There isn’t a day goes by that I do not get questioned about a patient’s facial appearance that includes puffy eyelids, dark circles as well as wrinkles.  We let’s face it; our looks are of great interest and concern.  I recently had a chat with dermatologist Dr. Bobby Buka, section chief in the Dept. of Dermatology at Mount Sinai School of Medicine in New York City about this. 

“Puffy eyes are progressive,” he said.  “As we age, we all lose fat pads (called subcutaneous tissue) that rest below our eyes. These dark circles that may appear underneath your eyelids and can be visible as a discoloration or bluish color with puffiness of the eyelids is actually blood coursing through veins beneath.”

Buka also mentioned that getting enough water and fluids optimize “hydration”, and this is very critical.  Doing this can replenish the deeper layers of the skin with water delaying drooping of skin, and improve the appearance of dark circles.  Avoiding dehydration can help to decrease the effect of gravity as adequately hydrated skin tends to sag less with advancing age! Buka also recommends a well-balanced, high-vitamin diet.

Those affected by allergies, particularly children and young adults, may have the presence of a horizontal crease on the middle part of the nose.  This may reflect persistent upward “rubbing” of the nose from itchiness and explain the appearance of a nasal “crease” associated with allergies, especially if your allergies are not adequately controlled or treated.  In other words, get proper therapy for your allergies so you can feel better and look better!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Dear Yvonne,
How can a guy tell if he’s just crushing on a well-performing co-worker versus really liking her because the other company at work is pretty lousy?
-Allen

Dear Allen, 
What makes this a tough issue is that a man has to sort through if he really likes the woman or if he really likes that she’s his co-worker. When she performs well in the workplace, it can only make him wonder how she’ll perform in the sack. And if she’s dependable, good at what she does, and great company, a man will naturally have some affection for her. Most of us like people with such qualities. Furthermore, as we get to know somebody and find out that we have a lot in common, we tend to like them more – and when you share the same workplace, you share a lot of the same experiences, which further fosters bonding.

Many people find their mate through work because it involves access to others and requires spending a great deal of time together – basically plenty of opportunity. In keeping himself in check, a man has to evaluate if he’s daydreaming about a co-worker on his own free time (versus simply looking forward to seeing her as he’s en route to the office), if he’s making excuses to work with her, for example wanting to stay late to get a project done, or simply spending time with her because she’s his favorite co-worker. One thing he can ask himself is how he’s reacting to women outside of the workplace. If he finds others more interesting, then it’s likely that he’s not crushing on his co-worker as much as he thinks. 

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

I love veal parmesan, but the customary recipe calls for breading and fried cutlets—a no-no if you’re trying to eat healthy. This grilled version offers the same flavors without the extra fat and calories. You save 500 calories and 14 grams of fat!

Ingredients:
4 4-oz. boneless veal cutlet
Salt and pepper
1 tsp garlic powder
1 tsp dried oregano
1/3 cup prepared marinara sauce
1 cup shredded part-skim mozzarella cheese

Directions:
1. Place veal cutlets in between 2 sheets of plastic wrap and flatten with a meat mallet until ¼ inch thick.
2. Season both sides of the cutlets with salt, pepper, garlic powder, and oregano.
3. Preheat the broiler and heat a grill pan and grill cutlets 3 minutes on each side. Remove from the grill and place on a baking sheet.
4. Add 1 tbsp marinara sauce to each cutlet and top with ¼ cup shredded cheese. Place under the broiler and cook until cheese is bubbly and begins to brown. Serve immediately.

Serves 4

Nutritional Content: 362 calories ∙ 3 g carbohydrates ∙ 0 g fiber ∙ 51 g protein ∙ 15 g total fat ∙ 7 g sat fat ∙ 737 g sodium

Tanya Zuckerbrot, MS, RD is a nutritionist and the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

Regardless of sex or age, the most common question my patients ask is how the overall aging process can be prevented. Unfortunately, the answer is not simple. The key to anti-aging is taking care of your skin starting at infancy and continuing through the rest of your life. 

While genetics, environment and stress play a factor in the aging process, the most significant factor that causes skin to age, discolor and wrinkle is sun exposure. There is a 10-20 year lag period from the time you’re exposed to ultraviolet light, sun irradiation, environmental toxins and pollutants to the development of both skin cancer and aged skin. Basically, sun damage accumulates over a long period and is visible 10-20 years later. 

