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Addiction Damage in America

April 9th, 2019

The US Centers for Disease Control and Prevention reported some disconcerting news last month when it released the results of a study on drug overdose deaths among American women ages 30 to 64.

The study, published in the CDC’s Morbidity and Mortality Weekly Report on January 10, found that death rates in this group skyrocketed 260 percent from 1999 to 2017.

According to the study investigators, who reviewed death certificate data from the National Vital Statistics System, the death rate among women rose from 6.7 deaths per 100,000 people, or 4,314 total overdose deaths, in 1999 to 24.3 per 100,000, or 18,110 deaths, in 2017.

(Although not investigated by the study, some researchers suggest similar increases in overdose deaths are being seen in American men.)

The study also looked at the types of drugs responsible for the overdose deaths. Investigators found huge increases in deaths involving heroin, as well as those caused by synthetic opioids and by benzodiazepines such as Xanax and Valium, drugs primarily used to treat anxiety.

These statistics highlight the horrendous problem with addition to prescription medications, particularly opioid painkillers, this country now faces. Our first reaction might be to try to find someone – doctors, insurance companies or the pharmaceutical industry – to blame for the problem. However, your brain might be the most culpable.

When it comes to opioids in particular, anyone can become addicted. When you take these drugs, they activate powerful reward centers in your brain. They release those feel-good endorphins, which dull your perception of pain and enhance feelings of pleasure. They also create a sense of wellbeing.

When these drugs wear off, however, so do those good feelings. But you want those feelings to continue, so you keep taking the drugs as prescribed until you develop a tolerance to them. That’s when the dose you’re taking no longer provides the same good feelings they used to and that you desire.

At that point, you might start taking more medication than prescribed or taking it more often. Eventually, you find it impossible to make it through the day without the drug. You feel you simply can’t live without it. That’s addiction.

If your doctor prescribes an opioid pain medication, and you take it as directed, you decrease your risk for becoming addicted. But some of the more than one-third of all Americans in chronic pain do get addicted, and there are often warning signs that they’re in trouble. Here are seven warning signs of painkiller addiction courtesy of WebMD.

  1. You think about your medication a lot. – You’re preoccupied with when you can take your next dose and whether you’ll have enough medication to get you through.
  2. You take different amounts than your doctor prescribed. – As mentioned, you take more than prescribed or take it more often than prescribed.
  3. You “doctor shop.” – You try to find different physicians who will give you prescriptions for the painkillers when your own physician restricts your supply.
  4. You get medication from other sources. – You order the drugs over the Internet, steal them from relatives or friends, or buy them on the street.
  5. You’ve been using the painkillers for a long time. – You’re still taking the painkillers long after the pain should have gone away, or you’re taking them because of the way they make you feel.
  6. You feel angry when anyone talks to you about your use of the drugs. – You get irritated or defensive whenever anybody approaches you about taking the medication.
  7. You’re not quite “yourself.” – You stop taking care of yourself like you used to. You’re less concerned about your appearance. You’re moody, angry, nervous or jittery. You sleep more than usual, and you ignore your responsibilities.

If you suspect you have an addiction problem, seek help. Talk to your doctor. He or she can recommend an addiction recovery center, or you can call a center directly.

You can also call 800-662-HELP (4357). This is the national helpline run by the US government’s Substance Abuse and Mental Health Services Administration. This administration provides free, confidential information and referrals for substance abuse and mental health services.

The most important thing is that you be honest with yourself and your doctor about your drug use. And if you think you have a problem, open up and seek help. Don’t become another number in next year’s overdose death statistics.

Opioid Independence

Break free from narcotics with medical marijuana.

Ten years ago, after getting out of the Army, Nicole Ensminger was in a world of hurt. She felt pain in her feet, shins, knees, neck and nearly everywhere else. She wondered if the physical demands of her military service overstressed her body and led to her painful circumstances.

Nicole Ensminger’s chronic pain was treated with medical marijuana by Dr. Kelly King of Releaf MD in Brandon.

Nicole says that in addition to having less pain, she feels stronger, mentally and physically.

“I saw doctors and got a CT scan,” Nicole recalls. “I found out I had a few residual injuries and some arthritis. I was diagnosed with fibromyalgia and autoimmune thyroid disease, which made my pain worse. I also had a few vertebrae in my neck that were really bad.

“All that left me in chronic pain. It felt like a train ran over me every day. Every morning, I woke up feeling like somebody beat me up. Then every night going to bed, I struggled to get to sleep. I just tossed and turned. In addition to chronic pain, I had insomnia, anxiety and depression. I suffered from bouts of sadness because I was in pain all the time.

“I went to a pain management clinic, where they gave me a handful of pills. The doctor put me on opioid pain medicine, muscle relaxants and sleeping pills, and I took them for ten years.”

Nicole never liked taking the pills and eventually became frightened of their potential effects. She saw reports on TV about the nation’s problem with opioids and how people were becoming addicted and dying from the narcotic drugs.

“I was concerned because as I took the medicine, my body got used to it, so I had to take more of the drug to get pain relief,” Nicole admits. “I didn’t want to become addicted, and I didn’t want to die because of the medicine. I just wanted to feel good and live a pain-free life.

“My pain management doctor mentioned that Dr. King visited his office to talk about medical marijuana, and he gave me her information. I did a lot of research before I contacted her, but then I did. It was the best thing I’ve ever done.”

Kelly Ennix King, MD, is a board-certified internist who is licensed to treat patients in Florida with medical marijuana. The practice she co-founded is Releaf MD in Brandon. There, Dr. King tailors safe treatment plans for patients with various conditions, including chronic pain, using medical cannabis.

“Our mission at Releaf MD is to educate the public, patients and medical community about the health benefits of medical cannabis,” Dr. King explains. “We also help patients obtain appropriate treatment plans and understand the process so they know what to do when they go to a cannabis dispensary. I’m one of only three percent of physicians in Florida who do this.”

When Nicole met Dr. King, she was impressed by the physician’s approach to treatment. Nicole found comfort in knowing the doctor didn’t expect her to quit her pain medication cold turkey.

“Dr. King said, If you hurt and need your pain medicine, take it. We’re not just taking it away,” Nicole confirms. “She said she’d transition me. She’d have me try a little bit of the medical marijuana and see how I feel, what works for me. I felt no pressure to make a big life decision. And I was able to guarantee I wouldn’t be in pain.”

Nonlethal Alternative

In her role as an internist, Dr. King often sees patients who suffer from polypharmacy, meaning they take multiple medications. Some of the medications are used to treat side effects of other drugs, particularly narcotic pain relievers. Side effects may include sluggishness, constipation and depression.

“Currently, we have a huge opioid epidemic in the United States that includes opioid overdoses and addiction,” the doctor observes. “Medical cannabis is highly effective at getting patients off of narcotics while relieving their pain using relatively
minimal doses.

