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Picture Perfect

Advanced technology leads to successful treatment of vision, eye disorders.

Much like a camera, the eye uses a lens to focus on images. When a camera’s lens becomes cloudy, it cannot take clear pictures. The same is true of the eye, which can naturally become cloudy as people age. This natural clouding of the eye’s lens, known as a cataract, affects more than half of Americans by age 80.

Photo by Michelle Brooks.

Dilip “Dr. Samy” Rathinasamy, MD and Ana-Maria Oliva, MD

The only way to treat cataracts is by surgically removing the affected natural lens and replacing it with a clear, synthetic intraocular lens, or IOL. To achieve the best possible outcomes for their patients, the cataract surgeons at Florida Eye Specialists & Cataract Institute employ the most advanced surgical technologies.

An example is the LENSAR® Laser System. LENSAR is on the leading edge of femtosecond laser technology. Its added functions and precise laser incisions enable surgeons to remove cataracts with increased safety and position IOLs with greater accuracy. These innovations lead to better vision following surgery.

“I have performed thousands of cataract surgeries during my career, and I must say, the LENSAR technology is one of the most exciting innovations I’ve seen,” asserts Gregory L. Henderson, MD, who founded Florida Eye Specialists & Cataracts Institute in 1981.

Photo by Fred Bellet.

Gregory L. Henderson, MD

“The LENSAR Laser System replaces the blades and instrumentation of the past with an advanced femtosecond laser. Even the most experienced surgeon’s hand cannot match the precision and gentle touch of the LENSAR system.”

The LENSAR automates certain aspects of cataract surgery that were traditionally done by hand. The surgery is more efficient, more effective and safer.

“The laser makes the initial incision into the eye,” Dilip “Dr. Samy” Rathinasamy, MD, says. “It can also create the capsulotomy, which is an opening into the thin, fragile membrane that holds the cataract. And it does so with exceptional precision.

“A capsulotomy done by hand can be less than perfect. The importance of having a perfect capsulotomy is that the replacement lens can then sit in a more optimal position, which ultimately gives the patient better vision.”

Three in One

Another example of advanced technology used by the cataract surgeons at Florida Eye Specialists & Cataract Institute is the PanOptix® trifocal lens by Alcon.

“The PanOptix trifocal intraocular lens became available in the United States in late 2019, and it is the only trifocal lens approved for use in the US,” Priya M. Mathews, MD, describes. “It has quickly become a popular lens choice because it virtually eliminates the need for glasses following cataract surgery.

Photo by Jordan Pysz.

Priya M. Mathews, MD

“People today have more active lifestyles and use their computers and smartphones with greater frequency. They want to be able to see at all distances following cataract surgery, and they do not want the hassle of glasses.”

“The PanOptix trifocal lens gives people that luxury because it gives them near, intermediate and distance vision, eliminating the need for spectacles,” Dr. Samy adds. “The PanOptix uses different locations on the lens, called the optic, to enable clear vision at these three different focal points.”

Nontraditional Transplant

The eye’s cornea is made up of five layers, and during a traditional cornea transplant, the entire cornea is removed and replaced with donor tissue. With the newer surgical techniques performed at Florida Eye Specialists & Cataract Institute, surgeons can select the diseased layer of the cornea and replace only that layer.

“One technique is called DMEK, which is an acronym for Descemet membrane endothelial keratoplasty,” Dr. Mathews explains. “During DMEK, the surgeon removes and replaces a very thin layer of the cornea. In this case, it is two layers, the Descemet membrane, the basement membrane that lies deep in the cornea, and the endothelium.

“Techniques such as DMEK, which transplant only a portion of the cornea, provide patients with much better vision than can be achieved by replacing the entire cornea. And because the patient is keeping most of their own cornea and only receiving a small piece of donor tissue, there is less chance for rejection.”

Dr. Mathews also performs keratoprosthesis surgery, which is the replacement of the entire cornea with an artificial cornea. This may be an option for patients who are not suitable candidates for fresh
tissue transplant.

Seeing Is Believing

The eyes are one of the first things people notice when meeting someone and can say a lot about that person.

“When we first meet someone and initially make eye contact with them, we immediately begin to form our first impression of that person,” asserts Craig E. Munger, MD, PhD, an oculoplastic surgeon. “We judge that person to be tired, sad, angry or pleasant based on the appearance of the area around their eyes.”

Photo by Jordan Pysz.

Craig E. Munger, MD, PhD

Puffy or drooping eyelids can make people look old, tired or even mean. When their patients have sagging eyelids, Dr. Munger and colleague Robert J. Applebaum, MD, often recommend blepharoplasty, a safe, effective and cosmetically appealing procedure also known as eyelid surgery.

Blepharoplasty is a surgical procedure that involves removing excess eyelid tissue. It can be done on the upper and lower eyelids, and can make a dramatic difference in the appearance of the face.

“With upper blepharoplasty, excess skin is removed from the upper eyelids, which can drop due to muscle weakness,” Dr. Applebaum describes. “The repairs we perform help functionally because the excess tissue can get in the way of vision and endanger the patient. It can also cause headaches and other problems.

“I also perform blepharoplasties for cosmetic purposes, when people are unhappy with the appearance of their lids. These surgeries can significantly improve the look of their eyes.” The lower lids can project a poor first impression as well.

“Most of us are born with five bags of fat around the eye to protect it and hold it in the socket,” Dr. Munger notes. “With aging, however, that fat can come forward and manifest itself as puffiness under the eye. Lower blepharoplasty can diminish the look of tiredness and aging by decreasing excess fat and skin beneath the eyes.”

Dr. Applebaum and Dr. Munger also offer a variety of nonsurgical facial cosmetic services. These include BOTOX® Cosmetic injections, a variety of facial fillers and intense pulsed light, or IPL. These options can help reverse the changes associated with aging.

Photo by Jordan Pysz.

Dr. Applebaum evaluates a patient at Florida Eye Specialists & Cataract Institute.

Lashing Out

A common condition treated at Florida Eye Specialists & Cataract Institute is blepharitis, an infection of the eyelids and eyelashes. Blepharitis commonly occurs simultaneously with dry eye. If left untreated, these conditions can lead to permanent eyelid and tear gland dysfunction as well as corneal damage.

“Blepharitis is most commonly caused by an overgrowth of bacteria that live along the margins of the eyelids and at the base of the lashes,” L. Ray Alonzo, OD, reports. “Not only do these bacteria cause the symptoms of blepharitis, they also produce the substances that inflame the oil glands in the eyes, causing dry eyes.

“Blepharitis should be taken seriously because of its link to dry eyes and because it can lead to complications. These include lashes falling out, lashes growing in the wrong direction because the base of the lash gets scarred, and lashes growing inward toward the eye and damaging the cornea.”

Photo by Jordan Pysz.

L. Ray Alonzo, OD

The complications associated with blepharitis and dry eye can be treated and possibly prevented if eyelid hygiene is properly undertaken. For years, hygiene options included cleaning the lids with diluted baby shampoo or eye scrub pads. Now, there’s also the BlephEx®. The BlephEx is a handheld machine with a medical-grade micro sponge that gently spins to scrub and massage the eyelid margins, cleaning and exfoliating the eyelids and lashes, and relieving symptoms.

