Top10MD Blog

STRESS IS EVERYWHERE!

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Managing stress in the 21st century can feel like an overwhelming task. The demands placed on achievement, work-life balance, and shuffling between computers, tablets, and smartphones can easily flood your brain with overstimulation. When you’re unable to process the information adequately, it can lead to health problems with heart disease, stomach ulcers, and stroke.

Don’t let the everyday hustle and bustle get you down – there are simple steps you can take to get your mojo going again. Consider taking a few small steps towards relaxing your mind and body.

  • Don’t sit and simmer – move your body! If you work a desk job, set an alarm that goes off hourly to remind you to take a walk or get some fresh air. Movement can have a tremendous affect on your mental health.
  • Make time to do something you enjoy every day. It’s important you have YOU time.
  • Get enough sleep! Although it varies per individual, the average is eight hours per night to feel rested and rejuvenated the next day.
  • Don’t forget to breathe! A deep inhale and exhale can do wonders for clearing your mind and relaxing your muscles.
  • Find what is triggering your anxiety or stress. Is it work? School? A relationship? The first step to addressing your stress is by finding out where it’s coming from.

If you find these steps just simply are not enough to change, alter, or rid of your stressors, you can always turn to professional help. A board-certified psychiatrist can help.


IT’S NOT A RACE, IT’S A JOURNEY | WEIGHT LOSS

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As we settle into 2017, this year’s most popular new year resolution is weight loss with life improvement trailing behind in second place. These two resolutions are mutually beneficial. With life improvements, such as better eating habits, physical activity, and an overall general positive attitude, comes the increased opportunity to lose weight. In addition, weight loss can have huge benefits for improving your daily life, such as having more energy, feeling better mentally and physically, and lowering your risk for diabetes and heart-related conditions. Why not try for both? After all, you can have your cake AND eat it too!

According to the Centers for Disease Control, a surprising 1 in 3 Americans are considered obese – that’s somewhere between 26-32% of the US population. For some diet, exercise, and moderation can only take you so far in achieving the body you’ve always dreamed of. If you’re looking for a drastic change in your life this year, there is help out there! Dr. Sheetal Patel is one of Dallas’ premier bariatric surgeons. If your BMI is above where it should be perhaps its time to look at a gastric sleeve or other weight loss procedure. Call today to learn more. Monthly seminars are available.

Dallas Bariatric Surgeon Sheetal Patel, MD is Director and Founder of 360 Bariatrics. Dr. Patel is Fellowship trained and Board Certified by the American Board of Bariatric Surgery. Dr. Patel uses the Da Vinci Robotic System to perform robotic weight loss procedures, foregut surgery (hiatal/para-esophageal hernias) and uses single site robotic technology for the removal of the gallbladder. 360 Bariatrics enables patients to lead healthy, happy and productive lives without experiencing unhealthy weight gain in the future. Dr. Patell has been named 2016 | 2017 Top10MD an honor only 1-in-3 doctors succeeds with this recognition in the United States. Call Dr. Patel’s office today and schedule an appointment at (972) 596-5225.


THE WINTER ITCH | TREATING ECZEMA & DRY SKIN

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Winter is here! You reach for a cup of hot chocolate and curl up to the fireplace as the temperature continues to drop outside. That warm, cozy sweater you’ve been excited about wearing for the winter season is rubbing your skin raw – triggering an unpleasant itch and irritation. With continued scratching, you find your skin begins to develop a rash. You believe you just have dry skin, but in some cases, you have a condition called eczema. Eczema can be an embarrassing and frustrating issue. Those dry, itchy patches of skin seem only to worsen when cold, windy weather hits, leaving your skin even more inflamed and sensitive. Eczema is a common skin condition affecting over 31 million Americans yearly. Don’t suffer through the chilly winter with blotches or blisters; there are steps you can take to ease the irritation and tenderness.

So, What Is Eczema?

