9 HEALTH&HEALING • VOLUME 16 NUMBER 1 CYNTHIA GREGG, MD, FACS R ecently Barbara Marquis, who is 66, went to a school event with her daughter, Jina, who is 41, and her two little grand-daughters. There they met the principal, Dr. Bob, who said to Jina, “How nice. I didn’t know you had a sister.” Accustomed to such comments, Jina responded, ‘Dr. Bob, this is my mother, not my sister!’” What is at work here? Is this an example of exceptionally good genes on display? Is Dr. Bob simply a courtly South- ern gentleman? No, says Barbara Marquis, the source of her seemingly ageless beauty is her relationship with Dr. Cynthia Gregg, one of the area’s pre-eminent facial plastic surgeons. “I first went to Dr. Gregg six years ago, and the truth is that Dr. Gregg, with her amazing caring and expertise, simply wiped away 20 years from my appearance. (see before-after photos) People around me who I have known for a long time were simply astonished by my new look. And I continue to be amazed every time I look in a mirror. “It took me 10 years to decide to do this, and a lot of courage, but without question this is the greatest gift I’ve ever given myself. It’s impossible to fully de- scribe how this has changed my life—but it has been entirely positive, personally, socially, in every way. And given the option, I would do it all over again, in a heartbeat.” A VERY NEW LOOK Notes Dr. Gregg, “When Barbara first came to us, she was 60 and in good health. We talked at length about what she wanted to change about her appearance, and about realistic expectations. My question to Barbara, as it is to most new patients, was: ‘What bothers you the most?’ “She said she thought she looked tired, and old beyond her years. The excess skin on her upper eyelids was giving her a tired look. A facelift and pre-jowl implant helped overcome the aging of the face. La- ser resurfacing was important because of sun damage and wrinkling. Taken together, it was a full facial rejuvenation. When the healing was done, both she and I were absolutely delighted with the outcome. “There are advantages in doing all of these procedures at one time. It is, of course, a more complete rejuvenation of the face; and there’s only one anesthesia, one down-time, one recovery period—and there are financial advantages, as well. So if the patient is in good health, without con- traindications, and we are doing medical procedures that we can do safely together, I may recommend this approach. “Barbara also wanted to do a rhino- plasty to correct her nasal appearance, and we did that as an important finishing touch eight months after completing these other procedures.” CHIN IMPLANT In considering the overall rejuvena- tion plan, Dr. Gregg’s suggestion of a chin implant came as a surprise to the patient. “In doing a facelift,” she explains, “it’s the same incision to do the chin implant— you’re already there. Our concern is about balance. Barbara’s nose was over-projected and her chin was under-projected. Also, as we get older, there is some bone remodel- ing and bone loss, particularly in this area we call the pre-jowl. “As we age, our chin tends to look separate from the rest of our jaw line be- cause we sink in a little bit in front of each jowl. This implant—called a pre-jowl im- plant—allows us to augment and increase the area where the patient has lost bone on either side of the chin. The result is a nice youthful jaw line. “When Barbara first came to me, it was important to get her on a good skin care regimen. Aging of the skin includes four main factors: genetic history, sun exposure up to the age of 20 to 25, any smoking history, and stress. Barbara had sun damage to her skin, and a lot of stress in her life, especially related to her husband’s health—which is now much better. “For this patient and all of my pa- tients, I constantly stress the need to be sun-smart. It’s important to understand that what people start seeing in their ap- pearance in their 30s and 40s may be the result of the sun exposure they accumu- lated in their teens and 20s. Certainly everyone that has youngsters in the family needs to have them faithfully wearing sunscreen—along with a hat and protec- tive clothing. “But there’s still hope for those of us who went through these earlier times without taking those wise precautions. We have many products now that we can use to reverse sun damage and protect the skin. Sunscreens are better, and we have exceptional skin care products with antioxidants and retinols and retinoids that are very beneficial. While over-the- counter products may be fine, products available through a doctor’s office are of higher concentration and more targeted to specific problems, and are not necessarily more expensive. “We’re always pleased to provide free consultations, and samples of products for people to try that specifically relate to the condition of their skin.” h&h Sister or Mother? DECADES OF EXPERIENCE D r. Gregg is double board-certified by the American Board of Facial Plastic and Re- constructive Surgery and the American Board of Otolaryngology—Head and Neck Surgery, a Fellow of the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Otolaryngology—Head and Neck Surgery, American College of Surgeons, and the North Carolina Medical Society. Before opening her private practice in Cary in 1999, she was an Assistant Professor of Facial Plastic and Reconstructive Surgery at Duke University Medical Center. She performs the full range of facial plastic surgery procedures, including forehead and brow-lift surgery, facial scar treatment, otoplasty (to correct protruding ears), rhino- plasty nasal surgery, blepharoplasty eyelid surgery, rhytidectomy face lift surgery, and mid-face lift. For more information about the practice, contact: CYNTHIA GREGG, MD, FACS 0 NW Cary Parkway, Suite 00 Cary, NC 7 Telephone: (99) 97-0097 www.cynthiagreggmd.com Barbara Marquis, before and after facial rejuvenation. Dr. Gregg with her very grateful patient. “As we age, our chin tends to look separate from the rest of our jaw line because we sink in a little bit in front of each jowl.” Originally published in Health & Healing in the Triangle, Vol. 16, No. 1, Health & Healing, Inc., Chapel Hill, NC, publishers. Reprinted with permission.
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C Y n t H I A g R E g g , M D , f A C S
Recently Barbara Marquis, who is 66, went to a school event with her daughter, Jina, who is 41, and her
two little grand-daughters. There they met the principal, Dr. Bob, who said to Jina, “How nice. I didn’t know you had a sister.” Accustomed to such comments, Jina responded, ‘Dr. Bob, this is my mother, not my sister!’”
What is at work here? Is this an example of exceptionally good genes on display? Is Dr. Bob simply a courtly South-ern gentleman? No, says Barbara Marquis, the source of her seemingly ageless beauty is her relationship with Dr. Cynthia Gregg, one of the area’s pre-eminent facial plastic surgeons.