“I have patients such as Nicole who were on opioids for years and are now maintained on ten milligrams of cannabis twice daily. They’re completely off the narcotics. They’re happier, they’ve lost weight and, most important, their pain is controlled.”

One of the biggest issues connected to the opioid crisis is the rising number of overdose deaths. Dr. King believes that by treating more people in chronic pain with medical marijuana, those numbers can be dramatically reduced.

“Medical cannabis is a very powerful alternative to narcotics for pain relief, and it’s nonlethal,” she asserts. “No one’s ever died from cannabis therapy, and people die every day as a result of narcotics.”

Much has been learned about the mechanisms of action of medical marijuana. Studies suggest there are multiple compounds called cannabinoids within marijuana that contribute to its effectiveness. Two main cannabinoids are THC and CBD.

“CBD is a very potent anti-inflammatory as well as an anxiolytic,” Dr. King informs. “It’s extremely effective at diminishing anxiety in patients and helping to relieve depression. It’s also neuroprotective, which is why we use it to treat seizures.

“THC is the psychoactive component of cannabis that’s responsible for giving people the head high. CBD works to balance out that psychoactivity. When I formulate a treatment plan, I generally use CBD and THC in a one-to-one combination, so there are equal amounts of both cannabinoids. That way, patients get the benefits but not the head high.”

Dr. King explains that CBD works at the body level where pain is experienced. There, it relieves pain by decreasing inflammation. THC works at the brain level, where it alters patients’ perception of pain.

“Patients experience an overall relief in pain both at the body level, because the inflammation is being addressed, and at the brain level, with changes in perception of pain,” Dr. King verifies. “They become less strongly connected to the pain they’re experiencing. That’s why medical cannabis is so effective. It works at multiple levels of the pain pathway.”

Spreading the News

After ten years of being on narcotic pain medication, Nicole found substantive relief using medical marijuana instead. When she returned to her pain management physician for a follow-up appointment, he was amazed when she brought a near-full bottle of the medication.

“I filled the prescription two weeks after I started medical marijuana, and when I met with the pain doctor two months later, the bottle still had pills in it,” Nicole shares. “The doctor said, Wow! You have so much medicine left. For the first time in ten years, I did not refill my pain medicine last month.

“Before, I hurt all the time, even when I took the pain medicine, because it didn’t kill the pain one hundred percent. Now, there are times when I don’t have any pain. I still hurt some. It’s probably something I’ll have to deal with for the rest of my life. But now, the pain is nothing compared to what I used to go through.”

Nicole says she can’t believe the effect medical marijuana has had on her. In addition to having less pain, she feels stronger overall, mentally and physically.

“For the first time ever, I don’t have anxiety when I talk to people,” she enthuses. “I’m more active now as well. I have energy, and I’m riding my bike and moving around again. And I sleep without handfuls of medicine and their side effects.

“I’m so excited and happy about medical marijuana that I gave my resume to Dr. King at Releaf MD and begged her to help me find a job in the field. I want to help people feel the same kind of relief I achieved.”

Single-Day Smiles

Entire arches restored in one visit.

When Ron Tyrie, 63, was a child living in his hometown of Lafayette, Indiana, he had several bad experiences with his family’s dentist. Those experiences left him reluctant to seek dental care as he got older, and the health of his teeth suffered as a result.

Dr. Michael Hashemian of The Dentofacial & Cosmetic Surgery Institute in Lecanto, Spring Hill and Land O’ Lakes gave Ron Tyrie a new upper arch of teeth in one day

Ron is one of many patients to take advantage of the 
All in a Day Teeth process.

So did his smile.

“I never had great teeth, and I really didn’t take good care of them like I should have, so they were in pretty bad shape,” Ron admits. “It got so bad I was uncomfortable with my smile. I didn’t show my teeth when I smiled or talked.

“My parents moved our family to Florida when I was fourteen, and as an adult, I finally found a wonderful dentist in Homosassa. About twelve years ago, my dentist referred me to Dr. Hashemian to replace a single tooth with a dental implant.”

Ron’s dentist sent him to skilled oral and maxillofacial surgeon Michael Hashemian, MD, DMD, of The Dentofacial & Cosmetic Surgery Institute, which has offices in Lecanto, Land O’ Lakes and Spring Hill. Ron was immediately impressed by Dr. Hashemian’s expertise and chairside manner.

“Dr. Hashemian cared, and he took good care of me,” Ron says. “I felt he truly had my best interest at heart. After my first visit to Dr. Hashemian, my dentist told me I was going to need some additional work, so I went back to Dr. Hashemian a few more times to have other teeth replaced with implants.

“When my dentist retired, I asked Dr. Hashemian to recommend a new one, which he did. My new dentist looked in my mouth and asked, Where do you want to be ten years from now? You’ve been replacing what was there. It might be better to do something else.”

After discussing the matter further with Ron, Ron’s dentist consulted with Dr. Hashemian. Based on Ron’s wishes, Ron’s dentist and Dr. Hashemian came up with several options that they later presented to Ron.

“Ron didn’t want to go with anything removable in his mouth because he couldn’t tolerate it,” Dr. Hashemian explains. “He always wanted something fixed to replace his missing teeth.

“That’s why every time he lost a tooth, he opted for a dental implant with a crown. After several years of getting this type of treatment, it was suggested that he treat his entire upper arch.”

The option Dr. Hashemian recommended and Ron agreed to called for Dr. Hashemian to remove Ron’s remaining natural upper teeth, which were failing, and replace them with an upper denture secured by dental implants. The oral surgeon offered to perform the conversion using his All in a Day Teeth process.

“With All in a Day Teeth, we work in conjunction with the patient’s general dentist to complete the process in one day,” Dr. Hashemian describes. “I perform the surgical procedure, removing the teeth and placing the dental implants.

“The general dentist converts the denture, which was fabricated ahead of time, to a fixed bridge that fits securely over the implants. Sometimes, a dental lab technician comes to the office to assist the general dentist in the bridge conversion process. At the end of the day, the patient goes home with brand-new teeth.”

“Dr. Hashemian set aside his entire morning for me, and even opened an hour early,” Ron relates. “With my dentist, a person from the dental lab and their assistants all present, Dr. Hashemian began working on me at seven o’clock in the morning. He was done at noon. Then my dentist and the lab technician took over.

“I walked out of Dr. Hashemian’s office that afternoon with an absolutely perfect set of beautiful, straight, full teeth on the top of my mouth.”

Old and New

Ron’s full arch restoration procedure included Dr. Hashemian’s implant surgery followed by the conversion of his pre-fabricated denture into a fixed bridge by his dentist. Dr. Hashemian says there are several advantages of performing this procedure using the All in a Day Teeth process.

“Many people are attracted to this solution because the downtime is minimal,” the oral surgeon informs. “They get the surgical portion of the procedure done and receive the prosthetic all in the same day and basically, they’re done.

“Now, the prosthetic the patient gets on that day is made of acrylic. After six months, that prosthetic is converted to a hybrid bridge, which is a combination of titanium alloy and acrylic. These restorations are very strong and natural looking.”

