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A Better Solution

Fit, feel and taste give implant-secured dentures edge over traditional dentures.

After friends of New Hampshire native Maurice Whipple invited him to Florida for a visit, he decided he liked the state and wanted to retire here. Maurice bought a home and became a permanent Florida resident in the late 80s, but he still spends the hot summer months with his children up north.

Photos by Jordan Pysz.

Maurice Whipple

These living arrangements work out well for Maurice. Unfortunately, not everything has worked out positively for him. For years, the retired electrical contractor had trouble with his teeth, and it got to a point that he began losing them.
“My dentist told me I had very hard teeth, but they were prone to cavities no matter how much I brushed and flossed,” Maurice shares. “I knew I was going to end up with dentures eventually, but I managed to put it off as long as I could.
“Around 2000, I got my upper teeth pulled and replaced with a denture. Eighteen years later, my bottom teeth started heading south on me, and I knew I would have to have them pulled out as well.”
While Maurice contemplated a denture for his bottom jaw, he also considered replacing his upper denture with an improved appliance. He learned about dentures that are secured by dental implants and thought implant dentures were the better way to go.
“With my upper denture, the plastic covered the whole roof of my mouth to create a vacuum to hold it in place,” Maurice describes. “The denture fit well, but it made me gag a lot, so I knew I needed to get rid of the roof part of my denture. I heard implant dentures don’t have plastic over the top of the mouth, so I looked into them.
“I called three dentists who offer implant dentures, and Dr. Gaukhman was the most experienced. He was also convenient. His office is located close to where I live. He also had the best deal and was very pleasant to work with. That’s the main reason I chose him.”
Maurice’s choice for dental care was Alexander Gaukhman, DMD, of Siesta Dental in Sarasota.
Dr. Gaukhman, who offers exceptional general, cosmetic and restorative dentistry, also has offices in Venice and Osprey. The dentist agreed that implant dentures were a good option for Maurice.
“I told Dr. Gaukhman what I wanted, and he said, That’s what you should have,” Maurice remembers. “I did a lot of research before I made this move. I looked into individual dental implants, but that route was too expensive for me. Implant dentures addressed my concerns and were something I could afford.”

Classic Example

Dental implants are screw-like posts that are surgically placed into the jawbone to serve as the foundation for replacement teeth, such as crowns and dentures. When they’re secured by implants, dentures don’t slip or move; they stay in place when patients speak and eat. There are other advantages of implant dentures over traditional dentures, Dr. Gaukhman notes.
“A drawback of traditional upper dentures is a decrease in taste,” the dentist describes. “The tongue is mainly responsible for discerning taste, but the palate also plays a role. Because traditional dentures cover the palate, patients can be deprived of sensing the full complement of tastes. Implant dentures, on the other hand, are horseshoe-shaped and do not cover the palate, improving taste.”
Another issue that can occur with traditional upper dentures is a gag reflex. Some patients, including Maurice, experience this problem due to the denture being over the palate. By not covering the palate, implant dentures eliminate this gag reflex.

Photos by Jordan Pysz.

Maurice can relax comfortably now that he has implant-secured dentures.

Traditional lower dentures are generally more difficult to keep stable than upper dentures. Because there is no palate on the bottom of the mouth, less suction is produced to naturally hold lower dentures in place. As a result, they tend to slip while patients are eating and speaking.
“Adding dental implants stabilizes lower dentures, so they do not move around,” Dr. Gaukhman observes. “In addition, dentures secured by implants have stronger chewing capability than traditional dentures. Patients can eat foods they could not eat previously, improving their quality of life.
“Implant-retained lower dentures are generally secured with two implants. We typically secure upper dentures with four implants because they have to work against gravity. Maurice is a classic example of what we offer for implant dentures. We gave him a new upper denture stabilized by four implants and a new lower denture with two implants.”

Perfect Match

Maurice looked forward to getting his implant dentures, but he made it clear he wasn’t looking forward to the dental work that would get him there. Dr. Gaukhman took care of that issue as well.
“I told Dr. Gaukhman I wanted to be put to sleep when he did the drilling and other work, and he did that for me,” Maurice says. “He made me very comfortable. I didn’t experience the slightest bit of pain, not even after Dr. Gaukhman put in the implants.
“I’m very happy with Dr. Gaukhman’s process. When I got my upper denture eighteen years ago, the dentist pulled my teeth and put in my denture before my gums had completely shrunk back to their normal size after being swollen. As a result, I ended up with a loose denture.
“Dr. Gaukhman placed the implants, then waited a few months until the bone adhered to the implants and my gums healed. He gave me temporary dentures to wear during that time. I got my permanent dentures in January, and they fit perfectly.”
As it turned out, Maurice was in New Hampshire during the time his implants were healing, so when he returned to Florida, he was ready to receive his permanent dentures. He’s thrilled with the finished products.
“I love my dentures,” Maurice raves. “The bite is perfect, and they look good. Dr. Gaukhman pretty much copied the look of my old denture on the top, and for the bottom, he showed me sample teeth and let me pick what I wanted. Some were narrow teeth and some were wider, but they matched up really well.
“The dentures Dr. Gaukhman made for me look very natural. People don’t know they’re not real teeth. I’m so lucky. Everything turned out perfectly.”
Maurice is especially pleased that his new upper denture has no plastic covering the roof of his mouth. He points out that one benefit of that is he can better taste his food. But that’s not even the best part for him.
“The main benefit for me is it eliminated the gagging I experienced for eighteen years with my old upper denture,” he says. “And my bottom denture doesn’t move in my mouth at all. I should have done this in 2000 instead of waiting.
“I definitely recommend Dr. Gaukhman and Siesta Dental. They did excellent by me. Nobody could do a better job than they did.”

Redefining Rehabilitation

Hospital’s tailored program enhances patient outcomes.

Retired air traffic controller Gene Hosack was born in a small town in South Florida called Pahokee, but he spent most of his adult life in North Florida, where he has always been a very active individual.

Photo by Nerissa Johnson.

Gene Hosack

“I was a runner for many years,” Gene shares. “I don’t run anymore, but I ride my bike three thousand to four thousand miles a year.”

Now 78, Gene’s active lifestyle has helped him to stay in good physical shape. His conditioning was put to the test this past July when he relocated to Vero Beach. Unfortunately, Gene’s back didn’t quite pass the test.

“Being active, I’ve had back pain on and off for a long time,” Gene explains. “When I get that pain, I typically ice down my muscles, and the pain gets better. But after moving a couple of households of furniture, that didn’t happen this time.”

Gene’s back pain didn’t prohibit him from riding his bike. As he has for years, he continued to ride 15 miles a day without issue. Oddly, though, he couldn’t walk more than 50 feet without his back seizing up on him.

“The pain was enormous,” Gene describes. “It was brutal. I was literally on my hands and knees going up the stairs. Sometimes, I just sat and shuddered because it was so bad. I always thought I had a high pain tolerance, but I couldn’t deal with that.

“The only time it didn’t hurt was when I was sitting or bending over. My wife kept telling me to straighten up, but I couldn’t because it hurt too much. Finally, I went to my doctor, and he told me I had bulging discs, spinal stenosis and pinched nerves.”

Gene’s doctor initially referred him to a pain management specialist who tried several steroid injections to ease his back pain. The injections were unsuccessful, however, so Gene’s doctor’s next suggestion was to see a spinal surgeon.

“The pain management doctor said my back was very compacted,” Gene recalls. “The nerves were being crushed by my vertebrae, so the shots weren’t doing anything. As soon as I saw the surgeon, he did an MRI and said I needed surgery.

“I opted to go ahead with that. The surgery was performed on January thirtieth. The next morning, I went to Encompass Health for rehabilitation. That was a good move because they worked miracles for me.”

Encompass Health Rehabilitation Hospital of Treasure Coast is an acute-level rehabilitation hospital located in Vero Beach. It’s the only facility in the area that offers that level of care. Encompass Health creates a personalized program of treatments for patients’ post-surgical rehabilitation.

Center of Excellence

Major surgery, such as Gene’s back surgery, can be a life-changing event requiring rehabilitation and retraining on activities of daily living. Surgery in and of itself often causes some disability because spending time in bed recuperating involves prolonged immobility.

“Encompass Health can definitely help with that,” assures Dawn Bucaj, RN, BSN, senior rehab liaison at Encompass Health. “We provide hospital-based inpatient rehab services to improve our patients’ independence and get them back to their active lives and their loved ones.

“Returning to regular routines after surgery or serious illness can be a struggle for patients. That’s why we have a team of specialists working together to help patients regain their confidence and paving their path to recovery following surgery.”

The Encompass Health team is led by their medical director, a physiatrist, and includes rehab-certified nurses, physical therapists, occupational therapists and speech therapists. They assist patients in navigating through the post-surgical recovery process. Each patient’s recovery is different, so the rehab approaches taken by the Encompass Health team are individualized.