Eczema is a chronic skin condition, defined by itching, red, irritated skin. This skin condition occurs due to loss of moisture in the skin; while genetics can play a role in who develops eczema, it is commonly associated with seasonal allergies and hay fever. It can be exacerbated by contact with environmental irritants or allergens.

Symptoms of Eczema

  • Dry, itchy and scaly skin
  • Red rash on the elbows, knees, or nape of the neck
  • Rough, thickened skin on the neck, face, and around the eyes
  • Associated skin infections

How Do I Treat Eczema & Dry Skin?

For the winter season specifically, there are some tips and tricks you can try at home:

  • Moisturize Often. If you take long, hot showers, you probably know how dry your skin feels afterward. Throw in some cold, dry air on top of that, and you will be itching and peeling in no time. Thoroughly moisturizing on a daily basis can do wonders for your skin. Liberally apply a thick moisturizing cream or ointment to your body twice a day. Petroleum jelly is a cheap but effective option.
  • Avoid Irritants and Allergens. Hopefully, you have a pretty good idea as to what irritates your skin – do your best to avoid triggers. Wash your clothing with a detergent designed for sensitive skin. Choose soaps for sensitive skin. Avoid any perfume or chemicals that may aggravate eczema.
  • Humidifier. You may have noticed how the heater in your home can quickly dry out the air. The heat can do the same to your skin. Keep your environment free of dry air, with the use of a humidifier. However, be cautious not to allow the skin to sweat and overheat which may contribute to itching.
  • Visit your Dermatologist. Often if you have not been able to control eczema at home, your dermatologist may suggest a prescription-strength topical medication eases the inflammation and itching.

Winter is here for another two months– seek the opinion of a board-certified dermatologist today and rid your itch today. Call Dr. Daneeque Woolfolk and schedule an appointment.

Daneeque Woolfolk, MD is a board-certified Dermatologist in Dallas, Texas. Dr. Woolfolk’s practice, Blackburn Woolfolk Dermatology, PLLC provides the highest standard of care in medical, surgical, and cosmetic dermatology, and continually introduces the latest advances in treatment. Dr. Woolfolk has been named 2017 Top10MD an honor only 1-in-3 doctors succeeds within the United States. Contact Dr. Woolfolk today or call (214)630-5256.


IS BREAKFAST IMPORTANT?

 3 months ago    Leave a comments (0)



As a child growing up, we were told that breakfast is the most important meal of the day. But is this true? Often, we find ourselves skipping it. A survey by the NPD Group found that 31-million Americans, about 10 percent of the U.S. population, do not eat breakfast.  Some people skip it due to weight loss, lack of time or it’s simply too early to be hungry. Researchers found that each person reacts differently to missing breakfast. After extensive researching, there is no evidence that missing breakfast leads to weight loss or that eating breakfast leads to gain weight or less energy. Although skipping breakfast might necessarily not be harmful to your health, it can work in your favor in many ways. Breakfast not only gives you fuel but allows you to manage lunch portions and stave off hunger pangs.

“There’s no real standard definition of breakfast,” says Megan McCrory, Ph.D. McCrory tells us that some people consider a banana or yogurt a good breakfast, while others may eat a larger portion of eggs, bacon, and toast. The definition of breakfast varies from person to person. Regardless of what you eat, it will benefit you to have something in your stomach before starting your day as it helps to get your metabolism going.

What If I Grab A Donut?

A healthy breakfast is crucial! Donuts don’t cut it. It’s okay to treat yourself sometimes, but moderation is the key. It is better to stick with foods that are lower in sugar and carbohydrates as these can encourage more snacking throughout the day. High protein foods such as granola, lean meat, eggs, soy, Greek yogurt, and vegetables will give you lasting energy and help you feel fuller longer.

Breakfast & Disease

According to the American Journal of Clinical Nutrition, some diseases are associated with not having breakfast. A healthy breakfast helps to lower your chances of both diabetes and heart disease.

Although there is not any evidence that skipping breakfast is a risk to you, there are plenty of great reasons why you should make breakfast the first meal of your day.


