Category: Health & Wellness

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Ask Dr. Renae: A quandary worthy of Solomon

Dear Dr. Renae,
I have been alternating weekly living with each parent since I have been five years old. My parents explained to me that the judge ordered this plan. The arrangement was one which I never questioned since it feels like it has always been that way. Lately, I have been wanting to have a different arrangement, but I am afraid of hurting the feelings of the parent I want to spend less time with. I also do not want to cause further problems between my divorced parents since they do not get along with each other. I am sure my bringing it up would cause more conflict, but it just doesn’t seem fair that I need to move back and forth each week just because they are no longer married! My friends are encouraging me to talk to my parents rather than waiting another year and a half when I go off to college. I can’t decide if it is worth the risk and I will regret bringing it up.

                                                                                                                                                    Torn at 17.

Dear Torn at 17,
Your parents love you so much and I’m confident they would want to make sure you are happy. If this is something you really think would be beneficial, I would suggest talking to one of your parents about it!! See what they think, and maybe you can come up with a good solution. Listen to your heart and do whatever makes you happiest! I feel that your parents will understand no matter which direction you go.
A Caring Friend

Dear Torn at 17,
It’s very difficult to move your entire life from one house to another every week or so. Your feelings of wanting to spend more time in one house are very valid; everyone deserves to settle down in one place because it helps keep you stable. I believe that if you bring it up in a non-emotional way then your parents may be okay with the change. Tell them that you want to spend more time in one house rather than with one parent. You’re not preferring one parent or the other, you just want to feel settled down and constantly moving is not helpful. I wish you all the best and I hope everything works out.                                                    A High School Senior

Dear Torn at 17,
I always believe communication is key, and I think it is of the utmost importance in your situation. I understand that you are leaving in a year and a half, but your feelings in the present are just as valuable. Every party involved is mature and so you should not be afraid of having conflict. Compromise and discussion are important to have, so I advise having a meeting with your parents whenever everyone is available. I hope everything goes well for you.
Your Fellow Teen

Dear Torn at 17,
I suggest that you consider the time you cherish with each parent outside of the location where you sleep. Your parents will value more time with you in specific activities you enjoy with each of them. You might request a weekly dinner night, movie night, day trip, or time engaged in a shared hobby. Explain to your parents that the time you spend alone in your room, sleeping in your bed under their roof is not the important part of their parenting. If you pair your request for sleeping nightly in the same home with spending more quality time together engaged in enjoyable activities, you will be closer to meeting the needs of the parent whose home you would not be sleeping. Focus your conversation on enjoying the relationship with each parent for now and the long- term future. Keeping your thoughts and feelings to yourself is not emotionally healthy and detracts from the honest relationship you hope to have with your parents. You are in a position to determine the type of communication YOU have with each parent, not the relationship they have with each other. The conflict they have with each other is not your fault, nor are you able to control it. I hope they appreciate your honesty and recognize your efforts to improve YOUR relationship with them. Your parents are so lucky to have you as their child!
Dr. Renae

 

TEENS: Curious as to what other teens would say? If you have a question or problem you would like to present to other teens, please email: askdrrenae@att.net and include your age, grade, and gender you identify with. All questions are published anonymously and your identity and contact information will be kept confidential.

PARENTS OF TEENS: Would you like to anonymously and confidentially ask the panel of teen Peer Counseling Writers to comment on a parenting issue you are struggling with? If you are ready for a variety of honest opinions from real teens, please address your questions to askdrrenae@att.net.

Dr. Renae Lapin, a licensed marriage and family therapist with 40 years experience, currently maintains a private practice in Boca Raton, Florida. For more information about Dr. Renae and her practice, visit her website:

Welcome

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Archery and the awakened self… really!

By Amy Martin

When we think of meditation, we typically think of sitting still, perhaps in a candlelit space, with an abundance of silence, while quieting the mind. When we think of activities and sports that elicit a similar mental focus and meditative effect, we tend to think of more popular sports such as golfing or fishing, or even the more fashionable East Asian influences of t’ai chi and yoga.

Infrequently do we think about archery. Archery has a long history, practiced for thousands of years. We know that ancient Egyptians were among the first to regularly utilize archery in 3000 B.C.E. for hunting and warfare.

However, the oldest remnants of bone and stone arrowheads have been located in South Africa dating back 60,000-70,000 years. Originally devised across cultures as a tool for survival, upon the discovery of gunpowder in 9th-century China and the creation of fi rearms in 10th-century China, archery had become relatively dispensable and obsolete.

Luckily, by the late 18th-century, archery found an enthusiastic revival among the aristocracy and nobility as recreation and sport. In 1879, the National Archery Association of the United States was founded. Today we know this organization as USA Archery, and it is recognized by the United States Olympic & Paralympic Committee.

