Author Archive

Repair Bone Loss

A once weekly, 15-minute strengthening program can rebuild bone.

After suffering for years with endometriosis, Shirley* and her husband turned to infertility treatments to help them conceive.

Photo courtesy of OsteoStrong.

During an OsteoStrong workout, patients apply
pressure on patented equipment designed to stimulate the body’s natural impulse to rebuild bone.

While those treatments were not successful, Shirley and her husband still got the child they always wanted through adoption.

In the aftermath of the infertility treatments, however, Shirley was left with a serious side effect resulting from prolonged use of infertility drugs – osteoporosis.

Bones are made of tissue that is constantly broken down and replaced. But when new bone creation does not keep up with degeneration, osteopenia and osteoporosis can occur.

About 54 million Americans have osteoporosis and low bone mass, placing them at increased risk for osteoporosis. Breaking a bone is a serious complication of osteoporosis, especially as we get older. Osteoporotic bone breaks are most likely to occur in the hip, spine or wrist, but other bones can break too. In addition to causing permanent pain, osteoporosis causes some to lose height. When osteoporosis affects vertebrae, or the bones of the spine, it often leads to a stooped or hunched posture.

“I had a friend of mine who was a nurse advise me to get a bone density screening because she knew that many women on the same infertility drug had severe bone loss,” Shirley recalls. “So, I had my first bone scan performed when I was thirty-eight.

“The results indicated I was osteopenic, which means I had early onset of osteoporosis.”

That was 13 years ago.

“At that time, doctors told me to do weight-bearing exercises and increase my calcium and Vitamin D intake. They had no answers and no real plan.”

When a friend’s mother died of osteoporosis, Shirley vowed she would not succumb to the condition herself.

“I have a child, and there is just no way that after everything I’ve been through I will allow osteoporosis to win,” Shirley says. “It isn’t going to happen like that for me.”

Despite joining a gym and following a rigorous exercise regimen, she continued to see her bone density scans get worse each year.

“My numbers kept going down,” Shirley recalls. “I felt like there had to be something out there that would help.”

In 2015, through online research, Shirley found a unique program called OsteoStrong that helps rebuild bone through once-a-week, 15-minute sessions using specialized strengthening equipment.

“It is difficult to explain the difference between our equipment and that used at a traditional gym,” educates Marc Cannon, owner of OsteoStrong in Sarasota. “This equipment is isometric, which means tension is developed without contraction of the muscle. There is no force pushing against you, which means that you create the force. On the leg press, for example, I’ve had ladies in their eighties weighing one hundred pounds who can press a thousand pounds. Because it is isometric, it is different.”

To understand the difference he describes, Marc invites people to come in and try the equipment for themselves.

“We offer one free session so that people can see what we mean by isometric,” Marc shares. “They have the opportunity to use the equipment and see exactly what it is like.”

A Proven Solution

“Osteoporosis is a silent disease that most people are unaware they have until they fracture a bone,” educates Marc. “Statistically, one in two women and one in four men over age fifty will have an osteoporosis-related fracture in their lifetime.”

Marc says OsteoStrong is a proven, effective, natural solution to reverse bone loss for all age groups. “This is an amazing concept that culminated after twelve years of research that looked into the body’s own adaptive response to growing new bone and muscle structure and improving the density of the bones we have.”

Marc loves to share stories that highlight the program’s long-term value.

“OsteoStrong is a miracle for me and has changed my life!” – Shirley

“I met Shirley at an OsteoStrong conference in Albuquerque and after hearing her story, we connected instantly because in my view, her story is a success,” Marc says. “The program utilizes a concept called osteogenic loading, which is a fifteen-minute, once-a-week, resistance-based session that increases bone density, prevents fractures and strengthens muscle tissue.”

Shirley admits that initially, she was uncertain about how well a 15-minute workout, once a week, could rebuild bone.

“At first, I was skeptical, but after I read a lot about it and researched its success, I was convinced,” she says. “The patient applies pressure on the patented equipment through short, acute activities that stimulate the body’s natural impulse to rebuild bone and tissue loss. Once the tissue growth process has been triggered, the body will naturally rebuild tissue and bone.”

Sessions are deliberately scheduled once a week.

“Studies have determined that doing an OsteoStrong session more than once a week doesn’t promote any additional benefit,” Marc explains. “Overall, studies have found that OsteoStrong improves people’s bone density by about seven percent a year.”

Better Late Than Never

Shirley knows that had she found OsteoStrong years earlier, her bone loss would not have been as substantial.A once weekly, 15-minute strengthening program can rebuild bone

“I’ve already lost twenty percent of my bone in my hip and twenty four percent of bone in my arm,” Shirley explains. “If I were to lose another twenty-five to thirty percent, I would have the bones of a significantly older woman who could have a fracture at an early age.

“In the first six months, I had a significant bone increase in my hips because of the OsteoStrong program,” she continues. “I was in tears when my latest bone scan results showed that increase. I had not had a gain in twelve years.”

Shirley’s life has been so dramatically improved because of OsteoStrong that she and her husband invested in a franchise.

