewives of Beverly Hills gave it a try after following it on Instagram. She and her daughters went to a goat yoga class as a way to spend more time together. As they moved through yoga poses, the goats gently climb on top of their backs and underneath their legs. Promoting it over the airwaves seemed to have given the fad more steam as more people wanted to seek out the experience. Although goat yoga has taken off on Instagram and reality TV, Morse said that "the focus of this class is not just to take pictures for Instagram," the goal is to combine nature, goats, and yoga to de-stress. If anyone from this area wants to combine their yoga with feeling, one with a goat, Goat Yoga classes are being held at Knowhere Farm, 537 Arneytown- Chesterfield Rd., Chesterfield, NJ, 08515, the 1st and 3rd Saturdays of the month from 10AM to 11:30AM. Classes are held with lead instructor, Allison, from Zephyr Yoga, rain or shine, on the front lawn or in the barn. Bring Friends! Knowhere Farm can also host your Group Events- Available by Request. Cami Gunther, owner of the Millstone Times and Gunther Publishing Inc., decided to try goat yoga herself along with 22 friends and family members. She loved the beautiful environment of the farm, seeing the other farm animal, listening to the roosters in the back- ground and the peaceful feeling of tranquility. She interacted with a very friendly and pregnant goat named Cincinnati. They put goat food on the mat and on her back to encourage the goats to come closer as the yoga instructor taught class as she normally would. The baby goats have free rein to come and interact with you in your practice. Two of the goats, “Spanky and Pippin are trained to jump on people during key yoga poses such as plank, down dog, upward dog, child's pose, boat pose, bridge, and wheel. Cami and her entourage enjoyed their experience interacting with the goats. It’s not every day you get to have an experience like that. Do you think this is something for you? Would you like to meet Spanky and Pippin? You can call Mary at (609 386 6168) or David at (609 351 0276) for more information. https:knowherefarm.com or visit them on Facebook. Visits to the farmstead are welcomed by appointment... You'll come upon mama and baby goats, cage-free-egg-laying chickens, cows, a vegetable garden, a comfy guest cottage, and lots of love on our farmstead here in the middle of Knowhere. This is a busy working farm and our home, so please do make an appointment before visiting. Other services offered- cow cuddling, party hosting, goat milk soap and other accessories sold. Hours (Seasonal): Tuesday - Friday: By appointment • Saturday: Special Events or by appointment • Sunday -Monday: Closed

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Skin safety at the beach By Lauren Kowlacki If you’ve been to the Jersey Shore, you probably know that sun isn’t hard to come by! Even if you’re not trying to get a tan, you’ll most likely end up with a freckled nose by the time you leave. The reason for this is because water, and especially salt water, attracts the sun. Also depending on where you’re beaching, the sand might attract rays as well. It’s important to protect your skin from unhealthy UV radi- ation at all times, but especially when you’re on the sand. It is always important to keep your skin covered. Sunscreen is the most important thing you can use on your skin daily. Not only is sun damage extremely bad for your skin’s overall health, but it also increases the chances of fine lines and wrinkles. Sunscreen also has the benefit of protecting your skin from other environmental stressors such as pollution and free rad- icals that we are all exposed to everyday. This is because sun- screen is packed with antioxidants, and in result protect from more than just sun. Look for sunscreen that has an easy application, sheer visi- bility and lightweight and aim for 50+. 50+ may seem pretty high, but the more the better to protect your beautiful skin! You can also try a tinted sun protection. Not only is it the per- fect primer or base, it also evens out your skin tone creating a flawless look. Don’t forget your lips! If you’ve ever had sunburnt lips you know that it is nothing short of a nightmare. Look for a lip sunscreen that doesn’t get sticky and conditions your lips as well while it protects the sun. Lip protector is also great to have with you at all times, not just not on the beach.

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Q: LEADERS IN LEAST INVASIVE PAIN & SPINE PROCEDURES How can Platelet Rich Plasma Treatment Help Shoulder and Knee Pain?

