Author Archive

Seriously Shingles

November 14th, 2017

If you’re over 50, and especially if you’re 60 or older, you need to think seriously about shingles. In the US, there are an estimated one million cases of shingles each year, about 50 percent of them in people 60 or older. It affects one in three Americans during their lifetime. I don’t know about you, but I don’t like those odds. And from what I’ve heard, shingles is a real pain!

Shingles is a painful skin rash that usually appears in a strip on one side of the face or body. The pain has been described as excruciating, aching, burning, stabbing and shock-like. The rash eventually turns into clusters of blisters that fill with fluid then crust over. Shingles is caused by the varicella zoster virus, the same bug that causes chickenpox. Shingles is also called herpes zoster.

What happens is after you’ve had chickenpox, the virus stays in your body, but remains dormant in your nerves. In some people, a disease, stress or simply aging weakens the immune system (it’s not completely understood how), and that dormant virus reactivates, triggering a shingles outbreak. This is important to know because studies show more than 99 percent of Americans age 40 and older have had chickenpox, even if they don’t remember having it.

The active varicella zoster virus is contagious, but it doesn’t spread shingles to other people. The virus can cause chickenpox in those who’ve never had it or never been immunized against it. Since chickenpox vaccine has been a routine part of the childhood immunization schedule for years, this is a rare occurrence.

Symptoms of shingles often come in phases. It may start with a stabbing pain on one side of the body. You may experience a tingling, burning, stinging or itchy sensation followed in a few days by the outbreak of the rash. Other, associated symptoms can include headaches, fever, chills, nausea, malaise, swollen lymph nodes and body aches.

A shingles rash typically lasts from two to four weeks and is treated with antiviral and pain medications. However, one in five people with shingles will go on to experience severe pain long after the rash clears up. This condition is called post-herpetic neuralgia, and it can be debilitating. This pain can last for months or even years.

That’s why the Centers for Disease Control and Prevention (CDC) recommend people 60 and older be vaccinated against shingles. A single-dose vaccine, Zostavax®, has been in use in the United States since 2006. Now, people looking for protection from shingles have two choices. On October 20, the FDA approved a second vaccine called Shingrix. It is touted to offer stronger protection against the virus than Zostavax.

Studies showed Shingrix offered 98 percent protection against shingles in the first year, and that protection remained at 85 percent or higher three years after vaccination. By comparison, Zostavax offers 51 percent and 67 percent protection respectively. Shingrix also reduces the risk of post-herpetic neuralgia by 90 percent.

Two-dose Shingrix is expected to be available to consumers by the end of 2017.

Stimulating the Brain

November 14th, 2017

There’s good news and bad news about Parkinson’s disease, the neurodegenerative disorder that affects movement. The bad news is that an estimated seven to ten million people worldwide have it, and that number is growing with the aging population. The good news is there might be a new, noninvasive way to treat it.

Treatment for Parkinson’s, as well as other movement disorders such as essential tremor, rigidity, stiffness and walking problems, are generally initially treated with medications. These medications target cells in the brain that make the chemicals that help cells pass along messages telling the body to move. Many people respond to this therapy.

For years, when people were at the point their disorder did not respond to medicines, or it began interfering with daily activities, they had few good options. Then in 2002, the FDA approved a procedure called deep brain stimulation (DBS) as a therapy for advanced Parkinson’s disease. After that, its use in thousands of patients in the US and Europe prompted studies of the treatment in earlier stages of the disease as well.

DBS is a surgical procedure that blocks nerve signals in targeted areas of the brain, which are generally identified using MRI or CT imaging. During DBS, a battery-operated medical device, similar to a pacemaker, is implanted to deliver electrical stimulation to the specific brain areas to control movement and other Parkinson’s symptoms.

The DBS system has three components, including the lead, which is a thin, insulated wire that is inserted through a small opening in the skull and implanted in the brain. The extension is another insulated wire that is passed under the skin of the head, neck and shoulder and connects the lead to the third component, the neurostimulator. That is the battery pack, and it is usually implanted under the skin near the collarbone or in the abdomen.

DBS has proven very effective in helping to reduce symptoms and medication use, as well as increase patients’ quality of life. However, DBS surgery has risks, including infection, stroke, cranial bleeding and other complications. Then in June, researchers at MIT announced they developed a new, noninvasive method for deep brain stimulation.

The MIT researchers, in collaboration with investigators at Beth Israel Deaconess Medical Center and the IT’IS Foundation, have developed a method to stimulate regions deep in the brain using electrodes placed on the scalp. This approach could make DBS less risky, less expensive and more accessible to patients.

The approach involves generating two high-frequency electrical currents using the electrodes on the scalp. These currents are too fast for the brain cells, or neurons, to respond to. However, the two currents interfere with one another, and when they intersect, deep in the brain, they essentially cancel out all but a small, low-frequency current. This current can influence the neurons’ response, while the high-frequency current has no effect on surrounding tissue.

Using the electrodes this way, researchers can target the areas they want deep inside the brain, without affecting any other brain structures. Also, without having to move the electrodes, they can direct the location of the stimulation by altering the currents. They can stimulate the brain for treatment or research.

The new method has shown promise in mice, and researchers have started testing the strategy on people without disorders to see if it works on human brains. A clinician at Boston Children’s Hospital and Harvard Medical School said if those testing results are promising, he would collaborate with the MIT team to evaluate the technique for treatment of another disorder, epilepsy.

