Monmouth County's Ask the Doctor July-August 2021

Ask The Doctor is CNJ’s only magazine that only contains editorial regarding health and wellness.


Local Physicians Answer Your Health Questions

NEWS YOU CAN USE: • Kids’ Health • Beauty • Eating Well • Fitness • Aging • ...and more

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


Platelet Rich Plasma erapy also referred to as PRP erapy, 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 e ec- tive for numerous joint and so 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 cu tears. e procedure is simple and is performed in the o ce. e PRP process begins when a small amount of the patient’s blood is removed from the arm and placed into a special container. e 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. ese 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.

is 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 sca olding on the site. e damaged tissues use this framework to regenerate and repair. e 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. is 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. A er 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 ve 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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OUR DEPARTMENTS Health Articles and Q&A....................5 Your questions answered from local physicians, medical news and information Kids’ Health & Camp..........................11 Information, news and expert advice to raising healthy children from pregnancy to 18 As We Age.......................................... 14 Articles and physician information just for seniors Family Matters ................................. 19 Information, resources and news related to the health and well-being of your families future The Healthy Palate............................23 Recipes to enjoy and local dining options for eating out Healthy Home................................... 25 Here you will find expert tips to make your home healthier, safe and fabulous


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What’s the Difference Between Sleep and Anesthesia? By Pam Teel The anesthetic state and natural sleep share many neurobiological fea- tures and yet are two distinct states. There are two main sleep states: rap- id eye movement (REM) sleep and non-REM sleep. The brain and body slow down during non-REM sleep, while REM sleep is very much like an awake state. Through the night, you go between the two states in cycles of about 90 minutes, four to six times total. It’s a natural physiologic pro- cess that needs to take place for your mental and physical health.

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

During sleep, the brain moves between the slow waves of non-REM sleep and the fast waves of REM sleep. Anesthesia is nothing like that. Under general anesthesia, brain waves are held hostage in the same state and remain there for the length of the operation until they turn the an- esthetics off and allow you to slowly come out of it. General anesthesia is a drug-induced, reversible coma that has a few components: Analgesia- you don't perceive pain, unconsciousness- you're not aware of what's happening, Amnesia- you’re not forming memories, Akinesia- you can’t move.

Sleep is actively generated in the brain and is dependent on homeostatic drive and circadian rhythms. The ease of onset and mainte- nance of sleep is subject to environmental factors such as temperature, noise, light and chemical stimulants. Once NREM is established, there is regular cycling between this state and REM sleep at approximately 90-min intervals. The onset of sleep is known to be regulat- ed by a variety of neurotransmitter systems. In recent years, the prevailing supposition is that sleep–wake regulation is contingent on fast neurotransmitters such as GABA and glutamate. The ventrolateral preoptic area (VLPO) is known to be important in sleep onset. GABAergic neurons project from the VLPO to arousal areas such as the histaminergic tuberomammillary nucleus in the posterior hy- pothalamus, the serotonergic dorsal raphe and the noradrenergic locus coeruleus. Adenosine is one of the brain's chief somnogens and accumulates as a degradation product of adenosine triphosphate during prolonged intervals of waking. Adenosine binding in the VLPO is associated with increased activity in this region, promoting non-REM sleep. General anesthesia keeps the body in a stable state by maintaining a consistent blood pressure, heart rate, and body temperature. Re- gional anesthesia blocks pain perception in a specific area without making the patient unconscious. It’s a common technique for ortho- pedic surgeries in the lower part of the body, like knee surgery. Sedative drugs block memory formation and make the patient less aware of what’s going on, which is helpful for uncomfortable procedures like colonoscopies. Anesthetic drugs block the brain’s ability to send information between regions. Many of the commonly used anesthetics bind to GABA receptors, a type of receptor found in inhibitory interneuron’s all over the nervous system. These interneuron’s act like routers in a com- puter network: they connect and modulate all the excitatory neurons in the brain. If you control the interneuron’s, you can control the rest of the circuits in the brain. Binding to GABA receptors activates interneuron’s to inhibit the rest of the brain. The enhanced inhib- itory activity changes the character of brain waves, the synchronized electrical activity of groups of neurons. They transform from very high frequency, small amplitude waves to very low frequency, large amplitude waves. As long as the patient receives the anesthesia, the brain stays in this state. The brain waves become so structured and regimented that they can't transmit information anymore. As a consequence, brain regions can no longer communicate with each other, resulting in profound unconsciousness and amnesia. The anesthesiologist may administer an opioid and muscle relaxants to ensure adequate anal- gesia and akinesia, respectively. When the drug wears off, the brain rhythms slowly return to normal, and the patient comes to. You can’t dream if you're under full general anesthesia and unconscious, but if you're in a lighter state of sedation, then you certainly can dream. Sometimes, after sedation, people wake up with a good feeling and interpret it as being well-rested. That's because sedative drugs can induce the release of dopamine, which gives you a sense of feeling good. It is not the same feeling as waking up from a good night’s sleep. If a neuroscientist used electroencephalography (EEG) to record your brain’s electrical activity while you were under anesthesia, the results would look different from how they appear when you are sleeping. In fact, your brain waves under anesthesia would more closely resemble those seen were you to have the terrible misfortune of falling into a coma after brain illness or injury. Doctors often tell surgery patients that they will be ‘put to sleep’ during the operation, but in terms of the neurological effects of the anesthesia, it would be more accurate (and more unsettling) to tell them that they will be put into a reversible coma. Some people do experience side effects after coming out of the anesthesia which include: temporary confusion and memory loss, al- though this is more common in the elderly, dizziness, difficulty passing urine, bruising or soreness from the IV drip, nausea and vomit- ing, shivering and feeling cold, and sore throat from the breathing tube.

