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in Urology. This compreOen~ ptostate caocel
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aoo led by William Fig lesthaler, Mo, a ooard
certified urologist and expe<! in perfOlming
centers in N<lpies, Bonita
Since founding the da \/loci" robotic surgery
program in Soothwest Florid! in 2005, Or.
Fig lestha1er h115 performed thousands 01
successful robOIic procedures on patients from
aoo
FOIt
al Specialists in Urology include twelve bo.lrd
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Or
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Contents December 2011
6 Controlling Cra....ings:
20
8
23
Strategies for 51 rress
Prostate Specific Antigen
Effect ive Treatment Options
for Low Back Pain
SeeSpol.
See Spot
Change.
Female Sexuality
Inaccurate Blood Test Versus
lifesaving ScreerWIg Tool
9
Happy 50th Birthdayt
Now, What About Yo..- Health?
24 ""'"..... '" \VOght """
25 we;.. e~ I Face Uft: The M
of Facial Rejuvenation
1 a The AGE-ing Process: Staying 26 ct......... ">l the RiIjrt Restoration
Young by Eating Smartl
11
VAX-O Therapy Relieves
27
Put Your Best face Forward
See Riverchase Dermatologv.
this Holiday Season!
Back Pain
14 ArttYitis of the Foot and Ankle 29
16 Help for Depression
Overcome the Blues this
Holiday Season
18
31
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Difficulties to Emot ional
Problems... We Can Help!
Spiritual Wellness
Down With Groan Ups!
Prepare Now to Transform
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19 A New Concept to Change
the Way We Exercise!
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6
Health &. Wel lness December 2011 - Collier Edition
hick & Thin
CONTROLLING CRAVINGS:
STRATEGIES FOR SUCCESS
By Dr. Caroline Cederquist and AnneElena FootBf
CM*!at ...tIen they feel like Webrating. ...tIen they are hlMng
fun with friends, Of ...tIen they just find themse/Ves in an
unusualI)' good mood . Good food is an enhar.cement to most
enp,-able e.>:periences.
o mall)' cha llenges. You m/ly !\ave
holiday parties to SUrvive. You\<e got
holiday treats in the fridge and a host of
cookies and candies and other ~Oes
that everyOne will bring in to work and
leave lying tantalizingly around.
But )'Ou\oe got also )'Our New Yea~s resolution, howewr
)\luVe flamed it this ~J-no caros, less fats. better
exercise, more ffesh fruits and vegetables- and )Olj're
already warming up to it.
so pemaPs !<lure steeled 8g;linst those scattered temJ)lations. M8\'t)e IWW armed }(IurseW with little reminders of )!l'Jf motiVations for eating better, losing weight
arid getting healttly. Maybe )Uure making ~ easier by
exiling the jun~;ou used to eat and getting the house
stocked with the good foods ;ou should be enjoying.
But no matter ""'at else )UU do, )UU're still going to
haw cravings that hit )UU out of nowIlere. Irs like
having a guerrilla enemy trying to undermine )(Iur best
dietary intentions. These recurrent, unwanted urges
can derail )Uur weight-loss efforts and erode )(Iur confidence. But)Uu don't have to let them.
I reall)' canl CM*!mphasQe the significance CfIlYings have for
people with entrellChed weight issues. They are a big pan of
the problem. M a result. we put some considerable effort into
helping people identify and unde!stand theirindividualtril?8lS.
and ultimately break the assodatioos that cause them.
But even if JOU don~ have a structured approach for
breaking the root of the craving problem, there are th ings
JOU can do to effectively respond ""'en a craving arises, SO
we've created a defensiVe arsenal for )(Iu.
Distraction
There'S a saying: "II )(Iu don~ like hOW JOU're feeling. change
""'at JOU're doing," You can apply ~ to almost arry leeling,
but ~·s especially helpful for dealing with the urge to eat A
simple shift in )Uur current activity is often all ~ takes to
derail a craving, instead of letting the craving derail )(Iu. SO
""'en)(lu feel a craving about to oYerwhelm )(Iu. do some·
thing else.
Think about )Uur dream vacation. Get out 01 the house and go
for a walk. phone a frieI1d. anyth ing to take )OUr attention ~~
from the urge to eat If jOUVe armed JOUrself with a list or
notecards itemiIing )OUr motiVations for losing weight. by all
means. take a momem and read those. preferably out loud.
TypOcally. JOU onl)' have to distract )(Iursell for a brief period.
as cravings typically pass with in minutes or eYen seeonds.
But if cravings bombard )UU all d~ long, confronting the
enemy may be a better strategy.
Understanding the Enemy
Cravings result hom various physical, psyeholog;cal and
environmental fac:tors that affect the w~ )(Iur body and
brain function . The causes tall roughl)' into four genera l
categories: time of day. places. actMties and feel ings.
Most people feel hungry around "dinner time," whatever
that is for them. Going to )(Iur mothers house, Of eYen
past the local donut shop, can stimulate a desire to
eat Watching television is an activity that's notorious
for raising the impulse to eat
Confrontation
The confrontation approach pits )Uu against )(Iur urges as
though the)' uul)' were )OUr foe. If)(lu are struc~ by a craving
for ice cream,)(Iu can pretend the craving is another person
trying to COrMnce)(lu to eat the ice cream , You can argue
with this person and assert that)(lU will not succumb, and
state )(Iur reasons why not
Anotl1er approach is to visualize the food itself. cartoonishfy
animated and beckoning)'Ou with promises of lulfillment
But jI:IU are a th inking, reasonable being, You wil l not be led
Emotions can be the most compelling stimulus of all.
astra)' by a mere carton of ice cream. You recognize the
Marry times. uncomfortable feelings such as anxiety or
craving aoo take charge. You can tell it. "You are but a
resentment cause people to reach for food. But good
passing urge. You are not the boss of me. I am in control 01
feelings can trigger an eating spree, too. Many people
my own life and my weight." End 01 dlscusskln.
_____________________ www.swfHealthandWeliness.com _____________________
Collier Edition· December 2 0 1 1 Health & Wellooss
7
Commonly Asked Vein Questions
By Dr. Johrl P. larldi. MD. FAGS, RPVI, RPhS.
~le (J
arirose and Spider Veins affect millions
01 people lI'ItIu!tW 1he 'IO'd. 00Is1he last
ten years the treatment of bQth Varicose
and Spider Veins has chan~ drastically.
Initially. tile only 8'l8llable treatmenl for Varicose Veins
was a radical surgical procedure called 'ligation and
Stripping"""'ich required multiple incisions and multiple
stitclles. this has now- been replaced by teehnlques that
close the leaking I'aNes of the veins with either a Laser or
Radio Frequency instrument Spider Veins""'ich were ini·
~ally treated only with an IrritaUng sal ine solution with
multiple potential side effects has largely been replaced
by Foamed SClerotherapy, ,.."ich has ellOOllent results
and very few side effects.
In my vein practice there are a multitude of commonly
asked qves~ons concerning veins and these will be
addressed in the next few paragraphs,
What CaLises Varicose Veins?
this Is the most common qves~on proposed 10 me.
Varirose Veins have marly laClOl'S that can lead 10 their
formation, The most common reason for Varicose Veins to
form is strictly a heredit)' component If one's mom or
dad has Varicose Veins then there is a strong propensity
for this to be passed on to their children,
The second most common cause of Varicose Veins in
women is pregnancy. This is due to the uterus putting
pressure on the pelvic veins resulting in weakening of the
l'alves leading ultimately to Varicose Veins, Other
common causes of Varicose Veins are trauma, prolonged
standing. aging and prolonged inactivit)',
What are the complications of
Varicose Veins?
Varicose Veins can lead to many potential complica·
tions. These can inClude clots in the veins called
·Superficial Ph lebitis· or ·Superficial ThrombQphlebi·
tis.· In addition to this. Varicose Veins can bleed. They
can cause ·Ulcerations" and they can lead to a condi·
tion cal led ·Chron ic Venous Insufficiency· ,.."ich is a
discoloration and swelling of the leg from backup of
blood over a long period of Ume.
The Amer\carl Board (J PIieboIogy
What happens to blood In the leg after
Varicose Vei ns are treated?
This IS one of my most cummonly asked questions in
patie nts who undergo Laser Ve in Ab latio n_ One must
remember that Ihe Saphenous Vein is a Superficia l
Ve in _So, In treating th iS \'e ln ~'e are only treating \'e ins
in the Supe rfi cia l System. There are actually three
leve ls 01 veins in the body_ A Superficial Syslem, a Oe€P
System and a Connecbng System_ The Deep and Connecti ng Systems are not louched, therefore. once tile
Supe rfic ial System is closed, blood wil l ~ow norma lly
through the Co nn ecti ng Syslem to the Deep System
withOut any change In the functio n ol the leg
What Is Phlebitis?
Phlebitis is essentially an inftammaton of the veins and
there are two kinds of Phlebitis. One is ca lled Superfida l
Phlebitis or SuperfICial Thrombophlebitis, which is due to
a clot in a Varicose Vein. ThiS is usually treated with warm
compresses and anti·inflammatory medication and
usually resolves within ten days to two weeks, The<e is a
very low threat 01 this prowessing to a Deep Thrombophlebitis and Pulmonary EmbQlism. On the other
hand. Deep Venous Thrombophlebitis Is a dot of the
deeper veins. namely the Femoral and Poplitea l Veins
and also the Iliac Veins. These are veins located deep in
the body. Clots that develop in these areas are serious
and must be treated with anticoagutation consisting
usually with Heparin and Coumadin. They also carry a
risk of breaking off and going to the lungs to cause Pulmonary EmbQlisms.
Do varicose Veins recur after treatment?
The recurrence rate of Varicose Veins after Vein OOSIJre
Treatment Is approrimately five percent within five years. H
veins do occur then a source for tile recurrence must be
estabfished. This could be othef valYes that have reopened
or Accessory Veins that have formed or eYeII missed or
duplicated l'eins. Again. this can be ascertained by a
Ouplex Ultrasound.
How do YOLi treat Varicose Veins?
The treatment of varimse Veins. as mentioned in the first
paragraph. is to close tile leaking valYes with either a Laser
or Radio Frequency deonce. This is done in an office envi·
ronment undef a loca l anesthesia with mild sedation and
carries an excellent cosmetic result. The<e is no Iongef a"1
need for extensive Incisions or any prolon~ surgery,
Another commonly asked question Is, for
how long do I wear Compression Hose
following Vein Treatm ent?