“My husband and I were looking for a business venture, and after experiencing OsteoStrong, and with my own personal situation, we decided to buy a franchise ourselves.

“The important thing is, my numbers are increasing now, and I owe it all to OsteoStrong,” she says. “It’s been a miracle for me and has changed my life!”

Because of her significant improvement in her bones, Shirley says she likely will start having bone scans every other year once she turns 55.

“We’ve already had success stories in our center even though it’s been open for a short amount of time,” Shirley shares. “I tell women who come to our center here – we can reverse bone loss and you don’t have to be in fear of having a fracture.”

It is important for those who suffer from osteoporosis to consider that OsteoStrong is a program that caters to all age groups.

“Osteoporosis is not just something that only happens to old people. We have clients from young to old and everything in between. We have a lot of women in our center that are younger than I was when I was diagnosed.

“Men aren’t immune either,” she adds. “When they start losing their testosterone, their bone loss becomes more rapid.

“OsteoStrong wants to help educate people about bone loss. The framework is the most important part of your body and you need to take care of it and be aware of changes to it.”

While there are many factors in a person’s life that can cause osteoporosis, thankfully programs like OsteoStrong can help a person reverse the damage.

“OsteoStrong has been a miracle for me and has changed my life!,” Shirley raves.

*Patient’s name withheld at her request.

Sound Advice

Acoustic wave technology delivers hope for ED.

Years ago, when Calvin* was in the United States Marine Corps, he was stationed at a radar installation. Somehow, signs designating the area around the control room were removed, and Calvin was exposed to a type of radiation.Dr. Robert Lupo of Physical Medicine Center in Tampa treated Calvin’s (alias) erectile dysfunction using GAINSWave® therapy.

Calvin can’t say for sure that it was the radiation exposure that caused it, but soon thereafter, he started having problems with erectile dysfunction (ED), which is the inability to achieve or maintain an erection suitable for sexual activity.

“After that incident, I was told I’d probably never have children either,” Calvin shares. “Fortunately, God intervened, and I had three great kids. But I’ve had severe erectile dysfunction for almost twenty-five years, since I was about forty-seven or so.”

Some men may be embarrassed to talk about ED, but it’s a common issue, one that affects about 52 percent of all men. And of those affected, more than half are aged 40 to 60.

ED is frequently related to impairment of the tiny blood capillaries in the penis and urogenital area, which hinders the natural erectile response. Vasculogenic issues, causing decreased blood flow, are estimated to affect about 80 percent of men with the condition.

“I went to a urologist back home in Maryland who said my ED was pretty classic,” Calvin continues. “He said it often starts with position. At first, I couldn’t lie in bed and have sex with my wife; I had to stand up. Eventually, even standing up, I couldn’t keep an erection. We’d start having sex, and I’d lose it. It frustrated my wife to the nth degree.”

While living in Boston, Calvin went to a men’s clinic for advice and treatment. Doctors there diagnosed him with very low testosterone, and initially treated him through hormone replacement therapy.

The increased testosterone in his system caused him more side effects than benefits, and did little to correct his ED. As a result, Calvin later tried medications such as Viagra®, Cialis® and Levitra®. He also used an ED pump and took ED injections. None produced the desired effect.

Then, after relocating to Florida several years ago, Calvin began searching for a new doctor to treat his ED. Calvin discovered that Robert C. Lupo, DC, of Physical Medicine Center in Tampa offered a non-drug treatment for ED called GAINSWave®.

“I spoke with Dr. Lupo, and he asked me what I wanted to achieve with the treatment,” Calvin says. “I told him I just wanted to be able to get an erection and that I’d been exposed to radiation while in the Marine Corps and again in 2008 as part of my treatment for prostate cancer. That also contributes to ED, and he said, We can start therapy today, but I make no promises. I agreed to the treatment and started therapy with GAINSWave.”

Unique Treatment

“GAINSWave is a unique treatment that uses sound-wave technology to clear the tiny microvessels in the urogenital region,” explains Dr. Lupo. “This increases circulation to the penis, which improves sensitivity and the quality of the erection, intensifying the entire sexual experience.”

Dr. Lupo says GAINSWave uses the same technology that has been effective for years in the US and Europe to treat plantar fasciitis; heel, knee and elbow pain; scar tissue, tendonitis and connective tissue injuries.

“GAINSWave emits concentrated blasts of sound waves akin to ultrasound or sonar technology,” he educates. “These sound waves travel faster than the speed of sound, and when applied through the correct number of pulses, frequency and energy, they can have a positive effect on tissue to restore blood flow and nerve sensitivity.”

Some men have experienced a renewed ability for healthier erections after only a few GAINSWave treatments, reports Dr. Lupo. Just two painless treatments per week over a three-week period is all most men need to restore or improve erectile function.

“GAINSWave’s ability to improve blood flow, increase new vascularization and increase nerve sensitivity in the urogenital region has been pretty phenomenal,” declares the doctor. “The erection ability is stronger, longer, better and more impressive. It’s taking men back to more youthful times in their lives without the necessity for medications.”

