November 2013

We all know the basic function of a bridge is to span a gap between two locations, enabling citizens to travel between them more easily. But certain bridges in key locations also span a gap in time – it connects past, current and future generations together. Once in a while, a signature bridge of great architectural design becomes an inspiration to its community. The San Francisco-Oakland Bay Bridge is this type of structure.

In the early 1900’s, California road builders felt the bay water that separated the two metropolitan communities was too deep and wide, making a bridge an engineering impossibility. For decades, commuters piled onto a fleet of ferry boats, whether by foot, automobile or trolley, to leisurely cross between the East Bay and the city of San Francisco.

San Francisco and Oakland grew up as separate communities, even with the constant, but measured, flow of goods, services and people between them. During the year of 1928, ferries carried over 46 million passengers between the two shorelines. Finally, with the exploding popularity of the automobile, it was determined that a bridge was necessary and such a structure could financially support itself with tolls.

The challenges of building this bridge were monumental. California State Highway Engineer Charles C. Purcell was put in charge of organizing the design and construction of the Bay Bridge. Fortunately, Yerba Buena Island was located about halfway between the two shorelines. This allowed for two independent spans that would meet at the island, connecting via a tunnel.

Spanning the western section between the San Francisco and Yerba Buena Island required ingenuity on a grand scale. The water, 100 feet deep at some points, and the underlying soil conditions, required new techniques for placing bridge foundations. The solution was to build two consecutive suspension bridges using the same basic architectural design as the Golden Gate Bridge.

The eastern crossing from the Oakland shoreline to Yerba Buena Island was also an immense feat of engineering, although less difficult than the deep water crossing on the western side. This bridge span was designed as a double cantilevered section (adjoining Yerba Buena Island) connecting to a double-deck truss bridge leading to the Oakland shoreline. The cantilevered section was 10,176 feet long, the longest bridge of its kind at the time. It also employed theworld’s deepest bridge pier, sunk 242 feet below water level.

Construction took three years, and was completed six months ahead of schedule. The bridge had consumed over six percent of the total steel output of the nation in 1933. Total costs were $77 million, including the construction of the Transbay Transit Terminal. The bridge opened in November, 1936, about six months before the Golden Gate Bridge. While an efficient vehicle transport system, cantilevered and truss bridges were a common style for dozens of railroad bridges built in the US at that time. Architecturally, the eastern span seemed to echo the demographics of Oakland, a working class community, and was nowhere as inspirational as the Golden Gate Bridge or the western span of the Bay Bridge!

In its early years, the bridge carried three lanes of auto traffic in each direction on the upper deck. The lower deck was reserved for truck traffic and inter-urban railways. This included the Key System street cars that ran through many communities in the East Bay and carried commuters to San Francisco throughout the day.

But automobile traffic increased greatly over the post-WWII years. In 1958, the railway system was removed and the upper deck was re-aligned to carry five lanes of westbound truck and auto traffic. The lower deck carried five lanes of eastbound traffic.

The Bay Bridge became the work-horse for the inter-city automobile traffic, with 270,000 vehicles crossing it each day. It was a crucial support element in the economic growth of the Bay Area. There were a few minor bridge closures, mostly for accidents or maintenance, until the Loma Prieta earthquake struck in 1989. There was an inherent design flaw in the eastern span, where the cantilevered section abutted the truss section. This caused a portion of the upper deck to fall onto the lower deck. Further study indicated the bridge had narrowly avoided a more catastrophic failure. The Bay Area would experience significant economic disruption if the Bay Bridge ever suffered such a cataclysmic failure.

Caltrans determined it would be less expensive to build an entirely new eastern span than to seismically retrofit the existing one. The initial design proposed was an elevated viaduct or skyway, consisting of reinforced concrete columns and roadway segments. The seismic design criterion for the new bridge required it to survive an 8.5 magnitude earthquake. The replacement bridge was authorized in 1998 and construction of the skyway segment began in January, 2002.