“The BlephEx removes all the debris around the base of the eyelashes and helps keep the lids cleaner,” Pauline Thai, OD, confirms. “That takes away the food for the bacteria causing the redness and inflammation around the eyelids that occur with blepharitis and dry eye.

“We do a one-minute cleaning of the lid margins in one direction, then press a button and the machine spins in the opposite direction. We go back over the lids, and the sponge removes everything that was loosened on the first pass. I’ve seen really great improvement in blepharitis and dry eye using the BlephEx.”

Pressure Cooker

Glaucoma, the second leading cause of blindness in the country, is the degeneration of optic nerve fibers that are sending signals to the brain, enabling vision to occur. Glaucoma has been associated with abnormal eye pressure due to elevated intraocular fluid pressure (IOP). This increased pressure damages the optic nerve fibers.

“Glaucoma can occur at any age,” William A. Reeves, MD, observes, “but the risk increases with age. Unlike cataracts, the vision loss from glaucoma cannot usually be restored. Consequently, early detection and management of this disease is important to try to prevent progression of vision loss.”

Many people are affected by glaucoma, and some are unaware the condition is there.

Photo by Jordan Pysz.

Ignatius C. Cyriac, MD

“It is estimated that about 4 million people have glaucoma, half of whom don’t even know they have it,” Ignatius C. Cyriac, MD, asserts. “That is why early detection is so important.

“There is not a cure for glaucoma yet, which is another reason early detection is so critical. Once we diagnose glaucoma, we can control it, and the earlier we catch it, the easier it is to control.”

“When we diagnose glaucoma early, patients may never have a problem with their vision,” Dr. Reeves says. “What we are trying to do is prevent them from ever developing one, so our treatments are really geared toward reducing pressure within the eye. This reduction in pressure has proven to slow down or halt the progression of glaucoma.”

“The latest in the treatment of glaucoma is microinvasive glaucoma surgery, or MIGS,” Ana-Maria Oliva, MD, points out. “That is a procedure we are actually able to perform during cataract surgery. Twenty percent of the population that has cataract surgery also has mild to moderate glaucoma.”

MIGS is done while the patient is already in the operating suite and prepped for surgery. It is performed immediately following the cataract surgery, after the replacement lens is implanted, and takes less than five minutes to complete.

“A new device used during MIGS is called the iStent inject®,” Dr. Oliva describes. “The iStent inject is used in adults with mild to moderate open-angle glaucoma as well as cataract patients currently using glaucoma medication. The iStent inject creates new pathways in the drainage system for better fluid flow out of the eye.”

Retinal Restraints

The two most common disorders of the retina are diabetic retinopathy and macular degeneration, two leading causes of blindness in adults. Marguerite Kohlhepp, MD, has expertise in
treating retinal diseases.

“Diabetic retinopathy is the most common eye disease associated with diabetes and is caused by changes in the blood vessels of the retina,” Dr. Kohlhepp states. “In some cases, abnormal blood vessels develop on the surface of the retina. In others, blood vessels begin to bleed or leak fluid.

“Diabetic retinopathy generally has no symptoms in its early stages, so screening and early diagnosis are of incredible importance. We have treatments that will overturn poor visual outcomes, but they require early detection.”

Macular degeneration is another serious threat to sight that can occur as people age. It is a disease in which the main images in vision become less discernible.

“Think of the retina as being 10 layers thick with many blood vessels nourishing it,” Dan P. Montzka, MD, elaborates. “Macular degeneration is a disease in which some of those layers essentially become diseased and waste away. As a consequence, some of the blood vessels pop and leak.

“The first situation, where the layers waste away, is what we consider dry macular degeneration. When blood vessels start popping and leaking, that’s what’s called wet macular degeneration. This type does considerable damage that translates into poor vision.”

Diabetic retinopathy and macular degeneration are examples of medical retinal disorders.

“Of the surgical disorders, some of the more common are retinal tears and retinal detachments,” Nandesh Patel, MD, reports. “Then there are other disorders called macular pucker and macular hole.

“Macular pucker and macular hole are not as catastrophic as retinal detachment or vitreous hemorrhage, where there’s complete loss of vision that evolves very quickly, sometimes within hours or days. Macular pucker and macular hole are conditions that come on somewhat slowly and involve a disruption in the normal architecture of the macula.”

Dr. Patel suspects a retinal tear when patients report flashing lights or floaters, which are common complaints. Flashing lights and floaters can be due to normal changes of the eye, but one of five who present with those symptoms will likely have a retinal tear.

“A retinal tear is an unwanted consequence of a normal, age-related process where the vitreous gel between the lens and retina is liquefied, but that process is complicated by the vitreous inadvertently pulling at the retina,” he describes. “That’s how a retinal tear is formed.”

Kid Stuff

FHCN file photo.

Ronni Chen, MD

Ronni Chen, MD, a pediatric ophthalmologist, sees patients at the Brandon clinic on a part-time basis. She treats all the eye conditions that are commonplace during childhood and adolescence. Often, her patients are children who have failed screening exams by their physicians or schools.

“Three eye disorders that I treat that can be corrected easily with eyeglasses are myopia, hyperopia and astigmatism,” Dr. Chen relates. “These are all refractive errors – vision problems caused by the eye’s inability to properly focus light on the retina to form clear images.

“Myopia is also known as nearsightedness, and hyperopia as farsightedness. Astigmatism is an irregularity that forms in the corneal tissue, causing part of the cornea to be steeper along one axis than another.”

Weathering Dry Eyes

Retired hurricane hunter can see clearly after combination therapy.

Once a hurricane warning is issued, most Floridians secure their homes and brace for the high winds and torrential downpours that accompany the tempest. Not James Roles. He made his living defying the alarms and flying directly into the eye of the storm.

Photo courtesy of James Roles.

James Roles

Before retiring in January, James worked for 30 years as an electronics engineer for the National Oceanic and Atmospheric Administration, which operates a fleet of “hurricane hunter” aircraft for research and surveillance.

“My primary job was to manage the scientific instrumentation on the aircraft,” James describes. “There was radar; temperature, pressure and humidity sensors; as well as many prototype instruments.

“In addition, I served as a crewmember aboard the plane to operate the equipment during the flights. For the last 10 years of my career, I worked as a manager and didn’t fly as much. But for the first 20 years, I flew through most of the major hurricanes, including Gilbert, Hugo and Katrina.

“We didn’t count the number of hurricanes we flew through, but we did count the times we flew through the eye of a hurricane. I did that more than 250 times.”

Despite the dangerous nature of his work, James says his job rarely scared him. In fact, he can remember only one instance when he became truly frightened, in 1989.

“The scariest moment came during Hurricane Hugo,” he remembers. “Another plane that was flying at the same time as mine started having problems, and we almost lost it. I knew everybody on that plane so it was a pretty scary day.”

