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AARP report: Heart health can lead to brain health

Published on Thursday, February 13, 2020

By: Karen Bascom, [email protected]

A consensus paper from the AARP and the Global Council on Brain Health echoes what University of Mississippi Medical Center experts have said for years: “What’s good for your heart is also good for your brain.”

A Medical Center expert on brain aging and dementia helped prepare “The Brain-Heart Connection.” Dr. Tom Mosley, Robbie and Dudley Hughes Distinguished Chair and director of The MIND Center, was one of the 11 experts selected worldwide to review research and prepare guidance for people over 50 and health care providers.

Published Feb. 10, the report summarizes the importance of managing blood pressure, blood sugar, weight and other cardiovascular risk factors in preventing dementia.

Portrait of Dr. Tom Mosley
Mosley

“Dementia is a major cause of disability in older adults, affecting more than 50 million people globally. It is an enormous public health problem,” said Mosley, who studies Alzheimer’s disease and other forms of cognitive decline. “However, even in the absence of cures, we see that certain risk factors, if controlled, may lessen the risk of cognitive decline and dementia in older adults.”

These risk factors include high blood pressure, high cholesterol, diabetes, smoking, sedentary lifestyle, obesity, high salt intake, poor sleep quality and irregular heartbeat. Each can raise the risk of heart disease, stroke and different forms of dementia.

“We know that cardiovascular risk factors can lead to stroke and vascular dementia, but we’ve also found that the same factors increase risk for other types of dementia, most notably Alzheimer’s disease,” Mosley said.

Mosley said it was an honor to be included on the report’s expert panel, saying it underscores the research achievements made by The MIND Center.

The MIND, or Memory Impairment and Neurodegenerative Dementia, Center at UMMC leads research on and provides clinical care for patients with Alzheimer’s disease and other forms of dementia. Studies at The MIND Center include the multisite Atherosclerosis Risk in Communities Neurocognitive Study, or ARIC NCS, Study, which has studied cardiovascular disease and brain aging in 16,000 people, including approximately 4,000 African-Americans from the Jackson metropolitan area.

For example, Mosley said, The MIND Center has “found that even in the absence of brain changes related to clinical stroke, controlling high blood pressure and diabetes may decrease the risk of dementia later in life.”

This finding extends to people with “high normal” measurements, such as pre-hypertension and pre-diabetes, during middle age.

In the absence of stroke, Mosley considers hypertension, diabetes and smoking to be the most influential dementia risk factors outlined in the report, based on their prevalence and their outsized effect on brain and heart health.

“However, if an individual has atrial fibrillation or a history of excessive alcohol use or another risk factor, that could be the most influential risk factor for them,” Mosley said. “It’s never too late to start taking steps to lessen your risk for dementia, and the earlier in life you start, the larger the risk reduction will be.”

Graphic: Better Heart Better Brain. A heart-healthy lifestyle reduces the risk of cognitive decline. Take steps to improve your brain helth. Stay active and exercise - strive for at least 150 minutes of weekly, moderate aerobic activity. Don't smoke - if you smoke, quit. If you don't smoke, don't start. Check your blood pressure & cholesterol - work with your doctor to manage blood pressure and cholesterol levels. Manage blood sugar levels - diabetes increases the risk of stroke, cognitive decline, and dementia. Sleep well - aim for 7 to 8 hours of sleep in a 24-hour period. Eat healthy - limit salt intake. Avoid excessive alcohol consumption.

A new report from the AARP outlines the evidence that heart-healthy habits can also reduce the chance of developing dementia.

The report also highlights where experts still don’t know enough. Mosley said we are still unsure of the causal mechanisms that link brain and heart health.

“What is it about damage, often subtle, to blood vessels that damages the brain, beyond the known effects of a stroke?” Mosley asked. One possibility is that blood vessel damage produces chronic inflammation and immune responses that promote brain aging and cognitive decline, but more work is needed to understand the underlying mechanisms.

The MIND Center’s ongoing research includes a collaboration with Johns Hopkins University studying cardiovascular risk factors and amyloid plaques in the brain, a marker for Alzheimer’s disease. They are also part of the UMMC MIND Center-Mayo Clinic Study of Aging, studying geographic and racial differences in risk and burden of dementia.

“We want to elucidate the factors that explain why cognitive decline and dementia are more prevalent in our region and in African-Americans,” Mosley said.

“The Brain-Heart Connection” has received the seal of approval from multiple health-related associations.

“The American Heart Association endorses this report and commends AARP for focusing on the heart-brain connection. Despite growing science about this relationship, most people are not aware of it,” said Dr. Mitchell Elkind, president-elect of the American Heart Association.

Mosley said it is an important publication because there is “a lot of false and misleading information” on the Internet about unproven remedies and prevention strategies for dementia. This report gives people evidence-based recommendations on how to preserve brain health as they age.

“People are understandably very worried about dementia,” Mosley said. “The AARP and the Global Council on Brain Health have done important work in getting this information out to the public.”

To download a copy of “The Brain-Heart Connection,” click here

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2020 Dental Alumna of the Year passionate about dentistry, community

Published on Thursday, February 13, 2020

By: Kate Royals, [email protected]

Dr. Barbara Mauldin, a 1984 graduate of the School of Dentistry at the University of Mississippi Medical Center and the 2020 Dental Alumna of the Year, almost didn’t become a dentist.

This is despite the fact she began her career as a dental hygienist and that her father was a dentist in her hometown of Vicksburg.

But after her husband completed graduate school while she was working, she approached him about going back to school herself. She told him she wanted to go to medical school.

He agreed, but asked why she would want to leave dentistry.

