I have been out of the office since Thursday, so I apologize if it has been difficult to get a response from me in a timely fashion. Fairhope, Alabama is a lovely town that is a nice tourist destination without too much heat and humidity in April. I have spent the past few days with Dr Charles Runels, the inventor of the Vampire Facelift (R), Vampire Breastlift (R), Orgasm Shot (R), and Priapus Shot (R). While I have already begun to perform all of the procedures listed above with the exception of the Priapus Shot, I wanted to see firsthand how the originator of the procedures performed them as well as obtain firsthand experience with the Priapus Shot and Dr Runel’s latest innovation to restore hair loss.

First, a rundown of the procedures… The Vampire Facelift will treat aging skin and restore lost volume and is an excellent add-on to improve the outcomes of the Bladeless Facelift and Precision Tx procedures to remove sun damage, age spots, and deep wrinkles. I have been very impressed with our own patient’s outcomes from combining the above procedures resulting in decreased down-time from redness and swelling with even greater improvements that ever seen previously. The Vampire Breastlift can be used to naturally increase or restore breast volume, correct nipple inversion, and improve the look of aging breast implants. Excellent results thus far with our own patients! The Orgasm Shot (O-Shot) will help restore the vagina to a younger state and has been used to treat urinary incontinence, painful intercourse, and vulvodynia. I have personally injected three patients already with reported improvements in sexual satisfaction from both the patient and partner. I have been even more impressed with the report from a patient that has suffered from vulvodynia (pain in the vaginal area) that is very similar to migraine headache type pain and can be incapacitating when it occurs. This patient had experienced vulvodynia for more than 10 years and was extremely discouraged with the treatment options offered by “modern” healthcare. After her initial treatment she reported a 70-80% improvement in her pain within the first week. This is for a procedure that doesn’t achieve peak results until up to three months after treatment. Truly life changing!

Now for my procedures… The Priapus Shot will help rejuvenate and enlarge the penis and has been very successful in improving the erectile dysfunction that normally occurs as part of the aging process but is usually made much worse by prostate surgery and diabetes. I have long believed that I need to personally experience the procedures that I perform. While I’m not a candidate for the O-Shot due to my anatomy, I have the required hardware for the Priapus Shot. So… yesterday I was able to experience both the Priapus Shot as well as treatment for my receding hairline. I wouldn’t compare either procedure with getting a massage but both were very tolerable WITHOUT the benefit of local anesthesia. (I don’t expect my patients to forego local anesthesia for any of these procedures.) I will keep our readers updated on both my own results as well as the results of our patients through our Constant Contact emails as well as our Facebook posts. Next- the science behind the names.

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, FAA AME, paramedic, ski patroller, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. Comments or questions? His email address is: DrRath@FusionMedicalSpa.net.

Last year’s January article was entitled New Year, New You! The article’s main point was for readers to become more involved in their personal health. In 2014, health care changes bring even more reasons that we should be involved in taking care of our selves. However, there’s a twist. It requires a vested interest in a new partnership.

I’m an optimist. While I have yet to speak to a single physician that believes the Affordable Care Act (ACA) will improve health care in the United States; I hold the hope that we may actually be able to make a little progress toward better health care. As a United States Air Force flight surgeon, I find similarities between the system the ACA proposes and the system that we use to take care of our military members and veterans. As both a current military member and a veteran, I have been able to experience the services provided within both systems and have been satisfied with my health care.

Does my satisfaction have anything to do with knowing that I could trust the system to ensure that my annual wellness visits, my blood work, and required exams were taken care of? Not a bit! My satisfaction came from knowing that my vested interest kept the train on the tracks. I learned the hard way that I always needed to keep a copy of any military record. More than once I had to produce my copy to ensure that I wasn’t charged for an item that I had returned to the supply sergeant or to prove that I had received the required immunization. Our systems will always be fallible. We will always need to take a personal interest to ensure that our concerns are well represented. After all, who cares more about you than you? (Okay, your mother may be an exception, but it is doubtful that she will be involved in your healthcare).

New Year, New Methods. We have all tried things in the past that haven’t worked very well. Call any gym in the world and ask when their membership picks up. January! The gym is always crowded the first 2-3 weeks of January as the New Year’s resolutioners try again to desperately make changes that haven’t been possible in the past. Sure, there are a few folks that will still be present as winter turns into spring, but the majority of the new members will have given up. Why? Change is difficult!

We need to change more than just the surface level. For change to survive it has to be systemic. Systemic change requires help. Going to the gym on your own hasn’t worked in the past, so find a personal trainer. Kicking that habit didn’t happen, so enlist the aid of a life coach or counselor. You weren’t able to keep the weight off on your own, so get professional help!

