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Stop Hemorrhoids Now

FDA-approved treatment is covered by Medicare and most insurance plans.

“I’ve been dealing with hemorrhoids most of my adult life,” recalls Larry.* “They seem to run in the family: my father and my siblings have all had problems with them, too.”
A variety of factors can affect hemorrhoid sufferers, including heredity, pregnancy, a sedentary lifestyle, and constipation. In Larry’s case, the problem became severe.
“Within the last ten years, the hemorrhoids seemed to become more of a problem in that there was occasional bleeding associated with them,” he explains. “I could never tell when that was going to happen.”
Then Larry’s wife read about a nonsurgical treatment called Ultroid offered by Linh B. Nguyen, MD, of Advanced Hemorrhoid Solutions.
“Rather than go through the painful hemorrhoid surgery that my sister and brother went through, I figured I’d give this a shot,” he says.

The Ultroid treatment

“Hemorrhoids, which are swollen veins in the rectum or anal canal, are extremely common,” explains Dr. Nguyen. “In fact, more than fifty percent of people age fifty or older have them to some degree.”
Most sufferers are understandably reluctant to try the available treatment options, some of which have traditionally been both painful and inconvenient. Studies estimate that hemorrhoid sufferers spend over $1 billion a year on medications and treatments for symptomatic hemorrhoids.
“For prevention, it’s good to have a high-fiber diet, including fresh fruits and vegetables,” acknowledges Dr. Nguyen. “Other helpful measures include drinking adequate fluid daily and avoiding heavy lifting. However, change in habits alone may not effectively treat existing hemorrhoids.”
Fortunately, Dr. Nguyen offers a revolutionary, nonsurgical method for treatment of hemorrhoids that can be performed on an outpatient basis.
“Ultroid is an FDA-approved technique to treat hemorrhoids,” says Dr. Nguyen. “A low current is applied to the base of the hemorrhoid, causing a chemical reaction that induces the hemorrhoid to shrink. The procedure is well-tolerated by patients and does not require anesthesia.
“The Ultroid system is considered revolutionary because it is highly effective, safe, and convenient. Up to ninety percent of people who have it done get relief from their hemorrhoids. It doesn’t cause the agonizing pain often associated with traditional hemorrhoid surgery and it is covered by most insurances and Medicare.”
The treatment can be safely repeated as needed.
“There’s no need to take any special preparation to clear the bowels,” adds Dr. Nguyen. “Patients can have the procedure done and go back to work immediately, so there is no downtime. The entire procedure takes approximately twenty minutes.
“Some of my patients suffered miserably with hemorrhoids for twenty or thirty years, and the Ultroid treatment changed their lives.”

Stop the bleeding

The treatment definitely changed Larry’s life, he says.
“After the very first treatment, I experienced almost immediate relief,” he marvels. “I haven’t had any bleeding since the treatment started. I had several very large hemorrhoids, and they took two to three treatments each.”
He notes that he was able to return to activities immediately following each treatment.
“In one case, I flew to Las Vegas the next day and was playing golf with no problem,” he reports.
Larry adds that the positive aspects of the care at Advanced Hemorrhoid Solutions extend beyond the treatment room.
“I think the whole experience is very respectful, both of the patient and of their time,” he assures. “I never felt rushed, and the doctor is very calming and pleasant to deal with.
“Considering the area being treated, it was as good an experience as I could possibly have.”

*The patient’s name has been withheld at his request.

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Time for Some Real Changes

August 24th, 2012

There’s not a day that goes by that there’s not some news story about Obamacare or Medicare or the costly health care system. I’ve decided to throw my two cents in and talk only about Medicare and how to help save the very beneficial program for seniors.

Most people don’t pay a Part A premium because they paid a rather small Medicare tax (1.45%) while working, and this same amount is paid by the employer. The first part of my proposal is to increase the Medicare tax to 1.60% for all individuals earning over $75,000 per year. For an individual that earns $100,000 per year, the current Medicare
tax would be $1,450 per year. My proposal would increase that by $150 per year, or less than $3.00 per week. The employer would also be responsible for a similar amount.

With this slight increase that would affect approximately 37% of the working population, it would increase the Medicare coffers by approximately $890 million per year.

The second part of my proposal has to do with Medicare deductibles. According to CBS Money Watch, Medicare Part B premiums went up $3.50, to $99.90 per month in 2012. The Medicare Trustees report had previously projected an increase of $10.20, to $106.60 for 2012.

