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Holding Off Heart Disease

February 17th, 2019

It’s February, and you know what that means – it’s American Heart Month. It’s that annual opportunity to review what we know about heart disease. And it’s our chance to be sure we’re doing everything we can to prevent or manage it in our lives.

After all, heart disease is the leading cause of death for both men and women in the US. In fact, one in every four deaths in this country is the result of heart disease, to the tune of about 610,000 deaths each year. What’s more, almost half of all Americans are at risk for developing the condition. The good news is heart disease is preventable in most people.

Heart disease encompasses a wide array of different conditions affecting the heart and blood vessels. These include arrhythmias, cardiomyopathy, congenital heart defects, heart infections and the main form of heart disease, coronary artery disease (CAD).


Heart disease is often grouped with stroke and related conditions under the more global term cardiovascular disease (CVD). CVD involves a number of diseases of the heart and circulatory system. Other conditions that fall under CVD include heart attack, heart failure and valve disorders.

While stroke, heart attack and the other CVD disorders are serious conditions, we’ll concentrate our discussion today on heart disease and primarily on CAD, its most prevalent form.

CAD is a disorder of your coronary arteries, the blood vessels that supply your heart muscle with fresh, oxygenated blood. In CAD, the coronary arteries become blocked with a fatty material called plaque, which prevents the oxygen and nutrients from getting to your heart. This can lead to a heart attack and to the death of  heart muscle tissue.

Common symptoms of CAD include chest pain or discomfort, a sensation of pressure or squeezing in the chest, shortness of breath, nausea and feelings of indigestion or gas. Symptoms of heart disease can differ in women and may include dizziness or lightheadedness; anxiety; jaw, neck or back pain; cold sweats and fainting.

There are certain factors that put you at a higher risk for developing CAD. They can also make it more likely existing heart disease will get worse. Some of the risk factors, such as age, having a family history of heart disease or a history of pre-eclampsia during pregnancy cannot be changed.

Age is a big factor. Your risk increases if you’re a women over age 55 or a man over 45. The same is true if your father or brother had heart disease before age 55, or your mother or sister had it before age 65. These are all things you can’t do anything about.

There are other risk factors, however, that you can control. These include having high blood pressure and/or high cholesterol, having diabetes or prediabetes, smoking, being overweight or obese, being physically inactive, eating an unhealthy diet and drinking a lot of alcohol. These are the risk factors you should be putting your energy into.

The best way to determine your risk for CAD or other type of heart disease is by partnering with your doctor. He or she will evaluate your blood pressure, cholesterol level, blood glucose to check for diabetes, weight, personal and family medical history, and lifestyle.

Your doctor can then recommend steps to lower your risk for heart disease or treat the condition if you already have it.

If you are at risk for heart disease or have been diagnosed with it, there are some steps you can take to reduce the chance of getting heart disease or keep it from getting worse. Your doctor may recommend simple lifestyle changes and/or drug treatments.

One of the changes you can make to reduce your risk of heart disease or slow its progression is by controlling your high cholesterol and high blood pressure. This can often be done by adjusting your diet and getting more exercise, but it may require medications. Be sure to have your cholesterol and blood pressure checked regularly.

Lifestyle changes are pretty much common sense. They including eating a heart-healthy diet rich in high-fiber foods and low in saturated and trans fats; becoming more active; getting and staying at a healthy weight; quitting smoking; drinking alcohol in moderation and managing stress, which can have a negative effect on your heart.

If you’re at high risk for heart disease or already have it, your doctor may recommend you take an aspirin every day to reduce your chances of having a heart attack. Don’t take aspirin on your own without talking to your doctor first, however. It isn’t the best course of action for all people.

Now that you’ve been reminded about the basics of heart disease and CAD, you can better take care of your heart health.

Trailblazing Treatment

New, minimally invasive technique resolves acid reflux disease.

The misery often starts with a burning sensation behind the breastbone that radiates to the neck and throat. In addition to this pain, known as heartburn, there may be nausea, regurgitation, bad breath and, eventually, tooth decay. These are some of the telltale signs of a common condition known as gastroesophageal reflux disease, or GERD.Dr. David Napoliello, with offices in Bradenton and Venice, discusses hiatal hernia, gastroesophageal reflux disease (GERD) and a new treatment option for GERD called the LINX® Reflux Management System.

The term gastroesophageal refers to the stomach (gastro) and the esophagus, or food pipe. The esophagus empties into the stomach through a circular band of muscle called the lower esophageal sphincter (LES). If the LES doesn’t open and close properly, digestive acids from the stomach can flow back into the esophagus and cause symptoms.

“When this backflow of stomach acids happens persistently, the condition is diagnosed as GERD,” explains David A. Napoliello, MD, who is board certified by the American Board of Surgery and is a Fellow of the American College of Surgeons. “Over time, GERD can damage the esophagus and lead to serious complications.”

Among these complications are esophagitis, or inflammation of the esophagus; and stricture, a narrowing of the esophagus due to scar tissue from acid erosion. Other complications include the formation of ulcers in the esophagus and the development of precancerous changes in the tissue, a condition called Barrett’s esophagus.

Being obese or pregnant, smoking, overeating, eating late at night; eating certain foods, such as fried or fatty foods; drinking alcohol or coffee, and taking certain medications, including aspirin, can contribute to the weakening of the LES and the development of GERD. Another factor associated with GERD is hiatal hernia.

“There is a natural space in the diaphragm, the thin muscle wall that separates the chest cavity from the abdomen, that allows the esophagus to pass through to the stomach. It’s called the hiatus,” Dr. Napoliello educates. “The hiatus can become abnormally large from actions such as years of coughing or straining. The stomach can inappropriately slip upward into the chest cavity though that enlarged hiatus. That is a hiatal hernia.

“The normal position of the stomach is a major force in reflux management. When the stomach and its connection to the esophagus are in the wrong anatomical position, the proper food depositing mechanism is broken. This contributes significantly to the heartburn and regurgitation associated with GERD.”

With GERD and hiatal hernia, people can experience all of the usual symptoms of GERD and also suffer additional symptoms attributed to hiatal hernia. These can include difficulty swallowing and respiratory issues such as chronic coughing and asthma-like symptoms.

Anti-Reflux Routes

People can have GERD without having a hiatal hernia and a hiatal hernia without having GERD, but in most instances, people with hiatal hernia also have GERD. They generally co-exist.Dr. David Napoliello, with offices in Bradenton and Venice, discusses hiatal hernia, gastroesophageal reflux disease (GERD) and a new treatment option for GERD called the LINX® Reflux Management System.
In some cases of simple hiatal hernia, there may be no symptoms, but symptomatic patients are treated with medication or surgery, Dr. Napoliello notes.

“There is a type of hiatal hernia called a paraesophageal hiatal hernia that is dangerous because with it the stomach can get constricted and its blood supply can get cut off,” he informs. “With that type of hiatal hernia, surgery is indicated upon diagnosis.”

When surgery for GERD with hiatal hernia is warranted, Dr. Napoliello can typically treat both conditions during one surgical session. He performs most of these combined procedures as laparoscopic surgeries with the patients under general anesthesia. Laparoscopic surgery is a minimally invasive technique that uses thin instruments and a camera inserted into the abdomen through tiny incisions. The surgeons view the esophagus, hiatal hernia and surrounding tissue on a video screen.

