Author Archive

New Depression Therapies Bring Renewed Hope

College student finds relief through ketamine infusions.

William Storey remembers a childhood filled with hopelessness and loneliness instead of birthday parties and bike rides.

“I was abnormal at an age in which abnormality is very unhealthy,” states William, now 23.

William Storey suffered from emotional problems much of his life but says Dr. Pollack’s treatment has been a lifesaver, giving William hope for the future.

William Storey (right) and his father, Peter, relax during a recent visit with Robert Pollack, MD.

The abrupt and dramatic cultural change caused by his family’s move from Maine to Georgia when he was eight complicated the challenges William already faced. Over the years, he’s been diagnosed with attention deficit hyperactivity disorder, bipolar disorder, severe depression and Asperger’s syndrome, a higher-functioning form of autism.

Generally, Asperger’s patients struggle to communicate with and relate to others. They may lack empathy and have difficulty reading other people’s moods and making friends.

During his early years in private school, William felt isolated and misunderstood, especially by classmates, and by teachers who disciplined him for “being out of control.”

He explains the mindset of those teachers this way: “I like to think of it as, This nail doesn’t seem to be fitting into this particular piece of wood quite the same way the rest of them do, so we should probably hit it more.” 

By the time he reached fourth grade, William wanted to die.

“I hated my life,” he recalls. “I hated everything.”

In seventh grade, William switched to a public school, where he thrived for two years.

“I was a straight-A student,” he notes. “I was well-liked by my teachers. I had no social problems.”

Halfway through his freshman year of high school, however, he “hit a breaking point.”

“I think a lot of it had to do with age, hormonal imbalances, feeling more ostracized from my peers,” William shares. “I had a handful of people that I was at least acquaintances with up until that point. But they stopped interacting with me as much when high school started, for their own reasons.”

He stayed behind when his classmates moved on to tenth grade. As William repeated his freshman year, his conflicts with teachers led school administrators to threaten expulsion if he caused further problems. He managed to finish ninth grade, then transferred to a “less academically rigorous” school.

“It was honestly kind of a joke,” he relates. “I barely did anything, and I still made straight A’s.”

Disappointed and frustrated, he entered an early enrollment program at the University of West Georgia. William lived in a dorm and worked on his high school studies and college classes at the same time.

“I did well the first year,” he points out. “The second year, I had similar problems to when I was in the ninth grade again. It resulted in my father pulling me out of the program and bringing me home.”

More than 18 months later, he was ready to return, but by that time, he was too old for high school. He obtained his GED, but West Georgia didn’t consider that sufficient to re-admit him until William and his family successfully appealed to the state’s board of regents.

Though back in college, he wasn’t back on track. William was desperate for consistent relief from the depression that had plagued him for much of his life, despite taking “nearly every antidepressant on the market.”

Then, last spring, William’s father called Robert Pollack, MD, a friend since their days together at Yale University, to inquire about IV ketamine infusions, a relatively new therapy for treatment-resistant depression.

Finally Feeling Better

Dr. Pollack’s Fort Myers-based practice, Psychiatric Associates of Southwest Florida, embraces newly emerging therapies based on pioneering discoveries about the brain. Those include genomic testing to determine which antidepressant might be most effective according to the patient’s genetic profile, as well as transcranial magnetic stimulation (TMS) and theta-burst stimulation (TBS). Both use magnetic pulses to rouse areas of the brain and relieve depression.

Since 2015, Dr. Pollack has also used ketamine, an anesthesia drug introduced in the 1960s that can alleviate suicidal thoughts and act more quickly than many antidepressants. He estimates that 72 to 75 percent of his patients treated with ketamine have had a positive response.

William traveled to Fort Myers for a series of six infusions over two weeks. Following each 30- to 45-minute procedure, it took him a short while to get his bearings.

“I was very woozy, then I went to the hotel where we were staying, got food and I was fine the rest of the day,” he asserts. “Within two weeks of the initial treatment, there was a definite change. I was far less harsh on myself. I was far less miserable.”

When his depression was at its most devastating, William wouldn’t leave home or interact with anyone.

“By the third treatment, he shook my hand and said, Good morning,” Dr. Pollack reports. “I’ve known him a long time, and that’s a first. People with Asperger’s don’t usually gain a lot of social skills. But William now sits here and laughs. He tells jokes.”

Preventing a “Ruined Life”

William calls Dr. Pollack “a godsend” whose scientific approach is “radically different” from the many other mental health professionals William has seen over the years. He recommends keeping “an open mind about some of the more experimental treatments, because everything has to start experimentally.”

William’s new regimen has him taking fewer medications, which has allowed him to lose weight. He returns once a month for booster infusions. While still “a bit anti-social,” William says he’s getting better and eventually may overcome it.

A student of philosophy, he’s also well on his way to completing his four-year degree at West Georgia in Carrollton, where he has his own apartment and is looking ahead to a career. Teaching is a possibility; so is the legal profession.

“There are so many paths, and I’m not really sure which one I’m supposed to go on yet,” William states. “But I’m also not too bothered by that because at least I’m aware that there is a way forward.”

He’s eager to share his story because he wants people to know how much he and others like him have suffered, he says.

“The way kids with autism tend to be treated, at least in the area I grew up in, is damning,” William declares. “It results in lost lives. Even if they may not end up as suicidal as I was, it really warps a person. It makes it very hard to move on, to be productive, to be happy. And it seems as though people just don’t care, and that really saddens me.

“Misunderstanding may be the cause, but at the same time, I have trouble differentiating between misunderstanding and willful ignorance, because the end result is still a ruined life.”

Brighter days are ahead for those living in darkness, William affirms, and life is worth living.

“There is hope for the future,” he concludes, “that I certainly did not feel a year ago.”

It’s National Migraine and Headache Awareness Month

June 26th, 2018

Migraines are not “all in your head,” and the pain is not only real but may have serious consequences for your life and bank account.

June is National Migraine and Headache Awareness Month, a time to support those whose lives are often made unbearable by chronic migraines that can be difficult to treat, even with prescription medication.

An estimated 36 million Americans suffer from migraines, but only one of every three talks to a doctor about them, according to the American Migraine Foundation.

A migraine is an inherited neurological disorder in which specific areas of the brain become overexcited, the foundation defines. Sufferers are more susceptible to “triggers” that raise their risk of having a migraine attack.

Those triggers include hormonal fluctuations, weather changes, bright lights, specific smells or foods, alcohol, poor sleep and high stress.

A chronic migraine recurs 15 or more days a month for at least three months and has the features of a migraine at least eight days out of the month, according to the Chronic Migraine Awareness organization.

“Chronic migraine poses a greater impact on the patient’s life than episodic migraine, including lower household income levels, less ability to do chores and more missed workdays,” according to the tax-exempt group’s blog.