As a ru le of thumb , fo llowing laser Vei n Ablation or
RadiO Freq uency Ab lation, two weeks of Co mpre5Slo n
Therapy is recomme nded. Thi s usua lly consists 01 a
grad ua ted Comp re5Sion Stoc ki ng or Su pport
Bandages. In refe rence to Sp ider Vein Treatme nt
usua ll y lOI1y -eighl ho urs 01Compre5Sio n Thelapy is all
Iha t IS necessa ry.
How Is the diagnosis ofValYular
Insufficiency made?
The ans....1lr to this question is that an a.te nsive Duplex
Ultrasou nd of the Venous System will make the diagno
SISof Valvu lar Insufficiency.Th is sIIould be done by a Certifted Technician and interpreted by a Physicia n Certified
10 read Du ple>: Ultrasoun ds.
Dr. John P. Lalldl at the bme 01 thIS w~ting is one 01 less
tha n 1.000 physjcians v.OOdwide to obtain the designa \Ion 01 Diplomate 01 tile AmellC<l n Boaro 01 Phleoolog)'. In
add ilxln to thIS, he obta ined his RPVl (Registered f'tIysi
dan Vascular Interprotation) and he is also one 01 less
tha n 200 pe<lple both pI1ysIcIans and non pl!ys>cians
v.OOdv.'ide to obtain the RF'tIS (Regislered Phlebolog)t
Sonowapher)_ He has performed CM!r 12,000 vein
closure procedures In oo\h laser and '/NUS Closure_He
MS aM treated thousands of pabents for spider vein
resolution . He is medlCO l director oIVo nish Vein and Laser
Cente r located In Naples v.flic/1 has been a state 01 tile art
Vein Center designated to vein treatment for CM!r 12 :.ears.
In addllioo to this he is medlCO l director 01 laBella Mia
MedlCO l Spa whICh IS attached to The va nish Vein and
laser Center,
Are the treatments of Varicose Veins and
Spider Veins considered "Cosmetic?"
The answer to thiS question can be bQth Yes and No.
How do you treat Spider Veins?
Varicose Veins are almost always a non-(osmetic Issue
Spider
Veins are treated usJng Sderotherapy, which is the
when it can be proven that they are due to valvular Insuf·
injection
of a solution to eradicate the vein. There are
ficiency. Valvular Insufficiency is proven by an extensive
many
forms
of Scerotherapy including: Liquid ScleroVenous Ultrasound. Spider Veins on the other hand can
therapy. Ultrasonic Gu ided SClerotherapy and Foamed
be due to Valvular Insufficiency, This occurs in about one
SClerotherapy. There aoe also ma"1 ~inds 01 Sclerothird of Spider Veins and is proven by an extensive
therapy agents including, the detergent agent sodium tetVenous Ultrasound. However. if there is no Valvu lar Insuf·
radecyf
and tile Irritan~ glyr::erin. The old Sderotherapy of
(2391403·0800 I www.l.i.m lshyeln.com
ficiency demonstrated then Spider Veins wou ld be con·
Hypenonic
Sal
ine
is
raoely
used.
sidered strictly cosmetic.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
8
Health &. Wellness December 2011 - Collier Edition
PROSTATE SPECIFIC ANTIGEN
Inaccurate Blood Test Versus Lifesaving Screening Tool
By William M. Flglesthaler, M,o.
P
=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 a significant number of prostate cancers
being diagnosed at early clinical stages. In fact. eacll
year over 200,000 cases of prostate cancer are diagn<»ed in the United States alone andover 30.000 men
die of this disease annually.
Early Diagnosis is Key
Early diagnosis is a key ingredient 10 successful cure
rates with decreased moTbidity. Current knowledge 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 the 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 One time. Using these pammcters was
successful in minimizing thc "over diagnosis" of
prostate cancer in elderly males with clinically insig_
nificant prostate cancers. Unfortunately, many
younger patients with more aggressive cancers were
left undiagnosed until they had non-organ-confined
disease, which negatively impacts cure rntes as well as
morbidity of IrCatmcnl.
In addition to !he total PSA blood test, free PSA testing
may be used 10 increasc the specificity of a borderline or
high PSA result (4-1 OngIdl). F~ PSA is reponed as a
percentage of the IOIaJ PSA, and represents !he fiaclion
of scrum PSA Iha! 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 values in the screening
of men for prostate cancer. It is imponant to include
in this discussion the necessity of the digital rectal
exam which if aboonna! must he evaluated, regardless of the PSA result:
• PSA levels over 2.Ongldl in males under the age
of SO and PSA levels over 2.Sngldl in males under
the age of 60 slwuld be OOIlsidered abnormal.
• PSA levels over 4.0 ngldl should always be considered abnonnal and wanant urological evaluation.
• An increase in PSA (PSA velocity) of O.7ngldl
over an IS-monlh time span should be considered
significant. even if within the nonnal range for PSA
(0-4ngldl).
• Free PSA levels below 1O'Y. indicate a significant
risk for prostate cancer.
• PSA levels should be considered inaccurate if
obtained in the presence of a urinary tract infection,
prostatitis or aller a traumatic foley catheter placement. A period offour to six weeks after treatment
should be sufficicntto allow the PSA to return to
baseline.
• 5-a·reductasc inhibitQTS such as Proscar or Avodan
the PSA by SO-A. over a six-month period of
time. and discontinuing these medications will resull
in the return to the baseline PSA reading over 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 prosta\e
biopsy. 11 is important to question patients who are
prescribed these medications regarding treatment
compliance when in\erpTCting their PSA values.
10,,"'CI"
PSA Blood Test is a Valuable Adjunct to
Digital Rectal Exam
In summary. the PSA blood ICSl is a valuable adjunctlO
the llIII1uai digital rectal examination. In order 10
rrw:imizc the benefit ofPSA. it is essenliallO properly
interpret !he result as it relates to the patient's age,
velocity of change and oIhcr ~ which rould alter
the PSA value such as infection, lJ'auma or medications. The primary care provider is !he fmt responder
when it comes 10 detennining when a patient may be
al an elevaled risk for prostate cancer based upon
arutual screening. Both the digital rectal exam and the
PSA blood test an: nocessazy 10 properly screen male
patients for prosta\e cancer. Urological refC1T1lI should
be ccnsidered whenever there is a question of an
abnormal PSA or digital rectal exlUTtirunion.
Hilliur M. Figlatltllkr, M.D.. is a CUm
all/lMllS of Wake Forest University ~.i,g'::'"~'N l
"'ith ""Mrs from the Uni",nily of North Carolina
Sclwol ofMedici1Ui 01 Chapel Hill. NCo
Dr. Figleslhaler campleled his urological ,~"''''d
training 01 Ihe University of Kenruc/cy, Alben B.
Oandler Medical Center in winglan, KY.
published l'I?uarch "" proslate cancer in cooperalian "'ith Jah/U Hapki/U Uni''eI'Sity. BaMman!, MD.
and Iw,s given nW1UirollS presenlati(}ll.f at bath
rtgional and noli"",,1 confel'l?lICes.
H,'" I
AlllQllg his specinl inlereslS is lile treatment ofprwlate
CIlIICtr. including da Vinci robotic radical prostatecIOMy (/Ilip:J/youJlJJe.comIspecialislSim.rology). His
rm.11S for ewe, preserwliOll of bladder COII/1OI,
1t1um 10 _ I acli>'ilies and Il!C<Wery of rewal
fiurctian an!oulStanding and second 10 MM. lIe often
has nugeoru scheduling ,uilS 10 Naples /() OOser'Yl! his
I«hniqla'S and has treated palums from over 20
Stales, eight countries, Ihree txmtirwnlS and counh·ng.
lie WW" IIJOjI rncemly featured on /lle ABC evening
/lell-3" local affilialefor his ma.<leryofthis.rwgery.
Dr. Figleslholer is board unified, a Diplomate ofthe
Americtln Board of Urology, W" well as a Fellow of
lile American College ofSurgemu.
Or FiglesthaJer is illCluded in Castle Conll(l/ly~ lop
doctors I'I?ferrol guide based 011 plt)-3"icimr-leaJ
remuch and peer roW..... by leoding hospilOU and
medical professionals.
239-434-6300
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfhe althandw e llness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - December 2011 Health & Wellness
Happy 50th Birthday!
Now, What About Your Health?
By Millennium Physician Group
hen
your
vehicle
reaches
100,000 miles, mosl manufacturers m:ommend taking it in for
a complete tunc-up,
Michael Wang, M.D., suggests to his patients thaI
Ihey think of their 50th birthdays as a good time for
the ~IOO,OOO-mile check-up." "fifty years of
age----« 100,000 miles. so to speak-is when you
see Ihings really start to go wrong," says Dr, Wang.
who pnlCtices with Millennium Physician Group in
Naples, "A lot of Ihese medical issues could be
asymptomatic, meaning you don't know Ihere is
anything wrong. It is beSI to have a complete
physicaL"
lm, Pozniak and Wang say they completely under_
stand why patients hesitate to get Ihe exam, It's an
invasive procedure that involves inserting a tube in
the m:lUm to look for polyps. which can be cancerous or lead to colon cancer. "Women tend to deal
better because most have been getting pap smears
for years and are more used 10 an invasive SCreening," Dr, Wang says.
Many patients also hesitate because of the preparation, he says, "The day before the exam. you nced to
drink a laxative that can cause diarrhea and bloating,
and you cannot eat," he says,
Fifty is also the recommended age for many
screening exams for both men and women, One
important test- and probably the least favorite of
patients-is the colonoscopy. About 90 percent of
colom:tal cancers occur in prople 50 and older.
and colorcctal cancer is the second most common
deadly cancer for men and women in our country.