“I first went to Dr. Gregg six years ago, and the truth is that Dr. Gregg, with her amazing caring and expertise, simply wiped away 20 years from my appearance. (see before-after photos) People around me who I have known for a long time were simply astonished by my new look. And I continue to be amazed every time I look in a mirror.
“It took me 10 years to decide to do this, and a lot of courage, but without question this is the greatest gift I’ve ever given myself. It’s impossible to fully de-scribe how this has changed my life—but it has been entirely positive, personally, socially, in every way. And given the option, I would do it all over again, in a heartbeat.”
A VERY nEw LookNotes Dr. Gregg, “When Barbara first
came to us, she was 60 and in good health. We talked at length about what she wanted to change about her appearance, and about realistic expectations. My question to Barbara, as it is to most new patients, was: ‘What bothers you the most?’
“She said she thought she looked tired, and old beyond her years. The excess skin on her upper eyelids was giving her a tired look. A facelift and pre-jowl implant helped overcome the aging of the face. La-ser resurfacing was important because of sun damage and wrinkling. Taken together, it was a full facial rejuvenation. When the healing was done, both she and I were absolutely delighted with the outcome.
“There are advantages in doing all of these procedures at one time. It is, of course, a more complete rejuvenation of the face; and there’s only one anesthesia, one down-time, one recovery period—and there are financial advantages, as well. So if the patient is in good health, without con-traindications, and we are doing medical procedures that we can do safely together, I may recommend this approach.
“Barbara also wanted to do a rhino-plasty to correct her nasal appearance, and we did that as an important finishing touch eight months after completing these other procedures.”
CHIn IMPLAntIn considering the overall rejuvena-
tion plan, Dr. Gregg’s suggestion of a chin implant came as a surprise to the patient. “In doing a facelift,” she explains, “it’s the same incision to do the chin implant—you’re already there. Our concern is about balance. Barbara’s nose was over-projected and her chin was under-projected. Also, as we get older, there is some bone remodel-ing and bone loss, particularly in this area we call the pre-jowl.
“As we age, our chin tends to look separate from the rest of our jaw line be-cause we sink in a little bit in front of each jowl. This implant—called a pre-jowl im-plant—allows us to augment and increase the area where the patient has lost bone on either side of the chin. The result is a nice youthful jaw line.
“When Barbara first came to me, it was important to get her on a good skin care regimen. Aging of the skin includes four main factors: genetic history, sun exposure up to the age of 20 to 25, any smoking history, and stress. Barbara had sun damage to her skin, and a lot of stress in her life, especially related to her husband’s health—which is now much better.
“For this patient and all of my pa-tients, I constantly stress the need to be sun-smart. It’s important to understand that what people start seeing in their ap-pearance in their 30s and 40s may be the result of the sun exposure they accumu-lated in their teens and 20s. Certainly everyone that has youngsters in the family needs to have them faithfully wearing sunscreen—along with a hat and protec-tive clothing.
“But there’s still hope for those of us who went through these earlier times without taking those wise precautions. We have many products now that we can use to reverse sun damage and protect the skin. Sunscreens are better, and we have exceptional skin care products with antioxidants and retinols and retinoids that are very beneficial. While over-the-counter products may be fine, products available through a doctor’s office are of higher concentration and more targeted to specific problems, and are not necessarily more expensive.
“We’re always pleased to provide free consultations, and samples of products for people to try that specifically relate to the condition of their skin.” h&h
Sister or Mother?
DeCaDeS OF exPeRienCeDr. Gregg is double board-certified by the American Board of Facial Plastic and Re-
constructive Surgery and the American board of otolaryngology—Head and Neck Surgery, a Fellow of the American Academy of Facial Plastic and reconstructive Surgery, the American Academy of otolaryngology—Head and Neck Surgery, American College of Surgeons, and the North Carolina medical Society.
before opening her private practice in Cary in 1999, she was an Assistant Professor of Facial Plastic and reconstructive Surgery at Duke university medical Center.
She performs the full range of facial plastic surgery procedures, including forehead and brow-lift surgery, facial scar treatment, otoplasty (to correct protruding ears), rhino-plasty nasal surgery, blepharoplasty eyelid surgery, rhytidectomy face lift surgery, and mid-face lift.
for more information about the practice, contact:
CYNTHIA GREGG, MD, FACS���0 nw Cary Parkway, Suite �00
Barbara Marquis, before and after facial rejuvenation.
Dr. gregg with her very grateful patient.
“As we age, our chin tends to look separate
from the rest of our jaw line because we sink in a little bit in front of each jowl.”
Originally published in Health & Healing in the Triangle, Vol. 16, no. 1, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.
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a s she eases comfortably into middle age, Bonnie Hunter notes that she and her dentist in Raleigh, Dr. Steven Andreaus, have much in common.
“He’s equal parts artist and perfectionist,” she says with a laugh, “and it’s quite amazing how he simply will not let go of the smallest detail until it is resolved to his satisfaction. He is so focused and so intent—and I think those are the hallmarks of a first-rate artist.”
Notes Dr. Andreaus, “In patients who are 45 and older, such as Bonnie, we’re often dealing with problems of occlu-sion—the normal spatial relation of the teeth when the jaws are closed—and quite frankly, I often down-play the type of dentistry many of these patients think they want.
“Some patients are influenced by the ‘extreme makeover’ approaches they may see on TV, where people are having ex-tensive dental work that is permanent to their beautiful teeth. When I say ‘permanent,’ I mean it is work that is permanently changing the surface of the tooth—and no restoration is as good as a healthy natural tooth.
“With that in mind, in this practice we prefer to serve the patient by minimizing the cosmetic work, and we end up with a more natural appearance because the majority of the teeth are still their natural teeth. Matching restorations to natural teeth is one of the most challenging things we do.
