Louis B. Cady, MD – CEO & Founder – Cady Wellness Louis B. Cady, MD – CEO & Founder – Cady Wellness Institute Institute Adjunct Clinical Lecturer – University of

Southern IndianaAdjunct Clinical Lecturer – Indiana University School of

Medicine Department of PsychiatryChild, Adolescent, Adult & Forensic Psychiatry –

Evansville, Indiana

The Gathering Storm, The Breaking Dawn II:New Challenges & Opportunity for the Health of America

H - 2

“There are two objects of medical education: to heal the sick and to advance the science.”

- Dr. Charles H. Mayo, MD

“The glory of medicine is that it is always moving forward, that there is always more to learn.”

- Dr. William J. Mayo

Disclaimer: Pharmanex supplementation and the

BioPhotonic Scanner are not FDA approved for the diagnosis, treatment, prevention, or cure of

ANY disease or “medical condition.”

They ARE appropriate to support the structure and function of the human body.

Learning objectives• Define a problem: American’s medical and

financial health is declining.• MD’s and HCP’s are getting squeezed and are

dropping out.• Answer the question of “but I just don’t GET it

about those antioxidants.”• Answer the objections about the scanner “gizmo.”• Review the literature. Achieve state of the art, up

to date knowledge. • Review some personal reflections.

The health of society & the doctors to treat it

• Doctors are going to get squeezed: more will quit, YOUR out of pocket costs are going up.

• Americans will have less money to pay for bigger health care costs

• Average people need to do something NOW to maintain health and minimize costs.

And why we should all start paying attention to those “filthy rich doctors” and

how they are getting paid.

The Problems & The Solution

The good ole days:•People had jobs•People had insurance•Insurance PAID.•Society was healthier.•Doctors were plentiful.•Your healthcare was essentially “free,” no matter how stupidly you behaved.

Problems:•2001/2008 recessions•Outsourcing•More medical technology•More activism from groups such that “everything must be covered.”•2013-14: More government interference in free market

The RESULTS:•Medical insurance costs more $$$.•Fewer doctors available.

• Doctors are quitting.

• Insurance companies/ government = defacto RATIONING.

•Now, you “gonna have to PAY” for poor health habits, poor nutrition, obesity, smoking, etc.

Everett Napier, an unemployed miner, said he pawned various items while he has been looking for work, including rifles, tools, jewelry and two guitars he used to play at church. 'I just swallowed my pride and quit playing. That's all you can do.' David Stephenson for The Wall Street Journal. November 26, 2013

CURRENT PRACTICE OF MEDICINE: What a patient had to say about her “specialists”:

“They just monitor my degeneration.”

www.billfoster.com - Reviving American Manufacturing, accessed 1 27 2014www.billfoster.com - Reviving American Manufacturing, accessed 1 27 2014

Unemployment, underemployment are contemporary problems…

http://www.scdigest.com/assets/newsViews/08-06-12-2.php accessed 01 27 2014http://www.scdigest.com/assets/newsViews/08-06-12-2.php accessed 01 27 2014

Look out Pharma reps!!

Feb 6, 2014

- The “SGR” cut: 24 – 30% of Medicare fees- Has been “patched” 15 times since 2002 for c. $140 billion

- Additional source: McDonough J.E. “Health Stew” column 12/22/2013 http://www.boston.com/lifestyle/health/health_stew/2013/12/advice_to_congress_pass_sgr_repeal_and_do_not_pay_for_it.html accessed 2/7/2014

Business 101 – 3 doctor internal medicine clinic

INCOME

NET Revenue: $1.5 million

EXPENSES:

Overhead* : $1 million[support staff salaries, rent, depreciation,

malpractice insurance, license fees, “MOC” fees, equipment costs, consumables,

cleaning, office supplies, facilities insurance, Workman’s comp, retirement plans for staff

and docs, CME, vacation pay, sick pay, insurance plans for staff and docs]

Salaries – 3 docs: $500K

Total expenses: $1.5 million

Income less expenses =

ZERO. This balances.

Business 101 – 3 doctor internal medicine clinic

INCOME

(prev) Revenue: $1.5 million

Less 24% cut: - $360,000

Total income now:$1,140,000

EXPENSES:

Overhead* : $1 million[support staff salaries, rent, depreciation,

malpractice insurance, license fees, “MOC” fees, equipment costs, consumables, cleaning, office supplies, facilities insurance, Workman’s comp,

retirement plans for staff and docs, CME, vacation pay, sick pay, insurance plans for staff and docs]

(What’s left over for salaries: $140,000)

Total expenses: $1.14 million

Income less expenses = ZERO.

