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XEN® at Work

Eye stent relieves high pressure of glaucoma.

As an engineer with the Merchant Marine, Sean Grace bears responsibility for the operation of a self-contained city at sea. The merchant vessels transport goods and materials throughout the world and require an array of personnel to sail efficiently.

Sean Grace

“We have three departments: the deck department that navigates the vessel, the steward department that feeds the crew and the engineering department that provides the propulsion,” Sean relates. “Engineering also repairs any equipment and maintains the generators, which produce our electricity, and the evaporators, which make our water.

“In addition, we do extensive training and drilling in anticipation of an emergency, such as a fire, because we can’t call the fire department in the middle of the Pacific or Atlantic. My job is like the movie Groundhog Day. It’s the same thing repeating over and over, but it’s a very intensive job in a very isolated environment.”

Sean, 54, started his career as a wiper, an entry-level position, making him a junior member of the engineering crew. Over time, he worked his way up to second engineer. With the advancement, Sean became a licensed officer and joined a trade union, the Marine Engineers’ Beneficial Association, which requires a yearly physical. During one of those exams, Sean learned he had glaucoma, an eye disease associated with high pressure in the eye.

“I had no symptoms that I was aware of,” Sean says. “Occasionally, I got a sharp pain in my eye, but then it would go away and not happen again for six months or a year. In retrospect, I realize that was a sign, but there were no overt or glaringly obvious signs that I was suffering with glaucoma.”

Initially, Sean visited a specialist in his native New York who prescribed two eye drop medications to reduce the pressure. Later, he moved to Florida and bought a home in Brandon, so he began seeing the eye specialists at Brandon Eye Associates. When the high pressure persisted, doctors added a third medication.

“I normally work for three or four months at a time, sometimes longer,” Sean states. “I’d get a 90-day supply of medication and then go to work, and sometimes I’d run out. There were other times when, due to the nature of my job, I wasn’t able to take my drops as regularly scheduled, so my pressures remained high.

“Not long ago, we were sailing in Asia, and I wasn’t home in Brandon for about a year. When I got back, my pressures were up again. And I actually lost some field of vision on the periphery, so my doctor at Brandon Eye Associates, Dr. Jennifer Landy, suggested that I see Dr. Ilyas and get a certain procedure.”

Haroon Ilyas, MD, is a board-certified, fellowship-trained eye surgeon at Brandon Eye Associates. He measured Sean’s eye pressure and evaluated his compliance with treatment.

The doctor recommended using the XEN® gel stent, which is implanted during a minimally invasive glaucoma surgery (MIGS), to reduce Sean’s eye pressure when medications aren’t controlling the disease.

Normal pressure is typically around 21 millimeters or less, the doctor explains. Sean’s pressures were in the 30s.

“Because his glaucoma was progressing, we elected to use the XEN stent, which is a surgical implant designed to lower high eye pressure in open-angle glaucoma when medication treatment is not controlling the disease,” Dr. Ilyas says.

“The XEN stent is an exciting option to decrease medication burden and cost for patients, and it eliminates compliance problems.”

Eyelash-Sized Conduit

Open-angle is the most common type of glaucoma. It occurs when the drainage angle formed by the cornea and iris remains open but the specialized tissue responsible for draining the fluid of the eye, the trabecular meshwork, is partially blocked. As a result, fluid builds up and pressure increases. Elevated eye pressure eventually damages the optic nerve and retinal ganglion cells, causing vision loss.

“The trouble with open-angle glaucoma is that the early signs are typically never noticed by patients,” Dr. Ilyas notes. “It is a slow, progressive disease that causes vision loss, and the only way we know of definitively controlling it is to lower the eye pressure.”

In Sean’s case, that wasn’t happening with medication, so Dr. Ilyas opted for the XEN gel stent. The eye surgeon performed the procedure on Sean’s left eye in early November.

“My left eye is done and my pressure is excellent. And it’s being maintained without any of the maintenance medications or drops.” – Sean

“The XEN gel stent is a small tube, about the length of an eyelash,” Dr. Ilyas describes. “When this tube is surgically inserted into the eye, it becomes soft and flexible. It draws fluid from inside the eye to outside the eye, which helps lower eye pressure.

“The XEN stent is made of porcine gelatin cross-linked with glutaraldehyde, an organic compound. It is placed under the conjunctiva, the clear membrane that covers the white of the eye, and is designed to remain in the eye permanently.”

MIGS to insert the XEN gel stent can be performed as a standalone operation or during cataract surgery. Sean’s surgery was a standalone procedure.

“I was awake for the surgery, but they numbed my eye,” Sean recalls. “Dr. Ilyas said, Let me know if you feel anything. At one point, I did feel a little something, so I let him know, and he numbed my eye a little more. I’ve been recovering for about a month now, and I’m only using a steroid drop in my left eye.”

“The goal with Sean was to lower his eye pressure surgically so he can stop using the eye drops and won’t have to worry about forgetting them when he gets busy at work,” Dr. Ilyas discloses. “We were successful in doing that in his left eye, and he plans to have surgery on his right eye.”

Sean enjoys playing guitar when he’s not working with the Merchant Marine.

Excellent Recovery

For Sean, surgery and the XEN gel stent succeeded in reducing the elevated pressure related to glaucoma. As a result, he’s been able to discontinue the medications in the operative eye.

“My left eye is done and my pressure is excellent,” Sean raves. “And it’s being maintained without any of the maintenance medications or drops. The pressure in my right eye remains high, with medication.”

The recovery process includes massaging the operative eye three to four times a day. Dr. Ilyas explained to Sean how this helps.

“As I understand it, the eye has fluid going through it continuously day and night, and the massaging helps to push fluid out and keep the pressure down,” Sean says. “Dr. Ilyas said I only have to do the massaging for a couple of months and then my eye will regulate itself.

“I highly recommend this procedure to anyone with glaucoma, and I highly recommend Dr. Ilyas and Brandon Eye Associates. I have nothing but the highest praise for them. They take great care of me!”

FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. Xen graphics courtesy of mkb

Comfort Zone Ahead

Customized, personable care helps build strong relationships with patients.

A retired nurse, Frances Allen knows what qualities to look for when it comes to finding a reputable and skilled dentist.