Fortunately, Dr. Napoliello has expertise in surgically treating GERD with hiatal hernia. He is a specially trained reflux surgeon who completed a fellowship in minimally invasive and advanced laparoscopic surgery at the world-famous Mayo Clinic.

“During the combined GERD/hiatal hernia surgery, we begin by repairing the hiatal hernia,” Dr. Napoliello states. “That involves first putting the stomach back into its appropriate position. Then we sew the defect in the diaphragm closed with or without the use of a biologic mesh patch. After that, we pursue the anti-reflux procedure.

“There has been classically one type of anti-reflux surgery, called Nissen fundoplication, during which the surgeon wraps the upper portion of the stomach around the esophagus. This adds pressure to the LES and lower end of the esophagus. This procedure, although tried and tested, has some rare pitfalls that would favor a simpler intervention.”

Now, however, there is a new option for GERD treatment that is less invasive and proving to be equal, if not more effective than fundoplication in reducing GERD symptoms. This technique uses a reflux-preventing device called the LINX® Reflux Management System.

Magnetic Mastery

The LINX system is a drug-free treatment for patients who continue to experience significant GERD symptoms despite conservative treatments such as lifestyle changes and acid-suppressing medications. The LINX procedure is considerably less invasive than fundoplication because it doesn’t require any surgical changes to the anatomy.Dr. David Napoliello, with offices in Bradenton and Venice, discusses hiatal hernia, gastroesophageal reflux disease (GERD) and a new treatment option for GERD called the LINX® Reflux Management System.

“The LINX device is a small, flexible, circular band of interlinked magnetic beads made of titanium,” Dr. Napoliello describes. “The device is placed around the base of the esophagus, and it essentially acts as a new, artificial lower esophageal sphincter.

“The beads in the device form a strong magnetic bond, which holds this artificial LES tightly closed. When patients swallow, the movement of food passing through the lower part of the esophagus breaks that bond and allows food to pass from the esophagus into the stomach. After that, the magnetic bond quickly reforms, which resists gastric pressures and prevents acids from flowing backward.”

Surgery to install a LINX Reflux Management System can be done as an outpatient procedure or with an overnight stay in the hospital. A standalone LINX procedure takes about one hour to perform. When done as a GERD/hiatal hernia repair, surgery time is slightly longer, about an hour and a half. The LINX device can be removed or replaced if necessary.

“The LINX device was developed by pioneers in reflux surgery and studied for more than ten years,” Dr. Napoliello reports. “The LINX Reflux Management System is a safer choice for people whose GERD has not responded to medications, and surgery is the next step in treatment.”

The LINX technique is also a good option for those who are concerned about the risks and side effects of long-term medication use to manage their GERD symptoms, adds the doctor.

“There have been reports recently questioning the standard medical management of GERD, especially the use of proton pump inhibitors,” Dr. Napoliello observes. Proton pump inhibitors are a group of medications that stop production of a protein in the stomach that is necessary for acid secretion.

“These medications have been linked to decreased calcium and magnesium, stomach tumors, blood clots and even the development of dementia. Patients who have concerns about these risks now have a new answer for treatment of their GERD. It is the less invasive surgery using the LINX device.

“The LINX Reflux Management System is a simpler, more readily reversible option that can provide significant GERD relief. The LINX procedure is excellent for GERD, especially for GERD in combination with hiatal hernia.”

Dual-Action Remedy

Anxiety and pain relieved with medical marijuana.

In 2001, Amanda* was working nights unloading trucks at a discount department store. She was handling a case of antifreeze, but the bottom of the box was not sealed tightly. The bottles began falling out, and as Amanda tried to catch them, she wrenched her back and injured it badly. That started the severe pain that’s plagued her to this day.Dr. Mark Fallows of Pain Institute of Central Florida in Lecanto treated Amanda (alias) for chronic, non-cancer pain with medical marijuana.

“The pain was horrible after my back injury,” recounts the Massachusetts native. “And it just got worse over the years as different things happened.”

Following her back injury, Amanda decided to seek the assistance of a physician to help her manage her pain. She did some research and chose pain management specialist Mark Fallows, DO, of Pain Institute of Central Florida.

Dr. Fallows is uniquely qualified to manage his patients’ complex pain issues. He is certified by the American Osteopathic Board of Anesthesiology and the American Board of Interventional Pain Physicians (ABIPP), which has certified fewer than 400 physicians nationally. Further, Dr. Fallows is the only physician in Citrus County who is board certified in interventional pain management. He has served area residents since 1990.

“After I hurt my back, things just went downhill for me,” relates Amanda. “My pain started getting really bad after I was diagnosed with fibromyalgia in 2010. But the worst was when I got hit by a truck in my car in 2013.

“At that time, my life got ripped out from underneath me. My left shoulder was injured, so now I can’t raise my arm over my head. The accident left me with nerve damage in my left arm and left leg. I had to quit the job I had for twenty years at a hospice. After that, I suffered from depression, post-traumatic stress disorder and body-wide pain.

“Right now, I have terrible pain mostly in my back, left shoulder and neck. It used to be my left leg was worse, but now I feel awful pain in my right leg. I had been active. I loved to swim and ride my motorcycle, but I had to stop doing those things.”

Dr. Fallows tried several treatments for Amanda’s pain, including physical therapy, pain patches and spinal injections, but they didn’t do the job for her. He then resorted to opioid pain medications, but after a time, Amanda no longer wanted to take them.

“I’m still on one painkiller, but after so many years, I don’t want to be on it anymore,” verifies Amanda. “Right now, we’re trying to wean me off of it.”

After all the conservative methods of treatment that he tried with Amanda failed, Dr. Fallows tried another, less conventional route to treat her pain.

Factors in Effect

At Pain Institute of Central Florida, Dr. Fallows offers comprehensive treatments to ease his patients’ suffering. He specializes in a variety of pain management techniques, including spinal cord stimulation, spinal infusion pumps and radiofrequency ablation. Recently, Dr. Fallows added medical cannabis, or medical marijuana, to his toolbox of pain management treatments. This was an option he chose for Amanda.

“At fifty, Amanda is a relatively young person, and she suffers from chronic, widespread pain,” describes the doctor. “She’s had injections in the past and was on opiate pain medications, but they stopped working for her. When I saw she was not improving with other treatments and was devastated by the pain, I decided to try medical cannabis.”

In Florida, medical marijuana is available as an extract to be vaporized, drops that go under the tongue, capsules and a topical preparation, reports Dr. Fallows. Unlike many other states that have legalized medical cannabis, Florida has not legalized the smoking of marijuana.
Dr. Fallows chose the drops as the method of administration for Amanda.

“I find that sublingual drops are the best way to start because I can easily adjust the dose,” he explains. “I can control the dose milligram by milligram and change how many times a day the patient uses the drops. Ultimately, the patient may need a larger dose fewer times a day.”

Dr. Fallows notes that it’s unknown exactly how medical marijuana works, but it has three major components that are known factors in its effectiveness. These are THC, CBD and terpenes.

“Many of my patients do well with CBD oil alone, and I generally have them try that before moving on to medical marijuana,” the doctor discloses. “CBD oil is legal in every state. If that doesn’t help them, then they may need the
combination of CBD, THC and terpenes.

