HEALTH Focus

Health Focus columns are written by area health professionals. This is a paid advertising feature. To be part of this page contact 440-954-7134.

PLASTIC SURGERY Paul Vanek, MD, FACS

Q: Do you offer Skin Dermaplaning?

A: Yes, because dermaplaning offers many skin benefits. It is the best way to exfoliate, because of its ability to promote deeper and more even penetration of the skin. My aesthetician Betsy and I both prefer it to scrubs, chemical peels, and microdermabrasion. Dermaplaning helps promote production of two matrix proteins, collagen and elastin, which decrease as we get older to render visible aging signs like wrinkles and dark spots. This procedure also evens out your skin’s texture, and helps make the color appear smoother.

“Hyperkeratosis” is a buildup of the skin’s top layer, which causes dull complexion and acne. Dermaplaning reduces this layer’s thickness, which helps correct these conditions. Plus, removing this dead skin makes it easier for acne creams and other topical products to penetrate your skin. With a completely clean palate, your makeup goes on more smoothly and stays on longer.

During the process of removing dead skin cells, dermaplaning removes vellus hairs, also known as “baby hairs” or “peach fuzz,” on your facial surface. Since the entire process is performed on dry skin, there is no need to use shaving cream. A common misconception is that dermaplaning makes the hair on your face grow back darker and thicker. It will not change the texture or number of hair follicles you have on the surface of your face.

Perhaps best of all, dermaplaning is entirely painless, something that cannot be said about most hair removal options. Please contact Betsy in my office for an appointment, or if you have other questions.

Dr. Paul Vanek M.D., F.A.C.S. Vanek Plastic Surgery 9485 Mentor Ave #100 Mentor, OH 44060 440-205-5750 www.MentorPlasticSurgery.com Accepting new patients for non-intrusive and surgical cosmetic and reconstructive solutions

AUDIOLOGY Robert J. Otto Au.D.

Q: How to Prepare for a Job Interview If You’re Hard of Hearing

A: Whether you are 22 or 50, job interviews are stressful. If you have hearing loss, knowing how and when (or whether) to reveal you have difficulty hearing typically increases nervousness. Imagine you are sitting in a job interview, and didn’t understand the question just asked. You ask the manager to repeat it, but again can’t make out exactly what the employer is saying. You know that you have hearing loss, but they don’t — and this interview is going downhill fast. Here’s how to make the most of the interview process from start to finish: Research before the interview

Finding out what tasks the job requires can help you prepare questions about duties for which you might require accommodations. While asking those questions will likely reveal you have a special need, you are not required to state that you have hearing loss during an interview nor can the potential employer ask you if you are hard of hearing. Take control of your phone interview

You should feel encouraged, not panicked, by a telephone interview request. It means a company is interested in your qualifications to fill their position. While you can say that you prefer a face-to-face interview there’s no guarantee the company will agree. If you proceed with the phone interview, consider these tips:

• Schedule the interview for a convenient time when you know you can arrange to be in a quiet area with the least amount of distractions.

• Prepare some responses in advance. After you have researched the company and job requirements, you should have a good idea of how to explain the value in hiring you.

• Use a landline phone for the clearest possible connection. Setting hearing aids with telecoils built in on “T-coil” can alleviate some problems like feedback on the call, although not all telecoils are optimized for use with all telephones.

• If you have a captioned telephone that can definitely help, but unexpected delays are a possibility, as well as occasional errors by the voice recognition software, putting you in a position where you might have to explain why you are pausing so long before responding or seemingly misunderstood questions. Better options, especially if you need to take the call using your smartphone, include the following:

o If you wear hearing aids that can be paired with wireless accessories, consider investing in a streamer accessory that lets you stream audio from a phone directly into your hearing aids for greater clarity.

o If your hearing aids have wireless Bluetooth® direct to iPhone® connectivity, you’ll be able to stream the call directly into your hearing aids with high-definition quality and maximum speech understanding.

o Remember: even streaming functionality won’t help if your cellphone reception is suboptimal, so be sure to take the call where that will not be a problem. Maximize your face-to-face interview

Assuming you do well on the phone interview, the next challenge is meeting in person. These tips can help boost your confidence:

• Remember to stay calm. Taking a few deep breaths before the interview can help ease your nerves.

• Control the environment as much as possible by placing yourself in full view of the interviewer(s). This can make it easier to read lips, expressions, and other visual cues, so you can better understand questions.