The noninvasive GAINSWave therapy is also used to successfully treat a painful syndrome called Peyronie’s disease. This condition is the result of a build-up of scar tissue and causes curvature of the penis.

In addition to receiving GAINSWave treatments, Calvin was also given another treatment by Dr. Lupo called the P-Shot®. The P stands for platelet-rich plasma, or PRP, which Dr. Lupo says he uses in really tough cases when there is a lot of scar tissue, damage or Peyronie’s disease.”

With PRP, Dr. Lupo extracts the patient’s own platelets from his blood to obtain a high-quality platelet solution. He then injects the solution into strategic points in the penis. The PRP contains many growth factors and healing substances, so it begins to rejuvenate and heal the tissues of the penis.

“The P-Shot is like fertilizer that makes the cells in the tissue grow,” notes Dr. Lupo. “It helps patients with scar tissue achieve more improvement with GAINSWave. In Calvin’s case, the combination therapy made him responsive to TriMix, which he had not responded to previously. TriMix is a different type of injection made up of three medications that help men achieve and maintain erections.”

Full of Appreciation

Calvin had many factors working against him. In addition to the radiation exposure in the Marines, he had additional exposure during his treatment for prostate cancer. He also had the resulting scar tissue as well as the low testosterone level. It was a lot to overcome, but he felt he made tremendous strides with GAINSWave.Dr. Robert Lupo of Physical Medicine Center in Tampa treated Calvin’s (alias) erectile dysfunction using GAINSWave® therapy.

“I started GAINSWave, and very slowly, things started to happen,” Calvin recalls. “I woke up one morning with an erection, and I can’t remember the last time I had a morning erection. I was thrilled to death. Then a week or two after that, I woke up several times during the night with nocturnal erections, which are normal in healthy men.

”My condition since GAINSWave is better,” enthuses Calvin. “To have intercourse with my wife and have it to completion, I still need an injection of TriMix, but to me, GAINSWave therapy has been successful because I’ve come so far. I’m thrilled with the results I’ve achieved.”

For Calvin, GAINSWave is not a one-and-done treatment. He regularly returns for follow-up sessions to further the improvement he’s made with the therapy.

“I went through the initial course of therapy and renewed the treatment several times,” he states. “Now, I call Physical Medicine Center, go in and get treated a few times. Then, I stop for a month or two, then go in for a few more treatments. I truly appreciate everything Dr. Lupo has done for me.”

Adds Dr. Lupo: “We’re very encouraged by what GAINSWave has done for hundreds of ED patients without harmful side effects. Any man who wants to restore youthful performance should call us to explore this option.”

*Patient’s name withheld at his request.

Joint Investment

Regenerative technique relieves severe knee pain without surgery.

High-flying airline pilot Raymond* made a career of defying gravity and soaring through the open skies. He did that for 28 years, then took a job as a building-code examiner for Pasco County. That job meant long hours on his feet, which aggravated the arthritis progressing in his knee.Dr. Erick Grana regenerated Raymond’s (alias) arthritic knee using stem cell therapy at Regenerative Orthopedic Institute in Tampa.

“My right knee was the one giving me problems,” Raymond clarifies. “I went to a doctor, who took x-rays and discovered my knee joint was bone-on-bone. I felt a sharp pain in that knee every time I moved the joint. One bone would grind over the other, and that caused the pain, which was usually so intense, I could hardly walk. I had to give up golfing because I could barely move. The pain averaged nine on a scale of one to ten.”

At his doctor’s recommendation, Raymond tried a couple of different avenues for pain relief, including cortisone shots and wearing a knee brace, but received little or no lasting relief from them. Mired in agony as a result of the failed treatment attempts, Raymond didn’t feel any better after learning the follow-up option his doctor suggested.

“The brace helped because it separated the bones, but it was cumbersome and difficult to wear all the time,” Raymond explains. “The brace also cut off the circulation in my leg, so I wasn’t happy about wearing it. Then the doctor told me the next step was a knee replacement. I wasn’t ready to do that yet, so I told the doctor, No, a knee replacement is my last alternative.

Hoping to help her husband avoid surgery, Raymond’s wife, a registered nurse, researched nonsurgical options to treat painful, arthritic knees. One treatment that caught her attention was the use of a patient’s own cells to rebuild damaged tissue. The provider she found who offered this treatment is Regenerative Orthopedic Institute in Tampa.

Regenerative Orthopedic Institute is where Erick A. Grana, MD, specializes in regenerative medicine. He treats patients with a nonsurgical regenerative technique called stem cell therapy. This therapy uses the patient’s own specialized stem cells to promote the growth of new tissue in joints ravaged by arthritis or injury.

“Today, there are options that we can offer to osteoarthritis patients that allow them to avoid taking on the risks of a surgical procedure before they get to the stage where they need joint replacement,” Dr. Grana reports.

“Not only can we relieve the pain, we can also reverse some of the damage done by the osteoarthritis. This is accomplished by regenerating the cartilage and connective tissues in and around the joint area.

“Regenerative medicine treats disease and injuries by harnessing the body’s own healing powers. The natural healing process is accelerated by a combination of growth factors and bioactive cells in the form of stem cells and platelet-rich plasma (PRP).

