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Spinal Solution

Vacuum effect heals painful, herniated discs.

When Ken Hoydic, 64, was in his 40s, he suffered a herniated disc in his back, the result of years of heavy lifting at his job in a hospital warehouse. With care, the Connecticut native got his back pain under control, then returned to living as usual with the condition. In 2017, however, Ken experienced new, excruciating pain in his back that he couldn’t live with.

Dr. Aderholdt treated Ken Hoydic for back pain with VAX-D® therapy.

VAX-D therapy helped Ken get back on his feet

“After that herniated disc, I was fine, and I could do everything,” confirms Ken. “I hiked. I golfed. I umpired baseball and softball games and refereed high school sports. I never worried about my back.

“Then in September, the day after Hurricane Irma came through, I was up on a ladder taking down my hurricane shutters when the ladder broke and I fell. At the time, my foot and shoulder were hurt, but there was no pain in my back, which I thought was strange.”

One month later, Ken’s worst nightmare came true. As he volunteered at a local animal reserve, his back suddenly stiffened and locked up. Then, the pain hit him – hard.

“I almost couldn’t get into my car to go home,” he says. “It was a constant, sharp pain, a ten out of ten. I couldn’t do anything. I couldn’t golf or do any of my activities. I couldn’t exercise. For the first five days, I couldn’t walk without crutches. I couldn’t even lie down in bed without pain. I slept sitting up on the couch. I was miserable.

“I went to a chiropractor, and my friend had to take me because she had an SUV I could climb into. It hurt too much to bend to get into a regular car. I had an MRI, and it showed I had three herniated discs. I reinjured the first disc and also injured two others.”

Unfortunately, the chiropractor couldn’t help Ken, so he tried physical therapy. He wasn’t happy with that physical therapist’s approach, so he began seeing another physical therapist, who performed a stretching procedure on Ken that helped him a little.

That got Ken thinking that stretching his back might lead to greater pain relief, so he started looking for centers that offered therapies that decompress the spine. That’s how he found Back Pain Institute of West Florida, where Dr. Aderholdt offers a unique, nonsurgical treatment calledVAX-D® Therapy.

“Ken had a very painful back condition, and for him, as with many patients with similar painful conditions, I recommended VAX-D therapy,” notes Dr. Aderholdt, who is one of the few doctors in the country who offers this patented, FDA-approved medical decompression technique for alleviating pressure on the discs of the spine.

Valuable Tool

Dr. Aderholdt stresses that while VAX-D therapy is a medical decompression technique, it is not a traction device. It works differently and achieves significantly better results.

“For many patients, chiropractic adjustments alone can actually relieve the pain,” he discloses. “However, for select people with sciatica or herniated, bulging or
degenerated discs, VAX-D treatment has proven extremely effective.”

During VAX-D treatment, the patient relaxes on a comfortable, computer-controlled table, secured with a pelvic belt or patented cervical collar, depending on the area to be treated. Carefully specified tension and pressure changes guide the use of VAX-D, allowing the therapist to focus decompression at the exact level of spinal dysfunction.

The VAX-D system is computerized, so it enables the table to make subtle but targeted movements, which create a powerful vacuum within the disc space. This vacuum gently draws the disc back to its proper orientation, which pulls nutrient-rich spinal fluid into the disc and stimulates repair cells that effectively mend the disc.

“Nothing else can create such a powerful vacuum,” asserts Dr. Aderholdt. “That is what makes VAX-D such a valuable tool for pain relief. There are imitators, but the vacuum effect is the most powerful one known. It doesn’t allow the muscles to contract like other machines might. In fact, VAX-D is the only nonsurgical treatment that has been clinically proven to reduce disc pressure to negative levels.”

VAX-D treatment has, over the years, developed a long track record of many satisfied patients, observes Dr. Aderholdt. Long-term studies have shown that VAX-D is effective in more than 88 percent of patients who go through the treatment.

“I consider VAX-D one of the most effective nonsurgical medical treatments for low back pain, neck pain and sciatica today,” he declares. “This revolutionary technology is one more tool I can offer my patients as we work toward relieving pain and maintaining the health of the lumbar and cervical spine.”

Ready to Run

Dr. Aderholdt determines the number of VAX-D treatments for each patient based on their unique condition. People must complete their entire course of therapy to receive the full benefit of the treatment, but some people, including Ken, begin to feel pain relief earlier in the process.

“After the first four weeks, my pain decreased considerably until I had just a little pain in my groin. On a pain scale of one to ten, that was a one or two, and I only felt it when I bent down,” reports Ken. “Then, about four weeks later, that pain went away completely. Since then, I have been pain free.”