She considered her husband’s point.

“I had never given a thought to being a lady dentist because there weren’t any, to my knowledge, back in that time period,” Mauldin remembered. “I had never (considered) being the dentist and not just an auxiliary in the office.”

Woman and man hug.
Mauldin shares a hug with Dr. Kevin Holman, Dental Alumni Board president and a 1990 School of Dentistry alumnus.

That conversation would shape the rest of her life.

After returning to the University of Southern Mississippi to complete her degree and prerequisite courses, she applied and interviewed for a spot in the dental school along with her older brother.

She began dental school at 24 years old as one of five women in a class of 50.

“I’ve always felt as if I’ve been blessed by God with giving me the idea of pursuing dentistry,” she said.

She said times were different then, but the education she received was superior.

“I remember being at one of the clinics with one of these graduates (a resident from another school), and he was asking me, as a junior, how to do certain procedures. He didn’t know what I already knew and I’d only had two years to his four,” she remembered. “I thought at that moment, ‘I’m in a very, very good school.’”

Her education has served her well, she said. She has run her own practice in Petal since 1984 while remaining involved in her community, raising four children of her own and a foster son and taking on leadership roles in organized dentistry.

She is currently the president of the Mississippi Dental Association, where she was the first female dentist to become Speaker of the House in 2007. 

Dr. Butch Gilbert, professor emeritus in the School of Dentistry, was one of Mauldin’s teachers during dental school.

Portrait of Dr. Butch Gilbert
Gilbert

“Barbara came to the dental school as a dental student with high academic abilities, leadership skills and commitment to service. That has translated into what she has accomplished in her practice and community through the years,” said Gilbert. “Her integrity, compassion for others and leadership abilities make her a wonderful role model for dental students and young dentists. As to her accomplishments and values, she is what the Alumnus of the Year award represents.”

As Gilbert and those who know Mauldin will say, community and service are important to her, values for which she credits her parents.

“One of the things I learned from my parents is communities don’t just happen,” she said, explaining how she watched her father in his dentistry practice in Vicksburg.

As soon as she opened her own practice, she joined the Petal Chamber of Commerce. When Rotary Club began accepting women, she joined her local chapter and became president in 1999. She is now involved with the organization at the district level, which spans southeast Mississippi and southeast Louisiana, including New Orleans. 

She has been on mission trips to Nicaragua, Honduras, Peru and Nepal. She was involved in the creation of the Fellowship Health Clinic in Hattiesburg. The clinic provides medical, dental and pharmaceutical care to uninsured and underinsured people in Forrest and Lamar counties, and Mauldin performs free tooth extractions for patients who are referred to her from the clinic. 

Portrait of Dr. Barbara Mauldin and Dr. Charles Harrell.

Mauldin poses with her friend and colleague, Dr. Charles Harrell, a 1990 School of Dentistry graduate and a fellow dentist in Petal.

Her dedication to service is what prompts Dr. Charles Harrell, a fellow dentist in Petal, to describe her as “very kindhearted and passionate about what she does.”

Harrell, a 1990 graduate of the School of Dentistry, remembers how Mauldin took him under her wings when he first started his practice just down the street from her practice.

“She’s done a lot for the dental profession and works to provide better patient care,” said Harrell, referring to her longtime involvement with the Mississippi Dental Association.

Mauldin was honored during the annual Dental Alumni and Friends dinner on Friday.

“It really does mean a lot to me,” said Mauldin. “I’ve had a lot of accolades over the years, but to be recognized by my peers is something that stands out to me.”

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Photos: 340 JPS students receive free dental care during Give Kids a Smile

Published on Monday, February 10, 2020

School of Dentistry students and faculty welcomed and treated nearly 400 elementary school students from the Jackson Public School District last Friday during the 14th annual Give Kids a Smile event.

The children received free dental treatment in the form of cleanings, fluoride treatments and sealants, and dental students, in return, got needed experience and a chance to give back to their community. Plus, they had fun: many School of Dentistry students dressed up as tooth fairies and wore colorful costumes to amuse the sometimes nervous child.

The American Dental Association began the Give Kids a Smile program in 2003 as a way for dentists to join with the community to provide dental services to underserved children. In 2017, the School of Dentistry incorporated Give Kids a Smile into a new, weeklong effort providing care to underserved and uninsured adults and veterans from across the state called Dental Mission Week.

Girl in yellow dental glasses looks at her teeth in mirror.

Ivori Williams inspects her newly cleaned teeth.

Dental student brushes girls teeth.
Ali Bounds, a fourth-year dental student, brushes Tamyra Austin’s teeth.
Close up of dental student working with patient in foreground.

Justin Starnes, a second-year dental student, finishes a cleaning.

Dental student looks on as her professor checks out a pediatric patient.

Lakymberya Buckner, a third-year dental hygiene student, watches Dr. Bill Boteler, an assistant professor of dentistry, prepare to check Williams’ teeth.

Two dental hygiene students lean out of interior office window.

Emily Revette, left, and Ashtin Hunter, fourth-year dental hygiene students, await the arrival of more JPS students.

Close of up patient with dental tools in mouth.

Cortez McGee receives a fluoride treatment.

Man in blue scrubs, center, looks at child and dental student in foreground.

State Sen. Hillman Frazier, a regular attendee and supporter of Dental Mission Week, observes a child being treated during the Give Kids a Smile event.