A:

Platelet Rich Plasma Therapy also referred to as PRP Therapy, is a progressive non-surgical treatment to treat a variety of conditions including arthritis, ten- don injuries, and ligament injuries. PRP is part of a group of state-of-the-art treatments collectively referred to as Regenerative Medicine. PRP treats an injured area naturally using your body’s own growth factors to accelerate healing. It has been shown to be safe and effec- tive for numerous joint and soft tissue injuries. It has been extensively researched in numerous medical journals and publications all over the world. Some of the many uses of Platelet Rich Plasma include osteoarthritis (degenera- tive arthritis) of the spine, knee, shoulder, hip, hands, and feet, as well as menis- cus tears, plantar fasciitis, and rotator cuff tears. The procedure is simple and is performed in the office. The PRP process begins when a small amount of the patient’s blood is removed from the arm and placed into a special container. The blood is then placed into a device called a centri- fuge which spins the blood to help the separate the portion of the blood which becomes concentrated with platelets, thereby giving the procedure its name. These platelets are important because they release growth factors to recruit stem cells and to assist in healing an injured area naturally. Once the PRP is isolated, it is injected to the injured area under the guidance of an ultrasound machine to help accelerate healing and reduce pain.

This healing works on the simple principle that your body is perfectly capable of healing itself. Your blood contains all the essential components that the body produces to repair tissue damage. Each time you have an injury, the platelets in your blood along with growth factors, stem cells, cytokines, and other elements create a scaffolding on the site. The damaged tissues use this framework to regenerate and repair. The entire process takes approximately one hour, and pa- tients are sent home the same day. Patients on average report more than 50% improvement in 6 weeks and up to 100% improvement in 12 weeks. This may eliminate the need for more aggressive and expensive treatment options such as long-term medication or surgery. In a recent study, researchers at Hospital for Special Surgery gave patients with early osteoarthritis an injection of PRP and then monitored them for one year. After one year of the PRP injection, physicians evaluated the knee cartilage with magnetic resonance imaging (MRI). While previous studies have shown that patients with osteoarthritis can lose roughly five percent of knee cartilage per year, the Hospital for Special Surgery investigators found that a large majority of patients in their study had no further cartilage loss. At minimum PRP also prevented further knee deterioration.

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7 Summertime Health Risks You May Not Know About By Orlando F. Mills, MD, MPH When the weather is warm and the skies are blue, road trips and outdoor fun are almost always on the agenda. But health risks abound—especially during the summer. Here are a few uncommon ways that a fun time can be interrupted by a medical issue. 1. High-Altitude Sickness – Hiking is a popular pastime during the warmer months. While New Jersey’s mountains aren’t high enough to spark an unpleasant reaction to the altitude, many popular hiking destinations, like the Rocky Mountains, are. You may begin to feel the effects of decreased oxygen in the atmosphere at altitudes over 5,000 feet above sea level, with the condi- tion most commonly felt by those in altitudes of 8,000 to 10,000 feet above sea level. Symptoms include dizziness, headache, fatigue, shortness of breath, and, in extreme cases, facial or leg swelling or congestive heart failure. Preventive care can help prevent the effects of decreased oxygen. If you’re planning a trip to a mountainous area, ask your doctor to prescribe Diamox, a diuretic and carbonic anhydrase inhibitor that can prevent illness. The medication works best when taken one day before travel and several days after. If you experience altitude sickness, try to rest while your body becomes more accustomed to the altitude. If symptoms persist, particularly if you have other chronic medical conditions, seek medical attention. 2. Swimming Solo – While taking a dip in the ocean after the beach has cleared out and the lifeguards have packed up may sound heavenly, it’s risky to swim alone. Even mild to moderate rip currents can pull you out to sea. To stay out of harm’s way, only swim at the beach when a lifeguard is on duty. The chance of drowning at a beach while a lifeguard is working is 1 in 18 million, according to the U.S. Lifesaving Association. Additionally, learn how to spot a rip current and check water conditions before going in. And, the old adage is true: eating a heavy meal before swimming can cause painful stomach cramps, so plan accordingly. 3. Beach Chair Bruises – That brightly colored cooler chair may be comfortable, but if you’re not careful, you may injury your fingers. Be sure to read the chair’s operating instructions before using and take care to keep your fingers and hands away from the hinges when opening or closing the chair. Also, be sure to place your chair on even ground to prevent a tumble. 4. Road Trip Tightness – Summer traffic can be brutal. If you’re planning a lengthy road trip, be sure to take a break everyone and a half to two hours to stretch your back, move your legs and hips, and refocus your mind. You also may want to invest in a lumbar support pillow or back roll for the car to relieve pressure on the disks in your spine. 5. Eye Illnesses – You know that it’s important to protect your skin from harmful UV rays but it’s equally important to protect your eyes. Ultraviolet (UV) rays from the sun can cause melanoma of the eye, a form of cancer. It’s important to protect your eyes, especially on sunny days when the sun’s light can reflect off the sand, magnifying its impact. Protect your retinas by wearing sunglasses and a hat and staying under an umbrella when possible. 6. Menacing Mice – You’ve probably heard that ticks transmit Lyme disease after contracting the Lyme bacteria from deer, but did you know that the white-footed mouse also is a source? Knowing the symptoms of Lyme disease is important, especial- ly in this part of the state. In fact, in 2017, Monmouth County ranked second in the state in number of new cases of Lyme disease reported. If you’ve been in wooded areas, check your skin for small deer ticks and see your doctor if you experience pain, aches or swelling in your joints after finding a tick on your skin. It’s important to note that symptoms can take weeks or even months to develop. If you suspect that you’ve been bitten by a deer tick, call your doctor, who may administer a western blot test, a type of blood test. It’s difficult to know if someone has Lyme disease just based on symptoms alone, so testing is a crucial step in diagnosing the condition. Left untreated, it can cause myocarditis, a type of inflammation of the heart, or nervous system inflammation. 7. Halting Hydration – Water, water everywhere… in the ocean, in the pool, in our drinks, but it’s not uncommon to become dehydrated in the summer, when high temperatures and prolonged sun exposure can sap our bodies of the water it needs to function properly. To prevent dehydration, be sure to drink at least two additional 8-ounce glasses of water each day. Stomach illnesses like vomiting or diarrhea also may cause dehydration. The signs that your body hasn’t had enough water include weakness, dry mouth, light headedness, dizziness and confusion. If you think you may be dehydrated, call your primary care physician. Each summer, several of my patients travel to Colorado to hike and attend an annual festival. Last year, a female adult in the group experienced swelling in her legs and face, the classic signs of high-altitude sickness. She drank water and rested a bit, and the symptoms eventually subsided. This year, I prescribed Diamox to help her body better adjust to the terrain and prevent illness from sidetracking her vacation. A little prevention goes a long way. Take the steps necessary to ensure that you and your family have a safe—and active— summer. Orlando Mills, MD, MPH, is a board-certified family practice physician on staff at CentraState Medical Center. He can be reached by calling 866-CENTRA7.

