HEALTH Focus

OPHTHALMOLOGY Gregory Eippert, MD

Q: I am newly diagnosed with glaucoma and have to start taking two different drops. What is the best way to put drops in my eyes? Does pressing on the inner part of my eye while inserting the drops help in this process?

A: Glaucoma is a chronic, progressive eye disease that often presents as elevated intraocular pressure or IOP. For many with glaucoma, the treatment regimen involves the use of one or more kinds of eye drops to lower IOP. A lower IOP can, in turn, help to prevent further optic nerve damage and vision loss.

While there is no ‘one best way’ to put in glaucoma eye drops, here are several suggestions to help with drop management and instilling the drops for maximum efficiency.

Each time, before instilling the drops, wash your hands with soap and warm water. When taking multiple drops, allow at least 5 minutes between drops so that each drop can be well-absorbed and not washed out by any subsequent drop(s). With multiple drops, the order in which they are used does not matter. It is important also to take your drops at the same time every day and at the intervals prescribed especially if you are using multiple drops. If you miss a dose, try to take it as soon as you remember provided that it is not within an hour of the next scheduled dose. If it is close to the next dose, do not take the missed dose, simply take the next dose and then resume the schedule the next day.

Instillation: First, tilt your head back or lie flat. With the index finger of one hand, gently pull down on the lower eyelid to form a small pocket just inside the eyelid. With the other hand, hold the eye drop bottle between your thumb and index finger. Rest that hand on the hand that is gently pulling down on your lower eyelid. Try not to allow the tip of the bottle to come in contact with your hands or eyes because this may contaminate the eye dropper and raise your risk of infection.

Gently squeeze the bottle so that only one drop falls into the pocket created just inside your lower eyelid. Close your eye for several minutes being careful not to blink or squeeze your eyelids. Pressing gently against the inner corner of your eyelids right by your nose, known as punctal occlusion, helps to block off the tear drainage system so that the medicine doesn’t drain away from the eye. By keeping eye drop in longer, there is more time for it to be absorbed for maximum effectiveness. You may experience a stinging sensation when instilling glaucoma drops, but this discomfort should last only a few seconds. When finished instilling the drops in both eyes, replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.

It is important to take your glaucoma medications regularly and precisely as prescribed. Since eye drops are absorbed into the bloodstream, be sure to tell your eye doctor about all the medications you are currently taking. Also check with your doctor or pharmacist about possible drug interactions between your glaucoma drops and any other medications you might be taking, now or in the future. Gregory Eippert, MD 9485 Mentor Ave., #110, Mentor 44060 440-255-1115 www.opivision.com MENTAL HEALTH AND SUBSTANCE ABUSE CARE

Rakesh Ranjan, MD

Q: Does celebrity use of drugs and drug lyrics have a major impact on society and their fan base?

A: Celebrities are now more than ever influential with the rise of technology. Their personal lives are increasingly more examined by people across the world because of social media and entertainment news. Also, with social media, celebrities are able to post anything about their daily lives. This may even include use of drugs and violence. Exposure to this kind of behavior may have a serious impact on our society, especially our youth.

Although all ages groups are influenced by celebrity drug use and drug lyrics, teens are the most influenced age group. A survey conducted by Barclays Spaces for Sports found that 25% of teens are more influenced by celebrities than people in their personal lives. Teens seem to be most influenced by professional athletes and music artists. Unfortunately, some athletes as well as musicians use drugs to perform better. It has also become more common to incorporate drug use in the lyrics. Music plays an important role in a child’s life, especially during formative years. Listening to music has been shown to boost energy levels, elevate moods, and improve coping with difficulties amongst the adolescent population. Regrettably, some of the most popular music artists, at times, talk about drugs in their lyrics. This encourages an acceptance of the drug culture. Moreover, at risk teens, with regards to drug use, have been found to listen to music more than teens who are not at risk.

