Author Archive

Arresting Symptoms

Tailored, minimally invasive vein treatments resolve leg pain.

In 1972, John Olasin won the lottery. It just happened to be the military draft lottery. He was No. 1 on the list that year, but he wound up feeling like a winner anyway.

With his varicose veins gone, John now has “perfect legs.”

“They took me right out of college,” John recalls. “I served in the United States Navy as a flight engineer on a jet aircraft. I taught flight instructors as well. I enjoyed the service so much I stayed in for 20 years and 18 days, then I retired.”

With the education received through the military, John earned a degree in criminal justice. He entered Florida’s police academy and became a law enforcement officer.

“I actually worked 75 days in the Monroe County Sheriff’s Office before I got out of the Navy,” John clarifies. “After I retired, I became a deputy sheriff for Monroe County in the fabulous Florida Keys.”

For six months, John patrolled the streets, but because of his teaching background, he was pulled off that beat and placed in the school system to serve as a school resource officer. He taught the Drug Abuse Resistance Education program and appeared on a weekly television show to address relevant safety topics. John also joined forces with four other officers in the state to found the Florida Sheriffs Explorers Association.

“The Explorers is a program backed by the sheriff’s office to mentor kids who want to become lawyers or police officers,” John explains. “I started out with three kids, and after nine years there were more than 150 students in my program. I loved it. I loved teaching kids.”

Dating back to his days in the Navy, John was plagued by symptomatic varicose veins in his legs. He blames their development on the pressure generated by flying jets at high altitudes and the forces created by wearing steel-toe shoes on concrete. The condition caused significant swelling and pain that eventually required treatment.

“The veins in my legs got really bad, and in 1987, while I was still in the Navy, I had some of them stripped,” John recounts. “That procedure was a serious operation, and they put me out while they did it. But afterward, my legs felt great.”

Following surgery, John’s legs remained symptom-free until this past year, when the pain and discomfort returned with a vengeance.

“Almost every night, I got violent cramps in my legs,” John describes. “I would get out of bed crying because my legs hurt so bad. On a daily basis, there was a prickling pain that rated about a six on a scale of one to 10. I didn’t let the pain keep me from doing anything. I just sucked it up, thinking the leg pain was just going to be a part of my life.

“Then in July of last year, I visited my dermatologist. She took one look at my legs, saw all the varicose veins and referred me to Dr. Sharma.”

Signs and Symptoms

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

During John’s initial visit, Dr. Sharma ordered an ultrasound of John’s legs. It showed a number of deep leg veins leaking and restricting blood from flowing back toward his heart, a condition called venous insufficiency.

Chronic venous insufficiency has multiple causes.

“The swelling and achiness in my legs are all gone now.” – John

“After long periods of sitting or standing, the blood in leg veins can pool,” Dr. Sharma informs. “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, indicators that the veins are not functioning properly. Signs, which can be seen, include bulging varicose veins as well as swelling, thickening and discoloration of the skin of the ankles or legs. Symptoms, which are felt, include throbbing, aching, stinging, burning, itching, nighttime leg cramps and restless legs.

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

Choosing A Physician

Dr. Sharma goes on to describe the qualities patients should look for when seeking a physician for care.

“It is crucial that people choose surgeons who specialize in venous diseases and only venous diseases,” he stresses. “I recommend staying away from physicians in large practices that offer a variety of services and perform venous treatment as a side service. Vein treatment must be tailored to the individual. There is no one-size-fits-all approach.

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

Minimally Invasive Options

Premier Vein Centers offers a range of advanced, minimally invasive treatments to address varicose and spider veins. These options include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections and VenaSeal.

Microphlebectomy has replaced vein stripping, an outdated, more invasive procedure during which doctors removed the large veins by making big gashes across the leg, often leaving sizable 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 contends. “And with this procedure, patients end up with tiny marks on the skin or no scars at all.”

EVLA is performed using a sterile laser fiber that is introduced into the incompetent vein through 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, small twisted veins that are visible through the skin. Dr. Sharma uses ultrasound-guided sclerotherapy (UGS) to guide the injections that gently close the problem vessels.

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

“I look 10 years younger since having the laser treatment.” – Jameson

Dr. Sharma relies on his expertise to determine which procedures will work best based on each patient’s symptoms and health status.

“In Mr. Olasin’s case, I felt that the VenaSeal procedure would produce the best results,” Dr. Sharma states.

The advanced treatments offered at Premier Vein Centers are 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 observes. “And they are happy to learn that they can resume activities right away following the procedure.”

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

“Perfect Legs”

Following a thorough evaluation of John’s legs and review of his symptoms, Dr. Sharma used VenaSeal and microphlebectomy to close John’s leaking veins, most notably his great saphenous veins, the large veins that run from the ankle to the groin. John’s treatments were completed over several visits in August and September.

“It was fun to watch as Dr. Sharma performed those procedures,” John enthuses. “He used ultrasound, so when he put the numbing solution in my leg I could actually see it travel all through the vein. And when he removed my bad veins, I felt almost instant relief. It was amazing.

John reports the leg cramps have been absent since October.

“The swelling and achiness in my legs are all gone now,” he states.

While John wore shorts before his treatment at Premier Vein Centers, he was always very conscious of the appearance of his legs. But since his treatment, John is happy with the look of his legs in shorts.

“I’ve got good-looking legs now,” John raves. “There was a lot of scarring after the vein stripping, but Dr. Sharma used little incisions to remove my bad veins, so there’s hardly any scarring on my legs. And the visible varicose veins are gone. I have perfect legs now.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb

‘A Dream Come True’

Novel dental implant solves ‘complicated’ case, restores youthful smile.

By age 9, Cheryl Richards knew she wanted to work in health care. Her father was a physician, and by then she had already witnessed firsthand the difference a dedicated medical professional
can make in people’s lives.

Cheryl Richards

But it wasn’t until she lost her teeth in an auto accident at age 16 that her career path came into focus.

“We were on our way back from a winter school play, and it was snowing,” Cheryl, 75, recollects. “Our car skidded off the highway, rolled over several times and landed on its roof. I received considerable head and facial trauma, including fractured teeth.

The sound that followed the removal of every broken tooth the dentist had to pull still echoes in her head.

“He had a stainless steel metal plate, and every time he pulled a tooth, I could hear him drop the tooth onto that plate,” she recalls. “I lost all my upper teeth and my posterior bottom teeth as a result of that accident.”

To replace the lost teeth, the dentist fit Cheryl with a traditional, removable upper denture. It was uncomfortable and awkward, but in adjusting to it, Cheryl called to mind a phrase her mother often voiced: Remember to count your blessings.

With each passing day, she took that expression to heart as she learned to accept her fate. In time, though, acceptance morphed into inspiration as Cheryl pursued a career in dentistry.

She went on to work as a chairside dental assistant for 38 years and taught in the field for seven more. During those years, she learned about advances in denture technology, specifically the use of dental implants to stabilize dentures.

