TENS (Transcutaneous Electrical Nerve Stimulation) devices have been used for years for muscle and joint pain. Up until now, they have only been available by prescription.

Icy Hot SmartRelief, Omron Electrotherapy Pain Relief, AccuRelief TENS Pain Relief System are now available without a prescription and studies appear to show similar benefits when compared to their Rx cousins. These products, which are safe, work by transmitting low voltage electrical impulses which then decrease pain perception by the sensory nerves. These devices do not work for everyone and should not be used in patients who have a pacemaker, epilepsy or are pregnant.

Wearable medical devices: The future is now

Imagine a world where otoscopes attached to your smart phone or other monitors that fit inside pendants, bras, socks and watches! At a recent medical conference in California, a headset was demonstrated to monitor brainwaves, an armband tracked heartbeats and jewel-like sensors monitored your sunlight exposure. There was also a device that was inserted under the skin to check on blood sugar levels. There was also a computer chip inserted into a stethoscope to aid physicians in interpreting heart sounds. All of this is made possible through your smart phone!

The biggest question is: Will computers replace physicians?



Holiday heart attacks

drinksDecember is a peak month for heart attacks, in part due to binge drinking, which can lead to heart attacks and even death, especially among people who already have underlying medical conditions.

When people binge drink, they dehydrate themselves and deplete their bodies of necessary electrolytes. The heart can go into atrial fibrillation, which occurs when the upper chambers of the heart quiver instead of contracting regularly and allow the blood to pool inside the heart.

Then, people sit down for a big meal, and their blood pressure shoots up. In some cases, the heart can’t handle all the strain and goes into cardiac arrest.

This can be especially dangerous for people who aren’t necessarily “drinkers,” but choose to imbibe during the holidays, because it can be a shock to their system.

To minimize your risks of a heart attack this season, you should avoid excessive eating and drinking, and try to pre-hydrate the day before a big party. Make sure to get in plenty of sodium and potassium.

Many thanks to Harvey S. Mishner, MD for contributing this post. Visit his website http://kaizentotalwellness.com

Harvey S. Mishner & KAIZEN Total Wellness join MAXhealth!!

We are pleased to welcome Harvey S. Mishner, MD and his team to our expanding network!

“I am very excited to announce that effective July 1, 2013, my practice and Kaizen Total Wellness have joined the MAXhealth network.” Harvey Mishner

We will maintain the same dedicated staff, personal home-like environment and state of the art equipment. As a part of the MAXhealth network, we will have the opportunity to bring you additional services and added value to your healthcare.

Harvey S. Mishner, Board Certified by the American Board of Internal Medicine has been practicing preventive medicine since 1983. He has many years experience performing stress tests, pulmonary function tests, sonographic evaluations of the cardiovascular system, ankle brachial indices and electrocardiograms as well as dietary and exercise counseling.

Also, we are pleased to announce Dr. Daniela Kassabov, board certified in Family Practice, will be joining us July 15th. She has special interests in preventive care and women’s health. Both Doctors share the philosophy of preventative medicine- that it is “much less costly to teach wellness than treat illnesses.”

The practice will offers three distinct wellness programs to meet the needs of everyone from busy executives, to athletes, to individuals of all ages who want to improve their health and physical well-being. MAXhealth Lakewood Ranch brings medical expertise, nutritional guidance, and personal physical fitness training to our three convenient and affordable locations in Bradenton, Sarasota, and Lakewood Ranch, FL.

Dr.Clulow Speaks at the Manatee Tiger Bay Club Meeting

Dr. Clulow, president of the Manatee County Medical Society spoke at the Manatee Tiger Bay Club meeting May 2.The discussion focused on whether or not there should be an increase of a half-cent to the sales tax to help finance healthcare for the poor. The sale tax now 6.5 % would increase to 7% if approved with an estimated revenue of $23 million annually. You can read the full story at Bradenton Herald. or visit manateetigerbay.org for more info

MAXhealth welcomes our new Laboratory

labAs many of you have already heard-Gulf Coast Medical Specialists is now MAXhealth. This change is a result of our efforts to improve our family of services to you, providing you with the most comprehensive, preventative  and proactive healthcare  available to you. This include the addition of our new physician (POL) laboratory services, conveniently located just outside our office. We are open from 7:30-4pm, and our staff works after hours to ensure fast delivery of test results.

Here at MAXhealth we know your time is valuable, and we want to give you accessible healthcare so you don’t have to go far next time you need lab tests done.We work hand in hand with your doctors to improve patient care by offering timely and high standard laboratory tests and services with our new state of the art equipment. We strive to provide our test result with the highest accuracy and any additional information that may help your doctor further diagnose the cause of your illness.

Our laboratory services range from general lab work such as blood counts to highly complex tests that assist doctors in diagnosing many types of diseases, tumor markers, and other conditions. We specialize in testing in areas such as hematology, oncology, cardiovascular disease, etc.