“Medical marijuana is federally illegal, so there is only beginning to be good research done on it. However, it has been shown to help relieve pain and reduce the symptoms of a number of conditions, including anxiety and post-traumatic stress disorder.

“Anxiety is often part of the pain patients’ experience,” continues Dr. Fallows. “They worry about when the pain will come back and how bad it will be when it does. With medical marijuana, not only do we reduce the pain, we also reduce the anxiety component. So the treatment helps the patient on two fronts.”

Enthusiastic Evaluation

“I get anxious about why I can’t get rid of the pain,” confides Amanda. “Sometimes when I have pain, I get a pins-and-needles feeling in my left arm. Then I get an achy feeling with chest pain, and I worry, Am I having an anxiety attack or a heart attack? That stresses me out.”

Dr. Fallows says it’s important to keep in mind that medical marijuana can be used to treat pain as well as many disorders, but it does not cure them. So far, it has proved to be a good option for Amanda.

She is currently being treated for her pain with medical cannabis that she receives in the form of sublingual drops that she takes three times a day. The early results of the unconventional therapy have her encouraged.

“My mood is a lot better,” she enthuses. “My family has noticed that I’m more social with them now, which is very positive. I’m still having some issues with anxiety, but it’s much better than it was before.

“The medical marijuana is helping with my pain, but it’s hard to tell just how much at this point. I’m weaning off the painkiller right now, and when you’re detoxing, everything is uncomfortable. My goal is to get off of the medication completely and manage my pain with the medical marijuana alone.”

Amanda says her experiences with Pain Institute of Central Florida are always excellent. She is especially happy with the care she receives from Dr. Fallows.

“Dr. Fallows is wonderful,” she raves. “He truly cares about his patients. If anyone is looking for an awesome doctor who really listens to you, Dr. Fallows is the one to see.”

*Patient’s name withheld at her request.

Tailored Treatment

Expertise, leading-edge technology allow for customized care.

For 42 years, Henry Landrum worked as a registered nurse, 30 of them in the emergency room. He spent hours on his feet caring for patients. He also sat for long periods noting patients’ symptoms and treatments in their medical charts. Add all that to a genetic predisposition for them, and Henry eventually developed severe varicose veins.

Dr. Ravi Sharma of Premier Vein Centers in Homosassa and The Villages® treated Henry Landrum and Mary Jim Campbell for venous insufficiency using various minimally invasive procedures.

Henry’s vein treatment makes working on the farm a lot easier

“I had really bad veins in my upper and lower legs,” confirms the Brooksville native. “I inherited them from my mother, who had terrible ulcers on her legs. I’ve had varicose veins for years, and they’ve bothered me off and on for about ten years. I’ve been retired now for five years, and my veins have gotten worse within the last three or four.

“I felt a lot of pain in my legs toward evening. I had achiness, swelling and cramping at night, and it became hard for me to walk, which is problematic when you live on a farm as I do. What really alarmed me, though, was when my feet and legs started to become discolored. I knew then I really had a problem and needed to do something about it.”

Henry’s daughter, an ultrasound technician, encouraged him to have his legs evaluated by a vein specialist. He knew of one in the area, Ravi Sharma, MD, of Premier Vein Centers in Homosassa and The Villages®. Dr. Sharma is a board-certified cardiovascular surgeon with expertise in blood vessel disorders affecting the legs.

As a longtime cardiovascular surgeon, Dr. Sharma spent many years working with the intricate blood vessels surrounding the heart. He now focuses his practice full-time on treating patients with venous disease of the legs. Henry was surprised to find that he had crossed paths with Dr. Sharma in the past.

“I had heard of Dr. Sharma; he was a chest surgeon in the Tampa area,” Henry relates. “He had a very good reputation as a surgeon, so I decided to have him check me out. I’ll be darned if he isn’t the same doctor who worked on my father at one time. I could hardly believe it.

“Dr. Sharma is very knowledgeable. He is also a very nice gentleman and very professional. He is very confident in what he does. He performed the ultrasounds on my legs and said I needed to have several procedures to take away the swelling and get my legs better so I could walk again. I decided to go ahead and have them done.”

Among the procedures Dr. Sharma used to help Henry was the latest technology, non-thermal VenaSeal.

Symptoms Unseen

The human circulatory system is composed of an intricate series of blood vessels. Veins are the vessels that return oxygen-depleted blood back to the heart. There are three types of veins: superficial veins, deep veins and perforating veins. Superficial veins lie close to the skin, deep veins lie in groups of muscles, and perforating veins connect the superficial veins to the deep veins.

“When the leg veins cannot pump blood back to the heart, it is a condition called venous insufficiency,” Dr. Sharma states. “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, Dr. Sharma adds. 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 those things that are felt, not seen. They include throbbing, aching, stinging, burning, itching, nighttime leg cramps and restless legs. These are all indications that the veins are not functioning properly.

Dr. Ravi Sharma of Premier Vein Centers in Homosassa and The Villages® treated Henry Landrum and Mary Jim Campbell for venous insufficiency using various minimally invasive procedures.

Mary Jim Campbell

“For patients who experience any of these signs or symptoms, it is important that they have their veins assessed,” Dr. Sharma stresses. “Leaving the condition untreated can lead to more serious difficulties, including leg ulcers, infection and a breakdown of the skin.”

The cardiovascular surgeon reports that venous insufficiency is more common than many people think. It is estimated that more than 30 million Americans suffer with symptomatic venous insufficiency. Venous vascular disease is five times as prevalent as peripheral arterial disease, or PAD, and more than two times as prevalent as coronary artery disease.

“A huge problem in getting venous insufficiency properly treated is that many of its symptoms are invisible and often misunderstood by patients,” Dr. Sharma notes. “One of those symptoms is leg pain. Pain is common with many disorders, so venous insufficiency is often overlooked or misdiagnosed.

“Patients and physicians alike need to understand that vein problems are often present before they are visible on the surface. Symptoms such as pain, heaviness and restless legs can signal vein disease without the corresponding visible varicose veins. With the right diagnosis, a patient’s leg pain can be relieved with simple, minimally invasive techniques.

“When seeking a physician for care, it is crucially important for people to choose surgeons who specialize in venous diseases. The physicians should also be experienced in the advanced procedures available to treat these diseases. Physicians with these qualifications achieve the best outcomes.” 

Advanced Options

At Premier Vein Centers, a full range of advanced, minimally invasive treatment options for addressing varicose and spider veins is available. These treatment options include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections and the new, non-thermal procedure, VenaSeal.

Microphlebectomy has replaced stripping, an outdated, more involved procedure during which doctors treated 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 assures. “And with this procedure, patients end up with tiny marks on the skin or no scars at all.”

Dr. Ravi Sharma of Premier Vein Centers in Homosassa and The Villages® treated Henry Landrum and Mary Jim Campbell for venous insufficiency using various minimally invasive procedures.

Henry Landrum

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, which are tiny, dilated blood vessels in the skin that become swollen with stagnant blood. 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 a small amount 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 aren’t necessary.

Dr. Sharma uses his expertise to determine which procedures to use 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 acknowledges. “And they’re happy to learn that they can resume activities right away.”