“This process results in a safe, effective, nonsurgical treatment, and unlike traditional invasive surgery, which can result in blood loss, scarring and long, painful recovery periods, stem cell therapy requires only injections into the damaged joint and offers a much quicker recovery than surgery. Typically, patients begin to feel a noticeable decrease in pain after six weeks.”

“Tremendous Potential”

Stem cell therapy is autologous, meaning it utilizes stem cells, PRP and growth factors from the patient’s own body. Using the patient’s own cells eliminates the chances of reactive side effects or rejection.

Stem cells are extracted from the patient’s bone marrow or fat, and PRP is taken from the patient’s own blood. The harvested cells are then injected into the painful area to stimulate regeneration of damaged tissue and the healing of tendons, ligaments, joints or spinal discs.

“When I was first introduced to stem cell therapy, I recognized its tremendous potential for patients who would otherwise have limited treatment options for pain relief,” Dr. Grana discloses.

Dr. Erick Grana regenerated Raymond’s (alias) arthritic knee using stem cell therapy at Regenerative Orthopedic Institute in Tampa.

“The pain in my knee went from a nine to a one, maybe one and a half. My stem cell treatment was a definite success.” – Raymond

“Patients with osteoarthritis, such as Raymond, have very few choices other than surgery when the condition advances and damages the joint. Since surgery has potential complications, when we treat arthritic joints without surgery, patients do much better.”

Dr. Grana has developed a system for the delivery of stem cells and PRP into the pain generators in and around joints such as the knees, shoulders and hips. It’s called RegenaJoint.

He developed a similar system to treat the spine. That process is called RegenaSpine. RegenaJoint and RegenaSpine are both minimally invasive procedures that are performed right in the doctor’s office using a local anesthetic. Patients typically resume normal activities right away.

To precisely deliver stem cells into the painful area, Dr. Grana uses image guidance through ultrasound and fluoroscopy (continuous x-rays). He uses imaging to ensure precise placement of the stem cells, which restore function, improve quality of life and reduce or eliminate the need for surgery and/or narcotic medications. Many other clinics don’t use this process.

“This imaging guides us to put the stem cells where they need to go,” the physician asserts. “Not everybody does it this way, which is a shame because the results are much better when the stem cells are delivered to the area where they’ll do the most good.”

Threefold Target

The main culprit in many of the joint issues patients bring to Regenerative Orthopedic Institute is osteoarthritis.

“Osteoarthritis is the degeneration of the joint that happens over time,” Dr. Grana notes. “It’s a mechanical as well as a chemical disease, where harmful chemicals inside the joints prevent them from repairing themselves. Thus, the normal wear and tear occurs without regeneration.

“Within three minutes, RegenaJoint reduces chronic inflammation. It restores the normal chemistry of the knee joint so there is balance again, allowing regeneration that can heal the wear and tear occurring inside the joint. At the same time, it can repair some of the damage that has occurred previously.”

Dr. Grana stresses that when combined with concentrated platelets and growth factors, stem cells become a powerful, natural repairing mechanism for painful joints and aching backs.

“Patients usually have three goals for RegenaJoint and RegenaSpine: first, to get their pain relieved; second, to resume former activities that they weren’t able to do because of their arthritis; and third, to avoid surgery,” Dr. Grana observes. “These are the main goals that most patients want to achieve.”

“Grow New Cartilage”

Raymond says he was initially a bit apprehensive about receiving stem cell treatment because there were no guarantees. He went to the Institute anyway and spoke to the nurse, whose findings encouraged him to go ahead with it.

“The nurse looked at my knee through an x-ray and said, There’s still some cartilage in there, so we can grow new cartilage,” Raymond recalls. “She went on to explain exactly how it is they do that, so I agreed to have the procedure, which was performed in October.

“The staff at Regenerative Orthopedic Institute took two big syringes of my fatty tissue and two big syringes of my blood and spun the plasma out of my fatty tissue and took out the actual stem cells.

Dr. Erick Grana regenerated Raymond’s (alias) arthritic knee using stem cell therapy at Regenerative Orthopedic Institute in Tampa.

Stem cells are extracted from the patient’s own bone marrow or fatty tissue and can be used to regenerate joints such as the shoulders, knees and ankles.

“Then they took my blood, spun it and removed the platelets. They mixed the stem cells and platelets together, then Dr. Grana injected the mixture into my knee. I’ve had shots in my knee before, and if they’re not done properly, they can be very painful. But Dr. Grana did this one properly. He knows what he’s doing with the knee because I really didn’t feel anything at all.”

Ongoing Progress

Though patients typically begin to feel the effects of stem cell treatment about six weeks after receiving it, Raymond felt improvement after only four weeks. His pain continued to decrease as time went on. Today, he continues to recover and is still experiencing results from his procedure.

“After about a month, I noticed the pain was starting to feel a little better,” he enthuses. “Then it kept getting better and better. Some days now, I have no pain. Other days, I have a little bit of pain, but it’s going down at a rapid rate. That’s a very good sign for my recovery.

