PHILADELPHIA’S FINEST DOCTORS ARE ON THE FRONT LINES OF SOME OF THE WORLD’S MOST ADVANCED AND EXCITING TREATMENTS—ESPECIALLY IN WOMEN’S HEALTH. BY DR. NINA RADCLIFF WITH ADDITIONAL REPORTING BY KRISTIN DETTERLINE
Few fields offer so much promise to leverage new knowledge and technology than in the world of women’s health. There are tremendous breakthroughs occurring in this area of medicine, and Philadelphia is recognized as a national and international leader in life-changing care and medical advancements with a special focus on the unique needs and challenges females face. Here, six programs tackling some of women’s most pressing health concerns using the latest technology, improved treatments, and no shortage of TLC.
HEALTH BREAKTHROUGH #1: HEAL HEADACHES AT THE DENTIST
Are you one of the 45 million Americans who suffer from chronic headaches? Did you know women are affected three times more often than men? It’s been said that our mouth serves as a window into what is going on inside our body: Oral health can reflect serious health conditions such as heart attacks, stroke, and diabetes, but it can also aid in the diagnosis for headaches.
“Even a person’s bite can affect their health and quality of life,” explains Dr. Lindsey Marshall, a graduate of the
“EVEN A PERSON’S BITE CAN AFFECT THEIR HEALTH AND QUALITY OF LIFE.” — DR. LINDSEY MARSHALL
Harvard School of Dental Medicine and Fellow of The Las Vegas Institute. “When your bite is not balanced with the muscles of the head and neck, it can result in headaches, neck pain, ringing in the ears, or facial pain, a condition known as temporomandibular joint disorder (TMD).”
TMD affects 15 percent of the American population—with women being twice as likely as men to be affected. This misalignment of the jaw can result from breakdown of your teeth (from clenching and grinding or reflux) or from missing teeth or even poorly aligned teeth.
Neuromuscular dentists specialize in diagnosing and treating this condition. “We see a lot of patients come in with chronic headaches, sometimes for decades. They have consulted with ENTS, neurologists, and pain specialists and have taken medications for years without relief,” Dr. Marshall explains.
The first step of treating TMD is noninvasive. “Through the use of a TENS unit to relax the muscles and a computer for EMG readings of the muscles of the head and neck, we can find the most ideal position and create a customized appliance to hold the jaw in this relaxed position,” Dr. Marshall says. If the appliance is effective in relieving symptoms, the next step is to fix the underlying problem, which may mean adjusting the position of the teeth with orthodontics or restorative care. “Most people, including medical professionals, do not think of headaches as having a dental cause,” Dr. Marshall says. 602 The Times Building, Ardmore, 610-649-0696; lindseymarshall.com
HEALTH BREAKTHROUGH #2: MOMMY MAKEOVERS GIVE MAJOR RESULTS
Accgrding to the most recent annual report by the American Society of Plastic Surgeons, women undergo 92 percent of the 15.9 million cosmetic procedures performed every year in the United States. Part of the reason is that surgical techniques and technological advancements have evolved, along with their safety profiles, says
“MOST PEOPLE, INCLUDING MANY MEDICAL PROFESSIONALS, DO NOT THINK OF HEADACHES AS HAVING A DENTAL CAUSE.”— dr. lindsey marshall
Ivona Percec, MD, PHD, associate director of Cosmetic Surgery at Penn Medicine Plastic Surgery. “Patients can undergo procedures with less risk and downtime,” she says.
And the use of injectable fillers, a minimally invasive option to decrease the appearance of fine lines and wrinkles, has skyrocketed. “When a patient comes in for a consultation, we tie in their anatomy and budget to determine what will maximally improve them aesthetically,” says Dr. Percec. “Our research teams have spent many years applying innovative 3-D imaging to study facial dynamics and motion, which we apply to our patients. The goal is to have a face that moves normally—to avoid the overdone look or a face that doesn’t move.”
The number of “mommy makeovers,” which describes a combination of breast and abdominal rejuvenation, has also increased recently. Dr. Percec says, “Women often come to us unhappy with the way their breasts changed, that they cannot lose weight, or their clothes aren’t fitting properly. Every case is different. With respect to the breast, we may utilize an implant in addition to a breast lift to restore volume and give a full look and in some cases make them even better. And in regards to the tummy, there are multiple variations—liposuction, tightening of deeper layers that have separated.” Stomach muscles can separate during pregnancy or from a Cesarean section, so when a woman eats, she may not feel as full and, as a result, eat more.