Dr, Pozniak says,
\1,,,;ng wurk ",onuther t:,clur th," pul, pc'Uplc uO',
With preparation and the ""mal exam, which
....'<ju"e' ane"the";a, a fX:n.un could be ab"-'!II jor
two day, of their jah, That a particularly big concern
in light "fthe cum'!lt ""'onomy, he say,. adding that
sche'<luhng a culunuscopy on a \lunday could mean
",i"ing "nly one day of work
There i, ,uch a thing a, a CT colonography. or
'irtual ~ulonu,<'upy, on which Ih~ culon" scanned
with a CT machine . [t', not on,",i,'e and dl"" nO{
re4utrc ane,lhe,;a. bul pat,en" hayc 10 du Ihe ,,1me
preparation and the yiew (}f the culon " not a,
complete "M,"t phy,ician, lend to fa' ", the !Tadittunal colonu,eupy exam, wh,eh enables them to
take care "f the polyp, right away during the pm_
«'<l ure," Dr. Pu/mak ,ays
\len ,hould al", rece,,'e " prustatc c"ncer ,<'r<'Cning hy the ir 50th hirthday,. alth"ugh it i, one of the
mure euntr"""",i,,l " ...."'ning e~am', he ,ay"
During the ,,,<'<'n ing, the phy,ieian i, lookong t'>r a
p,,"tate"fX:cific antigen. or PSA, that can mdicate
canceL "Yuu euuld ge1 a numlal readmg ,nth
cancer and an "h"o,.",,,1 reading without," he s"y'
What phy""an, "re really looking fur " huw lhe
rSA change, during the years. "We fulluw the trend
of the screenin!:-" If your rSA i, a I the fiN exam,
"lid a 1.2 the ,,-,<,"nd time, thcn you"", pmoohly OK
lfil goe, fmm a Ito" .1,then yuu ,hotlld folluw
wilh an ",,,l"g'''''' he
Why is 50 the magic numbcr'! Mostly it has to do
with statistics. says Luis Pozniak, M.D .. also with
Millennium Physician Group in Naples, "Population studies tend to go by decades, like the <lOs, 50s
and 60s. Based on those studies. age 50 is the line
of demarcation when your risk ofheallh problems
and disease increases exponentially."
Patients should get their blood pressure. cholestewl and blood glucose levels checked every year
by age 50. Dr, Wang says, "The goal of every physician is preventive medicine. As prop1e age, their
cholesterol S\aIlS to creep up, Their blood pressure
and blood sugar s\aII creeping up, too. Ifwe catch
this early enough. we can often prevent it from
getting WOT$C," he says.
9
ur
"'J'"
Women ,hould also rccci,c a hone den,ity te" at age
SO, Thc liN exam ""ts a, a ha.",lit)C to lind OUI how
Michael Wartg, M,D.
Luis Pozniak, M,D,
m..:h de'l,it)' the woman" lu,;ng ea<:h year. Dr.
l'"""ak "'y',
A comprehen,i,·c phy,ical can "",m intimidating to
•
~
•
MILLENNIUM
PHYSICIAN GROUP
www,MlllennlumPhysleliln,org
Michael Wang, M.D.
1284 Creekside St, SIt. 107, Naples, FL34IOS
239-249·7830
Luis Pozniak, M.D.
1750 SW Health Parkway, Building 1, Naples, FL 34109
239-249·7800
th"", who arc afraid they will hear had t)Cw ,. Dr.
Wang ""y" H"WeH'T, 111<"t pc'l'pic arc diagl1<w..'<l
wilh en"rely m"n"gcable he"lth
he "'Y"
'''''Co,
What of the n1<>rC scriou, health ,,,,,,,," "B}' naturc,
we tend to ignore thing, that dnn ' t gi", us prnhlems
T<'1l nr 14 yea" later. it can tak a hite nut or yuur
body and ",on'l g"'c il b:ock," Dr P""""k "'Y" ",,,,
a ph}";,c",n, it " my ~'TCal s"tish1cH"" to make sure
yuu don 't liw U/IC day Ie,,, b,xau", "l!I..,th ing could
haw ht:en rrnentcd ."
lntere,k-..i in " f"ll heallh che'l:k·"p'.' S.:h<.'<l"k "n
appotnlmc!l1 "ith one uf uur phY>lclUn, "xby,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWellness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
10
Health &. Wellness December 2011 - Collier Edition
The AGE-ing Process
Staying Young by Eating Smart!
By Betsy Opyt. RD, LOIN, COE - The Southwest Inslitute for Cardiovascular Fitness & Treatment
hen we often think aoout Ihe
aging proceSS, we usually
think about wrinkles, gray hair.
""",, motor function and loss of memory. It is
something we will all go through sooner Or laler.
What if I lold you lhat you have more control
ovcr your aging process than you once though.?
After all. you have heard the saying, "You are
what you Cal." What you an: ealing may end up
killing you faster.
What are AGE's?
AGE's is nOl jusl a number determining your
decade. but a lethal oombination of sugars and
fats that create a destru<;live compound in our
bodies and shift our aging proceSS imo fifth gear.
AGE's is an abbreviation for Advanced Glycation
End products and are found in some of our most
common cooking methods - grilling. frying, and
microwaving - along wilh the way foods are processed oommen.:ially. Ifyw have a high alllQ\lnl
of AGE's in your diet, even in your 20's. y<:>u arc
On your way to developing chronic diseases y<:>u
would nonnally see later in life , JUSt by culling
ywr AGE's consumption, you can save your
eyesight. your menwry, skin and blood vessels,
and delay "Father Time's" natural process_
AGE's Desboy Healthy Cells
This may be a new concept for you to digest, but
AGE's have been around ever since ea,'ernen
discovered fire, AGE's fonn when dry heal
causes sugar and fat to bn:ak down inlO protein
molecules that shrivel up and tum brown or
black. Well-done meats. erispy coaling 00 chicken,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
SW'CFT
Cardiology
Tt<
t<»
~<M I~
~~
f~'tT~
James V. Talano. MD MM FAce • Peter R. Foster, MO FACe
Sajan K. Rao, MD FAce· Janet K. Sparker, PA-C RN
1-- - - - 239.261.2000 - - - --I
www.swicft.org
615 Ninth Street N. Suite 101
973 North Collier Blvd
Marco Island, FL 34145
Naples, Florida 34'02
W~,~~," ''''''',I~'id''"'"d accept most insurance plans.
28281am0mi T~~ Hot\I1, ~~ Aofida 34103 I 239·681·2165
7890 &mnerIi1 Lakes DrM!. Fo:t M)'n Florida 33907 I 239·7SB-6396
YffnI.l'tJysIela IISReha bliltatlon.eom
VAX-O Therapy Relieves Back Pain
~I
Alial Decxwnpression. VAX·D is
a rmUlionart
non-lrnasi'Ie treatmeot for patients 'I>tlo soffef from
chronic low bad<. pain 01 ned! pain, as well as leg pain and
nurnllness caused from herniated 01 degenerated (lscs
and posterior facet syndll:llTle. Patients 'I>tlo I\a'.'e had back
01 ned! SlIrget)\ )eI continue to experienI;:e low back pain
and/or sciatica pain,lTI3'I also be candidates torVAX·D.
Back pain can disrupt dally Irte, making it dill\ctl~ to
complete simple tasks 01 eniO'J' certain actiVities. While
I)a(:k pain $ lJSlIally treated with a coml)nation of ttJer&.
pies. Including medication, bed·rest, chlropl'llCtic care,
and exercise, mall! of these treatments only temPOlluily
reducesymptOmS.
V.AX·D is the only medical device that delr.ers treatment
throof11 its patented Iogarlthmio: (Iecompoesslon curve.
The treatment is desi~ to relieve pressure on struc·
tures that may be causing back (l( neck pain usually
associated -..ith bulging 01 herniated discs and
live disc disease. V.AX·D is sate
I
and efleclive and does oot in·
vot.oe the risIrs associated with
surgery 01 injections also used
to treat cnronio: pain,
_11ef&-
Priof to VAX·D treatment. patients are fitted with a patented
'peMc harness' and then are placed in a pror.e position on a
VA.'(·D table and console {patients remain fully clothed
during treatment). The V.AX·D The.apeutic Table and COOSOIe
technology applies and maintains a baseline tension of 20
to 24 pcM.lnds to the patient's peMs throo~ the treat·
ment session (e\IeIl 'IItle!l at rest) , Distr3ction cycles then
rJlC7..e from the 20 to 24 pcM.lnd range up to a pre-detennined
tension based on the patients' oondition.
During treatment. patients U'tilili! handgrips to extend the
arms aboYe the head (like hanging from a bar) to stabilili!
and restrain the upper body during lumbar distraction, Our
newest Genesis 3 table allows those paVents with
shouldef or arm issues, to lie on their back and utilize a
special attachment under their arms to achiew pain free
treatment The cervical collar is utilized for those patients
needing ned< treatments.
VAX·D differs from COI'fo'entiona l mechanical traction in that
~ uses this spec;al rogarith im, and
creates a negative pressure in the disc
that aclteiYes the same goats as
surgery. ..reducing pressure In the discs.
Many patients ", III fIOtlce a benefit earl, on In the treat
ment protOCOl , and as treatment prog!esses, they " ill
e'-P€rience a gradual reduction of symptoms.
Patients .,hose back pain Inc ludes Inl lamma!lOn
may be presc ri bed non ste rOIdal ant i Inf lammatory
agents or other medications, Pat,ents who have
tumors, bone fractures or osteoporOSIS are not can
dldates for th is treatment
VAX D cli nics have s.uccessfully operated for more than
~fteen ~ars in the Unrted States, as well as in Canada.
Puerto RICO, Me<ico and Austra lia. More tnan 3.000
patients each d<ry receive VAX D therapy I~ the United
States_ ."th stua,es repMmg high levels 01 success
Physlc.an s Rehabd,tation IS one 01 the lev, treatment
centers that offers VAX·D therapy in comb ination with
physical tMrapy. It is bell (M)d that thiS blende<l treat·
ment results In the best outcomes lor patients. Not ooly
does P'hysicians Rehabil,tation offer complete com prehen~lve treatme"t 1m chrQ"1C bilck OJnd ne<;k p,,,", they
do 0;0 I",th Ihe best pnce~ In Ihe ~reOJ' For mOle Informatron on VAX-D treOJtments OJnd pri Cing, or to mOJke ~n
OJPPOIntment ple~se COlI!
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Everything
in balance.
back into I
Pain Management Center of Naples. PA
~
~
a yop nance.
family filllnces.
!he day-to-day. we III seek a sense of
balance aM harmony. And no time is more
deserving than the retirement years when
Of" JUS!
Ce .... lcal & Lumbar Epidural InJ.etlon.· Lumbar & (e",lc.1 Faut BIoct
Occipital Henr. iliad· lumbar & C.rvitallbodj~,,...u.ncy Ablation
s..crolliac Jo;nl Inj_clio.... Tria" Point InJoCllons· (eUac PInus Block
after I fulltime locus on career, child~ and
othoer cornrnitments, the time anives to re.lp
!he rewmls 01 living ~l
AI TheAriington. the neweSt
retnmen!
lifestyle choice in the Naples aoo Marco
IslaM area.)'OII can continue to live the life
)'OIl'.,. planned ... haw1and with peace of
mind ... knowing ewrything is in place for
the ruwre. including an emphasis on fitneSs
and welloess, and the availability of on-site
heahll care. if needed.
