Stem Cell Therapy Shows Promise In Toddler With Down Syndrome

Dr. Harris BramToday, I’m sharing this report on the remarkable potential of Stem Cell Therapy to help support the success we have had with it in treating a number of less-severe conditions. Our experienced pain management doctors regularly use Stem Cell Therapy to treat tennis elbow, knee pain, shoulder pain, Achilles injuries, degenerative disc disease, and sports or overuse injuries. My intent is that if you learn how this non-invasive procedure is performing miracles with an incurable condition like Down Syndrome, you might open your mind to trying it for relief from ongoing pain.

Improvement and hope

Recently, doctors in New Delhi reported that a three-year-old boy born with subnormal motor skills from Down Syndrome, responded positively to stem cell treatment. Although Down Syndrome is a genetic disorder with no permanent cure, experts concluded that Stem Cell Therapy can lead to some improvement and hope for a better quality of life.

The toddler was brought to a local stem cell specialist with serious delays in his development, the inability to speak, no neck-holding capacity, cardiac defects, and other issues. (About 50 percent of all babies born with Down Syndrome have a congenital heart condition.)

No adverse effects

The boy was treated with two sessions of Stem Cell Therapy, the first lasting approximately three months. A stem cell expert explained that after the first session, the toddler was able to recognize family members, and he began to crawl and babble. Also, the muscle tone in all his limbs improved. It was remarkable progress with no adverse effects.

These truly eye-opening results and improvements support the belief that stem therapy has the potential to replace damaged neurons, re-establish lost nerve connections, and provide treatment for various neural and congenital disorders.

Stem Cell Therapy is a medical breakthrough that provides hope for the future. But this simple, safe and natural treatment has already been helping patients at New Jersey Pain Care Specialists. If you suffer from a painful condition that has not responded to traditional care, contact our office to discuss what Stem Cell Therapy can do for you.

At the present time, Stem Cell Therapy is not covered by medical insurance.

 

 

 

 

 

 

4 Basic Benefits Of PRP Therapy For Pain Management

Dr. Harris BramPlatelet Rich Plasma (PRP) is one of the most popular treatments offered at New Jersey Pain Care Specialists. PRP Therapy a fast, simple, non-invasive procedure that provides superior relief for acute or chronic pain by promoting the natural healing potential of the body. It accomplishes this by using platelets from your own blood.

If you have a tendon, ligament and joint injury that hasn’t responded to traditional treatments, you might want to learn about PRP Therapy

For starters, here are four basic advantages:

PRP Therapy is Safe 

Because the procedure uses platelets harvested from your own blood, there is no risk of disease injection or transmission. There is also no risk of allergic reaction or rejection.

PRP Therapy is Convenient

It does not involve complex surgical procedures. Your pain management doctor simply extracts platelets, plasma and any other needed cells to customize the optimum formula for your specific needs.

PRP Therapy is Natural

Because this treatment uses your own platelets, your body doesn’t feel any sense of being violated by foreign matter. As a result, your system won’t act to reject it. Platelet Rich Plasma Therapy simply enables your body to heal itself naturally.

PRP Therapy is Cost Efficient

Because all the necessary components for healing are taken directly from your body, and the one-hour process is done right in our office, it can avoid running up a hospital bill.

Interested? We are eager to tell you more about Platelet Rich Plasma Therapy and how it can work for you.  Our doctors have extensive experience using PRP to treat a variety of tendon, ligament and joint injuries. These include rotator cuff injuriestennis elbow, Achilles’ tendon, plantar fasciitis, meniscus tears, bursitis of the hip, knee pain or ligament sprains.

Please contact our nearest office to discuss whether you’re a good candidate for this remarkable procedure.

At the present time, Platelet Rich Plasma treatments are not covered by medical insurance.

Painkillers: The Difference Between Opiates And Opioids

Dr. Harris BramOne of the most frequent reasons people visit their family doctor is to get relief from pain. If an over-the-counter pain reliever isn’t working to their satisfaction, the doctor can prescribe a stronger pain medication. Unfortunately, when it’s not taken according to the doctor’s instructions, or it’s used for an extended period of time, this stronger drug can lead to addiction.

A study released earlier in 2016 revealed that almost half of all Americans personally know someone who has been addicted to prescription meds – opiates or opioids. As a pain management specialist, I’ve found that many people aren’t clear on the difference between these two types of drugs. So, for your information, whether you someday need to discuss them with a health care professional, family member or friend, here’s a brief overview.