While archery has evolved and taken many forms throughout the centuries, with many varying intentions — we rarely think about archery as an art form — let alone a meditative practice.

However, dismissing archery as anything but, does a great disservice to this masterful skill, and to the archer, or the artist, herself. There is a great gift to be found in this centuries-old art form, and you may discover that gift within yourself.

My first experiences with archery began as a child with my father and brother. We would travel all over Northern New Jersey in search of outdoor wooded ranges, with our brown bag lunches and moderately-worn gear in tow.

I’ll never forget receiving my first bow (a Bear compound bow, which I still have), feverishly running down the street of my suburban hometown with the bow string drawn, perhaps alarming the neighborhood, thrilled to show my friends. I knew I loved archery from the very beginning.

But as the years went by, I had forgotten about my beloved pastime.

Much later, while in college studying for my philosophy degree, I stumbled upon “Zen in the Art of Archery,” by Eugen Herrigel, a German philosopher who traveled to Japan to study the art, and the practice, of attaining a state of zen through archery.

Much like the revitalization in the 18th-century, for me, archery was discovered once again. I had already been practicing meditation and yoga for years, and I found that my love of archery was still very ever-present.

This simple and profound text had suddenly awakened my spirit, reinvigorated my passion, and taught me valuable lessons about the significance of an awakened self, focused breathwork, achieving a meditative state where all else disappears, and performing complex movements with unconscious control from the mind.

Great archery masters know that where you place your feet, how you maintain your posture, where you hold the bow, and how you breathe when you release the arrow are all determining factors of your end result. The bow itself is a limb, an extension of the archer herself. The breathwork is the lifeforce behind each action.

Nowadays, when I feel particularly stressed, or otherwise not myself, I find myself at the range. Yes, I would say, on those days, I literally find myself there.

If you would like to learn more about attaining your state of zen through the art of archery, visit these websites for local information:

Fort Lauderdale Archers, a private membership club – BYOBow
https://www.fortlauderdalearchers.com/

Go Archery, mobile archery lessons – https://goarchery.net/

Markham Park, outdoor range – BYOBow https://www.broward.org/

Parks/ThingsToDo/Pages/MarkhamParkArcheryRange.aspx

Bass Pro Shops, indoor range – BYOBow https://basspro.com

For my Dad. Thank you.

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Motherhood on the autism spectrum

By Amy Martin

Carly Fulgham is recognized for quite the impressive life and career. She is a mother, wife, and Vice President of Document Services Strategy for a major worldwide bank. She is also the first autistic President of the Board of Directors of the Autism Society of Ventura County, VP of the Autism Society of California, and is on the Board of The Art of Autism.

She was recently a guest on “Spectrumly Speaking,” A Different Brains® podcast, with hosts Haley Moss and Dr. Lori Butts.  Carly explains that for the first twenty years of her life she didn’t realize that she had autism. She had been using workarounds until she experienced burnout and needed Social Security disability.

One day, she found an article about a boy with autism and suddenly her own
disability became clear. She was finally diagnosed at 28 years old. Becoming
involved in the Autism Society shortly thereafter was a no-brainer.

Navigating her disability on her own was one thing, but doing so with children
was another. She knew that she had a complicated medical history and that she (and her medical team) would need to be prepared for her specific needs, and communication was key.

Carly had prepared a very long birth plan, including a huge section about
her sensory issues, and how she might respond to pain and other experiences. She discusses how certain types of touch can trigger her issues, how variations of feather-light touches and knife-sharp pain may cause different reactions.

When she noticed that one nurse during her labor communicated differently than her, she politely requested a different nurse, and possible miscommunications were averted. She even prepared for the
sounds and the chaos in the operating room by wearing noise-canceling
headphones.

Carly stresses that many women don’t even fi nd out that they have autism
until their own children are diagnosed, meaning that maternity nurses have likely cared for plenty of undiagnosed autistic patients. She says the nurses are, “Used to all kinds of sensory things like, ‘I have to have low music playing,’ or ‘I have to have this lavender scent’ or ‘I have to have it scent-free.’”

Haley Moss adds that there already exists a bias in medicine for women,
and for autistic people in particular, where pain is often not taken seriously
or believed. She shares her own fears on becoming an autistic mother in the future, asking, “What if I’m in pain and someone doesn’t believe me because they think autism impairs my sense of judgment?”

Carly explains hospitals in general have a poor system for pain scales, replying
that often only a diagram with facial expressions and numbers is available to
measure pain. For the autistic patient, this vague representation may be difficult to understand. Someone’s level four pain may be someone else’s eight. Carly stresses that you have to be really descriptive, giving
examples like “It feels like someone’s stabbing me with a knife”, or “It feels like ants are crawling on me.”