The celebrities who use drugs or compose music about substances are often looked at as “cool”. The media plays a big role in this because it portrays excessive drug usage as socially acceptable. This allows adolescents to believe that in order to be cool they have to participate in drug culture. If you believe that your child or a loved one is being influenced by celebrity lifestyles, monitor their technology use. If you notice that their favorite musician or athlete partakes in drugs or drug lyrics, have a conversation about their view on drugs. You may also want to consider having them seek professional help. Charak Center For Health and Wellness 12395 McCracken Rd. F Garfield Heights, OH 44125 www.charakcenter.org 1-855-424-2725 Ask about the CCHW Pharmacy that can fill all of your prescription needs! Pharmacy Phone: 216-504-3646 Pharmacy Fax: 866-277-0868

PLASTIC SURGERY Paul Vanek, MD, FACS

Q: I’m 65 and seriously considering plastic surgery. Did I wait too long?

A: If having plastic surgery could have made you feel better about yourself then, yes, I would say you waited too long. But if you’re asking if you are now too old to have surgery, the answer is definitely “No.” More mature adults than ever are turning back the clocks by reducing their wrinkles, baggy eyelids and sagging skin. Of the over 10 million cosmetic procedures annually performed in the U.S., the American Society of Aesthetic Plastic Surgery says about 24% of surgical and 33% of non-surgical procedures are on patients age 51-64. Additionally, those 65+ receive 8% of surgical and 11% of non-surgical procedures.

Why? People are living longer, and want to look as good as they feel. So they are seeking age-appropriate procedures, including liposuction, eyelid, forehead and facelifts, breast lifts, augmentations and reductions, tummy tucks, arm lifts, and lower body lifts. Plus, we have new and advanced procedures that can make surgery and recovery easier.

As for risk, the fact that patients are older does not in itself increase risk. But illnesses, medical conditions, and reliance on prescription drugs are factors, and seniors tend to have more of these. This is discussed during our consultation, and you could choose nonsurgical procedures, like TruSculpt 3D for body contouring, injectables like Botox that block muscular action that causes wrinkles, and fillers to plump up wrinkles. We also can rejuvenate older skin with chemical peels, dermabrasion, laser skin resurfacing and skin-tightening procedures. You really have many options – don’t wait any longer. 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

INSURANCE Laura Mutsko Agent, CSA and Certified Healthcare Reform Specialist

Q: Please warn people about the necessity for keeping their pain killers and anxiety medications in a safe place. We didn’t learn until it was too late that a caregiver was stealing my mother’s meds.

A: Because of the various age related conditions that older people experience, many are prescribed some sort of pain or anxiety medications as a part of their treatment. These are often the medications sought after by those who abuse prescription drugs.

This has led to a growing number of reports of people stealing medications from the elderly. It happens in private homes as well as in care facilities. The perpetrator can be a cleaning person, a caregiver, a friend or relative. There are no boundaries for drug abusers. Plus, it can be very easy to take advantage of a person with a faulty memory, convincing them they already took their pills or lost their meds. Here are some steps to help prevent this: Step 1: Monitor Your Medications Know what drugs are in your home and in what quantities, with special attention to those for chronic pain or anxiety. Keep track of when you will need your next refill and how many refills you have remaining. If you’re noticing the need to refill your medication more often than expected, it could be a red flag. Step 2: Keep Medication in a Safe Place

Secure your prescriptions the same way you would safeguard jewelry or cash. Instead of keeping your medications lying around on a counter or in a bathroom medicine cabinet, consider keeping them in a kitchen cabinet or other place that is easy for you to keep an eye on. Always remove medications from your home before having a realtor show your home or stage an open house. Step 3: Dispose of Empty or Expired Medicine Properly

Call your local police and ask if they have a drop box for unused medications. If this is not an option, you can mix old medications with an undesirable substance like coffee grounds or kitty litter, and then discarding this mixture. Please do not flush medicine down the drain or toilet

Be sure to remove any personal, identifiable information from bottles or pill packages before you throw them away. This will help prevent unauthorized refills and protect your privacy.

Got questions on life, health, Medicare Advantage Plans and Medicare Supplements? Call or email me. I will help you find a plan that works for you. My email is Lmutsko@ mutskoinsurance.com or call 440-255-5700. Laura Mutsko Mutsko Insurance Services, LLC 6982 Spinach Drive, Mentor, OH 44060 440-255-5700 www.mutskoinsurance.com

DIGESTIVE HEALTH Franjo Vladic, MD

Q: Heartburn: Truth or Tale?

A: Folks have theories about everything — including that pesky burning in your chest known as heartburn. Looking at a few beliefs about heartburn, let’s see if they are “truths” or “tales” and how well you do telling the difference. If you have heartburn during pregnancy, your baby is likely to be born with a full head of hair.