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What is Cognitive Dissonance? By, Surabhi Ashok

Cognitive dissonance, a highly researched theory in social psychology, is the conflict of attitude/belief and behavior. An example of this is not picking up after your dog (be- havior) even though you know you should abide by your communities’ guidelines (cognition). When your behavior doesn’t coincide with your knowledge, it creates a mental discomfort.

H E A L T H A R T I C L E S A N D Q & A Different factors affect the intensity of this discomfort. Per- sonal beliefs, beliefs that are held with significance, and the number of the conflicting beliefs can all create more disso- nance. Cognitive dissonance is caused by three things: forced compliance behavior, decision making, and effort. Forced compliance behavior is when you act against your beliefs. Because your action was in the past, you alleviate your mental discomfort by forcing your attitude to match with what you did. Decisions also cause cognitive dissonance because choosing one alternative means you haven’t chosen the other. For instance, if you had to decide between finishing work from school or going out with your friends, you might feel dissonance. If you finished your work, you would miss your friends and the probable fun time they were having. If you went with your friends, you would feel guilty that you did not complete your assignments which may cause stress. To solve this cognitive dissonance, people often partake in “spreading apart the alternatives,” which is increasing the appeal of the option they chose while decreasing the appeal of the other option. Cognitive dissonance is caused by putting so much effort into achieving something and it proves to be not worthwhile and a waste. The result could be disappointing, or your accomplishment of the goal could make you feel dissatisfied. An example of this would be putting in a lot of time and energy into getting a promotion for your job when you realize that the spot has already been filled by someone else. To avoid the resulting dissonance, people often use the method of “effort justification.” This is persuading oneself that the accom- plishment was worth the amount of work put in and regarding it with esteem. People also try to downplay their effort as if they did not tirelessly use up their energy on a disappointing end result. Essentially, cognitive dissonance is reduced by the change, addition, and devaluation of existing attitudes or behavior. It is also com- mon to see people look for information, like the negative campus life of a college for example, that might outweigh the dissonance of not choosing to go there. Another method is reflected in a popular phrase “You only live once,” which convinces someone to do something they wouldn’t normally do because life is short and should be exciting. There are significant effects on people who experience cognitive dissonance as well. These people may feel anxious or guilty, try to hide their actions or beliefs, rationalize their choices, avoid conversations about certain topics, disregard or keep away from any contradicting information, including research and articles, and maybe even change their behavior. The cognitive dissonance theory was first established by Leon Festinger when he studied a cult that believed the Earth would be destroyed by a flood. When the flood did not happen however, some members re-interpreted the result to say that the flood did not occur because they were so committed to this cult. The theory states that each and every human being tries to keep their attitudes and behavior aligned, which is called cognitive con- sistency. Therefore, people try to eliminate any disharmony that may occur because it is in their nature. Cognitive dissonance affects your daily life in the decisions you make and the experiences you have. While it is an uncomfortable

feeling, cognitive dissonance can lead to reevaluation, positive growth, and change. Sources: |




Dr. Steven Linker, OD

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

QUESTION: What is Optomap retinal imaging?