I would like to say that my military training and background prepared me to go it alone and do well throughout life. I was certainly well prepared to stand on my own through any manner of difficulty. I appreciated the camaraderie and fellowship that is difficult to achieve outside the military. However, it wasn’t until I got married that I truly appreciated the value of having someone that would always have my back.

The New Year is an opportunity for change. Stale marriage? Invest more time with your spouse and change it! Stale sex life? Work on improving your libido and spice things up! Stale body? Shape it!

Enlist someone else’s help. Going it alone hasn’t worked well in the past. Try partnering with someone else!

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, FAA AME, paramedic, ski patroller, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He is very fortunate to have found a loving partner that doesn’t complain while she puts up with his other interests. Comments or questions? His email address is: DrRath@FusionMedicalSpa.net.

I don’t think of myself as an easily excitable person. As an anesthesiologist and paramedic I have had to face many critical situations with trauma patients and maintain my cool to ensure that I provide optimum medical care. As a pilot I can’t get excited and lose sight of the big picture while flying. That said, I am truly excited about changes and developments in the aesthetic medicine world as well as in my medical practice.

Allergan, world famous for bringing Botox to the market, recently obtained FDA approval to start marketing Juvederm Voluma in the United States. According to Allergan, only the top 20% of aesthetic medicine practices are eligible to purchase Voluma for the initial rollout and Fusion Medical Spa has already received its first shipment! Voluma, approved for use in Europe for more than 3 years, received FDA approval in October 2013 and was released by Allergan in time for Christmas in December 2013. Voluma “reverses signs of age-related volume loss in the mid-face” with results lasting up to two years in the majority of subjects.

Why is this exciting? We have a new dermal filler that, in my opinion, will revolutionize how we treat typical signs of facial aging. Volume loss in the mid-face and cheek area is one of the major reasons that women come through the door of my practice. Volume loss in women usually starts to become apparent in the early 30s and continues to progress as age increases. This volume loss, accentuated by decreased skin elasticity, causes the cheeks to descend until the smile and then the lower jaw and neckline are affected. Voluma can reverse this volume loss better than any previous fillers.

I was even more excited to learn that Fusion Medical Spa had achieved “Gold” level status with Allergan. Gold status is reserved for the top 15% of Allergan’s aesthetic medical practices. We achieved this status in less than 3 years! Not bad for a practice located in Ruidoso, New Mexico.

Decreased volume and descent of the mid-face accelerates the look of facial aging. Unfortunately, the descent doesn’t stop at the neckline. Descent of bodily fat tends to accumulate around the mid-section and contributes to an increase in clothing size. Fusion Medical Spa recently received an early Christmas present to combat fat and cellulite from Cynosure.

The Smartlipo TriPlex system is Cynosure’s newest laser liposuction platform designed to treat stubborn fat, tighten loose skin, treat cellulite, and eradicate overactive axillary sweat glands. I have been following the progress in laser liposuction for the last three years and am confident that our new platform will allow us to treat issues that have historically been difficult to treat with traditional liposuction. Smartlipo laser liposuction is a vast improvement on older technology as it melts fat and tightens tissue simultaneously while allowing faster recovery.

Finally, Fusion Medical Spa will celebrate three years in operation as of December 27, 2013. My family and I have enjoyed the warm welcome that we have received since our transplant from Texas and we are happy to be a part of the Ruidoso community. Thanks for making our business a success!

Merry Christmas!

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, FAA AME, paramedic, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He is happy that his long walks on the humid Galveston beaches have been replaced by brisk walks in the mountains. Comments or questions? His email address is: DrRath@FusionMedicalSpa.net.

Winter is officially here as the Ruidoso area has been through two large storms this season with more predicted to follow. I’m excited! Winter brings new opportunities for exercise to include ice skating, sledding, snowshoeing, cross-country skiing, snowboarding, and my personal favorite: downhill skiing. Many of you know that I am the medical director of Ski Apache Ski Patrol and have been a pro patroller since the 2004-2005 ski season. This year’s snow may yet rival that banner year if predictions hold out.

Winter also bring new challenges for exercise. It is more difficult to plan a daily walk and workout routines often must be adjusted. Join the RAC or get a treadmill! Gym membership is frequently less expensive than purchasing all the equipment that you should be using at the gym. A home gym is another alternative for those that find it more difficult to get out. But, beware of the home gym option! The home gym has been known to succor many suckers into thinking that getting into shape will be much easier away from others. Anessa Collins, ACE certified personal trainer has been known to pull people out of bed to ensure that they get on the ball with their workout routine. If you home workout routine has stagnated, look up Anessa!