However, an extensive amount of political infighting and financial squabbling followed for various aesthetic, financial, and political reasons. In the end, it was decided to build a “signature” section as part of the new eastern span. For various reasons, this design of this section is based on an asymmetric, single-tower, self-anchored suspension architecture, which is very rare yet quite elegant. Construction on the “signature” span, which is located above the shipping channel and connects the skyway portion of the bridge to Yerba Buena Island, began in September, 2007. The entire bridge was completed in mid-2013 at the phenomenal cost of $6.4 billion. The grand opening was held immediately after the Labor Day holiday with very little fanfare.

While it will carry about the same amount of traffic as before (five lanes in each direction), it’s much safer for many reasons. The seismic design goal of the bridge is to withstand the largest potential earthquake the Bay Area might have in 150 years! For drivers, there are now shoulders on the roadway where one can pull over if they run out of gas or have a mechanical vehicle issue. For pedestrians and bicyclists, there is now a walkway attached to the side of the bridge. For night driving, the lighting on the bridge and in the Yerba Buena Tunnel is much brighter.

Most of the span was designed to be causeway style – very open with all supports underneath the bridge on the skyway segments. This creates a very “open feel” for drivers crossing the bridge, especially in the east-bound direction where before, they were enclosed within the lower deck of the prior double-deck bridge. For west-bound drivers, the views to the north and west are open and expansive (unless the fog is in). One does not get a claustrophobic feel when stuck in heavy traffic!

My initial drive across the new eastern span was one of mixed emotions. I was locked in the back seat of a Highway Patrol escort car at the time, so that may have affected things. It’s hard to get the full visual effect of the new suspension architecture when looking thru bars.

However, I was inspired by the new “signature” span. It is a work of art and will have a lasting positive impact on every tourist’s initial impression of Oakland, when one drives easterly in to the east bay community. It also imparts a sense of awe for drivers and passengers driving westerly into San Francisco because of the awesome view from Berkeley to Alcatraz to the Golden Gate Bridge.

Whether the cost of construction will end up being worth it, this new Bay Bridge definitely has the cache to become one of the most highly regarded in the world.

 

It’s been a great journey following a little piece of history in the making, as the project I began in 2008 just kept getting better and better. So many wonderful photo opportunities have come my way—from land, sea and air—that it’s difficult to pick just a few to share.

Many late (sometimes very chilly) nights were spent on Yerba Buena and Treasure Islands, exploring different views of the Bay Bridge with my friend and dedicated driver, Rod Harris. Exciting aerial shoots were had, thanks to my pilot friend, Chris Chilson and fun photos from the Bay were possible thanks to my dearly departed friend, tugboat Captain Eric Gohs.

 

On August 17, 2012, I had an incredible private tour of the Bay Bridge construction site with Bridge Safety Engineer, Edward Garcia, who went out of his way to show me around. The elevator ride up to the bridge was a little scary but I was thrilled, and as I stepped out onto the construction site, I was blown away with the immense scope and details of the bridge project. Needless to say, my cameras were put to work immediately, and as I was shooting, I realized that future photos of the site would never be the same as a long parade of concrete trucks would be arriving the very next day to cover up the detailed roadwork I’d been documenting.

On August 28, 2013, I witnessed, firsthand, the historic closing of the Bay Bridge from the roof of the Toll Plaza (watching drivers jockey to be the very last car to go through) and then stood in the middle of the closed freeway to photograph the closed Toll Plaza. Who would have thought I’d get those exciting photo ops!

During the bridge closure, I had some amazing opportunities to explore and photograph the old, eerily quiet bridge. Most impactful though was standing on the 50-foot section of the old East Span’s upper deck where it collapsed during the 1989 Loma Prieta earthquake. My thoughts and prayers were definitely with those who lost their lives there.

Seeing “the troll” attached under the bridge (put there in the wake of the 1989 disaster, to honor the workers who repaired the old bridge, and to protect it from future damage) was another memorable highlight.