“We tailor a fully coordinated program of rehab treatments to ensure each patient receives the best care for their particular needs,” Dawn informs. “The approach we take is personalized to the patient’s diagnosis or condition and abilities.

“As a hospital, our patients receive daily visits by two physicians and twenty-four-hour rehab nursing care. Their tailored rehab programs include three hours of therapy per day, every day. Therapy is started based on the patient’s current level of ability.”

“The occupational therapist showed me how to wash, dress and shower,” Gene reports. “During physical therapy, they did a lot of exercises for my arms. They also had me walk using the parallel bars. I did therapy three hours a day, an hour and a half in the morning and an hour and a half in the evening. I accomplished a lot during therapy. The therapists did a good job with me.”

Photo by Nerissa Johnson.

Gene is excited to be back on his bike now that his physical therapy is complete.

Comfortable Cruising

Dawn stresses that Encompass Health is certified by the Joint Commission on Accreditation of Health Care Organizations in brain injury and stroke. It’s also been designated a Stroke Center of Excellence.

“We achieve designations such as these because we offer the most advanced treatments as well as state-of-the-art technology,” she observes. “These factors result in the best patient outcomes.

“It’s important to know the difference between a rehabilitation hospital and other post-acute settings such as nursing homes and assisted living centers. As a hospital, Encompass Health provides complete inpatient care as well as rehabilitation services, and that makes a huge difference in outcomes.”

She also notes that it’s important for patients and families to ask for Encompass Health by name.

Following his back surgery and rehabilitation at Encompass Health, Gene is feeling good and moving comfortably again. He believes the therapy he did at Encompass Health helped him turn the corner in his recovery from surgery.

“I just came back from a seven-day cruise, and I did a lot of walking up and down stairs on the ship,” Gene enthuses. “I was sore, but nothing outrageous. I actually went swimming on the cruise as well. I swam laps in the pool and about one hundred yards in the ocean. That’s pretty remarkable. And I can now stand and walk around. Three months ago, I couldn’t have done that, so I’m doing pretty well.”

During the height of Gene’s back problem, he rated his pain a ten out of ten. While he still has some pain, it has decreased significantly.

“Now, my pain is maybe a three,” he says. “It might not even be that high, so maybe it’s only a two, but I can certainly manage that.”

While Gene can now walk without pain and go up and down stairs on his feet, he decided to take a little more time before returning to all of his activities.

“I waited a little longer before I got back on my bike,” he relates. “I wanted to see how I responded to physical therapy, and I was afraid of falling. I used to wear biking shoes, but I’ll never do that again now that my back is fixed. I wear regular, ordinary shoes instead, so if I fall, I’m able to get my feet down.”

Having surgery was necessary for Gene due to the multiple problems with his back, but it’s a major procedure with a painful and immobilizing recovery process. He’s extremely pleased with his two-week stay at Encompass Health.

“The staff was beyond nice, and very attentive,” Gene states. “And they always told me what was going on. The nurses were wonderful. They managed my pain, and anytime I called them, they came immediately. I was treated very well.

“I really thank Encompass Health Rehabilitation Hospital of Treasure Coast. The care was outstanding, and the staff were on top of their game. They made my stay as nice as it could be, that’s for certain. And I appreciate that.”

The Rest of the Story

Procedures end pain, disability of spinal fractures.

As an adult, Patricia Martyka, 76, played numerous roles. She was a mother and homemaker as well as a cheerleader and coach for her children. She also worked outside the home as an administrative assistant at a local mill. All of her life, Patricia loved animals. For years, she also fostered pets from animal shelters in her Illinois hometown.

Photo courtesy of Patricia Martyka.

Patricia enjoys time with her dog, ToTo.

Ever the animal lover, when Patricia relocated to Florida three years ago, she kept multiple pets of her own. But as she grew older, she tired of running to pet stores for dog and cat food and hauling the heavy bags back home. She switched to an online delivery service instead, but it was a delivered bag of food that was her downfall.

“I ordered a twenty-five-pound bag of dog food, but when it was delivered, my husband brought it in and put it by the cabinet,” Patricia recalls “When I saw it by the cabinet, I was miffed and said, I’m going to put this in the container, so I bent over and picked it up. I felt something snap in my back and stomach, and immediately, I was in pain and couldn’t move.

“The pain was worse than delivering a baby. It went through the entire circle of my midsection, from my abdomen around to my side and into my back. It felt like somebody was constantly stabbing me. I couldn’t walk. I couldn’t sit. I couldn’t lie down. It was awful. Ice, heat and ibuprofen were my best friends.”

Patricia experienced a similar event years earlier. She felt a snapping sensation in her back after bending to take cookies out of the oven. Back then, she didn’t suffer a serious injury, and the condition healed on its own. She assumed this was nothing serious as well and didn’t seek treatment. Eventually, that changed.

“After a few weeks of not being able to do anything, I called my family doctor,” Patricia shares. “He sent me for pain management, and that’s how I met Dr. Cordner. When I went for my first appointment, I was all bent up and in excruciating pain. I had been like that for weeks.”

Harold J. Cordner, MD, is a pain management specialist at Florida Pain Management Associates in Sebastian and Vero Beach. Dr. Cordner has a complete arsenal of noninterventional and interventional services for managing his patients’ pain. His first step with Patricia was to send her for an MRI of her back.

“I sent her for an MRI because I suspected she had a spinal fracture,” Dr. Cordner notes. “Sure enough, the MRI showed she had two acute fractures in her spine. There are several options for treating spinal fractures, including leaving them alone.

“They can eventually heal on their own, but that can take months. Another option is to put her in a back brace and try to immobilize her spine. Or, I could perform a procedure such as vertebroplasty or kyphoplasty.”

During those procedures, physicians place a needle into the bone at the site of the break and inject bone cement to stabilize the fracture. Because Patricia was in so much pain from her acute fractures, Dr. Cordner recommended kyphoplasty for her.

Clarifying Misconceptions

Vertebroplasty and kyphoplasty are extremely effective at easing pain associated with spinal fractures, reports Dr. Cordner. The procedures also work quickly, so patients don’t suffer for months in severe pain while waiting for their fractures to heal.

“More than ninety percent of patients achieve good to excellent pain relief within the first twenty-four to forty-eight hours of these procedures,” the doctor asserts. “Patients can then quickly return to their activities of daily living.”

The speedy results associated with vertebroplasty and kyphoplasty are among the reasons Dr. Cordner advocates their use. He clarifies misperceptions from recent reports on studies that suggest providing no treatment for spinal fractures results in the same degree of pain relief as that achieved with vertebroplasty or kyphoplasty.

“Let’s set the record straight,” Dr. Cordner states. “Those studies looked at patients at twelve months post-fracture. Even if you treat a patient conservatively, that fracture is not going to hurt that much a year later. It’s had time to heal.

“What those studies don’t look at is what happens to patients during the acute phase of their injury. That’s when they go to the emergency room, are hospitalized or enter rehab facilities because they’re in agony and can’t function. There are huge numbers of health care dollars going into getting patients through this phase of agonizing pain and disability.

“But we can get patients through that acute phase and back to activity in twenty-four to forty-eight hours with a vertebroplasty or kyphoplasty. The results are overwhelmingly positive in favor of these procedures as far as health care dollars spent.

“In addition, disability, morbidity and even mortality are reduced significantly when fractures are stabilized in the acute phase. Studies have also shown that life expectancy is prolonged with early treatment in these patients.”

Enthusiastic Response

Patricia is one of the 90 percent of patients who achieved excellent pain relief from a kyphoplasty within a short time of the procedure. She’s thrilled by her response to the treatment, which she was eager to try.

“When Dr. Cordner told me he could fix the fractures pretty easily, I remember thinking, Anything’s better than this pain,” Patricia states. “I thought I was going to be put to sleep for the procedure, but I wasn’t. I was awake the whole time.

“I was lying on a table and actually heard what was going on. I was surprised by that. But on the day of my kyphoplasty, I walked into Dr. Cordner’s office in misery, and I walked out pain free. I still can’t believe it.

“I have osteoporosis and osteoarthritis, so I still have some discomfort, but it’s nothing like I had before. The pain relief Dr. Cordner gave me is fantastic. I can lie on my back again; I can garden, use the pool, take care of my pets and do my everyday activities. The procedure was one hundred percent successful.”

Before suffering the spinal fractures, Patricia underwent a hip replacement and was doing physical therapy. After Dr. Cordner gave her the go-ahead, she returned to physical therapy to keep her spine mobile against the arthritis.

