Author Archive

Oral Health and the Body

An emerging field of study is the relationship between the health of the mouth and the overall health of the body. Researchers have already linked poor oral health to several serious medical disorders, including cardiovascular disease, diabetes and certain respiratory illnesses.

The mouth is teeming with bacteria, most of which are harmless. The body’s natural defenses and good oral hygiene – proper brushing and flossing – generally keep these bacteria under control.

But if people don’t practice good oral hygiene, plaque can build up along the gumline, creating an environment for more bacteria to accumulate between the teeth and gums. This can lead to a gum infection called gingivitis. Left untreated, gingivitis can progress to a more serious gum infection called periodontitis.

People with untreated periodontitis have up to a 20 percent increase in risk for heart disease. In addition, these people have increased risk for stroke, peripheral vascular disease and myocardial infarction (heart attack).

Advanced periodontal disease is also associated with increased risk for the development and progression of some cancers. Pancreatic cancer risk can go up 59 percent. Smoking related cancers can increase by 150 percent. Also, breast cancer has a greater chance of recurrence.

Medical and dental professional organizations agree on the connection between cardiovascular disease, clogged arteries and stroke with the inflammation and infection caused by bacteria from the mouth.

Reduction in symptoms and improvement in prognosis of arthritis may result from therapeutic treatment of periodontal disease.

Other conditions linked to periodontitis are premature birth and low birth weight. And certain bacteria from the mouth can enter the lungs and cause pneumonia and other respiratory diseases.

On the flip side, some health conditions affect the mouth and teeth. Diabetes reduces the body’s resistance to infection and puts the gums at risk. Gum disease tends to be more frequent and severe in people who have diabetes. And people who have gum disease have a more difficult time controlling their blood sugar levels. Patients with rheumatoid arthritis have increased risk of developing periodontal disease.

Oral problems, such as painful sores in the lining of the mouth, are common in people with HIV/AIDS, and osteoporosis is linked to periodontal bone loss and tooth loss. In addition, certain medications to treat osteoporosis can damage the bones of the jaw. Further, worsening oral health can occur as Alzheimer’s disease progresses.

There are other conditions that might be linked to oral health. These include eating disorders, rheumatoid arthritis, certain cancers and an immune system disorder that causes dry mouth called Sjogren’s syndrome.

In many cases, the mouth serves as a vantage point for detecting early signs and symptoms of diseases elsewhere in the body. The Academy of General Dentistry reports that more than 90 percent of all diseases produce oral signs and symptoms. For example, the first signs of AIDS and diabetes are often sores in the mouth.

People can protect their overall health by practicing good oral health habits. These include:

  • Brushing at least twice a day with a soft-bristled brush and fluoride toothpaste
  • Flossing daily and using a flushing device such as a Waterpik®
  • Using mouthwash to remove food particles left after brushing and flossing
  • Eating a healthy diet low in added sugar
  • Replacing their toothbrush every three months or whenever the bristles become splayed or worn
  • Seeing the dentist for routine checkups and cleanings

Time Used Wisely

Once-a-week, slow-cadence workouts safe, effective during pandemic.

They didn’t start dating each other until a few weeks after graduating from high school, so Jeanette and Karl Kudick never considered themselves high school sweethearts. They have been sweethearts ever since, though.

Photo by Jordan Pysz.

Jeanette and Karl say their 20 Minutes to Fitness workouts are more
convenient and more effective than traditional workouts.

“There was a very popular song out when we started dating called Too Young, and that’s what everybody said about us,” Jeanette says. “They said we were too young to be together, too young to be married. And we were very young. But we made it work.”

They’ve been making it work for 64 years. That’s how long Jeanette and Karl, who hail from a town of about 1,400 in eastern Wisconsin called Mishicot, have been married and making a life together.

Most of those years have been spent in Mishicot, where the couple raised four sons, but after Jeanette retired from her job as a medical assistant and Karl retired from his career in banking and finance, the couple moved to Florida.

Since then, they have developed a passion for golf and physical fitness. At 83 and 84, respectively, Jeanette and Karl believe that staying fit is more important than ever, and they are truly dedicated to it.

Their routine used to include working out three or four days a week at a gym near their home, but they recently altered that routine after a friend suggested they could get a better workout at 20 Minutes to Fitness.

“I didn’t know what 20 Minutes to Fitness was when we first tried it out, but it’s amazing,” Jeanette raves. “On our first day there, we met a woman in her 90s, and she raved about it. That sold me on it right then and there.”

Tailored Training

At 20 Minutes to Fitness, clients work out one-on-one with a nationally certified personal fitness coach, who creates and supervises an individualized workout program. The program is designed to do what the business name implies: achieve results through a weekly 20-minute session.

The workouts are structured around an exercise method known as slow-cadence training. The coach guides the client’s pace and form as weights are lifted in ultraslow movements on highly specialized equipment. Repetitions during each workout take approximately 20 seconds, thereby maximizing muscle performance.

The slow-paced movements create continuous tension on muscle fibers. This allows clients to get more physical benefits than they would in a traditional workout program involving three or four hours per week.

“In fact, this method is actually more effective, because in this program, you have more time under tension on those muscle fibers,” says Blake, general manager at 20 Minutes to Fitness of Downtown Sarasota. “The longer the muscle is challenged, the deeper it reaches into the tissue.

“While each repetition in a traditional workout lasts for one or two seconds up and then one or two seconds down, we stretch that out to a 10- to 12-second count. It’s a big, big difference that achieves far better results.”

Each workout consists of five to seven exercises of two minutes each, with the goal being to reach what is known as peak performance. When muscles reach this level during strength training, blood flows to the site. That supercharges the body and helps it burn fat while it rebuilds and strengthens the muscle naturally.

“Participants get the maximum benefit through one 20-minute workout per week,” explains Angela Begin, part-owner of 20 Minutes to Fitness. “By going slowly, we get down deeper into the muscle fibers and force them to work at their peak performance. We work the entire body to keep it strong.”

The program has years of research and plenty of science behind the success, The weight-training equipment features a patented double-stacking system, where weight can be increased in increments of 2 pounds instead of the traditional 5, 10 or 20. The equipment also is calibrated to work specific muscle groups without putting undue stress on joints or ligaments.

Research has shown that in addition to improving strength, weekly 20-minute slow-cadence training sessions can also help improve the immune system, increase energy, control arthritis, increase bone density, fight symptoms of diabetes and reduce back pain.

“I am absolutely sold on 20 Minutes to Fitness. I’m stronger, more fit and my golf game has improved thanks to the workouts.” – Jeanette

“We have clients who are planning to have hip or knee replacement surgeries, and their doctors refer them to us,” Angela says, “because they know we can help them build the muscle around those joints prior to surgery. This allows for a quicker recovery after surgery.”

“We’ve even had some people who have been able to hold off on those surgeries because they’ve built up the muscle around the joint.

Most of our clients, though, are people who want to stay fit and don’t have the time or don’t want to spend hours in a gym and possibly risk injury.

“They want a safe, quiet, private studio environment, and that’s what we offer, in addition to building back that muscle that people lose as they age. The other thing is, you’re never too young or too old to do this. We have teenagers who come in, in addition to clients who are in their 90s. We have clients who have never worked out, as well as athletes. We build your strength from where you are today.”

Tremendously Effective

Jeanette and Karl first tried 20 Minutes to Fitness about a year ago, mostly out of curiosity. They have since found it to be far more convenient and effective than the traditional workouts they were pushing through at their gym.

