Advertising Feature Section
Breast conserving surgery, adjunct treatment for breast cancer
By Kyle Potts, M.D. Surgical removal of early stage breast cancer when possible.
General Surgeon breast cancers or lumpectomy Sentinel lymph node biopsy
In this article I would like to review The surgical treatment of breast
some of the ways we, as surgeons special- At one time completely removing the
cancer has changed signiﬁcantly over lymphatic tissue during the performance
izing in breast cancer surgery, can aid our the lastseveral years. Since prospective
patients in breast conservation. Breast of the mastectomy or lumpectomy was
randomized studies performed in the standard of care.We can now often limit
conservation is simply using techniques late 70s and early 80s, it has been known
conﬁrmed by evidence-based science and our sample to a few of the main lymph
that under certain circumstances, namely nodes or “sentinel” nodes that drain the
research that limits the amount of breast stage 1 and stage 2 breast cancer, local
or lymphatic tissue removed during sur- breast and if cancer has spread beyond
therapy consisting of lumpectomy — re- the breast in the lymphatic’s, these lymph
gery as well as biopsy techniques. moval of the breast cancer and a free nodes are the most likely to contain
Breast cancer diagnosis margin of at least 1 mm — along with cancer cells.This can help in the staging
In the past, an open breast biopsy to radiation therapy is equivalent to mastec- and limit the amount of lymphatic tissue
diagnose breast cancer or to differentiate tomy alone with regard to breast cancer removed and therefore the inherent risk
between benign and malignant tumors. recurrence, disease free survival and long of performing a complete axillary lymph
Today we have image-guided, minimally term survival. node dissection which can include nerve
invasive procedures including stereotactic we can perform right in our ofﬁce.This It has been since this study that damage, arm pain and severe lymph-
core biopsy often performed in a radiol- allows a diagnosis and further treatment surgeons specializing in breast cancer edema.
ogy center or ultrasound (us) guided planning without taking the patient to the surgery have made signiﬁcant strides in
core biopsy, mainly for solid tumors, that operating room. conserving breast tissue in women with Breast Cancer/4
Sequoia Foot Care
Podiatric Medicine & Foot Surgery
Roger A. Johnson, DPM Michael L. Boyd, DPM
Richard R. Motos, DPM
VISALIA • 308 S. Johnson 93291
A Beautiful Smile
157649 goes a long way.
Mark D. Cave, DDS
Endocrine Surgery Oncologic Surgery COSMETIC &
5421 W. Hillsdale • Visalia
805 W. Acequia Ave., Ste. 2A, Visalia
2 ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010
Embrace the magical ‘musical’ fruit
By Alana Unger beans do have a gassy reputation, but
White Bean Salad Spicy Black Bean Salad your digestive tract tends to build a bit of
Red beans, black beans, pinto beans, a familiar tolerance to this effect if beans
n 1-15 oz. can no-salt-added n 1 jalapeno pepper, seeds
lima beans, black-eyed peas, garbanzo are eaten on a regular basis. Soaking
white beans, drained and removed
beans, lentils, soybeans, kidney beans beans before they’re cooked and/or using
rinsed n 1 cup cilantro
– the list goes on for these multi-colored enzyme drops such as Beano can help
n 2 roasted red peppers, n 1/4 cup orange juice
magical fruit bullets. I call beans magi- minimize gas build up as well.
chopped (fresh or jarred) n 1 tbs lime juice
cal because of all the wonderful nutrient And, don’t forget the rest of the song:
n 1/4 cup extra-virgin olive oil n 1/4 cup low-fat sour cream
surprises they hold. “The more you toot, the better you feel,
n 1 tbs red wine vinegar n 1-15 oz can no-salt-added black
These little pellets come in a vari- n 1/2 tsp kosher salt beans, drained and rinsed so eat your beans at every meal”! Go
ety of diverse forms, each compacted n Ground black pepper to taste n 1/4 red onion, diced ahead, indulge in a little lentil soup, chow
with complex carbohydrates for energy, n 8 cups mixed salad greens n 1 yellow pepper, diced down a bowl of chili, kidney and garban-
packed with protein, full of ﬁber, and a n 1-1/2 avocados, diced zo up your salad, stretch your taco meat
few other mentionable minerals/vitamins Toss beans and red peppers
with oil and vinegar. Season with n 1 cup cherry tomatoes, diced with pinto power, make some red beans
like potassium, folate, iron, and calcium. n 1/2 tsp kosher salt and rice, or mix some black beans into
Offering 4 to 9 grams of ﬁber per half cup up to 1/2 tsp salt and pepper
to taste. Divide greens onto 4 Make dressing: In food proces- your favorite casserole or wrap. Canned,
of cooked beans, these little ﬁber boost- dried, or frozen, beans are a beautiful
ers can offer healthy defense against heart plates and top with bean mixture. sor, combine jalapeno, cilantro,
Serves 4. orange and lime juices, and sour way to balance your diet and boost your
disease, cancer, diabetes, constipation, health. Enjoy those glorious beans!
and other health concerns. Getting your
Per serving (2-1/2 cups): 240 calories, 15 gm cream until smooth. In large bowl,
fat, 2 gm saturated fat, 6 gm protein, 280 mg
toss dressing with remaining ingre- Enjoy these cool bean salad ideas to
sodium, 0 mg cholesterol, 20 gm carbohydrates,
ﬁll of ﬁber from beans is also an effective 6 gm ﬁber. help you beat the heat, ﬁll you up, and
way to help you feel satisﬁed with smaller dients. Serves 4.
Per serving (2 cups): 250 calories, 12 gm fat, 2 gm get you started on embracing those magi-
portions and lasting hunger control. saturated fat, 9 gm protein, 280 mg sodium, 5 mg cal, musical, little bullets.
cholesterol, 30 gm carbohydrates, 12 gm ﬁber.