Carly notes that through her non-profit work, her autism, and the awareness of
the developmental stages have helped her become a better mother.

She recounts a story about her son from before he could talk, where they were
sitting at the breakfast table and he started screaming. Carly says she took
a moment and thought, ‘Okay, there’s something that’s upsetting him’. So she
followed his eyeline and he was staring outside in the backyard at a blue ball.
She asked her son, “Do you want me to put the blue ball away?” and he nodded
his head in the middle of his wailing. So Carly went out, put the ball in the box it’s normally kept in, and he instantaneously stopped screaming.

For more of this conversation you can listen to the entire podcast, or read the transcript, here:

https://www.differentbrains.org/motherhood-on-the-autism-spectrum-with-carly-fulgham-spectrumly-speaking-ep-107/.

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Ask Dr. Renae: Worried about the cost of the COVID school gap

Dear Dr. Renae,

I hear some teachers commenting on this school year being a lost year and all the students winding up a year behind. I am aware that I didn’t learn as much as I would have since online was not as good as in person for some subjects. I worry about being prepared for college entrance exams and college coursework. I am even more worried about my younger sister who is struggling to learn how to read. I notice how frustrated the teachers are as well. Many of my peers are upset about missing out on social activities but I am thinking about my future. Am I weird for worrying about my education?

Unprepared High School Junior

Dear Unprepared High School Junior,

It is completely normal to be worried about your education! Education is a major cornerstone in our lives, so I understand where you are coming from. It helps to remem-ber that every person in the world is facing the same issue that is happening to you, and so I believe people will be more mindful and understanding of the circumstances you have come from. You could not control the cards you were dealt, and educators know that. It is my belief that they will have to be accommodating to any issues that may arise from online education, if they would want to dutifully fulfill their jobs. Hopefully, I assuaged some of your fears, and I wish you the best of luck in your academic journey.

Your Fellow Teen

Dear Unprepared High School Junior,

It’s completely understandable being concerned about your academics. Commendable, even. Whilst students have been heavily affected by this pandemic, it’s important to re-main optimistic. Junior year is a crucial time for prospective university students but with everything going on, universities might be lenient with requirements. Now is also a fantastic time to build your student resumé. If you haven’t already decided on a university, now is the perfect time to take a look and reach out to universities. This is the fun part! As far as preparation goes, there’s plenty of practice SAT samplequestions available online as well as books to read. It’s important to be studious but not too hard on yourself. Stay safe!

A Caring Friend

Dear Unprepared Junior,

You are not weird for worrying about your education at all. From reading your submission, I can tell you care about your education which is really important. Since I’m not in college just yet, I asked my 25-year-old sister for some advice I could give you. The best thing she told me was from her college experience, as long as you keep up your studying, work ethic and motivation, you will be fi ne. To tell you the truth, she told me that high school did not prepare her for college; college prepared her for college. Stressing right now over something you don’t know will happen will drive you crazy! It’s best to start good habits during online school that you can later use in college. I hope this helps!

Your Friend

Dear Unprepared Junior,

It is true that most students did not learn as much academic curriculum as they would have if school was in person as usual. The timing and speed at which learning takes place, however, is not indicative of future happiness and success. Many professionals took an unexpected alternative path and timeline in preparing for their career which helped better lead them toward  success. Struggling with the lifestyle changes required during the pandemic has given you an opportunity to learn much more than academics. Conquering boredom and anxiety, along with navigating a new daily structure has taught you flexibility, creativity, and perseverance. Those skills help you to be significantly prepared for college as well as your future. Take pride in the personal growth you have experienced in order to acquire more confidence in your ability to adapt to the future.

Dr. Renae

 

TEENS: Curious as to what other teens would say? If you have a question or problem you would like to present to other teens, please email: askdrrenae@att.net and include your age, grade, and gender you identify with. All questions are published anonymously and your identity and contact information will be kept confidential.

PARENTS OF TEENS: Would you like to anonymously and confidentially ask the panel of teen Peer Counseling Writers to comment on a parenting issue you are struggling with? If you are ready for a variety of honest opinions from real teens, please address your questions to askdrrenae@att.net.

Dr. Renae Lapin, a licensed marriage and family therapist with 40 years experience, currently maintains a private practice in Boca Raton, Florida.

For more information about Dr. Renae and her practice, visit her website: https://askdrrenae.com

 

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One year anniversary of COVID-19

Believe it or not, March marks a year since our lives changed drastically. At the beginning of March 2020, COVID-19 spread throughout the world, requiring individuals to forgo their usual routines and adapt to a new lifestyle. Now, a year later, we are living our lives very differently.