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

The Preacher’s Wife

Preachers never retire, and neither do preachers’ wives. Mary Jim Campbell has assisted her husband in building churches in many states, including Florida. A few years ago, they returned to Florida and settled in Summerfield. Soon after, they began a new church, where Mary Jim’s husband continues to minister.

“As a preacher’s wife, I work with him,” Mary Jim explains. “When we build churches, I’m right alongside him doing whatever needs to be done. I work to promote him and make his life comfortable because preachers in this day and age deal with a lot of issues.”

Mary Jim recently had a few issues of her own to deal with. For one, she had a bulging varicose vein on her left calf. She’d actually had it for many years, but it never really concerned her. It bulged, but was barely visible because of its location on her leg.

“That vein appeared after a tumbling accident in high school,” Mary Jim reports. “I had a bulge, but it was on the inside of my leg right about where the muscle is. That one didn’t bother me. I’ve just lived with it since the Fifties.”

While Mary Jim ignored the vein on her left leg, she did become concerned when unsightly veins suddenly began appearing on her right leg. She was self-conscious about the highly visible veins and considered having that leg treated.

“After we moved to Florida, a vein popped out on my right thigh and started crossing over my kneecap,” Mary Jim confirms. “It was very unsightly. Of course, in Florida I was wearing shorts more, and it felt like everybody was noticing it. I had a little swelling in my legs as well, and some painful leg cramps.

“I’m not really vain, and I’ve lived with the vein on my left leg for many years, but I really felt I needed to take care of the ones on my right leg.”

Mary Jim’s desire to seek treatment for her leg veins led her to Dr. Sharma.

“I thought I was going in for cosmetic treatment until I had my consultation with Dr. Sharma,” Mary Jim remembers. “He explained that my problem had to do with circulation and that if I didn’t do something about both legs now, I would have major problems down the line. Treatment would eliminate the unsightly veins as well.”

Through the use of ultrasound images, which he obtained after learning of her health history, Dr. Sharma diagnosed Mary Jim with venous insufficiency. Dr. Sharma recommended several procedures to address her condition.

Dr. Ravi Sharma of Premier Vein Centers in Homosassa and The Villages® treated Henry Landrum and Mary Jim Campbell for venous insufficiency using various minimally invasive procedures.

Mary Jim says, “My legs look as good as they possibly can for a seventy-eight-year-old woman”

Treatment Trio

Mary Jim was impressed with Dr. Sharma’s expertise. She was also intrigued with the treatments she received at Premier Vein Centers, where Dr. Sharma addressed her venous insufficiency by employing a trio of procedures.

“I had laser ablation, microphlebectomy and sclerotherapy, and I was amazed by how little pain was involved,” Mary Jim marvels. “During one procedure, Dr. Sharma actually took out a piece of my vein and showed it to me. It was fascinating.

“To do the vein over my kneecap, he made a small incision in the knee with a scalpel and punctured the skin. There were no stitches with any of the procedures, and you can’t tell at all now that I had anything done to my legs.”

Dr. Sharma used the same three procedures, as well as VenaSeal, to treat Henry’s venous insufficiency, and they achieved positive results with him as well. Henry is very pleased with how his legs look and feel since his treatment at Premier Vein Centers.

“My legs look a lot better,” he enthuses. “They don’t swell nearly as much as they did. The color is also much better than it was. Overall, the circulation has improved one hundred percent. I’m amazed.

“I went from excruciating pain to no pain.

“I’m also walking a lot better than before. I can walk for extended periods of time, and walking great distances doesn’t bother me. Before, it was getting so my legs hurt so badly that I couldn’t walk very far without having to stop.”

Mary Jim credits Dr. Sharma and his staff with making her experience a positive one. They even let her husband sit in on one of the procedures. She was truly pleased with the ease of the procedures and very happy with the results.

“I can’t say enough about the thoroughness and friendliness of Dr. Sharma and his staff,” Mary Jim says. “They told me what they were doing when they did the procedures. There was no fear involved, and I was very comfortable. I felt very confident in what Dr. Sharma was doing.

“My legs look and feel fine now. All my bulges and bumps are gone, and there’s no swelling or cramps. I can’t say I ever had beautiful legs, but they sure look a lot better now than they did before I went to Dr. Sharma. My legs look as good as they possibly can for a seventy-eight-year-old woman. I no longer have any concerns whatsoever about wearing shorts.”

Completion of Henry’s vein treatment was delayed because he had to stop midway and have his hip replaced. While it seemed like an extra-long process for him, Henry says the results are well worth the wait.   

“The knotty varicose veins on my legs are gone,” he describes. “I just have a few little spider veins, and those are going away as well now that Dr. Sharma gave me the injections, so my procedures were all very successful.

“I know there are a lot of places out there advertising vein treatment, but Dr. Sharma is the number one doctor in Central Florida without question. I have confidence in him. I recommend him to anyone who wants to have these procedures done.”

According to Mary Jim, the caring, comforting treatment she received in Dr. Sharma’s operating suite is given everywhere at Premier Vein Centers. Because of the inviting atmosphere, Mary Jim says she actually enjoys her visits there, which is not typically the case with her doctor appointments.

“I don’t go to the doctor unless it’s necessary,” she shares. “But with Premier Vein Centers, I look forward to going there. Dr. Sharma and his staff are friendly and happy. They create a family-type of environment.

“If anyone has varicose veins, I recommend the treatments I had done, and I recommend they go to Dr. Sharma at Premier Vein Centers to get them done. On a scale of one to ten, I give them a ten!”

Bypassing Blockages

Noninvasive therapy boosts collateral circulation in heart.

After retiring from the United States Navy in 1983 following 26 years of service, Daniel Segovia, 78, worked for a while for the US Postal Service, then joined his brothers in a business venture. Unfortunately, the Michigan native then experienced a series of health challenges that eventually brought his working life to a halt.

Dr. L. Amarchand of Brooksville treated Daniel Segovia for shortness of breath and lack of energy using a circulation-boosting therapy called enhanced external counterpulsation (EECP).

EECP has Daniel feeling like a kid again.

“I retired for good when I fell down my steps and broke an arm and a leg,” Daniel shares. “I fell again and broke an ankle and the other arm. After that, I suffered a heart attack, then I had a stroke, actually two strokes. I also have diabetes.”

While these issues put a stop to Daniel’s professional life, they didn’t stop him entirely. He continued to work around the house, keeping himself busy and active. He became concerned, however, when everyday activities became difficult to manage.

“One day, I realized I couldn’t walk from one side of the room to the other without huffing and puffing,” he recalls. “Outside in the yard, I’d work about five minutes, and I’d be huffing and puffing. I was short of breath all the time.

“I didn’t have any chest pain, but I didn’t have any energy. I didn’t want to do anything because I knew I was going to be tired out. No matter what I tried to do, I just didn’t have the energy to do it.”

These symptoms, caused by problems related to Daniel’s heart attack, left him physically and emotionally deflated. He was open to new ways to get his energy and breathing back to normal. He discovered a new way in the pages of a newspaper he found in the office of one of his doctors.

“I like to read, and when I went to see my diabetes doctor, there was a copy of Florida Health Care News in the waiting room,” Daniel confirms. “I got interested in an article about Dr. Amarchand and his procedure, and I wanted to learn more about it.