James took his perilous job in stride but grew uneasy last year when his eyes became so dry and irritated that he stopped wearing his contact lenses. James reports that his eyes have always been a little dry, a problem that got substantially worse five years ago. When it got so that he couldn’t wear his contacts, he broke down and consulted his doctor.

“The dryness seemed even worse at night,” James recalls. “Every hour or so, I had to put drops in my eyes, otherwise the dryness would wake me up. When it was really bad, I was getting up four or five times a night. And when I woke up, my eyes were irritated.

“My dry eye was worse at certain times of the year as well due to allergies. I worried that my eyes could be damaged if they stayed this dry for a long period of time.

“I talked to my doctor about my dry eye, and he recommended I visit an ophthalmologist. I did some research on eye doctors in the area and chose Brandon Eye Associates.”
That’s where he met Haroon Ilyas, MD, a board-certified, fellowship-trained eye surgeon.

“James came to us suffering from significant discomfort and fatigue in both eyes due to dry eye disease,” Dr. Ilyas recalls. “He tried over-the-counter drops to help with the discomfort and the blurriness in his vision, but they were unsuccessful. He came to us for alternative treatments, and I recommended a combination of therapies.”

Maintain Moisture

Dry eye disease is a common condition affecting 30 million to 40 million Americans, Dr. Ilyas reports. It is an inflammatory disorder where there is not enough moisture on the surface of the eyes to maintain comfort and provide for visual needs.

Symptoms of dry eye include burning, stinging and dryness. Some people with dry eye feel eye fatigue, especially toward the afternoon and evening hours. Blurred vision and fluctuating vision are common symptoms as well.

It is not uncommon for people with dry eye to have a condition called blepharitis, which can contribute to dry eye development. Blepharitis is a chronic infection and inflammation of the eyelids and lashes. James had significant blepharitis on his eyelids.

“In our office, we have several treatments for dry eye,” Dr. Ilyas notes. “One of them is the BlephEx®.

This is a small machine that thoroughly cleanses the eyelids and lashes to reduce the bacterial load that leads to the chronic infection of blepharitis.”

The second treatment is called MiBo. This uses a probe that delivers thermal pulsations to the eyelids to help the glands there secrete the oils they produce. This oil helps maintain a lasting tear film on the surface of the eye, keeping it moist.

“My eyes are definitely less dry than they were when I started treatment at Brandon Eye Associates. I definitely think my eyes are in better health.” – James

“The third treatment we have is called intense pulsed light, or IPL,” Dr. Ilyas explains. “This has been used by dermatologists for years, but ophthalmologists have found it useful to treat Meibomian gland disease along the lids and lashes. Meibomian gland disease contributes to dry eye by blocking the production of essential oils.

“IPL delivers light pulsations to the Meibomian glands so they create more of their natural oils and release them onto the surface of the eye.”

Since dry eye is an inflammatory disease, it can also be treated medically. Dr. Ilyas often uses anti-inflammatory eyedrops to calm the eyes’ immune cells. Examples of these medications include RESTASIS®, XIIDRA® and CEQUA™. LOTEMAX® is a another anti-inflammatory medication that is also a steroid.

“Punctal plugs are another treatment for dry eye that we often use,” Dr. Ilyas points out. “These are little plugs placed in the tear ducts to retain more moisture on the surface of the eye.”

“Definitely Less Dry”

As part of his combined treatment, James underwent three IPL treatments last summer.

“Dr. Ilyas also prescribed RESTASIS and LOTEMAX eye drops,” James explains. “He did a cleaning process on my eyelids and gave me a cleansing regimen to follow at home.
“I still use LOTEMAX, but only when I wear my contacts, which I don’t do much anymore. I plan to undergo three more IPL treatments this summer, and Dr. Ilyas will perform another assessment of my eyes after that.”

The therapies offered through Brandon Eye Associates significantly improve dry eye symptoms, but there is no cure for the inflammatory disease. Ongoing follow-up and treatment are typically necessary to maintain eye comfort and clear vision.

“My eyes are definitely less dry than they were when I started treatment at Brandon Eye Associates,” James relates. “For one thing, I wake up less at night to put drops in my eyes – maybe once a night compared to four or five times. And I definitely think my eyes are in better health.

“The treatment certainly helped, but it’s not a magic cure. Dry eye is something I’ll have to deal with for the rest of my life. But I think that if I hadn’t gotten treatment, it would eventually cause damage to my eyes.

“Dr. Ilyas is a very nice and knowledgeable doctor. Everyone at Brandon Eye Associates is nice, and it’s a big place with lots of people. When I went back for a follow-up visit after the reopening after COVID-19, the staff handled the situation very well and I felt safe.

“I recommend Dr. Ilyas and Brandon Eye Associates. The practice is very good. They have professionals that cover almost every aspect of the eyes. Dr. Ilyas is the only doctor I’ve seen, but he is very good. I’m very happy with his work.”

Extra! Extra! Read All About It

July 5th, 2020

Most of the news we’ve been reading about COVID-19 lately seems to be bad news: New cases are spiking across the country. Hospital ICUs are filling to capacity with seriously ill patients. And experts are warning of escalating infection rates in the coming months.

But if you look a little closer, you can find some tidbits of good news as well. Here’s one story I came across recently that gave me hope. On July 1, the pharmaceutical giant Pfizer and its partner the German biotech company BioNTech announced that its experimental COVID-19 vaccine has shown promising results in early testing.

The initial clinical data from the study revealed that volunteers who took low or medium doses of the vaccine in two injections about a month apart developed immune responses to the virus in the range expected to be protective.1 In fact, their immune defenses were stronger than those of the average recovered COVID-19 patient.

The study involved 45 healthy volunteers. Twelve received a 10 microgram dose of the vaccine, 12 received a 30 microgram dose, 12 received 100 micrograms and nine received a placebo. The main side effects were fever and injection site soreness. The 100 microgram dose caused fevers in half of patients receiving it, so a second dose was not given to those patients.

Pfizer’s experimental vaccine generated antibodies against SARS-CoV-2, the virus that causes COVID-19, and some of those antibodies were neutralizing. That means these antibodies may prevent the virus from functioning.

The level of neutralizing antibodies in the study volunteers were 1.8 to 2.8 times that found in recovered COVID-19 patients, but researchers aren’t sure yet if higher antibody levels lead to virus immunity. Pfizer is planning large-scale studies to prove that people getting their vaccine are 50 percent less like to become infected. Those studies are set to begin this summer.

For its vaccine, Pfizer used specific genetic material called messenger RNA, or mRNA. This mRNA contains directions for making a certain protein used by the virus to invade human cells. The mRNA is taken up by the body’s cells, which then follow the directions and make the protein. The body’s immune system recognizes the protein as foreign and make antibodies to disable it if the virus tries to invade.

The vaccine in this study is one of four candidate vaccines being developed by Pfizer. The company reported that additional information from this particular trial will help it to pick a leading candidate and dose level for a much larger study. Based on the initial trial results, BioNTech and Pfizer hope to progress to a larger US trial involving 30,000 participants.