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New Minimally Invasive Procedure Offers Brain Bleed Patients Safe and Effective Alternative to Open Surgery Minimally invasive technique also enables treatment for previously inoperable brain bleeds

Patients suffering from subdural hematomas – the type of brain bleed most often caused by head injuries – have traditionally had two options: brain surgery or finding a way to manage the symptoms, which can include dizziness, nausea, seizures and more. Now, Dr. Kyle Chapple and the team of neurosurgeons at Atlantic NeuroSurgical Specialists (ANS) – one of the largest neurosurgical practices in New Jersey and one of the most advanced in the coun- try – are advocating for a new, minimally invasive technique called endovascular embolization. Endovascular embolization enables neurosurgeons to safely and effectively treat subdural hematomas without open brain surgery. Instead, a catheter is inserted in a large blood vessel at the top of a patient’s leg and navigated up into the blood vessels in the head. Through that catheter, microscopic particles called embospheres are delivered to stop the bleeding. The procedure offers a solution for a much wider range of patients than an open craniotomy. Not everyone is a candidate for a crani- otomy given limitations on the use of general anesthesia for older patients and those with health complications.

Dr. Kyle Chapple, a board-certified neurosurgeon at Atlantic NeuroSurgi- cal Specialists (ANS), is the Principal Investigator for a new study focusing on the benefits of endovascular embo- lization for brain bleed patients.

“This allows significantly more people who truly need surgical intervention to get it,” adds Dr. Chapple. “Being a minimally invasive procedure, it also carries far fewer risks and potential side effects, and requires much less recovery time. In fact, patients can go home the very next day.” Dr. Chapple is the Principal Investigator for a new randomized study that compares patient outcomes from endovascular embolization versus traditional craniotomies. He notes, “At ANS, we have seen fantastic results in our patients who have undergone this procedure over the past few years, and we’re now in the process of generating formal medical research that we believe will support its safety and efficacy.” To learn more, contact Dr. Chapple at ANS at 973-285-7800 or visit www.ans- docs.com.