Opiates – A Natural Pain Medication

Opiates are derived from the opium poppy. Opium is a strong pain-relieving medication used in different opiates:

  • Morphine
  • Codeine
  • Heroin
  • Opium

Opioids – Synthetic Pain Remedy

Opioids are synthetic or partly-synthetic drugs that are manufactured to work in a similar way to opiates:

  • Methadone
  • Percocet, Percodan, OxyContin (oxycodone)
  • Vicodin, Lorcet, Lortab (hydrocodone)
  • Demerol (pethidine)
  • Dilaudid (hydromorphone)
  • Duragesic (fentanyl)

How Opiates And Opioids Work

Both types of painkillers don’t actually “kill” the pain – they alter the way the pain is perceived. They attach onto opioid receptors in the brain, which send inaccurate measures of the severity of the pain that the person is experiencing. So, it actually feels like less pain than it would if the brain wasn’t being tricked.

(These powerful drugs are popular for another reason too: People who are not in pain take them because they affect how the brain perceives pleasure. They provide a feeling of elation, followed by deep relaxation and/or sleepiness.)

Addiction To Opiates And Opioids

When people use opiates and opioids to treat pain as directed and for a short time, they are less likely to become addicted. Addiction occurs when patients develop a tolerance for the level of medication they have been described and no longer get the same level of relief. So they take more and more. And they just can’t stop without help.

Before It’s Too Late

If you’re at a point where an over-the-counter or prescription pain medication is not working for you – or you’re getting concerned about how much you’re taking, please contact New Jersey Pain Care Specialists for a consultation with one of our elite pain management doctors. We offer a variety of interventional and minimally-invasive procedures – including Stem Cell Therapy and Platelet Rich Plasma (PRP) – that can help relieve your pain without dangerous drugs, surgery and a lengthy recovery. 

Does Winter Weather Make Pain Worse?

Dr. Harris BramWintry cold has hit most of the country with a vengeance. And many people are noticing that their aches and pains are getting worse or happening more frequently. Why? Not only does the colder air cause flare-ups of many conditions, changes in barometric pressure or humidity can also make ailments worse.

How much does cold weather contribute to pain?

As we endure snow storms and brutal weather, many people experience increased pain in the joints, neck and back. It can be very painful for those with severe conditions, such as complex regional pain syndrome, arthritis, and low back pain. Some people can predict approaching cold weather by how much pain they feel.

Studies have found a strong relationship between short, cold, damp days and arthritis flare-ups. Some research suggests changes in barometric pressure worsens knee pain in people with arthritis, while freezing temps can cause painful changes in joint fluid thickness. Cold weather can actually shrink the tissues causing them to pull on the nerve endings, thus causing joint pain. When it is cold, your nerve endings are extremely sensitive and the muscles surrounding your nerves tense up. When the barometric pressure drops, there is less atmospheric pressure to hold the tissues back and it causes more inflamed tissue to swell and thus, cold weather causes pain.

Tips to minimize the painful effects of cold weather

  • Keep bundled up so that your muscles and nerves stay warm. This can help the muscles not contract as much around your nerve endings, thus minimizing the pain you feel.
  • Make sure you stretch in the morning and evening. This can help keep you stay limber and not tense up.
  • Make sure you exercise regularly, preferably indoors. It is important to stay active to keep joints from getting stagnant. When you don’t move your muscles or joints regularly they will stiffen and make it more painful when you do move them.
  • If you must shovel snow, be sure to use your legs, not your back, when you bend down to clear it. It’s best to push snow rather than lift it – and to use an ergonomically designed shovel. It’s lightweight with a curved shaft, which will help you keep your back upright. Pick up smaller batches of snow for less weight per shovel. Also, try to shovel in both directions. Shoveling in one direction repetitively across the body, can exacerbate strain.
  • Walk on ice carefully. It’s a balancing act that causes you to unconsciously tense your body bracing for a fall – which actually makes you more likely to injure yourself. Be conscious of this body tension – it can take a toll on your muscles, making you feel achier at the end of the day. On ice, the safest thing to do is a shuffle step without lifting your feet. Also, make sure your footwear is sensible and comfortable, with good arch support.
  • When you hurt, try to swim in a heated pool, to help alleviate pain.

