“There are many healthy outcomes for patients who have thought long and hard about correcting a physical feature that has plagued them for years,” said Martha S. Matthews, M.D., Head of the Division of Plastic and Reconstructive Surgery at Cooper University Hospital. “Both physical and psychological discomfort can be healed through the many options of plastic surgery,” she said.

A tummy tuck – the medical term is abdominoplasty – is a major surgical operation that minimizes the abdominal area by removing excess fat and skin from the middle and lower abdomen, and then tightening the muscles of the abdominal wall.

Liposuction is a body-contouring procedure that uses a stainless steel suction tube, called a cannula, to surgically remove fat cells from certain areas of the body. Liposuction is an option to remove bulges and improve body shape. The abdomen is one of the most commonly treated areas.

Patients with flabby midsections, however, are sometimes confused about which procedure – a tummy tuck or liposuction – might be best for them, Dr. Matthews said.

“It is important to understand that the final result of liposuction depends on the skin’s ability to shrink down after the underlying fat is removed. For patients with poor skin tone, for example a lot of stretch marks or a lot of loose skin above the navel, liposuction would not be the best choice. Some people benefit from both liposuction and tummy tuck,” Dr. Matthews said.

The best candidates for tummy tuck are men or women who are in good physical condition but are bothered by large fat deposits or loose abdominal skin below the navel that does not respond to diet or exercise.

“Generally, people who intend to lose weight, and women who plan future pregnancies, should postpone tummy tuck surgery until after they’re within 10 or so pounds of their goal weight and have had all the children they plan to have,” Dr. Matthews said.

What’s crucial for anyone considering any kind of cosmetic surgery, noted Dr. Matthews, is to first make a consultation appointment with a plastic surgeon who can discuss and explain options, and answer specific questions.

“I often see people for consultation to explain to them what the likely results will be and advise them on what I think is best for their particular needs and condition. I also explain the pros and the cons of every option so that patients can make an informed decision based on their individual needs, as well as any factors that might increase risk or lead to less-than-perfect results,” Dr. Matthews said.

While consultations with plastic surgeons typically require a fee (At Cooper, the fee is applied as a credit to any surgery scheduled within one year.), Dr. Matthews invites anyone with questions to telephone her office.

“In our practice, prospective patients can call and talk to our cosmetic surgery coordinator, Connie, or to our nurse, Carlene, at any time, at no charge. Both of these women are very knowledgeable and can provide lots of information, including a rough idea of costs, with no obligation on the part of the caller.

“So, for anyone just ‘shopping’ or thinking about cosmetic surgery but not yet ready to commit, feel free to call our practice at 856.342.3113 and ask for Connie or Carlene who can answer your questions,  or e-mail us directly at plastic-surgery@cooperhealth.edu,” Dr. Matthews said.

Dr. Matthews sees patients at two office locations:  6017 Main Street, Voorhees, and Three Cooper Plaza, Camden.

Related Links

• Health eTalk Web Chat: Nip, Tuck…or Not
• Division of Plastic and Reconstructive Surgery at Cooper University Hospital

While some of these problems become more prevalent with age, medical science has made significant progress in developing innovative treatments and cures.

Still, sexual dysfunction is a topic that many men are hesitant to discuss.

“Unfortunately, many men often suffer in silence with sexual dysfunction,” said Allen D. Seftel, M.D., a nationally recognized specialist in sexual medicine and Head of the Division of Urology at Cooper.

“Sexual dysfunction is a medical condition that can have a tremendous impact on a patient’s quality of life. It’s important for people to understand that the right medical intervention can help the majority of men,” Dr. Seftel said.

Sexual dysfunction can be caused by various physical and/or psychological problems. Physical causes include such medical conditions as heart and vascular disease, diabetes, and hypertension, as well as drug abuse and alcoholism. Side effects from certain medications also can be a cause. Psychological causes include stress and anxiety, marital or relationship problems, depression, and concerns about sexual performance.

“That’s why a thorough evaluation is needed for proper diagnosis and optimal treatment,” Dr. Seftel said.

