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More Than Meets the Ear

A diagnostic hearing evaluation saved this woman’s life.

Nora Drown’s mother, Betty, proved the age-old adage that “mother knows best.” Two years ago, frustrated by Nora’s inability to hear clearly, Betty encouraged her daughter to undergo a hearing evaluation at EarCare in Melbourne.

A hearing exam was the difference between life and death for Nora Drown.

Nora says she can hear her mom, Betty,
much more clearly when she’s driving.

“Mom was already a patient there,” Nora explains. “When I took her in for her annual hearing exam, she told them, My daughter can’t hear very well at all. Can you check her hearing, too? Of course, I told them I was fine and that I could hear. I was reluctant to do it, but I went ahead and did so to appease my mother.”

Nora was given a complete diagnostic evaluation conducted by Karen Cowan-Oberbeck, AuD, owner and Doctor of Audiology at EarCare.

What Dr. Cowan-Oberbeck uncovered was far more than the average hearing loss.

For starters, Nora was surprised to find out she had a profound hearing loss in her right ear.

“I honestly had no idea because my left ear would compensate for the loss in the right ear, so to me, it was balanced when it really was not,” Nora recalls. “I never had to turn the television up really loud, and I don’t recall asking people to repeat themselves, although my mom would disagree. The fact that I was completely deaf in that ear and had no idea really raised concern with Dr. Cowan-Oberbeck. She sent me to an ear, nose and throat specialist and that decision saved my life.”

Life-Saving Diagnosis

“Nora had some off and on dizziness that she complained of as well,” Dr. Cowan-Oberbeck explains. “I found that her hearing was severely asymmetrical, with a profound hearing loss in the right ear. So, I recommended she have an MRI. The results showed that she had a schwannoma tumor growing on her eighth cranial nerve, which is the nerve that sends hearing information to the brain.”

Common symptoms of a schwannoma tumor are what Nora experienced: one-sided hearing loss and buzzing or ringing in the ear. Dizziness may also occur.

The exact cause of the acoustic schwannoma was unknown.

“The doctors said it probably took fifteen years to get to the size it was,” Nora explains.

She underwent a seven-hour surgery to remove the tumor, followed by four days in the hospital.

Don’t Delay Screenings

The hearing professionals at EarCare emphasize the importance of starting annual hearing screenings around age 50 in order to establish a hearing baseline and to accurately detect hearing loss. Hearing healthcare should be part of everyone’s overall health regimen.

“Too often, there’s a stigma attached to having hearing aids,” Dr. Cowan-Oberbeck says. “Some people think hearing aids make them look or feel older than they are. We have patients from all walks of life and various ages. Hearing loss can affect anyone at any age, so screenings are vital.”

The personal consequences of vanity can be nearly life altering. Untreated hearing loss means giving up some of the everyday sounds you are used to enjoying. Vanity could severely reduce the quality of your life. Research now shows untreated hearing loss  contributes to reduced brain function, social isolation, depression and balance issues.

Balanced Hearing

Because Nora had a total hearing loss in the right ear, her left ear had been overcompensating for several years.

To assist with her hearing, Bea McCabe, a hearing aid specialist at Earcare, recommended a CROS type hearing aid, ideal for those suffering from single-sided hearing loss. A microphone positioned on the weaker ear picks up information (sound) and sends it to the better ear.

“It’s really a wonderful improvement for Nora,” Dr. Cowan-Oberbeck says.

Today’s hearing aids come with advanced technology and longer life spans.

The average life expectancy of a hearing aid is about five years. After that, the electronics within the device begin to wear out, affecting its performance. It is no longer as reliable, and the acoustic response is not as accurate.

“An important reason that people choose to upgrade their technology is that the hearing aids they’re currently wearing are not performing up to the standards or meeting the performance levels that are expected for best hearing,” explains Dr. Cowan-Oberbeck.

The capabilities of today’s hearing aids are another reason to upgrade technology. The most significant change is wireless connectivity: the ability to wirelessly pair hearing aids with external devices, such as televisions, telephones and computers.

Because the advanced technology can initially be intimidating to patients, the audiology professionals at EarCare set up strategic appointments for training. These allow the hearing aids’ capabilities to be introduced, practiced and expanded upon as the patient becomes more familiar and comfortable with the technology.A hearing exam was the difference between life and death for Nora Drown.

“Manufacturers are always coming out with new technology, and it is important to us to be able to provide those advancements to our patients and for them to understand how to use them properly,” Dr. Cowan-Oberbeck says. “We take our time when we meet with the patient to thoroughly explain the hearing aids and how they work.”

Patient for Life

The EarCare staff wants people with hearing loss to know that once they become a patient, they will never need to go elsewhere for adjustments.

Dr. Cowan-Oberbeck emphasizes the clinic’s Patients For Life program, where they service a patient’s hearing aids for the life of those hearing aids. This includes regular maintenance and adjustments every few months and annual hearing evaluations.

Every one to two years, a patient’s hearing is evaluated in depth to ensure the hearing aids are working properly for them. Nora says she is amazed at what she thought she could hear before compared to what she can hear now.

“I had an ambulance drive up alongside me the other day, and I was amazed at how clear that sound was and how I could hear it from both sides,” Nora shares. “Even in a noisy restaurant, the sound is so much better than before, and I thought it was good then.

“I can’t tell you how thankful I am to my mother for pushing me to have my hearing checked and to Dr. Cowan-Oberbeck and everyone at EarCare. They saved my life!”

FHCN article by Judy Wade. Photo by Nerissa Johnson. Graphic from istockphoto.com.

Young at Heart

Residents enjoy fun-filled days.

Carol Steeber, 90, appreciates the active lifestyle Hibiscus Court provides residents, like herself, to keep their minds young and fresh.

Carol Steeber enjoys the many activities offered at Hibiscus Court in Melbourne.

Paige helps Carol with
word puzzles.