“I’ll often use an approach such as Invisalign® (see box) and perhaps consider using bonding as a minimally invasive procedure. Often it’s necessary to do significant restorative work on teeth that have had restorative work in the past, such as an old crown, big fillings, or an old veneer.
“As we’re using Invisalign to straighten teeth, we often use a highly effective teeth-whitening process. Even patients in the 45 to 65 year-old group with tetracycline stains from childhood can have success in removing those stains within six months to a year.”
The results of this careful, artistic, and conservative work have won national attention. Dr. Andreaus is one of about 500 dentists who have earned accreditation by the American Academy of Cosmetic Dentistry.
BonnIE HuntER’S nEw SMILEWhen Bonnie Hunter first slipped into Dr. Andreaus’s
dental chair, “she had two crowns that were definitely showing considerable wear and tear,” the doctor notes. “They were in need of replacement, if not for aesthetic reasons, then realistically, for functional reasons. There was clear evidence of deterioration of the margins.
“Bonnie is in that mid-life group where occlusion is an issue, which was high on our list for attention and correction.
She is an excellent example of the benefits of bringing aesthetics, cosmetics and Invisalign together in the hands of an experienced practitioner. We were able to remove her failing crowns, and replace them with attractive, high quality provisionals—and so quickly Bonnie was looking quite wonderful even though her bottom teeth were at that time still crooked and crowded.
“With the provisional in place, we are able to continue the Invisalign process and complete whitening at the same time, so at that point she no longer had discolored margins and exposed worn areas. Steadily, Invisalign was moving her teeth into an attractive, healthy position (see photos). And her bite improved as we proceeded with this multi-specialty approach, all under the care of the same experienced dentist in the same office.
“Meanwhile, through this process, we were able to main-tain and manage the provisionals throughout the Invisalign process, while at the same time ensuring that the whitening of her teeth was working exactly as she wanted it: not too white, but at the same time a little brighter than before.
“She’s a lovely lady, and she wanted to have a beautiful, natural looking smile—and that’s exactly what we accom-plished together.” h&h
f I V E P o I n t S C E n t E R f o R A E S t H E t I C D E n t I S t R Y - S t E V E n A n D R E A u S , D D S
Rejuvenation for Aging Teeth
Dr. Andreaus and his patient, Bonnie Hunter, share pleasure in the outcome of her aesthetic and corrective dental work.
Bonnie Hunter’s smile, before and after Dr. Andreaus’s accomplished touch.
Invisalign® is a blessing for many adults (and teenag-ers, as well) who want straight, attractive teeth with-
out the hassle of wires or metal in their mouths.“As the name suggests,” says Dr. An-
dreaus, “Invisalign is an invisible way to straighten teeth without braces. rather than metal braces, we use a series of clear, removable, hard plastic aligners (see photo) that over time gently and steadily move teeth into alignment.
“Typically, a patient wears each set of aligners for about two weeks, removing them only to eat, drink, brush, and floss. As we replace the aligners with the next in the series, the teeth will continue to move into the desired position. We’ve had Invis-align cases as short as three months, and as long as 24 months.” Designing the se-ries of aligners is a custom-fit, computer-assisted process.
Dr. Andreaus is a Premier Provider for Invisalign—one of an expert group of doctors who, the company says, “have achieved the highest level of Invisalign ex-pertise.”
for more information on dental cosmetic procedures, or on helping to support the “give Back a Smile” program (which provides free cosmetic dental care
to survivors of domestic violence), contact:
STEVEN B. ANDREAUS, DDS THE FIVE POINTS CENTER FOR AESTHETIC DENTISTRY
�6�7 glenwood AvenueRaleigh, nC �7608
telephone: (9�9) ��6-90��www.drandreaus.com
“In patients who are 45 and older ... we’re often dealing with problems
of occlusion—the normal spatial relation of the teeth when the jaws are closed.”
inViSalign®: StRaighten teeth
WithOUt WiReS OR Metal
Originally published in Health & Healing in the Triangle, Vol. 16, no. 1, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.
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By Doug Jackson, Certified ARISE Interventionist
Many of those most deeply hurt by alcohol and drug addiction don’t even drink or use drugs. Those who
bear unseen scars are the children living in families of addiction. Alcoholism and drug addiction affect everyone in the family, in-cluding children; and children from families of addiction/alcoholism are at high risk for addiction and mental illness themselves. Over 50 percent of the alcoholics in the U.S. are children of alcoholics.
Multiple research studies show that alcoholism/addiction runs in fami-lies—there is a genetic component, as well as familial traits and environmental factors. Addiction is a disease that affects the entire family, both nuclear family and extended families, and by “families” we
mean families of origin, families of choice, and families of convenience.
Tragically, the “survival rules” learned by children in a family suffering from addiction—Don’t talk, don’t trust, don’t feel—have a powerful negative influence on their own lives. Children as young as five can be riddled with sadness/depression, guilt/shame, confusion, and fear. Many of these children believe that addiction is their fault, so they grow up too quickly and miss out on their childhood—setting themselves up for substance abuse, depression, or even suicide as adults.
It is essential to spare children from unnecessary years of suffering. A family in-tervention can help stop the downward spiral of addiction and lead the family to healing and recovery.
We are certified interventionists trained in the ARISE model of “family recovery.”
At Intervention and Family Recovery, an intervention is described as a kind, loving, well-orchestrated and discrete process led by a professional. This process guides the family into healing and recovery.
A family living with an alcoholic/ad-dict becomes very ill just by virtue of living the drama and chaos surrounding substance abuse. Intervention and Family Recovery signs a contract to work with the entire fam-ily for six months. This takes the pressure off the active alcoholic/addict and dimin-ishes the power of the illness of addiction. Frequently there are children living in the home. We find appropriate referrals for each family member, regardless of age.
At Intervention and Family Recovery, we are not affiliated with any particular treatment facility. Our client is the family. We want to know that we are referring to the best possible match for treatment for the
families we work with. We want the best for our clients/families. This includes individual-ized recovery plans for each family member. We want the children of all our families to learn that addiction is not their fault. They need the tools to understand the disease that they themselves could inherit.