While many cases of sexual dysfunction can be corrected by treating underlying physical or psychological problems, other treatment strategies include impotence drugs (such as Viagra or Levitra), testosterone replacement therapy, and mechanical aids, such as penile implants.

In some cases, sexual medicine specialists use a combination of treatment strategies to achieve better results. For example, “When drugs aren’t fully effective, adding testosterone (hormone replacement) can enhance the effectiveness of the drugs,” Dr. Seftel said.

But careful, comprehensive monitoring and regular follow-up are an essential part of specialty care.

“Everybody is different when it comes to treatment. We continually review issues with patients, and our treatment plans are highly individualized. We make sure each patient understands his condition, his treatments, and his options. With regular monitoring and open dialogue, we make sure that patients are well served. The goal is to restore good, sexual functioning and quality-of-life by making sure that treatment is the best it can be,” Dr. Seftel said.

Related Links

• Division of Urology – Male Sexual Dysfunction
  There’s no need to suffer in silence anymore. Nearly 1 in 5 American men over age 18 experience some form of sexual dysfunction, ranging from loss of interest in sex, to the inability to attain or maintain an erection, to premature ejaculation and finally, difficulty reaching climax and orgasm.

Gastrointestinal problems affect more than a million people in the U.S. every year. Selecting the physicians and practice that provide the best care for your unique needs is extremely important.

The Cooper Digestive Health Institute, the largest outpatient gastroenterology center in South Jersey, provides patients with the most advanced testing and treatment in a state-of-the-art outpatient facility. Cooper gastroenterologists diagnose and treat many complex disorders and diseases of the digestive tract, but one of the more prevalent health problems being seen in patients is gastroesophageal reflux disease (GERD).

GERD is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus. Heartburn is the most common symptom of GERD and is described as a burning chest pain that begins behind the breastbone and moves upward to the neck and throat. For most people, over-the-counter antacids can help, but the cause of the problem remains.

“People that tend to be overweight, smoke, overeat and consume a lot of caffeine or alcohol are more susceptible to this disorder,” said Steven R. Peikin, M.D., Director of the Cooper Digestive Health Institute and author of GERD: It’s More Than Just Heartburn. “I think what some people don’t realize is in many cases, gastroesophageal reflux disease can be prevented through simple diet and lifestyle changes.”

Some ways to manage heartburn include the following:

• Monitor the medications you are taking – some may irritate the lining of the stomach or esophagus.
• Quit smoking.
• Eat smaller portions.
• Do not lie down or go to bed right after a meal.
• Limit alcohol consumption.
• Elevate the head of the bed six inches.
• Lose weight, if necessary.

If you’d like to learn more about GERD, including available treatment options, we invite you to download and read GERD: It’s More Than Just Heartburn, a free eBook by Dr. Steven Peikin, online at cooperhealth.org/gerd.

Related Links

• Cooper Digestive Health Institute
  Located at 501 Fellowship Road in Mount Laurel, New Jersey, the Cooper Digestive Health Institute staff is committed to implementing innovative medical techniques and maintaining excellence in patient care, while offering a full range of gastrointestinal services.
• Download Your Free Digestive Health eBook
  This short book is available free as an Adobe PDF; an EPUB file, which can be viewed on a number of devices including the iPhone and Sony eReader; or a MobiPocket file, which can be viewed using a Kindle, Blackberry and other mobile devices.

This recipe is heart healthy. This recipe is diabetes friendly.

Ingredients

• 2 6-ounce filet mignon
• 2 tsp olive oil

Cocoa crust

• 2 Tbsps cocoa powder
• 1 Tbsp cumin
• 1/2 tsp onion powder
• 1 tsp cayenne pepper
• 1/2 tsp white pepper
• 1 Tbsp sugar
• 1/4 tsp of salt
• 1 tsp cinnamon

Preparation

1. Coat both sides of each filet with the cocoa crust mixture thoroughly.
2. Pan sear each side of the filet for 60 seconds in olive oil (optional).
3. Transfer filet to a baking dish and roast in the oven at 350 degrees until the filet reaches an internal temperature of 155 degrees.
4. Let the filet rest for 10-15 minutes before serving to allow it to cook fully.