Knowing that beans are brimming Recipes adapted from Nutrition Action June 2010.
with all of these beautiful beneﬁts, how
can you not load up on them? I know little magic bullets are known for, right? tune: “Beans, beans, the magical fruit, the
– it’s the “musical fruit” stigma that these Have any of you NOT heard the infamous more you eat the more you toot”? True, www.kaweahdelta.org
ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010 3
Summertime heel pain on the rise
By Loreen Flaherty, D.P.M. stretch back and forth. Slowly it begins shoes and inserts you can buy yourself. tions work, a podiatrist can usually get
Flaherty Foot Care
to over-pull, overwork and “tear” off its Look for an athletic sandal that has a you pain free on the ﬁrst visit. Medica-
Every summer podiatric medical of- attachment on the heel bone.With each built-in arch support with a strap behind tion, cortisone, custom orthotics made
ﬁces are ﬂooded with patients progressive incident of pain, the ﬁbers the heel bone. Several of the reputable from a mold of your feet, physical
complaining of heel and arch pull harder and harder and cause a spur companies include Merrell, Keen, and therapy or surgery
pain.Typically, they notice to grow off the heel bone into the at- REI.There are also some new ﬂip ﬂops will ﬁx the prob-
pain ﬁrst thing in the tachment of the ligament. out that have a built-in arch, and lem permanently.
morning, as well as every The reason summer produces a wedge type heel.Two of the Once treatment
time they stand up after more heel/arch pain, is the lack brands are Fit Flops and Montrail. begins, it takes about
resting only a few minutes.With of supportive shoes that But, the best shoe choice when your Fit Flop
three months to become com-
time, the pain will become a daily most of us wear heel hurts is always a good running shoe. pletely pain free.
occurrence and interfere with job — ﬂip ﬂops, Asics, adidas, New Balance and Saucony
performance and exercise routines.
Merrill Sandal My best advice is not to wait.The lon-
bare feet, ballet ﬂats, are a few of the well-made brands. ger arch and heel pain persists, the harder
The culprit of this diagnosis, plantar etc. Just like eyes needing In addition, pick up a pair it is to get it under control.
fascitis/heel spur syndrome, is a ligament eyeglasses, or the mouth of over-the-counter orthot-
on the bottom of the foot that supports needing a retainer, if the ics such as the Superfeet Flaherty Foot Care
the arch. It runs from the heel bone structure of the foot is inadequate, Saucony Running Shoe brand carried at most sport- Paul Mayo, D.P.M. / Loreen Flaherty, D.P.M.
2914 W. Main, Visalia, 559.627.2849
to the ball of the foot.Think of it as a then it will need mechanical support to ing goods stores. (corner of West Main and Mill Creek)
rubber band that is losing its ability to function without pain.You can begin with In none of these do-it-yourself solu- www.ﬂahertyfootcare.com
Breast cancer is partial breast irradiation. A special
catheter is implanted in the lumpectomy
rence rate and better cosmetic results.
Keep in mind, this is a newer therapy and
Remember, the best way to treat breast
cancer is to ﬁnd it early.
Continued from page 2
cavity either during the initial surgery or, recommended usage is limited to a nar- Always perform monthly self breast
Partial breast irradiation at a later time, usually in the surgeon’s row patient population. exams, obtain yearly clinical breast exams
Radiation therapy is an important part ofﬁce under us guidance.This is used The diagnosis of breast cancer can be by your physician and, for women over 40
of breast treatment after lumpectomy to locally irradiate the site of the prior overwhelming. For those women who years of age, yearly mammograms prove
for breast cancer.The standard of care cancer, the advantage being less radiation have this diagnosis it can be a great relief invaluable.
remains external beam radiotherapy in to the rest of the breast and chest wall. to ﬁnd that newer treatments are avail-
which the whole breast and portions of Therapy is twice a day for ﬁve days versus able which can help preserve breast tissue Kyle Potts, M.D.
the chest wall are externally treated. daily for six weeks. All current studies with similar treatment results and excel- 805 W. Acequia Ave., Ste. 2A, Visalia, 738-0450
However, an evolving form of treatment indicate equivalence in treatment, recur- lent cosmetic outcomes. www.PottsSurgery.com
Walk Away From Pain Paul Mayo, D.P.M.
Offering a full array of podiatric services
to help you maintain healthy feet
Foot Surgery • Vascular Testing • Heel Pain • Diabetic Footcare • Wound Care
Ankle Pain • Sports Medicine & Orthotics • Bunions • Ingrown Toenails
2914 W. Main • Visalia • 627-2849 • www.flahertyfootcare.com
4 ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010
Procedure could make your bed partner happy
By Lyle B. Stillwater, M.D.
The LAUP procedure is a minimally
invasive palatal surgical procedure for
the treatment of snoring and mild
obstructive sleep apnea that involves a
reduction and reshaping of the tissues
of the uvula and soft palate that has
been widely performed since 1993 to
remove excessive vibratory tissue from
the palate and uvula.The procedure is
performed in an ofﬁce setting under lo-
All patients considering LAUP
should undergo a formal objective sleep
assessment.The patient should have
obstruction at the level of the palate and
uvula. Patients with nasal obstruction
should also be evaluated for that level of
obstruction. Patients with a BMI of less
than 28 will have a better outcome at 3
months post-op. A patient with an un-
controllable gag reﬂex may not be able
to tolerate the LAUP procedure.
The procedure is usually performed
with a CO2 laser under local anesthesia
with minimal oral pre-op sedation.The
patient and all members of the surgical
team must wear eye protection prior Several days of post-op throat pain re- the procedure and 67% no longer slept
to laser deployment.The CO2 laser is quiring oral analgesics is common. Oral in separate rooms.Two year effective-
a useful tool for this procedure mainly Carafate is used to coat the operative site ness is at least 62%; 75% of patients had Lyle B. Stillwater M.D.
because controlled tissue incision and post-op as well. at least a 50% improvement in snoring 812 W. Main, Visalia, 732-3888
obliteration can be performed with great For many snoring patients, snoring after 3 years. VISALIAENT.com
accuracy. volume and snoring time are reduced.