“I’m back to doing my physical therapy every day,” Patricia confirms. “I’m not doing it to the same degree yet, but I’m back to about ninety-nine percent as far as being able to do what I was doing prior to my kyphoplasty.

“Dr. Cordner’s procedure at Florida Pain Management Associates is amazing. Medicine has come a long way, and that’s a very good thing.”

Cancer Vaccines Offer Hope

August 20th, 2019

Vaccines, as you probably know, are medicines that help your body fight disease. If you’re like most people, you received vaccinations against a bunch of disorders – from chickenpox to whooping cough – when you were a kid. Vaccines work with your immune system to recognize and destroy harmful substances, such as disease-causing viruses, that attack your body.

Scientists today are exploring new and better ways to boost the power of the immune system, using vaccines aimed at battling cancer. Cancer vaccines can be used to prevent or treat cancer.

Preventive vaccines currently available include the HPV vaccine, which protects against human papillomavirus (HPV). An HPV infection can lead to cervical, vaginal, vulvar and anal cancer. The hepatitis B vaccine is another preventive cancer vaccine. Hepatitis B infection can cause liver cancer.

Vaccines to treat cancer are a type of immunotherapy because they work directly with your body’s immune system. Cancer treatment vaccines can do several things. These include destroying residual cancer cells after other treatments, stop a tumor from growing or spreading, and prevent cancer that was treated from coming back.

Currently, there are only a handful of active immunotherapies that are approved for treating cancer. There are, however, hundreds more being investigated in clinical trials, in which cancer patients can participate. Clinical trials are research studies that test the safety and effectiveness of new medications, therapies or devices.

While there are numerous cancer clinical trials ongoing, estimates suggest only three percent to six percent of eligible cancer patients participate in them. This not only slows the progress of new treatment development, it also means more than 90 percent of cancer patients may be missing out on potentially life-saving new treatments.

An example is a vaccine developed by researchers at the University of California San Diego Health and the La Jolla Institute for Allergy and Immunology, which is currently in clinical trials. This vaccine, which is for people with deadly metastatic cancer, is specifically created to match each patient’s cancer mutations and immune system.

Study researchers begin by testing patients’ tumors and identifying the neoantigens, or mutations, that cause their immune systems to respond. Researchers then culture the neoantigens with the patients’ T-cells, a type of immune system cell, and give patients a series of three vaccines of the modified T-cells.

To ensure the T-cells remain activated once they reach patients’ tumors, researchers also give patients the immunotherapy medication Keytruda. The bolstered T-cells then go to work destroying the tumor cells.

Another clinical trial, led by researchers at Stanford University School of Medicine, tested a combination immunotherapy for the treatment of two types of non-Hodgkin’s lymphoma, a type of blood cancer. The two types are diffuse large B-cell lymphoma and follicular lymphoma.

The treatment tested was a combination of an experimental antibody developed by researchers at Stanford and a commercially available anti-cancer antibody called rituximab.

The experimental antibody works by blocking CD47, a protein that inhibits immune cells called macrophages from attacking and devouring cancer cells. Rituximab amplifies signals to the macrophages to do their job of consuming the cancer cells.

The results of this small, multicenter clinical trial are promising. Half of the 22 people enrolled in phase 1 of the trial had a positive response to the therapy, and about one-third went into complete remission.

These are just two examples of clinical trials looking at new cancer treatments that take advantage of patients’ disease-fighting immune systems. Researchers are hosting many more trials to test vaccines for other types of cancer.

These include cancer of the bladder, breast, cervix, colon, rectum, kidneys, lungs, pancreas and prostate. Other clinical trials are investigating treatments for brain tumors, leukemia, melanoma and myeloma.

If you’re interested in participating in a clinical trial, talk with your doctor about appropriate studies for your situation. You can also look for clinical trials being conducted in your area at clinicaltrials.gov.

By participating in a clinical trial, you may discover a life-altering treatment that works for you when others have failed. You may also help make a new therapy available to others with cancer who previously had no hope. Talk to your doctor and consider taking part in a clinical trial.

Beyond Standard

Eau Gallie center expands services for cancer patient.

In 2017, medical aesthetician Victoria Hicks, 35, discovered a lump in her right breast. At first, it appeared to be a benign growth. Then it grew into an 8-cm mass. A series of tests revealed the Springfield, Virginia native and mother of one had Stage III HER2-positive breast cancer.

Photo by Nerissa Johnson.

Victoria enjoys playing basketball with her son, Jaxson.

Following her diagnosis, Victoria was referred to the Eau Gallie location of Cancer Care Centers of Brevard in Melbourne. That’s where she met Sumeet Chandra, MD, a board-certified medical oncologist and hematologist who specializes in treating cancer patients using medications such as chemotherapy.

“When I met with Dr. Chandra, he had already spoken with my general surgeon,” Victoria says. “They had a whole game plan ready for me. Dr. Chandra got things moving really quickly. Within a week of my diagnosis, I had a chemotherapy port put in, and within two weeks, I was getting my first chemotherapy treatment.”

The care given to Victoria came in the wake of a recent expansion of services by the Eau Gallie center. Now in its tenth year of service overall, the Eau Gallie center joined forces with Cancer Care Centers of Brevard two years ago, primarily in an effort to offer an even wider range of care to the community.

Participation Ramp-Up

“Currently, we administer chemotherapy, but we’ve also added several ancillary services that we’re excited about,” Dr. Chandra describes. “We now have acupuncture and physical therapy, and we work very closely with a clinical psychologist.

“We don’t offer radiation oncology at our center, but if patients require radiation therapy, we refer them to radiation oncologists that are partners with Cancer Care Centers of Brevard at multiple locations.”

One program that will grow significantly through Eau Gallie’s partnership with Cancer Care Centers of Brevard is clinical trials. The Eau Gallie center has some experience with clinical trials, but they will be able to ramp up their participation as part of the larger practice.

“Clinical trials really advance the science of oncology, which is changing all the time,” Dr. Chandra observes. “It’s always good to be a part of that change and offer new treatments that go beyond the standard of care for patients who’ve tried everything else. We should have a pretty robust clinical trial program within the next year or so.”

Dr. Chandra chose a standard form of treatment for Victoria, treating her with chemotherapy ahead of her eventual surgery. He chose that route, he says, because of the large size of the tumor, and the approach worked as intended. Dr. Chandra reports that following surgery, no evidence of active cancer was found in Victoria.

“I just got my latest tumor marker blood test, and there’s no evidence of disease,” Victoria enthuses. “That really improves my survival rate. Now, I’ll just see Dr. Chandra every six months for four years for check-ups.”

Victoria believes Dr. Chandra’s kind and supportive manner helped her get through her treatment, both physically and emotionally.

“I loved how much time Dr. Chandra spent with me and how he answered all of my questions,” she says. “And no matter how much anxiety I had going into treatment, I felt better when I left because Dr. Chandra gave me hope.

“The mind is a powerful tool,” she adds, “and Dr. Chandra and the chemotherapy nurses at the Eau Gallie center really helped put me in the right mindset for my treatment. That’s the key to a successful outcome.”

Signature Smile

Woman’s restored smile shines on daughter’s special day.

Wendy Felton is a dedicated mother and doting grandmother, but during her working years, she was also devoted to assisting low-income, first-generation American students in accessing college. She led workshops and seminars for students across the country and often spoke publicly on the issue. She even authored a book on the subject.

Photo by Nerissa Johnson.

Wendy Felton

“I fell into my path while raising my own kids,” Wendy describes. “I got a position helping other people’s kids when I obtained a grant through the US Department of Education’s Talent Search program. I also wanted kids to have a comprehensive guide on how to get into college that they could use after I retired and died. That was the motivation behind my book.”

Retirement for Wendy, a New Jersey native who moved to Florida in 2018, came a few years ago, but not before she went through some serious personal struggles that included undergoing three brain surgeries. During that stressful time in her life, Wendy also began grinding her teeth at night.

“The grinding got so bad that my dentist could see horizontal grooves in my four front teeth,” Wendy shares. “My dentist filled in the grooves, and we thought my teeth were repaired, but ten years later, those four teeth broke off.

“My smile is my signature, especially with public speaking. I lived in Atlanta for a while, and people there nicknamed me Sunshine because I was smiling all the time. They said, When you smile, you bring in the sun with you.

“But when I looked at my teeth in the condition they were in, I was embarrassed. I tried to cover my mouth. I was also embarrassed that I didn’t have dental insurance to cover the cost of the dental work that needed to be done to repair my smile.”

To make matters worse, Wendy was a longtime soda drinker. Her dentist told her the acid intake from the soda had erased most of the protective enamel from her teeth, which deteriorated them even further.

It was a problem that was only exacerbated by Wendy’s favorite comfort food – hard pretzels. With the protective enamel all but gone, Wendy’s teeth began to break whenever she ate the pretzels.