The pulses of electricity delivered by DBS can improve the quality of life for people with Parkinson’s disease. They can also be used to treat those with obsessive-compulsive disorder, depression and other psychiatric disorders that fail to respond to medication. This noninvasive approach to DBS could help more people enjoy that improvement.

Skin Deep and Beyond

November 13th, 2017

Let me ask you this: How often do you think about the health of your skin? When you do, how often do you consider the skin that’s NOT on your face? After all, the skin is the largest organ in the human body, safeguarding everything underneath. Want to learn a little more about this protective organ and how to take better care of it? Read on.

Skin has many functions, including shielding our bodies from germs and the harsh elements outside. It also helps control the temperature inside the body and enables us to feel touch. It is composed of three main layers, the epidermis, or outermost layer; the dermis, the middle layer; and the hypodermis, the deeper tissues.

Because it is exposed, skin is susceptible to a variety of health problems, including the serious and potentially fatal cancer, melanoma. There are also a number of other disorders of the skin that are less serious (although often annoying and unsightly) such as acne. This scourge not only affects the face, but also the neck, back, shoulders and chest.

Eczema, which causes itchy, dry and red skin due to inflammation; seborrheic dermatitis, which leads to oily, waxy patches on the scalp (as well as other forms of dermatitis); and non-lethal types of cancer are other common skin disorders. There’s also psoriasis, an autoimmune disease that can cause rashes. In many cases, these rashes turn into thick, scaly plaques on the surface of the skin.

Some of these disorders, like many skin cancers, can be avoided by taking the appropriate preventive steps. Others, like acne and eczema, you can’t escape but you can control with the right skin care products and proper skin care routines. That leads us into the second half of our story: caring for your skin.

Keeping your skin hale and hearty is the focus of Healthy Skin Month, which is celebrated in November. Just look on the Internet and you’ll find numerous articles with tips on being good to your skin. There are a few suggestions many have in common, like “drink plenty of water” and “avoid taking hot, hot showers and baths.”

To make for a quicker read, I’ve put together a list of common tips for maintaining healthy skin, including some tips for winter skin care. More tips can be found in these articles. But to sum them up, here are a few highlights:

  • Don’t skimp on sleep. The cells of your skin use the nighttime hours to refresh and repair themselves. If you don’t sleep, your cells don’t get a chance to do their thing. Then your skin starts to show the wear-and-tear of constant exposure to the elements such as the sun and air pollution.
  • Get sweaty. Doing some form of aerobic exercise in the morning increases blood flow to your skin, which keeps it supplied with the oxygen and nutrients it needs to stay healthy and glowing.
  • Resist over-exfoliating. Exfoliating too often can lead to microscopic tears in the skin that can result in inflammation, redness, dryness and peeling. Many common exfoliating scrubs recommend you use them no more than twice a week.
  • Use softer soaps. Harsh bath soaps and laundry detergents can irritate the skin. Try softer soaps like fragrance-free or sensitive skin brands. The same holds true for deodorants. Try a sensitive skin or natural deodorant instead of scented versions.
  • Remember to humidify. Use a humidifier, especially in the winter months, to keep moisture in the air, which moisturizes the skin as well.
  • Avoid wet gloves and socks. If your gloves and socks get wet due to rain or snow, get them off. If you linger in these wet clothes, it can lead to itching, cracking and sores on the skin, even flare-ups of eczema.
  • Support your immune system. The typical winter ailments, colds and flu, can stress your skin to the max. Try to avoid these illnesses by taking preventive measures, such as consuming Vitamin C and getting your flu shot. Practice general good hygiene to avoid picking up or spreading cold and flu germs.

There are many more healthy skin tips out there, so don’t stop here. During National Healthy Skin Month, take some time and investigate more ways to keep your skin looking and feeling its best!

Hidden Harm

Leg ulcers are a result of underlying venous disease.

Last November, Brenda Ryan noticed a small sore on her right leg near her ankle. She didn’t know what caused the wound, and didn’t think much about it. She treated it herself, but it didn’t go away. Instead of healing, it got larger and uglier. Brenda finally sought the advice of her family physician.

Photo by Fred Bellet.

The ulcer on Brenda’s right leg is completely healed.

“My doctor gave me some salve and wanted to keep an eye on it,” recalls Brenda. “When I went back the next week, the sore had gotten bigger. She decided to send me for a biopsy because she said it looked like skin cancer to her.
“I went to a local surgeon who did a deep tissue biopsy. She said it would be a couple of days before the results came back, but the following day, I called her. I told her the area was very painful and swollen. She said that was normal after a deep tissue biopsy.”
Brenda’s condition continued to deteriorate over the next few days. She struggled to get through a day of work as a server at a local restaurant. By the end of her shift, she could barely walk because of the pain and swelling. Her leg was also severely discolored.
“The sore on my leg was very painful. It was a short, stabbing pain,” she describes. “My leg was also very swollen. The surgeon and my family doctor put me in the hospital and gave me a strong IV antibiotic. I was in the hospital for almost a week, but the wound got worse.
“They sent me to a wound care clinic where they cleaned it, used different salves and tried every other kind of treatment, but nothing helped. After twenty-two weeks at wound care, the doctor there said, I think we need to send you to a vein clinic. Dr. Joyce has wonderful results with wounds like this that won’t heal.
Douglas H. Joyce, DO, of Joyce Vein & Aesthetic Institute in Punta Gorda understands that non-healing wounds, or ulcers, on the legs are often the result of an underlying disease of the leg veins. He combines his empathy and expertise in the Ulcer Center at JVAI, a unique center committed to patients who suffer with this facet of venous disease.
“During my first appointment, Dr. Joyce looked at the wound on my leg and said, I can fix this,” remembers Brenda. “He was so down-to-earth and so confident he could do something, it put me at ease.”
To help Brenda understand her condition, Dr. Joyce explained that there are two systems of veins in the legs. There are the high-pressure, deep veins in the middle of the leg, and the low-pressure, superficial veins near the surface of the skin.
“Valves in the deep veins are designed to close tightly to keep blood flowing toward the heart,” he educates. “When the valves are not working properly, which is venous disease, pressure eventually builds up in the superficial veins.”
This pressure can lead to symptoms such as swelling, varicose veins and a feeling that the legs are getting progressively heavier. Over time, venous disease slowly worsens. Left untreated, it can lead to skin discoloration, thickening and, ultimately, ulceration.