With his therapy completed and his pain relieved, Ken’s life is getting back to normal. He can now bend to get into his car, sleep in his bed and walk without assistance.

“Now, I feel good,” he enthuses. “I’m actually doing some yard work, but I’m being careful. After the VAX-D treatments, I’m able to walk, cut the grass, ride my exercise bike and lie on my back to sleep. I have no pain doing those things.”

Ken reports that while he feels much better, he hasn’t returned to the golf course yet. He says Dr. Aderholdt advised him to not overdo his activities until the discs have had more time to heal. Ken has returned to some other sports activities, however, and hopes to do more soon.

“I umpired a softball game, but then the season ended,” he relates. “Refereeing high school sports is my part-time job, so I don’t want to miss that. I start volleyball soon and basketball right after that. I don’t want to do anything to screw up my back before that. I feel like I can run right now, but I’m going to see what happens with my recovery.”

Ken is pleased with the results he achieved with his VAX-D therapy. He credits Dr. Aderholdt and his unique, nonsurgical treatment for his excellent outcome.

“If anybody has a problem similar to mine with a herniated disc, I would
recommend that they get VAX-D therapy at Back Pain Institute of West Florida in a heartbeat,” shares Ken. “Dr. Aderholdt said my condition was pretty bad, so it probably took me longer than it takes most people to get better, but waiting was well worth it.”

Raising Sepsis Awareness

September 18th, 2018

Every month of the year celebrates awareness of a health disorder or healthy behavior, and September is the national month for a ton of things. One of the September celebrations is Sepsis Awareness Month. I thought we could all use a little more awareness about this potentially fatal condition.

For example, did you know that sepsis is the third leading cause of death in the United States, and the leading cause of death in US hospitals. There are more than one million Americans diagnosed with sepsis every year. And more than 250,000 people die from sepsis every year in the US.

Sepsis is a serious medical condition that occurs when the body’s immune system has an overwhelming response to an infection. In the case of any infection – bacterial, viral, fungal or parasitic – the immune system releases chemicals to fight the invading germ. The result is inflammation at the site of the infection. Inflammation is the damage caused by the fight between your immune system and the infection.

With sepsis, the germ-fighting chemicals cause inflammation throughout the body, which impairs blood flow. This undermines blood getting to the body’s organs and tissues, depriving them of oxygen and nutrients, and leading to organ damage. This whole-body reaction to infection spread through the bloodstream is sepsis.

Anybody can end up with sepsis, but some people are at greater risk for developing it. These include very young babies, seniors, people with chronic illnesses such as diabetes and AIDS, people with compromised immune systems such as those receiving treatment for cancer or following organ transplantation, and people in hospitals at risk for infections from IV lines, catheters, surgical wounds or bedsores.

There are three stages of sepsis: sepsis, severe sepsis and septic shock. Symptoms of sepsis include a body temperature above 101 degrees F or below 96.8 degrees F, a heart rate higher than 90 beats per minute, a breathing rate higher than 20 breaths per minute, and a probable or confirmed infection.

When your organs begin to fail, you’re headed for severe sepsis. Common symptoms of severe sepsis include decreased urination, changes in mental ability, chills, weakness, problems breathing, abnormal heart function, low blood platelet count and unconsciousness.

Add very low blood pressure to the symptoms of severe sepsis and you’ve got septic shock. That’s when there’s not enough blood pressure to keep your organs and tissues infused with blood and they fail. The organs most likely to fail include the lungs, the heart and blood vessels, the kidneys, and the brain and nerves.

Sepsis should be treated as a medical emergency as quickly and efficiently as possible as soon as it has been diagnosed. The first lines of treatment are IV antibiotics and IV fluids. The antibiotics given initially are broad-spectrum that kill a variety of bacteria. When the specific germ is identified, the medication can be adjusted to target the specific germ.

IV fluids are given to help keep the blood pressure from dropping dangerously low and throwing you into septic shock. The fluids also help the organs and tissues do their work, and they may help reduce organ damage from sepsis.

There are other treatments that may be used to support your functioning during your hospitalization. These might include kidney dialysis to help filter waste from your blood and mechanical ventilation to help you breathe if you’ve gone into septic shock. You may also be given corticosteroids to help reduce inflammation or vasopressors to tighten blood vessels and force the blood pressure to increase.

The outlook for people with sepsis depends on their age, health history, overall health status, how quickly the sepsis was diagnosed and the type of germ that caused the infection. Most people recover from mild cases of sepsis, but septic shock has a mortality rate of nearly 50 percent.

