From 3.14 of the IEEE Technical Activities Board Operations Manual

Healthy Women
& Ovarian Cancer:
Being Healthy
50 Sweet!
Do You Suffer with Hormonal Symptoms?
We Have
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o..rt.s Kilo, M.D.
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Contents September 2011
6 living with Oiabetes?
7 Ovarian Cysts and Insulin
8 Prostate Specific Antigen
Improving Our Ability to Treat
Vascular Birthmarks
Healthy Women and
Ovarian Cancer. The Key is
Earty Detection
Myths and Facts
Hallux Rigidus: Small
Joint Causes Big Pain
16 Cholesterol Awareness
Restorative Healing From
the Inside Out
Being Healthy Never
Tasted So Sweet
Five Estate Planning
What is Cervical Facet
'P",1,1/tt{f; 1)u;(r
What Is Cau~ng My
Back Pain?
Is That SweHing in My Limb
As Society Ages
Regarding Varicose Veins
II's All About Attitude!
Mistakes by the Unw&y
European Face Lift
Know Your Numbers...
Save Your Life
'1IC~f; eMf;
Spiritual Wall nass
Listen Anxious HearLPRAYt
E=edingyaur Expect111ians!
Find us on
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Health &. Wel lness September 2011 - Collier Edition
Living with Diabetes?
Understanding the Disease from a Diabetologist's Perspective
By Kara Jacx:tIs
iabe1cs is a tern most Americans
Understandin DiabetiC Terms
are becoming 100 comfortable w ith
The key question that Dr. Kilo is often asked is to
e ~plain the difference between Type I and Type 2
diabetes, " Type I diabetcs is the auto-immune
process that deStroys insulin producing cells in the
pancreas that usually occurs under the age of 18,"
he says. "Type 2 diabetes differs because it is
usually age, genetically, and lifestyle related,"
in their daily life. Recent scudies
show that more and more of our local population
arc being diagno!iCd willi diabctcs--a disease Ihal is
largely preventable.
Charles Kilo. M.D., of Millennium Physician
Group in Naples, remembers grow ing up when the
diabetes rates wen: signilkantly lowC1". "When I
was growing up I in every 30 Americans were
diabetic," he says. "Currently I in every 16 Americans arc now a diabetic."
And, thaI's why some local physicians are taking a
stronger stance in the fight against diabetcs. And the
first Slep in the fight? Providing bc:1tcr education to
patient's when they first learn they may be heading
towards a diabetes diagnosis. "I w<>rl:: with patient's
every day in regards 10 their diabetcs management,"
says Dr. Kilo. " Making sure they have the right
answers 10 their questions is key."
Passion for Diabetes EducatIOn
Dr. Kilo grew up with his mind on diabetes. " My
dad was endocrinologist so I ",'Cnt on to follow in
his footsteps, nOt as an endocrinologist but as a diabetologist." Not only did his father's profession
impact him, but he remembers a pal1icular study
growing up that changed his view of diabetes,
"I remember when the University Group Diabetes
Program (UGD┬г> Study) concluded that glycemic
(sugar) oontrol didn't matter. My father was <me of
the first endocrinologists to state the Study was
flawed, as ",'C alllrnow today that sugar control is one
of the JnQSt imponant aspocts of controlling diabetes.
That study changed my life growing up and I still
have the original aniele hanging in my office today."
There are many benefits 10 seeing a primary care
physician who is also a diabetologisl. Adiabetologist wlely spedali~es in diabetes, "Any doctor that
is up-to-date on diabetes care is important," he
says. "A diabetologist, however, can see the
patient's needs and goals as a diabetic."
It's with Type 2 diabetes where local physicians
arc seeing an epidemic among children, " It used to
be that we would never see TYpe 2 diabetes until
later in life, but nOw children undcr the age of 18
arc being diagnosed with Type 2,"
The biggest impact on the fight against diabetes in
children is making sure they get enough e ~ ereisc
and a healthy diet. " Encouraging your child to
ellercise in the afternoon after school---even
playing in the backyard---is extremely helpful to
their health," says Kilo. "We also want to assist
them in choosing healthier food options,"
Dla nosln Diabetes
So how does diagnosis of diabetes WOTk? '"Testing a
patient's fasting blood sugar, a random blood sugar
test, or an old fashioned gllJC05<: tolcrnr><.:e test that
measures the body's response to sugarcan all diagnose
diabetes. ~ says Kilo. "Knowing your numbers tS
essential in taking control of the condition,~
Knowing your "number" relates to your blood
glucose number. " If a patient's blood glucose
reading is over 100 then that patient is in the prediabetes range." says Kilo. "Anything 126 or
greater is Diabetic,"
If your blood glucose reading is JUSt a linle over
100. then patients should take the term "prediabetes" seriously.
It's the perfect time to sit
down with your physician and plan lifestyle
choices that will lead to a healthier future.
akin Control of Diabetes
Understanding what your body needs is essential in
keeping your diabetes in oontrol and not in control of
you. Additionally. diabetes affects many organs in
the body and it is nw:ssary that a diabetic coordinate their care between many physicians, Between
Ophthalmologists and Podiatrists many diabetics
become overwhelmed by the amount of can: needed,
"You need a quancrback to help call all of the shots
in your diabetic care and your primary care physician should be the one calling the plays."
"Patients have to understand their diabetes to
achieve a healthy life with diabetes. If you ignore
it you are ignoring your future, Don't wait for
diabetes to take oontrol Over you, Take the initiative 10 take control over diabetes," says Dr. Kilo.
1495 Pine Rid# Rd., Suite 4 - Naples, FL 34109
139-594┬╖5458 www.MlllenniumPhyslelan.O.l!
_____________________ www .swfH eal th and _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition┬╖ September 2011 Health & Wellness
Ovarian Cysts and Insulin Resistance:
More Influences of Excess Weight
To complicate matters, there's no one simplc blood
test 01' scan that enables a PCOS diagnosis. Even if a
woman has an ultrasound that reveals numcrous
ovarian cysts, that's no telltale indicator. Women can
have multiple ovarian cysts that never become problematic and are totally unrelated 10 the disorder. Ultimately, a diagnosis is accomplished by identifying the
usual symplOms and ruling out other possible causes.
By Dr. Caroline Cederquist and Anne Elena Fosler
varian cysts aren't usually a big
Most women get a few
through the eoUJSe of their lives and
never even know it. On the other hand, if you ever
had one bu~t, you'd never forget it.
The rupture of an ovarian cyst can be excruciatingly
painful. While it's generally hannless. medically
speaking, the pain often sends women tCTTified IOthc
emergency room, convinced tbeir appendix has
given out, or worse. It's not an experience you'd
cver want 10 repeal.
But women with pol~ystic ovary syndrome often
have to. As the namc implies. these gals often have
many ovarian cysts. It doesn't mean they'll rupture,
or rupture any more often, but there arc actually
Other characteristics of polycystic ovary syndrome,
or PCOS, that could be more impot1ant than even
that awful pain. That's ~ausc women with PCOS
are far more likely 10 have insulin resistance, which
makes them subject to higher rates of diabetes and
hean discase. And not stuprisingly, most women
with PCOS are overweight.
What's the trouble? _ _ _ _ _ _ _ __
PCOS is boIh a hormonal and a metabolic disorder.
Women with PCOS produce tOO much androgen. a
male hormone. An ""cess of androgen can c.ause
menstrual irregularities. weight gain, acne, excess hair
growth, and the production of those ovarian cysts.
They're also overwhelmingly likely 10 have insulin
resistance. a condition that develops over time and
makes it harder and harder for )'OW' body 10 metabolize energy, so it kicks up its insulin production 10
compensate. Peoplc with insulin resistance gain
weight more easily and have a harder time losing il.
And for womcn with PCOS. the more thcy gain, thc
worse their PCOS symptoms become.
But there's something of a chicken,am!,the-egg situation here. Researchers aren't sure whether PCOS
makes a woman more likely to gain weight, or if iI's
the weight gain that increases the likelihood of
developing PCOS. One study last year showed
that 32 perccnt of ,,'Omen with PCOS were
obese, and another 24 percent were overweight.
but not yet obese.
But whether PCOS is the instigating culprit Or
not. the chances are that they'll keep gaining, and
if they do, that's going to make thcir PCOS condition worse.
Ut1detected trouble .!'!"'!!!~-'!"-''''
Unfot1unately, wOmCn with PCOS often don't
know it, and there are quite a few around. The
condition is estimated 10 affect about 6 percent of
American women. They go on dealing with the
spectrum of problems it brings without necessarily connecting them. Physicians, too, often don't
connect the dots, panly ~ause the symptoms
are likely to be dealt with by different specialists.
Rough, dark skin Or acne problems may take a
young woman with PCOS to a dermatologist. If
she's having painful periods or intm:ourse.
which are both common, she may see her gync.
cologist. A woman having trouble conceiving
may go 10 a fcttility specialist. And thc abnonnal
hair growth and weight gain? Most women will
probably try dealing with those in a non-medical
settings altogether.
But often women JUSt endure their discomforts
without seeking help at all. That's not good.
~ause again, the painful monthly c~les and thc
daily discomforts caused by skin and hair
problems arc only the tip of the iceberg. It's the
more serious health problems like diabetes and
canctT that are the real worries.
Cederqui st Medical Wellness Center
not complicated to treat.
mean i
most of the symptoms can be addressed i
prescribing anti-hair growth medications for the ;
sutism, for instance, and dennatology tr<:atments
the skin problems. probably the most univcrsally
helpful treatmcnt for overall relief is weight 10$$.
And that-cspecially with the complications of
PCOS-is never a simple task.
It helps that patients with PCOS are motivated . Some
initially find it hard to believe that weight loss can
offcr so much relief, or even a IOtal remission oftheir
symptoms. BUI remember that there is that chickenand-egg mystery still out there with PCOS. Often,
paticots who have Struggled with an increasing
weight problem, even when they're CCT\ain they're
not eating any differently. But that's an outcome of
the insulin resistanc<: that is a factor in two-thirds of
PCOS cases. It's hard to deal with the underlying
issue if you're not aware of it, and the failures at
weight can be tremcndously demoralizing.
But when patients learn how much improvement
really is possible fOl' all their symptoms, many carnestly apply themselves to the task of taking off the
excess weight. Some doctors use medications to help
manage their PCOS patients' blood sugar and insulin
production, but I've often found that insulin resistance can be countered through dietary mcasures
alone. That may not always be the ease, however, and
PCOS patients have 10 be evaluated with consideration for their other body chemistry issues.
But for PCOS patients who do make dietary and
activity level adjustmcnts and begin losing weight,
there are usually many very immediate improvements. When symptoms start to resolve as their extra
pounds gradually fall away. these are people with
more to eclebrate than most.
As with many illnesses, there is a clear connection
between excess weight and the risk of more pro.
nounced symplOms or even progression to more
serious conditions. But with PCOS, doctors aren 't sure
if the condition is causing the weight problem 01' the
other way around. But they do know that dropping
excess weight inevitably leads to improvements.
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Health &. Wel lness September 2011 - Collier Edition
Inaccurate Blood Test Versus Lifesaving Screening Tool
By William M. Flglesthaler, M.D.
=wc cancer screening has received a
great deal of press over the past decade or
two. The introduction of the prostate specific antigen blood test (PSA) in the late '80s has
resulted in II significant number of prostate cancers
being diagnosed at early clinical stages. In fact. eacll
year over 250,000 cases of prostate cancer are diagnosed in the United States alone and over 40,000 men
die of this disease annually.
Early Diagnosis is Key
Early diagnosis is II key ingredient 10 successful cure
rates wilh decreased moTbidity. Current koowledge on
how to use PSA values 10 determine which men need
urological evaluation is vitally important to primary
can: providers, especially when dealing with healthy
males between tbe ages of 40 and 80 years of age.
It was once considered standard of care to intcrpn:1
any PSA reading between zero and 4.Ongldl as
normal. Fluctuations within this range were given
linle if any significance. In addition. levels as high as
6.5ngldl were even OOIlsidered acceptable in men over
the age of10 at OnC time. Using these pammClcrs was
successful in minimizing thc "over diagnosis" of
prostate cancer in elderly males with clinically insignificant prostate cancers. Unfortunatcly, many
younger patients with more aggressive canCCTS wcre
left undiagnosed until they had non-organ-confined
disease, which negatively impacts cure rntes as well as
morbidity of treatment.