As always, if you ever experience severe pain or swelling, or worsening or extended discomfort, contact us as New Jersey Pain Care Specialists and our attentive staff with explain what we can do to help.

 

 

Stem Cell Therapy: To A Healthier Future

Dr. Harris BramOnce again, we enter a new year with hope for a healthy and happy future. To me, that includes exciting new medical advances for treating injuries, conditions and, some day, for reversing the damage caused by serious diseases. Right now, I’m placing a lot of hope in the science of regenerative medicine, which includes stem cell therapy. As you may already be aware, stem cell therapy is a procedure our expert staff at New Jersey Pain Care Specialists has been successfully using to repair damage from conditions such as degenerative disc disease, desiccated discs, spinalstenosis, facet arthrosis, sacroiliac joint syndrome, osteoarthritis of any joint, and sports or overuse injuries.

However, looking toward the future, stem cells have the potential to treat even more conditions and some of the more serious diseases and medical issues affecting the world.

Stem cells and human development

To fully harness the potential of stem cells, health and medical researchers must continue to study how stem cells transform – or “differentiate” – into the diverse range of specialized cells that make up people. Because diseases like cancer and conditions such as birth defects are thought to be caused by problems in the differentiation process, understanding the development that happens in normal cells can help treat developmental problems.

Stem cells and cell-based therapies

Another potential application of stem cells is to form cells and tissues for medical therapies. Currently, donated organs and tissues must be transplanted to replace damaged or dysfunctional ones. Unfortunately, the waiting lists are lengthy and many patients die before they receive what they need. Stem cells offer a viable source of replacement cells to treat diseases. and can potentially save many lives. 

Stem cells and drug testing

New drugs could be tested on stem cells to assess their safety before they are tried on animals and humans. 

Stem cells and disease reversal

Directing stem cells to differentiate into specialized cell types can provide a renewable source of replacement cells for people suffering from diseases. There is even the possibility that stem cells can someday reverse damage from conditions such as:

Heart Attack – Damaged tissue caused by a heart attack could be replaced by healthy new muscle cells.

Parkinson’s Disease – The destruction of brain cells could be reversed with new, functioning brain cells.

Genetic Defects – For defects that are present from birth, introducing normal healthy cells could restore function and health.

Severe Burns – Instead of tissues being donated, stem cells could be used to produce new and healthy tissues. A very small patch of skin could be grown to cover a burn that is much larger than the original skin sample. 

The potential for stem cell therapy is enormous and endless. For the many people it can someday help, it can’t come soon enough.

From the entire staff at New Jersey Pain Care Specialists, all the best to you and your family in the new year!

At the present time, stem cell therapy in the U.S. is not covered by medical insurance.

 

Tips For A Happy, Pain-free Holiday

Dr. Harris BramThe end of each year brings emotional relief to many people. On the other hand, it can cause a need for pain relief too. All the holiday preparation, travel, celebrating and hosting can trigger flare-ups from pain old and new. Here are a few tips and reminders to minimize the chances of an unjoyful experience.

Carry luggage and packages carefully

Lifting heavy suitcase, gifts and food supplies can easily lead to back pain or shoulder pain. It’s important to know how to pack, carry and lift anything heavy.

  • If you have a choice, use luggage with wheels.
  • Pack lightly – only the things that are necessary. Try to use a few smaller bags instead of one large piece of luggage. 
  • When lifting something heavy, bend your knees and lift it with your leg muscles rather than your waist and back. Hold it close to your body.
  • When storing luggage or packages in an overhead compartment, first lift the item onto the top of the aisle seat. Then place your hands on its left and right sides and lift it up.
  • To avoid shoulder strain, evenly balance the weight of a backpack. Padded straps help make it more comfortable to carry. 
  • When carrying a shoulder bag or a duffel, alternate shoulders.
  • Carry – don’t drag – your luggage when climbing stairs.

Travel comfortably

Regardless of whether you’ll be sitting in a car, train or airplane, use lumbar support to ensure a proper sitting position to help avoid back pain. Place something as simple as a pillow between your back and the seat.

Make sure you’re sitting on your “sitting bones” and not your tailbone. A small cushion or folded-over towel can help. If you’re traveling by car, plan regular stops to get out, stretch and walk around. If you’re on a train or airplane, stroll the aisles when it’s safe to leave your seat.