Walking and taking photos out on new Eastern Span of the Bay Bridge on opening day (before the Bridge was opened to the public) was an extra special treat. I must have set the world record for the number of times one can say, “WOW,” in one day. As I documented an unforgettable, “moment in time,” the question kept entering my mind: How could life get any better?

Special thanks to Officer Daniel Hill and the California Highway Patrol for giving me so many incredible photo opportunities during the bridge closure. For more Bay Bridge images, go to www.SusanWoodPhotography.com

This holiday season, Danville’s Nicole Ludwig (43) is thankful for so many things in her life. She’s thankful for the beautiful daughter, Nadia, she and her husband adopted four years ago; she’s thankful for her wonderful husband, Jim who carried the emotional load when their lives were turned upside down in 2011, and, she’s immensely thankful for the heart she received last year that allows her to be with the ones she loves on Thanksgiving Day.

Having recently met the family of Charles Barry, whose heart Nicole carries, the Ludwig’s are especially thankful that the Barry family’s selfless act of kindness will allow Nicole to honor their son and brother’s memory for many holidays to come.

Nicole Smith was born in Walnut Creek. After her parents’ divorce, she spent time living with her mom in Alamo and her dad in Sunol, before she struck out on her own at the age of sixteen. After nearly a decade of fast food, fast cars and fast times, at the young age of twenty-six, she was diagnosed with dilated Cardiomyopathy (an enlarged heart). She was told she would die if she didn’t change her diet and lifestyle. Initially feeling indestructible, it took her almost six years before she quit smoking and drinking, started eating right and began a regular exercise routine which essentially allowed her to shrink the size of her heart. Her amazed doctors gave her a clean bill of health, took her off medication and sent her on her merry way.

For the next ten years, life for Nicole was good. She met, pursued and in 2006, married her husband, Jim Ludwig. Three years later, they were introduced to their future daughter, Nadia, through the Contra Costa County’s Foster/Adoption program. The adoption was finalized on November 20^th, 2010 and the Ludwig’s were officially a family. Feeling truly blessed, Nicole walked marathons, was active in the community, and began acclimating to motherhood.

While on a hike one day with Nadia, Nicole noticed she was having trouble breathing. It dawned on her that she had been experiencing fatigue, dizzy spells and weight gain for several months, but she had attributed it to her increasingly chaotic schedule. That night, she followed her intuition and went to the emergency room at Kaiser Walnut Creek where she was told her heart condition had returned and was worse than ever. Simply put, her heart was misfiring.

“For the next twelve months I was sick a lot. Needing a procedure called a T-Maze, I had to wait until I was healthy enough for the doctors to laser the part of my heart that was misfiring,” Nicole explained to me. On July 8^th, 2011 the procedure was performed and the next day Nicole was sent home to celebrate Nadia’s upcoming 7^th birthday. Unfortunately, the following day things took a turn for the worse and she landed herself back in the emergency room. “The doctors had to shock my heart back to life 15 times in a 24 hour period. My heart and organs were failing, I was dying.”

Nicole would spend the next one hundred thirty days in three different hospitals, in desperate need of a new heart. “I spent 17 days at Kaiser in Walnut Creek where I received a defibrillator. The defibrillator was used to shock my heart back into rhythm. Sadly, I was unconscious most of the time and unable to assist in the decision making process about my care,” she says.

Truth be told, Nicole has no recollection of her time at Kaiser, Walnut Creek, and it was Jim who had to make the gut-wrenching, life or death decisions. She was transferred to Kaiser Santa Clara in August, where she spent 33 days in their cardiac unit. Finally, she was moved to Sanford Hospital’s Cardiovascular Medicine Department in Palo Alto for her first heart procedure.

On September 9^th, 2011, a machine called an *LVAD (Left Ventricular Assist Device) was implanted into Nicole’s chest. After nearly nine weeks at Stanford Hospital, Nicole was transferred to a small apartment near the hospital’s campus where her team of doctors and nurses could keep a close eye on her as she began to rehab. This is also where Nicole and Jim learned to live life with the LVAD.