Our Lab uses electronic records, keeping open communication between your providers, doctors, specialists, and diagnostics. So if we notice any abnormalities in your test results we will notify your doctor immediately as well as call you and inform you of your test results, and answer any questions you may have. We, along with MAXhealth team provide you with the support and resources you need to give you the highest quality care and preventative services available to you.






Gulf Coast Medical Specialists is now MAXhealth

Name change
Name change

As many of you may have already heard…
Gulf Coast Medical Specialists joined the MAXhealth Network in June of 2012.  In conjunction with some of the great new services we will be offering, we are changing our name.  Effective May 1, 2013 –

Gulf Coast Medical Specialists is now MAXhealth.

Don’t be alarmed when you see MAXhealth on your bill, hear MAXhealth when your give us a call or walk into the office and see an unfamiliar name. This change is a result of our efforts to improve our family of services, because we believe you deserve the best care available to you.

We have maintained the same amazing doctors, staff and personal services.  And, in an effort to give you the most comprehensive, preventive and proactive healthcare – MAXhealth now offers Medical Specialists, Laboratory Services and Diagnostics.

We want to hear from you, so tell us how we are doing.  Patient feedback is the best way for us to improve.  Visit our website at www.mymaxdoc.com or e-mail at info@mymaxdoc.com.


MAXhealth Proudly Welcomes Bradenton Physicians Medical Center To Our Family!!

We are excited to introduce the newest addition to our MAXhealth family: Bradenton Physicians Medical Center!! Dr. Aruna Narasimman, Dr. Werther Marciales, Dr. Shahnaz Ahmed, Dr. Suguna Kona, and Carol Lewis, ARNP, are delighted to continue to serve our community under their new roof. (We fondly refer to them as BPMC, and welcome our patients to do the same!) After much anticipation and hard work by the physicians, staff, families, and many more, we are pleased to welcome our Manatee community to schedule appointments in our beautiful, state-of-the-art, new facilities. Click here to learn more about our physicians! THANK YOU to everyone who helped us to open our doors, and we look forward to having all of our past, present, and future patients visit us in the new office! We are currently accepting new patients! Please call us at 941.357.5550 to schedule an appointment today!

Medical Myths

Do we really need to drink 8 glasses of water daily?  Should everyone be on a daily aspirin or multivitamin?  Medical myths, or half-truths, are just that.  There is no scientific evidence behind these claims.  These myths, for one reason or other, have pervaded and persisted into our popular culture.
We don’t necessarily need to drink a full 8 glasses of water a day.  The majority of fluids we need to stay hydrated are already found in the food and drinks we take in during a typical day.  Too much water can actually be toxic!  We actually use more than 10% of our brains!  Studies show that there are no silent or dormant areas of brain activity.  Not everyone should be on a daily aspirin.  Aspirin benefits those who have known cardiovascular disease, but not for those who are generally healthy.  The risks of bleeding can actually outweigh the benefits.   Daily multivitamin or supplements only benefit those with a true vitamin deficiency (B12, folate, iron, Vitamin D), osteoporotic, and pregnant patients.  A daily multivitamin has not been shown to prevent chronic disease.  Too much supplementation can actually be harmful, as extra vitamin E can actually increase prostate cancer risk.
Some physicians, when queried, even believe some of these myths to be true and are espousing the messages to their patients.  Albeit, the majority of the myths are harmless, we as physicians and educators owe it to our patients to provide the best evidence based medicine.

Coffee Consumption Lowers Mortality

Yes, I had to do a double take when I read that headline.  I enjoy my latte just as much as the next person and the idea that drinking coffee would lessen my risk for dying…well I had to investigate.

In the May edition of the New England Journal of Medicine, the largest study about coffee and its health benefits concluded that there was an inverse relationship between coffee consumption and total mortality.  Between 1985 and 2008, as a part of the National Institute of Health-AARP Diet and Health Study, 230,000 men and 173,000 women participated.  Ages ranged from 50-71 years and those with cancer, stroke, and heart disease were excluded.

Initially, the researchers found that coffee actually increases mortality.  It was thought that those that drink coffee were probably more likely to smoke, not exercise, and eat less healthy.  After adjusting for these confounders, a truly different picture emerged.
Men and women who drank 6 or  more cups of coffee daily had a 10% and 15% decrease in their risk for death respectively compared with those who drank no coffee.  Specifically the association was seen for deaths associated with heart disease, diabetes, respiratory illnesses, infections, injuries, and accidents but not for cancer.

So, what do we make of that data?  First the study was observational meaning no direct cause and effect relationship can be totally linked.  Maybe it means that if we are already nonsmokers, exercise, and eat right, that coffee probably does not have an adverse effect on our health.
I am quite hesitant to recommend 6 or more cups of coffee to my patients.  It can raise blood pressure, possibly increase LDL ‘bad cholesterol’, exacerbate or even initiate cardiac arrhythmias, irritate GERD, and keep you up way past your bedtime.  Having said all this, I think I’ll keep my coffee consumption about the same, exercise when I can, and try to not overindulge in too many sweets.  If that helps me live longer, that’s definitely a plus.

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