This balances.Salaries – for 3 docs

= 46,667 per doc

Instant replay

• 24% cut to gross receipts

• 72% cut to doc salaries (from $166,667 down to $46,667– Working 50 – 60 hours per week– Hassled by paperwork, Medicare reviewers,

prior authorizations, constant threat of malpractice lawsuits, continued baseline 2% inflation per year and no way to make it up.

• WHAT WOULD YOU DO???

Business 101 – 3 doctor internal medicine clinic – what does this REALLY MEAN?

As your fees stagnate or are cut, and as your overhead continues to rise, you will:•Pinch pennies on overhead, do 5-7 minutes per patient and try to be cheap. (Unsuccessful).•Work harder and longer hours to keep pace and feed your family (and burn yourself out)…

• …And not get to see your kids grow up. • Marital problems; divorce.• You will miss out on life.

•Use the “work ‘til you drop” retirement plan.•Or you will quit if you’ve made enough and either retire or do something else.

Doctors quitting medicine

• Suicide* (2004):– 1.41 X for male physicians vs. general pop.

• "Half of primary care physicians in survey would leave medicine ... if they had an alternative." -- CNN, November 2008

* Schernhammer ES, Coldit GZ. Am J Psychiatry. 2004 Dec; 161 (12):2295-302.

“Why I Left Medicine: A Burnt-Out Doctor’s Decision to Quit”*

• “It may be dramatic and self-serving to frame my career change as a way to avoid suicide, but I can attest that medicine was not conducive to my health.”

http://commonhealth.wbur.org/2013/10/why-i-left-medicine-a-burnt-out-doctors-decision-to-quit date 10/18/2013 – accessed 01/07/2014

REASON: “EHR” requirements. “Would cost too much in his small medical practice.”

“But I’m not a doctor; I’m not going to have those problems.”

• Dentists, optometrists, DC’s – mixed fee for service model (at present) and insurance.

• EVERYONE will be having higher deductibles (and be cash strapped). – Manifestations: deferred maintenance (Mercedes)

• If hospitals, or clinics close, service providers connected with it will lose their jobs.

• If you are a cosmetologist or server – declining business, declining tips

A TALE OF THREE WOMEN

Evansville Courier & Press: May 29, 2006

As of 03/20/2014

Could it happen to you?

What causes oxidative stress?

• Environmental Toxins– Heavy metals – including Mercury (fillings!)– Pesticides/herbicides– Preservatives– PCB’s, Dioxins, Phthalates

• Toxins produced in the body– Yeast and bacteria– Products of cellular metabolism

• Emotional Stress– Anxiety/Tension– Fear– Anger

Oxidative stress in the BRAIN

Why is the brain so susceptible to oxidative stress?

• Burns glucose – generates free radicals.• Uses 20% of total oxygen and energy consumed

by the body.• ½ of this is for electrochemical nerve

transmission.• Contains IRON• Contains essential fatty acids, which can be

OXIDIZED (“rancid fat”)• Limited supply of own antioxidants• Limited ability to regenerate/repair damage

What are some consequences of oxidative stress?

• Impaired cognitive function• Decreased memory• Depressed immune system• Increased inflammation• DNA damage• cancer• Behavioral deterioration

Antioxidant assessment

Reference:www.cadywellness.com/cadywhitepaper2008.pdf

Reference:www.cadywellness.com/cadywhitepaper2008.pdf

Center for Biomedical Optics – Dixon Laser Institute, University of Utah

• Werner Gellermann, Ph.D. – Research Professor

• Colleague – Igor Ermakov, Ph.D., et al.

• Technologies – “Novel Raman Spectroscopy and Raman Imaging.”

• Funding:– National Institutes of Health– State of Utah– Spectrotek, LLC

(c) 2013 Louis B. Cady, M.D. - all rights reserved

“A method and apparatus are provided for the determination of levels of carotenoids and similar chemical compounds in biological tissue such

as living skin.”

“But is the scanner really valid and dependable?”

Scientific Validation: Peer-reviewed by the medical & research communities

• Society of Investigative Dermatology, May 25, 2000.