The Arlington
A Lutheran Life CommunilJ
M ODEl AND INFORMAT ION CENTER
12276 TamiamiT",il Easc.Suite 501. Naples, Florida 34113
(239) 206·2646 or toll-free (866) 98~9690
www.Arlington Naples.org
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com - - - - - - - - - - - - - - - - - - - - -
Th.I •• rag.women 911nl3O pounds Mth menopause. Yoo do
nol ha •• to accept ~I W. can help r. . . ... metabolic changes
tho' occur during menop~u" so yoo c~n surt losing thOSt
unwanted pounds.
Dr. Cederquist is a nltionally recognized boriatric: physician
sptCi~1Iy trained ~nd ctrtified in .,.,.;ght manlgtll1trlL
We specialize In womtfl \\tIo 1m. tried ev«ythln9 for
weight lou and 11111 ean' lose. W. can help.
Yoo'lilook and ltel spectlI<;tIt. Ind ..
,
•
Yoo'. be amazed at howthose STUBBORN POIImfs
su", vanishingl
See for yourself...
C&g~r.ghJN
Weight Lon and Well"'$$
Caroline J. Cederquist, M.D.
-~"--.-­
"'--""'-"._'.'
Call right now! 239.591.0444
Get Your FREE Diet Profile Log on 10 wwwOrCed erqulStcom
MI
MP
P
our physicians are accepting new patients
-,
o..rt.s Kilo, M.D.
/~,,_
..
u_ ~
/1~SJr
..... _ J. /w
..... _J.'w
239·594·5456
I4c ct prin9 New Po/ienlS
Som e Day I4ppoirrfm e nl> 14 . 01/001 .
___
239·249-7800
MILLENNIUM
•
•
PHYSICIAN GR.OUP
.........w.MltlennlumPhl'$l(lan.org
_____________________ www.swfHealthandWeliness.com _____________________
14
Health'" Wellness December 2011 • Collier Edition
Arthritis of the Foot and Ankle
By Myles Rubin $amotin, MD - Board Certified Orthopaedic Surgeon. Fellowship Trained in Fool and Ankle
The signs and symplontS of anhrilis are gC1lmllly
the same throughout the body and this holds true for
the foot and ankle joints. Stiffness, swelling, tcnd<,:r_
ness and pain arc associated with lower c~tremily
(fool and ankle) arthritis. Bone spurs may form at
the joints and since the foot is made IIlQStly of bone,
thesc spurs may Slick out and make the join! appear
lumpy. The joint may become defonned. Some-
times, with the weight_bearing joints such as foot
and ankle, Ihcjoinl may fccl '"Unstable~ or fccl like
it is ready to give OU\. The worst symptom will be
that any walking may bewrnc quite painful.
The good thing about fool and ankle arthritis. if
thcre is one, is thai then,: an,: many types of conservative trcaUTIrn! that can be usod in order to alleviate
the symptoms, which is mainly pain with stiffness.
Simple steps such as steroid injections, ami_inflam_
matOf)' pain rcliC'VefS. placing pads, arch suppons or
OIher inserts into footwear, and even CUStom
footwear or brncing of !he foo! or ankle can all be
used to relieve symptoms. Physical therapy, exercise
and even a weight loss program can be a benefit to
easing)'QUl" symproms. A Sp<X:ialist in foo! and ankle
is gencmlly aware of all these treatment types and
will utilize !hem in an attemp! to help !he patient
Howcver. like the large joints such as hip and
knee, conservative treatment sometimes will not
work at all on a patient and more likely, will help
for awhile, bUI duc to the increasing severity oflhe
arthritis, will eventually cease helping the patient
Surgical oplions will then need 10 be considered. If
you have mild or moderate anhrilis., especially in the
ankle only, an ankle arthroscopy may be warranted
10 help CUI back on Ihe 3nhrilic changes in Ihe ankle
joint In the foot and toe joints, as well as more
arthritic ankle joints, surgery may involve an
anhrodesis (fusion) of the joint to eliminate pain. In
some rare cases of severe ankle anhritis. a specialist
may recommend an ankle replacemenl using prostheses, which are used in hip and knee replacemenl
surgery. But, mOSI Sp<X:ialists will generally avoid
Ihe ankle replacement surgery. !;inee the lechniques
and proslheses are not as advanced as they are in
hip and knee replacement surgery and they have
been known 10 have many more implant failure!;
with catastrophic results.
The most imponant thing about anhritis of the fOOl
and ankle. which I have stated !;<.:veral times, is to be
seen and followed by the proper clinician who can
help you in many ways to solve your anhritic ankle
Or fOOl and help you return 10 a more pain-free, less
symptomatic life. r am a Board Cenified Onhopaedic Surgeon with a Sub-specially, Fellowship
Trained in FOOl & Ankle surgery. In fact, I am the
only surgeon wilh these qualifications in our area. r
believe this makes me uniquely able 10 deal with
Ihese problems in a !itatc-of-the-an atmosphere and
method that will keep you in good hands and
provide you with the mOSt dc!;ired result
Myles Rubin Samotin, MD
Boa ,d C. rtlfled Orl ho l>Mdte Surgeon
feoow.",p lr •• M<! . s..,1>$i><'< .al •• t . ~ """t an<l """'e Su'go',
C",um"'. Uol...,,,I!y..... """mde .... """"" Cent",.
II"...,."", JoiOl Dise • ..".. N"", yO"< Cit\'
239_514.4200
810" tin A...... uHIo,'n. Su,'.4
N.pIo~ rk><od.! .!-Il08
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
0.. Myle'S Silmotin is a Columbia Universiry Graduate and
Fello\VShip Trained at the Hospital for Joint Diseases In New York City.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com ________________________
16
Health &. Wellness December 2011 - Collier Edition
Help for Depression
Overcome the Blues this Holiday Season!
By Oavid Schimmel, CEO - Oavid l awrence Center
illions of Americans struggle
with depression. Depressive
disorders represent a major
public health problem affecting approximately 15%
of adults and 8%ofchildrcn. While th= "",a lot of
miSpcrcqllions about depression, il is important for
those of us al the David Lawrence Center. a notfor_profit, behaviQllll health agency that provides
comprehensive, ;ruwvative mental health and substance abuse solutions for children. adults and
families in Southwest f lorida, 10 cducare the community Ihat there is help for depression and its
symptoms can be OVe1'Come.
A depressive disorder is a syndrome Ihal rcf1e.:ls a
sad {)1" irritable mood e~ceeding nQrn'lal sadness {)1"
grief. Depressive signs and symptoms can be characterized by negative thoughts. moods, and behaviQl'S, but can also affect s~ific changes in bodily
functions (crying spells, body aches, low energy Or
libido), as well as problems w;ch eaeing, wcighc or
sleeping. Many of thesc Symp10mS are caused by
changes in the nervous syscem of the brain chac can
result in withdrawal from daily activity levels.
Individuals suffering from depression who do not
seek treatmen1 can have dramatic loss of productivicy and absenteeism from work, as well as a
variccy of other physical symptoms. Adolescents
suffering from depression are at risk for developing obesity, and medical studies have indicaccd
that depression causes significanc problems in
functioning more SO than arthriti s, hypertension.
chronic lung disease and diabetes. Depression can
coexist wich vinually every ocher mencal health
illness and we are seeing a growing crend of
depression in the elderly.
-r
DAVID LAWRENCE CENTER
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www .swfHeal thandW ellness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Expert PSYC
Care
Can
Count On
David Lawrence Center is a not·for-profit, behavioral health agency
that provides innovative menial health and substance abuse solutions
for children, adults and families in Southwest Florida. With the largest
network of board certifie<l child, adolescent, adult and geriatric
psychiatrists in Collier County combined with our comprehensive
inpatient, residential, outpatient and community based services,
you and your family are in expert, caring hands.
MEDICAL SERVICES
Compreheo~ve
,
psychiatric evaluations
Certified in Suooxooe' detoxification
Treatment planning and re/efTals
Mulople speciaHies
Medication management
Co-occurring treatment services
Crisis stabilization and Baker Ad referrals
Telemedince
Medicaty supervised inpatient detoxification
Bilingual treatment services
-r
..
DAVID LAWRENCE CENTER
ADDITIONAL MEDICAL STAFF
E. 50$;1, M.D.
o. ~, IIUl. CPA
O. Ebaugh,ARNP
M. Genity, PA
NAPLES 239-455·8500 • IMMOKALEE 239·657-4434 • OavldLawrenceCenter.org
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
18
Health &. Wellness December 2011 - Collier Edition
to Transform Your Life in 2012!
By Madeline Ebalini, MATP, RYT and Deborah lee, PhD, AN
Integrative Mindfulness, Bonita Sprirogs I Better Ch0ic6s Health Coaching. Naples
However, equally impOrtant in the 1nlnSfonnation
process is often an exploration of sulxonscious reasons
why YOU'Vel 1101 made the changes you know you need to
make. Habitual behavior panentS (those neural
pathways) frequently emerge in response to ongoing
strossors or past traillT\atic events. We may 001 even be
aware of how OW" subconscious mind retains old, painful
emoIions. We don~ like 10 feci these wtpleasan\
cmoIions and may engage in coping behaviors _ like
smoking, overeating, or other unhca.Ithy habits - 10 temporarily soothe the pain they bring. These coping behaviors may provide temporary comfon. But the Iong-1CIm
impact on the body and our lives can be serious.
Research shows us what it takes to make lasting,
healthy change. Because these changes are difficul1.
and lake lime 10 develop, consider engaging a
partner who's in your comer and will support you as
you do what it takes to actualize your long-tcnn life
vision. An 'nugratil't: lIeilllll Omen , and a regular
Mindfulness Practice, can be the perfect platfonn
fTom whK:h 10 make your vision a reality. Your Integrative Health Coach, and your own personal mindfulness
practice, can help you clarify your most important
values and priorities (your motivators) and help you
cope with stress beller. so that your unhealthy coping
behaviors eventually fall away.
Integrative health coaching is about looking at
your whole life- everything that makes you who
you are - including your personal and professional
development, relationships, communication,
physical environment, and spirituality.lntcgr3tive
health coaches won with you to develop a plan
and set goals that are imponant to you. Your
coach provides structure. suppon, motivation.
information and acrountability necessary to make
your transfonnation a sustainable reality.
