Tips « The Professional Geriatric Care Manager’s Blog

National Women’s Health Week

May 17, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Advocacy, Health, Life, News, Personal, Safety, Tips

May 13^th-19^th is National Women’s Health Week. It is a very important week that women really need to look deep into, taking some personal time and care for one’s self. This week-long health observance was coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health. It brings together communities, businesses, government, health organizations, and other groups in an effort to promote women’s health. The theme for 2012 is “It’s Your Time.” National Women’s Health Week promotes women making their health a top priority. It will also encourage women to take the following steps to improve their mental and physical health and lower their risks of certain diseases. Women need to:

Visit a health care professional to receive regular checkups and preventive screenings: mammograms and pap tests, a colonoscopy, and cardiac testing.
Get active and start a regular exercise program. Regular activity can help prevent unhealthy weight gain and also help with weight loss.
Eat Healthy: eat lots of fresh fruit and vegetables, fat-free or low-fat versions of milk, cheese, yogurt and other mild products. Incorporate of fish, skinless poultry, lean red meats, beans, eggs and nuts. Avoid saturated fats and Trans fats. Low sodium and no added sugar are very important to follow in a women’s diet.
Pay attention to mental health, including getting enough sleep and managing stress.
Avoid unhealthy behaviors, such as smoking and not wearing a seatbelt or helmet when riding a bicycle.

With National Women’s Health Week, we remind women everywhere that they need to visit the doctor, make sure their screenings are up to date, and just take time to think about their own health.

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange County with nurses licensed in New Jersey and New York. We help families dealing with various issues related to their elderly loved ones and would be happy to discuss any concerns you may have related to long term care.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

The Goodness of Red Wine

May 3, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Dementia, Diet, Health, Prevention, Red Wine, Reservatol, Study, Tips

A few years ago there were many publications on research studies on the active ingredient in red wine known as resveratrol. Scientists discovered that red wine could help protect people at high risk from heart disease and diabetes.

Researchers discovered that an antioxidant found in red grapes can lower blood sugar levels and reduce blood pressure. Resveratrol is a phytochemical, which is found in the skins of red grapes, peanuts, blueberries and blackberries is now also being studied for assisting in preventing dementia and as well as decreasing progression of dementia.

A 2007 study of elderly Italians showed that drinking alcohol in moderation may slow the progression to dementia in elderly people who already have mild mental declines. Defined in the study as less than one drink a day, low to moderate drinking was associated with a significantly slower progression to dementia among people with mild age-related cognitive declines, this was compared with non-drinkers.

Resveratrol acts to slow the progression of dementia, as it is explained by a study published in the 2004 “Journal of Neural Transmission.” Researchers explain that memory deficits can be decreased by antioxidants, like reseveratrol, as they are able to do so by decreasing inflammation and oxidative damage to brain cells.

Cornell University neuroscientists published a report in 2009, with direct evidence on how resveratrol produces a neuroprotective effect in Alzheimer’s patients. Cornell’s research group studied mice given an experimental effect in Alzheimer’s patients. The mice were given resveratrol for a period of 45 days. Their brains were evaluated to see if they were suffering damaging inflammatory plaques normally found in Alzheimer’s patients. It was found that the plaque formations had been reduced by 48% to 90%. Accompanying these changes were also increases in brain antioxidant molecules. They felt that this was a successful study that leads to the conclusion that dementia or Alzheimer’s could be delayed or reduced.

I had just completed an article about the Mediterranean diet and how people in that part of the world tend to consume red wine on a regular basis and they live about 10 years longer than any another population. Studies have shown that Alzheimer’s disease is less common in populations that consume moderate amounts of red wine. I heard a Neurologist speak last week about this topic and he believes very strongly of the positive benefits from red wine and resveratrol. He recommends that all his patients drink a glass of red wine every day, as long as they are not on any medications that would be affected by the consumption of alcohol.