Stop & stretch!

To avoid pain or to get pain relief, take breaks from cooking, sitting and chatting, or watching TV. Your muscles get stiff just like your joints, so loosen up with the stretching tips below. Warning: If you feel any back or neck pain or other discomfort, stop immediately! Same goes for all other stretches or movements.

  • Neck stretch – Sit on your right hand and slowly lower your left ear down toward your left shoulder until you feel a stretch in your right shoulder. Hold the stretch for 20-30 seconds and repeat 2-3 times on each side.
  • Mid-back stretch – Slowly pinch your shoulder blades together for 3-5 seconds. Repeat 3-5 times. You can do this stretch every 10-15 minutes.
  • Lower back stretch – Sit in a straight-back chair with your feet on the floor. Grasp your left knee with both hands and bring that leg up toward your chest. Hold, return to the starting position, and repeat with your right leg. Repeat 3-5 times.
  • Hamstring stretch – While sitting, extend one leg out straight, bend forward and reach toward your toes until you feel a stretch behind your knee. Hold for 20-30 seconds, then switch sides.

Avoid alcoholic beverages

It’s not worth it for a number of reasons: 

  • Alcohol can cause restless sleep and result in back pain that could last all the next day, or longer.
  • Alcohol interferes with many medications. For example, the combination of alcohol and painkillers can slow down your nervous system and respiration, and possibly hasten an overdose.
  • The liver’s process of breaking down alcohol creates dangerous by-products, which can damage liver cells and increase painful inflammation throughout the body.

As always, if you ever experience severe pain and swelling, or worsening or extended discomfort, call New Jersey Pain Care Specialists. An experienced and caring professional will discuss your condition and explain what we can do to help as quickly, safely and non-invasively as possible. 

We wish you a happy and healthy Hanukkah, Christmas and New Year. Stay safe and pain free!

PRP Helps Heal Rotator Cuff Injuries

As you know, I’ve often written about the positive experiences that top athletes are having with Platelet Rich Plasma (PRP) Therapy. Stars including Kobe Bryant, Peyton Manning, Steph Curry, Rafael Nadal, David Ortiz, Vijay Singh and, most recently, NBA forward D’Angelo Russell. Perhaps, as a regular person reading about the results, you’re a bit skeptical. Thinking that their super-powered physical conditions make them more receptive to a “miracle” treatment. Wondering if PRP also works for mere mortals like you and me.

A few months back, a small pilot study appeared in PLOS ONE, a non-profit publication featuring peer-reviewed scientific research. It found that a single PRP injection helped reduce pain and heal injured tissue in patients with chronically sore shoulders caused by rotator cuff tears. 

In addition to these benefits, keep in mind that this fast, non-invasive, in-patient procedure also helped these people avoid the anxiety and ordeal of undergoing surgery, not to mention the extended recovery process.

The simple PRP procedure involved harvesting platelets from the patient’s own blood. Blood is made up of red and white blood cells, plasma, and platelets. Following an injury, platelets in our bodies are activated and release healing proteins called growth factors, which help to speed up wound and tissue healing. By delivering a higher concentration of these platelets directly into an area of need, the natural healing process is intensified. Doctors are able to get the PRP from blood quickly, easily and safely. There is virtually no risk of a transmissible infection and a low risk of allergic reaction.

And, yes, the PRP patients in the study were “regular” people

One was a retired police officer, who claimed she had spent two years trying everything for her shoulder. “Physio would help for a bit but then the problem would still be there. I tried acupuncture, Kinesio tape, cortisol injections – you name it, I tried it,” she explained.

“Once I did the PRP Therapy, it really did fix everything!” At age 58, she says her injured shoulder feels like new. “I can shoulder-check now and brush my hair. I can work out and be active again!”

According to the lead author of the study – a sports medicine physician at the University of Alberta’s Glen Sather Sports Medicine Clinic in Canada: “We studied patients 35 to 60 years old with rotator cuff tendinopathy due to normal aging. For the first time, we were able to not only find reported improvements in pain and mobility, but also in the tissue. The MRI before and after showed structural change and a decrease in the size of tears.”

The results were very real

“We saw improvements in the tissue six months later in five of seven patients undergoing the PRP procedure and an appropriate rehabilitation program. The healing in the tissue appeared to correspond with the reported improvement of the pain and, also with the clinical assessment of function,” added a physical therapy specialist at the Faculty of Rehabilitation Medicine.