Nutrition Information Per Serving

Recipe Yields 2 Servings
Calories 304
Fat 14 g
Saturated Fat 4 g
Cholesterol 84 mg
Sodium 376 mg
Carbohydrates 3 g
Fiber 2 g
Protein 37 g

Creamy Cauliflower Puree

Ingredients

• 1 cup water
• 1/2 cup skim milk (Non Lactaid only)
• 1/2 cup 2% Milk (Non Lactaid only)
• 2 cups cauliflower, chopped
• 1/2 tsp salt
• 1/2 tsp white pepper
• 1Tbsp margarine

Preparation

1. Mix together milk and water in a medium pot and bring it to a simmer.  Add cauliflower into mixture and simmer for 10-15 minutes or until tender.  Strain, reserving one cup of milk/water mixture.
2. Transfer cauliflower to a blender, adding salt and white pepper and reserved liquid. Puree until fluffy. Add margarine to taste.

Nutrition Information Per Serving

Yields  4 servings
Calories 65
Fat 4 g
Saturated Fat 1 g
Cholesterol 3 mg
Sodium 157 mg
Carbohydrate 6 g
Fiber 1 g
Protein 3 g

The H1N1 vaccine is already, or will soon be, available and it will continue to be available throughout the influenza season, into December, January, and beyond. This is because the timing and duration of flu activity can vary.

If you or members of your family are in the following target groups, you should be vaccinated against H1N1:

• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated.
• Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus.
• Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients.
• All people from 6 months through 24 years of age
  • Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread.
  • Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population.
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.

Cooper University Hospital will be vaccinating our employees following the recommendations of the CDC. Clinics for other high-risk groups are being planned. Our web site will continue to have updated information about vaccination clinics.

The most readily available clinics are being offered by county health departments. You can find dates, locations and times on your county’s web site or by calling their office. Or you can call the New Jersey H1N1 Hotline, Monday through Friday, 9 a.m. to 5 p.m., at 1-866-321-9571, for locations close to you. The vaccine is free of charge.

For more information about H1N1, including our Frequently Asked Questions (FAQ), be sure to visit the H1N1 Influenza Resources page on cooperhealth.org.

Here are a few reminders to share with your own ghosts and goblins before they head out into the night:

ALL DRESSED UP

• Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
• Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
• Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives.  Hats should fit properly to prevent them from sliding over eyes.
• When shopping for costumes, wigs and accessories, look for and purchase those with a label clearly indicating they are flame resistant.
• If a sword, cane, or stick is a part of your child’s costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
• Obtain flashlights with fresh batteries for all children and their escorts.
• Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost.

CARVING A NICHE

• Small children should never carve pumpkins. Children can draw a face with markers.  Then parents can do the cutting.
• Votive candles are safest for candle-lit pumpkins.
• Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and should never be left unattended.

HOME SAFE HOME

• To keep homes safe for visiting Trick-or-Treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.
• Parents should check outdoor lights and replace burned-out bulbs.
• Wet leaves should be swept from sidewalks and steps.
• Restrain pets so they do not inadvertently jump on or bite a Trick-or-Treater.

ON THE TRICK-OR-TREAT TRAIL

• A parent or responsible adult should always accompany young children on their neighborhood rounds.
• If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.
• Only go to homes with a porch light on and never enter a home or car for a treat.

Because pedestrian injuries are the most common injuries to children on Halloween, remind Trick-or-Treaters:

• Stay in a group and communicate where they will be going.
• Carry a cell phone for quick communication.
• Remain on well-lit streets and always use the sidewalk.
• If no sidewalk is available, walk at the far edge of the roadway facing traffic.
• Never cut across yards or use alleys.
• Only cross the street as a group in established crosswalks (as recognized by local custom). Never cross between parked cars or out driveways.
• Don’t assume the right of way. Motorists may have trouble seeing Trick-or-Treaters. Just because one car stops, doesn’t mean others will!
• Law enforcement authorities should be notified immediately of any suspicious or unlawful activity.

HEALTHY HALLOWEEN

• A good meal prior to parties and Trick-or-Treating will discourage youngsters from filling up on Halloween treats.
• Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
• Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
• Try to ration treats for the days following Halloween.

