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As Climate Week comes to an end, I would like to share some of the things I have learned over the past six months thanks to my daughter Julia and her increased involvement in preserving the environment. Not only was it a great excuse to spend time working on this article together, but we were able to collect categorized recommendations on how to alter everyday habits to better help the environment. While we are sure we have not covered everything, these tips are a great place to start.

Beauty Recommendations

  1. Use shampoo and conditioner bars. This will save on water, packaging and money since the bars last longer.  Some of the manufacturer’s include Lush (they will give you a free container of a face mask if you return 5 empty face mask containers!) Human Kind, Sterling Soap Company, Skin & Company, and Naples Soap Company.
  2. Use Safety Razors. These razors do not rust, are cost efficient, and are not plastic, therefore can eventually be recycled.
  3. Dental products. You can use Bamboo toothbrushes in place of plastic toothbrushes.  Tooth tabs can replace your toothpaste.  Biodegradable floss is also available.   If you are resourceful, you can make your own toothpaste, mouth wash, and deodorant.

Food

  1. Meatless Mondays. Cutting back on meat will contribute to less water waste and decreases your carbon footprint.
  2. Composting companies. There are entities that will pick up your compost (for a small monthly fee) or you can drop it off at a facility.  Two recommendations are Bennet Compost and Circle Compost.  Typically, there are composting areas located at Farmer’s Markets.
  3. Buying locally sourced foods and in season foods. This is healthy because there is not as much cost and carbon expense involved.  This also helps support local and often smaller businesses.
  4. Buy in bulk! This means that you can go to a local bulk store or Whole Foods (call ahead, not all of them have this option), whichever is more convenient.  Bring your own glass container or cloth produce bag, which can be an amazing way to stop using small plastic bags.  These containers can be used for cereal, vegetables, pasta, nuts, beans, etc.  If you are wondering what products can come in bulk, it is basically anything that a vegan could eat… grains, oils, candy, flour, and everything else I mentioned earlier! By doing this it cuts down one use plastic packaging.

Storage

  1. Water bottles. Metal water bottles are always the best option, because by using a single-use plastic water bottle, you are exposing yourself to microplastics that will contaminate the water by seeping into it. They are also extremely cost efficient. The average human spends over 1000 dollars on single-use plastic bottles per year, but you can change that by buying a good quality metal bottle that will last for an extremely long time.
  2. Bring your own supplies. I have to admit this takes getting used to. I remember being very surprised when I watched my daughter pull out a metal teaspoon from home so I would not use a plastic spoon supplied by the local ice cream vendor.   Bringing a reusable bag cuts down on needing to use a single-use plastic bag.   Other states and countries charge for supplying plastic bags, which is a good deterrent.  It has been nice to see stores supplies these reusable bags instead of paper or plastic bags.
  3. BUY GLASS/METAL. Seek out metal cans or foods stored in glass containers.  By buying items in these containers, you allow them to be recycled unlike buying the same product in a plastic container that will not biodegrade.

Miscellaneous:

  1. Earthhero is a good source for zero waste products. Like wax storage wrap, zero waste gum (it does not contain plastic and artificial ingredients like traditional gum) and bamboo or glass straws.
  2. Using the real stuff when you can. What I mean by this is, if you have access to silverware, glasses and plates, use them instead of plastic or paper plates.  Remember, paper plates have a plastic layer to keep them from breaking down easily, hence, not making them biodegradable.
  3. Using public transportation or carpooling whenever possible is an obvious way to cut down on our carbon footprint.
  4. Keep in mind that even when we recycle, these products needs to be stored or burned somewhere and this also contributes to pollution. Frequently, this takes place in poorer neighborhoods.  The goal is to have zero waste, so no one would be subject to extra pollution.

I would also like to recommend looking into joining some organizations that are helping to push these changes locally.  A group started by young activists is the Sunrise Movement and Philly Thrive is working to keep the pollution down by fighting to keep the local refinery closed.  Keep in mind, that any individual mindfulness is always going to be helpful, but the bigger changes need to come through industry changes, and we can be more successful as a group.


