Author Archive

Suffering from shin splints?

May 7th, 2018

It’s not just fitness fanatics adamant about getting in their daily jog who are in danger of developing shin splints. Anyone who has flat feet, poorly fitting shoes or weak ankles, hips or core muscles are susceptible to shin splints as well.Stock photo from

Referred to by some doctors as medial tibial stress syndrome, shin splints usually develop as a result of continuous force being applied to the shin bone (tibia) and the connective tissue that attaches the shin bone to the muscles around it.

That continuous force can lead to a swelling of the muscles around the tibia. When those muscles are swollen, more pressure is applied to the tibia and the result can be a variety of symptoms, most of which are more annoying than anything else.

For example, someone suffering from shin splints may feel nothing more than a dull ache in their shins or a swelling in the lower leg. Others, however, may experience sharp, jabbing pains in and around their shin during exercise or numbness in their feet.

In more severe cases, the shin of someone suffering from shin splints may feel hot or painful to the touch, the lower part of their legs may feel weak, or they may experience prolonged bone or muscle pain in the lower leg and calf.

In those more severe cases, some of which are the cause of small cracks or fractures in the bone, it may be best to consult a doctor. In most cases, however, shin splints can usually be treated by adhering to some common treatment methods.

The most effective treatment method is rest – and lots of it. Depending on the cause of your shin splints, the time needed to recover properly can be anywhere from three to six months. In less severe cases, however, a few weeks of rest may do the trick.

That may seem like a lot, particularly for a workout warrior type who is accustomed to hitting the gym three or more times a week or running every day, but there are other activities that can be done to maintain good fitness while shin splints are healing.

Riding a bike, swimming or using an elliptical machine provides many of the same cardiovascular benefits that running does, and none of those activities put the same degree of stress on the legs that running does.

In addition to rest, icing the area of the leg that is painful or uncomfortable for 20 to 30 minutes three to four times a day until the pain is gone helps to reduce the bothersome effects of shins splints, too.

As is the case with a lot of aches and pains, taking non-steroidal anti-inflammatory medicines such as ibuprofen, naproxen or aspirin if your doctor allows it will further advance the healing process as well.

With extensive use of all the above, though, some side effects such as bleeding and ulcers can develop. Always be sure to follow label directions specifically when using those over-the-counter aids and if possible consult your doctor before taking them.

Finally, for those whose shin splints are more a result of physical issues such as flat feet or poor-fitting footwear, the use of orthotic shoe inserts or a better fitting pair of shoes can make all the difference in the world.

You’ll know your shin splints are gone when you resume whatever constitutes normal activity and you can apply pressure to the area that used to hurt without feeling pain or run and jump without feeling any pain in or around the shins.

Prior to that, though, strengthening your core muscles and the area around your hips and increasing your intake of foods such as milk and yogurt that are high in calcium and Vitamin D can help prevent shin splints from coming back.

Remember, it’s not just weekend warriors and fitness fanatics who get shin splints. Anyone can get them. The good news is that no one has to suffer from them for very long.

Alternative to Surgery

New procedure eliminates pain from spinal stenosis.