“I talked to my diabetes doctor and said, I’ve been feeling a loss of energy like the person in this article, and I think I want to see this doctor. My diabetes doctor said Dr. Amarchand was a good doctor, so I went to see him.”

Daniel’s doctor recommended L. Amarchand, MD, a board-certified cardiologist and internist in Brooksville. The article Daniel read was about the unique treatment protocol and surgical alternative that Dr. Amarchand offers his patients. The treatment is a safe, noninvasive, circulation-boosting technique called enhanced external counterpulsation (EECP).

Dr. Amarchand uses nonsurgical EECP to treat patients with heart disorders such as congestive heart failure, blocked coronary arteries and angina pain, all of which can cause the lack of energy and shortness of breath Daniel experienced. Using EECP, Dr. Amarchand has an impressive record of success in maintaining his cardiac patients’ heart health and independence.

Timed Rhythms

In addition to shortness of breath and loss of energy, a tightening or pressure in the chest, weakness and other symptoms can all be caused by a lack of oxygenated blood flowing through the heart.

As these symptoms get progressively worse, it’s not unusual for people to restrict their activities in order to reduce their discomfort. As a result, their quality of life quickly diminishes. EECP can reverse these symptoms by working like a natural bypass procedure.

“More than twelve million Americans have found relief from their symptoms and had their energy restored while also receiving other benefits through the use of EECP,” declares Dr. Amarchand.

Dr. L. Amarchand of Brooksville treated Daniel Segovia for shortness of breath and lack of energy using a circulation-boosting therapy called enhanced external counterpulsation (EECP).

“After two or three EECP treatments, I knew it was doing me good. My legs weren’t tired. My body wasn’t tired. I had energy, and I could breathe better.” – Daniel

Typically, EECP is delivered through a series of 35 hour-long sessions over the course of seven weeks. During an EECP session, the patient reclines, fully clothed, on a cushioned table while listening to music or watching a movie. Compression cuffs are wrapped around the patient’s calves, thighs and buttocks to apply pressure in rhythms carefully timed to the patient’s heartbeat.

“The pressure propels more blood upward and into the coronary arteries, enlarging the arteries and improving collateral circulation,” informs
Dr. Amarchand. “It helps the patient’s own circulatory system bypass coronary artery blockages and opens up the underused collateral blood vessels.”

“It felt like a comical situation because there I was in a funny outfit, all hooked up and lying on a table,” Daniel relates. “Then they turn on the machine, and I start bouncing up and down, a little to the left and a little to the right. The treatment didn’t hurt; it relaxed me. It made me feel better.”

EECP is the perfect option for individuals who want to try a noninvasive procedure before resorting to open heart surgery, notes Dr. Amarchand. It’s also good for those who have not achieved relief with prior surgical procedures such as bypass and angioplasty, and for patients who aren’t candidates for surgery.

“According to studies done on the procedure, eighty-five percent of patients completing EECP treatments obtain substantial and sometimes dramatic relief from their heart-related symptoms,” states Dr. Amarchand. “The same percentage realizes increased exercise tolerance, mental alertness and reduced need for nitroglycerin to relieve angina pain.

“EECP can be repeated as often as needed because it is noninvasive,” adds the doctor. “However, its beneficial effects can last from three to five years.”

EECP treatment is FDA-approved and Medicare-reimbursed.

Feeling Young Again

While all 35 treatment sessions are needed to get the full benefits of EECP, many patients begin to feel relief of their symptoms after just a few sessions. Daniel started to feel better early in the course of his therapy.

“After two or three EECP treatments, I knew it was doing me good,” he reports. “My legs weren’t tired. My body wasn’t tired. I had energy, and I could breathe better. I got home and I walked back and forth from room to room with no problem. After supper, I walked around the house, and it felt good.”

Daniel is amazed by the improvement in his condition. He’s happy he no longer suffers with the symptoms he experienced before EECP therapy. The treatment has him feeling young again. He tells everybody he knows about his miraculous turnaround.

“Everything’s come back, my breathing and my energy,” Daniel enthuses. “I joke around with my family and say I’m like a sixteen-year-old guy. I feel like I did when I used to play around with my kids when they were five and six years old. I have all of the energy, all of the get-up-and-go. I’m even going to the gym.

“Every chance I get, I tell people about Dr. Amarchand and EECP. If I hear somebody say they’re having trouble, I tell them to read up on the procedure, and if they have any questions, call Dr. Amarchand. I’m a firm believer in him and his EECP therapy.”

Add Hearing Test to Routine Screening Schedule

Long Island native Henry Resling is a retired investigator for the New York State Police. During his career in law enforcement, the 76-year-old was
regularly exposed to sirens and other loud noises. The constant, intense sound eventually had an impact on his hearing.

“My wife kept saying that my hearing was getting bad, and it was,” Henry admits. “I was missing some words when people talked to me, and I had a ringing in my ears for a long time. My wife also complained about my television being too loud. My volume level was a lot different than hers.

Henry Resling’s hearing loss was treated with a hearing aid by Sandra Maras, HAS, at Hearing 4 Life in Palm Beach Gardens and Greenacres.

Henry came to realize the importance of having a hearing test.

“Initially, I didn’t believe I had a hearing problem, so when I heard about Hearing 4 Life, I didn’t pay much attention to it. Then, a woman from the hearing center called me, so I decided to schedule an appointment for testing. My wife and I both went and got tested, and it was very evident I had a hearing loss.”

At Hearing 4 Life in Palm Beach Gardens, Henry consulted with hearing aid specialist Sandra Maras, HAS.

“Henry came in initially for a hearing evaluation because he noticed some issues with his hearing,” Sandra notes. “His problem was mostly that he wasn’t hearing clearly in crowded situations, and he couldn’t make out certain words in conversation.

“Through testing and evaluation, I determined he had a high-frequency loss, the type of loss is called sensorineural hearing loss. There’s no medication or surgery to treat this type of hearing loss. The only treatment is appropriate hearing aids determined by test results.”

Henry says he is often wary of store owners trying to sell him something, but he didn’t get that feeling from Sandra. Instead, he quickly developed a strong trust in her.

“Sandra was fantastic,” Henry raves. “She has a great bedside manner, so to speak. She’s very knowledgeable, and I was very impressed. She gave me a comprehensive evaluation and testing. It took almost two hours, then I got my hearing aids.

“Before I chose them, though, Sandra explained how different hearing aids worked, and we tested a few of them. Sandra had my wife go down the hall, and I could hear her all the way out in the front office. Without the hearing aids, I could barely hear her outside the door, so it was a considerable difference.”

After Henry and Sandra reviewed several hearing aid models, Henry chose a model that goes behind his ears with very slim tubes that go down into his ears. Henry learned that his hearing aids will help him in two ways.

“Sandra explained that these hearing aids will not only improve my hearing now, they’ll also stimulate my nerve endings to prevent my hearing from getting worse,” Henry relates. “I wear these hearing aids every day. They’re flesh-colored so they aren’t very visible. No one’s noticed them since I’ve had them, not even my kids.”

Hearing Screenings

Hearing is one of the body’s five major senses. It’s a key factor in human communication, and it helps people stay connected to the world around them. Sandra stresses the importance of maintaining good hearing. She recommends people add hearing testing to their routine health screenings.