At the core of who you are is mindful awareness; being present and aware in each moment
of your life. as it unfolds. The health and emotional benefits of a regular mindfulness practice
are vast, as the explnding volume of medical and
scientific research demonstrates. Cultivating
mindful awareness, through learning and maintaining a regular mindfulness practice. builds a
sense of calm and case in your 1ifc and goes
hand-in-hand with making and sustaining lifestyle change. Your regular practice might be a
gentlc and therapeutic yoga sequence, Or a period
of ! ining practice focusing on the breath. You
might li ke "'a/king mea,'tation. or the practice of
mentally scanning your body nocicing how each
pan fccls(known asa body !can). You'llicam all
of these practices in a Mindfulness-Based Stress
Reduction (MBSR) course.
lin the nat MISR COUI'M
runs Jan. 2nd through .1wd. 6th,
1It_.L. . . illlu .. lL......
MIt
or mil (239) ~1113.
Madeline Ebelini, MATP, RYT Integrative Mindfulness
Madeline Ebelinl, founder of l nte~atJVe Mindfu ln ess In Bon ita Spnngs, holds a Master of Ms degree In Transperwnal
Psycholog, (MATP), ana IS a Registered Yoga Teacher (RYTI. She compteted professlona I traln"'g in MIndfu Iness
Bawd Stress Red uction (MBSR) With -;en lor faculty at the Center for Mindfulness In Med 'cloe, Health Care, and
Soc let, at the Un iversity of Massachuwtts Med ica l School, Includln~ Dr. Jon Kabat1,nn . Integrative Mindfu ln ess
offers the 8-week MBSR COu rse throughout the \'Car, and free monthly introductory talks . TM ne.o:t free introd uctory talks ""II be Tues. Dec_ 6th at IPM arld 7PM . The next MBSR coorse ""II begin )an 2. 2012 Register at
www.lntegrativeMirldrulness.net. Madellfle also leads a tree love guoded mindfu lness pract.:e on li ne each Thursday
morning at SAM at www.emindfu l.com!mirldfulnesspractice_htm l. lrrte!r..tiwMlndfutnessisacom pi lmentaryresource
for cQ/lo.'eO\lonal hea~hcare and wellness Madeline can be reached at Madeline@[rrtegratiYeMindfulness,net
Deborah A. Lee, PhD, RN Better Choices Health Coaching
Deoornh Lee. PhD. RN IS an l ote~ati,e Health Coach and President of Better Choices Health Coaching baSC<l In
Nap les She received her tra,n,ng at Duke I nte~atJVe Medoclne's Integrative Health Coach Prof=a l Tra," ,"~
Prol}am where sne is currently v.ur\<.Jog towards ce"i1ica~on as an Inte~atove Health CoaCh . She brings 30 )ears ot pro
fessional and persona l elPenence to her inte~"tiv" health coach,ng proUic,,_ After worl<ing oS a ho&ll ital and home
care nurse. researcher, university professor,pcb"c hea lth prolewonal and hea lth care administrator In the U. S. and
Canada. she deoded to return to thc root of why she bccJme a nurse: to hetp people feci better and stay healthy.
Deborah can be reached at [email protected]
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ w w w.swfHealthandWellness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edit ion - December 2011 Health 3< Wellness
19
A New Concept
to Change the Way We Exercise!
8yCOnooptl0l0
20 Minutes a Week Is All You Need to Be In Great Shape!
The Company, called Concept 10 10, is Now Expanding Worldwide!
Concept 10 10 Method of Training
The Concept 10 10 metitod of training is unlike
anything else you might have tried before.
Paradoxically. it is both amazingly fast and very,
very slow.
How Concept 10 10 Differs from
Conventional Exercise
We asked him "Why not just do jogging, aerobics or
some olher eonvenlional activily?" His answer was
pretty thought provoking:
This technique will take each muscle that is
worked to a state of complete fatigue in just a few
repetitions. Doing so sets offnumcrous metabolic
changes Ihal grow Ihe muscles, slrengthen the
bones, signal the body 10 bum more fal, and
increase the musele's ability to draw oxygen from
the blood. thus providing optimal cardiopulmonary
fitness in addition to strength.
"If you are out of shape and begin to jog, for
uample, you'lI slrenglhen your thighs, calves, hips
and abdomen, but not the rest of your museles and
bones. lbe Concepl 10 10 program slrenglhens
these same muscles along with all the rest - to a
much. much grealer degree, and in about one tenlh
the time. $(I if it is strength you are looking for as
you grimly jog mile after mind-numbing mile three
or four times a week to Stay fit, why not save your
ankles. hips, knees, and back, and spend less Ihan
thirty minules a week doing Concept 10 10 instead?
NOI only will you gel slronger fasler and more
safely, you'll also have the 3-4 hours you saved to
do somelhing you lruly enjoy."
Jorgen Albn:<.:htsen, President and CEO of Concept
10 10. Inc . explains the training Concept of 10 10
in those words and he is convinced Ihat the
ConcepllO 10 way of ex ere ising is the fU1Ure for
those who want results and personal anenlion and
where time is a major issue.
"The same applics if you are playing tennis. rac_
quetball, baskelball, aerobics, or any olher spon a
couple of times a week JUSt to Stay in shape (0. 10 gel
in shape) and nOI really for Ihe enjoyment of Ihe
game. Drop it. Spend a fraction of that lime doing
Although you will complete a total body strength
training session in about 20 minutes, you will
perfO"" each exercise with exquisite slowness.
How the Technique Works
Exercise in
it
Fraction of the Time
Free
Seminar
Thursday, December 22nd
5:30PM
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20
Health &. Wellr.ess December 2011 - Collier Edition
Effective Treatment Options
for Low Back Pain Secondary to
Lumbar Spondylosi
By Pralhima Moorthy, M.D.
A
s the name dire<:ts. Lumbar Spondylosis is a condition in which the
Lumbar Vertebrae are degenerated
due to slippage of discs and occurrence of OSIOO-
phytes commonly known as the Ixmc spurs. Spo;mdylosis is the disease oflhc spine. In this condition
the vertebrae lend 10 mOve and slide OvCr OnC
another. This condili<m is also referred as Spinal
Osteoarthritis. This condition occurs due 10 Ihe
defect in facet joints (spine joints). As the lumbar
region of the spine bears maj.mty of the weight of
body and also lolerate chronic forces acting on it,
then spondylosis is mOre likely 10 occur, thus it is
known as Lumbar Spondylosis. In this medical condition the patient feels chronic pains in the lower
part of the vertebral column due to the misplacement of the vertebrae. The age factor plays a signifi_
cant role in the cause of spondylosis and the
condition is mostly seen in people having the age
above 40-45.
Following rould M Ih" mlljor ChllllCes ..>/rich alii
/""dlh" pt:rSOll 10 Spolld}1Ilsis:
• Age Factor (mostly seen in p<X>ple above 4045
years of age and common m the age of 60)
• Constant sining position for a long period of time
•
•
•
•
Restless and SIrong physical activities
Lifting of heavy objects
External injury
Genetic issues
TREATMENT OF SPONDYLOSIS
The lreaDnCnt of the disease can be carried out by
various methods sueh as:
•
•
•
•
•
•
Physical therapy progam
Hot and cold water treatmenlS
Aquatic therapy
Analgesic applications
Oral Medications
lntervcntional ~ures sueh as lumbar facet
JlCf'.'C blocks or lumbar radiofrequency ablalion
• Swgory
What is Radiofrequency?
Radiofrequcncy waves an:
electromagnetic
waves which travel al the speed of lighl, or
18MOO miles per second (300,000 kmls).
Radiofrequency Energy is a type of heal energy
thai is created by a special genenllor al very high
or super high frequencies. With the use of this
specialized generator, heat energy is m:ated and
delivered wilh precision to target nerves thai carry
pain impulses. The "-'Suiting Hlesion"involves a
spherical area oflissue deslruction mthe lip of the
RF needle that can include pain-canying nerves.
How is this procedure done?
Once a structure has been detennined 10 be a pain
generator, its nerve supply is targeted for intem.Jption. A small insulated needle or Rf cannula is
positioned next to these nerves with fluoroscopic
guidance (live vidoo X_Ray). Your doctor knows
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edition - December 2011 Health & Wel lness
are at elevated danger for ulcers or other dangers
from H, pylori, for instance stomach cancer, One
should kecp in mind that make )'<Jur surroundings
clean, green and geon fre<: because it helps in
decreasing the h. pylori infection risk.
H pylori Symptoms and Treatment
By Shardul A Nanavall, MD
H
21
Treatment of H Pylori
clicobacter pylori are also known as
"h pylori" is a bacu:rium liable for
Il10SI ulcers.11Iis bacteria deteriorates
the defensive coating of Slomach. pcnnining digestive juices to irritate sensitive abdomen inside layff.
lJo<.:um have \:OI\firmcd that in the majority of cases
of h pylori illncs.s gencmtes no vital signs or
symptoms as compared to ulcer or gastritis in which
you may haVl; pain in abdomen, bloating, dyspepsia indigcscion, fecI hungry and mild nausea. Sympcoms
thai can happen with H. pylori infection includes:
a) A dull pain or flaming pain in abdomen
(chronic gastritis)
b) NauscaAnd Vomiting
e) Repeatcd burping
d ) Bloating
e) Serious wcight loss
r:::--~
What callses H pylori?
By extensivc rescarch it is
found that world'$ half inhabitants are contaminated with
Helicobacter pylori symptoms.
What is the real process of its
diagnosis? This is usually
passed from one person to
another without showing any
symptoms. 11 is interesting to note that countless
people got this organism in their abdomen, bul
don't obtain any ulcer or gastritis. Heavy coffec
drinking, chain smoking, and alcoholism
increase the risk and causes of ulc~ from H.
pylori. Often peptic ulcc~ arc there with dyspepsia which is higher abdominal ache with dull
gnawing). Some patients would feel pain al
nighttime and they testimony release from pain
by taking food with antacid but feel a reappearance of pain in 2 to 3 hou~.
Medical Test For Helicobacter pylori
You should ~uest an immediatc appointment wilh
a specialized doctor if you observe any continual
signs & symptoms that worry you too mU\:h, Inquire
about instant mcdical aid if you e~perience severe
pain in abdomen. trouble in swallowing your food,
having blood filled or dark tarry stool or bloody
vomit after meals.
At medical laboratory, hasic blood and stool
tests can verify your infection with H. pylori and
if you contain symptoms. the doctor will decide
whether you should go through screening tes\.