Confident in the technology, Cheryl was eventually fit with two dental implants in her lower arch. She also wanted to get an implant-supported denture for her upper arch, but five dentists told
her they couldn’t do it.

“My case was too complicated, they all said.”

The reason: After 59 years of wearing an upper denture, the bone between the roof of Cheryl’s mouth and sinuses had thinned due to the denture’s repeated hammering against her palate.

Cheryl was certain, though, that the right dentist could give her the implant-supported upper arch she wanted. When she began asking friends who they would recommend for such a job, one name came up repeatedly: Michael A. Pikos, DDS.

“I knew Dr. Pikos professionally,” Cheryl reveals. “I attended one of his classes on dental hygiene and advances in technology. The professionals I consulted with agreed that if anyone could get me out of a removable denture and into implants, it was him.”

Dr. Pikos is a board-certified oral and maxillofacial surgeon and the founder of Coastal Jaw Surgery. He is also a global leader in dental implants and surgical reconstruction known for developing the smile restoration process called Same Day Teeth®.

“Same Day Teeth is an innovative treatment that allows for the placement of dental implants and new teeth on the same day,” Dr. Pikos details. “It restores the aesthetic appearance of the smile and provides optimal functionality.”

Cheryl was first examined at Coastal Jaw Surgery in January 2020. Afterward, the news Dr. Pikos delivered was music to her ears. “He said, Yours is a complicated case, but I’m going to take it on,” Cheryl remembers.

Zygomatic Implants

“Like Cheryl, many patients in this situation are told by other dentists they don’t have enough bone for implants or bone grafting,” Dr. Pikos explains. “But at Coastal Jaw Surgery we have a solution for these patients, a novel type of dental implant called zygomatic implants.”

Zygomatic implants are longer than traditional implants. They can be as long as 2 inches because they are anchored in the patient’s cheekbone and come down into the mouth. The surgical team at Coastal Jaw Surgery is highly trained in the use of zygomatic implants.

Coastal Jaw Surgery is a certified ZAGA center, one of only two in Florida and the first in North America.

“Their work is amazing.” – Cheryl

ZAGA stands for Zygoma Anatomy-Guided Approach, which means that instead of basing treatment on an established technique, tools and processes are adapted to the patient’s anatomy.

“There are eight to 10 ZAGA centers in this country and 50 throughout the world,” Dr. Pikos discloses. “We are a focused group centered on helping patients who have otherwise been rejected for implants and feel utterly hopeless. Our methodology is grounded in science, and we are trained differently than other surgeons with regard to using these site-specific implants.”

Dr. Pikos used zygomatic implants for Cheryl’s Same Day Teeth process, which began with a cone beam CT scan of her head and neck. During the initial appointment, Coastal Jaw Surgery’s prosthodontist, Philip J. Hedger, DMD, MS, was brought in.

Dr. Hedger is the tooth-replacement specialist and “smile architect.” He designs the new teeth as part of the Same Day Teeth treatment.

“Our process is entirely digital,” Dr. Pikos asserts. “Once Dr. Hedger designs the patient’s smile using special computer software, all the records are sent electronically to a dental lab we work with in Los Angeles. Using the same software, the lab designs the final set of teeth based on our input and the patient’s age and desires.”

The lab also creates digital models for the implant surgery.

Cheryl is “thrilled” with her new smile.

Dr. Pikos uses the models to determine the precise location for the implants. Precision is required because there is minimal bone mass in the cheekbones.

In treating Cheryl, Dr. Pikos placed two zygomatic implants on each side of her upper jaw. Following surgery, Cheryl was left with small posts protruding from her gums and was sent home to recuperate. When she returned to Coastal Jaw Surgery two days later, Dr. Hedger fit her with a temporary prosthesis.

“Any small changes that need to be made to the smile are done when the temporary prosthesis is received,” Dr. Pikos informs. “Patients undergoing this procedure are then instructed to remain on a soft food diet for four months. This time allows the implants to integrate with the bone and tissue to heal. Then, after four months, the patient receives an even more beautiful, final permanent set of teeth.”

Cheryl is “thrilled” with her new smile and appearance.

“If you take a picture of my smile now and compare it to a picture of my smile at 16, this is the most natural I’ve looked in all those years,” she rejoices. “Dr. Hedger matched my teeth beautifully. They don’t look like anything other than my natural teeth. And they’re also functional. It’s a dream come true.”

One thing about Cheryl’s experience stands out to her: the coordination between Dr. Pikos and Dr. Hedger.

“I call Dr. Pikos my world-class architect and Dr. Hedger is the museum-quality artist,” she raves. “Dr. Hedger’s got the technology for the smile, and Dr. Pikos has everything it takes for the function. Their work is amazing.”

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

Autism Answers

April 5th, 2021

Autism, or more correctly autism spectrum disorder (ASD), is a complex developmental condition. Typically, people who have ASD face persistent challenges with communication and social interaction, and often perform repetitive behaviors. ASD is considered a “developmental disorder” because symptoms generally appear in the first two years of life.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the book of standards for diagnosing a host of conditions published by the American Psychiatric Association, divides the symptoms of ASD into two categories: problems with communication and social interaction, and problems with restricted or repetitive patterns of behavior or activity.

Problems with communication include having difficulty sharing emotions and interests, and maintaining a back-and-forth conversation. Your child may also struggle with nonverbal communication, such as maintaining eye contact or reading other people’s body language. Difficulties developing and maintaining relationships also fall under this category.

Your child may have ASD if they repeat movements, motions, or speech patterns, or rigidly adhere to a specific routine or behavior. Another symptom is an increase or decrease in sensitivity to a particular sensory input from the environment; for example, reacting strongly to a certain sound. Being fixated or preoccupied with an object or task is also a symptom listed in the DSM-5.

While people with ASD face many challenges, some may also have many strengths. Some people with ASD can learn things in detail and remember information for a long time. They may be strong visual and auditory learners, and be highly skilled in math, science, music, or art.

The exact cause of ASD is unknown, but research suggests there is no single cause. Rather, it’s believed that genetic factors combine with environmental influences to affect development in ways that lead to ASD.

There are certain factors that may increase your child’s risk for developing ASD. The suspected risk factors for autism include: having an immediate family member with the condition; having fragile X syndrome, tuberous sclerosis, or another genetic disorder; being born to older parents; having a low birth weight; having a metabolic imbalance; and being exposed while in the womb to certain medications, such as valproic acid or thalidomide. Multiple sources have concluded that the disorder isn’t caused by vaccines.

Typically, ASD symptoms become clearly evident during early childhood, between 12 and 24 months of age, but symptoms may appear sooner or later. The American Academy of Pediatrics recommends that all children be screened for autism at their 18- and 24-month well-child visits. But if your child is high-risk for ASD, additional screening may be recommended.

The Modified Checklist for Autism in Toddlers (M-CHAT) is a common tool used by many pediatric practitioners to screen for ASD. The M-CHAT is a simple survey that is filled out by the parents. The answers to the survey questions can help the provider determine if additional testing is needed.