“First of all, the exercises are different than anything I’ve experienced,” Jeanette says. “It’s a totally different way of building muscle and strength, and the coaches and trainers that work with you are so amazing.

“I’ve worked with trainers at other gyms and most of them are very good, but the trainers and coaches at 20 Minutes to Fitness are so engaged and encouraging and supportive. I’ve never worked with anyone like them.”

Jeanette and Karl’s workouts at 20 Minutes to Fitness had to be postponed for a while due to the COVID-19 outbreak, but upon their return, they were pleased to see that the staff had taken steps to ensure clients are safe and protected from the virus.

“They do a great job of sanitizing all the equipment, and everything is spread out in such a way that social distancing is not a problem,” Jeanette reports. “The other thing they do is have you wait in your car until it’s time for your workout.

“Once your workout is done, they have you walk out a different door so you’re not running into anybody who might be coming in. They’ve really done a great job as far as keeping the facility clean and safe for their customers through this virus.

“I am absolutely sold on 20 Minutes to Fitness. I’m stronger, more fit and my golf game has improved thanks to the workouts, and the same goes for Karl. A friend recently told us how much better we’re hitting the ball since we’ve been going there.

“I love 20 Minutes to Fitness so much that I am literally a walking billboard for it. I mean that. I have a 20 Minutes to Fitness T-shirt that says, A New Way of Exercising, and I wear it all the time. That’s how much I believe in it.”

The Case for Antioxidants

High levels of oxidative stress have a negative effect on health.

All people experience stress. But too much stress can have a negative impact on the body. That’s why stress management should be a routine part of everyone’s healthy lifestyle.

Unlike mental and physical stress, the kind that people feel directly and is more conspicuous, oxidative stress and inflammation occur internally, at the cellular level. But just as it is with physical stress, too much oxidation in the cells is bad for health.

“The good news is that the oxidation process can be neutralized by antioxidants,” asserts H. Gene Steele, DDS, who along with J. Terry Alford, DMD, practices general, cosmetic and restorative dentistry at Advanced Dental Cosmetic Center in Bradenton.

“In fact, reducing oxidative stress and inflammation with an optimal status of relevant nutrients strengthens the immune system,” Dr. Steele continues. “And today, having a healthy immune system has never been more important.

“Low levels of the nutrients Vitamin A, Vitamin D or zinc have been associated with an increased risk of infection. Poor nutrient levels have also been associated with inflammation and oxidative stress. And sufficient protein intake is necessary for optimal antibody production.”

But how can people know whether they have enough antioxidants to help their body combat oxidation? It’s as easy as taking their temperature through a quick, painless laser scan of the skin, and that is available at Advanced Dental Cosmetic Center.

What Is Oxidative Stress?

Accelerated oxidation from too many free radicals leads to imbalances, which result in oxidative stress and its subsequent ill effects on health, contributing to the fact that 70 percent of non-communicable diseases are preventable. Free radicals, which are unstable molecules with unpaired electrons, appear naturally in the body but can be increased by environmental and lifestyle factors such as stress, pollutants, poor diet and substances such as alcohol and nicotine.

“Infections that are chronic and not always painful, such as gingivitis and periodontitis, also cause inflammation,” Dr. Steele explains. “And inflammation increases oxidation, which is very apparent in the mouth because of bleeding when brushing or flossing.

“But oxidative stress and inflammation do not only negatively affect the immune system, they also increase susceptibility to chronic diseases such as rheumatoid arthritis and vascular diseases, including those that lead to heart attack and stroke.”

Science has also shown a link between the health of oral tissues and overall health of your body including your heart, lungs and brain.

Studies have been published in the New England Journal of Medicine and Journal of the American College of Cardiology affirming the link between periodontal disease and vascular disease.

What can be done to improve immune system function and reduce the risk of chronic diseases?

“Getting adequate nutrition including appropriate levels of Vitamin A, Vitamin D and zinc, as well as sufficient protein helps reduce the risk of infection,” Dr. Steele observes. “In addition, increasing the levels of antioxidants in the body neutralizes the oxidative process.

“Increasing antioxidants and decreasing inflammation can be aided by eating fruits and vegetables in the correct proportions that provide adequate Vitamin C, Vitamin E, carotenoids and polyphenols. But eating enough of the right variety of fruits and vegetables is not feasible for everyone.

“In those cases, dietary antioxidant supplements are available to get the correct levels of antioxidants that are protective. Topical antioxidants are available for application on oral tissues as well.”

About 75 percent of Americans across all age groups are taking supplements. But are their supplements working to get these people to the antioxidant levels required to boost their immune function and protect them against diseases?
“Perhaps you are in this group?”

Dr. Steele asks. “At Advanced Dental Cosmetic Center, we now have a cutting edge laser device that can noninvasively measure the levels of carotenoids for our patients, giving an indication of their overall antioxidant levels. The information we gather helps us make appropriate recommendations to our patients regarding nutrition and supplementation.”

Article courtesy of Advanced Dental Cosmetic Center.

Immunization: It’s Not Just For Kids Anymore

August 17th, 2020

Most people think immunization is just for kids. But National Immunization Awareness Month, which is celebrated in August, underscores the importance of vaccination for people of all ages. After all, the old adage that says “an ounce of prevention is worth a pound of cure” holds true throughout life.

The term immunization refers to the action of making people resistant (immune) to certain infectious diseases, many of which can be very serious or even deadly. Immunization is typically accomplished through inoculation with vaccines.

If you’re like me, you probably received a series of vaccines when you were a child. Over the years, the schedule of vaccines given to children and teens has evolved as doctors have learned more about various infectious diseases and new and improved vaccines become available.

For the current guidelines from the US Centers for Disease Control and Prevention, see Recommended Child and Adolescent Immunization Scheduled for Ages 18 and Younger.  And here, the American Academy of Family Physicians describes the recommended vaccines in greater detail: Childhood Vaccines: What They Are and Why Your Child Needs Them.

Most vaccines are made using a weakened version of the infectious germs, such as bacteria or viruses, that cause the disease, or materials that resemble those germs. Vaccines work by prompting your body’s own defense against disease, your immune system, to produce infection-fighting cells to attack the invading germs.

To better understand how vaccines work, let’s take a closer look at how the immune system fights infection.

When germs invade your body for the first time, your immune system uses certain white blood cells to destroy them. Special white cells called macrophages consume and digest the germs. B-lymphocytes produce disease-fighting antibodies that attack the germs, and T-lymphocytes attack cells in the body that have already been infected by the bacteria or virus.

Once antibodies are created in response to an initial infection, your body keeps them and uses them to fight future infections with the same germ. That’s how vaccines provide protection for the long haul. Many vaccines protect you for years, some for most of your life. But sometimes, a vaccine loses its effectiveness over time. In that case, you may require a “booster” later in life.

Adults need boosters of certain vaccines they received as children, such as the Tdap, which is the vaccine for tetanus, diphtheria and pertussis (whooping cough), and the vaccine against hepatitis B. People of all ages should get a tetanus booster every 10 years. A booster is recommended any time you’re exposed to the tetanus toxin as well.

It is also recommended that adults receive vaccines for diseases such as influenza, pneumococcal pneumonia and shingles. Here’s a rundown of the recommended vaccines for adults. In addition, vaccination against diseases that are common in other countries is recommended before you travel outside the US. Here’s more information about vaccines for travelers.