NERVE PAIN VS. NERVE DAMAGE

 4 months ago    Leave a comments (0)



Nerve Pain and Nerve Damage are similar but not the same. The thing about it is, you can have one without the other, but you cannot have the other without the one. Let that sink in. Sounds like a riddle. You can experience nerve damage without nerve pain, but you cannot experience nerve pain without nerve damage. That may seem odd to you, but when you understand the difference between the two, you will understand how nerve pain and nerve damage works. Both are such a bother, but there are ways to get relief.

How Do Nerves Work, Exactly?

Nerves are all over the body. They work through electrical impulses. The nerves control the heartbeat, the lungs, and even muscles. You probably do not associate nerves with these parts of the body, but they are what control them. Without nerves, these body parts would not function properly. Nerve functions through electrical signals. As these signals are triggered, it creates a ripple effect until an action is produced. The brain controls it all. The brain acts like a tree. The nerves are like roots that extend out from the bottom of the tree. Although you cannot see them, they are crucial for the proper functioning of the brain. If there is damage, the brain cannot communicate with the area of the body that experienced the damage.

How Nerves Affect Your Game

If you are an athlete, nerve pain and nerve damage can end your career. It’s hard to have real success in your sport when you’re always in pain. For athletes, nerve pain and nerve damage tend to affect the extremities. Peripheral nerves are mostly affected. Athletes often experience injuries in their arms and legs. No matter what sport you play, it requires the use of your extremities. Over the years, your body undergoes a lot of wear and tear. Sometimes these injuries lead to pinched and damaged nerves. The bones and joints shift, and it can put pressure on the nerves. If that pressure is not resolved, you can end up with permanent nerve damage; causing lifelong weakness and numbness. When nerves become totally severed, you will end up with paralysis. If you are paralyzed, you have damaged your nerve, but you will not have any nerve pain. An accident can cause paralysis, but injury, especially, sports injuries are another reason. Normally paralysis is only in small portions of the body like the fingers or wrist. It is rare to become paralyzed in the arms and legs, but with the right amount of force, it is possible.

Treatment Can Help

No one likes being in pain, especially nerve pain. The pain can be irritating, and sometimes pain meds do not solve the problem. If you play sports, nerve pain is not a good sign. Seeing a sports medicine specialists is the best option at this point. They can analyze where the nerve pain or nerve damage is and provide you with the best treatment. Do not ignore nerve pain. Get the treatment you need before it becomes permanent.

Dallas Sports Medicine Specialist Dr. Sherine Reno is a Board Certified American Board of Physical Medicine & Rehabilitation Specialist focusing on performance sports medicine and injection procedures. Dr. Reno is Medical Director of Performance Sports Medicine, a clinic devoted to the treatment of pediatric to elite level athletes. Dr. Reno has been named 2015-2016 Top10MD an honor only 1-in-3 doctor’s in the United States succeed with this recognition. Contact Dr. Reno today on her profile or call 214.342.0400.


PROSTATE CANCER & THE GLEASON SCORE

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If you’re scheduled for a prostate biopsy, you will receive a Gleason score, which is a measure of how aggressively your cancer might behave. Pathologist Dr. Donald Gleason discovered this system in the 1960s. He founded the five different types of prostate cancer cells, ranging from least aggressive to most aggressive.

To begin, your doctor examines tissue samples from your prostate biopsy under a microscope. Your cancer tissue pattern will be compared with healthy tissue and assigned a grade on the Gleason scale of any number in the set 1 through 5.

  • Grade 1 – The least aggressive type of cancer cell; it looks the most like normal tissue.  
  • Grade 2, 3, 4 – The most common tumor patterns on the scale; much like Grade 1, these tissues pose little danger of spreading quickly.
  • Grade 5 – The most aggressive type of cancer cell and is recognized when the cancer tissues have spread through your prostate and differ widely from the features of healthy cells.

Many men have more than one prostate cancer cell type.