The fixed bridge is secured by dental implants. For dental implants to become solid in the jaw, the patient must have sufficient bone mass to fuse with the implants. In some cases, general dentists recommend bone grafting before implants can be placed. This wasn’t necessary in Ron’s case.

“The All in a Day Teeth process essentially eliminates the need for bone grafting,” Dr. Hashemian reports. “Generally, there is enough bone that we can use tilted implants and place them where the bone is most dense. These tilted implants have the same strength as straight implants. It’s a new technique in implant dentistry, and it makes the process quicker and easier on the patient.

“Here’s another thing that’s notable about patients like Ron who’ve had multiple implants placed in the past. We are able to use those single implants that are embedded into solid bone to help secure the full arch, or fixed bridge.

“The crowns may need to come off, but the implants themselves don’t have to be wasted. And we may need to place one or two additional implants, but we can still use the old ones to fix the new denture.”

Stage Presence

The results of Dr. Hashemian’s All in a Day Teeth process gave Ron a tremendous confidence boost. With his new denture, he no longer hides his teeth when he smiles.

“I love my smile now,” Ron raves. “As one of my passions, I’m a bluegrass musician. I play banjo and a little bit of guitar, and the folks I play with say I’m smiling a lot more when I’m playing.

“I like to think my playing has gotten better,” he jokes. “It hasn’t, but my self-esteem has increased. Anytime you increase your self-esteem, it’s a positive change. My wife is even happy we decided to go in this direction.”

Ron hasn’t kept Dr. Hashemian’s expertise a secret. He shares his personal knowledge of the oral surgeon’s exceptional abilities and sterling reputation with anyone who might need the services Dr. Hashemian provides.

“I’ve recommended Dr. Hashemian to several people I used to work with who’ve had abscesses and needed to get their teeth pulled,” Ron confirms. “There’ve also been neighbors who’ve been to other oral surgeons and wanted to get second opinions. Dr. Hashemian has taken care of them and met their needs, and I’ve never gotten bad feedback.

“Dr. Hashemian is a very compassionate doctor and a very skilled surgeon. I feel very fortunate to have been referred to him, and I’m proud to refer others to him.”

A Dialogue on Bleeding Disorders

March 26th, 2019

When most people get a cut or other trauma to their bodies, specialized cells are immediately transported to the site of the injury to form a blood clot and stem the bleeding. To form a blood clot, you need a type of blood cells called platelets and certain proteins known as clotting factors.

During the clotting process, the platelets clump together at the site of the injury to form a “plug.” Then, the clotting factors group up to make what’s called a fibrin clot. Fibrin is an insoluble protein that creates a mesh. The fibrin clot holds the platelets together in place and prevents blood from flowing out of the injury.

If you don’t have enough platelets or clotting factors, or if they aren’t functioning properly, you end up with a bleeding disorder. When you have a bleeding disorder, the clotting process takes much longer to complete. This puts you at risk for complications from bleeding too much from an injury to bleeding internally into your tissues and organs, including your brain.

Bleeding disorders are a group of conditions affecting blood clotting. The most well-known is hemophilia, but it’s not the most common bleeding disorder. That distinction belongs to von Willebrand disease. Hemophilia is rare, affecting about 20,000 Americans. Von Willebrand disease, on the other hand, is found in up to 1 percent of the US population, or 3.2 million people.

In addition to hemophilia and von Willebrand disease, there are many other bleeding disorders that have been identified. They include Factor I, II, V, VII, X, XI, XII and XIII deficiencies, named after the specific clotting factors involved.

Most bleeding disorders, including hemophilia and von Willebrand disease, are inherited, which means they are passed on from your parents to you. They’re usually the result of defects on specific genes on your DNA. In rare cases, they can be acquired as the result of another disease such as liver disease or as a side effect of certain medications such as blood thinners.

Each bleeding disorder has its own set of symptoms, but there are a few general symptoms commonly experienced by people with these disorders. They include:

  • Easy bruising
  • Bleeding gums
  • Heavy bleeding from small cuts
  • Frequent nosebleeds
  • Heavy menstrual periods
  • Excessive bleeding following surgery or dental procedures
  • Bleeding into joints

Because bleeding disorders are passed along in families, your doctor will probably ask you a lot of questions about your family’s medical history, as well as your personal history, when making a diagnosis. The doctor will also give you a complete physical examination and will likely order blood tests.

These blood tests may include a complete blood count (CBC), which measures your total amount of red and white blood cells; a platelet aggregation test, which examines how well your platelets clump together, and a bleeding time test, which calculates how quickly your blood clots.

Treatment varies depending on the type of bleeding disorder you have and how severe it is, but it often includes iron supplementation to replenish the iron you lose when you bleed a lot. This can keep you from developing anemia, a condition in which your blood lacks enough healthy red blood cells or hemoglobin, which carries oxygen to your body.

Blood transfusions are a common treatment for bleeding disorders. During a blood transfusion, the blood you lose from bleeding is replaced with blood taken from a donor. Some disorders, including hemophilia, can be treated by injecting often synthetic clotting factor components into your bloodstream. This is called factor replacement therapy.

Another treatment is the infusion of fresh frozen plasma that contains certain clotting factors such as factors V and VIII, which are important to the clotting process. People with severe bleeding disorders may remain on a routine treatment regimen, or prophylaxis, to maintain enough clotting factor in their bloodstreams.

Bleeding disorders can’t be cured, but treatment can help to relieve the symptoms and allow you to live a relatively normal life. It can also help to prevent or control the complications associated with these disorders, including bleeding into the organs and tissues.

But you have to seek treatment as soon as possible, so if you notice any of the symptoms of a bleeding disorder, see your doctor right away.

Concerning Colorectal Cancer

March 17th, 2019

With cancer, the cells of a part of your body grow out of control. When this occurs with the cells of your colon or rectum, it’s colorectal cancer. Colorectal cancer is an equal-opportunity disease. It affects men and women of all racial and ethnic groups. Aging is a key factor for this disease, so it’s more common in people ages 50 and older.

According to the American Cancer Society, colorectal cancer is the third most common cancer diagnosed in both men and women in the US, excluding skin cancer. ACS estimates there will be more than 100,000 new cases of colon cancer and more than 44,000 new cases of rectal cancer in this country in 2019. Colorectal cancer is also expected to claim more than 51,000 lives in 2019.

On a positive note, death rates from colorectal cancer have dropped over the last 30 years in both men and women, and are still dropping. This decrease is attributed to more attention being given to screening and early detection, as well as the development of improved methods of diagnosis and treatment.

As with other cancers, colorectal cancer is caused by changes, or mutations, in your cells’ DNA, which controls cell growth. Some of these mutations are inherited; they’re passed along in families. These include certain genetic disorders such as familial adenomatous polyposis (FAP). With FAP, many growths called polyps form on the inner lining of the colon and rectum. Most colorectal cancers start as polyps.