– Non-Invasive Raman Spectroscopic Detection of Carotenoids in Human Skin.

• Arch Biochem Biophys. 2010 Dec 1;504(1):40-9. Epub 2010 Aug 1.

– Validation model for Raman based skin carotenoid detection

• J Eur Acad Dermatol Ven. 2011 Aug;25(8):945-9.

– Skin carotenoid levels in adult patients with psoriasis.

• “The totality of the evidence supports the use of skin carotenoid status as an objective biomarker of fruits/vegetable intake…”

• “..skin carotenoids may effectively serve as an integrated biomarker of health…”

• “The totality of the evidence supports the use of skin carotenoid status as an objective biomarker of fruits/vegetable intake…”

• “..skin carotenoids may effectively serve as an integrated biomarker of health…”

• “Thus, this biomarker holds promise as both a health biomarker and an objective indicator of fruits & vegetables intake….”

• “Thus, this biomarker holds promise as both a health biomarker and an objective indicator of fruits & vegetables intake….”

Where to read more…

“The Complete Idiot’s Guide to the “Cady White Paper”

• Pp 1-3 Patent claim synthesis: assessing the overall antioxidant status in human tissue via Raman spectroscopy via measuring carotenoids– Carotenoids are antioxidants

• Identified in 1992

• Potent antioxidants

• Lycopenes and carotenoids appear to diminish risk of prostate CA.

• P 4 Further discussion of prostate CA

Carotenoid correlation with other antioxidants (pp 4-6)

• Cited: carotenoids as chemopreventive agents*

• Carotenoids as first line of defense, associated with “antioxidant network” – with Vitamins C, E, Coenzyme Q10, ALA, and SE. **

• Yeum et al: need to measure water AND fat soluble vitamins identified.***

*Peng YM et al. Concentrations and plasma-tissue-diet relationships of carotenoids, retinoids, and tocopherols in humans. Nutr Cancer. 1995;23(3):233-46.

** Packet, Lester. The Antioxidant Miracle. John Wiley & Sons, Inc. © 1999***Yeum et al. Biomarkers of antioxidant capacity in the hydrophilic and lipophilic

compartments of human plasma. Arch Biochem Biophys. 2004 Oct 1; 430(1):97-103.

Relationships of carotenoids to other more conventionally measured antioxidants (p 6 -7)

• Svilaas et al (2004): – 2, 670 adults studied with serum carotenoids

measured and correlated with vitamin consumption

– serum carotenoids were stronger predictors of other antioxidants than were alpha, beta, delta, and gamma tocopherols, as well as glutathione.*

* Svilaas A, et al. Intakes of antioxidants in coffee, wine, and vegetables are correlated with plasma carotenoids in humans. J Nutr. 2004 Mar;134(3):562-7.

Convenience of carotenoids as antioxidant measurement (pp 7-11)

• Hata, et al (2000) – correlated skin carotenoids (Raman) with carotenoid levels from skin from abdominoplasty patients (HPLC).– “Our technique can be used…for assessing

antioxidant status and the risk for diseases related to oxidative stress.”

*Bernstein P et al. Raman detection of macular carotenoids pigments in intact human retina. Invest Opthalmol Vis Sc. 1998 Oct;39(11):2003-11. **Hata et al. Non-invasive Raman spectroscopic detection of carotenoids in human skin. J Invest Dermatol. 2000 Sep; 115(3):441-8.

The Svilaas/Hata Syllogism:

• Hata (2000) – Raman measurements of carotenoid == HPLC skin measurements of carotenoids

• Svilaas (2004) – serum carotenoids = better predictor of antioxidant status than mixed tocopherols and glutathione

• THEREFORE [Cady]: Raman spectroscopy is a better measure of antioxidant status than mixed tocopherols and glutathione.