At 75, Michael* wasn’t ready to feel old. Yet, maddening back pain made it difficult for him to feel youthful and stay active. The pain from his back traveled all the way down his right leg, which affected his walking and put a stop to his morning exercise routine. Even standing was painful, and Michael found himself instead sitting in his chair doing nothing. When he tried to cook, he had to lean over his kitchen sink, which provided some relief from the agony in his back and leg.Stock photo from
“I really enjoy cooking for my family,” Michael shares. “It’s something I have always tried to do several days a week, but the pain I would get in my back when I stood too long at the stove forced me to stop cooking as much as I used to.”
Michael’s primary care physician suggested a few options to help ease his pain. But when a trial of conservative treatments, including heat and ice, physical therapy and pain medications, failed to deliver lasting results, Michael’s doctor recommended he visit Harold J. Cordner, MD. Dr. Cordner is board certified in pain management and anesthesiology, and practices at Florida Pain Management Associates in Sebastian and Vero Beach.
At Florida Pain Management Associates, all patients who come in with severe back and leg pain are given a careful evaluation that includes a thorough history and physical examination, as well as imaging studies such as x-rays and an MRI. After his evaluation, Dr. Cordner was able to confirm his initial suspicion; Michael was suffering from spinal stenosis.
The spine is made up of 24 small bones called vertebrae. The vertebrae are stacked one on top of the other with an open canal in the middle through which the spinal cord runs. On the back of the vertebrae are projections of bone called spinous processes. Between these sections of bone are openings called neural foramen, where the spinal nerves exit the spinal cord and travel to the rest of the body.
Spinal stenosis is the narrowing of the spinal canal and the neural foramen. Because these spaces become narrower, the nerves become crowded or pinched, causing symptoms.
“Generally, the symptoms are back pain with leg weakness or a feeling of heaviness or pain into the legs,” describes Dr. Cordner. “Sometimes, the patient just has back pain; other times, the pain radiates into the legs. The pain is typically worse with prolonged walking or standing, and is relieved as soon as the patient sits down or leans forward.”
Spinal stenosis is most often caused by the wear and tear of arthritis that occurs with aging. To make up for the degenerative changes caused by arthritis, the body sometimes grows new bone to help support the vertebrae. These new bone pieces are called bone spurs. They can narrow the openings for the spinal cord and nerves. Arthritis can also cause the ligaments in the spine to become larger, which can irritate the nerves and cause symptoms.

A New Option

Traditionally, treatment for spinal stenosis begins with nonsurgical steps, such as physical therapy, anti-inflammatory medications, chiropractic manipulation and steroid injections. When all nonsurgical efforts have failed, surgery is generally the next step.
“The treatment for spinal stenosis was often epidural steroid injections,” confirms Dr. Cordner. “If those did not help, patients would undergo a decompressive laminectomy. However, there are patients who are elderly or have other diseases or complicated medical illnesses who cannot get cleared for or are too sick to have surgery.”
During a laminectomy, the surgeon removes some of the bone, and any bone spurs and/or pieces of ligament that are compressing the nerves. Doing this opens up the space for the nerves and relieves pain. However, it requires one large or multiple smaller incisions and a lengthy recovery, and may fail.
Now, Dr. Cordner offers an alternative to laminectomy. It’s a new, minimally invasive procedure to treat patients with spinal stenosis who have back and leg pain that is relieved by bending forward or sitting.
“The procedure uses an implanted device that decompresses the spine,” states Dr. Cordner. “The device goes in and opens up, enlarging the space where the spinal nerves exit as well as the central canal.”

Product photos courtesy of Florida Pain Management Associates.

Superion InterSpinous Spacer

Product photos courtesy of Florida Pain Management Associates.

The Superion InterSpinous Spacer is placed where the vertebrae have collapsed. There it opens up and pushes the bones apart.

The device is the VertiFlex® Superion® InterSpinous Spacer System. The Superion spacer is an H-shaped implant made of a titanium alloy that fits between two adjacent bones in the lower back. It is designed to limit movement of the spine when the patient stands and walks, and to open up the nerve spaces, relieving symptoms. VertiFlex describes the Superion as a “Safe and effective alternative when conservative treatment has failed and laminectomy is too aggressive.”
“During the implant procedure, I make a small incision in the back and clear out some tissue between the spinous processes,” explains Dr. Cordner. “Then, I insert the device through a small tube about the size of a dime. As I engage it and screw it open, two arms emerge that push the spinous process bones apart, and that creates more room inside the spinal canal and the neuroforamen.
“The ideal candidate for this procedure is a patient who has spinal stenosis that is worse with standing or walking, and relieved with bending over a little bit. These are patients who are walking in the stores leaning over their shopping carts, which helps ease the pain.”
Such was the case with Michael, as he mentions he found relief when he would bend over, but not when he was standing up straight.
Implanting the Superion device is a simple, outpatient procedure with less tissue damage and blood loss than surgery, and a rapid recovery time.
There was a similar device in the past called the X-StopPK®. However, there were drawbacks to it. In some cases, it moved out of its implanted position. With the Superion, there have been no reports of the devices moving out of position in the thousands of cases that have been performed to date.

Product photos courtesy of Florida Pain Management Associates.