“When I moved here about five years ago, that was one of the things that attracted me to the place – there was always something fun going on,” Carol recalls. “No one wants to just sit around and get old. After all, age is just a number.”

The Melbourne assisted-living community works tirelessly under the direction of Paige Blossom, resident programming director, to provide a wide range of physical, social, and cognitive activities to stimulate the mind and occupy the days. In her 13 years at Hibiscus Court, Paige is mindful that there are 78 residents with very different personalities that call Hibiscus Court home. As a result, the programs offered are varied and individually tailored to make sure each resident feels connected to the community.

“Our goal is to always have something to look forward to,” Paige says. “We plan excursions, activities, big events, anything we can think of that provides them enjoyment and gives them the opportunity for a full social calendar.”

Life Is Meant to Live

Carol has no intention of letting life keep her down.

She is a fixture at morning exercise classes and enjoys crossword puzzles, playing cards and listening to the live entertainment that Paige arranges.

“Carol is one of our most active residents. She is always doing something and it is really beneficial to her because she is not sedentary.

“We want our residents to be happy and have activities fill their days,” Paige continues. “It is so beneficial for them to be here in our community enjoying their days rather than being at home, isolated and inactive.

“I believe quality of life is much more important than how many years we have left. To make sure residents stay active and social, we work hard to provide something for everyone. We offer things like brain games, sing-alongs, excursions, fitness class, bowling, chair volleyball, educational opportunities – anything they need to stay engaged.”

Every Friday, residents enjoy Friday Fest, with live music, entertainment, hors d’oeuvres and refreshments. “The Friday music is upbeat and festive. I try to incorporate as much fun into the program as I possibly can. I work hard to keep them on their toes!,” Paige describes.

Bridging the Generational Gap

Paige says one of the programs she is most proud of that she developed at Hibiscus Court is the intergenerational program.

“We have partnerships with a few local schools. We arrange for the students to come in and sing, dance, perform and entertain the residents,” she explains. “I can remember learning so much from my own grandfather about history and life in general. I want to bring the generations together here at Hibiscus Court and allow the young and old to interact and bridge that gap that age tends to get in the way of. It’s been a great learning experience for all involved. Our residents love it when the kids come and the kids love them back.”

Families are an important piece of the puzzle at Hibiscus Court.

“All of our activities are open to family members to participate in,” Paige relays. “If we go on field trips, family members are encouraged to come along. Friends and  family members can come in and participate in games, listen to the live entertainment, whatever they want to do to spend time with their loved ones. We understand how important family is in maintaining overall mental health.”

Carol says she is happy and content in spending her days indefinitely at Hibiscus Court.

“I really like it here and I love Paige and the rest of the staff,” she says. “There’s so much to do, there’s no excuse not to be active.

“Everyone here is helpful and friendly. It’s really a wonderful place!”

FHCN article by Judy Wade. Photo by Nerissa Johnson.

Add Years to Your Smile

LANAP laser-assisted surgery is used to treat gum disease.

Debi Grover knows that a person’s smile is the first thing we notice about others.

As an investment REALTOR® and design consultant, Debi is face to face with people all day, and her own smile is something she became concerned with.

“With my job, I have to greet people every day, and the first thing we notice is a person’s teeth,” Debi says. “I had suspected for a while that I had periodontal disease. I didn’t have any bleeding or anything like that when I brushed, but I had extreme plaque buildup, and I knew that over time, damage had been done to my gums. I wanted to be able to smile and not feel like I had to hide my teeth. The most important thing to me was saving my natural teeth. I got to a point where I knew I needed to find a dentist who could help me do that.”

After researching LANAP® laser-assisted gum treatment online, Debi came across Advanced Dentistry of Fort Myers.

“I read that they are very skilled and knowledgeable in treating gum disease with this laser, so I made an appointment in order to gain additional knowledge about it.”

Debi met with Joseph H. Farag, DMD, at Advanced Dentistry of Fort Myers to discuss this option and decide if it was the right treatment for her.

LANAP Zaps Disease

Periodontal disease is an inflammatory process that can be a chronic or an acute problem. According to Dr. Farag, periodontal disease is an infection of the tissue that supports the teeth. The American Academy of Periodontology (AAP) estimates between 50 and 75 percent of Americans have some form of periodontal disease, some through no fault of their own.

“Debi had moderate to advanced stages of periodontal disease,” describes Dr. Farag. “We offered her the option of conventional surgery to repair the gums or the LANAP laser-assisted treatment option. Because Debi had already researched LANAP, she knew right away she wanted that procedure done.”

In the past, traditional gum treatment involved cutting away the infected gum tissue and placing sutures to hold the reduced tissue in place during the healing process. During conventional gum surgery, the scalpel cannot differentiate between healthy and diseased gum, so the patient loses healthy tissue as well as diseased tissue.

This approach always results in recession of the gums – a lowering of the level of gum tissue. If the gum tissue recedes too far, it can leave the sensitive tooth roots exposed.

Healthy gums adhere closely to the teeth, supporting them so they don’t become loose in the jawbone. When people develop gingivitis, a mild form of periodontal disease, it causes irritation, redness and swelling. As periodontal disease progresses, the bone is lost around the tooth and the pockets around the teeth get deeper. If left untreated, gingivitis may lead to a second, more serious stage called periodontitis.

Research studies show that laser-assisted dental gum therapy is superior to conventional surgery in a number of ways. The most notable to the patient is that they don’t lose their gumline. “We do not want the gums to recede, which can make the teeth appear longer,” says Dr. Farag. “The goal is healthy gums that reattach naturally to the teeth.

“During the first laser pass,” continues Dr. Farag, “three goals are accomplished. First, the energy vaporizes the diseased lining, leaving the healthy tissue intact. Second, it dehydrates the tartar on the tooth, making it very brittle and easy to remove from the tooth. Third, it kills the bacteria on the gum that is exposed to the laser.