A patient, center, looks up at Dr. Woodward as she chats before two dental students on the left and right begin work.
Dr. LouAnn Woodward, standing center, UMMC vice chancellor for health affairs, gives a few words of encouragement to Ja’Niya Flemmons before getting the JPS student gets her teeth cleaned by Lien Huynh, left, a fourth-year dental hygiene student, and Ashlynne Baney, a third-year dental hygiene student.
Student in a gold hat laughs.

Louis Montgomery III, a fourth-year dental hygiene student, shares a laugh with his fellow students.

Two dental students lean over a pediatric patient while working.

Brandon Bouldin gets a cleaning with the help of Montana Mills, left, a fourth-year dental hygiene student, and Alexis Hollingsworth, a third-year dental hygiene student.

Girl in gold cape.

Jackie McGrath, a first-year dental student, entertained and played with JPS students in the dental clinic’s waiting room.

Dental hygiene student with pediatric patient.

Rebecca Jenkins, a fourth-year dental hygiene student, finishes McGee’s cleaning.

Two dental students work on pediatric patient between them.
Brooke Barnes, a dental assisting technology student at Hinds Community College, and Trent Johnson, a third-year dental student at UMMC, work on Christopher Bouldin’s teeth.
Dental students high five elementary students.
First-year dental students, from left, Will Allen, Julianna Woodward, Kaeton Long and Codi Ballard give high-fives to Johnson Elementary School students.
Two women pose for portrait in front of dental clinic doors.

Jessica Edwards, left, community relations liasion for Garner Dental Group, and Shirley Hamm, marketing director for Garner Dental Group, show up in support of Give Kids a Smile. Garner Dental Group donated $20,000 to GKAS this year.

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What is a labiaplasty and what does it involve?

what is a labiaplasty?

Even though plastic surgery is very common, very few people have heard about labiaplasty. You may have heard the name but may not have any idea what it is and which part of the body is involved.

Well, if you are here, then maybe you want an insight. Today we will give you some insight into labiaplasty and what it entails.

What is a labiaplasty?

A Google search may yield other terms like “vaginal rejuvenation” or “designer vagina,” however, the goal of this article is to first distinguish a labiaplasty from other forms of vaginal rejuvenation, then educate you on the actual labiaplasty procedure.

Vaginal rejuvenation is a broad term that encompasses a tremendous number of options for this ever-growing field of elective healthcare. New devices and treatments are entering the market almost every month, as more and more women are utilizing these treatments more frequently.

Therapies for “vaginal rejuvenation” typically include energy devices like lasers, radiofrequency and ultrasound just to name a few. Most vaginal rejuvenation procedures utilize some form of energy to accomplish a myriad of outcomes such as vaginal tightening, decreasing incontinence and eliminating vaginal dryness.

However, the FDA recently released a statement on these types of treatment, explaining that some of the manufacturers of these devices were not being totally transparent with the clinical claims of these devices.

The main difference between a labiaplasty and another treatment under the “vaginal rejuvenation” umbrella is a labiaplasty is a surgical procedure. The labiaplasty procedure aims to decrease the size of the labia minora (inner tissues of the female genitalia) so that it is flush with the labia majora (outer part of the female genitalia). This procedure involves utilizing several different surgical techniques depending on the patient’s specific situation. There are no energy devices required with a labiaplasty, and you will work with your plastic surgeon to determine the goals of your surgery.

Reasons for a labiaplasty

There are a host of reasons females have enlarged labia, including childbirth, aging, sexual activity and genetics. Females choose to have surgery for several reasons. First, there are several functional benefits when electing for a labiaplasty. Many females who suffer from an enlarged labia experience difficulty with exercise, hygiene, urinary tract infections, sexual activity and other physical activity.

Furthermore, with the increasing trend of wearing yoga pants, workout pants and swimming suits, an enlarged labium can make it difficult to wear such clothes. However, most female patients describe feeling extremely self-conscious when becoming romantically involved with their partners. These reasons and others are what females consider when choosing a labiaplasty.

Labiaplasty procedures

Initially, there was a single procedure for labiaplasty, and it was very popular as well. With the change of time and advancement in techniques, several techniques have evolved. Some of them are as follows:

Trim procedure

It is the original technique and is most natural to perform. It is also the most widely used technique used by surgeons. In this procedure, the excess part of labia minora is removed and sutured so that it is symmetrical with the labia majora.

Wedge procedure

In this procedure, a partial thickness wedge is removed from the thickest part of the labia minora. The submucosa (layer tissue beneath a mucous membrane) must be left intact by removing only a partial thickness. This procedure gives the vagina a natural look after the surgery as well, preserving the wrinkled edges.

There are several other techniques for reducing the labia minora, and all these techniques have certain advantages and disadvantages. If you are considering a labiaplasty, the key to ensure appropriate outcomes is to make sure you are going to a board-certified plastic surgeon that specializes in this procedure.

Anesthesia for a labiaplasty

Labiaplasty is an outpatient surgery. The procedure can be performed within an hour, either individually or with other cosmetic surgery. It can be performed under local anesthesia or general anesthesia, depending on the treatment plan discussed with your plastic surgeon.

Postsurgical care

The genital region of females is very sensitive and requires proper care in general. So, when undertaking a procedure like a labiaplasty, there are some post-operative instructions you need to be aware of before having the procedure.

You should avoid long showers and should pat the wound dry every time after washing. The antibiotics prescribed by the surgeon should be taken to reduce pain and inflammation, which can be present after the procedure Riding bikes, running and other physical activities will need to be avoided until you have been released by your plastic surgeon. Premature return to the activities can exert pressure on the wound and will unnecessarily delay the healing process. You should not wear tight clothes or undergarments as they cause friction against the wound. Also, you cannot indulge in sexual intercourse for at least four weeks.