During her extensive time in a hospital bed, in and out of consciousness, fed through a tube, Nicole had lost a tremendous amount of weight, her muscles had atrophied and she had virtually no upper or lower body strength. She literally had to learn to walk again. After approximately two weeks, which included a scary (and embarrassing) shower incident that required being rescued by the Palo Alto Fire Department, the Ludwig’s returned home on November 22^nd, , the day before Thanksgiving.

Along the way, Jim and Nicole had to help train members of the Danville Fire Department on working with the LVAD. Additionally, they were placed on PG&E’s Life Alert, in case of a residential power failure. Nicole lived with the LVAD for 5 ½ months (a LVAD user can live up to ten years), during which time she returned to a near normal life that included working out, volunteering at the elementary school and even sex. As grateful as Nicole was for the LVAD, there was no getting around the fact that she needed a new heart.

Stage 4 heart transplant candidates are on one of two lists. Nicole was immediately placed on 1B status, meaning she could be given a new heart at any time, however patients with 1A status have priority status. 1A status is essentially a 30-day high priority window so it’s critical for patients and their doctors to know exactly when to move up to 1A status because if a suitable heart is not found during that period of time, they move to the back of the 1B line. Nicole was placed on 1A status on February 1^st 2012 and 25 days later got “the call.” Getting that call was very emotional for Nicole for a variety of reasons. “I had been functioning well on the LVAD and I knew the transplant would make me very weak again for a long period of time. This also meant having to miss more time with Jim and Nadia who had already been through so much during my prolonged absences.” Sadly, there was also the realization that to receive a heart, someone somewhere had lost their life and that weighed heavy on Nicole’s mind as well. “Without knowing who they were, I felt a deep sadness for the donor family.”

The heart transplant procedure went incredibly well and Nicole was released from the hospital on April 8, 2012, the day before Easter. On February 26, 2013, Nicole passed the critical one year period. It is standard practice for the donor family and heart recipient to wait at least six months before requesting any type of communication with the other party. Nicole made a hard, but conscious decision to wait twelve months, simply out of respect for the family. Once that request has been made, either side can choose to accept or deny contact. Eight months after her transplant, the Berry family (from Reno, Nevada) reached out to Nicole through the Donor Network social worker. Communication started with a letter from Charlie’s sister, Holly. From there, it moved to email and then to Facebook.

In September, the Berry and Ludwig families met for the first time, in-person, while participating together at the Donate for Life 5K in Santa Clara. Emotionally Nicole shared, “We laughed and cried a lot, but it was a wonderfully cathartic experience. Coincidentally both Charlie’s mom and I brought a stethoscope.”

You genuinely won’t meet many people with a bigger heart than Nicole, even if it’s not technically hers. She has a permanent smile on her face and spring in her step. Nicole credits her, “I need to live,” attitude with helping her cope with everything she went through. “I had a husband and daughter who needed me and a life I wanted to get back to,” she says. “Even my doctors had doubts, but they never gave up because they knew I wasn’t going to ever give up.” Needless to say, Nicole is thankful for so many things this holiday season, not the least of which is just being here.

On a side note: I, as much as anyone, am thankful that Nicole is here today. Their daughter Nadia is my great niece. It’s a long and complicated family story. Suffice it to say, my sisters, wife and I are so incredibly grateful that Nadia is in such a good and loving home with truly wonderful parents..

*The LVAD, developed by Thoratec in Pleasanton, is a mechanical device that circulates blood throughout the body when the heart is too weak to pump blood on its own. Two leads exit the body and attach to an exterior controller. The user wears a vest which holds the controller and is equipped with two VHS tape size batteries, each with an approximate twelve hour life span. The batteries are changed out, one at a time, at least two times a day. If the batteries fail, the patient has approximately 15 minutes to live.