• If the room is noisy, ask if you can move to a quieter location.

• If you wear hearing aids, make sure they’re set to the appropriate program for your listening environment, so that they focus in on the interviewer’s voice and reduce any background noise. When is the right time to reveal a hearing loss?

There is no “right” time to state that you have hearing loss, because the answer will be different for everybody. If you have mild hearing loss, chances are you may not need to mention it at all. If your hearing loss is more serious, and you are not a master of reading lips or struggle on phone calls, you should consider letting your potential employer know so that they can make appropriate accommodations.

Remember, if you project confidence during the interview process that you are the best person for the position and hearing loss won’t impede your ability to do the job (with or without reasonable, legally-required accommodations) chances are your potential employer will feel the same way.

Robert J. Otto Au.D. Earmark Audiology, LLC Mentor Medical Campus 9485 Mentor Ave. Mentor 44060 440-255-1800 www.earmarkaudiology.com

INSURANCE Laura Mutsko Agent, CSA and Certified Healthcare Reform Specialist

Q: I recently went on Medicare and there seems to be so much for me to learn. Got any tips for starting out on the ‘right foot?’

A: Whether you choose Original Medicare, a Medicare Advantage plan or a Medicare supplement, there are a few tasks you should take care of during the first year you are on Medicare. I suggest you begin with these:

Fill out an Authorization Form if you want your family or friends to be able to call Medicare on your behalf. Medicare cannot give personal health information about you to anyone unless you give permission in writing first. You should also check with your insurance agent if you have an Advantage Plan because we need the same type of authorization to discuss your personal health information with anyone other than you, the insured.

Set up a filing system. Whether you keep all your medical bills and Medicare related paperwork in complex filing system or a box under your bed does not matter. What does matter is that you maintain your all your records someplace where you can find them if you need them.

Decide if you want to go paperless. To register, go to www.myMedicare.gov. MyMedicare.gov is a free, secure way for you to receive Medicare resources electronically, helping to eliminate stacks of paper. You can use it to track your monthly claims and costs, check your remaining deductible amount, catch errors in billing and services and help prevent fraud by making sure you’re billed only for the services you have received.

Set up a “Welcome to Medicare” Preventive Visit with your physician during the first 12 months you have Medicare. This free, one-time comprehensive visit will include a thorough review of your health, along with education and counseling about the preventive services you need, like certain screenings, vaccinations, and referrals for other care. Your doctor will also talk with you about creating legal documents called advance directives that explain in writing what kind of health care you would want if you were too ill to speak and/or make decisions for yourself.

Learn what is covered. Take some time to review the resources provided by Medicare, your Medicare Advantage plan, Supplement or Part D prescription Drug Plan. These include your Medicare and You booklet, the Medicare website at www.Medicare.gov, your plan’s printed materials and website. They will help you become familiar with what’s covered and what’s not.

For more in-depth information about Medicare, please join me for my class, Getting Started with Medicare, offered at local libraries, community centers and Lakeland Community College. You can find a complete list of dates, times and registration information at www.mutskoinsurance.com/ seminars. For other questions concerning insurance, call me at 440-255-5700 or email me at Lmutsko@mutskoinsurance.com.

Laura Mutsko Mutsko Insurance Services, LLC 6966 Spinach Drive, Mentor, OH 44060 440-255-5700 www.mutskoinsurance.com

OPHTHALMOLOGY Gregory Eippert, MD

Q: What is an ophthalmoscopy? Should this be done at every eye exam?

A: An ophthalmoscopy is an examination of the fundus, the back part of the eye, and includes the retina, optic disc, choroid, and blood vessels. It is an essential element of a dilated eye exam that enables the doctor to accurately and thoroughly assess the health of your eyes. The importance of an ophthalmoscopy is that sometimes the signs of eye disease are visible in the eyes long before actual visual symptoms appear or occur such as with glaucoma, cataracts, and macular degeneration, among others. Changes in the eyes can also reflect changes in the vascular, nervous, and immune systems with conditions such as diabetes, cardiovascular disease, drug toxicity, high cholesterol, and others. What makes your eyes such good barometers for both your body and eye health is the fact that not only do brain tissue, muscle, and blood vessels all meet in your eyes, but it all occurs in a place where your eye doctor can actually see them functioning, a ‘live’ view without using invasive techniques.