Empowering youngsters with healthy life skills is the ultimate prevention. h&h
Doug Jackson has decades of experience as a pharmacy investigator and as a specialist in the addiction field.
for more information about addiction and the ARISE intervention program,
I n t E R V E n t I o n & f A M I L Y R E C o V E R Y
Devastated by addiction? Love Someone Who Is?
W hat is healthy aging? Is it having a plan, remaining realistic, or just being grateful for the benefits of good health?
Aging is inevitable though some of us accept it more graciously than others. Planning for our later years requires some insight into our wishes, expectations, and is frequently more involved than how well we have saved for retirement.
We may forget or take for granted quality-of-life details. many of us who are animal lovers cannot conceive of the notion that at some point we may not be able to physically, cognitively, or financially maintain the ability to be responsible for a pet. We will always expect to have a pet in our life regardless of our living environment and not worry
about the ability to provide adequate care. Historically animals have been an integral
part of society—both past and present—whether they met agricultural needs, provided companionship, or assisted with functioning. For some, maintaining a connection with an animal is vital in ensuring a sense of self-worth or purpose. Acknowledging and respecting one’s history with animals may aid in validating a sense of self.
As we age, our ability to live independently may change. When living in a communal environment individual relationships with a domesticated animal may be lost due to facility policy, the physical or cognitive limitations of the individual, or financial and environmental restrictions. Creating alternative ways for maintaining contact with animals may not only enhance one’s lifestyle but may also provide health benefits.
For all of us, relationships change as we age, including those with our animals. In addition to companionship and unconditional love, our pets may meet the changing needs in our lives in a wide variety of ways, including:
• providing assistance
• helping maintain a sense of purpose and responsibility
• increasing our mobility or exercise opportunities
• serving as a status symbol that sets us apart
from others
• increasing socialization—as the pet may serve as a conduit to interactions with others
• helping normalize our environment
• having a calming effect and reducing anxiety
• decreasing our focus on an illness or stressful situation
• serving as a buffer with family conflict and relationships.
It’s an impressive list of supportive benefits.Sadly, however, it is not uncommon for
seniors to be separated from their pets due to their inability to provide proper care, financial restrictions, or safety concerns. Some older adults may not seek help for their own care and remain isolated from others out of fear that they may be separated from their pet; their love and concern for their companion supersedes their own needs.
many seniors are fortunate to have family, friends, neighbors, or the financial resources for paid assistance to possibly help out with the care of their pets but others may not. While society
Laurie Ray explains: “I established Compassionate Options for Progressive Eldercare (COPE) in 2004, as the only nonprofit geriatric care management organization in the region. It grew from the idea that everyone should have access to a GCM and the resources needed to live safely as they age, regardless of their environment and financial limitations. As a GCM, my role is to advocate, educate, and coordinate the resources necessary as we age. The ultimate goal is to promote independence, safety, and quality of life. For more information, visit us at www.copeeldercare.com, or call 919-481-0410.”
in serviceB Y L A u R I E R AY, C M S w, C - A S w C M
inService is a new column supporting the work of non-profit health organizations in the triangle. to learn more, call (919) 967-6802.
(continued on page 29)
“Those who bear unseen scars are the children living in families of addiction. . . . Over 50 percent of
the alcoholics in the U.S. are children of alcoholics.”Doug Jackson is continually discovering the most current evidence that addiction is, in fact, a medical disease.
aging and the human-animal Bond: Multiple Benefits in nurturing these Relationships
Originally published in Health & Healing in the Triangle, Vol. 16, no. 1, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.
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here’s a prescription to accelerate the aging process: smoke at least a pack of cigarettes each day and spend
your spare time sun bathing—without bothering with sunscreen.
“That combination is really a recipe for disaster for many people,” says Dr. Eric Challgren of Southern Dermatology and Skin Cancer Center in Raleigh. “Thankfully, it is behavior that is less the norm than was true even a short time ago.
“People who treat themselves—and their skin—in this way might look great to themselves and their counterparts when they’re 25, with the glow of a suntan. But, keep up this behavior and, at age 45, the signs of aging will be evident. At 60, they will look 10 years older than their age. Smoking is caustic to the skin in general, and especially produces noticeable wrin-kling around the mouth. And unprotected exposure to the sun is the principal cause of skin cancer as well as the primary cause of photo-aging. So for many, today’s ‘healthy glow’ will be replaced 20 years from now with multiple brown spots, blood vessels,
an array of wrinkles—and, in the worst case, skin cancer.”
The good news, says Dr. Challgren, “is that we now have a range of products and procedures that in many instances can dramatically improve the condition and appearance of aging skin. They really can represent an effective anti-aging regimen.
“For example, Fraxel is a fairly new laser treatment that is producing excellent results for many of our patients (see before-after photos). Fraxel is able to precisely treat thousands of mi-croscopic areas of the skin, using pinpoint laser beams that penetrate beneath the skin’s surface to eliminate old, damaged skin cells. This treat-ment stimulates the body’s own natural healing process, which replaces damaged skin with fresh, glowing, healthy skin.
“Fraxel has FDA approval for treating wrinkles around the eye, age and sun spots, brown spots, acne scars and surgical scars, and skin resurfacing.”
MAnY CHoICESBut the first critical step in achieving
“a new, younger look” is to protect the skin from excessive exposure to the sun, Dr. Challgren emphasizes. “Using an appropri-ate sunscreen—providing protection from both UVA and UVB rays—needs to be an everyday habit as routine and important as brushing your teeth.”
That achieved, patients have numerous anti-aging choices, including:
Collagen Replacement therapy. “The FDA has approved injectable gels such as Re-
stylane, Juvvederm, and Radiesse to treat facial wrinkles,” Dr. Challgren notes. “Studies show that these products are safe and effective for filling moderate to severe wrinkles around the nose and mouth. Most patients need only a single injection to get optimal correction, and the benefits last about six months.