“At this point, my knee is great. The procedure was done in October. It’s now January, and I’ve gotten back about eighty-five percent of my knee. The pain in my knee went from a nine to a one, maybe one and a half, and that’s manageable. My stem cell treatment was a definite success.”

The reduction in Raymond’s knee pain is a game changer for him, especially because he achieved it without surgery. While he’s not golfing yet, he is walking comfortably again. He credits Dr. Grana and his stem cell therapy for the turnaround. Raymond believes the doctor and his treatment are worth bragging about.

“I’ve already recommended Dr. Grana and Regenerative Orthopedic Institute to several people,” he says. “As far as stem cell therapy, I was a skeptic at first, but now I’m a firm believer based on the outcome with my knee. I recommend the treatment totally!”

*Patient’s name withheld at his request.

Are You at Risk for a Hernia?

Learn the facts and figures in this Q&A.

Nearly one out of every ten people will suffer some type of a hernia during their lifetime, and while hernias most often occur in men over the age of 40, women and children are not immune.
Men, women 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. That’s why more than a million hernia repairs are performed each year in the United States.
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.
Because everyone is 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.
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.

A Letter to FCS

December 16th, 2018

Image from Rare DR - Rare Disease ReportIt took Tampa local Charles “Alvin” Middleton more than 10 years to receive an accurate diagnosis of familial chylomicronemia syndrome (FCS), a rare genetic lipid disorder that causes fat buildup in the body and often leads to unpredictable and potentially fatal attacks of pancreatitis. Alvin has been in and out of the hospital for more than a decade, and once was put into a medically induced coma for more than 40 days. His husband and family were told at the time that he had a 5% chance of survival. Alvin still suffers from daily symptoms including severe fatigue, abdominal pain and brain fog, and recently had to leave his job. His only option is to adopt a lifelong extremely restrictive low-fat diet (10-12 grams of fat per day), but even that is not often not prevent his symptoms.

Alvin decided to write a letter to his disease, looking back on his journey and voicing his frustrations as well as his hope for a treatment for this devastating disorder. There are no approved treatments available for FCS, which is why Alvin and the entire FCS community as part of a new national campaign are urging the FDA and pharma industry to approve a treatment currently in development – you can learn more via this recent press release.

Here is Alvin’s “Dear FCS” letter:

Dear FCS,

Looking back 11 years ago, I considered myself normal. Someone who had a job, hung out with friends and family, and was in relatively good health. But then our journey together started when I experienced my first symptom because of you, severe stomach pain while on a flight home to Tampa Bay. An ambulance was my welcome home vehicle as I was immediately brought to the emergency room, where I was diagnosed with acute pancreatitis. The doctor said that my case was so bad there was only a 5% chance I would survive. I didn’t know it at the time, but because of you I would eventually undergo seven surgeries, have my gallbladder and spleen removed, be in and out of the hospital with pancreatitis, and see doctors every other week. I am grateful that after a decade a young hospitalist finally figured out that you are the cause of my constant pain and frequent hospitalizations – but I am writing this letter to tell you I want nothing to do with you!

You have caused me, my husband, family and friends tremendous pain over the years. Not only have you caused a significant decline in my physical health but now I am also often emotionally and spiritually withdrawn. Life with you can be a lonely experience. I try to be strong for my friends and family, and especially my husband who has been my rock throughout this journey. You also cost me thousands of dollars that I could have used to help others and now I have accumulated $2 million in medical debt. You even tried to kill me 10 years ago, forcing me into the ICU for more than 40 days in a medically induced coma, but God had a different plan for me.

I feel like I try to please you, but nothing works. I follow the strict low-fat, no carbohydrates, and no sugars diet and exercise regularly as directed by my doctor. I take my prescribed medication. Yes, I sometimes cheat and eat food I’m not supposed to, but generally I do everything I am told — and yet you still cause me pain. Doctors who didn’t know about you would tell me I must not be maintaining the suggested diet, exercising enough, or taking care of myself. Every time I was hospitalized with severe vomiting and pain, doctors would accuse me of drinking alcohol or not following my strict diet. Sometimes I thought I was crazy or a hypochondriac, but it was all you. I was so discouraged and frustrated by many doctors’ responses that I disconnected from the conversation and gave up all hope that I would ever find the cause of my pancreatitis attacks and other symptoms.

I have known for years that something was seriously wrong with me. There have been times when I have been so fatigued from the constant pain that I just wanted to give up on life. You took away my love of gardening, cooking, socializing with my friends, being able to go someone’s house and eat without getting sick, and most recently you forced me to leave my job. You are the reason for my constant fear, anxiety and stress about my health which, combined with feeling out of control and powerless, can be overwhelming. Often, I forget that feeling terrible every day isn’t normal.

Life with you can be a lonely experience. It has ended my career and changed me forever in many ways. Despite the many challenges I’ve faced, the most rewarding experience of my journey has been meeting other FCS patients and knowing that I’m not alone. By sharing our stories with one another and how you have impacted our lives, we are encouraged and hopeful that someone is going to find a treatment to beat you. Together we are building a stronger community of support and sharing information that can help improve our quality of life and educate others who might not know about you. If one person sees my story and learns about you, then all my efforts are worthwhile.

