MedCenter TMJ – November 2016 Newsletter

A Special Dedication This Month

Ronald C. Auvenshine, DDS, PhD

capture1I would like to dedicate this month’s newsletter to a very special person in my life. Her name is Heather Gothard. Many of you may remember Heather because she was a Dental Assistant and Health Learning Coordinator in my practice from 2002-2006. Heather was one of the bravest individuals I’ve ever met. She was super intelligent, wonderful with people, and a real joy with whom to work.

At the age of 32, Heather was diagnosed with an enlarged heart and the inability of her heart to pump blood to her brain. After many tests and several weeks in the hospital, it was determined that Heather could only live if she had a heart transplant. For the next three months, the doctors at St. Luke’s Texas Heart Institute tried desperately to stabilize Heather so that she could receive a heart transplant. She was to be sent home with an artificial heart while she waited for her name to become available for a heart transplant. You see, the unique thing about Heather was that, because of a genetic predisposition and her sensitive immune system, she couldn’t have just any heart; she had to have “the perfect” heart.

On the evening before she was to receive the surgery for the artificial heart, a “perfect” heart was made available and was at Hermann Memorial Hospital, just a few blocks away. The only hang-up was the fact that Heather was seventh on the transplant list. Early the next morning, Heather’s family was notified that the six people ahead of Heather had signed off on the heart so that Heather could receive the perfect heart. The heart transplant was successful and after another three weeks inpatient, Heather was able to go home, after almost 4 months of staying in the hospital.

Much prayer went up on behalf of Heather. I became very familiar with her caregivers at the Heart Institute because of so many visits to hospital after work. I would go by and hold her hand and talk to her, although most of the time she was unconscious.

After about six months of rehab, Heather returned to my office to work part-time. Her vibrant smile, her willingness to help, and her constant joking made all of us feel so comfortable. The days just seemed to pass with great ease. After about a year, Heather became ill and went through additional tests, thinking that it was heart or transplant related. However, this diagnosis was more critical- she had tumors in her abdomen. The doctors diagnosed her with cancer. Heather received all kinds of medications and treatments and even though she was ill and did not feel well, you never could tell by the way she lived her life. Shortly, after her new diagnosis, Heather became so ill she had to quit work. I could only see her on special occasions when she was in the Medical Center or would just come by the office to say “hello.”

On September 28, 2016, Heather lost her battle with cancer. My heart is extremely heavy as I write this tribute because of my deep respect and love for her. You see, when you’re involved in a practice such as mine and you share the work day with special people, you become very close to one another. You become family. Heather was always there when I needed her to stay late in helping with a case or to get to the office early to set up for a special procedure. She was a totally beautiful person and her captivating smile will be cherished in my heart’s memory for the rest of my life.

Heather was totally devoted to her daughter, Kendall, and her husband, Greg, as well as her best friend, Michelle. Many times Heather would bring Kendall by just for us to see how she had grown. Kendall is a phenomenal softball player and will probably get a college scholarship. Heather, even in the darkest of days, attended every game that Kendall played. No matter where the tournaments, Heather was always there.

Heather Gothard, mother of Kendall and wife of Greg, daughter of Ken Robbins, close friend, confidant, and cherished employee. We remember you.

Heather was 42 years of age.


Ronald C. Auvenshine, DDS, PhD

Diplomate, American Board of Orofacial Pain


Dr. Pettit’s Tip for Healthy Living: A Nitty Gritty Look at Salt

Nathan J. Pettit, DMD, MSD

Dr. Nathan Pettit
Dr. Nathan Pettit

Last month we discussed the craving for sugar which seems ubiquitous among us. This month I’d like to focus on another commonly hidden ingredient. Like sugar, this ingredient is also vital to life and health, but when consumed in high amounts, can hinder your well-being. This nutrient is a mineral vital to control of fluid levels and nerve function.  We could not live without it. The mineral I refer to is sodium, found in salt.

Sodium is usually added to foods as sodium chloride (salt), sodium bicarbonate, or monosodium glutamate. Our taste for salt can vary depending on our level of consumption. As we eat higher amounts of salt, our craving for salt will increase. Likewise, if we begin to limit our salt consumption, in time we will not feel the need to add as much salt to our food. Our kidneys help us regulate the levels of salt in our bodies, and can accommodate a wide range of intake.

The most publicized negative effect of too much sodium consumption is the effect on blood pressure. Contributing to this population-wide increase in hypertension is not only the increase in sodium consumption, but also a decrease in potassium consumption. These two minerals affect one another, potassium having a protective effect against higher levels of sodium. Many other factors also play a role in regulation of blood pressure, including physical activity, stress levels, and alcohol consumption.