Your best bet is to seek treatment as soon as you start noticing symptoms so your doctors can begin treatment right away. Early and aggressive medical attention can help prevent sepsis from progressing to severe sepsis and then septic shock, and give you the best opportunity for a positive outcome.

I Lost It

Even when every diet on the planet didn’t work.

recent transplant to Florida, Tina Lay-Flanagan was born in St. Louis, Missouri and moved to Louisiana at the age of 14. Years later, a job in the marketing department of an assisted living community brought her to the Sunshine State. Her new home and her new job also brought her the solution to an ongoing battle.

Tina Lay-Flanagan lost 25 pounds using Dr. Michael Burr’s weight-loss program at Spring Hill Chiropractic & Wellness in Spring Hill.


“I have struggled with weight issues ever since I had my son,” shares Tina. “Then, when I reached my late forties, I started putting on a lot of weight. We lived on a farm at the time, and my husband didn’t want me to work. He just wanted me to stay at home and take care of the family and the household. That’s when I started gaining the weight.

“The extra weight caused a lot of problems for me. When I walked, I couldn’t breathe. I had problems with my back because I carried so much weight. I was diagnosed with high blood pressure, and my doctor put me on medication for it. It was bad.”

By the time Tina moved to Florida, she tipped the scale at 190 pounds and was miserable. In her job at Mariner Palms Assisted Living in Spring Hill, she helped organize an event at the community. That’s where she met Dr. Michael E. Burr and his assistant Sandy and learned that Dr. Burr was a wellness consultant as well as a chiropractor at Spring Hill Chiropractic & Wellness.

“I met Dr. Burr and Sandy at our grand opening,” Tina says. “I thought
Dr. Burr was just a regular chiropractor, but Sandy told me they have a special weight-loss program. I’ve done every diet on the planet with no results, but I talked with Sandy a little more about their program and decided to go to their office.

“When I got to Spring Hill Chiropractic and Wellness, Dr. Burr did some tests on my body. They found that my body was depleted of fat-burning hormones. It was all messed up, and it affected my metabolism.

“I wanted to find out why my metabolism was broken and stopped working, so I decided to go ahead and do Dr. Burr’s program.”

Coach Me Up

“When we met Tina, she was unhappy that people weren’t recognizing her because she gained so much weight,” reports Dr. Burr. “Like many overweight people, she tried everything to lose weight and nothing worked.

“Most people try to lose weight by eating less and exercising more, but that’s not the solution for many. Our program takes a different approach, based on positive lifestyle changes and improved body function. Tina got excited about our program because she knew it would literally change her life.”

Tina was grateful for the encouragement of her weight loss coach, especially at the start of the program. She struggled at first because she was eating well and still gaining weight.

“I ate a lot of healthy foods and fruits, but everything I ate just stuck to me, even if it was just one little thing,” she relates. “So, it was hard to lose weight at first. But I was determined to stick with the program, and my coach really helped me. I started eating the recipes in the book they gave me, then the weight just started coming off.”

Something Broken

Dr. Burr has found that overweight people have one of two problems that keeps them from losing weight: Either they have a broken metabolism or broken behavior patterns. Sometimes, they have both.
Dr. Burr’s weight-loss program teaches participants how to change their behavior patterns in a positive way while also becoming healthier. Together, these make it much easier to become better at fat burning.

“Our goal is to show people strategies that change their behavior patterns and how to have fun while they’re doing it,” he notes. “We also determine what’s broken with their metabolism and talk to them about factors that impact metabolism, such as decreased energy, digestive issues, hormones, stress, sleep challenges and more.

“All those factors play a role in how the body processes food, so if it can’t handle sugars very well, the body will go into fat-storing mode. If it can’t handle stress, it will go into fat-storing mode. We show people how to change their biochemical reactions to stress and the food they eat so they don’t store fat. We help them fix
what’s broken.”

For most, the program begins with a no-charge introductory class during which participants learn ten ways to help their hormones work to turn them from fat-storing machines into fat-burning machines. During the class, people are relieved to learn that there are underlying reasons making it difficult to lose weight and keep it off. It’s not just their discipline or willpower, but partially their body’s physiology.

“As people begin to change their lifestyles and eating habits through our easy-to-follow steps, they get healthier,” observes Dr. Burr. “Many people come in and tell us how their lives are so much better with improved energy, relationships and work performance, fewer cravings, less irritability, and no more mental fog or pain. Patients even tell us about their doctors taking them off medications they’ve been on for years. Sometimes, they forget to mention they’ve lost forty pounds because they’re so excited about
the other things.