Not only are we more conscious of our surroundings, but we are more hygienic. For example, if you go to a store or a gym, you will see employees or trainers sanitizing equipment and merchandise every few minutes. We spend more time washing our hands and taking care of ourselves than we ever did before.

“I forgot my mask!” is a common phrase you catch yourself saying, and traveling out of the country or state is an all-too-real distant dream. With all the isolated time we have been given during the pandemic, we have learned how to slow down, organize our homes and closets way too  many times, bake banana bread, and enjoy the outdoors.

With all these new hobbies we have acquired, all we want to do is to continue living our lives the way we did a year ago, but it is not that simple.

University of Michigan senior, Donna Neuman, longs for an in person graduation ceremony more than anything. “I really just want a graduation and nothing else right now is important to me. My friends and I have turned a lot of negatives into positives; for example, instead of going out with friends we hang in together. Those things are replaceable, but graduating is not.”

Our lives have changed in many more ways than one. As we sit and reflect on the one-year anniversary of COVID-19, it is hard to believe that it has only been a year.

When I think about the timeline it almost feels like a century. Masks are a part of our uniform and getting tested for COVID is the new trend.

Since it is risky for older adults with health restrictions to spend time with their younger loved ones, we have utilized FaceTime or Zoom to still get our personal family time.

Fortunately, the vaccine has been distributed to many essential workers, and soon to the rest of the world.

With the new year, all we can hope for is to say goodbye to COVID-19 and hello to living. By March 2022, I hope for good health, love, and for our lives to be more adventurous and spent with the ones we love most.

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Virtual care becomes new standard in era of COVID-19

The coronavirus pandemic has forced a reshaping of the landscape of healthcare, requiring the medical community to look for new, safer approaches to patient care.

To keep patients and team members safe, virtual visits are now conducted via remote communication technology, such as Telehealth and Telemedicine. This is the new normal of patient doctor interaction, and represents a new era of healthcare delivery, and one that will continue into the foreseeable future.

As the pandemic continues, frontline workers at doctors’ offices and hospitals have been put to the ultimate test. In response, new and better programs of communications via Internet technology were enhanced, and audio check-ins restructured. Through telehealth and telemedicine, doctors and nurses can now engage patients via digital devices to meet basic healthcare needs.

During the height of the pandemic, most elective procedures at hospitals and doctors’ clinics were cancelled. With new variants of the virus threatening the country, a new challenge has been created. With elective procedures canceled, questions arose on how to safely care for emergency and non-emergency patients in a safe environment.

The solution was a broadening of virtual care to interact with patients, maintain safe environments, and adhere to mandated social distancing guidelines. The Centers for Medicare & Medicaid Services (CMS) increased access to Medicare telehealth services so beneficiaries could receive a wider range of care from their doctors without them having to travel to a healthcare facility.

“To protect both staff and patients, some medical practices closed their doors to in-person visits because of concerns over the risk of transmission,” said Randall M. Taubman, M.D., CPE, regional medical director at ClareMedica Health Partners LLC, Miami Lakes. “We remained open; our staff wore personal protective equipment (PPE) and each patient was thoroughly screened. Anyone screened as a possible COVID candidate was seen remotely.”

According to Dr. Taubman, video-based visits are preferred and more effective. “The doctor and the patient can see each other and it’s a more natural interaction,” he said. “Plus, if there are any physical changes, doctors can analyze the problem, and that’s a big benefit over an audio virtual visit.” Differences also exist between the way medical codes are applied and how video-based visits are billed.

Scheduling a remote health visit
Telehealth visits can be Web-based or done through a phone call to the office, but prior to the online interaction, most practices require verification of identity and insurance information. “Patients must consent to this form of care, and when they ‘meet’ with their doctor, the visit is conducted in much the same way as an in-person visit,” said Dr. Taubman. “The one exception is that doctors may ask additional questions about a patient’s general health and well-being.”

Before opting for a telehealth or telemedicine visit, patients should make a list of questions. They should also be prepared to explain any symptoms and list medications, dosages, and times they are taken daily.

“The best way to prepare for a virtual health visit is to find a quiet, private room where there are no distractions,” Dr. Taubman said. “Patients need to download any applications needed for the two-way communications and decide beforehand if the visit will be done on a computer, tablet, or phone. The doctor’s office needs to be aware of the patient’s choice. When prescribing medications, doctors still use electronic prescribing to send the script to a pharmacy — a routine practice even before the start of the COVID-19 pandemic.”

A new revenue stream
Reaching out to patients and serving them remotely is now a necessity to sustain physician practices. It is even a benefit to hospitals where there has been a revenue decline in long-standing money-making units such as operating rooms, interventional radiology, and outpatient services. Virtual care is now a proven means of caring for patients safely while tapping into a revenue source that helps offset the decline of in-person visits.