Painting Over Mold

Dr. Joyce describes leg veins as a ladder, with one side being the high-pressure, deep veins and the other the low-pressure, superficial veins. The connecting perforator veins serve as the rungs in between. The perforators have valves that keep blood flowing from the low-pressure veins to the high-pressure veins.
“If those valves aren’t working properly, blood goes from the high-pressure side to the low-pressure side,” he explains. “When it does, it hits the veins under the skin at one point, so the pressure at that spot becomes extremely high.
“Because of this high pressure, the arteries can’t get fresh blood to the area, and they can’t take waste products out, so the cells begin to die. Then, all it takes is a small trauma – a nick, a cat scratch, hitting the side of a table while walking, anything that opens the skin – to create a wound. Some patients even get wounds that spontaneously open.”
A pioneer in treating all of the causes of venous disease of the leg, Dr. Joyce developed several treatment techniques, including single-needle laser ablation. This procedure is a noninvasive method of sealing the diseased veins responsible for advanced venous conditions. He used this technique to close the veins causing the ulcer in Brenda’s leg.
“My first vein procedure was at the end of May. I had six procedures in all,” says Brenda. “After the third one, I could see a difference. Dr. Joyce told me the treatment was working, just be patient. I said, You’ve already done more in three treatments than they did in twenty-two at the other place.
At the Ulcer Center at JVAI, Dr. Joyce uses leading-edge procedures and state-of-the-art technology to treat patients and give them the best chance at a positive outcome. He corrects the underlying vein problem that is causing the wound. This allows the treatment provided by wound care centers to be successful and lasting.
“If a venous ulcer heals without fixing the vein disease that caused it, statistics show that up to forty percent may open back up in the first year,” reports
Dr. Joyce. “I tell patients it is like painting a wall that has mold on it. It looks great, but it does not last. One day, you walk into the room, and there are spots of mold coming out on the wall again. It is the same reason: You never fixed the problem underneath. Fix the real problem and you get a lasting result.Before and after images courtesy of Joyce Vein & Aesthetic Institute.
“Our approach at the Ulcer Center at JVAI is to find the underlying problem with the veins and do everything we can to fix it in the easiest way possible for the patient. And we’ve been very successful. Our cure rate is in the high ninety percent range.”

Miracle Worker

According to Dr. Joyce, Brenda’s was a classic case of underlying venous disease leading to a skin ulcer. She required laser procedures on multiple veins to correct her problem. Dr. Joyce performed six procedures on her and achieved positive results.
“After the sixth procedure, my wound was completely healed,” enthuses Brenda. “Now, the swelling is gone, and I have no pain. The discoloration on my ankle has faded, but Dr. Joyce said it will take a while for the redness and darkness to go away.
“My procedures were very successful. Every time we see Dr. Joyce on TV, my boyfriend tells me to stand up and salute him. He’s a miracle worker!
“I’ve recommended him a hundred times since my treatment. I tell people, If you have a sore on your leg that won’t heal, don’t even waste your time going to wound care. Go straight to Dr. Joyce at Joyce Vein and Aesthetic Institute!

Enjoy Life, Hear Better

Treat yourself to the best in hearing technology.

As a Realtor®, Susan* relied on her communication skills. Buying and selling property was successfully negotiated through group discussion and debate. After retiring and moving to Florida, the New York native struggled to understand conversations due to a nagging hearing loss.Stock photo from istockphoto.com.
“I’d been having difficulty hearing for a long time,” she admits. “If I was in a room with people speaking and they were far away, I couldn’t hear them. One-on-one, I could usually hear okay, but if it was something like an audience situation, I didn’t hear well at all.
“My TV had to be very loud for me to hear it. I had difficulty hearing at movies and in crowds unless the sound was loud. I also couldn’t hear noise around me. I couldn’t hear if somebody walked up behind me; I wouldn’t know anyone was there. So, there was a safety factor, too.”
For years, Susan lived with her hearing loss, but it got progressively worse. Eventually, it bothered her enough to start thinking about hearing aids. She just wasn’t sure what kind to get or where to get them.
“I was very uncomfortable with getting hearing aids, especially since I wasn’t familiar with them,” she relates. “Finally, a friend recommended I go to Hearing Partners of South Florida.”
Hearing Partners of South Florida is a family-owned business with offices in Boynton Beach and Delray Beach. Nimet A. Adam, AuD, a board-certified doctor of audiology, is president of Hearing Partners as well as a member of the American Speech and Hearing Association.
Other doctors of audiology on staff at Hearing Partners include Dr. Arthur Zinaman, Dr. Matthew Seldine and Dr. Phoebe Clouser. Clinical audiologist Meredith Resnick and licensed hearing aid specialist Shayne Taplin are also on the Hearing Partners team. Meredith was the audiologist who first assisted Susan.
“The process of getting hearing aids is stressful because you don’t really know what you’re getting involved with,” notes Susan, “but the Hearing Partners staff was terrific.
“Meredith was extremely knowledgeable about my testing and about the products. She explained the different hearing aids and how they work. She was also very warm and inviting. She made me feel very comfortable.”
Susan decided to treat herself to the best hearing aid option for her needs and lifestyle. She chose to go with the completely-in-the-ear Lyric hearing aids.
“When I showed her the Lyric, she was definitely interested,” confirms Meredith. “She loved the idea that they were hassle free with no batteries to change, and even showerproof. When she needs a new device, she would simply return for a short office visit.”