At that point, Wendy could no longer avoid the problem with her teeth. She knew she had to take action to repair her teeth and restore her smile. She was particularly concerned because a very special event was coming up, and she wanted a bright smile to show off to her friends and family, and for photos.

“My daughter was graduating from law school in May 2019, and I wanted to be able to smile,” she elaborates. “I wanted to have my teeth right so that I had a good smile. I was also going to see family members who hadn’t seen me with my bad teeth, and I refused to be embarrassed.”

Restoration Recommendation

As Wendy set about looking for a dentist to restore her smile, she took note of one dental practice that was close to the mall in Melbourne where she often shops. That practice was Implant Dentistry of Florida. She decided to see what the practice had to offer, and it was there that she met with William S. Vaughn, DMD.

At Implant Dentistry of Florida, Dr. Vaughn works alongside Clark F. Brown, Jr., DDS, to provide a full range of dental services. They perform cosmetic and general dentistry as well as all phases of dental implant surgery and smile restoration. Just what Wendy needed.
“I went to Implant Dentistry of Florida about a month and a half before my daughter’s graduation,” Wendy relates.

“Dr. Vaughn had such a wonderful, friendly and loving spirit that I knew right away that I was in the right place.”

“My new dentures are gorgeous. They look so natural, you’d never know I had dentures. . . . I feel so good about smiling now.” – Wendy

“When Wendy first came to us, she had several broken teeth and generalized wear and tear that tends to occur over time,” Dr. Vaughn notes. “We decided that it would be in her best interest to remove her teeth and replace them with full dentures. That way, she would no longer have any teeth maintenance and she would get a complete smile restoration at the same time.”

“My teeth were in horrible condition,” Wendy reports. “At first, I thought, I like dental implants. I need to find out how much it will cost to get implants. I discovered that getting dental implants in my whole mouth would be a huge job. We talked about partials, but
Dr. Vaughn recommended pulling all of my teeth and giving me full-blown dentures.

“I explained my situation to the staff at Implant Dentistry of Florida. I told them that I didn’t have dental insurance and would be paying for my treatment out of pocket. They were wonderful and worked with me so I could get the dental work done.”

Photo by Nerissa Johnson.

Wendy is proud to show off her new smile for grandson, James.

Denture Designs

Dr. Vaughn and Dr. Brown sometimes recommend using a few dental implants to better support a patient’s denture, but Wendy had enough bone support in her jaw so that her dentures would fit well on their own, so no implants were necessary.

Wendy had her teeth extracted and her dentures placed on the same day. The dentures were made in advance from an impression that was taken of Wendy’s mouth and sent to a dental laboratory.

“From that impression, the laboratory fabricated custom pieces that we used to take final impressions and establish Wendy’s bite, which showed how long her teeth were going to be, and how the dentures would fit together” Dr. Vaughn explains.

“Once we had Wendy’s final impression and bite registration, we returned that to the laboratory. With it, we sent shade information, which Wendy chose, a photo and other information she gave us about how she wanted her teeth to look. The laboratory then fabricated the dentures based on those specifications.”

“When Dr. Vaughn told me I could have any teeth I wanted in the dentures, I started looking at people’s teeth on TV and taking pictures,” Wendy says. “My sister and I look a lot alike, and her teeth are gorgeous. They’re so white and bright, so I submitted a picture of my sister and said, Now, they can call us twins.

The photo Wendy submitted provided Dr. Vaughn with a clear guideline to follow when restoring Wendy’s smile to its former grandeur. He is extremely pleased that the dental lab was able to recreate the smile Wendy wanted.

“Our laboratory did a wonderful job of matching the size and shape of Wendy’s teeth as well as the custom shade she chose,” he observes. “We were able to work ahead of time to produce the final cosmetic appearance that Wendy was looking for, and she is very pleased with her new smile.”

When this step was completed, Wendy was given an opportunity to examine the dentures to ensure they met her standards and that she was satisfied with them. Only then did Dr. Vaughn remove her existing teeth and place her dentures.

“The immediate dentures, the ones we place right after the teeth are extracted, actually serve as bandages,” Dr. Vaughn informs. “They cover up the extraction sites and encourage the gum tissue to heal to the shape of the underside of the dentures.

“Later, we made some adjustments to Wendy’s dentures that almost always have to be made during the healing process. Usually, there is a point when the dentures have to be relined because the gums and bone recede as they heal. In those cases, we simply reline the dentures with acrylic so that they tighten up and fit again. But all the teeth remain the same.”

“When Dr. Vaughn told me he was going to pull all of my teeth in one day, I thought, I don’t think I can handle that,” Wendy says. “But when he actually pulled the teeth, I didn’t feel anything, not even any pressure. I couldn’t believe it.

“I didn’t even know he was finished until he said, Okay, all done. We’re going to fix you up with your dentures now. He popped in the dentures and told me to leave them in overnight until the swelling goes down, then come back and get them fitted.”

Being Sunshine

Wendy is thrilled with her restored smile, and she’s extremely happy that her dentures turned out exactly as planned. She likes that people can’t tell that her teeth are dentures, and in some cases, she chooses to keep it that way.

“My new dentures are gorgeous,” Wendy raves. “They look so natural, you’d never know I had dentures. The teeth are just right, not too big or too small. The family members I was trying to hide from didn’t even know I had dentures. I was talking to my pastor’s wife, and she said, They’re dentures? Are you sure? They look so real.

“My niece, her husband and their kids don’t know I have dentures. My son and daughter-in-law know because they were there with me when I was getting them. My one-year-old grandson looks at me strange when I pop out my teeth. He must think, She looks like me.

“I feel so good about smiling now. I feel that I can be Sunshine again with my smile, and I feel good about that.”

Dr. Vaughn noted that dental implants weren’t necessary in Wendy’s case to support her dentures. Suction from the roof of her mouth is sufficient to keep her upper denture solidly in place, with very little wiggle room.

Photo by Nerissa Johnson.

Dr. Brown and Dr. Vaughn with the Implant Dentistry of Florida staff.

“My bottom denture just goes over the row of gums where my bottom teeth were,” Wendy explains. “On the bottom, I simply put a little adhesive on the front of the denture and on the sides. That allows me to eat pretty much anything, although I do cut up my food a little smaller. But I can even chew my hard pretzels now without my teeth breaking.”

Not only did Dr. Vaughn and his staff provide Wendy with natural-looking dentures that restored her smile, they were able to meet her deadline. Wendy’s smile was ready in time for her daughter’s May law school graduation. Wendy is grateful to the dentist and his staff for their efforts, as well as her outcome.

“My daughter thinks my dentures look fantastic,” Wendy says. “She’s so happy I had them done because she didn’t want pictures of her graduation without me smiling.

“Everyone at Implant Dentistry of Florida was so loving and wonderful, and they all remembered my daughter’s graduation. Last week, I went to the office and took them a picture of me and my daughter at the graduation, and I was smiling.

“I recommend Implant Dentistry of Florida to anybody, and not just for dentures but for any adult dentistry needs. My son and daughter-in-law didn’t have a dentist, and I told them, You’ve got to go to this practice, so now they go there, too.

Dr. Vaughn and the staff at Implant Dentistry of Florida are phenomenal. I recommend them in a heartbeat.”

Skin Deep

Dermatitis, ulcers advanced signs of vein disease.

Originally from Texas, Allison Ferguson, 42, grew up in the Houston area but relocated to Florida in June 2017. Her life is now devoted to her dual careers as the mother of an 11-year-old son and 13-year-old daughter and as a computer professional.

Photo by Jordan Pysz.

Allison Ferguson

“I work in the IT area at the corporate headquarters for Chico’s clothing stores, White House Black Market clothing stores and Sonoma stores.” Allison elaborates. “It’s also the headquarters for another brand called TellTale.”

Living in Florida, Allison likes to spend her free time at the beach with her family and friends. She loves to swim, walk and enjoys other outdoor activities, but early last year, a strange rash appeared on her leg that made her favorite pastimes less enjoyable.

“In February 2018, I noticed these red dots on the ankle of my right leg,” Allison relates. “They bothered me, but I didn’t think that much about them at first. They just came and went, and I let it go.

“My leg was extremely itchy, so it felt good to scratch it. But the more I scratched, the more red and inflamed it got, and it became a situation. At Chico’s, we have a health clinic on campus, so I went there. The nurse gave me a steroid cream to put on my leg, but the rash didn’t get better.

Then the nurse suggested I see a dermatologist.”

The dermatologist diagnosed Allison’s condition as eczema and prescribed a medicated cream, but the condition of Allison’s leg got worse instead of better. Her leg started swelling, and she broke out in hives. The redness, inflammation and itching became more intense as well.