Pfizer notes that if its vaccine proves safe and effective, and is approved, it expects to make up to 100 million dose by the end of 2020 and “potentially more than 1.2 billion doses by the end of 2021.”

The good news is there. But you might have to look beyond the front page.

The Right Care, Right Now

Emergency dentistry addresses the problem as well as the pain.

Norman Jewett recommends services and facilities in his community to people temporarily living in the area. His work is part of a concierge service he owns and operates that caters to out-of-towners who are in Sarasota for the season or on vacation.

Photo by Jordan Pysz.

With his abscess healed, Norman can eat without pain.

Norman’s service finds hotels and restaurants for clients, locates area health care providers and makes arrangements for activities, including procuring tee times for golfers and boat rentals for those wishing to spend a day on the water.

In early April 2016, Norman needed his own service. He found himself in a situation that required finding a local dentist who handles emergencies. He immediately thought of Alexander Gaukhman, DMD, of Siesta Dental.

“I woke up one morning and the top of my mouth on the upper right side was hurting so bad I really couldn’t get out of bed,” Norman describes. “The pain was to the point where I couldn’t eat, drink or do anything. The pain was going all the way down my mouth and into my jaw.”

Norman was not a patient of Dr. Gaukhman at the time, but he had referred several clients to Siesta Dental and in return received rave reviews about the care they received.

“Being a concierge, I went over and talked to the folks at Siesta Dental when they first came into the neighborhood,” Norman remembers. “Since then, I had sent several people to them, and they all told me how good and polite they were.

“I knew they had emergency services and that you could pretty much call them anytime. So I called Siesta Dental, and they got me in that same day.”

Getting in on the same day was impressive enough, but how the dentist and staff treated Norman amazed him even more. He says that despite being a newcomer to the practice, he was made to feel like family.

“They didn’t know me, but they said, Okay, come in,” he relates. “They took care of me like they knew me, like I was their best friend.”

Dr. Gaukhman determined that the cause of Norman’s pain was an abscess, a bacterial infection of the tooth that can begin in the root or the space between the gums and tooth.

Though it is generally accompanied by pain and swelling, an abscess often requires extraction of the affected tooth, which is what was required of Norman’s abscessed tooth.

“Dr. Gaukhman did a really nice job of pulling the tooth,” Norman says. “He also cut out some of the soft tissue underlying the tooth. That was to keep the infection from spreading down into my heart or into my blood, where it could get down into the new hips I recently had replaced and infect those. They took good care of me.”

Pain Tells a Story

Emergency dental problems don’t always crop up on weekdays between 9 a.m. and 5 p.m. the way Norman’s did. When they don’t, patients need a dental practice that offers emergency services to diagnose and treat their condition appropriately and effectively. Siesta Dental is committed to treating those patients as well.

“The most common emergencies we see are extreme tooth pain caused by abscesses, broken teeth and mouth trauma from accidents,” Dr. Gaukhman observes. “These are situations that need to be treated immediately. We also see lost fillings and broken dentures, bridges and crowns. These also require care as soon as possible.

“It is important that these patients are seen quickly so we can relieve their pain and get their dental issue resolved. I, or one of my associates at Siesta Dental, is available 24 hours a day whenever a patient calls with an emergency. We can schedule an appointment for them the same day or first thing the next day. We also see patients after hours and on weekends in one of our three locations in Sarasota, Venice and Osprey.”

“Going to Siesta Dental was a very good experience, an absolute 10 out of 10. They made me feel comfortable in every way, shape and form.” -Norman

Not all dental emergencies involve pain, but tooth or mouth pain is often a good indicator that something needs attention. When tooth pain is sudden and excruciating, it can be related to a serious infection that can damage the tooth to the point that it fails and requires extraction.

“Some people will get an infection but let it go until it becomes an abscess, and then the damage is done,” Dr. Gaukhman explains. “Often, the tooth cannot be saved and has to be removed. In these situations, we give the patients all the information about what to do and what not to do after the extraction so that they heal without complications.

“This post-extraction information includes how to take care of the extraction site and their mouth as a whole to keep them healthy. We take very good care of our patients who come in with emergency needs. Many of them, like Norman, refer others to us because of the excellent treatment they received here.”

Dr. Gaukhman points out that if emergency dental services aren’t available, patients are basically left with one option.

“Patients with tooth pain and no access to an emergency dentist generally have to suffer,” he says. “They could go to the emergency room, where they will likely be prescribed antibiotics and pain medication, but they will not have their real dental problem addressed until they can make an appointment with their dentist during regular business hours.”
The dentist adds that Siesta Dental’s services go above and beyond in other ways.

“As part of our services, we can create or repair dentures on the premises in one day.”

A 10 Out Of 10

Luckily for Norman, there was an emergency dentist available when he needed one, and he was extremely pleased with the services he received. The dentist’s efforts relieved Norman’s pain and allowed him to put his life back in order.

“Dr. Gaukhman numbed the area a little and then he was very careful with the extraction,” Norman remarks. “When he was done, he stitched it up. The day after, it was sore, but since then it’s been absolutely perfect. I’ve had no problem at all.”

Being a concierge, it’s important for Norman to make sure the services he recommends are top-notch. After being treated by Dr. Gaukhman, Norman knows when he suggests Siesta Dental, he’s referring clients to one of the area’s top dental providers.

“Going to Siesta Dental was a very good experience, an absolute 10 out of 10,” he states. “They made me feel comfortable in every way, shape and form. The staff was smiling and upbeat, and they were all laughing and joking.

“And when Dr. Gaukhman came in, even he was laughing and smiling. They really treated me well. I would highly, highly recommend Siesta Dental.”

Coming from someone who makes recommendations for a living, that says a mouthful.

Tiny Cut, Huge Relief

Removal of herniated disc alleviates stenosis, ends leg pain.

David Davis, 53, has been a deputy with the Hillsborough County Sheriff’s Office for 33 years.

Photo by Jordan Pysz.

David Davis

“Most of what I do is administrative,” David says. “When people are released from jail, I process their paperwork and complete the physical process of releasing them from our custody. I love the work because I’m a people person, and I enjoy dealing with people. It’s my favorite part of law enforcement.”

There was a point when David considered working in the field, but he realized how happy he was with his inside role and opted to stay put.

“Fifteen years ago, when I was a little younger, I thought about changing jobs and going out on the road,” he recounts. “But I decided to remain where I was because I love what I do. Besides, those guys on the road have jobs that are a lot harder than mine.

“I’ll be retiring soon, and during my retirement, I plan to sit back and enjoy life, even though my wife says she’s going to find things for me to do. We’re going to do some traveling, and we have a 4-year-old granddaughter I want to spend more time with. I may join my wife’s gym, but mainly I intend to ride my bike around the neighborhood a lot.”

For most of 2019, David couldn’t even think about riding his bike. That was after he injured his back lifting a fire pit while working on his patio last April. The resulting pain was so excruciating and disabling that David required hospitalization to regain his mobility.

“I didn’t lift the proper way,” David explains. “I just bent over, picked up the fire pit, and boom, my back went out and I couldn’t move. I had to spend the night in the hospital. They told me that I had a herniated disc and my spine was narrowing, which they called spinal stenosis. They said that happens as people get older.