CBS Money Watch reported that “Premiums have not increased for retirees since 2009, thanks to a ‘hold-harmless’ provision – since there were no cost of living increases in the Social Security income benefit for 2010 and 2011, Medicare premiums could not rise without effectively reducing seniors’ Social Security income. Typically, Medicare Part B premiums are deducted from Social Security income checks.

“The premium for new retirees in 2011 was $115.40; this group of retirees now pays the standard premium of $99.90 per month, for a reduction of $15.50 in their monthly premium. New and prior retirees will receive a net increase in their Social Security check, given the recently announced cost-of-living increase (COLA) for 2012 of 3.6%. The 2012 COLA will increase Social Security monthly checks by an average of $43 per month, more than offsetting the modest Part B premium increase for prior retirees.

“The good news didn’t stop there – the Medicare Part B deductible actually decreased by $22, from $162 last year to $140 for 2012. The deductible for Part A hospital coverage increased from $1,132 in 2011 to $1,156 in 2012, a lower-than-expected increase, below increases in prior years, and below the rate of inflation. This comes on top of news that premiums for Medicare’s Part D, the prescription drug program, would decline ever so slightly, too.”

My proposal for Medicare Parts A, B and D deductibles is a little more complicated than the increase in Medicare Part A payroll taxes. For seniors with incomes of $25,000 or less, I propose reducing the deductible by 40% to 50%. For seniors with incomes of $25,000 to $50,000, the deductible would remain the same. For seniors with incomes of $50,000 to $100,000, the deductible would increase by the cost of living, even if there’s not a COLA for Social Security. For seniors with incomes greater than $100,000, the deductible would increase by 10%.

With these adjustments, the lower income seniors would probably no longer have to debate about seeing the doctor or having food on the table. For the higher income seniors, the modest increases in deductible would only mean a shorter cruise on their next vacation. For the Medicare trust fund, it would only mean an extra $100 million per year.

My final recommendation is for the primary care physicians to receive a greater fee from Medicare, and the specialists receive a greater fee directly from the seniors with incomes greater than $100,000.

Congratulations to Florida Health Care News!

July 23rd, 2012

Each year, the National Business Committee for the Arts (BCA) recognizes 10 companies in the United States for their exceptional commitment to the arts. Florida Health Care News, Inc. was a finalist in the 2011 BCA TEN. Nominated by The David A. Straz Center for the Performing Arts, Florida Health Care News was proud to be one of two companies in Florida included as finalists.

FHCN Supports Taste The Best of Tampa Bay

July 23rd, 2012

For more than 15 years, Florida Health Care News, Inc. has been a proud supporter of Taste the Best of Tampa Bay, proceeds from which help support the educational and outreach programs at both the Straz Center for the Performing Arts and the Patel Conservatory.* Please visit

*Patel Conservatory’s ballet program was winner of the “Outstanding School” 2011 New York Finals Youth America Grand Prix.

Beware of Hernias

Adults and children alike can develop hernias as a result of heavy lifting, straining, coughing, or any unusual stress that causes a sudden increase of intra-abdominal pressure.

More than 600,000 hernia repair surgeries are performed in the United States annually, and everyone is at risk. Adults and children alike can develop hernias as a result of heavy lifting, straining, coughing, or any unusual stress that causes a sudden increase of intra-abdominal pressure. Some hernias are congenital, or present at birth, whereas others develop as a result of a predisposition for hernia, and anyone who has surgery may experience a weakening of tissue at the incision site that could result in a hernia.Napoliello_iStock_13976265
Because we are all at risk, Florida Health Care News turns to a specialist in minimally invasive surgery, David A. Napoliello, MD, to learn more about hernia repair. Dr. Napoliello, practicing in Venice, Sarasota, and Lakewood Ranch, is board certified by the American Board of Surgery and is a fellow of the American College of Surgeons.


According to Dr. Napoliello, a hernia is a defect of the abdominal wall that allows a protrusion of an organ or structure through the wall that normally contains it.

Q: Dr. Napoliello, what is the most common type of hernia?
A: The most common type of hernia is called an inguinal hernia. It is a defect or weakness in the abdominal muscle wall through which intestine and fat layers protrude, forming a visible bulge in the groin area.
To visualize the dynamics of it, think of an automobile tire. The abdominal wall is like the thick outer wall of the tire. Should the tire get damaged, the inner tube can push through the weakened area or crack and form a small bubble. If the abdominal wall becomes weakened, the thinner, flexible tissue that lines the inside of the abdomen and holds the intestines in place, called the peritoneum, can bulge into the outer wall. In the tire, it is easy to see that the inner tube can become strangled by the pressure of the edges of the crack through which it is protruding. It is the same with a hernia.