In addition to !he total ┬г>SA blood test, free PSA testing
may be used 10 increase the specificity of a borderline or
high ┬г>SA result (4-1 OngIdl). F~ PSA is reported as a
pcn:cntagc of the IOIaJ PSA, and represents !he fiaclion
of SCTUm PSA thai is unbound 10 a carrier proICin.
Patients with prostate cancer have less fn:e PSA.
Guidelin-es for Interpreting PSA Values in the
Screening for Prostate Cancer
The following guidelines represent the current
standard for interpreting PSA valucs in the screening
of men for prostate cancer. It is important to include
in this discussion the necessity of the digital rectal
exam which if aboonna! must he evaluated, regardless of the PSA result:
тАв PSA levels over 2.Ongldl in males under the age
of SO and PSA levels over 2.Sngldl in males undcr
the age of 60 should be OOIlsidered abnormaL
тАв PSA levels over 4.0 ngldl should always be considered abnonnal and warrant urological evaluation.
тАв An increase in PSA (PSA vclocil)') of 0.75ngldl
over an 18-month time span should be considered
significant. even if within the nonnal range for PSA
тАв Free PSA levels below 1O'Y. indicate a significant
risk for prostate cancer.
тАв PSA levels should be considered inaecurate if
obtained in the presence of a urinary tract infection,
prostatitis or after a lJ3umatic foley cathCler placement. A period '1f four t'1 six wl'Cks after treatment
should be sufficient to allow the PSA 10 return 10
тАв 5-.a┬╖reductasc inhibitors such as Proscar or Avodan
lower the PSA by SOOA. over a six-month period of
time. and discontinuing these medications will resuh
in the return to the baseline PSA reading '1ver a
similar time frame. Therefore, a patient who is
started on Avodan, takes it as directed and then has a
similar PSA reading a year later should be referred
for urological evaluation and possible prostate
biopsy. 11 is important to question patients who are
prescribed these medicalions regarding treatment
compliance when interpreting their PSA values.
PSA Blood Test is a Valuable Adjunct to
r:~~Flglesthal.r. MD.
Hilliur M. Figlatltllkr, M.D., is_';.:~;m;;':;';,j l
all/lMllS of Wake Forest U~iwnily::
,,'ilh honon from the U~i"'r.fily of North Corolino
Sclwol of Medici"" al Chapel Hill. NC.
Dr. Figleslhaler compleled his urological.~"''''d
lroining al Ihe Uniwnily of Kenruc/cy, Albut B.
Oandler Medical Center in Lexinglon. KY.
published n?uarch "" proslale caru:er in COOpt'rolion "'ilh JohIU HopkiIU Uni''efSily. Balti""'n?, MD.
and has given numerous presemmi(}ll.f m both
"'Eional and IUJti"",,1 canfem..:es.
H."" I
AlIIQIIg his specinl inJereslS is lhe treatment ofprwll1te
ronctt: including do Vinci robotic radical ptWlI1lt"Ctomy (/I11p:J/ywtubuomispeciolislSinruo/Qgy). His
rm.11S for ewe. preserwtiotr of b/odde1" cantro/,
If:tum 111 _ I activities and TtCaVi'ry of rewal
fiurctWn a",oulSlI1nding and second 10 MM. lIe often
has nugeoru scheduling ,tiilS 111 Naples /() observe his
t┬лhniq= and has tmJte</ pati<:ms from over 20
Sillies, eight countries, Ihree canti_1S and counh┬╖ng.
He "w 1IJOj/ rnamtly fetltured on lhe ABC evening
/lell-3" local affilio/efor his lIUlS/eryofthis.nugery.
Dr. Figles/haler is board unified, a DipllJll1ateofthe
Americtln Boord of Urr>Iow, as well as a Fellow of
lhe American College ofSurg<!atU.
Digital Rectal Exam
In summary. the PSA blood test is a valuable adjunctlO
the llMual digital rectal examination. In order 10
rrw:imize the benefit '1f PSA. it is essential 10 properly
interpret !he result as it relates to the patient's age,
velocil)' of change and oIhcr ~ which rould alter
the ┬г>SA value such as infection, lJ'auma or modications. The primary can: provider is !he 1m! responder
when it comes 10 determining when a patient may be
al an elevated risk for prostate cancer based upon
aMual scn:cning. Both the digital rectal exam and the
┬г>SA blood test an: nocessazy 10 properly scn:cn malc
patients for prostate cancer. Urological referral should
be considered whenever then: is a qllCSlion of an
abnormal PSA or digital rectal examination.
Or Figlestholer is included in Castle C""no1ly~ lop
doc/QrS n?ferrol guide based ()II plt)-3"icimr-lead
remuch and peer M'iew by leading ho.spill1l.s and
medical professionals.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfhe althandw e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - September ZOII Health & WeInes$
Improving Our Ability to Treat
Vascular Birthmarks
By Da niel l. Wasserman, MD FAAD, Board cer1~ied DermatologiSt
that grov>1h is too mpid. Lasm; can belfJ hall this
gnr.o-1h suac ....:I in some cases so:imulate their
regression . All other birthmarks discussed here tend
be permanent and can often grow with age .
тАв What are the complications from
. lNhat am the different birthmarks?
The: easiesl WI " 10 calegoriu birtluMrks is 10 Po,.,
' Arc they brown or red?' I will concentrate on the
rcd ones.
Tbcrc ~ sevcnr.l differmt types of vascular or 'red'
birthmarb. The most rommon ones ~ pori-wine
stains (PWS) ....:I infantile heman~ There ~
some additional typeS of vascular birtlunarks such as
arteriovenous malfonnations (AVM). venous malformations. ....:IlyrtII)hangiomas
. lNhat am the differences between these
These binhmarks arc defined by their microscopic
make-up. PWSs ~ made of dense collections of capillaries. Hemangiomas an: collections of dilated. o;avcmoos blood vascls. AVMs an: a collc:ction of
artcrial....:l vo:nous blood vessels. Venous malformations speak for themselves while lymphangiomas ~
coll┬лtions of lymphatic and blood vessels.
тАв Vvtlat all the treatmerlts fa" these bi1to, BkS?
Laser therapy is the: standard of we for the!e binhmarl:s. Blood happens to absorb cenain wa~lcnglhs
oflight more titan other components in the skin, therefore we can selco;tively WgCI blood vessels while
avoiding damaae 10 0Ihcr struc:turts..
Hemangiomas, as mentioned above. can ulcerate
and ~imes scar. PWSs and venous malformations can grow throughout the: life of an individual
and bcaousc of their in=ascd local blood supply
can somctllnel ~h in lin asymmetric growth of the
undcriying SlnICtures. It is not unr.:vmmon to _
bigger lips, biggcr checks. underlying bone growth,
thicker arms Or legs in individuals who have had a
lifelona; binhmarl<. JII$I think that the $lll'l'
tissue il n:cci\"ing rro.:>re food: oxygen..
тАв Can
we treat birthmarks?
Hemangiomas often go away on their own,
howevcr s ince one docs not know whether it will
ulcente and Kar in the futUfe. treating it in onkr
to either slOp growth or induce regression is a
good opIioa. PWSs ~ve the best chance o f permanent removal when they are trealed as early IS
possible, Even as carly 115 тАв few wecks old. The
skin is v~ thin in inranu. as well 1111 tbe PWS.
The laser can only penetrate 2mm into the skin and
~fore il has the best chance of pcrmarocntly
removing these birthrrwics when they ~ lrelted
as yDllng as possible. Adulu also bcrn::fit, but the
chance of permanent removal is lower and ollen
requirc$ more treatment K'lSions. VC1>Oll' malformations can sometimes be treated by la5Cf"S as
well, but differmt than the more common laser
used for PWSs. Lymp~tic malformations and
AVMs are rarer lesions and often require a consult
to detennine the bcstllpproach.
тАв W. birthmarkS go away all by themselves?
Hemangiomas an: the only binhmarks that often go
away on their own and the teaching is that 90% of
hemangiomas will be gone by the time a child is 9
yean old. H_"(VeI", despilC Ilw:ir disappearance,
lle!nangiomas can go through a rapid growth phase It
around 6 months old and thus can ulcerate and sear if
IOI~C'oo, t
r ┬╗ , _ O r.
111 .... 1... ...
nON.e.Io! ....... JO.l
..... R... n:hlHl)e' ... tot0O".com
тАв How does the laser work?
The laser is selectively absorbed by hemoglobin
which is found in OIIr blood and not anywhere else
in the skin. As. l"C$ult oflhis selcdi ve helling. we
can damage the blood vessels and not the surrounding tissue .
тАв Are there any risks?
Lasers are not without risks. AI
result of Ihe
large collection of blood in tbcsc lesions, a lot of
laser lighl absorplion can take place which can
~Iy result in a bum . [I is important thaI paticnu
seek trcatments wilh physicians who Ire specifically trlined and e~pcrienced in the laser treatment
тАв Are there any new treatments coming
down the pipeline?
Yes, there are. There is a 101 of research going on
now combining laser therapy with topical or
systemic medications as I 'Nty of blocking the
potential for these lesions to grow back in bet\1o┬╖""
se┬╗ ions. This is still in the rcsearch phase and has
many yem beforc being implemented in the
medical community. but prescnU an interesting
approach to these dilflCul! to treat lesions .
Dr. /JtJltid JJluu r"'/lIt is тАв
fellowship-tRincd laser and
,kin cancer surgeon. For
morc information on treatment options Md othcr dermalologic concerns call his
olflCe ( 1-800-}(iI -DERM) at Riverdwe Dermatology and Cosmetic Surg~ at the Downt.....on
Naples location or visit Rivcn:haseDcnnatology.oom.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www . swf HealthandWeliness.eom - - - - - - - - - - - - - - - - - - - - -
Health &. Wellness September 2011 - Collier Edition
+ How Dr. Stanciu treats Crows-Feet
To reduce their appearance and pm'O'l1 new ones from forming. Or_ StanCiu
injects the area willi Ilocox Cosmc:1ic*. In your 20s and 3Os, you sIIould ....
Bow. as a way W prevent crow'.. f"", and soften any lines. As you age BoIOx
O:tsrr>eticC> can be usod to treallhese lines and make them less visible.
+ How Dr. Stanciu treats tired droopy eyes
The best mode of1fCatmem for dart cj",l.,. and bags under the eye i. with
hyalumnic acid fillers, soch as In,'tderm and Restylanc which fill in
hollows 10 give the illusion of fe",er bags. Now, lherc are no shadows and
the dart pigmentation i. diminished. To COfTeCI sagging or drooping ofthc
eyelids and rtmOv.1 of CXC($$ rat. BIq>hamp1asty or eye lid lift can be
performed. This procedure an give. more youthful appearance,n an othcrwi"" older. more Ii"'" looking rocc, For some indivWuals il may rmtedy
cenain vision problems causod by drooping eye lids. In thi, case lUualiy
medical insurance will oover the operation.
Both hyaluronic injectabl<:s and oollagen┬╖$lirnul31.
ing filion can reinstate deflllilion 10 the eh┬лh,
giving. more deli""" profile and a similar look lO
",bars achi.,"┬л! with fat without surgcr)' or the
┬лforever" facio<. Fill .... are useful in reestablishing
the shape of the cheek arour.d the orbital rim.
wJ.en, the signs of aging often begin, To get the
moot natural look thaI doesn'l look "done" or
Minjc:ctcd" filler should be placed in lhe fronl oflhe
chttks. iI$ 0pp06┬лI 10 the outside of lhe chttkbones, which causes the filler to push the eyes up.
iI$ nasolabial folds. these unplcasam lines
result when fat is lost from the ~ around the moutIt
Willi age oomc changes in fiocial fat. and thi. loss of
volume results in nasoIabiaJ folds. The rJ'IO<l: fat that's
lost, the rJ'IO<l: prominenl \hey are, Hyaluronic acid
f,IIOB like Juvcderm and RC5IyIanc are best for filling
these lines. For pa!icnlS that oompIa,in of somewhat
deeper folds, Dr. Stanciu may inject the cheeks with a
bil offillen"", 10 lift the fold.
+ How Dr. Stanciu augments thin lips
Hyaluronic acid┬╖based f,llers. like Juvcdcrm and RCSly_
lane can be injec1cd inlo \he lips 10 add volume sinee
they a11"",1 waler 10 lhe area and .well lhe lips i"lemany.
They wod greal 10 define lhe lips and lip line bul somelimes \hey can look overdone iflOO mod filler is used.