 

Theodore Roosevelt once said, “This country will not be a good place for any of us to live in unless we make it a good place for all of us to live in.”  The East Bay Regional Parks District (“EBRPD”) runs a volunteer trail maintenance program each year that extends from April through November and includes approximately eight separate projects throughout the East Bay parks system. On Saturday, September 28^th, over sixty volunteers, including twenty-five employees of Cassidy Turley, a national full service commercial real estate company, put in a hard day’s work at the Diablo Foothills Regional Park near Castle Rock Regional Recreation Center in Walnut Creek.

The volunteers worked from 8:30 am to 1:00 pm in a scenic canyon along Pine Creek creating a new hiking path and eliminating an old trail that had become obsolete and troublesome. Whiff Collins, Senior Managing Director of Cassidy Turley’s Walnut Creek office said, “It was a wonderful opportunity for our three East Bay offices (Oakland, Pleasanton and Walnut Creek) to come together outside of the normal nine to five workday and give something back to the community. Sean Dougan, a Senior Planner with the Trails Development Programs of the East Bay Regional Parks District was impressed with the teamwork displayed by Cassidy Turley. “Swinging a pick-axe for five hours, side by side with your fellow desk jockeys, isn’t a bad way to spend part of a day,” said Dan Moylan of Cassidy Turley.

EBRPD encourages companies and groups to sign up for these types of events as a team building exercise to promote synergy and collaboration. “There are a wide variety of community service projects available in the East Bay and they should be sought out by everyone as a way to give thanks and to participate in something beneficial for the community”, said Jeff Starkovich, Senior Managing Partner of Cassidy Turley’s Oakland office. To quote Winston Churchill, “We make a living by what we get, but we make a life by what we give.”

To find out more about the East Bay Parks trail maintenance and restoration projects visit their website at www.ebparks.org/getinvolved/volunteer/trail.

 

 

Do you have that special event—wedding, reunion, graduation, vacation, etc.—coming up and you need to know a good timeline for all those special cosmetic procedures that can make you glow in the happiness of the moment? If you are plagued with mild acne, rosacea, sun damaged, aging skin, cellulite, or excess fat at neck, hips, waist and belly, plan a consultation with a board certified dermatologist 4-6 months before the big event. Individual results and needs will vary but the following time guide can give you a reference to the time required in order to see the best results.

4-6 Months

Ultherapy®is the only FDA approved non-invasive treatment for lifting and tightening the skin on the neck, face and brow without any downtime. Ultherapy focuses ultrasound waves to generate a plumping effect that reaches deep below the skin surface to initiate your body’s own repair process that strengthens existing collagen and elastin fibers to produce fresh new tissues over a 3-6 month period. Ultherapy is an option to consider, preventing the need for a facelift as long as possible. Advanced Laser & Skin Care Center has a dedicated Ultherapist on staff who is a nationally recognized expert and trainer. We provide nothing but the best for our patients.

3-6 Months

Cellulaze™Laser Cellulite Reduction delivers the best results for women who are not significantly overweight but have mild to moderate cellulite. Cellulite is not a fat problem; it’s a structural problem below the skin. Only Cellulaze attacks the brittle structural bonds beneath the skin that are the real cause of cellulite’s dimpled appearance. A very small tube is inserted under the skin to release the fibrous bands that pull the skin down causing the orange peel look. The area is numbed with local anesthesia so the procedure is comfortable. Following the treatment, you may experience some slight soreness, but you will be able to return to normal activities in a day or two.

6 Weeks

Smart Lipo™ Laser Liposuction permanently melts away fat from jowls, neck, thighs, stomach, chest, arms and love handles. This is a safe in-office procedure, requiring no general anesthetic. Ninety-eight percent of our patients return to work in three days and full active sports in 3-6 weeks. Because SmartLipo™ actually tightens tissue, there is less dimpling and sagging afterwards, as you improve your overall body shape. We have performed more than 2,000 liposuction treatments since 1997. Experience counts. Beautiful body sculpting with liposuction requires experienced technique and an artist’s eye. We are accomplished in both.