The World Health Organization considers migraines one of the 10 most disabling medical illnesses globally, with chronic migraines impacting patients even more severely.

Migraines cost the United States more than $20 billion each year, the American Migraine Foundation reports. That includes direct medical expenses such as doctor visits and medications and indirect expenses such as missed workdays.

“But the burden doesn’t stop there. Those afflicted with migraines are more likely to have depression, anxiety, sleep disorders, other pain conditions and fatigue,” according to the foundation.

“People who have a history of experiencing an aura phase (migraine with changes in vision) have been shown to be at an increased risk for stroke and heart attack,” the foundation adds.

How do you know if you’re suffering from a migraine as opposed to a garden-variety headache? Consider these migraine symptoms:

  • A headache with moderate to severe pain;
  • A headache that worsens with physical activity
  • A throbbing headache that’s often worse on one side of the head;
  • A headache that leads to missed school, work or other activities;
  • Increased sensitivity to light, sound or smells during the headache;
  • A headache that lasts four to 48 hours if left untreated.

If your migraines are negatively impacting your quality of life, and over-the-counter medications don’t help, visit your primary care provider, who may refer you to a neurologist or a headache specialist.

For more information on migraines, visit or

Goodbye Floaters

Vitreolysis makes irritating eye debris vanish.

To William Mee, it looked like an insect scurrying across his floor or the fly from the horror movie The Ring that buzzed across the static on a television screen.

Photo by Jordan Pysz.

William can once again drive without distractions.

In reality, William was among millions of people plagued by an irksome eye floater, which can show up as a fleck, cloud-like spot, dot or cobweb darting in and out of the field of vision.
William was fortunate that the chronic floater in his left eye didn’t affect his distance sight or hamper him while he drove.
“But it was definitely annoying for close-up stuff because I’m of a generation where I do quite a bit of reading,” shares William, who enjoys a wide range of fiction and nonfiction books, including legal thrillers, adventure stories, biographies and histories. “It’s better than just watching television.”
The floater also vexed him when he used his computer. William sought a solution from a local ophthalmology practice but “received the disappointing conclusion that nothing could be done about this; just put up, shut up, live with it,” he recounts. “At that point, I gave up on it.”
Then he read an article in Florida Health Care News about Peter J. Lowe, MD, of Retinal Eye Care Associates, and how he makes floaters disappear without surgery. The board-certified ophthalmologist uses laser vitreolysis, which is noninvasive, requires no incisions and causes no discomfort. He estimates he’s performed more than 500 of those ten- to 15-minute procedures over the past five-plus years.
William made an appointment with Dr. Lowe at his Delray Beach office last August and underwent extensive testing to check for any retinal vascular diseases, such as macular degeneration, or any retinal tears or detachments.
“Mr. Mee was a relatively unhappy patient when we first saw him in August 2017,” Dr. Lowe reports. “He’s a young, active, sixty-five-year-old man who was having a lot of difficulty seeing out of both eyes, which were otherwise healthy, because of the cloudy vitreous in his left eye. The floater had come on slowly, but then after a while encompassed the entire field of vision of his left eye.
“Mr. Mee was living in a cloudy world even on a sunny day,” Dr. Lowe continues. “When you’re outside in the sun, your pupil constricts, which lets less light into the eye, and if you have a dense enough floater, it can certainly create a visual obstruction. When a floater lets less light into the eye, you can still see things, but they look duller. And then as the floater moves back and forth, sometimes you get clear vision and then the floater comes through your field of vision, and it gets worse. So that’s what he was dealing with, and that’s what ultimately made him come to see us.”

Casting Shadows on the Retina

An eye floater is the debris left after what Dr. Lowe calls “a vitreous detachment.”
“The vitreous is a cellophane-like lining on the inside of the eye,” he educates. “As the eye naturally ages, or after surgery, most commonly to remove cataracts, the cellophane lining will sometimes come loose. Occasionally, it stays in small, almost completely transparent sheets. Sometimes, however, it clumps up into larger debris fields and casts shadows against the retina.
“If you’ve spent a great deal of time and money on cataract surgery to attain excellent vision, then suddenly something’s in your eye, your first thought is something’s happened to your cataract surgery and/or you’re going blind from a problem previously undiagnosed,” Dr. Lowe expounds. “So those people often come in mortified of floaters.
“In a younger person who’s never had surgery, they often demonstrate even more of what you’d call ‘white-knuckle syndrome.’ They’ve looked up floaters or visual blurring on the internet, and they’ve read about everything from retinal detachment to hemorrhages. Everybody always expects the worst to come out of a doctor’s mouth. So, they’re often surprised that floaters are a normal physiologic change to the eye.”
Most acute floaters go away on their own, “passing uneventfully as the jelly that holds them disintegrates, and the floaters tend to move up toward the bottom of the eye,” Dr. Lowe informs. “So, we’re only talking about a small percentage of patients in which what’s floating gets stuck in the vitreous jelly or is large enough to present a significant obstruction.
“No one can really point to any given patient and say floaters will be a problem for that person, nor can anyone point to any individual floater and suggest that it’s going to be a problem as time goes on,” he comments. “Floaters come in different sizes and shapes, and different people have different levels of concern. A floater is not a disease. I tell people it’s a dis-ease. So, it’s often relative to the individual how uneasy seeing a floater makes them.”
In the past, those with persistent, bothersome floaters were told the best option was to do nothing. That’s because not all ophthalmologists perform laser vitreolysis, and the only other effective alternative is a vitrectomy, a surgery to remove some or all of the vitreous jelly which fills the space between the lens and the retina. The procedure carries the risk of infection, retinal detachment, lens damage and other complications.
“My patients have told me how they’ve tried all kinds of oral medications, eye drops or other so-called remedies that promise results but don’t deliver,” Dr. Lowe continues. “Some of the lasers that were used previously didn’t vaporize the floaters but merely fragmented them, leaving more floaters rather than providing a cure.”

After Vitreolysis, Vision Restored

William traveled to Dr. Lowe’s Lake Worth location, where the Ellex Ultra Q Reflex laser he uses is located. After William’s eye was anesthetized with just a drop of topical anesthesia, Dr. Lowe’s precision laser converted William’s loose tissue into harmless gas bubbles, which dissolved into the fluid of his eye.
“It gradually just disappeared,” William marvels. “You could still see a faint outline or something floating in there, but basically after about a month and a half or two months, it was pretty much gone. I was pleased with that. And my vision in my left eye actually improved, so it was like a double bonus.
“All in all, it was a beneficial experience, and I would recommend it to anybody who’s annoyed by floaters.”
William was so pleased with Dr. Lowe and his staff, describing them as “very attentive and very personable,” that he plans to return to Retinal Eye Care Associates for a laser treatment on his right eye.
“No sooner did I get my left eye treated than the same thing showed up in my right,” he notes. “I had Dr. Lowe look at it, and he said, It’s in a perfect location. We can take care of that one for you, too.”

