Author Archive

Multi-Trauma Program

Return to independence after life-threatening injury.

Last year, auto body specialist George*, 62, was living a care-free, unfettered life in his native St. Thomas in the US Virgin Islands. In early July, George slipped and fell and hit his head on a rock. At the time, he underwent an MRI at the local hospital and was told he was fine.
Two months later, Hurricane Irma hit the tranquil island, and life changed dramatically in St. Thomas, George’s life was especially impacted by events on that late summer day.
“I was in my house trying to secure my stuff during the hurricane,” he shares. “Part of the roof came down and hit me on the head. I went to the hospital in St. Thomas, and they found I was bleeding in my head.”Stock photo from istockphoto.com.
According to George’s sister, Rita*, George has difficulty recalling exactly what happened during and right after the time of the hurricane. She offers to fill in some of the details.
“When the hurricane hit, George was in his house, and he witnessed windows being blown out and the roof collapsing, and he realized he lost everything,” states Rita. “He became depressed and went to his girlfriend’s house. She noticed he was acting strangely and took him to the emergency room in St. Thomas. When they found bleeding in his head, they airlifted him to a hospital in Miami.
“The doctors there figured that something that happened to George during the hurricane – or facing the reality that he’d lost everything – had triggered the bleeding, even though his injury actually occurred two months before.”
Doctors in Miami diagnosed George with a bilateral hematoma, meaning blood was accumulating on both sides of his head. They quickly performed surgery to release the pressure of the blood on his brain.
“I had surgery on my head,” confirms George. “They had to cut my head and put in tubes to drain the blood. I was in the hospital in Miami for about a month.”
When George was released from the hospital, Rita made arrangements to have him transferred to her home in Vero Beach, where she could care for him. He was with her about a week when he began experiencing terrible headaches.
“I knew something wasn’t right, so I took him to the emergency room in Vero Beach,” relates Rita. “They discovered he was bleeding in his head again, so they rushed him back to the hospital in Miami to do the surgery a second time. He stayed there another month.”
George was in critical condition following his second surgery and needed extensive rehabilitation. Rita chose the only rehabilitation hospital in the area because they would be capable of handling George’s serious situation. She reached out to HealthSouth Treasure Coast Rehabilitation Hospital in Vero Beach.
“I was in bad shape when I first got to HealthSouth,” reports George. “I couldn’t talk or walk. I couldn’t eat. I was on a feeding tube for a long time. I didn’t even know where I was until about a week after I got there.”

Multi-Trauma Treatment

When George hit his head on that rock, he suffered a traumatic brain injury. A traumatic brain injury is complex, has a broad scope of symptoms and leads to a wide range of disabilities. When George arrived at HealthSouth, he had severe disabilities, and the hospital’s dedicated staff was determined to help him overcome them.
“George came to us in critical condition,” notes Dawn Bucaj, RN, BSN, senior rehab liaison at HealthSouth. “He had multiple systems failing. He was on feeding tubes, couldn’t walk or talk and was experiencing other common complications of traumatic brain injury.
“To complement our comprehensive brain injury rehabilitation program, HealthSouth created a multi-trauma rehabilitation program for advanced critical care conditions. This program provides optimal recovery for traumatically injured patients.”
The multi-trauma program at HealthSouth provides comprehensive rehabilitation services to keep pace with the wide range of traumatic conditions, including closed head and spinal cord injuries. The program offers a team approach to establishing an individualized plan of care based on the patient’s specific needs and diagnosis.
“A physiatrist, a physician who specializes in physical medicine and rehabilitation, directs the team throughout the patient’s stay,” explains Dawn. “Other members of the team include an internal medicine physician, nutritional specialist, occupational and physical therapists, rehabilitation-certified registered nurses, and respiratory and speech therapists.
“We also work with many consulting physicians from the community who assist as needed to address a patient’s specific injuries and needs.”
After George’s admission to HealthSouth, when he was alert enough, he was started on the therapy portion of the program. He worked hard, and before long, he and the therapists started seeing improvement.

“I really believe that if it wasn’t for the cheer, love and attention they gave George at HealthSouth, he probably wouldn’t have made it.” – Rita

“When he woke up, George went straight into physical, occupational and speech therapy,” verifies Rita. “Then one day, he just started blurting out words and talking again. I think he was able to do it because of the attention they gave him at HealthSouth.”
The multi-trauma program offers a higher level of care than rehabilitation centers and nursing homes. As a hospital, HealthSouth provides daily physician visits and round-the-clock certified registered nursing care to help patients reach their goals and ultimately return home quicker. Patients also work with experienced therapists who guide them toward their goals.
“Our patients deserve that level of care, and HealthSouth is the only provider on the Treasure Coast who can provide it,” observes Dawn. “Patients with multi-trauma conditions, such as traumatic brain injuries, typically are admitted from a hospital. Still, it’s important that patients and families ask for HealthSouth by name.”

Independence Day

George’s memory of what happened that day in September may be murky, but he clearly remembers the effort it took to get his health back. He recalls the patience and dedication of the physicians, nurses and therapists at HealthSouth.
“The staff began giving me all types of therapy,” comments George. “I had everything. I had to start from scratch to learn how to eat. I finally got into a wheelchair, but I was determined to walk again. It took a good month to do it.”
George was recently released and walked out of HealthSouth after more than a month in the multi-trauma program. He’s amazed by how far he’s come with the help of the hospital’s staff. Now, he’s back home with his sister, and he can talk, eat and walk again. He’s excited about his progress.
“Now, I do things for myself,” he enthuses. “I don’t need anybody to help me get to the bathroom, and I can put on my own clothes. I feel like I’m back. Now, I do everything to push myself to get stronger. I walk. I ride my bike. I exercise and do leg balance exercises.”
Rita is impressed by George’s comeback as well. She also credits the staff at HealthSouth for treating him so well when he was there. They helped him get healthy when he started out in critical condition.
“George has really progressed,” marvels Rita. “While he was in the hospital in Miami, he lost a lot of weight. He went down to one hundred thirty-five pounds, and this was a man who was almost two hundred pounds. I took him to the doctor this week, and he’s back up to one hundred eighty-one.
“I really believe that if it wasn’t for the cheer, love and attention they gave George at HealthSouth, he probably wouldn’t have made it. They gave him such good care that when he came back to my house, he said, Those nurses were so nice. I want to do something nice for them. So, he got a cake and brought it to them as a way of saying, Thank you.”
“I got wonderful care at HealthSouth,” agrees George. “Someone was always there when I needed help. If I rang the bell, someone always came right away. HealthSouth Treasure Coast Rehabilitation Hospital is the place to go if something happens to you.”

*Patient’s and sister’s names witheld at their request.

Whole Person Approach

Physical therapy: an integral component of the recovery process.

One day in 2004, Nadine*, an assistant customer service manager, was bringing in carts from her store parking lot. The front entrance didn’t have a straight curb; it curved. To get into the store, employees had to make a turn. When Nadine, a Maryland native living in Florida, turned that day, she heard a “pop.”

Photo by Jordan Pysz.

Dr. Peavler (left) and Dr. Boyle believe physical therapy helps in the recovery process.