Those that have a regular walking or outdoor exercise routines would do well to pay extra attention on our snowy or icy days. I’ll admit that I don’t think there are many things more invigorating than taking a breather after a hard workout in below freezing temperatures. That said, please take precautions to avoid a trip… to the ER. Icy roads, snowy sidewalks, and frozen ground can bring winter activities to a halt. Stay safe and warm this winter!

Winter blues? Also known as Seasonal Affective Disorder, the shorter days have a tendency to increase the risk for depression. This risk is greater in those individuals that also have symptoms of hypothyroidism. While exercise doesn’t have a significant effect on low thyroid; it has been proven to do wonders in reversing the winter blues. For the couch potatoes- the studies use an increased heart rate and respiratory rate (think heavy breathing or blowing like you are trying to catch your breath) to define exercise.

Santa doesn’t get off the hook either! A recent meta-analysis looking at more than 60,000 patients was published in the December 2013 Annals of Internal Medicine. “Metabolically healthy” obese patients had a 24% increased risk for cardiac events or death compared to metabolically health patients of normal weight. Overweight patients didn’t fare much better at 21% increased risk. So much for the “jolly old fat man”! I imagine that he will start hitting the gym this January after reading these statistics. I’ve heard that health care around the North Pole is rather limited even if you have managed to sign up for it.

Finally- what about those winter days that are so cold and icy that it isn’t safe to venture outside? I’ve got the perfect exercise routine for you! If you haven’t read the previous Ageless Medicine column entitled The Big “O” (and I don’t mean Ohio), find it on the Ruidoso Free Press website. The physical and psychological benefits of sex have been well documented and it might be safer to stay home and get your heart rate up under the covers on some of our snowier winter days. Please re-reference two paragraphs above for a good definition of exercise. If you aren’t blowing when you’re going at it you probably need to adjust your routine.

Merry Christmas!

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, FAA AME, paramedic, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He continually quarrels with his wife on the appropriateness of being able to see his breath in the bedroom, especially in the winter months. Comments or questions? His email address is: DrRath@FusionMedicalSpa.net.

Ageless Medicine or Wellness Medicine deals with keeping people feeling young and vibrant for as long as possible. I have the opportunity to address exercise, nutrition, hormone replacement, and aesthetic treatments that all play a crucial role in a person’s wellness and quality of life. I also talk about the physical and psychological benefits of sex. What does sex have to offer? Ask my patients over 70 who haven’t had sex for ten years before bioidentical hormone replacement therapy. Men and women alike say they miss it! Sex can rekindle feelings of intimacy that have been long gone. Sex done right will also lead to the Big “O”.

“Oh my goodness! He isn’t going to talk about orgasms is he?” The orgasm is the natural end point or climax to sex. Men know that orgasms are healthy. We know that it is reprehensible to fake something that has such obvious health benefits. Indeed, the December 1997 British Medical Journal (BMJ) entitled Sex and Death: Are they Related? paints a “glowing” picture of the health benefits associated with orgasms in men. Men that experienced an average of 300 orgasms per year had a 50% decreased mortality rate compared with men that only experienced 100 orgasms per year. As reported in the Men’s Journal according to Dr Michael Roizen, chair of Cleveland Clinic’s Wellness Institute, 350 orgasms per year can increase average lifespan by four years. Math isn’t my strongest subject, but 300+ per year is even a bit more frequent than the 3 times per week that both my wife and I recommend to our patients to maintain vaginal mucosal health.

Now I know at least one woman is reading this article and thinking “Hmm, so he might live four years longer with frequent sex. I can withhold sex and have him kick off sooner!” Ladies, the benefits aren’t just restricted to the guys. Ever heard the phrase “cutting off your nose to spite your face”?

So, an orgasm is beneficial in reducing the risk of death from coronary artery disease. I don’t have any major risk factors for heart disease. Are frequent orgasms important for me? Depends… Do you have risk factors for depression, anxiety, sleep disorders, osteoporosis, chronic pain, Alzheimer’s, or stress? Even if you aren’t afflicted with any of the above diagnoses you certainly have risk factors for them. Orgasms have been shown to improve all of the above!

