Best rated pregnancy tests online shopping? MomMed is focused on delivering helpful quality products for women trying to conceive and for expectant mothers. Its notable products are tests strips series for women and baby scales for babies. All of MomMed’s products are carefully curated to be useful during certain periods along with the conception, pregnancy, and parenthood journey. Our mission is to equip every family, and especially women who are trying to conceive, with the most professional guidance and companionship. Always be positive in life. MomMed will be with you every step of the way to and during motherhood. Read additional info at maternity products online store.

If you’re TTC and want a little more info at your disposal, you can actually purchase a pregnancy test kit. This one, from Easy@Home, includes 10 pregnancy test strips and 40 ovulation test strips. Ovulation test strips work just like pregnancy tests, but they check for a rise in luteinizing hormone (LH). This tells you if you’re likely to ovulate in the next 24 to 48 hours so you know when to get the baby-making on. Then, two weeks after doing the deed, you can use one (or a few) of the pregnancy test strips to see what happened. This is a budget-friendly option if you are going to be doing a lot of testing for ovulation and pregnancy without having to buy a bunch of separate (and more expensive) tests. You can also download the company’s free app, which helps simplify tracking your cycle.

Restrict Access To Your Breasts: Another smart approach for mothers trying to stop breastfeeding for a 2-year baby is limiting the access their babies have to their breasts. Put on several layers of clothing or a bra when cuddling with your toddler. If that happens, they will have a hard time getting to your breasts when they yank your top down in the hope of getting to breastfeed. This way, they will get a clear message that they are not getting your breasts now. Some mothers cover their nipples or apply unpalatable substances to repel the babies when they latch. When winning a nursing session becomes a struggle, your toddler will gradually lose interest and stop asking for it.

The Tummy Shield is the only highly engineered pregnancy seat belt positioner that safely redirects the seat belt away from the baby bump. It has been crash tested to prove that the seat belt still works as intended but without the possible intrusion into the belly and while eliminating the potential of the pregnant woman to slide under the seat belt causing the seat belt to move up on her belly. The Tummy Shield has been strength tested to prove it can withstand as high amount crash forces as the seat belt system itself.

In the largest study of over-the-counter pregnancy tests to date, First Response proved to be 97 percent accurate from the day of your missed period. Easy to find online and in stores, this simple, accurate, and affordable test is by far a user favorite (and can be a great choice if you just want to know — NOW!). It comes with three tests per pack, and you can buy a two-pack. In addition to being the most sensitive at-home test, First Response Early Result has an ergonomically designed handle that’s easy to hold (you’d be amazed how many sticks we almost dropped in the toilet). You can hold it under your stream of urine as you pee with no need to pee in a cup and dip. It’s also available in a digital format if you’re concerned about reading the results correctly. Read more info on https://www.mommed.com/.

Best rated ankle surgery information by Dr. Michael Moharan? Ankle surgery may be your best option to repair an ankle injury or arthritis, but any surgery can seem overwhelming. What can be even more overwhelming, though, is the recovery period after the procedure. The downtime after ankle surgery requires a great deal of patience, but there are some practices you can follow to smoothly move along your recovery process and heal faster. The following are a few key tips to help you recover quickly and effectively after ankle surgery. See additional info at Michael Moharan.

Dr. Moharan is an foot & ankle surgeon who currently holds expertise in the treatment of foot and ankle trauma, reconstructive surgery for sports injuries, arthritis, diabetes, stroke and other neuromuscular conditions. Dr. Moharan is currently serving patients at his private practice in Norwood, Massachusetts. There, he offers high quality treatment for all acute conditions, as well as treatment for chronic issues, including both medical and surgical management for foot and ankle conditions.

To help make your home as conducive to healing as possible, consider: Moving your primary sleeping, dressing, and bathing areas to the main floor of your home (as much as possible) to avoid unnecessary trips up and down the stairs. Thoroughly cleaning your home of clutter, unnecessary furniture, cords, or other obstacles that could pose tripping or navigation hazards. Setting up night lights around the house so that, if you do have to move about in the dark, you can always see where you’re going. Relocating any frequently used items (pantry items, cookware, clothing, etc.) to places where you won’t have to reach up high or bend over to access them. Installing grab bars, non-skid mats, and other aids to bathrooms, kitchens, and anywhere else you need a little extra stability.

Any surgery is somewhat traumatic for your body. Your ankles and feet are important in your day-to-day activities, so you need to be prepared for some downtime. To set yourself up for a successful outcome and quick recovery, you should begin familiarizing yourself with what you’re going to need after surgery at least a week before your procedure. You should read your post-surgery instructions a couple of times, and note any questions that occur while you’re reading the first time. During your second read-through, make a list of supplies you’re going to need.

In 2006, Dr. Moharan earned multiple medical doctor degrees from New York College & abroad. Thereafter, he went on to complete his residency at St. John’s Episcopal Hospital. Dr. Moharan also completed advanced training at Kennedy Health systems in New Jersey where he was awarded certifications in medical and surgical treatment of foot and ankle conditions. He has performed over 2000 successful surgeries of the foot and ankle , Dr. Moharan is considered an expert in the field of foot and ankle reconstructive surgery.

Reliable business visitor massage Gyeyang? Magazine Business Trip Massage Boca: The reason why we recommend all subscribers of Boca massage to use the business trip massage magazine regularly is because you can check related good information and updates of new companies while using business trip massage. Articles written on your blog can help you learn relevant new information. Or, it is helpful for the types of massage by themes that you have not known before, as well as specialized terminology and interpretation. Even if it is not such a professional learning, it is very helpful for the benefits of regional use reflected in the establishment and in real time.

However, we have introduced a deferred payment system, so it is safe. Companies that do not take measures to falsely describe their profile and age group, such as hype, should be rejected. Sometimes, it is not a prepayment, but companies that cheat employee careers and proceed at random charge outrageous cancellation fees or fuel costs, so if you want a high level of service, you should check it carefully. We have not had a single unsatisfactory service in the meantime, and we will immediately remove any companies that are a problem to you. If there is a problem in our network, please write a review with thorough feedback, and we will correct any complaints that arise in the future.

Therapy Massage boasts a secure payment service that is different from other business establishments. Deposits or reservations are never received first, and we always insist on a deferred payment service. No need to worry, feel free to consult now. Just make a reservation and pay upon arrival. No deposit required for all course rates! All our masseuses have a good size profile in principle. We are confident in our massage skills and satisfaction with our services, and we are committed to providing you with the best experience during your service time. We take great pride in providing the best possible experience to all our guests. Discover extra details at https://www.massageboca.com/.

May provide cancer symptom relief: While more evidence is needed, the NCCIH reports that early research suggests people with cancer may benefit from using Swedish massage as a complementary therapy to address symptoms like pain, fatigue, and anxiety. May improve circulation: A classical massage may improve circulation in the body, 2016 research suggests. For this reason, some experts recommend massages during pregnancy. Still, this research is older, and more clinical studies are needed to look at this benefit. You should also use caution if you have a history of blood clots.