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. 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

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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How common are taste disorders? Many of us take our sense of taste for granted, but a taste disorder can have a negative effect on your health and quality of life. If you are having a problem with your sense of taste, you are not alone. More than 200,000 people visit a doctor each year for problems with their ability to taste or smell. Scientists believe that up to 15 percent of adults might have a taste or smell problem, but many don’t seek a doctor’s help. The senses of taste and smell are very closely related. Most people who go to the doctor because they think they have lost their sense of taste are surprised to learn that they have a smell disorder instead. To learn more about your sense of smell, read the NIDCD publication, Smell Disorders. How does your sense of taste work? Your ability to taste comes from tiny molecules released when you chew, drink, or digest food; these molecules stimulate special sensory cells in the mouth and throat. These taste cells, or gustatory cells, are clustered within the taste buds of the tongue and roof of the mouth, and along the lining of the throat. Many of the small bumps on the tip of your tongue contain taste buds. At birth, you have about 10,000 taste buds, but after age 50, you may start to lose them. When the taste cells are stimulated, they send messages through three specialized taste nerves to the brain, where specific tastes are identified. Taste cells have receptors that respond to one of at least five basic taste qualities: sweet, sour, bitter, salty, and umami [oo-MOM-ee]. Umami, or savory, is the taste you get from glutamate, which is found in chicken broth, meat extracts, and some cheeses. A common misconception is that taste cells that respond to different tastes are found in separate regions of the tongue. In humans, the different types of taste cells are scattered throughout the tongue. Taste quality is just one way that you experience a certain food. Another chemosensory mechanism, called the common chemical sense, involves thousands of nerve endings, especially on the moist surfaces of the eyes, nose, mouth, and throat. These nerve endings give rise to sensations such as the coolness of mint and the burning or irritation of chili peppers. Other specialized nerves create the sensations of heat, cold, and texture. When you eat, the sensations from the five taste qualities, together with the sensations from the common chemical sense and the sensations of heat, cold, and texture, combine with a food’s aroma to produce a perception of flavor. It is flavor that lets you know whether you are eating a pear or an apple. Most people who think they have a taste disorder actually have a problem with smell. When you chew food, aromas are released that activate your sense of smell by way of a special channel that connects the roof of the throat to the nose. If this channel is blocked, such as when your nose is stuffed up by a cold or flu, odors can’t reach sensory cells in the nose that are stimulated by smells. As a result, you lose much of our enjoyment of flavor. Without smell, foods tend to taste bland and have little or no flavor. What are the taste disorders? The most common taste disorder is phantom taste perception: a lingering, often unpleasant taste even though there is nothing in your mouth. People can also experience a reduced ability to taste sweet, sour, bitter, salty, and umami—a condition called hypogeusia [hy-po-GYOO-zee-a]. Some people can’t detect any tastes, which is called ageusia [ah-GYOO-zee-a]. True taste loss, however, is rare. Most often, people are experiencing a loss of smell instead of a loss of taste. In other disorders of the chemical senses, an odor, a taste, or a flavor may be distorted. Dysgeusia [dis-GYOO-zee-a] is a condition in which a foul, salty, rancid, or metallic taste sensation persists in the mouth. Dysgeusia is sometimes accompanied by burning mouth syndrome, a condition in which a person experiences a painful burning sensation in the mouth. Although it can affect anyone, burning mouth syndrome is most common in middle-aged and older women. What causes taste disorders? Some people are born with taste disorders, but most develop them after an injury or illness. Among the causes of taste problems are: • Upper respiratory and middle ear infections • Radiation therapy for cancers of the head and neck • Exposure to certain chemicals, such as insecticides and some medications, including some common antibiotics & antihistamines • Head injury • Some surgeries to the ear, nose, and throat (such as middle ear surgery) or extraction of the third molar (wisdom tooth) • Poor oral hygiene and dental problems. How are taste disorders diagnosed? Both taste and smell disorders are diagnosed by an otolaryngologist (sometimes called an ENT), a doctor of the ear, nose, throat, head, and neck. An otolaryngologist can determine the extent of your taste disorder by measuring the lowest concentration of a taste quality that you can detect or recognize. You may be asked to compare the tastes of different substances or to note how the intensity of a taste grows when a substance’s concentra- tion is increased. Scientists have developed taste tests in which the patient responds to different chemical concentrations. This may involve a simple “sip, spit, and rinse” test, or chemicals may be applied directly to specific areas of the tongue. An accurate assessment of your taste loss will include, among other things, a physical examination of your ears, nose, and throat; a dental examina- tion and assessment of oral hygiene; a review of your health history; and a taste test supervised by a health care professional. Can taste disorders be treated? Diagnosis by an otolaryngologist is important to identify and treat the underlying cause of your disorder. If a certain medication is the cause, stop- ping or changing your medicine may help eliminate the problem. (Do not stop taking your medications unless directed by your doctor, however.) Often, the correction of a general medical problem can correct the loss of taste. For example, people who lose their sense of taste because of respiratory infections or allergies may regain it when these conditions resolve. Occasionally, a person may recover his or her sense of taste spontaneously. Proper oral hygiene is important to regaining and maintaining a well-functioning sense of taste. If your taste disorder can’t be successfully treated, counseling may help you adjust to your problem. If you lose some or all of your sense of taste, here are things you can try to make your food taste better: • Prepare foods with a variety of colors and textures. • Use aromatic herbs and hot spices to add more flavor; however, avoid adding more sugar or salt to foods. • If your diet permits, add small amounts of cheese, bacon bits, butter, olive oil, or toasted nuts on vegetables. • Avoid combination dishes, such as casseroles, that can hide individual flavors and dilute taste. Are taste disorders serious? Taste disorders can weaken or remove an early warning system that most of us take for granted. Taste helps you detect spoiled food or liquids and, for some people, the presence of ingredients to which they are allergic.