Charles “Alvin” Middleton

Forever Young

Innovative technology improves complexion, erases signs of aging.

Every day is a beach day for Anna*. That’s how it is when you make your living coaching the fast-growing sport of beach volleyball.Stock photo from

“I started playing beach volleyball in college and became a coach after that,” Anna says. “I like that I’m giving something back to the sport because I love everything about it.”

Well, almost everything. Anna, who is rather light skinned, has never cared for the constant exposure to the sun that her skin gets.

“It’s caused a lot of damage,” she says. “I had a lot of sun spots and my skin had a rough texture. I heard that there was a treatment for that, so I decided to look into it.”

Anna’s search led her to the Institute of Health & Wellness in Stuart, where the practice’s founder and director, board-certified colorectal surgeon Deborah A. DeMarta, MD, FACS, FAARFM, specializes in integrative and anti-aging medicine.

Following an aesthetic consultation to determine her specific skin type, Anna began receiving BroadBand Light (BBL) skin treatments, which are designed to treat a variety of skin conditions, including sun spots, fine lines, wrinkles and rosacea.

“The treatment is called Forever Young BBL, and in addition to effectively removing solar damage, it is also one of the most cost-effective ways to complete the goal of anti-
aging for skin on any part of the body,” Dr. DeMarta explains.

“The way it works is simple. The broadband light heats the tissue, and part of the response, which has been proven through real science, is that collagen is actually rejuvenated and grows. So, it serves as a great, natural filler for your face.

“Clinical studies have been done proving that having two or three Forever Young BBL treatments in a year can remove as much as eleven years of aging from your face. It’s a really lovely and versatile procedure.”

Quick, Easy, No Downtime

Forever Young BBL treatments can be completed in an hour or less and begin with the technician performing a skin cleansing to remove any residual oils. The technician then applies a colorless gel that keeps the skin cool.

The treatment itself is performed using a handpiece that has a crystal-chilled applicator attached to it. Depending on the skin type and treatment objective, adaptors and filters are used to ensure the treatment delivers the desired results safely and effectively.

“There’s a specific filter that targets brown spots such as freckles, age spots and hyperpigmentation caused by sun damage,” Dr. DeMarta educates.

“Another filter targets redness, as in rosacea and broken blood vessels, another filter treats acne and another filter is used for tightening of the skin.”

Upon completion of the procedure, patients can return to normal activities the same day. Forever Young BBL treatments require no downtime for recovery, and most patients begin to see the effects within a week or two.

That’s how it was with Anna, who says her sun spots began to flake off. That prompted her to get a second treatment, after which she began to notice a positive change in the texture and appearance of her skin.

“The Forever Young treatments took care of my sun spots and made my skin look and feel younger,” Anna relates. “It’s a great treatment that I recommend to anybody who has sun damage or just wants to look younger.”

*Patient’s name withheld at their request

“Wasting” a Donation

July 2nd, 2018

During Digestive Disease Week in early June, a group of researchers from the University of Alberta in Edmonton, Canada presented the results of their study to a gathering of physicians and researchers in the fields of gastroenterology, endoscopy, gastrointestinal surgery and liver disease. The study results came from a 32-question online survey of about 800 people in the US, Canada and UK.

Graphic from

Lead researcher Breanna McSweeney, a medical student at the University of Alberta in Canada, says “As studies come back showing that fecal transplant is beneficial for more conditions, most likely we’re going to need more donations.”

The purpose of the survey was to gauge the respondents’ attitudes toward donating stool samples for fecal transplantation. That’s right, poop donations. But before you laugh, consider how donated stool is used in medicine and how it can help people who’ve failed all other treatments.

Currently, fecal transplants are used to treat Clostridium difficile infections. C difficile is a bad news bacterium that can cause life-threatening diarrhea if its allowed to flourish in the digestive tract. It generally runs wild after people have taken a lot of antibiotics that have killed off all the beneficial bacteria. These “good” bacteria keep the environment in the gut balanced and healthy.

C difficile causes nearly half a million infections and 15,000 deaths in the US each year. In many cases, C difficile infections are resistant to most available antibiotics. This leaves many infected people with no effective treatment. Remarkably, fecal transplantation has been shown to be a lifeline for these otherwise untreatable patients.

During fecal transplantation, doctors take a donated stool sample from a healthy donor and purify it. The purified sample is then used in the sick individual to create colonies of healthy bacteria in the digestive tract. This levels the playing field. One, healthy bowel movement can help up to five people.

Right now, the FDA has approved fecal transplantation only as a last-ditch treatment for C difficile infection, but studies have shown it’s just as effective as antibiotics as a first-line treatment, too. Researchers are currently studying its potential to treat other nasty gut disorders as well, such as irritable bowel disease and ulcerative colitis.

What makes a person agreeable to donating? According to the study results reported in June, the majority of respondents said the opportunity to help others was their primary motivation. The payment for donating helped a little, although the amount is minimal, from $15 to $40 depending on the country and the donation center. The researchers also noted that the majority of those who agreed to become donors were also blood donors. Altruistic at heart, I guess.