Most a(X:urate medical test to spot H. pylori is by
upper-endoscopy of stomach, esophagus or
duodenum. Since this procedure is all-encompassing therefore it is noonally applied only on
people assumcd to have u1c~ problcm or they
Aller subsequent advanced treatment by specialized
doctOls the breathing and stools test can verify
whether you haVl; been healed of thi5 infection or
nOi. Patients who are suffering from H. pylori
symptoms and ulcer problem as well arc almost certainly going to benefit from being treated. And those
unusual patients who suffer of acid reflux, hean_bum
and H. pylori are less likely to benefit from Ihis trealment whieh means thai this lreatment usually doesn'l
work with all patients.
H. Pylori IreaUllCnI must be taken ONLY when
advised your prescribed doctOl and it usually lasts fOl
duration of for 8 to 15 days. Medications included are:
a) 2 dissimi lar antibiotics are given which include
metronidazole (Flagyl). clarithromycin (Biaxin),
tetracyclines or amoxicil1in.
b) Some doctors refer proton pump inhibitor. for
instance esomeprazolc (Ncxium) omcprazole
(Priloscc) or lansoprazole.
c) Bismuth subsalicylate (Pepto-Bismol) is also
Ii"en in some unusual cases ofHelicobacter pylori
symptoms for fast treatment to patients.
To INrn mono about H. Pylori treatment ples$O
c all Dr. Na navaU at 239-593-9599.
Advanced Gaatroenterology of Naples
3439 Pine Ridge Rd .. NapIM, fL 34 t 09
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22
Health'" Wellness December 2011 • Collier Edition
and Limb Swelling
By Acute Wound Care
he holidays are here, which means
many will be traveling 10 visil their
l'1ved ones, or for those of you who
are snow birds. you're heading back 10 lhe wann
wealher down soulh . Many individuals choose air
travel to reach their destination. For those who
suffer from venous insufficiency or Lymphedema.
Ihis can be a painful process. Vour Lymphalic
system endures an extreme amount of pressure
when flying al high al1iludcs. Flying may worsen
symploms after enduring exlrcme pressure.
Funher. the risk of Lymphedema rises for those
who have already undergone radical surgery
which may have impacled lhe tymph nodes. After
going under the knife for vari'1US surgeries, having
joinlS replaced. or lymph nodes removed. your
body's Lymphalic syslem isn'l going 10 be
w'1rking at ilS top pcrfonnance.
Keep Circulation Flowing
Trying to get home for the holidays isn't always
easy when you have painful swelling in your
limbs. The Lymphalic syslem is a major player in
the body's immune process. so it's imponant t'1
kcq> your cireulali'1n fl'1wing wilh good heahh.
Flying ec'1n'1my elass is the route m'1st prefer t'1
lake when money becomes lighl.leaving you in an
uncomfortable cramped seal allowing you 10
become more susceptible t'1 cireulation problems.
Some individuals may develop blood clOIS in Iheir
legs Over lime from flying. Deep vein Ihromhosis
can be caused by cramping Ihat air travelers
endure under high ahiludes. This is a lifc-lhrealening medical problem Ihal can be prevenled Ihrough
compression the-rapy. Those who develop small
blood elolS may nol experience any complicalions,
leaving Ihem untrealed. The compression pump
sleeves squee~e the muscles ohhe legs or arm as
Ihey inflate in a sequenlial pal1cm dislal to
proximal. Then Ihey deflale and Ihe muscles are
able to relax . This pumping acti'1n promotes the
cireulation of the blood prevenling blood clots
from occurring.
A Noninvasive Treatment Option
A compression pump is a noninvasive treatment that
allows patienu to alleviale their symptoms while circulating!he lymph fluid !hat has built up. Vour Lymphalic SyslCm gets assiSlance through a massaging
aClion that genlly moves the fluid naturally from
your limbs back into !he rhytlun at which the Lymph
system cireulales. Each chamber ofthc sleevc moves
the fluid undernealh Ihe skin in Ihe direction of Ihe
lymphalic flow enabling Ihe body 10 gel rid of Ihe
fluid and wasle build up.
Main Purposes of Lymph Nodes
The Lymphatic system is Ihe anatomical underpinnings of Ihe immune system. Ihrough a complex
network oflhe lymphoid organs, tissues, and lymph
nodes . Your lymph nodes have two main purposes
which are to filler lymph Ihen lranspon it back 10 the
blood slream, and aclivale!he immune system. The
lymph nodes are found slfBtcgically placed throughout lhe whole body. so when a sile encounlers
antigens or something foreign, a red flag is drawn
and an attack is m'1unted. This mcans when your
Lymphatic syslem isn'l working lhe way ifs
supposed 10, Ihis is a gateway for infeclions 10 al1ack
the body without defense. Any swelling is poten_
lially an indicator for Lymphedema.
.9"~a &p;~UJo"e/~!p \t
ACUTE WOUND CARE
Contact Acute Woond Care lie today. Through patient edu·
cation and compression thernpy. we can provide a better
qual ity of Iffe for \Wt Call 239-949-4412 or lUi!
IWIW.ACIJiEVIOONDCARE.COM
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Collier Edit ion - December 2011 Health 3< Wellness
9!~a44~~
Choices·
ACUTE WOUND CARE
Are you suffering from lymphedema and chronic swelling
When somrone berom.. .."iously ill.
of upper or lower extremities?
it can b< difficult
We Can Help!
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24
Health &. Wellr.ess December 2011 - Collier Edition
Easy Exercise for Weight Loss
By Mar1ena Cecil, PA-C
I Have a Confession to Make
I
am nOl an exercise fana,ic. As a mat1er <)f
facl [am more likely to work oUlless Ihan
three days a week than more. Am I aware
of all the health benefits - the lower blood
pressure. lower cholesterol, decreased change of
cardiovascular disease and reduced Slress levels?
Vou bet - all my medical training drilled those
A Realistic Exercise Plan
We all know e~=ise makes losing weigh( and
staying at your goal weigh( much easier. llK= mck is
(0 re.alis(ically find ways (0 ge( me most ou( of your
e~=ise program and incorponuc i( imo your lifCS(yle.
• S", R,,"Ii$lie GO/lls - [f walking rwil'(: per week
is all you can do - that is a Great Start!
facts and mol"<' in10 my head so 1ha1[ can sh~ 1ha1
information wilh all my patients.
So many of my patients as well as family and
friends (here fore want (0 know how [ finally beat
my lifelong s(ruggle (since! was 14) with weight.
More importantly they want to know how I am
keeping the weight ofT. Well an honest question
deserves a fully diselosed honest answer! Even
though I was taking PhenTabz as an appetite suppressant and weigh( loss enhancer. r have to give
eredi( to the small changes in my diet and exercise.
PhenTab7. provides me with an abundance of
energy - this of course increased my motivation to
exercise and made the prospect of exercising regularly very possible!
Since working out 5 days a week Or running the
New York Marathon was not a realistic approachI had 10 do something drastic ... .1 had 10 be honest
& genuine about my exercise gools. While this
task might seem easy a1 first, coming to terms wilh
what [ could commit to long term (ah - Ihe catch)
took SOme serious soul searching.
Starting Slow IS Starting
l..e('s be honest - walking one day a week is
MUCH betler than none at all. This simple troth
inspired me to see the bencfit of simply starting my
exercise rou(ine. I Can commit (0 an easy form of
exercise 2-3 days a week with my busy schedule
(and general lack of desire (0 exercise). Thus
began the march (owards reaching my goal weight
and breaking the lifelong cycle of fad dieting.
Before you doub( the efTtl:liveness of moderate
exercise; please no(( that I have not only lost my
30 pounds but happily I am easily keeping it om
B" Happy - Be sure to pick an ae(ivi(y you
ac(ually enjoy doing.
•
Wllleh I/o" CI/lCk _ Your body clock. that is. Try
(0 work out a( thc time you have (he most energy.
If you're a morning person, schedule your
fitness activities early in the day; if you pen up
as the day goes along; plan your activities in the
afternoon Or evening.
)"011
wiD be 1I_lfuI !
rr.u.uv"'" -
~aiJMlII'
When you
10se weight, up to 25% oflhe loa may come from
IllU$(Ie, ~ in a slower mr:tIboIism. Weigbt
lifting will help ~or rdNild any musc:lc
you lose by dieting. Muscle keeps your metab0lism revved UfI wlti(:h in Ium, bums more
calories, fat. and g[ucose: ($Ugar).
l .. ~ Artivily Uuo tDotr DAily Life Walk instead of taking me bus, pari< your car
farther from the mall and walk across (he parl<ing
lot. take Slai~ instead of the elevator, and wash
your car by hand.
15 Mi....res Pf"s - During the first [5 minutes of
cxercise, your body bums store.:! carbohydrales
(glycogen). After thaI (imc, your body bnms
stored fal. So. while \he first [5 minutes are very
helpful in losing "'cigh( - cvery minute afta (hat
is a pure OONUS to bring you closer to your goal!
THE BIG SECRET
(Specific Thermal Dynamic Effect)
110w 10 make a 30 minute walk - the benefits of a
45 minute walk!
Plr~" Tab: increases your metabolism for hours al a
(ime which means you are burning more calories and
fal throughoul the day. Hov.·ever, your metabolism
will increase by up 10 50% immediately aller a
healthy meal! This means you will burn extra
calories by incorporating your exercise a( this (ime!
It's like a FREE BONUS EVERVTIME!
f« iofonnation 00 CMying PhenTabz at jIlUr pr.lCIice 01"
to onIef PhenTabz calt 888-066-1714
Phen Tabz Rx~
(Ampheta-HCL)
PhenTabz..com
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Collier Edit ion· December 2011 Health 3< Wellness
25
~ropean ~e 2ft
The Art of Facial Rejuvenation by Dr. Alina Stanciu
European "?ace .Lift
is a unique facial
rejuvenation treatment that Dr. Stanciu developed as an alterruuive to surge", Dr, Stanciu's
te<:hnique of Auid face sculpting and lifting
combines dennal fillers with injtttabies such as
BotoX@ Cosmetic in order to correct wrinkles
and defy aging. "The combination of these
products in the hands of a skillful surgeon like Dr.
Stanciu could give re~lIllts mo", dei;irable than an
invasive face lift.
Visit www.stanciu eyecare.com lO see
SOme of the amazing trarufonnations of some of
our patients.
Join us for a %tJfit
If yw are concerned about the foUowing
signs of aging:
01 Forehead Lines
02 Crow's feet and tired droopy eyes
03 l,.oss of volume
04 Laugh lines
05 Lines around your lips and mouth
To !cam moreon how to treat
'DiswIl:r y>"r 'F",mt<tin
t~
arc..sand
of Yourli Ii' W
y>"r"llt:!t
rlii! 'J-U..u.!I Se450n join u' fur an informativ<:
pre<tn...ion on December 7 at 5pm.