Ever since his presentation last week, I have been trying to drink more red wine with dinner. I’ve started to like wine a little more after researching for today’s blog.

Before you go running to the store and purchasing bottles of red wine, please speak to with your medical doctor and make sure it is safe for you consume red wine.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283

Why Just Drink Plain Water. Try Sparking Water Instead.

April 12, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Health, Life, Tips

I decided to look into the facts about carbonated water (seltzer or sparkling water). You may have swapped out your daily soda for sparkling water, or you just like to drink something that has bubbly stuff because plain water can is too boring -I wanted to see how healthy carbonated water really is.

Fizzy water is not only refreshing, but it also can hydrate your body as well as regular old water. Carbonated water is created (or exists naturally) by dissolving carbon dioxide (CO2) in water. This creates carbonic acid, which is more acidic than regular water; it falls more in the range of apple or orange juice, but is much less acidic than stomach acid.

You may have heard that carbonated water can cause erosion of tooth enamel, but not to worry, because the damage is minimal; and one would have to drink huge amounts of sparkling water in order to wear away enamel faster than it’s renewed. But, in a 2001 study the Journal of Oral Rehabilitation showed that sparkling mineral waters showed slightly greater erosive potential then water. Soda, on the other hand, contains phosphoric acid, which can definitely rot your teeth. I also know from speaking with a doctor years ago, that soda can cause calcium loss from your bones and lead to osteoporosis. No studies have been found to back this up from drinking sparkling/carbonated water. Actually, I read that drinking it may even help keep calcium locked in your bones.

I really like flavored sparkling water; while many varieties are enhanced with natural fruit juices, others contain sugar or artificial sweeteners. So be careful reading labels and avoid unnecessary calories. Some mineral water or club soda can also contain high amounts of sodium, which can contribute to high blood pressure. But, they do make sodium free seltzer that is a good substitute.

The other real health concern with drinking carbonated water is the aggravation of irritable bowel syndrome due to the release of CO2 which could cause bloating and gas. So if you suffer from irritable bowel syndrome, it may be best to limit or avoid drinking any carbonated beverages. If not, carbonated water is a good way to increase water intake and is also a very refreshing way of diluting the calories in high calorie beverages like juice and white wine. My son’s favorite drink is cranberry juice diluted in seltzer. He loves it!

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

Time To Clean Your Kitchen

April 5, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Family, Help, Life, Tips

It is now spring once again and there are so many things to look forward to during this time of year. But, really, who wants to clean their kitchen? Martha Stewart is the only person I could think of! Spring and the upcoming holidays give us all a change to catch up on some spring cleaning. We all know that the heart of the home—is your kitchen.

I found this great tip list on Real Simple Magazine website from this past March 19^th issue.

As you’re cleaning, make a list of things that you need to replenish in your kitchen, from cleaning supplies to basic cooking items. Hand soap, dish soap, paper towel, cooking oil etc. and write it all down.

Give your sink a good scrubbing. Keeping your sink clean is a good way to get inspired to do the dishes instead of leaving them pile up. Fill the sink to the rim with water and pour in a cup of bleach to disinfect it. Scrub the inside of you wink with baking soda to get rid of the extra tough stains. Rinse and finish with a shining spray or wipe.
Empty out you cupboard and drawer, sweep out crumbs and dust and clean any stains with a wet cloth. Keep an eye out for frozen dishes and other kitchen accessories. Donate or throw them away. If you’re up for it, put new contact paper on the bottom of draws or shelves.
Clean the exterior of your cabinets and drawers. You may be surprised at how different your kitchen looks when all the fingerprints have been wiped off.
Organize your pantry. Throw out anything that’s expired, including canned goods, herbs/spices, cereals, cake mixes or just anything that has been in there for too long. Anything that’s been in there longer than a year may have gone stale.
Clean your refrigerator and freezer. Do a thorough cleaning after you have thrown away all expired or unwanted food. If your shelves are removable, take them out and wash them in the sink or dishwasher. Scrub out the inside of your fridge with a wet, soapy cloth. Wipe everything clean with a damp cloth.
De-clutter the front of your refrigerator. Make sure you emergency contact list is up front and visible.
Clean your microwave. To get tough gunk off, fill a microwave-safe bowl with water and microwave it on high for a few minutes. Keep doors closed for a couple more minutes to let the steam work on spills, then wipe everything down with a soapy rag. Rinse and wipe dry.
Deep clean floor. Sweep under the oven and refrigerator.
Dust and wipe down walls, baseboards and the top of the refrigerator.
Wash the insides of your garbage cans. Try using a strong bleach-and-water solution. Rinse them out and let them dry outside.
Clean drains and garbage disposal. Run a lemon or cup of white vinegar through your garbage disposal to get rid of any unfortunate smells.
Clean your oven and give your stove top a good scrubbing.
Run your dishwasher while it’s empty. Add a little white vinegar to it beforehand to get rid of any odors. If you have a food trap in the bottom of you dishwasher, clean it out.