Choosing to have a labiaplasty

Labiaplasty has functional and cosmetic benefits. Most women undergo surgery to reduce the excess labia which twists and turn and causes pain and irritation. Others want to restore their youthful look after childbirth or aging. Though the reasons are numerous, you should seek a board-certified plastic surgeon that understands the medical, mental and emotional factors of a procedure like a labiaplasty.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Eye care providers can often spot the unexpected during routine exams

Published on Thursday, February 6, 2020

By: Ruth Cummins, [email protected]

When a third-grader has trouble seeing the board at school, a routine visit to the eye doctor likely will end with a new pair of glasses.

For Ridgeland resident Grace Thaggard, however, the appointment revealed something much more life-changing. Dr. Kimberly Crowder, now chair of the Department of Ophthalmology at the University of Mississippi Medical Center, saw significant inflammation that immediately concerned her.

“Dr. Crowder pulled my mom aside and said, ‘I see something, and it’s worth checking out,’” said Thaggard, now a 21-year-old chemistry major at the University of Alabama-Birmingham

Portrait of Grace Thaggard
Grace Thaggard of Ridgeland is a junior at the University of Alabama-Birmingham.

Crowder referred Grace to pediatric ophthalmologist Dr. Nils Mungan, a professor in the Department of Ophthalmology. The diagnosis: Grace was positive for HLA-B27, a protein on the surface of white blood cells that places you at a higher than average risk for autoimmune diseases such as inflammation of the bones of the spine and arthritis.

Grace also was diagnosed with bilateral iritis, a swelling and inflammation in the colored ring around the pupil of the eye. That condition is often found in people who develop certain autoimmune diseases that have a possible genetic association.

A blood test pinpointed Grace’s HLA-B27, which can be genetically passed down. “I wondered if it had come from me,” said Grace’s mom, Carol Thaggard. “I knew I had something rheumatological.”

Grace’s father and Carol Thaggard’s husband, Dr. Anson Thaggard, is an associate professor in UMMC’s Department of Radiology.

Carol Thaggard was being treated by Dr. Vikas Majithia, UMMC division chief of rheumatology, for the autoimmune disorder mixed connective tissue disease. “He tested me, and I had HLA-B27,” she said. Years later, Crowder diagnosed her with iritis.

Other than the inflammation that she never felt, Grace had no symptoms when Crowder first examined her. HLA-B27 is just one example of conditions that an ophthalmologist or optometrist can detect or suspect from a routine eye exam, Crowder said.

“I don’t think that I will ever stop being amazed that I find the unexpected on eye exams,” Crowder said.

Patients can learn for the first time they have one of an array of conditions or diseases – diabetes being a frequent one – thanks to an eye exam. High blood pressure, autoimmune diseases, sexually transmitted diseases and some cancers are among conditions that can come to light during an exam, in addition to warning signs that a patient may be at high risk for stroke.

The eye is the only place in the body where a doctor has an unobstructed view of blood vessels, nerves and connecting tissue without performing surgery. They use special instruments and powerful lenses to examine the front and the back of the eye, looking carefully for conditions that can affect each of those areas.

It’s why the American Academy of Ophthalmology on its website calls an eye exam “a window to our soul and body’s overall health.”

Portrait of Roya Attar
Attar

Dr. Roya Attar, an optometrist and assistant professor of ophthalmology, remembers examining a healthy patient who was experiencing vision changes. As Attar peered into the woman’s fundus, or the back part of the eye, “I noted that she had a unique bleeding pattern in her eye,” Attar said. Retinal hemorrhages with a white center, known as Roth spots, are relatively rare.

Concerned, Attar referred her patient to UMMC retinal specialist Dr. Brian Tieu, assistant professor of ophthalmology. Following that retinal consult and a medical workup, the patient was diagnosed with multiple myeloma, a serious blood cancer. Because the eye exam resulted in the cancer being discovered early, Attar said, “her survival rate improved dramatically.”

In many cases, patients don’t seek out an eye professional unless they’ve noticed a change in their vision or have significant eye irritation or pain, Attar and Crowder say. “And unfortunately, the majority of patients don’t have regular annual eye exams, despite the universal sentiment that sight is our most treasured sense,” Attar said.

Patients also may not realize that blurred vision, eye irritation and redness can’t always be remedied by glasses or over-the-counter eye drops, Attar said. They can be clues that a patient has a far more serious eye or other health condition, such as diabetes, one of the most common causes of blindness worldwide. Diabetic retinopathy, a complication of diabetes, is the top retinal vascular disease.

Signs a patient could have diabetes include sudden shifts in a patient’s eyeglasses prescription or sudden blurred distance vision. Attar advises such patients to see their primary care physician for an evaluation of their blood sugar and other diabetic markers before their eye care provider prescribes glasses.

In Grace Thaggard’s case, the partnership between Department of Ophthalmology providers and those in other Medical Center specialties was critical to her treatment, which continues today. Grace also saw Majithia, who placed her on medications to control the autoimmune issues associated with HLA-B27.

Make no mistake: An eye exam should never replace the need for patients to regularly see their primary care provider, Crowder said. “I am not a primary care doctor, and I will never have that knowledge and expertise without going back to repeat residency training,” she said.

If Mississippi is going to make an impact on chronic diseases like obesity and diabetes that place the state “in the top 10 on all the wrong lists,” Crowder said, primary and population health programs must vastly improve.

“If I’m diagnosing diabetes in an adult, then the system is very broken, because once I see diabetes in the eyes, the patient has had the disease undiagnosed for quite some time,” she said. “The focus has to be shifted to prevention. I agree with appropriate referrals to eye doctors for many disease processes, but it upsets me to see the current system is failing our population.