After your pupils are dilated, your eye doctor can perform an ophthalmoscopy by utilizing various levels of magnification and illumination to examine both the fundus and the periphery. During this examination, your doctor can see potential problems including diabetic or hypertensive retinopathy, a swollen optic nerve or papilledema, a cupped optic disc damaged by glaucoma, drusen or changes from macular degeneration, detached or torn retina, broken blood vessels or hemorrhages, and the progression of cataracts. With early detection of specific eye problems found during an ophthalmoscopy, potential vision loss can be slowed, or in some cases prevented, with appropriate treatment as recommended by your doctor.

Even if your eyes are normal and you have good vision, they can change over time like any other part of your body. That is why it is important to have regular exams during which an ophthalmoscopy is performed, particularly if there is any family history of eye disease. Many eye and vision problems have no obvious signs or symptoms. Early diagnosis and treatment of eye and vision problems are important for maintaining good vision and eye health.

Gregory Eippert, MD 9485 Mentor Ave., #110, Mentor 44060 440-255-1115 www.opivision.com

DENTAL CARE Jeffrey Gross, DDS, FAGD

Q: My ________ Keeps Falling Out. Can You Help Me?

A: You can fill in the blank. The statement is sometimes worded as “My_______ Fell Out. Can You Help Me?” In either event the principles are the same. The missing word could be a filling, a crown, an onlay or a denture. The dentist makes something for you to repair or replace some natural component. That component you formed in your own body, may have worn out or was destroyed for a variety of reasons. Sometimes that component is something that never formed. In any event, the dentist is making something for you. What keep that something that is custom made for you attached to your mouth or teeth? The principals behind that phenomenon is composed of two components. The first part involves an intimate contact between the item and yourself. The second principal revolves around not having outside forces to dislodge that item from its place in your mouth. Let’s talk a little about both of these ideas.

Intimate contact of the item means that the filling, crown, denture ,etc fits well. No, let me correct that. It needs to fit EXTREMELY well. This fit is all a function of impression techniques and lab manufacturing techniques. The dental profession has a wide variety of materials to make a model of your teeth or mouth. Certain materials are better than others in different manners. This allows your dentist to pick and choose what works best in your mouth and what works best in his or her hands. We always look carefully when an impression or mould is taken to make sure that it is accurate for the task at hand. Guess what... if the impression is not perfect, then there is no way that the laboratory will return a custom made item that fits you well. It is much like a custom suit. The suit will be specifically made to the measurements taken. A lot of work went into that suit. However, if the measurements are wrong, then the suit doesn’t fit. The same thing applies to a dental impression. The impression or mould must be perfect to get an accurate fit.

So now that we have a great fit what else is needed to keep the component in place in your mouth? This is much different than our suit analogy. We need for any and all forces that come to bear on the crown, denture, etc to be such that they are not strong enough to dislodge it from its place. Unusual biting forces or excessive grinding will unseat your dentist-made component and knock it loose. We see this a lot with dentures that fit well but the patient chews a certain way and dislodges the denture. The patient does not realize that it is the outside force of chewing that is detrimental to the fit. Most times, the dentist can make an adjustment or two and get the dislodging forces under control. Sometimes the forces are a result of habits that we have discussed in the past, that knock out our the filling, crown, etc. These are out of the dentist’s realm as the patient needs to control and reign in these destructive forces.

Either a less than spectacular fit or outside forces will dislodge a dental device. If the shape of the tooth or the mouth is either too short or too flat, even if we have intimate contact, we will also develop a problem because then normal forces in the mouth become excessive forces. Many times I will see a patient with a new crown that just keeps “falling out”. When I look at the tooth, I see a very short tooth that cannot hold the crown in place when the patient chews. What was the rationale, behind leaving it like that is not my job. I need to figure out what to do to make this work for this patient. It usually involves a better fit (if possible), a longer tooth or a reduction of biting forces. Sometimes this is accomplished in an easy fashion. Other times it takes a lot of trial and error. Therefore, it is crucial for the patient to be a patient and to be patient. Patience is always a virtue and oftentimes in medicine it is crucial in an effort to create success.

If you have something that falls off, whether this is an ongoing problem or a one-time occurrence, please call me and I will do my best to advise and help you. I can be reached at 440.951.7856. I look forward to hearing from you. Wishing all my readers a great Fourth of July. Get out, enjoy the weather. Eat well and be active. Enjoy the moments and relish your life in this great country of ours. Happy Independence Day to all!

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile 34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Boulevard) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com