“It Gave Me My Life Back”

Former baseball coach finds relief without drugs, surgery.

Tom Bush has spent a lot of time on baseball diamonds across his 74 years, playing in his younger days before coaching high school teams during his career in education.

Photo by Jordan Pysz.

Tom enjoys a quiet moment with his grandchildren, Joshua (far left), Mary, Joseph and Javari.

A social studies teacher, he landed his first coaching job in the fall of 1966, in an era when public schools still segregated black and white students. Tom won state championships in his first two seasons coaching prep baseball. After he transferred to DeLand High in 1970, the teams he managed always posted a winning record.
Tom eventually retired and slowed down, as most people do. Among his life’s pleasures are watching college sports and pro football, plus having fun with his grandkids. He has six, ages 12 to 27.
In the summer of 2016, however, Tom began suffering from what he describes as an “awful pain” in his back that nearly ended life as he knew it.
“It was hard to walk or to bend,” Tom recalls. “It cut down on a lot of the things I normally did, like walking a lot and playing with the grandkids. I didn’t feel good about that because I’ve always been active and was used to playing with them. They’d ask, Granddaddy, do you want to come out here and play with us? And I’d have to say, Oh, not today. Granddaddy can’t do it.
Tom’s aching back also made it nearly impossible for him to rest.
“At night, I couldn’t sleep,” Tom recounts. “You just sit there and your eyes are open and you’re saying, Oh, Lord, I’m just miserable. You almost want to give up.”
Tom had no idea why his back was bothering him. He hadn’t strained it lifting anything heavy. He hadn’t had an accident. And he’d never played football or other contact sports.
After three months of agony, Tom heard from a friend at church about Jeremy M. Gordon, DC, and made an appointment for an evaluation at DeLand Chiropractic & Spinal Decompression.
“We did x-rays, which showed arthritic and degenerative changes,” Dr. Gordon reports. “But x-rays have their limitation in that you can’t see the soft tissue. You can’t see the discs or the thickening of those ligaments. You can’t see the nerves and the muscles. Based on the x-ray findings, we treated him accordingly.
“We did some regular chiropractic care, a four- or six-week treatment plan,” Dr. Gordon continues. “While he got some good relief intermittently, his symptoms tended to come back after a period of time. We started digging deeper, and that’s when he had an MRI, which showed the more significant spinal stenosis, multiple disc bulges and nerve impingement issues. What we typically see when there’s significant stenosis or disc issues is that the chiropractic care doesn’t provide lasting relief.”
Graphic from stenosis, or narrowing of the spinal canal, “is usually a consequence of a multitude of things,” Dr. Gordon educates. “Disc issues are one of the most prominent causes. There are also things like arthritic and degenerative changes in the joints of the spine. There’s thickening of some of the ligaments within the spinal canal. The fourth thing that can contribute would be some misalignment, or shifting forward or backward, of bones in the spine.”

Gentle Stretching Is Key

Dr. Gordon suggested that Tom undergo spinal decompression on the DRX9000 system, which he uses because of its precision and reputation for effectiveness. The noninvasive, nonsurgical therapy relieves pressure from bulging, herniated or protruding spinal discs.
It’s also used to relieve spinal stenosis, degenerative disc disease and neuropathy in the arms or legs, as well as post-surgical neck and/or back pain. Radiating discomfort, numbness or tingling often results from protruding discs in the neck or back that contact or compress nerves extending into the limbs.
“Think of it as an overinflated tire or water balloon that’s being squeezed from above and below so that it bulges or distends outward,” Dr. Gordon explains.
Tom began what the chiropractor calls the “full protocol,” which is 24 visits over ten weeks. The DRX9000 system gently stretched Tom’s spine while he lay on the treatment table. Through gentle motion, the therapy increased his disc space and restored nutrients and hydration to allow his discs to heal.
“It felt really good,” Tom says of the treatments. “The people who administered it were very courteous, very polite, and that helped a lot. They are so happy to work with you and are so friendly. Every time I go in there, they always say, Mr. Bush, how are you doing?”

“Most patients who receive spinal decompression therapy are starting at a pain level of eight, nine or ten on a scale of ten. Most bring that down to a one or a two. Many people become pain free.” – Dr. Gordon

A lot of the arthritic and degenerative changes caused by spinal stenosis are permanent and can’t be resolved without surgically removing ligaments and other tissue, Dr. Gordon points out.
“One of the only things that you can address conservatively in a noninvasive way for severe stenosis is the disc itself,” he adds. “By doing the decompression treatment, you can reduce the size and severity of the disc bulges or protrusions and open up the spinal canal. It doesn’t have to be a drastic change in order to get some drastic results and reduction in symptoms for these patients.
“I’ve seen patients on whom we do pre- and post-decompression MRIs, and the radiologist will indicate a three-millimeter reduction in disc bulging, or something along those lines, and the patient will be totally symptom free. So, it doesn’t have to be a huge, ninety percent reduction in the size of the actual bulge in order to achieve some significant changes.”

Descending the Pain Scale

Dr. Gordon’s usual goal for his patients is a 50 percent improvement in function and a 50% reduction in pain within the first two weeks. He emphasizes, however, that each person’s case is unique, and not all patients achieve the same results.
“Most patients who receive spinal decompression therapy are starting at a pain level of eight, nine or ten on a scale of ten,” he states. “Most bring that down to a one or a two. Many people become pain free.”

Photo by Jordan Pysz.

Tom has resumed his normal routine and is working out regularly.

Tom says his pain was at ten when he started spinal decompression and that he felt better by the third or fourth treatment.
“His pain level had dropped about fifty percent by that point,” Dr. Gordon concurs. “The pain and numbness in his feet started to improve, and that’s something we typically see when we start working on these conditions.
“As that spinal canal is opened up with the decompression, the nerves are not withstanding the same amount of compressive force. As a result, the nerve impulses are able to travel down to the legs and back and forth, and the patient is able to perceive better sensation in the legs and feet, and the pain level decreases usually quite quickly.”
Now, Tom rates his pain at one, and he reports that he has resumed his normal routine. He is also strengthening his back with workouts, though nothing strenuous, at a local fitness center.
“We tell patients if they can follow through with the core strengthening and stabilization exercises that we recommend for them when they’re wrapping up the treatment protocol, it’s very rare that they ever have to come back and do any kind of follow-up on the decompression,” Dr. Gordon stresses.
Though Tom and Dr. Gordon no longer see each other regularly, they share an affinity for one of their community’s landmark institutions: DeLand High School, established in 1922.