The Superion InterSpinous Spacer is placed where the vertebrae have collapsed. There it opens up and pushes the bones apart.

There are four years of data to support the effectiveness of the Superion InterSpinous Spacer. According to studies, 48 months after having the procedure done, patients’ leg pain was reduced 79 percent, and patient satisfaction was 87 percent.
“Thus far, there have not been any patients whose condition deteriorated after the procedure, which certainly can happen with back surgery,” stresses Dr. Cordner.
“The Superion is the only FDA-approved, standalone device for the treatment of moderate lumbar spinal stenosis. Medicare has approved it as well, and I am the only physician in Indian River County certified to do this procedure.”

Nonsurgical Relief

For Michael, Dr. Cordner was the answer to a prayer, and the Superion spacer was a godsend. He became one of those patients in the “satisfied” category.
After having the device implanted, Michael’s pain is gone. He is now able to get out of his chair and take his morning exercise walks. He can cook without leaning over his sink, and he no longer feels the aching all the way down his leg.
“It’s been a miracle for me, it truly has,” Michael raves. “I am so thankful that I found Dr. Cordner. I feel better than ever, and I no longer have to live with pain!”
Michael is back to being active and feeling more youthful. And that’s affected his attitude about his age as well.
He remarks, “Seventy-five isn’t old at all!”

* Patient name witheld at their request.

Plantar Warts

Don’t let them go untreated.

Verruca plantaris, or plantar warts, can be painful and embarrassing.
The most common breeding grounds for plantar warts are communal showers, floors in public swimming pools, even your shower at home. Breakouts can also occur among people who share gym or athletic facilities or in settings where bare feet are the rule. Stock photo from
“Warts can occur on any compromised skin surface, but they are most common on the bottoms of the feet and on the hands,” explains board-certified podiatric surgeon Robert P. Dunne, DPM, who has offices in Melbourne and Palm Bay. “They tend to invade the skin through small abrasions or cuts, some that you may not even realize you have.
“The plantar wart can be quite painful since you are putting pressure on the area by simply standing. Paring them down can often relieve some of the pressure, but a more aggressive treatment may be required.”
Dr. Dunne treats a wide variety of podiatric complaints such as fungal nails, tinea pedis (athlete’s foot), dermatitis; heel, foot and ankle pain; tendonitis, plantar fasciitis, hammer toes, bunions and other bone issues.
“There are several treatment options for a plantar wart, but not all are invasive,” the doctor reveals. “Treatments can be oral, such as Tagamet®, or topical, such as salicylic acid or retinoid cream. There is also a slightly invasive procedure called cryotherapy, which causes the wart to scab and fall off, or an invasive procedure, where there is an excision of the wart. Both of these procedures are done in the office in just a few minutes.”

Risk Factors for Plantar Warts

There are many risk factors for plantar warts, especially in our Florida environment.
“Age can be a factor in the development of a wart,” explains Dr. Dunne. “Children are more susceptible because they have not built up an immunity to the virus.”
Dr. Dunne accentuates that “there are several over-the-counter and home remedies that people can use to treat plantar warts, but we strongly caution those who are susceptible to infection or persons with diabetes not to try these without consulting their doctor.”
People with weakened immune systems are particularly susceptible to the virus, he notes. People should keep in mind that warts are contagious and, if affected, one should take precautions so as not to spread the virus.
Preventative measures include: not touching other people’s warts; not sharing towels, shoes or socks; wearing flip-flops in the shower (if affected, this should be at home or in a community shower setting), covering the wart to prevent exposure and not scratching or picking at the wart, which can easily cause them to spread.
Lake Washington Foot & Ankle is a comprehensive podiatric medicine clinic offering treatment for everything from bunions to hammertoes. “We treat ingrown toenails, warts and neuromas,” assures Dr. Dunne. “We also do clinical trials for onychomycosis [fungal toenails] in an effort to find better and more effective treatment for this ailment.
“Our patients come first, and we recommend they take action now if they have a problem.”

Article courtesy of Lake Washington Foot & Ankle Center.