“The itching was terrible,” Allison shares. “It was like poison ivy. It was truly consuming. And the rash was getting redder with bleeding and scabbing, so I worried about it getting infected. In May, the dermatologist tested me for skin mites and shingles, but the results came back negative.”

When nothing the dermatologist suggested helped, the doctor recommended Allison visit a rheumatologist to determine if an autoimmune disease was the cause of her symptoms. The rheumatologist couldn’t find a link, but wanted her to see a specialist at The Mayo Clinic in Jacksonville. That was a long drive from Allison’s Fort Myers home.

“Before I did that, I thought, Let me try an allergist,” Allison recalls. “I had allergies and took allergy shots in the past. But as soon as I walked in, the allergist said, This is not an allergy issue. You need to go to the University of Miami Center for Dermatology. I figured that was closer than The Mayo Clinic in Jacksonville.”

“I would definitely have the ClosureFAST endovenous ablation procedure again if I had to. And I’d definitely recommend getting that treatment from Dr. Magnant at Vein Specialists.” -Allison

Doctors in Miami ran a slew of tests and told Allison her problem was with her leg veins. That’s when she found Joseph G. Magnant, MD, of Vein Specialists in Fort Myers and Bonita Springs. Dr. Magnant, a board-certified vascular surgeon, is dedicated to the comprehensive, modern evaluation and most-advanced minimally invasive treatment of vein disorders.

Dr. Magnant explained that Allison’s problem was venous insufficiency, a disease that occurs when the valves in the leg veins that keep blood flowing toward the heart begin to fail.

As a result of the failure, blood leaks backward, or refluxes, and pools in the legs and ankles. This pooling leads to signs and symptoms such as varicose veins, swelling, heaviness, itchiness and inflammation of the skin of the legs, and venous ulceration.

“Allison was an atypical venous insufficiency patient because she simply had a rash and itching with no noticeable varicose veins,” Dr. Magnant describes. “The doctor she saw in Miami performed a biopsy that came back positive for stasis dermatitis, or inflamed skin.”

Stages of Development of Varicose VeinsStasis dermatitis is serious, but it is among the less common signs of venous insufficiency. Unfortunately, some physicians fail to attribute it to venous disease and treat it as a “skin” condition rather than consider a venous origin. That’s what happened to Allison.

“When the diagnosis of stasis dermatitis due to venous insufficiency was made, Allison was already eight months into her ordeal,” Dr. Magnant relates. “By that time, she felt like she had been bounced around, been prescribed a variety of different medications, and not found anyone who could really help her until she made it to Vein Specialists. We were able to to establish the underlying cause of her skin problem.”

That help began with an ultrasound examination to determine the presence of leaking vein valves, the exact veins affected and the severity of the valve leakiness causing Allison’s signs and symptoms. The results brought the issue into focus and led to a recommendation for a solution to the problem.

“When Dr. Magnant gave me the results, he showed me pictures of the veins in both legs that weren’t working properly and said he could fix them with a procedure called endovenous ablation,” Allison states.

Endovenous closure is a method of sealing leaking leg veins by using heat(thermal) or medical adhesive. During endovenous thermal closure, Dr. Magnant inserts a small intravenous needle into the abnormal vein through which the heating catheter (radiofrequency or LASER) is inserted and advanced into the vein. Liquid is injected around the vein to collapse it around the catheter and to absorb the heat from the vein wall during the heating process.

There is also local anesthetic in the liquid that prevents the patient from feeling pain. The vein is then heated with either radiofrequency or LASER energy, and it shrinks into scar tissue.

“I had the ClosureFAST™ [radiofrequency] procedure done on my right leg on April 7, 2019,” Allison reports. “It was pretty effortless and painless. It was performed right in the office with a little numbing medicine, and I was able to drive home afterward. It was very convenient; it only took about an hour. Two weeks later, I had the procedure done on my left leg.”

Old Man Legs

Eighteen years ago, North Carolina native Josh Bolton, 35, was in an ATV accident that resulted in multiple injuries to his body, including injuries to his legs. Josh, now a physician assistant in the emergency department of a local hospital, continued to suffer from the consequences of that accident 18 years after it occurred.

Photo courtesy of Josh Bolton.

Josh Bolton

“The injuries led to blood clots in my legs, which then resulted in venous disease,” Josh shares. “Because of that, my legs were always swelling, and I experienced an aching and a heaviness in them. They always felt tired and painful, and they were horribly discolored. They would turn purple and blue and all different colors.

“I also had venous ulcers on the inside of my ankle on both legs. As a PA, I knew the problem was venous disease because venous ulcers are an advanced skin complication of venous insufficiency.”

Like Allison, Josh visited a number of physicians looking for answers to his uncomfortable symptoms, but none were truly able to help him.

“I saw numerous doctors back home in North Carolina, in Virginia and also here in Florida,” Josh confirms. “They ranged from dermatologists to wound care specialists and a few vascular surgeons.

“The vascular surgeons always referred me to the wound care doctors, who would debride my ulcers, apply different prescription creams and wrap my legs in compression bandages. That was my life.

“All the doctors I saw essentially treated my wounds and did everything locally, but never addressed the underlying venous disease. I always questioned that, but they just talked around the issue.”

Though slowed by the symptoms associated with his venous disease, Josh refused to let those symptoms stop him. He continued to participate in his favorite activities, including exercising, fishing and paddle boarding.

“I still did everything I love to do; I just did it in a lot of pain,” Josh describes. “It was pretty uncomfortable, especially in the Florida heat, to go out with heavy dressings on my legs and try to enjoy being outside. That was difficult.”

Josh put up with the discomfort until this past December, when he visited another dermatologist in Fort Myers. This doctor told him about Dr. Magnant. Soon thereafter, Josh’s situation began to improve.

“Literally within three days of the first treatment, my wound was starting to close up and new tissue was growing around it.” -Josh

“Josh is a weightlifter, so when I met him, he was fit as a fiddle,” Dr. Magnant remembers. “From his knees up, he looked great. But from his knees down, he looked like an old man. He came to me with chronic venous ulcers on both legs.

“On one leg, the ulcer was so deep, I could put the tip of my finger inside about halfway up to my knuckle. On the other leg, he had diffuse, spotty wounds on the leg and ankle. His legs were also swollen, heavy and purple.”

As he did with Allison, Dr. Magnant immediately ordered an ultrasound to evaluate the blood flow in Josh’s legs. The ultrasound revealed the underlying problem, which was venous insufficiency. After seeing the results, Dr. Magnant discussed a variety of treatment options with Josh.

Photo by Jordan Pysz.

Allison says her legs are “healing well” following her ClosureFAST treatment

“He ultimately recommended an endovenous radiofrequency ablation, which essentially heat seals the problem veins and doesn’t allow any more reflux of blood, which improves the ulcers on my legs,” Josh reports.

“I was able to watch Dr. Magnant perform the ablation on an ultrasound screen,” Josh recalls. “I was awake the whole time, and there was no pain associated with the procedure, so I have no complaints about the procedure at all.”

Unseen Symptom

Allison and Josh are young, healthy, active adults, but both suffered with chronic venous insufficiency. Their cases make it clear that venous insufficiency is not a disease that only affects older adults.

Though it is more common among older adults, venous insufficiency is a common disorder that affects more than 50 million Americans and is five times as prevalent as peripheral arterial disease (PAD) and twice as prevalent as coronary artery disease.

Neither Allison nor Josh had the most obvious signs of venous insufficiency, which are varicose veins. They did, however, have the more subtle, yet more advanced skin-related signs of stasis dermatitis and ulcers.

“Patients can have stasis dermatitis that doesn’t show through the skin,” Dr. Magnant stresses. “In those cases, the patient’s legs may get very itchy as their day wears on. The itch occurs primarily in the lower half of the calves. Patients expect to see something there when they look down, such as red spots or a red area, but those signs may not be present.

“Even in the absence of that physical sign of inflammation, the patient may still have stasis dermatitis because that’s how it starts. Allison’s stasis dermatitis essentially began with intense itching on her leg that became a full-blown rash after she scratched it.”

Dr. Magnant notes that venous ulcers are not uncommon in young people like Josh. In fact, most leg ulcers in the younger population are related to vein causes. When an ulcer is identified, the initial step is to investigate the patient’s vascular supply to ensure there’s adequate arterial blood flow and venous return in the area.

“That’s why my advice to patients with leg wounds is to have an early vascular evaluation at an accredited vein center,” Dr. Magnant asserts. “This evaluation can rule out any underlying venous or arterial pathology.

“Patients will really benefit from a thorough vascular evaluation, including a pulse check and a special Doppler ultrasound, because that evaluation will often disclose the underlying problem.

“In Josh’s case, it was great saphenous vein insufficiency. He then had the endovenous ablation, and his wounds started closing almost immediately.”