A mild narcotic with Tylenol is used The LAUP procedure eliminates
for pain management and the patient is snoring in 60% of the patients and Stillwater
instructed to use liquid lidocaine (4%) improves snoring in an additional 21%; 157638
as a gargle to reduce post-opdiscomfort. 72% of bed partners were satisﬁed with
Allergy Diagnosis and Treatment
The weather is warm and the skies are blue. It’s the perfect New Home Sublingual Desensitisation Treatment
time to get outside and enjoy the day. It’s also a good time Audiology & Hearing Aid Services
you to think about getting healthier. Simply dropping a few Rhinoplasty Surgery
pounds can boost your conﬁdence, help you feel better Snoring Laser Surgery and Somnoplasty
know? physically and prevent some of the illnesses associated
with obesity, such as heart disease, stroke and some
ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010 5
New treatment for sciatica, bulging discs & leg pain
By Dr. Russ Horine, D.C. your back are cushioned by spongy discs. Another study presented at the Ameri-
In a healthy back, the discs work like can Academy of Pain Management in
Having back and leg pain can feel like shock absorbers and help keep the spine 2007 showed…
a crippling condition. ﬂexible. “Patients reported a mean 88.9%
You might not be able to play golf,
When discs undergo stress, the disc improvement in back pain and better
work, or even sit in the car for a 30-min-
wall can weaken and begin to bulge out function…No patient required any in-
ute drive. It’s almost impossible for any-
and press on surrounding nerves.This can vasive therapies (e.g. epidural injections,
one around you to understand how you
cause a sharp shooting pains, numbness surgery).”
feel.You can’t remember the last time
and tingling, and even weakness in your These are just two studies out of a
you even had a restful night’s sleep.
lower back that runs down your leg.. dozen done in the last few years, all
Do you have any of the following? Non-surgical spinal showing promising results.
n Sharp pains in the back of the leg decompression Here’s the point of all these studies,
n Lower back pain During a treatment session, the bones …while everyone responds differently to
n Herniated/bulging discs of the spine are slowly and methodically care, and no doctor can ever guarantee a
n Numbness in your arms or legs separated to reduce pressure within the cure for any condition … spinal decom- “But I feel ﬁne – as long as I take
n Shooting hip or thigh pain disc. As the vertebrae separate, a vacuum pression has a good success rate with my pain pills.”
If you’ve suffered from any of these an- is formed, “sucking” the gelatinous center helping disc herniations, sciatica, and There’s a time to use pain medications,
noying conditions, you may have “Sciatica”. of the disc back into place reducing disc back pain. BUT not before seeking a natural way to
Sciatica is a compression of the sciatic bulges and herniations. correct the CAUSE of the problem!
And the best part about it is …
nerve, usually by an L4 or L5 disc hernia- These reductions take pressure off the Ask yourself … after taking all these
No Dangerous Drugs, No Invasive
tion. As you know, sciatica can be a very nerves and can dramatically reduce pain. pain medications and playing the ‘wait
Procedures, And No Painful Exercises
painful problem, even crippling at times. The vacuum effect also pulls nutrients and see game,’ maybe for years…are you
Spinal decompression treatments are
Nothing’s worse than feeling great and ﬂuid back into the discs allowing any better off? Spinal decompression just
very gentle. In fact, I even catch a few
mentally, but physically feeling held back healing to begin. may be the answer that you’ve been look-
patients sleeping during sessions every
from life because your back or sciatica ing for.
“What’s the chance this once in a while.
hurts and the pain just won’t go away! For more information on this or other
will work for me? Patients simply lie on their stomach or
Fortunately, if you are suffering from chiropractic treatment options call our
A medical study found patients went back, whichever is comfortable, and then
any of these problems, they may be ofﬁce.
from moderately painful to almost no a specialized belt is gently put around
relieved or eliminated by non-surgical
Bulging and herniated discs
pain with decompression treatments.
Those that took pain pills improved less
than 5%. – Am Society of Anesthesiolo-
the waist.The machine is set to focus on
the problem area – then the advanced
decompression computer system will do
The vertebrae that form the spine in gist, 2006 Chicago, IL the rest. 2336 W. Sunnyside Ave., Visalia, 559.625.1100
HORINE C H I R O P R A C T I C
According to the Centers for Disease Control and Prevention, breast
cancer is the second most common form of cancer in women. (Non-
you melanoma skin cancer is the leading form of cancer among women.) In
2006, the most recent year for which statistics are available, 40,820 157439
know? women died from breast cancer. That same year, 191,410 women were
diagnosed with breast cancer. Among Hispanic women, breast cancer
Consultation & Examination
is the No. 1 cause of cancer death, while it is the second most common $57.00 (a $110.00 value)
cause of cancer death among white, black, Asian/Paciﬁc Islander, and (Offer good through August 31, 2010)
American Indian/Alaska Native women. Overall, the incidence of breast
cancer in women in the United States is 1 in 8, or 12.5 percent. Still, Call Today.
roughly 2.5 million women in the U.S. have survived breast cancer. In
addition, though it’s highly uncommon, breast cancer is not exclusive Dr. Horine can ONLY accept
to women. Though less than 1 percent of all new breast cancer cases
occur in men, estimates suggest roughly 2,000 men are diagnosed with
8 new patients with this offer.
breast cancer each year.
