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The anti-aging breakthrough of the decade is a skin-resurfacing treatment known as fractional CO2. Combining the effectiveness of traditional carbon dioxide lasers with a new application technique, it delivers powerful results without the traditionally harsh side effects and downtime. How Does the Fractional CO2 Work? The laser works by vaporizing the tissue and drilling microscopic beams into the epidermis. Traditional carbon dioxide lasers are the “gold standard” for treating deep fine lines and wrinkles, and acne scars. However, in the last 2-3 years there has been a real shift to fractionated lasers because the treatments involve less complications and downtime. “Essentially, you are getting all the benefits of laser resurfacing, still the best way to remove wrinkles, but you’re getting it without the downtime and…
Thursday, 31 May 2018 15:45

Got Blood In Your Urine?

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Many men, women, and children are told by their primary care physician of incidental finding of blood in the urine (hematuria) in routine laboratory examinations.  Now, is this cause for concern?  What is a proper way to address it?  
Presence of blood cells in the urine of more than five red blood cells per high power field in formal urine analysis (UA) is not normal. However, in the majority of patients, this is due to benign conditions, such as urinary tract infection, kidney stones, prostate enlargement, inflammation, or certain non-cancerous kidney conditions.
Patients on blood thinners are specially at higher risk for urinary bleeding.  In general, urologists get more concerned when patients with a history of smoking (active or former) have blood in their urine. This is because carcinogens within cigarettes are a well-documented cause of bladder cancer and cancers of the upper urinary tract.  
Blood in your urine can be microscopic (not visible) or gross (reddish color of urine or dark red with clots).  It can be painful, bleeding or painless.  However, any persistent presence of blood in the urine or gross hematuria warrants a complete history and physical exam (including pelvic and rectal exam) and a visit to a urologist.
He or she will likely request cross-sectional imaging of the urinary tract (CT urogram), and cystoscopic examination of the bladder.  It is extremely important that you take persistent presence of blood in your urine seriously and see a urologist to assure of its cause.  More importantly, stop smoking immediately.   All carcinogens cigarettes eventually end up in your bladder and sit there and damage your bladder.

Thursday, 31 May 2018 15:36

Obstructive Apnea and Bruxism

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Most references for obstructive apnea (OA) are geared to when one is asleep and referred to as obstructive sleep apnea (OSA) caused from deep relaxation during sleep decreasing muscle tone of the tongue and associated structures, thus allowing it to fall back into and block the throat and cut-off breathing.
In the early 1990’s the term “hypopnea” was introduced to describe partial blockage of the throat or airway with impaired breathing.
Both conditions are anatomic and signal the body of immediate threat to life, triggering compensatory responses to reverse this condition ASAP at a subconscious level to open the airway and keep us alive. The objective is first and foremost to keep air flowing to and from the cells and a close second is unblocking the throat.
The fight or flight response releases the stress hormone, norepinephrine, into the blood stream. This increases the rate of breathing through a partially blocked throat and forcing the tongue out of the way.
At the same time norepinepherine increases muscle tone throughout the body affecting body posture including head and neck posture.  This is commonly recognized in changes in sleeping position. On one’s side to on one’s back often causes OSA and the snoring sound from partial obstructions. This is less recognized, but just as important to understand, while awake.
Bruxism is a subconscious reaction to move the tongue forward by “grinding” and expand the lateral throat muscles, nasal cavity and sinuses by “clenching” the teeth together. Clenching effectively flattens and lowers the hard palate through pressure on the periphery of the related bones of the skull to increase ease of breathing.
In the Journal of the American Dental Association (JADA) this past February, a patient handout associates bruxism with feeling stressed and describes it as an adult and preschool childhood habit of grinding and clenching teeth and moving the jaw forward over and over again while asleep and awake and being of unknown origin.
If the dental and medical academic communities integrate and focus on the anatomy they will recognize that OA exists while awake.  An OA cause and effect relation can be heard in snorting from relaxation during laughing and felt in the stress response, induced by distractions, triggering loss of control of tongue related muscles, thus impairment of breathing.
My next article will focus on how habits are “hard wired” compensations and how each one can reveal what function they provide for survival. This impacts the design, choice of, modification and successful utilization of oral appliances for OA and OSA.

The latest technology in non-surgical vaginal rejuvenation is called the Geneveve® – and it is a clinically proven treatment that is revolutionizing feminine wellness as we know it.  Currently it is used in 52 different countries around the world and has benefited thousands of women improving their health and quality of life.
What is the Geneveve?
Excessive stretching of the vaginal muscles is a common occurrence after vaginal birth or due to aging. Therefore, many have sought out different treatment options to help get their bodies back.  The Geneveve does all this and more. This treatment uses clinically-proven cryogen-cooled monopolar radiofrequency (CMRF) to uniformly deliver gentle volumetric heating while cooling delicate surface tissue. This unique technology stimulates the body’s natural collagen formation process.
What to expect?
The treatment is a comfortable, single-session, 30-minute treatment performed by a trained healthcare professional in an outpatient setting.  During the visit, the doctor uses a small treatment tip (about the size of your thumb) which is then inserted into the vaginal opening. The tip is then rotated while it alternately cools the surface and heats the soft tissue beneath. Women typically begin to feel the results at about 30 days and the full effect at about 90 days. Depending on how you respond, a touch up treatment every year or as you see fit, is recommended.
Is there any downtime?
During this treatment the vaginal tissue swells slightly. Patients should abstain from intercourse for 48 hours although resuming other normal activities right after receiving treatment is acceptable.  This includes exercise and bathing.
What does the Geneveve treat?
Vaginal tissue ages over time.  With age and childbirth, certain symptoms can occur such as vaginal dryness, urinary incontinence, sexual dysfunction, vaginal pain, air passing from the vagina, less satisfaction with intercourse, and increased self-consciousness.  All of these symptoms are easily treatable with the Geneveve and patients have seen amazing results across the world.  In fact, 90% of the women who had the procedure in clinical studies, reported significant, sustained tightening, sensation, satisfaction and noticeably reduced bladder incontinence 12 months after treatment.
What makes the
Geneveve different?
Traditional invasive surgical procedures are expensive, can have a long and extremely painful recovery time and carry significant risk.  Geneveve is non-invasive, painless, discreet, safe and very effective.

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