“The people in the program become super healthy, and when a person is super healthy, it’s really tough to be overweight. That’s our ultimate goal – to have people live a one-hundred-year lifestyle.”

Breathing Happy

Once Tina got accustomed to her new, healthier lifestyle, she began to see results with her weight loss. She’s pleased with what she’s accomplished in her first months on the program.

Tina Lay-Flanagan lost 25 pounds using Dr. Michael Burr’s weight-loss program at Spring Hill Chiropractic & Wellness in Spring Hill.

Tina After

“So far, I’ve lost at least twenty-five pounds,” she enthuses. “It took me about two months to lose that weight.”

Losing the weight has made a difference in Tina’s health as well. Without the extra pounds, the problems she was experiencing before have been significantly resolved.

“I feel awesome,” she reports. “I have more energy, and I can breathe better. I’m so thankful I can walk around and breathe. I also haven’t had any problems with my back. I haven’t had my blood pressure checked by my doctor yet, but I have a blood pressure machine at home. When I checked my blood pressure recently, it was perfect.”

Dr. Burr’s weight-loss program has helped fix what was broken inside Tina’s body and what was keeping her metabolism from working efficiently. Tina’s hormone levels are now improving, and she credits Dr. Burr, his staff and her coach for helping her reach this point.

“I’m so grateful I found Dr. Burr and his program because the weight is just coming off,” she relates. “I have a little way to go, but eventually, it will all come off, and they do it the right way. Because the program is a lifestyle change, I don’t plan to ever get off of it.

I encourage anyone who wants to lose weight to check out the program at Spring Hill Chiropractic and Wellness, because you can only get it through a doctor. It’s not your normal weight-loss program. It’s a lifestyle change, and Dr. Burr and his staff teach you how to make it. They’re there for you, and they’re just awesome!”

Glioblastoma: A Ghastly Cancer

September 11th, 2018

On Saturday, Aug 25, Arizona Senator John McCain succumbed to an especially heinous brain cancer called glioblastoma. Glioblastoma, the most common of all of the malignant primary brain tumors, is the same illness that killed Sen. Ted Kennedy and Beau Biden, the son of former Vice President Joe Biden.

John Sidney McCain III (August 29, 1936 – August 25, 2018)

In the United States, there are approximately 18,000 people diagnosed with glioblastoma every year, and an estimated 13,000 die from it annually. As you can see, glioblastoma is a very deadly disease. It is a primary tumor because it starts in the cells of the central nervous system, the brain and spinal cord, and quickly spreads to other cells in the brain.

Glioblastoma is more common in men than in women, and the chances of getting it increase with age. Glioblastoma tumors tend to occur in adults between 45 and 70 years old. A study conducted between 2005 and 2009 found that the median age group for death from brain and other central nervous system cancers was 64.

There are two main types of cells in the brain: neurons, which transmit messages from cell to cell, and glial cells, which provide support to neurons and help regulate the transmission of those messages. Glioblastomas start in the star-shaped glial cells called astrocytes. The tumors generally begin in the cerebrum, the largest part of the brain.

A glioblastoma tumor is highly malignant, or able to spread, because it can rapidly invade nearby healthy brain tissue. As the tumor grows, it puts increasing pressure on the brain, which leads to various symptoms. These include headaches, blurred or double vision, difficulty thinking or remembering, changes in mood or personality, seizures, vomiting and trouble speaking.

In most cases, the exact cause of glioblastoma is not known. In rare cases, it can occur in people with certain genetic syndromes. In these cases, the affected people typically also have additional symptoms characteristic of those syndromes. Those syndromes are generally caused by mutations to a specific gene.

Diagnosing glioblastoma begins with a history of symptoms and a full physical exam. Your doctor will likely order an imaging test, most commonly an MRI. The MRI can show the size and location of the tumor. Your doctor may also perform a biopsy, the removal of a sample of  tumor tissue to study under a microscope.

If you are healthy enough to have a procedure, treatment for glioblastoma will begin with surgery to remove the tumor. Due to the location of the tumor and how far it has invaded into healthy brain cells, doctors are often unable to remove the entire tumor. However, removing as much as possible, or debulking it, can release some of the pressure on the brain and help reduce symptoms.

Following surgery, you will be given radiation therapy and chemotherapy. Radiation therapy uses high-energy beams, such as x-rays or protons, to kill cancer cells remaining after surgery. Chemotherapy uses drugs to kill cancer cells. For people who are unable to undergo surgery, radiation therapy and chemotherapy are the primary treatments for glioblastoma.