“The doctor gave me pain medication, and within a couple of weeks, the back pain was gone. But a sharp pain in my left leg above my knee continued. The pain medication didn’t help the leg pain at all.

“I visited several specialists, and all of them sent me for physical therapy. They said they had no idea why I was having leg pain. I should be having back pain. But I kept telling them, No, the pain is in my leg. From April to September, I suffered daily with intense leg pain. It was a nine on a scale of one to 10.

“Finally, I told my primary care provider that I couldn’t take the pain anymore. There must be somebody who could help me. He recommended Dr. Panchal at the National Institute of Spine and Pain.

“I’d recommend Dr. Panchal in a heartbeat.” – David

“I first went to see him in October, and when he looked at my x-rays he told me why I was in pain, which is something no one else was able to do. He explained how my herniated disc was sitting on a nerve and that was causing my leg pain.”

Sunil J. Panchal, MD, is a board-certified interventional pain specialist. He is the president and medical director of National Institute of Spine and Pain, which has offices in Lutz and Tampa.
“David previously injured his back and had pain radiating to the front of his left thigh,” Dr. Panchal reports. “He was treated with physical therapy, home exercises and opioid pain medications prior to visiting me.Graphic from iStockPhoto.com.

“Upon evaluation, I determined that the disc herniation in David’s lower back was compressing a nerve and contributing to his stenosis, which was causing his leg pain. To give him immediate relief, I performed epidural steroid injections, but their relief was short-lived.

“I gave David several options for fixing the problem and he ultimately chose to undergo a discectomy to remove the herniated disc material. I performed the procedure endoscopically.”

Precision Through Tubes

Endoscopic discectomy is performed through an incision that is less than a centimeter wide. A fiberoptic camera and the surgical instruments are introduced into the body through a tube inserted into the incision. The procedure is less invasive than open surgery, which involves incisions that are several inches wide.

“The first thing I do when performing endoscopic discectomy is identify the damaged disc and the easiest pathway to it using fluoroscopy,” Dr. Panchal describes. “I then inject an introducer needle, and through that, I insert a guidewire. Once the guidewire is in place, I remove the needle and make a small incision in the skin.

“Through that incision, I place a tube over the guidewire to dilate and stretch the tissue, then I place a second tube to further dilate the tissue. That tube serves as the working channel. In that tube, I insert fluid tubing to maintain saline flow, which creates pressure to minimize bleeding and wash away blood, providing a clear view through the camera.”

Through the working tube, Dr. Panchal also places the fiberoptic camera and the surgical instruments, which are long and thin. Using these instruments, Dr. Panchal can shave bone or grab herniated disc material and create space around the spinal nerves that are being compressed and causing pain.

Photo by Jordan Pysz.

Since undergoing an endoscopic discectomy, David has been pain-free.

“There are multiple factors that contribute to reduced space around the nerves that are exiting the spine through openings called foramen,” Dr. Panchal explains. “When a disc bulges, its material seeps into the disc space and takes up room. Arthritic changes may cause bone overgrowth, which also takes up space and contributes to foraminal narrowing and nerve compression.”

“Absolutely Zero Pain”

Dr. Panchal performed David’s surgery on December 16. David reports that he experienced almost immediate pain relief from the endoscopic discectomy and that he has been pain-free since.

“The day of the procedure I was a little groggy, and the next day, there was a little discomfort, but not pain,” David remembers. “After that, I felt much better.

“I was only out of commission for a couple of days, but I was able to enjoy the holidays, and we had a great Christmas. I felt absolutely zero pain.

“I’d recommend Dr. Panchal in a heartbeat, and I’d leave it up to him to determine if endoscopic discectomy is your best treatment option.”

Blessing for the Eyes

Astigmatic patient is glasses-free following cataract surgery.

Influenced by her teachers at school, Dolores Wehle was only 7 years old when she discovered what she wanted to do with her life.

Photo by Jordan Pysz.

Dolores sees colors more vividly following cataract surgery.

“I knew I wanted to be a nun,” Dolores shares. “The sisters who taught me at school made an impression on me. I felt something calling me to be just like them, and as I grew, the call grew.”

A Tampa native, Dolores was still a teen when she answered that calling, joining a convent out of high school. She went on to serve chiefly as a primary school teacher in Florida. Now retired at age 79, she will soon celebrate her 60th anniversary with the Sisters of the Holy Names of Jesus and Mary.

Though satisfying, her calling also presented some challenges.

“When I entered the novitiate, it was the first time I left Florida and the first time I was far away from my family,” remembers Dolores, who lives with five fellow sisters at a senior living community. “It was challenging, but God gave me the grace to do what I needed to do, and I persevered.

“My first mission in Florida was in Opa-Locka near Miami. From there, I went to Key West and was a teacher and principal for many years. I also taught in St. Petersburg, Pinellas Park, Tampa and Port Charlotte. I served for a while in leadership positions within my community in Albany, New York, and in Canada, so it’s been a very interesting 60 years.”

When Dolores was 30, she realized she needed eyeglasses to see clearly at a distance. She was dependent on those glasses for years, and as she grew older, her eye doctor warned her of another issue with her eyes.

“Over the years, whenever I went for eye exams, my doctor would say, You have cataracts growing,” Dolores relates. “My main problem was that the lights at night made it difficult to drive, so I didn’t drive a whole lot at night.

“I hated the thought of cataracts growing in my eyes because I heard that you have to be awake and keep your eyes open during cataract surgery.”

After Dolores moved to the senior living community, an eye doctor was invited to talk to the residents, and she went to hear him. Afterward, she asked questions about cataracts, then made an appointment to visit him.

That speaker was Craig E. Berger, MD, a board-certified, fellowship-trained ophthalmic surgeon at Bay Area Eye Institute in Tampa. In addition to his practice, Dr. Berger was an adjunct assistant professor of ophthalmology at University of South Florida Eye Institute for 15 years. With these two positions, he developed extensive expertise in cataracts and cataract surgery.

Protein Problem

“Cataracts result from protein buildup in the lens of the eye, which prevents light from passing through and makes the vision look cloudy,” Dr. Berger describes. “Symptoms include cloudy or foggy vision, glare, difficulty seeing at night, loss of color intensity and double vision.”

A common problem, cataracts typically are related to aging. Other factors, such as diabetes, sun exposure, smoking and family history, can cause the condition to develop at a younger age.

“Typically, cataracts become a problem later in life, but they actually start around the age of 40 and progress at different rates in different people,” Dr. Berger informs. “For this reason, they can occur in younger people as well.”

Toric lenses correct astigmatism and help patients become independent of glasses following cataract surgery.

Surgery to remove cataracts is generally done on an outpatient basis and involves the surgical removal of the affected lens and its replacement with a synthetic intraocular lens, or IOL.

Before he recommended a replacement IOL for Dolores, Dr. Berger met with her and described the advantages and disadvantages of different lens options. The doctor also reviewed Dolores’ lifestyle and activities to find the best lens match.