Frances Allen

“My local dental office changed hands, and I was no longer satisfied with the care I was receiving,” she explains. “I wasn’t happy with my smile. I had some discoloration along the top in the front, and I grew tired of looking at it. I was always smiling with my lips, never showing my teeth. When I asked them for a plan to fix things, they always put me off.”

In addition to the discoloration, Frances says she was waking up with jaw pain almost daily.

“I was grinding my teeth at night, which was causing other issues with my bite,” Frances adds. “I decided I needed to find a dentist who could create the makeover I always wanted.”

Frances read an article in Florida Health Care News about Stephen Blank, DDS, who practices cosmetic and functional dentistry in Port St. Lucie.

“From everything I read in the article, his patients seem to love him, and that was important to me. I want a dentist I can talk to and who truly cares enough to listen,” Frances relates.

She made an appointment and quickly discovered it was the right move.

Initial Exams

Dr. Blank conducts a thorough examination on new patients to determine their dental needs and develop a custom treatment plan, just as Frances wanted.

The 90-minute assessment includes a complete oral examination, including TMJ, bite and soft-tissue evaluations; computerized periodontal measurements; digital x-rays; an intraoral video tour that allows the patient to see what the dentist sees; and an oral hygiene evaluation.

“The goal is to build a solid dental relationship that allows each patient to achieve the best oral health possible and, with proper care, maintain that level of health for a lifetime,” Dr. Blank assures. “It’s not your typical five-minute dental exam.”

Afterward, Frances said it was the most thorough exam she ever received.

“I had a one-on-one meeting with Dr. Blank in a very relaxing atmosphere,” Frances confirms. “He discussed my x-rays, talked about what I was facing and presented all of the options. He made me feel comfortable. He wanted me to be sure about the decision I was about to make.”

Dr. Blank says crowns were the best option for Frances, given her history with grinding.

“I hated the shape of my teeth and the discoloration,” Frances continues. “A lot of them were uneven because of the grinding. After talking with Dr. Blank, I took his recommendation and chose to proceed with crowns.”

Crowning Achievement

During Frances’ diagnostic visit for the crowns, Dr. Blank designed the size, shape, color and position of the restorations. Models of her teeth and photographs of her mouth were taken and sent to the lab for a wax-up.

“With Frances, we did what we call a smile design visit, where we take measurements of the teeth and follow that with a full series of photographs. We then did a mock-up of the teeth with some temporary resin so we could guide the lab to create the results we wanted.

“From that smile design visit, we ordered a wax-up of the teeth that fulfilled Frances’ cosmetic need. That way, Frances was able to see how her teeth would look in the end.”

On Frances’ next visit, her teeth were prepared for placement of the restorations. Impressions were made for the lab, and resin temporaries that match the wax-up were created for her to wear home.

Dr. Blank says this allows the patient to take their new teeth home for a “test drive.”

“Thanks to Dr. Blank and his great staff, I’m not hiding my smile anymore.” – Frances

“The temporaries give patients the opportunity to see how their new smile will look,” Dr. Blank comments. “At the temporary stage, changes can be made, such as adding a bit of length or a little curvature or a slight reduction. We give the lab instructions on coloring, translucency and brightness. Then, the teeth are scanned and digital images are sent to the laboratory. In most cases, scanning has replaced the need for the gooey rubber impressions.”

Dr. Blank assures that today’s products provide durability and longevity to patients.

“Dental aesthetics have come a long way from when I was in dental school,” Dr. Blank says. “Today’s crowns are made of all-ceramic porcelain materials, so 10 years from now, if the gum line shrinks at all, Frances will not see a dark area above the top of the crown, which often occurs with crowns made with metal components. Today, products are created for longevity and with better aesthetics than ever before.”

A final aspect of Frances’ treatment plan was the creation of a bite guard to protect her teeth from further damage due to nighttime grinding.

“The bite guard takes the beating, so to speak, so that her new crowns do not suffer any damage,” Dr. Blank explains. “And her jaw will no longer ache when she wakes up each morning.”

Frances says she is delighted with how her bite guard has improved the way her jaw feels.

“No other dentist ever recommended a bite guard before,” Frances says. “That is just one example of how Dr. Blank goes the extra mile to make sure all bases are covered. The bite guard works great, and I have no more morning jaw pain.”

Connecting with Patients

Frances is delighted with her new smile.

Dr. Blank, who has been practicing in Port St. Lucie for more than 35 years, emphasizes that an important aspect of his success is the relationships with his patients. He stresses the importance of delivering customized, personable care.

“I want people to understand all of their options and be educated before making any decisions,” he emphasizes. “Everyone is different, and not every option is going to fit well with every person. I do my very best to understand a person’s long-term wants and needs. I give them eye contact and explain to them from start to finish what to expect, and I hold nothing back. I’m honest because I know that is what people want in a dentist. Honesty and integrity, both of which I strive to bring to the table.”

Frances says Dr. Blank is more than a dentist – he’s a true professional.

“He’s not at all a stuffed shirt,” she says. “He’s very personable and is interested in you as a person. His staff is very professional, also. Thanks to Dr. Blank and his great staff, I’m not hiding my smile anymore.”

Back On Track

Eye procedures repair retinal tears that derailed vision.

James Turner was employed by CSX for more than 20 years, serving primarily in the coal-mining regions of Kentucky, West Virginia and Tennessee. In 2010, James received a promotion and was transferred to the railroad’s corporate headquarters in Jacksonville.

James says that Dr. Moreno went “beyond expectations”
in treating his retinal problems.

“I joined CSX as an assistant trainmaster in the small town of Russell, Kentucky, and moved up from there,” James shares. “An assistant trainmaster supervises the trains and engine crews. Eventually, I became a safety manager, regional manager and locomotive shop superintendent. Here in Jacksonville, I was their chief mechanical officer.”

James retired from CSX this past June, but he wasn’t ready to give up working altogether. After a few months of leisure, James found another job that suits his talents.

“I’m working at Amtrak,” he states. “I’m a supervisor and superintendent. Retirement is nice, but I’m only 59 and I really miss working. I figure I’ll work for another year or two and then try retirement full time.”

James might not be ready to retire, but he’s at the prime age for cataracts to begin forming. His cataracts progressed to the point that he required surgery, but he developed complications about a month later.

“After surgery on my right eye, I noticed floaters that looked like black dots,” James describes. “There were also faint light flashes that looked almost like dishwater was floating around in front of my eye.