Newer treatments that have been showing promise are biological therapies. These therapies target the specific biological functions that are essential for the tumor to grow. They are also designed to be less toxic to healthy cells than radiation therapy and chemotherapy.

Often, glioblastoma tumors return after treatment. If this happens, you can repeat the cycle of surgery, radiation and chemotherapy. You may also want to consider a clinical trial of a new treatment still in the testing phase. Ask your doctor about available clinical trials in your area or visit

Your doctor may also recommend palliative care. This is a specialized type of medical care that aims to provide relief from your pain and other symptoms. The palliative care doctors work with you, your family and your cancer specialists to provide care that complements any other treatment you may be receiving.

Unfortunately, because glioblastoma is such a malignant and aggressive cancer, the outlook for those affected by it is not promising. There is currently no cure for the disease, and many people who get it live less than a year after their initial diagnosis. Currently, the median survival for adults with aggressive glioblastoma is approximately 14.6 months. The two-year survival is 30 percent. Thank God this is a relatively rare cancer.

Experience Matters

Choose a full-time vein specialist for the best outcome.

For most of his career, Carmen Putrelo was the assistant controller of an insurance company, where he sat behind a desk to perform his accounting duties. Little did the Upstate New York native realize, but his years of sitting had an adverse effect on his legs. The resulting discomfort peaked in late 2017, prompting a trip to his family physician.

Dr. Ravi Sharma of Premier Vein Centers in Homosassa and The Villages treated Carmen Putrelo and Mary Jim Campbell (from HER 18C) for venous insufficiency using various minimally invasive procedures.

Carmen is happy that his dog Bella can sit in his lap again.

“There was dull pain in my left leg almost constantly,” he describes. “I have a very loveable dog that likes to lie on my lap, but I couldn’t let her because it would really hurt. More often than not, by the end of the day, my legs felt heavy and fatigued. They were uncomfortable and tired, like I just ran a marathon.

“I was visiting my primary care doctor, and we were talking about my sleep. When I mentioned waking up a lot at night, as well as my other symptoms, he looked at my legs. He put his hand behind my calf and said, You’ve got some veins here that are protruding. Would you consider seeing somebody about them?”

When Carmen agreed to visit a specialist, his doctor recommended Ravi Sharma, MD, a board-certified cardiovascular surgeon with expertise in blood vessel disorders of the legs. Premier Vein Centers, Dr. Sharma’s practice, has offices in Homosassa and The Villages.

Dr. Sharma has extensive expertise treating vein disorders. As a cardiovascular surgeon, he spent many years working with the intricate blood vessels surrounding the heart. Now, he focuses his practice full-time on treating patients with venous disease. Carmen was instantly impressed by the experienced surgeon.

“Dr. Sharma told me how he was a cardiovascular surgeon but does nothing but leg vein work now,” relates Carmen. “I found him very genuine, and I felt he really knew what he was talking about. He described the process he uses to identify and correct leg vein issues.

“He explained everything about veins and how the circulatory system in the body works. He told me that sometimes difficulties in blood flow occur, and that these difficulties are partly from genetics and partly due to lifestyle. A sedentary lifestyle can contribute to blood flow problems, and that’s what I had for years with my office job.”

The vein surgeon also told Carmen that as people age, their veins stretch, enlarge and fail to compress as effectively as needed to move blood efficiently. In addition, the one-way valves in the veins weaken and leak, and the system of returning blood to the heart becomes inadequate. Leaking blood pools in the legs, causing pain, heaviness and other symptoms.

The condition that results in weakened and leaking valves is called venous insufficiency. Using ultrasound imaging, Dr. Sharma confirmed that Carmen had venous insufficiency in both legs.

“The ultrasound unit had a screen, and Dr. Sharma showed me how certain veins were larger,” says Carmen. “He found five veins that were problematic, two in my right leg and three in my left leg. He told me he was going to rectify the problem and explained how he was going to do that. He then asked if I was okay with the
procedures he recommended.

“Dr. Sharma performed the procedures on one vein at a time. He anesthetized the area, made a little cut and entered the vein. Using a laser, he collapsed the vein. Then, he cut out a little piece of it so it can never open back up again. Because he is an experienced vein surgeon, he can do that. Many other doctors who aren’t vein surgeons can’t, and the vein may open up again five or ten years down the road.”

About a week after Dr. Sharma completed the first procedure, he performed a second ultrasound on Carmen’s treated vein to ensure complete closure. He then moved on to the next vein.

“The entire process took about six months,” reflects Carmen, “and the whole thing was pretty painless.”