“I ended up having a tear and bulging discs in my lower back,” she describes. “That year, I had my first surgery. The doctors scraped off the discs and sealed up the tear. Because my discs were bone-on-bone, they also put some caulking between the bones. That repair lasted a long time.” Unfortunately, she was left with some pain, despite the effectiveness of the repair.
Ten years later, Nadine was again at work, this time helping to stock shelves. She was on her knees placing items on the bottom shelf. When she went to stand up, she heard another popping sound.
“I said, No way, not again,” she relates. “This time, the injury affected my nerves. The doctors once again got my back all cleaned up and put more caulking between the bones. They also unwrapped the nerves, but I had severe nerve damage on my left side.
“After that surgery, I had intense, sharp pain in my back. It was often a nine or ten on a scale of one to ten.”
Because her pain was so severe, Nadine’s doctor recommended a third surgery to fuse the discs in her lower back. Nadine, however, did not want to go through another surgery. The doctor then suggested a pain management specialist who prescribed opioid pain medication.
Like many others taking these powerful drugs, Nadine slipped into addiction. From there, her life went into a downward spiral. Nothing mattered but the drugs. And for her, access to them was easy.
“I would get the pain pills every month,” she reports. “I didn’t even have to go to the doctor’s office. My pharmacy would just send me a text telling me my prescription was ready. I went downhill fast.”
Nadine’s family was concerned for her and sought options for help. After a particularly bad episode with the pain pills, Nadine found her way to Riverside Recovery of Tampa.
“I don’t have much memory of how I got there,” she admits. “I was told I passed out on our porch and was taken to the hospital. Apparently, after the hospital, I was admitted to Riverside Recovery.
“I stayed to myself pretty much the first week I was there because I was in a lot of pain and wasn’t walking very well. Then the doctor asked me if I’d be willing to start physical therapy, and I said, Okay, I’ll try it. That’s when I met Dr. Peavler and everything changed.”

Total Health

At Riverside Recovery, the staff views recovery as embodying total health. That consists of mental, spiritual and physical health. The staff includes qualified clinicians who help clients achieve mental and spiritual health. Physical therapists help clients achieve the third component, physical health.
“Physical therapy is a profession grounded in the use of exercise, education, manual therapy and other modalities to improve people’s physical health,” explains Leighton Peavler, DPT, doctor of physical therapy at Riverside Recovery. “They are the gatekeepers, so to speak, from a physical health standpoint.
“The beautiful thing at Riverside Recovery is there are experts in mental health, medicine, nursing, clinical services and behavioral health. When you add physical therapists, there’s a nice harmony under one roof. It makes the facility more well-rounded and comprehensive in its ability to help clients recover.”
Dr. Peavler notes that physical health is an integral component of the recovery process because being physically unhealthy is often a barrier to recovery. He points to the current opioid crisis and how many people who are addicted to the drugs started out in physical pain.
“People need to be physically strong to be mentally strong,” he asserts. “A physical impairment, such as pain or difficulty performing a functional task such as sitting, walking or reaching overhead, interferes with recovery. More than half of my clients are here for opioid addiction due to a physical health problem.
“The biggest part of our treatment is education about pain, what it is and why the clients feel it. Teaching them why they have pain has been shown to reduce their pain levels.”
At the same time, manual therapy and exercises are being taught and administered. Manual therapy includes massage therapy, myofascial release techniques and joint mobilization. Exercise includes stretching and exercise to music. Eventually, the therapists wean the clients off manual therapy and into techniques to manage their pain on their own.
“At that point, we spend more time working through their internal controls with exercise that mirrors what they’ve been doing in treatment,” confirms Dr. Peavler. “So, when they have pain, they don’t reach for a pill. They take internal control. It’s more powerful that way.”
“During my second week at Riverside Recovery, I was allowed to go outside for a while,” states Nadine. “I had to go down some steps, and I ran down them. I thought, Wow, I couldn’t do that before I started physical therapy.”

“Thanks to the physical therapy, I didn’t have any pain when I left Riverside Recovery. Best of all, I’m five months clean.” – Nadine

Shannon Martin, LCSW, director of clinical services at Riverside Recovery, is impressed by Dr. Peavler’s physical therapy program. She likes that he gives clients with opioid addictions drug-free strategies for managing their pain. She’s worked at other recovery centers, and only Riverside Recovery offers the physical therapy component. They take a whole person approach to recovery.
“When people are in recovery, they’re going through a lot. It’s often the worst time in their lives,” says Shannon. “They go to therapy and process trauma and their life decisions. When they’re done with that, they’re given an opportunity to focus on their bodies. This also allows them to disconnect from those really intense feelings they’ve just shared.
“At Riverside Recovery, we’re seeing clients get healthy – mentally, spiritually and physically – right before our eyes. That wouldn’t happen without Dr. Peavler’s physical therapy program and his staff. What’s happening here is absolutely miraculous.”

Relieved and Clean

When Nadine entered the physical therapy program at Riverside Recovery, her pain level was severe. She was skeptical the program would give her the pain relief two surgeries had failed to provide. By the time she was done, she was converted into a believer.
“The amazing part is that Dr. Peavler listened to my problems,” marvels Nadine. “First, he massaged all the knots out of my lower back. I didn’t have any strength to lift my left leg, and I didn’t have normal range of movement with it.
“By the time I left physical therapy, I could lift my leg normally and had full range of movement. I could also stand up straight and bend down, which was painful before. Toward the end of my treatment with him, we were doing exercises to music, and I kept up with him and even passed him once.
“I still have all the materials he gave me, including the two exercise routines. I love those because it’s a lot more fun for me to exercise with the music.”
For Nadine, the total person approach at Riverside Recovery was effective at reducing her pain and eliminating her addiction to the opioid pain medication. She credits the staff and the entire process for improving her life.
“Thanks to the physical therapy, I didn’t have any pain when I left Riverside Recovery,” she enthuses. “Right now, my pain level is good. It’s very low. The pain goes up to about a one or two now and then, but that depends on the day, what I do and the weather.
“Best of all, I’m five months clean. I feel great.
“I rate Riverside Recovery an A-plus,” she adds. “Everybody there is awesome!”

*Patient name withheld at their request.

Hear Better and Live Better

Michigan-born Michael Day has had issues with his hearing for years. In the mid 1990s, he bought a pair of hearing aids but was unhappy with them. The devices didn’t fit comfortably, so he returned them and never got new models. He was determined to live with his hearing loss, but his hearing only grew worse over time.

Photo by Jordan Pysz.

Michael is enjoying life to the fullest again.

“Eventually, I started having trouble hearing in almost every environment, including in restaurants and even in my living room,” shares Michael. “If the TV was turned up so I could understand the dialogue, I couldn’t hear my wife talking to me. I was having trouble hearing my wife all the time, and it was getting very frustrating for her.
“My hearing loss affected me in everyday situations, as well. At the store, the cashier would ask if I wanted paper or plastic, and I’d be digging around in my wallet or unloading the cart. I heard the voice noise. I heard someone speak, but I couldn’t tell what they were saying, and I didn’t know they were talking to me.
“It finally got to the point where I figured it was time to see a doctor for an evaluation. Trinity Hearing and Balance Center was on my insurance plan and it happened to be close to my home, so I decided to go there.”
At Trinity Hearing & Balance Center, Michael met with Kelly Hansen, AuD, a certified doctor of audiology. Dr. Hansen immediately impressed Michael with her intelligence and her thorough approach to evaluating his hearing loss and his needs.
“Dr. Hansen is very knowledgeable,” Michael says. “I mean, she didn’t just give me a hearing test. We did a survey so that she could find out where I find it most difficult to hear and if I have an active or sedentary lifestyle.
“She also asked what type of environment I’m most often in during the day, and she took all that into account in assessing my situation. After that, I had no doubt she was going to take care of my hearing problem.”

Thorough Evaluation

Dr. Hansen’s examination of Michael extended beyond the hearing test and survey of his lifestyle and daily living environment. She also did some physical examinations to determine the root cause of Michael’s hearing loss.
“I checked to make sure he didn’t have wax in his ears, then did testing to make sure there was nothing functionally wrong with his middle ear, such as fluid in the ear,” Dr. Hansen explains. “I also made sure there was nothing medically going on.”
Dr. Hansen determined that Michael’s hearing loss stemmed from nerve damage and that he would benefit from hearing aids. The hearing aids, she noted, would improve not only Michael’s hearing but his overall quality of life.