I hope these tips above that I have found are useful to you and your family. Happy Spring Cleaning!

Gastrointestinal Infections on the Rise

March 30, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Health, Life, Personal, Prevention, Safety, Tips

The majority of gastrointestinal infections typically involve diarrhea, vomiting, and abdominal cramps and those infected make a full recovery after a few days. Increasingly, gastrointestinal infections are responsible for more deaths in the United States, particularly in the elderly.

The Centers for Disease Control and Prevention reported that deaths from gastrointestinal infections more than doubled from 1999 to 2007. The majority of those deaths were due to the bacterium, Clostridium difficile. The second leading cause of death from gastrointestinal infections was due to the norovirus. Individuals most often contract Clostridium difficile in hospitals and nursing homes, and in most cases occur primarily among those taking an antibiotic. C. difficile bacterium has two forms, an active infectious form that cannot survive in the environment for prolonged periods and a nonactive form that can survive in the environment for weeks and even months. This form cannot cause infection directly, but when ingested can transform into the active infectious form. The spores can be found on bedpans, toilet seats, furniture, linens, telephones, stethoscopes and floors. It takes bleach or other strong disinfectant to kill the spores. The disease is spread by the fecal-oral route, which makes hand washing after using the toilet so important.

Since healthcare settings are responsible for so many cases of C. difficile, it is important for surfaces to be cleansed with bleach and for healthcare workers to wear gloves and gowns when dealing with infected patients to prevent spreading germs to others.

Individuals with C. difficile can have a high fever, severe diarrhea and abdominal pain which can lead to dehydration and disturbances in the electrolytes in the body. Increasingly, C. difficile has become virulent and drug resistant. Since the overuse of antibiotics can cause C. difficile, all antibiotics should be used prudently. Using antibiotics without an accurate diagnosis or proper reason should be discouraged.

The norovirus causes a highly contagious infection. It is sometimes called the winter vomiting illness and spreads rapidly on cruise ships, prisons, dormitories, hospitals and nursing homes. Symptoms include vomiting, watery diarrhea, fever, stomach pain, tiredness, headache and muscle aches. Symptoms may be more severe in elderly patients. Individuals with the norovirus who are unable to replace their fluids and develop signs of dehydration will need medical care. As with C. difficile, norovirus infections can be prevented using good hand hygiene.

In the past few years, researchers have found deaths from gastrointestinal infections have leveled off. Doctors, nurses, other healthcare workers, hospitals and nursing homes need to continue to take responsibility for preventing gastrointestinal infections as the majority of all gastrointestinal infections occur in healthcare settings.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

Great Benefits From Walnuts!