“During the second step, I use an ultrasonic instrument. Its fine tip vibrates and removes the tartar, breaking it away from the tooth. We then flush with an antimicrobial substance that stops the growth of new bacteria. In this step, we affect the bone around the tooth and remove the diseased lining of the tissue.

“The third step involves another pass with the laser at a different setting. This last pass stops any bleeding and creates the best antimicrobial seal possible, preventing re-infection and releasing growth factors from the blood cells to regenerate the attachment.”

Debi’s procedure was completed in one day.

“That is the other advantage of this procedure, as opposed to the conventional surgery,” Dr. Farag educates. “Debi’s gums were treated in about three hours, as opposed to multiple visits with the conventional surgery. This is faster and there’s less discomfort afterward.”

Feeling Confident Again

Dr. Farag emphasizes the importance of follow-up dental care after having periodontal disease treated.

“When we sit down and discuss treatment options for gum disease, I want to be assured by that patient that they are committed to taking care of their teeth afterward,” he describes. “The laser treatment is the first step in getting the teeth healthy. The patient needs to be committed to keeping the teeth healthy long-term in order for it to be effective.”

Patients are encouraged to have their teeth cleaned regularly, brush and floss daily and be aware of any sudden changes to their oral health.

“In order to keep the gums healthy, people need to keep the teeth clean. That requires daily commitment,” Dr. Farag reiterates.

Debi says she has a renewed desire to maintain a healthy mouth now that the procedure is complete. She looks forward to continuing her care with the team at Advanced Dentistry of Fort Myers.

“Dr. Farag and the entire staff are personable and knowledgeable, and they make me feel confident.”

FHCN article by Judy Wade. Photos by Jordan Pysz. FHCN file graphic.

Look and Feel Young Again

Platelet-rich plasma helps rejuvenate youthful glow.

Mary “Sissy” Abell likes to stay active at 85. She enjoys spending time with friends playing bridge, dining at local restaurants and going on vacation cruises.

Friends Maureen Walsh and Mary Abell had facial rejuvenation done at Marbela Medical Wellness.

Both Maureen (left) and Mary (right) are happy with their results thanks to Dr. Nabavi (center).

“You only live once – might as well enjoy every minute of it,” says Sissy from her Cape Coral home. “I love all of my friends and getting out and enjoying myself with them. We find new and exciting things to do to keep busy. I cherish them all.”

One of those friends, Maureen Walsh, met Sissy through a local bridge club where the two play. One day, Maureen told Sissy about an idea she had to undergo facial rejuvenation to eliminate wrinkles and tighten her skin.

“She told me she read an article in Florida Health Care News about Marbela Medical Wellness and the facial rejuvenation they do there,” Sissy recalls. “She wanted me to go with her and try it. I had very deep lines on my face. I got those from my mother, I suppose, and I always hated them. If I had a chance to get rid of them or minimize them, I wanted to do it. She didn’t have to ask twice. I’m always up for a new adventure.”

Maryam Nabavi, MD, of Marbela Medical Wellness in Fort Myers, integrates primary care and medical aesthetics. One of the services she provides is facial rejuvenation using platelet-rich plasma (PRP) therapy. This is the procedure Maureen read about.

“As soon as I read the article, I was intrigued,” Maureen says. “I always hated the tiny lines I had around my eyes and on my forehead. I’m seventy-three, but I felt like I wasn’t too old to give it a try. I wanted someone to go with me. I mentioned it to Sissy, and she was all for trying it. It’s so much fun to be able to do something wonderful for yourself and to do it with a friend.”

One and Done

“The great news is that the PRP facial rejuvenation only needs to be performed one time,” Dr. Nabavi explains. “It’s not like BOTOX® Cosmetic or fillers, which need to be injected every few months. Instead, it is permanent until new signs of aging actually occur. In about two to three years, patients may see new signs of aging. At that time, we can repeat the PRP treatment, if necessary.”

Physicians and surgeons have been taking advantage of the healing properties of platelet-rich plasma since the mid 1990s. Over time, more benefits of the treatment have been uncovered, and its applications in health care have increased.

“Platelet-rich plasma has been used for years to address orthopedic issues such as joint pain,” educates Dr. Nabavi. “It’s also been used for wound healing and soft tissue disorders. However, during the last three years or so, more plastic surgeons and dermatologists have begun using it aesthetically.”Friends Maureen Walsh and Mary Abell had facial rejuvenation done at Marbela Medical Wellness.

Human blood is made up of liquid called plasma and several other components, including platelets, red blood cells and white blood cells. The main job of the platelets is to help form blood clots when there has been an injury to the tissue. Platelets also contain many substances that help initiate the healing process. This makes them useful for various treatments.

“A sample of the patient’s blood is taken and spun in a centrifuge, which separates the platelet-rich plasma from the rest of the blood,” states Dr. Nabavi. “The PRP contains growth factors, which are complex proteins that create tissue growth. PRP also contains leukocytes and stem cells, which also allow for cell division and growth.”

The PRP is then injected into the area of the body where tissue growth is desired. Regeneration occurs within the tissues. It grows local cells, matching the tissue found where the PRP is injected. For example, when injected into a knee with arthritis, where there is either damaged or worn cartilage on the joint’s bones, the PRP will create new cartilage cells. Growth and repair continue for up to one month after the injections.

“When using it for aesthetics, new collagen cells are being produced just below the surface of the skin,” informs Dr. Nabavi. “By activating the growth of collagen, which is the main structural element in the skin, PRP therapy gives the patients a more natural, youthful look. Their skin ends up looking like it did when they were younger.

“PRP therapy can be used in any area I would normally inject foreign substances, such as BOTOX Cosmetic or fillers,” she adds. “With this type of facial rejuvenation, new collagen is forming in areas where there currently are deep lines, wrinkles and the droopiness of the skin caused by gravity.”