There were a couple turn-offs to stool donation, of course. The inconvenience of donating was one. Most centers ask for a donation three times a week for at least two months. Talk about pressure! In some cases, donors have to make their donations at a hospital if their transplant centers aren’t set up to accept them. The ickiness of collecting their own stool was cited as another hindrance to participation.

Becoming a poop donor isn’t as easy as it seems. Potential donors go through a rigorous screening process that includes an exhaustive questionnaire, a thorough clinical evaluation, and intensive stool and blood screening. In the end, nearly 97 percent of applicants are rejected. Apparently, they’re pretty particular about poop. That doesn’t mean you shouldn’t try to find a stool bank and make a deposit!

To find a provider near you, please visit the Fecal Transplant Foundation.

Nonsurgical Vaginal Rejuvenation

An exciting new treatment for vaginal rejuvenation promises to restore what aging and loss of collagen in vaginal tissue can take away. It also helps women experiencing vaginal laxity after childbirth or from the natural aging process.Dr. Deborah A. DeMarta, MD, is now offering treatment with ThermiVa® for vaginal rejuvenation at Institute of Colorectal Health & Wellness.

ThermiVa® procedures revitalize vulvovaginal tissue through the application of gentle radiofrequency energy. Treatments performed in the doctor’s office are painless, with no downtime. They can help resolve the aging process of menopause, including the vaginal dryness and thinning of vaginal walls that can make sexual intimacy less enjoyable or even painful.

Hormonal imbalance can cause pelvic floor weakness leading to prolapse or the gradual descent of the urinary bladder, rectum and small intestine from their normal positions before menopause.

Two of the most severe complications of prolapse include urinary incontinence when coughing or sneezing as well as fecal incontinence.

“ThermiVa works by restoring collagen in the vagina, along with restoring tightness, moisture and support,” states Deborah A. DeMarta, MD, at the Institute of Health & Wellness. “It can relieve the symptoms that can occur from hormonal imbalance.”

“I’m thrilled to offer women this procedure,” she continues.

Improving Tone and Laxity

Many women may know to expect hot flashes and night sweats during menopause and perimenopause. They may not, however, be aware of how hormonal changes will affect the health of their vagina.

A decline in estrogen contributes to vaginal walls becoming thinner and producing less moisture.  The vaginal canal can also become shorter and less flexible. Results include vaginal dryness that not only makes sexual intimacy uncomfortable but also raises the risk of frequent yeast infections and urinary tract infections that may become recurrent.

Dr. DeMarta is a board-certified colorectal surgeon who also specializes in integrative and anti-aging and aesthetic medicine. The goal of her holistic approach is to help patients achieve optimal wellness and feel their best. She founded the Institute of Colorectal Health & Wellness to offer a comprehensive approach through medical, surgical and aesthetic services that promote health rejuvenation.

To help restore colorectal function, the ThermiVa device gives individuals an additional option for successful treatment of fecal leakage or unsightly perianal hemorrhoid skin tags.

“Fecal incontinence can be treated through dietary modification and physical therapy to strengthen the pelvic floor. However, some women need more than that. Previously, the options were pretty invasive,” notes Dr. DeMarta. “The exciting part about the ThermiVa is that it is much gentler and noninvasive.”

The ThermiVa procedure takes approximately 30 minutes, and feels like a warm massage. A treatment is recommended once a month for three consecutive months.

“No anesthesia is needed,” says Dr. DeMarta. “Patients come in, have the procedure and go home. Due to the non-existence of leakage, a pad is not needed, and normal activities can resume immediately.”

Treatments work on both the internal and external regions of the female pelvic floor. Stimulation occurs through radiofrequency and heat generation to restore collagen in the affected tissues. The formation of collagen helps improve laxity of the vagina and surrounding tissues to the pre-menopausal state.

“Most importantly, ThermiVa treatments improve a woman and her partner’s interest and sexual response that may have diminished through vaginal changes,” notes Dr. DeMarta.

“The ThermiVa is a superior addition to help women and their partners achieve and accomplish enjoyable intercourse,” she adds. “I’m excited to have this option for my patients. It not only results in enjoyable intercourse for couples, but also solves concerns such as laxity, prolapse, leakage, UTIs vaginal dryness, painful intercourse, lack of sexual desire and orgasmic dysfunction.”

A Message About Men’s Health

June 3rd, 2018

This blog may be about men’s health, but women need to read it, too. Women have to encourage the men in their lives to pay more attention to their health. June is Men’s Health Month, and it’s the perfect time to review a few of the biggest health issues men face.Message About Men’s Health

Since forever, women have lived longer than men. The US Centers for Disease Control and Prevention report that on average, women today live more than five years longer than men, and that gap is getting wider. Men have higher rates of death in most of the top ten causes of death. They also tend to have higher rates of complications from many disorders.

According to a report from the World Health Organization, men have higher death and complication rates for conditions like coronary heart disease, high blood pressure, diabetes and cancer. Yet, many of the risk factors for those diseases that have increased in the past few years aren’t male-specific and are preventable. These include increases in smoking, alcohol consumption, sedentary lifestyles and obesity.