“At night, I couldn’t sleep. You just sit there and your eyes are open and you’re saying, Oh, Lord, I’m just miserable. You almost want to give up.” – Tom

Dr. Gordon, who moved to DeLand as a third-grader, graduated with the Bulldogs’ Class of 1991. He was there during Tom’s tenure but never took any geography or history classes from him.
DeLand may be a “decent size” city of 20,000 to 25,000 residents, Dr. Gordon estimates, but it still retains some small-town characteristics.
“It’s not an uncommon thing to run into people that I may have gone to school with or had as a teacher at one time or the another,” he states.
The two men also share a natural rivalry because Dr. Gordon went to Florida State University, while Tom roots for the University of Florida. Tom is also an ardent Washington Redskins booster and often sports the team’s burgundy and gold. The fact that those colors are very similar to Florida State’s garnet and gold was the source of a lot of ribbing from Dr. Gordon.
“Every time I’d wear my Washington Redskins colors, he’d say, Oh, you’re wearing Florida State colors,” relates Tom, who describes Dr. Gordon as a “fantastic guy.”
“He’s very patient, always wants to help you and give you the best solution that he feels is necessary,” Tom adds. “I just enjoy him. He’s a very nice guy.”
As for spinal decompression, “it has helped me tremendously,” Tom raves. “It gave me my life back.”

Glaucoma: The Silent Thief of Sight

Former boxer and craft enthusiast defeat vision-robbing disease.

For former boxer Michael Harris, the fight to preserve his eyesight has become one of the biggest, most important challenges of his life.
Michael boxed as a light heavyweight while in the Army before turning pro as a heavyweight. While training for a bout in Germany in 2004, his sparring partner, a former champion, hit him in his right eye with a jarring uppercut.

Photo by Jordan Pysz.

Even glaucoma couldn’t knock Michael out.

“It was a different kind of pain,” Michael recalls. “I heard a click. My vision wasn’t messed up, but I can still remember it.”
Michael went on to compile an undefeated professional record, 11-0, fighting most of his matches in the Tampa area. After spending years in the ring, and at the urging of his wife and his church family, Michael retired from boxing and pursued a more long-term career in law enforcement.
“I’ve met a lot of fighters, some of them have even won championship belts, but they have no retirement, no nothing,” he notes. “So, I got a good job as a deputy with the Hillsborough County Sheriff’s Office. It’s a great organization, a great department to work for.”
Although Michael’s professional boxing career was behind him, the near-knockout punch he’d endured introduced complications he never saw coming. He began experiencing difficulty seeing out of his right eye during a strenuous exercise session at his gym last summer.
He assumed the combination of the sweat from the workout dripping into his eyes and the steam from his post-workout shower caused the sudden visual impairment. However, when he arrived at work the distortion remained. When his vision cleared after a bit, Michael dismissed the problem as a minor irritant in his eye.
“The vision problem in my right eye started in August, but it didn’t get bad until December,” he remembers. “I was working and suddenly lost vision in my right eye. I could not see the person in front of me talking. I couldn’t see their mouth moving, and their face was really blurry. I thought, Man, I’m through.”

Dodging a Knockout Blow

Michael immediately scheduled an appointment with his eye doctor, who referred him to Sandra M. Johnson, MD, a board-certified ophthalmologist who is fellowship trained as a glaucoma specialist at The Eye Institute of West Florida.
Dr. Johnson soon discovered that Michael was suffering from glaucoma, a disease that threatened to rob him of his eyesight and put his career in law enforcement at risk.
Often referred to as the silent thief of sight, glaucoma can cause irreparable damage before a patient even notices any vision loss or experiences any sort of symptoms. Glaucoma is caused by increased pressure inside the eye due to improper drainage of the aqueous humor, a clear fluid that flows in and out of the eye through a mesh-like channel to nourish nearby tissues.
Glaucoma is a group of diseases that damage the optic nerve, a bundle of more than a million nerve fibers carrying information from the retina to the brain. The retina, the light-sensitive tissue at the back of each eye, is vital to good vision.

It was the hardest punch I ever got hit with, in boxing and anything else in life. -Michael

The two main types of glaucoma are open-angle and angle-closure, which refers to the drainage angle where the iris (the colored part of the eye) meets the cornea (the outer covering). Open-angle is the most common type of glaucoma, accounting for at least 90 percent of the cases in the United States.
Because glaucoma is a chronic disease, patients require “continuity of care” that may extend over years and even over multiple generations, Dr. Johnson explains.
“Glaucoma is often hereditary,” she says. “But somebody without a family history can be the first one to get the gene defect. I treated a father who had it, and it was diagnosed in the daughter and grandson. The father went completely blind, and then the daughter became blind in one eye. I operated on the grandson while he was in high school. Each generation did better because they were aware of the disease and began treatment earlier and earlier. This is a typical example of hereditary glaucoma.
As we get older, normal aging with glaucoma will cause these channels to get clogged. When that happens, fluid can build up and the pressure rises. Michael’s glaucoma was worse in his right eye because of the blow he received in training. However, he had glaucoma in both eyes. The trauma he received in his right eye made it most susceptible to damage, but if he hadn’t come in he would have become blind in both eyes from glaucoma.
Michael’s glaucoma was worse in his right eye, the eye that received the blow during training so many years before. Normal eye pressure ranges from 12 to 22. Michael’s readings were dangerously high – 53 in his right eye and 51 in his left – which came as a surprise to him.

“Almost Blinded in One Eye”

“I was shocked because I have six brothers and one sister, and none of them have glaucoma,” Michael says. “It was the hardest punch I ever experienced – in boxing or anything else in life. I thought, Wow. I’d worked out all my life, eating healthy, organic food and something like that just comes along.”
Michael was treated as an emergency patient during his initial visit to The Eye Institute of West Florida. The severity of his high eye pressure required immediate care. He underwent numerous tests and received prescription eye drops to clear his vision and lower his pressures.
Dr. Johnson stresses that Michael had been seeing an optometrist who “fortunately referred him to a glaucoma expert to take care of his problem.
“I took care of the episode of high eye pressure and educated him on his disease and how it could affect his work and life,” she adds. “He was almost blinded in one eye, so I placed him on a regimen he could live with. Now, he’ll see me on a regular basis moving forward to ensure his vision remains stable. He’ll need his eyes for decades longer.”
At his last check-up, Michael’s pressure readings were 12 in his right eye and eight in his left. Thanks to Dr. Johnson’s emergency intervention and skilled follow-up care, he’s able to see well and has returned to his normal daily activities without worrying about sudden loss in vision.
“I go to the gun range – I shoot expert – and I’ve been working out, taking hot showers and nothing bad has been happening,” Michael marvels. “So, it’s been awesome.”

Specialized Care Helps

Gloria Duck enjoys getting crafty, whether she’s sewing clothing, coloring pictures, making greeting cards, working with plastic canvas or creating fabric yo-yos.
“I do it three mornings out of the week,” she shares. “I’m not afraid to be challenged. If somebody else is teaching something new, I’ll learn it.”