“Restylane, for example, is made with hyaluronic acid, a natural substance that already exists in the body, and is used to provide volume and fullness to the skin. As we age, the skin’s collagen layer thins and small wrinkles form. Restylane replen-ishes the skin’s collagen layer, resulting in a smoother, more youthful look—as is true of these other products, as well.”
Chemical Peels. “We offer the Neo-Strata Skin Rejuvenation System, a glycolic acid peel system, which can only be per-formed as an in-office procedure. Patients see immediate improvement, with no recov-ery time required. We also offer trichloro-
acetic acid peels, which consistently reduce fine lines. It is intended especially for more mature skin.”
laser treatments. “Pulsed dye lasers, or V-beam lasers, were developed to rid pa-tients of unsightly benign vascular regions, and we’ve had great success using this type of laser in the treatment of rosacea, facial veins and redness, leg veins, port wine stains, and hemangiomas. This is the same laser that is used on infants and children for the removal of port wine stains.
“intense Pulsed light therapy is a treat-ment technology that combines light colors to treat aging or sun-damaged skin gently and effectively. It is effective in treating the effects of aging and sun exposure on all types of skin, including benign brown and red blemishes—‘age spots’—fine lines, and broken blood vessels. The procedure is non-abrasive and non-invasive.”
hair Removal. Says Dr. Challgren, “We use the Gentle LASE® System, a state-of-the-art long-pulse, high energy laser that transmits a gentle beam of light that passes through the skin to the hair follicle, destroying the follicle while leaving the sur-rounding skin unaffected. For people who want to rid themselves of unwanted hair, it provides outstanding results. We also use the GentleYAG® laser for hair removal on dark and tan skin. This is a revolutionary treatment option for people of color.”
Spider Veins. “Spider veins are similar to varicose veins, but smaller,” says Dr. Challgren. “They are closer to the skin than varicose veins, and they are often found on both the legs and the face.
“We use sclerotherapy to effectively re-move spider veins. The treatment involves injection of a solution into the vein that causes the lining of the vein walls to swell, stick together, and eventually seal shut. The flow of blood is stopped and the vein turns into scar tissue. Typically, veins fade within several weeks. The result is that a treated leg looks younger, clearer, and healthier than an untreated one. The GentleYAG® laser is also very effective for treating spider veins.
“Finally, let me add the importance of the basics for all of us, if we want to have and keep healthy, attractive skin: stress re-duction, a good exercise regime, sun protec-tion and non-smoking are gifts to all of our body parts, including our skin.” h&h
for more information about skinconditions and their treatment, contact:
SOUTHERN DERMATOLOGY & SKIN CANCER CENTER
(formerly The Dermatology & Skin Cancer Center)
Gregory J. Wilmoth, MDEric D. Challgren, MD
Margaret R. Boyse, MDLaura D. Briley, MD
Tracey Cloninger, PA-C��0� Lake Boone trail, Suite �00
(formerly The Aesthetic & Laser Suite)��0� Lake Boone trail, Suite �07
Raleigh, nC �7607 telephone: (9�9) 86�-007�
S o u t H E R n D E R M A t o L o g Y & S k I n C A n C E R C E n t E R
Rapid aging? Smoke
While You Lie in the
SunDr. Challgren advises a patient about ways to protect and preserve her skin.
“For many, today’s ‘healthy glow’ will be replaced 20 years from now with multiple brown spots, blood vessels, and an array of wrinkles—and, in the worst
case, skin cancer.”
Results before and after treatment with the fDA-approved fraxel laser.
Originally published in Health & Healing in the Triangle, Vol. 16, no. 1, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.
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n o R t H C A R o L I n A C E n t E R f o R A E S t H E t I C D E n t I S t R Y
a s he moved into his seventies, Stephen—a real patient with an assumed name—spent several years seeking relief of symptoms that were finally
recognized as TMJD: temporomandibular joint dys-function.
“I didn’t experience a great deal of really intense pain,” says Stephen, “but an almost constant level of pressure and discomfort—facial and scalp pressure that was always there, ranging from moderate to quite severe. It tended to concentrate around my right eye and right cheek, but would spread across my whole face and scalp when it was turned on high.”
Stephen and a variety of doctors puzzled over his condition, testing for lots of possibilities: Dysbiosis? Al-lergies? Mini-stroke?
Paradoxically, it was an ear infection that finally led him to Dr. James Harold in Raleigh, the area’s pre-eminent neuromuscular dentist. The ear problem first took him to an ENT physician when, after several weeks, his clogged right ear failed to clear. The specialist did a thorough exam, and rendered his own verdict: “Stephen, you don’t have a problem with that ear. My guess is that you have TMJD.”
tHE gREAt IMPoStER“When patients come to us with high levels of dis-
comfort or intense pain, the first thing we do is look for the obvious,” says Dr. Harold. “Is there anything going on in the mouth that may be related to the symptoms?
“For Stephen, that was an easy call. He had a failed bridge on the lower left of his mouth, which had not been replaced. How long had the teeth been missing? About two years. How long had he had these very uncomfortable symptoms? About two years.
“We call TMJ disease or dysfunction the great im-postor, because it mimics so many other things. It’s the body-brain connection. Stephen’s neurologist thought he had a mini-stroke, even after a negative MRI. A gastro-enterologist thought he had intestinal problems. And on and on. What he had was missing teeth. Our tests showed there was torque affecting the muscles of the face and of the whole body. It’s like one table leg that is too short; it throws everything out of balance.
“TMJD, caused by an improperly aligned jaw, contributes to a great array of problems,” Dr. Harold ex-plains. “The centerpiece goal of neuromuscular dentistry is to bring the jaw and teeth into balance and harmony with the muscles. If the jaw is not in the proper position as it relates to the muscles, muscles become overstretched and place undue strain on surrounding bones, nerves and tissues, causing increasing amounts of pain. Over time, the pain can become intolerable.