Every prostate cancer biopsy is assigned two numbers: the first is called the primary grade, it represents the most common type of cancer cell present. The second (or secondary grade) accounts for the second most common type of cancer cell present.  The sum of these two numbers is your Gleason score, a number between 2 and 10. The best score you can get is two (1 + 1). The lower your Gleason score, the less dangerous your cancer and the most reasonable a conservative approach would be.

  • Men with high Gleason scores (8 or greater) have a more dangerous and aggressive type of cancer. Their cancerous cells look very different from normal tissue, described as being “poorly differentiated.” This is still an early-stage prostate cancer since it has not spread, but if you are high-risk, it means your cancer is likely to grow or spread within a few years.
  • A Gleason score of 6 or lower is considered low-risk. This means your prostate cancer is unlikely to grow or spread to other tissues and organs for some years.  It is important that you know both of the numbers in your Gleason score. Discuss both your primary and secondary grade numbers with your doctor.  

To help guide you to understanding your Gleason score and the significance of it and lead you to the best treatment for your condition, make sure you talk to your board certified urologist about things other than your Gleason score.

  • Gleason scores predict the rate your cancer will grow, not your prognosis.
  • Make sure you also understand your cancer stage and your PSA level.

Understanding the whole picture is the key to zeroing in on the best treatment that suits your current condition.


WAX IN, WAX OUT

 4 months ago    Leave a comments (0)



You put your finger in your ear and feel something nasty and sticky. This is known as earwax. Most of us find it completely gross. Sometimes the thought is since you have ear wax, you did not clean your ears. This is not the case and contrary to popular belief, ear wax is a good thing. Ear wax is one of those things in the body that we find gross and see no purpose for but in actuality serves a major purpose.

What Is Earwax?

Ear wax may also be called cerumen. Sometimes you hear the term cerumen impaction at the doctor. This simply means the impaction of earwax inside the ear canal. Ear wax plays a very important role in the ear. It is part of the ear’s defense system. Ear wax protects the ear from foreign bacteria, debris, water, and insects. Ear wax helps in cleaning the ear as well as lubricating the ear. Some people naturally makes more ear wax than others. Having too much ear wax may seem like you will gain more protection, but it can create problems, specifically with hearing.

What Causes Earwax Impaction?

The more ear wax you make, the greater risk you have of getting wax impaction. Wearing hearing aids and earplugs a lot puts you at risk for ear impaction as well. When you think about cleaning your ears, the first thought is to grab alcohol and Q-tips. This is the worst thing you can do. Q-tips are bad because it pushes the wax further down into the ear canal. The wax ends up building to the point where sound becomes muffled. Sometimes it is not until this happens that you realize how important your ears are for balance. This impaction may cause dizziness as well as ringing in the ears. It may require a doctor’s visit to get the wax removed.

If you notice ear wax impaction, you should look for over-the-counter ear drops. The drops help dissolve the wax. When over-the-counter medications do not work, the doctor may have to use water and a syringe to rinse out the impacted wax. Once the wax is removed, you will feel much better. You will gain your balance back, and your hearing will be restored. Ear wax does not typically cause any damage or anything, so you do not have to worry about follow-up treatment.  

Managing Earwax

If you thought ear wax was disgusting at first, maybe understanding the purpose of it will help you like it more. Everyone has ear wax and some people just has more than others. If wax becomes impacted, it can have a direct effect on your hearing and balance. Although ear wax is good for you, you still need to make sure you clean your ears so that it does not build up. If you are suffering from too much ear wax, get the treatment you need. Make sure your ears are open and clear.  

Fort Worth Otolaryngologist Dr. Marc Dean is a Board Certified by the American Board of Otolaryngology and practicing full time in private practice. Dr. Dean specializes Otolaryngology/Head and Neck Surgery and conditions and diseases of the ear, sinus and disorders of the eustachian tube. Dr. Dean completed an Internship, in General Surgery and his Residency at Louisiana State University Health Science Center, where he now serves as Assistant Professor Otolaryngology/HNS. Dr. Dean is current President and CEO of the Otorhinologic Research Institute. Contact Dr. Dean today on his profile or call 817-332-4060. Dr. Marc Dean was named Top10MD 2015 | 2016. Only 1 in 3 doctors succeeds with this recognition in the United States.