With Halloween just a few days away, even the most health conscious eaters will be faced with the temptation to overindulge. Maryann Codd, M.S., R.D., C.D.E., pediatric outpatient dietician at Cooper University Hospital, offers some advice for maintaining healthy eating habits during this difficult time of year.

“Today’s families are very busy, so unfortunately a lot of thought does not go into what treats are given to children, especially at Halloween,” says Codd. “People tend to buy big bags of “fun size” candies because they’re convenient and cheap, not realizing how many calories are in each bite-sized snack.”

A few healthy treats to hand out to children that won’t disappoint include individual bags of pretzels, popcorn, animal crackers and Goldfish crackers. In addition, 100 calorie cookies and snack mix bags make a great choice.

“After children finish Trick-or-Treating, parents should have them choose a few pieces of their favorite candy and store it somewhere out of reach. The rest should be removed from the home – and I don’t advise bringing it to work!” adds Codd.

She says giving kids a piece or two of their “saved” candy for dessert or a treat for the week or two after Halloween is perfectly reasonable.

If your child has diabetes, Codd urges you to consult his or her physician regarding insulin coverage. The doctor can recommend the amount of candy that can be consumed without drastically raising sugar levels.

So what should you do with the unwanted candy? “Check with your church or local grammar school to see if a post-Halloween Candy Drive is planned,” she says. “Some organizations gladly accept ‘extra’ Halloween candy and ship it to soldiers serving overseas or donate it to needy or sick children. If not, be a leader and organize a candy drive yourself!”

According to the Centers for Disease Control and Prevention (CDC), the H1N1 flu has hit pregnant women especially hard. About 700 cases have been confirmed in pregnant women since late April, about 100 pregnant women have required admission to intensive care units, and 28 pregnant women have died from the H1N1 flu, the CDC reported earlier this month.

“Because pregnant women who get influenza have a greater chance for serious complications, it is important they receive both the 2009 H1N1 flu shot and the seasonal flu shot.  Receiving these vaccines is the best way pregnant women can protect themselves – and their newborns – against the flu,” said Rosalie Pepe, M.D., infectious disease specialist at Cooper University Hospital.

Research has found that women who get a flu shot during pregnancy get sick with the flu less often than pregnant women who do not get a flu shot. The same holds true for their newborns. Babies born to mothers who get a flu shot during pregnancy get sick with the flu less often than babies born to mothers who did not get a flu shot during pregnancy.

A woman can receive both the seasonal flu shot and the H1N1 flu shot at any time during pregnancy. But, pregnant women should get the vaccines by injection – a “flu shot” – not by nasal spray. The nasal spray vaccine is not approved for pregnant women.

The injectable vaccine is made with inactivated flu virus. It is given with a needle, usually in the arm. The nasal spray vaccine is made with live, weakened flu virus and should be used only in healthy people ages 2 to 49 years old, and women who are not pregnant.

Following delivery, new mothers can safely get either the injectable or nasal spray vaccine, even if they are breastfeeding. In fact, vaccinated mothers who are nursing can pass on vaccine antibodies to their infants and reduce their babies’ chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies because they are too young to be vaccinated.

Dr. Pepe reminds pregnant women to get both a seasonal flu shot and a H1N1 flu shot as early as possible.

“You will need both shots this year to fully protect yourself and your baby against the flu. Both shots are absolutely safe and recommended for pregnant women and nursing mothers,” she said.

Additional H1N1 Flu Resources from Cooper University Hospital

• H1N1 Influenza and Seasonal Flu Information and Resources – Cooperhealth.org
  Visit our H1N1 resource page for information to help you and your family prepare for this year’s flu season. We will be updating this page as new information becomes available.
• Health eTalk Web Chat: Your Questions about H1N1 Pandemic Flu – Cooperhealth.org/etalk
  Join Rosalie Pepe, M.D., of Cooper University Hospital’s Division of Infectious Diseases, as she answers your questions live on Cooperhealth.org.  No question is too big or too small, as she’ll help you sort through the rumors and debunk the myths.