Combined Effects

In addition to PRP, Maureen also underwent Ultherapy®, which uses ultrasound to firm and tighten the skin by initiating the restoration of collagen.

“As the skin matures and ages, collagen fibers that normally provide the internal support for the skin become worn,” informs Dr. Nabavi. “As a result, the person gets that droopy, wrinkly effect on the skin. Ultherapy’s ultrasound energy reaches below the surface of the skin and initiates the body’s own natural repair process.”

“I had sagging skin, and I wanted it to be smoother and tighter around my chin and neck,” Maureen shares. “So, I had both the PRP and Ultherapy. One treatment of each and the results are great!”

“In certain patients who need even more collagen, such as older patients, I combine Ultherapy with the platelet-rich plasma treatment,” observes Dr. Nabavi. “The two work wonderfully hand-in-hand because there is a doubling up of collagen production. The most rejuvenation I’ve seen is with Ultherapy in combination with PRP.”Friends Maureen Walsh and Mary Abell had facial rejuvenation done at Marbela Medical Wellness.

Platelet-rich plasma contains many growth factors that also stimulate the formation of collagen. With PRP therapy, new collagen is created just below the surface of the skin.

Ultherapy is the only FDA-cleared, noninvasive procedure that lifts the skin on the neck, chin and brow, and significantly decreases wrinkles, explains Dr. Nabavi. Unlike other treatments, Ultherapy is not a toxin, filler or cream. It’s an ultrasound machine that starts collagen rebuilding, which revitalizes the skin using heat. “Ultherapy does this by dropping lines of heat with the ultrasound energy into the deep tissue below the skin.”

Looking Lovely

Both Maureen and Sissy are more than happy with the results they see when they look in the mirror.

“I am amazed at how those deep lines I used to have are minimized,” Sissy says. “I may be eighty-five, but I’m never too old to feel good about myself. If I don’t do it, who will?”

Maureen agrees, saying that she is thrilled with the fact that both procedures were noninvasive and the results have been amazing.

“I only had one treatment of each, and I can see amazing results,” Maureen confirms. “I’m so glad Sissy did this with me. It is an experience we can share now with others.”

Both women say they highly recommend Dr. Nabavi and Marbela Medical Wellness.

“I am extremely satisfied,” Maureen says. “They are very professional and treat you in a kind, professional manner. It was a positive experience.”

  “I tell people not to hesitate no matter what age they are,” Sissy adds. “Dr. Nabavi is absolutely wonderful. She is informative and never pushes you to do anything unnecessary.

“Vanity keeps us ladies going, you know.”

FHCN article by Judy Wade. Photos by Jordan Pysz. Before  images courtesy of Marbela Medical Wellness.

Doctor Knows Best

Neurologist finds the perfect fit for hearing aids.

Dr. Stephen Hirsch’s struggle to hear began years ago in his native state of New York. A practicing neurologist at the time, he often had a hard time hearing his patients during consultations.Dr. Stephen Hirsch received hearing aids from Physician’s Choice Hearing & Dizziness Center

“I found myself asking them to repeat things a lot, and after a while, you get embarrassed about it. Phone calls were hard to get through, as well as conversations in crowded rooms. I hated ordering in a restaurant because I could never really hear myself well enough or hear what the server was asking me.”

Dr. Hirsch moved to the Sunshine State in 2001, and shortly thereafter decided it was finally time to be fitted for hearing aids.

“I saw audiologists back in New York, but I never followed through. I’d go in for the initial appointment, but never took that next step and actually got hearing aids. Once I moved here, my wife pushed me to get them. There’s only so long you can go until you drive everyone around you crazy asking them to repeat everything.”

Dr. Hirsch was fortunate to find the hearing professionals at Physician’s Choice Hearing & Dizziness Center in Tampa.

“As a doctor myself, I knew what I was looking for in an audiologist, and I can say that they have easily lived up to my expectations.”

The Perfect Fit

Before hearing aids are recommended, patients undergo a diagnostic hearing evaluation. The evaluation helps determine the type of hearing loss, and the level at which a patient can detect and understand speech.

“Dr. Hirsch is a very active person, so it was decided that he needed a device that is placed inside of the ear canal to serve him best with his lifestyle,” shares Jeff Clark, AuD. “We decided that Lyric® hearing aids were his best choice.”

Lyric is positioned completely inside the ear canal, using the ear’s natural anatomy to funnel sound to the eardrum. The unique design and placement helps reduce background noise and provides natural sound quality. Lyric can be used when exercising, showering, talking on the phone, and sleeping.

There are no batteries to change, no maintenance is needed, and no daily insertion or removal.

“I just put them in and go,” Dr. Hirsch shares. “I really love them. They are very small and no one sees them!”

Dr. Hirsch and his wife, Jeanne, spend much of their time outdoors playing tennis and biking. The Lyric hearing aids do not get in the way.

“They are secure, so I never have to worry about making a wrong move and risk them falling out,” Dr. Hirsch describes. “They are a perfect fit for me!”

Life-Changing

Dr. Clark, along with audiologists Scott Sims and Amanda King, strives to provide customers with the best service and products available.

“We get to know each patient and understand their needs before recommending a specific hearing device,” Dr. Clark says. “Not only will you have the best options for your hearing solution, but we offer convenient parking, comfortable exam rooms and we pride ourselves on being on time for appointments.”

Dr. Hirsch says he wished he hadn’t waited so long to do something about his hearing loss.

“Sometimes, we put things off in our lives for no real reason,” he admits. “I wasted a lot of years procrastinating. Now, I can hear the smallest noises I never truly heard before. These hearing aids are great! A real life-changer.”

FHCN article by Judy Wade. Photo by Jordan Pysz.

Getting Back Up Again

A retired teacher has much to smile about after mouth reconstruction.

teacher for 31 years in Oklahoma, Carmelita Hampton was a month shy of retirement when an accident changed her world.Carmelita Hampton received a complete smile makeover involving implant-supported bridges after losing many of her teeth in a fall.