Going 10 Dr. Slaneiu who i. a facial "'iuvenalion .peciali'l and inje<:lable treatmenl expert is one of lhe best
ways 10 avoid lips thaI look obviously injec1cd. Ask
abou1 NEW Juvcdcrm XC w;lh lidoca;ne.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition┬╖ September 2011 Health & Wellness
Healt~y. Women
ana Ovarian Cancer:
The Key is Early Detection
ByTracye L. ZIobI, M.D.
n:ventative female health mandates an
annual gynewlogic e~am for bn:ast,
cervical, uterine and ovarian cancer
screening. While modem medicine has provided
outstanding technology to SCreen for many cancers.
ovarian cancer n:mains a nemesis of women's
health. Even though the incidence of ovarian
cancer is only 1.6%, it claims rnon: lives than any
other gynecologic cancer. In fact, in 2010 allUQl;{
22,000 wQmen in the U.S. were diagnosed with
ovarian canc<:r and 14,000 died from their discase.
According to the Centers for Disease Control, it"s
the 8th most common cancer and the 5th leading
cause of cancer death among American women.
The primary n:awn for such poor statil;1ics is the
advanced stage of disease at diagnosis with this
cancer: 70-75~. of cases an: diagnosed in advanced
stages (Stage m-IY) when the 5 year survival is
only 20-30010. Compan: this to thc woman with
stage [ disease (before it has spread) who has a
90-95% cure rate.
Obviously, early de1ection is key and here are some
tips 10 alert you to potentially lifesaving warning
signs: PeTSistent and progressive symptoms of
increased bloating, pelvic or abdominal pain, difficulty eating Or feeling full quickly, change in your
bathroom habits such urinary urgency or frequency.
back pain, vaginal discharge or bleeding tbat'S
abnormal for you. Persistent and progressive is the:
important IDCS$lIge here as these symptoms arc very
common in all of us on QCCasion. HQWcver, if you
an:: experiencing symptoms like these of increasing
severity for 20 out of 30 days you should schedule
an appointment with your doctor.
Women at highcst risk of Ovarian Cancer arc
middle-aged Or older. The median age of diagnosis
is agc 63 and over 70% Qf ovarian cancer occurs
after the age of 50. Those having one first degree
relative with ovarian cancer have a 3-5% lifetime
risk. Gene mutations like the BRCA-I. BRCAI_2
and the HNPCC confCT up 10 a 45% lifetime risk
depending 00 the particular gene mutation they
have. Women who have never given binh QI" have
had trouble ge11ing pregnant are factors that have
long been associated with the disease duc 10 the
increased amOunt of ovulations. Women who are
obese. have a history of endometriosis or have an
Eastern European Jewish background are also at an
increased risk of developing ovarian CanCer.
What can women do to protect
themselves from developing ovarian
cancer? A single pregnancy confeTS a 20-40%
reduction in lifetime risk and each subsequent
pregnancy decreases the risk another 10-1 S%. Oral
Contraceptive Pills (OCPs) can reduce a wQman's
risk by as mych as 60"10 and thi~ effoxt appears to
last for decades after last pill use. Hysterectomy or
Tubal Ligation reduce the risk Qf ovarian cancer by
30-40"10 and in the highcst risk WQl11en a prophylactic bilateral salpingo-oophorectomy (both ovaries
removed) reduces the risk by at least 90%.
W~ /C4 W~
M .,
20 1 Eighth St South, Suite 201, Naples
There is nQ reliable screening test for Qvarian
CanCer in wOmen who do nOt have any signs Or
symptoms. The pap smear docs nOt check for
ovarian tancer! If you have symptoms talk to
your doctor. If you havc achange in your baseline
gynecologic history. risk factors or an abnonnal
pelvic e~am your doctor may order a transvaginal
ultrasound, a teSt called a CA - 125, Or a new teSt
that evaluates multiple biomarkers called Ova-I.
If these tests detect the presence of a pelvic mass
that is suspicious for an ovarian malignancy your
doctor may make a referral to a gynecologic
oncologist to evaluate this mass surgically.
Primary pre vention and screening of ovarian
cancer are paramount to identifying this discase
in its early stage and maintaining our health. T he
American College of Obstetricians and Gynecologists (ACOG) and the Society of Gynecologic Oncologists (SGO) recommend wQmen get
an annual gynecologic exam with an annual
pelvic e~am for routine preventative health care.
It┬╖s vitally important for women to realize the
imporlance of their annual well-woman visit as
an opportunity for examination and an appropriate time to discuss her individual risk factors.
prevcntion stratcgies and her Own awareness
regarding symptOmS of ovarian cancer. Until we
have a screening test for this nemesis of
women's health we mUSt ann ourselves with
infonnation and be alert to the subtle signals our
body may be giving us.
_____________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Health'" Wellness September lOll - Collier Edition
Myths and Facts
Regarding Varicose Veins
By Dr. John P. Landi, MD, fACS, APVI, APhS, Diplomate 01 The American Soard of Phlebology
arimse Veins and Spider Veins are conditions that affeet millions of people throughoul the wOOd. In the past there were only
two lMIilable treatmeots for...eins. For Varicose Veins a
procedure ca lled Ligation alld Stripping which il"MllVed
multiple incisions and a long downtime, and lor the
Spider Veins, injection with a sa line solution which was
pa inful arid caused ~gnificant complications of diseolofation and ~ ulceration. ~ the last eigM years both
of these treatments haw been replaced by state of the art
procedUfflS resulting in excellent restJlts with little or no
dc7wntime, Varicose Veins are treated primarily with a
Laser or Radio Frequency calheterto cause closure of the
incompetent \'(lives. The Ilottom line with Varicose ~ns is
that they appear when in the ~ins don' close
properly leading to reYl.'!Sal of now down the valves and
ultimately into the skin. Spider veins can also be due to
valVular insufficiency and are now treated with SdelOSing
Solutions primarily deYised to treat these wins without
3rrj significant side ~.
DeSp~e the fact that the current treatment of Varicose
and Spider Veins has been avai lable for at least II1\!
laSI eight ~ars. there are stil l mal'l\' myths associated
with Varicose and Spider Veins. These myths and truths
wi ll be addressed in the following paragraphs:
was the only
ment has been replaced by val'oe closure procedures using
either LASER or RadiofrequeriC)'
is due to a
spider veins recurring will
patent's I~etime and these
u~mate/y, the vatl'es. wet' the course of time. lose the
ability to dose properly aod this could resuH in variwse
veins. The essential element in the cause of variwse veins
is YIIIat is called Valvular Insuffldency. Blood roormally flows
from the feet up the legs througfl a seIies 01 vatl'es .mich
dose as the musdes contract. ~ these vatl'es becXlme
weakened and wet'- stretched the blood cannot lP ttuoogh
them roormally and Ilasica!y 9:les aroond the vatl'es
throoftl the skin to form the varicosities and spider veins.
majority of
patents with vein issues
Myth 1#3
SlIPlIOrt Stockings wi ll make Varicose Veins 10 away.
This is not True. Support stockings will symptomatically
help to compress variwse veins and spider veins and try
to do the worll of wives that have failed. HoY.\:Mlr. suppOrt
stocking<; are only a temporary measure. ~ the underlying
problem is Valvular 11ISI.IfficierIc. once the support stock... gs are feIl'IOI'ed.the prilTlilry calISe of varicose veins continues. Although. support stockings may iJ'o'e symptomatic
relief they do not resolve the problem.
. recur usually ~
vaM!, .mereas. some
course of a
be treated by
. ma" men haYe
wricose vein aod veOOIlS insufficiency issues. In fact. OYer
the last eigllt )ears in .mich I haYe tleen doing vein
therap)'. my proportion of male patients has ~e from
approximately IiYe percent 10 around thirty percent.
Myth #4
Myth 1#1
varicose veins I re l lIemltal}' problem.
This is not a Myth. This is True. The single most common
calISe of varicose veins is hereditary. It is not unusual for
vancose veins to run in famUy lines and not uncommon
for a wandmother. mom and daughter 10 all haYe significant varicose veins. In fact. in l'IQIf1en. varicose \'eins are
something fO< .mich a woman can blame both her mom
and her Children.
Myth 112
varicose valns .re due to pl8In. ncJ . ...
This is not a Myth, Pregnancies do lead to varicose veins
fO<the following reason - during pregnancies the presSUre
of the baby prewng on the pelvic \'eins causes dilation of
the \'eins .mich in turn leads to stretching Of the vaNes.
~~~~~ i
the leg which
can break off and enter the lung causing a Pulmonary
Embolism. There are three levels of veins in the 1ei;5.
There is a Supe!ficia l System. Connecting System and a
Deep System. aats that form in the Deep System can
lead to Deep VeOOIlS Thrombphlebitis which can ultimately
form a Pulmonary Embolism.mich could be a life threatening problem. SupetflCia l Phlebitis on the other hand is
a form of aot Formation only in the Superficial Veins. These
do not breakoll aod IJlIO the lungs. It is not life threatening
and is treated locally with Compression. warm Compresses
and Anti-Inflammatory Medication.
La Bella Mia Medical Spa
239-403-0800 I vanishvein_com
lO10lhStreetNO!th N"ple, fL34102
Dr. Johft P. lAtufi ailM Ii"", ojlhis ,.rih┬╖ng is """ ojln4
IMn 1.m pityoicWIU warIdwide 10 obtain ~ design<l/ial!
oj Diplomate oj 1M A"",ricat/ Board oj PhI~boIofIy. In
<>ddi/ial! k> Ihis. M obtaiMd his RPVI (R~1тВмmI Phyoi_
cion VIUCU/a, Inl~rprHan'QfI) and M is also """ ojIf!$$ l/taft
75 ~e bad! pity>idalUand """ plrysidallS worldwide 10
obtain 1M RPItS (R~lernd PhI~boIosY Sanognlp/Ie'). I/~
Ita.t pnftxmed ow, 10.000 l~n closure prr><Wk<rf'.! in iK>lh
Lo.ser tmd YNUS Closure. Heitas aw I1'eQled I""'=nds oj
palientsfr spider veill ru<>lusicn. !I~ is mdical direclOr oj
Vanish V~jn tmd Lz~, Cmt┬л 10000led in Naplu ",hich Ita.t
ban "SlOre ojlM "" Vein Q!r:1'" designated 10 vein 1rruI_
",..,., fr over 10 yea.... In addi/ial! 10 Ihis M is medical
dil'┬лlOr of lAlkllQ Mia Medical Spa which is alk>Ch┬лi 10
"'" Vanish Velft and Lzer Cenltt
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See Spot
See Riverchase Dermatologv.
Same week appointments available.
SWFL's Most Comprehensive Skin Center
тАв Three Fel1owship-traincd Mohs Surgeons
тАв Dermabeam Non-surgical Radiation T herapy
тАв Camisa Psoriasis Center
P,r/Qrm,d "y Q VaS(u/ar Surg.Qn "m/
Bo(,.d Curift,d in Phl,holog].
тАв Cosmetic and Laser Dermatology
WouW,,'! you ralherlruSl)'ourvcin care 10
a VascularSu'l;ffl" who ha, performed
7,000 Lascr Vein l'roccd"res:
тАв Aesthetic and Plastic Surgery ┬╖ Spa Blue MD - Medical Spa
John P. Landi, M. D.
c.rti6<d Su<g┬л>n
Worldwide Certified by the
of Phlebology
La Bella Mia Medical Spa
20 ltH11 Strwt North, Napln, FlOrid. :UI02
(239) 298-8126
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Health &0 Weiness September 2011 - Collier Edition
Hallux Rigidus
Small Joint Causes Big Pain
By Myles Rubin SarnoIWl, t.тВм) - Board Certified Orthopaedic Surgeon, felowship
Traned., foot andAnkIB
s we know, anhriti, can attack GUr
jQints. and we know many pwple
who have had "joint replacement" of
their big joints. the hips, kncc=s or shoulders. But
what if you developed anhriti, in тАв real small joint
such as the joints in your thumb or big toe. You
would prob.bly tty to wort around ii, using. differC1lt hand or grip to open !.hat jar, or \\1m that screwdriver. But try dQing that with your big toe. YQU
can't do that siroce the big toe has 10 bend with every
Slep we take. So what can we do7
In any joint in our body. we have cartilage which we
ull anicular canilage. For mlny different reasons.
includin, the biomc.:;haniel or struc:tunl abnormalities o f our f~ and toes. we can develop anhrit;s into
any joint ""ith a resulting w~ar and tnr ofthe anicular eaniLage. When this ~UfS, it allo"" our bones to
rub agaillllt each other, creatin, an overgrowth of
bone. [t especially happens on the top of the bone of
our big toe, where it bends. The overgrowth can
prevent our toe from bending resulting in a stiff toe.
which we in onhopedics call hallu.x rigidus.