“We saw a patient recently who was told that she would have to live with painful knots in her shoulders the rest of her life. After TMJ treatment, and placing of a corrective orthotic, her pain, and the knots, disappeared in one day.
“In this practice, we’ve had significant success with patients suffering with many different types of prob-lems, including headaches, facial pain, worn, chipped, or cracked teeth, cracking or chipping of dental restorations, neck and shoulder pain, jaw pain, ear congestion, ringing in the ears, clicking or popping in the joints, clenching or bruxing, limited opening of the mouth, loose teeth, and even tingling in the fingers.
“TMJD is not necessarily the root cause of all of these problems, but in many instances it contributes to the discomfort in a direct way. Basically, the problem is often a lack of harmony between the joint, the muscles, and nerves, and is thus ideally suited for neuromuscular treatment.”
ACHIEVIng BALAnCEAfter a careful initial exam to determine that a pain or
function problem is really muscular in nature, Dr. Harold uses an array of high-tech devices to properly align the jaw.
“What I usually quickly discover is an imbalance in the position of the jaw as it relates to the muscles in the joint, and in the closing pattern of the jaw as it relates to the teeth.
“Our first therapeutic goal is to find the position of the jaw where the muscles are relaxed and at rest—a
three-dimensional position in space—and we rely on a series of neuromuscular scans to accomplish this.
“We will, for example, use a low-frequency T.E.N.S. device to relax muscles. It delivers a mild electrical im-pulse to the muscles that move the jaw, and the rhythmic pulsing relaxes the muscles. After 45 minutes, the muscles are in a deeply relaxed state. At this point, we have a com-puterized diagnostic device that records this position of the jaw, and transfers this information to casts of models of this ideal jaw position.”
Other scans track the motion of the jaw, and electro-myography provides an objective measurement of masti-catory muscle electrical activity “which accurately repre-sents the physiologic state of rest,” Dr. Harold explains. “It’s similar to a cardiologist taking an EKG, to measure electrical conductivity of the heart muscles. We’re doing the same thing, only we’re measuring the electrical activity of the facial muscles.
“We also use a lightweight sonography headset over each TM joint that gives us tissue vibrations emanating from joint sounds. Sound data is valuable in determining joint function, and we can obtain this information simply and non-invasively.”
tHERAPEutIC oRtHotICSOnce Dr. Harold and his team have determined the
comfortable position of the lower jaw, the next critical task is to fabricate an orthotic that allows the jaw to close to this ideal position. “In this position, the muscles are at an ideal length and will not go into spasm,” he explains. “Muscles will heal, pain trigger points will subside, and joint capsules will heal. We leave this orthotic in place for three months, 24 hours a day. Some patients remove the orthotic while eating, most do not.
“It is imperative that patients be pain-free for two to three months while wearing the orthotic before start-ing the next phase. Phase two may consist of either full mouth reconstruction, to permanently place the jaw and teeth into the new bite, or orthodontics, to move the teeth into the corrected bite. In some cases, a limited bite adjustment is all that patients need in order to correct the problems.”
Stephen had his orthotic placed on a Monday, and returned the next day for precise adjustments. He joined the long list of Dr. Harold’s TMJ patients who are grate-ful and amazed. “I was told I might experience relief from the facial pressure, and neck pain, within 48 hours. In fact, I began to notice a significant difference within the first hour of wearing the orthotic, as I was driving home. And then, quite amazingly, I noticed a beneficial effect throughout my entire body, of feeling more balanced, more stable. If I take the orthotic out of my mouth for an hour or two, the symptoms return. But while it’s in place, and healing is going on, I have complete relief of very unpleasant sensations. And my right ear has also cleared up.” h&h
for more information about neuromuscular dentistry, contact:
JAMES R. HAROLD, DDS NORTH CAROLINA CENTER FOR AESTHETIC DENTISTRY
with Stephen in the dental chair, Dr. Harold makes precise adjustments to the orthotic he will wear ��/7 to support restoration of alignment of his jaw and bite.
“When patients come to us with high levels of discomfort or
intense pain, the first thing we do is look for the obvious,” says
Dr. Harold. “Is there anything going on in the mouth that may be related to the symptoms?”
Originally published in Health & Healing in the Triangle, Vol. 16, no. 1, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.
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Dr. Todd Staker of Staker Chiropractic Center in Cary got a welcome note from a colleague a few weeks ago.
It read: “Enclosed is an article from Spine, which I think is very pertinent. This multi-center study confirmed my opinion that CMT (chiropractic manipulative therapy) is of great benefit to patients.”
The note was signed by Dr. Dennis E. Bullard of Triangle Neurosurgery.
The study reported in Spine zeroes in on the common condition of low-back pain, which is “exceedingly common, costly, and a significant cause of long-term sick leave and work loss.” Over a lifetime, as many as 84 percent of adults will seek treat-ment for the condition, the study notes.
The study included about 100 military per-sonnel, ages 18 to 35, all suffering with intense low-back pain. Half of the group was treated with standard medical care (SMC); the second group received the same SMC along with chi-ropractic manipulative therapy (CMT).
SMC included diagnostic work-up, physical therapy, referral to a pain clinic, and pharmacological management as pre-scribed. Participants receiving both SMC and CMT received chiropractic treatment twice a week for four weeks.
The study notes, “Seventy-three percent of participants in the SMC plus CMT group rated their global improve-ment as pain completely gone, much better, or moderately better, compared with 17 percent making those same as-sessments who had received standard medical care alone.”
“Chiropractors have been treating low-back pain for many years, with a great deal of success,” notes Dr. Staker, “but quite honestly we simply do not have the resources, as a profession, to conduct extensive studies supporting the efficacy of
what we do, so a report such as this, while not surprising, is welcome.
“As the study notes, chronic low-back pain is a common ailment which gets our focused attention, especially in the con-text of encouraging all of our patients to consider chiropractic care an essential part of both their episodic and on-going health care needs.