“I was walking up a ramp outside one of the buildings at the school when my shoe got caught and I lost my footing,” Carmelita recalls. “I fell flat on my face and knocked out a few of my teeth. My bite later collapsed and a few other teeth became loose. It was devastating to me. My entire appearance changed.

“I had an implant done in Oklahoma in preparation of replacing one of the missing teeth on the bottom,” she continues. “But, I chose not to fully complete it until I moved to Orlando about a month later. That’s when I was referred to a cosmetic dentist in the area, but I was not happy at all with their plan. They were all over the place. They would fix things here and there. I felt like they were patching things up.

“I went for six years without being able to chew food. I was on a liquid diet, basically. I could only chew very soft foods.

“This dentist in Orlando wanted to pull teeth that were perfectly healthy, so that’s when I decided enough was enough. I had always taken care of my teeth, and there was no way I was going to lose them for no reason.”

Carmelita eventually moved to Melbourne to be closer to her daughter and grandchildren. One day, her daughter showed Carmelita an article in Brevard Health Care News featuring Richard Leong, Jr., DDS.

“After reading the article about him, I called his office right away to make an appointment,” she confides. “He seemed like someone who would genuinely help me.”

A Dental Partnership

“When I went to Dr. Leong’s office, he was honest and reassured me that I would be a part of the planning process, which was not the case in the past,” Carmelita recalls. “It was difficult for me to trust another dentist after what I had been through, but his demeanor and his expertise reassured me. He talked to me for about two hours that first visit. There was no pressure from him to do any one thing; he just wanted to hear my story.”

“Carmelita couldn’t bite properly or chew solid foods,” Dr. Leong recalls. “The last thing she needed was to have teeth pulled. That first meeting with her, I sat and listened and took a lot of notes. She had come from a bad situation with another dentist, so what would make me assume she would trust me?”

Once she decided to proceed with Dr. Leong, a full examination was the first step in determining a plan of action.Carmelita Hampton received a complete smile makeover involving implant-supported bridges after losing many of her teeth in a fall.

“A full visual examination of Carmelita included x-rays, photographs, a CT scan and a lot of measurements,” Dr. Leong describes. “It was very,
very involved.”

Analyzing Patient Needs

Dr. Leong describes the numerous steps he takes in determining if a person is a candidate for dental implants, which were being considered for Carmelita.

“There needs to be adequate bone, healthy gums and a proper bite first,” he explains. “They need to have a proper overall environment in their mouth in order for implants to be successful. They also need the proper attitude about taking care of themselves and their teeth. They can’t just think that they can come in, get implants and never think about those teeth again. That is the furthest thing from the truth.

“Furthermore, their medical health needs to be in check. They may have medical conditions that could preclude them from having long-term success with their teeth. Ailments such as cancer, diabetes, cardiac issues or hypertension need to be considered.

“Lastly, they have to be committed to follow-up care. Routine cleanings and exams are vital to maintaining the implants, as well as their overall oral health. These are an investment, and the patient needs to be invested in it for the long haul.

“I went through all of these steps with Carmelita because of the extent of the care she needed.”

Specialized or Regular Implants

Carmelita’s overall reconstructive plan included bone grafting, realignment of her bite, dental implants and bridges.

“The first step was to get her mouth healthy,” Dr. Leong explains. “We removed any infection she had in the gums and did some bone grafting in the front. I also had to re-establish her bite and align it so the implant-secured bridges on the bottom and upper denture would all fit properly.”

Dental implants are metal anchors implanted in the jawbone to hold replacement teeth. The root sits in the jawbone, below the gumline, and the visible tooth, or crown, is attached to it. Implants support individual artificial teeth, bridges and dentures. They look and feel like natural teeth.

Plate form implants, which Carmelita had placed in the back of her mouth, are made of a titanium alloy that fuses with the patient’s bone to become a solid unit. These specialized implants differ from standard implants in that they are smaller in width. Their length varies. Because they are smaller, they eliminate the need for bone grafting before placement.

“In the back of her mouth there was not enough space to add bone, so I opted to place plate form implants there,” Dr. Leong adds.

The process for plate form implants requires less invasive surgery with a shorter healing time. These specialized implants are not placed by many experienced dentists who perform implants because they are not as familiar with all implant varieties as Dr. Leong.

Carmelita Hampton received a complete smile makeover involving implant-supported bridges after losing many of her teeth in a fall.

Carmelita is a retired teacher who enjoyed working with special education students.

“From start to finish, Carmelita’s case took about a year to complete,” Dr. Leong shares. “It was a lot of work, but very satisfying to see the end result with her. Her case is really an amazing transformation.”

Chew on This

Carmelita says that while taking the fall was a traumatic experience, the end result is amazing.

“This experience affected every aspect of my life,” she says. “I lost my smile and my self-confidence. Our smile is a big part of our personality. People treat you differently when your smile has flaws. I experienced that first hand and it was awful.”

Carmelita says she smiles with confidence now and is grateful that she can eat solid foods once again like meat, fruits and vegetables.

“The first place I wanted to go once everything was complete was Olive GardenSM,” Carmelita recalls. “I hadn’t eaten salad in six years because of my bite and my teeth. And let me tell you, it tasted so good!”

Carmelita is glad to have found an honest and skilled dentist in Dr. Leong.

“He gave me back my life and my ability to feel good about myself again,” she raves.  “He’s amazing!”

FHCN article by Judy Wade. Photos by Nerissa Johnson. Before and after images courtesy of Richard Leong, Jr., DDS.

Couple Now See Eye to Eye

Precision laser removes cataracts in people with astigmatism.

Married for 46 years, William and Janet Martin retired to the Sunshine State two decades ago from Michigan. “We don’t miss the snow one bit,” Janet assures. “The winter months here are glorious compared to up north.”William and Janet Martin both had cataracts removed with femtosecond laser at Pasadena Eye Center.