When anhrilis forms in the hi, 100:: (the haJlu.x). like
any other anhritic joint, the symplOmS ",.~ usually
~Iop can be several including pain, wbich occun
when you push off with the big toe when walking,
'welling, a possible bump on the 100:: from the formation of osteophytes. and Sliffness in the toe. with the
inability to bend il up Of down. Unfortunately. whcn
we walk we use other joints as well as our toes. such
as ankles, knees and hips, lbesc ltlIy become painful
as well. siroce we win usually alter the WlY"'C walk
to prcvnIt aggravating !he arthritic join!.
HowcQn you tell if you ho~ this' If you are having
SQme of these sympt<Hm, you should see your
medical doctor. e$pe<.:ially a medical doctor who is an
onhopcdic fOOl and ankle spe<.:ialist. Th is condition.
hallu~ rigidus. can be easily treated if it is discovered
and treated CMly. If)'Qu wait until the bony bump is
fonned on the lop of your areat 100::, ostoophytes
(bone spurs) will already have fonned and the hallux
rigidus will be much harder to \fell.
need a pain relievn such as oral anti-infbmm.uOf)'. and
padding of the area around the joint and physical
therapy. Especially for tlu: gJCatlOo::. special shoe: modi.
fications and possibly the us.gc of onholics will be
also be used. Injections of steroids ltlIy be attempted,
bul genenlly do not work very weill! this point
be sevenl primary reasons !.hat a patient
will c ' - to haVl: surgery performed on a haJlwc
rigidus. They may want 10 \felt the problem, not
accommodate il. progression of the problem to the
point that \hcre are othcrproblerru now occulTing, Ot
that non┬╖surgical treatment failed. The patient may
also decide for surgery to prevent further detman┬╖
tion or deformity of the grcattoe.
lbrn: are several differmt types of surgery (or this
problem, ScJonc, involVl: rep]ao:emcnll or tendon
Whcn you see youronhopcdic (oot and ankle specialist, he will probably order re,ular X-Rays of
both your feet to dctennine what is nonna! and
what. if anything, is abnonna!. Also, he will
perfonn I proper clinical e~am to determine the
$even ty and limitation of your hal1u~ rigidus.
From both your X-Rlys and physical ",am, as
""ell IS )'QIU' history. will proper mod.olily treatments be detcnnincd..
transfenor can involve a fusion, The most imponant
thing I can say is that special care must be given to
Ihe type of surgery perfonned. ,irn;e an impropct
s urgery may not give the best results that could be
obtained. Having the best onhopcdie specialist
making the proper choice for you will a llow you the
best outcome possible..
Since)'O\l can't walk on your hands. pain in your fCC1
needs to be properly and quickly o:vIIluated. You need
10 be evaluated by a Board Ctrlined Or1hOpledi~
SurgtOn 1\I.1).... ith I S ub-spcda1ty, Fe llows hip
Tnlned In fOOl & A n kle s urgtry. In fact I am the
only surgeon with these qualifications in our area. I
believe this makes me uniquely able to deal with
these problems in a state-of_the-an aunosphere and
nxthoci !.hat will ktcp you in good h.ands and provio.k
you with the most desired result.
Myles Rubin Samotln , MO
ao...d Certlned OrUIOj)Mdtc Surgeon
SoJt>sIl'!Ql~st ln Foot'rId AnkJt s.,'gery
CoIIJrnboII \IM-ersit)'. Mo lmono:lcS MocHc,,1 Cente,.
HospoWl to< JoOnl Dc"'.ses. N.... 'lilt!< COt)'
As like many other conditions. there are both nonsurgical and surgical treatmcntJ" Non-swgica1treat┬╖
mall of an anhritio; joint, C\'CIl the great toe. is
genenl1y tho: same as other joint$, .. tho: palimt will
870 I 11th A _
тАв. "Iopin, _
J.4 loa
Ull 10< rnformanon 00 our nelt semonar.
~onn. 5<ot~
- - - - - - - - - - - - - - - - - - - - - www.swIHealtha"dWelinns. com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Think Foot. тАвтАв Think Ankle
Avoid Disaster
Myles Samotin, MD
Naples ONLY Orthopaedic Surgeon
Fellowship Trained in Foot & Ankle Problems.
fyou are looking for excellence in FOOT and ANKLE care; if you are
looking for a doctor who practices state-of-the-art medicine; if
you afe educated enough to understand that you may only want
an ORTHOPAEDIC SURGEON tOlouch your feet, then you owe it to
yourself to make an appointment.
There are many people with very serious problems of the foot and ankle
who go from doctor to doctor and remain undiagnosed or poorly treated.
The typical patient coming to see Dr. Samotin has been evaluated by many
other doctors. The patient usually finds Ih(lt Dr. Samotin is the last doctor
they have to set'.
Myles Rubin
motin, MD
Board Certified
Fellowship Trained, Sub-specialist in Foot and Ankle Surgery
Columbia Uni ve rsity. Hospital fo, Joint Di seases. New yo, k Cit y
870 111th Avenue North, Naples, Florida 34108
Call for information on our next seminar.
┬╖We are now BlueCross BlueShield and AETNA providers.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www .swf Healthand _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Health &. Wellness September 2011 - Collier Edition
Cholesterol Awareness
The Southwest Institute for Cardiovascular Fitness & Treatment
By Sajan K Rao, MD, FACC
t ;s evident that we are all. or at least we
should be. becoming more and more aware
nfhow imporlan! it is to take Care of Our
heart. Likewise, the signif..:.ance of our cllolcstcrol
levels seems 10 be receiving a great amount of attcmiort
Righdy so. as high choleW:rol levels can lead to hardening ofthc arteries and ultimately hcart attack or stroke.
We will use this article to relay irnponant information
about cholesterol and why it is imperative to control
your risk factors. First, lei's get a basic understanding
of whal exactly we are dealing with: OlOlestcrol is a
waxy, fat-like substance that your body needs. But,
when you have too much in your blood, it can build up
011 the wans of your ancries with a substance known as
plaque. This can lead 10 hean disease and stroke.
Found mainly in foods that come from animals,
there "'" two types of cholesterol: LOLcholesterol
(the bad guy) and HDL choicstCT(l1 (the good guy),
The combination of both LDL and HDLalong with
the level of triglycerides (another bad guy) makes
up your IOtal cholcs1ero1 measuremen1.
Low-density lipoproteins (LOL) cholesterol
make up the majorily of!he body'scbolesterol. LDL
is known as "bad" cholestC1'OI be<:ause having high
levels can lead 10 plaque buildup in the ancries and
n:sult in hean disease.
High-density lipoproteins (HOLj cholesterol
absorb cholesterol and carry it back 10 the liver,
which nushes it from the body. 11 also has powCfful
anti-oxidant and anti-inflammatory effects. High
levels ofH DL. or "good" choles1Crol. reduce lhc risk
ofhean disease and slrokc.
The breakdown Oflhc HDL, LDL and uiglyccridcs
is most imponam. 11 is common 10 have a higher
reading of LDL than HDL, but !he wom reading
would be a very high tOlal cholcslerol consiSling of
very low HDL and very high L DL.
Your blood choleslerollcvel is affected nOl only by
whal you cal bul also by how quickly your body
makes LDL cho1eslC1'OI and disposes of it In facl,
your body makes alilhe cho1cslcrol il needs. and it
is not necessary 10 take in any addilional cholesterol
from the foods you cat.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swf Heal th and _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
in balance.
~<M I~
James V. Talano. MD MM FAce тАв Peter R. Foster, MO FACe
Sajan K. Rao, MD FAc e┬╖ Janet K. Sparker, PA-C RN
1-- - - - 239.261.2000 - - - --I
615 Ninth Street N. Suite 101
973 North Collier Blvd
Naples, Florida 34'02
Marco Island, FL 34145
)'Qg.l Stln(e, the family finan<:6,
or just the day┬╖to-<Dy. _ all seek a sense of
harmony. And no time is more
deserving Won the retirement )'ears wilen
after a fulltime focus on career. children and
other cOl1\l1lilrr1en(:$, the time al'1"ive$ to reap
the rewards of livWlg well.
At The Arlington, the newest retiremeot
lifestyle choice in the NlIpies aoo Marco
Island area, you can continue to live the life
you've pbn~ ... happy and with peKe of
mind ... knowing everything is in pbce lot'
the future, including an empIwis on ~tneSS
and wellness.and the availability of oo-site
heilth care, if r.eeded.
The Arlington
A Lutheran Life Communit)'
12276 TamiamiTrail E:m.Suite SOI,NapIe.. FIorida 34111
(239) 206-2646 or toll-free (866) 986┬╖9690
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Health'" Wellness September lOll┬╖ Collier Edition
Restorative Healing From the Inside Out
AJ?athway To Optimal Health
"Nutrition is the fOWldation of everything we do,"
said Callan. ''Overweight people an.: malnourished
and people in the U.S. don't know how IQ eat. Most
of the American diet is processed food - pasta,
,creal and many other things. We want peQple on a
low glyctmic diet that includes at least 50010 vegetables and does not include foods that make blood
sugar rise rapidly. Proper nutrition ultimately
comes down to how a person fuels their body and
using food as a 'drug.' Because we believe so
strongly that body detoxification is ,ritical to restoring optimal health, we offer detoxification 'shakes'
and provide counseling for starling, completing and
maintaining the dctox prQcc5$. Our first Tell>Seminar is called 'Vitality Now: Detox for a Bener
You.' [t starts with a preparatory session and is
followed by a four-step guided dctox pn.><.:ess and I
final what┬╖iO-OO-next session. The detOX TeleSeminar will be held in October."
hile most people find it difficult
to admit. the body o llen starts
changing in Our early to midthirties. By the lime "'C reach our ((lnies, those
changes can become more pronounced. Unintended " 'eight gain, fatigue, achy joints and diminished \/;lIIlily arc some of the things thaI can show
up and leave us fccling as if we're living some-
where outside our respective comfort zoncs.
The fact is thaI whether a person is in their thirties or
forties, or is a fifty-something who wants \0 put the
boom back in the Boomer tag, there is a way \0
restOR: our oplimal health and gCl back inlo our
comfort zones. Doingso will help reduce the risk of
de,doping degenerative diseases like diabetes.
strokes, obesity, dementia, gastrointestinal issues,
hean disease, osteoporosis, osteoarthritis and
cancer. The key !O getting our health and vitality
back is to undco;!and !he COns<:qUC1lCCS of poor
nutrition, IQ make the necessary dietary shifts, to rid
the bOOy of toxins and to ultimately achieve optimal
balance at a ,dlular level throughout the body.
Restorative Hea]ing From the Inside Out is a new
Estero-based company that is commined IQ won:ing
with individuals IQ restore and maintain their
optimal health. lIS founders bring a wealth ofrescorative healing experience to the process. Teresa A.
Sievers, MD is a physician who is Board Cenified in
both Internal Medicine and Anti-Aging. Regenerative and functional Medicine. Karen R. Callan is a
cenified Holistk Health Coach and a Mtmber of the
American ACadtmy ofDrugiess Practitioners.
Sieven and Callan are combining their considerable skill sets to provide nutritional testing, detoxification programs, One on One coaching, weight
loss programs that are designed On an individual
basis, supplement therapy to replenish diminished
nutrients, meal planning, on-site group presentations that will demonstrate how a pathway to bener
health can be achieved and their signature Vitality
Now Tele_Seminar series that will present and
guide participants through I panicular ""pc<:t of the
restorative healing pn.><.:ess. Their goal is 10 restore
optimal balance throughout the body.
"Restoring the body's optimal balance is first and
foremost ahout nutrition, diet and detoxification."
said Sievers. "There is no prescription drug or over
the counter remedy that can achieve that balance.
It's a mailer of the individual choices people make
every day. What we're tal king about is ,ommon
sense medicine that works for all adults, no mailer
what their age. 1\ all starts with detoxification. No
matter what else you do, if you don't detox you will
reabsorb toxins from the environment, from prescription medications you might betaking and even
from your own hormones. Toxins ,an affect your
health. Toxin imbalances can increase yourpredisposition to many different degenerative diseases,
indUding can,er. Detoxification along with proper
nutrition and the use of physician grade supplements Can help prevent those diseases. Its that
simple and that challenging"
Teresa A. Sievers, MD
_rd Cenffied In tnwrIIl Medld"" o.nd fur.cllon&l Medldne
Karen R. Callan
Cent!ied HoII,Uc Hulth
RHtMltlw Hulirog from the tnslde OUt
10201 A"os Aw. ~ 201, Eotero
wrn Mono About bstor.ti ... H.... ting from Ih.tn_ OUt at
"Health is 95% what a person doesand 5% genes."
said Sievers. "Changing habits that are thiny,
fony or even fifty ye= old won't happen overnight. [t takes developing a basic understanding of
how toxins and what you eat can impact your
health and your quality of life. Most imponanily,
it ta),;es a commitment to doing something good
for yourself and to making changes that will positively impact vinually every aspect of your life.