A combination of tests may be used to diagnose ASD. These tests often include DNA testing for genetic diseases, behavioral evaluations, occupational therapy screening, and the Autism Diagnostic Observation Schedule (ADOS).

The ADOS uses planned social situations to trigger target responses and interpersonal interactions, which elicit a wide range of verbal, physical, and social exchanges between the tester and the person being tested. The reactions to the situations are given a score. A high overall ADOS score indicates a high degree of impairment due to ASD.

There is no cure for ASD, but research has shown that early intervention treatment services can improve your child’s development. Early intervention may include physical, occupational, and speech therapy to help your child with walking and talking. Additional therapy, such as play therapy, can help your child learn key social skills such as interacting with others.

Those with ASD may be referred to specialists who provide behavioral, psychological, and educational therapy, or skill-building interventions. These therapies, which are typically highly structured and intensive, are designed to reduce challenging behaviors, build skills necessary to live independently, increase strengths, and teach social, communication, and language skills.

If you suspect that your child has ASD or if you’re concerned about the way your child plays, learns, speaks, or acts, contact your child’s doctor and share your concerns. Have your child tested for ASD so a diagnosis can be made and treatment services can be initiated as soon as possible.

Intervene early and help your child with ASD reach their full potential!

Rein In Pain – Without Surgery

Modern protocol rebuilds arthritic joints, spurs unbridled enthusiasm.

Sylvia Evans fell in love with horses the very first time she laid eyes on one. By age 7, the farm girl had a horse of her own. Unfortunately, she was forced to give up her four-legged friend a few years later, when her family moved to the city.

Sylvia Evans painting and smiling brightly.

Sylvia responded quickly and positively to the regenerative medicine protocol.

Her equine enthusiasm never waned, though, and after marrying, she acquired another horse.

“I wanted to show horses, so I took lessons to learn how to do it correctly,” reminisces Sylvia, 78. “My husband and I later moved to the state of Washington and bought a boarding and training stable, where we kept 57 horses.

“All of our horses were northern horses, but we had a good sampling of breeds in our stable. We boarded Arabians, Appaloosas, quarter horses, thoroughbreds and saddlebreds.

I trained horses for 25 years or so before I finally retired.”

As part of her daily training routine, Sylvia rode five to 10 horses a day.

She also taught lessons in English and Western riding.

One day in 1978, a horse got the better of her, and the result was a debilitating injury.

“We took in this horse for training before we owned the stable,” Sylvia recalls. “He was a nice horse, but he didn’t like to be ridden. He threw me and I landed on my left knee. Right away, the knee swelled up, and it was extremely painful. I couldn’t walk, and I definitely couldn’t ride because I use my left leg to climb on and off the horses.”

Once the swelling subsided and pain decreased, Sylvia was able to walk and use her left knee without issue. The knee remained trouble-free until 2011, when degenerative arthritis began to take a toll.

“The cartilage in my knee deteriorated,” Sylvia recounts. “My knee didn’t swell that much, but it was painful. In the beginning, the pain wasn’t that bad, a one or two on a scale of one to 10. But as time went on and the arthritis worsened, the pain shot up to a seven or eight. I could walk, but I couldn’t jog or run. My doctor recommended a knee replacement. Then I met Dr. Taylor.”

Joseph L. Taylor, DC, is a chiropractic physician at Renewed Wellness Integrative Medical Center in West Palm Beach. His office employs regenerative medicine to restore arthritic and injured joints.

Sylvia met Dr. Taylor at one of the seminars he offers to educate people about regenerative medicine. After hearing the doctor’s discourse, Sylvia opted to move forward with treatment.

“Sylvia came to us for an initial evaluation in March 2020,” Dr. Taylor reports. “At that time, she was experiencing significant pain and instability in her left knee, but she did not want surgery at her age. We were very optimistic we could help her. She began our regenerative medicine protocol in April.”

Healing Inflammation

Renewed Wellness Integrative Medical Center’s regenerative medicine protocol generally begins with an injection of platelet rich plasma, or PRP, which contains a hefty proportion of growth factors and healing substances. PRP is obtained from blood drawn from the patient and placed in a centrifuge, where the platelets are separated from other blood products.

“Typically, the PRP injection is followed by eight to 16 treatments with our Class IV laser,” Dr. Taylor observes. “At that time, we initiate very light rehab. The next step is to inject mesenchymal stem cells, which can transform into other types of cells, including cartilage cells. These stem cells work to repair and rebuild the damaged joint.”

Laser therapy normally continues about a week following the injection of the stem cells. The patient then begins more intensive rehab. Sometimes, the stem cell injection is followed by a second PRP injection, which acts as a booster to fuel the growth of the stem cells.

The rehab portion of the protocol aims to stabilize the damaged joint and addresses the muscle imbalances that cause instability. Sylvia’s rehab included exercises to strengthen her quadriceps and hamstrings, and their opposing muscles.

“Sylvia did not want surgery at her age. We were very optimistic we could help her.” – Dr. Taylor

“The goal of our protocol is improvement in joint function,” Dr. Taylor contends. “Pain is simply an indicator that something is wrong, and a major cause of pain is joint dysfunction. Thus, rehab is essential to achieving long-term pain relief.”

Without following a rehab program, the joint will continue to be unstable and eventually return to its previous painful state.

“We do not want any patient to experience pain, but the marker by which we gauge treatment success is the patients’ ability to perform desired activities because that contributes to quality of life,” the doctor says.

“The nurse practitioner actually performed the injection procedure, and she was very good,” Sylvia comments. “She made sure my knee was numb when she injected the stem cells, so I felt absolutely no pain.”

Dancing Machine

Sylvia responded quickly and positively to the regenerative medicine protocol. Her pain began to diminish shortly after the injection, allowing her to skip surgery.

Sylvia still experiences a little stiffness and aching in her left knee when the weather is cold, but Dr. Taylor notes that residual discomfort is not uncommon when extensive degenerative changes are taking place in the joint.

Since the treatment, Sylvia has adopted a revised version of her fitness routine. She hasn’t returned to jogging or dancing, but her knee allows her to move in ways she couldn’t beforehand.

“I like to put on one of my recordings and scoot across the floor,” she describes. “I also own a stationary bike, and when it’s warm I pedal it to get exercise.

Sylvia asserts her treatment is an “absolute success.”

“Unfortunately, I now have arthritis in my right knee,” she advises, “As soon as my left knee is totally squared away, I’m going back to Renewed Wellness Integrative Medical Center to have my right knee addressed as well.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. js

Rejuvenate On The Fly

Lunchtime nonsurgical face-lift quickly and easily tightens and smooths skin

In 2008, Debra Leonard left her native New York and moved to Florida, where she and her husband got into the restaurant business.

Cigdem Gali Standing in Galiderm

Cigdem is a physician assistant specializing in aesthetic medicine.