“I haven’t heard birds chirping in forty years. Now, they’re so loud, I walk outside and almost want to say, Would you all shut up?” – Michael

“When people with hearing loss are missing out because they’re not hearing family members and friends, they tend to withdraw,” educates Dr. Hansen. “It can make them depressed, and they may give up doing the things they enjoy because they can’t hear. Fitting these people with hearing aids restores their lifestyle and, as a result, improves their quality of life.”
Michael was given his choice of five different hearing aid options. Upon first being fit for the pair he chose, Michael could not believe what he was experiencing. He was so happy, he became emotional.
“I cried. I honestly cried,” Michael admits. “With the hearing aids in, I could hear clearly. I could hear things I haven’t heard in years. I could actually hear somebody whisper.”
“When I turned on his hearing aids, Michael got tears in his eyes,” verifies Dr. Hansen. “It was amazing to see this grown man tearing up. He was able to hear his wife right away. That was great for us to see.”

Unique Philosophy

It is Trinity Hearing & Balance Center’s philosophy and dedication to patient care that sets it apart from other hearing centers.
“Trinity Hearing and Balance Center is proud to be an AudigyCertified™ practice,” declares 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, its members 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.”

Chirping Birds

The first week Michael had his new hearing aids, he and his wife went to his wife’s sister’s house in Venice to spend the weekend. The sister’s house has an open floor plan with high ceilings, and Michael always had difficulty hearing in the home because it echoed.
“Before, when I tried talking to my brother-in-law, I only heard mumbles and couldn’t tell what he was saying,” relates Michael. “That weekend was the first time I sat in the living room and was able to carry on a conversation with my brother-in-law, who was sitting on the other side of the room. And the TV was on. It was quite moving. I darn near started crying.”
With the help of his new hearing aids from Trinity Hearing & Balance Center, Michael says that in addition to his hearing being much better, his overall quality of life has improved as well.
“When I get up in the morning, I put in my hearing aids and turn on the TV,” he states. “I usually have to turn it down from the night before. I can hear my wife get out of bed and the dog walking across the floor, all sounds that someone with normal hearing never misses.
“I often work in the garage or out in the yard. When I do, I hear the birds. I haven’t heard birds chirping in forty years. Now, they’re so loud, I walk outside and almost want to say, Would you all shut up?”
“Michael also had difficulty hearing in church,” discloses Dr. Hansen. “The church he attends has a hearing loop, and the hearing aids we gave him can be used with that loop. Now, he hears very well at church.”
Michael chose Trinity Hearing & Balance Center because it was convenient, but he had a tremendously positive experience there. He believes his better hearing has given him a better life. He says everyone at the center deserves credit for the role they played in enhancing his life.
“Dr. Hansen and her staff at Trinity Hearing and Balance Center are great,” he comments. “I would recommend them in a heartbeat!”

Malignant Melanoma

In 2000, a mole on John Bass’ forehead began to grow and change colors. His family doctor referred him to a dermatologist who immediately performed a biopsy. The diagnosis was malignant melanoma.

FHCN file photo.

John takes time from his cancer fight to relax and fish.

“I went to a local cancer center, where they were very thorough,” recounts John. “That September, they did surgery to remove the mole, and they also removed six lymph nodes around my neck. They said the cancer generally goes there first if it spreads.”
After the surgery, John needed a dermatologist to regularly examine him for recurrence of the melanoma on his skin. John’s doctor recommended Alla Gruman, MD, a board-certified dermatologist at Family Dermatology in Osprey.
“I started seeing Dr. Gruman every year for surveillance,” elaborates John. “Then in March 2015, I felt a knot as big as a golf ball under my arm. I called the cancer center, but had trouble getting an appointment right away.
“I called Dr. Gruman and told her I couldn’t get in at the cancer center. She talked with them and got me an appointment immediately. After they checked out the knot, they told me it was metastatic melanoma. I had three to six months to live.”

Risks and Warnings

Melanoma is a form of cancer characterized by uncontrolled growth of the pigment-producing cells in the skin. It is the most dangerous type of skin cancer. If it’s allowed to grow, it can quickly spread to other parts of the body.
“When melanoma is found early, however, it is very treatable,” assures Dr. Gruman. “For that reason, people need to be aware of its risk factors and warning signs.
“People who used tanning beds or had blistering sunburns between the ages of twenty and fifty are at higher risk. Others at risk are those who live in sunny climates, have had many years of sun exposure, a family history of melanoma or other cancer, fair skin and blue eyes, or many moles or large moles.”

“In March, I’ll have made it three years instead of three months, and Dr. Gruman guided me through all of it.” – John

A change in the size, color or border of a mole is a warning sign of possible skin cancer, as is the sudden presence of a new mole. Contrary to popular belief, melanoma lesions are not always dark. They may appear pink, beige or light brown.
“Some signs of melanoma are subtle,” warns Dr. Gruman. “For example, people who’ve had moles for a long time often think they are normal. These people don’t get in the habit of checking their moles, so they don’t notice any changes or the appearance of a new mole. Regular skin inspections by a dermatologist help catch melanoma in its earliest, most treatable stages.
“Melanoma is a vicious cancer. If not caught and treated early, it can cause serious morbidity and even mortality down the road years later.”

Precious Gifts

Doctors at the cancer center told John his cancer was now on his chest, under his arm and in his liver and left lung. The only thing they could do for him was enroll him in clinical trials for new cancer drugs. The first one he tried caused his cancer to grow. “The second drug was a miracle,” reports John.
“In March, I’ll have made it three years instead of three months, and Dr. Gruman guided me through all of it.”
Since the return of his melanoma, John has his skin examined by Dr. Gruman every six months. With her support, he celebrates every day as a precious gift.
“Dr. Gruman is so concerned and knowledgeable, especially about cancer,” he says. “I don’t think there’s a better doctor when it comes to knowledge and caring!”

Making Gains with GAINSWave™

Men with ED regain function with noninvasive therapy.

Recent studies reveal that more than 30 million men in the United States experience erectile dysfunction (ED). Men with ED are unable to achieve or sustain an erection suitable for sex. While ED is more common in older men, it can occur at any age, and it does not discriminate. It happens to men of all races and ethnicities.
ED is sometimes a difficult topic for men to bring up to their health care providers, but it shouldn’t be. ED is a medical condition, and in most cases, it can be treated. Stock photo from istockphoto.com.
“Erectile dysfunction is essentially a circulatory problem,” notes Nicholas H. Kalvin, MD, medical director at Gulf Coast Men’s Health in Fort Myers. “Normally, when it is stimulated, the penis inflates with blood into two large chambers, resulting in an erection.
“However, the inflow of blood can decrease with age or with some health conditions, including diabetes, cardiovascular disease and high blood pressure. Blood flow can also decrease because of certain lifestyle factors such as smoking and obesity. Due to decreased blood flow into the penis, men can have incomplete erections.
“An incomplete erection means the blood vessels at the base of the penis are not opening completely. When the man attempts to have intercourse, his penis collapses or folds, and the blood goes back into his body. That’s ED.”
Historically, there were three general methods available to treat men with ED. One was with medications such as VIAGRA® and CIALIS®. Dr. Kalvin explains that the medications for ED currently on the market vary in terms of longevity, peak blood level and duration of dose, but do the same thing. Medications, however, can lose their effectiveness over time.
“The next treatment is injections,” states Dr. Kalvin. “Instead of treating the whole patient by mouth with medication, the penis itself is treated by injecting it with very powerful vasodilators. These open up the closed blood vessels and enable erections. Injections do not work in all men, and as men age, they may stop working.
“The last method used to be penis implants. This is done when pills and shots fail. The doctor clears out the two chambers and implants plastic tubes in the penis. The tubes are inflated with liquid by pressing on a valve in the scrotum or under the skin of the belly. Implants are generally considered a last resort treatment.”
Today, however, Gulf Coast Men’s Health offers another, better option for treating men with ED. It’s called GAINSWave therapy, and it’s drug-free, noninvasive and virtually painless.
“The ED medications can have uncomfortable side effects,” says Paul DeJohn, Jr., owner and director of patient care at Gulf Coast Men’s Health. “Some men hear about the injections into the penis, and it scares them. GAINSWave is a new solution to their ED that is completely noninvasive, with no pain or side effects.”