As a pain management specialist, I am very pleased to see these positive reports. They support the benefits that the doctors at NJ Pain Care Specialists are already achieving when they use PRP Therapy to treat other painful conditions, including tennis elbowknee painAchilles injuries, degenerative disc disease, and sports or overuse injuries.

Is PRP Therapy right for you? Contact our nearest office today and speak with a caring and knowledgeable staffer to learn more. 

PRP Therapy For NBA Star’s Injured Knee

When discussing pain management solutions with a patient, there are often questions about some of the relatively new and exciting procedures we offer at New Jersey Pain Care Specialists. To put things in perspective, I like to bring up the expanding list of top professional athletes who have chosen procedures like Platelet Rich Plasma (PRP) and Stem Cell Therapy as safe, fast and effective alternatives to surgery.

One of my key points is that these are world-class performers whose lucrative careers can be at stake when they’re injured. Their teams have the assets and willingness to provide them with the best and most expensive care in the world. But, more and more, these stars and their teams are choosing one-hour, minimally invasive procedures like Platelet Rich Plasma to help get them back in action without long-term treatment, extended care, and a season or more on the sidelines.

Weeks vs. a Lengthy Recovery

The latest example I’ve seen involves Los Angeles Lakers starting point guard D’Angelo Russell. He recently received a Platelet Rich Plasma injection in his painful left knee, which has been affecting his game. His coach said he didn’t believe Russell would need surgery: “I like to keep it pretty positive. If they tell me that they think this is going to help and get him back out there, then I’m going with [the idea] that in two weeks, he’ll be ready to play again.”

D’Angelo joins the lengthening list of athletes who have used Platelet Rich Plasma to heal their injuries and, in some cases, extend their legendary careers – Kobe Bryant, Peyton Manning, Steph Curry, Rafael Nadal, Maria Sharapova, Tiger Woods, David Ortiz, Mark Teixeirra, Alex Rodriguez, Zack Greinke, and Hines Ward (who, after being told he would miss Super Bowl XL, was awarded the game MVP).

What is PRP?

Platelet Rich Plasma is a simple, non-invasive procedure that provides superior relief for injuries or acute or chronic pain by promoting the body’s natural healing potential. Growth factors are taken from a patient’s own blood and concentrated before being injected back into the body. These concentrated growth factors then accelerate healing. And because PRP uses your own blood to jump-start and accelerate the healing process, it is considered a very low-risk procedure.

At New Jersey Pain Care Specialists, we are very experienced in using Platelet Rich Plasma and other procedures to treat tendon, ligament and joint injuries that have failed more traditional therapies. Treatable ailments include knee pain, rotator cuff injuries, tennis elbow, Achilles’ tendon, plantar fasciitis, meniscus tears, bursitis of the hip, and ligament sprains.

And, as you know, you don’t have to be a pro athlete to be hurting. Contact us today to discuss the best pain-reducing game plan for you.

At the present time, PRP Treatments are not covered by medical insurance.

Pain Reducing Tips for Thanksgiving

First off, my staff and I at New Jersey Pain Care Specialists wish you and yours a Happy Thanksgiving.

We all know how hurting can ruin a good time – even more so on special days when family and friends are gathering to be thankful for what we have. And pain is definitely not on that list.

Here are a few actions you can take to minimize the chances of a holiday pain flare-up, so you can fully enjoy the feast and festivities. Of course these same tips apply every day of the year.

Travel comfortably

Regardless of whether you’ll be sitting in a car, train or airplane, use lumbar support to ensure a proper sitting position to help prevent lower back pain. Place something as simple as a pillow between your back and the seat.

Make sure you’re sitting on your “sitting bones” and not your tailbone. A small cushion or folded-over towel can help. Traveling by car? Plan regular stops to get out, stretch and walk around. If you’re on a train or airplane, walk around when it’s safe to leave your seat.

Avoid alcoholic beverages

It’s not worth it for a number of reasons: 

  • Alcohol can cause restless sleep and result in pain that could last all the next day, or longer.
  • Alcohol interferes with many medications. For example, the combination of alcohol and painkillers can slow down your nervous system and respiration, and possibly hasten an overdose.
  • The liver’s process of breaking down alcohol creates dangerous by-products, which can damage liver cells and increase painful inflammation throughout the body.