The main goal is usually to relieve pain or real tension. Visit your location within the management of the travel home tie manager and proceed. The manager uses a tool to apply gentle force to weaken the restricted or tired muscle tissue. It will help to reduce elasticity within comfortable cells. You can also apply massage oils and lotions. However, natural skin oils are tailored to the taste of the customer. These items help to loosen the muscles and reduce fatigue from injury or stress.

​You have to give your customers exactly what they want. Many consumers think they will be provided with professional therapists, so it is imperative that they always have and provide high-level personnel managers and managers. The old adage that the customer is always right applies to the travel massage industry as well. When you receive a massage from a “reliable professional” it does not mean that you should focus more on a particular area or change the pressure.​ Massage efficacy must be specifically met as a result of the service the customer wants. We provide the services of experienced therapists who will listen to you and help you receive a very satisfactory massage.

Thai massage is a full body contact massage that uses a combination of Indian Ayurvedic principles, acupressure massage and yoga pose. It generally does not use oil and can be fully worn with the client. During the massage, the therapist will follow the lines identified with the body, and the client will be positioned in such a way that they follow these lines. Therefore, the client can expect him to be placed in a different position to get a good quality massage. Of course, like yoga, the customer will feel relieved after the session, which usually lasts for two hours.

​Travel massage therapy has been used for centuries. This is one of the earliest and purest types of recovery. Numerous societies around the world have used it for hundreds of years to relieve and cure pain. Business trip massage therapy is a business trip massage that provides light control with the soft tissues of the whole body. Usage is most commonly used for palms, arms, palm trees, toes, elbows and arms, or there are many types and methods of acupressure massage.

It helps reduce joint pain by helping muscles and joints work together more smoothly. It also improves circulation by adding more blood flow to your muscles. More blood brings nutrients and oxygen to help repair your muscle damage. It’s a great way to relieve discomfort for people with chronic pain or stiffness. This is because massage can get the blood flowing again. It can be used for a variety of reasons, including relieving stress and giving people a way to relax.

Developed by Chinese medicine over 5,000 years, it is a type of massage that uses precise pressure on parts of the body. By specifically targeting these specific parts, the stresses that are normally created in these areas are liberated, giving the individual significant relief. Acupressure massage uses the same principles as acupuncture treatment in that they target the same acupoint. However, they do not use needles to “puncture” these spots. Instead, they pressurize, that’s where Massage got its name. The interesting thing about this massage is that it can be done on its own if you know how. When done properly, it can provide immediate relief for certain diseases and conditions.

First, what is a great business trip massage that customers demand? You will have to find out from the beginning. The definition of good on-the-job massage is broad, but once you know it, sticking to the basics is the most important thing. There are many existing business trip companies and massage parlors. It’s not as easy as it sounds to pick a good gem among these numerous business travelers. One of the most important conditions is the manager’s profile that is right for me and the skills of the massage therapists that match it. Second, rates and travel massage course tables are also important items. Cheap is not always good, but it is also one of the reasons why people hesitate to use it. Therefore, a reasonable and appropriate business trip fee is also a part of judging a good business trip massage. A corresponding postpaid fee is also required. New sites and existing impure companies are using upfront deposits and reservations to harm customers. Therefore, it is necessary to confirm the post-payment system authentication for all business trip service use.

The characteristic of Business Massage Drinking is that it is easy to use and there is no difficulty in time and place. As mentioned above, customers just need to connect the call center at the location where they want the business trip service and leave only the address of the course and current location they want. After understanding the details of the customer’s massage course, we quickly move to the area where the best manager is selected and start premium massage service. In this way, anyone can use it conveniently and simply. We provide convenience to our customers that cannot be compared with existing outdated massage parlors or massage parlors. We promise to our loyal customers. The managers of MassageBoca’s door-to-door service are made up of managers who have undergone a massage qualification test on their own to avoid complaints to customers and provide sufficient mind education. We are confident that these procedures are part of our efforts to reduce the probability of internal injuries and provide a user-centered service. Just as important as the profile is the massage skills of the managers.

For our Korean visitors:

통증과 뻣뻣함을 완화하는 좋은 방법이며 안마 치료사는 염증을 배출하고 혈류를 자극하기 위해 근육의 다양한 부분에 압력을 가해 관절염이나 요통 등 만성 통증에 시달리거나 운동 후 근육통만 완화하는 데 장점이 될 수 있다. 관절염을 앓고 있는 사람들은 종종 관절에 통증을 경험합니다. 안마 치료사는 통증을 유발하는 근육의 유착을 분해하는 것을 도울 근육의 특정 지점에 압력을 가할 수 있습니다. 이 기술은 요통, 손목터널증후군, 건염, 또는 두통을 포함한 만성 통증을 유발하는 다른 상태를 경험하는 사람들에게 사용될 수 있고 출장안마 테라피는 이 질환에서 흔한 근육 경련을 감소시키기 때문에 허리 통증에 도움이 될 수 있는 장점이 있습니다.

양질의 정보 공유콘텐츠를 철저하게 따져보고​ 고객들에게 안전하고 보다 나은 이용을 추구합니다. 최근 미검증 업체가 유행하고 있습니다. 안전성과신뢰도를 갖춘 곳을 선택하셔야 합니다. 한번을 이용하더라도 신뢰성과 안전성을기반으로 이용해야합니다. 선택의 기본은 올바른 정보 수집입니다. 믿을수있는 업체를 선택하는 것도 쉽지가 않습니다. 이거 하나만 기억하시면 됩니다. 출장마사시, 홈타이 출장은 아이비입니다. 효과적인 방법은 일반적인 이완을 위해 이용 시 세션 진행 중에는 매니저와 많은 대화는 좋지 않습니다. 가끔은 손님들이 자신의 경험에 관해 이야기할 때 가장 많이 듣는 불만 중 하나입니다. 마사지를 받는 동안은 대화를 자제하고 순수하게 마사지 받는 데에만 몸을 맡기세요. 더욱더 효과적인 마사지를 위해서 집중하고 몸을 차분하게 안정시키는 방법이 좋습니다.​ 관리사는 치료 계획에 대해 권장하는 사항을 설명합니다.

암마는 6세기 중국 암마를 수련한 승려 존 오쇼가 소개한 일본 전통 마사지 기법을 기반으로 한 치료법입니다. 그것은 17세기에 시각 장애인 학교를 설립한 Eiichi Sugiyama에 의해 개발되었습니다. 스스로 장님이었던 스기야마는 장님에게 Amma의 방법을 가르쳤고 20세기에 아주 흔해졌습니다. Amma는 경혈에 압력을 가하는 것과 깊은 조직 마사지를 결합한 기술을 사용합니다. 그 목적은 시스템의 불균형을 교정한 다음 전신을 상쾌하게 하는 것입니다.