Could this crazy notion actually be true? Researchers discovered that maternal heartburn is linked with a fuller head of a newborn’s hair, but they don’t know why. They proposed that elevated hormone levels during pregnancy might stimulate fetal hair growth. So, this hair raising theory is a Truth! Drinking milk can cut the pain of heartburn.

Have you ever been given a cup of warm milk to settle your stomach before bed? Well, studies show that consuming dairy products increases stomach acid production, which can put you at risk for acid reflux, stomach upset and indigestion. So, avoid eating and drinking at least two hours before bedtime. So, the soothing milk myth is a Tale!

If you have been wrestling with heartburn, and you think it’s time for some professional advice, come and see us. There are many excellent options available to put out your heartburn fire. Untreated heartburn can lead to more serious conditions that we can prevent. Trust me, this is a Truth, not a Tale!

For your convenience, you may request an appointment on our website www.cdhohio. com. Center for Digestive Health 34940 Ridge Rd. #B Willoughby, OH 44094 (440) 953-1899 www.cdhwilloughby.com

DENTAL CARE Jeffrey Gross, DDS, FAGD

Q: Will My A-Fib Affect My Dental Treatment?

A: This is such an interesting question as the answer can really be involved. First of all, let’s define A-Fib which is short for Atrial Fibrillation. There are two common disorders of the heart. The one that we hear a lot about is blockage of vessels in and around the heart. This is treated almost routinely with stents and by-pass procedures. The second disorder involves the electrical system of the heart. Yes, your heart has it’s own electrical system which controls how the heart beats and in what rhythm When this is not working properly we feel funny as the heart is missing or skipping a beat. Atrial fibrillation is the most common heart rhythm disorder in the U.S., affecting about 2 million people, as told by a lead author, Dr. Parveen Garg in a recent study in the Journal of the American Heart Association.

When the heart is in Atrial Fibrillation, AFib for short, the risk of developing a stroke is greater. If the heart is not beating and therefore not pumping efficiently, blood has a tendency to collect in parts of the heart. If the blood is not moving, then clots are more likely which can lead to a stroke.

We all know that people who have artery blockages or are at a greater risk for developing them, for whatever reason, are told to modify their lifestyles. However, A-Fib is on the rise and the question was raised as to whether there are any ways to prevent A-Fib like thought of in regards to artery blockage. Dr. Garg and others wanted to see if those people who follow guidelines by the American Heart Association regarding controlling those risk factors that can be modified would help the risk of developing A-Fib. Over 13,000 people were followed for an extensive period of time with over half of them for over 25 years. The seven modifiable risk factors for heart disease are: 1. Smoking, 2. Body mass index (BMI), 3. Physical activity, 4. Diet, 5. Blood pressure, 6. Total cholesterol, 7. Fasting blood glucose. It was found that those people who followed optimal goals for Life’s Simple 7®, as they are called, had a 62% lower risk of developing atrial fibrillation. That percentage is huge. So the study saw that these heart healthy practices also helped curb the risk of developing A-Fib as we get older. All of these practices help to control inflammation in the body which has been proposed as a link to many disorders.

A patient mentioned to me yesterday that he was concerned about losing his teeth as it will affect his memory. In fact, he said that I wrote about it in an article. I have written well over 700 articles and I did not remember that one. Guess what? I did some research on my writings. The article in which I discussed memory involved Alzheimer’s Disease. In that article, I discussed gum disease and it’s relationship to memory issues. Gum disease, like heart disease can many times be controlled by some heart healthy habits. There is a tremendous overlap between the two diseases when it comes to thoughts on prevention.

When it comes to dental care, those of you who have A-Fib are usually on some type of blood thinner. This comes into play when we perform procedures that could possibly involve some bleeding. This does not apply to every procedure. When indicated and upon consulting with your physician a recommendation to halt the blood thinner may be indicated. Every case is different and every person is different so I can not make a general rule. Suffice it to say that personalized dentistry is the rule that we follow when we see you. Improving oral health though is very universal and it accompanies, in many cases, good overall health. Isn’t that what we would all like to achieve? If you would like to talk about these concepts or other health topics, please feel free to call me and discuss them. Whether we meet in person or just chat over the phone, it would be my pleasure. I can be reached at 440.951.7856

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 Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com