Photo by Jordan Pysz.

Gloria sees well enough now to thread a needle.

Good vision is vital to Gloria’s ability to do such detailed work, such as making bunnies and chicks from yo-yos, which are gathered circles of cloth secured with a simple running stitch.
“It’s important to see well,” she says. “Otherwise you start rubbing your eyes and saying to yourself, why can’t I see that? I would be very frustrated if I couldn’t see, and I would probably give up my hobby and not do anything.”
Gloria wears glasses while crafting and reading and is especially vigilant about her eyesight because she has glaucoma, the leading cause of blindness in the United States. She’s a winter visitor to Florida from the Albany/Schenectady, New York area. An ophthalmologist in upstate New York has been monitoring her disease.
That physician decided Gloria needed cataract surgery and a procedure called a trabeculectomy to create an alternate drain for the fluid in her left eye. However, the pressure in her eye was still higher than it should have been. Since she was heading south to Zephyrhills, her doctor referred her to the nationally recognized The Eye Institute of West Florida.
After seeing a comprehensive ophthalmologist, Gloria was referred to glaucoma expert Dr. Sandra Johnson. After a thorough examination, Dr. Johnson determined that the trabeculectomy had failed due to scar tissue which had occluded drainage of fluid out of the eye. Although her New York ophthalmologist had prescribed a number of medications, the pressure in Gloria’s eye was still not low enough. Her pressure was 20 but it needed to be half that much.
Though Gloria couldn’t feel the dangerously high pressure, she was at risk of losing even more vision in her left eye.
Dr. Johnson adjusted Gloria’s medications and performed a procedure known as needling. After numbing her left eye, Dr. Johnson was able to carefully dissect the scar tissue that was occluding the drainage and which restored the flow of fluid out of the eye to reduce the pressure.
“She had really good results,” reports Dr. Johnson, who continues to monitor Gloria’s eye pressure.

Why a Glaucoma Specialist?

Many ophthalmologists have been doing glaucoma procedures for a long time. If and when those procedures fail, they refer patients to a glaucoma specialist for either a second procedure or to free the scar tissue that was formed from the first procedure. Having an expert improves outcomes.
Dr. Johnson is the first glaucoma specialist Gloria has seen, and she’s been thrilled to have such expert care during the months she spends in Zephyrhills. She’s been impressed with Dr. Johnson since that first appointment.

I found the staff there very helpful and concerned. I can’t say enough about the practice. I’m very, very glad that I found them. -Gloria

“She’s great, very sociable,” Gloria raves. “She makes me feel relaxed. Dr. Johnson explains everything. She listens. No question is a silly question.”
Dr. Johnson has specialized in glaucoma cases for 20 years and performs between 200 and 300 surgeries on such patients each year.
Dr. Johnson emphasizes that glaucoma specialists have more tools when it comes to taking care of glaucoma patients. “Many of these advanced cases may require surgery at some point in the future. With a specialist, you are getting the best possible care available and have an opportunity for a broader approach to taking care of your eyes.”
Dr. Johnson offers advanced testing and monitoring services that non-specialists do not necessarily have. This includes measuring and photographing degrees of vision loss and the density of the nerve fibers that are still viable in the back of the eye. Depending upon the viability of those nerves, specialists can determine how low the pressure needs to be so that a glaucoma patient does not lose any more vision.
“You have to make sure the pressure is low enough for that particular set of nerves,” Dr. Johnson educates. “We do this to establish a baseline, so I don’t just follow the patient’s intraocular pressure. That doesn’t show us the whole picture of what’s going on.

“Continuity of Care”

Gloria’s condition has stabilized. She’ll continue on her current medications and have her eye doctor in New York monitor her glaucoma until she returns to Zephyrhills and to Dr. Johnson’s care next winter.
“I couldn’t be more enthused about Dr. Johnson and the staff at The Eye Institute of West Florida,” Gloria declares. “I found the staff there very helpful and concerned. I can’t say enough about the practice. I’m very, very glad that I found them.”

Back in the Swing of Things

TMS offers a better outcome for patients with treatment-resistant depression.

Doug McCrea was used to being “a very active, involved” person, playing tournament tennis; working in advertising, sales and marketing; managing employees and helping develop various businesses over the years.

Photo by Jordan Pysz.

Doug McCrea

But depression robbed him of his zest for life and his drive to achieve. While he still exercised, Doug says he wasn’t as effective at work and often languished at home.
“The only time I felt better was when I was on the tennis court,” he shares. “I was always the guy driving things, and all of a sudden, I was sitting there like a vegetable. When I started something, I would only go so far instead of completing the task. I put things aside. Tomorrow was better than today.
“The engaging nature of what I am as a person went away as well, the social engagement,” Doug continues. Finally, he received an ultimatum. “My wife said, You’re going to see a psychiatrist, or you’re going to be kicked out.”
Doug’s wife, Irene, is a nurse practitioner in geropsychology, a branch of psychology that addresses the concerns of older adults. She and Doug have been married for 46 years, during which time Irene has been an active advocate for her husband’s mental health care.
Doug tried the anti-depressant Wellbutrin® while living in California 20 years ago but wasn’t satisfied with how it affected his performance on the tennis court. So, he quit taking the pills.
“I was always trying to find something that would enable me to have a better reaction time,” Doug recalls. “The only thing that did it was stopping the medication. I was okay for a while, and then the symptoms arose again.”
Doug tried other treatments over the years, including eye movement desensitization therapy, which uses rapid eye movements in an effort to weaken the effect of negative emotions and memories. But nothing worked well enough for him.
Finally, about two years after the couple moved to Florida, Irene again urged Doug to seek help for his depression. Doug began researching options and found Robert Pollack, MD, of Fort Myers-based Psychiatric Associates of Southwest Florida.
“Credentials were important to us,” Doug emphasizes. “His background spoke a thousand words in what he could provide. My wife and I were extremely impressed with him – his educational background, his demeanor, his approach, the no-nonsense attitude of Let’s try and test these things and find out which one works.”

Safe, Innovative Therapies

Dr. Pollack embraces emerging therapies for treating depression based on pioneering discoveries about the brain. Those include genomic testing to determine which antidepressant might be most effective according to the patient’s genetic profile, as well as transcranial magnetic stimulation (TMS) and theta-burst stimulation (TBS). Both use magnetic pulses to rouse areas of the brain and relieve depression.
Dr. Pollack also uses ketamine, an anesthesia drug introduced in the 1960s that can alleviate suicidal thoughts and act more quickly than many antidepressants.
“Doug has a sensitivity to different medications, so I thought ketamine would be a bad choice,” Dr. Pollack reasons. “Also, his genomic testing did not reflect somebody who would do well with ketamine. He had a tremendous amount of anxiety, and TMS tends to have better results for anxiety.
“I don’t think Doug trusts medications,” Dr. Pollack adds. “He prefers treatments he can control. Even with TMS, he wanted to control his position in the chair. He’d say, When I put my head over here, I rolled my eyes over here, and that gives us a better response. Chances of that being true are not great, but if he needed to have control, my feeling is that’s fine.