Over the months, regulatory and reimbursement barriers that hindered the widespread use of telehealth were relaxed, allowing providers more freedom to use virtual care for their patients. The Centers for Disease Control (CDC) says that during the first quarter of 2020, the number of telehealth visits increased by 50 percent. This allowed providers to scale their technology, learn more about various platforms, and reshape strategies that would be the most benefit to patients.

The difference between Telehealth and Telemedicine
The words “telehealth” and “telemedicine” are sometimes used interchangeably, but they don’t mean the same thing. The Health Resources Services Administration (HRSA) says telehealth is the “use of electronic information and telecommunications technologies to support long-distance clinical health services, patient and professional health-related education, public health, and health administration.” These technologies include videoconferencing, the Internet, store-and-forward imaging, streaming media, and wireless communications. Telemedicine, however, refers to “specific remote clinical services.”

Both play a critical role in the new era of patient care. Virtual care allows doctors to communicate with patients at a variety of locations that include their residence, a nursing home, an emergency room, or specific divisions within hospitals such as wards, special care units, and even psychiatric units. In addition, access to remote care greatly reduces the potential of exposure to the virus and lowers demands on frontline workers.

Types of remote visits
The three basic types of access routinely used are: Medicare Telehealth (MTH) visits, Virtual Check-ins (VCI); and E-Visits (EV). MTH utilizes telecommunication systems between the provider and patient and may include office visits, out-patient visits, or consultations. The VCI is a brief phone check-in with a practitioner to discuss whether an in-office visit is required, or a remote evaluation can be conducted where a patient can submit images (as in the case of dermatology) to his or herdoctor for  evaluation. The EVs are a format to communicate between patient and provider via an online patient portal.

Telehealth popularity
According to the CDC, the number of telehealth visits in the U.S. increased by 50 percent during the first quarter of 2020 and providers reshaped their strategies to engage with patients. “The use of telehealth is a trend that I don’t foresee diminishing even if COVID improves,” commented Dr. Taubman. “It can help with physician shortage and travel issues in the medical industry, so I believe it’s here to stay.”

According to a Telehealth Impact Claims Analysis conducted by the COVID-19 Healthcare Coalition Telehealth Impact Study Work Group, the latest numbers on telehealth claims in Florida peaked at around 700,000 in April of 2020, and the primary diagnosis of circulatory issues exceeded 200,000. Claims nationwide for circulatory issues in the country exceeded five million in February of last year, and total claims exceeded 12 million.

New advances in digital health technology have transformed patient treatment models internationally. Greater access and more efficiency are the keys to serving patients in the era of COVID-19.

 

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Stretch Zone for 2021

Looking for a solution to help relieve the aches and pains of everyday activity? Stretch Zone of Coral Springs provides guests with Flex-ability for Life. Using proprietary stretching methods and a patented stabilization system, Stretch Zone seeks to improve guest health and wellness through practitioner-guided
stretching.

For more than 15 years, Stretch Zone has helped many individuals seeking a solution to help them feel better and live life to the fullest. Stretch Zone facilities offer a welcoming environment, knowledgeable staff, and comfortable equipment, all of which allow clients to relax and fully benefit from our methods.

Whether you are a professional athlete, week-end warrior, or senior, ages 14 to well over 100 are welcome. Come and see how we can help you with a complimentary first stretch class.

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Stretch yourself

Looking for a solution to help relieve the aches and pains of everyday activity? Stretch Zone of Coral Springs provides guests with Flex-ability for Life. Using proprietary stretching methods and a patented stabilization system, Stretch Zone seeks to improve guest health and wellness through practitioner-guided stretching.

For more than 15 years, Stretch Zone has helped many individuals seeking a solution to help them feel better  and live life to the fullest. Stretch Zone facilities offer a welcoming environment, knowledgeable staff, and comfortable equipment, all of which allow clients to relax and fully benefit from our methods.

Whether you are a professional athlete, week-end warrior, or senior, ages 14 to well over 100 are welcome. Come and see how we can help you with a complimentary first stretch class.

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A “hip” approach to state-of-the-art care

Dr. Leone’s specialized surgical approach, combined with personalized care, linked to faster recoveries for hip and knee patients.

More than a decade ago, Dr. William A. Leone, head of The Leone Center for Orthopedic Care at Holy Cross Health in Fort Lauderdale, made an intentional and compassionate decision, transforming the patient care model for his orthopedic practice. It was founded on his vision of providing state-of-the-art orthopedic care while treating every patient with how he would want his family members, and himself, cared for.