Dr. Russell Horine, DC
2336 W. Sunnyside Ave. Visalia 625.1100
6 ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010
Local doctors disagree with Visalia Imaging
breast cancer screening 157438
recommendations Bulging Veins & Spider Veins
Endovenous Laser Treatment (EVLT)
By D.A. Steve Griswold, M.D. under 50, in keeping with our experience Ultrasound Guided Sclerotherapy
Visalia Women’s Imaging Specialists
here. Spider Vein Laser & Sclerotherapy
The United States Preventive Services All Non-surgical Ofﬁce Treatments
n Screening mammography may be Laser Hair Removal
Task Force (USPSTF) recently withdrew
the most carefully studied test in medi-
its support for screening mammography Dr. Montague is honored to have become the
cal history, with 7 of the 8 world-wide ﬁrst board certiﬁed physician in Phlebology in Fresno,
for women age 40-49 and for women Madera, Kings, Tulare, Kern and San Luis Obispo counties.
randomized screening trials showing
who are over 75 years of age, and further
a 30-44% overall decrease in breast
recommended that women age 50-74 be
cancer deaths in women screened with
screened every two years instead of annu-
mammography, and non-randomized
ally. In addition, they speciﬁcally recom-
screening studies showing up to a 63% center, m.c.
mended against clinical breast examina-
decrease. The USPSTF disregards these Model
Paul R. Montague, M.D.
tion and breast self-examination.
data and claim only a 15% reduction in Board Certiﬁed – Phlebology & FP
Those of us involved in the diagnosis Serving Central California for over 30 years
breast cancer deaths in women age 40-
of breast cancer inVisalia disagree with Our Staff: Peggy, Mike, Jan, Luci, Sheila, Kathy and Julie
49. The actual decreased mortality in this
these new guidelines. Under the current
age group was between 23% and 44%. 7335 N. First St., Suite 103, Fresno, CA 93720
set of screening guidelines that have been (559) 438-2800
n The USPSTF argues that false posi-
in place for many years, we have seen a 1-866-576-VEIN
tive screening examinations cause “harm” www.californiavein.net
signiﬁcant drop of 30% in total breast
to patients by increasing pain and anxiety.
cancer deaths among women of all ages.
In fact, the vast majority of screening
Here are some real concerns we have
mammograms actually relieve anxiety California Vein
with the USPSTF and its recommenda-
about breast cancer with a very low false 157636
negative rate. For the vast majority of
n The 16 members of the USPSTF
women, it is a “good news” exam.
making recommendations regarding
We all know that there is no perfect
mammography included not a single
test in medicine, and that mammography
physician specializing in breast cancer
is no exception. However, it is by far the
screening, diagnosis, or treatment.
best weapon we have in our war against
n Within our practice inVisalia
breast cancer, and it is a proven one. We
at Mineral King Radiological Medi-
feel it is unwise to disregard it and urge
cal Group, owners ofVisaliaWomen’s
you to encourage your patients to contin-
Imaging Specialists, we have diagnosed
ue to follow the unchanged recommen-
350 patients with breast cancer within
dations of the American Cancer Society
the last 4 years (includes studies read at
and the American College of Radiology:
other area sites). Sixty-ﬁve of these were
SCREENING MAMMOGRAM FOR
among women younger than 50. That’s
WOMEN EVERYYEAR, BEGINNING
19%, about 1 in 5. Similar study of data
from a larger, slightly younger ethnically
AT AGE 40. Your “Private” Imaging Center
similar population in New Mexico served
by X-Ray Associates of New Mexico
found that 25% (188) of the diagnosed
breast cancers (766) were among women 1700 S. Court St., Suite A, Visalia, 559.734.5674
ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010 7 0000157438
Reducing blood pressu
By Peter J. Muran, M.D. blood viscosity (thickness) and be stopped and in many instanc- de
increased coagulation, making es reversed. is
The two main mechanisms by vs breaking down a clot.These Deﬁning Blood Pressure ing
which a heart attack and stroke risk factors are indicators and/ n Blood pressure is the cal
develop are artherosclerosis or contributors that a progres- pressure exerted by the blood of
or clogged arteries and forma- sive change is occurring along ﬂow on the walls of the arteries. with
tion of a thrombus-embolism the inner walls of the arteries n It is determined by the (r
or blood clot, which dislodges known as the endothelium.The force and amount of blood tha
leading to an arterial blockage. underlying commonality of all pumped by the heart and by the of
The risk factors for de- the risk factors is inﬂammation. diameter of the arteries. pum
veloping either of the two Understanding the mecha- n It consists of two com- and
above conditions are divided nism of these risk factors directs ponents: Systolic pressure and the
into the primary and second- the management of the disease Diastolic pressure, normally (the
ary risk factors.The primary process with improvement of 120 and 80 mmHg, respectively mod
risk factors are elevated blood vascular health and subsequent- (120/80).
pressure, elevated cholesterol, ly, overall health of all organs n High blood pressure or
diabetes, obesity and smoking. including the heart and brain. hypertension is when the blood
The secondary risk factors are Dr. Dean Ornish proved that pressure exceeds 140/90.
hormonal changes, increase in progressive vascular disease can The body’s response to
• Family Practice • Immunizations • Counseling
• Obstetrics/Gynecology • Sports & School Physicals • Health Education
• Internal MedicineHealthcareChidren’s Dental
Family • Adult & • Laboratory
• Pediatrics • Behavioral Health • Free Transportation
WE ACCEPT Most Health Insurance Plans, Private Pay,
SlidingFee, Medi-Cal, Medicare
ENROLLMENT ASSISTANCE Accredited By
Healthy Families, Medi-Cal, Social Services, Medication The Joint Commission
Assistance Program, Access for Infants and Mothers (AIM),
Child Immunizations (CHDP), Family Planning (Family Pact),
Prenatal Education (CPSP)
CHOOSE THE ONE WHERE FAMILY COMES FIRST
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784-5465 651-2301 734-1939
323 W. Putnam 30979 Road 67 501 N. Bridge Street
400 E. Oak Street 101 N. Palm
OPEN Late Evenings & Weekends
8 ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010
sure without the use of medication
develop elevated blood pressure ceutical agents that diminish the sure or hypertension. Based on n Emotional/Psychological n Salt raises blood pressure.
is best understood by examin- effects of epinephrine (adrena- the understanding that arterial Stress. n Women do not have hy-
ing the actions of pharmaceuti- line) and other stress hormones constriction is a direct result of n Hormonal Imbalance. pertension.