“That was a great experience, and I enjoyed it,” Debra shares. “I loved owning my own place and interacting with people. That’s what I do really well because I’m a relationship builder. We owned the restaurant until 2014. “Debra hit a rough patch after losing the restaurant. She gained weight and was uncomfortable with her appearance. Then she met Cigdem Gali, MSPA, PA-C, a physician assistant specializing in aesthetic medicine with GaliDerm Aesthetics & Plastic Surgery in Royal Palm Beach.

“Cigdem is my hero,” Debra enthuses. “I lost 35 pounds with her that I’ve kept off for almost six years. At GaliDerm Aesthetics & Plastic Surgery, I’ve had just about every possible treatment done. When I walk into the office there, I say, Here I am. Do what you need to do. I trust Cigdem completely.”

“Beautified by Cigdem”

“Debra has been my patient for more than six years,” Cigdem reports. “Over the years, she has enhanced and maintained her youthful appearance by keeping up with her beauty
treatments. Most recently, she had a lunchtime face-lift, which is a minimally invasive, safe and effective alternative to surgery. With the lunchtime face-lift, there is little to no downtime and the results are spectacular.”

With facial aging, there is bone loss, facial muscles weaken and relax, and the fat pads begin to separate and droop, causing the skin to sag. Cigdem, a national trainer for PDO threads,
uses nonsurgical dissolvable threads to lift, tighten and add volume to the area being treated.

“The threads induce collagen production, dissolve within six months and create an immediate, visible result that continues to improve and lasts up to a year and a half,” Cigdem informs. “We typically use a combination of threads, fillers and a neurotoxin for the lunchtime face-lift.”

Following the threads, Cigdem introduces fillers to add volume, lift and further define the patient’s face. “We lose volume as we age, and restoring that lost volume rejuvenates the face, making the patient appear more youthful and rested.”

I’m 63 but look 45, I attribute that to Cigdem.” – Debra

GaliDerm Aesthetics & Plastic Surgery employs the full range of fillers on the market, including JUVÉDERM®, RESTYLANE®, VERSA® and RADIESSE®. They also carry the newest filler, the RHA® Collection from Revance Therapeutics, which is available only at elite centers. Cigdem finishes the lunchtime face-lift by injecting a neurotoxin such as BOTOX® Cosmetic, JEUVEAU®, XEOMIN® or DYSPORT®. Neurotoxins relax facial muscles so they cannot be stimulated to move. They not only prevent future wrinkles but will also help eliminate or soften existing fine lines and wrinkles.

“During the facial assessment I determine which technique, treatment and products will give my patient optimal results based on their desired aesthetic outcome and current appearance.” Cigdem explains. “I evaluate each patient’s
needs and tailor the treatment to the individual, but in every lunchtime face-lift we lift, tighten, and smooth the skin. And with the right combination of
treatments, the procedure can make patients look 10 years younger.”

“I’m 63 but look 45. I attribute that to Cigdem,” Debra says. “And every day when I look in the mirror, I thank her. I’ve never felt the passion and trust for anyone that I feel for her. My slogan is, Beautified by Cigdem.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. js

Keeping Up With Kidney Health

March 29th, 2021

If you’re like most people, you have two kidneys, the bean-shaped organs about the size of your fist that lie just below the rib cage, one on each side of your spine. March is National Kidney Month, so let’s review what the kidneys do, examine a few common diseases that can affect them, and learn some ways you can help keep them healthy.

Adult and child holding kidney shaped paper, world kidney day, National Organ Donor Day, charity donation concept

The primary job of the kidneys is to filter waste products and excess fluid from your blood, but they perform other functions as well. They also help regulate blood pressure, make red blood cells, control the pH level in your body, and keep your bones healthy. Each of your kidneys is made up of about a million filtering units called nephrons.

But the kidneys are susceptible to damage and disease. The most common condition affecting the kidneys is chronic kidney disease, or CKD. According to the National Kidney Foundation, CKD affects an estimated 37 million people in the US. That’s 15 percent of the adult population, or 1 in 7 individuals. And 90 percent of those who have CKD don’t know they have it.

With CKD, your kidneys become damaged, usually by diabetes or high blood pressure, and can’t function properly. This can cause waste products to build up in your body, which can result in health problems such as anemia and heart disease. Uncontrolled CKD can lead to kidney failure, but early intervention can slow its progression and help preserve kidney function longer.

There are other conditions that can affect the kidneys as well. Glomerulonephritis develops when the tiny clusters of blood vessels in the nephrons called glomeruli become inflamed and damaged due to infection or disease and can’t ’do their job of filtering blood. As a result, your kidneys can’t remove wastes and excess fluid from your body. If it becomes severe, glomerulonephritis can lead to kidney failure.

Polycystic kidney disease, or PKD, is an inherited disorder in which fluid-filled cysts form throughout the kidneys. This causes the kidneys to become enlarged and lose function. In fact, PKD is the fourth leading cause of kidney failure. There may be other health complications as the kidney cysts grow larger, including high blood pressure, anemia, and liver disease.

The kidneys can also be affected by cancer. There are certain factors that increase your risk for kidney cancer, such as being obese or having a family history of the cancer, but it’s caused by inherited or acquired mutations to the genes that control kidney cell growth and reproduction.

These gene mutations cause the kidney cells to grow out of control and form tumors, which interfere with kidney function. Treatment for kidney cancer includes surgery, radiation therapy, immunotherapy, and chemotherapy.

Another kidney condition is kidney stones, which are hard deposits of minerals and salts. Kidney stones generally don’t cause symptoms while they’re forming, but can cause severe pain once they move into the ureter, the tube that connects the kidney to your urinary bladder. If you can’t pass the stones in your urine, you’ll need medical treatment to prevent infection.

There are things you can do to help prevent problems with your kidneys. First of all, it’s essential that you achieve and maintain good control over any chronic conditions that can lead to kidney damage and loss of function. These conditions include diabetes and high blood pressure.

Here are some other tips for maintaining kidney health:

•          Eat a diet that’s good for your entire body, one that’s rich in fruits, vegetables, whole grains, and low-fat or fat-free dairy products, and low in saturated and trans fats, sugar, and salt.

•          Quit smoking.

•          Maintain a healthy weight.

•          Stay active.

•          Get enough sleep. The National Sleep Foundation recommends between 7 and 9 hours of sleep per night.

•          Limit your alcohol intake. Men should have no more than two drinks per day; one drink per day for women.

•          Say well-hydrated. Drink fluids throughout the day.

Further, your doctor may also advise you to reduce your protein intake. Your kidneys must work harder to process the wastes that result from protein breakdown.

Follow these tips to prevent kidney disease and keep your kidneys healthy!

Not A Dry Eye In Her House

New protocol unclogs glands, brings lasting relief from chronic condition.

Matina Soutsos sitting on beach

Matina Soutsos

For most of her young adult life, Matina Soutsos worked in mortgage banking. In the midst of that career, she began restoring historic homes as a hobby. Before long, that pastime became a career.