“I went back to the place that did my cataract surgery, and they performed a laser treatment to seal a retinal tear. Three weeks or a month later, I started having the same issues with my left eye. They said the retina in that eye was starting to detach and sent me to Florida Retina Institute.”

At Florida Retina Institute, James met with Tomas A. Moreno, MD, a board-certified, fellowship-trained retina specialist. Dr. Moreno performed a second laser procedure for a new retinal tear in James’ right eye and recommended cryotherapy to seal the tear and prevent a retinal detachment in the left eye.

Cryotherapy freezes the retinal tear and creates a scar around it to avert a detachment. Because James’ tear was quite large, Dr. Moreno was not sure the procedure would work, but he wanted to try that before a more invasive procedure known as a vitrectomy.

“Dr. Moreno moved pretty quickly because if the tear was not treated promptly, I could lose the vision in my eye,” James recalls. “Dr. Moreno said there was a 50/50 chance at best that the procedure would work, and unfortunately it didn’t, so a few days later he performed full-blown surgery on me.”

Peeling Wallpaper

James condition was due to changes in a jelly-like fluid inside the eye called vitreous. The vitreous is attached to the retina, the light-sensitive membrane that sits like wallpaper on the back wall of the eye. As people age, the vitreous begins to liquefy and tug at the retina, causing it to peel off the wall.

“Some parts of the vitreous attach to areas of the retina pretty forcefully,” Dr. Moreno educates. “When the jelly detaches from the retina, those parts of the jelly can be very adherent to the retina and cause it to tear.

“A retinal tear can lead to bleeding or pigment inside the eye, which is what people see as floaters. In addition, the retina cannot sense pain, so when it is getting abnormally tugged by the jelly, the only signal it can produce is a flash of light. If people notice flashing lights or a new onset of floaters, they should see a retina specialist right away for an evaluation.”

The vitreous can move through the tear, go behind the retina and lift it away from the back of the eye. That is the cause of a retinal detachment.

Vitrectomy repairs a retinal tear or detachment.

“If people notice flashing lights or a new onset of floaters, they should see a retina specialist right away for an evaluation.” – Dr. Moreno

“During a vitrectomy, we enter the eye with tiny instruments, including a light and a small knife,” Dr. Moreno describes. “We cut out the jelly, which removes the traction against the retina that is causing the tear or detachment, and replace the jelly with plain fluid.

“We flatten the retina against the back wall of the eye, essentially putting the wallpaper back on the wall. We place a gas bubble in the eye, which acts like a Band-Aid to push the retina against the wall and allow it to stick properly. Then, we use a laser to spot-weld the tear so it does not detach again.

“James did very well following his vitrectomy. He is seeing 20/20 or 20/25 in each eye. He saved his vision because he came to us early, as soon as he began to experience symptoms. Had he waited, he could have lost vision in both eyes.”

“Beyond Expectations”

James underwent two laser procedures for retinal tears in his right eye, one by doctors at the practice that performed his cataract surgery and one by Dr. Moreno at Florida Retina Institute. Those treatments were sufficient to seal the tears and resolve his symptoms. But that wasn’t the case with his left eye, which required a vitrectomy.

“I haven’t had any more issues with tearing in my right eye since the laser treatments,” James confirms. “When I continued to have some detachment in my left eye after the freezing therapy, Dr. Moreno performed a surgery where he went into my eye and placed a gas bubble. Then he went all around the retinal tears and sealed them.”

James sought help as soon as he noticed the floaters and flashing lights in his vision, and that early intervention prevented further damage that could’ve cost him his eyesight. He’s grateful that his cataract surgeon referred him to Florida Retina Institute. “Dr. Moreno went beyond expectations, and I don’t say that very often about people in the medical world,” James exudes. “He was extremely patient in telling me what was wrong with my eyes and what steps he could take to help correct them and save my vision. He took time to explain the procedures and all their risks and benefits, and that’s what I wanted to hear: the facts.

“I went to the Florida Retina Institute offices in Jacksonville and St. Augustine. They’re very nice places. The housekeeping is immaculate, Everything is super clean, especially with COVID. The staff is extremely polite, just as good as Dr. Moreno. I absolutely recommend Dr. Moreno and his team at Florida Retina Institute.”

Time Used Wisely

It only takes a moment to learn the benefits of slow-cadence workouts.

When Barbara Robinson had a routine bone density test a few years ago, the results indicated some loss. She was surprised – and concerned.

Barbara built bone density using the 20 Minutes to Fitness slow-cadence strengthening system.

“I considered myself physically fit,” says the 77-year-old from Sarasota. “I walk a couple of miles several times a week and I play golf. I thought that was enough.”

Then she saw an ad for 20 Minutes to Fitness in Lakewood Ranch and thought, This sounds almost too good to be true, Barbara recalls. “I had a meeting with one of the trainers and we talked about the program. I decided to try it because it seemed ideal for what I was concerned about.”

The type of training used at 20 Minutes to Fitness is referred to as slow-cadence training, and there’s plenty of science behind it.

In this training, weights are lifted in a series of ultra-slow movements, with the targeted muscles doing all the work with each repetition. Specialized equipment (designed for use in physical therapy) with a patented double-stacking weight system is used, with each repetition lasting 20 seconds.

This combination of slow movements and specialized equipment eliminates the benefits of gravity and momentum, so the muscles have to do all the work. Therefore, in just a few minutes on each piece of equipment, the muscle group being worked reaches peak performance.

And that’s the point.

As muscle fatigue is achieved, the body recovers over a period of three to six days. During this recovery period, a series of physiological changes takes place that supercharges the body to burn fat and rebuild muscle.

“Participants get the maximum benefit with just one 20-minute workout per week,” assures Angela Begin, part-owner of 20 Minutes to Fitness.

Rebuild Bone

The slow-cadence strengthening system helps control arthritis, fight symptoms of diabetes, improve memory function, build strength, reduce back pain and more.

It is especially useful for those at risk for osteoporosis, a condition in which bones become more porous and susceptible to fractures – particularly in the hip, spine and wrist.

According to the National Osteoporosis Foundation, more than 52 million Americans are afflicted with this silent disease, and studies suggest that about half of the women and up to a quarter of the men 50 and older will break a bone due to osteoporosis.

However, slow-cadence training helps combat the onset of osteoporosis and can even reverse bone loss.