Instead of shoveling snow, the couple now spend their days enjoying their view of the Gulf of Mexico from their Gulfport home. They stay active by exercising regularly and getting out in their community.

“We keep busy here, that’s for sure,” Janet says. “There are always some activities to do nearby. There’s no slowing us down.”

In recent years, however, the cataracts that developed in both William’s and Janet’s eyes began affecting their daily routine.

“I sing in a choir and I noticed that I was having a hard time reading the sheet music,” Janet shares. “Driving at night was something I avoided because of the glare from oncoming headlights. I also had trouble with certain colors. For example, I couldn’t distinguish between black and blue very well at all.”

Janet suspected that the cataracts she was diagnosed with several years ago were finally at a point where they needed to be removed. She sought the expertise of Nathan R. Emery, MD, board-certified ophthalmologist at Pasadena Eye Center where she was an existing patient.

“Cataracts are something all of us develop as we age, and the only way to ultimately eliminate them is through surgery,” Dr. Emery explains.

When cataracts develop, people describe a variety of symptoms, including a loss in the vibrancy of colors or the need for frequent changes in eyeglass prescriptions. It also becomes increasingly difficult to read, especially in low-light situations.

“Janet described several of these symptoms to me, as well as her difficulty seeing at night. The clouding of the lens can result in diffraction of light entering your eye. This can cause a halo to appear around light sources, such as the headlights of oncoming cars. Rings around every light, sometimes in a variety of colors, can make driving very difficult. After some testing I determined that it was indeed time for her to have cataract surgery.”

In addition to the cataracts increased progression, Janet also had astigmatism. Astigmatism is a result of irregular corneal shape that can distort vision at all distances.

After You, Dear

William says that one perk of living on the water is being able to enjoy the colorful sunsets Florida has to offer.

With his cataracts getting worse, William says those sunsets were often disappointing.

“There was an increased blur and the colors were just off,” he says. “I do a lot of reading, and I could tell that even with glasses on, I was straining to see the words on the pages. Like Janet, I had trouble seeing at night when driving.”

After witnessing the success Janet had with her surgery, William, who also had astigmatism, decided to have Dr. Emery perform his surgery as well.

“She was the guinea pig,” William laughs. “I told her you go ahead and have your surgery first and I’ll see how you do. It was a piece of cake for her, it really was. I decided to have Dr. Emery perform my cataract surgery also.”

Pasadena Eye Center is thrilled to be able to offer patients like William and Barbara femtosecond laser technology to treat their astigmatism while removing the cataracts.

The femtosecond (bladeless) laser surgery is the most technologically advanced cataract surgery in patients with astigmatism. This laser provides unmatched accuracy, as each procedure is customized to the specific patient’s eye.

“Removing the cataract does not necessarily correct the astigmatism,” Dr. Emery explains, “but with this technology we use this laser to change the shape of theeye and correct that astigmatism at the same time. This laser was made specifically for cataract patients with astigmatism.”

“With the femtosecond laser-assisted tool, the laser makes the incisions, both at the surface of the eye and inside the eye. It is consistently a precise incision,” Dr. Emery explains. “We commonly refer to the incision that treats astigmatism as an LRI, which stands for limbal relaxing incision.”

The laser divides the cataract into segments that are removed. The surgery can be performed with greater efficiency and accuracy using the femtosecond laser.

Oh, So Many Choices

It is routine for patients to have Intraocular Lens (IOL) implants after cataract removal. Based on the health of the eye and factors determined in the exam, Dr. Emery, along with the patient, decides which lenses to use. Many factors are taken into consideration when choosing a lens, including the needs of the patient and their long-term goals.

Monofocal lens: These lenses are the most commonly implanted lenses today. They have equal power in all regions of the lens and can provide high-quality vision. Monofocal lenses are in sharpest focus at only one distance. Patients who have monofocal intraocular lenses implanted usually require reading glasses.

Multifocal lens: Multifocal intraocular lenses are one of the latest advancements in lens technology. These lenses have a variety of regions with different powers that allow some individuals to see at distance, intermediate and near ranges. While promising, multifocal lenses are not for everyone. They can cause more glare than monofocal or toric lenses, and some patients still require glasses or contact lenses to achieve the clearest vision.

William and Janet Martin both had cataracts removed with femtosecond laser at Pasadena Eye Center.

William and Janet can spot dolphins and other marine life clearly now.

Toric lens: Toric lenses have more power in one specific region in the lens, especially to correct for higher amounts of astigmatism. Some patients require both LRI by femtosecond laser and toric lenses to correct the full amount of astigmatism. Toric lenses are also used to correct distance vision. While toric lenses can improve both distance vision and astigmatism, the patient will still require corrective lenses for all near tasks, such as reading or writing.

Healthy Eyes for Life

Dr. Emery stresses the importance of annual eye exams to check for diseases, such as glaucoma and macular degeneration.

“Various diseases can develop that can cause damage in their initial phase, that the person is unaware of until it is too late to reverse the damage, such as glaucoma and macular degeneration,” he explains. “We call those the ‘silent thieves of sight.’ Those are great examples of reasons to have an annual eye exam to make sure those diseases are not developing.”

Both William and Janet say they are very pleased with the results of their surgery.

“The sunsets are wonderful again,” William says. “I can distinguish colors like never before.”

Janet says she can read her sheet music without difficulty and says the surgery was easier than she even thought it would be.
      “I don’t need my glasses on to read the music anymore,” Janet shares. “Dr. Emery was very reassuring and explained everything beforehand. I just think his demeanor and his skill are second to none. We have recommended them to several friends and will continue to do so. The practice is wonderful!”

FHCN article by Judy Wade. Photos by Jordan Pysz.

Hope for Osteoporosis

Regain bone loss and improve strength and balance.

Joyce Spencer takes annual trips to New York City with a handful of friends, all former educators.

Joyce Spencer improved her bone density, balance and agility at OsteoStrong.