Oral Cancer Concerns

April 10th, 2018

Let’s discuss something we don’t usually think about and don’t often hear about: oral cancer, or more specifically oral cavity and oropharyngeal cancer. Often grouped together, these cancers are not among the most hyped, but they’re disfiguring – and deadly – just the same.Stock photo from

Where are we talking about? The oral cavity, essentially the mouth, includes the lips, inside lining of the lips and cheeks, teeth, gums, front two-thirds of the tongue, floor of the mouth under the tongue, and bony roof of the mouth, or hard palate.

The oropharynx is the top part of the throat that starts in the back of the mouth. It begins where the oral cavity ends. The oropharynx generally includes the area behind the wisdom teeth, the last third of the tongue, the back part of the roof of the mouth (soft palate), the tonsils, and the side and back wall of the throat.

Anatomy of the pharynx (throat). The three parts of the pharynx are the nasopharynx, oropharynx, and hypopharynx.

There’s a lot we don’t know about what causes cancer, but we know it often occurs when mutations in certain genes cause certain cells to grow out of control, causing tumors to form. What researchers are trying to pin down in most cases is what causes the mutations in the first place. That’s a really simplistic explanation.

Here, I’m going to tell you about risk factors and symptoms, so maybe you can catch an oral cancer in its early stages. Then, I’ll give you a few strategies for prevention, but if you want the full scoop on oral cavity and oropharyngeal cancer, read this information from the American Cancer Society.

One of the things you’ll read is that the American Cancer Society estimates 51,540 American will get oral cavity or oropharyngeal cancer in 2018, and an estimated 10,030 of them will die from it. Fortunately, the death rate has actually been declining over the last ten years. These cancers are much more common in men than women.

Let’s start with risk factors. What traits and behaviors put you at greater risk for becoming one of those estimated 51,500 people to get one of these cancers. The top two risk factors are using tobacco and drinking alcohol. The tobacco risk increases the more you use it and the longer you’ve done so.

Also, about seven out of ten people with oral cancer are heavy drinkers. The risk is increased even more in people who use tobacco and drink heavily. Some studies suggest the combination leaves people as much as 100 times more at risk than people who don’t smoke or drink.

There are some genetic syndromes that can lead to oral cancer, and a weakened immune system can make a person more susceptible. Risk also increases with age and is affected by an unhealthy diet. Researchers are now finding that infection with the HPV virus is a rising risk factor for some forms of oral cavity and oropharyngeal cancer.

These cancers generally appear as a growth or sore in your mouth that doesn’t go away. It can be on anywhere in your mouth, including your lips, tongue and cheeks Here are a few other symptoms to watch out for:

  • White, red or speckled patches in your mouth
  • Unexplained bleeding
  • Loss of feeling
  • Pain or tenderness
  • Difficulty chewing or swallowing
  • Hoarseness or persistent sore throat
  • Lump in the neck

There are other signs and symptoms as well.

Oral cavity and oropharyngeal cancer are generally treated with chemotherapy, radiation, or surgery, or a combination of these treatments. The choice of treatment depends on the patient’s age and how advanced the cancer is, it’s stage. Treatment can leave you disfigured or with problems speaking or eating. Additional treatment may be necessary.

Today, patients also have the benefit of biological and targeted therapies. These therapies kill cancer cells without damaging the surrounding healthy tissues.

Some of the risk factors can’t be controlled, but these are things you can do to reduce your risk or find oral cancer early. These include:

  •  Limit your tobacco use
  • Drink alcohol in moderation
  • Eat a healthy diet with lots of vegetables
  • Protect yourself against HPV infection
  • Examine your mouth at least once a mouth and look for lumps or spots
  • See your dentist regularly. The dentist can often spot suspicious areas in your mouth before you do.

You don’t want to be one of the 51,500 who will get oral cavity or oropharyngeal cancer this year, and you especially don’t want to be one of the 10,000 who don’t make it. Now that you know about these cancers, be aware of your risk factors and on the lookout for symptoms.

Easy and Effective

Microcurrent electrolysis relieves hemorrhoids without surgery.