According to WHO, there’re other factors that can contribute to a poorer life expectancy for men. For instance, men generally have greater exposure to occupational hazards such as physical or chemical hazards. They tend to engage more often in behaviors involving risk-taking, they’re less likely to see a doctor when they’re sick, and when they do, they’re less likely to fully report their symptoms.

A board member of the Men’s Health Network notes that certain conditions common in men, such as high blood pressure and high cholesterol, have no detectable symptoms. Many cancers also have few detectable symptoms in their early, most treatable, stages, so health care monitoring is crucial.

That’s where women can come in. We can help our men be aware of screenings, adopt healthy eating habits and promote exercise by setting an example and doing it with them. We can also encourage them to see the doctor when they complain of not feeling well or show signs of illness. They’re protecting the family by staying healthy.

So, what are the big health issues facing men? I read a couple of articles that listed the Top 10 or Top 5 Men’s Health Issues, but I’m going to condense the list to three big ones. You can read more at these three sites:

Still high on the list is cardiovascular disease. The American Heart Association tells us that one in three men have some form of cardiovascular disease. It’s the leading cause of death for men in the US, responsible for one of every four male deaths. Another condition that’s common in men and can contribute to cardiovascular disease is high blood pressure, which slowly damages the heart and blood vessels over time. These disorders can be controlled if detected early.

Here’s one you might not have thought of but is a growing problem. It’s skin cancer. Men 50 and older are at high risk for developing skin cancer, more than twice as likely as women. The reason is because men have generally had more sun exposure and tend to have fewer visits to the doctor for skin checks. More men than women die of melanoma, a lethal form of skin cancer. Regular skin checks can catch skin cancer in its early stages.

Diabetes is a problem in itself, and it can result in a whole bunch of other problems. It can lead to erectile dysfunction and lower testosterone levels. Low testosterone also decreases a man’s muscle mass and energy level. Low blood glucose can cause depression and anxiety, as well as damage to the nerves and kidneys and lead to heart disease, liver disease, stroke and vision issues. Routine blood work can monitor blood glucose levels and detect pre-diabetes.

Men face many more health issues that affect them not just physically, but mentally as well. This month, encourage the men in your life to take advantage of screenings, get regular physicals, lead a healthy lifestyle and see the doctor when necessary. Help them take control of their health and live longer.

“Brain Attack” Can Strike Anyone, Anytime

May 31st, 2018

Strokes don’t just happen to the elderly. They can disable or kill men and women of working age, too. That fact is just one of the awareness-raising messages the American Heart Association/American Stroke Association is spreading during May, which is American Stroke Month.

A stroke or “brain attack” happens when blood flow to part of the brain is cut off. As a result, brain cells are deprived of oxygen and begin to die, which threatens the abilities controlled by that area of the brain, such as muscle control, speech or memory.

Someone who suffers a minor stroke may have only temporary challenges, such as slurred speech or weakness of an arm or leg. But more serious strokes may lead to permanent paralysis or inability to speak. More than two-thirds of stroke survivors are left with some form of disability.

The faster a stroke victim receives treatment, the better the chances for survival and recovery. For each minute a stroke goes untreated and blood flow to the brain is blocked, the patient loses about 1.9 million neurons, which are nerve cells that transmit information throughout the body.

Be alert for these common symptoms of a stroke and call 9-1-1 immediately if they occur. Also, note the time the first symptom appears, because that can affect treatment decisions.

  • Sudden numbness or weakness in the face, an arm or a leg, especially on one side of the body;
  • Sudden confusion, difficulty speaking or understanding what’s going on or being said;
  • Sudden difficulty seeing out of one or both eyes;
  • Sudden trouble walking, dizziness or loss of balance or coordination;
  • Sudden severe headache with no known cause.

There are two types of “brain attacks” classified as strokes. A hemorrhagic stroke happens when a brain aneurysm bursts or a weakened blood vessel leaks. An ischemic stroke is caused by a blood clot that blocks a vessel carrying blood to the brain.

A transient ischemic attack, commonly known as a TIA, can mimic stroke-like symptoms and lasts less than 24 hours. A TIA occurs when blood flow to part of the brain stops for a short period of time. While they generally don’t cause permanent brain damage, TIAs are a serious warning sign of a future stoke and shouldn’t be ignored.

Some risk factors for strokes can’t be controlled, including age, gender or family history. But people can minimize other things that make them more susceptible, such as high blood pressure and/or cholesterol, smoking, drug and/or alcohol abuse, poor diet and lack of physical activity.

The bottom line: Up to 80 percent of strokes can be prevented.

Here, courtesy of the National Stroke Association and the American Heart Association, are other stroke facts by the numbers:

  • A stroke happens every 40 seconds.
  • Nearly 800,000 people experience a new or recurrent stroke every year.
  • Stroke is the leading cause of adult disability in the United States.
  • Stroke is the No. 3 cause of death in women and the fourth leading cause of death of men in this country. Some 185,000 people die from a stroke each year.
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