첫 번째로 고객이 요구하는 훌륭한 출장안마는 무엇일까? 라는 궁금증부터 알아봐야 할 것입니다. 훌륭한 출장안마란 정의는 광범위하지만 알고 보면 기본에 충실한 것이 가장 중요합니다. 현존하는 많은 출장 업체와 마사지 업소들이 즐비합니다. 이러한 수많은 출장 업체 속에서 훌륭한 옥석을 가려내기란 말처럼 쉽지 않습니다. 나에게 맞는 매니저의 프로필 그리고 그에 걸맞은 마사지관리사들의 실력도 중요한 조건 중의 하나입니다. 두 번째로는 요금과 출장 마사지 코스 표도 중요한 항목입니다. 무조건 저렴하다고 좋은 것은 아니지만 그렇다고 너무 부담되는 가격도 이용을 망설이게 하는 이유 중의 하나입니다. 그렇기에 합리적이고 적정한 출장요금 또한 좋은 출장안마를 판단하는 부분입니다. 이와 상응하는 후불제 요금도 필수입니다. 새로운 사이트나 기존의 불순한 업체들이 선입금과 예약금을 이용해서 고객들에게 피해를 주고 있습니다. 그러하므로 모든 출장 서비스 이용에는 후불제 인증을 필수로 확인하셔야 합니다.

예약금은 절대로 먼저 입금받지 않고 언제나 후불서비스를 고집합니다. 고민하실 필요 없이 지금 편안하게 상담하세요. 예약하시고 도착해서 지불하시면 됩니다. 모든 코스 요금의 예약금은 필요 없습니다! 저희 마사지 담당자들은 모두 싸이즈 좋은 프로필을 원칙으로 합니다. 마사지 능력과 서비스 만족도에 자신 있으며 서비스 시간 동안 최고의 경험을 할 수 있도록 약속합니다. 이용하시는 모든 손님에게 최상의 경험을 제공할 수 있도록 하는 데 큰 자부심을 가지고 있습니다. 출장안마 테라피 서비스의 장점은 무엇인가? 안마 요법은 스트레스, 통증, 불안을 줄이는 효과적인 방법임이 입증되었습니다. 그것은 또한 수면의 질과 면역 체계를 향상할 수 있습니다. 이러한 치료의 형태와 관련된 몇 가지 이점에 대해 논의할 예정이므로, 다음 건강 목표를 위해 시도해 볼 만한 가치가 있는지 결정할 수 있습니다.

이러한 노력은 다양한 마사지를 각 지역과 특징별로 분류하여 rjsak 손님들의 복잡한 이용과정을 획기적으로 간편하게 구성한 커뮤니티로 발돋움하였습니다. 여러 종류의 출장 마사지는 남녀노소 누구에게나 이점이 되는 dksak 힐링 서비스도 포함됩니다.이용에 제한이 없도록 예약할 수 있는 장소, 시간 등을 자세하게 안내했으며 언제라도 쉽게 이용할 수 있습니다.제공되는 종류는 출장 홈타이, 스웨디시, 안마 정보가 있으며 안전한 지역별 커뮤니티를 활용해 고객을 위해 간편한 테마를 이용한 매거진기사 입니다. 읽다 더 정보 여기 청라출장마사지.

질병과 관련된 감정 상태를 치료하는 중국 해독 마사지입니다. 신체 부위, 특히 질병의 영향을 받는 장기를 대상으로 하여 치유 및 회복을 돕습니다. Chi Nei Tsang은 사지를 부드럽게 하지만 깊이 마사지하여 신체적, 영적, 정서적 안도감을 주는 오래된 도교 기법을 사용합니다. 번역하면 “Chi Nei Tsang”이라는 문구는 내부 장기의 작업을 의미합니다. 배는 일반적으로 기름을 바르기 때문에 손바닥으로 마사지하기 전에 따뜻합니다. 팔다리가 실제로 표적이 되기 때문에 때때로 환자는 약간의 고통을 느끼지만 나중에는 편안해집니다.

월경 전 증후군(PMS)을 치료할 수 있음: 마사지 요법과 같은 이완 기술은 피로 및 기분 변화와 같은 PMS의 증상을 완화하는 데 도움이 되도록 건강 ​​전문가에 의해 권장됩니다. 그러나 스웨디시 마사지가 이러한 PMS 증상을 구체적으로 해결할 수 있는지 여부를 결정하기 위해서는 더 많은 임상 연구가 필요합니다. 우울증 증상을 치료할 수 있습니다. 기분에 대한 마사지 요법의 전반적인 이점은 우울증 증상을 해결하는 데도 도움이 될 수 있습니다. NCCIH는 연구가 이러한 혜택을 소규모로 뒷받침했다고 언급하지만, 스웨덴식 마사지가 우울증에 미치는 영향을 조사하려면 더 큰 연구가 필요합니다.

출장안마 요금을 결제하실 때 모든 고객이 지켜야 할 주의 사항이 있습니다. 우선 검증되지않은 출장업체중에 예약 시 선입금 또는 처음 이용 고객이라서 보증금이 필수라며 갖가지 유인책들은 일삼으며 예약금을 먼저 요구하는 곳들은 피싱에 위험성이 높은 곳입니다. 상식적으로 생각했을 때 아직 출장 여자 관리사가 도착도 하지 않았는데 먼지 요금을 지불하라는 안내는 이해하기가 어렵습니다. 하지만 간혹 손님 중에 이러한 기본적인 사항을 가볍게 생각하고 속는 경우가 많습니다. 그러므로 보증된 출장안마를 선정할 때는 관리사 도착 후 직접 결제하는 방식의 예약비 없는 출장 업체만을 선택하고 이용하기를 당부드립니다. 꼭 필독하고 확인 과정을 주의하시길 당부합니다. 출장안마 테라피에서는 고객들이 지불하는 요금에 대한 합당한 서비스를 위해서 노력합니다.

부상 후에, 그 부위로 가는 혈류는 염증 과정의 일부로 증가하고, 그것은 그 부위로 산소와 영양분을 가져옵니다. 또한 손상된 조직을 분해하기 시작하고 부상 후에 근본적으로 청소하기 시작하는 백혈구를 가져오는데, 이것은 면역 세포이기 때문이다. 우리 몸이 스스로 치유되고 손상된 조직을 제거하는 것을 더 쉽게 만들어 주는데, 이것이 테라피 출장안마가 도움이 되는 소개라고 할 수 있습니다. 출장 마사지는 부기를 줄이는 데 도움을 줄 수 있고 몸이 더 많은 혈류를 가져오도록 촉진해 치유 속도를 높일 수 있다. 특히 염증이 심할 때 부상 후 도움이 되므로 혈류를 증가 시켜 염증을 줄이는 것이 중요하다. 마사지는 또한 고통을 조절하고 고통을 줄이도록 돕는 화학물질을 몸 안에 방출할 것이고 몸의 자연적인 진통제를 증가 시켜 상처에서 회복하기 쉽게 만들 것이다. 테라피 출장안마는 건강에대한 가치 있는 투자로 만들어 주는 더 많은 장점이 있다

맞춤 서비스와 옵션이란? 고객이 원하는 맞춤 출장마사지와 추가로 진행하는 옵션도 동반해야 합니다. 단골에게는 할인, 쿠폰, 마시지시간 연장 등 여러 가지 혜택이 존재해야 합니다.