Atlantic NeuroSurgical Specialists (ANS) is New Jersey’s largest neurosurgical prac- tice and one of the most advanced in the country. Since its founding in 1958, ANS has specialized in the diagnosis and treatment of disorders affecting the nervous system. For more information, visit www.ansdocs.com.

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Dr. Steven Linker, OD

QUESTION: What is Optomap retinal imaging?

ANSWER:

H E A L T H A R T I C L E S A N D Q & A Your retina (located in the back of your eye) is the only place in the body where blood vessels can be seen directly. This means that in addition to eye conditions, signs of other diseases (for example, stroke, heart disease, hypertension and diabetes) can also be seen in the retina. Early detection of life-threatening diseases like cancer, stroke, and cardiovascular disease. It also facilitates early protection from vision impairment or blindness Early signs of these conditions can show on your retina long before you notice any changes to your vision or feel pain. While eye exams include a look at the front of the eye to evaluate health and prescription changes, a thorough screening of the The optomap ultra-widefield retinal image is a unique technology that captures more than 80% of your retina in one panoramic image while traditional imaging methods typically only show 15% of your retina at one time.

free. It is suitable for every age, even children. The capture takes less than a second. Images are available immediately and you can see your own retina and exactly what your eye care practitioner sees in a 3D animation. Most importantly, early detection means successful treatments can be administered and reduces the risk to your sight and health.

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Dr. Steven Linker, OD Monmouth Vision Associates 50 Rt 9 North Suite 206 Morganville, NJ, 07751 Tel: 732-617-1717

retina is critical to verify that your eye is healthy. Getting an optomap image is fast and pain-

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H E A L T H A R T I C L E S A N D Q & A

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Dr. Sam Jonuzi specializes in bioionic chemistry, detoxification, and clinical nutrition. He earned a Bachelor of Science degree in biochemistry from Rowan Univer- sity in 1986 and a Doctor of Naturopathy degree from Trinity College of Natural Medicine in 2001. Dr. Jonuzi also earned an Integrative Health Practicioner degree at the Advanced Integrative Medical Institute inWashington, DC. Dr. Jonuzi is a Diplomat of the College of Natural Therapies and a Member of the American Association of Dr. Sam Jonuzi specializes in b ionic chemistry, detoxification, and cl nical nutrition. H earned a Bachelor of Science degree in biochemistry from Rowan Univer- sity in 1986 and a Doctor of Naturopathy degree from Tr nity Coll ge of Natural Medicine in 2001. Dr. Jonuzi also earned an Integrative Health Pract cioner degree at the Advanced Integrative Medical Insti ute inWashington, DC. Dr. Jonuzi is a Diplomat of the Coll ge of Natural Therapies and a Member of the American Association of Dr. Sam Jonuzi special zes n b ionic chemistry, detoxification, and cl nical nu rition. He earned a Bachelor of S ience degree n biochemistry from Rowan Univer- sity in 1986 and a Doctor of Naturopathy deg ee from Tr nity Coll ge of N tural Medic ne in 2001 Dr. Jonuzi also earned an Integrative Health Practicioner degree at the Advanced Integrativ Medical Insti ute inWashi gton, DC Dr. Jonuzi is a Diplomat of the College of N tural Therapies nd a M mber of the American Association of Dr. Sam Jonuzi sp cial zes in b oionic chemis ry, detoxific tion, and cl nical nutrition. H rned a Bachelor of S ience degree in biochemistry from Rowan Univer- sity in 1986 and a Doctor of N uropathy degree from Tr nity C llege of N tural M dicine in 2001. Dr. Jonuzi also arned an Int grative Health Pra ticioner degree at the Adva c d Int grative Medical Insti ute inWashington, DC. Dr. Jonuzi is a Diplomat of the Coll ge of N tural Therapies nd a M mber of the American Association of • Chemical Detox • ADD/ADHD • Executive Functioning • Mood Issues • PTSD/Anxiety/Depress o • Dementia & Other • Neurological Conditions • Enhancement of • Sports Performance BRAIN REJUVENATION PROTOCOLS FOR: Integrative Medicine. Dr. Jonuzi is Founder and Managing Director at Atlantic Integrative Medi- cal Center in Pleasantville. Integrative Medicine. Dr. Jonuzi is Founder and Managing Director at Atlantic Integrative Medi- cal Center in Ple santville. Integrative Medicine. Dr. Jonuzi is Founder and Ma aging Di ec or at A lantic Integrative Medi- cal Center in Ple santville. In grative Medicine. Dr. Jonuzi is Founder and Ma aging Di ec or at Atlantic In grative Medi- cal Center in Pleasantville.