“It worked for me very well, very quickly, probably within four or five sessions. It’s like night and day.” -Doug

“The more people talk, and the more they function during a course of TMS, the better they do,” Dr. Pollack asserts. “It increases brain activity. We had someone who ran a board meeting during TMS, and it was their best treatment.”
A noninvasive therapy, TMS was approved by the US Food and Drug Administration in 2008 for people such as Doug with treatment-resistant depression, as well as those who can’t tolerate the side effects of antidepressants.
TMS is also used to treat chronic pain, anxiety, migraines, obsessive-compulsive disorder, fibromyalgia, bipolar disorder and other illnesses for which medication has not had the desired outcome.
Dr. Pollack administered TMS to Doug over 36 sessions at the Psychiatric Associates of Southwest Florida office. All Doug had to do was sit in a chair and relax.
“They put this device on top of your head, and the first session is spent trying to identify the exact spot within your brain that affects depression,” he describes. “There’s no pain whatsoever. It’s like a little woodpecker tapping you very lightly. Once they find that small spot on the left side of your brain, your right thumb starts to twitch, which is sort of funny.”
Unlike medication, nothing involved with TMS entered Doug’s bloodstream or clouded his thinking. But the therapy did leave him tired.
“I’m not a nap person, but I found myself napping early in the evening,” he recounts. “The other thing that happened, which was fascinating, is that after the first three sessions, I told the technician, I’ve noticed that digital signs along the street seem brighter. And she said, That’s good because it normally takes a while. Some people have said that’s one of the things that happen when the TMS is working.
“It’s been almost a year since I completed it, and I still look at the digital signs to see how I’m doing, and they’re bright,” Doug assures.
Dr. Pollack believes that “treatment of depression is a family affair,” so he made sure Irene had all the information she needed to understand and evaluate her husband’s TMS treatments. She also served as his motivator.
“When he would say, Maybe I don’t need to do this, she pushed and she was strong,” Dr. Pollack states.

“It’s Like Night and Day”

As with any patient, treating Doug involved becoming familiar with his history and his personality, then evaluating how those impacted his emotional well-being.

Photo by Jordan Pysz.

Doug is back playing tournament tennis.

“Doug tends to look back at things for cause and effect, rather than accepting reality,” Dr. Pollack points out.
For instance, Doug wondered whether his past alcohol abuse (he’s been sober for 41 years) and the seven or eight concussions he suffered while growing up, mostly playing football and other sports, contributed to his depression.
Dr. Pollack isn’t convinced they did. He believes Doug “most probably” struggled with “an underlying biological depression” aggravated by situations at work and his frustration with the inevitable effects of aging, which diminished his ability to play tennis as well as he once did.
“He’s not happy with being seventy-two,” Dr. Pollack states. “Now, he’s able to sit and joke about it, which he wasn’t before.”
Thanks to TMS, Doug is also more outgoing, Dr. Pollack reports, and is eager to spread the word about the benefits of magnetic-pulse therapy.
“It worked for me very well, very quickly, probably within four or five sessions,” Doug marvels. “It’s like night and day. I’m more rested, more sociable. I’m teaching tennis part-time, and I’m volunteering with SCORE, a group of former business executives who help entrepreneurs.
“I’m back playing tournaments again,” he adds. “That’s the best result of the TMS treatments. It’s got me back to being me.”

What a Pain

April 24th, 2018

Diagnosing and Treating Sciatica.

  • When you stand, does pain shoot from your lower back, down your thigh and maybe to your knee?
  • Do you have tingling, numbness, weakness or difficulty moving your leg or foot?
  • Does one side of your buttocks constantly ache?
  • Do you have hip pain?
  • Does your discomfort worsen when you bend at the waist, cough, sneeze or sit?

If you answered yes to any of those questions, there’s a good chance you’re suffering from sciatica.

This common condition, which often shows up in middle age, involves irritation to or inflammation of the largest nerve in the body. The sciatic nerve starts from nerve roots in the spinal cord in the low back and extends through the buttocks to send nerve endings down the lower limb.

Sciatica – not to be confused with other back pain – is often caused by a herniated disc in the lower back pressing on or pinching the sciatic nerve. Other causes include spinal stenosis, which is a narrowing of the spinal canal; nerve irritation from adjacent bone; tumors; infections; arthritis; injury; pregnancy; or prolonged sitting on an object such as a wallet in a back pocket.

Sometimes, no direct cause of sciatica can be found.

Doctors diagnose sciatica by conducting a physical exam and taking the patient’s symptoms and medical history into consideration. Sometimes, x-rays and other tests such as a CT scan, an MRI and an electromyogram are used as well.

Pain management specialists, chiropractors, orthopedists, rheumatologists, internists, general practitioners, physical therapists and massage therapists are among the health care professionals who evaluate and treat sciatica. It can last for days or weeks, or it can become a chronic ailment.

Traditionally, bed rest was the recommended treatment for sciatica. But how realistic is that approach? Many people, especially those who have jobs, children or other responsibilities, don’t have the luxury of lying around and doing nothing for weeks.

And there’s no guarantee that lying low will ease a bout of sciatica. One study by a research team in the Netherlands showed that patients who rested for three months showed a level of improvement equal to those who practiced “watchful waiting” during that period. The two groups also had similar rates of absenteeism from work and of surgical intervention.

Stock photo from, what can you do to ease the agony of sciatica? Don’t expect to find a lasting solution from over-the-counter pain medications, heating pads, cold packs or dietary supplements. They either don’t help or provide only temporary relief.

Chiropractic adjustments performed over multiple sessions can be effective. TENS units, which send stimulating pulses across the surface of the skin and along the nerve strands, are sometimes useful, too.

Physical therapy, as well as low back conditioning and stretching exercises, are other options, as are muscle relaxers, cortisone injections, prescription medications, acupuncture and activity restrictions. For those whose sciatica results from nerve compression at the lower spine, surgery sometimes is required.

Once patients recover from sciatica, they need to use common sense and a healthy lifestyle to prevent it from coming back. That means exercising regularly, maintaining proper posture and bending at the knees while lifting heavy objects.

Goodbye Contacts and Glasses

Clear lens replacement surgery brings the world back into focus.