Other mutations are acquired, meaning they occur during your lifetime and you don’t pass them on to your children. There are certain risk factors that can lead to these mutations in your DNA. Some risk factors you can’t control, like your age, but others you can control, and doing that can help you lower your chance of developing this cancer.

Many controllable risk factors are linked to your lifestyle habits, including diet, weight and exercise. The risk of developing colorectal cancer is higher in people who are overweight or obese, are inactive, or eat a diet high in red meats and processed foods. Other lifestyle habits that can have a negative impact include smoking and heavy drinking.

Colorectal cancer might not have symptoms in its earliest stages, and some of its symptoms are common to other disorders. But if you experience any unusual symptoms for four weeks or longer, see your doctor right away. Symptoms of colorectal cancer include:

  • Changes in bowel habits
  • Diarrhea, constipation or a feeling that your bowel is not emptying completely
  • Blood in your stool that makes it appear black
  • Bright red blood coming from your rectum
  • Frequent gas pains, bloating or cramps
  • Unexplained weight loss
  • Feeling very tired
  • A feeling of fullness in your belly, even after not eating for a while

If your doctor suspects colorectal cancer after you describe your symptoms, he or she will likely perform a digital rectal exam (DRE) to feel for lumps in your rectum. Your doctor may then order certain tests to confirm a diagnosis. Among these tests are a fecal occult blood test (FOBT), which looks for blood in your stool, and a barium enema, during which x-rays are taken of your colon and rectum after you drink a contrast liquid called barium.

Your doctor may also order a sigmoidoscopy, which looks inside your rectum and lower colon with a lighted scope, and/or a colonoscopy, which looks at your rectum and deeper into the colon. These tests are used to look for and remove polyps and/or take tissue samples for examination under a microscope for signs of cancer, which is called a biopsy.

Surgery is the most common treatment for colorectal cancer. Your doctor will remove the areas affected by the cancer using one of several techniques, which cut out varying sections of the rectum and/or colon. The technique used depends on the stage of the cancer and how far it has spread. But all of the techniques have the same goal: to remove as much of the cancer as possible.

Chemotherapy and radiation therapy are other options that are sometimes used, often following surgery to kill any remaining cancer cells. Ablation is another treatment option that destroys cancerous tumors without surgery to remove them.

Ablation can be accomplished using radiofrequency waves, microwaves, ethanol or cryosurgery. These treatments are performed through a probe or needle that is guided by ultrasound or CT scanning technology.

Targeted therapy and immunotherapy are newer methods for treating colorectal cancer. Targeted therapy works differently than standard chemotherapy. It uses drugs aimed at specific genes and protein changes known to cause the cancer. Immunotherapy works to boost your body’s own immune system to fight against the cancer cells.

While not all cases of colorectal cancer can be prevented, you can take steps to lower your risk. Make changes to those controllable risk factors: eat healthy, manage your weight, exercise, stop smoking and moderate your drinking. Also, follow your doctor’s advice about when to get screening exams for colorectal cancer.

The outlook for people with colorectal cancer varies by the extent of the cancer, but is best when the cancer is found in its early stages. That can only be done if you’re vigilant about managing your risk factors, monitoring your body for symptoms and getting screened appropriately. Do that and you can be a survivor.

Fact graphics courtesy of
Fight Colorectal Cancer

Pet Friendly

Senior living community opens doors to residents’ furry friends.

It’s a fact supported by research: Having a pet has benefits, especially for seniors. Seniors with pets are never alone, so they don’t feel lonely. Pets inspire them to socialize more and make new friends. Walking a dog encourages a more active lifestyle. Pets can lower stress levels and help seniors feel safer.

Residents Sandra Laettner and Gail DuBose discuss living at Concordia Village of Tampa with their pets. Chief Operating Officer Brian Hortert describes Concordia’s background and its rationale for allowing pets at the community.

Sandra Laettner and Buffy

These facts were not lost on the leadership of Concordia Village of Tampa. That’s why they opened the community to their residents’ furry friends. Being pet friendly was one reason Sandra Laettner chose to make Concordia Village of Tampa her new home last year.

“It was very important to be able to have Buffy with me,” shares the Buffalo, New York native. “Buffy is a Coton de Tulear. It’s a combination of Lhasa Apso and Maltese. She’s a white fluffball. She’s actually my adopted pet. I lived with my daughter-in-law for five years before moving to Concordia Village, and Buffy was her second dog.

“During the time I lived with my daughter-in-law, Buffy attached herself to me so much, I felt it would be painful for both of us to leave her behind when I moved. I asked my daughter-in-law if the dog could come live with me, and she said yes.

“When I moved to Concordia Village of Tampa, it was the first time in my life I didn’t live with someone. Having Buffy by my side made it easier.”

Sandra may have felt a bit unsure when she first arrived at Concordia Village of Tampa, but Gail DuBose was already comfortable and familiar with the community when she moved there in July 2018.

A former volunteer who performed music and led activities when Concordia was still St. Joseph’s John Knox Village, Gail became a resident after selling her home to cover her sick husband’s medical expenses prior to his passing in October. Having the couple’s pets with her at the community held a special significance for her.

“I had two pets when I moved into Concordia Village of Tampa, but my little Bonnie has since gone on to doggy heaven,” shares the Illinois native. “I still have Jackson, a twenty-pound, black-and-white tuxedo cat. Jackson and I get along pretty well in our little apartment.

“It was important to have Bonnie and Jackson with me when I moved because they were part of our family. It would’ve been very difficult to give up those guys. I think it’s important for most people because pets are a connection to what they used to have. It’s a big change when you move into a senior living community.

“For me, my pets, especially Bonnie, were a connection to my husband as well. He was very close to that dog. He was close to both pets, but Bonnie was his dog. She passed away the day after my husband died.”   

Member of the Family

Concordia Village of Tampa is part of Concordia Lutheran Ministries, which was established in 1881. Concordia Lutheran Ministries began in Western Pennsylvania as an orphanage and expanded into senior care in the 1950s.

“We currently operate fifteen senior living communities, most of which are in Western Pennsylvania,” reports Brian Hortert, Chief Operating Officer at Concordia Village of Tampa. “There’s also a community in Akron, Ohio, and now Concordia Village of Tampa in Florida.

“Concordia Village of Tampa offers independent living, assisted living, memory care, long-term nursing care and short-term rehabilitation. In addition, Concordia Lutheran Ministries operates homecare, hospice, medical equipment and pharmacy services, primarily in Western Pennsylvania.”

As COO, Brian oversees all operations of the skilled facilities, assisted living facilities and the retirement community at Concordia Village of Tampa. He was instrumental in the decision to operate Concordia Village as a pet friendly community. Several factors were considered when making that decision.

“We’ve always believed that pets become part of residents’ families,” Brian describes. “We wouldn’t expect them to move to a new home without a child. It’s the same feeling with pets for many residents. When they move to Concordia Village of Tampa, they become part of our family, and we think it’s just right to allow them to live with their family pets.