cal agents in the management on the heart (beta-blockers) inﬂammation then by identify n Infection/Dysbiosis (Yeast). For continuing information
of hypertension. Let’s begin thereby decreasing the pumping the causes of inﬂammation and n Toxin Exposure. regarding cardiovascular health,
with a simple model of a pump force; decrease the ﬂuid in the using foods that act on arterial n Detoxiﬁcation Difﬁculties. please sign up for our newslet-
(representing the heart); a pipe system (diuretics); or relax the relaxation then a non-pharma- There are myths about hyper- ter at www.longevityhealthcare.
that connects from the output piping so that they could expand ceutical management of hyper- tension com and join our special series
of the pump to the input of the (ACE inhibitors, calcium chan- tension is realized. Some of the n Expected disease of aging. on Extreme Health!
pump (the arteries and veins); nel blockers or Angiotensin stressors or inﬂammatory agents n Can only be managed by
and a valve to release the ﬂuid of II blockers). Conversely, is it are as follows: medication. Longevity Healthcare
Peter J. Muran, M.D.
the piping system to the outside the compression or constric- n Allergy or sensitivity reac- n Nothing to worry about 1405 Garden St., San Luis Obispo, 805-
(the kidneys). Based on this tion of the arteries that cause tion (food or environment). if it is controlled with medica- 548-0987
model there are some pharma- an increase in the blood pres- n Malnutrition. tions. www.longevityhealthcare.com
Did According to the World Health Organization (WHO), half of the world’s population is at risk of malaria. Though it might be common for those in the Western hemisphere to assume malaria is not a
major world health issue, an estimated 243 million malaria cases occurred in 2008. That same year, 863,000 people lost their lives to malaria. An overwhelming majority of those deaths, 89 percent,
you occurred in Africa. While malaria continues to be a health concern, particularly in Africa, the good news is that the world is beginning to realize the gravity of the problem. Whereas international fund-
ing commitments for malaria control were roughly $300 million as recently as 2003, by 2009 those commitments had risen to $1.7 billion. Much of that increase is due to the emergence of the Global
know? Fund and increased commitments by the U.S. President’s Malaria Initiative, the World Bank and a handful of other agencies. To learn more about malaria, visit the WHO Web site at www.who.int.
ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010 9
Glaucoma must Eyes are a window
be taken seriously to your health By Dr. Kelly O’Shea retina can be observed by the optometrist
By Dr. Steven Serrins
and any abnormalities will be reported to
Over two millions Americans have The old saying goes “the eyes are the
the patient’s primary care physician..The
open-angle glaucoma and half of them windows to your soul,”, but they are also
optometrist will also evaluate the lens of
don’t even know it. windows to your health. Most patients come
the eye for cataracts, the optic nerve for
Glaucoma is the second most common for their eye examination when they feel
glaucoma, and the macula for age related
cause of blindness in the United States. it is time to check their eyesight or if they
It is a condition that may occur when are having trouble with their vision, but it
will either allow ﬂuids in the eye to ﬂow If your eye doctor and your primary care
intraocular pressure (IOP) builds inside is important to have a yearly eye examina-
more freely or they will reduce the ﬂuid physician identify diseases or conditions that
the eye. Even though you can’t feel it, tion to check on the health of your eyes.
produced by the eye. Following doctor affect your health, continuing visits to the
high intraocular pressure can damage the Of equal importance, optometrists can
recommendations will reduce the eye optometrist and your physician can assure
optic nerve.When this damage occurs, see evidence of disease or life threatening
pressure and slow the progression of that your situation is well monitored.These
it can cause a loss of your side vision and conditions throughout the body when they
glaucoma. visits are important when you consider
may lead to blindness. come in for a regular eye exam. During a
Dr. Steven Serrins and his new associ- the nature of these conditions and diseases
High eye pressure is caused by too comprehensive eye examination an optom-
ate, Dr. Kelly O’Shea are both certiﬁed described below:
much ﬂuid in the eye. Over time, the etrist will look for a variety of diseases and
to diagnose and treat glaucoma.They n Diabetes affects the small blood ves-
ﬂuid can build and put pressure on your threatening conditions.These include dia-
both recommend regular eye exams and sels in the body.The small blood vessels in
optic nerve, pressure you can’t feel. Be- betes, hypertension (high blood pressure),
following your doctor’s prescribed treat- the eye are also affected. In many patients
cause there are usually no symptoms with and high cholesterol. Patients are also at
ment plan. Be sure to ask questions dur- with diabetes, these blood vessels eventually
high eye pressure, it is very important risk for developing cataracts, glaucoma, and
ing your doctor visit and tell them about leak and damage the retina of the eye.This
that you see your eye doctor regularly. age-related macular degeneration.
all of your prescription and non-prescrip- can cause blindness if left untreated. Diabe-
The good news is that high eye pres- A comprehensive eye examination tes can also lead to loss of limbs, kidney and
sure can be treated. Studies show that tion medicines, even herbs and vitamins. includes checking the vision of a patient, ﬁt-
Call today to schedule an appoint- major organ failures.
if eye pressure is lowered, the risk of ting the patient for glasses or contact lenses n Cataracts are a clouding of the lens
glaucoma may be lowered.Your doctor ment. if needed, and checking the health of the of the eye.The lens may become discolored
will typically try lower eye pressure with Dr. Steven Serrins / Dr. Kelly O’Shea patient’s eyes.Typically, the optometrist will or clouded due to UV light exposure, the
prescription eye drops. Depending on 1618 E. Caldwell, Visalia, 737-9690
Hanford, 582-0392 place drops in the eye to dilate the pupil. aging process, or diabetes.An optometrist
the type of drop that is prescribed, they www.drserrins.com The pupil is the dark center in the middle can evaluate the lens of the eye and tell the
of the iris (the colored part of the eye) that patient whether a surgical intervention is
constricts in light and expands in darkness. appropriate.
