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Healthy Veins

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Jessica Plotnick, PA-C, MMSc

Venous disease affects roughly 70% of women and 40% of men. However, many cases are never diagnosed and therefore never treated. Vein expert Jessica Plotnick, PA-C, MMSc explains that varicose veins and spider veins are fully treatable, with little to no downtime.

Is it important to treat varicose veins & spider veins?

Some veins are merely cosmetic, pose no health risk and do not require treatment. However, Jessica has found that many patients who believe their veins are simply cosmetic in fact have underlying venous disease. Moderate to severe venous disease should be treated, as it can increase the risk of blood clots, skin ulcerations and skin breakdown. Patients with venous disease may experience leg swelling, heaviness, aching, bruising easily, itchiness and pain-although some, even with severe disease, may have no symptoms at all.

Who does it affect? When and why does it happen?

Venous disease is typically a genetic disorder that starts for most people in their late teens and early twenties, it is not an “old lady disease.” The one-way valves along a vein start to fail which causes blood to reflux. This results in too much volume in the veins below it, causing them to dilate.

Why are varicose and spider veins more common in women?

Women naturally have higher levels of estrogen and progesterone. These levels further increase from birth control pills, IUDs, HRT, as well as from hormone surges during pregnancy and menopause. These hormones dilate the veins thereby worsening a genetically pre-existing condition.

What are the treatment options?

The majority of unhealthy veins can be treated with sclerotherapy, considered the gold standard in care. This involves injecting a solution into the vein, which irritates the inside of the vein wall, causing it to collapse. To help the veins close down more rapidly, Jessica recommends wearing graduated medical compression stockings after the procedure for 2-3 days. Patients generally require multiple treatments to fully close down the veins. The sclerotherapy process needs to be done methodically and precisely. The results are well worth the time and cost, as the veins will be permanently closed. The treatment will eliminate the diseased veins as well as preventing the spread and formation of more unhealthy veins.

Occasionally, a patient requires an ultrasound to determine if a larger valve is incompetent. If this is the case, a surgical procedure might be necessary. Jessica never recommends laser treatment for veins. She firmly believes it is substandard care, is ineffective and often causes scarring.

A word of caution

Insurance fraud and unnecessary surgeries and procedures have sadly become a common practice in the world of vein treatment. Pop-up “vein clinics” are emerging and claiming to take all insurance with “no cost to you.”

The truth: Most insurance will cover an ultrasound if someone has symptoms and bulging varicose veins. Most insurance will cover surgery if proven medically necessary. However, since sclerotherapy is rarely covered by insurance, these clinics opt to perform more invasive and unnecessary procedures which often, not only don’t fix the presenting problem, but leave scarring.

Jessica Plotnick, PA-C, MMSc has been a vein specialist for over 20 years and practiced emergency medicine for 12 years in NYC. She is a graduate of Emory School of Medicine and Binghamton University and was a Faculty Professor at NYU from 2016-2020. Jessica’s expertise also includes many cosmetic procedures including injectables and laser devices. She is the owner of CPW Vein & Aesthetic Center, 75 Central Park West in NYC since 2004. Jessica recently opened a 2nd office in Chappaqua. To make an appointment at either location call 212-639-1259 or visit www.cpwmedspa.com

Start the New Year with a New Career at Club Fit!

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If you’ve pondered a career in the world of fitness, a golden opportunity awaits you!  You’ll also have a chance to meet your own fitness goals while helping others do the same.

Here’s how: Join a growing team that’s passionate about fitness, wellness, and making a difference in the community!  Club Fit is hiring, and hosting a Career Fair to find talented individuals to join in shaping a healthier future.

The Career Fair is happening in two locations on two consecutive Saturdays:

January 18th at Club Fit Jefferson Valley & January 25th at Club Fit Briarcliff. Each fair will take place from 12 p.m. – 4 p.m.