“Not everyone has a hearing loss, but everyone should check their hearing regularly, just like they check their blood pressure,” Sandra suggests. “We go for annual physical exams to make sure everything about our health is normal, and if something is not, we take care of it.

“Hearing should be a part of that annual routine as well. We should be sure our hearing health is normal, and if it’s not, we can take steps to address it.”

Allowing hearing loss to progress without treatment can have a damaging effect on many areas of a person’s life. Unchecked hearing loss has been linked to a number of physical and emotional health disorders.

“Many studies have shown a direct link between hearing loss and Alzheimer’s disease and other forms of dementia,” Sandra asserts. “When people can’t hear, they’re not processing sound, so the brain begins to forget specific sounds. And without sound, the brain is not being effectively stimulated, and it loses some of its ability to function.”

Depression and social isolation are also directly linked to hearing loss. There are several likely reasons that loss of hearing leads to these conditions in so many people.

“Communication, which is vital to social interactions, becomes a source of stress when someone strains to hear others speak,” Sandra explains. “The frequent misunderstandings that occur can result in embarrassment.

“Because of this, people often start to refrain from social engagements to prevent the embarrassment. They begin to isolate themselves socially, and that leads to loneliness and depression.”

Further, low-frequency hearing loss is associated with and could be considered an early indicator of a higher risk for heart attacks and stroke. Hearing loss is also tied to a three-fold higher incidence of injury-causing falls, as well as more frequent and longer hospital stays.

There are several types of hearing loss: conductive hearing loss, sensorineural hearing loss and mixed hearing loss. All three types can be treated with hearing aids.

“Conductive hearing loss results from a problem with the inner and middle ear,” Sandra educates. “Sensorineural hearing loss is the deterioration of nerves in the cochlea, and mixed hearing loss is a combination of both.

“Sensorineural hearing loss is the most common. About ninety percent of people with hearing loss have the sensorineural type. It can be caused by trauma, aging, the side effect of a medication, noise exposure or a combination of those factors.”

When people come to Hearing 4 Life, Sandra first completes her thorough evaluation and testing to determine which type of hearing loss they have and whether or not amplification is needed. If Sandra determines that amplification is needed, she then recommends hearing aids appropriate for their hearing loss type.

“The most important thing is for people to come in and have their hearing tested, whether they’re having trouble or not,” she urges. “Many people wait years to take action on their hearing issues when a simple test can point them in the right direction to correct them.”

Volume Reversal

After Henry got his hearing aids from Hearing 4 Life, he was amazed by the clarity of the sounds around him. He is extremely pleased with his hearing aids and points out the best part about having them.

“I can hear,” Henry marvels. “And yesterday, my wife asked me, How’s the ringing in your ears? It was then I realized I didn’t have the ringing in my ears anymore. I don’t know what the hearing aids do for the tinnitus, but it’s not a problem anymore. Until my wife mentioned it, I’d forgotten about it, and it used to be very bad.

“The volume on my television is down,” he adds. “Now, my wife sits next to me and asks if I can turn it up. It’s funny because the volume situation has been reversed.”

At Hearing 4 Life, a hearing aid purchase is not the end of the person’s relationship with Sandra. She provides a comprehensive maintenance plan as a complimentary service to all of her hearing aid patients.

“After you get your hearing aids, Sandra schedules you every three months for maintenance,” Henry verifies. “She checks your hearing aids, cleans them out and replaces the battery. It’s all part of her service, and you don’t have to pay for that, which I think is fantastic.

“Being in law enforcement for as long as I was, I got to where I could size up people pretty well, and Sandra is the real deal. I absolutely recommend her and Hearing 4 Life to anybody.”

Looking Ahead

Premium lens implant keeps vision clear now and in the future.

As a psychiatric nurse, Gerald Smith devoted 43 years to the New York State Department of Mental Hygiene, including working part-time after he retired. For most of those years, Gerald had near perfect vision, so he was greatly discouraged when his eyesight began to fade.

“Several years ago, I reached the age when my eyes just stopped working like they used to,” reveals Gerald, 69. “I started going to an eye clinic in New York and began wearing glasses. Over those years, my vision issues progressed, and I had to get stronger and stronger prescriptions, which was a pain.

Gerald Smith had his cataracts removed by Dr. Q. Jocelyn Ge at Premier Eye Clinic in Port Orange and Ormond Beach. His cloudy lenses were replaced by Trulign® intraocular lens implants. The Trulign lenses also corrected Gerald’s astigmatism and presbyopia, leaving him virtually glasses free after surgery.

Gerald Smith

“I ended up having to wear trifocals every day. Many times, when I tried to look at something, like to read or paint, I’d have to tip my head up high to look through the bottom of my glasses. Doing that gave me pain in my neck.”

Constantly wearing glasses took a toll on the glasses as well. Gerald says the trifocals he wore every day were always getting scratched and smudged.

“They got so bad, I could barely see through them,” he states. “When I moved to Florida, the street I lived on took me right past Premier Eye Clinic. I thought, I need new glasses. I’ll stop in there and see if I can get an appointment for an eye exam.”

Premier Eye Clinic is the practice of board-certified ophthalmologist Q. Jocelyn Ge, MD, PhD. After performing a comprehensive evaluation of Gerald’s eyes, Dr. Ge describes what she discovered.

“When I first met Gerald, he told me he was having trouble both seeing far away and reading up close and was wearing his glasses one hundred percent of the time,” Dr. Ge notes. “He was also having difficulty with nighttime glare. He was wearing the correct prescription glasses and was still having trouble with his vision.”

Gerald was not prepared for the results of the doctor’s examination.

“I was pretty surprised when Dr. Ge told me I had cataracts,” Gerald shares. “I had some of the symptoms, like blurry vision and trouble seeing at night, but I attributed that to the condition of my glasses. Dr. Ge told me the cataracts were to the point where they should be removed.”

During cataract surgery, a minor, relatively painless procedure, the cataract, or clouded, natural lens, is replaced with a clear, synthetic lens implant.

“I decided to go ahead and have cataract surgery,” Gerald recounts. “Dr. Ge performed additional tests, and we discussed replacement lens options. She told me about the standard lenses, but with those, I’d still have to wear prescription glasses. I really wanted to get rid of the prescriptions and not have to wear glasses at all.”

Hurdling Obstacles

Before recommending a replacement lens implant for Gerald, Dr. Ge first needed to evaluate his overall eye health. The doctor identified several conditions affecting Gerald’s eyes that needed to be overcome.   

“In addition to cataracts, Gerald had significant astigmatism in both eyes,” Dr. Ge describes. “He also suffered with presbyopia, an age-related condition in which the eyes start to lose their power to see close up. These conditions can be corrected with cataract surgery and the appropriate intraocular lens implants.

“There are two main types of presbyopia-correcting lens implants, which allow patients to see both far and at reading distances without glasses. One is a called a multifocal lens, which creates multiple focus at the same time through specific optic designs on the lens implant.

“The second type is called an accommodating lens implant, which moves inside the eye through contractions of the eye muscles. It only has one clear focus, but when patients want to see far, the lens moves backward. When they want to see close up, it moves forward within the eye.”

Gerald had yet another obstacle to hurdle in his quest to be glasses free after surgery. He had a strong family history of age-related eye disease. His mother had macular degeneration and glaucoma, which put Gerald at increased risk for those diseases in the future as well.