The Great Disconnector

According to Dr. Zinaman, hearing loss is the great disconnector. More than any other one of our senses, hearing loss disconnects people from the world around them. Being in a silent world takes communication, contact and joy out of life.
“Being out of contact, not associated with your environment, friends, family or neighbors, creates many issues, that include not hearing conversations and lack of enjoying life activities, but also medical issues, such as depression,” he states. “People need to have healthy ears and good hearing to enjoy life to the fullest.”
“There is much at stake when we choose to ignore hearing loss,” adds Dr. Adam. “Adults with hearing loss report more falls, more hospitalizations and more periods of poor mental and physical health. Some adults experience an accelerated rate of cognitive decline.
Stock photo from istockphoto.com.“As audiologists, we know if hearing loss treatment begins early, patients have better results and enjoy a better quality of life.”
There are many types of hearing aids, from entry level to advanced. The audiologists at Hearing Partners take time to learn about their patients’ needs and goals before making recommendations for hearing devices.
“In my assessment, I talk to my patients to understand their lifestyles,” describes Dr. Clouser. “Knowing their level of activity helps me determine which hearing device is best for their needs. Cosmetics sometimes is a concern for patients, which is when Lyric may be a good option. I like to get to know my patients so I can make the best recommendations for them.”
“Hearing loss is a communication disorder,” observes Dr. Seldine. “I talk specifics with my patients regarding their daily communications, activities, environments they’re typically in and the key individuals they generally speak with. I ask them about their hearing goals so I can help them succeed in having a better hearing experience. The endpoint of that discussion is selecting the best hearing device for the patient.”

Engaging the World

The depth of sound Susan can hear with her new Lyric hearing aids amazes her. Some sounds she’d almost forgotten. Her communication with others is easier and more engaging. She’s also less anxious because now she can hear when people walk up behind her.
“My TV is a lot lower, and I didn’t know there were birds chirping where I am,” she enthuses. “I haven’t heard birds in many years. Now, I can hear people speaking to me, and when I’m in a group, I can hear what people are saying. I didn’t know how much I was missing.
“With my hearing aids from Hearing Partners of South Florida, it’s like a whole new world opened up for me.”
It was the sensitivity and expertise of the audiologists at Hearing Partners that led to finding hearing aids that work for Susan. At Hearing Partners, she treated herself to the best in hearing health care and technology. That gave her better hearing and a better quality of life.
To Susan, being a patient of Hearing Partners is a treat in itself. She has high praise for the hearing center and its staff.
“Everyone at Hearing Partners is absolutely competent, and Meredith is phenomenal,” she says. “The office staff is very warm and welcoming, and they’re all knowledgeable. They make me feel very at ease. When I first went there, they told me, We’ll do whatever it takes to make you feel comfortable, and they did. They’re great.
“I recommend Lyric hearing aids to anyone with hearing loss, and I’ve already recommended Hearing Partners. I think they’re incredible. The staff is amazing, and working with them is stress free. I wouldn’t go anywhere but Hearing Partners of South Florida!”

*Patient’s name withheld at her request.

Clean and Sober

Find recovery from the disease of addiction.

The oldest of four girls from an average middle-class family, Cassandra Luke went to good schools, was a good student and spent much of her free time playing sports. She was popular, had a lot of friends and always had the essentials to live comfortably. Cassandra also had a problem with alcohol.

Photo by Jordan Pysz.

Cassandra describes the center’s holistic approach to a new patient.