25/Sep/2019

I frequently get asked about what you can do to help with bags under the eyes. We are born with three fat pads under our eyes, and as we get older this fat can start to herniate. Swelling in this area can also be an issue with fluid accumulating around your eyes. The good news is, there are a few different options to treat bags under the eyes!

I always recommend starting with the least invasive treatments, and if you aren’t getting the results you wish, then you can move to the next option.

At-home Remedies that can help with bags under the eyes:

  1. Cool compresses. – Put 2 spoons in your freezer, and every morning place the spoons over your eyes for 5 to 10 minutes.
  2. Stay hydrated! This might mean to also cut back on your alcohol.
  3. Allergies can cause puffiness around your eyes. If you suffer from allergies, trying taking a Claritin or Zyrtec during the day and Benadryl at night.
  4. Sleep with an extra pillow so your head is elevated a bit more. This helps prevent the pooling of fluid in your face and around your eyes.
  5. SLEEP! It’s so important to get 8 hours of sleep!
  6. Cut back on the salty foods! Salt causes fluid retention and can make you puffy everywhere not just your eyes.

Next Step –> Skin treatments:

Microneedling – This treatment stimulates collagen and also helps with tone and texture of the skin. With this treatment, you won’t get instant gratification. You will need 3-6 treatments spaced about 1 month apart. The downtime is about 48 hours, in which you are red and should not wear any makeup. You also need to be careful about sun exposure after this treatment. To expedite the healing process and for better results, you can opt to include PRP (Platelet-Rich Plasma), also known as the Vampire Facial.

Next Step –> Injections:

HA (hyaluronic acid) Fillers are great for bags and hollowness under the eyes. It is the only form of filler that is safe to inject in this area. My favorite product to use for under eyes is Restylane. This procedure takes about 15-30 minutes and costs roughly $600. The results last about 1 year and you can expect 40%-60% improvement. It is extremely important you are being treated by someone with the correct credentials as well as someone who has been performing this treatment for years. There is potential for bruising so you want to make sure you don’t have any events coming up within the next two weeks. Results are instant but you can have a little extra swelling from the injections, this can take a few days up to two weeks to completely go away.

Next Step –> Surgery:

If all else fails, there is a surgery that you can have done that removes these 3 fat pads under your eyes. It’s called a Lower Blepharoplasty. Some Plastic Surgeons require you to have general anesthesia for this procedure, and others perform this procedure under conscious sedation. The actual procedure itself takes roughly 10-15 minutes per eye, there are no sutures and scaring as they make the incision inside your eyelid. You can expect to have a great deal of bruising and swelling in this area that can last a few weeks. The nice thing about this treatment, the results are fantastic and they are permanent



One of the top reasons patients come in to see their primary care provider is because they are having musculoskeletal pain or chronic pain. It is common for patients to want a “quick fix” or something that will take away their pain immediately, but non-pharmacologic pain management often has better outcomes and better long-term pain control. Additionally, it has been shown that the long-term use of pain medications have diminishing effects over time and can cause other chronic health problems.

Pain, especially chronic pain, does not always correlate to the physical state of the body but there are many contributing factors including sleep, nutrition, stress, and emotions. A non-pharmacologic approach to pain management includes, but is not limited to, physical therapy, exercise, acupuncture, and psychotherapy.

  • Physical therapy: Physical therapists are highly trained and skilled in assessment and diagnosis of causes of pain. They can prescribe exercises targeting your specific impairments and help you with lifestyle modifications and pain management strategies that can safely decrease pain symptoms. The results from physical therapy often have long-term benefits
  • Exercise: It is often thought that when in pain resting is the best method to ease discomfort, but it is actually shown to increase pain and cause weakness in the area. Gentle movements and walking can successfully decrease pain and prevent the area that is causing discomfort to become stiff or weak.
  • Acupuncture: Alternative modalities and holistic approaches to pain management have varying degrees of efficacy but many studies show that acupuncture is clinically proven to reduce pain with long-term benefits. Many insurance companies are now covering acupuncture services as pain management therapy.
  • Psychotherapy: Pain is often rooted in depression, anxiety or mental stress. Seeking care from a mental health professional or engaging in cognitive behavioral therapy can greatly reduce pain symptoms.