We introduce dietary changes gradually, often as
the person is beginning the detoxification process.
The 'ombination of the nutritional shifts and the
detox typically leaves them feeling better and
willing to go funher. It's a process."
"We ),;now this approach works and so do the
people we've worked with." added Callan.
"People with weight issues, rheumatoid Inhritis,
sleep apnea, high blood pressure, diabete~.
diminished libidos and gastrointestinal problems
have reclaimed their health using this approach.
Being healthy is a choice. Getting a person there
is our passion."
To learn more about Restorative Healing from the
Inside Out and to register for the Vitality Now:
Octox for a Better You Tele-Seminar, visit
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - September 2011 Health & Wellness
Restorative Health & Healing Center
10201 Arcos Avenue, Suite 201, Estero 33928
Teresa A. Sievers, MO
Board Certified in Both Internal Medkine &.
Anti-Agi ng. Regenerative &. Furu:tional Medicine
A Healthy Body is a Balallced Body!
Restore Your Body's Optimal Balallce!
Nutritional Testing &: CQun$eling тАв Body Balance Weight Loss
Program' Natural DetQKification Programs' Heavy Metal
Testing and Chelation ' Male &: Female Bioidentical
HQrmone Therapy' High Gr.. de Nutraceutic.. ls
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www. swfH eal th andWe _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Health'" Wellness September lOll┬╖ Collier Edition
may surprise )'QU to know thai cholesterol
itself isn't bad. In fact, cholesterol is just one
High cholesterol is one of the major eontrollable
risk factors for coronary heart disease, heart attack
and stroke. As your blood cholesterol rises, so
does your risk of coronary heart disease. If you
have other risk factors (such as high blood
pressure or diabetes) as well as high cholesterol,
this risk increases even more. The more risk
factors you have, the greater your chance of developing coronary heart disease. Also, the greater the
level of each risk factor. the more that factor
affects your overall risk.
of the many substances cn:atl:<.! and used by
Our bodies to keep uS healthy. Some oflhc cholesterol we need is proouced naturally (and can be
affected by your family health history), while some
ofil comes from the food we eal_
Cholesterol comes from 1WO sources' your body
and food. Your liver and olher cells in your body
make about 75 percenl of blood cholesterol. The
other 2S percent comes from the foods you eal.
There are two types of cholesterol: HDL "good "
and LDL "bad." II's important 10 understand the diffc'"<'nee. and to knQw the levels of "good" and "bad "
cholesterol in your blood. Too much of one type or not enough of another - can put you at risk fw
coronary hcart disease, hcart anack or slroke.
+ High' Den~ty Upoproteln ┬╖ HOl "Good" Cholesterol
A cholesterol screening measures your level of HOL
and LOL. HOL is the "good" cholesterol which helps
keep the LOL "bad" cholesterol from gening lodged
into your ar!cry walls. A hcalthy level of HOL may
alSQ prolect againsl hear! ana\Ok and stroke, while low
levels ofHOL have been shown 10 inerease the risk of
hear! disease.
With HOL cholesterol, higher levels arc bener. Low
HOL cholesterol puts you at higher risk for heart
disease. Smoking, being overweight and being sedcmary can all result in lower HOL cholesterol To
raise your HOL level, avoid 1Obacco smoke and
maintain a healthy weight.
Studies show that regular physical ac1ivity also helps
your body produce more HOL. Reducing trans fats
and eating a balanced, nutritious diet is another way
to increase 110L. [flhese measures are nOI enough 10
incrcase your HOL to goal, your heahhcare practitioner may prescribe a medication spc<:ifically 10
increase your HOLs.
+Low┬╖Denslty Upoprote in - LDl "Bad " Cholesterol
LOL cholesterol is the "bad" cholesterol. When 100
much of it circulatC$ in the blood, it can clog arteries.
increasing your risk of heM ansek and s1roke.
LOL cholesterol is produced natwally by the body.
but many people inherit genes from their mother.
father or even grandparents thai cause them to make
too much. Eating satwated fat, 1rnns fats and dietary
cholesterol also increases how much you ha>-e. If
high blood cholesterol runs in your family, lifestyle
modifications may not be enough to help lower
your WL blood cholesterol.
The lower your LOL choleslerol. the lower your
risk of heart anack and stroke. [n fa(:1, it's a bener
gauge of risk than total blood cholesterol. Your
other risk factors for heart discase and stroke help
detennine what your LOL level should be. as well
as lhe appropriate treatment for you. A heahhy
level for you may nOt be healthy for your friend or
neighbor. Everyone is different. so work with your
doctor to find a treatment plan that's best for you.
Triglyceride is the most common type of fat in
the body. Many people who have heart disca┬з(: or
diabetes have high trigly\Oeride levels. Nonnal
triglyceride levels vary by age and sex. A high
triglyceride level combined with low HOl. cholesterol or high l.OL cholesterol seems to speed
up atherosclerosis (the buildup of fatty deposits
in artery walls). Atherosclerosis increases the
risk for heart attack and stroke. Many people
have high triglyceride levels due to being
overn'eight/obese, physi\Oal inactivity. cigarene
smoking, excess alcohol consumption andlor a
diet very high in carbohydrates (60 p<=rcent or
more of calories). High triglycerides are a
lifestyle-related risk factor; however, underlying
diseases or genetic disorders can be the cause.
When lOll much l.Ol. (bad) choleslerol circulates
in the blood, it can slowly build up in the inner
walls of the arteries that feed the heart and brain.
Together with olher substances, it can fonn
plaque, a thick, hard deposit that can narrow the
arteries and make them less flexible. This C(>ndi tion is known as atherosclerosis. If a clOI fonns
and blocks a narrowcd artery. a heart attack or
stroke can result.
To detcnnine how your cholesterol levels affect
your risk of heart disease, you will also take imo
account other risk factors such as age. family
history, smoking and high blood pressure.
Minimize your risk for heart disease and stroke by
knowing your cholestcrol numbers. A simple
blood test, often called a lipid profile will test the
levels ofHOl.. LDl.. and Triglycerides. Lucky for
you. such tests are available without a doctor's
TC<JuCSt at l.ipid Labz Inc., 2800 Oavis Blvd S1<: 108.
+Call 239┬╖331┬╖3109 to schedule your eholes┬╖
terol screening todayl
l.ipid l.abz otTers Cholesterol Screenings as well
as other tests. With Or without insurance,lab work
Can be expensive. If you are like so many families
today, you have little or no health insurance and
getting life_saving testS may not have been an
option for you until now! l.ipid l.abz tests are
priced at costs that everyone \Oan afford. Even if
you have insurance. Lipid Labz may be able to
save you money because the \Oosts are oftentimes
far less lhan most insurance deductibles. Stop in
today for a lcst thai may save your life. No
appointment or dOCIOr'S nOle is required for any of
the tests available at Lipid Labz. Take control of
your health today!
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - September 2011 Health &. Wel lness
lIere's a good solution. Arrange 10 speak to a
specific pcrson every day. A friend. family member,
neighbor or care provider can be your direct link to
safety. If you have a friend who also lives alone,
make il a daily habit 10 keep in touch _ even for a
brief moment. A simple phone call will do. Have a
set time for the call so that if one person d~n't
hear from the other, they get help right away.
he older we get, the faster life moves.
Unfonunately, as our body ages, we
take on the strain of our years. Keeping
pace in a hoctic world can takc its toll. Elderly
people need to use extra care to ensure their safety.
When we're young, we can fall and almost bounee
back up. Our bones and muscles are flexible enough
to handle extreme spons. Then, age scts in. The
warning signs comc in brinlc bones and wcakened
muscles. At this point in life, even a simple slip and
fall can have disastr<;>us consequences.
What can older people do to safeguard themselves? Seniors need to take steps - cautiously _ to
a safer way of lifc.
Maintain a secure footing. Here an; some tips
for preventing falls around thc house.
тАв Make sure carpets and rugs are securely fastened
to the floor, especially at the comers.
тАв Don't ovcr extend yourself to reach objects. Usc
a stable. secure foot stool to reach high places.
Treat medications with respect.. Many seniors
require medication on a daily basis. Though
drugs may be an essential element of your
healthy lifestyle. always remember that medication can be dangerous in thc wrong hands.
1f you are looking for a qualified and caring extra
hand to assist you Or a loved one around the home
private duty care providers may be the best option
for you. Privale dUly home care providers are
trained, licensed, insured. and dependable.
тАв Always dispose of unused medications by
flushing them down a toilel.
IT Privale Duty Home Care provides assistance
тАв Never take prescription medicine intended for
someone else.
тАв Always keep medicine in ilS original comainer.
with dosage and instructions clearly labelled.
тАв Keep a log of when prescription medicines are
taking for reference by someone else should you
be unable 10 take your medicine yourself.
тАв Usc a non_slip mat in the bathtub or shower.
тАв Keep a finn grip on handrails while climbing or
descending stairs.
тАв Avoid slippery surfaces such as icy sidewalks,
and watch where you are walking to avoid pitfalls
along the way.
Have a safety back-Up plan. Quite often.
seniors live alone. Thcy may not have a daily
routine that brings them in eontaCt with other
people. For people in this situation, a fall or
other mishap at home could lead to catastrophe
unless a safety plan is in place.
bt<:on,.. ...,riously ill.
it can II<, difficuh '0 know wlu, 'YP"
of Cir' i, ba, ... Or whe .. to Turn for help.
V lTAS ca n he lp.
with daily needs and activitie~. shon or long tenn,
and allows individuals to safely maintain their
independence in the comfon of their residence. A
nurse i~ jU~1 a phone call away (no answering
service). 24 hours a day. 7 days a week. Care and
progress is monitore.:i closely, as each client
receives a clinical aSSeSSment by an RN every IS
days for no eXira charge.
If you have any questions about private duty home
care services or would like more tips on making the
home a safe place 10 age please call (lJIJ)
81J6-6581. JT Private Duty Home Care is dedicated
on providing exceptional care, and supreme
customer service. Because, when it comes to your
care, there are no ShOncUIS, you deserve Ihe beSI.
Running a Practice Is Hard
Work - Let Paychex Helpl
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Ame,iGO┬╖' nospice leader. founded in t978
Proudly Serving patients & f~mihe, in Collier County
1.8OO.93.VJTAS ┬╖ 1.800.938.4827 """",
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Health'" Wellness September lOll┬╖ Collier Edition
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - September 2011 Health & Wellness
A single Insured may de!)OSII up to S3,05O annually Into
their tax-qualified H.$.A. aox:ounL A family insured may
de!)OSII up to $6.150 aMually. ,t.r;j ff)OU alll 0'0'eI" a3l55.
)OU have the ability of contribuling an additional
The ABCs of HSAs
By Jennilef L WSflke, CPIA
A. An H_S.A_ stands for Health SlIYIngs Account_
Another acronym by the InsurarlCll irldustry thillieads many
to confusion_
tt Is a tax-free savings account available to only qualified High
Deductible Health Plans. The Inlormation 'M! will share willi
JOU i$ strictly the insurarlte component of the p~m. It
should not be considered tax a!Mce. ThereiOOl. 'M! strongly
encourage ,ou to discuss this option willi both JOUr ticensed
health insurar.ce agent and )OUr trosted tax advisor before
making arYl decisions.
B. Can any medical plan haYe a Health SaYIngs
Account? The anS'M!r is no. Md thill'S whe<e 'M! find many
consumers being contused. According 10 tRS. publication 969
at _.irs.jlY, only certain types High Deductible Heallh
Plans qualify lor the tax-free savings aocoont The medical
insurarlCll component of the contract must haYe the following
un;que leatures:
tient and outpatient services. as 'M!II as prescription drugs
are paid by )'O'J In full. arid applied tooram l'Jur dedllClible ,
тАв Typically. flO cop3')'R1enlS are offered. But in recenl )lears.
Insurers flOW offer a COP<l'l' lor prescription drugs-afte("
satisfying the caleoOar )f!ar deductible,
- With the passage 01 Heallhcare Reform on 10/ 01/2010,
plllYefllNe screenings under the High Deductible H.S-A.┬╖
qualified plan are no longer subject W )OUr deductible; arid
paid at 100% fn-network.