A PRICELESS PRESENT | TUMMY TUCK

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As we are closing out 2016, it’s time to start thinking about your resolutions for the New Year. Is a tummy tuck something you’ve considered but had repeatedly put off over the years? Perhaps 2017 is the time to act! Between 2008 and 2013, researchers found that approximately 25,000 Americans had a tummy tuck and that number keeps growing.

What is a Tummy Tuck?

Abdominoplasty, also known as a tummy tuck, involves surgically removing excess skin and tissue from the abdomen and tightening up your abdominal wall. Removing the excess skin and tissue helps to create a smoother and firmer abdominal profile. It’s ideal for excess fat located in the abdomen and to finally resolve that pooch.

How Does it Work?

Your Top10MD board certified plastic surgeon will tighten your abdominal muscles back to their original position i.e. pre-baby. Your excess skin and fat are then removed, stretched and tightened over the abdominal muscles. Your surgeon then closes the abdominal incision. The belly button stays intact but is repositioned to its normal position. Tummy tucks take approximately 3-hours to perform and are performed under anesthesia. Full recovery typically takes 2-6 weeks. YEA! No vacuuming for two months!

What to Take into Consideration?

  • Are you finished having children?
  • Are you healthy? Do you smoke?
  • Are you finished losing weight?
  • Do you have a bulging upper or lower abdomen?
  • Do you have loose skin or stubborn excess fat that cannot be diminished?

What’s the Next Step?

Ultimately, the decision you come to when discussing this with your surgeon will lead you in the right direction. Your decision to have a tummy tuck is personal. If you are looking at getting into that swimsuit this summer, now is the time to do it!  
Schedule your consultation today with a board-certified plastic surgeon for a plan tailored to suit your desires and needs. It’s time to act now and make 2017 the Year of YOU!

Schedule an Appointment


OPIATES & PATIENT SAFETY

 6 months ago    Leave a comments (0)



Does an 85-year-old female need the same dosage & quantity of opiates as a 35-year-old male? Does a ligament sprain require the same as a broken hip? Do any other factors play a role such as stress, smoking, or sleep? Does time of day matter in regards to a patient’s pain level?

America makes up about 5% of the world’s population but consumes over 95% of the world’s hydrocodone. This “investment” in opiates has not translated into better pain control, increased functionality and decreased disability either. In fact, we have observed quite the contrary.

What Must Prescribing Change?

We must demolish the way opiates are prescribed. The imprecision in the way opiates are currently prescribed has had fatal consequences, both to our patients as well as to our health care system.

In fact, the Center for Disease Control and Prevention have declared overdoses from opioid painkillers to be a public health epidemic.

Opiates are a class of drugs that include both illicit (heroin) and licit prescription pain relievers such as hydrocodone, oxycodone, fentanyl, morphine and others. Although Opiates are dangerous and their prescription must be individualized for specific patient needs.

Substance abuse, addiction, street sales and overdose death are being facilitated by the imprecise, over-prescription of opioids and this issue is not simply just “the doctor’s fault.” It is much more complex than that.

The Pain Process

Physicians have a very challenging time prescribing opioids. Pain is now considered the “fifth vital sign.” While the other four measures are objective (heart rate, blood pressure, oxygen saturation and respiratory rate), pain is currently not.

Pain is a subjective measure that has now been placed into an objective category. This is extremely dangerous.

In addition, hospitals and physicians are beginning to have their reimbursements tied to patient satisfaction with their pain, or lack there of. This relationship has not only led to over-prescription of opiates, but also the dangerous leverage for patients to demand more opiates.

To make matters worse, the current prescription of opiates are schedule 2, which requires physicians to regularly prescribe a larger quantity of narcotics than necessary to patients to prevent patients from potentially running out of pain medicine before their next follow-up visit.