“Nearly two dozen cross-sectional and longitudinal studies have shown a direct and positive relationship between the effects of resistance training and bone density,” according to the National Institutes of Health.

“The workout goes down deep into the muscle fiber,” Angela educates. “The fast twitch fibers pull on the bone, and this increases the production of osteoblasts (bone-forming cells), which increases bone density.”

Barbara is proof that it works.

“When I had my bone density scan last year, I was elated because I had improvement in my neck area and significant improvement in my hip area,” she raves.

Angela recalls that Barbara came in very skeptical at first, “as most of our clients do.”

“However, after training at 20 Minutes to Fitness for two years, she had an 11 percent increase in bone density, which is significant,” Angela says. “Usually, doctors are happy with 4 percent.”

Barbara, who works part time for the Baltimore Orioles during spring training, informs that her goal was to not have any more bone loss.

“An overall feeling of wellness came with building my strength” – Barbara

“I was pleasantly surprised that not only had I accomplished that, but I had improvement,” she proclaims. “The slow-cadence weight movement really works!”

In addition to building back bone density, Barbara says she is stronger and feels better all around.

“An overall feeling of wellness came with building my strength,” she says. “I’m not a big person – about 5 feet, 120 pounds – and right now with the leg press I’m moving 300 pounds.”

She also added about 30 yards of distance to her golf swing, “an unexpected plus.”

One-on-One Encouragement

In addition to being an effective, quick and relatively sweatless workout, slow-cadence training is appropriate for all fitness levels and ages, from teenagers to octogenarians.

“No one is too old, too young, too in or out of shape to benefit from this program,” Angela asserts.

Trainers “challenge people at their fitness levels,” she continues. “We can start as low as 20 pounds. It depends on the person and how strong they are when they come in. But we’re going to challenge them at their level and continue challenging them.”

With a commitment of less than a half-hour once a week, the 20 Minutes to Fitness workout is shorter than traditional workouts. And with a fitness professional at your side the entire time, it’s also much safer.

“You have a coach with you keeping you safe, making sure that you’re doing things properly, staying in perfect form on safe, specialized equipment,” Angela notes.

Barbara joined gyms in the past but “did not use the weight equipment because, frankly, I was concerned about hurting myself,” she admits. At 20 Minutes to Fitness, “there is a trainer with me every moment to make sure that I’m doing it correctly and that my posture is correct, so I don’t hurt myself.”

In addition, 20 Minutes to Fitness offers a complimentary orientation, and there are no annual contracts or membership fees.

“Come in and learn a little bit about this unique system, learn the science and try it out,” Angela encourages. “There’s no obligation to continue, and it’s a great way to make an educated decision about whether or not this will work for you.”

Barbara is not only pleased that she has improved her bone density, strength and overall well-being through her weekly workouts at 20 Minutes to Fitness, but she is also impressed with the staff and her experience there.

“They’re encouraging. They’re pleasant,” she enthuses. “Sometimes, I amaze myself. As we’re training, I find that I can do more than I thought I could. I can do that one more rep when I thought I was finished. The overall facility and the staff have been wonderful.”

Feeling Safe With Fillings

Getting ahead and going beyond the FDA’s warning on amalgam.

At Advanced Dental Cosmetic Center, both J. Terry Alford, DMD, and H. Gene Steele, DDS, stand in the forefront of patient safety. For example, out of concern for his patients, Dr. Alford stopped using dental amalgam, which contains mercury, more than 35 years ago.

As it turns out, Dr. Alford was well ahead of the curve.

On Sept. 24, the FDA identified certain groups as being at increased risk for harmful effects from dental amalgam fillings. Those include pregnant women and their developing fetuses; nursing mothers and their newborns; women planning to become pregnant; children, especially younger than 6; people with neurological ailments such as multiple sclerosis, Alzheimer’s or Parkinson’s disease; people with impaired kidney function; and those with a heightened sensitivity (allergy) to mercury or the other components in amalgam, which include silver, tin and copper.

“The FDA stated what some have been saying for a long time, that amalgam releases small amounts of mercury vapor over time,” notes Dr. Steele. “Elemental mercury has long been known to be toxic, and warnings have been issued about exposure.”

Dental amalgam is about 50 percent elemental mercury. In its September 2019 scientific review, “Epidemiological Evidence on the Adverse Health Effects in Relation to Mercury from Dental Amalgam,” the FDA recognized that mercury in dental amalgam can convert inside the body into toxic methylmercury, which is the same type of mercury the FDA warns about in fish. Furthermore, the FDA recognized the bioaccumulation effects of mercury.

“With environmental sources of mercury already exposing patients, dental amalgam is another source that can contribute to toxic levels,” Dr. Steele warns. “Environmental sources include high-mercury fish, occupational exposures and waste incinerators.”

At a scientific advisory committee meeting in November 2019, a group called Consumers for Dental Choice persuaded the FDA to take another look at its amalgam policy. The FDA learned of the bans on amalgam use in children issued by the European Union, Vietnam and Tanzania as well as other changes around the world on amalgam rules. These included phase-out dates set by the Philippines, Ireland, Slovakia, Finland, Nepal, Moldova, the Czech Republic and New Caledonia.

As a result, the FDA advisory committee made recommendations to patients about the risks of dental amalgam, especially in vulnerable populations, and agreed that the use of dental amalgam should end.

“It’s important to note that the FDA does not recommend removal of existing amalgam fillings in good condition unless considered medically necessary, as with hypersensitivity to the amalgam material,” Dr. Steele observes. “Removing dental amalgams may result in a temporary increase in exposure to mercury vapor released during the removal process.

“In our practice, to ensure the safest environment possible when amalgams need to be removed, water is used to suppress mercury vapors and high-speed evacuation is used to capture mercury vapor that may be emitted and capture particles of solid amalgam.”

The FDA also does not find that the available evidence supports a complete ban on future use of dental amalgam.

“Patients can feel safe at Advanced Dental Cosmetic Center because we far exceed the recommended precautions for patient safety,” Dr. Steele assures. “Our choice of filling material is just one of many things we do to keep our patients safe.”

Say No To Back Surgery

Sessions on VAX-D Therapy table eliminate age-old spine pain.

When 92-year-old John Fought was a younger man, he served his country in the US Navy. During his years of service, John performed highly specialized and dangerous duty.