The most effective defense against unhealthy, aged skin is to use a broad-spectrum UVB/UVA sunblock in your daily skincare regimen. Everyone in your family, regardless of age should apply sunblock daily – from infancy onwards.
 
To reverse or at least slow down the aging process, I recommend that in your early 20’s, you begin incorporating an antioxidant topical like Reservatol, idebenone, vitamin C or vitamin E in addition to broad-spectrum sunblock. Products containing retinoids or an alpha-hydroxy acid derivative help build new collagen and slow down the aging process.

In your 30’s and 40’s, the signs of aging start to become visible with variations in tone and texture of your skin, and dark spots (or darker areas) start to come to the surface. I recommend you start laser and light treatments to counteract the appearance of damage. Intense pulsed light (IPL) is a very effective first line of defense to counteract aging that can have a significant impact on discoloration and diffuse redness in your skin. 
 
For those with more extensive aging and damage, there are a wide variety of technologies and treatments that can be incorporated into your anti-aging program. If your skin is becoming lax or wrinkles are more evident, skin-tightening technologies can be extremely effective. These technologies include Thermage, Titan, Refirme and Affirm. They all use different techniques to tighten skin and reduce the appearance of wrinkles. In choosing the technology best for you, you should take into consideration your skin needs, your pain tolerance and the amount of downtime required. 
 
Skin health and appearance also improves when skin cells are turned over to reveal healthy, balanced skin. Treatments include chemical peels and laser rejuvenation. There are many different technologies and treatments ranging from regular facials with light glycolic peels and microdermabrasion to more comprehensive rejuvenation technologies such as Plasma Portrait, Fraxel or Smartxide CO2 fractional resurfacing. 

These more involved treatments usually have increased downtime, but the results are well worth it as they can help your body build and stimulate new collagen growth over time. They can actually slow down the aging process, making your skin healthier, decreasing the incidence of skin cancer and decreasing the need for more invasive surgical procedures.

The steps are simple. First get a broad spectrum sunblock and start using it everyday. While the anti-aging benefits may not be immediately visible, I assure you that this is the first and most important step in maintaining healthy skin. Introducing new, high-potency antioxidants in your 20’s and IPL and laser collagen stimulating technologies in your 30’s, can not only slow down the aging process and decrease the instance of skin cancer, but give you healthier, more natural looking skin. The best advice I can give is to start early in order to maintain healthy, youthful skin throughout your life.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Dear Yvonne,
A friend of mine recently shared that he suffered from testicular torsion as an adolescent. I didn’t want to seem stupid in not knowing what that is. I am assuming he pulled something… What happend to him?
-Rusty
 
               Dear Rusty,
Testicular torsion is when the spermatic cord in a male’s scrotum twists around one of his testicles, cutting off blood supply to the gonad. It is a very serious condition that may occur as a result of injury to the scrotum or strenuous activity, or for no obvious reason at all.

Symptoms include sudden, severe pain, swelling, tenderness, and enlargement of the harmed testicle. Diagnosis and emergency surgery are required immediately, as waiting for more than 4-6 hours to treat could result in the testicle being damaged or permanently lost. If a male experiences sudden, acute pain in his testicle lasting more than 10 minutes, he should have this attended to immediately. Testicular torsion happens more often to males in their teens.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

This makes the perfect combination of fiber and protein, helping you to avoid the mid-morning munchies and keep you feeling full all morning long.

Ingredients:
1 container (5.3 oz) Greek Yogurt (such as Fage 0%)
2-3 tbsp water
½ cup Fiber One cereal
½ cup strawberries, sliced
¼ cup blueberries
1 packet Splenda
Cinnamon (optional)

Directions:
1. Mix Greek Yogurt with water to thin it out.
2. Stir in Splenda and cinnamon to sweeten the yogurt evenly.
3. In a dish or tall glass, spoon 1/3 of the yogurt.
4. Top with strawberries and then ¼ cup Fiber One.
5. Repeat layer, but use blueberries for the fruit. Top off with last 1/3 of yogurt.