Immunization is important for two reasons: It protects you from disease, and it protects the people around you. How vaccines protect you has already been explored, but how do vaccines protect your community?

If a large number of people in a community are vaccinated and immune to a disease, the germs that cause it can’t spread from person to person as easily. Spreading germs this way can make the people around you sick and lead to an all-out outbreak of the disease. The protection that results from community-wide vaccination is called herd immunity.

There are some people who don’t get vaccinated because they fear side effects. Most vaccines cause only miner side effects such as a mild fever or soreness at the site of the injection. And there is no credible evidence that vaccination leads to autism, as some people suggest.

All in all, immunization is a safe and effective way to protect against many serious, possibly deadly, infectious diseases. Thanks to immunization, diseases such as polio and smallpox are near obliteration in this country.

Keeping Americans safe from those diseases and many others is why spreading the word about immunization is a priority of National Immunization Awareness Month.

An Ounce Of Prevention

Practice establishes measures to ensure patient safety amid pandemic.

As the world hopes to slowly move its way back to normalcy amid the coronavirus pandemic, medical professionals are finding their work to be incredibly challenging.

Richard Leong, DDS, has accepted that challenge as if he were ordained to do so.

Buoyed by his belief that the time he spent sheltered in place was an opportunity to better himself, grow closer to family and strengthen his faith, Dr. Leong spent part of his down time learning as much as he could about the coronavirus.

What he learned has greatly impacted the way he now runs his Melbourne-based practice, where he performs all aspects of dentistry, including periodontics, oral surgery and the placement of crowns, bridges and dental implants.

“What we now know is that this is a very transmissible disease and that many carriers of the coronavirus are asymptomatic,” Dr. Leong stresses. “Therefore, we must treat everyone that comes into our office as if they may have the virus.

“I want to emphasize that this is especially important inside a dental office, where aerosols have been generated already by the use of drills and ultrasonic cleaning equipment, and the risk of transmitting the virus is therefore much higher.

“That’s why to ensure the safety of our patients as well as the members of our staff, I have instituted a series of dramatic changes to our office, changes that I believe make our dental office safer than even your own home.

“I say that because these changes go far beyond the minimum guidelines recommended by the American Dental Association, the U.S. Centers for Disease Control and Prevention, and the Occupational Safety and Health Administration.”

The changes Dr. Leong has instituted include:3

Before Treatment

Patients will be notified of these measures in advance of their appointments, which will begin with a meeting in the parking lot, where their temperatures will be taken and they will be asked to sign a consent form. The practice asks that, if at all possible, patients come alone to their appointments. If that is not possible, anyone accompanying the patient will need to go through the same pretreatment as the patient. Also, appointments are now being scheduled so that no more than three patients are in the office at one time and so that no more than one patient is being treated by Dr. Leong or the hygienist at a time. In addition, waiting room chairs have been spaced at least six feet apart in accordance with CDC social distancing guidelines.

Preventive Measures

Patients will be required to wash their hands upon arrival at the office. For this purpose, hand soap and drying towels will be provided. In addition, the office has long been equipped with automatic on/off water faucets and paper towel dispensers that help prevent cross contamination of virus and bacteria. Also, for anyone needing to sign forms, a new pen will be provided that will be the patient’s to keep.

Cross-Contamination

Because a dentist and a patient can infect each other, Dr. Leong and his staff are being tested frequently to ensure they do not have the virus. Ideally, patients should be tested ahead of their appointment so as to avoid contaminating the dental office, staff and other patients. Because testing for every person is not feasible, first-line defenders such as dental personnel are being tested.

Personal Protective Equipment 

PPE, or personal protective equipment, refers to outer garments and face equipment that dentists and staff members must wear to protect themselves from virus contamination. Dr. Leong and his staff members are using the same PPE used by hospital personnel when treating COVID-19. That includes disposable gowns covering the entire body with long sleeves; gloves that cover the hands and pulled over the sleeves to prevent leakage of the virus onto the wrist and forearm; face masks with ventilators that have higher filtration to stop viruses from traveling to a staff member or patient; eye protection in the form of glasses/goggles or face shields to keep aerosols out of the eyes of the dentist and staff; and surgical head shields that prevent aerosols from getting into the hair.
Specific protocols are being followed in Dr. 0ong’s office to prevent virus contamination. For example, once an appointment has been completed, staff members are required to follow specific guidelines for removing PPE. This includes hand-washing before removing each specific article of PPE and donning a new gown, head piece and mask. In addition, each patient coming into the office will be met by dental staffers with new PPE so that no coronavirus is cross-contaminated from one patient to the other.

Proper Handwashing

For staff members, the universal method of handwashing for at least 20 seconds while covering all surfaces, including the wrists and under the fingernails, has long been in practice at Dr. Leong’s dental office. Dr. Leong and all assistants are required to wash their hands before, during and after each procedure to prevent cross-contamination and are now required to wash their hands four to five times when donning and doffing PPE.

Preparation of Each Operatory

Research has shown that aerosols from the use of a dental drill can spread as far as 30 feet from where the patient is seated. Therefore, decontamination of each operatory inside Dr. Leong’s practice will be done between each appointment to prevent the spread of virus and bacteria from one patient to another. The sanitation process will be done using alcohol and Lysol spray. These agents have proven to be the most effective in killing the virus and are being used on counters, surfaces around the room and in the air where the aerosol droplets remain. In addition, all handles on lights, cabinets or doors are covered ahead of or sterilized after each patient appointment.

Sterilization of Working Instruments

Dr. Leong’s practice has replaced all dental instruments that cannot be autoclaved with instruments that can so all instruments can be sterilized thoroughly after each use. This includes the three-way syringe used to squirt water and air into the patient’s mouth as well as the high-volume evacuator (HVE) or suction instrument.

“I made the decision to buy new instruments, because I thought about what I would want in my mouth if I were sitting in that chair,” Dr. Leong explains. “I would want the best sterilization possible so that I have the least chance of having coronavirus passed to me by an asymptomatic patient.

“Therefore, I purchased these new instrumentations because I know that no bacteria or virus will be passed between patients when using three-way syringes, HVE suction handles and saliva ejectors that can be and are sterilized.”

Air Filtration to Remove Aerosols

Because aerosols linger in the air for more than three hours, if they are not mechanically removed, filtration devices must be utilized to maintain proper patient flow. The practice has equipped each operatory with Blueair Pro L air purifiers. This air purifier has been rated the best on the market by Clinicians Report, an independent dental product-testing organization.

Dental Hygiene Visits

To further prevent the spread of aerosols during dental hygiene visits, the hygienist is limiting the use of the ultrasonic high-speed cleanser and prophy jet polisher, both of which spread large amounts of aerosols into the air during use.

High-Volume Evacuation

In an effort to reduce aerosols that may contain the virus,
Dr. Leong is now using a high-volume suction (HVE) instrument during all procedures involving a drill as well as cleanings. This special instrumentation, called Isolite, uses high-speed suction, and covers and protects the throat and tongue at the same time. When used in conjunction with the standard saliva ejector tube that hangs out of the corner of the patient’s mouth, the special HVE suction reduces the amount of aerosol produced by 95 percent.
HVE is the first line of defense for removing aerosols in the patient’s mouth. Other aerosols are removed by the air purification units. Very few dental offices have both HVEs in the mouth at the same time and few, if any, have air-purification units working in conjunction with HVEs to essentially remove up to 100 percent of aerosols in the air.