Serrins When your optometrist uses eye drops, they n Glaucoma is a disease that affects the
157440 expand the pupil to help the optometrist see optic nerve of the eye. Glaucoma does not
evidence of any serious conditions. have any symptoms at the beginning stages
Following eye dilation, blood vessels of of the disease, but can eventually cause
Dr. Steven Serrins, Optometrist the retina will be observed in the back of blindness starting with a patient’s peripheral
New state-of-the-art ofﬁce located at
1618 E. Caldwell Ave., Visalia the eye in their natural state.The retina is (side) vision. If detected early the disease
Join Us in welcoming our new associate
Dr. Kelly O’Shea like camera ﬁlm. It collects the light in the process of glaucoma can be slowed and
Complete Eye Care for the Whole Family back of the eye. Diabetes, high cholesterol, blindness avoided
Dr. Serrins • Comprehensive eye exams • Glaucoma testing • Treatment and management Dr. O’Shea and high blood pressure may all harm the n Age related macular degeneration
of eye diseases and glaucoma. • Children’s Vision A Specialty • Cataract and
Diabetic eye evaluations blood vessels in the back of the eye that
We accept most Vision Plans, Medi-Cal & Medi-Care. Call for an appointment. Eyes/11
nourish the retinaThe blood vessels in the
Visalia 737-9690 Hanford 582-0392
Open Mon-Sat • Se Habla Español • www.drserrins.com
10 ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010
MMR vaccine link
to autism debunked
The debate continues regarding routine mised that it wasn’t exactly the MMR vac-
childhood vaccines and their possible link cine that caused the autism in his studies,
to autism. Many parents are concerned but a gastrointestinal reaction to the shot
about having their infants and toddlers that led to autism. According toWakeﬁeld,
receive the recommended inoculations. “the virus used in the vaccine grew in
However, a recent study retraction by the the intestinal tract, leading the bowel to
medical publicationThe Lancet may help become porous because of inﬂammation.
individuals make more informed decisions Then material seeped from the bowel into
regarding their children’s health, espe- the blood affecting the nervous system
cially about the MMR shot. and causing autism.”This theory has been
In February 2010,The Lancet retracted since discredited.
a controversial 1998 paper that linked Columbia University, Massachusetts
the measles, mumps and rubella (MMR) General Hospital and the Centers for
vaccine to autism.The study was dis- Disease Control and Prevention have since
credited by further research, and it was replicated parts of Dr.Wakeﬁeld’s paper
determined that the lead doctor on the and found no correlation to GI problems
study, Dr. AndrewWakeﬁeld, had acted or subsequent autism. SinceWakeﬁeld’s
unethically. Investigations revealed that study in 1998, more than 20 other studies
Dr.Wakeﬁeld had chosen a biased selec- have been conducted around the world
tion of patients. ﬁnding no correlation between MMR vac-
Dr.Wakeﬁeld has denied any wrongdo- cines and autism.
ing in a written statement and claims his Parents who are still concerned about
Lancet paper never deﬁnitively said that vaccines should always discuss their
MMR vaccines cause autism. He is quoted anxiety with their children’s pediatrician.
as saying, “The Lancet paper does not He or she can offer the most up-to-date
claim to conﬁrm a link between the MMR information about childhood vaccines and
vaccine and autism. Research into that potential side effects.
possible connection is still going on.” The CDC urges parents to remember
Many parents who have held off on the that vaccines are generally safe and should
MMR vaccine for their children or denied be an important part of children’s well
it entirely have quoted the 1998 paper as visits.
part of their reasoning. Dr.Wakeﬁeld sur- — Metro
Eyes Blindness will occur centrally and patients
will have problems reading or distinguishing
and other factors, including smoking, can
lead to early onset of many of these condi-
You have only one pair of eyes to help you
see your way through your life.Your op-
Continued from page 10
is a disease that damages the macula.The details in front of them. tions. Patients who work outdoors consis- tometrist can help you keep them safe and
macula is the part of our retina that helps us Patients in the CentralValley of Califor- tently should have regular eye checkups healthy.
distinguish detail and color vision. Macu- nia should make annual visits to their op- particularly if they believe their occupation
lar degeneration occurs when the cells of tometrist, primary care physician and take my include exposure to long periods of Dr. Steven Serrins / Dr. Kelly O’Shea
1618 E. Caldwell, Visalia, 737-9690
the macula can no longer dispose of waste special precautions to assure their overall bright light, dust, or pollen. Children should Hanford, 582-0392
products resulting in damage to the macula. eye health.The bright sunlight of our area also have appointments with an optometrist. www.drserrins.com
ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010 11
New procedures: Carotid stenting in stroke prevention
Stroke is a major medical challenge. It are present, then medical treatment is complications including tia and stroke has
is the third most common cause of death not adequate. Recently carotid artery been less than 2.5%.This is the equiva-
among adults and leading cause of long stenting has emerged as an alternative to lent of carotid endardectomy, another
term disability. Carotid artery stenosis is carotid endardectomy. In this procedure, approach for this disease without surgical
an important cause in ischemic stroke. In a ﬁlter is placed in the distal artery to complication, including local complica-
this, the artersclerotic plaque builds up prevent migration of smaller particles to tions, particularly cranial neuropalsies.
in the carotid arteries causing signiﬁcant the brain and a carotid stent is depoted at While there is some debate in national
compromise of blood ﬂow to the brain. the site of narrowing.There is a national literature, it appears carotid artery stent-
This can present as a tia/stroke mostly in controversy about the procedure, but in ing appears to be the ideal choice.
the form of loss of vision, speech distur- 1 Catheter is
2 Stent is
3 Catheter is excellent hands the procedure has excel- For further information, contact our
inserted placed removed
bances, and weaknesses of the upper/ lent outcomes. ofﬁce.