Closed and Cleared

The endovenous radiofrequency ablation on Josh’s left leg was done in March, and the procedure on his right leg was performed in April. Josh is amazed by the success of the procedures.

“Literally within three days of the first treatment, my wound was starting to close up and new tissue was growing around it,” Josh recalls. “Now, the ulcer on my left leg is completely closed.

“There’s no ulceration there at all anymore. There’s tissue growing, and the skin is healing very well. I’m getting a normal skin color back to my ankle, which I haven’t seen in years. The ulcer on my right leg is closing up as well, and the color is starting to return.

“My swelling has decreased tremendously. Before, when I worked in the ER, my feet would be swollen within two hours. Now, even after ten to twelve hours, my feet are barely swollen. It’s like I only worked for an hour. And I don’t feel any pain at all. It’s great.”

Allison is also quite pleased with the outcome of her ClosureFAST procedures.

“The dermatitis is not one hundred percent cleared yet, but it’s probably eighty percent cleared, so it’s healing well,” she states. “Dr. Magnant says it takes time for the blood that is stored in my legs to work its way out and for the skin to heal, but the treatment is definitely working.

“My skin hardly itches anymore, so I would definitely have the ClosureFAST endovenous ablation procedure again if I had to. And I’d definitely recommend getting that treatment from Dr. Magnant at Vein Specialists. In fact, I’ve already recommended them.

“A colleague at work told me her mom has the same issue as me and has been to a dermatologist, but they couldn’t find out what’s wrong. I told her about my procedure and said she should go to Dr. Magnant. I absolutely recommend him.”

So does Josh, who dealt with the ulcers on his legs for 18 years before he saw Dr. Magnant and found some relief.

“I recommend Dr. Magnant because he’s a great guy and because the results of his treatment far exceeded my expectations,” Josh says. “I’ve shown my legs to multiple doctors and PAs who saw my legs before, and they’re all astonished by how great they look now.

“My case proves how important it is to pay attention to the underlying problems behind the ulcers. That way, people can actually start being comfortable again and stop being in pain like I was.”

Home Sweet Home

Residents are “family” at retirement community.

After decades in first marriages, Lee and Ron Seaman found themselves widowed and alone. They found each other while attending a dance and began dating. Soon, they fell in love and married. They’ve been together for the past 11 years. Two years ago, they reached another milestone in their relationship.

Photo by Jordan Pysz

Lee and Ron Seaman

“We were living in Westchase, and I was having some health problems,” Ron, a New Jersey native, shares. “Lee doesn’t drive, and I started thinking, If I were to leave this planet, she would be stuck. Two things were concerning me. First, we’re old. Secondly, we weren’t in a place where Lee could live comfortably by herself.

“We decided to move and spent time looking at Independent Living Communities. We probably looked at six or eight places in Hillsborough and Pinellas Counties before we decided on Concordia Village of Tampa.

“I wanted a place that had all the services I might need before I die such as independent living, assisted living, memory care, long-term nursing care and short-term rehabilitation,” Ron continues. “There are very few places around here that offer it all, so that was a major factor for me. Concordia Village of Tampa is a Continuing Care Retirement Community [CCRC] that has all those levels of care.”

Having extended care was important to Ron, but Lee was most impressed by the community’s environment and the warm, personal welcome she received.

“To me, Concordia Village is a very comfortable place,” Lee, who is originally from Puerto Rico, states. “It’s casual, friendly and homey. From the moment we walked in, we were greeted by people who have lived here for many years. I was a little overwhelmed at first, but in a good way. I think the community is wonderful, like a big family.”

“I agree with Lee,” Ron asserts. “The people at Concordia Village are very friendly, and I don’t find them cliquey, like they can be at other places. The community itself is spacious, and they’ve got several acres of landscaped grounds for walking.”

Lee and Ron moved into an independent living apartment at Concordia Village of Tampa in 2017. However, it wasn’t long before Ron needed a helping hand. But following emergency treatment for a serious illness, the couple continued their independent living routine. Still, the staff at Concordia Village of Tampa is always available to assist if needed.

“A few months after we moved in, Ron suffered a stroke,” Lee explains. “He’s doing well now, but thank God we were here when it happened because the staff took care of him right away.”

“I drove up until I had my stroke,” Ron acknowledges. “Now, the staff is so accommodating as far as my transportation. They take me to the hospital, the doctor, any place I need to go.
They’re fantastic.”

A key goal of Lee’s and Ron’s retirement plan is to maintain a dynamic lifestyle. They agree that Concordia Village of Tampa offers plenty of opportunities to engage with other residents and to participate in events and activities.

“I’m very active and energetic,” Lee says. “I am eighty-eight years old, but I feel like I am sixty. There’s so much to do here. You don’t get bored unless you choose to not do anything. I work as a volunteer in the flea market, and I look forward to being there every Monday and meeting new people. There are so many other activities to enjoy as well.”

“It’s easy to get involved,” Ron assures. “There’s some sort of party at least once a week. Sometimes, they have an entertainer playing guitar and singing outside by the pool, and they will serve root beer floats or pizza and invite everybody to come. There’s always something going on here. They are always finding an excuse to have a celebration.”

Concordia Village of Tampa’s staff are resident-oriented and highly qualified for their roles. They treat all residents with compassion and respect. That’s another reason Lee likes living at Concordia Village of Tampa.

“The staff members are terrific,” she says. “The people in the marketing department care so much about the residents, and the food service staff are always looking out for those who need help. They treat us with so much kindness, and not just because we are older, but because we are a family.”

Special Touch

Concordia Village of Tampa is part of Concordia Lutheran Ministries, a place for caring and healing for more than 135 years. Concordia Lutheran Ministries began as an orphanage and expanded into senior care in the 1950s.

“Currently, Concordia Lutheran Ministries operates fifteen senior living communities, most of which are in Western Pennsylvania,” elaborates Brian Hortert, Chief Operating Officer at Concordia Village of Tampa. “There’s also a community in Akron, Ohio, and Concordia Village of Tampa is their first venture into Florida.”

In addition to their senior living communities, Concordia Lutheran Ministries also operates homecare, hospice, medical equipment and pharmacy services, primarily in Western Pennsylvania.

“Concordia Village of Tampa provides the complete range of senior living services, including independent living, assisted living, memory care, long-term nursing care and short-term rehabilitation,” Brian notes. “This range of services enables our residents to age in place.”

As COO, Brian oversees all operations of the Tampa campus. He stresses, “When it comes to retirement living, there are many factors seniors must consider before deciding which community is right for them. When residents move to Concordia Village of Tampa, they become part of our family.”

Extending the family experience, Concordia Village of Tampa welcomes residents’ pets to the community. They believe pets provide companionship, as well as a level of comfort to residents, especially those in new situations. They understand the importance of these benefits and want residents to experience them.

“We have always believed that pets become part of residents’ families,” Brian observes. “We wouldn’t expect them to move to a new home without a child. It’s the same feeling with pets for many residents. We think it’s the right thing to do to allow them to live with their family pets.”

Husband and wife residents Ron and Lee Seaman discuss their lives at Concordia Village of Tampa.

Lee, Allie and Ron love the warm, friendly atmosphere at Concordia Village.

This was good news for Lee and Ron, who had a beloved dog when they moved into Concordia Village of Tampa two years ago.

“I never had a pet of my own,” Lee relates. “Then about nine years ago, Ron decided to give me a puppy. But instead of buying one, we went to the rescue shelter, and I’m so glad we did. Our little dog is a Shih Tzu-Maltese mix, and she’s beautiful.

“Our dog is very well behaved, and a staff member suggested that I should have her trained as a therapy dog. I thought that was a wonderful idea, so now she’s a legal therapy dog, and she visits the residents in the community’s nursing facility.”

Welcome Wagon

Lee and Ron are happy with their lives at Concordia Village of Tampa. They stay active by participating in the community’s events, and they feel whole with their beloved dog by their side. They are also pleased with the amenities Concordia Village of Tampa offers to other members of their family when they visit.

“I like that Concordia Village has guest rooms on site,” Lee discloses. “When we have company, they can stay on campus and be close by in an apartment that is nice and comfortable. Having these guest rooms is a plus because people from out of town can come to Tampa and stay right here with their families. It’s a great benefit.”

Ron states, “The Concordia Village staff also welcome visitors at any time. We frequently see children and families at the swimming pool, using the putting green, shuffleboard or bocce ball courts, and the staff are very accommodating to events such as birthday parties.

“I just turned eighty-eight and had about fifty people come to my birthday party. I was able to reserve a room, and the staff served what I ordered. They were very helpful.” 

“Concordia Village of Tampa is just like home,” Lee adds. “Anything that you did at home, you can do here.”

Flash Forward

Medical marijuana calms distressing symptoms of PTSD.