“I bought one home and restored that,” relates Matina, 56. “Then it went from one home to 10, and 10 went to 20 and so on. Eventually, I didn’t have time for my mortgage banking job and ended up restoring homes full time.”
And now, she’s a building developer repurposing existing historic structures.

“Currently, I’m in Indianapolis turning a church that was built in 1927 into a hostel,” Matina says. “Repurposing involves taking the structure down to its studs and redesigning and reengineering it inside to create a really cool space. We bring the structure back to its original state on the outside. There are lots of people involved including architects and workers from every possible trade.

“I love my job because I get to create, and each property is different.”

Originally from Long Beach, California, Matina moved to Denver in 1994. She and her husband traveled south in 2020 to ride out the COVID-19 pandemic in Florida.

“I’m a breast cancer survivor and suffer with chemo cold,” Matina relates. “We came to Florida in May and never left. We’re moving to Florida permanently because we love it there. I love the weather. It’s more soothing for my body. I don’t experience chemo cold down there.”

Matina has dealt with another exasperating condition that made her life miserable: dry eye. It proved immune to various treatments, and the eye doctors she visited failed to help. But an answer presented itself when Matina’s husband underwent LASIK surgery this past year.

“I’ve always had horrible, chronic dry eye, and it bothered me all day and night,” Matina shares. “In the morning, it used to take me five minutes to open my eyes because they were so dry. Then I’d go through the day constantly dousing my eyes with drops, gels — you name it. Even in the middle of the night, I’d wake up because my eyes were so dry that it felt like I had cracked glass in them.

Matina and her husband, Amedeo, standing next to each pther on the beach

Matina and her husband, Amedeo.

When the problem first started, Matina had no idea of the cause.

“I thought maybe it was the weather or something I was eating or something in the environment,” she recollects. “All I knew was that my eyes were always crackling, and I went to specialist after specialist. Nothing they prescribed worked, and believe me, I tried all the drops.

RESTASIS® worked for a while but became very painful to use because it burned my eyes. After that, it was like no one could help me. Every other doctor said, This is just the way it’s going to be. It’s the way your body is built. Eventually, I gave up. I figured I just had to live with the dry eye, but it was horrible to do so.”

Ahead of his LASIK procedure, Matina’s husband researched eye care providers and discovered The Dry Eye Spa & V.I.P. Laser Eye Center and its founder, cornea specialist Clifford L. Salinger, MD. He noted Dr. Salinger’s reputation for treating dry eye and recommended him to Matina.

“Matina came to us experiencing quite a bit of discomfort in both eyes,” Dr. Salinger reports. “We diagnosed dry eye disease and Meibomian gland dysfunction, a condition in which the oil glands in the eyelids become clogged with thickened material.

“We started her on an extensive treatment protocol, which includes anti-inflammatory steroid drops, antibiotic drops, artificial tears and artificial tear ointment at bedtime, hot compresses, lid cleaning with lid massage, and vitamin supplements containing omega-3 and omega-6. This comprehensive treatment addresses the multiple factors that contribute to dry eye disease, and is often quite beneficial to relieve symptoms and improve their dry eye condition.”

That helped some, but it wasn’t until Matina received treatment with the LipiFlow® Thermal Pulsation System that there was a significant difference in the clinical appearance of her eyes and the symptoms of discomfort, the doctor said.

Combined Functions

The LipiFlow treatment, from TearScience®, combines the controlled application of therapeutic heat with a gentle, pulsating massage. These functions work to liquefy, then remove clogging debris from the eyelid glands, enabling them to function efficiently.

“LipiFlow is a revolutionary breakthrough for treating chronic dry eye disease,” Dr. Salinger contends. “It relieves dry eye symptoms by removing blockages of the eyelids’ oil glands. Opening and clearing the blocked glands enhances the natural production of the oils needed to restore a healthier tear layer on the surface of the eye.

At the Dry Eye Spa, LipiFlow is a three-step process.

“First,” Dr. Salinger says, “we do a thorough deep cleaning of the eyelids followed by the LipiFlow treatment itself. After that, we perform a manual expression of the Meibomian glands to remove any remaining clogging material. This makes room for healthier oil material to populate the glands and flow normally so the tear layer is more stable and uniform, which improves the dryness.”

Matina says the LipiFlow treatment, performed on August 10, was not painful.

“I’m not used to keeping my eyes open that long, and Dr. Salinger didn’t want me to blink,” she recalls. “That was the only uncomfortable part about the procedure. Otherwise, it was very mild.”

One month later, there was significant improvement in her condition, Dr. Salinger reports. Three months later, there was no irritation, gritty sensation or blurred vision.

Dr. Salinger calls for the treatment protocol to continue for at least a month after LipiFlow. If the patient responds well, the frequency of the treatments decreases until reaching the minimum amount to maintain the improvement achieved with LipiFlow.

“Our treatment is a comprehensive approach to dry eye disease,” Dr. Salinger informs. “LipiFlow is a very important component, but in and of itself is not the answer. It is critically important for patients to maintain good ocular health, and one of the best ways to do that is to continue their dry eye treatment.”

Exceeding Expectations

Matina had low expectations because nothing else she tried relieved her dry eye symptoms. But she was pleasantly surprised.

“Dr. Salinger told me I should notice a difference in my dry eye within 30 days,” Matina recalls. “I noticed a difference within three days. I was no longer waking up in the middle of the night with that feeling of having cracked glass in my eyes. I couldn’t believe it.”
Her eyes continued to improve until the symptoms disappeared.

“After 25 years, I don’t have dry eye any longer,” she raves. “Dr. Salinger changed my life.”

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

A Brief Overview of Brain Injuries

March 23rd, 2021

March is Brain Injury Awareness Month, and organizations such as the Brain Injury Association of America (BIAA) want you to know more about these dangerous injuries and their aftermath. Here’s a little information to help.

According to the BIAA, injuries to the brain that are not hereditary (passed down in families), congenital (present at birth), degenerative (get worse over time), or caused by birth trauma are considered acquired brain injuries, or ABIs. These injuries involve changes to brain activity that affect the physical integrity, metabolic activity, or functional ability of nerve cells in the brain.

There are many possible causes of ABIs. Electric shock is a typical cause of ABI, as is oxygen deprivation, stroke, seizure disorders, exposure to toxins, trauma, and tumors. Lightning strikes, certain infectious diseases such as pneumococcal and meningococcal meningitis, and substance abuse and overdoses are also common causes of ABIs.

A traumatic brain injury, or TBI, is a type of ABI that occurs when a sudden trauma causes damage to the brain.

The US Centers for Disease Control and Prevention define TBIs as brain injuries “caused by a bump, blow or jolt to the head, or a penetrating head injury that disrupts the normal function of the brain.” TBIs are most often the result of falls, but can also result from being hit by an object, a motor vehicle accident, or an assault.

TBIs are a common occurrence in this country. In fact, every 21 seconds in the US, someone sustains a TBI. According to the CDC, 2.8 million Americans suffer a TBI every year, and more than 56,000 people die as a result of their TBI. These injuries disable six times more people each year than spinal cord injuries, MS, HIV/AIDS, and breast cancer combined.