John Fought

John Fought

“I was in naval aviation and was assigned to a hurricane hunter squadron,” the Northwest Ohio native recounts. “We flew around looking for hurricanes, and when we came upon one, we flew into it and dropped buoys to measure the wind speed and waves. Afterward, we tried to duck out of the storm without any problems. I served on that squadron for two or three years, but that was back in 1952 or 1953.”

After John left the Navy in 1954, he returned to school and took courses to prepare for a career as a test engineer. He began his career servicing the equipment of large companies such as RCA Government Services and General Electric. But after a few years, John took a job with the military.

“I entered a training program at a missile range on Florida’s east coast,” John describes. “From there, I went down to Grand Bahamas, St. Croix, Antigua and Dominican Republic to work. I stayed down there for a while then returned to Florida to work at a missile range in the Tampa Bay area.

“When they needed someone to go to Guantanamo Bay Naval Base to ride aboard ships and aircraft and check the accuracy of their equipment, I agreed to go. I worked in Cuba for about 12 years. I came back to Florida for a few years then went back to St. Croix, where I worked for another nine or 10 years before retiring at 65 and returning to Florida.”

At John’s age, it’s not unusual to have a few aches, but his lower back pain goes back years, a problem his doctor attributes to an injury sustained as a youngster.

“I was a teenager during World War II, and everybody had to do their part and work,” John relates. “I worked with a gentleman who was a roofer and painter. We went up and down ladders carrying heavy buckets of paint and other materials. The doctor told me I screwed up the vertebrae in my back doing that.

“Because of those vertebrae, my back seldom, if ever, felt good. It was always stiff and sore, and the pain was an eight or nine on a scale of one to 10. In the morning, I would be bent over and couldn’t straighten up until 9 or 10 o’clock. When I tried to get out of a chair, I would be stuck in a sitting position due to the pain. I was told surgery could take care of the problem, but I didn’t want to have my back operated on.”

John visited many chiropractors over the years seeking relief. When the pain flared up recently, he looked for a new chiropractor but wasn’t familiar with any in Bradenton. Then, his routine reading revealed a provider that he believed could help.

“I saw an article about Dr. Aderholdt in Florida Health Care News and became intrigued,” John remembers. “From what the people in the article said, it sounded like he could probably do me some good, so I said, It’s time to visit Dr. Aderholdt.”

Craig S. Aderholdt, DC, of Back Pain Institute of West Florida, provides the most advanced treatments available for patients in severe pain. Among them is VAX-D® Therapy, a patented, FDA-approved medical decompression technique for alleviating pressure on the discs of the spine.

Dr. Aderholdt is one of the few doctors in the country who offers VAX-D Therapy. Based on his examination of John, John’s symptoms and what he saw on the x-ray he ordered, Dr. Aderholdt recommended VAX-D Therapy for John.

Beyond the Imitators

Dr. Aderholdt says VAX-D, which stands for vertebral axial decompression, is not a traction device. It works differently and achieves significantly better results.

“For many patients, chiropractic adjustments alone can relieve their pain,” Dr. Aderholdt points out. “But for select people who suffer with conditions such as sciatica or herniated, bulging or degenerated discs, VAX-D Therapy has proven extremely successful.

“John was a good candidate for VAX-D because the treatment is effective at alleviating low back and neck pain. It also helps with numbness, tingling and pain that radiates down the arms and legs.”

VAX-D treatments typically last about a half-hour each. The patient relaxes on a comfortable, computer-controlled table, secured by a pelvic belt or patented cervical collar, depending on the area to be treated. Carefully specified tension and pressure changes guide the use of VAX-D, allowing the therapist to focus decompression at the exact level of spinal dysfunction.

The VAX-D system is computerized, which enables the table to make subtle but targeted movements that create a powerful vacuum within the disc space. This vacuum gently draws the disc back to its proper orientation, pulling nutrient-
rich spinal fluid into the disc and stimulating repair cells that effectively mend the disc.

“Nothing else can create such a powerful vacuum,” Dr. Aderholdt maintains. “There are imitators, but VAX-D’s vacuum effect is the most powerful one known. That is what makes VAX-D such a valuable tool for pain relief. In addition, VAX-D doesn’t allow the muscles to contract, like other machines can. In fact, it is the only nonsurgical treatment that has been clinically proven to reduce disc pressure to negative levels.

“I consider VAX-D one of the most effective nonsurgical medical treatments for low back pain, neck pain and sciatica. This revolutionary technology is one more tool I can offer patients as we work toward relieving pain and maintaining the health of the lumbar and cervical spine.”

Studies show that VAX-D is effective in more than 88 percent of patients who go through the protocol. Many patients report a significant reduction in back or neck pain after only a few treatments. Dr. Aderholdt stresses, however, that actual healing takes longer because bulging or herniated discs require a series of sessions to fully reposition.

“Some patients think they will get relief after a handful of sessions and they can just quit, but that’s not the case,” he observes. “Patients must follow through with all of the required treatments to get the full benefit.”
Another advantage of VAX-D Therapy is that it can eliminate the need for surgery.

“Like John, many patients with severe back or neck pain want to avoid surgery, and that is something that VAX-D allows,” Dr. Aderholdt reports. “With surgery, there is the potential for serious complications. Because VAX-D is noninvasive, those complications are avoided.”

“There’s No Pain”

As Dr. Aderholdt recommended, John completed the full course of VAX-D Therapy on his lower back, and it resulted in an excellent outcome.

John Fought

VAX-D Therapy relieved the pressure in John’s back so he has no pain when he moves.

“The chiropractors I saw in the past did the twisting and pulling procedures,” John notes. “Dr. Aderholdt’s treatment is altogether different, and it has really helped me because my vertebrae were pretty messed up.

“What his machine did was gently stretch and tug, and eventually it relieved the pressure on my back. Now, my back is pretty well straightened out. I can get up in the morning now with no trouble. I have balance problems, so I’m a little stiff when I walk, but there’s no soreness anymore, no more aches and pains. Sometimes I have a little pain, but it’s like a one on a scale of one to 10. But by 9 or 10 in the morning I don’t have any pain in my back at all, and I can sit in a chair. And when I get up, I can move. And there’s no pain.”

John was so pleased with the results of VAX-D Therapy on his lower back pain that he recently returned to Back Pain Institute of West Florida to receive the therapy for some aggravating neck pain.