Serves 1

Nutritional Content: 187 calories ∙ 42 g carbohydrates ∙ 17 g fiber ∙ 16 g protein ∙ 1.2 g total fat ∙ 0 g sat fat ∙ 185 g sodium

Bon Appetite!

Tanya Zuckerbrot, MS, RD is a nutritionist and the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

Crooked teeth have been a problem since 50,000 BC according to archaeologists who have found ancient Greek orthodontic appliances—the precursor to today’s braces.

When it comes to modern braces, it’s not just kids anymore.  According to the American Association of Orthodontists, the number of adults opting for orthodontia is steadily increasing each year. Veneers too are on the rise with more than 1.6 million getting that procedure in 2006.  But braces and veneers are not just a cosmetic fix, they also can be key to maintaining a healthy mouth. 

Crooked teeth, in addition to being unattractive, also can increase the chances of cavities and gum disease by creating pockets in the mouth where food can get trapped.  Also, a misaligned bite can be responsible for everything from painful TMJ to eventual tooth and bone loss.

A question I sometimes get is why spend the time in braces when veneers can be done so much more quickly?  The answer once again has to do with the health of your teeth.   True veneers require some filing down of each individual tooth to allow room for the added porcelain layer. (We‘re not talking about the kind that are glued over your existing teeth as these can often cause a problem by over-contouring the natural teeth).  A custom veneer, made of a special porcelain ceramic, is then permanently bonded to the remaining tooth structure creating a perfectly aligned tooth.  This is a wonderful procedure for weak, thin, worn down or damaged teeth because, in effect, it makes them strong and new. But it’s not always the answer.  Because veneers require preparation (filing) of tooth structure and need special care, I don’t always recommend them purely for cosmetic reasons.  

If your teeth are healthy but just out of alignment, it makes better sense (and is often less costly) to opt for braces. Getting veneers for crooked, healthy teeth might be compared to shaving your head and wearing a wig just because it’s a style you like.  If you have one or two teeth that are damaged or discolored, veneers can be done later, after the straightening process is finished.  While braces including removable orthodontic appliances (Invisalign) generally require much more time than veneers, this approach is still the least invasive and most cost effective to insure a healthy mouth.

Regarding veneers, today, we have the technology to ones that look completely natural.  But it’s important to remember that creating veneers is an art as each must be individually sculpted.  If the teeth are too “perfect”, they can look fake (which is why some patients opt to have slight adjustments made to make their new teeth look more genuine.)  Be sure to consult a dentist who specializes in aesthetic dentistry.

Dr. Gerald P. Curatola is a renowned aesthetic dentist and pioneer in the emerging field of rejuvenation dentistry, which improves patients’ overall health and appearance by integrating total wellness with cutting edge oral care and restorative procedures. In addition to his private practice, research, and work as a Clinical Associate Professor at NYU College of Dentistry, he is an internationally sought after speaker, author and expert who has been featured widely in print and broadcast media. For more information, go to DrGerry.net

There has been much debate surrounding the dramatic increase of asthma in the United States and throughout the world over past several decades.

A study released by a group of researchers from New Zealand published in the September 20, 2008  issue of the The Lancet found an association between paracetamol use in infancy (known as acetaminophen in the U.S., and a very commonly used non-aspirin containing analgesic) and childhood risk of asthma, allergy and eczema in children at 6-7 years.  The authors suggested  the use of this commonly prescribed pain reliever and fever reducer might be a risk factor for the development of childhood asthma. 

 There has been an increased use of these non-aspirin containing analgesics over the past five decades, especially in children.  Additionally, the researchers reported those children that were given more frequent doses were more likely to develop asthma on a risk adjusted basis. 

 It is important to note that approximately, and this is just an estimate,  about 10 percent of adults and children with asthma find aspirin and non-steriod anti-inflammatory drugs (NSAIDS) actually worsen their asthma.  Aspirin “intolerance” appears to be more common in those patients with moderate to severe asthma, particularly individuals that also have nasal polyps and sinus disease. 

Another study reported in the journal Thorax found at least in adult women that aspirin may reduce asthma risk.  The authors cautioned  their findings were “still not enough to recommend taking aspirin regularly.”  Separately, the incidence of asthma is increasing and other asthma researchers believe another cause for this possibly is an association with obesity and dietary factors. 