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Time to Celebrate the Parents By Nicole Iuzzoli o

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When thinking of the month of July, one holiday comes to mind mighty quick, and that most likely is the Fourth of July. Howev- er, there is a holiday that is often overlooked and one that should be more celebrated. This holiday is National Parents Day, which is a holiday that truly deserves more than one day as they do so much for us. This lovely holiday takes place on the fourth Sunday of every July. For most of us, without our parents, we would not be where we are today, and we should really show them how grateful we are. National Parents day was created in 1994 by former President Bill Clinton and his intentions were to make children appreciate their parents not with gifts like one would on Mother’s or Father’s day, but with actions and kind gestures. When signing this bill, President Bill Clinton stated that the day is about, “recognizing, uplifting, and supporting the role of parents in bringing up their children.” In 1987, the Parenting Magazine was introduced to stands around America, and the circulation skyrocketed all the way up to 2.2 million. Unfortunately, it was discontinued in 2013 after. The Parents’ Day Council plays a huge role in celebrating this holiday. One thing the council does is nominate a set of “parents of the year,” to honor exemplary figures in their community. There are many ways you can celebrate National Parents Day with your parents. The key to celebrating this holiday is the simple the better. There have even been rallies across the nation in recent years to show appreciation. Showing love and appreciation for your parents can be done through simple gestures. For example, setting cards or flowers is an easy way to say “I love you” and “I appreciate you”. Maybe bring your parents out to dinner or lunch, it is a perfect way to get the family together. If you live far away from your parents, give them a surprise visit on their special day! Make it a surprise they will never forget. A “DIY” approach is also a great way to show love and appreciation. Creating a scrapbook or a memory book is the perfect gift for any parent. This is some- thing that they can cherish forever, and look back at all the fond memories they had through the years. Or if you are younger, give your parents the one gift they will love; the clean bedroom they have been asking you to clean. At the end of the day, parents should not only be celebrated on National Parents Day, but truly everyday. Our parents try to give their children the world and more, even if it means clothes of their own backs. Take time everyday to appreciate what parents do for us. Make sure to say “I love you” more often, as it will really make your parents day.



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TikTok Facilitates Inspiring Teenage Interactions By, Surabhi Ashok

During times like these, it is encouraging to see acts of kindness being performed, whether it be to strangers or friends. The impact teenagers have on each other despite being in so many different parts of the world is extraordi- nary. On TikTok for instance, one specific video spread quickly and warmed thousands and thousands of hearts. 18-year old Sara Sadok made a series of videos called “Let’s Eat To- gether,” encouraging people with eating disorders to turn on her video and share a birthday meal with her. In her first video she had said, “If you ever have a hard time sitting down for a meal, let’s have a meal together. I’ll take the first bite to make it a little less intimidating for you, and you can have your first bite after, okay?... I know that was hard, and I’m really proud of you. Let’s have our second bite togeth- er…” The TikTok was made to counter the toxic diet culture that also plagued the app. Young kids are especially affected, as they develop a mentality that they have to change their weight and/or the way they look to fit societal standards. In addition, Sadok wanted to help her own friend who strug- gles with an eating disorder.