“The answer is not, and never will be, ‘Get more eye exams.’”

Her parents’ diligence in ensuring she get good eye care, however, made all the difference for Grace.

Being diagnosed in elementary school “was a lot,” she said. “Your main fear as a third-grader is going blind. It was overwhelming at first, but I knew that if it had been untreated, you could have degenerative effects.”

She managed her condition with steroid drops until they eventually caused problems with the pressure in her eyes. On her current medications from Majithia, “I haven’t had a flare-up in three years, and I haven’t had to use the drops.”

A UAB junior, Grace is studying German and forensic science in addition to chemistry, with plans to pursue her doctorate in inorganic or environmental chemistry.

“The good news is it doesn’t hurt,” she said of her condition. “The bad news is that my body isn’t going to give me warning that something is wrong. That’s why I go to the eye doctor every six months and have bloodwork.

“But had I not had problems seeing the board as a third-grader, I don’t know when we would have figured this out. The main problem had nothing to do with my eyes.”

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Tackling common tummy tuck myths

tackling common tummy tuck myths

For men and women alike, a toned and flat stomach is considered to be the epitome of a fit, healthy and attractive figure. But whether due to genetics, childbearing, weight fluctuations or lifestyle habits, achieving that slim and smooth belly can feel impossible with so many factors actively working against you.

Tummy tuck surgery, otherwise known medically as an abdominoplasty, is a frequently requested surgical cosmetic procedure that helps patients attain the otherwise unattainable by tightening the abdominal muscles and eliminating excess fat and skin from the midsection for a more toned and sculpted stomach that lasts for years to come.

If you are bothered by the appearance of stretched skin, stubborn fatty deposits or weakened muscles in the abdominal region, tummy tuck surgery may be the perfect solution for getting the body you want. We’ve debunked some of the more common myths about tummy tucks to help you determine whether tummy tuck surgery is right for you.

Myth: Tummy tucks are a weight loss procedure

One of the more common misconceptions patients have regarding tummy tucks is that it is a surgery intended for those who would like to lose a substantial amount of weight from their midsection. However, a tummy tuck is not considered to be a weight loss or bariatric procedure.

In fact, the ideal candidate for tummy tuck surgery is someone who is at or close to a normal weight for their physique and who is otherwise active and healthy but is troubled by the appearance of a protruding abdomen or sagging, loose skin on their stomach.

That’s not to say that a tummy tuck won’t address excess fat within your abdominal region. Often times, liposuction techniques will be utilized during your tummy tuck surgery to gently minimize stubborn zones of fat that have proven resistant to diet and exercise to improve the contours and tone of your midsection.

While your stomach will be flatter and slimmer after your abdominoplasty, it will not drastically lower the number you see on your scale. For this reason, if you are considering a tummy tuck you should be within a reasonable range of your goal weight before undergoing the procedure but will also need to have maintained a stable weight for at least six months. Any future significant weight fluctuations can start to reverse the results of your surgery.

Myth: You can get tummy tuck results with diet and exercise

When it comes to getting the slimmer and sleeker stomach you desire, diet and exercise are well-known as the most effective tools in your toolbox for losing weight, building muscle and improving your overall health and wellness.

However, while each of us should incorporate eating right and exercising into their daily lives, traditional weight loss methods still have their limitations in terms of the results they can provide. No matter how much time or energy you put into these efforts, you cannot control where you will lose weight from and may still struggle with a stubborn belly even if you’ve hit your target weight.

Additionally, there are some aesthetic concerns that working out and eating right simply cannot address alone. Excess or stretched abdominal skin, for example, can usually not be reversed or tightened without surgical intervention, especially when it is a result of pregnancy or massive weight loss.

Childbearing or significant weight fluctuations can also weaken the abdominal muscles and stretch the inner girdle of connective tissues known as the abdominal fascia, which only further exacerbates the appearance of a protruding belly. If your skin, abdominal wall or fascia have become stretched, tummy tuck surgery is the only way to restore a taut and youthful midsection.

Myth: Tummy tucks are only for women

Tummy tuck surgery was the fourth most popular cosmetic surgery among women in 2018 with 152,446 women undergoing the procedure. Abdominoplasty has been an incredibly popular cosmetic option for women for years, in part due to the many irreversible changes to the midsection that accompany pregnancy and childbirth, such as stretched skin and abdominal muscles.

A tummy tuck is frequently included in “mommy makeover” procedures, which refer to a full suite of cosmetic surgeries performed concurrently to help women restore their pre-baby body and men to regain a leaner physique.

While women did make up for 96.8 percent of the total tummy tucks performed in 2018, men can also benefit from this procedure. Tummy tuck surgery was the fifth most popular cosmetic surgery for men in 2018. While men may not have to worry about the physical changes that women’s bodies endure from pregnancy, they are not necessarily immune from developing a “dad bod.”

Heredity or significant weight loss can leave men with stubborn belly fat or loose skin that leaves them feeling self-conscious of their midsection. Whether you are male or female, tummy tuck surgery will tighten and tone the contours of your abdomen to allow clothes to fit better and restore a fit and youthful stomach you are thrilled to flaunt.

Myth: You’re too old to get a tummy tuck

When it comes to cosmetic surgery, age truly is just a number. While a majority of patients who underwent tummy tuck surgery in 2018 were between the ages of 35 and 50 (56.3 percent), 21 percent were between the ages of 51 and 64 and four percent were over the age of 65.

There is no wrong age to opt for a tummy tuck procedure, however, there are more critical factors that will be considered by your board-certified plastic surgeon when determining your candidacy for the procedure.