“This new device is going to increase early diagnosis of pancreatic diseases and cancer,” said Adam B. Elfant, M.D., Director of Therapeutic Endoscopy at the Cooper Digestive Health Institute. “The ability to finally biopsy difficult-to-reach areas within the ductal system and pancreas will allow patients to be treated sooner if cancer is found, leading to better outcomes for patients. This is a remarkable step in diagnosis for this devastating cancer,” Dr. Elfant said.

Cooper is the only center in South Jersey that offers the SpyGlass™ system.

SpyGlass™ uses a tiny fiber-optic camera – not much bigger than a pencil point – inserted through a catheter (or tube) via the mouth into the upper digestive tract. Threaded through the stomach and into the bile ducts, the camera can be “steered” in four directions, allowing physicians to pinpoint the spot they want to examine. With SpyGlass™, physicians are able to see clear, three-dimensional, color images in real time. SpyGlass™ also uses a light probe and miniature forceps for physicians to take tissue samples for biopsy. Most procedures are done on an out-patient basis.

Until now, direct visualization of the pancreatico-biliary system was not widely performed due to the limitations of traditional visualization systems and diagnostic testing.  For many patients, exploratory surgery has been the only way to secure a diagnosis.

Being able to diagnose pancreatic disease without the need for an invasive surgical procedure represents significant progress.  With a more timely diagnosis, patients can begin treatment much earlier, resulting in the potential to dramatically improve outcomes.

According to the American Cancer Society, in 2008 nearly 38,000 Americans were diagnosed with cancer of the pancreas–the fourth-leading cause of cancer death in the United States.  Pancreatic cancer is a “silent” disease, with patients often not exhibiting symptoms until late in the disease process.  As a result, the majority of patients with late-stage disease have a poor prognosis for survival.

Symptoms like unexplained weight loss, persistent loss of appetite, or light-colored stools should always prompt concern. Consistent or worsening discomfort (abdominal pain and/or bloating), nausea, vomiting or diarrhea also is worrisome. If you feel something’s not right, see your doctor.

This recipe is heart healthy.  This recipe is diabetes friendly.

Ingredients

• 1 Tbsp paprika
• 1 tsp chili powder
• 1 1/2 tsp brown sugar
• 1/2 tsp cumin
• 1/4 tsp kosher salt
• 1/2 tsp freshly ground black pepper
• 4 cloves garlic, minced
• 1/4 cup beer or 1/4 cup white wine
• 1 lb jumbo shrimp, unpeeled
• 1 1/2 cups fresh or frozen mango, cubed (defrost if using frozen)
• 1/4 cup low-fat yogurt
• 1 tsp canola oil
• 1 small red onion, finely chopped
• 1 Tbsp jalapeno chile, finely chopped
• 2 Tbsp finely chopped fresh cilantro

Preparation

1. Combine paprika, chili powder, brown sugar, cumin, salt, pepper, garlic and beer or white wine in a blender or food processor. Puree until a smooth paste. Put shrimp in a large bowl. Pour marinade over shrimp and toss to coat. Cover and refrigerate for 15 minutes.
2. Meanwhile, combine mango and a 1/4 cup of water in a blender or food processor, puree and set aside.
3. Heat oil in a nonstick saucepan set over medium-high heat. Add red onion and jalapeno, cook until lightly browned, about 3 minutes. Add the mango puree; bring to a boil, stirring occasionally. Reduce heat and simmer 1 minute. Remove saucepan from the heat.  Stir in the yogurt.
4. If cooking outside on a grill, set the temperature to medium-high heat. Spritz grill rack with nonstick cooking spray. Or if cooking indoors, spritz a large nonstick grill pan with nonstick cooking spray and set over medium-high heat. Add shrimp and cook about 2 minutes on each side. Remove from grill, sprinkle with cilantro and serve with sauce and plenty of napkins.

Nutrition Information Per Serving

Recipe Yields 4 Servings
Calories: 194
Fat: 4g
Saturated Fat: 1g
Cholesterol: 174mg
Sodium: 332mg
Carbohydrates: 15g
Fiber: 1g
Protein: 24g