Get out and walk!

While sitting for a long meal, your joints can stiffen and cause joint pain. And even though all that turkey will make you feel tired, don’t retreat to the sofa for football and a nap. Take a brisk walk around the neighborhood to keep your joints lubricated to keep pain at bay.

Stop & stretch!

Throughout the day, take breaks from cooking, sitting and chatting, or watching TV. Your muscles get stiff just like your joints, so loosen up with the stretching tips below. Warning: If you feel any pain or discomfort, stop immediately! Same goes for all other stretches or movements.

  • Neck stretch – Sit on your right hand and slowly lower your left ear down toward your left shoulder until you feel a stretch in your right shoulder. Hold the stretch for 20-30 seconds and repeat 2-3 times on each side.
  • Mid-back stretch – Slowly pinch your shoulder blades together for 3-5 seconds. Repeat 3-5 times. You can do this stretch every 10-15 minutes.
  • Lower back stretch – Sit in a straight-back chair with your feet on the floor. Grasp your left knee with both hands and bring that leg up toward your chest. Hold, return to the starting position, and repeat with your right leg. Repeat 3-5 times.
  • Hamstring stretch – While sitting, extend one leg out straight, bend forward and reach toward your toes until you feel a stretch behind your knee. Hold for 20-30 seconds, then switch sides.

As always, if you ever experience severe pain and swelling, or worsening or extended discomfort, call us at New Jersey Pain Care Specialists and we’ll explain what we can do to help. 

Thanks for giving us your time! 

How Doctors Measure Pain

In my recent blog on identifying pain, I promised a follow-up on measuring pain. This is a challenge for many practitioners, because only the person with the pain can actually feel it, and every individual perceives pain differently. Unfortunately, there is no widely-accepted device that can measure pain accurately. When you’re not feeling well, a thermometer can quickly read your temperature. If you have hypertension, your blood pressure can be checked at a medical office, pharmacy, or even at home. Pain is not so cut and dried.

Communication is vital

If you schedule an appointment to have a pain issue diagnosed, take a moment to make a detailed list before you go, including:

  • When you first felt the pain
  • The affected body area
  • The characteristics of the pain– throbbing, acute, vague, etc.
  • What triggers it/what relieves it
  • Symptoms other than the pain
  • And any other information that could be relevant.

Also, keep track of your pain in a diary or journal, and bring it along too. This will give your doctor a better understanding of your pain so he or she can diagnose and treat it.

Pain scales help

Some healthcare professionals use pain scales to assess current pain and whether any medications you might be taking are helping. There are different pain scales for infants, children, adults and patients with difficulties communicating.

A pain scale usually includes a range of choices to help express different intensities. It might feature numerals or illustrations of pained faces, from smiling to crying. For example, “How bad is your pain right now on a scale from 0 to 10, with 0 being no pain and 10 being the worst pain ever?”

There are also tests that some doctors administer to get a better picture of a patient’s pain by identifying its cause:

  • X-rays produce images of the body’s internal structures and can detect broken bones and joint problems
  • Electrodiagnostic procedures, like electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies, can show which muscles or nerves are affected by weakness or pain
  • Imaging, especially Magnetic Resonance Imaging (MRI), provides pictures of the body’s structures and tissues. Magnetic Resonance Imaging uses magnetic fields and radio waves to differentiate between healthy and abnormal tissue
  • A neurologic exam can test a patient’s movement, reflexes, sensation, balance and coordination, and reveal a nerve problem.

The aim of all these tools is to assess your pain as accurately as possible so your doctor can diagnose your condition and recommend a pain management solution that works best for you – such as Platelet Rich Plasma Therapy, Stem Cell Therapy, Facet Joint Injections, Shoulder Injections, Epidural Steroids, Lumbar Sympathetic Blocks, Spinal Cord Stimulation, and others.

 At New Jersey Pain Care Specialists, we offer a variety of interventional and minimally-invasive procedures to help relieve painful conditions. If you’re experiencing acute or chronic  pain that hasn’t been responding to home care and over-the-counter medication, contact us today to find out more about an expert evaluation. Dr. Harris Bram and his elite staff  will devote the necessary time make you feel comfortable and confident that you’re in experienced and caring hands.