You can anticipate exploring your potential to fill a wide variety of Open Positions:

These include:

  • Personal Trainers, Fitness Coaches, and Group Fitness Instructors
  • Receptionists, Café Workers, and Childcare Workers
  • Massage Therapists
  • Lifeguards & Swim Instructors
  • Basketball Coaches

Club Fit requests that you complete the prescreen form to secure your onsite interview, and kick off a fulfilling career in 2025: https://www.clubfit.com/career-fair-rsvp/

Northern Westchester Hospital Gala Raises Record $2.5M for New Pediatric Behavioral Health Program

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(From left): Jane Donaldson, philanthropist & co-chair of Northern Westchester Hospital’s annual gala; Dr. Vera Feuer, medical director of child and adolescent psychiatry at Northwell Health; and Lisa Schwartz, Northern Westchester Hospital Community Foundation board member, co-chair of its Community Health Committee, and co-chair of the annual gala held on Nov. 2. 

MOUNT KISCO, NY – Northwell Northern Westchester Hospital (NWH) has raised $2.5 million at its annual gala, marking the highest amount the hospital has generated at an event in its 108-year history. More than 700 hospital supporters came together at the former Reader’s Digest building in Chappaqua to pledge support for the hospital’s new pediatric behavioral health program dedicated to meeting the needs of children and adolescents.

The highlight of the evening was a lively paddle raise during which an auctioneer invited enthusiastic attendees to raise bid cards at various donation levels. The vast majority of the audience participated, contributing both large and small donations, and raised over $631,000 – another record for the most on-site fundraising in the hospital’s history. The gala was jointly chaired by Lisa Schwartz, a Northern Westchester Hospital Community Foundation board member and co-chair of its Community Health Committee, and longtime philanthropist Jane Donaldson.

“This year’s gala struck a powerful chord with our audience, showcasing the overwhelming generosity of our guests while highlighting our new behavioral health program for children and adolescents,” said Derek Anderson, FACHE, president, Northwell Northern Westchester Hospital. “This initiative comes at a crucial time when nearly 20 percent of children in the U.S. face mental health challenges. We owe it to our children – and our future – to do better.”

NWH’s mental health initiative focuses on education and awareness, partnering with local schools and community groups to improve behavioral health literacy and promote early intervention. Goals for 2025 include the opening of a comprehensive child and adolescent psychiatric practice and establishing a stand-alone behavioral health center for rapid crisis care. In addition, an intensive outpatient program will be launched for patients who do not require hospitalization but would benefit from more structured support.

To meet these objectives by spring 2025, the Northern Westchester Hospital Foundation aims to raise $1.1 million over the next several months to achieve its total fundraising goal of $7 million for this initiative. To date, $5.9 million has been pledged with donations coming from individuals, private foundations and corporations.

“Young people make up approximately 25 percent of our population, but they will be 100 percent of our future,” said Ms. Schwartz. “Addressing their mental health crisis is our moral responsibility, so we are continuing to ask for the support of our community to make this bold vision a reality. Lives depend on it.”

A similar behavioral health program launched by Northwell Health in other regions of downstate New York in 2020 has led to a 60 percent average reduction in emergency room visits for child and adolescent behavioral health concerns. Northwell has committed to investing $500 million over the next several years to expand pediatric and adolescent behavioral health services across its network.

If you would like to contribute to NWH’s mental health initiative, please contact Whitney Hartmann-Peris at (914) 242-8382 or whartmann@northwell.edu.

About Northern Westchester Hospital:

Northern Westchester Hospital (NWH), a member of Northwell Health, provides quality, patient-centered care that is close to home through a unique combination of medical expertise, leading-edge technology, and a commitment to humanity. Over 700 highly skilled physicians, state-of-the-art technology and professional staff of caregivers are all in place to ensure that you and your family receive treatment in a caring, respectful and nurturing environment. NWH has established extensive internal quality measurements that surpass the standards defined by the Centers for Medicare & Medicaid Services (CMS) and the Hospital Quality Alliance (HQA) National Hospital Quality Measures. Our high-quality standards help to ensure that the treatment you receive at NWH is among the best in the nation. For more information, please visit Northern Westchester Hospital and connect with us on Facebook.

 

News and Photo Courtesy of Northwell Health

Visit us at Northwell.edu

Journey from Startup to IPO

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The lifecycle of a private company is evolving.

Over the last two decades, the timeline for companies to seek an entry to the public market has increased. This public market parade has only confirmed the story that data is telling us – companies are choosing to stay private longer.