March 29, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Health, Life, Memory, Research, Tips

Last week as I was driving in my car and listening to a news station on AM radio. During a commercial break, Dr Oz came on to advertise California Walnuts. He spoke about how wonderful they are for your health and how he eats walnuts with just about every meal. This is what Dr Oz states about walnuts “They are, in my mind, one of the best foods around. Walnuts are portable, healthy and satisfying, and they provide the body with plenty of Vitamin E, manganese, copper and omega-3 fatty acids.” I usually never really pay attention to Dr Oz, because he is all over the place with medical information and I think he is too extreme on many issues.

I have done a blog on high fiber foods and spoke about almonds, so I figured I’d focus on walnuts this time. I have been reading many interesting articles that speak of wonderful facts and even research studies that have been developed for elderly people to see how walnuts are so beneficial in their diet.

The study that I read about was conducted by researchers with the Human Nutrition Research Centre on Aging (HNRCA) at Tufts University in Boston.

They used rats in this study to test their memory and motor skills. The rats were fed a mixed diet containing two, six or nine percent of walnuts in their diet, or no walnuts at all. The study found that in aged rats, the diets containing two or six percent of walnuts were able to improve age-related motor and cognitive skills, while the nine percent walnut diet also improved in memory. The study stated for comparison, the six percent walnut study diet was equivalent to eating about seven to nine walnuts daily.

I also read that walnuts have also been shown to help reduce stress and help with sleep. A 2010 study in the Journal of the American College of Nutrition found that individuals whose diet was supplemented with walnuts or walnut oil had better responses in stressful situations. Walnuts contain melatonin in a bio-available form. Melatonin is a hormone which is involved in inducing and regulating sleep and is also a powerful antioxidant. Walnuts sound like a like the perfect snack for getting a natural good night’s sleep. Other studies have found that walnuts may help reduce the risk of heart disease and diabetes.

Enjoying just 4 walnuts a day significantly increased blood levels of omega-3 essential fatty acids, alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). EPA is a longer-chain omega-3 fat and is found in cold water fish, but is not found in nuts, which contains the shorter-chain omega-3 fat, ALA. But, a study confirms, our bodies can make EPA from the ALA provided by walnuts, which are the richest source among all the nuts. A recent study, was published in Nutrition, Metabolism and Cardiovascular Diseases, showed that even a very simple change in diet by adding walnuts, can have very beneficial and long-lasting effects on one’s health.

Increasing your body’s supply of anti-inflammatory omega-3 fatty acids couldn’t be any easier, by just adding a few walnuts to your morning cereal, your evening salad or a handful just before bedtime for a healthier you. Dr Oz would have to agree to this.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

The Benefits of Vitamin D

March 16, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Diet, Education, Health, Life, Personal, Tips, Vitamins

Vitamin D is a fat soluble essential vitamin. It has been used to treat weak bones or osteoporosis and for preventing falls and fractures in people at risk for osteoporosis. Vitamin D is also used for conditions of the heart and blood vessels, including high blood pressure and high cholesterol.

Research has shown that increasing blood levels of vitamin D may additionally protect an individual from chronic or life-threatening diseases, such as diabetes, obesity, muscle weakness, multiple sclerosis, rheumatoid arthritis, chronic obstructive pulmonary disease, asthma, bronchitis and tooth and gum disease. It is also used for boosting the immune system, preventing autoimmune diseases and cancer. In addition, deficiencies of vitamin D may be responsible for neuropsychological disorders including depression and memory loss.

Sun exposure is an easy way for individuals to get vitamin D. The necessary exposure time varies with age, skin type, season and time of day. Ten to fifteen minutes of sunshine three times a week is enough to produce the body’s requirement of vitamin D. The sun needs to shine on the skin of your face, arms, back and legs.

Vitamin D deficiency is common. Individuals stay indoors more, cover up when outside or use sunscreen to reduce skin cancer risk. The elderly are particularly at risk for vitamin D deficiency. They are less likely to spend time in the sun, have fewer receptors in their skin that convert sunlight to vitamin D and may not get enough vitamin D in their diet.