“And in today’s high-stress environ-ment, some people claim they are ‘too busy’ to attend to something as ‘minor’ as a nag-ging back pain.
“Others, in our current economy, put caring for themselves way down on their ‘To-Do’ list, and I think that is really a sad and unfortunate mistake. The old saying, ‘An ounce of prevention is worth a pound of cure’ is absolutely true when we’re talking about the health of the spine. That nagging back problem, left untreated, could fester into a long-term, chronic problem. As many as 8 out of 10 adults in the U.S. have back problems, as this study notes, and that number is not going to come down because of economic hard-ship. It’s more likely to rise.
“But there is one thing each of us can do, no matter how fragile the economy seems. We can take care of ourselves. We can exercise, eat properly, get restorative rest, and maintain spinal health with peri-odic chiropractic care. The health problem you put off today could be a major health problem in the near future.”
tHREE PHASESChiropractors such as Dr. Staker and
his colleague, Dr. Ben Schemmel, have a fundamental interest in the health of the spine, and most of their work is involved with adjusting the spine to promote good health.
“Spinal degeneration is of critical con-cern to us,” he notes, “and we separate our cases into three phases. Phase I degenera-tion is most common up to age 20. There’s a loss of the normal spinal curve, and evidence of disc, joint, muscle, and nerve damage—all of which respond extremely well to chiropractic treatment. Our goal is always to encourage patients to come to us with their aches and pains, and for regular adjustments, to keep all problems from advancing beyond Phase I.
“In Phase II degeneration, most com-monly seen between the ages of 20 and 40, there’s increasing decay, disc narrowing, and bone deformation, and a narrowing of the spinal canal may occur. Fatigue is a common symptom of the problem. Phase II also responds very well to chiropractic treatment.
“Phase III is more severe, and is commonly seen in our patients age 40 and older. There’s greater posture imbalance, increased nerve damage, permanent scar tissue, and advanced bone deformation. Treatment options become more limited, but some reversal is possible. And in older patients, there more commonly is severe de-generation of the cartilage and bone, bone fusion, constant pain, loss of height, and inability to turn, bend and twist.
“And so it is easy to conclude that there’s a strong relationship between age and spinal degeneration, but in fact this is a yes-and-no situation.
oLD AnD fIt“I well remember a 90-year-old woman
who came to our office. She told me she had been under chiropractic care since the age of 20, because her brother was a chiropractor. She had come to me because she was looking for a graduate of Palmer College, where her brother had gone to school. He had died five years earlier, when she was 85, and she had not had an adjust-ment since.
“I took an X-ray of her spine. At age 90, she was perfectly normal—with the spine of a healthy 20-year-old. She was a walking example of the potential for each of us of regular chiropractic adjustments.” h&h
Dr. Ben Schemmel, left, and Dr. todd Staker study the x-ray of a patient being treated for low-back pain.
Study Confirms Benefits of Chiropractic Adjustments
for more information about chiropractic treatment, contact:
M. Todd Staker, DC Ben Schemmel, DC
STAKER CHIROPRACTIC CENTER���0 nw Cary Parkway, Suite �0�
Cary, nC �7���telephone: (9�9) �60-����
www.stakerchiropractic.com
S t A k E R C H I R o P R A C t I C C E n t E R
“That nagging back problem, left untreated,
could fester into a long-term, chronic
problem.”
Originally published in Health & Healing in the Triangle, Vol. 16, no. 1, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.
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Over more than three decades, Darlene Holloway, founder of the Alternative Health Center of Cary, has repeat-
edly observed the critical importance of a healthy colon.
“As we age, there’s a natural tendency to experience some level of atrophy of our muscles,” she points out, “and of course that includes one of the most important muscles of all—the colon—which is, in fact, four layers of muscle. As we age, those muscles age with us.”
Because of her understanding of and skill with the colon irrigation therapy pro-cess, in 2009, Ms. Holloway was honored as the Colon Therapist of the Year by the Inter-national Association of Colon Hydrotherapy.
“Let me point out that the lower abdo-men is a busy place,” she says, “home to a range of critically important organ systems: kidneys, gallbladder, the liver, the spleen, pancreas, uterus, ovaries, plus five to six feet of colon and the small intestines.
“And with an aging colon, it is sometimes like water that is stagnant in a pond. Things start growing that shouldn’t be there. A healthy colon needs constant movement to keep muscles toned.”
Colon hydrotherapy, she reminds us, “is the safe, gentle infusion of warm filtered water into the rectum using no chemicals or drugs. It is a restorative procedure that is re-laxing and effective—extending beyond the rectum to cleanse the entire large intestine.”
What is less well known is that, in the hands of an expert, colon hydrotherapy is a
highly individualized procedure. “So much depends on the needs of the individual cli-ent,” she says. “It’s common, for example, for us to work with patients who are being treated for cancer with chemotherapy—and that requires its own special protocol. On one hand, we want to make sure the chemo drugs remain in the system long enough to do their work, and at the end of the chemo cycle, we want to draw those toxins out.
“The clients coming to us with painful gallstone or liver issues also require unique co-lon hydrotherapy protocols. Our goal may be
to target the liver, and any time you detoxify the liver, you must also detox the colon. All these body parts release into the colon, so if the colon is not kept clean, and you start detoxing other organs, you are likely to exac-erbate problems. When toxic substances are reabsorbed back into the body a second time, their impact is more powerful.”
Diet is a critical issue, notes Ms. Hollo-way. “We’re not seeking one ‘right’ avenue of approach,” she says, “but are concerned chiefly with the function of the body as a complete system. We need to know about all health issues. Often, people come to us and we are their last hope. It’s not unusual for us to find an uncomplicated solution to what has long seemed to be an intractable problem. A person may come in, having seen many practitioners, and we find they have had a hysterectomy, C-section, or a hernia operation. The build-up of scar tis-sue may literally be pressing down on the colon, and it is in the process of closing
for more information about colon hydrotherapy and other therapies
offered at the Center, contact:
ALTERNATIVE HEALTH CENTER OF CARY
9�9 kildaire farm Road Cary, nC �7���
telephone: (9�9) �80-00�� www.ahealthcenter.net
www.coloncleansenc.com
healthy aging
Healthy Muscles
understanding and supporting muscle function, especially of the colon, is a critical part of Darlene Holloway’s therapeutic work.