With venture capital money flooding into the private sector and generally fewer regulations to comply with, remaining a private company offers the flexibility to grow and innovate at high-speed. But, what happens to shareholders along the way?

Private companies often grant equity-based compensation to retain talent and drive performance. Shareholders in the private market are holding onto equity waiting for the moment they can transform their stock options into monetary wealth.

Where did all this begin? Well, quite fittingly, it began with startup companies. When your company is just starting out, cash can be limited. Granting equity compensation may supplement cash to attract and incentivize the talent you need to grow your business.

Startup Equity Basics

As a startup company leader, here are a few things that may be helpful to know as you administer your equity program:

  1. An organized cap table to show equity transactions from investors, founders and employee-shareholders.
  2. An up-to-date 409A valuation, which ensures you’re compliant with IRS regulations when offering equity compensation.

Startup founders may view equity management as a necessary administrative task, rather than a mechanism for growth. They may be looking to grant equity compensation, show investors they are organized and know the company ownership stakes, maintain compliance and model some financial choices like comparing term sheets.

Equity Management While You Grow

After the startup grind, your equity needs and perspective can begin to change. New needs will arise, including added complexity to your equity administration and compensation strategy.

In the growth stage, a company has likely:

  • added a more substantial employee base
  • faced more compliance requirements like financial reporting
  • gone through multiple funding rounds
  • considered expansion

In terms of equity management at this stage, you might have a dedicated resource handling your cap table and compliance, whether that is a CFO or Stock Plan Administrator. You may also have a solid number of shareholders with vested stock options.

Those shareholders may be looking to see the value of their equity. It may be beneficial for them to have visibility not only for transparency, but also to help create a culture of ownership.

Another part of company growth is adjusting your compensation strategy. As you’ve moved through funding rounds, your cap table has potentially grown from a few founders, key team members and early-stage investors to a wider range of employee grants and investor holdings, which may have required heavy-duty cap table organization.

With these changes, you may not be granting equity to every new hire and with more cash at hand from those funding rounds, your compensation plans may have shifted to a custom mix of equity and cash.

Late-Stage Equity Management

Assuming your company doesn’t go through an exit, you will soon evolve from a growing company to a mature company. And once again, your needs will change.

Compliance might be an even bigger concern for you now, as is advising on liquidity events and a path to the public market.

As a mature company, your cap table is a complex and living organism, tracking transactions from grants to funding rounds, vesting schedules and terminations. You may seek a tender offer to present a liquidity opportunity to long-term shareholders, or you may seek an IPO.

If you’ve expanded globally, your team is likely looking to understand additional regulatory requirements as well as navigate local tax rates and rules for dozens or hundreds of jurisdictions. Our Global Intelligence tool may be able to help as you navigate global growth in your equity program.

Whether you’re an emerging tech company with a handful of names on your cap table or a late-stage life sciences organization, your equity and compensation needs are sure to change over time. Morgan Stanley at Work can provide equity solutions for any stage of your company’s journey.

DISCLOSURES

Article by Morgan Stanley and provided courtesy of Morgan Stanley Financial Advisor.

Richard bloom is a Financial Advisor in 1290 Avenue of the Americas at Morgan Stanley Smith Barney LLC (“Morgan Stanley”). He can be reached by email at Richard.Bloom@MorganStanley.com or by telephone at 212-893-7597. His website is https://advisor.morganstanley.com/the-mayergelwarg-group

Insurance products are offered in conjunction with Morgan Stanley Smith Barney LLC’s licensed insurance agency affiliates. Not all products and services discussed are available at Morgan Stanley.

Morgan Stanley Smith Barney LLC (“Morgan Stanley”), its affiliates and Morgan Stanley Financial Advisors and Private Wealth Advisors do not provide tax or legal advice. Clients should consult their tax advisor for matters involving taxation and tax planning and their attorney for matters involving trust and estate planning and other legal matters.

This article has been prepared for informational purposes only. The information and data in the article has been obtained from sources outside of Morgan Stanley. Morgan Stanley makes no representations or guarantees as to the accuracy or completeness of the information or data from sources outside of Morgan Stanley. It does not provide individually tailored investment advice and has been prepared without regard to the individual financial circumstances and objectives of persons who receive it. The strategies and/or investments discussed in this article may not be appropriate for all investors. Morgan Stanley recommends that investors independently evaluate particular investments and strategies, and encourages investors to seek the advice of a Financial Advisor. The appropriateness of a particular investment or strategy will depend on an investor’s individual circumstances and objectives.