“Apparently, there are some bad vertebrae in my neck as well,” John states. “That caused strain on one side of my neck, and I was getting headaches every day. The headaches ran from the back of my head and shoulders and went over my head all the way to my left eye.

“But after only three treatments, I felt some relief from the strain and the headaches started to go away. I’m confident that everything will be fine once I finish the full course of treatments.”

When John first visited Back Pain Institute of West Florida, he approached other patients in the waiting room to get their perspectives on Dr. Aderholdt and his care, and he came away impressed.

“The people in the office believe Dr. Aderholdt uses his God-given gifts for healing purposes through his care,” John elaborates. “And they seem very pleased with the treatment they receive from him.

“I recommend Dr. Aderholdt and VAX-D Therapy. It’s a life-changing treatment.”

Her Happy Place

Senior community proves to be a perfect fit for retired homemaker.

 Photo courtesy of Savannah Court of Orange City.

Mary Stone

Outside of dignitaries and high-ranking public officials, there aren’t a lot of people who can say they’ve seen the Queen of England and a sitting pope up close. But Mary Stone, a 92-year-old former homemaker, can.

Mary, who lived in Germany for four years while her husband, a career US Army officer, served there, encountered Queen Elizabeth II during a royal birthday procession and John XXIII while on a tour of the pope’s summer home.

“That was way back in the late ’50s and early ’60s,” Mary says. “When you live in Europe, you can actually get around to several countries in just one day, and I was fortunate to get around a bit when I was living there.”

Mary says she has lived “all over,” and she’s not exaggerating. In addition to Germany, she has also lived in Guam, Kansas, New Jersey and Florida. Since March, Mary has called Savannah Court of Orange City home.

“I was living on my own in Orlando, and my children didn’t like that,” Mary explains. “I had fallen a couple of times, and that worried them and me, so we all decided to find a place that was safe and secure where I could get good care if I need it.”

Mary and her family found all of that at Savannah Court, a senior living community nestled between metro Orlando and Daytona Beach that offers a cozy, small-town ambiance and the amenities necessary for residents to maintain an active lifestyle.

Provided by an experienced staff specializing in personalized care and hospitality, the amenities include assisted living services in private apartments, senior day care services for caregivers needing a day for themselves, and respite care for seniors recovering from illness or surgery.

“We provide the kind of support residents can’t get at home or at a lot of other places,” says Todd Brown, marketing relations director at Savanah Court of Orange City. “We’re a smaller, more intimate community, and that has many advantages.

“Everybody goes out of their way to make you feel comfortable and at home here.” – Mary

“Because we’re smaller, we have a direct hands-on approach with our residents. That allows us to make sure they are cared for in the best way possible and are as independent and active as they want to be with the various programs we offer.”

Those programs include an array of activities, including arts, crafts, music and games. Savannah Court also offers exercise programs to suit their residents’ needs and tastes and community events designed to promote camaraderie.

Mary says she’s “never been a bingo player kind of gal,” but she appreciates the opportunity her new home affords to interact with others. She says that while living on her own, she spent a lot of time on her own. That’s no longer the case.

“I’ve made a lot of new friends here, and I really like that because I enjoy being around other people,” Mary says. “I’d say the people are what I like the most about living at Savannah Court.
“All the people – the residents and the staff – they’re all so nice. Everybody goes out of their way to make you feel comfortable and at home. And if there’s anything you ever need, they take care of it for you.

“I definitely made the right choice coming to Savannah Court. The time was right, and I’m so comfortable and happy here that I’ve told some of my friends about it. I think it’s a great, happy place to live.”

From Ozone To Comfort Zone

Injection therapy uses oxygen to relieve joint, back pain.

A little more than 25 percent of all adults in the US donate an average of three hours per week to volunteer efforts each year. Joyce Harrigan, 76, has long been among those who gladly gives of herself to help others.

“I’ve done volunteer work practically my whole life,” Joyce explains. “After I first moved to Florida, I volunteered at the Indian River Medical Center for nine years. Now I volunteer at Indian River Estates, the retirement community where I live.

“I’m a member of several committees, including the hospitality committee, and I run singalongs for the independent living residents. I’m also a member of the Joy Singers, so I stay pretty busy. I’m a very active person.”

Prior to retiring, Joyce worked as a teacher in adult education for several years, sold real estate and managed a flower shop. She became something of a “jack-of-all-trades,” she says, because her husband’s job kept the couple on the move.

“My husband was in advertising, and his job transfers took us all over the country,” she says. “Our last stop for his work was New Jersey, and from there we moved to Florida. We’ve been here for 19 years now.”

For the past 12 years, Joyce and her husband have placed their health care in the hands of Melissa Dean, MD, of the Dean Wellness Institute. Dr. Dean practices traditional medicine while also offering patients a holistic approach to wellness.

Dr. Dean’s specialties include hormone balancing, adrenal support therapy and bioidentical hormone replacement therapy (BHRT), which is considered the most natural and effective solution for hormone-related issues.

Her clinic also specializes in intravenous therapies, including IV vitamin therapy, anti-aging/regenerative medicine and aesthetic treatments such as neuromodulators, hyaluronic acid-based fillers and microneedling with PRP.

“My husband and I have been patients of Dr. Dean’s since she started her practice,” Joyce states. “Over the years, she has advised us on a number of alternative approaches to medicine, including one while I was preparing for surgery for breast cancer.

“That was a couple of years ago, and Dr. Dean advised me to get vitamin C infusions before and after my surgery to build up my immune system and help with healing. I followed her advice and my surgeon was absolutely amazed at how quickly I healed.

“I have a great deal of faith in Dr. Dean’s recommendations, so when she suggested a couple of years ago that I try Prolozone® therapy for my sore shoulder and knees, I was happy to give it a try.”

Master Class

Prolozone is a reconstruction and pain management treatment in which ozone gas is injected into damaged areas of the body. This increases the amount of pure oxygen in the body, which helps relieve all forms of musculoskeletal and joint pain.

Dr. Dean, who also has a master’s degree in metabolic and nutritional medicine, has trained with some of the pioneers in alternative medicine and Prolozone therapy, including
Dr. Frank Shallenberger, Dr. Charles Runels and Dr. Patricia Kane.

“With Prolozone therapy, we typically give the patient a series of three injections where the amount of ozone gas that is used is contiguous to the joint or area we’re treating,” Dr. Dean educates. “But it’s not just ozone that’s in the injection.