TBIs range from mild, when there’s a brief alteration in mental status, to severe, when there’s an extended period of unconsciousness and resulting disability. Most TBIs that occur each year are mild, commonly called concussions.

Concussions are caused by an injury, such as a blow to the head, that causes the brain to move rapidly back and forth inside the skull. Some people might sustain a cut or bruise on the face or head, but generally, there are no visible signs of a concussion.

You don’t have to lose consciousness to have a concussion, but many people do. Sometimes, someone with a concussion will look a little dazed and might forget what happened just before the trauma occurred. Most people fully recover, some within a few hours, some need a few weeks.

Concussions have become more common in sports on every level. This may be due to a growing emphasis on the risks for these injuries, especially in contact sports such as football. Fortunately, many coaches and trainers have been taught to recognize symptoms of concussion in their players and participants.

Severe brain injuries are those that cause unconsciousness or coma that generally lasts no more than a few weeks. With a severe brain injury, the person may suffer life-changing and debilitating problems.  Some people will remain in a coma and others will enter a different type of unconscious or minimally conscious state.

People with severe brain injuries rarely recover. Those who do are typically left with  a range of physical and neurological deficits that are difficult to overcome.

Brain injuries that do heal, don’t heal the same way as other injuries such as broken arms or legs. Healing involves a recovery of brain function, and how much and how fast varies. No two brain injuries are alike, so each person’s response to injury and recovery from it are different.

In general, patients with mild brain injuries tend to recover well. There may be minor residual symptoms such as headaches that improve over time. Approximately 60 percent of those with moderate brain injuries make a positive recovery, but an estimated 25 percent are left with a moderate degree of disability.

Only 25 to 33 percent of people with severe brain injuries achieve positive outcomes. About 33 percent do not survive, and the last few percent remain in a persistent vegetative state, in which they wake and sleep but are unconscious of the world around them.

There are a few steps you can take to help reduce the chances of sustaining a traumatic brain injury, including:

•          Drive safely. Buckle-up every time and never drive under the influence of drugs or alcohol.

•          Wear a helmet when riding a motorcycle, bicycle or horse; playing a contact sport; skiing or snowboarding; or inline skating.

•          Evaluate your fall risk. Review your medications with your doctor or pharmacist to identify any that may cause dizziness. Have your eyes examined regularly and update your glasses prescription as needed.

•          Use appropriate protective equipment to make your home and yard safe for children.

Creative Solutions

Innovative approaches solve challenging dental problems.

Robin Black’s 15 minutes of fame came when she was offered a staff position on then-Sen. John F. Kennedy’s team as he began his run for president.

Robin Black on her patio holding a blue birdhouse and smiling.

Robin is “delighted” with the implant-supported hybrid prosthesis created for her upper arch.

“My uncle was a Capitol Hill photographer, and I often went with him to big dinners and luncheons to write down the order of the politicians and celebrities in the photos and to gather any other information he needed,” Robin recounts. “It was my uncle who found out that JFK was looking for a secretary, and he told me about it.

“I went to the Senate office building and was interviewed on four occasions. They wanted me to be his private secretary. He was getting ready to run for president, and his current secretary couldn’t handle all that went with that. They wanted me to work with her and ultimately replace her, but the job demanded my entire life so I turned them down.

“Almost being JFK’s secretary is my claim to fame.”

Robin, 87, is a North Carolina native who resided in the Washington, DC, area for most of her adult life. Her family owned a business in Florida, so she regularly visited the Sunshine State. In 2001, she made Florida her permanent home. After relocating, she transitioned most of her health care to Florida providers. The exception was her dental care.

“As a youngster and into my 30s, I had horrible dental experiences, so I was traumatized when it came to going to the dentist,” Robin shares. “But in Silver Springs, Maryland, I finally found a wonderful dentist who took away all my fears and apprehensions.

“Even after moving to Florida, I continued to go up to Maryland a couple times a year to see that dentist. Then a few years ago, going there became more difficult due to scheduling conflicts and getting older. I knew I needed to find a local dentist.”

Robin thought finding a local dentist as good as the one she had in Maryland would be an impossible task. Then a friend had what he described as an “outstanding experience” with a teeth-whitening service offered by Stephen P. Lester, DDS, at Park Avenue Dentistry in Edgewater. Based on her friend’s review, Robin decided to give Dr. Lester a try.

“Right away, I was impressed,” Robin recalls. “After two appointments, I realized that the impossible had become possible.

Dr. Lester was wonderful. He allayed all the apprehensions I had and made me feel very comfortable. His manner and expertise were top of the line and state of the art. He’s exceptional, and I knew I could trust him.”

Hybrid Prosthesis

Dr. Lester began his care of Robin by replacing a failing lower bridge with a porcelain bridge that runs along the front of her lower arch. He then addressed her upper arch, where Robin’s bridgework was failing because of decay on the teeth supporting that bridge.

“That upper bridge was falling apart piece by piece,” Dr. Lester explains. “My recommendation to Robin, and she committed to it, was to replace that bridge with a single piece, a full upper arch of teeth resting on and retained by a half-dozen dental implants.”

The process of replacing Robin’s failing upper bridge and teeth began with Dr. Lester examining Robin’s jawbone three-dimensionally with a CT scan to ensure there was enough bone mass to secure the implants.

“People have no idea I don’t have my own teeth.” – Robin

“The CT images are also used to determine where to place the dental implants,” explains Dr. Lester, who also took impressions of Robin’s teeth to make molds to follow when creating replacement teeth.

During the next phase, Dr. Lester pulled the remaining 14 failing teeth in Robin’s upper jaw. Initially, Robin wore a transitional denture so that at no time was she without teeth.

“There are many dentists who advertise under various trademarked and brand names what are essentially teeth-in-a-day services,” Dr. Lester points out. “We offer a similar service at Park Avenue Dentistry.

“As part of our service, we first fabricate a denture. When the denture is ready to be placed in the patient’s mouth, we extract the teeth and put in the denture. Shortly after, it could be the same day, we place the implants. If the implants are nice and sturdy, we screw the denture onto the implants, fixing it into place.

Complete bottom teeth that secure to multiple implants

Full Lower Arch of Teeth

“I do not market this service as teeth in a day because there are several preparatory appointments. Those appointments are necessary for designing and creating the dentures prior to the day of tooth extraction and implant placement.”

Once patients receive the fixed dentures, they wear them about three months. During that time, the jawbone grows around and fuses with the implants to become a strong, solid unit.

“At the end of the three months, we throw away the transitional denture and create a really nice, strong and aesthetically pleasing permanent denture that goes the distance,” Dr. Lester says. “The technical term for this is an implant-supported hybrid prosthesis. It is called a ‘hybrid’ because it is not a denture alone; there are implants involved.”

Robin states: “My final prosthesis, which is porcelain, literally screws onto the implants, which no one can see unless they’re a dentist. Even I can’t see or feel them.”