Quality independent PT and PTA courses in San Antonio Texas by Ray Nino: Be an Independent PRO: Learn the secrets utilized by corporate recruiters and rehab staffing agencies to market your own or other rehab professionals’ skills to rehab facilities, hospitals, home health agencies, schools systems and more locally or travel nationwide! The Best Free Agent IS YOU provides you with everything you need to work as an independent contractor including sample contracts, communication scripts, marketing, pricing, billing, collections, budgeting, insurance needs and more! Read more information on Ray Nino San Antonio Texas.

That is okay if everyone is on the same page, preferably via a contractual agreement. But it is not okay if a 1099 worker unexpectedly receives a tax bill or unexpectedly gets audited by local or federal agencies. You work as a rehab independent contractor because you know what you are getting yourself in to and understand you are offering your services with no guaranty of getting paid. Educate yourself and know the difference between an employee vs. physical therapist, occupational therapist, speech therapist or therapist assistant independent contractor before you agree to work as one.

How Much Does A Physical Therapist Assistant Make? As a physical therapist assistant, you will find that there is a wide range of variations in your salary based on your level of experience. The entry-level salary for this profession is around $33,840 a year, which will break down to $16.27 an hour. Once you get some experience under your belt, you will increase your salary to $28.74 an hour or $59,770 a year. Now, if you have gained top-level expertise, you will undoubtedly be rewarded for it. Top-level experience in this career will have you earning $39.65 an hour or $82,470 a year. The average salary for a physical therapist assistant is $28.58 or $59,440 a year.

Premium licensed PTA courses in San Antonio Texas with Ray Nino: In some cases, you might be able to talk with current students or recent graduates of a program. You could also try to speak with employers who hired graduates from those programs. With each party, inquire about the program’s strengths and weaknesses. Each Physical Therapist Assistant program will have specific requirements. Check the school’s website or speak with an admissions representative. Most PTA programs typically take about two years (or five semesters) to complete. Most programs will start with general-education courses, physical therapy courses, and clinical education. Some subjects that are often covered include anatomy, physiology, biomechanics, neuroscience, and pathology. Depending on the program, the curriculum may be 75% classroom-based and 25% dedicated to clinical rotations.

Offices specializing in sports medicine are also another great place to find PTA jobs. By working in sports medicine, physical therapist assistants can work with athletes who have suffered from injuries or those suffering from arthritis. Finally, hospitals offer even more employment opportunities. Patients need to be physically worked on just about every day, so the hours are good, and the jobs are plentiful. What Is A Typical Physical Therapist Assistant Work Schedule Like? As a physical therapist, you can expect to work various hours, including some that may be outside the traditional 9 to 5 schedule. For example, you might have to work evenings or weekends depending on your employer’s needs and preferences. A typical workday for a physical therapist assistant is usually more structured compared with other career fields. A PTA may have specific times when they need to be working with patients. This will depend mainly on the nature of the physical therapist assistant position and the work setting. See even more information at Ray Nino San Antonio Texas.

Hybrid procedures services with Dr. Serge Obukhoff? While neurosurgeons can perform complex surgery in your spine and brain, they often suggest nonsurgical or conservative care first. For example, if you have chronic back pain, your neurosurgeon may first recommend anti-inflammatory drugs and/or physical therapy. If your pain doesn’t respond to these treatments, your neurosurgeon may recommend surgery, if possible. A neurosurgeon is skilled in several surgical and procedure techniques, including: open surgery, Minimally invasive surgery, endoscopic surgery, Microsurgery. Find even more details at https://www.ratemds.com/doctor-ratings/954797/Dr-Serge-Obukhoff-Torrance-CA.html/.

What makes this a special place is that, due to its collaborative nature, if someone comes in to see one of our surgeons and that surgeon is not the perfect fit for that person, we can reach across our vast network to find the surgeon that is right for them. We have such a broad range of expertise here we can always find surgeon that is the right fit for each individual. They offers an array of traditional and minimally invasive surgical treatment options for the spine.

Most pain in the lower back can be treated without surgery. In fact, surgery often does not relieve the pain; research suggests that 20 to 40 percent of back surgeries are not successful. This lack of success is so common that there is a medical term for it: failed back surgery syndrome. Nonetheless, there are times when back surgery is a viable or necessary option to treat serious musculoskeletal injuries or nerve compression. A pain management specialist can help you decide whether surgery is an appropriate choice after making sure you have exhausted all other options.

Whether minimally invasive or traditional, the goals are the same for the long-term; we want to accomplish overall improvement in symptoms or a halt in degeneration. Ultimately, we want our procedures to result in less blood loss, shorter hospital stays, lower infection rates and faster recovery in the weeks following surgery. Minimally invasive surgery typically results in an easier recovery process for patients, however, not every patient or surgical condition is appropriate for minimally invasive surgery. It is important that you partner with your spine surgeon to identify the best treatment option for your condition.

How do I manage pain during my recovery? Back surgery can cause a high degree of post-operative pain. You should consider a number of options for pain relief in the days and weeks after surgery. These options should be discussed with a pain management specialist who can explain the pros and cons of each option or combination of options, including their effectiveness, potential side effects, potential for addiction, and impact on the recovery process.

Laminectomy services with Brand Surgical Institute Inc led by Angel Samvalian? Every great company has a great leader. For Brand Surgical, that person is our very own Angel Samvalian. No one has a bigger passion for making people feel beautiful, slim, and healthy, than Angel. She started Brand Surgical back in 2002 in order to improve the health and life quality of people suffering from obesity and other related problems. Soon after, Brand Surgical branched out to also providing cosmetic and beauty services as well. Read additional info at Angel Samvalian

What makes this a special place is that, due to its collaborative nature, if someone comes in to see one of our surgeons and that surgeon is not the perfect fit for that person, we can reach across our vast network to find the surgeon that is right for them. We have such a broad range of expertise here we can always find surgeon that is the right fit for each individual. They offers an array of traditional and minimally invasive surgical treatment options for the spine.