It is difficult to get enough vitamin D from food sources alone. Very few foods naturally have vitamin D. Vitamin D can be found in small amounts in a few foods including fatty fish such as herring, mackerel, sardines and tuna, beef liver, cheese, egg yolks and mushrooms. Vitamin D has been added to most dairy products, some juices, cereals and soy beverages. Some individuals may have to take a vitamin D supplement in order to boost their level. The Recommended Dietary allowance for vitamin D for those age 9 to 70 is 600 IU daily. Adults over age 70 should take 800 IU daily.

The best measure of an individual’s vitamin D status is a blood level. Levels below 30 ng/mL are too low for bone or overall health and require a supplement. Vitamin D is important to the body in a number of ways. As with all medications and supplements, speak to your doctor, pharmacist, or other healthcare provider about starting a vitamin D supplement. Vitamin D may interact or interfere with one’s prescription or over-the-counter medications and how your body absorbs or uses them.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

Hepatitis A In The Elderly

March 15, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Aging, Health, Life, Personal, Prevention, Tips

Today I went to see one of my long term clients who happens to be 80 years old. She has been living in a skilled nursing facility for over a year now and has been doing very well. She loves everything about the facility, except for the food. She really misses her own home cooked foods that she loves and is part of her ethnic background, which she is so familiar with. She is a beautiful Japanese woman who really misses her Sushi and Sashimi.

As her Geriatric Care Manager, I explained to her that the facility does not offer Sushi to their residents and that I also needed to speak with the Dietician on staff about the safety perspective of bringing food in from the outside, and also needed to consider her medical history and what foods she may be restricted from.

The Dietician educated me that eating raw fish or oysters can contribute to food poisoning. Food poisoning occurs when you consume toxins, bacteria or viruses from water or food that contains harmful substances. Symptoms of food poisoning include nausea, diarrhea, abdominal cramps, headache, weakness and nausea and vomiting.

Sushi lovers are at high risk for Hepatitis A virus infection. Hepatitis A, or HAV, is an acute viral infection of the liver. Symptoms of liver infection are similar to food poisoning; nausea, vomiting, diarrhea, exhaustion, jaundice and pain in the right upper abdomen. HAV is caused by the transmission and ingestion of microscopic contaminated feces that can be found on or within fruit, raw vegetables, drinking water or exposure to an infected person who showed lack of hand washing.

You need to be extremely careful of what restaurants you choose to dine in and the safety that is necessary during your own home preparation of food. Stay with what you know best. According to the Centers for Disease Control, most healthy people recover from HAV infection without complications and could even develop immunity again re-infection. But, HAV exposure in older adults my cause severe and serious symptoms, with risk of both morbidity and mortality and this could increase with age. There are vaccinations available to you for both Hepatitis A and B for its prevention. People that do a lot of traveling to many countries are encouraged to get the Hepatitis A vaccination. Please ask your own physician about the Hepatitis A vaccination and see if they feel it is right for you.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450

The “Good Bacteria” Found in Yogurt

March 8, 2012 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Health, Life, Personal, Prevention, Tips

I remember, as a little girl, the TV commercial for Dannon Yogurt. The commercial starts off with a choir of Russian men singing and dancing. Then the camera closes in on one particular man. Then the voice-over talks about how great Dannon Yogurt is and that the older man agrees with this because he has been eating the yogurt for 105 years.

The history of yogurt and other fermented milk products have primarily been accidental discoveries, as a result of milk being stored by primitive methods in warm climates. Historians attribute yogurt being developed by the people of Central Asia around 6000B.C.. Herdsmen began the practice of milking their animal, and the natural enzymes in the carrying containers curdled the milk, essentially making yogurt. The milk then kept longer and it was thought that people preferred the taste, so they continued the practice of making yogurt, which then just evolved over centuries into our commercial yogurt making. We have the Turkish immigrants to thank for bringing yogurt over to North America in the 1700s.