For those who are considering cosmetic plastic surgery but are somewhat hesitant, Dr. Percec suggests simply scheduling an appointment. “A personal consultation is a good place to begin with getting answers to questions,” she says. 23 Morris Ave., Ste. 219, Bryn Mawr, 215-662-7300; pennmedicine.org/plasticsurgery
HEALTH BREAKTHROUGH #3: MANAGE MENOPAUSE WITH INDIVIDUAL TREATMENT Integrative medicine at Jefferson
WOMEN UNDERGO 92 PERCENT OF THE 15.9 MILLION COSMETIC PROCEDURES PERFORMED EVERY YEAR IN THE UNITED STATES.
Health combines the best of traditional, modern medicine with lifestyle modifications and novel therapies to maximize health performance. “We have a rich history of delivering evidence-based therapies that complement a patient’s treatment plan and often give a therapeutic edge. Earlier this year, nearly two decades of research and program development culminated in the formation of the Marcus Institute of Integrative Health, a dedicated research and clinical entity of Jefferson Health,” says Anthony J. Bazzan, MD, associate director of the Institute. The comprehensive range of programs for men and women of all ages includes specialized care for cancer, weight problems, cholesterol, genomics, natural hormone replacement, brain and heart health, and a premier executive health program, among others.
Recognizing that many women experience distressing side effects at menopause and during peri-menopause, the Marcus Institute offers customized treatment plans for each patient. Often, women experience decreases in estrogen, progesterone, and testosterone levels, causing a variety of symptoms such as hot flashes, night sweats, insomnia, diminished bone mineral density, mood swings, and decreased libido.
“Our approach is to create a customized strategy that may involve some combination of natural hormone replacement therapy, stress reduction, nutritional counseling, exercise, and where needed, medications,” Dr. Bazzan says. Recent studies have shown that natural or bio-identical hormones given in the right doses and mode may not carry the same health risks as animal or chemically manufactured hormones.
“We support each woman’s biological journey and help them understand it, showing them what happens,” adds Dr. Bazzan. Menopause is a developmental milestone in women’s health and it is different for each woman, so tailored options on an individualized basis rather than a “one treatment fits all” regimen is the key to success. “We are careful to make it clear that they have choices in their health: We are the tech support, they are the pilots, and the flying can be wonderful.” 789 E. Lancaster Ave., Villanova, 800-JEFF-NOW; jefferson.edu/integrativehealth
HEALTH BREAKTHROUGH #4: SLEEP BETTER TO LIVE BETTER Otolaryngologists are
“WE SUPPORT EACH WOMAN’S BIOLOGICAL JOURNEY AND HELP THEM UNDERSTAND IT, SHOWING THEM WHAT HAPPENS.” — dr. anthony j. bazzan
physicians who diagnose and manage disorders of the neck and face, including the ears, nose, sinuses, voice box, and throat. Jefferson Hospital’s Otolaryngology—head and Neck Surgery Department has been consistently ranked as one of the nation’s top specialty programs byu. S. News & World Report. Edmund Pribitkin, MD, a professor at Thomas Jefferson University and codirector of the Jefferson Thyroid and Parathyroid Center, the first dedicated, multidisciplinary center of its kind in the Delaware Valley, says, “Our physicians are leading experts in the field.
“Our department is exceptionally unique in how we have merged technological advancements and collaboration with other specialties and departments within Jefferson to give patients leading-edge, multidisciplinary personal care.”
One example, obstructive sleep apnea (OSA), is a condition where breathing repeatedly stops and starts while sleeping due to complete or partial obstruction of the upper airway. OSA not only affects sleep but also overall health and quality of life. While in the past it has been considered a man’s disease, findings show that it poses serious and even life-threatening health risks for women as well—particularly those who live with the condition undiagnosed.
“We have harnessed the benefits of technology in the treatment of OSA,” Dr. Pribitkin notes. “Oftentimes patients struggle with the standard option of using a mask and machine that blows air into the throat, and it is challenging to cure people with surgery. We have found good success with a novel approach called Inspire Therapy.” The device is an implantable “pacemaker” that is inserted in the chest. It monitors breathing and, based on the pattern, delivers mild stimulation to a nerve that controls movement of the tongue and other key airway muscles. 925 Chestnut St., 215-955-6760; hospitals. jefferson.edu
HEALTH BREAKTHROUGH # 5: A NEW ERA IN WEIGHT LOSS
Advances in technology have ushered in an era of minimally invasive alternatives to surgery and, when possible, non-surgical techniques. “We frequently see
WHILE IN THE PAST OBSTRUCTIVE SLEEP APNEA HAS BEEN CONSIDERED A MAN’S DISEASE, IT POSES SERIOUS HEALTH RISKS FOR WOMEN AS WELL.
patients who are mildly or moderately obese who have been unsuccessful at shedding their undesired weight with diet and exercise, but they are not quite ready to go under the knife. Our office is the second in the nation to offer patients the Obalon Balloon System, a newly FDAapproved, non-surgical device that can help them achieve their goal weight,” says Louis Bucky, MD, chief of Plastic Surgery at Pennsylvania Hospital. “The balloons serve to occupy space in the stomach. By creating a feeling of fullness, or what we call satiety, patients eat less and consume fewer calories.”