“I always consider the patient’s activities, hobbies, the type of work they do and their visual requirements before I recommend a specific lens,” Dr. Berger acknowledges. “Then I do a complete eye exam. I look at the patient’s tear film, the retina, the cornea and the optic nerve. I also look for astigmatism, which is an imperfection in the curvature of the cornea that affects how light reflects onto the retina.

“I recommend implants based on all of that information, and I encourage patients to take the time to gain a clear understanding of the benefits of each of the different intraocular lenses before making a choice. It is important to note that no one lens is ideal for everyone. Lenses come in many sizes, with a variety of features and benefits.”

In addition to cataracts, Dolores also had significant astigmatism in both eyes, the doctor says. For that reason, he recommended toric IOLs. Toric lenses correct astigmatism and help patients become independent of glasses following cataract surgery.

“Wonderful Work”

Dr. Berger performed cataract surgery on Dolores’ left eye in November and on her right eye in mid-January. In each case, he replaced Dolores’ natural clouded lenses with toric IOLs. Dolores now needs glasses only for reading.

“Prior to the first surgery, I was nervous, but Dr. Berger and his staff were very encouraging,” Dolores says. “There was even somebody by my side to hold my hand during surgery, so it wasn’t as bad as I thought. I was really surprised.

“In December, Dr. Berger said, Are you ready to do the other eye? Once again, Dr. Berger and his staff were excellent. They were understanding and compassionate, and very professional as well.”

Just a few days after her second surgery, Dolores took a tumble while walking across the parking lot to her apartment. She fell on her face and was concerned that she injured her eyes in the fall.

“I could tell that my face was hurt, so I was worried,” Dolores confirms. “I went to the emergency room, and it turned out that I broke a bone under my left eye. The ER staff thought the eye was okay but wanted me to see a particular doctor. I said, I’m going to Dr. Berger.

“The next day, I called Dr. Berger, and he got me in that day. He performed a thorough check of my eyes and determined that they were fine. He said the broken bone would heal on its own.

“Today, the bone under my left eye is okay. I can see well and I don’t have any problems with that eye. Thankfully, I didn’t mess up Dr. Berger’s wonderful work. I’m so grateful to him for seeing me right away. He’s so compassionate and kind.”

Standing Ovation

Minimally invasive procedures eliminate retired teacher’s spider veins, leg cramps.

For Catherine Chamblin, teaching is a family tradition.

Photo by Jordan Pysz.

Catherine Chamblin

“Teaching goes way back in my family,” Catherine, 63, confirms. “My great-grandfather was a teacher and principal as well as a superintendent in the Florida school system. My mom, aunt and grandmother were all teachers.

“I kept the tradition going. I was a teacher in Citrus County for 33 years. I retired in 2016. I taught elementary school, mainly kindergarten. My favorite thing about teaching young children was the way they responded to new learning.”

Yet, teaching wasn’t Catherine’s first career choice.

“When I was in high school, I worked for a tennis pro and played in many tennis tournaments,” Catherine relates. “I wanted to become a tennis instructor, but my dad put his foot down. He said, You’re going to do something worthwhile, meaning go to college. I did what he said. I went to college and got a degree. But I don’t regret it. I had many good years in teaching.”

As a kindergarten teacher, Catherine stood all day on a hard floor with nothing but a thin rug between the concrete and her feet. As a result, she developed unsightly spider veins in her legs. Spider veins are tiny, dilated blood vessels in the skin that become swollen with stagnant blood.

“The spider veins appeared when I was in my 30s,” Catherine recalls. “My genetics didn’t help. My mom had varicose veins, and spider veins are a precursor to varicose veins. Standing on concrete eight hours a day for 33 years just added insult to injury.

“My spider veins were primarily a cosmetic concern. I have my own pool where I wore a bathing suit, but I wouldn’t wear a bathing suit or shorts in public. I also experienced pain in my legs. Sometimes, the leg cramps were so horrible at night that I couldn’t sleep.

“Ten years ago, I read about Dr. Sharma in various magazines and newspapers, and also in Florida Health Care News. I cut out the articles and saved them. My plan was to go to Dr. Sharma when I was ready to do something about my veins because he’s so qualified to treat them. I waited until I finished my teaching career, then visited him.”

Ravi Sharma, MD, is a board-certified cardiovascular surgeon with expertise in blood vessel disorders affecting the legs. His practice is Premier Vein Centers, which has offices in Homosassa and The Villages®.

Immediately, Dr. Sharma ordered an ultrasound of Catherine’s legs. It showed a number of veins were leaking and not enabling proper blood flow back toward her heart. This condition is called venous insufficiency, and it was the cause of Catherine’s spider veins and leg cramps.

Dysfunctional Veins

“Venous insufficiency occurs when deep leg veins, which lie in groups of muscles, cannot pump blood back to the heart,” Dr. Sharma explains. “Chronic venous insufficiency has multiple causes.
Over long periods of sitting or standing, the blood in leg veins can pool. This increases the venous blood pressure and weakens the vein walls and valves, thereby damaging the valves. Damaged valves prevent proper blood flow back to the heart.”

Venous insufficiency has many signs and symptoms. Signs are the issues that can be seen, such as bulging varicose veins, swelling, and thickening and discoloration of the skin of the ankles or legs. Symptoms are felt. They include throbbing, aching, stinging, burning, itching, nighttime leg cramps and restless legs. These signs and symptoms are indications that the veins are not functioning properly.

“I no longer have the leg cramps at night, so I can sleep. And without the spider veins, I can wear a bathing suit with pride.” – Catherine

“It is extremely important that patients experiencing any of these signs and symptoms have their leg veins assessed,” Dr. Sharma stresses. “Leaving the condition untreated can lead to more serious complications, including leg ulcers, infection and a breakdown of the skin.

“When seeking a physician for care, it is crucially important for people to choose surgeons who specialize in venous diseases and only venous diseases. I recommend staying away from physicians in large practices that offer a wide variety of services who perform venous treatment as a side service.

“The physicians people choose should also be experienced in the advanced procedures available to treat venous diseases. In addition, they must also express genuine concern and compassion for their patients. Physicians with these qualifications achieve the best outcomes.”

Catherine found all those qualities in Dr. Sharma.

“Dr. Sharma is very patient,” Catherine describes. “When I met with him, he listened to me and answered all of my questions, and I had a list of them. He wanted to make sure that I knew exactly what he was going to do and what to expect. He’s very compassionate and attentive as well. He made me feel like I was the only person there.”

A full range of advanced, minimally invasive treatment options for addressing varicose and spider veins is available at Premier Vein Centers. These treatment options include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections and VenaSeal.

Microphlebectomy has replaced vein stripping, the outdated, more invasive procedure during which doctors removed the large veins by making big gashes across the leg that often left the patient with large scars.

“With microphlebectomy, the incision is tiny – about the size of the tip of a scalpel – and we can do much more through that small incision,” Dr. Sharma observes. “And with this procedure, patients end up with tiny marks on the skin or no scars at all.”

Photo by Jordan Pysz.

Following her vein Treatments, Catherine shows her legs with confidence.