6 Weeks

Micro-Fractional CO2 Plus Erbium Laser Skin Rejuvenation can make you look 3-10 years younger on your face, neck, chest, hands and arms. This procedure combines two powerful lasers in one treatment to smooth and tighten the skin and reduces wrinkle lines on the face, neck & chest as well as acne scars and unwanted pigment and sun damage. You may return to work in 7-10 days. You’ll want to schedule a comprehensive one hour consultation with us before considering any other laser or face lift procedure.

3-4 Weeks

Fillers: Restylane®, Juvederm®, Perlane®,Radiesse® etc. to treat deep lines, creases, individual acne or chickenpox scars. This is also a wonderful product and procedure to enhance the appearance of cheekbones and lips. Fillers are pure hyaluronic acid gel which exactly matches the hyaluronic acid gel in our own skin that is lost through aging and sun damage. We can artistically enhance the face to give you a softer, more sensuous natural appearance, without that “overdone” look. We combine a host of acupressure techniques, ice, painless dental blocks and the experience of over 25,000 treatments since 1981 to deliver the best results possible. As with anything, experience counts and for your face it makes an important difference.

3 Weeks

Botox®, Dysport® and Xeomin®to safely erase the frown lines and wrinkles on the forehead above the nose and crow’s feet at the corner of the eyes. Give yourself that stress free relaxed look that comes with the easing of the fine line muscles on the face. We have performed more than 15,000 treatments since 1992, all virtually pain free. We use a combination of acupressure, cold compresses and the smallest diameter needle possible to minimize both discomfort and bruising. You owe it to yourself to have the best, most experienced professional, when it comes to your big event.

2-3 Weeks

Micro Laser Peels are for the patient looking for a deeper peel (12-50 microns) than the microderm abrasion but without the 7-10 day downtime of CO2PLUS.This procedure refreshes, rejuvenates and evens the tone and texture of the skin. It does leave you with a “sunburned” appearance for approximately 1-4 days but quickly heals to a smoother, healthier, more vibrant skin texture.

**1-2 Weeks (series of 5 treatments spaced 2-4 weeks apart is best)**

BBL (Broad Band Light) & IPL this treatment is a wonderful innovative procedure to help turn back the clock on aging skin. Premature aging of the skin is the result of years of over exposure to the sun, collagen depletion, hormone loss, smoking, poor diet, excessive alcohol intake, stress, age and even genetics. Through the BBL process, dark areas in the skin absorb light more intensely than lighter areas. The dark areas are then heated and the light destroys the pigment carrying cells which lead to an evening out of the discoloration of the skin. Besides dark pigment, the BBL can also treat red pigment cells in rosacea-prone skin types. Improvement in skin tone, texture and color with reduced or eliminated brown spots and redness will be gradual and will accumulate with each session, depending on the condition being treated. For best results, usually 3-5 treatments are recommended, spaced 2-4 weeks apart. Smoother skin with less noticeable fine lines, brown spots, red/purple blood vessels will lead to a more vibrant and younger look and feel to the skin.

2 Weeks

Physician Strength Products & Peels are cosmeceuticals that are provided exclusively for our patients to provide the best quality, most effective skin care merchandise at the most reasonable price. Cosmeceuticals are available only through a physician’s office and are not sold over the counter.  Much of the skin care products available today are high price marketing items with very little science or efficacy. We have chosen the products we feel offer the most value for improving our patients’ skin health. We also, have an extensive selection of effective sunscreens which are the cornerstone to any skin care program. Our various peels are applied by a highly trained medical aesthetician who chooses the appropriate peel to freshen your skin and relax your mind before the Big Day. The face becomes a perfect palate for makeup, a more even skin tone, and diminished lines and wrinkles. We also treat the neck, chest, hands and back area if your dress is low-cut.

1 Week

MicroDermabrasion is the gentle exfoliating of the top layers of skin to add that healthy smooth glow and allow skin care products better absorption into the skin. After lightly removing the top layer of dead rough skin cells our medical aesthetician can also apply a hydrating collagen mask or other serums to augment and nourish the skin for a more radiant look and supple feel. Hands can also be treated in this manner to add a refreshed glow and smoothness to the touch.