Before we get into all the reasons why an IPL photofacial is great, let’s cover the basics. For starters, an IPL (Intense Pulsed Light) therapy is used to treat sun damage, wrinkles, stretch marks and age spots. IPL is also known as photorejuvenation or photofacial. Treatments can be used to erase mild sun damage, brown spots, freckles or irregular pigmentation on the face, neck, chest, hands, arms, shoulders, back and legs. If you suffer from severe acne and experience issues combating the redness and inflammation caused by acne, IPL treatments can help. IPL can help eliminate large pores and thus reduce the appearance of acne on your skin without the need to constantly apply topical products that dry out the skin.

If you suffer from rosacea or any other type of skin condition that diffuses redness into the skin, IPL photofacial therapy is a great treatment solution for reducing the appearance of redness and helping create an even and natural complexion. Have you noticed any broken capillaries around your nose or on your cheeks? We can treat those with an IPL photofacial!

While IPL isn’t necessarily an anti-aging solution, it does have lasting effects in helping reduce the signs of aging such as wrinkles, sunspots and other indicators of aging. By treating a deeper layer of the skin, IPL stimulates collagen growth and helps improve the skin’s texture, reducing the appearance of fine lines and wrinkles.

Another great benefit of IPL photorejuvenation procedures is that they can be done in conjunction with other treatments such a microdermabrasion, chemical peels, Microneedling, and other facial skin treatments that target the outermost layer of the skin. Since IPL treatments target the deeper layers of the skin, they can safely be performed with other treatments that target the outermost layer of skin.



Getting an appropriate amount of restful sleep is important for a variety of reasons. Sleep effects our mental and cognitive function, our immune systems, and our general overall health. If we are not getting enough sleep, we may experience poor health outcomes including new or worsening anxiety and depression, obesity, and cardiovascular disease. Adults should get 7-9 hours of sleep each night. Unfortunately, about 1/3 of adults in the United States are not getting enough sleep.

There are many things that we can do to help improve our quality and duration of sleep. If you are struggling to get adequate sleep, try to incorporate at least a few of the following recommendations into your daily bedtime routine:

– Have a sleep schedule: Try to go to sleep and wake up at the same times each day.
– Avoid naps, especially later in the day.
– Limit caffeine during the day, especially within 4 to 6 hours of bedtime.
– Exercise daily: The current recommendations are to get 150 minutes per week of moderate-intensity exercise.
– Avoid using electronics at least 30 minutes before bed.
– Create a relaxing sleep environment: this may include a cool bedroom, blackout curtains or an eye mask, and a sound machine or ear plugs.
– If you wake up in the middle of the night and have trouble falling back asleep, go into a different room and participate in a relaxing activity until you feel drowsy enough to fall asleep again.



Many of us look forward to the summer: the warmer weather, the vacations, the longer days, the extra sunlight.

But for some, the summer months are not a relief from the seemingly endless winter months. For some, summertime brings on depression. Sometimes, summer depression has a biological cause, like a chemical imbalance, while other times, the particular stresses of summer can pile up and bring on feelings of sadness and depression.

It can be even more frustrating to feel like you are supposed to be happy and enjoying life because it’s the summer and instead, you are bogged down by depression.

Many are familiar with “seasonal affective disorder,” or SAD.  SAD typically causes depression as the days get shorter and colder.  What is less known is that people with SAD can actually get it in the reverse — the onset of summer triggers depression symptoms.

Specific symptoms of summer depression often include: loss of appetite, trouble sleeping, weight loss, and feelings of agitation or anxiety. Summertime depression can also create an increased feeling of isolation.

Here are some things that may cause an increase in summertime depression:

  • Disrupted schedules in summer. Our schedules can get shifted during the summer time months and often times, that disruption can offset depression especially with people who need a reliable routine to keep balanced.
  • Body image issues. Feeling unhappy and self-conscious about one’s looks in summer clothing can also increase depression.
  • Financial worries. Summers can be expensive. With vacation, meeting up with friends for a night out, dinners out, etc. spending can increase and thus, results in increased worry and depression.
  • The heat. It’s not enjoyable for everyone. It can be very oppressive physically and mentally.

So what do you do if you think you are suffering from summertime depression?