David* suffered from hemorrhoids for ten years and never told anyone, not even his wife. During visits with his doctor, he didn’t mention them.Stock photo from
His silence wasn’t because the hemorrhoids weren’t bothersome. “I’d wake up in the middle of the night, itching like crazy,” he confides. “I’d use hemorrhoid cream but it didn’t do anything. It was horrible.
“I guess like a lot of people I was too embarrassed to talk about it.”
David is retired after a career in the broadcasting industry, where he managed radio and television stations. He learned about HemRelief and heard its question – “Why suffer in silence?” – and had a moment of recognition.
“I said to myself, You know, that’s me. I’m not telling my wife. I’m not telling anybody,” recalls David. “I went home and said to my wife, I’m having a little problem down there. I’m going to make an appointment.

Microcurrent Electrolysis

“Hemorrhoids, which are swollen veins in the rectum or anal canal, are extremely common,” notes Linh B. Nguyen, MD, of HemRelief. “In fact, more than fifty percent of people age fifty or older have them to some degree.”
Most sufferers are understandably reluctant to try the available treatment options, some of which have traditionally been both painful and inconvenient.
Fortunately, Dr. Nguyen offers microcurrent electrolysis (MCE), an FDA-approved, nonsurgical method for treatment of hemorrhoids. The noninvasive, relatively painless outpatient procedure has been helping patients for more than 20 years and is completed right in the doctor’s office.
Graphic from“A low current is applied to the base of the hemorrhoid, causing a chemical reaction that induces the hemorrhoid to shrink,” explains the doctor. “The procedure is well tolerated by patients and does not require anesthesia.
“The MCE method is considered revolutionary because it is highly effective, safe and convenient. Up to ninety percent of people who have it done get relief from their hemorrhoids,” Dr. Nguyen reports. “It doesn’t cause the agonizing pain often associated with traditional hemorrhoid surgery and is also covered by most insurances and Medicare.”
The treatment is quick, convenient and can be safely repeated as needed.
“There’s no need to take any special preparation to clear the bowels,”
Dr. Nguyen notes. “Patients can have the procedure done and go back to work immediately, so there is no downtime. The entire procedure takes approximately twenty minutes.”

Quick Results

David appreciated how Dr. Nguyen helped him feel at ease. “Dr. Nguyen makes you feel very comfortable,” he reports.
The procedure was painless, he says, and results were evident right away. The constant itching was gone.
“I walked out of the doctor’s office after the procedure, and I felt like a
new person.”
David is no longer embarrassed to talk about hemorrhoids. In fact, he talks about them freely now, in case it helps others.
“I tell people that this is the most comfortable treatment and it’s not an embarrassing situation,” he notes. “If you’re putting treatment off because of embarrassment, don’t wait another second. Pick up the phone and get it done because it’s not embarrassing at all.”

* Patient’s name withheld at their request.


Decreasing “Diabesity”

February 20th, 2018

Obesity is a huge problem in our country, pun intended. According to the Centers for Disease Control and Prevention, more than one third (37.9 percent) of adults aged 20 and over in the US are obese, which is defined as having a Body Mass Index of 30 or above. Obesity puts people at risk for a number of health problems, including high blood pressure, heart disease and stroke.Graphic from

One of the most common health conditions associated with obesity is diabetes, specifically Type 2 diabetes. These conditions are so intricately entwined that experts have coined the term “diabesity” to describe their relationship. Type 2 diabetes accounts for 95 percent of all cases of diabetes in the US, and more than 90 percent of people with the disorder are overweight or obese.

Our bodies need energy to function, and they get that energy from the food we eat. During digestion, food is broken down into a sugar called glucose that travels through the bloodstream. Insulin, a hormone made by the pancreas, is like a key. It opens up your body’s cells to let the glucose enter to be used by the cells as fuel.

Some people’s bodies don’t make enough, or any, insulin, or they don’t use insulin appropriately, and glucose remains in the blood instead of getting into the cells. When the glucose level in your blood is too high, you’ve got diabetes. High glucose levels can damage many parts of the body, including the eyes, heart, kidneys, nerves and feet. With Type 2 diabetes, your body does not make or use insulin properly. Its onset can occur at any time, but it most often starts when people are middle-aged or older.