To be a good candidate for abdominoplasty, patients must be:

  • Physically healthy: You must be in good overall health before undergoing invasive surgery to prevent complications.
  • A nonsmoker: Smoking can inhibit the healing process or cause serious complications both during and after your tummy tuck surgery. If you do smoke, you will be asked to quit for two months before and after your procedure.
  • Within a stable, healthy weight: Tummy tuck surgery is not intended for significant weight loss or for treating obesity.
  • Realistic with their expectations: While a tummy tuck will dramatically enhance the contours of your midsection with long-lasting results, no cosmetic surgery will stop the aging process or deliver perfection, or fully camouflage a larger core abdominal shape.

Next steps on your tummy tuck journey

When you are ready to schedule your tummy tuck consultation, be sure to choose a board-certified plastic surgeon on the ASPS Plastic Surgeon Match service.

Board-certified plastic surgeons undergo a rigorous training process and are vetted by their peers through both a written and oral board examination process. Each and every ASPS member surgeon is board certified in plastic surgery, making them the most qualified plastic surgeons to perform your procedure.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Nursing alum receives national award for diabetic peds work

Published on Monday, February 3, 2020

By: Kate Royals, [email protected]

Dr. Katelyn Armstrong has a particular passion for the patients she works with as a nurse practitioner at the University of Mississippi Medical Center – because she’s been in their shoes.

When the UMMC Center for Telehealth approached Armstrong and her colleagues in the pediatric endocrinology clinic, she saw an opportunity. Armstrong, who has been working with diabetic patients in the clinic since 2014, translated the partnership into her project while in school for her Doctor of Nursing Practice degree.

That project, “The Impact of Remote Patient Monitoring on Pediatric Patients with Diabetes,” made her the only D.N.P. student in the nation to receive the American Association of Colleges of Nursing’s Excellence in Advancing Nursing Practice Award this year.

Armstrong has plenty of personal experience with diabetes. At 16, she was diagnosed with type 1 diabetes. As a child, she watched her father cope with the disease. 

The firsthand knowledge makes her an exceptional, and unique, provider, and is the reason she enrolled at the University of Mississippi School of Nursing for her Bachelor of Science in Nursing when she was 20 years old. Over the next 11 years she continued her education while working and received all three of her degrees from UMMC.

“I just felt like having been there, I could help other people … I think especially for a younger patient, coming from someone who’s been through what you’re going through (is different) than someone just saying  ‘You should do this, you should do that,’” she said. “I try to level with them.”

From left to right, AACN Board Chair Ann Cary, Katelyn Armstrong and AACN President and CEO Deborah Trautman share a smile as Armstrong displays her award.
Ann Cary, left, AACN board chair, and Deborah Trautman, right, AACN president and CEO, share a smile with Armstrong after presenting her with the award.

But Armstrong is also aware that working with her patients is about more than just making sure they know what to do.

“With diabetes, you have to have a passion for it … it’s easy to just say, ‘if you don’t do these things then too bad, I can’t help you,’” she explained. “But it’s a lot more than the patient knowing what to do. It’s figuring out what the barriers are in their life.”

For example, a teenager who may not want his friends to know he has the disease.

Or a young child whose family struggles to afford healthy foods.

“There are lots of different things you have to consider when you’re managing diabetes – and you’re working with the whole family unit,” Armstrong said.

In her project, Armstrong looked at two years’ worth of data from the partnership with her clinic and the Center for Telehealth in which 89 diabetic patients received a glucose monitor that connects to an iPad. The iPad communicates blood sugar readings to the Center for Telehealth and also contains educational modules for patients. 

The results showed the tool worked.

Overall, there was a decrease in hospital and emergency room visits and a decrease in patients’ hemoglobin A1C levels, which measures a person’s average level of blood sugar over the past two to three months.

While patients were using the iPads for remote-patient monitoring and sending in their information, nurses and staff at the Center for Telehealth had a protocol for when to call Armstrong and other providers and when to recommend an emergency room visit or to call 911.

The system also allowed Armstrong and her team to intervene in a preventative way.

“Even if we just noticed a trend in (a patient’s) blood sugar being higher or lower, we could look at it and make insulin adjustments in between visits” every three months, she said.

Portrait of Michelle Palokas
Palokas

Dr. Michelle Palokas, assistant professor and director of the DNP program, is one of the faculty members who nominated Armstrong.

“She improved care for the diabetic patients she sees in clinic,” said Palokas.

And although the project is complete and she graduated with her doctorate, Palokas doesn’t expect Armstrong to ever quit trying to improve how she cares for patients.

“I think she’s going to be very influential and always look for things that need to be changed or improved – and she will lead those changes. I really believe that,” Palokas said.

Armstrong said she is indebted to the School of Nursing for the education it offered her.

“I feel like I kind of grew up here,” Armstrong, who received her bachelor’s, master’s and doctoral degrees at the School of Nursing, said. “The faculty at the SON is so wonderful. That’s so important when you’re in school, to have people who support, guide and help you.”

Armstrong received the award at the AACN’s Doctoral Education Conference on Friday in Naples, Fla.

Dr. Ann Cary, chair of AACN’s Board of Directors, called Armstrong’s work “groundbreaking” and “innovative.”

“AACN is pleased to recognize Dr. Katelyn Armstrong from the University of Mississippi with the 2019 Outstanding DNP Project Award for her groundbreaking work in the area of remote monitoring of pediatric patients with diabetes,” said Cary.  “Her innovative work serves as a model for other DNP students who are working to translate the latest scientific evidence related to safe patient care into contemporary nursing practice.”Source

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How better body contouring options give you more choices

better body contouring options give you more choices

There are many people out there who feel they could benefit from some sort of body contouring but are confused about which body contouring option would be best for them. The phrase “body contouring” encompasses a wide variety of cosmetic procedures and treatments.