Dissolved carotenoids in stratum corneum

27 days

BTW – what does that “SCS” actually mean in REAL LAB MEASUREMENTS?• Y = 12703 * X + 5891.7

– Where Y is the SCS, and X is the carotenoid concentration in MICROgrams/ml, viz:

• 25,000 = 12703X + 5891.7• 25,000 – 5891.7 = 12703 * X• 19,108.3 = 12703 * X• 19,108.3 /12703 = X• X = 1.50 MICROgrams /ml

• Rule of thumb: 1,000 on SCS = .06 ug carotenoid/ml blood serum

• (e.g., SCS of 71,000 = 4.26 ug carotenoid/ml)

Source: NuSkin/Pharmanex

“RSS spectroscopy is a reliable method for non-invasive measurement of B-carotene levels in skin, and may be used as an important biomarker of antioxidant status in nutritional and health studies in humans.” Ramirez-Velez, et al. Endocrinol Nutr. 2012 April

How are we doing? 2006 Data Histogram: N =2,591,667

Mean SCS = 26,673

Skin Carotenoid Score

Fre

qu

ency 5-9 Fruits & Vegetables

SmokersAverage (2-3 Fruits & Vegetables)

Obesity

LifePak

LifePak +5-9 Fruits & Vegetables

THE LIFE PAK’ERS!

Source: data reported by Pharmanex

16,103 people – 1994 – 1996.

ZERO got 100% of all required vitamins and nutrients- Highest – B12 =- 82.8% got enough- 66.8% - had adequate folate- Lowest – Zinc – only 26.6% got enough.

What’s New since the “cady report” (2006 & 2008)?

Lipid peroxidation, antioxidant status & survival in institutionalized elderly

• Plasma MDA predicted mortality independently of all other variables.

• B-carotene and alpha tocopherol were independently associated with survival. Huerta JM et al. Free Radical Research

2006, vol 40, no 6. pp 571-578.

Angela Mastaloudis Ph.D. Senior Scientist, Global Research &

Development, Pharmanex

“RS accurately measures total carotenoids in human skin with less intra-individual variability than measurement of

serum carotenoids by HPLC analysis. RS technology is a valid and reliable noninvasive method to rapidly assess carotenoid nutritional status in humans.” (J Am. Coll Nutr 2009)

Epidemiology of Vascular Aging (EVA)

• Study population:– N=1,389; age range {59-71 yoa}– 9 year study

• Relative risks:– all cause mortality at 2.94X in men in lowest

quintile (95% CI, P=0.03)– cancer 1.72X in men (95% CI, P=0.01

• “Total plasma carotenoids levels were independently associated with mortality risk in men.”

Epidemiology of Vascular Aging (EVA)

Vitamin/mineral supplementation & cancer, cardiovascular, and all-cause mortality (EPIC-Heidelberg) Li K, Kaaks R., et al. Eur J Nutri July 2011

• Purpose: evaluate vitamin/mineral supplementation with CA, CV dz, and mortality

• Methods:– 23,943 healthy participants, followed x 11 years– Baseline and “new-use” supplementation noted

• Results: 513 CA deaths, 264 CV deaths– “No MVI supplement had any significant effect”

– Baseline users of antioxidant supplements had significantly reduced risk of cancer [HR 0.52] and all cause mortality [0.58]

• “sick user” phenomenon discussed.

Antioxidants and brain tumors?

• “free radicals are another etiological factor of brain tumor and are removed by cellular antioxidants in the human body.”

• Inverse correlation between:– antioxidant levels and oxidative DNA damage– Grades of malignancy

• Decrease in antioxidants are associated with severity of malignancy

Conclusions

• “It is concluded that administration of antioxidants could reduce the incidence of brain tumors and probably other types of cancer.”

• - Shewelta SA , Sheikh, BY Curr Drug Metab. 2011 Jul;12(6):587-93. (Dept.of Biosciences & Technology, Alexandria University, Egypt.)

The GREAT news about a BAD study

Conclusions: “In older women, several commonly used dietary vitamin and mineral supplements may be associated with increased total mortality risk; this association is strongest with supplemental iron.”

Not so fast!• 18 year duration; 38,000 “older” white

women in Iowa

• Supplements: MVI’s, A, D, E, Beta-carotene, B –vitamins, iron, calcium, copper, magnesium selenium, and zinc.

• The real results:– Early results showed women who used C, D,

E, and Calcium had significantly lower rates of death

– Iron supplementation was highly correlated to death rates (but these results were mixed in)

A real hatchet job on MVI’s• Study measured “who dies over 18 years?”

– Average age at start – 61 yoa– Average age at end of study 82 yoa– Average mortality for all women – 80 yoa in

2003 (during the study)

• Conclusion: Over 50% of the women in the Iowa study lived longer than the average life expectancy.

Mursu, Harnack et al – Dietary supplements and mortality rate in older women…. Arch Intern Med 2011 Oct 10;171(18):1625-33.