In the state of Florida. irldividual health inSIJrance is
subject to medical uoderwnting; and is not guaranteed le>r
al1)Ql\e <:wer age 19. Therefore, jOO will complete an insur┬╖
ance application with a medical questionnailll and SlJbm~
to the camer lor uoderwrillng appl"OIIiIl.
C. You choose the deductible level you feel
comfo rtable with based on the premium you
тАв Deductibles are combined to a -single family deductiblelor those Insunng IhemseMs with a dependent (I,e. spouse
and/or c/1 ild(ren).
can afford_ Then the inSIJr&nce contract will begin
reimbursement based on the -co-insurance' level I'JU
seleC1 (I ,e. I()()'jf" 90/10. 80/20, etc ,).
- The minimum deductible lor a single Insured is $1.200 willi
a maximum out-of-poCket (i"chld ing l'Jur deductible) of
$5.950 In a calerldar )lear,
Md atthough I'JU Pill' lor all these e~nses In full W
$8~$1y ,our calendar )f!~ r deductible, ,ou should stay
'in-netwo",'to Pill' the discounted fees lor service. which
haYe already been pre-negotiated lor ,ou between the
insu rance compafl)' and the partieipa~ng physicians and
hospjtals. As I'JU Incur medical expenses that are applied
towafd JOUr calendar )f!ar deductible. ,ou wi ll pay for
them throoglll'Jur tax-qualified Health Savings Account
тАв The minimum deductible lor a flImily insured is $2.400 with
a maximum out~f-poc:ket (locIudlng JOUr deductible) 01
$11,900 In a calendar )f!ar.
- One InSlJred family member can satisfy the combinedsingle lamily deductible: or a combination 01 ewl)' family
member's medical expenses.
- Alt eligible medical expenses aocrue tooram satisfying the
selected deductible. This means office visits. lab teSts. ifIpa_
ShoUld I'JU have a oolance in l'Jur tax-qualified Health
Savings ~ccounl at the end 01 the )f!ar. ~ rolls <:wer W the
new calendar )f!ar, which eorrelates to when ,our
calendar )'ear deductible resets, Withdrawals are w~hout
pena~ from the tax-qual ified H.S-A. for all eligible
medical, dental and .ision expenses based on the IRS
gu idelines (_.irs,jlY for mOIll details), Ifl'JU use the
money fe>r arYl other purposa. JOU wi ll be taxed and penalized for the unqualified withdrawal.
In most casas. High Deductible Health Plans offer lower
premiums. In the individual health marlce~ the premium
is determined oosed on several underwriting factors Indudlng age. gtrlder. Wbacc:o-use, geographic residential area and health status.
\'00 Sill respons;ble to P<I'l' lor medical and prescrip~on
expenses until the calerldar )f!a r deductible is satisfied.
Thelll/ore. I'JU should gi..., serious consideration and
evaluate ha.r ffequently I'J" must see JOUr physician , the
frequency of lab W(lrl< and anticipated prescription drug
costs W understand JOUr potentia l financia l responsibility In sa~sfying )'Our CalendarYear Deductible.
Fe>r more information about Higll Deductible Health Plans
and the tax-qua lified Heallh Savings Account. contact me
for a free eva luation .
Lut gert Ins urance
Jennifer L. Wenke , CP IA
Other expenses ,ou may incur that may not be CoYered by
the insurance contract. but can be withdrawn from l'Jur
tax┬╖qualffied H.S-A. account indude. and are not l i m~ed
to. dental alXl vision ,
Alternative Approach Clinic, PA
Dr. Bonnie Heidel, MSOM, OMD, DipL L.Ac.
Board Cert ified Acupuncture & Herbal Medicine;
Integrative and Primary Care Physician
Spm.,I4i"1l '" I"t.egrati-e Mdkld I'nHocob from Genctie Nuni!;oo for the
Roversal of Chronic Illness and Weigh! 1<:>\$; Prolotherapy, Electto-acupunc and
Pbysical Medicine For Pain Management
Modic.aJ and Spa level tna$$8gCS and skin care _Combining the
mos! ~hens;"" moda~!ies oFEas!em and Wes!em Medicine.
in Southwest Florida
Serving NaplN Residents for over to ytar5!
[malt i_nkrItlu'g<rtinlU'l1>┬л ,com
I'l l;" www.Lutg<┬л.com
Phon e: 239 .418.2106
. Wenke, C PIA
Individual & Group Medical. Life, Disability. Retirement & Supplemental Plans
Momber of the Florida Stole Chapter of tho Nation., Association of HтАвтАв llh Undo""';, ...
LNrgcrl l1rS""'''U ~4"dl~s Properly .I C4' N41ry iMN'UU pro,,,,,,,, fe, 8iJrh yeN'
b",/"", тАвтАв"d perl"104/ iM"'4nce needs.
~.kuflng Our Chents'
1rust Sll1ce 195,
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Health'" Wellness September 2011 - Collier Edition
Five Estate Planning Mistakes by the Unwary
By ROBERT H. EARDLEY, Esq., Florida Bar Board Certified Willi, Tru sts '" ESlales Attorney
Estate PI,nnlng Realty 1$ For E"ryone
Many assume that "estate plaMing" is only for \tie weatttrt
HoweYef.lIOIhing 00lJ1d be further from the truth. In realit;\
eYeI)UIII! has an estate, \\tlether it is a modest $100,000
condo aod a ban~ account - or millions of dollars in stock
sod real estate. Therefore. a "plan" is needed to designate
YIOO sha ll control aod ~herit the estate.
chusetts) are establishing special un its and protocol to
audtt persons who daim Rorida tax residency but still
maintain an abo<!e In the northem state.
Thus, it is crueial that the seasonal person obtain legal
and tax advice 10 establish a secure Florida tax resideocy.
Mistake No. S - 1mpropel' Benelldary DesIjpIatIons
for 1RA$ n LJfe 11l$Unn:e
01' Revocable Trust does
not control the transfer of an IRA. or life insurance at
deatl1. Instead. upon the owne~s death tI1e IRA administrator or insurance company reviews the ClJrrent benefi┬╖
ciary form signed by the owner and pays the funds to the
pelSOO idenVfied on the beneficiary form.
Of surprise to mant, one's Will
And it is critical thaI the estate plan be valid so 1M! one's
wishes are impleme<1ted at death. Unfortunately, it is
common that one's objeetiYes. at least in part, are
thwarted by improper estate planning.
AII!Ioogh a variety of estate planning "mistakes" ocwr,
experience s/K:I'II's that &Ie mistakes are the most common.
Mistake No.1 - VoId Exeartor AppoIntments
The E:wcutor (Ill" technically the "PelSOOal Representawe") is the party designated in the Will that has respOnsibility fill" handling all aspectS of the estate at death.
Unbeknownst to many, Florida I!rw limits the individuals
who may serve as one's ~OI to either (i) a Flori<!a
resident, or (ii) a close relatiVe. Stated another way, a
close friend 01' illMsor that does not live In Florida cannot
be one's Exeeotor.
Also. a corMcted felon (including one's spouse 01' child)
cannot be the E:wcutor - eYen if the crime was a
"jOuthful; non┬╖dangerous type committed decades ago.
What does the COurt 00 if one's Will nominates a"nonqualifted" person as Executor? Stated simply. that
nomination is unlawful and it will not be honored by the
COurt. Instead, an altemate &ecutor will be installed by
the COurt and who is either a back┬╖up &ecutor nominated In the Will 01' the person or pelSOOS k:fenufied by
Rorida statute.
Mistakfl No.2 - Accidental - 8equest- of the Home
to the Children Before Husband and WHe Are Both
Florida law is YefY protectiye of the homestead. For
e>;ample. uoder Florida's constitution a married pe!SOO's
homestead can only be bequeathed outrig!lt to the spouse
(if it is notjointty crwned by them). Any other bequest of the
home (i.e. in trust) is invalid.
Mant estate plans, partiaJlarty those not updated for
AoIida law compliance, do not address this potential 'SIlI~
ownersh ip" arrangement, ThUs. upon the first spouse's
death the childref1 automatically become C(H)WneIS of the
home with the SlJMving spouse and are entitled to a share
of the sales proceeds upon a future sale.
Fortunatety, this suMving spouse/children split ownership
situatioll can be ~ i minated with proper iKMInce planning.
Ml$takfl NO.3 - Jointly Owned Property
One's Will or Re-.┬лable Trust generally is relied upon to
transfer all property at death. ~,jointty-<lWOOd
property (such as real estate 01' an irnestmerJt account) is
one glaring exception to this rule.
A joilllly-owned asset, instead of passing to one's heirs
named in the Will Ill" Re-.┬лable Trust, passes directly to the
SlJMvingjoim 0WIIef by reason of joint propen)' law. Unfor┬╖
tunatety, In such a case the asset may pass to an unln┬╖
tended recipient
Also, if an asset is jointly-owned with just one child. at
death this can result in that child reeeiVing a larger share of
the 0IeI'a1i estate than his 01 her siblings. This is because
that cI1 i1d inherits 00th the joint assetAND an equal share
of the assets which pass uoder the Will OI'Trust.
The mistake Is tI1at tile "wrong person " may receive IRA
or insurance money.
For elI:iImpie. Mrs. Smith desiWl8leS her 4 SOlIS, by name. as
heirs of her $ 1 million IRA using the standatd beneficiary
form fOI' m irflOeSlme!lt compant. Unfortunately, Mrs.
Smith┬╖s oldest son, John, predeceases her but Mrs. Smith
fails to update her beneficiary designation before her death.
Who inllerits John's S25O,000 share of the IRA? tt may be
John's children, Of his brothers, or his wife - or !!Yell Mrs.
Smith's probate estate. There is no uniform aoswer. Instead,
~ Is necessary to read the "~-j)late- pI'(Msions of the
beneficiary form to determine who receiYes the ~
the IRA
01 life insurance is made payable to one's
"Estate; two problems are created. First. the funds become
~I assets of the Estate and thus subject to the
deceased's creditors. Second, in the case of an IRA, the
annual minimum withdrawal amount may weatly increase.
~nt estate planning mistakes are all too easy to make.
Therefore, tt is only prudent to retain quaWfied ~I cour.<.el to
i'Ilpiement avalid and oomprellensr.oe estate plan.
Mistake No.4 - Improper Tax Planning by Dual
State Residents
Florida IJI\Mde:S ma"" \a:l; breaks for i!s residents, including (i)
Fa ilure to establish a Ronda primary tall residence will
f1erih 8". ikHlnl C~fin
HYIJ, T,.,.m ""d mr"la
"/rOmey, ~DId. ~ i.< J.D. dqru
f"'''' t~e U";l'enity "f Ke"tucky
CMhp ofUnv ""d " M....1n of
fA .... (LI~ ,\f.) dtgru ;11 mlllte
PlIf""ingf""" rhe U"ivn:<!ty of
gMl the "n(l(\hem - state grounds to tax the person's
MI"",; Sdool
no state income Iai(, and (i ) no state death Iaio:. Howewr,1O
obIaIn these \a:l; benefiIs tt is critical that the person 'I>f'Io has
a resitIence i'I Aorida and also in another state 10 establish
the Florida residence as the prtmary \a:l; residence.
MoreoYe(, if the Will does not bequeath the home outright
r:{J .dt~y i. If PIf,I"U wirh the
en~re income or estate, illduding retroactive/)\ Interest┬╖
to the SlJrvMng spouse, then the Aorida Constitution
f\""P'~' I.... fir", of S"I ..." " ,;, HOod & 8udd, ""d h~
ingly, as JlOIed in the wall Street Journal. there is a oet
or hiJ <IS"'la"r, Sue Spr"uu. CIf" H ruched " I (2J9)
prwides that the spouse and the childref1 automatically
annua l migration of 400,000 people to "00 tall" states
beaNne co-o.mers of the home.
SIlCh as florida, and thus some states (including Massa_____________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - September 20 II Health & Wellness
Think you are too YOUNG for Long-Term Care
Insurance?? .... Think Again!
By Rosemarie Hurley, GSA - Long-Term care Insurance Specialist
I am often asked" What is the right age 10
consider Long-Tenn Care insurance?
There are basically IWO ways 10 generale a claim.
One is Ihe inability to perfonn 2 of 6 Activilies of
Daily Living. The AClivities of Daily Living (A.D.