What Is To Be Done?

As a medical consultant to VEEP Works technology, we are collaborating on creating the intelligence and real-time technology to empower physicians with extremely valuable data evaluating a patient’s subjective, objective, and biochemical markers to individualize a patient’s need for opiates. With this information, only the exact quantity of pills at the exact dosage will need to be prescribed, leaving less pills in the bottle to become addicted to, sell on the street, or accidentally overdose on.

This will make this world more intelligent, precise, and safe for our patients.

Dr. Amit Mirchandani is a Texas Pain Management Specialist and double Board Certified by the American Board of Anesthesiology and the American Board of Anesthesiology – Pain Management. Dr. Mirchandani joined Metropolitan Anesthesia Consultants in 2011 and specializes in Orthopedic based Anesthesia as well as Regenerative Medicine, i.e. Stem Cell Replacement Therapy. Dr. Mirchandani has been named 2016, 2017 Top10MD an honor only 1-in- 3 doctor’s in the United States succeed with this recognition. To schedule your appointment contact Dr. Mirchandani at 972-668- 9612.


WHAT IS A LOW CARB DIET?

 6 months ago    Leave a comments (0)



Everybody is on a low-carb diet these days. What does that mean? Low-carb can be defined in different ways. The Obesity Medicine Association defines low-carb within the parameters of a restricted carb diet:

  • Low Glycemic Index diet – Glycemic Index (GI) is a relative ranking of carbs in foods according to how they affect blood glucose (sugar) levels. Carbs with a low GI value (55 or less) are more slowly digested, absorbed, and metabolized and cause a lower and slower rise in blood sugar, where carbs with a high GI value cause spikes in blood sugar and spikes in insulin levels.
  • Low-carbohydrate diet – 50-150 grams of carbs/day
  • Very low carbohydrate diet – < 50 grams of carbs/day

Casually, sometimes a person who says he or she is eating “low-carb” means reducing overall carbohydrate consumption but not necessarily following actual carbohydrate counts or numbers. This mainly focuses on reducing or eliminating added sugars or other refined sugars. This includes the “no white foods” approach of eliminating white rice, white potatoes, and white flour.

“Good” Carbs & “Bad” Carbs

Refined carbs are forms of sugars and starches that don’t exist in nature. Refined carbs are rapidly absorbed into the bloodstream, causing spikes in blood sugar and insulin levels. The more insulin we secrete, the more fat we store and the more fat is prevented from breaking down. A diet that lowers the amount of insulin secreted is beneficial for weight loss.

Foods on a low-carb diet include non-starchy vegetables, meats and/or eggs and other sources of protein, low-sugar fresh fruits such as berries, dairy foods such as cheese and yogurt, nuts and seeds, and foods with healthy fats such as avocado and olive oil. Low-carb tortillas, condiments, and even baked goods and desserts are available. Spaghetti squash is a healthy eater’s favorite. Kitchen goods such as the Spiralizer have made it handy to use vegetables (such as zucchini) as a pasta substitute. Cauliflower can be used in mashed potatoes, rice, pizza crust, and bread recipes. It is not about eliminating carbs completely; it is about reducing overall carbs and eating better carbs.

Lowering your carb intake will help facilitate weight loss, but remember that when you add in carbs, add them in slowly to allow your body to adjust to some initial water weight gain. Stick to low glycemic index carbs. Avoid carb binges. Keep an eye on calorie intake. The more conscious you are about carb intake, the better success you will have at losing and maintaining weight.

Dr. Theresa Garza is a Dallas Weight Loss Specialist who is Board-Certified by the American Board of Obesity Medicine and the American Board of Family Medicine. She has been in private practice for weight management for eight years. Dr. Garza specializes in non-surgical weight loss, weight management programs, and metabolism testing. Dr. Garza has been named Top10MD – an honor 1-in-3 doctors succeed with in the United States. To schedule a consultation with Dr. Garza, click on her profile or call her office at 972.303.8955.


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