Confounding Conundrum

It has been said that physicians make terrible patients. Yet, Randall Whitney, MD, was a willing and cooperative patient when he needed the services of a fellow provider. His years as a doctor taught him to recognize when a problem was beyond his medical facility.

Dr. Whitney at home standing in front of his fireplace with an aqua dinner jacket on.

Dr. Whitney can flash his bright, new smile with confidence.

“I went into practice on July 1, 1965, a month before President Lyndon Johnson signed Medicare into law,” he notes. “I was board-certified in family practice but also did obstetrics for a while. I operated a freestanding birth center in Daytona Beach in the late ’70s, early ’80s. That was the last time I did obstetrics. Since then, I do mostly family practice and gynecology, all here in Central Florida.”

When he developed an abscess, or infection, in his gums, Dr. Whitney took the old saying, “physician, heal thyself,” to heart. Because he knew which antibiotic to use, he successfully treated the infection himself. Of course, he also knew that to stave off another infection, the underlying problem needed to be addressed by a qualified dentist. He found just such a dentist while visiting another doctor for another issue.

“Earlier this year, I was at my cardiologist’s office in Port Orange, and I picked up a newspaper, which was Volusia Health Care News,” Dr. Whitney relates. “In it was a very good article about Dr. Lester, who is a master dentist in the Academy of General Dentistry. I was quite intrigued because there are not many master dentists in the country.

“I was considering getting a second opinion regarding what to do about this 2-year-old abscess. Food was getting trapped in the gap between two adjacent crowns, and that gap was difficult to access and clean.”

Inspired Solution

The first dentist suggested replacing the failing crowns, but Dr. Whitney knew that would not address cause of the problem because the gap would still be there. Dr. Lester presented a different plan, which Dr. Whitney knew would resolve the problem. The approach called for an endodontist to perform root canals on the teeth with the failing crowns.

Dr. Lester would then put his creativity to work to complete the process of ridding Dr. Whitney of the unusual dental issue.

“Dr. Lester would follow up the root canals by preparing a single crown that would fit around two teeth,” Dr. Whitney shares. “It was quite unique. He bridged the new crown so that it was one unit, and it fit me perfectly. I was just delighted. I couldn’t believe how nice it felt, how perfect it was.

Prior to beginning that work, Dr. Lester ordered a comprehensive three-dimensional scan of Dr. Whitney’s left maxillary sinus and jaw area.

“When I read the report, I realized how bad that abscess had been,” Dr. Whitney explains. “It was very close to the maxillary sinus, but I don’t think it penetrated the sinus because I have no sinus trouble.”

Dr. Whitney was astounded that Dr. Lester went so far as to examine the possible effects of the infection on other facial structures. In fact, many qualities about Dr. Lester were remarkable.

“I understand he also flies a helicopter,” Dr. Whitney comments. “That’s amazing to me. His wife also works in the office. She has her own business.”

The entire staff at Park Avenue Dentistry is outstanding, Dr. Whitney says.

“Dr. Lester is a brilliant, kind and quiet-spoken gentleman who is very attentive and bright,” he observes.

Individual Ideas

At Park Avenue Dentistry, unusual dental problems are a common occurrence. But Dr. Lester has an exceptional talent for finding nonconventional paths for overcoming these obstacles. Dr. Whitney’s case is one example.

“In his case, we were able to find a creative solution to the problem, and it worked for him,” Dr. Lester observes. “However, it’s not the answer for everybody in a similar situation.”

Dr. Lester describes how any solution begins with a thorough understanding of the patient’s problem, as well as lifestyle and hygiene habits. He considers all information before presenting treatment options.

“We treat everybody as an individual,” Dr. Lester offers. “Everybody is different in some way, whether it’s physically, dentally, psychologically or regarding the health issues they have. We are very exhaustive in our workup. We give each patient a thorough exam and ask many questions to really get to know them before we ever lay hands on them or even start making plans about the kind of treatment we think they need.”

“I think Dr. Lester is an exceptional person and dentist.” – Dr. Randall Whitney

The dentist notes how a detailed exam can reveal areas of weakness or damage that need to be addressed before a procedure can be performed, or areas to be avoided during a procedure. This can save the patient from unnecessary complications and pain.

“When we took Dr. Whitney’s full-mouth x-rays, part of our comprehensive workup on new patients, we found something that looked amiss in his left sinus,” Dr. Lester notes. “To pursue that, we performed a three-dimensional CT scan on him, and we sent the scan to an oral and maxillofacial radiologist, who is a specialist for reading dental scans. The good news is that everything came back OK.”

Having access to high-quality CT images enables Dr. Lester to discover conditions very early in the process, when they can be addressed before other dental work is started.

Multidimensional Care

Dr. Lester’s modern approach to dentistry is a byproduct of his commitment to continuing education and advanced training. He performs most required dental procedures so patients don’t need to travel to other providers.

“There are times, if it is in the patient’s best interest, when I do refer patients to qualified specialists for specific procedures and therapies,” Dr. Lester notes. “There is a group of specialists in the community I work with that I have vetted and know provide the highest quality patient care and treatment.”

Dr. Lester’s ultimate goal is to improve his patients’ overall dental health, no matter their dental situation or age.

“Robin may be 87, but patients are never too old to achieve good dental health,” he comments. “Good dental health contributes to good general health and helps people look good. And looking good makes them feel good, which makes them want to go on living and being active and healthy.”

Exceptional Choice

The road to superior results is one Dr. Whitney will gladly travel again. He is impressed with Dr. Lester and his creativity in finding a solution to his unusual problem. He is also thrilled with the finished product.

“It’s just like they’re my original teeth,” Dr. Whitney describes. “You can’t tell the difference. It looks fine and feels wonderful, so I’m very pleased with the results. I have no discomfort whatsoever.”

He likes the atmosphere and he feels that it makes his time there more pleasant.

“It’s a beautiful office,” he relates. “Everything about it is very well done. He even has a little room for patients to sit and compose themselves or just relax. I think he’s put it all together. “When you’re sitting in the dental chair, looking out the window while he’s working on you, you’re treated to a very picturesque view with waterfall buckets in cascading fashion, and a very attractive display. It’s very relaxing.”

As a new patient of Dr. Lester and Park Avenue Dentistry, Dr. Whitney has just begun to witness the creative thinking that sets the practice apart. What he does know is that he’s happy to be there and happy with everyone who is a part of it.

“I had a cleaning after all this crown work was done, and Dr. Lester’s dental hygienist gave me the best cleaning I’ve ever had, says Dr. Whitney. “I’m very delighted with the work, and I think Dr. Lester is an exceptional person and dentist. I’m very happy with my new dentist.”

High Praise

Robin was impressed by the care taken to ensure her bite was correct, and the prostheses looked natural and were in the proper positions. Dr. Lester’s efforts, she insists, made a visible difference in the quality of the finished product.