“Patients who have glaucoma or macular degeneration are not candidates for multifocal lens implants,” Dr. Ge alerts. “But they are candidates for the accommodating lens implants. Those include the Crystalens®.

“The Crystalens works with the muscles inside the eye to very gently move the lens implant back and forth. These are the natural eye muscles that stretch and contract to change the natural lens’ shape. It gives patients the near focus they had when they were young.”

Gerald didn’t have macular degeneration or glaucoma, but thinking ahead, Dr. Ge wondered if that would still be the case 15 or 20 years from now. If he did, the Crystalens would continue to provide 100 percent of the light and wouldn’t become a limitation to Gerald’s vision. The same could not be said for multifocal lenses.

“The Crystalens, which is a flexible lens, can also treat astigmatism,” Dr. Ge observes. “These lenses that provide the range of vision and treat astigmatism are called Trulign® Toric lens. That’s what I recommended for Gerald.”

Dr. Ge clarifies that accommodating lens implants such as Crystalens or Trulign lens don’t always leave patients 100 percent glasses free. Some may need low-power, over-the-counter reading glasses for close-up work. Before cataract surgery, Gerald told Dr. Ge he wanted his vision to be clearest at arm’s length because that is the distance where he does most of his work.

“I wasn’t that concerned about reading the newspaper, the directions on a prescription bottle or anything else with very small print,” Gerald relates. “Dr. Ge told me I would probably have to get a pair of cheater glasses to read those things. I didn’t mind having to do that as long as I could see clearly at arm’s length.”

Gerald was amazed by the difference in his vision after cataract surgery. He was pleased to see things fully and clearly again. It made him realize just how bad his eyesight had become.

“The first thing I noticed was the difference in clarity and colors,” Gerald observes. “When I watched TV, the colors were so much brighter. I didn’t realize how much my vision decreased, especially while the cataracts progressed. It happened so slowly. After the procedures were done, I could see a huge difference in my vision.”

The surgery and Trulign lenses gave Gerald the freedom from his glasses he sought. He’s extremely pleased that he no longer has to wear the trifocals. To him, they were uncomfortable and annoying.

“It was a real pain with them because I was always moving my head searching for the right vision to see with,” he discloses. “I don’t have to do that now. I just look at what I want to see, and I don’t have to turn my head.

“My experience at Premier Eye Clinic with Dr. Ge and her staff was excellent. Dr. Ge explained everything to me, and she listened when I expressed my opinions on what I preferred. The staff was very good, as well. I definitely recommend Dr. Ge and Premier Eye Clinic.”

Your Last Diet EVER!

Program emphasizes strategies for long-term success.

Over the years, I’ve tried different ways to lose weight and failed,” admits Sandy, wife of Michael E. Burr, DC, a wellness consultant and chiropractor at Spring Hill Chiropractic & Wellness. “If I lost weight with some forced diet, I gained it all right back.

Program emphasizes strategies for long-term success

Dr. Burr’s weight-loss program worked for Sandy.

“But once I began Dr. Burr’s program, the weight seemed to come off automatically. It came off consistently each week. I realized that in order to succeed, I needed to make a lifestyle change and live healthier.

“I have high cholesterol and high blood pressure, so for me, the program was an overhaul in my lifestyle for long-term results over short-term, temporary results. I needed to feel better to do what I loved like bicycling, walking and paddle boarding.”

Through his research, Dr. Burr has discovered that overweight people have one of two problems keeping them from losing weight: Either they have a broken metabolism or broken behavior patterns. His program gives patients the tools to fix these problems in order to lose weight by becoming healthier.

“Regarding a broken metabolism, we find that people are frustrated that their bodies are so stubborn in burning fat,” notes Dr. Burr. “We determine what’s broken and fix it, making it easier for people to get results.

“In addressing behavior patterns, we begin by learning why the patient wants to lose weight. Most people say, I want to be healthier, but I look for a specific reason such as wanting to avoid a heart attack because five people in that patient’s family had heart attacks.

“We help patients discover the whys that motivate them to follow the program and do the right things. People aren’t going to succeed with a forced discipline, willpower diet for the rest of their lives, but that’s what most people try to do.

Rewarding Journey

“The goal of our program is to figure out what’s making it so hard for people to lose those unwanted pounds and make it easy for them to be at their target weight. We get their hormones working for them instead of against them, transforming their bodies into fat-burning machines.

“These are some examples of the tools we teach to fix behavior and metabolism issues for a lifetime of success, and we help to make this the last program people will have to do, so there’s no more yo-yo dieting.”

Sandy’s why was dual-focused. She was concerned when she learned of her abnormal cholesterol and blood pressure results, consequences of being overweight, and she vowed to get those levels back to healthy ranges. She also wanted to gain back her lost energy and vitality and be a better role model to her children.

“I lost forty-eight pounds on Dr. Burr’s weight-loss program,” Sandy enthuses. “In addition, my high cholesterol and high blood pressure resolved. I have now kept the weight off for almost two years.

“I thank Dr. Burr’s program for giving me the tools to be healthier for the rest of my life.”

Doing It Digitally

Smile restored using dental implants with Same Day Teeth®.

The threat of severe dental health issues has long loomed over Brooklyn, New York native Cira Stang. For years, dentists warned the now 86-year-old about deteriorating gum disease and the impact the condition could eventually have on her teeth.

Cira Stang received implants and a Same Day Teeth® smile reconstruction from Michael Pikos, DDS, at Coastal Jaw Surgery in Spring Hill.

Cira Stang

By 2016, her smile was indeed devastated.

“As I got older, my gum problems got worse, just like the dentists said it would,” she shares. “My teeth weakened and started falling out. I ended up with only eleven teeth in my mouth, six on the top and five on the bottom.

“My diet consisted of soup and pasta, things I could swallow without chewing because I had no molars. I’m a happy person, but it was very difficult to smile in front of people because all they could see was two teeth in the front and nothing else.”

Determined to regain her healthy smile, Cira was disappointed when the first dentist she consulted on the matter told her that the remaining teeth needed to be removed but said she was not a candidate for dental implants to secure a denture due to bone loss in her lower jaw. Cira sought a second opinion, and that dentist said he would do the implants, but wanted a surgical consultation.

“He said I had to be interviewed by a surgeon before he would do the implants,” confirms Cira. “He gave me the names of some surgeons, but he indicated that Dr. Pikos was the best.”

The surgeon recommended to Cira was board-certified oral and maxillofacial surgeon Michael A. Pikos, DDS, of Coastal Jaw Surgery. Dr. Pikos is a global leader in dental implants and surgical reconstruction. In addition to his stellar reputation, he is also known for his unique process for smile restoration called Same Day Teeth.

Cira liked Dr. Pikos immediately and chose to stay with him for her restoration treatment.

“I was very comfortable with Dr. Pikos,” she relates. “He made me a full upper denture, performed surgery and put dental implants in my bottom jaw. Then he put the temporary teeth in immediately.”

Virtual to Reality

Many dental practices offer dental implants, but Coastal Jaw Surgery sets itself apart by using an advanced approach. Unlike most others, the dentists at Coastal Jaw Surgery use a fully digital process for planning and performing implant surgery.