Many studies have demonstrated a link between obesity and diabetes, but just how diabesity occurs is complex and yet to be understood fully. What we do know is that people who are overweight or obese put added pressure on their bodies’ ability to use insulin properly to control glucose levels in their blood. This makes them more susceptible to developing diabetes.

One way obesity may lead to diabetes is by triggering changes in your metabolism, the processes that occur in your body in order to function. It’s believed that these changes cause fat tissue to release fat molecules into the blood. The increased fat in the blood affects the cells that are responsive to insulin and reduces insulin sensitivity. Calorie-dense foods leads to increased fat accumulation, and calorie-dense diets are common with overweight individuals.

When the body has to store excess fat and cannot properly control insulin levels in the blood, substances called free fatty acids are deposited in the liver, causing a condition known as fatty liver. Free fatty acids also move through the circulatory system causing reactions within other organs such as the pancreas, heart and muscles. This starts a vicious cycle of organ damage, inflammation, and deteriorating insulin resistance and insulin secretion from the pancreas.

Where the fat accumulates on your body is also a factor in diabesity. If your fat is primarily located around your belly, which is a predictor of visceral fat that lies around your internal organs, you are at an increased risk for developing Type 2 diabetes. Like diets high in fat and carbohydrates, visceral fat is associated with worsening insulin resistance.

It’s no surprise that major factors contributing to diabesity are chronic unhealthy behaviors, including eating a high-calorie diet and avoiding physical activity. We know weight loss has a beneficial effect on blood glucose control and fat metabolism, so lifestyle modification through changes in diet and exercise is generally the first diabesity management strategy. If you are also taking diabetes medications, your doses will have to be reviewed regularly, as they may need to be adjusted as you lose weight.

In certain cases, weight loss medications may be used to assist those with diabesity achieve and sustain substantial weight reduction. For some people, a surgical weight loss option, such as a gastric band or bypass, is a good choice, especially if they’ve not achieved positive results with lifestyle modification and medication therapies.

With 90 percent of people with Type 2 diabetes being overweight or obese, diabesity is expensive, too. More than one in five US health care dollars are spent on diabetes, about $245 billion. That doesn’t include the indirect costs of absenteeism, reduced work productivity, inability to work and lost workers due to premature death, accounting for another $68.6 billion.

Because it can damage many organs and tissues, diabesity lowers quality of life as well. If you are overweight, especially if you notice any symptoms of diabetes, have your blood glucose level checked by your doctor. Type 2 diabetes doesn’t always have symptoms, but some of the possible symptoms include increased thirst, frequent urination, hunger, fatigue and blurred vision.

Don’t wait until diabesity damages your body, get tested today, and get on the road to weight loss and glucose control. And a healthier, higher quality of life!

Holiday Stressed?

December 19th, 2017

According to a survey report from the American Psychological Association released last month, more than half of Americans consider the present the lowest point in US history they can remember. This conclusion came from people of every generation including those who lived through Word War II and Vietnam, the Cuban Missile Crises and the attacks on September 11. The purpose of the survey was to measure stress in America.Stock photo from

If we’re already stressed, how are we going to handle the upcoming holidays, which can be stressful on their own? For many people, the holidays also bring feelings of sadness and depression. And some are affected by the shortened days and dearth of daylight at this time of the year. Most of us need some help to get through it.

Don’t worry. There are many steps you can take to help manage stress, and the anxiety and depression that can come with it. I’ll tell you more about that later. But first, let’s consider one reason the holidays are so stressful to start out with.

According to an article from Harvard, it’s a brain thing. The article’s author noted another survey whose respondents reported financial demands, dealing with family and maintaining personal health habits as their main holiday stressors. Responding to challenges like these requires shifting our cognitive strategies, and that’s where brain function comes in, specifically cognitive function.

Cognitive functioning is a type of executive functioning, which is responsible for getting things done. This type of functioning is done by the frontal lobe of the brain. The skills that are part of cognitive functioning include managing time, being attentive, switching focus, planning and organizing, and remembering details.

These skills are in very high demand during the holidays. People who manage holiday stress the best are those who have “cognitive flexibility.” They are able to shift their attention between tasks and rapidly adapt to changing environments. Unfortunately, that flexibility can be difficult to achieve for most people.