Sound Repairs

GAINSWave therapy works to improve blood flow by directing low-intensity sound waves to the penis and surrounding areas. The treatment also stimulates the growth of new tissue, which is vital for achieving and maintaining healthy erections.
“GAINSWave uses ultrasound, or sound waves,” confirms Dr. Kalvin. “It does not work with radiation. Instead, it works through the physical vibration from sound. Think of the feeling you get if you hold one end of a board and start hammering a nail into the other end, or the shockwave from an airplane going through the sky.”
The ultrasound waves travel at the speed of sound, and are applied through the correct number of pulses, frequency and energy. They have a positive effect on the tissue and blood vessels, and help restore blood flow and improve sensitivity to the penis.
“GAINSWave therapy works by promoting the vascular health of the penis,” observes Dr. Kalvin. “The ultrasound stimulates stem cells in the penis to multiply and replace damaged cells. In addition, the stem cells also stimulate the blood vessels to grow extensions. This increases blood flow.”
“The sound waves also help stimulate the tissue in the penis by breaking up scar tissue and plaque,” adds Paul. “When this is done repeatedly over a brief period of time, it restores the tissue of the penis and improves blood flow.
“Sometimes, men who have not had good erections or intercourse for a long time start to lose sensitivity during sex. Another benefit of GAINSWave therapy is by increasing blood flow, the nerve endings in the penis are also stimulated, improving sensitivity of the penis.”
According to Dr. Kalvin, studies show markedly increased blood flow into the penis in men who had ultrasound treatments such as GAINSWave therapy.
“Results do not happen right away,” he acknowledges. “It takes several treatments, but most men notice a significant change in their status between treatments six and eight.”
Every man is different, and treatment at Gulf Coast Men’s Health is tailored to each man’s symptoms and needs. In general, however, younger men typically require six GAINSWave treatments. Men of middle age and beyond may require up to 12 treatments.
“The effect of the GAINSWave therapy will last one to two years,” reports Dr. Kalvin. “Some clinics recommend a refresher ultrasound treatment every three to six months.
“In Europe, GAINSWave therapy is typically the first option for treating men with ED. I believe in the future, it will be the first-line therapy in the United States as well.”

Problem Solving

Gulf Coast Men’s Health believes treating ED is essential because sexual health can affect a man’s overall well-being. Paul notes that the center’s staff approach ED treatment much differently than most other clinics.
“Our goal is to get men to where they do not need any medication,” he stresses. “We do not want our patients to have to use substances for the rest of their lives. We try to avoid that at all costs. With GAINSWave therapy, we work to solve men’s ED issues so they can get back to really living again.”

“With GAINSWave therapy, we work to solve men’s ED issues so they can get back to really living again.” – Paul

Paul relates that GAINSWave therapy is also a good option for those men who have lost their wives after 30 or 40 years and are getting back into the dating scene. The therapy can make the transition as easy as possible by helping the men regain the function they had years before.
“The old saying, If you don’t use it, you lose it, rings true for a lot of these men, and we help them in any way we can,” he discloses. “With GAINSWave treatments, we can completely restore function in many men.”
The ED treatment process at Gulf Coast Men’s Health is not a one-size-fits-all therapy such as it is with VIAGRA and CIALIS. The staff is dedicated to finding the correct treatment for each man’s specific concerns.
“We determine which is the best course of action for each patient,” expounds Paul. “We give them options of what’s available to restore their function. We really put the patient first.
“At Gulf Coast Men’s Health, we’re very encouraged by how GAINSWave has been used to successfully treat hundreds of patients with ED without drugs, pain or harmful side effects. Men who want to restore youthful performance should explore whether this is the right option for them.”

Gentle Geneveve™

A nonsurgical technique for vaginal rejuvenation and urinary incontinence.

Most women are aware of the effects of aging on the face. But aging affects other areas of the body as well. One area that suffers with age is the vagina. Aging of the vagina can lead to several issues that can disrupt a woman’s everyday life and her intimate relationships.
With age, the tissues of the vagina lose collagen, the main structural protein in skin and connective tissue. Once collagen is lost, the vaginal tissue becomes lax, which can lead to dryness, decreased sensitivity and urinary incontinence. This condition is called atrophic vaginitis.Stock photo from istockphoto.com.
“Tension in the vaginal tissue is provided by collagen fibers that due to trauma, aging and vaginal deliveries decrease in strength, causing laxity,” confirms Luis A. Aponte, MD, medical director of Marbela Medical Wellness in Fort Myers. “Now, there’s a new, nonsurgical technique for vaginal rejuvenation, called Geneveve, that’s proven to increase collagen in the vaginal tissue.
“Geneveve uses cryogen-cooled monopolar radiofrequency, or CMRF. The equipment looks like an ultrasound machine, but it works differently. It delivers a uniform amount of radiofrequency heat to the deep tissue while keeping the outer tissue cool. In that way, the deep tissue is treated without hurting the surface tissue.”
When applied to the deep tissue, the tiny pulses of gentle radiofrequency energy stimulate the body’s natural collagen formation process. While this biologically active process is initiated, which causes an inflammatory response, the cooling of the surface tissue minimizes pain, redness and irritation.
The unique Geneveve technique, which has been dubbed the “Women’s Viagra®,” provides the surface vaginal tissue with a more youthful tone and resiliency. At the same time, the treatment delivers the proper amount of gentle heat for the appropriate length of time to the deeper cells, which reinvigorates the inner vaginal tissue.

Simple, Easy, Convenient

The nonsurgical Geneveve approach to vaginal rejuvenation has been described by doctors as simple, easy and convenient. The procedure is typically completed in one comfortable, 30-minute session, and is performed by a trained professional in the office at Marbela Medical Wellness.
“The Geneveve treatment does not require any type of anesthesia or analgesics, so there’s no grogginess or residual numbness, as with surgery,” observes
Dr. Aponte. “And there’s generally no need to repeat the procedure. Most patients feel a sensation of warming and cooling during the treatment, but typically there’s no pain or discomfort.
“There’s also no downtime with Geneveve. And because there’s no pain, women are able to return to work and other activities immediately without any restrictions.”
The doctor does recommend that his patients wait 24 to 48 hours after the session to resume sexual activity. Waiting allows the treated tissue to recover and enables the collagen formation process to progress.
Dr. Aponte cites clinical studies that report a 98 percent satisfaction rate with the treatment. In addition, it’s unlikely women will experience any side effects from the procedure, though there is the potential for them, the doctor reports.
“Side effects of the Geneveve treatment can include swelling, pelvic discomfort, redness, numbness and vaginal discharge,” he discloses. “These are minimal and generally go away within hours to a few days. In addition, these side effects are very rare.”
According to Dr. Aponte, most women begin to feel improvement in their vaginal issues within a few weeks after receiving the Geneveve treatment. They will likely notice improvements in sensitivity and tightness, as well as improved urinary control.
“With this treatment, the radiofrequency energy penetrates deep into the vaginal tissue, which helps sustain its results,” asserts the doctor. “In general, the effects of Geneveve last approximately one year, although they may last longer in some women.”