lower extremeties. control of diabetes mellitus, the use of We have offered this procedure at
Primary and secondary prevention of antiplatlet and statin therapy. Nonethe- Kaweah Delta Hospital since 2006.Today
stroke and carotid artery disease includes less, if signiﬁcant carotid artery block- we have performed over 300 procedures Shashi Sharma, MD, FACC
blood pressure reduction, aggressive age is present, especially if symptoms with excellent outcomes, procedural 1070 N. Cherry, Tulare, 685-8384
Lactose intolerance occurs when an individual is unable to fully digest the milk sugar, or lactose, in dairy products. Also known as lactase deﬁciency, lactose intolerance is not typically dangerous
but it can be very uncomfortable. Many people, in fact, have low levels of lactase, but most would not know, as there are no noticeable symptoms or signs. Those who do feel strange after consum-
you ing dairy and feel they might be lactose intolerant should know that symptoms such as diarrhea, nausea, abdominal cramps, bloating, and gas are some of the signs of lactose intolerance. These
signs and symptoms typically appear within 30 minutes to two hours after consuming dairy. When a person is lactose intolerant, that’s because the cells lining the small intestine are not producing
know? lactase, which attaches to molecules in the food a person eats and breaks them into two simple sugars -- glucose and galactose -- which are then absorbed into the bloodstream. However, with
insufﬁcientlactase, food moves into the colon unprocessed, where it then interacts with normal intestinal bacteria, an interaction that often results in the aforementioned uncomfortable symptoms.
P HYSICAL T HERAPY
Shashi Sharma, MD, FACC
With additional certiﬁcation in Interventional Cardiology,
Nuclear Cardiology & Pacing SPECIALIZING IN:
Specializing in: • HEAD, NECK & BACK PAIN
Cerebro-Vascular Diseases • SPORTS INJURIES
Peripheral Arterial & Venous Diseases
• POST SURGICAL REHAB
• Providing care for Chest Pain, Shortness of Breath, Heart Palpitations, Dizziness,
Stroke, Leg Pain (P.A.D.), hypertension and for high cholesterol.
• Providing Non-Invasive procedures including Monitors, Echo & Stress Tests SEAN TRUJILLO, MPT • BRYAN PACILLAS, MPT
including stress nuclear scans. Screening for stroke, heart attack, peripheral,
arterial SAME DAY APPOINTMENTS
& venous diseases.
• Interventional/Therapeutic procedures for Coronary/Carotid/Peripheral/
Open M-Th 7am-6:30pm Fri 7am-noon Se habla español
Reno-Vascular Disease (diagnostic angiograms & stents), Pacemaker & ICD 1138 N CHINOWTH VISALIA • 713-1222
Get checked! CORE_PT@SBCGLOBAL.NET
Call to make an appointment.
Many golfers play/practice each day not knowing what golf posture they
685-8384 have or how to correct. The best way to ﬁnd out what postural charac-
teristics you have is to be screened by a certiﬁed Titleist Performance
Institute (TPI) professional. The screening process is the cornerstone
Located in Visalia, to ﬁnding & correcting your physical limitations. Call Sean 280-9411.
inside the Willow Plaza
1070 N. Cherry • Tulare (Inside Tulare Family Practice) “People don’t care how much we know, until they know how much we care.”
12 ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010
Need help with a pain in the neck?
By Bryan Pacillas, MPT Left untreated neck pain could lead to been present for years, there is a possi-
C.O.R.E. Physical Therapy migraine headaches, chronic headaches, bility for improvement. Physical therapy
Neck pain is a common problem shooting pain or numbness and tingling can greatly improve your tolerance to
for many in today’s society.With the into the arms and or hands. If the prob- all activities, and signiﬁcantly reduce
prevalence of computers, gaming, and lem is severe enough it could also cause one’s complaints of pain. A typical treat-
phone messaging, repeated and or loss of arm/hand strength. It could sig- ment might include soft tissue massage,
prolonged poor posturing can contrib- niﬁcantly decrease a person’s tolerance ultrasound, electrical stimulation, moist
ute to signiﬁcant amounts of pain, and to lying down and sleeping, as well. heat, gentle stretching, strengthening
muscle tension in the neck and upper For many of these dysfunctions modi- exercises along with posture training,
shoulder. Anxiety and stress is another ﬁcation of posture, and work/computer neck traction, and possible education on
cause of signiﬁcantly increased amounts stations can signiﬁcantly decrease the modiﬁcation of work station set up.
of muscle tension and tightness in neck amount of stress placed on the delicate We here at CORE Physical Therapy
and upper shoulder region. Neck dys- soft tissue structures of the neck. For are happy to work with private insur-
function can also stem from a variety of those whose problems do not resolve ance, cash pay, and lien cases.
physiological dysfunctions. Herniated or with correction of posture, a visit to
bulging discs, muscle strains, whiplash your doctor and subsequent referral
secondary to car accidents, repetitive for physical therapy should signiﬁcantly
and or overuse syndromes,TMJ dysfunc- improve one’s chances of getting rid of P H Y S I C A L T H E R APY
tion, chronic poor posture, and a variety that type pain. 1138 N. Chinowth, Visalia, 559.713.1222
of other problems. Even in cases of neck pain that have email@example.com
Top 5 baby concerns in the home
One day an infant will transform safety hazards around the home. investigative children.There are gates
from a relatively sedentary little person n Choking hazards: Infants and that are designed for the top and bot-
content to stare at the crib to an active toddlers are often enamored with their tom of stairs to make it easier to open
adventurer satisfying his or her curios- older sibling’s toys.These toys may and navigate for adults.
ity with just about everything in the have small parts or magnets, and can n Water: It takes only a few inches
home. Making sure the home is safe for be choking hazards for little ones. Be of water to drown a young child.
baby’s travels becomes essential. sure that small toys are not left strewn Never leave a baby unattended when
While every child develops at his or around. Choking can also occur when water is around. Secure toilet seats and
her own pace, most parents can expect babies try to eat foods that are too be sure to keep within arm’s reach of
the day will soon come when their sophisticated for undeveloped teeth. the child when he or she is bathing.