“Sometimes, artificial teeth are set back too far and there’s no natural protrusion and meeting with the lips,” Robin observes. “But mine aren’t like that. They look wonderful. I’m delighted with them. People have no idea I don’t have my own teeth.”

Robin offers high praise for the skilled dentist and his staff.

“Dr. Lester and his staff are the best,” she says. “They are professional, congenial and easy to work with. I recommend Dr. Lester to anyone who needs a dentist. You can’t do any better!”

© FHCN article by Patti DiPanfilo. Robin Black’s photo by Jordan Pysz. Dr. Randall Whitney FHCN file photo. mkb

Treatment Trifecta

Clear vision follows surgery to lift brows, remove cataracts, ease glaucoma.

Lawrence Podschelne

During two military tours totaling 19 months and 21 days, Lawrence Podschelne roamed the dense jungles of Vietnam in search of enemy combatants. But his dedicated service during the Vietnam War left him combatting physical and emotional enemies.

“I’m one of those veterans with Agent Orange problems,” Lawrence shares. “I developed Type 2 diabetes and extreme nerve damage in my feet, hands, knees, low back and neck.

The troughs we drank water out of were contaminated, and it messed up my kidneys. While my kidney function isn’t dangerous, it’s lower than normal. I also suffer with PTSD [post-traumatic stress disorder].

“But at 75 years old, my brain is still good and my heart is fairly strong.”

Lawrence’s doctors attribute most of his health problems to a delayed response to his Agent Orange exposure. But before his health began to deteriorate significantly, Lawrence enjoyed a career with the US Postal Service.

“After the military, I worked for the post office for 28 years and retired from there,” he elaborates. “Of course, I first retired from the Marine Corps.”

Lawrence deals daily with multiple issues affecting his body, so he was not particularly alarmed when another condition evolved: drooping eyebrows. He lived with the annoying condition for some time, but when it became too bothersome, he finally sought care.

“My eyebrows were sagging and I couldn’t open my eyes all the way,” Lawrence describes. “I have long eyelashes, which are the envy of my wife, but I was having to look through my eyelashes to see.

“Then, when I went to a regular eye place to get new glasses, they told me I had cataracts forming. My wife had cataract surgery a few years earlier, and she said, Lets go to Dr. Ge.

Q. Jocelyn Ge, MD, PhD, is a board-certified ophthalmologist at Premier Eye Clinic, a medical and surgical practice reputable for high quality eye care. New patients at her practice receive a complete eye examination and evaluation. The exam she gave Lawrence revealed a number of issues.

“My vision couldn’t be better.”–Lawrence

“Lawrence came to us in the beginning of 2020,” Dr. Ge recalls. “His main concern at that time was droopy eyebrow, and it was severe. He had to either hold his eyebrows up with his hand or tape them up to see. That’s a condition called brow ptosis, and the procedure to correct it is called brow lift. He also had some droopy eyelids, but it was not as severe compared to the brow ptosis.

“We learned additionally he had significant cataracts affecting his vision. Furthermore, his optic nerve appeared abnormal. We conducted glaucoma testing and discovered he had open-angle glaucoma, a condition associated with abnormal intraocular pressure that can damage the optic nerve over time and, if not treated, can cause blindness.”

As an initial step in the treatment of Lawrence’s glaucoma, Dr. Ge prescribed eye drops to lower the fluid pressure in his eyes. Then, she performed the brow lift procedure to correct his droopy eyebrow and to open up his field of vision.

Prior to Dr. Ge beginning that work, Lawrence expressed some concern.

“With my PTSD, if someone comes up to me and puts their hand on my face, I’m going to punch them.” Lawrence asserts. “I was worried about that because they don’t put you totally asleep for eyebrow surgery or cataract surgery, and they talk to you during the procedure. But they did a good job of relaxing me. I know Dr. Ge is good because she performed successful cataract surgery on my wife.”

As it turned out, Lawrence’s brow lift surgery was uneventful and his recovery was fast, Dr. Ge recalls.

“We raised his eyebrows, which widened his field of vision,” the doctor states. “His entire appearance also looked more upbeat and refreshed.

Combination Technique

The next phase was a combined surgery to remove the cataracts and more effectively control the glaucoma.

“After a successful first surgery to lift the eyebrows, we swiftly moved on to the next surgery, and the same outcome held true for his cataract surgery,” Dr. Ge reports. “In fact, because Lawrence had the dual diagnosis of open-angle glaucoma and cataracts, we were able to tackle both at the same time through combined cataract surgery and minimally invasive glaucoma surgery, or MIGS.”

MIGS is a brief add-on procedure performed at the same time as cataract surgery, with minimal added risk. During Lawrence’s surgery, Dr. Ge implanted two tiny titanium tubes called iStent inject® stents, which assist with fluid drainage and lower the eye pressure.

The procedures were done on Lawrence’s right eye at the end of June, and the left eye two weeks later. Once his eyes were stable and his eye pressure decreased to a safe level, Dr. Ge took him off the glaucoma drops.

During the cataract procedures, Lawrence’s clouded natural lenses were replaced with artificial intraocular lens implants, or IOLs. Like contact lenses, IOLs are available in different focusing powers to clarify vision.

“Lawrence has natural monovision, where one eye sees distance and the other eye sees near,” Dr. Ge details. “That made him a perfect candidate to keep what Mother Nature gave him, so during cataract surgery we corrected one eye for sharp distance vision and the other for near vision. Now his overall vision is crystal clear and he does not need to wear glasses.”

“The second eye cataract surgery was even easier because I knew what to expect,” Lawrence declares. “The anesthesiologist gave me something to relax me, but I could hear
Dr. Ge working. I knew she was doing something but I couldn’t feel anything. The cataract surgery was not a problem for me.”

“Following his brow lift, Lawrence felt much more at ease with having eye surgery even with his PTSD,” Dr. Ge confirms. “As it turned out, the experience and results of each surgery made him feel more comfortable and confident with the next one.”

Goodbye to Glasses

Since being fit with iStent injects, Lawrence’s eye pressure has been perfect. It currently measures 9 in one eye and 11 in the other without any glaucoma drops. Normal eye pressure ranges from 10 to 21. Dr. Ge is also pleased with how the brow lift turned out.

“Lawrence’s treatment went very well, and he’s more confident without the droopy eyebrows,” the ophthalmologist remarks. “His life is easier as well because he no longer has to hold up his eyebrows or tape them up to see well enough to perform his daily tasks.”

Lawrence raves that his vision could not be better.

“My eyelashes are out of my vision,” he explains. “Dr. Ge left me with monovision after my cataract surgery. I don’t need to wear glasses anymore, and I’ve worn them since I was in sixth grade.”

Lawrence adds that he was extremely impressed with the staff at Premier Eye Clinic.

“They treat me really nice,” he acclaims. “They’re all very polite and well-trained. I told Dr. Ge, You did a wonderful job. What you’re doing is very professional. And Dr. Ge is safe. I recommend that place to anybody!”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. Before and after images courtesy of Premier Eye Clinic. js
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