Available Alternative

Nonsurgical Geneveve stimulates the body’s natural rejuvenation process. There are no medications involved, so there are no concerns about medication allergies, interactions or side effects. Because the procedure is nonsurgical, there is no risk of bleeding or of blood clots or infections forming.
“Most women are candidates for Geneveve,” verifies Dr. Aponte. “Those who are not candidates are those who have implantable defibrillators or pacemakers. That’s because the radiofrequency energy we use may interfere with the operation of those devices.”
The Geneveve procedure is used to treat many conditions associated with vaginal atrophy. These include bladder leakage, as well as laxity and loss of lubrication, resulting in painful intercourse. Dr. Aponte explains how increasing collagen in the vaginal tissues helps improve these conditions.

“There’s also no downtime with Geneveve. And because there’s no pain, women are able to return to work and other activities immediately without any restrictions.”– Dr. Aponte

“Geneveve assists with incontinence because adding collagen strengthens the pelvic floor, which helps control the flow of urine,” he informs. “It also aids women who are struggling to enjoy sexual intercourse because of vaginal laxity. Once the collagen deficiency is corrected, there is an increase in sensation. In addition, the correction increases vaginal lubrication, reducing painful intercourse.”

Graphic courtesy of Marbela.

Ask Marbela about a quick, comfortable and lasting vaginal collagen treatment for dramatically improved sexual sensation and satisfaction.

Dr. Aponte stresses that the goal of providing the Geneveve treatment at Marbela Medical Wellness is to improve women’s lives through intimate wellness. Geneveve generates new collagen, which tightens the vaginal tissue and gives women a renewed feeling of youthfulness. He’s pleased to offer this treatment at the center.
“The Geneveve technique has been used for more than a year for the face, lips and other areas,” he describes. “At Marbela Medical Wellness, we’re excited to now make this technology available to our patients for other types of clinical treatments.
“Geneveve is a clinically proven safe and effective treatment that provides patients with an alternative to surgery for vaginal rejuvenation and urinary incontinence.”

Correct the Cause of Pain

Follow stretching protocol for pain-free, flexible back and neck.

Career business executive Robert Wolf had long-term issues with his back. When he relocated to Florida upon his retirement two and a half years ago, the Iowa native looked forward to a life of leisure and golfing. His body had other ideas.

Photo by Jordan Pysz.

Robert Wolf

“I’ve had lower back pain throughout my life from playing sports, and I just lived with it,” Robert shares. “I’ve been to many doctors and chiropractors, but nothing really helped. For years, I just put the pain in the back of my mind and went on with my life.”
When Robert first moved to Florida, he played golf four or five times a week, which he’s sure aggravated his condition. Over time, the pain became severe and got to the point where he could no longer tolerate it. He was eventually forced to give up golf and had difficulty with other activities as well.
“When I would swing a golf club, I would almost scream from the pain, and I’d fall to my knees,” he describes. “It was very troublesome not only to me, but to the golfers playing with me. I had to stop golfing altogether.
“I also had to give up walking. I have a Golden Retriever, and we like to go for walks, but I couldn’t walk him. My wife had to do it. Then a friend told me about Dr. Johnson and Sedative Stretching, so I made an appointment.”
Robert was referred to Jeffrey P. Johnson, DC, of Johnson Medical Center in Venice. At his practice, Dr. Johnson offers a unique treatment protocol called Sedative Stretching. Sedative Stretching is an expanded and comprehensive form of Manipulation Under Anesthesia, or MUA.
“When I first saw Robert, he told me he’s had recurring lower back pain for the past forty years,” reports Dr. Johnson. “His most recent episode started six months prior to coming into my office. He was not improving and at times, the pain was debilitating.
“An MRI of the lumbar spine showed advanced degenerative changes occurring in his lower back. Robert rated his pain as an eight, and described it as aching, sharp, stabbing, stiff and tight.”
“Dr. Johnson said he believed Sedative Stretching would be very good for me,” says Robert. “I said, Let’s do it.”

Increased Stiffness and Pain

Like Robert, Colleen Sterling had long-term issues with her back. When she was in her 20s, she learned she had scoliosis. As she got older, the curvature in her spine became more pronounced. Because her spine was not straight, she suffered constant pain in her lower back and neck.

Photo by Jordan Pysz.

Without back pain, Colleen can work in her yard.

“I’m kind of a vain person,” Colleen admits. “I never wanted the scoliosis to look bad, so I would try my best to fight my body and stand as straight as I could. But that effort made my lower back and neck very painful.
“Thankfully, I have a high threshold for pain, so I was able to manage it pretty well and work through it.”
A year and a half ago, after she moved to Florida from Ohio, Colleen needed to find a chiropractor experienced in treating scoliosis patients. A friend in her condo association, who also has scoliosis, recommended Dr. Johnson.
“Dr. Johnson was great,” she relates. “He explained that with scoliosis, I have muscles on one side of my body pulling my spine. On the other side, the muscles are stretching my spine. He said he thought Sedative Stretching would help me.
“Dr. Johnson never tried to push me to have Sedative Stretching or said, You need to get this done. He’s a great doctor and very professional, so I trusted him and decided to go through with it. It’s the best thing I’ve ever done.”

Restricted Movement

Sedative Stretching can benefit many people with various painful muscle and joint conditions. Ideal candidates are those with conditions such as unresolved neck and back pain, herniated discs, spinal stenosis, sciatica, frozen shoulder, acute and chronic muscle spasm, headaches and failed back surgery syndrome. The procedure can also benefit people who want to regain lost flexibility or those who are “sick and tired” of being “stiff and sore.”
The sooner a person addresses the cause of that condition, the better. The chronic stiffness, tightness and pain causes excessive “wear and tear” on the joints of the spine and extremities, resulting in permanent degeneration and arthritis.

Photo by Jordan Pysz.

Robert’s dog, Buddy, is also benefiting from his owner’s recovery.

“People start losing flexibility when their typical, daily activities cause a minor injury that leads to chronic, low-grade inflammation. Many times, this occurs in early childhood and is a long-forgotten event,” informs Dr. Johnson. “Inflammation is part of the body’s natural healing process, which lays down a mesh of connective tissue, commonly known as scar tissue. Over time, layer upon layer of scar tissue can form in the muscles, tendons and ligaments around the joints, restricting the joints’ ability to move properly. These layers of scar tissue are called adhesions.”
The slow and insidious loss of flexibility is among the warning signs and symptoms generally associated with adhesions, as are increasing achiness and soreness. Most people attribute this to normal aging. While it’s very common to become stiff and sore with age, it’s not normal.
“When this occurs, people will compensate how they move their bodies, although they don’t always realize it,” acknowledges Dr. Johnson. “This is evident everywhere while watching the way people walk, bend, twist and turn.”
Sadly, many people wait until significant damage has occurred from excessive wear and tear before seeking appropriate care. Often, patients will utilize over-the-counter and prescriptive medications, which help alleviate their symptoms. Unfortunately, this gives the patient a false sense of being “cured” while the underlying scar tissue continues to cause excessive damage.

Flexibility Protocol

During Sedative Stretching, the patient is put under light sedation, sometimes called “twilight” sedation. With the patient relaxed, doctors can then take the affected joints through their normal full range of motion, freeing the adhesions that have developed between the joints that are causing the pain.
“While the patient is sedated, we use light, comprehensive stretching techniques,” explains Dr. Johnson. “Since we don’t have to contend with tense, guarded muscles, we are able to free up the scar tissue and mobilize the joints without causing the patient any discomfort. This would be impossible to do without the use of sedation.”