There are conflicting reports on the recommended dose of sodium one should consume each day. Age, gender, level of physical activity, genetic composition and other health conditions can affect your optimal level. In Houston, we tend to sweat more and may require slightly more sodium because of it. Most of us would do well to cut back the level of sodium we get from processed foods and from salt added at the table. A healthy range of salt likely falls between 1.5 to 3.5 teaspoons a day.

For those of us susceptible to frequent headaches, we should consider sodium levels in our diet. Sodium comes in various forms, some of which are powerful triggers for headaches. You may be chemically susceptible to certain forms or be feeling the effect of sudden changes in blood volume. Replacing snacks high in sodium with fresh fruits and vegetables is sure to benefit your health, physically and mentally. Pay attention to your salt intake this week and look for ways to cut back. Your health is important to us!


Giving Thanks for All the Amazing Caregivers in Our Lives

Disabled Senior - Fun

Dr. Auvenshine’s beautiful tribute to friend and former colleague Heather Gothard is the perfect inspiration this holiday season. At MedCenter TMJ many of our patients rely on others to help them when their symptoms flare up. Many people who have had a serious medical condition, illness or injury know just how invaluable these caregivers are to the people they help.

This Thanksgiving we’re giving special thanks to all of the caregivers who selflessly help their loved ones. We’d also like to say thank you to all of the caregivers at MedCenter TMJ that make our work possible. Day after day they work tirelessly to ease the pain of others and improve their quality of life.

In this world there is very little certainty, and you never know when you may be the one who needs the help of a caregiver. If you know a caregiver take a moment during the holiday to tell them how much you appreciate and respect what they do.


Getting Ready for a Turkey Trot

Lacing upThis time of year many cities prepare for an annual turkey trot. Most turkey trots are organized by food banks and charities that feed the less fortunate. These fun runs are a great way to burn off those Thanksgiving calories and help a great cause.

Before you strap on your sneakers, it’s important to make a few preparations to protect your health and make the event a little more comfortable.

  • Start training a few weeks before the event. If you plan to walk, then set aside time to walk the distance of the turkey trot.
  • Make sure you have good running shoes that fit properly. Many injuries occur because people don’t wear appropriate footwear.
  • Stock up on cold weather outerwear. If you have TMJ be sure to wear earmuffs, a cap and scarf in cold weather conditions.
  • Plan to wear an outfit that’s layered. To keep yourself comfortable, dress in layers that can easily be removed as you build up body heat.
  • Drink plenty of water before, during and after the event. Dehydration is possible even when it doesn’t feel like you’re sweating. Every adult needs to consume at least 9-13 cups of fluids each day. If you’re exercising fluid intake needs to be increased.
  • The day before the event avoid eating high-fiber and fatty foods that take longer to digest. The morning of the turkey trot eat a light meal or snack two hours prior to the start.

Turkey trots are fun events that are focused more on charity than competition. Even if you walk the three miles, you’ll get exercise and can feel good knowing that you’re helping make the holidays better for others who are less fortunate.


Incredible Low-Sodium Thanksgiving Gravy

capture3When you have TMJ that’s aggravated by eating, finding ways to soften food becomes a daily challenge. One delicious way to make foods easier to eat is to drizzle on gravy.

During the Thanksgiving holiday gravy takes the center stage, which means it’s the perfect time to try making it at home. Most gravy is loaded with salt, but this gravy recipe from is low-sodium and vegetarian.


  • 8 tablespoons of vegetable oil
  • 3-6 minced garlic cloves
  • 2-3 slices of yellow onions, chopped
  • 8 tablespoons of all-purpose white flour
  • 4 teaspoons of nutritional yeast
  • 4 tablespoons of low sodium soy sauce
  • 2 cups of water
  • 1⁄2 teaspoon of sage (optional)
  • 1⁄4 teaspoon of ground black pepper
  • 1⁄2 teaspoon of salt substitute (optional)
  • 5 -6 white mushrooms, sliced (optional)


  • Pour the vegetable oil into a small saucepan.
  • Cook the garlic and onion in the vegetable oil for two minutes on medium to medium-low heat until the onion is tender and translucent.
  • Add the flour, yeast and soy sauce to create a paste.
  • Slowly add the water, stirring constantly with a whisk.
  • Bring the gravy mixture to a boil on medium to medium-high heat, stirring constantly. If you want to thicken the gravy add 1-2 more tablespoons of flour.
  • Once the gravy has thickened to your liking add the pepper.
  • Stir in the sliced mushrooms, if using them in the gravy.
  • Add salt substitute to make the gravy taste saltier, if desired.

In a matter of minutes you’ll have a low-sodium homemade gravy that makes meats, potatoes and breads easier to eat!

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