Dr. Leone’s unique integration of clinical, surgical, and technological expertise, combined with caring, personalized attention from him and his entire staff, have helped restore mobility and improve the quality of life for thousands of patients from throughout the United States and around the world. He cares for people in their 80s and 90s who refuse to relinquish their independence and opt for surgery to regain their quality of life. He also treats patients in their 20s and 30s who desire an active lifestyle and want to feel “normal” again.

His comprehensive and patient-centered approach begins with the initial consultation and persists throughout the entire post-operative period. Patients are guaranteed increased availability with Dr. Leone and his entire staff, work with a designated and responsive patient liaison, and are educated on what to expect throughout the entire process. This ensures each patient’s entire experience is as positive and comfortable as possible, resulting in successful results and faster recoveries.

“A wonderful trend I’ve seen over my extensive career is that each year my patients are getting well faster and recovering easier than ever before. My surgical procedures are more precise and reproducible and today’s implants are vastly improved compared to years prior,” said Dr. Leone. “Combined with less invasive and more anatomically-sparing surgical techniques and my emphasis on preempting, preventing, and down-regulating pain have all led to patients getting well faster than ever before and regaining their quality of life.”

To avert pain, medication begins prior to surgery, special anesthetic techniques combined with local injections and nerve blocks, gentle soft tissue handling with precise soft tissue balance, and post-operative medications from different families of drugs taken on a schedule, have all made a world of difference. One of the reasons Dr. Leone’s patients recover so quickly is that they are well prepared for their surgery. When patients go into surgery knowing what to expect before, during, and after their surgery, they are less anxious, recover quicker with more confidence, and have an overall superior experience.

“In my experience, a respected, well-informed patient not only has a faster, smoother recovery but also a much better experience, which contributes to a superior outcome,” said Dr. Leone. “Choosing the right surgeon with the right team and at the right hospital is critically important. Education combined with confidence are key ingredients for success.”

Dr. Leone encourages anyone considering hip or knee surgery, to browse his website. He’s written more than 100 blog articles; some are shared thousands of times each month. There is a section on “Frequently Asked Questions,” and he’s particularly proud of the hundreds of inspiring testimonials from patients who share their gratitude and inspiring stories.

The Leone Center for Orthopedic Care provides superb, highly personalized, orthopedic care for people with arthritic hip and knee conditions and for patients who develop problems with a prior joint replacement. Dr. Leone offers patients the latest, most-promising innovations for joint replacement surgery in a compassionate, patient-focused setting. He has performed over 13,000 joint surgeries throughout his career, restoring mobility and improving the quality of life for thousands of patients from around the globe.

The Leone Center for Orthopedic Care at Holy Cross Health is located at 1000 NE 56th Street in Fort Lauderdale. For more information or to schedule a consultation, please call 954-489-4575 or visit holycrossleonecenter.com.

 

 

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Ask Dr. Renae: Teen protecting endangered family member is not alone

Dear Dr. Renae,

A member of my immediate family living in my home has a medical condition which makes them immune compromised. Out of love, respect and fear for their safety, I have limited my social interactions. My friends understood at first but have begun subtly pressuring me to go out. I feel very left out, and it really makes it so much harder since I am missing out on so much. I am also worried about infecting my family member, so I have not even been attending school in person. I feel isolated and may be becoming depressed. I just want my friends to understand.

Alone at 17

Dear Alone at 17,

Your concern for your family is very honorable. You’ve made the right decision by staying home to keep your family safe. I would suggest talking to your friends and explaining to them how you feel and why you don’t want to go out. I would hope that your friends are mature enough to realize that you are making the right choice in staying home. After that I would suggest just talking to them over the phone or having zoom nights together. There’s a lot of online games that you and your friends can play together, or you can just relax and talk to each other. Remember that you can always have fun even if you’re not physically together. I wish you the best of luck.

High School Senior

 

Dear Alone at 17,

You are not alone!! There are so many people who are going through the exact same thing as you. I think that you are being very responsible and caring, and I’m sure your friends will see that! I suggest finding a group of people to have nightly zoom calls with and plan fun things to do together on the phone. Another example is to ask your friends to have a socially distant lunch!! I for one have been extremely cautious during COVID like you and one thing I have done to see my friends is having a socially distant lunch or hangout! You pick an outdoors area and go separately with your own blanket and sit apart in a huge circle… lots of feet apart! During these trying times, it is definitely important to find people that can support you on your off days. I hope you are doing well.

A Caring Friend

Dear Alone at 17,

I have people around me who also pressure me to go out, so I completely understand where you are coming from. I found the best way to remedy the situation is with communication. It may help to communicate with your friends through a video chat or voice call  about your experience with the pandemic and how you feel left out. It would also be helpful to come up with some stay-at-home events your friends can do together. I suggest game nights, powerpoint nights, or just chatting on the phone. I hope you don’t feel so alone in the future.