“We use a computer software-based approach,” verifies Dr. Pikos. “Our diagnostic work is done this way, and our treatment is carried out using models and guides created by the software.

“We begin the process by taking impressions of the patient’s mouth and getting a cone beam CT scan. That information is introduced into the software at the lab we use in Reno, Nevada. We then have an online meeting with myself, the restorative dentist and the lab.”

During that meeting, all of the data on the patient is combined. Using that information, the software simulates the final result and identifies the steps to achieve it.

The results of the simulation include a view of the final result’s appearance. They also indicate the types of implants required as far as length and diameter, and the proper placement locations for the implants.

Cira Stang received implants and a Same Day Teeth® smile reconstruction from Michael Pikos, DDS, at Coastal Jaw Surgery in Spring Hill.

Before and After Dental Treatment

“All of that is predetermined,” says Dr. Pikos. “We begin with the end in mind and literally work backward. Most dentists do the process differently, using an analog approach as opposed to our all-digital process.”

To assist Dr. Pikos further, the lab creates a detailed, three-dimensional model of the patient’s mouth, and performs the implant surgery on it. From this, the lab creates very precise surgical guides that detail the steps of the surgery.

“The guides act like a flight simulator and allow me to perform the surgery virtually,” notes Dr. Pikos. “It’s like doing the surgery in my mind. Then, on the day of surgery, my brain links the virtual with reality. My brain thinks I already performed the surgery, which technically I did. Because of that extra, virtual step, the surgery goes perfectly.

“In addition to making a full upper denture, I put five implants in Cira’s bottom jaw, and they hold a twelve-tooth bridge. For Cira, we knew ahead of her procedure what we needed to do to achieve an excellent result with our Same Day Teeth process: a brilliant smile and full function.”

Wonderful Feeling

Cira reports that the Same Day Teeth process at Coastal Jaw Surgery wasn’t difficult at all. She received temporary teeth the day of the procedure, and she has since received her permanent dentures. She couldn’t be happier with the results.

“It feels wonderful being able to eat again,” she enthuses. “Now, I can have steak and pork chops. I eat chicken wings and spareribs. There’s no limit to what I can eat. My dentures also look natural. The color matches my skin tone.”

Before Same Day Teeth, Cira was ashamed of her teeth and hesitant to smile. Now, she’s proud to show off her new teeth.

“I’m happy with my smile now,” she comments. “I smile all the time.”

She credits the dentist and his process for her excellent results.

“I recommend Dr. Pikos and Coastal Jaw Surgery, as well as their Same Day Teeth process, one hundred percent,” offers Cira. “I was comfortable withDr. Pikos, and his staff made me feel like I was family. I definitely recommend them.
Dr. Pikos is a saint on earth!”

Learn About Low Vision

February 10th, 2019

Do you worry about your vision? Many of us do. Vision loss is a common condition in the United States. It’s estimated that 25 million Americans are blind or visually impaired. One in 28 Americans ages 40 and older have low vision. Since low vision is so prevalent, I thought we ought to learn more about it.

First of all, let’s define low vision. It’s a significant visual impairment that can’t be corrected by any type of prescription lenses, or by medication or surgery. Low vision can make it difficult to perform your daily activities, as well as to read, use a computer, drive and watch TV. This can make you feel cut off from the world around you.

Low vision can also affect your mobility. It can interfere with your ability to get around independently. When mobility and communication are hampered, it can lead to feelings of anxiety and depression, and quality of life can be negatively affected in some people.

Eye disorders and injuries to the eye are the primary causes of low vision. These include diseases like macular degeneration, glaucoma and diabetic retinopathy, and genetic conditions like retinitis pigmentosa, as well as conditions like cataracts and traumatic brain injury, including head injuries, brain tumors and stroke.

There are a few common types of low vision. The first is the loss of central vision in which there’s a blur or blind spot in the middle of your vision, but your peripheral, or side, vision remains intact. This can occur with macular degeneration because the macula is responsible for central vision.

Low Vision Chart

  • 20/30 to 20/60, this is considered mild vision loss, or near-normal vision.

  • 20/70 to 20/160, this is considered moderate visual impairment, or moderate low vision.

  • 20/200 to 20/400, this is considered severe visual impairment, or severe low vision.

  • 20/500 to 20/1,000, this is considered profound visual impairment, or profound low vision.

  • less than 20/1,000, this is considered near-total visual impairment, or near-total blindness.

  • no light perception, this is considered total visual impairment, or total blindness.


Other types of low vision include loss of peripheral vision. With this, you won’t be able to distinguish anything at one or both sides, or anything directly above and/or below eye level. Loss of peripheral vision can happen with glaucoma and stroke. With blurred vision, both your near and far vision is out of focus. Cataracts can cause this.

There’s also a condition called generalized haze, when it seems like there’s a film covering everything you look at. Extreme light sensitivity is another common type of low vision. This is when regular amounts of light feel overwhelming. With night blindness, another type, you cannot see outside at night or in dimly-lit places indoors. Various eye disorders can cause these conditions.

Anyone can be affected by low vision, but it’s more common as we get older. That’s true, in part, because conditions that often cause low vision, such as macular degeneration and glaucoma, most commonly develop as people age.

Low vision is more frequently seen in people over age 45 and even more frequently seen in people over age 75. In fact, one in six adults over age 45 has low vision, and one in four adults over 75 has it.

The best way to catch and control the diseases and conditions that lead to low vision is by having regular eye exams by an eye care specialist. But if you notice any changes in your vision, contact your eye doctor right away.

Your eye doctor will perform a complete eye exam to diagnose low vision, including tests designed to check your vision and look for eye diseases. Your doctor will test your eyes for visual acuity or how well you see. He or she may use different instruments and lights when testing your vision.

If your eye doctor diagnoses low vision, he or she may refer you to a low vision specialist. A low vision specialist will help you learn new ways to use your remaining vision, modify your home and teach you how to use devices to aid your vision. Visual rehabilitation is part of this process.

Visual rehabilitation begins by recognizing the challenges of vision loss and making adjustments to maximize what vision you have left. It’s a process of learning how to do tasks, such as reading and writing, in news ways.

For example, if you have a blind spot, you may be asked to imagine the object you want to see is in the center of a large clock. You’ll be told to move your eyes along the clock numbers and note when you see the object most clearly. The doctor will tell you to use the same viewing direction when you look at other objects to see them as clearly as possible.

There are also many low vision aids that can help you see when doing your everyday activities. These includes a variety of optical magnifiers, including those that attach to your glasses, those that are handheld and those that stand on their own hands-free.

Telescopes can help you see things that are far away. They can be handheld or attached to your glasses. Non-optical aids that are available include everyday devices that talk. Some examples are watches, timers and blood sugar monitors that have an audio component.

There are also electronic devices such as video magnifies in portable and desktop formats. These devices combine a camera and a screen to make objects, like printed pages, forms and pictures, look larger.

Also helpful to those with low vision are audio books and electronic books that allow you to increase word size and contrast. The latest technology in smartphones, tablets and computers can read aloud or magnify what’s on the screen.

Low vision may be preventable in people with diabetes if they maintain healthy blood glucose levels. The best way to prevent the progression of low vision is by getting your eyes examined regularly so your doctor can catch and manage the eye disorders that can contribute to low vision. Do your eyes a favor, keep an eye on them!

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