For those of us who are less flexible and need more help managing stress, there are many resources with coping strategies on the Internet. I’ve chosen these three to garner a few tips to note.3,4,5 There are more tips in these articles and elsewhere.

  • Be realistic and keep things in perspective. We often set high expectations for the holidays, but rarely do the actually experiences match our images. Accept that the holidays don’t have to be perfect, and remember what the season is really about. You don’t have to buy extravagant gifts to have a happy holiday.
  • Take time for yourself. You’ll be running around trying to make the holidays fun for everyone else, but take a few minutes to take a breath and take care of yourself. Even if it’s just 15 minutes alone, it will help recharge you. Do some yoga if you can or just some deep breathing.
  • Don’t neglect your healthy habits. Just because it’s the holidays, don’t give up your healthy diet or your exercise routine. Try to get at least eight hours of good sleep every night. These behaviors are natural stress busters, so try not to abandon them just because you’re busy with other things.
  • Learn to say “no.” For most of us, it’s impossible to make it to every party and do every activity scheduled around the holidays, and still fit in work. It’s okay if you can’t make it to someone’s event, and don’t feel guilty about it. They’ll understand how tightly your time is stretched. They’re going through the same thing!
  • Be grateful. The thoughts around the holidays generally center on “what I want” and “who is not here.” Instead, try changing your focus and thinking about “what I have” and “who is with me.” Recent research found that gratitude led to lower levels of stress and depression.

These are just a few ideas for managing the holidays. If you still suffer after taking steps to reduce stress, especially if you feel anxious or depressed, see a qualified therapist. Talking to a therapist can help you work through your struggle and feel better. The therapist can also give you additional strategies for your battle against stress.

Is It Cold or Flu?

November 4th, 2017

Flu season typically runs from early October and can last into May.

The Center for Disease Control (CDC) recommends healthy adults and children be vaccinated to prevent the oftentimes deadly virus from spreading.Photo from istockphoto

Symptoms of the flu come on suddenly and are worse than those of the common cold. Those symptoms may include:

  • Body or muscle aches
  • Chills
  • Cough
  • Fever
  • Headache
  • Sore throat

Flu-related hospitalizations since 2015 range from 140,000 to 710,000 annually, while flu-related deaths are estimated to have ranged from 12,000 to 56,000 that same year. During flu season, flu viruses circulate at higher levels amongst the US population.

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine.

There are two types of flu vaccines – the flu shot and the nasal spray vaccine.

The flu shot contains active flu viruses. The shot is FDA approved for children over 6 months of age, healthy people and those with chronic medical conditions. Studies show that the flu shot were more than 70 percent effective, compared to 60 percent for the flu spray.

The nasal spray vaccine is also made of live, weakened flu viruses and is FDA approved for people aged 5-49 and who are not pregnant.2.

The best time to get vaccinated is before flu season begins. It generally takes about two weeks after receiving the vaccination for antibodies to develop in the body that protect against the virus. The CDC recommends that people get a flu vaccine by the end of November, if possible.  Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout the flu season, even into January or later.

Vaccines are offered in many locations, including doctor’s offices, clinics, health departments, pharmacies, college health centers, as well as by many employers, and even in area schools.

While the single best way to prevent the flu virus is by getting vaccinated, there are still lifestyle changes you can implement to avoid contracting the illness including avoid close contact with those who are sick; cover your mouth and nose when sneezing or coughing, wash your hands frequently; avoid touching your eyes, nose and mouth, drinking plenty of fluids and maintain a healthy diet.

Breast Cancer Awareness Month

October 9th, 2017

October is Breast Cancer Awareness Month, an annual campaign to increase awareness of the importance of early detection of the disease. The pink ribbon is an international symbol of breast cancer awareness. Pink ribbons, and the color pink in general, identify the wearer or promoter with the breast cancer brand and express moral support for women with breast cancer. Stock photo from

Breast cancer is the most common cancer in American women, except for skin cancers. Currently, the average risk of a woman in the United States developing breast cancer sometime in her life is about 12%. This means there is a 1 in 8 chance she will develop breast cancer. This also means there is a 7 in 8 chance she will never have the disease.