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Has your weight loss journey extended for years leading to frustration with only meager results, or has your effort to lose weight only achieved temporary results? If so, the HCG Diet Program at Nutritional Infusions may be the perfect fit for you. HCG (human chorionic gonadotrophin) is a naturally occurring hormone present in both men and women which functions to liberate stored fat, in turn energizing and nutrifying the body when coupled with a 500 calorie diet. You will learn to administer the HCG by simple injection along with the special diet training for optimal results. The Program has helped thousands of people lose their desired weight from extreme, 1.5 lbs per day, to fine tuning with a minimal amount of weight lost for good. The majority of those on the diet say they were not hungry. Dr. Simeons, the originator of the HCGDiet spent more than twenty years scientifically testing every aspect of obesity. His story is remarkable. Dr. Simeons found that by injecting a small amount of HCG along with a specially tailored diet, he reduced a persons weight by a pound a day on average and you can expect the same. Our Doctors have over 50 years combined experience helping people realize their Best Health Possible. CALL TODAY, 732-780-8671, FOR YOUR NO- CHARGE, 30 MINUTE IN-OFFICE CONSULTATION.

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What Men Should Know About Menopause By Jyothi Rangadhama, MD

Menopause is much more than just the cessation of periods. Much like the changes men experience during the aging process when testosterone levels dip, fluctuating hormones bring challenging physical and emotional changes for women. Men can help their partners get through this time of transition by asking questions, being supportive, and most importantly, being patient. Technically, menopause occurs once a woman goes 12 months without a menstrual period, so it’s actually diagnosed once it’s over. The time of transition before menopause is called perimenopause, and that can be an emotional roller-coaster for women. She may say that she feels like she’s “going crazy,” but she’s not imagining these changes. Know the Symptoms – The transition to menopause may sometimes take two years. Not every woman will experience every symptom, and intensity will vary. The symptoms of menopause, which typically occurs around age 51, include: • Hot flashes • Night sweats • Mood swings • Memory lapses • Fatigue Ask Questions - Your partner will welcome your interest in what she’s going through, so I encourage you to ask questions to show your support and that you’re going through this together. Tread Lightly - Due to hormonal fluctuations, your partner may experience mood swings, depression, and increased irritability. Be patient; it’s only temporary. Give her space when she asks for it. Sleep May Be Elusive – Hot flashes and night sweats may make sleeping difficult. Unfortunately, a lack of sleep only compounds the emotional symptoms that she may be experiencing. Making the bedroom a bit cooler and using a thinner comforter will help, as will offering her a cold drink that doesn’t include caffeine. Avoid Weighty Issues – Your partner may gain weight, particularly around the middle, as her metabolism slows. Be sup- portive and encouraging if she takes steps to cut calories or fit exercise into her busy day. Plan a Date Night – I encourage you to spend time together as a couple. You both can and will survive this transition if you know what to expect and focus on what’s positive in your relationship. Go out for a nice dinner or a Broadway show. Remind her how beautiful she is and why you love her. Don’t Take it Personally - Sex can be sore spot, literally. Estrogen makes a woman’s vaginal tissues soft, so when estrogen levels drop, tissues can become thin and dry, and the vaginal canal may narrow. Lubricant can help. Additionally, a lack of testosterone may affect her sex drive. As difficult as it may be, it’s important not to take your partner’s reluctance to join you in the bedroom personally. Be patient; these changes are temporary. • Decreased concentration • Difficulty sleeping • Vaginal dryness • Decreased sex drive

M E N ’ S H E A L T H

Medications Can Help – Menopause is not the beginning of the end of your sexual relationship. Your partner’s doctor can prescribe medication to help alleviate symptoms if necessary. Encourage her to speak with her doctor if the symptoms are unbearable. Your partner is going through an emotional time. The most important advice that I can give is that these symptoms are temporary. Ask ques- tions and listen to her answers. And, be sure to share your feelings about how the aging process is affecting you as well. With some lifestyle modifi- cations and patience, you’ll get through this time stronger together. Jyothi Rangadhama, MD, is a board-certified ob- stetrician-gynecologist on staff at CentraState Medical Center. She can be reached by calling 866-CENTRA7.