By using both new and traditional procedures in addition to being able to choose between surgical, minimally invasive and noninvasive body contouring treatments, men and women are able to customize their body contouring to fit their needs.

Narrowing your search

With all the options you have available to enhance your look, it can feel as though the choices are overwhelming. Fortunately, there are five questions you can ask yourself to begin the determination of how to pick body contouring procedures.

  • Are you within 10 pounds of your optimal weight? People who are within a healthy weight range can benefit the most from liposuction or one of the many nonsurgical body contouring procedures. These individuals are considered to be generally fit but have particular areas of stubborn body fat that they wish to remove.
  • Is your body mass index (BMI) 30 or less? A person should have a BMI of about 30 or less in order to be fit enough for most body contouring procedures. If someone’s BMI is over 30, a good idea for them is to concentrate their efforts on diet and exercise before exploring procedure options.
  • Do you have sagging muscles or loose skin? Sagginess is a common cosmetic concern, particularly as people get older, have experienced weight fluctuation throughout their lives or lost a dramatic amount of weight recently. Separation of the abdominal muscles is common during pregnancy and can be addressed with an abdominoplasty. Excess skin and stretched and weakened muscles can be tightened or surgically eliminated.
  • Are you wanting quick results? Liposuction and other surgical body contouring choices can provide results that can be seen in a matter of days or a few weeks. Nonsurgical body contouring procedures often need multiple treatment sessions stretched out over time for the best results.
  • Do you have the time to recover? Surgical choices such as liposuction and tummy tucks need dedicated recovery time in which physical activities are restricted. Nonsurgical treatments can offer less downtime or even no downtime since they do not involve surgical incisions, anesthesia or needles. So, you can get back to your daily activities fairly quickly.

Surgical options for body contouring

There are many surgical and nonsurgical body contouring options to consider. Body contouring can be an excellent option for anyone who is looking to redefine their figure. It’s especially effective for people who have experienced major weight loss. A combination of procedures can help reduce the stubborn fat deposits and tighten up the loose skin and muscles often left behind.

Here are some common surgical procedures that people opt for:

  • Liposuction involves the removal of unwanted stubborn fat pockets to create a slimmer, more streamlined body. This can be performed on practically any area of the body that has excess fat.
  • Abdominoplasty, commonly known as a tummy tuck, involves the toning and tightening of the stomach area. With this procedure, loose skin is removed and stretched and weakened muscles are repaired.
  • A thigh lift and body lift can help the condition of baggy skin surrounding the buttocks and thighs which can be caused by genetics, aging or major weight loss. This is accomplished by getting rid of excess skin and stubborn fat and tightening the underlying musculature.
  • An arm lift can help improve the appearance of loose sagging skin on the upper arms by removing the excess, hanging skin.
  • A Brazilian butt lift can enhance the buttocks, providing a better balance of natural curves. This is achieved by using a person’s own fat cells to augment the buttocks.

Minimally and noninvasive body contouring options

Nonsurgical options can be great for individuals who want to address mild body contouring concerns that may not need extensive treatment from a surgical procedure. They are also a popular choice for people who have busy schedules and can’t take the necessary time to recover after surgery. For instance, a busy mom who wants to achieve some toning and tightening now has nonsurgical options to consider, where 10-15 years ago, a surgical mommy makeover was her only reliable contouring option.

There are many nonsurgical treatments to consider. Some use cold temperatures to kill unwanted fat cells, some use heat. There are also treatments that use ultrasound waves aimed at fat cells under the skin to break down the fat. All of these options then rely on your body’s natural cleansing process to remove the destroyed cells and create a slimmer look in the treated area. Most of these require a 30-90 minute treatment sessions, with several sessions needed for noticeable body slimming. In some cases, nonsurgical treatments can also tone and tighten the skin in the area being treated.

When considering nonsurgical options, it’s important to visit with several board-certified plastic surgeons to see which treatments they offer and find out why they’ve chosen one method over another. See how each one might be able to help your specific cosmetic concern, get pricing and take the time you need to make a good decision for your own goals.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Medical Center salutes Jim and Donna Barksdale for contributions to diversity and inclusion

Published on Friday, January 31, 2020

By: Gary Pettus, [email protected]

Mississippi-born philanthropists and entrepreneurs James L. “Jim” and Donna Barksdale were honored Thursday at the University of Mississippi Medical Center for contributions benefitting diverse and underrepresented communities.

The couple received the Inspiration Award, one of six institutional accolades, during the third annual presentation of The Pillars, a tribute to those who further diversity and a “climate of inclusion” at the state’s only academic medical center and within the community beyond.

The annual event is hosted by the UMMC Office of Diversity and Inclusion.

The Barksdale family name is linked to millions of dollars in gifts for initiatives to better the state, including one whose 20th anniversary was marked recently: the Barksdale Scholarships.

“They are heroes of the Medical Center and for the state of Mississippi,” said Dr. LouAnn Woodward, UMMC vice chancellor for health affairs and dean of the School of Medicine.

Dozens of scholars have benefitted from their gifts, including a large number of African Americans, many of whom are now practicing physicians in this state.

Portrait of Juanyce Taylor
Taylor

In announcing the award, Dr. Juanyce Taylor, UMMC’s chief diversity and inclusion officer, noted Jim Barksdale’s reputation as a “renowned business executive, philanthropist, faithful, genuine leader.”