“Pets also provide companionship, as well as a level of comfort to our residents, especially those in new situations. We understand the importance of these benefits and want our residents to experience them.”

With a 14-acre campus and many walking trails, Concordia Village of Tampa is a perfect place for residents to exercise their dogs and meet their neighbors. The campus is secure, so residents can feel safe while walking their pets.

Of course, there are a few rules to be followed in order to keep a pet at Concordia Village of Tampa.

“We ask that dogs be under twenty-five pounds and be well behaved,” Brian notes. “So far, we haven’t had any major issues with barking, which can be a quality of life concern for the other residents. Also, residents with pets must be able to take care of their pets themselves. It would be a huge challenge for our staff if they had to take care of multiple residents’ pets.

“Currently, we have about eighteen residents with cats and thirteen with dogs. We also have a resident with a fish tank. We have had a resident or two with a bird, but we don’t have any birds living with us right now.”

Retirement Bliss

Living at Concordia Village of Tampa has been beneficial for Sandra and Gail. It’s been a good experience for their pets as well. Both have made themselves comfortable at the senior living community.

Residents Sandra Laettner and Gail DuBose discuss living at Concordia Village of Tampa with their pets. Chief Operating Officer Brian Hortert describes Concordia’s background and its rationale for allowing pets at the community.

Gail DuBose and Jackson

“Buffy has become a more social dog since she’s been here,” Sandra reports. “I think it’s because all the dogs here are small and where she lived before, there were large dogs in the nearby houses. But now, she encounters other animals her size, so she’s extremely friendly and social. I think she’s happier here than she was living at the house.”

“Jackson is quite entertaining,” Gail offers. “He’s afraid of everything. As big as he is, you’d think it would be the other way around. Jackson doesn’t like the people who come in to clean the apartment, so he gets on top of the refrigerator and stays up there until they’re finished. That works out quite well for him.”

Sandra and Gail are happy with their living arrangements as well. For Gail, her life changed dramatically once her husband got sick, so living among friends at Concordia Village of Tampa made a difficult life experience easier to manage.

“Concordia Village of Tampa is a very nice place to live,” Gail confirms. “I was able to bring with me the things I really like, the things that make me smile, and that’s been a great comfort to me. Things that make me smile include my cat, Jackson, and I feel really blessed to have him with me.”

“Knowing Buffy’s little face is right here looking after me is really important to me,” Sandra adds. “I think it’s important to Buffy, as well. She’s the love of my life, and I love that she’s here with me. She’s just like another child to me.”

Macular Degeneration?

Wearable video magnifiers are changing lives for those with AMD and severe low vision conditions.

In the United States, one in 28 citizens ages 40 and older has low vision. That’s the loss of sight not correctable with prescription lenses, medication or surgery. Low vision includes various degrees of visual impairment, from poor night vision to legal blindness.

Bob Schrepfer, president of The Magnification Company in St. Petersburg, discusses wearable magnification devices for people with severe vision loss.

One of the functions of AceSight is to magnify printed materials or objects (as shown here with a can of soup), increasing its size 15 times.

“Many eye conditions can lead to low vision. Among the most common are age-related macular degeneration (AMD), glaucoma and diabetic retinopathy,” notes Bob Schrepfer, president of The Magnification Company
in St. Petersburg.

“Having severe low vision or being told by your eye care professional that you are legally blind does not mean that your visual independence is coming to an end.”

The good news is that with low vision or legal blindness, some sight is still present that can be enhanced by video magnifiers. These devices greatly enlarge materials to read and write, and they allow users to play music, play cards, view TV and computer screens, and recognize faces.

“The Magnification Company provides hundreds of innovative portable, desktop and wearable video magnifying products to help people with low vision regain their visual independence,” Bob describes. “We’re the only company in the state of Florida that provides all of these new wearable video magnifiers under one umbrella.

“While every device has its benefits, the wearable video magnifiers we offer are opening up a whole new world of visual independence to people who are legally blind. It is so rewarding to see people’s lives change when they can see the details of a loved ones face across the room, recognize objects and print inside their homes and on the go, as well as enlarge print to a whole new level of size that conventional hand-held magnifiers cannot do.

“The new wearable video magnifiers are changing people’s lives because instead of being confined to a magnifying machine that they bring reading materials to, they wear these  over their eyes to read and view whatever they want to see.”

Four Times the Technology 

With the release of a new AceSight® magnifier by Zoomax, the Pico e2 by NuEyes® and the revised IrisVision Live 3.0 device by IrisVision® at the end of February, Bob and his team at The Magnification Company now offer four models of wearable electronic magnifiers. Each wearable has features that address certain patient needs and has limitations based on weight, magnification range, ease of use and battery life.

“The original NuEyes is one wearable option that’s been out for about two and a half years,” Bob relates. “Its major drawback is that it has a limited field of view. The NuEyes Pico e2, released in February, has a one hundred degree field of view, a high-definition camera and will convert text-to-speech.”

All of the four new wearable devices have a “free-floating” reading option. The video camera on the front of the headpiece takes a photo of what the wearer is looking at, freezes the image on the internal screen and allows the displayed image to be viewed hands free.

“The IrisVision and NuEyes Pico e2 include an added value of being able to convert that text to speech, therefore reading your materials for you,” Bob explains. “People can have their mail, newspaper, magazine, recipe, almost any item that has print on it, be either magnified or read to them with these two wearables.”

The IrisVision, which has been out for about two years, is another totally hands-free wearable option. It magnifies distant, intermediate and near vision. It can increase or decrease magnification anywhere from one to 24 times, with a 70 degree field of view.

“With the IrisVision on, people can see across a room, recognize facial expressions, read text and access digital media,” Bob observes. “IrisVision uses a readily available but highly sophisticated virtual reality platform, which solves visual problems as well as keeps the units cost-efficient.

“One of the other attributes of IrisVision is it has its own internal battery. When it’s fully charged, it lasts for about three and a half hours of continuous use. If people need more, we provide a battery adapter that goes into a port underneath the unit. That will keep it going for as much as eight hours of continuous use.”

Bob Schrepfer, president of The Magnification Company in St. Petersburg, discusses wearable magnification devices for people with severe vision loss.

The Magnification Company offers a variety of devices to help those with low vision.

The fourth and newest model of wearable electronic magnifiers is the AceSight. This product uses augmented reality imaging, which offers second-to-none optical clarity for watching television and working on computers. It also provides exceptional stability for hands-free activities such as playing music and cooking.

“The AceSight is an improvement over the IrisVision. It offers  more magnification, is  lighter in weight on the face and allows the wearer to walk around with a bit more comfort and ease. It also lasts for more than four hours on a full charge.”

An advantage of AceSight over many other wearables is its unique open design that does not block the wearer’s peripheral vision. That and the model’s fast display rate result in an always smooth image as wearers move their heads to look around. This also reduces any risk of dizziness with those that are motion sickness sensitive.