Your Fellow Teen

Dear Alone at 17,

It is inconceivable to be robbed of your much anticipated social year and normal for you to feel a loss. Your love and respect for your family is admirable especially for a teen. You sound like you are comfortable with your decision, an important predictor for your ability to make future difficult decisions. Friends who acknowledge and respect your choice will likely stand out head and shoulders above those friends who do not understand. Focusing your attention on these true friends will likely bring you more comfort than focusing attention on those who regrettably surprised you with their lack of support. True friends will find creative ways to remain connected to you, especially now when you need your friends more than ever. In addition, when you are able to finally socialize in person, it will be helpful to know who your true friends are so you can count on them in the future.

Dr. Renae

 

TEENS: Curious as to what other teens would say? If you have a question or problem you would like to present to other teens, please email: askdrrenae@att.net and include your age, grade, and gender you identify with. All questions are published anonymously and your identity and contact information will be kept confidential.

PARENTS OF TEENS: Would you like to anonymously and confidentially ask the panel of teen Peer Counseling Writers to comment on a parenting issue you are struggling with? If you are ready for a variety of honest opinions from real teens, please address your questions to askdrrenae@att.net.

Dr. Renae Lapin, a licensed marriage and family therapist with 40 years experience, currently maintains a private practice in Boca Raton, Florida. For more information about Dr. Renae and her practice, visit her website: https://askdrrenae.com

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Simple but savvy moves for heart health

This month is all about hearts, love, and adding a little TLC to your everyday life. February is American Heart Month. This month is dedicated to driving awareness around heart disease, or cardiovascular disease (CVD). These are the leading causes of many health-related issues that can not only affect your ability to work, but impact your overall quality of life.

It’s important to know that some of the at-risk factors to heart health issues include poor diet, being overweight and lack of physical activity. To ensure that you’re on the right track to improve or maintain a healthier heart, show yourself a little more love by following some of these recommended adjustments for improving your diet by managing your portions and staying active.

Improve your diet

• Start the day with a low-fat breakfast. Try these simple ideas:

• In an electric blender, process 1⁄4 to 1⁄2 cup vitaminwater zero, 1 6 oz. carton Greek Style yogurt, and 1⁄2 cup fresh or frozen fruit to make a fruit smoothie.

• Spread toasted multi-grain waffle with 1 tablespoon peanut butter.

• Top oatmeal with chopped apple, raisins, or 1 tablespoon chopped walnuts.

• Eat every three to four hours or five to six times a day; this prevents you from becoming too hungry.

• Stay hydrated, drink plenty of water –eight to ten glasses a day will keep you hydrated. If you are looking for hydrating options in addition to water, try flavored varieties such as vitaminwater zero or sparkling water. Most importantly, remember that all beverages hydrate. Thirst is an indicator of dehydration and sometimes thirst is confused with hunger.

• Include more fiber in your diet such as whole grain breads and cereals, beans, legumes, and nuts. Higher fiber will aid in helping you feel full.

• Include more vegetables and fruits—these too will help fill you up, and not out.

Manage weight with right-size portions

It’s important to have a good relationship with food, so my mantra is “all foods and beverages can fit into a balanced diet in moderation.” Below are some guidelines to help you keep portion control in mind and some products that can help you do so.

• Choose 3-oz. portions of lean meat, fish, or poultry. This is a serving about the size of a deck of cards.

• For fruits and vegetables, consider a portion about the size of a baseball. If you enjoy avocado, go for one-half of a medium avocado.

• Servings for grains, beans, and legumes should compare to the size of an adult fist.

• Beverages also come in perfectly-portioned sizes. Coca-Cola has mini-cans available at about 7.5 ounces.

Keep it moving

Regular physical activity and exercise can have long term positive effects along with reducing the risk of developing cardiovascular disease. By getting your body moving, you can improve control of your weight, combat heart disease, increase your energy and mood, decrease stress, and improve your sex life.

Scheduling the time to exercise on your calendar will help make it part of your standard daily routine. If you cannot set aside a 30 to 45-minute block of time, do several 5-10-minute segments daily. The buddy system works well here—having a friend on board will help keep you both motivated and on task.

Take Away: Focus on heart health this month. Start to make life long changes to your lifestyle choices and show a little love to your heart and those you care about around you.

 

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Broward Health Coral Springs offers elite cardiac services

For many years Broward Health Coral Springs (BHCS) provided cardiac care services to the community, but one key component was missing—a cardiac catheterization lab for emergency catheterizations. Subsequently, patients were transported to other facilities, but that’s no longer the case.