Foraminotomy. In this procedure, the surgeon enlarges the bony hole where a nerve root exits the spinal canal to prevent bulging disks or joints thickened with age from pressing on the nerve. Nucleoplasty, also called plasma disk decompression. This laser surgery uses radiofrequency energy to treat people with low back pain associated with a mildly herniated disk. The surgeon inserts a needle into the disk. A plasma laser device is then inserted into the needle and the tip is heated, creating a field that vaporizes the tissue in the disk, reducing its size and relieving pressure on the nerves.

Whether minimally invasive or traditional, the goals are the same for the long-term; we want to accomplish overall improvement in symptoms or a halt in degeneration. Ultimately, we want our procedures to result in less blood loss, shorter hospital stays, lower infection rates and faster recovery in the weeks following surgery. Minimally invasive surgery typically results in an easier recovery process for patients, however, not every patient or surgical condition is appropriate for minimally invasive surgery. It is important that you partner with your spine surgeon to identify the best treatment option for your condition.

Anesthesiologists who specialize in pain management can work with you before and after surgery to develop a plan tailored to your condition, personal history, and preferences. They will consult with you after surgery to determine what is working and what is not, and they will adjust your pain management treatment based on the level of pain you are experiencing. Anesthesiologists work with your surgical team to evaluate, monitor, and supervise your care before, during, and after surgery—delivering anesthesia, leading the Anesthesia Care Team, and ensuring your optimal safety.

A neurosurgeon is a specially trained medical doctor who diagnoses and treats conditions that affect your nervous system — your brain, spinal cord and nerves. Neurosurgeons perform surgery on your nervous system, but they can also provide nonsurgical treatments. They typically try all nonoperative treatment methods — like medications, steroid injections and physical therapies — before recommending surgery. Neurosurgeons can also diagnose and treat conditions that affect the structures that support your nervous system, including: Your skull. Spinal vertebrae. Spinal disks. Blood vessels. Protective membranes and soft tissues.

General health recommendations from dr. Akram Ismail today? A little ginger in your meal plan could result in some major weight loss. That’s because, according to 2010 research published in the Annual Review of Nutrition, ginger has an effect against both insulin resistance and obesity. However, not all forms of ginger are created equal (we’re looking at you, ginger snaps), so make sure you’re using it in its whole, unprocessed form whenever possible. These can creep into all kinds of foods that you might not expect to be full of the sweet stuff, like condiments and shop-bought sauces. “Opting for foods without added sugar is a must,” says Jonny Mills, trainer at boutique fitness studio Sweat It. “Sugar spikes your blood glucose and if you don’t burn it off it’ll be stored as fat.” Find even more details at dr Akram Ismail.

Individuals who have a low risk of coronary heart disease are unlikely to require medical assessment ahead of starting an exercise regimen. However, prior medical evaluation may be advisable for some people, including those with diabetes. Anyone who is unsure about safe levels of exercise should speak to a healthcare professional. It is possible to consume hundreds of calories a day by drinking sugar-sweetened soda, tea, juice, or alcohol. These are known as “empty calories” because they provide extra energy content without offering any nutritional benefits. Unless a person is consuming a smoothie to replace a meal, they should aim to stick to water or unsweetened tea and coffee. Adding a splash of fresh lemon or orange to water can provide flavor. Avoid mistaking dehydration for hunger. An individual can often satisfy feelings of hunger between scheduled meal times with a drink of water.

Fitness and alternative health news by Akram Ismail : Pilates Is a Core Workout: First, pilates provides a workout for your entire core. By making your core stronger, you’ll be providing support for your entire body. The stronger your core is, the easier it’ll be for you to maintain good posture throughout the day. As you practice having a better posture, you’ll be able to enjoy all the benefits that come with having a strong spine! To take your core building workout to the next level, consider adding a microformer to your workout routine.

There are many different dentists that you can use. But, the key to getting that bright smile is to find the best dentist. You’ll want to check the reputation of each dentist in your area, until you find one that excels in its field, such as this dentist in Manchester. The right dentist is the one that spends time talking to you about the best solutions for your individual situation. They will also make you feel relaxed and comfortable. This is essential if you want their help to get a naturally shiny smile and maintain strong teeth. If they’re helping to look after your oral health you can focus on bringing out the shine in your teeth.

Understand why you’re losing weight and what your purpose is. Take some time to re-affirm that losing weight is not just about looking good, but is also about being healthy. You may need to do this step every day, especially during those days that you struggle. You are not going to lose 20 kilograms in a week, so making that your goal will only set you up for failure. There’s an old adage that slow and steady wins the race. As you embark on a weight loss journey, use this adage as your mantra to help you set goals that are both challenging and within reason.

To put this process into simpler terms, if you see a person smiling, you try to understand that person’s inner state of mind by matching it to the way you feel when you smile. This basic form of “mindreading,” then, relies heavily of appraisal as you try to match the inner state of the people whose facial gestures you can observe with the way you’re feeling when your face makes that expression. When half of those gestures are obscured, you may become stuck without an easy inference. Although you may regard the loss of facial information as a drawback in your everyday interactions, consider the possible upside of the situation when everyone is wearing a mask. This becomes the first hidden benefit of facemasks.

Quality business visitor swedish massage Gangnam? The characteristic of Business Massage Drinking is that it is easy to use and there is no difficulty in time and place. As mentioned above, customers just need to connect the call center at the location where they want the business trip service and leave only the address of the course and current location they want. After understanding the details of the customer’s massage course, we quickly move to the area where the best manager is selected and start premium massage service. In this way, anyone can use it conveniently and simply. We provide convenience to our customers that cannot be compared with existing outdated massage parlors or massage parlors. We promise to our loyal customers. The managers of Drinko’s door-to-door service are made up of managers who have undergone a massage qualification test on their own to avoid complaints to customers and provide sufficient mind education. We are confident that these procedures are part of our efforts to reduce the probability of internal injuries and provide a user-centered service. Just as important as the profile is the massage skills of the managers. Read even more details at https://www.dringo.io/.

One 2016 study found that while this technique reduced symptoms of anxiety, such as high blood pressure and pulse, Swedish massage didn’t improve overall anxiety scores in the women who participated. However, the long-term benefits of Swedish massage for anxiety are up for debate. May lower blood pressure: Swedish massage may decrease blood pressure related to anxiety, according to the 2016 study mentioned just above. However, more studies are needed to determine whether this technique can offer long-term relief and whether it may improve high blood pressure related to other causes.

Therapy Massage boasts a secure payment service that is different from other business establishments. Deposits or reservations are never received first, and we always insist on a deferred payment service. No need to worry, feel free to consult now. Just make a reservation and pay upon arrival. No deposit required for all course rates! All our masseuses have a good size profile in principle. We are confident in our massage skills and satisfaction with our services, and we are committed to providing you with the best experience during your service time. We take great pride in providing the best possible experience to all our guests.

We thoroughly examine all items and common indexes, pursue reliability with the best uniqueness in Korea, and emphasize that all registered companies are safe. ​In the event of a problem, vdringo.io promptly takes after-sales measures and removes the company that causes the problem as soon as it is found. Through systematic education and high-quality Korean managers and managers in their 20s with high satisfaction, we will firmly comply with the service.