Some Final Thoughts:

There are many people who say, “Just grow old gracefully.” The naturalists among us would say to age as healthfully and gracefully as we can. There is no question that being healthy is fundamental, regardless of your age. Keeping our body healthy and in good repair should be our number one priority. After all, we keep our homes and our cars in good repair and condition, so why not our bodies? Just like a refreshing coat of paint to our home or our car can improve their look and the joy we take in their appearance, why not do a few cosmetically restorative things for your body. Of course it is a decision we all get to make for ourselves.

We can choose a little or a lot, depending on our disposition. The minimum skin care decision would be to choose a SPF# 30+ sunscreen to wear daily, rain or shine. Although a comprehensive skin care routine with well-formulated cosmeceuticals (it always takes more than one product) can make a huge difference in the appearance of your skin, they simply cannot do what cosmetic procedures can do—it just isn’t possible.

Cosmetic treatments such as lasers, Botox, and fillers are the only ways to truly shave years off your appearance. Even the best skin-care routines and cosmeceuticals have limitations, but there is no question that after a certain time, the combination of a brilliant skin-care routine, coupled with corrective procedures, is the best solution to looking younger, longer.

One key factor to having a procedure done sooner rather than later is that it’s safer to have any surgery, including cosmetic, when you are younger versus older. First of all, your skin and your body are better able to heal when you are younger. The older you get, the longer it takes for the skin to repair and heal itself. Having cosmetic procedures sooner rather than later also is less dramatic when your face is just beginning to show signs of age, as opposed to when you already look older and people have become used to seeing your “older” face and neck.

Also, consider your expectations. If you expect cosmetic procedures to turn you into a model or a 20 year old version of yourself, you will be disappointed because that is not what will happen. Patients who report the greatest satisfaction after cosmetic procedures are the ones who kept their expectation realistic, not expecting the procedure to magically transform every aspect of their life. They also did it for themselves, rather than to please someone else.

Cosmetic care and procedures are not about shopping for a bargain. Truth is, most procedure costs are all fairly similar. Just remember this is your skin on your body and I’m pretty sure it’s the only one you have—so take care of it and find a health care professional with knowledge and experience. There are always risks and unexpected possibilities with any procedure or product, and the time of recovery differs. Individual reactions can be faster or slower, and any number of things can be different, depending upon the situation. What you want is someone with the experience and compassion to deal with any potential problems that may arise, not the cheapest bid available on “Groupon.”

Any doctor who glosses over risks or downplays your concerns is not one to trust with your appearance and well-being. Another important point is whether or not the doctor is willing to provide enough time for your consultation. There should be no sense of being rushed and you should leave the consultation feeling informed and empowered.

Another important point to finding a qualified dermatologist is to check for board certification with the American Academy of Dermatology. (AAD) Always check online with the aforementioned accreditation group before assuming that a framed picture of a certificate hanging on the wall has any validity or relevance.

In the end, whatever you choose is up to you. Your decision should be based on improving how you feel about yourself from the healthy perspective of wanting to look as good as you feel and feel as good as you look. If you are willing to take the time to find the right doctor, and keep your expectations realistic, then there’s every reason to go for it!  Have a wonderful Big Event!

 

 

Dr. Michael J Tomcik, M.D., FAAD is a Board Certified Dermatologist with over 35 years experience. Doctor Tomcik’s state-of-the-art practice at Advanced Laser Skin Care Center, is located at 101 Park Place in San Ramon (at the corner of Crow Canyon  and Park Place).

See their website at www.SanRamonDerm.com or call, 925-743-1488.

 

Feeling grateful for having shelter, food, clothes, money, and people that care about us is a healthy gift to our minds, bodies, and spirits. In this way, having an “attitude-of-gratitude” creates a positive state of mind and is a great stress-busting tool.