“Looking through the AceSight wearable video magnifier feels like looking at a fifty-inch screen several feet away,” Bob describes.

More Possibilities

Anyone can be affected by low vision, but it’s more common as people get older. That’s true, in part, because conditions that often lead to low vision, such as macular degeneration and glaucoma, most commonly develop with age. And the best way to catch and control the disorders that cause low vision is through routine eye exams by an eye care specialist.

Often, people diagnosed with low vision are referred to low vision specialists, who may recommend various magnifying devices to enhance remaining vision. These include the wearable electronic magnifiers.

Wearable electronic magnifiers offer people with low vision more possibilities than their portable and desktop counterparts. With their larger fields of view and increased magnification, they make the world bigger and clearer. Being hands-free, they enable wearers to be fully mobile. The bottom line: If your visual acuity ranges from 20/100 to 20/800 (legally, blindness is defined as starting at 20/200), chances are one of these new wearable video magnifiers would greatly improve your visual independence!

Added Insight

Eyes and face are at the heart of new specialist’s expertise.

As the son of a cardiologist, Robert J. Applebaum, MD, became interested in medicine at a very young age. His father also had an influence on the specialty Dr. Applebaum would pursue after medical school at the University of Florida.

Dr. Robert Applebaum has joined the staff at Florida Eye Specialists & Cataract Institute, which has locations in Brandon, Riverview, Ruskin and Sun City. He and Dr. Craig Munger discuss the services offered by the oculoplastic surgeons at the Institute.

Robert J. Applebaum, MD, MBA & Craig E. Munger, MD, PhD

“My father had a good friend who was an ophthalmologist,” the Tampa native recalls. “I spoke with him and got a feel for ophthalmology and what I could expect from it. I found ophthalmology intriguing. I was definitely interested in doing something surgical, and I wanted to be very specialized.”

With that in mind, Dr. Applebaum entered the ophthalmology residency program at the University of South Florida. Following his residency, Dr. Applebaum jumped at the chance to further specialize his skills with a fellowship in oculoplastic surgery, a specialty that concentrates on cosmetic and reconstructive surgery of the face and eye area. He completed the fellowship at the J. Justin Older Eyelid Institute.

“When the opportunity to specialize in oculoplastics became available, I decided it was worth taking the extra time to complete it,” Dr. Applebaum states. “That ended up being a good decision for me.”

It was an excellent decision because Dr. Applebaum is now using his skills in ophthalmology and oculoplastic surgery at Florida Eye Specialists & Cataract Institute, which has locations in Brandon, Riverview, Ruskin and Sun City. Along with his colleague Craig E. Munger, MD, PhD, Dr. Applebaum performs a host of cosmetic and functional procedures on the eyes and face.

Dr. Munger is a board-certified ophthalmologist on staff at Florida Eye Specialists & Cataract Institute. He is fellowship trained in oculoplastic, orbital and neuro-ophthalmic surgery. He and Dr. Applebaum treat patients with a wide variety of conditions, which Dr. Applebaum appreciates.

“I really enjoy ophthalmology and oculoplastics, so I feel fortunate to join the staff at Florida Eye Specialists and Cataract Institute, where I get to do what I enjoy,” Dr. Applebaum shares. “I’m able to practice a broad range of general ophthalmology, while also focusing more specifically on the eyelids and on facial cosmetic and reconstructive surgery.

“At Florida Eye Specialists and Cataract Institute, I have an oculoplastic-focused practice but still see general ophthalmology patients in the clinic throughout the course of the day. I also spend time at the Veterans Administration and treat many general ophthalmology patients there.”

Lasting Impressions

The eyes are one of the first things people notice when meeting someone, and the look of a person’s eyes often says a lot about that person.

“When we first meet someone and initially make eye contact with them, we immediately begin to form our first impression of that person,”
Dr. Munger asserts. “We judge that person to be tired, sad, angry or pleasant based on the appearance of the area around his or her eyes.”

Puffy or drooping eyelids can make people look old, tired or even mean. When their patients have sagging eyelids, Dr. Munger and Dr. Applebaum often recommend a safe, effective and cosmetically appealing procedure called blepharoplasty, also known as eyelid surgery.

Blepharoplasty is a surgical procedure that involves removing excess eyelid tissue. It 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 drop due to muscle weakness,” Dr. Applebaum describes. “The repairs we 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 of us are born with five bags of fat around the eye to protect it and hold it in the socket,” Dr. Munger notes. “However, with aging, that fat can come forward and manifest itself as puffiness under the eye. Lower blepharoplasty can diminish the look of tiredness and aging by decreasing excess fat and skin beneath the eyes.”

Eyelid Exposure

Exposure to the sun’s ultraviolet rays can lead to skin cancer, including cancer of the face and eyelids. The eyelid skin is especially sensitive to the sun’s rays because it’s very thin. The rays don’t have to penetrate very deep to reach the lower levels of the skin’s structures, where many cancers begin.

An effective cancer treatment technique called Mohs surgery, which removes cancerous tissue a layer at a time, is generally effective at removing skin cancer. However, it can leave large, open wounds on the surface of the skin. When these wounds are near the delicate eyelid area, oculoplastic surgeons must perform reconstructive surgery.

“We perform reconstructions after we remove skin cancer ourselves, as well as when patients are referred to us by our dermatologic colleagues,” Dr. Applebaum discloses. “In those cases, the dermatologists remove the skin cancer, but we perform the reconstructions because the operative areas are so close to the eyes.”

“As far as eyelid reconstruction, there are three factors that are very important,” Dr. Munger adds. “The first, of course, is to ensure complete removal of the eyelid skin cancer. Second, our reconstructive goal is to maintain the function of the eyelid so it can properly open and close. And third is to make the reconstruction as aesthetically pleasing as possible.”

Dr. Applebaum and Dr. Munger perform many other surgical procedures at Florida Eye Specialists & Cataract Institute as well. These include endoscopic eyebrow and forehead lifts, tear duct surgery, earlobe reconstructions and correction of eyelid malposition.

Fitting Fillers

In addition to the various surgical procedures, Dr. Applebaum and Dr. Munger also offer 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.

Dr. Robert Applebaum has joined the staff at Florida Eye Specialists & Cataract Institute, which has locations in Brandon, Riverview, Ruskin and Sun City. He and Dr. Craig Munger discuss the services offered by the oculoplastic surgeons at the Institute.

Dr. Munger in the surgical suite performing
eyelid procedures.

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

Among the fillers used by the doctors 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,” Dr. Applebaum describes. “We use these fillers in the cheeks to add volume and give the face a nonsurgical lift.

“We also use the 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.”

“Using a product like JUVÈDERM, people not only get the benefit of a more youthful appearance, but the results are also very natural looking,” Dr. Munger assures. “Patients don’t look like they’ve had anything done.”

KYBELLA® is another filler that’s 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.