On the outside, Trent* is a successful businessman at a thriving company. But few are aware of the struggles he faces internally. Most of his emotional distress can be connected to his two tours of duty in Iraq with the US Army Corp of Engineers.Dr. Kelly King of Releaf MD in Brandon treated Trent’s post-traumatic stress disorder with medical marijuana.

“During my second tour of duty, I was on the bomb squad, and our primary mission was to counter IED [improvised explosive device] operations,” Trent describes. “Our job was to go out every day and cruise the streets of Baghdad looking for roadside bombs to disassemble.

“We successfully disarmed just under two hundred roadside bombs, but we also had several explode on us. It was really scary when they exploded.”

Once Trent’s second tour in Iraq ended, he returned to the United States. At first, he felt fine and thought everything was going well. But over the course of the year, he began experiencing difficulties in his day-to-day life, and that concerned him.

“I wasn’t sleeping well, and I was facing some physical and emotional challenges,” Trent shares. “I had trouble concentrating, my anxiety level was high and I was suffering from headaches.

“I also experienced flashbacks to my time on the bomb squad and saw things that weren’t there. If I drove past a garbage pit where someone was burning garbage, that was a very strong flashback trigger for me. I finally realized I needed professional help.”

Trent initially sought assistance from the Veterans Administration, where medical center staff diagnosed his condition as post-traumatic stress disorder (PTSD). To treat it, the doctors at the VA prescribed medications for sleep, anxiety and depression.

“I tried the medications, but they didn’t work,” Trent relates. “And I was concerned about the serious side effects that can occur with them. I respect the doctors at the VA, but the tools they had available just weren’t helping me, so I started looking for alternative therapies. I did an internet search and found Dr. King at Releaf MD in Brandon.”

Kelly Ennix King, MD, is a board-certified internist who is licensed to treat patients in Florida with medical marijuana. At Releaf MD, Dr. King tailors safe treatment plans for patients with various conditions, including PTSD, using medical cannabis. She is among the three percent of Florida physicians licensed to prescribe medical marijuana.

“One of the main compounds found in marijuana is cannabidiol,” Dr. King says of the extract better known as CBD. “It is a very potent anxiolytic, meaning it is extremely effective at diminishing anxiety in patients and helping to relieve the other distressing symptoms of PTSD. That’s why I recommended medical cannabis as a good option for treating Trent’s condition.”

At first, Trent was a little uncertain about using medical marijuana for his PTSD, but after speaking with
Dr. King, he was motivated to try the alternative treatment.

“I’m a skeptical person by nature,” he states. “But with Dr. King, I felt confident that I was working with a doctor who was committed to me and believed in what she could do for me. When I walked out of her office at Releaf MD, I was excited about exploring an alternative to medication for treating my PTSD.”

Dispensing Relief

With PTSD, the thoughts about a traumatic event and the feelings about those thoughts originate in an area of the brain called the amygdala and the hippocampus, Dr. King explains.

“Another main compound in medical marijuana, THC, works at the amygdala and hippocampus to help uncouple those thoughts and feelings,” the doctor notes. “As a result, patients’ thoughts and feelings about their traumatic event are not as intense or debilitating.”

Another common problem affecting people with PTSD is difficulty sleeping.

“During the day, there are many inhibitions present as people focus on their daily activities,” Dr. King informs. “But at night, these inhibitions are no longer present. The thoughts about the traumatic event become much more prominent, and many times result in nightmares and night terrors. THC helps people relax and promotes sleep.”

Dr. King tailors a treatment plan to each patient’s symptoms and diagnosis. Often, she uses more than one strain of medical marijuana and more than one method of delivery, which might include sublingual drops or edible or topical formulations to fully address the patient’s needs.

“I use several combinations depending on what the patient’s symptoms are,” she verifies. “Indica is a type of cannabis plant that we prescribe for patients to use during the evening and at night. It helps with things such as relaxation and sleep, whereas Sativa is a strain that we utilize during the day. It is more energizing and stimulating.

“The dispensaries offer the different strains as well as extracts in which they adjust the levels of CBD and THC. That is the beauty of medical marijuana. I can use different formulations and rotate the routes of delivery to address a patient’s symptomology.

“Patients’ symptoms are going to be different throughout the day, so different strains and delivery routes are especially useful for addressing that. And one person’s PTSD is not exactly like another person’s PTSD. That’s why we target each person’s particular symptoms and circumstances.”

Initially, Dr. King made several suggestions for Trent’s treatment plan. After discussing the risks and benefits with Trent, Dr. King chose a treatment regimen consisting of a CBD-THC mixture using the two marijuana strains and several routes of delivery.

“At Dr. King’s recommendation, I use some medical marijuana products that are effective during the day and some that are more effective in the evening,” Trent states. “I might use drops in the evening and maybe something edible or a vape cartridge during the day. The best thing is, it’s working for me.”

Leaving Worries Behind

Dr. King’s treatment plan for Trent, with its combination of medical cannabis strains and multiple delivery methods, is working well for him. Trent’s PTSD symptoms are dramatically improved, and he is back to experiencing a more “normal” day-to-day life. He’s extremely pleased with his degree of improvement using the alternative therapy.

“The medical marijuana treatment at Releaf MD is absolutely successful,” Trent raves. “I sleep much better now, which is the best part of the results for me. My anxiety and headaches have also decreased dramatically.

“The flashback triggers still exist, but I’ve noticed that my threshold for the triggers is higher now. They’re much easier to handle.”

Not only were the medications from the VA doctors ineffective for Trent, he also worried about the drugs’ side effects. But after beginning his medical marijuana therapy at Releaf MD, he left most of those worries behind.

“I’m not currently using the majority of the medications the doctors at the VA originally prescribed because I no longer need them,” Trent says. “That’s probably the most important thing to me. I believe there’s a time and place for medication in treating disorders like PTSD, but they weren’t doing the job for me.

“Dr. King and her medical marijuana treatment are doing the job for me.
Dr. King is a godsend!”

*Patient’s name withheld at his request.

Shared Vision

Eye institute expands specialty services in Riverview.

The eye may be a small organ in the body, but it plays a big role in sensory perception. People receive more than 75 percent of their information about the world around them through the sense of sight.

Dr. Charles Luxenberg, Dr. Robert Applebaum, Dr. Marguerite Kohlhepp and Dr. Ronni Chen discuss the ophthalmic specialty services they provide at Florida Eye Specialists & Cataract Institute at Riverview.

Dr. Chen

The highly trained ophthalmologists at Florida Eye Specialists & Cataract Institute are committed to protecting eyesight and the health of their patients’ eyes. In April 2018, the Institute shared that vision and opened a satellite clinic in Riverview.

“Our vision is to be a full-service center in Riverview, taking care of a complete range of eye disorders,” emphasizes Robert J. Applebaum, MD, a board-certified ophthalmologist at the Riverview and Brandon locations. “We perform routine eye exams and prescribe eyeglasses, but we also treat more serious conditions such as diabetes-related eye diseases, macular degeneration and glaucoma, as well as perform cosmetic surgery.”

“It’s exciting for Florida Eye Specialists and Cataract Institute to have a location in Riverview,” offers Ronni M. Chen, MD, a board-certified ophthalmologist who is fellowship trained in pediatric ophthalmology. “I’m excited to provide specialty pediatric eye care in Riverview. I think it’s a great service to children and families in the area.”

Physicians in multiple specialties, including oculoplastic surgeons and retina specialists, rotate through the Riverview clinic, so area residents don’t need to travel for specialty eye care. And the physicians have access to advanced technology for testing and treatment.

“The Riverview clinic is state-of-the-art,” Dr. Applebaum asserts. “The office has the most updated equipment available, including a device that produces three-dimensional pictures of the retina as well as a high-tech peripheral visual field machine. We’ve also got two lasers that we use to treat various eye conditions.

“We have a very friendly staff, including a great office manager and front desk person. All of the techs who rotate through the clinic are highly motivated, really care about the patients and do an excellent job. I believe Florida Eye Specialists and Cataract Institute at Riverview is an excellent place to come for eye care.”

Laser Relations

As part of a routine eye exam, Charles A. Luxenberg, MD, a board-certified ophthalmologist, measures his patients’ vision and prescribes eyeglasses. The ophthalmologist also evaluates the overall health of his patients’ eyes and checks for any eye disorders.

“We treat many conditions in Riverview, including eye infections, inflammatory disorders, cataracts and glaucoma,” Dr. Luxenberg acknowledges. “If we discover cataracts, we refer the patients to our Brandon location for surgery, but we follow-up with them in Riverview for their postoperative care.

“Sometimes, a patient’s lens capsule will become cloudy following cataract surgery. If that occurs, we can perform a simple laser procedure to clear it up and return the patient’s vision to its post-surgery clarity.”