During EVLA, a sterile laser fiber is introduced into the incompetent vein via a small puncture in the leg. Laser energy is then delivered through the fiber, painlessly closing the vein in less than an hour, using local anesthesia.

Sclerosing injections are used to treat spider veins. Dr. Sharma uses ultrasound-guided sclerotherapy (UGS) to guide the injections that gently close the problem vessels.

VenaSeal is a non-thermal closure system that relieves symptoms by delivering small amounts of a specially formulated medical adhesive, or “super glue,” to the diseased vein. This permanently seals the vein. This procedure does not require multiple needle sticks and, in some cases, support stockings are not necessary.

Dr. Sharma uses his expertise to determine which procedures will work best based on each patient’s symptoms and health status. These advanced treatments are all performed in a comfortable office setting and result in little or no downtime and discomfort.

“Our patients are often very relieved to discover that there is no general anesthesia involved in our minimally invasive treatments,” Dr. Sharma relates. “And they are happy to learn that they can resume activities right away.”

Premier Vein Centers provides a free initial consultation and accepts most insurance, including Medicare.

Updated Wardrobe

To address Catherine’s leg cramps, Dr. Sharma used EVLA on the deep veins in her legs that were leaking. He treated her spider veins with UGS. Catherine is extremely happy with the outcome of these procedures.

“Even without an anesthetic, there is minimal pain involved with the Neo treatment, and it requires little downtime.” – Dr. Sharma

“I’m very pleased with my results and with how my legs look and feel now,” she enthuses. “I love to exercise, and now I can exercise pain-free. I no longer have the leg cramps at night, so I can sleep. And without the spider veins, I can wear a bathing suit with pride. I can wear dresses, skirts and shorts if I want as well.

“Getting treated by Dr. Sharma at Premier Vein Centers was a very worthwhile thing to do. I’m so glad I did it.”

Infection Control

Dental practice takes additional sterilization steps in coronavirus war.

Practicing dentistry during the COVID-19 outbreak has brought unique challenges for providers.

Photo by Jordan Pysz.

The staff at Advanced Dental Cosmetic Center is taking extra precautions to ensure
patient safety.

Up until mid-May, dentists were advised by the Centers for Disease Control and Prevention and the American Dental Association to refrain from treating patients except those with bona fide emergencies such as severe abscesses, gum swelling and fractured teeth, conditions that can create life-threatening infections.

J. Terry Alford, DMD, practices general, cosmetic and restorative dentistry, and is the clinical director of Advanced Dental Cosmetic Center in Bradenton. He followed the CDC and ADA recommendations, and has taken extraordinary precautions to protect his patients, staff and himself from the coronavirus and other infectious pathogens.

“Advanced Dental Cosmetic Center is somewhat unique in that we had multiple anti-microbial policies in place before the coronavirus became a problem,” Dr. Alford reports. “One system that was already in place was a hospital-grade water sterilization system, which sterilizes every drop of water that comes into the building.

“Also in place is a UV filtration system for our air conditioners. This system sterilizes the air that enters and circulates throughout the building.”

Dr. Alford first updated his building’s germicidal capabilities four years ago when he installed commercial ozonators. The ozonators, which are turned on at the end of the workday, kill bacteria, viruses and fungi, and reduce odors in the air.

“Because of the ozonators, the building is as sterile as it can be when my staff and I arrive in the morning,” Dr. Alford states. “And it makes a big difference in the health of my staff. As a result of the systems we have in place, there has been a significant decrease in employee sick days.”

After the COVID-19 pandemic began, Dr. Alford upgraded the antimicrobial systems in his building. He installed CDC-certified germicidal UV overhead bulbs in every room. These bulbs are turned on at night to sterilize all objects and surfaces in the rooms.

As of May 15, Advanced Dental Cosmetic Center once again opened its doors to all patients, and Dr. Alford has taken steps to protect the health of those patients.

“We are utilizing the same protocols that the CDC is using to screen patients that are on our schedule,” he elaborates. “We have them fill out questionnaires, we check their temperature three separate times and log the results in their charts.

“As our practice returns to normal, we are performing elective dental procedures and treating problems beyond bona fide dental emergencies. We are managing the dental conditions that were previously postponed when we were restricted to providing emergency care.”

Dr. Alford has been working to safeguard his staff as well.

“I want my staff to stay healthy and well, so each day, upon arriving at the office, staff members are temperature tested, and that information is recorded,” the dentist reports. “We do that because the staff are in contact with family members, and we do not want them to bring anything they pick up from their families into the practice.

“We use the antimicrobial systems and take the extra precautions to ensure the health and well-being of every staff member and patient. My goal is to make Advanced Dental Cosmetic Center the safest, most sterile and healthiest environment possible for my staff, myself and my patients during this coronavirus crisis.”

An Exercise in Relief

Unique therapy alleviates PE coach’s unbearable back, neck pain.

Patricia Bultema has worn a lot of hats during her 29-year career. An industrial engineer by trade, she began with traditional time studies and ergonomics. Over the years, she also worked as a quality engineer and process manufacturing engineer. She spent the final 10 years as a research and development engineer.

Photo courtesy of Patricia Bultema.

Patricia Bultema

But once Patricia retired from engineering, she discovered her true calling.

“After about eight months at home, I realized that at 50 years old I was way too young to be retired,” says Patricia, now 58. “I transitioned into the education field and became a physical education coach at an elementary school in Polk County. And I absolutely love it. I call it my comeback career.

“I work with approximately 650 children a day, kindergartners through fifth-graders. I do everything they do, from running the track to doing crunches to jumping rope. I teach them T-ball and softball. We shoot baskets and hula hoop and play parachute on a daily basis. I’ve worn quite a few hats over the years, but the one I wear now is my favorite.”

Becoming a PE coach was a natural transition for Patricia, who has always been athletic. But her active lifestyle came to a halt this past fall when she fell victim to a painful lower back and neck condition.

“I’m an avid runner, but last November, I started having a hard time walking, let alone running,” Patricia describes. “I was in terrible, excruciating pain. I couldn’t even bend to put on my running shoes. On a scale of one to 10, my pain level was an 11.

“The pain radiated through my entire left side. I could draw a line from my neck down my body, through my left gluteal muscle then into my hamstring and all the way down the back of my leg. I seriously thought I was going to be debilitated.”

An MRI revealed that Patricia had a degenerated disc in her lower back and three bulging discs in her neck. She visited several doctors, including a neurologist, seeking a remedy and tried multiple treatments, but she received no lasting relief.

Patricia refused to give up, though, and on the advice of her husband, she eventually visited the Back Pain Institute of West Florida, where Craig S. Aderholdt, DC, provides the most advanced treatments available for patients in severe pain.

“Along with my husband, several people in his company had been to see Dr. Aderholdt, so he came highly recommended,” Patricia reports. “During my first visit with him, he performed a complete work-up on me and ordered x-rays.”

Based on her symptoms, the results of his exam and what he found on the x-rays, Dr. Adherholdt recommended treating Patricia through a unique, nonsurgical protocol called VAX-D® Therapy.