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Men and Mental Health While mental illnesses affect both men and women, the prevalence of mental illnesses in men is often lower than women. Men with mental illnesses are also less likely to have received mental health treatment than women. Recognizing the signs that you or someone you love may have a mental disorder is the first step toward getting treatment. The earlier that treatment begins, the more effective it can be. Men and women can develop most of the same mental disorders and conditions but may experience different symptoms. Some symptoms include: • Anger, irritability, or aggressiveness • Noticeable changes in mood, energy level, or appetite • Difficulty sleeping or sleeping too much • Difficulty concentrating, feeling restless, or on edge • Increased worry or feeling stressed • Misuse of alcohol and/or drugs • Sadness or hopelessness • Suicidal thoughts • Feeling flat or having trouble feeling positive emotions • Engaging in high-risk activities • Aches, headaches, digestive problems without a clear cause • Obsessive thinking or compulsive behavior • Thoughts or behaviors that interfere with work, family, or social life • Unusual thinking or behaviors that concern other people Mental disorders can be treated: If you are unsure where to go for help, ask your family doctor. Asking questions and provid- ing information to your doctor and other providers can improve your care. Talking with your doctor builds trust and leads to better results, quality, safety, and satisfaction. If you or someone you know is in a crisis, get help immediately. You can call 911 or the National Suicide Prevention Line at 1-800-273-TALK (8255).

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10 Warning Signs Your Older Family Member May Need Help

Changes in physical and cognitive abilities that may occur with age can be difficult to detect—for older adults and their family members, friends, and caregivers. To help in determining when an older adult may need assistance in the home, the Eldercare Locator has compiled this list of 10 warning signs. Any one of the following behaviors may indicate the need to take action. It is also important to inform the older adult’s physician of these changes. 1. Changing eating habits, resulting in weight loss, appetite loss, or missed meals 2. Neglecting personal hygiene, including clothing, body odor, oral health, nails, and skin 3. Neglecting the home, with a noticeable change in tidiness and/or sanitation 4. Exhibiting inappropriate behavior, such as being unusually loud, quiet, paranoid, or agitated, or making phone calls at unusual hours 5. Changing relationship patterns, causing friends and neighbors to express concern 6. Showing physical injuries, such as burns, whichmay have resulted from general weakness, forgetfulness, or misuse of alcohol or medication 7. Decreasing or stopping participation in activities that were once enjoyable, such as a bridge or book club, dining with friends, or attending religious services 8. Exhibiting forgetfulness, resulting in unopened mail, newspaper piles, unfilled prescriptions, or missed appointments 9. Mishandling finances, such as not paying bills or paying them more than once and losing or hiding money 10. Making unusual purchases, such as more than one subscription to the same magazine, entering an unusually large number of contests, or increasing purchases from television advertisements Through the Eldercare Locator, older adults and their loved ones can find local resources that can help older adults to continue living independently in their homes and communities. To find programs and services in your area, contact the Eldercare Locator at 1-800-677-1116or https://eldercare.acl.gov.

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A S W E A G E

Our Fight For Life “Together We Can Survive” Prescription drug spending has increased to 4.6 percent in 2019. It is estimated that the increase will continue, on average, each year 5.5 percent through 2027. 7 WAYS TO LOWER DRUG COSTS 1. Consider switching to generics or other lower-cost drugs. There may be a generic or less-expensive brand-name drugs that would work just as well. You may be able to save money by using mail-order pharmacies plans. 2. Choose a plan that offers additional coverage during the gap. There are plans that offer additional coverage during the coverage gap. However, plans with additional gaps coverage may charge high- er monthly premiums. 3. Pharmaceutical Assistance Programs. Some pharmaceutical companies offer help for people enrolled in Part D. Find out whether there's a Pharmaceutical Assistance Pro- gram for the drugs you take. 4. State Pharmaceutical Assistance Programs. Many states offer help paying drug plan premiums and/or other drug costs. For example: PACE (PA), PAAD (NJ) & EPIC (NY) . Find out if your state has a State Pharmaceutical Assistance Program. 5. Apply For Extra Help Medicare and Social Security have programs that helps people with limited income and resources. Note: You must qualify for Extra Help or a Special Needs Program.

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