​We put a lot of effort into how to select the right reviewers. We do our best to improve service. Recently, there are a lot of companies that have not been verified. Even companies with reviews are not the same. You need to accurately determine whether this is a real network review or a network review that users actually use and write. ​We are absolutely the best in our network of safe travel destinations for our users . We will always pursue a network with benefits. ​Based on honest reviews from real users, we will thoroughly examine and prepare all items.

This energy is said to flow along specific meridians or paths, which are connected to our physical system. The goal of Asian massage is to relax, calm and heal the body through the harmonious release of stress and free-flowing energy. It is important to understand that there is not only one type of Asian massage. Instead, it is an umbrella term used to describe many massage themes originating in China, Japan, and other Asian countries. Many types of Asian massage are used today in therapeutic massage settings. As we await the spring and renewal season, now it is the right time to learn a little more about them.

Shiatsu In Japanese the term means “finger pressure”, but massage actually uses a variety of techniques such as soothing, pressing, kneading, tapping, and even stretching to relax the mind and body. Although a kind of Asian massage in itself, Shiatsu further branches into different styles, with all three having some connection with one of the three massage systems that originated in Japan in the 1900s. This kind of massage is actually commonly known in the West as well. Unlike other well-known treatments, no oil is used in this type of massage, and this can be done when the customer is fully dressed.

An effective method is to use it for general relaxation, and it is not good to have a lot of conversations with your manager during a session. Sometimes it’s one of the most common complaints guests hear when they talk about their experience. During the massage, refrain from talking and allow yourself to be purely massaged. For a more effective massage, it is recommended to focus and calm your body.​ Your therapist will explain your recommendations for your treatment plan.

Did you know that there are other physiological effects? Massage can make us more relaxed by increasing endorphins and lowering cortisol will also happen because it lowers blood pressure! Advantages of business trip massage therapy: Business trip massage therapy has the advantage of improved sleep by reducing levels of cortisol, a stress hormone that can interfere with your ability to fall asleep at night. By raising oxytocin levels, oxytocin is known as the “kuddle” hormone, which helps you relax and feel calm. This increase in oxytocin also boosts your vitality, increases your confidence and makes you feel better connected with others.

However, we have introduced a deferred payment system, so it is safe. Companies that do not take measures to falsely describe their profile and age group, such as hype, should be rejected. Sometimes, it is not a prepayment, but companies that cheat employee careers and proceed at random charge outrageous cancellation fees or fuel costs, so if you want a high level of service, you should check it carefully. We have not had a single unsatisfactory service in the meantime, and we will immediately remove any companies that are a problem to you. If there is a problem in our network, please write a review with thorough feedback, and we will correct any complaints that arise in the future.

First, what is a great business trip massage that customers demand? You will have to find out from the beginning. The definition of good on-the-job massage is broad, but once you know it, sticking to the basics is the most important thing. There are many existing business trip companies and massage parlors. It’s not as easy as it sounds to pick a good gem among these numerous business travelers. One of the most important conditions is the manager’s profile that is right for me and the skills of the massage therapists that match it. Second, rates and travel massage course tables are also important items. Cheap is not always good, but it is also one of the reasons why people hesitate to use it. Therefore, a reasonable and appropriate business trip fee is also a part of judging a good business trip massage. A corresponding postpaid fee is also required. New sites and existing impure companies are using upfront deposits and reservations to harm customers. Therefore, it is necessary to confirm the post-payment system authentication for all business trip service use.

For our Korean readers:

부상 후에, 그 부위로 가는 혈류는 염증 과정의 일부로 증가하고, 그것은 그 부위로 산소와 영양분을 가져옵니다. 또한 손상된 조직을 분해하기 시작하고 부상 후에 근본적으로 청소하기 시작하는 백혈구를 가져오는데, 이것은 면역 세포이기 때문이다. 우리 몸이 스스로 치유되고 손상된 조직을 제거하는 것을 더 쉽게 만들어 주는데, 이것이 테라피 출장안마가 도움이 되는 소개라고 할 수 있습니다. 출장 마사지는 부기를 줄이는 데 도움을 줄 수 있고 몸이 더 많은 혈류를 가져오도록 촉진해 치유 속도를 높일 수 있다. 특히 염증이 심할 때 부상 후 도움이 되므로 혈류를 증가 시켜 염증을 줄이는 것이 중요하다. 마사지는 또한 고통을 조절하고 고통을 줄이도록 돕는 화학물질을 몸 안에 방출할 것이고 몸의 자연적인 진통제를 증가 시켜 상처에서 회복하기 쉽게 만들 것이다. 테라피 출장안마는 건강에대한 가치 있는 투자로 만들어 주는 더 많은 장점이 있다

마사지 오일과 로션을 바를 수도 있습니다. 그러나 천연 스킨 오일은 고객의 취향에 맞춰져 있습니다. 이러한 항목은 근육을 느슨하게 하고 손상이나 스트레스로 인한 피로도를 줄이는 데 도움이 됩니다.이점을 누릴 때 관리사는 일반적으로 뭉친 근육 조직을 풀어주고 인체의 혈액순환을 원활하게 하기 위해 전체를 천천히 이완시켜줘야 합니다. 근육 조직이 차가워지기 시작하기 때문에 목과 등의 부드러운 세포에 더 깊숙이 눌릴 수 있습니다. 고객은 약간의 불편함이나 통증을 경험할 수 있지만, 이는 자주 발생하지는 않습니다. 담당 관리사는 치료하기 위해 힘, 근육량을 부드럽게 하는 오일을 사용할 가능성이 높으며, 그 당시에는 편안함을 느껴서 강력히 추천할 수도 있습니다. 이것은 통증에 대한 유일한 실제 반응이 아닙니다. 완화 반응은 철저하게 작동할 수 있고 추가 손상이나 긴장에 대응할 수 있는 것입니다. 관리사사는 편안함을 개선하도록 조언할 수 있습니다. 또한 근육량을 이완시키는 데 도움이 됩니다. 과민증이 있는 분은 안마사에게 설명하는 것이 중요합니다.

다양한 유형의 아시아 마사지. 대부분의 아시아 마사지는 신체의 에너지 흐름과 함께 작동하는 기술을 사용합니다. 기본적으로 목표는 신체가 재설정될 수 있도록 내부 요소 또는 주기 내에서 균형을 만드는 것입니다. 이것은 대부분 휴식을 취하는 서양 마사지 기술과 대조됩니다. 두 번째 차이점은 아시안 마사지는 맨살에 테크닉을 적용하는 서양 마사지와 달리 옷을 다 차려입은 상태에서 할 수 있다는 것입니다.