More hatcheting – poor controls• Hormones (Premarin/provera)

– 13.5% of supplement users– 7.2% of non-supplement users

• No explanation as to why so many women were taking iron.

• Excess levels of vitamin A in some MVI brands

• No evaluation of the quality or potency of the supplements

Mursu, Harnack et al – Dietary supplements and mortality rate in older women…. Arch Intern Med 2011 Oct 10;171(18):1625-33.

Nearly 2X as many!!

“Pending strong evidence …from randomized trials, it appears prudent for all adults to take vitamin supplements.” Fletcher & Fairfield, JAMA 2002

44 million inpatients, 460 sites, 2000-2010 = 20% of all US inpatient episodes (1.6% were on ONS during the inpatient episode.)

44 million inpatients, 460 sites, 2000-2010 = 20% of all US inpatient episodes (1.6% were on ONS during the inpatient episode.)

>/= 18 years. No terminal patients, tube feedings.>/= 18 years. No terminal patients, tube feedings.

RESULTS for “ONS”:•2.3 day shorter length of stay•Decreased cost of $4,734 / episode•2.3% reduced probability of early readmission.

RESULTS for “ONS”:•2.3 day shorter length of stay•Decreased cost of $4,734 / episode•2.3% reduced probability of early readmission.

CONCLUSIONS: “Use of ONS decreases length of stay, episode cost, and 30 day readmission risk in the inpatient population.”

CONCLUSIONS: “Use of ONS decreases length of stay, episode cost, and 30 day readmission risk in the inpatient population.”

Tomas J, et al. Am J Manag Care. 2013;19(2):121-128

So why do you need a SYSTEM in your vitamin supplement/mineral complex?? And what’s a ‘nano’?

What does “Nano” mean?

• Cylcodextrin ring – benign, digestable

• Feeds the gut microflora

How do nano-nutrients work?

Nano-encapsulated nutrients do not clump; they DISPERSE.

Fat-soluble nutrients like carotenoids and coenzyme Q10 CLUMP in watery milieu.

The Nanotechnology Differencepm

ol/m

g pr

otei

n

γ-cyclodextrin complex

5-fold increase in absorption!

Adapted from Craft et al, FASEB Journal. 2005; 19(4): Abstract #281.6, A449.

The train has left the station…

what about other

things besides carotenoids

and “Antioxidants”??

B12, Magnesium, Selenium, Zinc, fish oil…

vitaminsvitamins

mineralsminerals

Omega-3 Omega-3

fatty acidsfatty acids

Phytonutrients

Phytonutrients

Antioxidants

Antioxidants

(bone health)

(bone health)

LifePak Nano Contains

• All 8 forms of natural vitamin E• Buffered vitamin C, Alpha lipoic acid• Nano Carotenoids:

– as found in 5-10 fruits & vegetables per day

• Over 20 Flavonoids:– green tea catechins, quercetin, citrus bioflavonoids,

grape seed polyphenols, resveratrol

• Selenium, Copper, Zinc, Mg++, Mb++• B-vitamins complex, Biotin, D3 (150%)• 4 GRAMS fish oil (incl. 600mg EPA/400 mg DHA)

60+ Antioxidants, plus complete nutritional system

• Irritability• Apathy• Personality changes• Depression • Memory loss• Dementia• Hallucinations• Violent behavior• Anxiety

Symptoms of B12 Deficiency

• Diminished sense of touch and pain

• Clumsiness• Weakness• Pernicious anemia• Chronic fatigue• Tremors• GI problems

Mental Physical

LifePak Nano factoids - % RDA in 2 packets

• B12 - 1,000% (as 60 MICROgrams cyanocobalamin)

• Magnesium 76% (as 300 Mg amino acid chelate)

• Zinc 100% (15 mg as zinc chelate)

• Selenium 200% (L-selenomethionine & NaSeO3)

The Effects of high dose B vitamins on stress at work

• “Occupational stress is increasing in Western societies.”

• 3 month, double blind, placebo control, randomized study

• Measured: Personality, work demands, mood, anxiety, and strain

• After variances in personality and work demands were

controlled, the vitamin B complex treated group reported significantly lower personal strain and a reduction in confusion and depressed/dejected mood after 12 weeks.

Strough C et al. The effect of 90 day administration of a high dose vitamin B-coplex on work stress. Hum Psychopharmacol. 2011 Sept 8. doi 10.1002/hup.1229 (Swinburne University of Techbnology – Hawhorn, Victoria, Australia.)