Yogurt is so popular today, it seems as if a new frozen yogurt shop opens every month. Yogurt is so important, it’s been found, because of the positive benefits from Probiotics, which are the “good bacteria” that we receive from eating foods like our so loved yogurt and kefirs or can also be found in pill-formed dietary supplements. “By definition, a probiotic is any substance containing live-active organisms that, when ingested, have a beneficial effect on the host by altering the body’s intestinal micro flora,” says physician Robynne Chutkan, Associated Professor of Medicine at Georgetown University Medical Center in Washington, D.C. The theory is that certain strains of these live organisms are good bacteria and can then override the effects of all the bad bacteria in the stomach.

As a geriatric care manager, I have seen many physicians prescribe or recommend probiotics when they place their patient on an antibiotic. Antibiotics wipe the intestines of the bad and the good micro flora, which can be harmful to the person by decreasing their immune system, leading them at risk for other infections. The following information will provide you with more knowledge about the great benefits from yogurt and probiotics.

Fights against inflammation.
Reduces the risk of digestive disorders, colon cancers, inflammatory bowel diseases and infections caused by Helicobacter pylori- bacteria that causes infections on the upper and lower digestive tract.
Enhances the function of the immune system.
Reduces the risks of high blood pressures.
Reduces cholesterol levels.
Promotes healthy bone development.
Decreases and heals the chances of having arthritis.
Prevents vaginal infections.
Prevents diarrhea.
Heals symptoms of lactose intolerance.
Helps alleviate constipation.

Not only does yogurt contain live-active cultures of probiotics, it also contains calcium, riboflavin, vitamin B6, and vitamin B12. I encourage my family and my clients to eat yogurt with active cultures on a daily basis. It would be so wonderful if we all could live a long and healthy 105 years, just like the man I saw on that Dannon commercial.

Aging Eyes

March 2, 2012 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Aging, Eldercare, Health, Help, Life, Personal, Prevention, Tips

Your circadian rhythm is a biological clock that regulates many of the systems of your body, such as the sleep-wake cycle, the temperature regulation system and the endocrine system. Circadian rhythms are responsible for rallying the body in the morning and slowing it down at night so the body will rest and rejuvenate. The malfunction of an individual’s circadian rhythm causes circadian rhythm disorders leading to insomnia, heart disease and cancer.

Most of the time your biological clock or circadian rhythm is in sync with the 24 hour day-night. In some individuals, the circadian rhythm is out of sync due to several reasons, which include travel, shift work or neurological diseases such as Alzheimer’s. Symptoms found in individuals with circadian rhythm disorders include difficulty initiating sleep, difficulty maintaining sleep, daytime sleepiness, poor concentration, decrease in cognitive skills, headaches, gastrointestinal distress and poor psychomotor coordination.

Recently researchers have been studying the effect of the aging of the eyes as one of the reasons for some of the health problems that come with age. As we age there is a gradual yellowing of the lens of the eye and a narrowing of the pupil, which results in less sunlight getting through the lens and reaching key cells in the retina, which regulate the body’s circadian rhythm. Studies indicate that by age 45 the photoreceptors, cells in the retina that absorb sunlight and transmit messages to the part of the brain which governs our internal clock, receive only 50 percent of the light needed to stimulate the circadian system. By age 55, it is only 37 percent, and only 17 percent by the age of 75. Due to these changes it is felt that as an individual ages they should make an increased effort to expose themselves to bright sunlight or bright indoor lighting when they cannot get outside. Often older adults spend more time indoors and put themselves at increased risk.

The eye’s role in maintaining good health is becoming increasingly evident. In order to decrease some of the conditions that occur with age, such as depression, slower reaction time, memory loss and insomnia, it is important that the eyes get the proper light exposure they require to maintain one’s circadian rhythm.

Please contact us in our Ramsey or Ridgewood Office to schedule a consultation. 201-587-5283.

145 N. Franklin Turnpike, Suite 311, Ramsey, NJ 07446

45 N. Broad St., Suite 503, Ridgewood, NJ 07450