On the other hand, it is common to over-focus on what’s not right in our lives—especially during holiday times. Increased family pressures and demands on our time and money—create a recipe for “super-sized” holiday stress (it’s no wonder we overeat!) Can you relate?

Now, let’s not forget that holiday stress is exacerbated by unrealistic expectations (and their close cousin: perfectionism). When we feel nothing we do is ever good enough, we may become habitually stuck in a negative cycle. For example, we may have recurring thoughts like, “I’m not young enough, successful enough, and I’m a disappointment to my family.” Occasional comparisons are one thing, but chronically feeling “less than” can be a sign of low self-esteem. When we’ve lost sight of our inner value and become overly focused on our outer value, we may find ourselves sleeping poorly and waking up in the middle of the night worrying.

The good news is, here are two tools I often offer my clients (and use myself) to help reduce stress and embrace an authentic attitude-of-gratitude:

“What’s Buggin’ Me?”

Even though “positive thinking” is good for the mind, body, and spirit—denial—is not. That’s why I start my mood-shifting process by first exploring what is bothering me. Otherwise, if I go straight for the “Attitude-of-Gratitude” tool, I’ll be slapping white paint on the wall and ignoring the “mildew” growing underneath. So here’s a way to see if there’s wisdom…or an important message that the “mildew” is offering.

1) I begin by asking myself, “What’s buggin’ me?” I often journal a few paragraphs to vent about what’s up with me. I pay attention to angry or resentful feelings and explore below the surface to uncover any vulnerable feelings like fear, sadness, or guilt. In this venting stage I write freely without concern for spelling, punctuation, or “being nice.” In other words—I let it flow (with a fully-functioning shredder nearby).

2) After venting through journaling, I then think about whether there is some constructive action I can take. If something comes to mind, I go for it. Or, if it’s 3 am, I make a list of some “action steps” I can begin taking the next morning. I also consider doing research, getting advice, support, or whatever will help me get over and beyond the challenge that is worrying me. Taking action usually gets me out of the “helpless mode” and onto an empowered and productive track. After the “mildew” has been explored and any wisdom retrieved, I then reach for the following tool.

“Attitude-of-Gratitude”

Did you know that fear, anger, and sadness have difficulty coexisting with positive feelings like gratitude? Yep, they do. And, focusing on positive feelings moves us out of the victim role. So, to continue shifting out of my worry cycle, I often practice this simple “three-step process” by doing the following:

1) Pulling out a pen and a piece of paper.

2) Taking a few abdominal breaths to get “out of my head” and deepen my connection with my body.

3) Making a list of people, places, pets, and things for which I feel grateful.

Now, this may sound too simple, but it can affect our mood and outlook. If my brain resists shifting gears and nothing comes to mind, then I start exactly where I’m sitting. I mindfully look down to see if I have clothes on my back and shoes on my feet. If so, then these are the first things I write down. Is there a roof over my head? Great, then that means I’m both clothed and sheltered.

In addition, acknowledging the special personality traits—in our loved ones and ourselves—is a wonderful way to clarify what we’re grateful for. When doing this exercise, I look for qualities like compassion, reliability, creativity, and playfulness.

As a result, once we move out of the worry cycle, the positive juices usually start flowing. These two tools, “What’s Buggin’ Me?” and “Attitude-of-Gratitude,” are great stress-busters when we want to shift away from negativity and worry. The reward is to move from our heads into our hearts, and create a nourishing Thanksgiving holiday. Finally, let’s broaden our scope and cultivate an authentic “attitude-of-gratitude”…that is renewable all year long.

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Trina Swerdlow, BFA, CCHT, is a Certified Clinical Hypnotherapist, an artist, and the author and illustrator of Stress Reduction Journal: Meditate & Journal Your Way to Better Health. Trina has a private practice in downtown Danville. You can reach her at: (925) 285.5759, or info@TrinaSwerdlow.com.

Certified Clinical Hypnotherapy services in California can be alternative or complementary to licensed healing arts, such as psychotherapy.