~~.. Promodoa December ,. 2011
of 'Beauty
TOpics to be discussed: European Face Lift,
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Cosmetic/ Functional eye lid surgery,
skin care & Latisse®
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26
Health &. Wellness December 2011 - Collier Edition
Choosing the
Right Restoration
By De an Mourselas, ODS
find one of the most confusing dental procedures for pa~ents is tMt of a crown, Of even
worse, a veneer. I am often 10ld by patients
thaI they are riot really sore lOhat either one is, bot
between the two, they would r.I1l1er have a veneer. A
crown is usually a dental procedure that plWides oot
just a cosmetic re5I.I ~ b\II a lI,mellonal one as well.
~neelS are more oftefl used when cosmetics are the
only real coocem.
What III a Crown?
To put rt simply. a crown is a full covering /of a tooth. It
covers all aspee\:S of the tooth. in other words. the top
and all the sides. This is the procedure of choice when
portions 01 the tooth are io fact missing. either from
decay or fracture , Sometimes a fill ing can be used in
these circumstances. HoweYel, wIlether composite
resin ("Me) or amalgam (sil'lerJ is used as the fi ll ing.
these pl'OYide very little suength fof the tooth against
chewing. In fact, ~ is the remaining tooth structure
around a rilling that holds up against the pressure of
chewing. There Is an unwritten I'\lJe thaI ~ roughly
two-thirds of your tooth is fi lling, then a crown is necessary to prevent fractu re , and fl()S&bly lOOt caMI, or
even losing)OOr tooth a~ogether,
Crown. Made In a Variety of Way.
Crowns can be made in a variety of ways, In the past.
these were mainly made with fI/d.Tod<Jf, n they contain
metal, theo po~ain is usually fused to rt at the lab to
make it look more natural. HoweYer all porcelain (metal·
free) types have become extremely popular lately with
patients and dentists alike because they look ~at and
with advances in their making, can function as well as their
metal counterparts. These materials are usually ceramic or
the ceramic is fused to a zirconium substructure for strength,
arid are giYen fancy names like Da Vinci, Empress, Cemate,
lava. and eMax to name a few. These are simpi)' proprietary
brands glYen by companies that make these products. As
long as their prodllCl is FDA awroYed, and the materials
used are documented, theo they are safe. Frankly there are
8 lot of options for )00 and )'lur dentist to choose from.
What III a Veneer?
In addition to a full coverage crown, lI1ere is the option of
a veneer. This is sim ilarto a crown, however it only covers
lI1e front (lip or cheek) side of lI1e tooll1. This is a nice conseMtive wtrj to resurface a tooll1 will10ut having to
remove that much natural tooth stnJctu re . These restora·
~ons. however, do not provide much strength to a tooll1
and cannot be used in place of a crown. veneers are rea lly
only indicated for use in lI1e -smi le zone; which includes
lI1e front 6 to Sleeth in most people. In otherwords, they
are purely for cosmetic situations to enhance or improve
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Collier Edit ion - December 2011 Health 3< Wellness
27
Put Your
Best Face
Forward this
Holiday Season!
By Dr. Alexandra Konowal
The Number One Cosmetic
Treatment
BOTOX<!l Cosmetic is the first and only FDAapproved treauncnt indicated for the temporary
improvement in the appearance of moderate to
scvere frown lines in adult patients age 65 years or
less. BOTOX<!l Cosmetic is a purified protein
produced by the Clostridium botulinum bacterium.
It works by temporarily reducing the contractions
oflhe muscles that cause persistent frown lines that
have developed on Ihe forehead, betWeen the
brows, as well as Ihe crowsfeel from squinting Qver
the years. II has been used to treat conditions
caused by overactive muscles in over I million
patients worldwide for more than II years.
BOTOX<!l is indicated for the treatment of cervical
dystonia in patients with neck pain, blepharospasm
in people 12 years of age and above and migraine
headaches. It bas alSQ been found to aid patients
with hyperhidrosis. Qf e~eessive sweating of the
underarms, hands and fect.
Non-Surgical, Anti-Aging
Treatment
No anesthesia is required for BOTOX<!l Cosmetic
trealments, allhough SQme patients choose 10 have
the desired area numbed with a cold pack or anesthetic cream. The entire procedure takes approximately 10 minutes, with a number of injections
depending on the amount and severity of the
wrinkles or frown lines. Palients ~ TC$ume nonnal
activities afterward. since Ihere is no recovery lime
needed. An improvement in the frown lines and
wrinkles is noted within days and can last up tQ four
months. Results may vary and touch-ups may be
necessary for deeper furrows. If you do nOI continue
the treatments, the frown lines will gradually return
tQ Iheir appearance.
Open House· December 1st & 2nd· 5-9pm
AL TERNA TIVE APPROACH CLINIC
INVITES YOU TO A TTEND THEIR WINE AND CHEESE
SOCIAL EVENT TORING IN THE HOLIDAYS AND VIEW
OUR LOVELY NEW FACILITY. THERE WILL BE GIVEAWAYSANDGREATNETWORKING. ALSO. YOUCAN
SIGN UP FOR FUTURE EVENTS SUCH AS ART CLASSES,
MEDITATION CLASSES, AND FREE GENETIC
NUTRITION SEMINARS/CONSUL TS WITH THE DOCTOR.
RSVP 239-~-0212
ALSO. VISITOUR WEBSITE AND VIEW OUR SERVICES
WWW.Ai..TERNATIVEAPi.ROACHCLINIC.COM
Restorative Health & Healing Center
10201 Arcos Avenue, Suite 201, Estero 33928
239.948.71:91
Ter..sa A. Si.. vers, MO
Board Certified in Both Internal Medkine &:
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Restore Your Body's Optimal Balallcel
Nutritional T .. sting &: Couns .. ling • Body Balanc.. Weight Loss
Program • N~tura l DetoKifiution Programs' Heavy Metal
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28 Health & Wellr.ess December 2011 - Collier Edition
Establishing a Secure Florida Tax Residency
for the Seasonal Resident
By ROBERT H. EARDLEY, Esq., Florida Bar Board Certilied Willa- Trusts & Estates Attorney
Florida is well_known as onc of the
m<;>St
desirable
TCtirement destinations in tile world - and with good
reason. It boasts a wonderful climate, miles of beauliful bcacbcs and numcrws tourist attractions_
FLAWEDTAX RESIDENCY CONSEQUENCES
However, perhaps the greatest factor allraeting newCOmelS 10 Florida is its Ia>l benefits, such as:
• No income tax
• No death tax
• A 3% maximum annual increase
on homestead property ta~ asscssmcnlS
NO INCOME TAX
Florida is one of only 7 states Ihal impose no
income tax - and it is the only "no-tax" state in the
eastern U.S. Interestingly, Florida manages to
raise nearly 85% of its revenue JUSt from sales and
property taxes.
[mponantly. Florida's "no income tax" rule is SCI
forth in the State Constitution. Therefore, to impose
an income tax would rIXIuire a oonstitutional amendment ratified by vOtCTS - a most unlikely evcnt.
Hov.-ever, many states do impose additional death
taxes - even ifthen:: is no federal estate tax liability.
PROPERTY TAX BENEFITS
florida has a history of providing homestead property
tax relief dating back 10 the Great Depression.
Although Florida grants a $50.000 rOOtlCtion off
assessed value, perhaps Florida's most imponant
propeny tax benefit is the "Save Our Homes"
exemption provided in the State Constitution. This
exemption provides that the assessed value of one's
home may only be increased annually by the lesser
of (i) 3% from the prior year's assessment, or (ii) the
change in the consumer price index - regardless of
the aclual value increase of the home.
Unfortunately, the inoome tax of many states often
approaches 5% or higher. For example. New
Jersey's top rate is 8.97"/. and Wisconsin's is 7.75%.
For many rcti=. a Florida tllX residency is particularly useful because it eliminates nonhern state and
municipality taxation On IRA distributions and
investment inoome - even if the IRAsand ponfolios
remain in the nonhcrn staiC.
In shon, the benefit of Save Our Ilomes qualification
is that a Florida resident may pay thousands of
dollars less in property taxes than the next door
neighbor with a comparable "vacation" home.
NODEATHTAX
•
•
•
•
•
Another imponant tax benefit for Florida residents
is that, in practical effect, Florida imposes no
death tax.
Florida tax law does contain a '"pick-up" death tax
for estates that owe a federal estate tax - but no additional death tax is gcnrntted due to Florida residency. This is because the federal estate tax allows
a limited, dollar_for-doHar credit for state death
taxes. Florida law tracks this federal credit system
and only taxes an estate to the extent that the federal
system allows a full tax credit.
Thus, under Florida's tax system, no additional
death tax is generated - but instead a ponion of the
federal tllX is ITICTCly ro-allocated to Florida.
For income tax residency purposes., many no11hem
Stal<:S utilize an annual "day-counting" test tu make a
1"CSidency determination, backstopped by a 1"CSidency
'"intent" test if the day-counting test is avoided. The
inl<:nt tests generally evaluate ubjcctive faetOlS (i.e.
in which state are one's heirlooms) to dele"";ne
onc's "'true" residency.
Studies repo11 a net migration of rnot"C than 2 million
peOple over the past 6 years tu Florida and uther no
tax states. As a result of this and od!er factors. a
nwnber of nonhern states are cxperiencing crisis
budget situations and arc increasing effuns 10 tax
Florida persons.
For example. Massachusetts has established a " Residency Unit"' for the purpoSe uf auditing persOnS who
claim Florida resideneybut also own a Massachusetts
residence. Also. several states have adopIed policies
authorizing tax agents to search personal wcbsiteS such as Faccbook - to scck personal infonnation
inconsistent with a purponed Florida residency stalUS.
If une fails to establish Florida as the primary 1"CSidcncc, the nonhcm state will deem the perSOn a tax
resident of the northern state - which then gives that
state the legal jurisdiction to tax the person's ent;re
income or estate, including retroactively, and 10 assess
interest and penalties.
In any event. it is critical 10 take all appropriate steps
to become a Florida tax residence. and then implement mca$IJTC$ lu <:nSW"\! that the Florida residency
remains intact as the years pass.