son or daughter will be exploring the Pieces of food should be no larger than n Tipped-over furniture:There
home.While that notion can be excit- a dime to help prevent against chok- were 31 deaths in 2006 (and 3,000
ing, it can also be a bit scary.That’s ing. Children under 10 months old injuries) resulting from furniture and
because studies indicate more than should only be given pureed food, or other household items, like TVs, tip-
2,000 children die every year due to soft foods until molars for chewing and ping over and crushing children. Don’t cords so that they are not a tripping
home-related injuries. Many of these mashing develop. place tempting items atop furniture. If hazard or easily pulled out by curious
children are under the age of 1. n Stairs: Falls account for many furniture seems unsteady, always use kids. Also, don’t leave cords dangling
Taking safety precautions around childhood injuries. Falls down stairs anchors to bolt it to the wall. over the edge of counters. Little ﬁn-
the house ﬁrst requires knowledge of can be especially dangerous. Be sure n Electricity: Keep all outlet covers gers are sure to pull at them.
the top dangers. Here is a list of known to block stairs with sturdy gates from plugged with plastic protectors. Secure — Metro
ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010 13
Want to look younger? Start with your skin
“What can I do to look younger?” everyday, don’t the skin to give you more than just su-
That’s a question Dr. McCarley Billys bother with any perﬁcial results. Medical grade skin care
and Rhonda Bonilla, NP hear several other products. corrects from the inside out. By visiting
times a day. You’re just wasting MDspa you can be sure that a trained
“Do I need a ﬁller?” your money,” says professional will match you with the
“Will BOTOX help me?” Dr. Billys. best products for your skin.
And, inevitably, the next statement is “People tend When the wrapper has been ad-
“I know I really need a facelift but…” to underestimate dressed, Juvederm, Radiesse, Sculptra,
Dr. Billys and Rhonda encourage you the damage done BOTOX, and Total FX fractional CO2
to take a step back and re-evaluate your by the sun,” says resurfacing are complementary treat-
thinking … think of wrapping a plump, Rhonda, “because it ments to further highlight the package
juicy pear in a stained, wrinkled, brown happens gradually that is you. Obagi,Vivite, Neostrata,
paper. It is very difﬁcult to appreciate over time.” Visual Changes, BOTOX, Juvederm,
the beauty and contour of the fruit when But don’t de- Radiesse, Sculptra, IPL,Total FX, Light-
it has a dry, creased wrapper. spair, you can undo Sheer laser hair removal …
What the question really should be some of the damage
is “”How can I make my wrapper look and you certainly
better?” can prevent future
First and foremost is sun protection. damage.To do this mend medical grade skin care; skin care Cosmetic & General Dermatology
“If you’re not going to wear sunblock Dr. Billys and Rhonda always recom- that penetrates beneath the surface of 5530 Avenida de los Robles, Visalia, 625-1060
Bring on the Bronze!
157643 Extreme Health
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the whole person, your whole everyday.”
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Ask how you can get seven years of extreme
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answers with Dr. Muran.”
Facials • Obagi • Latisse Tammy Rayner, age 28
call 559.625.1060 We combine the best of conventional
to learn more medicine with holistic approaches to
promote natural healing and longevity.
McCarley Dermaspa It’s the kind of medical care you always
Cosmetic & General Dermatology hoped you could find, not medical care
5530 Avenida de los Robles Peter J. Muran, MD as it’s always been.
Visalia, CA 93274 1405 Garden Street, San Luis Obispo, CA 93401 805-548-0987
Sign up for our newsletter at www.longevityhealthcare.com
14 ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010
Local dentists bring a new era of implant dentistry
to the Valley that makes permanent teeth a reality
The age of sleep dentistry and dental complete exam to see if “teeth in a day”
implants is ﬁnally here! AtWhitlow Den- is right for you.
tal Care, Dr. KurtWhitlow and Dr. Ryan Don’t suffer any longer with painful
Dunlop are the CentralValley’s authority dentures that don’t ﬁt. If your teeth are
on sedation and dental implants.Togeth- falling apart and you don’t know who
er, they are helping thousands ofValley to turn to or have been told that you’re
residents with their dental needs in a not a good patient for implants, go to
cost-effective and efﬁcient manner.With Whitlow Dental Care and get a second
their extensive education and years of opinion!
expertise, Dr.Whitlow and Dr. Dunlop Their mission is simple: high quality,
can help you get the smile and function world-class dental care at reasonable
you’ve always dreamed of. prices in a caring, small-town ofﬁce with
Whitlow Dental Care offers services a passionate staff! Call today for more
that no other ofﬁces in the area can entire surgery before you come in! Once ing and outstanding cosmetic results, information and a free consultation.
provide. Because they have our own you arrive, you will be escorted to their and are willing to sit down and explain
state of the art dental laboratory, they comfortable sedation room, where the all the risks and beneﬁts of sleep den-
Dr. Kurt Whitlow, D.D.S. / Dr. Ryan Dunlop, D.D.S.
can offer teeth in a day that can last a doctors will start an IV and send you tistry and dental implants.They will go 1326 Van Ness, Fresno, 559.441.7700
lifetime! This amazing technology allows drifting off to a pleasant sleep. Then, all through your medical history and do a www.implantdentistfresno.com
the doctors to put you into a comfort- the “tough stuff ” is completed while you
able sleep, remove your failing teeth if sleep and dream about your new smile.
needed, place all your dental implants, When you wake up, the doctors are put-
and ﬁt you with a new smile that same ting the ﬁnishing touches on your new
day! Before the age of dental implants teeth.While the recovery period varies
and sedation, this was nearly impossible from person to person, most people ex-
… now it’s routine! perience little to no pain afterwards and
After an initial free consultation, Dr. are back to work in a day or two!
Whitlow and Dr. Dunlop may ask you Unfortunately, not all people are
to have CAT scan done on your upper good candidates for this amazing new
or lower jawbone. Using their computer procedure. Dr. Dunlop and Dr.Whitlow
technology, the doctors then plan your work tirelessly to ensure perfect heal-
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ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010 15
Making Your Life Comfortable!
Lift Chairs Make
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16 ADVERTISING FEATURE SECTION / VISALIA TIMES-DELTA / TULARE ADVANCE-REGISTER / JULY 2010