Orgasms release many different hormones including oxytocin, endorphins, dopamine, serotonin, HGH, DHEA, testosterone, and estradiol. Oxytocin, the so-called “cuddle” hormone increases feelings of intimacy. Endorphins help the body deal with pain. Dopamine and serotonin both act on the satisfaction and reward centers of the brain and gut. (Slow bowels or IBS- try increasing your orgasm frequency). HGH and DHEA help the body recover from cellular trauma and slow down the aging process. I’ve previously written about estradiol and it’s precursor testosterone. Hormone deficient? Have an orgasm!

“But wait, doc. How can I have an orgasm with low libido?” It’s a double-edged sword. Normal libido not only makes an orgasm easier to achieve, it also makes it more likely. Feel like your body just isn’t up to par or been out of the game for too long? Bioidentical hormone replacement therapy can naturally and safely bring your hormone levels back to normal.

This article was written to highlight some of the positive health benefits associated with orgasms. Feel depressed or like you’ve fallen off the wagon after reading this? Have an orgasm! Doctor’s orders!

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, FAA AME, paramedic, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He is committed to continuing his personal research into the benefits of the Big “O”! Comments or questions? His email address is: DrRath@FusionMedicalSpa.net.

I don’t want to sound like I’m beating a dead horse but I thought writing another article in an attempt to clarify thyroid issues might be in order. Additionally, an article discussing weight issues right before we kick off the holiday season might be beneficial to some of my readers.

Since I wrote the August 2013 article entitled “My Thyroid Is Low But My Doc Doesn’t Know”, I have seen many patients who have thyroid hormone concerns. I try to have them visit www.StopTheThyroidMadness.com before their consultation as this website does an admirable job of discussing many of the issues and symptoms shared by my patients.

During a typical consultation I will go over some of the hallmark symptoms associated with decreased thyroid function. The major symptoms can include fatigue, depression, inability to lose weight or weight gain, changes in hair, skin, and nails, cold intolerance, fibromyalgia, constipation or bowel function irregularities. Then I ask the patient to tell me about the symptoms they experience and I listen to their response.

My grandfather received his Texas medical license on May 20^th, 1946. His license to practice medicine expired in 1996 upon his retirement. During his 50 year history as a general practitioner he treated numerous patients with the symptoms listed above. His medical office was a part of his house and when he wasn’t inviting patients into his house he was visiting them in theirs. He talked to his patients and then his listened. Why? Lab tests during the majority of his practice were more expensive and the results took longer than they do now. He didn’t order labs without first having a few possible diagnoses in mind knowing that if the patient was very sick, the results might come back after the patient was already dead! He practiced medicine at its finest. If a patient described a few of the above symptoms consistent with low thyroid he often wouldn’t order a lab test at all. He had the diagnosis of hypothyroidism and increased thyroid replacement (he used Armour thyroid) until the patient’s symptoms improved and they got better.

Now? We order a simple thyroid screening test called TSH. The problem with any screening test is that they are designed to screen for possible disease that might go unreported. Screening tests were NEVER designed to be used on patients that reported symptoms. “Sorry ma’am. I know that you thought your thyroid wasn’t working properly but I checked your TSH and it came back normal. You just need to stop eating so much!”

I have lost count of the weight loss patients that had a normal TSH and knew they had thyroid problems that responded well when I put them on the same medication that worked well for my grandfather 65 years ago.

How much medication is enough? Most people need between 120-180mg of natural thyroid (Armour) or 200-300mcg of synthetic thyroid (Synthroid/ levothyroxin). If you have ever been diagnosed with hypothyroidism or borderline thyroid function and are on medication- take a look at your bottle. Odds are you are underdosed and STILL HAVE SYMPTOMS.

Why would you have symptoms if your thyroid is just borderline? Your doc is doing exactly what they were trained to do. Check the TSH (never intended to be used for someone with hypothyroidism) and keep it in the normal range. TSH isn’t a thyroid hormone. It’s a brain hormone (think gas pedal) that asks the thyroid to release more T4 and T3. What if there is a blockage in the fuel filter? It doesn’t matter where the gas pedal is- you need to check the tachometer to see how fast the engine is turning (free or circulating T4 and maybe T3). Total T4 and T3 aren’t good tests either. T4 and T3 are bound (made unavailable) by thyroid binding globulin.

My wife (board-certified OB-Gyn who takes Armour thyroid) said it best. “It doesn’t matter if you use a high dose, medium dose, or mini-pill for birth control. They all suppress normal hormone release. The thyroid behaves just like the ovaries! Too little thyroid replacement is as bad or worse than no thyroid replacement. If thyroid hormone is low you need to give the body what it needs!”

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, paramedic, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. Stay tuned for an article about the Big “O”! Comments or questions? His email address is: DrRath@FusionMedicalSpa.net.