“When I first came out of sedation, I felt cured! I hadn’t felt that kind of pain relief in a long time.” – Robert

A highly trained team of medical professionals coordinates the Sedative Stretching procedure. Generally, there are multiple health care providers present, including an anesthetist and several nurses. Patients usually require only one procedure. It is very rare that patients require a second procedure to fully address their condition.
Following the procedure itself, there are typically a couple of weeks of rehabilitation to reinforce the increased movement obtained from the procedure. During this time, patients are instructed how to perform stretching exercises to prevent the condition from recurring, notes Dr. Johnson.
“By following this protocol, patients regain the flexibility they had decades before, and typically, they return to activities they haven’t done in years,” he asserts. “This is truly correcting the original cause of their conditions.”

The Rest of the Story

Colleen reports feeling no pain after her Sedative Stretching session. That encouraged her as she continued with the rest of the treatment protocol. After the procedure, her daughter told her the “scoliosis hump” on her back was substantially smaller and that she was standing much straighter and taller.
“There’s more to do after the procedure is done,” she states. “I have to do my part with exercises at home. I do yoga every other day, and stretching on the days I don’t do yoga. This keeps the results going.”
Robert agrees that the follow-up program complements the effects of the Sedative Stretching.
“I was careful right after the procedure,” he says, “because I knew there was still work to be done if I wanted the relief to be long-lasting. I needed to do the rest of the program, which is therapy, stretching and exercise.”

“Now, I can do all the yoga positions I couldn’t do before without pain.” – Colleen

Both Colleen and Robert experienced pain relief and improved flexibility after their Sedative Stretching sessions. They were able to return to their activities without difficulties.
“When I first came out of sedation, I felt cured!” marvels Robert. “I hadn’t felt that kind of pain relief in a long time. Before, I didn’t get any relief unless I took some serious pain pills. But after Sedative Stretching, I was ready to golf that afternoon. I felt great.
“I’m back to golfing. I can also walk my dog, and he just loves me. He’s pretty happy, and so is my wife. It put quite a burden on her when I couldn’t do it. My pain is better now. I rate it as a zero, whereas it used to be an eight.”
“Since the treatment, my flexibility is amazing,” offers Colleen. “Now, I can do all the yoga positions I couldn’t do before without pain. I can do yoga like I did when I was in my twenties. My pain level now is about a two, and some days, I don’t feel any pain.
“I feel so blessed to have found Dr. Johnson because there aren’t that many doctors who do Sedative Stretching. He’s fifteen minutes from where I live, but I would drive an hour to see him if I had to. That’s how good I think he is. Dr. Johnson is an amazing healer!”

Muffin Top Meltdown

Lose inches quickly with easy, comfortable laser process.

Nine years ago, Kelly* gave birth to a beautiful baby girl. Though she was thrilled by the child’s arrival, pregnancy left Kelly with a stubborn muffin top. She had also put on a few extra pounds, and none of it would budge with diet and exercise. Kelly became more and more frustrated over time. By early 2018, she was fed up.Stock photo from istockphoto.com.
“My jeans and shorts didn’t fit,” shares Kelly. “Everything I put on was really tight, and I felt uncomfortable. Nothing I tried worked. Then, I heard about the results my chiropractor was getting with his program, and I asked if I could sign up.”
Kelly’s chiropractor is Larry D. Johnson, DC. In addition to his practice of chiropractic care, Dr. Johnson provides treatment for weight loss and spot fat reduction at Body by Design Laser Spa in Cape Coral. There, he offers a laser-assisted weight loss system called LipoLaser. With this completely noninvasive treatment, patients can lose three to seven inches of body fat in just weeks.
“The treatments are quick, painless and easy,” reports Kelly. “I treated my inner thighs and waist, as well as the muffin top. I did two nine-week sessions and lost seven and three-quarters inches, and my BMI [body mass index] went down two percent.”

Healthy Progress

Using the nonsurgical LipoLaser, there are no incisions or scars, and there is no downtime for recovery, observes Dr. Johnson.
“There is no discomfort during or after treatment,” he adds. “LipoLaser is also affordable. It’s less than half the cost of invasive procedures for weight loss or spot fat reduction such as liposuction, LAP-BAND® and gastric bypass.”
Before and after images courtesy of Body by Design Laser Spa.The doctor notes that the laser works more naturally than those other procedures. It simply targets fat cells and stimulates them to empty their contents. The process reshapes the cells, and the body, with each treatment.
“The laser causes the fat cell walls to open up, releasing what’s inside in the form of free fatty acids, water and glycerol, or triglycerides,” describes Dr. Johnson. “Once the triglycerides are freed from the fat cells, the body uses them as an energy source. The fat cells then shrink significantly, resulting in lost inches.
“Typically, people experience immediate results. The LipoLaser has been shown to stimulate the body to release forty to sixty grams of fat during a typical treatment. This fat is then safely eliminated through the body’s lymphatic system.”

I did two nine-week sessions and lost seven and three-quarters inches, and my BMI [body mass index] went down two percent.” – Kelly

When Kelly was trying to lose the weight and fat by dieting and exercising, she wasn’t seeing results, and she got frustrated. That wasn’t the case with Dr. Johnson’s LipoLaser.
“My clothes started to feel better within the first week,” she enthuses. “I felt good about the progress, and that encouraged me to keep going. Now, I feel better. I’m more energized, and I feel more positive about myself. I recommend this treatment to everybody.
“Dr. Johnson and the staff at Body by Design Laser Spa are fantastic. It’s so nice that the LipoLaser actually does what they say it’s going to do. That’s rare.”

*Patient name withheld at their request.

Shades of Distress

Discoloration signals advanced venous disease.

When David Snook settled in Florida, he found his niche teaching gardening to mentally disabled students. He also keeps busy as a wrestling referee.

FHCN file photo.

When he’s not teaching, David spends time in his garden.

“I settled in Florida about fifteen years ago,” shares the Grand Rapids, Michigan native. “I decided to get into education, and that’s what I’ve been doing for the last eleven years. I’m also an official for high school wrestling.”
Four years ago, David began experiencing distressing symptoms in his left leg, primarily his foot and ankle. The symptoms were both annoying and agonizing, and they began affecting him in his daily life and on the job.
“My leg started itching, and sometimes I would scratch it until I broke the surface of the skin, and it would bleed,” he describes. “It was really irritated and painful. It also swelled and changed colors; it was maybe four or five colors. My leg was pretty scary looking.
“I figured I’d have to stop officiating because I couldn’t be on my feet and have this much pain. I move around a lot while I’m refereeing, and that caused my symptoms to become even worse.”
While working a wrestling tournament, David finally accepted he had a serious problem. While David was changing his shoes, another official caught a glimpse of his foot. The colleague remarked that the foot looked severe and needed to be evaluated by a physician.
That comment prompted David to visit his doctor, who referred him to vein specialist Douglas H. Joyce, DO, of Joyce Vein & Aesthetic Institute. Dr. Joyce impressed David from the first appointment.
“Dr. Joyce looked at my leg and knew exactly what was going on,” remembers David. “I was a little worried about it, but he had so much confidence and said, I can take care of this issue so you don’t have to be in pain.”
As a vein specialist, Dr. Joyce immediately recognized venous disease by David’s symptoms. Initial symptoms of venous disease include swelling, tired legs, spider veins, 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 ulceration.

“Because of Dr. Joyce, I’m able to do what I want to do.” – David

“There are two systems of veins in the legs,” explains Dr. Joyce. “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. With venous disease, we find numerous connections between the superficial system and the deep system that are not functioning correctly.”
These connections, called perforator veins, can be identified using ultrasound, a safe and painless imaging test. Once Dr. Joyce confirmed the problem areas in David’s leg, he initiated his treatment plan.
“We scheduled the surgery,” relates David. “I was terrified at first, but Dr. Joyce has good people working at Joyce Vein and Aesthetic Institute. They made me feel relaxed. While I was a little apprehensive, the procedure was worth it because afterward I wasn’t in pain anymore.”