  • Get help. If you think you’re getting depressed, no matter what time of year, get help. See a psychologist, talk to your PCP, share with family and friends about how you are feeling.
  • Keep up with your exercise. Regular physical activity can help keep the risk and/or symptoms of depression down. But be careful not to overdo dieting and fitness.
  • Protect yourself. Don’t overextend yourself. Don’t feel obligated to do anything and everything. Take time for yourself.
  • Talk to your doctor about medication and/or adjusting current medications.


For many of us, summer is a wonderful time of year—the days are longer, offering more time to spend with family/friends, our moods improve, there are expanded opportunities for exercise, we go on vacation. At the same time, there are health considerations that we do not face during the rest of the year that can interfere with our enjoyment of these activities, if we’re not being careful.

For starters, there is the threat of sunburn and skin cancer, which most people are now aware of. To recap, you should apply a sunscreen with an SPF of 15 or higher 30 minutes before you will be out in the sun. Reapply completely every 2 hours or any time spent in the water. Try to avoid being out during the hottest hours of the day, between 10am and 2pm. Seek out the shade and stay covered when possible—hats, umbrellas, and clothing with an SPF factor are your friends!

Many people notice that they become more fatigued in the summer. This is due to a combination of factors. First of all, your body is working harder to maintain a safe body temperature in the heat. This is done primarily by sweating, which cools the body as it evaporates, and vasodilation, which dilates blood vessels near the skin and diverts more blood to this area to cool it down. Your heart rate and metabolic rate both increase to accomplish these efforts, utilizing more energy than your body normally does. In addition, if you are exercising in the heat, your body is also trying to divert adequate blood to your skeletal muscle to deliver oxygen to the working muscles. Combined with a lower blood volume (from sweating), this puts even more strain on your cardiovascular system. These changes also make exercise more difficult in the summer months, making you feel more fatigued after a workout. For some people, this fatigue can last for hours.

Finally, Exertional and Nonexertional heat illnesses, including Heat Exhaustion and Heat Stroke, are a real threat in the summer months. Heat exhaustion is characterized by the body’s inability to maintain adequate cardiac output (blood flow/delivery), combined with high body temperatures (101-104 degrees) and sometimes, dehydration. This typically manifests by collapse. Heat stroke is more serious, consisting of high body temperatures (>104 degrees) and central nervous system dysfunction, such as seizures or confusion, and multi organ system damage (heart, kidneys, muscle, etc.). This is an immediate medical emergency. The initial treatment for both of these conditions is rapid cooling of body temperature (most important), fluid/electrolyte replacement, and more aggressive medical intervention if needed.

So how do we avoid unpleasant or dangerous outcomes from the heat? Common sense measures, such as those noted above, combined with staying well hydrated (with water, smoothies, juices, and fruits/veggies that replace minerals lost through sweating) are key. Wear loose clothing that is designed to breathe. Limit outdoor workouts to earlier or later in the day, decrease the intensity of your usual workout, and consider shortening your workouts for a couple of weeks in the early summer to give your body time to acclimate to the hotter temperatures (this allows your body to expand blood volume, improve blood flow to the skin, and decrease the threshold at which sweating starts, among other adaptations that help to manage the heat). Be aware of factors that can decrease your heat tolerance and increase the risk of poor outcomes. Those at risk for heat illness include people who have sweat gland dysfunction, those who have viral/bacterial illness, those who use alcohol before/during time in the heat, and those on certain medications that interfere with cardiac function, heat response, or fluid/electrolyte balance. Such medications include blood pressure medications like ACE inhibitors or ARBs, antihistamines/decongestants, stimulant medications, and beta-blockers.



The summer months are filled with social events. From barbecues to pool parties to beach hangs, the dress code often includes shorts, tank tops, bathing suits, or dresses. It makes sense that this is a time when body image anxiety can arise. For anyone who has experienced eating disordered thoughts or a negative self image, the idea of putting on a bathing suit or other summer outfit can be understandably frightening. It can be easy to slip into negative self talk and restrictive eating.
If you find yourself feeling triggered by this season, try to use one of these tools:
Keep a positivity journal:
  • Each day, write down something positive about yourself.
  • Make a commitment to limiting negative self talk this summer.
Repeat positive affirmations to yourself. Here are some ideas:
  • I am lovable in this body.
  • Every body is a bathing suit body!
  • I accept myself as a beautiful work in progress.
Wear what YOU want. Don’t feel pressure to put on something that makes you feel uncomfortable.
Focus on how the food you are eating is nourishing you. Is it giving you energy? Is it giving you satisfaction?