Rubber Dam Treatment

A rubber dam is a thin rubber mask that covers the throat and tongue and does not allow saliva and contents from the mouth to be exposed while drilling is going on. It is clamped onto the teeth adjacent to where the work is being done, which helps prevent aerosols from entering the dental environment. This type of mask is used most extensively when doing root canal treatments or fillings. It was an often-used protocol method even before coronavirus was a problem but is now being used more frequently.

Avoid Touching Objects During Treatment

Inadvertent actions such as straightening glasses, and touching computer keyboards or drawer handles can break the chain of prevention that has been set up to prevent cross-contamination. At Dr. Leong’s practice, several steps have been taken throughout the office to ensure that chain is not broken, including covering all keyboards and handles with plastic wrap between each patient visit.

Housekeeping After Hours

Each night, our maintenance staff spends approximately four hours cleaning and sanitizing the floors and walls of each operatory. Like the members of our dental staff, our maintenance team members have all been trained extensively regarding the use of PPE as well as hand-washing and cross-contamination techniques.

Bathroom Use

The practice respectfully requests that anyone utilizing a bathroom while on the premises notify the staff of their use so that the bathroom can be sterilized following each person’s use.

Internal Building Architecture

Operatories with open doors allow for the escape and free flow from that operatory of aerosols that can result in cross-contamination of the virus. Though the open-door concept does have many advantages, all operatory doors at Dr. Leong’s practice will be closed during procedures both for privacy purposes and to prevent any possible escape of the virus.

Internal Staff Communication

To further reduce the potential for cross-contamination of the virus, the staff is now using handsfree voice actuated communication devices that eliminate the need to touch intercoms or telephones.

It’s Cataract Awareness Month

Here’s everything you need to know about cataract surgery.

Cataracts are a clouding of the normally clear lens of the eye. Cataract surgery, which involves the replacement of the cloudy lens, is one of the most common procedures in the country, with more than 3.5 million performed annually.

Thanks to medical advances, cataract surgery is safer and now provides better outcomes than ever. With this sophisticated technology, procedures can be customized to find the best fit for patients. But, it can be challenging to choose between the myriad of new options available.

It’s Cataract Awareness Month, which makes now the perfect time to review the signs of cataracts, the latest technology available for treatment and what to expect with surgery.

Signs You Need Surgery

“By age 80, more than half of Americans have been diagnosed with a cataract or have had cataract surgery,” says Rajesh K. Shetty, MD, ophthalmologist and CEO of Florida Eye Specialists. “However, many of my patients don’t realize that cataracts can begin to develop early in their 40s and 50s.”

Dr. Shetty says cataracts develop slowly and painlessly over time. In the early stages, symptoms may be so mild that patients don’t realize their vision is changing. But as a person ages, cataracts can grow to the point where they can get in the way of living an active, independent life.

“Cataracts can affect night vision, meaning you may not be able to drive home from work in the evening,” Dr. Shetty says. “As people continue to work later and later in life, this becomes a big problem for our patients.”

Those with advanced cataracts may also experience blurry vision, double vision, sensitivity to glare and light, and fading colors, and they may need to change their prescriptions for glasses or contacts more frequently.

Vision needs have become more demanding with advances in technology and today’s active adult lifestyle.

“Vision needs have changed a lot,” Dr. Shetty says. “We spend much more time looking at phones and other devices with our friends and family communicating with us constantly. We’re traveling more, looking at GPS, driving during dusk, dawn, rain and nighttime. We’re playing golf and reading. The demand for clear vision at all ages is the highest it’s ever been.”

Types of Surgery

If you are planning to have cataract surgery, there are two options to choose from: traditional and laser-assisted.

“Traditional cataract surgery is one of the most common and safest surgeries in the world,” Dr. Shetty says. He explains that one of the primary benefits to traditional cataract surgery is that most health insurance plans will cover at least part of the cost of the procedure.

However, Dr. Shetty says, traditional cataract surgery does have limitations. It cannot correct astigmatism, and patients who receive traditional cataract surgery will still need to wear glasses for intermediate and near vision.

Unlike traditional cataract surgery, where a scalpel is used to make an incision in the eye by hand, laser cataract surgery is guided by computer. The surface of the eye is mapped to tell the laser the exact location, size and depth for incisions. This results in a safer, gentler procedure.

The laser also creates a more precise and accurate outcome. Dr. Shetty says this allows eye surgeons to correct a range of vision problems – including astigmatism, farsightedness and nearsightedness – at the time of cataract surgery. This gives you the option to correct two conditions with one procedure, and reduces or possibly eliminates the need for glasses.

Dr. Shetty has had great experience with this procedure. Florida Eye Specialists was the first practice in Northeast Florida to offer laser cataract surgery to patients and has performed nearly 7,000 procedures to date.

Before and After Surgery

Prior to cataract surgery, Dr. Shetty says, your eye surgeon should walk you through the steps of the procedure to answer any questions that may come up. Some important questions to ask include what kind of cataract surgery is available to you and what kind of replacement, or intraocular lens (IOL), you can choose from.

“It can be hard for patients to remember the questions they should ask in the moment, so we recommend writing your questions out in advance and bringing them with you to the appointment,” Dr. Shetty says.

During the operation, you’ll be given a local anesthetic to numb the area around your eye. The sedation will make you feel a bit groggy afterward, so you’ll need someone to drive you home. Generally, cataract surgery patients do not experience any pain after surgery, Dr. Shetty says.

“There may be some itching or discomfort for the first few days, and you may need to wear an eye patch or protective shield on the day of surgery,” Dr. Shetty says. “Also, avoid bending at the waist or lifting heavy objects over five pounds for the first week after surgery.”

The recovery time is short. You will begin to see the results in your vision in the first few days and should make a full recovery within four to six weeks. Many patients report clear vision within several hours. But each person heals differently, according to Dr. Shetty, and you may need a week or two before you see images in their sharpest focus. Your recovery should be completed in about a month, when the eye is healed.

See Better Than Ever

Today, cataract surgery offers patients the opportunity to not only restore their vision, but to possibly see better than they ever have. It can reduce dependency on glasses and make daily activities such as reading and driving easy again.

“We do what we do because we can improve people’s lives,” Dr. Shetty says. “You lose so many faculties and abilities as you age – skills you didn’t realize you were losing, your energy, how fast you think and run. But here’s one area of your life you can actually improve upon. You can see better, function better and do things you haven’t done in years. These are truly phenomenal results.”

Eye surgeons recommend that patients aged 60 and older have a comprehensive dilated eye exam at least once every two years. In addition to cataracts, your eye care professional can check for signs of age-related macular degeneration, glaucoma and other vision disorders.

Article and photo submitted by Florida Eye Specialists.

Heal Your Headaches

Two-part treatment relieves neck pain, chronic migraines.

In early April, not long after the coronavirus began to spread wildly across the United States, the National Institutes of Health launched a study to determine how many people became infected by the virus before anyone really knew what it was.

Photo by Nerissa Johnson.

Robert Palmer

For more than 12 years, guiding the NIH through its decision to launch such studies was a task that belonged to Robert Palmer, who once owned a consulting firm that specialized in organizational development in the Washington, DC, area.

“My specialty was working with not-for-profit and large multinational organizations,” Robert says. “If they had a pain point, they’d contact me, and I’d go in, diagnose the problem, figure out how to fix it and then help them do it.