Laser Energy

There are six stages of venous disease, informs Dr. Joyce, and symptoms such as leg swelling, pain and varicose veins are common in stages one through three. Discoloration like David experienced occurs in stage four. A healed ulcer is stage five venous disease, and an open ulcer is stage six. Stages four through six are considered advanced disease. Joyce Vein & Aesthetic Institute specializes in treating advanced venous disease.
Before and after images courtesy of Joyce Vein & Aesthetic Institute.“Anytime patients have leg discoloration, they’re heading toward serious problems with their legs,” notes Dr. Joyce. “People who start to get discoloration need to have their veins evaluated right away, before ulcers form. Without correcting the underlying vein disorder, an ulcer is very difficult to heal permanently.”
For David, the leg itching was a particularly bothersome early-stage symptom. Dr. Joyce explains that itching is not unusual with venous disease. It is one possible reaction to the increased pressure caused by venous disease.
“That pressure stimulates the nerves in an unfamiliar manner, and the brain identifies that stimulus in different ways,” educates Dr. Joyce. “Some people feel pressure, some feel pain and some feel electrical shocks. Others might get the feeling of water on their legs or of insects crawling on their legs. Some people, like David, feel itching.”
Dr. Joyce approaches vein disease in all stages with the same purpose. He begins with an ultrasound examination to identify which veins are not working properly, and then determines the appropriate course of action to treat them.
“The problem is usually with the perforator veins and the long veins of the legs,” he observes. “We close those leaking veins with laser energy and reroute the blood through healthy veins. Fortunately, we have methods of doing this that are noninvasive and well tolerated.”
Dr. Joyce is a pioneer in treating all of the causes of venous disease of the leg. He has developed new techniques to treat venous disease, including single-needle laser ablation, a noninvasive method of treating the diseased veins responsible for advanced venous conditions.
“Joyce Vein and Aesthetic Institute is one of the few centers in the United States performing a significant number of the single-needle ablation procedures,” notes Dr. Joyce. “We teach physicians from all over the world how to do this technique. We have developed it to the point where it’s quite successful and have performed more than fifty-five hundred procedures, with a very high success rate and almost no complications.”

Absolute Success

David was thrilled with the results of his laser ablation. He began to feel a difference in his leg quickly after his procedure. To David, Dr. Joyce cured his venous disease and gave him back his life.Graphic from istockphoto.com.
“I had the procedure with Dr. Joyce, and I immediately started feeling some relief,” he confirms. “The next day, my pain was better. I couldn’t believe it. Now, the itching has been eliminated. There is no swelling, no pain and no discoloration. My leg is normal.
“The surgery was an absolute success. I’m able to do things I thought I couldn’t do or had to stop doing. Before, I thought I was not going to be able to officiate, but I’ve been officiating every year since. It would’ve been a loss of a lot of income if I couldn’t officiate.
“Because of Dr. Joyce, I’m able to do what I want to do.”
David adds that he would recommend Joyce Vein & Aesthetic Institute and Dr. Joyce without a doubt.
“Dr. Joyce is very confident, and that made me as a patient feel comfortable. He’s also knowledgeable and professional, and his staff is wonderful.
“Going to Joyce Vein and Aesthetic Institute was a great experience, and the procedure took care of my problem. If anyone asks me, I say, Dr. Joyce is the best!”

Dual-Use Dental Implants

Secured foundations stabilize lower and upper dentures.

Hailing from a little town outside Niagara Falls, New York, Gerald Conahan first became a snowbird in 1998 when he bought a condo in Venice. Shortly thereafter, Gerald’s annual, two-month stay in Florida turned into a nine-month stay, and now he’s officially a resident of the Sunshine State.

Photo by Jordan Pysz.

Gerald Conahan

In Florida, Gerald found more than warm weather and a great place to spend most of the months of his retirement years. He also discovered the answer to a longtime problem he had with his teeth.
“When I was very young, I had soft teeth,” Gerald shares. “Even though I went to the dentist regularly, I couldn’t keep my teeth from decaying. When I was in my twenties, one tooth got so bad that my dentist said he couldn’t save it. One thing led to another, and eventually, all my teeth had to be removed. I’ve been wearing upper and lower dentures ever since, for at least thirty, maybe forty years.”
In most cases, upper dentures fit securely because the palate enables the creation of enough suction to hold the appliance in place. This was true in Gerald’s case. The story is often different with lower dentures, however.
Lower dentures can be more difficult to keep stable. This is because there is no palate in the bottom jaw, due to the location of the tongue, and less suction is produced. As a result, lower dentures tend to slip and slide.
Like many people with lower dentures, Gerald had difficulties keeping his lower denture secure.
“After a while, my lower denture would become loose and get very sloppy,” Gerald describes. “It wasn’t comfortable, and I had trouble chewing. I really had to watch what I ate.
“I couldn’t eat anything that took a lot of heavy chewing, especially steak, unless it was a filet mignon, and even that had to be very, very tender. I couldn’t eat any other cut of steak or anything else that was tough to chew.”
Not long ago, Gerald learned how some dentists use dental implants to secure dentures and keep them from moving. He inquired about them at one dental practice but was told he was not a candidate because he lacked sufficient bone in his jaw to bond with the implants.
Gerald was not deterred. He mentioned his interest in dental implants to another dentist, who referred him to Alexander Gaukhman, DMD, of Siesta Dental.
Dr. Gaukhman is an experienced, skillful dentist who offers exceptional general, cosmetic and restorative dentistry at his offices in Sarasota, Venice and Osprey.
“I had already been to one dentist and had new dentures made,” relates Gerald. “Still, I had it in the back of my mind to look into the implants. When Dr. Gaukhman looked me over, he said, Yes. He could put the implants in with the bone I had left in my lower jaw.”

Atypical Scenario

“Gerald was referred to my practice by another dentist specifically because he could not keep his lower denture stable,” reports Dr. Gaukhman. “He could not eat because the denture would slide right out.
“The denture he had was made properly, but Gerald didn’t have enough bone in his lower jaw to support it, which is very common. However, he did have just enough bone to place dental implants. Securing a lower denture with dental implants is the most effective way to stabilize it. I recommended two implants to secure Gerald’s lower denture.”
Dental implants are screw-like metal posts that are surgically placed into the jawbone and serve as the foundation for replacement teeth. The replacements may be crowns in the case of single teeth, or bridges or dentures for multiple teeth. Implants are made of a titanium alloy that fuses with the patient’s bone to become a solid unit.

Photo by Jordan Pysz.

Gerald spreads his smile all around town now.

When dentures are secured by implants, they don’t rock or move; they stay in place when wearers speak and eat. Secured dentures also provided added strength for biting and chewing. At Siesta Dental, implants are often placed on the day of tooth extraction. In most cases, temporary dentures are also created at that time.
“Typically, once the patient’s problem is diagnosed and the treatment is determined, I take impressions of the teeth,” expounds Dr. Gaukhman. “When the dentures are ready, which is usually the same day or the next day, I extract the teeth and put the dentures in right away. The dentures act like a bandage. They stop bleeding and limit swelling.
“For the next three to six months, the patient wears temporary dentures until the implants fuse and the gums heal. Then the temporary dentures are replaced with the permanent appliances.”
Gerald’s situation was a little different. He had recently gotten new dentures and didn’t need another lower denture made for him, temporary or permanent. That was no problem for Dr. Gaukhman. He was able to adjust Gerald’s existing denture to fit with the implants.
“In Gerald’s case, I placed the two implants, and after they healed, I was able to retrofit his existing denture,” confirms Dr. Gaukhman. “We do not have to start from scratch for people who have relatively new, two- to three-year-old appliances. Retrofitting a denture essentially involves making two holes in the denture to accept the implant attachments.
“Since we have our own dental lab on site at Siesta Dental, it is especially easy for us to do this work. It takes just a couple of hours and can be done in one visit.”
“Dr. Gaukhman put in the implants for me, and that went very well,” says Gerald. “He gave me some type of Novocain®, and the procedure wasn’t too bad. I went back to the office regularly so he could check the implants and make sure everything was okay.
“Several months went by while we waited for the implants to fuse with the bone in my jaw. Just a couple of weeks ago, he prepared my lower denture with the clips that snap onto those implants, and everything went fine with that as well.”