A Jackson native, Barksdale, 77, the chair and president of Barksdale Management Corp., graduated from the University of Mississippi in 1962 with a degree in marketing before selling computers for IBM. Later, at Federal Express, where he held a variety of leadership roles, including CEO, he helped deliver a computerized package-tracking system.

Afterward, he became president and CEO of a cellular communications company whose prosperity prompted its purchase from AT&T Wireless.

Starting in 1995, he led Netscape Communications Corp. for about four years as president and CEO during the dot-com boom. The company’s success led to its purchase in 1999 by AOL for $10.5 billion.

He and his wife of four decades, the late Sally McDonnell Barksdale, gave Ole Miss $5.4 million in 1997 to create what is now the Sally McDonnell Barksdale Honors College – “to keep the best and brightest in the state,” as Barksdale said at the time.

Three years later, the Barksdale Foundation granted $100 million to the state to foil illiteracy through the Barksdale Reading Institute, led at one time by one of Jim Barksdale’s five brothers, attorney Claiborne Barksdale. The donation also funded the Mississippi Principal Corps, a program to develop highly-effective, homegrown school administrators.

With an additional $2 million endowment, Jim and Sally Barksdale established scholarships meant to encourage talented African American students to stay in Mississippi for their medical education, naming the awards after physicians in their family: Dr. Bryan Barksdale, Dr. Don Mitchell and Dr. Fred McDonnell. More than 50 of these students have received these annually renewable grants.

Some years after Sally Barksdale’s death in 2003, Jim Barksdale met Donna Kennedy of Magee, who for years ran her own clothing design business, while also forging a career as a leader in education, business, philanthropy, civic endeavors and more. She was president of the Junior League of Jackson when it voted to support the Children’s Cancer Clinic at UMMC.

After their marriage, the first Jim and Donna Barksdale Scholars entered the School of Medicine at UMMC as beneficiaries of grants presented to students of merit.

Now, some 20 years later, the total number of Barksdale Scholars  is around 90. The Barksdales’ medical school contributions have exceeded $17 million, paying for the education of scores of scholars, most of them African American, and all of them committed to living and practicing medicine in Mississippi for at least five years.

“I appreciate the honor,” Jim Barksdale said after the ceremony. “I’m so proud of our medical scholars; about 47 are now practicing in the state. We’re starting to make a dent in the physician corps in Mississippi.”

Held on the Medical Center campus, The Pillars’ Recognition of Service & Inclusive Excellence observance acknowledged the work of five more “visionaries and leaders,”  in Taylor’s words, who were named winners of the Excellence Award, Inclusion Award, Beacon Award, Lifetime Achievement Award and Esprit De Corps Award.

Another eight UMMC faculty and staffers were recognized as members of the inaugural 2020 Masters Class of learners from the Diversity and Inclusion Champion and Professional Development Certificate Program.

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Where will your breast implants be placed?

breast implant location

If you are considering breast augmentation there are many questions you will want to have answered by the plastic surgeon before making your final decision.

Among a host of other important questions that you should ask during your breast augmentation consultation is “where the breast implants will be placed?”

Many patients are not aware that there is an option when it comes to the placement of the breast implants. Implants may be placed either over the muscle or under the muscle, and there are several factors which help determine the optimal implant placement for each individual patient, including:

  • Your body type
  • Your current health
  • The actual size (cc’s) of the implants
  • Saline vs silicone implants
  • Your individual goals and desires

Board-certified and experienced plastic surgeons who have performed a high volume of breast augmentation surgeries will be able to direct the best position to determine optimal implant placement, and it is extremely important for breast augmentation patients to understand the pros and cons for the two different placement options.

Subglandular placement

Also known or referred to as “over-the-muscle” placement, the subglandular placement technique is where the implant is positioned between the chest muscle and the existing breast tissue areas. The over the muscle positioning is done so the implant lies below the glands of the breast, thus providing the ability for the patient to breast-feed in the future.

PROS: Patients tend to have less movement of the implants during physical activity, as well as less discomfort immediately following the surgery.

CONS: The appearance can me more artificial. In addition, during mammograms the readings may be less accurate. Also, patients may experience a higher rate of capsular contracture, which occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant.

Submuscular placement

The other option is known as submuscular, or under-the-muscle placement of the breast implant. This technique includes placement of the implant partially under the pectoralis major chest muscle.

PROS: Patients experience more accurate mammograms. In addition, the submuscular placement tends to produce a more natural appearance, and a reduced rate of capsular contracture.

CONS: Some patients experience slightly more discomfort after surgery, with a longer postsurgical recovery.

The role of the chest muscle

The muscles in the chest play an important role in breast augmentation procedures with regards to optimal placement of the implants. Each individual patient will vary in the amount of muscle they have and this could be a factor in determining whether subglandular or submuscular placement is best.

The anatomy of each patient must be factored in. For example, women who have very large or strong chest muscles will be best suited for over-the-muscle positioning of the implants. One reason for this is with larger chest muscles there will be a tendency for distortion of the breasts as the chest muscles move and are flexed. In these cases, subglandular placement is advised.

How much breast tissue is present

In addition to the muscle density and mass, the amount of tissue in the breast area before surgery will also have an impact on where the placement should be for optimal postsurgical results. When there is a significant amount of breast tissue, there will be adequate soft tissue coverage making the pectoralis muscle superfluous in this regard.

As you move through the process of selecting your breast surgeon, and during your consultation about the procedure, you will want to discuss the placement of the breast implants, going over which option – over the muscle or under – will be best for you.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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