“Along with the ozone, a mixture of vitamins and minerals is injected into the joint as well. There are a couple of specific recipes that we use. One, for example, would be anti-inflammatory for arthritic knees and similar issues.

“What these injections do is decrease inflammation and stimulate healing. And because you’re not injecting a medication, per se, there is no potential for side effects such as bone erosion that can come with something such as steroid injections.”

“Prolzone injections are an amazing treatment that I definitely recommend for anyone who has the kind of joint or back pain that I had.” – Joyce

Prior to recommending Prolozone treatments for Joyce, Dr. Dean conducted a thorough physical examination that included a detailed review of x-rays of Joyce’s knees and shoulder, all of which showed signs of advanced arthritis.

The recommendation to treat those areas with Prolozone was based on Joyce’s desire to avoid not only joint replacement surgery but also steroid and cortisone injections, which had been recommended by other doctors.

“When Joyce and I first started discussing Prolozone therapy, she had a number of joints that were bothering her, and she wanted to treat them naturally,” Dr. Dean reports. “Prolozone therapy is a great choice for someone like that.

“A lot of people like Joyce will take something like Aleve® for their pain every day, but who wants to take Aleve every day? If you’re just hoping to eliminate the pain, then Prolozone therapy is a great choice.”

Long-lasting Relief

The pain-relieving effects of Prolozone therapy can last for a year or more, according to Dr. Dean, and Joyce is proof of that. She received injections in her knees and right shoulder more than a year ago and says she remains pain free in those joints.

Since receiving those initial Prolozone injections, Joyce has also received Prolozone injections in her back. She says the combination has allowed her to resume the active lifestyle she prefers.

“Before I got the injections, my shoulder was so sore that I couldn’t raise my arm up over my head, and I had a hard time sleeping because of my back pain,” she says. “In fact, my back was so sore that standing became a problem for me, too.

“One of the things I like to do is make flower arrangements for different activities that we have here, and for a while, I could make three or four flower arrangements but then I’d have to stop because my back would start hurting.

“Now I can stand and make my flower arrangements without any trouble. I’m sleeping better and doing all kinds of other things. I’m even going to physical therapy and walking a mile every day, which is something else I had to give up.

“I am relatively pain-free, and it’s been several months since I got the injections, so I think Prolozone injections are wonderful. If my pain comes back, I will gladly go back to Dr. Dean for another injection because they have really worked well for me.

“Prolozone injections are an amazing treatment that I definitely recommend for anyone who has the kind of joint or back pain that I had.

“Of course, I also recommend Dr. Dean as well. She’s great. What I like most about her is that she listens to you and she works really hard to figure out what is wrong with you and how to fix it. I’ve recommended her to a number of friends and I’ll continue to do so.”

Tarsal Tunnel Syndrome

You don’t have to live with the pain.

According to Robert P. Dunne, DPM, a board-certified podiatric surgeon at Lake Washington Foot & Ankle Center, “Tarsal tunnel syndrome, or TTS, presents itself when nerves in the ankle, such as the tibial nerve, are compressed.

“TTS can have several different catalysts or triggers,” he continues. “Symptoms can be of a sudden onset or can gradually get worse over time. TTS can be the result of trauma or a congenital disease.”

Arthritis is a typical cause of TTS. It causes swelling, which in turn compresses the nerves. Like arthritis, diabetes also causes swelling that squeezes the nerves. The soft tissue swelling from sprains and strains will also create pressure on the nerves.

Other causes include flat feet, or fallen arches; scar tissue from a prior surgery or trauma; or varicose veins. Cysts or spurs can also compress the nerves and produce symptoms.

“When the symptoms initially present themselves, it is important to seek treatment,” cautions Dr. Dunne. “Immediate treatment of TTS can prevent permanent nerve damage and possibly reduce the need for surgical correction. Often, when a patient with TTS presents to the office for the first time, he or she will report symptoms similar to those of carpal tunnel in the hand,” says Dr. Dunne.

Symptoms of TTS may include tingling or burning. Sometimes, sufferers experience numbness, or loss of sensation, in the affected foot, particularly in the first and second toe, and the ankle. Others experience symptoms such as shooting or stabbing pains so pronounced that these sensations interfere with their day-to-day lives. Occasionally, these symptoms can be accompanied by weakness and the sensation that the ankle or foot could be “giving way.” Patients may also experience symptoms that are worse at night, radiate into the calf and can be aggravated by prolonged standing or walking.

Fortunately, Dr. Dunne and Lake Washington Foot & Ankle Center can help with the management and treatment of TTS, giving the patient several treatment options. These range from conservative to invasive in nature.

Diagnosing and Treating TTS

TTS is diagnosed in several ways. At Lake Washington Foot & Ankle Center, patients receive an extensive exam by Dr. Dunne, including a superficial testing of the nerves, a complete medical history and, depending on symptoms and history, x-rays. In some cases, Dr. Dunne will send the patient to a neurologist to have nerve conduction studies to learn if the patient’s symptoms are a result of TTS, or if there is another cause for the patient’s discomfort.

Lake Washington Foot & Ankle Center can offer TTS treatment that will vary with the patient’s needs and symptoms. In some cases, symptoms can be temporarily relieved through massage, rest and elevating the affected ankle.

“There are several treatment paths we can take with our patients, depending on symptoms, severity and length of discomfort,” notes Dr. Dunne. “Our first option is always conservative treatment.”

Conservative treatments might include custom-molded orthotics, ankle braces or splints. Oral anti-inflammatories may be used, as well as topical anti-inflammatories. Another option is physical therapy, including stretching and strengthening techniques.

A minimally invasive approach involves the use of cortisone, or steroid injections. The most invasive treatment is surgical correction using a procedure called tarsal tunnel release.

“Seeking treatment at the first sign of symptoms will make the outcome of the treatment more successful and reduce the amount of permanent nerve damage,” observes Dr. Dunne. “Again, earlier treatment can reduce or eliminate the need for surgical intervention in some cases.”

Lake Washington Foot & Ankle Center is a comprehensive podiatric medicine clinic. It offers treatment for everything from bunions to hammertoes to neuromas to diabetic complications.

Article courtesy of Lake Washington Foot & Ankle Center.

Finishing Touches

COVID-safe Evolve treatments tighten, trim and tone the body.