Simply Straightforward

VAX-D Therapy is a patented, FDA-approved medical decompression technique for alleviating pressure on spinal discs, but it is not a traction device. It works differently and achieves significantly better results.

“Chiropractic adjustments alone can actually relieve the pain for many patients,” observes Dr. Aderholdt, one of the few providers in the country offering the VAX-D treatment.

“But for select people who suffer with conditions such as sciatica or herniated, bulging or degenerated discs, VAX-D Therapy has proven extremely effective. Patricia was a good candidate because the treatment is effective at alleviating low back and neck pain. It also helps with numbness, tingling and pain radiating down the arms and legs.”

“I can’t begin to describe the relief I’ve experienced. … It absolutely amazes me what VAX-D Therapy has done.” – Patricia

Each treatment lasts about a half-hour. The patient relaxes on a comfortable, computer-controlled table, secured by a pelvic belt or patented cervical collar, depending on the area to be treated. Carefully specified tension and pressure changes guide the use of VAX-D, allowing the therapist to focus decompression at the exact level of spinal dysfunction.

The VAX-D system is computerized, which enables the table to make subtle but targeted movements. These movements create a powerful vacuum within the disc space. This vacuum gently draws the disc back to its proper orientation, pulling nutrient-rich spinal fluid into the disc and stimulating repair cells that effectively mend the disc.

“What makes VAX-D such a valuable tool for pain relief is that nothing else can create such a powerful vacuum,” Dr. Aderholdt asserts. “There are imitators, but VAX-D’s vacuum effect is the most powerful one known.

“Further, VAX-D doesn’t allow the muscles to contract, like other machines can. In fact, it is the only nonsurgical treatment that has been clinically proven to reduce disc pressure to negative levels.”

Research Results

VAX-D Therapy has a long track record of leaving patients such as Patricia satisfied, Dr. Aderholdt notes. Long-term studies show that VAX-D is effective in more than 88 percent of patients who receive the treatment.

Photo courtesy of Patricia Bultema.

Patricia is “amazed” at how much better she feels after VAX-D Therapy.

“I consider VAX-D one of the most effective nonsurgical medical treatments for low back pain, neck pain and sciatica today,” Dr. Aderholdt states. “This revolutionary technology is one more tool I can offer my patients as we work toward relieving pain and maintaining the health of the lumbar and cervical spine.”

Many patients report a significant reduction in back or neck pain after only a few treatments, although the total healing process takes longer, Dr. Aderholdt emphasizes. The reason it takes a longer period, the doctor says, is that bulging or herniated discs require a series of VAX-D sessions to fully reposition themselves.

“Some patients think they will get relief after a handful of sessions and they can just quit, but that’s not the case,” he reports. “Patients must follow through with all of the required treatments to get the full benefit.”

Indescribable Relief

Patricia began visiting Dr. Aderholdt in late December, and she’s been receiving VAX-D Therapy three days a week since January. The treatments have helped tremendously.

“I can’t begin to describe the relief I’ve experienced,” Patricia raves. “I’m running again. I’m working out. I’m 58 years old, and right now, I feel like I’m 28. It absolutely amazes me what VAX-D Therapy has done.

“When I first went to Dr. Aderholdt’s office, my pain level was definitely an 11. Now, I don’t have any pain. It’s incredible.

“I absolutely, 100 percent recommend VAX-D Therapy,” she adds. “And by all means, I recommend Dr. Aderholdt and Back Pain Institute of West Florida. Dr. Aderholdt is amazing!”

Let There Be Light

Newcomer expands practice’s use of laser dentistry.

Before COVID-19 crippled the world, H. Gene Steele, DDS, was preparing for an amateur ballroom dance competition. However, in the weeks that followed, his favorite hobby has taken a backseat to his new role at Advanced Dental Cosmetic Center, the practice of J. Terry Alford, DMD.

Photo by Jordan Pysz.

H. Gene Steele, DDS with patient

Dr. Steele joined the Bradenton practice in May, and he shares Dr. Alford’s philosophy of care. Both aim to provide patients with necessary dental services while preserving function, increasing comfort and improving satisfaction through results. The partners have a common interest in using lasers in dentistry as well. That’s how they met.

“I’ve been using lasers in my dental practice since 2006 and started using high-technology Fotona lasers last year,” Dr. Steele relates. “I was training with several doctors and heard that Dr. Alford offered courses on the Fotona, so I contacted him.”

Dr. Steele says lasers are not new to dentistry. Many dentists use simple lasers in their practice, but few use lasers the caliber of the Fotona. The advanced technology of these lasers enables biostimulation, a feature that boosts the body’s repair cells and helps healing. This feature provides a host of advantages.

“Biostimulation reduces pain and sensitivity for patients, and improves healing,” Dr. Steele confirms. “It enables decontamination of the affected tooth, killing bacteria completely. Ultimately, the treatment is more conservative. Less tooth must be removed, leading to quicker recovery times.”

Another benefit of the high-tech Fotona laser is that it uses two wavelengths.

“LANAP® is a popular laser procedure in dentistry that is used to treat periodontitis, or gum disease,” Dr. Steele describes. “But LANAP uses a single wavelength to do the job. The Fotona’s dual wavelengths work on more types of diseased tissue.

“In cases of infection, for example, one Fotona wavelength can be used to remove the blood, bacteria, pus and dead cells from the infection. The other can be used to clean out the irregularities in bone and hard tissue on the tooth.”

While lasers are becoming more common in modern dentistry, they don’t replace all standard dental instruments and are often used in conjunction with one another.

“Typically, we start a procedure such as a root canal or dental implant by using mechanical tools,” Dr. Steele explains. “When we go into disinfection and sterilization mode, that’s when the enhanced cleaning aspect of the laser’s light energy comes into play.

“The laser’s light bounces off the water inside the operative area and creates little sonic booms that kill the bacteria. It is a safe power-washing effect, that cannot be done using standard dental tools.”

“Healthy patients are happy patients” – Dr. Steele

For some patients, using lasers reduces the anxiety associated with many dental procedures and increases overall comfort.

“There is a pre-anesthetic treatment mode on the laser that is used with topical anesthetics to minimize discomfort during procedures such as filling cavities and even removing areas of gum tissue,” Dr. Steele notes. “Using this, we can avoid or significantly reduce the need for anesthesia.

“Some patients do not like the whirring buzzing noise and vibration of standard dental instruments. With the laser, however, there is little sound and no vibration, and patients are happier.”
Making patients happier is among the objectives Dr. Alford hopes to achieve by bringing Dr. Steele into the practice.

“Dr. Steele has a motto: Healthy patients are happy patients,” Dr. Alford explains. “He strives to make dental appointments a pleasant experience that end in a healthier more attractive smile. Dr. Steele welcomes new patients with the attitude that an open dialogue between patient and doctor will foster good oral health and allow him and the patient to reach their goals.

“That’s why we are excited to have Dr. Steele join our team. His background and commitment to excellence will foster the trust we’ve built in the Bradenton and Sarasota communities, and we invite new patients to give us a call or just come by and meet our new doctor.”

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