“During my career, I was fortunate to work with many of the agencies inside the United Nations, including the World Health Organization and the National Institutes of Health, which was my biggest client for about 12 years.”

While advising a smaller client, Robert visited Florida for the first time some 20 years ago. He loved the climate so much that he moved here shortly thereafter, but life in the Sunshine State has not always been sunny for this active 76-year-old retiree.

Twice in the past 12 years, he has been badly injured in accidents that occurred while riding his bicycle. The first incident resulted in Robert undergoing neck fusion surgery. The second resulted in work being done on his lower back.

Throw in that arthritis has developed throughout his spine since the accidents and he has suffered from migraine headaches since childhood, and Robert has spent most of the past decade in debilitating pain.

“I had to give up riding a bike because it actually made my back worse,’’ Robert explains. “Because of the vibration and the jarring movement that came with riding a bike, I’d finish up a ride and just be miserable afterward.

“There were times when the pain was so bad that I almost couldn’t walk and a couple of times when I wound up in the emergency room because the pain was so bad that I couldn’t sit or stand or even lie down.

“As for the headaches, they’re genetic. My maternal grandmother had one on her 100th birthday. I started getting them when I was an adolescent. They diminished a bit when I was in my 20s and 30s, but they came back with a vengeance when I was in my late 40s.

“I could tell when one was coming on because the first thing I noticed was that I would get sick to my stomach. Then my speech would become slurred, and sometimes I’d see what I call fireworks. That’s what they look like. I see them inside my head. It’s these flashes that are just like fireworks going off. But between the slurred speech and nausea, I know a headache is coming on.

“I tried everything I could think of to get rid of them, even acupuncture and Chinese therapies, and when triptans first came out in the 1990s, I was one of the first to start using them, and they’ve helped a lot.

“They’ve sort of allowed me to manage things over the years. Thankfully, I have a high tolerance for pain because I’ve really had to just kind of learn to function with these headaches as well as with the back pain.”

But a functional life is not the same as a rewarding life. As a result, Robert has continually sought relief for his pain. He finally found it at McGreevy NeuroHealth in St. Augustine, the practice of Kai McGreevy, MD, DABPN, RPVI.

A board-certified neurologist and interventional pain management specialist, Dr. McGreevy also has an office in Palm Coast. Robert discovered Dr. McGreevy through his primary care physician shortly after McGreevy opened his practice several years ago.

Flashes of Fireworks

“When Robert came to us, he was suffering with chronic headaches,” Dr. McGreevy remembers. “They initially started as episodes with discrete beginnings and endings, but over the course of years, they turned into daily headaches. The condition was in the context of a history of migraines.

“Robert described his migraines as one-sided, throbbing head pain accompanied by nausea and sensitivity to light and loud sound. The pain worsened with head movement to a point that even his hair hurt and his scalp was very sensitive. The headaches were disabling, and Robert tried various preventive medications, but none sufficiently reduced the frequency or intensity of his headaches.”

Dr. McGreevy began his evaluation of Robert’s condition with a full history and complete neurological examination. He also ordered imaging tests of Robert’s neck and head, and through those tests he was able to rule out a brain tumor, or some other mass or aneurysm.

“But during my exam, I noted a tenderness behind Robert’s head in the region of the occipital nerves,” Dr. McGreevy reports. “He also exhibited something called a Tinel sign. When I tapped over the base of his skull, he felt a brief electrical sensation on top of the nerves in question.

“It became quite obvious that Robert had a condition more complicated than simple migraines. He was suffering from occipital neuralgia that transformed into chronic migraines. I recommended BOTOX® as a treatment for this condition.”

“Dr. McGreevy is a very good diagnostician,” Robert relates. “He’s very thorough and meticulous in the testing that he does and in the comprehensiveness of his evaluations. So when he said, What about BOTOX? I said, Sure, fine. And it’s been a godsend.”

Little Injections

BOTOX is a treatment for patients who have chronic headaches, meaning they have at least 15 headache days per month, or for those who suffer from at least eight migraines per month, McGreevy explains.

“BOTOX treatment is a series of injections designed to reduce the electrical sensation around the occipital nerves and relax the muscles of the scalp and head,” the neurologist notes. “It also relaxes the neck muscles where they insert on the back of the scalp.”

The exact way BOTOX works remains unclear, but it’s believed that it enters the nerve endings and blocks the release of chemicals that are involved in pain transmission. This prevents the brain from triggering pain pathways.

“In Robert’s case, we are able to treat his cervical spinal arthritis as well as his occipital headache pain simply by targeting the appropriate cervical nerves.” – Dr. McGreevy

“The BOTOX treatments involve a series of little injections above my eyebrows and up my forehead,” Robert relates. “They’re placed all around my head, then Dr. McGreevy ends up at the top of my spinal column. And the injections are well worth it.”

“As a result of the BOTOX treatments, Robert experienced a dramatic reduction in frequency and intensity of his headaches, a reduction in migraines specifically, and a reduction in nausea, light sensitivity, phonophobia and scalp sensitivity,” Dr. McGreevy elaborates. “As a result of that, he was able to function better.”

But occipital neuralgia wasn’t the only problem Dr. McGreevy discovered during his examination of Robert.

“Robert also had cervical spondylosis, which is the wear and tear on the neck joints due to osteoarthritis,” Dr. McGreevy expounds. “This complicates the occipital neuralgia and migraines, so we complemented Robert’s BOTOX therapy using another treatment called radiofrequency ablation, or RFA, which concentrates on the nerves of his upper cervical facet joints.

“Radiofrequency ablation helps to stabilize the cervical spondylosis that produces occipital head pain. The goal is to target the source of the head pain, which ultimately leads to relief of migraines and chronic daily headaches.”

The Best Fit

RFA has long been used for the treatment of arthritis neck pain, and today’s pain management specialists have tailored it to treat pain patterns radiating from the neck up into the head or down into the shoulders and arms. RFA can now be customized to address various pain syndromes, their signs and symptoms.

Photo by Nerissa Johnson.

BOTOX
treatments are helping alleviate Robert’s chronic migraines.

“What is unique about radiofrequency ablation is that it does not involve steroids, it is long-lasting and it can treat multiple problems at once,” Dr. McGreevy notes. “So in Robert’s case, we are able to treat his cervical spinal arthritis as well as his occipital headache pain simply by targeting the appropriate cervical nerves.”

Before proceeding with RFA, Dr. McGreevy conducts a diagnostic nerve block, also called a medial branch block, which is an injection of pain-relieving lidocaine under local anesthetic. The purpose of the medial branch block is to further confirm that the pain is being generated by the suspected joints and nerves. It proves the suitability of RFA as a treatment.

“Robert received dramatic pain relief, greater than 80 percent, following each diagnostic injection,” Dr. McGreevy recalls. “That allowed us to proceed with radiofrequency ablation as a definitive treatment for his cervical arthritis.”

RFA is often used for patients who have not received sustained pain relief from other treatments, including epidural steroid injections, facet joint injections and nerve blocks. In many cases, RFA is the best fit to improve patients’ pain control, range of motion and quality of life.

RFA is a minimally invasive, nonsurgical, outpatient procedure during which patients remain awake but are lightly sedated to minimize discomfort and reduce anxiety. Doctors consider it highly effective in temporarily reducing the kind of severe back and neck pain that plagues nearly two-thirds of the world’s population.