Breast cancer is the second leading cause of cancer death in women (only lung cancer kills more women each year). Breast cancer incidence rates are highest in non-Hispanic white women, followed by African American women and are lowest among Asian/Pacific Islander women.

Certain breast cancer risk factors are related to personal behaviors, such as diet and exercise. Lifestyle-related risk factors include alcohol consumption, leading a sedentary lifestyle, certain birth control methods, decisions about having children, hormone therapy after menopause.

Early detection is the key to survival. Breast cancer that’s found early, when it’s small and has not spread, is easier to treat successfully. Getting regular screening tests is the most reliable way to find breast cancer early. Recommendations for early detection include annual mammograms, ultrasounds, MRIs, and breast biopsies. Annual mammograms are recommended for women aged 45 and older.

Breast cancers found during screening exams are more likely to be smaller and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis.

Stock photo from’s also important for women to know what signs or symptoms to recognize that may be related to breast cancer. Those can include:

  • Swelling of all or part of a breast
  • Skin irritation
  • Breast or nipple pain
  • Nipple retraction (turning inward)
  • Redness, scaling, or thickening of the nipple or breast skin
  • Nipple discharge (other than breast milk)

At times, breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast is large enough to be felt. Swollen lymph nodes should also be checked by a health care provider.

Although any of these symptoms can be caused by things other than breast cancer, if you have them, they should be reported to a health care professional so that the cause can be determined.

In support of those battling breast cancer, as well all survivors, please wear pink during the month of October and make sure you get that mammogram!

Don’t Put Off Treating Heel Pain

Skilled and compassionate podiatrist delivers excellent results.

The most common cause of heel pain is plantar fasciitis, or chronic inflammation of the plantar fascia. The plantar fascia is the rigid ligament along the bottom of the foot, and it often becomes a problem for runners and other athletes, people who are required to stand for long periods at work, or even as a result of pregnancy.Skilled and compassionate podiatrist delivers excellent results.

“Heel pain may worsen upon weight-bearing activity and after prolonged sitting or resting,” explains board-certified podiatric surgeon Robert P. Dunne, DPM, FACFAS. “Sometimes, it will improve slightly, going from intense to duller pain.

“With plantar fasciitis, people often have a problem with pain but they procrastinate about getting it addressed: they get up in the morning and their foot hurts, then it goes away during the day…but after they come home and sit down for the night, the pain returns when they stand back up. Just because it’s not bothering them during the day, they think it’s going to go away on its own eventually, but it doesn’t.”

Dr. Dunne treats a wide variety of podiatric complaints, including heel, foot, and ankle pain and difficult-to-heal wounds on the lower extremities. He ensures that he always offers conservative treatment to patients wherever possible before suggesting a surgical procedure.

“For plantar fasciitis, we may do injections of cortisone, anti-inflammatories, prednisone, night splints, walking boots, physical therapy and orthotics,” explains the doctor.

Minimally Invasive Treatment

In the event that conservative care does not resolve a patient’s pain problem, Dr. Dunne offers the latest in surgical techniques for the treatment of plantar fasciitis. Endoscopic plantar fasciotomy, or EPF, is a minimally invasive outpatient surgery performed under local anesthesia with mild sedation. The procedure takes only a few minutes, and patients can soon return to full activities.Skilled and compassionate podiatrist delivers excellent results.

“The patient is off their feet for a week and then they’re back on their feet, fully weight bearing, within a week,” he describes. “It’s an excellent option, and patients typically get a much better outcome with this procedure than with the traditional open fasciotomy procedure.”

Lake Washington Foot & Ankle is a comprehensive podiatric medicine clinic, offering treatment for everything from bunions to hammertoes. “We treat ingrown toenails, warts, and neuromas,” assures Dr. Dunne. “We also do clinical trials for diabetic ulcers, athlete’s foot and onychomycosis [fungal toenails].

“Our patients come first, and we recommend they take action now if they have a problem. Especially with plantar fasciitis, I’ve seen patients who reported that they lived with it for as long as two years, thinking that it would go away eventually. I would just encourage people not to wait so long to come in. The earlier we catch it, the easier it is for us to resolve the problem.”

FHCN staff article and file photo.
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