Cervical cancer is cancer that starts in the cervix, the lower, narrow part of the uterus. Most cervical cancers are caused by the human papillomavirus (HPV). Cervical cancer is the easiest gynecologic cancer to prevent with regular screening tests and vaccinations. It is also very curable when found and treated early.

What causes cervical cancer?

Most cervical cancer is caused by an infection with HPV. HPV is a virus that enters cells and can cause them to change. HPV is spread by skin to skin contact, which means that condoms may not protect you. Some strains of the virus cause genital warts, however most strains cause no symptoms at all. Most of the time, your immune system will clear the virus on its own. If HPV does not go away on its own, it may cause cervical cancer over time.

Other factors which can increase your risk of cervical cancer are:

  • Smoking
  • Long-term oral contraception
  • HIV or reduced immunity
  • Multiple sex partners
  • Multiple Births

What are the symptoms of cervical cancer?

Most of the time you may not notice any signs or symptoms of cervical cancer. Signs of advanced cervical cancer may include; abnormal bleeding or discharge from the vagina. These symptoms may not be caused by cervical cancer, but the only way to be sure is to discuss your symptoms with your provider

How often do I need to be screened for cervical cancer?

How often you should be screened depends on your and your health history. Talk with your provider to find out what is best for you

Most women can follow these guidelines:

  • If you are between the ages 21 and 29, you should get a Pap test every 3 years
  • If you are between the ages 30 and 64, you should get a Pap test and HPV test every 3-5 years
  • If you are 65 or older, ask your provider if you can stop screenings

How can I lower my chances of getting cervical cancer?

Prevention and treatment of cervical cancer continues to move forward; the best way to protect yourself is to make careful choices about sexual activity, consider getting the HPV vaccine and to continue your routine screenings and annual wellness exams.



What comes to mind when somebody says the word “physical activity”? Do you think of the walk you took to get from the garage to work this morning? Or the stairs you climbed on your way out of the subway?  What about the word “exercise”? If this word provokes different thoughts I am not surprised. You might have visions of sweating it out in spin class and loving every second of it, or maybe you have a feeling of dread as you picture dragging yourself to the gym. In celebration of May’s National Physical Fitness and Sports Month, I want to tell you that physical activity is what matters! You might spend an hour in the gym, but what happens during the other 23 hours is crucial. Picture your typical day, you sit as you eat breakfast, you may sit as you commute to work, sit at a desk, sit at lunch, go to the gym for an hour, then sit at the dinner table or in front of the TV. Even athletes can be considered sedentary if their only physical activity is during the hours when they are exercising!

This month, challenge yourself to think about physical activity as a way of life. What errands can you run on foot today? If you have a phone call to make, can you do it while walking or pacing? If you are stuck at your desk for hours in a row, can you make a point to stand up and stretch every hour? Can you stretch while you watch TV at night?

If you need some motivation…

Here are some fun facts on how physical activity can help prevent or reduce health conditions:

High blood pressure: Two brisk 10-minute walks a day can help to prevent high blood pressure. Think of this like your daily dose of movement medicine. As you start your walk, your body sends blood that contains oxygen and energy to your muscles so that they can propel you forward. This rush of blood exerts pressure on your veins causing them to loosen slightly so that more blood can flow through. By asking your veins to loosen twice a day every day, you are preventing stiffness!

High blood sugar: After you eat a meal that is high in carbohydrates your body will digest those carbohydrates and turn them in to sugar which will stay in your blood stream until your cells take it up for energy. If you have diabetes or pre-diabetes this state of high blood sugar can make you feel pretty icky. Luckily, physical activity can help you to bring down your sugar. Going for a walk after a large meal can help your cells to take up the sugar and leave you feeling much better!


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