Andy Polce had a decision to make: continue depending on glasses to correct his worsening vision or seek another way to see better.
Like most people still in the workforce, Andy’s eyesight is vital to his ability to make a living. As a realtor, he deals with contracts and other paperwork. He also does plenty of detail work as owner of the Dunedin House of Beer bar and microbrewery and is focusing on a wider distribution for his craft beers.Stock graphic from
About six years ago, he began having difficulty with his close-up vision,
especially discerning smaller print.
“You hit forty, you can’t read, and your arms are only so long, so you start using cheaters,” Andy relates. “I had to have glasses with me at all times. I had one pair for reading the newspaper and another for working on the computer. It just got to be a major pain.
“I had glasses everywhere, and every time I had to go somewhere, I had to put a pair in my pocket,” he adds. “I didn’t want to do that anymore. Enough was enough.”
Knowing his vision would only get progressively worse, Andy considered a laser procedure such as LASIK®, the most popular refractive surgery performed in the United States, to reshape his cornea and correct his presbyopia, which means “old eye” in Greek.
Presbyopia develops gradually and usually becomes noticeable in the early to mid 40s. It’s caused by a hardening of the eye’s lens, a clear structure about the size and shape of an M&M® candy. As the lens becomes less flexible, it can no longer change shape to focus on close-up images especially, making them appear blurry.

Photo by Jordan Pysz.

Andy is focused on greater distribution of his craft beer.

“When you’re young, your lens is very soft, and the muscles around it make it move inside the eye,” explains refractive cataract and LASIK specialist Robert J. Weinstock, MD, of The Eye Institute of West Florida.
“It’s called accommodation. You lose accommodation when you hit forty, and the lens actually starts to grow, almost like an onion, where it’s adding layers as it grows. And as it adds layers, the lens gets larger and more rigid and it can’t focus, which is why the vision starts to get blurry, and not just for reading vision but also middle and distance vision.’’

LASIK vs. Lens Replacement

Andy needed an expert to evaluate his eyes and explain his options, so he made an appointment with Dr. Weinstock. After a thorough examination and “all the tests,” Andy learned he was a good candidate for a clear lens replacement.
“People come in all the time thinking they want LASIK or some other procedure they’ve heard about,” Dr. Weinstock observes. “If they’re between the ages of forty and sixty and don’t have a mature cataract yet, but their lens is no longer working well, clear lens replacement is the perfect procedure. More and more people are doing it. As the word spreads that the latest generation of artificial lenses are better than ever and can give you natural vision without any side effects, the trend will continue.”
The specialists at The Eye Institute of West Florida are trained to treat every vision issue they encounter. Deciding which procedure is best for a patient like Andy involves taking more than just his age into consideration, Dr. Weinstock stresses.
“It depends on what’s wrong with the eye,” he comments. “Some people in their forties are wearing contacts or glasses, but they’re very nearsighted and were born with eyes in which the cornea, the front surface of the eye, is very steep. Their lenses are still working pretty well. In those cases, sometimes we’ll use LASIK.
“When it’s a gray area, I have to look at other issues and decide what to recommend. In general, LASIK works better for nearsighted people in their twenties and thirties whose lenses can still focus up close, and lens replacement works better in patients over forty whose lenses are losing their ability to work.”
Dr. Weinstock determined Andy’s distance vision had deteriorated, too,
“He really needed a prescription for distance glasses, middle and near, either progressives or bifocals, if he really wanted to see well,” the board-certified ophthalmologist notes. “But he was really not looking forward to wearing glasses or contacts to correct that.”
Dr. Weinstock discussed the pros and cons of replacing his flawed lenses with Symfony® Multifocal lenses, which can correct both distance and near vision.

“Life’s certainly been a lot easier since the surgery. I’d do it again in a heartbeat.” – Andy

The highly-advanced intraocular lens (IOL) is not only designed to correct vision at all distances, but provides seamless day-to-night vision and a lower risk for halos and glares than traditional lenses.
“We talked about restoring his vision back to the way it used to be, and he really liked the idea,” Dr. Weinstock reports. “It’s a very similar procedure to cataract surgery. We did a lens replacement in both of his eyes.”
The surgeon used a laser to remove Andy’s natural lenses in each eye, two weeks apart, after numbing them with anesthetic drops so he’d feel no discomfort. The surgery is called clear lens replacement because the natural lens is still clear, unlike the cloudy lens of a cataract.

No Worries About Cataracts

Andy describes his surgeries, performed over the winter holidays, as “real quick, in and out.” He noticed a difference in his vision “pretty much immediately.”
“They did my right eye first, and afterward, the whites were so much whiter,” Andy remembers. “The whites used to look like a smoker’s yellow. The colors are so much brighter, too.”
Besides freeing him from wearing glasses, the procedures will prevent Andy from developing cataracts later in his life.
“His Symfony lenses will never cloud up,” Dr. Weinstock confirms. “He’s got fresh, new lenses that will last him the rest of his life.”
Andy is very happy he trusted his eyesight to a doctor with a “good bedside manner” who is “very respected in the business.” He recommends Dr. Weinstock and The Eye Institute of West Florida to anyone needing skilled, specialized eye care.
“Life’s certainly been a lot easier since the surgery,” Andy enthuses. “I’d do it again in a heartbeat.”

Conquering Challenges

Whatever the issue, father-son dentists restore smiles.

Richard “R.C.” Besteder received good dental care while he served as a chaplain in the Air Force. When he retired from the service in 1995, his access to those high-quality dentists was cut off. Unfortunately, his need for their care only increased.

Photo by Nerissa Johnson.

Richard and Elaine Besteder are all smiles after visiting Deland Implant Dentistry

Over the years, R.C. lost so many teeth on the bottom right that he couldn’t bite or chew on that side of his mouth. In addition, a partial denture or bridge, installed years before to fill a gap left by the loss of his bottom middle tooth in a childhood wrestling match, had become obsolete and needed to be replaced.
“I had a lot of cavities and fillings all over the place,” R.C. recalls. “I ate a lot of sweets, drank soda pop and stuff, which I shouldn’t have.”
R.C.’s wife, Elaine, had a similar dental history. She lost at least eight teeth over the years and in some of the teeth that remained, she had cavities that needed filling. Her situation was such that steak, apples and other foods became difficult to eat, and she became self-conscious of her smile, which she described as “unattractive.”
One day, as R.C. drove one of the couple’s dogs to and from their veterinarian, he saw the sign outside DeLand Implant Dentistry and decided to make an appointment for a cleaning. During his initial visit, he was examined by Darshan Patel, DMD.
“Mr. Besteder came in for routine dental care and to make sure he didn’t have any infections or cavities,” Dr. Patel recalls. “That led to a discussion of his missing teeth and how it affected his bite and chewing abilities.”
Chewing on one side of the mouth can put too much stress on the teeth and the temporomandibular joint, potentially causing fractures and compromising movement of the joint and surrounding muscles, Dr. Patel cautions.
“It’s like putting on just one shoe and walking around with the other foot bare,” he compares.
Fortunately, R.C. didn’t experience any symptoms or more complicated issues.
“Next, we decided to look into how we could fill in some of those spaces with implants and implant crowns,” Dr. Patel continues. “It was something he was open to, so we did the diagnostic workup, which includes a CT scan and computerized planning of where the implants would be placed with his existing bone and how the teeth would look afterward in various implant positions.
“We do all of that digitally, on the computer, so the patient can see what their teeth and their bite will look like before the procedure is actually performed,” Dr. Patel explains. “Based off that planning, we ordered surgical guides that allowed us to place the implants exactly how we had planned them.”