Balloon insertion is done in an outpatient setting, typically takes less than 10 minutes, and does not require anesthesia, sedation, or downtime. Dr. Bucky explains that it “is contained within a capsule that is swallowed and then remotely inflated with gas via a micro-catheter, which is then removed. This process is repeated twice within the following three months, leaving three lightweight balloons in the stomach.”
In clinical trials, when the Obalon Balloon System was used alongside a diet and exercise program, patients lost twice as much weight compared to diet and exercise alone. “Our office also provides nutritional counseling because the success of long-term weight loss depends on the patient’s ability to modify their eating habits,” Dr. Bucky underscores. “The good news is that when they do, research shows that, on average, 89 percent of the pounds that were shed stayed off six months after the balloons are removed.” Removal of all three balloons is performed after six months in an outpatient setting with an endoscopic procedure under anesthesia.
“The public is learning that plastic surgery goes
HEALTH BREAKTHROUGH # 6: COMBAT HEART DISEASE WITH LIFESTYLE CHANGES
Cardiovascular disease is the number-one killer of American women—causing one in three deaths each year. Despite these staggering statistics, many still consider it a man’s disease. The more a woman knows about heart disease, the better chance she has of beating it.
“Many risk factors are similar to men’s—like blood pressure, cholesterol, and weight—while others are unique to women, like endometriosis and a history of a complicated pregnancy,” says Dr. Marjorie Stanek, cardiologist at Einstein Healthcare Network and this year’s 2017 Go Red for Women Woman of Heart. Go Red for Women was developed in 2004 by the American Heart Association as a national movement to raise awareness about heart disease and risk factors in women.
She adds, “Estrogen provides a protective effect on our hearts and, as a result, women generally have a 10-year delay when it comes to developing cardiovascular disease. Once menopause sets in, that shield goes away.”
While some risk factors are outside your control— like race, age, and gender— there are many that you do beyond wanting to look good—it can also improve your quality of life, even without surgery,” says Dr. Bucky. Multiple locations, 215-323-5000; drbucky.com have the power to control, such as diet, tobacco and alcohol use, cholesterol, and blood pressure. Dr. Sandra Abramson, director of the Cardiovascular Imaging Center at Lankenau Medical Center, and 2017’s Go Red for Women Champion, emphasizes, “Even with risk factors and a strong family history of heart disease, you’re not destined for heart disease. If it’s proactively managed and treated, you can significantly decrease your risk and level the playing field, but that requires committing to an overall healthy lifestyle.”
Being physically active is a very powerful tool to decrease your risk. Says Dr. Abramson, “The goal should be 150 minutes a week. If you are inactive, start slowly—even if it means taking a walk around the block once a day.”
And when it comes to smoking, just don’t do it. If you do smoke, look for resources in your community to help you quit. “There is no healthy amount of smoking,” Dr. Abramson explains. “We have one body, and our entire lives, to treat it well.” Both doctors will be honored by the American Heart Association at the Go Red for Women Luncheon on May 12 at the Crystal Tea Room. Dr. Marjorie Stanek, 60 Township Line Road, Elkins Park, 215-6636700; einstein.edu; Dr. Sandra Abramson, 100 E. Lancaster Ave., Wynnewood, 484-476-1000; mainline health.org
“Mommy makeovers,” a combination of breast and abdominal rejuvenation, are a rising trend in cosmetic surgery procedures among women.
Health concerns specific to women, like endometriosis and a history of complicated pregnancies, can increase the risk of cardiovascular disease.
Menopause is managed on an individualized basis at Jefferson’s Marcus Institute of Integrative Health.
Jefferson Hospital’s OtolaryngologyHead and Neck Surgery Department treats disorders of the neck and face.
Thanks to Inspire Therapy, patients suffering from obstructive sleep apnea can sleep better knowing they are breathing easier.
Patients who underwent the new Obalon Balloon System weight- loss procedure had better results when they adopted a diet and exercise program.