During RFA, radio waves are used to produce heat that is delivered through a probe to a group of specified spinal nerves. The heat creates a lesion, or wound, on the nerve tissue that interferes with the transmission of pain signals to the brain, thereby reducing discomfort in the troubled area.

By targeting and damaging the specific nerves responsible for carrying pain signals, RFA can effectively reduce or eliminate a patient’s pain for a few months or even years.

“There are many chronic pain conditions that respond well to radiofrequency ablation,” Dr. McGreevy asserts. “These include spinal arthritis and spine degeneration, as well as pain after spine surgery.”

Dr. McGreevy details the steps of the RFA procedure: “When we are doing the radiofrequency ablation procedure, the patient lies on a table on their belly, and an x-ray camera is used to take pictures of the region we are working on,” he describes. “That is how we can see all the landmarks we need to safely perform the procedure.”

A local anesthetic is then administered to the skin and deeper tissues to provide comfort so that a needle can be inserted and directed toward the targeted nerves. When the needle is precisely positioned, a stylet is pulled out of the needle and replaced by a thin probe.

“Today’s treatments are very advanced. There are options available now that never existed 20 or 30 years ago, and Dr. McGreevy is on top of all of it.” – Robert

“The probe is directed to the targeted nerve, and a radiofrequency generator is turned on,” Dr. McGreevy continues. “That generator provides 120 seconds of radiofrequency waves, or energy, that are delivered to the targeted nerve and create the lesion that cauterizes the nerve.”

When the nerve is cauterized, it can’t send pain signals, so nothing is received and interpreted by the brain. Subsequently, no return message to feel pain is sent back to the affected area of the body.

“Using radiofrequency ablation, Robert received a 50 to 75 percent reduction in pain consistently over the course of nine to 12 months,” Dr. McGreevy states. “He had dramatic improvement in his occipital headaches as well.”

Garden Sanctuary

For nearly 12 years, Robert has lived with neck pain from spinal arthritis that began following the accidents on his bicycle. But he now understands how, over time, the arthritis has affected the chronic headaches and migraines he’s suffered since his youth.

“Dr. McGreevy explained to me that if I get a migraine I’m also going to get an occipital headache, and those are caused by the arthritis and its pinching of the nerves in my neck,” Robert states. “So, I can have occipital headaches, cluster headaches and migraines all at the same time. But if we stay on top of the headache situation, I can live with it.”

Actually, Robert says that he feels better now than he has in a long time.

“That’s absolutely true,” he agrees. “And my treatment is on a schedule now. About the time that the RFA wears off, it’s time to go back. The BOTOX takes about a week to kick in, then there’s an immediate diminishing of the pain level. The relief lasts for about 80 days, which is great because I can get the treatment every 91 days.”

Without the neck pain and headaches, Robert can participate in his favorite hobby, which is gardening, without restriction.Photo by Nerissa Johnson.

“I have a gorgeous garden,” he boasts. “Everyone in town knows about it. Because this is a tourist town, many people walk by my garden and ask questions such as, What’s that thing? What’s that blooming? And I let them take pictures.

“My garden is a sanctuary of sorts for butterflies, bees and hummingbirds. I provide whatever they need to thrive. Take a butterfly, for example. The adults need nectar flowers to feed on but a different kind of plant to lay their eggs on. When the eggs hatch, they feed on those plants before they turn into a chrysalis and become a butterfly.”

Were it not for Dr. McGreevy, Robert might not be as active in his garden. That’s why he’s grateful for Dr. McGreevy and his staff and why he’s quick to recommend the doctor to others needing a neurologist or pain management specialist.

“Dr. McGreevy is young and knows about all the new research,” Robert describes. “Today’s treatments are very advanced. There are options available now that never existed 20 or 30 years ago, and Dr. McGreevy is on top of all of it.

“And he’s a nice guy, too. He has a nice bedside manner. He also has a great staff at McGreevy NeuroHealth. They’re all very well-trained, so it’s not just him.
Dr. McGreevy surrounds himself with good people, which is why I’ve sent a number of people to him.”

Coronavirus and the Eyes

Researchers continue to discover new ways that SARS-CoV-2, the virus that causes COVID-19, affects the body as a whole. While COVID-19 is primarily a respiratory illness, even the eyes are not spared from its effects.

“Most people realize that the coronavirus can cause fever and cough, but we are learning that it can also affect a number of other organ systems, including the eyes,” elaborates Jonathan A. Staman, MD, a board-certified, fellowship-trained retina specialist at Florida Retina Institute.

“Eye manifestations are more commonly seen in patients with more severe systemic disease,” the doctor continues. “Some case reports suggest that up to 30 percent of patients affected by COVID-19 have eye symptoms. Other studies have found eye involvement to be much less frequent and present in only 1 to 3 percent of those infected.”

COVID-19 has been linked to the development of an infectious eye condition called conjunctivitis, also known as pink eye. Conjunctivitis is inflammation of the clear surface of the eye, or conjunctiva, which can result in red, inflamed, swollen eyes.

“While COVID-19 can cause pink eye, it is very important to remember that most pink eye is not due to the coronavirus,” Dr. Staman stresses. “Allergies and other viruses are much more common causes. COVID-19 becomes more of a concern if the patient additionally has systemic symptoms such as fever, cough, shortness of breath, fatigue, or loss of smell or taste, on top of the red, teary, irritated eyes seen with pink eye.

“Because your typical viral pink eye is highly contagious and can be transmitted by tears, patients with pink eye should try not to touch their eyes. If they do, they should wash their hands right away,” Dr. Staman notes.

Conjunctivitis will usually go away on its own within a week or two, but if symptoms are severe or last longer than that, affected people should see their general eye doctor to make sure they don’t have a more serious eye problem.

In The Air Tonight

COVID-19 is typically spread through respiratory droplets that are released into the air when an infected person talks, coughs or sneezes.

“People can become infected with COVID-19 if these droplets are inhaled or also if they land on a surface that they touch with their hands then proceed to touch their mouth, nose or eyes,” Dr. Staman explains. “This is why everyone is being asked to clean their hands frequently and try to avoid touching their nose, mouth and eyes.

“Not only can the infection be spread to the eyes through hand-to-eye contact, but it can also potentially work in reverse. Since the virus has been found in tears, people who rub their eyes and then touch a public surface can potentially transmit the virus to others. Fortunately, the viral prevalence in tears is very low, so this would be an uncommon way for the virus to spread.”

The eyes have also been identified as a potential target for coronavirus in part due to the fact that the eyes have ACE-2 receptors that can be used by the virus to bind to cells.

“These receptors are also found in the respiratory tract and are believed to be a gateway for the virus to enter the body,” Dr. Staman elaborates. “Still, there remains only limited evidence of systemic transmission via the eyes, and this mode of transmission remains much less likely than that via the respiratory tract.”

It is not well understood why some people with COVID-19 suffer mild disease while others are more severely affected. Individuals older than 60 and people with compromised immune systems are typically affected more severely.

“While COVID-19 can cause pink eye, it is very important to remember that most pink eye is not due to the coronavirus. Allergies and other viruses are much more common causes.” – Dr. Staman

“The current estimates are that over a third of coronavirus patients are asymptomatic, and 40 percent of disease transmission occurs before someone feels sick,” Dr. Staman notes. “This reinforces the importance of wearing masks when people are in public and unable to socially distance.

“Whether you are symptomatic or not, by wearing a mask you help protect everyone around you from being exposed to your germs.”