Preaching to the Choir

Preachers never retire. Neither do their wives. Mary Jim Campbell, 78, has assisted her husband in building churches in many states, including Florida. A few years ago, Mary Jim and her husband returned to Florida and settled in Summerfield. Soon after, they began a new church, where Mary Jim’s husband continues to minister.

Dr. Ravi Sharma of Premier Vein Centers in Homosassa and The Villages treated Carmen Putrelo and Mary Jim Campbell (from HER 18C) for venous insufficiency using various minimally invasive procedures.

Mary Jim Campbell

“As a preacher’s wife, I work with him,” Mary Jim explains. “When we build churches, I’m right alongside him doing whatever needs to be done. I work to promote him and make his life comfortable because preachers in this day and age deal with a lot of issues.”

Mary Jim had her own issues to deal with, however. For one, she had a bulging varicose vein on her left calf. She’s had it for many years, but it never really concerned her. It bulged, but because of its location on her leg, it was barely visible.

“That vein appeared after a tumbling accident in high school,” she notes. “I had a bulge, but it was on the inside of my leg right about where the muscle is. That one didn’t bother me. I’ve just lived with it since the Fifties.”

While Mary Jim ignored the vein on her left leg, she did become concerned when unsightly veins suddenly began appearing on her right leg. She was self-
conscious about the highly visible veins and considered having that leg treated.

“After we moved to Florida, a vein popped out on my right thigh and started crossing over my kneecap,” she confirms. “It was very unsightly. Of course, in Florida, I was wearing shorts more, and it felt like everybody was noticing it. I had a little swelling in my legs as well, and some painful leg cramps.

“I’m not really vain, and I’ve lived with the vein on my left leg for many years, but I really felt I needed to take care of the ones on my right leg.”

Mary Jim’s desire to seek treatment for her leg vein issues led her to Dr. Sharma. She was amazed by what she learned from the acclaimed cardiovascular surgeon.

“I thought I was going in for cosmetic treatment until I had my consultation with Dr. Sharma,” Mary Jim recounts. “He explained that my problem had to do with circulation and that if I didn’t do something about both legs now, I would have major problems down the line. Treatment would eliminate the unsightly veins as well.”

Through the use of ultrasound images, which he obtained after learning of her health history, Dr. Sharma diagnosed Mary Jim with venous insufficiency. The doctor recommended several procedures to address her condition.

Prevalent Problem

The human circulatory system is composed of an intricate series of blood vessels. Veins are the blood vessels that return oxygen-depleted blood back to the heart. There are three types of veins: superficial veins, deep veins and perforating veins. Superficial veins lie close to the skin, deep veins lie in groups of muscles, and perforating veins connect the superficial veins to the deep veins.

“Venous insufficiency is a condition in which the leg veins cannot pump blood back to the heart,” informs Dr. Sharma. “Chronic venous insufficiency [CVI] has multiple causes. Over long periods of sitting or standing, the blood in leg veins can pool. This increases the venous blood pressure and weakens the vein walls and valves, thereby damaging the valves. Damaged valves prevent proper blood flow back to the heart.”

Venous insufficiency has many signs and symptoms, the doctor adds. Signs are the issues that can be seen, such as bulging varicose veins, swelling, and thickening and discoloration of the skin of the ankles or legs.

Symptoms are those things that are felt but not seen. They include throbbing, aching, stinging, burning, itching, heaviness, nighttime leg cramps and restless legs. These are all indications that the veins are not functioning properly.

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

Venous insufficiency is more common than many people think, notes Dr. Sharma. 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.

“A huge problem with getting venous insufficiency properly treated is that many of its symptoms are invisible and often misunderstood by patients,” points out Dr. Sharma. “One of those symptoms is leg pain. Pain is common with many disorders, so venous insufficiency is often overlooked or misdiagnosed.

Dr. Ravi Sharma of Premier Vein Centers in Homosassa and The Villages treated Carmen Putrelo and Mary Jim Campbell (from HER 18C) for venous insufficiency using various minimally invasive procedures.

Carmen Putrelo

“Patients and physicians alike need to understand that vein problems are often present before they are visible on the surface. Symptoms such as pain, heaviness and restless legs can signal vein disease without the corresponding visible varicose veins. With the right diagnosis, a patient’s leg pain can be relieved with simple, minimally invasive techniques.

“When seeking a physician for care, it is crucially important for people to choose experienced specialists who treat patients with venous diseases full-time. The specialists should also be experienced in the advanced procedures available to treat these diseases. Physicians with these qualifications achieve the best outcomes.”

Multiple Treatment Options

A full range of advanced, minimally invasive treatment options for addressing varicose and spider veins is available at Premier Vein Centers. These treatment options include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections and the new, non-thermal procedure, VenaSeal™.