In addition, Dr. Applebaum and Dr. Munger often use intense pulsed light, or IPL, therapy for patients needing specialized care. IPL is useful for treating a variety of conditions, including hyperpigmentation of the skin.

People with any face or eye condition can rely on Dr. Applebaum and Dr. Munger for their care. They can also rest assured, knowing these physicians are supported by the skilled staff at Florida Eye Specialists & Cataract Institute.

Solid Support

Memory care community sponsors caregiver group.

Certified dementia practitioner Bebe Kelly has worked with the senior population for more than 12 years. She began with independent caregiving and continued on to assisted living and memory care.Bebe Kelly, Tara Tosh and Nancy Nichols discuss the dementia support group offered at Symphony at St. Augustine.

“I’m also a community educator,” Bebe discloses. “I teach the community about dementia and Alzheimer’s disease, and about the advantages of aging in place. In addition, I run four dementia caregiver support groups, three in Flagler County and one in St John’s County.”

Through her networking circles, Bebe became acquainted with Nancy Nichols, marketing director at Symphony at St. Augustine, a memory care facility for people with dementia. Just before Symphony opened its doors in March 2017, the women spoke about the need for family members to have a place to talk about their caregiving concerns.

“I had already been running several Alzheimer’s support groups, and Nancy and I talked about starting one at Symphony,” Bebe remembers. “We decided to do it, and I began the support group there shortly after they opened in 2017.

“Most support groups run one session a month, but ours meets two days a month. That’s to better assist caregivers in crises. Many times, if someone in crisis has a comfortable place to go, the group can help diffuse many of their issues and lessen their heartache.”

The Symphony support group is not exclusively for caregivers of Symphony residents. Its doors are open to anyone from the greater community caring for someone with dementia. This is one demonstration of Symphony’s commitment to community outreach.

“We support our local community in all aspects,” emphasizes Tara Tosh, Symphony executive director. “We recognize that dementia caregivers are under a great deal of stress, and we want them to know they’re not in this by themselves. We don’t want anyone struggling with dementia to suffer.

“We offer the support group at Symphony to allow those caring for loved ones with dementia to openly express their concerns and not be embarrassed. It’s also a way for them to learn more about the disease process because there are so many unknowns with it.”

A support group is vital for family members dealing with dementia, Bebe insists. It’s a terrible disease that consumes their lives nearly 24/7.

“Even if their loved ones are in an excellent community like Symphony, caregivers still have the day-in day-out worries of when should I visit; will my loved one still know me, what’s the next stage of the disease,” she observes.

When the Symphony support group meets, Bebe sometimes introduces a topic for the participants to discuss, such as issues regarding loved ones who still drive. Most of the time, however, Bebe asks the people present if they have anything they wish to discuss.

“If someone’s in crisis, we talk about that immediately before we do anything else,” Bebe explains. “In many cases, they just need someone to listen to their concerns and offer possible solutions, which often come from other members of the group. I certainly don’t have all of the answers. I just facilitate the discussion.”

Often, members of the support group have already been through similar situations and know what the person in crisis is going through. They may have thoughts and suggestions on how the person can manage their current crisis.

Making Decisions

Discussion during support group meetings can provide caregivers with a clearer perspective on changes that occur during the various stages of dementia. This information can help family members decide when the time is right to find a memory care community for their loved ones.

“Often, families hold on to their loved ones at home as long as possible,” Nancy relates. “Then, an accident or emergency occurs, and they have to rush to find a place for their loved ones to live. That’s generally not the best way to find a community that’s a good fit. Instead, you want to have a choice.

“Sometimes, people are reluctant to visit a community because they think they’re going to be judged. If their loved one is a hoarder, for example, they don’t want to tell the whole story. Our staff knows how to deal with just about any situation.”

Symphony has an option that allows families to preview the community before they commit. Symphony offers a short-stay program for caregivers who want a brief reprieve to take a break or go on vacation.

“Sometimes, caregivers feel guilty and don’t want to take time out for themselves,” Tara observes. “But it’s important for them to know it’s okay if they need a break to refresh or go away. They can confidently bring their loved ones to Symphony for two weeks. Or, they can stop by anytime and take a tour.”

When looking for a memory care community for their loved ones, family members should consider several factors. Tara stresses that while it’s nice for people to make appointments to visit a community, it’s not necessary. They can drop in at any time.

“When they get there, they should make sure the community has a good variety of stimulating activities,” Tara suggests. “Even though their loved ones may not be engaged in activities at home, they may be totally different people when the

Bebe Kelly, Tara Tosh and Nancy Nichols discuss the dementia support group offered at Symphony at St. Augustine.

“The support group at Symphony is effective because it gives caregivers
a safe, trusting place to land when they’re trying to deal with loved ones
with dementia.” – Bebe Kelly

y’re around new friends.

“There are other factors that are important when choosing a community,” she adds. “These include the quality of the food and cleanliness of the building.”

“The friendliness of the staff is important as well,” Nancy relates. “Also the appearance of the residents. How do they look when they come into the building. Is everyone sitting around with sour faces or are they happy. It has to feel right, like home.”

“When families come to visit us, we go over all of the options with them to make sure Symphony is the right community for their loved ones,” Tara reports. “If not, we refer them to a community that’s a better fit for them.”

Facing Fears

Bebe understands that some people may be hesitant to participate in a support group and discuss their problems and fears. She wants everyone to know she never asks new members to speak.

“I ask them only to listen,” she assures. “Then, before they know it, they’re raising their hands and opening up. They feel free to open up because the group is a very trusting environment.

“Nothing that is ever said in that room leaves that room. And those who’ve been members of the group since it started are very welcoming and supportive of anyone new who joins us.”

The certified dementia practitioner reveals what may be the biggest stumbling block for people caring for loved ones with dementia. And she offers them hope.

“There are cures for heart disease and diabetes, and there are even cures for some cancers,” Bebe states. “But there’s no cure for dementia, and I think that’s what’s so frightening for people.

“The support group at Symphony is effective because it gives caregivers a safe, trusting place to land when they’re trying to deal with loved ones with dementia. The group gives caregivers the support they need to face their fears.”

Light on His Feet

Laser energy treatment relieves weighty leg disorder.

Degeneration caused John Darnell’s spinal discs to begin collapsing, placing pressure on his spinal cord and nerves. To ease the pain that resulted, John tried a number of treatments, including physical therapy and surgery. The pain, however, outlasted all attempts to relieve it.

Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated John Darnell for venous insufficiency and varicose veins using endovenous laser ablation (EVLA).

John Darnell

“I had several treatments on my back, including two surgeries by a spine surgeon, and still had pain,” John confirms. “I was going to my family doctor, and he referred me to a specialist who began treating me for the pain in my back.”

John’s doctor referred him to Kai McGreevy, MD, a board-certified neurologist and pain management specialist at McGreevy NeuroHealth in St. Augustine. Dr. McGreevy uses a variety of techniques to relieve his patients’ pain.