“As a teenager, I started to experiment with drugs and alcohol. At first, it seemed to be normal teenage behavior,” she admits. “As time went on, it became pretty apparent it was not just experimenting or typical teenage behavior. The way I partied with my friends was abnormal, and it was evident there was something different about me.
“I always drank more. I didn’t want the party to stop. I was a blackout drunk, and my friends had to tell me what happened the night before. It seemed like those situations never happened to them. At the time, I chalked it up to being young and crazy and just living my life.”
After high school, Cassandra’s drinking escalated. She had dreams of going to college and becoming a special education teacher, but drinking got in the way. She wasn’t able to succeed at school because alcohol always came before her education. For years, she maintained a cycle of going to school then dropping out, going back then dropping out again.
“I wasn’t homeless. I didn’t lose anything valuable, like a house. I was able to maintain jobs for the most part,” she relates. “Outwardly, it looked like my life was manageable, but I was very unhappy and dissatisfied. Everything was a lot more difficult for me to achieve because I continually put partying before everything else. Most people my age were finishing college, starting relationships and getting married.”
Cassandra became very depressed. Looking for help, she went to a couple of treatment centers in her native Chicago, but she failed to respond. She says she wasn’t ready for them to help her. Then, she moved to Tampa and went to another treatment center, but again, she wasn’t entirely ready.
“At that point, I hated myself. I couldn’t even look at myself in the mirror. I didn’t know who I was anymore. I felt like a shell of a human being,” she shares. “What’s the point of life if you live every day despising the person you are. I hit a very emotional bottom. I wanted to feel differently, and I wanted to feel better.”
Cassandra discovered a program that worked for her and has been sober since April 27, 2009.
With a clear head for the first time since childhood, Cassandra was determined to go back to school and finish her education. She decided to become a nurse and started taking classes one at a time.
“Before I knew it, I graduated as a registered nurse and was working in one of the major hospitals in Tampa,” she states. “I quickly moved my way up to charge nurse and got very involved in the organization. Then, I went back to school and got my Bachelor’s degree.”
Cassandra now serves as director of nursing at recently opened Riverside Recovery of Tampa. Riverside Recovery is a comprehensive center offering inpatient and outpatient services to treat all aspects of the disease of addiction.

Holistic Approach

Not only is Cassandra Luke, BSN, RN, now an experienced clinical nurse, she also has the personal experience of facing recovery. She believes it gives her an empathetic perspective when helping the people who come to Riverside Recovery of Tampa. She’s not alone.
“About seventy-five percent of our staff is in recovery,” she observes. “They have the ability to professionally assist the individuals who come to us for care, as well as to personally relate to the struggle they’re going through.
“We want to help remove the stigma of addiction. We want to tell the community we’re here and tell people suffering from substance abuse there is help. They’re not hopeless people. They don’t have a moral deficiency. They’re individuals with a disease, and it’s the disease of addiction.”
Graphic from istockphoto.com.At Riverside Recovery, a range of techniques are used to teach patients how to stay sober and clean and how to integrate themselves back into society. The techniques cover the scope of recovery services. They include group and individual therapy, motivational interventions, mindfulness-based relapse prevention and 12-step facilitation.
“We take a holistic approach to recovery,” elaborates Cassandra. “We offer services such as yoga and biofeedback, and a physical therapy group comes in and gives massages and treats the physical issues that can affect the body from drug and alcohol use. Even the food we serve is clean and healthy.
“Our clinical team is very knowledgeable about the disease of addiction and works on confining some of the disease behaviors, such as manipulation, as well as the guilt and shame that people carry.
“The medical component of our care is not a one-size-fits-all approach. Rather, it’s personalized. We meet people where they are and make them as comfortable as possible through the detoxification process. Our goal is to have them finish that process then move to our residential service.”
Riverside Recovery of Tampa is among the few centers in Florida that provides all levels of care under one roof. They combine a detox facility with a residential center and intensive outpatient services on one site.
“That gives us an edge,” offers Cassandra, “because our patients don’t need to travel to different facilities for their care. They start in our detox, where we get them medically stable, then they simply walk down the hall, and they’re in the rooms for residential care.
“This provides continuity of care and helps prevent inconsistencies in patients’ stories. It keeps everybody on the same page. I believe it gives patients a better overall experience and a better chance at staying sober and clean after they leave.”

Active Discovery

As part of the treatment at Riverside Recovery of Tampa, patients are shown they can live happy, normal, healthy lives without the use of drugs and alcohol. The center offers amenities and activities to guide them in this discovery.
“Before my recovery, I thought getting sober meant my life was going to be boring. I wondered what I was going to do; my whole life was drinking. Even though it wasn’t fun toward the end, it was the only way I knew how to do anything. But that isn’t the case anymore, and it doesn’t have to be for our patients.”Graphic from istockphoto.com.
Riverside Recovery has a half-court basketball court, a sand volleyball court and an exercise room with weight and elliptical machines, and they’re in the process of putting in a swimming pool. They’re also installing a dock on the nearby Hillsborough River so patients can fish, kayak and enjoy other water sports.
“We show patients they can have a lot of fun while sober and clean, doing things like working out, playing basketball, swimming or fishing, and they can enjoy it clear minded,” reports Cassandra. “They will actually have more fun than if they were drunk or high.
“We do the deep work here. We get to the root cause of what’s going on with people and show them their lives are not over. With the help of Riverside Recovery of Tampa, people with addiction can be happy and laugh and enjoy life again.”

Contemplating COPD

November 6th, 2017

How much do you know about COPD? For one thing, it’s a killer. In fact, it’s the third leading cause of death in the United States. Nearly 16 million Americans have COPD, but many more have it and haven’t be diagnosed, which pushes the estimate closer to 30 million. That’s because 50 percent of people who have it don’t know they do.Photo courtesy of istock photo

Chronic obstructive pulmonary disease, or COPD, is actually an umbrella term for a group of progressive lung diseases that includes emphysema, chronic bronchitis and non-reversible asthma.

With emphysema, the walls between the air sacs in the lungs are damaged, affecting the oxygen/carbon dioxide exchange and the amount of oxygen that gets into the bloodstream. Chronic bronchitis is the constant irritation and inflammation of the lining of the airways. Asthma is a chronic lung disease that inflames and narrows the airways.

COPD symptoms most often appear in people who are 40 and older. There are, however, certain cases in which it develops in younger people. An example is the genetic condition called alpha-1 antitrypsin (AAT) deficiency. AAT is a protein, and low levels of it can lead to COPD, especially if you are exposed to lung irritants such as cigarette smoke or chemical fumes.