Microphlebectomy has replaced stripping, an outdated, more involved procedure in which doctors treated the large veins by making big gashes across the leg that often left the patient with large scars.

“With microphlebectomy, the incision is tiny – about the size of the tip of a scalpel – and we can do much more through that small incision,” Dr. Sharma asserts. “And with this procedure, patients end up with tiny marks on the skin or no scars at all.”

During endovenous laser ablation, a sterile laser fiber is introduced into the incompetent vein via a small puncture in the leg. Laser energy is then delivered through the fiber, painlessly closing the vein in less than an hour, using local anesthesia.

Sclerosing injections are used to treat spider veins, which are tiny, dilated blood vessels in the skin that become swollen with stagnant blood. Dr. Sharma uses ultrasound-guided sclerotherapy (UGS) to guide the injections that gently close the problem vessels.

VenaSeal is a non-thermal procedure using a proprietary medical adhesive delivered endovenously to close the vein. This procedure has benefits such as not requiring multiple needle sticks and, in some cases, not needing to wear support stockings, as well as other benefits.

Dr. Sharma uses his expertise to determine which procedures to use based on each patient’s symptoms and health status. These advanced treatments are all performed in a comfortable office setting and result in little or no downtime and discomfort.

“Our patients are often very relieved to discover that there is no general anesthesia involved in our minimally invasive treatments,” observes Dr. Sharma. “And they’re happy to learn that they can resume activities right away.”

Premier Vein Centers provide a free initial consultation and accept most insurance, including Medicare.

Fascinating Finishes

Mary Jim was impressed with Dr. Sharma’s expertise. She was also intrigued with the treatments she received at Premier Vein Centers, where Dr. Sharma addressed her venous insufficiency by employing a trio of procedures.

Dr. Ravi Sharma of Premier Vein Centers in Homosassa and The Villages treated Carmen Putrelo and Mary Jim Campbell (from HER 18C) for venous insufficiency using various minimally invasive procedures.

Mary Jim is no longer concerned about wearing shorts.

“I had laser ablation, microphlebectomy and sclerotherapy, and I was amazed by how little pain was involved,” marvels Mary Jim. “During one procedure, Dr. Sharma actually took out a piece of my vein and showed it to me. It was fascinating.

“To do the vein over my kneecap, he made a small incision in the knee with a scalpel and punctured the skin. There were no stitches with any of the procedures, and you can’t tell at all now that I had anything done to my legs.”

Carmen was also amazed that the procedures to seal his leaking veins, as well as the recovery afterward, were easy and relatively painless.

“The only time I felt any discomfort was about an hour after the procedures, probably because the anesthesia wore off at that point,” he says. “It felt uncomfortable for just a little while. Dr. Sharma gave me pain medication to take if I wanted, but I didn’t need it. I just took a Tylenol®, and I felt better. The next day, I was absolutely fine.”

Mary Jim credits Dr. Sharma and his staff with making her experiences a positive one. They even let her husband sit in on one of the procedures. She was truly pleased with the ease of the procedures and very happy with the results.

“I can’t say enough about the thoroughness and friendliness of Dr. Sharma and his staff,” states Mary Jim. “They told me what they were doing when they did the procedures. There was no fear involved, and I was very comfortable. I felt very confident in what Dr. Sharma was doing.

“My legs look and feel fine now. All my bulges and bumps are gone, and there’s no swelling or cramps. I can’t say I ever had beautiful legs, but they sure look a lot better now than they did before I went to Dr. Sharma. My legs look as good as they possibly can for a seventy-eight-year-old woman. I no longer have any concerns whatsoever about wearing shorts.”

Carmen is pleased with the results he achieved as well. Without the discomfort in his legs, he can allow his dog to sit on his lap again, and at the end of the day, he no longer feels like he just ran more than 26 miles. Carmen is also delighted he doesn’t have large scars on his legs from the procedures.

“It’s incredible,” he enthuses. “I have no more pain in my legs. I feel like I have brand-new legs. If Dr. Sharma could only do that for the rest of my body, I’d really be happy!

“I also don’t have that uncomfortable heaviness and tired feeling in my legs anymore, and I’m walking more now than I ever have. I have absolutely no problems whatsoever with my legs after walking. I also ride my bike and play golf and have no issues with my legs after the fact.

“There’re also no obvious scars on my legs. All you can see are little, red marks where Dr. Sharma made the incisions, so appearance-wise, there’s absolutely
nothing there.”

