Making Sense of Birthmarks


Childrens FeetBirthmarks are a common finding in  children and require special attention since they are of great concern to  parents. These conditions can sometimes mimic more serious conditions and can even lead the clinician to suspect child abuse so a thorough understanding of the subtleties is warranted.

Erythma Toxicum – Don’t let the name fool you. This is not a serious condition. It is a rapidly transient skin lesion which presents with tiny erythemetous pustules and vesicles, which disappear and reappear in different parts of the body. Biopsy of the lesions will show the characteristic EOSINOPHLIA. They are present usually after 48 hrs from birth.

Capillary Hemangioma- Capillary hemangiomas are  proliferation’s of the vascular endothelial cells. They are usually not present during birth but appear within months of birth but can come on after 1 y/o. These lesions are bright red, raised usually appearing on the cheeks also known as “Strawberry” hemangiomas.

Mongolian Spot- These are black and blue lesions which have an indistinct border, they present usually within the first 2 weeks and can persist up to 4 years. They are often times confused with bruises,

Nevus Simplex- (Stork Bite, Angels Kiss) This is the remnant capillaries of the skin during neonatal development. The are the most common type of birth marks. They characteristically are present in the back of the neck (nape) and are called “Stork bite”. The lesions are flat and pink in color (also called salmon patch) They can also be found in the forehead and are also called “Angels Kiss”. They are present at birth and disappear within a year.

Nevus Flammeus (Port wine stain) – Is a permanent birth mark of vascular origin that most commonly appears on the face but can appear anywhere. The key is that this birth mark is permanent and will not disappear with time. It can be treated with lazer therapy if social and psychological stress persists. The occur due to venous malformations in the capillary beds. They present with irregularly shaped raised lesions which usually darken with age. They look as if “ Burgandy Port wine has been spilled on the persons face”.

Have a child with a unique type of birthmark? discuss your child’s health with our expert pediatric consultant. Make an appointment today.!


Fat vs. Muscle


Everyone has heard “don’t worry muscle weighs more than fat”, but have you seen what that really looks like or felt it?

I am little, small in frame, but my weight is only low when I am not training with weights for a prolonged period of time.  I stopped weighing myself about a year ago and started training with weights regularly.  Muscle forms a body sculpted.  The sag women see below the Buttocks?  The myth that it doesn’t go away with any amount of training is just that, a myth.  With the proper resistance training and cardiovascular training combined any person can sculpt their bodies.

“But I have to lose over 50 pounds!” Fine, then a good healthy diet, with the proper supplements and a well balanced exercise program, and together we can get any goal attained.  I recommend weight training for everyone.  Not only does it burn calories, looks better, but it strengthens muscles and protects joints.  Have an injury that prevents you from exercise??  MYTH!  Muscle strength around weakened joints strengthen and alleviate pain.  The proper form is the key and can always be learned…..

Working together there are no failures  or loss only a gain in health.

Dr. Amy H Fisch

Nutrition, its a lifestyle not a diet

What is your goal? Weight loss? To get off of medications? Increase energy and ability to exercise?

Everyone has a goal in their life when it comes to diet and exercise.  The one thing we all need to realize is that healthy living is a life change and a lifestyle and takes time and commitment to change.  That is what I am here for, to walk each patient through their individual needs to reach and even exceed their goals.  Even for those patients that don’t know how to make goal, I will work with you and create a goal step by step and acheive results.

I am not just a Nutritionist and Doctor, I am a fitness expert, and well trained in naturopathic supplements as well.  I am here to teach simple steps to lead you to a healthier and more fulfilled life.

Dr. Amy. H Fisch

Understanding Heart Failure


Congestive Heart Failure  (CHF)

Congestive Heart failure is a condition in which the heats pumping mechanism becomes weak, and is unable to push out the Blood in its chambers adequately enough. This is a condition that has many underlying causes. So its important to realize that the cause of the heart failure can be due to some other underlying pathology. In many ways CHF is as much a  SYMPTOM as  a DIAGNOSIS. CHF can be subcategorized, possibly given the physician a clue regarding the underlying cause of the heart failure. The two catagories are

Systolic Heart Failure – Refers to a weakened heart, meaning the heart doesn’t contract well  enough, to  pump out blood. This can be due primary cardiomyopathy, it can also be due to hypertension, which means the muscles will be working fine its just that they are pushing out against High Resistance of the  arterial vessels.

Diastolic Heart Failure refers to in adequate FILLING PRESSURES – This means that the Heart is really Stiff and wont allow the chambers to fill properly . Or it can mean that there is a blockage of blood flow on the right side. Thus there is inadequate venous return. A traffic jam if you will of blood flow and this traffic jam can be anywhere in the system behind the Left ventricle. So it can be due to lets say a Mitral Stenosis. Or  Pulmonary Heart failure, or Cor Pulmonale, Or Liver disease. So its important as a patient to understand the type of Heart Failure you are diagnosed with.

Have concerns about your Congestive Heart Failure Diagnosis? Contact us to schedule a consultation with our expert cardiologist!

Nutrition and Lifestyle

Amy Heather Fisch's picture

Every person has nutrition concerns or questions. Some go to media “experts” or diets to attempt success. Every person is different and no one popular item will find the cure for what they need. Some people want to look better, some need to and seek to eliminate medical problems such as High Blood Pressure or Diabetes. Most commonly, people seek Nutritionists to help them LEARN how to FEEL better and do everything they want.

I am happy to bring personalized Nutrition Counseling to Emote Medical, not only to aid Patients reduce their medial problems but also to teach any individual to achieve their goals to lose weight, overcome an eating disorder, learn about super foods and live their best lives.

I am not only an Anesthesiologist, but a Nutritionist and fitness enthusiast. I am ready to meet new clients and provide each person the individual attention they need and deserve.

Dr. Amy H.