Richard Bloom may only transact business, follow-up with individualized responses, or render personalized investment advice for compensation, in states where he is registered or excluded or exempted from registration, https://advisor.morganstanley.com/the-mayergelwarg-group.

© 2024 Morgan Stanley Smith Barney LLC. Member SIPC. # CRC#5984535 10/2023

Innovative Hand Surgery Technique Offers Comfort and Convenience

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For patients experiencing discomfort or struggling with daily activities due to chronic afflictions of the hand, advancements in hand surgery have brought new treatment options to help relieve pain and restore function in a convenient outpatient setting.

Dr. George Pianka,
orthopedic surgeon
at White Plains
Hospital Physician
Associates.

A technique known as Wide Awake Local Anesthesia No Tourniquet (WALANT) has proven transformational for patients, says Dr. George Pianka, a board-certified orthopedic surgeon at White Plains Hospital Physician Associates.

“Many procedures that were previously difficult to do without general anesthesia can now be done using WALANT,” explains Dr. Pianka, who has been at the forefront of the specialty for nearly 35 years. In addition to his board certification, Dr. Pianka holds a Subspecialty Certificate in Surgery of the Hand and is a member of the prestigious American Society for Surgery of the Hand.

Relieving Pain, Restoring Function

Dr. Pianka attributes the growing popularity of WALANT procedures to the ease, comfort and convenience they offer patients, especially those whose hand function has been compromised due to stenosing tenosynovitis, also known as “trigger finger” and Dupuytren’s contracture, an abnormal thickening of tissues in the palm of the hand.

Trigger fingers have multiple symptoms, including finger stiffness, a popping or clicking sensation as the finger moves, tenderness, and one or more fingers being locked in a bent position.

The WALANT procedure to address trigger fingers is known as percutaneous trigger finger release, and is performed in the office during a routine visit with a small needle puncture. The band of tissue along the tendon sheath at the base of the finger known as the A1 pulley is divided, allowing the tendon to move freely. The procedure takes one to two minutes and return to normal activity is allowed immediately. Patients can easily receive treatment for multiple fingers affected over time.

Dupuytren’s contracture is believed to be hereditary, although the specific causes are not known. Symptoms can include uncomfortable lumps and pits within the palm, bending of the finger(s) towards the palm and difficulty doing daily activities, such as washing hands or putting on gloves, or shaking hands.

Similar to trigger finger, patients with Dupuytren’s contracture can also find relief for their symptoms with a short in-office WALANT procedure known as Needle Aponeurotomy. During the procedure, under local anesthesia, the abnormal tissue in the hand is weakened with multiple passes of a needle and then separated to open the finger from the palm. There is no open wound.

Benefits of WALANT Procedures for Patients

In addition to comfort and convenience, a key benefit that WALANT procedures offer is making treatment available to patients who may not be candidates for traditional surgery due to the risks that general anesthesia may pose to their health, such as those with conditions such as asthma, chronic obstructive pulmonary disease (COPD); cardiovascular conditions; those who have had a recent heart attack or stroke; or who take blood thinners.

What’s more, patients who take medications to manage chronic health conditions who may have had to stop their medications in advance of a surgery can instead continue these regimens as normal. Additionally, many patients in good health but who are unable to take time away from work and family obligations for surgery can now access treatment that fits into their lifestyle. As a result, “a whole new patient population can get the care they need,” explains Dr. Pianka.

Many times, the consultation and procedure can be done in the same
in-office visit, after which patients enjoy rapid recovery, including minimal wound care. “A small adhesive bandage over the needle puncture is all that is required. Hand washing is allowed later that same day,” shares Dr. Pianka, emphasizing that patients can feel better and get back to their lives even faster.

This article originally appeared in Health Matters, a White Plains Hospital publication.

Dr. George Pianka sees patients at White Plains Hospital Physician Associates in Hawthorne and Yonkers. To make an appointment, call (914) 631-7777 (Hawthorne) or (914) 375-7777 (Yonkers).