Upper Denture Downside

Rita* is a retired administrative assistant and a Staten Island native who relocated to Florida four years ago to flee the cold and snow of New York. But she couldn’t flee from a deteriorating dental issue that had been dogging her for years.Stock photo from istockphoto.com.
“I knew for a while I had a problem with my upper gums, but I kept putting off doing anything about it,” recalls Rita. “Every time I went to the dentist, I’d hear the same thing about how my gums were receding.
“I had pain occasionally, and there was sensitivity because as my gums receded, more nerve was exposed. I was told to expect that.”
Dentists typically monitor progression of recession by measuring the gum pockets. These are the spaces between the edge of the gums and the teeth. The deeper these pockets become, the more likely it is that a tooth will loosen and the higher the risk of losing the tooth.
“I wanted to do something about my gums before my teeth fell out,” recounts Rita. “When I first moved to Florida, I lived in Bradenton, and I went to a dentist there. He wanted to fit me for a denture, but I wasn’t sure about that then.
“When I decided it was the right time to get the work done, I started looking around for a dentist. I wanted dental implants, and since I was told I probably needed a denture, I went online and did research.”
Rita wanted a dentist with expertise in dentures and implants to do the job, and her search led her to Dr. Gaukhman at Siesta Dental. She saw that Dr. Gaukhman scored rave reviews online. The dentist was also close to her new home in Venice, which was a bonus.
Rita’s mind was made up to visit Dr. Gaukhman when she read about his process for restoring smiles with implant-retained dentures in Florida Health Care News. She read that he makes the molds, extracts the teeth and creates a temporary denture in his in-office lab in one day.

“I’m very happy with the entire experience and my decision to go to Siesta Dental,
and I’m ecstatic about my results.”-Rita

“I wanted dental implants, and I saw that Dr. Gaukhman did implant surgery at Siesta Dental, so I went there,” offers Rita. “I had all my top teeth removed and got a temporary denture the same day. I expected that, but I didn’t expect the denture to look so nice or the process to cause so little pain.”
“When Rita first arrived, she had badly receding gums,” verifies Dr. Gaukhman. “When the gums recede due to periodontal disease, patients like Rita lose bone due to bacteria. The only treatment is to remove the teeth because those bacteria cannot be killed with just antibiotics.
“Rita had tried antibiotics and deep cleanings to treat her condition, but those attempts were unsuccessful. Her condition got worse until her upper teeth were no longer salvageable, so I extracted them and created a denture for her.”
While Rita was pleased with the appearance of her temporary denture, she was less than thrilled with the way it felt.
“It covered the roof of my mouth, and that was annoying, as well as a little uncomfortable,” she explains. “It didn’t hurt; it’s just that I couldn’t eat the way I wanted to because I couldn’t really bite into certain foods, like steak. I didn’t eat steak for six months.”

Secure Solution

Upper dentures generally fit securely because there’s enough suction from the palate to hold them in place. However, traditional upper dentures have some drawbacks that can be corrected by securing them with dental implants.
“The tongue is mainly responsible for discerning taste, but the palate, or roof of the mouth, plays a role as well,” informs the dentist. “When a denture is made for the upper jaw, it covers the palate, which can deprive patients of sensing the full range of tastes.
“In addition, some patients have a gag reflex due to the denture being placed over the palate. With an implant-retained upper denture, the shape of the denture is more like a horseshoe instead of a full, palate-covering appliance. It frees up the taste buds and eliminates the gag reflex. Implant-retained upper dentures are simply more comfortable.”
When Dr. Gaukhman creates implant-retained lower dentures, he generally secures them with two implants, as he did for Gerald. For upper dentures, however, he typically uses four implants.
“I use four implants on the top due to gravity,” he discloses. “Dentures work with or against gravity. Lower dentures move down with gravity, so two implants are sufficient. Implant-retained upper dentures have to work against gravity without the help of suction from the palate, so four implants keep them more securely in place.”

Lasting Impressions

After being told he was not a candidate for dental implants, Gerald didn’t give up. His persistence paid off when he found Dr. Gaukhman and Siesta Dental. Gerald is pleased with the dentist’s process, but his journey is not over yet. The clips currently on Gerald’s lower denture that attach it to the implants are temporary.
“I have to wait about six weeks until these clips loosen, and then Dr. Gaukhman will put in the permanent clips,” he states. “I also had to go back to the office early on to have the denture filed down a little because it bothered my gums, but they said that was normal. The dental technician fixed them, and now they’re perfect.”
From the beginning, Rita wanted implants for her upper denture to ensure its stability. Keeping the appliance off her palate and more comfortable became another important consideration after wearing the temporary. With her permanent upper denture secured by implants, Rita has that comfort and stability, as well as strength for biting and chewing.
“I love my permanent denture,” she enthuses. “It’s much more comfortable because I don’t have a plate covering the roof of my mouth. And it’s so much easier to eat; I can eat anything I want now. I’ve already eaten steak, hamburgers, all sorts of things.
“Steak was one of the first things I ate after I got my denture. Just to be able to bite into a hamburger now is great.”
Gerald finds it easier to eat as well. While he’s eating a lot more foods than he did before the implants, he isn’t rushing into all of his favorite hard-to-chew foods just yet.
“I’m eating and chewing a lot better, but I haven’t taken on steak yet,” he muses. “I’m going to wait until I get the permanent clips, then I’ll definitely be at one of those steak places trying out my denture. I’m looking forward to it.”
Comfort isn’t the only benefit of Rita’s new denture. She also likes its appearance and the ease of its wear and care.

“I would absolutely recommend the implant process and Siesta Dental. Everybody there is very professional, and they’re very patient oriented”-Gerald

“The new denture is wonderful,” she marvels. “Everybody tells me it looks absolutely natural. I really like that it doesn’t slip and slide all around. It snaps in and out. I take my denture out at night to clean it, snap it back in my mouth in the morning and I’m good to go.”
For Gerald, the most amazing thing is the permanence of his lower denture. Unlike before, the implant-retained denture doesn’t become loose and move around when he speaks and eats.
“Sometimes before, when I bit on something on one side of my mouth, the denture would lift up on the other side, so I had to chew on both sides of my mouth at the same time,” he observes. “Now, I don’t have to worry about that. I’m thrilled with the results.”
Rita and Gerald say their overall experiences at Siesta Dental were very positive. Rita gives Dr. Gaukhman and his staff credit for making her visits to the practice as easy and pain free as possible.
“When I walk into the office, everybody is so nice, and they take good care of me,” she comments. “Personally, I’m one of those people who hate dentists, but I can’t hate these people. Dr. Gaukhman is great. He made me feel very comfortable about getting this work done.
“I only have good things to say about Dr. Gaukhman and his staff because they’re just excellent. They’re so friendly and caring. I’m very happy with the entire experience and my decision to go to Siesta Dental, and I’m ecstatic about my results. I recommend Dr. Gaukhman to anyone.”
Gerald agrees.
“I would absolutely recommend the implant process and Siesta Dental. Everybody there is very professional, and they’re very patient oriented and concerned. After I had my implants put in, they called me to make sure I was healing properly, in addition to the regular appointments I had with them.
“I give Dr. Gaukhman and Siesta Dental a double A-plus rating!”

*Patient name witheld at their request.
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