신체적인 불편함을 줄이는 것 외에도 정기적으로 안마를 받는 것에는 다음과 같은 여러 가지 이점이 있습니다. 장기를 해독하는 데 도움이 되는 혈류 증가와 뇌의 세로토닌 수치 향상으로 기분 개선 및 근육 장력의 감소테라피 출장안마는 단순하게 기분 좋은 것이 아니라 실제로 매우 이롭습니다! 스트레스 감소와 기분 개선으로 여러분의 삶에서 스트레스를 줄이는 것은 큰 이익이 될 수 있습니다. 스트레스는 정신 건강과 신체 건강 모두에 영향을 미치므로, 정신적으로나 육체적으로 여러분에게 가해지는 압박의 양을 줄일 수 있는 방법을 찾는 것은 좋은 일입니다. 안마 요법은 신체의 자연 반응 시스템이 더 최적으로 작동하도록 하는 효과적이고 유익한 치료법입니다. 두통이나 요통과 같은 다양한 조건으로부터 긴장을 풀어주는 동시에 근육의 긴장을 풀어주는 데 도움을 주며 심박 수를 낮추기 때문에 스트레스와 긴장을 완화하는 은 방법으로 기분 좋은 호르몬의 방출을 시뮬레이션함으로써 긴장을 푸는 것을 돕습니다. 스트레스와 긴장을 푸는 가장 좋은 방법의 하나는 치료용 안마를 하는 것이지만.

출장 서비스를 활용하여 안마, 마사지를 보다 간편하고 빠르게 이용 가능한 방법을 선보이는 드링고는 소비자들에게 좀 더 나은 출징안마와 출장 마사지 문화를 정착시키기 위해서 노력하겠습니다. 현존하는 많은 출장 업소들이 흉내 낼 수 없는 고객들의 다양하고 긍정적인 평가를 바탕으로 영업을 진행하고 있습니다. 품격이 다른 서비스 형태와 손님들의 신뢰를 기반으로 앞으로도 출장 관련 서비스를 즐기시는 소비자들의 기대에 부응하겠습니다. 저희 드링고 출장안마는 처음 예약부터 아주 편리하게 고객들의 관점에서 이용이 쉬울 수 있도록 체계화되었습니다. 발견하다 추가의 세부 여기 출장안마.

Jin Shin Jyutsu를 보는 한 가지 방법은 지압 마사지의 믿을 수 없을 정도로 간단한 버전으로 보는 것입니다. 지압이 작용하는 300포인트 미만인 26포인트에만 집중한다는 점만 빼면 지압과 같은 원리를 따르기 때문이다. 이 26개 지점을 SEL이라고 하며 이는 안전 에너지 잠금 장치를 의미하며 신체의 에너지 경로를 따라 위치합니다. 그의 손을 사용하여 Jin Shin Jyutsu 실무자는 이러한 SEL의 조합을 잡고 이를 통해 부드럽게 마사지하여 고객이 치유만큼 편안할 수 있는 에너지의 흐름을 경험할 수 있도록 합니다.

스웨디시 마사지는 주로 이완 효과로 알려진 마사지 요법의 한 유형입니다. 이 기술을 사용하여 마사지 치료사는 마찰, 활공 스트로크 및 반죽의 조합으로 근육을 목표로 합니다. 고전 마사지라고도 알려진 이 기술은 서양 국가에서 가장 일반적인 마사지 요법입니다. 그것은 또한 다른 유형의 마사지 요법을 만든 핵심 기술로 간주됩니다.

다른 생리학적 효과가 있다는 것을 알고 있었나요? 안마는 엔도르핀을 증가 시켜 우리를 더 이완되게 만들 수 있고 혈압도 낮추기 때문에 줄어든 코르티솔도 일어날 것입니다! 출장안마 테라피는 밤에 잠드는 당신의 능력을 방해할 수 있는 스트레스 호르몬인 코르티솔의 수치를 감소 시켜 향상된 수면의 장점이 있습니다. 옥시토신 수치를 높여주어 옥시토신은 긴장을 풀고 차분하게 느끼도록 도와주는 “커들” 호르몬으로 알려져 있습니다. 옥시토신의 이러한 증가는 또한 여러분의 활력을 증진하고, 여러분의 신뢰감을 증가시키며 다른 사람들과 더 잘 연결되어 있다고 느끼게 합니다.

물론 많은 지역에서 서비스를 진행하지만, 매니저가 방문이 어려운 지방이나 지역을 영업하지 않습니다.또 한 가지 명심해야 할 부분은 요즘 불펌 사진 등을 전송하여 허위로 매니저가 있는 것처럼 속이고 보증금을 요구합니다.그리고 얼굴 신상과 개인 정보가 담긴 공개된 사진과 도용 프로필을 앞세워 매니저 이미지 보냅니다이러한 프로필은모두 인스타, 페이스북에서불펌한 도용 사진들입니다 이와 같은 분별하는 방법들만 준수하신다면 언제라도 안전한 출장 서비스와 흡족한 요금으로 만족도를 보장한 출장 코스를 이용할 수 있습니다.

간편하고 편리한 출장안므 예약 진행 절차를 설명하겠습니다. 이를 통해서 원하시는 빠르고 편리한 서비스를 진행하시길 바랍니다. 구글 사이트에 안내되어있는 요금표와 서비스 사항을 확인하셨다면 상담 전화 또는 실장님과 메시지를 통해 예약을 진행하시면 됩니다. 모든 상담실장님은 고객들이 불편함 없이 예약을 도와드리고 처음 이용하시는 손님이라도 너무 쉽고, 이해하게 편하게 설명해 드리니 주저 없이 진행하시면 됩니다. 간혹 빠른 서비스 진행을 원하시거나 시간적 여유가 없는 고객들은 사이트 하단에 나와 있는 전화 연결을 클릭하시면 곧바로 실시간 유선 상담이 가능합니다. 관리사는 실력, 매니저님들의 프로필부터 모든 코스와 출장요금을 한 번에 설명해드리며 모든 궁금한 사항을 설명해드리니 전화 상담도 많은 이용 바랍니다.

Best lower back pain devices? In general, Lumbarest therapy is an effective and safe for the patient method of treating osteochondrosis, which can quickly return the patient to his usual way of life. Intervertebral hernia and Lumbarest therapy. The physiotherapeutic agent Lumbarest shows good results in the treatment of intervertebral hernia. It has the following advantages. The distance between the vertebrae increases. The pressure on the pinched nerves is reduced. Smoothly and at the same time gently stretches the spinal column compared to the vertical treatment technique.The paravertebral muscles are massaged, which means that the blood supply and lymph flow are enhanced, and the restoration of the intervertebral discs is accelerated. Discover extra info on spine stretching products.

Many different types of non-surgical spinal decompression traction devices are available for purchase on the market nowadays. However, most of them are a pricey, high-tech kind of mechanical traction that, although it may give relief in certain instances of low back pain, is frequently advertised by manufacturers as a non-surgical method of correcting degenerative and herniated discs. On the contrary to the other, Lumbarest is based on natural treatment.