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Soon enough, Sara Sadok received so much positive feedback from her videos. People duetted her video, which is when the screen is split and two videos match their audio and message, to eat with Sadok. One teen called Sadok a “beautiful person” in the caption of her duetted video while another expressed her gratitude by making her own “Let’s Eat Together” video. Sara exclaimed, “Watching all the ‘duets’ is so heartwarming and really resonates with me because I never truly realized how much help I was. The most inspiring thing for me is to see the people who initially duetted my video to help them eat now creating videos of their own to help others do the same thing.” The reason as to why the 18-year old girl’s video was so helpful is because it shows a person with eating disorders that their worst fear will not occur if they decide to have a snack, according to therapist Carolyn Comas at Eating Disorder Therapy LA. Their mind can come up with many reasons as to why they should not eat. These reasons are dulled when someone takes a bite with you. Especially with the pandemic, not everyone has access to professional support. Comas commented that “eating disorders thrive

in isolation”, but can be helped with social interactions like Sara Sadok’s videos. Call the National Eating Disorders Association hotline at 1-800-931-2237.

TikTok also enables personal political expression in teenagers. It allows for the youth to share their experiences regarding racism for example to a wider audience that can relate. It facilitates stimulating discussions in the comment sections about social issues in the U.S. and the world. It spreads awareness on topics like climate change. On the flip side, the app is often a place to joke around and interact with people who have common interests in books, movies, music, etc. Particularly with Covid-19, TikTok has opened up a safe space for younger generations, helping teens communicate the best they can. Source:




Picky Eating Picky eating is typical for many preschoolers. It’s simply another step in the process of growing up and becoming independent. As long as your preschooler is healthy, growing normally, and has plenty of energy, he or she is most likely getting the nutrients he or she needs. Typical picky eating behaviors Many children will show one or more of the following behaviors during the preschool years. In most cases, these will go away with time. • Your child may refuse a food based on a certain color or texture. For example, he or she could refuse foods that are red or green, contain seeds, or are squishy. • For a period of time, your preschooler may only eat a certain type of food. Your child may choose 1 or 2 foods he or she likes and refuse to eat anything else. • Sometimes your child may waste time at the table and seem interested in doing anything but eating. • Your child may be unwilling to try new foods. It is normal for your preschooler to prefer familiar foods and be afraid to try new things. How to cope with picky eating Your child’s picky eating is temporary. If you don’t make it a big deal, it will usually end before school age. Try the following tips to help you deal with your child’s picky eating behavior in a positive way. • Let your kids be “produce pickers.” Let them pick out fruits and veggies at the store. • Have your child help you prepare meals. Children learn about food and get excited about tasting food when they help make meals. Let them add ingredients, scrub veggies, or help stir. • Offer choices. Rather than ask, “Do you want broccoli for dinner?” ask “Which would you like for dinner, broccoli or cau- liflower?” • Enjoy each other while eating family meals together. Talk about fun and happy things. If meals are times for family argu- ments, your child may learn unhealthy attitudes toward food. • Offer the same foods for the whole family. Serve the same meal to adults and kids. Let them see you enjoy healthy foods. Talk about the colors, shapes, and textures on the plate. Trying new foods Your child may not want to try new foods. It is normal for children to reject foods they have never tried before. Here are some tips to get your child to try new foods: • Small portions, big benefits. Let your kids try small portions of new foods that you enjoy. Give them a small taste at first and be patient with them. When they develop a taste for more types of foods, it’s easier to plan family meals. • Offer only one new food at a time. Serve something that you know your child likes along with the new food. Offering more new foods all at once could be too much for your child. • Be a good role model. Try new foods yourself. Describe their taste, texture, and smell to your child. • Offer new foods first. Your child is most hungry at the start of a meal. Sometimes, new foods take time. Kids don’t always take to new foods right away. Offer new foods many times. It may take up to a dozen tries for a child to accept a new food.

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Some groups of medicines may interfere with your brain function as you age Many older adults take medicines to: • Help control diseases like diabetes and depression • Manage risky conditions like high blood pressure and high cholesterol • Manage chronic pain While medicines can help you treat your health conditions, they may also affect you differently as you age. As you age, your body changes in ways that affect how you process and react to medicines. Your circulatory and digestive systems, liver, and kidneys slow down and can affect how fast medicines enter and leave your body. Weight changes may affect how much medicine you need. Get regular advice from a healthcare professional. Your medicines may interact with each other or with food, drink, vitamins, supplements, natural products, alcohol, or a health problem. Groups of medicines that may interfere with brain function include some that treat: • Allergies • Anxiety • Colds • Depression • Sleeping problems • Psychosis Some of these medicines are sold over the counter. This means you can pick them up off the shelf without a doctor’s order (or prescription). Talk to your health care professional about your medicines and their potential impact on your health and brain health, especially before you make any changes in the way you take them. Abruptly stopping a medicine can be dangerous. If necessary, talk about alternatives to your medicines. Visit the Centers for Disease Control and Prevention webpage on older adults and medicine side effects.