Q: What are some of the other common types of hernias?
A: An umbilical hernia takes place when abdominal contents protrude through the naturally occurring tiny opening behind the belly button. Incisional hernias can take place when a previous surgery leaves an abdominal wall defect that allows the abdominal contents to protrude through it and bulge out.

Q: How does a person know when he or she has a hernia?
A: A person may suspect a hernia if he or she notices a bulge under the skin. Additional symptoms may include discomfort or pain during any of the following: lifting heavy objects, sneezing or coughing, straining while using the toilet, standing or sitting for long periods of time. Because delayed treatment can sometimes result in the intestine being trapped inside the hernia sac, resulting in gangrene, any bulge should be brought to a physician’s attention immediately so diagnosis and treatment can begin. If left untreated, some complications from hernias can be fatal.

Q: Will a small hernia ever heal itself?
A: No, a hernia does not heal itself or improve over time without intervention. The only exception to this may be small umbilical hernias in
young children.

Q: What treatments are available for hernias?
A: Surgeons may choose one of several hernia repair techniques today, depending on the patient and the size of the hernia.
In the past, the only hernia repair option available was called a tension repair. In this open surgical procedure, the physician makes an incision at the site, pushes the protruding tissue back into place, and stitches the tissue layers together. The potential disadvantages of this type of surgery are relatively long recovery periods, relatively high recurring rates, and discomfort following surgery.
Today, we can offer a variety of both minimally invasive open procedures and laparoscopic procedures.

Q: Please describe the minimally invasive open procedures.
A: Unlike the tension repair, minimally invasive open procedures are tension free because the stitches or sutures used do not put tension on the sides of the defect to keep it closed. Instead, special mesh patches are used that limit the size of the required incision. These procedures offer lower recurring rates, quick recovery, and only minor discomfort following the surgery. Additionally, the minimally invasive approach allows the patient to avoid
general anesthesia.

Q: How do the laparoscopic surgeries differ?
A: There are two main options for laparoscopic surgery.  In the transabdominal approach, the physician makes a small incision and slides the laparoscope, which is a thin telescope, through the abdominal wall into the abdomen. For the preperitoneal approach, the laparoscope slides in between the tissues of the abdominal wall. With both approaches, the doctor views the hernia and surrounding tissue on a video screen.

Q: What are the advantages of laparoscopic surgery?
A: Depending on the patient, of course, there are several. Because it requires only small incisions, it will likely mean less pain and a shorter recovery time for patients, and because the physician has the advantage of looking through the laparoscope, previously undiagnosed hernias may be discovered. Additionally, the laparoscopic approach allows us to manage recurrent hernias and to optimize any repeat surgery because we do not have to go through the same
incision site.

Q: Is this surgery done on an outpatient basis?
A: Yes, and it is usually performed in under an hour as well.

Q: Do you have a preference between the minimally invasive open procedure and the laparoscopic procedure?
A: It depends on the patient. I specialize in minimally invasive surgery techniques and did my fellowship in minimally invasive and advanced laparoscopic surgery. In fact, I was involved in training surgeons using the laparoscopic approach when it was first developed.
When my patients are good candidates for either one, I provide them with information on both the minimally invasive open procedures and the laparoscopic procedures, and we make the decision together as to which one will be
more appropriate.

Q: Have there been any improvements to these surgical techniques in recent years?
A: Definitely. Scientific improvements to help hernia repair include the addition of very lightweight artificial meshes and biologic meshes such as processed skin grafts. Other improvements to decrease chronic pain associated with hernia repairs include the addition of absorbable tacking devices and dissolvable sutures, which help to decrease the risk of nerve entrapments.
These improvements are mainly geared toward decreasing pain and improving the repair, thereby shortening recovery time.

Q: Once the surgery has healed, will the patient experience any diminished quality of life?
A: No, most patients will be able to return to a normal routine. In fact, data show that within a week’s time, most people will feel well. Because I am conservative, I recommend that my patients avoid any physical strain for four weeks.

This interview with Dr. Napoliello was conducted by a member of the editorial staff at Florida Health Care News.


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