Dr. Luxenberg also uses a laser to treat the two main types of glaucoma, open-angle glaucoma and narrow-angle glaucoma. For open-angle glaucoma, the laser works directly on the outflow filter, or trabecular meshwork, of the eye. Opening up this meshwork with the laser enables the fluid in the eye to flow better, which lowers eye pressure.

“With open-angle glaucoma, something is wrong with the trabecular meshwork and its function is impaired,” Dr. Luxenberg explains. “As a result, there’s a back-up of fluid, which causes increased pressure in the eye. High eye pressure can damage optic nerve fibers, and that can lead to visual field defects and eventually blindness.

“With narrow-angle glaucoma, the angle of the outflow tract is narrow due to the anatomy of the person’s eye. This narrow angle causes the problem with fluid flow rather than the outflow filter itself being impaired. We use the laser to widen the angle.”

Treating patients with lasers is an important part of Dr. Luxenberg’s work at Florida Eye Specialists & Cataract Institute at Riverview. Another key function he performs is treatment for the terrible twosome of eye disorders: blepharitis and dry eye syndrome.

Blepharitis is an infection of the eyelids and eyelashes. It is most often caused by an overgrowth of bacteria living along the margins of the eyelids and at the base of the lashes.

Dry eye syndrome, which is generally the result of clogged glands, is a condition where there aren’t enough tears on the surface of the eye to keep it adequately lubricated, thus the eyes become dry.

Blepharitis and dry eye commonly occur simultaneously. If left untreated, these conditions can lead to permanent eyelid and tear gland dysfunction as well as corneal damage.

“We treat dry eye with various eye drops, including the prescription drops RESTASIS® and Xiidra®,” Dr. Luxenberg observes. “We also use a laser procedure to close the tiny openings in the eyelid that drain fluid, called punctum. This procedure, laser punctal ablation, keeps the tears on the surface of the eye longer.

“For blepharitis, we recommend eyelid scrubs twice a day and also suggest a very effective therapy using a machine called BlephEx®. During a BlephEx treatment, we use the instrument to clear all of the debris from the eyelid margin and the lashes. It also thoroughly cleans those areas to kill any bacteria growing there.”

Functional and Cosmetic

Dr. Applebaum is the son of a cardiologist, so he had no shortage of inspiration to become a physician himself. But he wanted to be highly specialized, so he opted to pursue ophthalmology and focus his skills further by completing a fellowship in oculoplastic surgery. Oculoplastic surgery is a subspecialty that concentrates on cosmetic and reconstructive surgery of the face and eye area.

Dr. Applebaum uses his skills in ophthalmology and oculoplastic surgery to perform a wide range of cosmetic and functional procedures on the face and eyes, including blepharoplasty, at Florida Eye Specialists & Cataract Institute at Riverview.

“Blepharoplasty is a surgical procedure that involves removing excess eyelid tissue, which can make people look tired, sad or even mean upon first impression,” Dr. Applebaum describes. “Blepharoplasty can be done on both the upper and lower eyelids, and can make a dramatic difference in the appearance of the face.

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

“I also perform blepharoplasties for cosmetic purposes, when people are unhappy with the appearance of their lids. These surgeries can significantly improve the look of their eyes.”

The lower lids can project a poor first impression as well.

“Most people are born with five bags of fat around the eye to protect it and hold it in the socket,” Dr. Applebaum educates. “However, with aging, that fat can come forward and appear as puffiness under the eye. Lower blepharoplasty can diminish the look of tiredness and aging by decreasing excess fat and skin beneath the eyes.”

Dr. Applebaum performs many other surgical procedures at the Riverview clinic as well. These include reconstructions following skin cancer removal, endoscopic eyebrow and forehead lifts, tear duct surgery, earlobe reconstructions and correction of eyelid malposition.

In addition to these surgical procedures, Dr. Applebaum also offers a variety of nonsurgical facial cosmetic services. These include BOTOX® Cosmetic injections and a variety of facial fillers. These options can help reverse the changes associated with aging.

“BOTOX Cosmetic is a synthetic toxin that is altered so that it is non-toxic to the body of a healthy person,” Dr. Applebaum notes. “It blocks the release of neurotransmitters that trigger muscle contractions.”

Among the fillers used by Dr. Applebaum are JUVÈDERM®, VOLUMA® and RESTYLANE®. Many fillers contain hyaluronic acid, a substance found naturally in the body that helps restore volume and hydration to the skin.

“Over time, materials in the skin, including the collagen and base membranes, break down, so the face begins to sag,” the doctor explains. “We use these fillers in the cheeks to add volume and give the face a nonsurgical lift.

“We also use fillers in areas slightly lower on the face to decrease the appearance of fine lines and wrinkles around the nose and lips. Oftentimes, we use them in the lips to give the lips more fullness.

“KYBELLA® is another filler that is used specifically to decrease the appearance of a double chin. It is injected into the fatty tissue of the chin, where it breaks down the fat cells, reducing the appearance of fat under the chin.”

Retinal Restraints

The retina is a thin layer of specialized tissue that lines the back of the eye. It senses light as it enters the eye and sends it to the brain to process as images. Unfortunately, there are many disorders that affect the retina.

The two most common disorders of the retina are diabetic retinopathy and macular degeneration, which are the two leading causes of blindness in adults. Board-certified ophthalmologist and fellowship-trained retina surgeon Marguerite Kohlhepp, MD, has expertise in treating retinal diseases. She offers that expertise at Florida Eye Specialists & Cataract Institute at Riverview.

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

“Anyone who has diabetes is at risk for developing diabetic retinopathy, and the risk increases with the duration of having the disease. The main reason: High glucose levels affect the blood vessels and make them unhealthy.

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

Another serious threat to sight that can occur as people age is macular degeneration. It is a disease of the central vision with which the main images in the vision become less discernible.

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

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

The most common treatment for wet macular degeneration is anti-VEGF therapy. That involves injections of a medicine called anti-vascular endothelial growth factor, which inhibits new blood vessel growth.

Dr. Kohlhepp treats both medical and surgical retinal disorders. Diabetic retinopathy and macular degeneration are two examples of medical retinal disorders.

Dr. Charles Luxenberg, Dr. Robert Applebaum, Dr. Marguerite Kohlhepp and Dr. Ronni Chen discuss the ophthalmic specialty services they provide at Florida Eye Specialists & Cataract Institute at Riverview.

Marguerite Kohlhepp, MD

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

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

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

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

If a retinal tear occurs, it’s critical that it’s treated right away. If not treated immediately with laser or freezing, a tear lends itself to developing into a retinal detachment.

“The big, gaping hole in the retina allows fluid to pass through it,” Dr. Kohlhepp informs. “This fluid is found on the undersurface of the proverbial wallpaper, and the next thing you know, the wallpaper is falling off of the wall, and that’s a retinal detachment.”

Child Friendly

As a pediatric ophthalmologist, Dr. Chen treats all of the eye conditions that are commonplace during childhood and adolescence. Often, her patients are children who have failed screening exams by their physicians or schools.

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

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

“I also treat other routine eye conditions, including blocked tear ducts, which can lead to infections, chronic tearing and foreign bodies children may get in their eyes while playing outside. Two of the most common eye disorders I see at the Riverview clinic are amblyopia and strabismus.”

Amblyopia, also called lazy eye, results when the eyes’ acuity develops unevenly. The brain accepts the visual images from the stronger eye and ignores the images from the weaker eye. Affecting four in every 100 children, amblyopia can be treated with eye drops or by placing a patch over the stronger eye, forcing the weaker eye to work harder.

Strabismus, or crossed eye, occurs as frequently as amblyopia and results from a misalignment of the eye muscles, which interferes with the ability of the eyes to work together. One eye may appear to drift, seemingly looking up, down, in toward the nose or out toward the cheekbone.

“Children coping with strabismus may squint one eye in bright sunlight or complain of eyestrain or headaches when trying to read,” Dr. Chen notes. “If the affected eye goes untreated, the child may develop amblyopia as a result of strabismus.

“Strabismus can occasionally be treated with eyeglasses that force the affected eye to work in concert with its partner. But the condition most often requires eye muscle surgery to align the eyes properly. Although this surgery is safe and effective, some children require more than one surgical procedure to fully correct the condition.”

On the days Dr. Chen provides her services at Florida Eye Specialists & Cataract Institute at Riverview, the office transforms into a child-friendly sanctuary. The environment and the personnel are all dedicated to the special needs of children. The staff use pictures, toys, even puppets to connect with the children.

“We have children’s movies playing, and we have a playroom for them,” Dr. Chen describes. “I’m a fellowship-trained pediatric ophthalmologist who’s been in practice for twenty-one years, and my staff is specially trained to treat children and make their eye exams as easy as possible for them.

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