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Over the past several weeks, I have had two unfortunate situations that have arose in my practice that have prompted me to write this article concerning something called “umbrella coverage.” Despite its name, this type of insurance coverage has nothing to do with protection from weather events. As will be seen below, “umbrella coverage” is another layer of insurance coverage that is recommended in order to properly protect you and your family against judgments and lawsuits arising out of your negligence or the negligence of a family member within your household. In one case, my client was significantly injured in a motor vehicle accident with a 17-year-old boy who had only recently received his drivers’ license. The automobile insurance policy on the young man’s vehicle had policy limits of $250,000.00 for the benefit of parties injured as a result of the negligent operation of the vehicle. The young man and his family live in a large home in an upper class Township within Monmouth County and, as such, it would seem that he and his family would have a reason to protect their assets over and above the $250,000.00 policy limits of their automobile insurance. Unfortunately, they did not have additional insurance coverage and, as such, given the significant nature of my client’s injuries, their personal assets could now be in jeopardy in the litigation. In another case, a client of mine caused a significant accident in which a number of people were injured. Although I only represented her on the traffic tickets she received, both her and her husband inquired as to whether or not it was likely that they were going to be sued for personal injuries arising out of the accident. Similar to the family above, my client and her husband only had automobile insurance with $300,000.00 in policy limits to cover the injuries sustained by the other individuals involved in the accident. The client’s husband was a medical professional and, once again, had significant assets over and above the $300,000.00 policy limits which he and his wife should have protected. When I asked them if they had “umbrella coverage” to further protect them, they did not know what it was. At a minimum, if you own a home and an automobile, you should have an automobile insurance policy that protects you against injuries you cause in a motor vehicle accident as well as homeowners’ insurance which protects you against injuries caused by you and your resident family members for negligent acts (other than an automobile accident) that cause injuries to others. All homeowners’ insurance policies contain an “automobile exclusion” for which the homeowners’ policy will not cover injuries to others as result of the operation of an automobile. If either of these policy limits are insufficient to “pay for” the injured parties’ injuries, “umbrella coverage” is intended to supplement your policy limits. Typically, “umbrella coverage” is purchased to supplement the above referenced automobile insurance policy limits and homeowners’ coverage policy limits; often at a reasonable rate. Such “umbrella coverage” is utilized and necessary to protect assets when your assets are greater than the policy limits afforded by either your homeowners’ policy or motor vehicle policy. Unlike homeowners’ coverage, “umbrella coverage” does not contain an “automobile exclusion” and, as such, would be available to supplement automobile insurance coverage in the two scenarios described above. Accordingly, while it is a good idea to review your insurance coverages on a regular basis with a qualified insurance agent or broker, you should always be cognizant of the amount of your automobile coverage and homeowners’ coverage in relation to the amount of assets you intend to protect. Importantly, regardless of the amount of assets you presently have, a judgment against you arising out of your negligent acts may last for 20 years or more and, therefore, assets which you accrue in the future may also be in jeopardy. So, regardless of the level of your present assets, it may be a good idea to protect your future with such “umbrella coverage.” Should you have any questions concerning this article, please feel free to contact my office or, alternatively, immediately discuss these issues with a qualified insurance agent or broker.


Large Firm Representation With Personal Attention

AREAS OF PRACTICE: • Municipal Court Practice, Including Defense of DWI, Traffic Tickets and Non-Indictable Offenses • Workers Compensation

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Certified by the Supreme Court of New Jersey as a Civil Trial Attorney Member of New Jersey and New York Bars

JOHN T. BAZZURRO, Esq. David P. Levine, Esq. Of Counsel to the Firm Michael B. Shaw, Esq., Associate Attorney 200 Meco Drive, Millstone Twp., NJ • BAZZURROLAW.COM

David P. Levine, Esq. Of Counsel to the Firm Michael B. Shaw, Esq., Associate Attorney 200 Meco Drive, Millstone Twp., NJ Email: 732-410-5350 •

Certified by the Supreme Court of New Jersey as a Civil Trial Attorney Member of New Jersey and New York Bars




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