Joyce’s strength has improved since using the equipment at OsteoStrong.

A retired school principalherself, Joyce says in recent years those annual excursions became difficult to navigate.

“I have osteoporosis,” Joyce confides. “And each year in New York, I’d always have to stop and rest more often than my traveling companions. My back hurt after just fifteen minutes on my feet, and you walk everywhere in New York. I felt like I was weighing the other women down because I needed to stop so often. I love the city so much that I just kept pushing myself to go each year. I didn’t want my condition to hold me back.

“I inherited osteoporosis from my mother. She’s had multiple compression fractures over the years and has also had back surgery,” Joyce continues. “I didn’t want to ever have to go through surgery. I decided I wanted to see if there were other treatments out there.

“I went online and did some research and discovered OsteoStrong®. I was intrigued by their concept. I put off going for years and finally decided to give them a try.”

Reversing Bone Loss

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.

“Osteoporosis is a silent disease that most people are unaware they have until they fracture a bone,” educates Mark Brady, president of OsteoStrong in South Pasadena. “It’s caused by bone loss. Statistically, one in two women and one in four men over age fifty will have an osteoporosis-related fracture in their lifetime.”

Mark says thanks to the groundbreaking technology provided through OsteoStrong, osteoporosis patients can reverse the harmful effects of the disease as a natural solution. He adds that OsteoStrong is an effective, natural solution for all age groups ranging from age 8 up to 97.

“We utilize a concept called osteogenic loading, which is a ten-minute, once-a-week, resistance-based session that increases bone density, prevents fractures, strengthens muscle tissue and improves balance.

“The machine we use applies pressure 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 over the long term.

“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. I’ve seen patients with their spines curved and who are hunched over regain the ability to stand up straight again. OsteoStrong has facilities nationwide, and has become popular as a natural treatment for osteoporosis.”

Balancing Act

Joyce says her strength and agility have improved drastically since her sessions began.

“I feel stronger and I can stand up straighter than ever before,” Joyce says. “I was able to balance on one foot after just two sessions. After the seventh session, I was able to stand on one foot, look forward and look up at the ceiling, all without falling over,” Joyce adds. “It has been truly amazing for me.”

Now, Joyce no longer has to worry about her trips to New York.

“I am confident that I can keep up with my friends and I won’t have to stop as often and sit down. I look forward to being able to walk for five or six miles around New York City with ease.

“Mark is very accommodating. He explains the equipment and keeps me updated on how I am progressing. He is in love with what he does. It’s written all over his face.

“I can’t tell you how thankful I am that OsteoStrong exists. It has given me new hope. I really feel like I can beat this!”

FHCN article by Judy Wade. Photo by Jordan Pysz.

Let the Blood Flow

Outpatient procedures performed in office-based vascular suite.

Working as a manager in an auto parts department keeps Thomas Krakowski on his feet most of the day.

Thomas Krakowski was treated for peripheral arterial disease in the new surgical suite at Vascular Interventional & Vein Associates.

Thomas easily walks up and down the stairs at work.

“I’m always walking around and carrying parts up and down stairs,” Thomas says. “It’s quite different from other jobs I have had that required a lot of desk work.”

About three years ago, Thomas noticed that his legs would hurt when he walked long distances. In recent months, the pain got worse and would occur much faster and within shorter walking distances.

“I started having this awful pain in my legs,” he describes, “when I was walking or going up and down steps. It was affecting me at work.”

Thomas consulted a vascular surgeon, who recommended an invasive surgical procedure to open up the restricted veins in his legs. The suggested surgery would require a two-week hospital stay, followed by two months of rehabilitation.

“That’s not what I wanted,” Thomas shares. “I didn’t want to miss that much work and be down and out for so long. That’s when I got a second opinion from Dr. Ramdev.”

Blocked Plumbing

Pranay T. Ramdev, MD, is a board-
certified vascular surgeon at Vascular Interventional & Vein Associates (VIVA). He diagnosed Thomas with peripheral arterial disease (PAD).

Peripheral arterial disease is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. Risk factors include smoking, diabetes, high cholesterol, high blood pressure, among others.

“This is not characterized by cramping at night when you are lying down,” Dr. Ramdev explains. “PAD symptoms only occur with activity, like walking. And the pain usually develops in the calves or thighs.”

In patients with PAD, the legs don’t receive enough blood flow to keep up with the demand, and this causes claudication, which was the case with Thomas.

“When claudication starts, people usually develop discomfort in their calves when walking,” explains Dr. Ramdev, “caused by blockages in the arteries. We test for claudication by checking for a pulse in the foot. When we can’t feel a pulse there, we know the ‘plumbing’ is blocked up. We use ultrasound to identify the exact areas of blockage in the circulation. We can then treat the problem without major surgery.”

Dr. Ramdev recommended an outpatient procedure for Thomas that involves placing stents in the iliac arteries – the arteries that run down both sides of the aortic valve. The iliac arteries provide blood flow to each leg. The stents were placed to open up those arteries and allow blood to flow properly.

Dr. Ramdev says he is pleased to have been able to perform Thomas’ procedure in his newly built, in-office vascular interventional suite. The suite is designed to provide patients with a comfortable, relaxed surgical atmosphere combined with the latest medical advancements.

“Instead of sending patients to a hospital for a procedure that required extended stays there, I chose to build a suite here in my office where I can perform minimally invasive, outpatient procedures in a day,” explains Dr. Ramdev. “It is much more convenient for the patient, who is then able to go home and begin their recovery that same day.”

Thomas Krakowski was treated for peripheral arterial disease in the new surgical suite at Vascular Interventional & Vein Associates.

Peripheral arterial disease diagram illustration

Doctor-Patient Connection

“In addition to providing patients with the latest technological advancements in arterial procedures, it is just as important to me that I connect with my patients,” emphasizes Dr. Ramdev. “I treat all my patients like family, because kindness and compassion are so important. You can have technical success with a procedure, but the patient’s experience is enhanced by the excellent care they receive.”