Last June, a new state-of-the-art cath lab became operational at BHCS. “We now have the ability to care for specifi c patients with ST Elevation Myocardial Infarctions (STEMI),” said Mohamed Osman, M.D., director of the Cardiac Catheterization Laboratory and specialist in Interventional Cardiology at BHCS. “This is a unique opportunity to provide an even higher level of care through angioplasty procedures.”

Designated as a Level 1 Heart Program by the Agency for Healthcare Administration, the new cath lab was termed a “milestone” by hospital CEO Jared Smith, one that “increases our ability to provide a high level of care and uphold our recognition (per Our City Magazine) as the area’s best hospital and Emergency Department.”

Gary Lai, D.O., and chief of Emergency Medicine says the addition of the STEMI heart program makes it possible for EMS to pre-alert the ER and send electrocardiograms prior to a patient’s arrival. “We can prepare immediately to stabilize, medicate, and expedite patients to the in-house cath lab,” he said. “This saves lives and maximizes outcomes.”

The new catheterization lab allows BHCS specialists to perform invasive cardiac procedures and utilize advanced imaging for diagnoses by using contrast dye to determine the severity of the arterial blockage. Once identified, a balloon angioplasty is performed, or a stent is inserted to clear the artery and save as much of the heart muscle as possible. Pacemakers and defibrillator implant procedures are also performed.

Generally speaking, the last 20 years has seen a rapid transformation of new techniques focusing on minimally invasive procedures, rapid care, and shorter hospital stays, according to Dr. Osman. “Although open heart surgery is certainly an option, the major shift has been toward less invasive, less traumatic procedures that obtain excellent results.” People with severe heart valve problems always required open heart surgery. A significant number are now treated with stents to reduce the risk of a major heart event.

Surgical progress in cardiology can be defi ned by an alphabet soup of acronyms: SAVR (Surgical Aortic Valve Replacement); CABG (Coronary Artery Bypass Graft); BAG (Bilateral Arterial Grafting); PCI (Percutaneous Coronary Intervention); TAVR (Transcatheter Aortic Valve Replacement); EVAR (Endovascular Abdominal Aneurysm Repair): and ICD (Implantable Cardioverter Defi brillator). The term Electrophysiology refers to leadless pacemakers and remote monitoring devices. “Because of these techniques, patients spend less time in the hospital, recover faster, and there’s less trauma to the body,” said Dr. Osman. “An aortic valve replacement once required open heart surgery, but now the TAVR procedure accomplishes the same goal by inserting a transcatheter through a small incision in the groin.”

Surgical complications 

Any medical procedure has the potential for complications such as excessive bleeding, stroke, and even death, but the key is how often complications occur as a result of surgery. “Both minor and major complications are possible, but keep in mind that no patient is the same,” said Dr. Osman. “If a younger patient requires open heart surgery the only problem is the heart and nothing else, so the focus is isolated, but older patients—especially those with underlying conditions such as diabetes, kidney problems, or a previous stroke, are in a high- risk category for complications,” the specialist said.

To show that one size doesn’t fit all, Dr. Osman uses the example of two patients with the same high percentage of blockage that would be treated differently. “The one who is asymptomatic can be treated with medications and dietary changes, while the other who has difficulty breathing and may have underlying medical conditions is a prime candidate for a stent.” He reminds us that everyone is different, and each patient requires a different mode of treatment depending on general health and underlying conditions. “The key is a full evaluation to create a treatment plan with the best benefit.”

Dr. Osman refers to the doctor-patient relationship as “the art of medicine.” The unique relationship includes listening, evaluating, diagnosing, and treating. “At the end of the day when pieces of the ‘puzzle’ come together it’s the collaboration between the surgeon and interventional cardiologist that makes it happen,” he said. He recently saw a patient with a 90-percent blockage of the artery. CABG open heart surgery was performed, and the person is expected to make a full recovery. Choosing the right therapy is the goal.

The COVID consequence

When COVID’s first wave peaked in March 2020, it impacted cardiology services.

With a focus on caring for acute COVID patients, the shift was away from elective cardiac procedures. “Many patients feared coming to the hospital out of fear of COVID and that posed a huge problem,” said Dr. Osman. “In cardiology, time is a big factor and the longer treatment is delayed the worse a condition can become.” He cited a patient who suffered a heart attack yet remained at home for two days. They were able to save his life, but the heart muscle was significantly damaged and he’s now living with a very weak heart muscle. “Things like this are still happening but not to such a high degree. Remember that the margin of error is much less with age,” he said.

The medical facility keeps a log on how long it takes after arrival in the ER to when a clogged artery is opened in the cath lab. According to Dr. Osman the best time to date has been 23 minutes.

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