In any event I have not observed any issues with acetaminophen analgesics in our allergy and asthma patient population when used in appropriate dosages and for the correct reasons.  Obviously more work and further studies are needed to explain the explosion of new cases of asthma, both in adults and children.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Dear Yvonne,

How do you know if you’ve been slipped a date rape drug?
-KC

Dear KC,
Rohypnol, a brand name of flunitrazepam manufactured by Hoffman-La Roche Pharmaceuticals, is a central nervous system depressant generally in the form of white tablets. It is also known as “roofies,” “roche,” “rope,” “rib,” “La Roche,” “ruffies,” “Mexican valium,” “Mind Eraser,” “Party Poppers,” and “rophies.”  It is odorless, tasteless, and ten times stronger than valium. 

The drug causes muscle relaxation and slows psychomotor responses and reportedly enhances the high produced by low-quality heroin, mellows the high of cocaine, and eases a user down from a crack or cocaine binge.  When taken with alcohol, it causes disinhibition and amnesia, and hence is also known as “the date rape drug” since it is sometimes used to seduce a victim into a sexual assault scenario. 

 Among the drug’s immediate effects:
- blackouts                                 
- sense of aggressiveness
- amnesia                                                          
- disinhibition                              
- nausea
- sense of fearlessness           
- dizziness                                 
- disorientation
- drowsiness                              
- decrease in psychomotor performance
- muscle relaxation                     
- nightmares
- tremors

Withdrawal symptoms include:
- headache                                 
- muscle pain
- irritability                                 
-  hallucinations   
- anxiety                                     
-  convulsions/seizures
- tension                                     
-  restlessness
- confusion

 Although it is illegal in the U.S. and Canada, Rohypnol is prescribed in more than 60 other countries to treat severe sleep disorders, to sedate patients before surgery, and to treat serious psychiatric disorders. It is an attractive drug to users because it can be inexpensive to buy, with prices ranging from .50 to $8 per tablet. Some young adults who use Rohypnol with alcohol claim that it intensifies their “buzzes.” If used over an extended period of time, a person may become psychologically and/or physiologically dependent upon it.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Tales of traders throwing themselves out of windows on Wall Street in the wake of 1929 were essentially myths, as John Kenneth Galbraith noted in his 1955 account of the crash.

Nevertheless, current economic woes are clearly impacting on our country’s mental and physical health. Stress is a well documented cause of depression, suicide, heart disease, stroke, predisposition to infection, and certain kinds of cancer.

Stress is often subliminal, it may overtake you before you realize it.  The last thing a person in financial trouble needs is to be simultaneously dealing with illness, yet stress-induced illness is common.
 
SOME WORRISOME EXAMPLES OF THE EFFECTS OF FINANCIAL TROUBLES:

* In New York, calls to the Hopeline network for people with depression or suicidal thoughts leaped 75 percent to 10,368 in the 11 months ending in July 2008.

* In Chicago, ComPsych Corp., the world’s largest provider of employee assistance programs, logged 21 percent more calls seeking help for stress from financial pressures in July than they received a year earlier.

* Hospital admissions for psychiatric services are up 10 percent this year over last year in claims submitted to UnitedHealth Group Inc., the largest U.S. health insurer.

* ValueOptions Inc., the fourth-largest U.S. provider of behavioral health and wellness services, reported that calls for assistance with home foreclosures, bankruptcy and other financial hardships have grown 89 percent this year over 2007.

* Research based on 17 years of Pennsylvania unemployment records concluded that employees affected by a mass layoff at a plant were 15 percent more likely to die of any cause over the next two decades.

* Harvey Brenner, professor emeritus at Johns Hopkins’s Bloomberg School of Public Health, projects that rising unemployment could cause as many as 47,000 more deaths than would have otherwise occurred, including 1,200 more suicides, as well as nearly 26,000 more heart attacks.

WHAT TO DO ABOUT IT:

* Seek emotional support, from loved ones and if needed, professionals.

* Try to continue to focus on business as usual, and to avoid obsessive negative thoughts.

* Emphasize regular exercise, try relaxation techniques such as yoga or meditation, eat regular meals, and as much as possible, observe regular sleep habits.

* Consult with your physician if your fear over your financial future is spiraling out of control. Anti-anxiety medication may be necessary to break the cycle of worry.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com