Dr. Ramdev goes out of his way to spend quality time with his patients, ensuring they have a thorough understanding of the disease process and the treatment options.

“I want people to feel they have full knowledge of what is going on inside their bodies,” Dr. Ramdev educates. “The more they know, the less daunting the process seems.”

Today, Thomas says he has no pain in either leg and can handle long days at the office and climbing those stairs once again.

“I’m getting the strength back in my legs now, and they feel much better than they have in a long time,” he says.

“I am really thankful I found Dr. Ramdev. He is great. He kept me from going and having major surgery that was really unnecessary in the first place. I feel he is honest and straightforward. I recommend him to anyone with leg vein issues.”

FHCN article by Judy Wade. Photo by Nerissa Johnson. Graphics from istockphoto.com.

Straighten Up and Smile

It’s never too late to have the smile you always wanted.

Ruby “Kaye” Miller was never quite content with her smile. While she’s been faithful over the years in maintaining preventative care appointments, her misaligned teeth bothered her and caused her to shy away from others.

Ruby “Kaye” Miller underwent Invisalign® to straighten her teeth by Dr. Stephen Blank of Port St. Lucie.

Kaye is thrilled with her smile.

“My bottom teeth began to push out of place over time,” Kaye explains. “That became a problem with chewing. I had a gap between the two top front teeth and I hated it. I wanted that closed up.”

A retired teacher from Miami-Dade County, Kaye stays busy filling in as a substitute at the local community college. At 81, Kaye says, she decided it wasn’t too late to straighten her smile.

“I’m always talking to students and other teachers, and I was tired of feeling uncomfortable about how my teeth looked to others,” she recalls. “I knew they were in good shape overall, but I wanted them to be straight. I wasn’t looking for a Hollywood smile; I just wanted to feel better about my smile.”

Kaye knew her dentist of 20 years, Stephen G. Blank, DDS, in Port St. Lucie could help.

“I’ve been his patient for a long time, and I trust him with my teeth,” Kaye relays. “I knew I didn’t want the traditional metal braces, so there had to be another option available.”

Before any treatment plan is put in place, all of Dr. Blank’s patients undergo in-depth testing and evaluations. The 1.5-hour exam includes a complete oral examination, including TMJ, bite and soft tissue evaluations; computerized periodontal measurements; digital x-rays; an intra-oral video tour that allows the patient to see what the dentist sees; oral hygiene fitness evaluation and more.

“It’s not your typical five-minute dental exam,” assures Dr. Blank. “The purpose is to build a good dental relationship for years to come that will allow patients to achieve the best oral health possible and, with proper care, maintain that level of health for a lifetime.”

Dr. Blank’s willingness to embrace the latest leading-edge technology is further indicative of his commitment to care and investment in each patient.

“We’re always learning and implementing the latest technologies and procedures to ensure our patients receive the best possible oral health,” he assures.

Finding the Solution

After a thorough evaluation and consultation with Dr. Blank, Kaye opted for Invisalign®, a system that works to straighten teeth over a period of months using a series of virtually invisible, removable plastic aligners.

“In Kaye’s case, we used Invisalign Express, which doesn’t take as long as the regular Invisalign,” Dr. Blank explains. “Kaye’s case was less complicated, so it involved just twenty weeks of aligners. In comparison, the traditional Invisalign treatment plan can take between twelve and eighteen months.”

Invisalign works in stages, and patients get a new set of customized aligners about every two weeks. Each set gradually moves the teeth to the specifications prescribed by the dentist.

“When we prescribe Invisalign, we treat the top and bottom because they fit together like the gears on a watch,” he explains. “If we need to make room for crowded bottom teeth, we need to move the upper teeth just a bit as well.

“With Kaye, she had the gap between her two upper front teeth that she wanted to eliminate. We were able to do that.”

Compared to other types of orthodontics, Invisalign doesn’t require metal or porcelain brackets, or wires, which can irritate lips and gums. The aligners are removable, so patients can continue to eat their favorite foods and practice proper oral hygiene and are virtually invisible.

“Patients love Invisalign because they can take the aligners out when they eat, and when they brush and floss. It’s much easier to perform those everyday tasks than with traditional braces,” Dr. Blank says.

Ruby “Kaye” Miller underwent Invisalign® to straighten her teeth by Dr. Stephen Blank of Port St. Lucie.

Invisalign does not require brackets and is virtually invisible.

Working in Harmony

Dr. Blank stresses that though many cosmetic dental procedures help patients’ smiles look better. Invisalign is also instrumental in improving function and preventing further dental damage.

Left untreated, misaligned teeth can lead to long-term dental damage. “When teeth are rotated, they bump into each other differently than they would if they were properly aligned,” explains
Dr. Blank. “People don’t notice it because it’s their bite. It’s what they have always had, and they are used to it.

“When we’re able to make the teeth fit together properly, then functionally they don’t cause each other to wear out. They work in harmony instead of in conflict with one another.”

Treatment with Invisalign is appropriate for patients of all ages, from teenagers to octogenarians, emphasizes Dr. Blank. “There’s no age restriction on doing Invisalign,” he says. “The only caveat is that the patient has healthy bone structure and a good overall dental foundation that supports tooth movement. In this particular case, Kaye was a perfect candidate.”

Kaye says she is thrilled with the care she has received at Dr. Blank’s office in the two decades since she first started going to his practice. She says perfecting her smile was on her bucket list, and she’s glad she was able to achieve it with Dr. Blank’s help.

“Dr. Blank and his staff are caring and compassionate, and I really love them,” she says. “They make you feel good about going to the dentist.

“I am really happy with my smile now,” she adds. “I have more confidence, I can chew much easier and it looks great!”

FHCN article by Judy Wade. Photo by Nerissa Johnson. Graphic from istockphoto.com.
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