Generally, COPD is not diagnosed until it is in an advanced stage. That’s mostly because people don’t recognize the early warning signs, or they attribute the coughing, shortness of breath and breathing difficulties they feel to a normal part of aging. Also, COPD can be developing for years without noticeable symptoms.

Other symptoms you may recognize include the inability to perform basic activities due to shortness of breath, the presence of a lot of mucus when coughing, a wheezing or whistling sound when breathing and tightness in the chest. There are additional, more serious COPD symptoms such as swelling in the ankles, feet or legs; weight loss; and lower muscle endurance.

If you are experiencing a fast heartbeat, decreased mental alertness, trouble catching your breath when talking, or discoloration of the lips or fingernails, you need immediate medical attention.

Long-term exposure to lung irritants is the cause of most cases of COPD, about 75 percent of them, and inhaled cigarette smoke is the most common culprit. Secondhand smoke also contributes to the development of COPD, as do air pollution, chemical fumes and dusts, both from the environment and from the workplace.

COPD is most common in current and former smokers. It’s estimated that smoking is responsible for nine out ten COPD-related deaths. Smoking is harmful to the whole body, but especially the lungs by causing inflammation and destroying the lungs’ air sacs.

This damage in the lungs is irreversible, but steps can be taken to manage and slow the progression of COPD. Treatment often starts by making lifestyle changes, such as quitting smoking and avoiding other lung irritants, following a healthy diet and finding a physical activity that strengthens the muscles that help you breathe.

Your doctor may also recommend pulmonary rehabilitation. This is a guided program that includes exercise, disease management training, and nutritional and psychological counseling. The goal of pulmonary rehabilitation is to help you stay active and able to perform your daily activities.

If you have a low level of oxygen in your blood, you may be placed on oxygen therapy. With this treatment, supplemental oxygen is delivered through the nose. Another way to improve breathing is by using bronchodilators, with or without inhaled corticosteroids. Bronchodilators relax the muscles around your airway, which helps open them up and make breathing easier.

Staying healthy overall is important, too. Disorders such as pneumonia and flu can lead to serious problems for people with COPD. Follow your doctor’s recommendations about getting the flu shot and pneumococcal vaccine to help avoid these conditions and their complications. Stay healthy and breathe deeply!

Double Dose of Care

One morning in 2004, Judy Baker woke up to a nightmare. As she sat on the edge of her bed, it felt like the ceiling was spinning. She couldn’t get out of the bed and was forced to lie back down. The dizziness she felt was overwhelming and intense.

Photo by Jordan Pysz.

Judy and Jim got two problems solved in one place.

After a while, Judy was able to get up and go about her day, but she never felt steady on her feet. At the end of the day, she was happy to go back to bed, but the next morning, she felt even worse. She was so dizzy when she woke up, she vomited.
“I was eventually able to get out of bed and function, but not like usual,” recalls the retired teacher. “I wasn’t feeling normal. I knew something was wrong, but I didn’t know what it was. I had to get to the doctor right away.”
Judy was able to make an appointment the next day with her ear, nose and throat specialist, whom she saw regularly for general ear care.
“I went to the doctor, and I discovered I was experiencing vertigo,” she states. “The doctor said, You need to see Dr. Kelly Hansen.”
Kelly Hansen, AuD, is a board-certified doctor of audiology at Trinity Hearing & Balance Center who specializes in treating hearing loss and dizziness. As luck would have it, Dr. Hansen was seeing patients once a week at Judy’s
doctor’s office. She explained the cause of Judy’s vertigo, benign paroxysmal positional vertigo, or BPPV, then treated her using a time-tested technique.
“BPPV is the most common cause of episodic vertigo, which can easily be diagnosed,” informs Dr. Hansen. “The condition is caused by small crystals of calcium carbonate that get into the inner ear balance mechanisms. When these particles become loose in the ear canals, causing symptoms of vertigo, they must be repositioned.
“In 2004, I relied on a manual table technique for repositioning known as the Epley Maneuver. In 2017, I use an advanced, software-driven machine, the Epley Omniax System. This allows me to pinpoint the location of the particles and make treatment decisions. It enables me to detect, differentiate, treat and manage balance and dizziness disorders.”
When Judy first saw Dr. Hansen in 2004, the doctor performed the Epley Maneuver on Judy, and she finally experienced some relief from her dizziness. Judy continues to be treated for recurring episodes of vertigo.
“The first time, Dr. Hansen positioned me right on an examination table,” remembers Judy. “More recently, I went to her after she got her new equipment. With that, she secured me in a chair, then put me up in the air for twenty seconds one way, and twenty seconds the other way. The chair does exactly what Dr. Hansen did on the table, but does it mechanically.”
Seeing how well Judy responded to Dr. Hansen’s treatment gave Judy’s husband, Jim, a positive outlook when he also suffered a battle with vertigo.
“When it hit me, I felt dizzy and I staggered, like I was half-drunk,”
discloses Jim. “When my wife had vertigo, she went to Dr. Hansen, and the doctor helped her right out. So, I went on Dr. Hansen’s special chair, too. Once she put me in that machine and moved me into different positions, I got my balance back again.”