1829 E. Franklin St. • Suite 200E • Chapel Hill, NC 27514phone: 919.967.8805 fax: 919.967.8205
Originally published in Health & Healing in the Triangle, Vol. 16, no. 1, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.
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Over the course of a year, UNC Health Care’s Department of Orthopaedics has as many as 60,000 patient visits and
its specialists perform some 20,000 surgical procedures in a dozen specialty areas, notes Dr. Edmund Campion, a professor and Acting Chair of the department.
“But notice how many more patients we see than procedures we perform,” he says, pointing out that specialists “do a great deal of non-operative management, and some practi-tioners only offer non-operative medicine.” (see box about OrthoNow)
Along with demanding research and teaching responsibilities, specialists see patients for issues related to the adult spine, foot and ankle, hand and microsurgery, joint replace-ment, orthopaedic tumors, pediatric ortho-paedics, shoulder and elbow, sports medicine, trauma and fractures, and, of course, general orthopaedics.
In nearly two decades with UNC Ortho-paedics, Dr. Campion, with his close associ-ate, Dr. Richard C. Henderson, has focused his skills on pediatric orthopaedics, offering state-of-the-art treatment for both congenital disorders such as clubfoot and spina bifida, and developmental disorders such as scoliosis.
Health&Healing: Much of your work relates to the topic of healthy aging.
DR. CaMPiOn: It’s true that many orthopae-dic issues of childhood, left untreated, can have devastating impact on healthy aging. For
example, we see a lot of Blount’s disease, which is a growth disorder of the shin bone that manifests as bowed legs. Untreated, it leads to arthritis as early as the teens to twenties.
In a few cases, we discover the problem in the first year of life. But for the vast majority of bowing in the first year, we simply observe as it resolves by itself. It is most often about the age of two before the condition starts to declare itself as pathologic and needing intervention. There is a small subset that we can treat with bracing that guides the growth of the legs, and we’ll know if it’s working in little more than a year.
When the condition is not resolved by that time, surgical intervention may be required, with a success rate of more than 95 percent. And there are other options to consider. There’s one intervention where we actually guide the growth, where we can place implants in that slow down the growth of the outside of the knee so the inside of the knee grows more, swinging the leg back out into different align-ment. We remove the implants after they’ve achieved the alignment we’re looking for.
We’re able now to do procedures with much less morbidity for the patient than was the case not too long ago.
There’s a little girl, a patient of mine, who has a form of rickets, which is a bone growth abnormality that caused her to have severe bowing of her legs. And we were able to suc-cessfully use this guided growth approach. She was four when I put the implants in, and over the course of a year and a half she completely corrected. It was then a minor procedure to remove the implants, and she is doing great—running about with all the other kids, with no limitations.
H&H: Scoliosis would seem to be another condition where early intervention is important.
DR. CaMPiOn: Well, there are different kinds of scoliosis. The most common kind that we see is called idiopathic scoliosis—which means we don’t know the pathology that caused it. That is usually picked up just before the adolescent growth spurt—10 to 12 years of age. And it is usually not symptomatic—it’s discovered through observation.
Pre-teen Suzy gets ready for the sum-mer and tries on her bathing suit, and Mom has only seen her in a parka over the winter. Suddenly she’s thinking “What’s going on here? She’s got one shoulder higher than the other, and her back is raised.”
For most kids with scoliosis, the curve in their spine doesn’t get bigger and doesn’t require surgery. In more serious cases, if we find them early we can brace the condition and prevent the progression of the curve—and prevent surgery, as well.
If they were untreated earlier, once the curve in their spine gets past 50 de-grees it will inevitably progress even when they complete their normal growth. That’s a real problem, because in that case there’s an effect on pulmonary and cardiac func-tion, as well as the issues of deformity and pain.
There is in fact a whole sub-specialty of adult deformity surgery for people who were not taken care of properly when they were younger. They began with some level of scolio-sis, and subsequently added osteoporosis which can lead to real spinal collapse. This is a much, much more difficult issue to treat. h&h
u n C H E A L t H C A R E - D E P A R t M E n t o f o R t H o P A E D I C S
healthy aging Begins in Childhood
Dr. Campion in the process of developing a treatment plan for a patient with scoliosis—curvature of the spine.
“It’s true that many orthopaedic issues of
childhood, left untreated, can have devastating impact
on healthy aging.”
unC Health Care’s orthoNow— formerly known as Prompt
Care—has expanded its hours, notes Dr. Campion.
This walk-in orthopaedic care facil-ity, located at Carolina Pointe II off of I-40 (with free parking), is now open monday through Thursday, 8 a.m. to 7 p.m., and Fridays from 8 a.m. to 5 p.m.
“orthopaedic injuries are common, painful, and can’t always wait for an ap-pointment,” says Dr. Campion, “thus we provide walk-in orthopaedic care—for people who can be transported by reg-ular automobile, not by ambulance or stretcher—in this clinic for those suffer-ing with sprains and strains, fractures and possible fractures, sports-related injuries, injuries that do not require stitches, and cast problems.”
He emphasizes that the clinic is not appropriate for head trauma, open frac-tures, or spine injuries, and the treatment of chronic or long-standing conditions or for pain medication refills. More informa-tion: call the clinic at 919-843-4711.
for further information and to arrange an appointment, contact:
UNC HEALTH CARE DEPARTMENT OF ORTHOPAEDICS
telephone: (9�9) 96�-66�7www.med.unc.edu/ortho
ORthO-nOW exPanDS hOURS
Originally published in Health & Healing in the Triangle, Vol. 16, no. 1, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.