For her 42nd birthday in April, Patricia* badly wanted to throw herself a party. Given that the coronavirus was raging, she opted to err on the side of caution and threw herself a virtual party instead.

She arranged a video conference with 12 of her closest friends and family members, who celebrated not just Patricia’s birthday, but also a monumental achievement: the loss of 24 pounds of excess body fat through a program called First Line Therapy (FLT).

Provided by Deborah A. DeMarta, MD, FACS, FAARFM, at the Institute of Health and Wellness, FLT is a therapeutic lifestyle program that helps people improve their health and avoid diseases through healthy lifestyle choices, including a modified Mediterranean low glycemic diet, medical foods, stress reduction and exercise.

“That was the real reason I wanted to throw the party,” Patricia says. “It wasn’t really about my birthday. It was about the fact that I had spent the previous year working to lose this excess weight, and I’d finally reached my goal.”

Patricia’s goal was to reach 145 pounds, her ideal weight when she married 12 years earlier. She reached her goal in late March but soon realized she still needed more than diet and exercise to regain the look she wanted.

“I’m still young, and I want to feel confident in the way I look when going to the beach or pool,” Patricia explains. “But even after losing all that weight, I didn’t like the few problem areas that needed to be addressed, along with the associated laxity of my skin.

“I didn’t like my waist line, where I was struggling to lose those last few inches that would give me the shape I wanted. I also had some unsightly skin laxity around my abdomen and inner thighs. I didn’t want those love handles.”

To address those issues, Patricia returned to the Institute of Health & Wellness, where Dr. DeMarta and her team offer a trio of body contouring treatments from InMode called Evolve Tite, Trim and Tone.

“These Evolve treatments are part of a completely customizable non-invasive hands-free all-in-one platform that uses multiple technologies to contour the body and remodel the skin,” Dr. DeMarta explains. “It’s designed for people such as Patricia, who are close to their ideal weight but are struggling to lose those last few pounds or simply need to tighten or tone up a few trouble areas.

“By the time I was done, I had that summertime bikini body that I was happy with and proud of.” – Patricia

“It’s effective on all skin types and works well for men as well as women. And there’s no downtime associated with these treatments. They’re painless and can be done in less than an hour, so it’s something you can schedule during your lunch break if you work and time is tight.

“The other thing that’s great about these treatments is that they’re hands-free, so they’re COVID-safe. We follow the highest standards to ensure COVID safety in our facility.
“This is a treatment ideally suited for someone who may have put on a few extra COVID pounds because of the inability to get to the gym during the global pandemic.”

Evolve Tite

Evolve Tite is an aesthetic remodeling solution that creates a slimmer look by tightening loose or sagging skin through leading-edge radio frequency technology, which generates heat to stimulate collagen production.

“The heat is similar to what you feel during a hot stone massage, and it causes elastin and fibroblast cells to go to work repairing the skin,” Dr. DeMarta explains. “Radiofrequency is a technology we’ve used for many indications such as skin tightening and vaginal rejuvenation.

“In this application, it’s use on the abdomen is perfect for someone who is postpartum and is experiencing loose or sagging abdominal skin. It also works very well on the arms, inner thighs, anywhere you have crepey skin or a loss of elasticity.”

Evolve Trim

Evolve Trim is a quick and easy non-surgical alternative to liposuction specifically designed to reduce the unsightly appearance of subcutaneous fat through the combined use of radiofrequency technology and ultrasound cavitation.

During Evolve Trim treatments, patients wear a specially designed belt that holds six treatment applicators that allow the radiofrequency energy to be distributed to the skin and underlying fat cells, which are destroyed through apoptosis.

The improved results noted with this new technology, compared to other devices on the market, are secondary to contoured thermal heating that are not operator dependent.

“Fat cells are like little water balloons, and during apoptosis, those little water balloons, or fat cells, are popped and deflated,” says Pamela Consbruck, CME, LE, at the Institute of Health & Wellness.

“The contents of those fat cells then go into the lymphatic system, and they’re eventually flushed out of the body. That’s why we do a little massage afterward, because the lymphatics help get rid of the fat through the kidneys.”

Pamela states with enthusiasm that Evolve Trim is an anti-aging treatment that can be used to trim or erase the appearance of fat from the abdomen, back, back of thighs, waist, bra strap area and buttocks. She adds that best results typically come from being treated once a week for about eight weeks.

“That’s the general recommendation for all of these treatments,” Pamela adds. “Most people begin to see gradual improvement in the treatment area after the first few treatments, but the best results come from getting weekly sessions for a duration of six to eight weeks.”

Evolve Tone

EVOLVE Tone’s four hands-free applicators allow for multiple areas to be treated simultaneously.

Evolve Tone is designed to increase muscle strength, tone muscle and add definition to areas such as the arms, legs, flanks, abdomen and buttocks. Unlike Evolve Tite and Evolve Trim, it uses electromagnetic energy to stimulate the muscle, which simulates a real workout.

“Evolve Tone is very powerful,” Pamela says. “I had a demo done on myself, and it really contracts the muscle. The next day, you feel like you had a major workout. But it’s hands-free and the muscle contractions it creates are all involuntary.

“You will definitely feel those contractions. That’s why the treatment can be adjusted so that you can get the maximum benefit from the procedure. A patient call button is available if the comfort level requires adjustment.

“In fact, all of these treatments have a patient call button that can be used if an adjustment needs to be made because once we strap the belt on you, the technician leaves the room so you can lay there and meditate or listen to music or just relax, enjoying the serene view of the river from the beautiful historic treatment room made of Dade County pine.”

Evolve Incredible

Patricia began Evolve treatments in June. For eight weeks, she received Evolve Tite treatments on her abdomen and inner thighs on one day and Evolve Trim treatments on her love handles and the back of her thighs on another. The results, she says, were incredible.

“After a couple of weeks I really started to notice a difference in all the areas that were being treated, and by the time I was done, I had that summertime bikini body that I was happy with and proud of,” she says.

“The Evolve treatments really worked wonders for me, and they were very comfortable. I got to the point after just a couple of treatments where I was really looking forward to that half-hour or 45 minutes of relaxation. It was like having a spa day.

“Now that I’ve got my body looking more the way I want, I’m going to start doing the Evolve Tone treatments to help keep it that way. Between the lifestyle and dietary modifications I learned from the FLT program and some home exercises, I can have the body I want and keep it!”

*Patient’s name changed at her request.


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