Second Front

After Judy and Jim were successfully treated for their dizziness, they returned to Trinity Hearing & Balance Center and Dr. Hansen. This time, they received assistance on a second front, a battle with hearing loss.
“We’re both in our eighties, and our hearing was failing,” reports Jim. “My hearing loss has been a prolonged issue. It started twenty years ago.
“I have a problem hearing high-pitched sounds. Fire alarms could go off, and I wouldn’t hear them. I also have had trouble in conversations. Words seemed jumbled. I learned to look at people when I’m talking to them, partially so I could read their lips.”
Dr. Hansen took time to learn about their daily activities and lifestyle, then suggested hearing instruments that matched their needs.
“Jim and Judy are very active and social, and go to many places with quite a bit of background noise,” notes Dr. Hansen. “People with hearing loss often complain about not being able to hear in those situations. Jim and Judy were also having a difficult time with the television. They could hear it, but they couldn’t clearly understand what was being said.
“I fit them with the newest technology hearing aids. With it, they have a Bluetooth® device that streams the TV sound directly into their hearing aids. Now, they can hear the TV and understand what was said.”

Measurable Expertise

Trinity Hearing & Balance Center’s philosophy and dedication to patient care set it apart from other hearing centers.
“Our center is proud to be an AudigyCertified practice,” acknowledges Dr. Hansen. “We are one of only two hundred and fifty clinics in the nation to hold this certification.
“AudigyCertified professionals are among the country’s most experienced hearing care professionals, possessing some of the industry’s highest credentials. Our expertise is measured by our commitment to patient satisfaction, continuing education and the expert application of current technologies.
“Many patients who have gone through our Patients for Life™ program experience greater satisfaction with their hearing technology and a greater quality of life.”
One of the most unique aspects of Audigy’s service is e-patient®, which brings their Patients for Life program into the digital world.
Graphic from istockphoto.com.“The e-patient program, a component of Patients for Life, is an educational tool that we provide for patients,” explains Dr. Hansen. “e-patient offers an overview of what’s going to happen during the appointment as well as explaining how someone’s hearing works. It is a treatment-focused software tool that enables us to quickly and effectively explain products and procedures to patients. e-patient has excellent visuals to show the patient how their hearing works and what happens when someone has a hearing loss.”

Advice From Experience

With Trinity Hearing & Balance Center’s comprehensive hearing and balance services, Jim and Judy were able to fight on two fronts with one weapon. The inclusive services also brought continuity and consistency to their overall care. Now, they no longer suffer the discomforts and inconveniences of living with dizziness and hearing loss.
“I had that bout of vertigo,” states Jim, “but I haven’t had it again since Dr. Hansen put me through the repositioning procedure.
“When I first went to Trinity Hearing and Balance Center, I was dubious like you would be with anything new. After a couple of sessions, however, I gained trust in them and in Dr. Hansen. It’s a really good place to go.”
“I can still get a little dizzy if I sit up or lean over too quickly, but otherwise, I’m just about normal,” says Judy. “When I put the hearing aids in, it’s like another world. They make a huge difference for Jim and me because now we can hear. They’re wonderful.
“I have some advice to anyone who has a problem with hearing or vertigo: You want to go to Trinity Hearing and Balance Center and see Dr. Kelly Hansen!”

Continuous Synchronization

Hearing aids communicate with each other 1200 times per second.

Chicago native Kasey Witte, 30, is a full-time nanny for her two nephews, ages three and one. In her role, she does everything from diaper changing to potty training, meal planning to providing first aid. When a change in her hearing affected her ability to hear her children, she worried about their well-being.

 Photo courtesy of Kasey Witte.

With her new hearing aids, Kasey says she hears everything.

“A few years ago, my family and friends noticed a major change in my hearing,” shares Kasey. “I was having a difficult time following conversations, and was not very engaged in the discussions. I was also having trouble hearing everyday things such as a knock on the door or the doorbell ringing. Talking on the phone was a problem as well.
“Over time, my hearing continued to decline, and I started having a hard time hearing my nephews opening doors and running around the house. It became a safety issue. That was my biggest concern.”
Kasey took her suspicions to her primary care physician, who suggested she visit a hearing specialist. She went to a local provider and was prescribed hearing aids the same day, but she was unhappy with the instruments they recommended and didn’t wear them.
“My family started searching for other hearing aid specialists, and they came across an article in Florida Health Care News about Knoblach Hearing Care,” recounts Kasey. “I read the article on one of their patients, and everything about it spoke to me. That’s when we decided to research the office further. Then, we scheduled my first appointment.”
Knoblach Hearing Care in Largo is the practice of Dean M. Knoblach, a board-certified Hearing Instrument Specialist. From the moment Kasey walked in the door, Dean made her feel welcomed and comfortable. Immediately, she felt she could trust Dean to find a good hearing solution for her.
“The first part of the visit was Dean just getting to know me, how I got where I was and where I wanted to be in the future,” she recalls. “The second part was the testing. He went through a step-by-step process and concluded I had a profound hearing loss. Then, I went through a trial of the hearing aids he recommended, and I was very happy with them.”

Industry Advancements

“Kasey arrived at Knoblach Hearing Care after having lackluster results with her previous hearing aids,” notes Dean. “In her work as a full-time nanny, Kasey needed devices that were adjustable. She had to be able to hear her nephews when they were a distance away from her and also when they were right next to her.
“Kasey needed something comfortable to wear that took care of the different environments she was in on a regular basis,” confirms Dean. “Some of the latest technology released in our industry, and the technology we recommended for Kasey, involves wireless pairing of the hearing devices.