Long-Term Solution

The actual implant process involves surgical placement of the titanium implant, which serves as an artificial tooth root anchored in the jawbone; attachment of a post, or abutment, once the implant is sufficiently healed, which usually takes from three to six months; and restoration of the tooth with a crown that’s attached to the abutment.
R.C.’s CT scan indicated he had enough natural bone to properly anchor the implant, “so everything went smoothly,” Dr. Patel reports. “I placed three implants for him and made him a three-unit bridge to give him teeth on his lower right side.”
The entire process took four to six months. Meanwhile, Elaine decided to have her teeth fixed, too, so she could eat properly. R.C. recommended DeLand Implant Dentistry. She scheduled a consultation with Dr. Patel’s father, Rajiv, a board-certified implantologist who founded the practice 30 years ago.
“She came to us with a lot of issues with her teeth,” he recounts. “She lost back teeth on the lower arch and some upper teeth on the back side. She also had cavities in her remaining teeth and was looking for a long-term solution.”
Over the next two years, Dr. Rajiv Patel placed crowns on about a dozen of Elaine’s teeth to preserve them and replaced her missing teeth with implant-supported restorations.
“Implants are best to replace missing teeth,” he stresses, “but there is no comparison with natural teeth, which are the best.”
Because the alveolar ridge – the bone beneath Elaine’s missing teeth – had
atrophied, Dr. Patel needed to shore it up to support the implants. Rather than do a graft with cadaver bone, he performed a ridge-split procedure to increase the width of her jawbone. This minimally invasive method involves cutting narrow horizontal and vertical slits into the bone and carefully spreading it.

No Pain, Much Gain

Placing the implant is painless, assures Dr. Patel, who notes that platelet-rich plasma (PRP) technology led to improved healing for both Elaine and R.C. It also aided the process by reducing discomfort and swelling, which helps to avoid post-operative complications.
A PRP gel is created by placing a sample of the patient’s blood into a centrifuge to separate plasma from red blood cells. The dentists use a second centrifuge to concentrate platelets that contain growth factors. The growth factors stimulate stem cells to quickly produce new tissue. The dentists then apply the gel to the implant site.
“My dad always jokes with his patients that once we place these implants, we’re going to be married,” Dr. Darshan Patel says. “We keep following up to make sure nothing’s changing with their bite, they feel comfortable and they’re still able to chew.”
The Patels’ goal is to deliver advanced, personalized, comprehensive care – from routine fillings to root canals, dentures, crowns, braces, implants, denture repairs and reconstructive surgery – in a comfortable, friendly atmosphere.
The Besteders, who sing the praises of the practice’s state-of-the-art equipment, affable staff and skilled, knowledgeable practitioners, say DeLand Implant Dentistry succeeded on all counts.
“I’m very satisfied; the work they did was superb,” says Elaine, who is back to eating the foods she was avoiding prior to receiving her care. “It takes you a while to get used to having something you didn’t have for so long, but it’s so pleasant.”
R.C. concurs. His smile has been restored, and he can now chew on the right side of his mouth again.
“My teeth look very nice now and so do my wife’s,” he enthuses. “Just like Elaine, I’m very satisfied with the results. I can’t see where you could find a better dentist in this area than Dr. Patel. I’ve known a lot of dentists, including some in the military who were really good, but he’s the best, absolutely.”

Breathe Easier Without Surgery

Balloon dilation cures chronic sinus infections.

Barbara Mulkey suffered from chronic sinus infections for almost two decades while living in St. Louis and then in Tampa. A move to DeBary and a new job in the education field brought her only a temporary reprieve.

Photo by Nerissa Johnson.

Barbara is more active now that she’s had the balloon sinus dilation procedure.

“For the first five years we lived here, I taught online,” she recalls. “I was at home all the time versus being in the classroom, and suddenly the sinus issues diminished.”
Then, in 2016, Barbara returned to public schools as an eighth-grade teacher and endured two sinus infections that year. Last September, she was sickened by another infection more severe than those before it.
“It didn’t respond to antibiotics or steroids,” she shares. “I had headaches. I couldn’t hear out of one ear. My throat bothered me. I would spit stuff up and cough, and I was worn out. I felt awful.”
Some days, she couldn’t drag herself in to work. When she was at home, Barbara spent much of her time in bed or on the couch.
“I felt like I was living as half of myself or only able to do half of what I used to do,” she notes. “And I did not have the mental capacity I had before. I would forget things.”
Barbara’s general practitioner sent her for a CT scan and was out of town when the results came back. Desperate for relief, she picked up the scan and, on a coworker’s recommendation, made an appointment with Daniel L. Rothbaum, MD, at Atlantic Ear, Nose and Throat.
“As soon as he saw the CT scan, he said, We’re going to have to do a procedure. More medications are not going to work,” Barbara relates. “He gave me a choice of having the balloon sinus procedure or the regular procedure. He took the time to explain both. He was very personable, very caring and extremely knowledgeable.”
Barbara had significant sinus inflammation or sinusitis. Her sinuses were not draining properly, leading to infection.

Less Risk, Quicker Recovery

Traditional sinus surgery, performed under general anesthesia, involves removing bone and tissue to enlarge the sinus opening, clearing blockages and restoring normal drainage. Pain and scarring are the downsides.
“Most people don’t require that level of aggressive procedure to improve their sinus function,” Dr. Rothbaum informs. “Balloon sinus dilation is much easier. It is a minimally invasive way to treat the problem without the longer recovery, the greater risks and the discomfort of the more traditional sinus surgery.
“Balloon sinus dilation can make a dramatic difference in the lives of people like Barbara who have struggled with sinus problems for years,” he stresses.
During the procedure, also known as Balloon Sinuplasty, Dr. Rothbaum temporarily places a tiny, flexible balloon catheter into Barbara’s nose to reach her blocked sinuses and then inflates the balloon to enlarge her sinus openings. The balloon is then removed.
“They gave me medication so I was relaxed,” Barbara says. “They numbed the area. I didn’t feel a thing. Dr. Rothbaum talked me through the whole process.
“Afterward, I had a little bit of discomfort from time to time, but nothing major,” she adds. “I took off work for three days to relax and make sure I was feeling better.”
The results were dramatic.
“I breathe better now,” Barbara reports. “I don’t have a stuffy nose or that fullness in my head anymore. My energy level is back to one hundred percent.
“It’s a very big relief.”

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