Magnesium mementos• One of the first minerals to disappear with:

– Processed food– Stress

• Decreased by EtOH, caffeine, sodas, meds

• Considered “anti-stress” mineral– Decreases cortisol (rel to sleep disruption)– Relaxes muscles, prevents cramps (sleep

disruption)– Decreases anxiety; improves sleep

Symptoms of Magnesium Deficiency

PSYCHIATRIC ISSUES:•Difficulty with memory and concentration•Depression, apathy•Emotional lability•Irritability, nervousness, anxiety•InsomniaAutismADHD

Migraine headaches

PMS Dysmenorrhea Fibromyalgia Fatigue CONSTIPATION

Health Conditions Associated with Magnesium Deficiency

SELENIUM DEFICIENCY in FASEB:

• “Adaptive dysfunction of selenoproteins from the perspective of the ‘triage’

theory: why modest selenium deficiency may increase risk of diseases of aging.”

Foundation of American Societies for Experimental Biology

McCann, J, Ames BM. FASEB J. 2011 Jun;25(6):1793-814.

Negative downstream effects from selenium deficiency:

“…cancer, heart disease, and immune dysfunction are prospectively associated with modest selenium deficiency…. suggesting that Se deficiency could be a CAUSATIVE factor”

McCann, J, Ames BM. FASEB J. 2011 Jun;25(6):1793-814.

“the foot soldier”

LifePak Nano has 200% of RDA of selenium.

Se+

THYROID HORMONE

Fast food (low Zn) is bad for you.

• Fast food = high energy density = low essential micronutrient density, ESPECIALLY ZINC

• Antioxidant processes are dependent on Zinc• Fast food = severe decrease in antioxidant

vitamins and zinc, correlating with inflammation in testicular tissue – with underdevelopment of testicular tissue and decreased testosterone levels

Special needs - Zinc

• Low Zinc- associated with low testosterone– Per USDA, 60% of US men between 20 – 49

years of age do not get enough.– N.B.: Do not supplement with > 50 mg daily (can

interfere with Cu+ metabolism)• Tsai, E.C., Boyko, E.J., Leonetti, D.L., & Fujimoto,

W.Y. (2000). Low serum testosterone level as a predictor of increased visceral fat in Japanese-American men. International Journal of Obesity and Related Metabolic Disorders, 24, 485-491

Essential Fatty Acids – relevant for:

“Psych”

• Depression• Bipolar depression• Schizophrenia• Autism• AD(H)D• Learning disabilities

“Medical”

• Seizures• Rheumatoid arthritis

(& anything with inflammation)

• Coronary heart disease (or health maintenance)

Do YOU Need Fish Oil?

5X reduction

What happens with biotin deficiency?

“Our results suggest that biotin deficiency promotes hyperglycemic mechanisms…and decreased insulin secretion and sensitivity to compensate for reduced blood glucose concentrations.”

Two LifePak Nano packets have 100% of recommended daily requirements of Biotin.

A personal close

How do you want to age?

Wrapping Up: The “Survival Curve” – Where Are You?

What can you do at 100?

• Rita Levi Montalcini, MD

• Nobel Prize – Medicine 1986

• Birthday – April 18, 1909

• “At 100, I have a mind that is superior – thanks to experience – than when I was 20.”

TR 90 – a look back

October 28, 2013 January 28, 2014Jan 29, 2014

Success and Failure (Jim Rohn) What about you? You’ve only got one body.

• “Errors in judgement” - High glycemic eating, no exercise, poor nutrition, lousy or no supplementation, high stress lifestyle.

- “Good disciplines” – appropriate diet, supplementation, exercise, hormones. Stress management. Decent lifestyle.

“For me, the practice of medicine has opened the door to the greatest adventure in life. Medicine is like a hallway lined with doors, each door opening into a different room, and each room openinginto another hallway, again lined with doors. Medicine is always wonderful and never will be finished.”- Charles H. Mayo, M.D.

Contact information:Louis B. Cady, M.D.

www.cadywellness.com

www.tmsrelief.com

Office: 812-429-0772E-mail: lcady@cadywellness.com

4727 Rosebud Lane – Suite FInterstate Office Park

Newburgh, IN 47630 (USA)

Download fromiTunes or Android App stores

now!