“Dean and the hearing aids he recommended have completely changed my life. I went from feeling like I was on mute all the time to hearing everything.” – Kasey

“It’s not Bluetooth® pairing, but rather continuous synchronization of the left and right hearing aids with each other. These devices identify what they are hearing and where the sound is coming from, automatically measure the room size through echolocation, and then adjust themselves for maximum speech clarity and noise management. They complete this process twelve hundred times per second.”
The most recent version of this continuous synchronization technology was just released in August 2017. It has all the capabilities of the current technology, but it is smaller.
“These new instruments are the size of a pencil eraser,” describes Dean. “They literally came out a few weeks ago. We started using them days after their release, and they’re amazing.
“These wireless devices that talk to each other have changed sound management. They’re the biggest change I’ve seen in the hearing aid industry since 1983.”
Improvements to the rechargeable battery technology are other recent advancements in the industry. The newer batteries can provide 24 hours of service from a single charge. If these batteries lose their energy, 20 minutes of charging can provide up to seven hours of battery life.
“These new batteries will last for five years,” elaborates Dean. “Before, batteries only lasted three hundred charges, which didn’t even get people through a year. Then, they had to replace the battery cell, which is costly and takes time. The older batteries also took four hours to charge, and there was no quick-charge capability.”

Enjoying Life Again

The continuous synchronization hearing aids from Knoblach Hearing Care make a huge difference for Kasey. She says her hearing is even better than normal because she can now hear things she never could before.
“Dean and the hearing aids he recommended have completely changed my life,” she enthuses. “I went from feeling like I was on mute all the time to hearing everything.
“My work has changed dramatically as well, especially from a performance and a safety perspective. Now, I’m able to hear everything my nephews are doing. It’s truly unbelievable.”
Kasey loves her new hearing aids, so she wears them. She’s no longer having difficulty with the activities she struggled with before. Now that she can hear people clearly in conversations, she’s spending more time with her family and friends.
“I’m more engaged than ever before,” she reports. “My social life is thriving. I’m back to being a regular thirty-year-old. I’m trying new stuff, getting back in touch with old friends and going out to lunch or shopping. I used to avoid making or returning phone calls because I couldn’t hear. Now, I want to do it all the time.

“You never know what you’re missing out on until you can really hear it. I wish everybody with a hearing problem could find the joy I feel” – Kasey

“That is a huge step for me, and a major confidence builder. I feel like I’m really enjoying life again.
“You never know what you’re missing out on until you can really hear it,” she adds. “I wish everybody with a hearing problem could find the joy I feel. I highly recommend Dean and Knoblach Hearing Care to anybody who is struggling with hearing loss! Anybody!”

Healing at the Cellular Level

Deep-tissue laser reduces pain & inflammation, accelerates recovery.

Two years ago, Amy Zepp developed elbow tendinitis as the result of limited mobility in her shoulder. The shoulder issue, which was due to a lifetime of working out and being active, put extra stress on her elbow. This stress led to pain and inflammation of the joint’s connective tissues.

Photo by Jordan Pysz.

After laser treatment on her elbow, Amy can work out her arms again.

“I suffered with tennis elbow for nine months,” she describes. “I got to the point I couldn’t lift weights or even raise my coffee cup. Picking up a milk jug was excruciating, and I would often drop it. Finally, I had enough and decided to go to physical therapy.”
Amy was familiar with FYZICAL Therapy & Balance Centers, so when she needed therapy, she knew where to go. When she arrived, she teamed up with physical therapist Tara Schwartz, PT, MPT. Tara designed a therapy plan to address Amy’s elbow condition and relieve her pain. The plan included manual manipulation, exercise, cupping and treatment with the deep tissue LightForce® laser.

Tissue Regeneration

The LightForce laser is a type of photobiomodulation therapy, a form of light therapy where a light source is placed near or in contact with the skin reaching the mitochondria of damaged or diseased tissue. This process can result in alleviation of pain, regulation of inflammation, immunomodulation and the promotion of tissue regeneration.
“The application of a therapeutic dose of light to injured tissue leads to a cellular response assisted by the mitochondria, which are also known as the powerhouses of the cells,” notes Tara. “The mitochondria stimulate production of ATP, the molecule that facilitates energy transfer within a cell.”

“My elbow improved to the point that I’m as active as I used to be, and I don’t have any pain.” – Amy

In addition to ATP, laser stimulation also produced free nitric oxide and reactive oxygen species. Nitric oxide is a powerful vasodilator and an important cellular signaling molecule involved in many physiological processes.
“The laser treatment feels a little warm, but it’s not uncomfortable, and it definitely improved my tendinitis,” shares Amy.
For most patients, as with Amy, the LightForce laser is used as part of a total physical therapy plan that may include soft-tissue massage and manipulation, and corrective exercises. In certain cases, however, it is used as a singular treatment. “At FYZICAL, we’ve seen a lot of success with the LightForce laser for various acute and chronic conditions.”

Absolute Trust

After putting Tara’s therapy plan into action, including treatment with the LightForce laser, Amy’s recovery progressed rapidly. She’s now back to her usual activities.
“My elbow improved to the point that I’m as active as I used to be, and I don’t have any pain,” states Amy. “I’m back to lifting weights. Holding a cup of coffee is easy, and I don’t have any issues picking up a milk jug.”
Amy is ecstatic by the quality of care she received at the center by the staff who treated her.
“When I recommend FYZICAL Therapy and Balance Centers, I recommend and absolutely trust all of them. They’re all wonderful; they’re just fantastic!”

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