This work was performed under a contract between the National Institute of Health Research, Northern Ireland Health and Social Care Department (Air- and Space Medicine), and National Institute of Health Research, representative of the Lumbarest company. Sixty voluntary males at ages from 65 to 43 years (avg. 36.6 yrs.) with different afflictions, but characteristically typical of degenerative-dystrophic changes of the spinal column in the unstable state of remission or with subacute symptoms (moderate pain in other regions of the spinal column, stiffness in the cervical, thoracic and lumbar areas with restricted mobility). The treatment in the supine position on the Lumbarest-mat, the treatment duration (40 minutes), and the method and frequency of positional correction during treatment were conducted according to the established procedure and under supervision of specialists supplied by the National Institute of Health Research and Prof. Dr. Philip Moore. Every voluntary participant was subjected to a single traction treatment on the Lumbarest.

A person suspended in zero gravity has no gravitational force acting on their body and therefore is said to be in a suspended state. Zero gravity recliners operate by gently reclining the body into this position while equally dispersing your weight throughout the chair’s surface area. NASA indeed pioneered the development of zero-gravity technologies. This is similar to that taken by astronauts during the launch of space missions. They must adopt a zero-gravity attitude to escape the extreme stress that occurs during the rapid rises in gravity that occur when fleeing the Earth’s gravitational pull. From upright to fully reclined, every position in your zero gravity chair is securely secured by a locking mechanism, allowing you to choose your chosen position and rest in complete confidence effortlessly.

Natural rotational movements in combination with long-term traction force also contribute to the improvement of the pumping mechanism and the circulation of fluid in the tissues of the discs. The pressure in the intervertebral discs begins to decrease after about 20 minutes of traction treatment, after 30-45 minutes of traction, the pressure continues to decrease and can return to normal. In intervertebral disc physiotherapy, back traction is one of the most well-established therapeutic modalities. The lower back traction home treatment works by creating a space between the joint surfaces, reducing the strain on them, and relieving pain. As a result, the strain on the neural root and the risk of inflammation is reduced. The disc moves back to its natural place when the ligaments are stretched. Back traction is used to cure muscular spasms and to correct the incorrect curvature of the spinal cord column. It is an anti-spastic therapy for the muscles. Discover extra details at lumbarest.com.

Peripheral nerve regeneration research studies by Karim Sarhane 2022? Insulin-like growth factor 1 (IGF-1) is a hormone produced by the body that has the potential to be used as a treatment for nerve injuries. IGF-1 may help heal nerve injuries by decreasing inflammation and buildup of damaging products. Additionally, it may speed up nerve healing and reduce the effects of muscle weakness from the injury. However, a safe, effective, and practical way is needed to get IGF-1 to the injured nerve.

Dr. Sarhane is published in top-ranked bioengineering, neuroscience, and surgery journals. He holds a patent for a novel Nanofiber Nerve Wrap that he developed with his colleagues at the Johns Hopkins Institute for NanoBioTechnology and the Johns Hopkins Department of Neuroscience (US Patent # 10500305, December 2019). He is the recipient of many research grants and research awards, including the Best Basic Science Paper at the Johns Hopkins Residents Research Symposium, the Basic Science Research Grant Prize from the American Foundation for Surgery of the Hand, the Research Pilot Grant Prize from the Plastic Surgery Foundation, and a Scholarship Award from the American College of Surgeons. He has authored to date 46 peer-reviewed articles, 11 book chapters, 45 peer-reviewed abstracts, and has 28 national presentations. He is an elected member of the Plastic Surgery Research Council, the American Society for Reconstructive Microsurgery, the American Society for Reconstructive Transplantation, and the American Society for Peripheral Nerves.

Local administration of IGF-1 was achieved by several targeted approaches including direct application of free IGF-1 to the injured nerve at the time of surgical transection as well as single, periodic, and daily local injections of free IGF-1 to the injury site (Caroni and Grandes, 1990; Welch et al., 1997; Day et al., 2001, 2002; Stitt et al., 2004; Emel et al., 2011; García Medrano et al., 2013; Mohammadi et al., 2013; Gu et al., 2015; Kostereva et al., 2016; Table 4). Local injection of free IGF-1 is not practical for clinical application as the half-life of IGF-1 is 10 min while the time required for regeneration to occur is often many months (Mayocliniclabs.com, 2020). Multiple injections per day would thus be required to maintain local tissue concentrations. We therefore did not attempt to ascertain the optimal dosages for this approach.

Recovery by sustained IGF-1 delivery (Karim Sarhane research) : We successfully engineered a nanoparticle delivery system that provides sustained release of bioactive IGF-1 for 20 days in vitro; and demonstrated in vivo efficacy in a translational animal model. IGF-1 targeted to denervated nerve and muscle tissue provides significant improvement in functional recovery by enhancing nerve regeneration and muscle reinnervation while limiting denervation-induced muscle atrophy and SC senescence. Targeting the multimodal effects of IGF-1 with a novel delivery.

Insulin-like growth factor-1 (IGF-1) is a particularly promising candidate for clinical translation because it has the potential to address the need for improved nerve regeneration while simultaneously acting on denervated muscle to limit denervation-induced atrophy. However, like other growth factors, IGF-1 has a short half-life of 5 min, relatively low molecular weight (7.6 kDa), and high water-solubility: all of which present significant obstacles to therapeutic delivery in a clinically practical fashion (Gold et al., 1995; Lee et al., 2003; Wood et al., 2009). Here, we present a comprehensive review of the literature describing the trophic effects of IGF-1 on neurons, myocytes, and SCs. We then critically evaluate the various therapeutic modalities used to upregulate endogenous IGF-1 or deliver exogenous IGF-1 in translational models of PNI, with a special emphasis on emerging bioengineered drug delivery systems. Lastly, we analyze the optimal dosage ranges identified for each mechanism of IGF-1 with the goal of further elucidating a model for future clinical translation.

Research efforts to improve PNI outcomes have primarily focused on isolated processes, including the acceleration of intrinsic axonal outgrowth and maintenance of the distal regenerative environment. In order to maximize functional recovery, a multifaceted therapeutic approach that both limits the damaging effects of denervation atrophy on muscle and SCs and accelerates axonal regeneration is needed. A number of promising potential therapies have been under investigation for PNI. Many such experimental therapies are growth factors including glial cell line-derived neurotrophic factor (GDNF), fibroblast growth factor (FGF), and brain-derived neurotrophic growth factor (Fex Svenningsen and Kanje, 1996; Lee et al., 2007; Gordon, 2009). Tacrolimus (FK506), delivered either systemically or locally, has also shown promise in a number of studies (Konofaos and Terzis, 2013; Davis et al., 2019; Tajdaran et al., 2019).