Researchers continue to search for answers to the COVID-19 mystery. In the meantime, Dr. Staman has a suggestion for lowering the risk of eye infection for contact lens wearers.

“Given that we want to minimize how often people touch their eyes, I recommend that most contact lens wearers consider switching to glasses for a while,” the doctor relates. “This will keep patients from touching their eyes while putting in or taking out their contacts. Wearing glasses can also act as a reminder to not touch their eyes.

“Glasses can also serve as a partial barrier to potentially protect the eyes from the aerosolized infectious respiratory droplets.”

Timely Treatment

Most medical practitioners postponed non-urgent medical visits for several weeks during the early COVID-19 pandemic. Most medical offices have now reopened, but the process for office visits may look somewhat different as providers incorporate recommended safety protocols.

“Our practice and many others have incorporated strict disinfection and hygiene precautions so that we can continue to treat patients in a manner that is safe for them and for our staff,” Dr. Staman underscores.

“At Florida Retina Institute, we treat many urgent conditions such as retinal tears, retinal detachments and conditions such as diabetic retinopathy and wet macular degeneration that require timely treatment. Postponing this type of care could leave patients with permanent vision loss and we are not going to let that happen. We always remain available for these patients.”

Back in Bloom

Ablation relieves lumbar arthritis, allowing return to garden sanctuary.

In early April, not long after the coronavirus began to spread wildly across the United States, the National Institutes of Health launched a study to determine how many people became infected with the virus before anyone really knew what it was.

Photo by Nerissa Johnson.

Robert Palmer

For more than 12 years, guiding the NIH through its decision to launch such studies was a task that belonged to Robert Palmer, who once owned a consulting firm that specialized in organizational development in the Washington, DC, area.

“My specialty was working with not-for-profit and large multinational organizations,” Robert says. “If they had a pain point, they’d contact me, and I’d go in, diagnose the problem, figure out how to fix it and then help them do it.

“During my career, I was fortunate to work with many of the agencies inside the United Nations, including the World Health Organization and the National Institutes of Health, which was my biggest client for about 12 years.”

While advising a smaller client, Robert visited Florida for the first time some 20 years ago. He loved the climate so much that he moved here shortly thereafter, but life in the Sunshine State has not always been sunny for this active 76-year-old retiree.

Twice in the past 12 years, he has been badly injured in accidents that occurred while riding his bicycle. The first incident resulted in Robert undergoing neck fusion surgery. The second resulted in work being done on his lower back.

Throw in that arthritis has developed throughout his spine since the accidents and he has suffered from migraine headaches since childhood, and Robert has spent most of the past decade in debilitating pain.

“I had to give up riding a bike because it actually made my back worse,’’ Robert explains. “Because of the vibration and the jarring movement that came with riding a bike, I’d finish up a ride and just be miserable afterward.

“There were times when the pain was so bad that I almost couldn’t walk and a couple of times when I wound up in the emergency room because the pain was so bad that I couldn’t sit or stand or even lie down. Thankfully, I have a high tolerance for pain, because I’ve really had to just kind of learn to function with the headaches and back pain.”

But a functional life is not the same as a rewarding life. As a result, Robert has continually sought relief for his pain. He finally found it at McGreevy NeuroHealth, the St. Augustine practice of Kai McGreevy, MD, DABPN, RPVI.

A board-certified neurologist and interventional pain management specialist, Dr. McGreevy also has an office in Palm Coast. Robert discovered Dr. McGreevy through his primary care physician shortly after McGreevy opened his practice several years ago.

“When Robert came to us, he reported localized pain in his spine, particularly in his lower back,” Dr. McGreevy recalls. “The pain was worse in the morning and was associated with stiffness and rigidity of the spine.

“Robert’s low back pain became worse with extension and rotation of the spine. It eventually became so severe that it limited his walking and, ultimately, his ability to function on a daily basis.”

Dr. McGreevy began his evaluation with a complete neurological evaluation, including an MRI of Robert’s back. Dr. McGreevy determined Robert suffered from lumbar spondylosis, a wear and tear of the joints of the lower spine due to osteoarthritis.

“Robert’s MRI confirmed that his issue was with his lumbar facet joints,” Dr. McGreevy says. “This is an extremely common problem, one of the most frequently seen in our neurology and pain management clinic.

“Low back pain is one of the most common reasons patients visit their primary care physicians and is a leading cause of disability in the United States.”

After examining Robert, reviewing his imaging and performing diagnostic testing, Dr. McGreevy decided that a procedure called radiofrequency ablation, or RFA, was the best option for relieving his low back pain.

The Best Fit

RFA has long been used to treat arthritis pain, and pain management specialists have tailored it to treat pain patterns radiating from the low back into the pelvis and hips, or into the legs and feet. RFA treatment can be customized to address various pain syndromes and symptoms.

Photo by Nerissa Johnson.

RFA treatments allowed Robert to resume his active lifestyle.

“What is unique about radio-frequency ablation is that it does not involve steroids, it is long-lasting and it can treat multiple problems at once,” Dr. McGreevy notes. “In Robert’s case, we are able to treat his low back pain simply by targeting the appropriate lumbar nerves.”

Before proceeding with RFA, Dr. McGreevy conducts a diagnostic nerve block, also called a medial branch block, which is an injection of pain-relieving lidocaine under local anesthetic. The purpose of the medial branch block is to confirm that the pain is being generated by the suspected joints and nerves. It proves the suitability of RFA as a treatment.

“Robert received dramatic pain relief, greater than 80 percent, following each diagnostic injection,” Dr. McGreevy recalls. “That allowed us to proceed with radiofrequency ablation as a definitive treatment for his lumbar arthritis.”

RFA is often used for patients who have not received sustained pain relief from other treatments, including epidural steroid injections, facet joint injections and nerve blocks. In many cases, RFA is the best fit to improve patients’ pain, range of motion and quality of life.

RFA is a minimally invasive, nonsurgical, outpatient procedure during which patients remain awake but are lightly sedated to minimize discomfort and reduce anxiety. Doctors consider it highly effective in temporarily reducing the type of severe back and neck pain that plagues nearly two-thirds of the world’s population.

During RFA, radio waves are used to produce heat that is delivered through a probe to a group of specified spinal nerves. The heat creates a lesion, or wound, on the nerve tissue that interferes with the transmission of pain signals to the brain, thereby reducing discomfort in the troubled area.

“There are many chronic pain conditions that respond well to radiofrequency ablation,” Dr. McGreevy asserts. “These include spinal arthritis and spine degeneration, as well as pain after spine surgery.”

Dr. McGreevy details the RFA procedure: “When we are doing the radiofrequency ablation, the patient lies on a table on his or her belly, and an x-ray camera is used to take pictures of the region we are working on,” he describes. “That is how we can see all the landmarks we need to safely perform the procedure.”

A local anesthetic is then administered to the skin and deeper tissues to provide comfort so that a needle can be inserted and directed toward the targeted nerves. When the needle is precisely positioned, a stylet is pulled out of the needle and replaced by a thin probe.

“The probe is directed to the targeted nerve, and a radiofrequency generator is turned on,” Dr. McGreevy continues. “That generator provides 120 seconds of radiofrequency waves, or energy, that are delivered to the targeted nerve and create the lesion that cauterizes the nerve.”

When the nerve is cauterized, it can’t send pain signals, so nothing is received and interpreted by the brain. Subsequently, no return message to feel pain is sent back to the affected area of the body.