L _s) are as follows: Eating , Dressing, Bathing,
Cominence, Toilcling, and Trans ferring. Since
companies meaSure funetionalily, if you are unahle
to perfonn 2 of Ihese 6 AD Ls. you qua lify for a
LTC claim. Your diagnosis is not importanl ... just
your inability 10 take care of yourself. The se<:ond
way to qualify for benefits is called Cognitive
Impainnenl. In simpler tenns: senility, dementia,
Alzheimer's Or a mental disease connected with
"My answer hasn 'I changed ....."as young as possible".
Actually ag<: 40 and up is best . . .hm if you haven't
looked inlO Ihis before now and you are over 40 , 50 is
better than 60 and 60 is better than 70 .... In other
words, NOW is the besllime.
Since the premiums for Long-Term Care insurance are
based on your age and also your CurTCnl health, naturally the younger and even more importanlly . . .the
II EALTI UER you are, the better. Sometimes I hear
from potential clients who ask me "wouldn't il be
am older and closer IOneeding this
benefil T I answer. unequivocally .. .. no! When you
postpone looking into LTC insurance you are risking
1\0.'0 things. One : you may not quali/)'. In olher words,
some health event may happen that precludes you from
qualifying. Secondly, it will always cost more if you
wail. The premium difference between buying this al a
younger and waiting unlil you think you are closer to
using ii, can be significant -- in some cases, as much
as $1 00 10 5200 per month difference.
bc1terlO wail unlill
The Waiver of Premium benefit on every Long-Term
Care policy sold, balances oullhe lotal premiums paid
into the policy before you have a claim. If you are
younger, the premiums are much less. This makes
perfeel sense, beeause lhe companies are expecting
actuarially that you will pay premiums longer than a
person, let's say who is 10}'ear$ older. Bul paying a
premium longer does not mean you are paying more
premiums. T hat's where Ihe substantially lower
premium comes in.
aging . These IWO ways 10 qualify for benefils are
mutually nclusive- you need only 10 meel one of
the above two conditions.
How you qualify for benefits is the same for all
companies offering a Long-Term Care policy.
And although we buy LTC insurance with our
older age in mind, il is possihle that an accident
or injury can generate a claim long well before
we are in a relirement mode.
R~umQrie lIurlej" O...nero/Senior hrsuronce Solutions. has worked i~ the senior heallheare market/or
11 years. She is a Cerlified Senior Advisorand has been a Long-Term Care Insurance Specialist/or over
18 years. She repreSeMS only Ihe/inl!!Jl insurllnce comfX1nies in the industry. Can be rellched 01
(139) 174-6678 in Eslero, or Websile:www:/
Pract;u Conu ntrat;ng ;", ..
Floride Ber Boerd Certified
w.o. Tnms 5. ESlalet l8W)'OI'
Mu tt ' 01 UI .... Otg_
ir1 E.lahl P1an";Rg
Will and T ru" Planning
Florida Residency Planning
Revocable living TruSl.
Esu,e Tax Minimiution
Prob3<e of Es .. ,e.
Prenuptial and POSlnupti.1 Agreement.
Power< of Attorney/livin g Will.
Pl anning for the future requires being educated
aboul polenlia l pitfalls. The articles I wrile each
month for the past 7 years, arc meant to be helpful
in educating you about how to protecl your financial fulure. And, as I always say, having a plan in
place guaranlees you can enjoy a pleasant future
wilhoul financial concerns.
Tho IW"'v "'.'-Y"';" ... _ _ _ _ "'"
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Nann ing fQ.r ,he I'uu ... io 10 impoe"""_ S. p~. ~n
:oil you can abou, oon>eIhing ,Ita, can joopard,.. ,he 6runcW
rU,"r~ of)'OUr on" ... r,mily. T:oIk wi,h тАв broker who ... pr~
.0,,,.:011 ,he m. jor
ere a"i~", . nJ has been .
Ca .. Speci:ol", for O"C 17 reo".
Compare before you decide.
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c- ~ bmbrinc.nth """1
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do< pion ""',.,.;.,,.,.,. - .
For a FREE Information Packel at 239,27-4.6678
Viii, our Wtb Si,,:II: """".looogt(I"IC2Iri~flf.o;:om
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Health'" Wellness September lOll┬╖ Collier Edition
What is Cervical Facet Syndrome?
By Prathima Moorthy, M.D.
ervical filCel syndrome Isa cause of pa in
in tile spinal region and, more noticeably,
. What Causes the
Cervical Facet Joints
in the neck. The facet joints are what
connect the l'ef!ebrae in the spine. They are jojnts, like
to Beeome Painful?
Osteoarthritis is probably
tile most common cause
of ceMcal filcet joint
pain. This degenerali'l'e
disease callSes progressWe cartilage deterioration. Without the spongy
others in JOUr body, which allow )'Our spine to mcwe in dif┬╖
ferent directions. Because of the constant motion, they
can become YIOm Oflom.
. Symptoms of Cenleal Faeet joint Disease
When suffering hom cervical facet syno'lOme, the facet
joints become inflamed and may bring with ~ ned pain.
Sl)(eness and or stiffness. Cervical facet Jolnl pain can be
fen in the areas of the I)ase of the skull, upper back and
shoulders. mid┬╖back or neck. In many cases, cervical facet
syndrome is the cause of trauma from an injury 10 the
facet pnL due to a degenerative disc disease or also due
to stress or strain in )'Our posture.
Individuals sutleling from cervical facet syndrome usually
feel wor.;e in the morning. They tend \0 haYe stiffness and
usually will feel somewIIat better after they hiM:! been
moYiog arouoo. As the day pro~. they teod to be ok as
oog as they keep IIlOI'ing. 1Iowe'Ier, fOf those haYing to WOII\
seated all day or WOII\ from a computer, they may firld they
are at
risk of ~rieocing pain ttuoogl1out the day.
Sufferers of cervical facet syndrome often have problems
with headaches as well. Pa in may be fe~ in different areas
and usually when moving tile head in up and down IIlOYements. Keadaches are less of an issve with joint problems
in this area. howevtr. stillness of the neck and tightness
and pain in tile shouldef area is present Neurological
symptoms, SlIch as numbness and muscle weakness, are
also factors of cervical facet joint disease. Patients often
experience headaches and neck pa in, and a dull, aching,
uncomfortable feeling in the back of the neck that may
mOYe. Of radiate, to the shoulder and middle of the back .
тАв Inltlal Treatment for Cervleal Faeet Syndrome
I'trfsical thefllP)' is one method which can help reduce the
pain by using ice to decrease the blood now to the injured
area and can also alleviate allY spasms which may occu r.
The use of ultrasound, electrical stimulation, muscle rel,"ants and non-steroidal antj┬╖lnnammatory med ication can
also be used etfectively to reduce the pain.
cartilagioous cushion. joint bones begin to rub against
each other when at rest and during fTIOYement Another
condition, Degenel1lliYe Disc Disease (0001 mil)' com┬╖
PJQfTIise tile structural intefi\Y of the intervertebral
discs causOng discs to lose normal height. loss of disc
heilN may cause the affected facet joints to become
pOSitioned too closely thereby disrupting the joint's
ability to function norma lly.
тАв Dlagnosls of Facet joint Problems
_ How Can Radlofrequency Ablation (RFA)
Relieve Symptoms?
RFA >s a minimally┬╖ifMIsi've procedure that disables and
prevents a specirlC SCinal nerve lrom transmitting pa in
signa ls. ~ was developed more than 3D rears a~ and is
performed by many pa in management special ists to
treat pa inlul lacet joints. RFA applies a precisely talgllted
electrical fi eld 10 change the function 01 nelVeS - in this
case, a specific branch 01 a spina l nerve rendering it incapable of transmitting pa in signals.
тАв What are Ihe Possible Complications with RFA?
As with any medical procedure. the re are risks and
potential compl i ca~ons Although comp lications rarely
occu r. patients need to know ..hat CIlu ld happen.The follow ing list is not CIlndusive: bleed ing. infection. nerve or
injury. all ergic or othe r reaction to medications used (eg.
тАв Is the Pain Relief Permanent?
For many pabents ..flo suffer duonic neck pain. RFA is an
effect~'e treatment that may provide reliel for sQ months or
longer. Even wI1en norma l function returns 10 the target.
pain relief may conbnue. If the pa~ent responded Wfll to
the first RFA.a seoond may be ~dered if pa in resumes.
Of COIJfSe. eadl patient is unique and " flat WOII<.s Wfll for
ooe person. may not worI\ Wfll O! at all for another.
The most definitive diagnosis of lacet joint pa in can be
made by a filcet joint block. This is an injection with a
small W1ume of a oombOnation of local anestlletic and
cortisone used to blod< the ne"" that innervates the
facet joint H a patient ~riences significant pain
reduction fJQfTI this procedure, he Of she mil)' be a can┬╖
didate for a Radiofrequency Ablation procedure. This is
a mlnlmalty┬╖if'MlSM! procedure ava ilable to diagnose
and aid In treatment of cervical facet syndrome. The
benefits of having this type of surgery vs. conservative
surgery indude. but are not limited to: no general anes-.
thesia; no hospital stay; and a quick re<X:lllery that
resufts in the patient being able to resume their normal
lifestyle in a minimal amount of time.
тАв How Is the Proced ure Pelfonned ?
Using gentle heat through the need le, the physidan can
cause muscte twitches or tingling sensations thet confirm
that the needle is property and preasely positioned next to
the targeted SCinai nerve branch. ElectJic energy >s tIIen
appfied for the next 90 seconds to ┬╖ablate- the nerYe.This
procedure is repeated lor each targeted ne"" mot In
general, there is minimal pain with this procedure .
тАв What Should Patients Expect?
like otller minimally┬╖ifMIsi've O\IIjla!ient procedures, some
post┬╖procedural pain or discomlOlt sIIou ld be expected.
Usually an OYer-the-COtJnter NSAIO is suffICient to relil1\'e
th>s discomlort In some cases. post-procedural pa in may
increase and the physician will prescnbe needed medication (e.g. anti┬╖inflammaIOty).
Facet Joints In Motion
In general, patients can expect a significant reduction of
their pre-procedural pa in in one to foo r weeks. It is recommended tIIat before detiding on the appropriate form of
treatment. thet ~ explore all Options and treatment pr0ced ures """ il able to \W
Pratnima Moorthy, M.D.
Pain Manage ment Center of Naples
3439 Pine Ridge Rd .. Naples, FL 34 109
______________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - September 2011 Health & Wellness
What Is Causing My Back Pain?
hile only a trained medical professional
diagnose your back problems
and recommend appropriate treatment. a basic
understanding of COmmOn causes of back pain
and how VAX-D works to alleviate them can kelp
you in making a more infonned decision coneeming your treatment options.
and injury may damage discs and vcnebrae.
putting pressure on nerves. This results in lingling.
numbness. muscle weakness. or even sharp.
shooting pain.
Shown in the illustration below are some of the
more common diagnoses for back pain that will be
covered al length in the coming pages.
Understanding How the Spine Works
---t- - -
Your spine is composed of24 bones called vertebrae. In between each vertebra is a fibrous disc
(annulus fibrosus) filled with a jelly-like substance (nuc leus pulposus). whieh provides flexibility and cushioning to the spine.
--+- "'~ Di┬л
InC'1rrect Lifting
C'1rrecl Lifting
The vertebrae protect the spinal cord. which runs
through a tube at the back of the spine called the
spinal canal. In the lower portion of the back.
spinal nerveS exit the spinal canal between the
vertebrae and unite as they m'1ve down through
the pelvis. Some of these spinal nerves j'1in t'1
become the sciatic nerves. which travel down
through the bUllocks. along the backs and sides '1f
the thighs and calves, and into the fttl.
Uft with Your legs, Not with Your Back!
With s uch a dense network of nerves traveling
throughout the back. it is easy to see how great
discomfort may be caused by a slight upset in
the delicate arehitttture of the spine. Accidents
Of course. there is nO right way to lift an object that
is simply too heavy. Listen to y'1ur body. and if you
fttl any diseomfort while doing heavy lifting, back
offand save your back!
Many bulging and herniated discs can be attributed to
lifting objects illCOlTectiy. When picking up an object
from the floor. bend at tbe knees. keeping the spine as
erect as possible. Rise using the strength of your legs.
as their sturdy. more simplistic architecture is
designed for such exertions. Putting great amounts of
pull or pressure on the spine. when bent forward Or
backward, can compromise its delicate alignment.
( ' \ Bonito Periodontics
/ \
I ~
Implants . Maintenance ' lASER Therapy
IV & O ral Sedation тАв
тАв Gum Grafts
~ wwwbo""" ,"pkm'
Do You Suffer From
Chronic Back or Neck Pain?