SUMMARY
ESTABLISHING A FLORIDA TAX RESIDENCY
A number of steps are useful for establishing a
Florida tax residency. including'
Obtain a Florida driver's license
Register to vote
File for the homestead exemption
File acounty De<:laration of Domicile
Update one's Will orTrus\ for Florida law
compliance
Focus one's major affairs and relationships
In Florida
Obtaining Florida's tax breaks is automatic for a
person who only lives in Florida. However, for the
person who also owns a non-Florida home. it is
critical tu establish Florida as lhe '"primary" home 10
obtain Florida's tax prol«tions and benefits.
For the seasonal resident, becoming a Florida tax
resident is c:sscntially a matter uf qualifying as a nonresident of the northern state under that state's law.
In conclusion. establishing a Florida tax residency is
the right economic dccisioo for most poople. However.
it should only be implemented with the utili~tion of
Florida and nonhem state legalltax counsel tu ensure
that one's Florida tax residency status is sccW't'.
1M rom",,"" af'l"<lUd ~''''in ~'" in....mJfor 1""""1 in/""
"",,"'-I P"'PO'U only afOd ,,,,,",Itl _IH ...lmI_ as 1*8<'1
advia. PI""" 00fLf0s1, 1.gaI <OO1Lf,1 '" obIdin 'f>'Cific adrit:,
for".., . i"",Ii"".
ROBERT II. EARDLEY
u ..
f1arida B .. , &aNI C"';fi..t
NYu, T,...m ..nd E....,a
..tromey, ~DId. ~ i.< J. D. dqru
f"'''' '~e U"Il'enity (If Kentucky
C<>II,ge ofUnv ""d .. Masin of
fA .... (LL.M.j dtgru I" &Ulle
PI"""i"llf""" .he U..ivn:<ity of
Miami Sdool (If fAw. .II"
e" , dley
P"""" ...i,h th
N ..pln III .. fi'''' of S ul ...' orl, Wo<Nf & Budd ""d
he or M. U.sU,,,,,,, Sue Sprou .., c"" In ,... ~lred "I
i."
(Ut) JJ1-41O/J.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWellness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Collier Edit ion - December 2011 Health 3< Wellness
1. Minimize to Maximize Your s.,ual'l footIp ·11 the
bll)'er is unable 10 erwision themselves living in )'Our
oome . they wilioot boy it It really is that simple. Remove
ALL excess furniture to make each room more accessible. spacious. and airy. this will help m8.llmlre )'Our
square footage by establish ing an easy flow throughout
the home. giving bu;ers a sense of what the space could
become il they lived there.
5. Curti AppNI - Mow. edge. rake. tackle the -..eeds. trim
shrubS/trees. and water the lilWI1 so it looks neat and
tidy. Replace any burnt out light bulbs. fill
borders/ra il ings. and paint the front door (~necessary).
Hthe olllside looks good. bll)'ers will want to see wIlat the
inside looks like too.
~ i minating pet odors. tobacco. and any strong cooking
smells. Once sanitired. use a lightly scented candle or
air lreshenef to create a fresh scent
8. $pnIce Up BedI'llClIM & Blitll'IICIIIII • Clean. clean.
and more cleaning. Replace old fr:<:tUres. toilet seats.
shower curtails. and neutralize window treatments and
towels. Rest assured. buyers will notice diny ule grout in
the bathroom. and excessive personal care items
throughout Easily remo..-e those distractions and create a
s;>ace that is both welcoming and functional .
3. Neutrllllze I'Ilnt · Use neutral paint throughout. The
7. Noise Control · When entering a home. oo;ers'
most popular neutral colors ior:lude wilite.i)eige. or ~
for the ~rior and shades of wIlite. ooige. and light
pastels for the interior. Many bll)'ers will run at tI1e sight
of wallpaper and borders, so try 10 limit the;r use.
Instead of using bright paint coIOIS. utilize color accents
wch as art, pictllres. dikor. pillows. and throws to <KId a
splash of color without detr&Cting from the overall room.
senses
2. AppNI to tile Senses - Thoroughly clean tI1e home.
4. 5up'tour Home - Mlnlmlre trink.ets and personal
items throughout the IIome as they are bll)'er distractions. Open curtains and blinds to bring in natorallight
and use mirrors to help ma~ i/)' a space and brighten
up a room. H )'lur IIome has a fireplace. show it 011 by
keeping it dean, well kept, and ensure the protective
screen is in good condition. Removing appliances and
gadgetS lrom countertopS wi ll help make )'Our IIome look
uor:luttered and il"lYiting.
29
are on alen lor anything unusual, tI1at includes
sounds. Make )'Our IIome a serene peaceful erwironment
by minimizing the amount 01 noise a potential OOjef will
encounlef. Make arrangements lor pets to i)e elsewhere
and avoid runn ing the lawnmower. dishwasher. washer. or
dljef wIlile ooyers are present Malle sure mechanical
~es are resolved so that noises are eliminated lrom
HVAC units and plumbing pipes too.
a.
CIeIn I IId O...,nIle - ClEANI Vacuuming, dusting.
sweeping, mopping. and scrubbing OO5eboaJds will help
do wonders 10 sell ;our home. Make sure the basement,
attic. laundry room. pantry. under the sink. ClJpboards. and
closets are organized and tid)( Blr)ers look EVER'l'WHERE
so do not clean one space by rTIOYing the items Into
anothef. A clean and org,lnized home ~ the appear·
ance the property is 'M!II maintained as it should be.
Practiu Cunun trati ng in ...
Robe rt H. E. ro;ll,y. E, q .
Florida Bar Boerd Ce<tffied
Wilo. Trusts & Estates llOW)'Ol"
Masta, 01 La,.. oag ....
50 Estate P1an,,"Il
•
,
,
,
,
,
•
Will.nd Trust Pbn ning
Florid. RC$idcncy PI.nning
Revocable living Trusu
Esc.ce Tax Mini",i~.tion
Prob.te ofEsutes
Prenupci.l.nd Postnupti.1 Agreeme nts
Power> of Anorney/ Living W ills
"._you_.. . .
.."' . . . you-_... -,--_
-owv.g ... _
.... _ _ .... _
...
.. _
__
OIl<
~'-'POO
ond.~.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ www.swfHealthandWeliness.com _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
From Memory and Thinking
Difficulties to Emotional
Problems ...We Can Help!
By Howard M. Kalter, Ph.D. and Ginny Kalter, M. S.
Brain Function Cljnlc & Psychological Services
e are proud to announce the ope!l ing of oor new office on MalCO
Island expanding our abil ity 10 pR:lYide services 10 ou r patients from
south Lee COunty and througtJout all of COll ier COunty as well,
As a Pl3ctice that offers booth neuropsychological ewluation along with standard psychological services,we offer sophisticated dlagoosti(: and treatment resources for a wide
3J1l1y of problems including evaluatioo aoo treatment of: wrying typeS 01 dementia, cognitive changes from stroke, traumabc bra in injury and other neurological disorders.
Other services include diagnosis and treatment lor AOHO in adu lts and children,
learning disabilities ,and emotional issl!eS such as depression and anxiety. Our treatment paradigm includes individua l and family counseling, support and education.
People will frequently I sk Whal Is I neuropsychologist? A neuropsychologist is a
licensed psyehologist (Ph.D Of Psy D) who has completed a two )'ear pOSt doctoral residency in the functioning of the brain and changes in behavior produced b)' brain illness
or injury, Non iMSive specialized testing and techniques are uti lized in order to
diagnose problems in functioning. A neuropsychological evaluation is indicated for a
patient who experiences changes In memory, th inking, reasoning, as well as alterations
in persona litt
Our geriatric specialization pJOYides expertise in evaluating cognitive (brain) abil ities and
limitabons, such as the differenbal diagnosis of l'arying types of dementia processes.
This emphasizes detection of short term memory problems. word finding difficulties. d~·
ficutly in processing new information and behavioral changes. This testing can also help
in diagoosing psevdodementia, e cond ition in ..tIich the individual exhibits impairments
in memory. HI!We'Ief. the problem is directly attributable to depression, and not aclllal
brain related pathology changes. Depression tends to be part of the total symptom
picture with marry types of dementias and likewise the depression itself is lillely to
worsen cogni!iYe deficits such as memory impa irment and other thinking skills.
A service that is unique to our practice is the performance of in-office driving evaluations.This consists of a one hour screening incorporating neuropsychological tests along
with computerized eval uation. This in-office evaluation compares with 98l1> accuracy to
performing an on-road test This pJOllides both patient and family with a safe w~ to
determine a dri'le(s capabilities behind the wheel. No WO!king knowledge of computers
is needed to perform the testl All diagnostic testing and \hefap~ are CO'o'ered b)'
Medica re and most major insurance camersl
An intewal portion of ou r thel'8P~ include cognitive retra ining. especially for individuals
who have suffered a strolle and are left with residual memory and thinking disabilities.
We have the patients peJfo(m exerdses with the assistance of comptller based training.
Furthermore . we can have patients releam tasks which they previously peJfo(med at
home but can no longer successfu lly complete since their illness or Injury .Patients suffering from early dementia can also profit from this training.
As a comprehensive practice we also offer therapeutic counseling setVices for a wide
arf!!\' of emotional reactions incivding depression. anxiety, relationship difficulties. and
other personal issues. We also provide extensive patient and family support. education.
and assistance with accessing appropriate community based services and resources.
Brain Function Clinic &
Psychological Services
Now Offerillg Ullique Nellrop\ycllOlogy Serl'i£'es
at our Marco blalld office
Howard M. Kalter, Ph.D.
Memory
EVillUiltions
Dementiil
Diilgnosis
In-office
i
EVilluiltion
I,
COunseling
PsyChOlogiCilI
Testing
COgnitive
Retraining
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Collier Edition· December 2011 Health & Wel lness
31
Dr. Rich Simler, Bloomingdale. Illinois, has served
the Chun;h in various positions thl"QUghout his 48
year ministry career. He repositioned in 2006 after
serving for 15 ye3J3 as President/CEO of Wheat
Ridge Ministries. Ikcontinues to scrve them pa"time as Senior Staff Associate as well as serving as
the Ambassador of Health,
Ilope. and Agingl (A li_HAl)
for Lutheran Life Communities, Arlington Heights, Illinois.
lie CQfltinucs to write, speak.
and CQflsull with other agencies
and organizations throughout
the world.
Dr. Rich Blmler
The Arlington
A Lu!heran Life Q,mmllnil)'
M ODEl AND I NFORMATION CENTER
t2276 TamiamiT,..it East-Suite SOt. NapIes.. Florida H t tl
('239) 206·26-46 or toll·free (866) 986_%90
wwwArlingtonNapIes."'l
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