“Initially, I was treating John’s back pain using medial branch nerve blocks, which provided some relief,” reports Dr. McGreevy. “We have now completed those nerve blocks, and we’re close to performing radiofrequency ablation (RFA) on his spinal nerves, which is the next step in his back treatment.

“Prior to starting those treatments, however, we did a full medical history and physical on John, and it was at that time that he relayed to us that he had been experiencing a little heaviness in his legs.

“Many times, those kinds of symptoms can be attributed to the spine, but upon inspection, I saw he had discoloration and swelling in both legs. He then told me that he had been experiencing cramping and fatigue as well.”

“When Dr. McGreevy first noticed my legs, he said, “They don’t look good,” John confirms. “He mentioned the discoloration and told me, That’s not a tan. It’s a circulation problem. Your legs are holding blood. He told me I had varicose veins, which surprised me because I didn’t have any bulging veins on my legs at all.

“My ankles swelled, particularly in the morning when I woke up and started walking, but as the day went on, I really didn’t notice it as much. I guess with activity, my blood started circulating in my legs. But when I would lie down in bed at night, the swelling would build up. I also had cramps in my legs, but it wasn’t a continuous problem.”

As part of the body’s circulatory system, leg veins have the job of pumping blood upward, against gravity, toward the heart. They get help from the power of leg muscle contractions. To further assist with this task, there are a series of one-way valves in leg veins that keep the blood from flowing in reverse, or refluxing.

“With age, heredity or long hours of sitting or standing, these valves can weaken, and blood can flow backward and collect in the legs and ankles, causing symptoms,” describes Dr. McGreevy. “This condition is called venous insufficiency.”

A Common Condition

Venous insufficiency is a very common condition. It is estimated that more than 30 million Americans suffer with symptomatic venous insufficiency. Venous vascular disease is five times as prevalent as peripheral arterial disease, or PAD, and more than two times as prevalent as coronary artery disease.

Symptoms of venous insufficiency include pain, aching, swelling, heaviness, nighttime cramps, restless legs, discoloration and, in later stages, skin ulceration, but it’s “hugely underdiagnosed,” asserts Dr. McGreevy. Symptoms are often attributed to other disorders.

“Symptoms of venous insufficiency, the things that can be felt by the patient, can result in sensory changes such as numbness, tingling, weakness and fatigue,” he states. “These are all things patients describe to me every day when I examine them and perform nerve conduction studies.

“These symptoms may appear neurologic at first glance, but there’s no perfect box they fit into, so I don’t make assumptions that they’re caused by nerve injury.  If I test and discover these symptoms are not nerve related, they can be generated from multiple sources.

“If these symptoms are accompanied by visible signs such as swelling in the legs, I look at other possible sources. I have to rule out a cardiac condition such as heart failure, as well as a liver condition, protein imbalance and other disorders that can lead to leg swelling.”

In the absence of those sources, Dr. McGreevy continues, there’s a high index of suspicion for venous insufficiency, the treatments for which are generally covered by insurance. They’re covered not just for pain relief, but also for prevention because there are complications that can occur later in life that are very expensive to treat.

To diagnose venous insufficiency, Dr. McGreevy performs a Doppler venous ultrasound examination that allows him to see the flow of blood from the legs toward the heart. In John’s case, the simple, noninvasive exam revealed significant venous insufficiency in both legs.

Dr. McGreevy responded by recommending John wear compression stockings for about four weeks to help eliminate the swelling and heaviness in his legs. The stockings had little effect, however. At that point, Dr. McGreevy knew a different course of action was necessary.

Painless Rerouting Procedure

The new treatment plan for John’s legs included a procedure called endovenous laser ablation, or EVLA, in which the doctor introduces a sterile laser fiber into the problematic vein via a tiny puncture in the leg.

During EVLA, laser energy is delivered through this fiber, gently collapsing and sealing the vein. Blood flow from the sealed vein then reroutes through other, healthy veins in the leg, which reduces the impact of venous insufficiency on the patient.

“EVLA relieves the symptoms, including pain, swelling, fatigue, itching and weakness,” notes Dr. McGreevy. “It also improves the aesthetics of the legs, reducing any discoloration and breakdown of the skin, as well as the appearance of varicose and spider veins.”

John describes the EVLA treatments as painless and says they begin with an attendant “rubbing my skin with a solution to deaden the pain. Then, a technologist puts needles in my leg. He had a scope that traced the vein Dr. McGreevy wanted to block off, then he injected it with numbing medicine.

“After that, Dr. McGreevy came in and performed the laser treatment. There was a little bit of a burning sensation, but it was bearable. Afterward, they wrapped my leg in ACE™ Bandages. I had the treatment on a Thursday and had to keep the ACE Bandages on with compression until Sunday, then I could take the bandages off.”

Looking, Feeling Better

“We performed EVLA on both greater saphenous veins in John’s legs, and he experienced significant physical improvement,” Dr. McGreevy says. “John was pretty amazed by how much better his legs felt as well. He had reduced discomfort in his legs with less fatigue, swelling and cramping.

Dr. Kai McGreevy of McGreevy NeuroHealth in St. Augustine treated John Darnell for venous insufficiency and varicose veins using endovenous laser ablation (EVLA).

John’s vein treatment at McGreevy NeuroHealth was “ABSOLUTELY” successful.

“Sometimes, when we perform EVLA, it takes a little while for the results to be fully realized by patients. In John’s case, however, he had a very quick response. Within a week of performing EVLA on his right greater saphenous vein, he indicated he’d already started to feel a difference in his right leg.”

John says that his right leg didn’t look much better that Sunday after his first EVLA treatment, but confirms that it did look and feel much better by the following week, when he returned to McGreevy NeuroHealth to have the treatment on his left leg.

“My right leg cleared up miraculously,” John raves. “It was very clear and had lightened up considerably compared to the leg
Dr. McGreevy hadn’t treated yet. When I first went into the office, the receptionist said, Look what happened here. I walked into the little staff area, and everybody looked at my right leg and said, Wow!

“I looked at my leg and said, Gee, I really did have a problem. I didn’t know the problem with heaviness in my legs was that bad, but since I had the procedures on my varicose veins, my legs are a lot lighter and I can walk much better. I must have gotten used to the heaviness. I don’t have the swelling anymore, either.

“And all this time, Dr. McGreevy is still treating my back pain.”

John is impressed by Dr. McGreevy and his staff at McGreevy NeuroHealth. He finds the neurologist to be knowledgeable, kind, understanding and worthy of his trust.

“Over the years, I had a knee replacement and a broken ankle that was due to my back and loss of balance,” offers John. “I went to physical therapy for both of those conditions. Nobody noticed I had a problem with my leg veins except Dr. McGreevy.

“My EVLA procedures were ABSOLUTELY, in capital letters, successful. I recommend EVLA for varicose veins, and I recommend McGreevy NeuroHealth and Dr. McGreevy. I have complete confidence in him.”

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