VAX-D Therapy
The Natt.a ... AppI-" to Enecttv. "-In n..........
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$p<>nr I.J.riCII тАв W"'*<r~ C.....p<-a- тАв F_ J..m.I
Dan Bartley, D.C. I CMIo".,.,..,. P.T.
Juan M. Teodoro, D.MD
Phy. lclan. Reh.b & Spine Center
TI>o 11<></1: ~ _k""", PIo1'l<<>J n..r.", c.~,.,.
165t1 V.ndt,bit, O,t тАвтАв (2 Mi lts Nonh of Wiggin< Rd.)
тАв OinicoI _ _
тАв Coro<ious
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"",_SodoIiOtI Co<ufIt<l
тАв l.ato< .......,ed Now _
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Bonit> Spnnp. Rondo HtlS
239.947.7844 тАв
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Health'" Wellness September lOll┬╖ Collier Edition
Is That Swelling in My Limb Lymphedema?
Lymphedema Can Be Broken Into
Three Stages
Post Cancer Side Effects and Other
Causes of Swelling
Slage J Lymphedema: The skin is still soft. Pressing
a thumb intO the s .....ollen area will lea\'C a dent in the
flesh . This differentiates Lymphedema from I'Cgular
edema., which does not leave a dent. There an: no
hardened areas of !he limb, and !he skin is still in
good condition. At this stage, Lymphedema can be
I'Cversible with treatment or elevalion.
By Palfid( Aidl. CEO, Acute Wound Care
ny edema or accumulation of fluid
is indicative of,," overloaded lym_
phatic system. II is IlOlcwonhy that
Lymphedema, related \0 lymph node damage, is
common in injuries, IrnceJhip replacements, radiation {)1" surgical call\:cr TClIlQval pro<.:edu~_ Lymphedema is a chronic. progressively debilitating
disease oflhe Lymphatic System
What is the L.ymphatic System?
The lymphatic System has been refcm.:d to as the
gaJbagc hauler ofthc body since it is responsible for
removal of waste products along with effective
~ion of!he immune system. If a node is damaged
or mnovod, one less "sewer drain" is available to
keep !he system clean and functioning and !he waste
can begin to accumulate in !he limb. This can have
serious and lifc Wca┬л:ning consequcnccs.
Symptoms of Lymphedema
Peoplc with Lymphedema often experience great fatigue. This may be caused by the
constant burden of carrying around swollen body
parts which can add pounds to a person's weight
It also can be caused by the "toxic soup" of lymph
fluid that has built up in the body.
Pain: Pain invariably ac;<;ompanies Lymphedema.
and thc pain can range from mild to debilitating.
The pain is caused by the preS$IIre the swelling
puts on the skin as well as on the veins and internal
structures of the elTectod body pan. Neuralgia,
simi lar to that experienced by diabetics, Can add to
the pain as welL
Skin Uluf'S: The increased skin tension and
changes in the skin caused by Lymphedema can
lead to skin ulccrations. Ollcn these ulcers will
weep yellow lymphatic fluid. The ulcerations are
difficull to heal due to the swelling and often
bcrome infected . The openings they cause in the
skin can lead to Cellulitis.
Cellulilis: Cellulitis is a constant danger and great
care must be taken to prevent cuts and bruises.
Any break in the skin can pennit bacteria to breach
!he skin and cause infection. Cellulitis infections cause
redneu. warmth, and increasod swelling. The infections quickly can become a life tltreatening condition.
Blood Clols: Blood clots arc another complication.
The increased swe lling in Lymphedematous legs
can impede blood flow, causing clots to fonn.
These usually cause pain and increased swelling.
Two Types of Lymphedema: Primary
and Secondary
Primary Lymphedema is inhe,iled. It is caused by
malfonned lymph vcsscls and affects legs more
commonly than other body pans. Congenital Lymphedema is also called Milroy's Disease. It can be
present at birth and manifest in the later yean of lik
This type of Lymphedema may have a trigger, such
as an injury, or bug bite, that causes it to OCCw".
Secondary Lymphedema is not inherited. but is
caused by some son of insult to the lymphatic
syscem. Then: an: many things that can cause injury
to !he lymphatics, among them: canur and the
accompanying lymph node diSS┬лlions; kneelhip
replacement surgery; radiation; bums that destroy
!he lymphatic layer under !he skin; scars that block
lymphatic flow; excess ....'Cight that presses upon
lymph channels and nodes; fractureS or other
inj uries that cause damage to the lymphatic system;
and immobilizing conditions such as paralysis, spina
bifida, and multiple sclerosis which cause swelling
by disabling the musele pump that transports lymph.
Oftentimes, Secondary Lymphedema does not occur
;mrno.:diately after the triggering event. The body
usually has cx~ lymphatic capacity and can do
quite well unless the capacity is somehow exceeded.
This can be caused by anotller injucy or something
as simple as overdoing activity. At this time Lymphedema will begin.
Stage 1 Lymphedema: Aller !he limb has been
affected with Lymphedema for awhile, it progresses
10 Stage 2. At this point, there is noticeable s.....elling
in !he affected area. Pressinga thumb inlO the $\VOllcn
area will not leave much of a dent because the skin is
becoming tighter as the area fills with lymph fluid.
The skin becon-Ies hard as changes occur in !he limb.
Tissue becomes fibrous and hard. This causes
increased swelling, because !he hardened, fibrotic
tissue blocks nonnallymph flow, causing even more
s,,'Clling. The condition is no longer n:versible if !he
limb is elevated. Treatment, however, can return the
limb to a more normal appearance. The hardened
skin is vulnerable 10 cracking and ulcerating, which
in~ a new problem: Cellulitis. Affec1ing !he
soft tissues, Cellulitis is an infection that can be viral
or bacterial in natW"e. Depending on !he 5e\'erity, it
can be life Wcatening.
Srag~ 3
Lymphedema: Occur$ after Cellulitis infec-
tions. The skin is hardened and inelastic and may
have open sores and ulcers. It is difficult to get these
wounds to heal because of!he large amount of skin
tension !he swelling causes. Often lobes of swelling
.....ill appear, hanging down and fonning skin creases
which can harbor fungal infections.
Earty Detection and Treatment Are Key
While Lymphedema is not curable, it can be treated
and diminished. The key is early detection and
treatment A proven method for reduction is the
Massaging Lymphedema l'urnp. This unit lightly
squeezes the limb and literally milks the lymph
fluid that has accumulatod in the tissues. Patients
often feel !he need to urinate this toxic fluid after
treatment It is not uncommon 10 see a 10--1 2%
reduction in limb size immediately following an
initial 45 minute session.
@,:-.....,, "/,;.1 mcn/Ijt//,,,? \#
For more infonnanon, contact the experts at Acute
Wound care, LlC, 239┬╖949-4412 or visit us on li ne at
_____________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - September 2011 Health & Wellness
As Society Ages
By dAna PoroaIli┬╖Blair,AEALTOR
day is
he American family is ever-changing,
and its primary space, the home, has
always changed with il. The present
exception: The largest segment of the
American public. the baby boom generntion, is
enlering retirement age in high numbers, and oonfronling "empty nests" when tile kids go ofT 10
college or marry and move out pennanently. presenting the challenge of what 10 do with the sudden
extra space (since most "boomers" prefer to "age in
place" ralher than leave their long-time twmes).
There is also the perennial family responsibility of
caring for older relatives as lheir health needs
require them to move back in with their grown
children and in.laws. Extended families (including
grandparents raising their grandchildren) have
also bttome more commonplace. Situalions like
Ihese can pose Ihe challenge nOI of how 10 deal
wilh exIra space, but how beSllo add more.
Changes which only affcct the inside of a house
can be the simpler type, but are not necessarily any
easier a decision. However, there are a number of
inviting options to consider. Mature baby boomers
who are ready to enjoy the froits of a lifetime of
work and have the funds to invest in doing so, are
converting the extra space vacated by the kids into
everything from '""wine cellars"' to libraries.
Horne offices are popular,
and tap into a growing trend.
Thcy COrne in handy for
organization and prIvacy.
whelher you've gOI a
business or merely need a
space 10 keep your bills and
personal files straight.
Hobbies are
boomers, so a hobby room
for sewing and other crafts
makes sense. A small horne
gym. with treadmill, wcights
and a TV 10 pass the lime, is
also a good investment for
hoth fun and health.
On the other hand, many of
today's homeowners
opting to add that extra room
- Or rooms - if they don't al ready have one,
for entertaining guests, housing returning relatives. or scl1ing up a separate but accessible
space for an elderly parent Or in-law. Before
you do this. there arc a number of questions to
address, including what local zoning ordinanCeS will allow for additions, and how the
aesthetics and sizc of the addition will affcct
resale value.
"Then: = also family maners to make sun: everyone
understands. While some younger families move
grandma in with them, SOme older ones sell the house
to a son or daughter and move into the addition them_
selves.; in all such silUations. it's important 10 agree
beforehand who owns what part of the house, whether
rent will be charged. who will pay for any extra utility
or propccty-tax costs, and other sensitive issues that
don't have to become divisive ones.
' '' ' ''''''
Face Lif"t
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Health & Wellness September 2011 - Collier Edi t ion
Listen Anxious Heart...
Sponsored By
by Terry Hoskins, Director 01 Oosis
"00 not be anxious about anything. but in everything, by prayer and petilion. with thanksgiving.
present your requests 10 God. And the peace of
God, transcends all understanding, will guard your
hearts and your minds in
eluisl Jesus."
(Philippians 4:6-7, NIV)
Prayer Changes Everything
Paul tells us how to deal with anxiety as we ~ in
the passage above. He tells uS to pray about everything. God's Word also, tells us 10 ')"Iy without
e<=asing." (I Thessaloniam 5:11, ESV) Someone
may ask why is prayer such a vital role to the Christian life? Prayer reveals our dependence on God.
Am I entrusting God 10 guide my life by filtering
my decisions with His guidance, QI" am [ using my
own IQgic and "'awning tQ make life choices?
Prayer measures our depth of faith. Do I pray first
or do I pray when all othcr optiQJIs are exhaustoo? It
seems thai most of us run to prayo:r as a last ditch
efron, when in reality it should be a way of life.
Praying f()l" all things sh<:Iuld be a way oflife!
helpless for theirs is Ihe kingdom of heaven. Those
who have failh arc not controlled by fear, worry, and
anxiC1y. They arc controlled by Ihe Holy Spiril who
resides inside oflhem.
Pray with a Thankful Heart
When we are all!lious we ovo:rlook the key element of
Philippians 4:6 which is "thankfulness." We often arc
consumed by Ihe presenl situation that we face. We
lose sight of God and His Sovereignty, and our
prayers become self-focused. This verse lells uS 10
continue to pray full of thanksgiving because we
rea lize we deserve nOlhing, and yet God CQntinucs
to bless us. "Dll not be an~ious aoout anything, but in
everything, by prayo:r and petilion, with thanksgiving,
present your requests to God." (Philippians 4:6, NIV)
God says stop worrying, stop frelling and start
praying with a Ihankful heart! This is a heart Ihat is
hent On praising and honoring God even in the midst
of lragedy. As we thank and praise God, as we
present our request to Him, He says that "Ihe
peace of God, transcends all understanding. wiLl
guard your hearts and your minds in Christ Jesus."
(Philippians 4:1, NIV) Let us learn to pray w ilh
OUI ceasing. with a heart filled with gratitude. recognizing thai God will ease our fearful and
an~ ious hearts.
Prayer at Oasis
At Oasis we pray because God calls us to pray. We
pray wilh our counselees. We need God's guidance
as we counsel individuals, marriages, and families.
If you are interested in Biblical Counseling please
call us 239-389-2073. May God bless you.
Oasis Q:Io.nseIing Center wants to refrnh y<┬╗I hope, heart.
arid life with Goers Word. We are located on Marco Island and
our phone #389-2073. We are friends of HOPE Coooseling
Center located in Fori Mvm. arid lhei" phone #481-4m.
Prayer Reveals our Dependance
When we read Philippians 4:6 that says,"pray
aoout cverything," (NLD we say "yes we sl>ould
pray ab<:>ut all situations b┬лau┬зe it reveals our
dependence on God, but remember all!liC1y
,'""IIly t,~" do wilh Ihe faci thai we are taking on
and worries thai ,,\e are supposed to be
10 God. The anxiety we experience is
reminding us 10 continue to
~P"'d ,," ,G';' inslead of ourselves. "Blessed are
poor in spirit, for Iheirs is the kingdom of
'(Manhew S:3, NASV) Jesus
f",rul"li "&
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