By targeting and damaging the specific nerves responsible for carrying pain signals, RFA can effectively reduce or eliminate a patient’s pain for a few months or even years.

“Using radiofrequency ablation, Robert received substantial relief from his low back pain that lasted approximately 12 months,” Dr. McGreevy reports. “Sometimes, the facet nerves grow back slowly, and if the pain returns in the same fashion but not to the same degree, we can repeat the procedure. We’ve treated Robert several times over three years.”

Garden Sanctuary

For nearly 12 years, Robert lived with back pain from spinal arthritis that began following his bicycle accidents. But he says that he feels better now than he has in a long time.
“That’s absolutely true,” he agrees. “And my treatment is on a schedule now. About the time that the RFA wears off, it’s time to go back.”

Without the back pain, Robert can participate in his favorite hobby, which is gardening, without restriction.

“Dr. McGreevy surrounds himself with good people, which is why I’ve sent a number of people to him.” -Robert

“I have a gorgeous garden,” he boasts. “Everyone in town knows about it. Because this is a tourist town, many people walk by my garden and ask questions such as, What’s that blooming? And I let them take pictures.

“My garden is a sanctuary of sorts for butterflies, bees and hummingbirds. I provide whatever they need to thrive. Take butterflies, for example. The adults need nectar flowers to feed on but a different kind of plant to lay their eggs on. When the eggs hatch, they feed on those plants before they turn into a chrysalis and become butterflies.”

Robert is grateful to Dr. McGreevy and his staff and is quick to recommend the doctor and his practice to others needing the care of a pain management specialist.

“Dr. McGreevy is young and knows about all the new research,” Robert describes. “Today’s treatments are very advanced. There are options available now that never existed 20 or 30 years ago, and Dr. McGreevy is on top of all of it.

“And he’s a nice guy, too. He has a nice bedside manner. He also has a great staff at McGreevy NeuroHealth. They’re all very well-trained, so it’s not just him. Dr. McGreevy surrounds himself with good people, which is why I’ve sent a number of people to him.”

Winning Adjustments

Technique to align atlas vertebra relieves headaches, other ailments.

Candi Walker has always lived a very active lifestyle. As a youth, she rode and showed horses. She was also a competitive ice skater. Over the years, though, those activities took a toll on her body. Photo courtesy of Candi Walker.

In addition to general pain and soreness, she has suffered from debilitating headaches that started when she was 12 years old after a fall from her horse nearly left her paralyzed.

“I have been to several neurologists over the years and on many different pain medications, but none of them provided permanent relief,” Candi laments. “Part of the problem, of course, was that I was only putting a Band-Aid on the situation.

“That went on for years until a friend suggested I see a chiropractor. So, 35 years ago, I started to receive atlas orthogonal procedures – basically, an alignment of the atlas vertebra, which is the uppermost vertebra in the neck.

“That was the only thing that managed my pain. I started those treatments when I lived in Atlanta, and when I moved to Sarasota, I found Stephen R. Zabawa, DC, at Atlas Chiropractic of Sarasota.”

The Atlas Procedure

An upper cervical chiropractor, board-certified in orthospinology, Dr. Zabawa uses gentle, precise adjustment protocols, including the atlas orthogonal technique, to treat misalignments of the spine.

The atlas adjustment procedures seek to maintain the precise alignment of the atlas vertebra, which is essential to good health. Misalignment of the atlas vertebra causes the spine to twist in an attempt to maintain balance.

This twist can pinch nerves and put pressure on the spinal cord or brain stem. In turn, the pressure can cause a variety of symptoms and problems, many of which can appear to be unassociated with the cervical spine.

To determine whether a person is suffering from misalignment of the atlas vertebra and is a candidate for the atlas procedure, Dr. Zabawa begins by performing a complete examination of the patient to check for subluxation.

Subluxations are often deceiving, however. Though symptomatic pain may appear in the lower back, legs, shoulders, arms or other parts of the body, the cause is very often located in the cervical spine.

“Subluxation is just a big word meaning that two bones are out of position and you have nerve pressure,” Dr. Zabawa explains. “If there is subluxation and we determine that a patient is a good candidate for the atlas procedure, we then take a series of extremely detailed, 3D x-rays.

“Since the adjustment is highly precise, the measurements we take and the analysis we make are also meticulous. When I know the exact angle at which a patient is misaligned, I know how to adjust them.”

Dr. Zabawa utilizes a light-force method of adjusting the cervical spine. This extremely gentle method delivers a precise, effective adjustment that takes pressure off the spinal cord.

“Unlike other chiropractors, I do not snap-crackle-pop you,” Dr. Zabawa explains. “Here, you lie on your side and, using one instrument, I gently realign your whole spine. It is that gentle adjustment that makes the upper cervical chiropractic unique.

“Regular upper cervical adjustments have helped me through sports injuries and stressful events all my life.” – Candi

“An upper cervical correction is very controlled so there is no pulling or jerking of such a delicate area. It’s so gentle that it almost feels like a puff of air touching you. This very gentle touch makes a very powerful correction.”

The instrument Dr. Zabawa uses to correct an imbalance of the atlas bone is a handheld device called a Laney instrument. The instrument works by delivering an extremely small but fast tap that produces enough force to realign the bone.

“It only hits once and produces quite a force,” Dr. Zabawa explains. “It is a force that you really cannot feel, but it is there. It goes through the soft tissue, through the muscle, to the bone. It moves the bone and takes the pressure right off the nervous system.”

The doctor determines precisely where to deliver this force based on the 3D x-rays he takes. Similar to how a professional pool player lines up a shot based on angles and trajectory, Dr. Zabawa compiles information about the spine to determine the angle needed.

“I get a 3D picture of how a patient is misaligned, so I know the exact angle to come in and correct it,” he assures. And by adjusting the upper cervicals, I’m actually adjusting the full spine, including the pelvis and sacrum.

“Once the spine, head and neck have returned to their proper positions, interference is removed. That takes pressure off the nervous system, and by removing that pressure, balance is restored to the body. It is an effective approach without any extreme manipulations.”

Body, Heal Thyself

Dr. Zabawa emphasizes that the atlas adjustments can help relieve symptoms from many different ailments, including bed-wetting, digestive disorders, asthma and even high blood pressure.

Photo courtesy of Candi Walker.

Candi lives a much more active lifestyle, thanks to the atlas adjustments.

“The human body has an amazing ability to heal itself,” Dr. Zabawa reminds. “But nerve interference can cause many problems and hinder healing. By aligning the bones of the upper neck – adjusting the upper cervicals – pressure is taken off the spine and nerves. When you take pressure off the nervous system, the body begins to heal.”

Candi can attest to that. She has given up showing horses and hung up her ice skates, but thanks to Dr. Zabawa and his upper cervical adjustments, she now enjoys the quality of life she once struggled to gain.

“Stress is another thing that my body does not handle well,” Candi reports. “Everyone has stress, which affects the body in many ways, including misalignment. But regular upper cervical adjustments have helped me through sports injuries and stressful events all my life.

“That’s why I am so happy to have found noninvasive, non-medication relief. I go regularly for my adjustments to keep things aligned and balanced. It’s just that easy, and
Dr. Zabawa is fantastic. He’s very gentle, yet accurate and precise.

“The staff at Atlas Chiropractic of Sarasota is exceptional, as well. They are all so professional and accommodating. They really do provide top-notch care there.”

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