According to Mary Jim, the caring, comforting treatment she received in the operating suite is given everywhere at Premier Vein Centers. Because of the inviting atmosphere, Mary Jim says she actually enjoys her visits there, which is not typically the case with her doctor appointments.

“I don’t go to the doctor unless it’s necessary,” she emphasizes. “But with Premier Vein Centers, I look forward to going there. Dr. Sharma and his staff are friendly and happy. They create a family type of environment.

“If anyone has varicose veins, I recommend the treatments I had done, and I recommend they go to Dr. Sharma at Premier Vein Centers to get them done. On a scale of one to ten, I give them a ten!”

Single-Day Smiles

Extractions and implants done in same appointment.

As a nurse, Donna Needham was a full-time caregiver. While she’s now retired from her hospital career, Donna is still caring for others. But these days, she cares for her grandchildren. It’s a job she loves. She also loves living in Florida, where she’s been a resident for almost 30 years.

Dr. Michael Hashemian of The Dentofacial & Cosmetic Surgery Institute in Lecanto, Spring Hill and Land O’ Lakes placed dental implants in Donna Needham.

Donna is happy to have a new, revitalized smile.

Donna’s always happy to talk about her grandchildren and life in Florida, but over the years, she became less confident in her smile. Despite routine dental care, Donna developed trouble with her teeth that progressively worsened with time. By 2018, she had several teeth that had deteriorated beyond repair.

“I had three teeth that had a lot of fillings in them, so there wasn’t a whole lot of tooth left for placing crowns,” she describes. “One of the affected teeth was the third from the front on my left side. When I smiled, there was a dark tooth in the way because of all the filling material. But I didn’t want an empty hole there, either.”

Donna’s dentist recommended she have the three failing teeth pulled and replaced with dental implants topped by crowns. For the implants, he referred her to skilled oral and maxillofacial surgeon Michael Hashemian, MD, DMD, of The Dentofacial & Cosmetic Surgery Institute. The institute has offices in Lecanto, Land O’ Lakes and Spring Hill.

“Donna was referred to me by another dentist to evaluate three teeth for extraction,” Dr. Hashemian confirms. “Those teeth had some areas of decay and were in poor condition. One tooth in particular affected her smile.

“The tooth in her smile line was in the front. The other two were in the premolar area midway in the back of her upper jaw. The rest of her teeth were in good condition. She didn’t have any excessive bone loss or periodontal disease.”

When Dr. Hashemian began presenting options to restore her extracted teeth, Donna wasn’t interested in hearing about them. She’d already made up her mind. She wanted the implant-supported crowns. Dr. Hashemian agreed with Donna’s choice and obliged.

“I wanted the implants with crowns because I wanted to have teeth,” states Donna. “I didn’t want to go around with missing teeth, especially the one near the front. I really didn’t want a gap there.”

Advantageous Option

Dr. Hashemian says placing implant-supported crowns was the right choice for Donna. He explains that for people who need to replace five, six or seven teeth in one arch, it’s more sensible to restore the arch with an implant-supported partial denture or bridge. Placing seven individual implants requires long hours in the dental chair and can be expensive.

“Those who are missing one, two or three separate teeth are better candidates for individual implants because they can be completed with less chair time and at less cost,” he reports. “It was an advantageous option for Donna.”

It was also advantageous because Donna was a candidate for the single-visit approach available at The Dentofacial & Cosmetic Surgery Institute. This approach streamlines the implant process and makes getting implants more convenient for the patient.

“Today, we can extract the teeth and place the implants during the same appointment. Also, on the same day, the patient’s general dentist makes temporary teeth, so the patient is never without teeth while waiting for their permanent crowns.”

With Donna, Dr. Hashemian removed her three failing teeth and added a slight amount of bone graft material before placing her implants. The bone graft was needed because there was a gap between the implants and her jaw sockets.
Dr. Hashemian says this is a common occurrence.

“I filled the gaps with the bone graft, so at the end of the healing process, the implants are entirely encased in bone,” educates Dr. Hashemian. “This bone integration is what gives implants their strength and stability, especially when patients eat and speak.”

When placing a single implant or two implants for crown restorations, the implants are submerged under the patient’s gums and left in the jawbone. The gum tissue is then closed over, and the patient waits for the implants to heal.

The time it takes for implants to heal varies with each person, but the process generally takes between four and six months. During that time, the implants integrate with the bone and become a solid unit. Once the implants are healed, the permanent crowns can be attached.

“We waited about four months before placing Donna’s implants,” reports Dr. Hashemian. “At that time, I exposed the implants, put the attachment pieces on them and sent Donna back to her general dentist, who put on her final crowns.”

Ultimate Trust

For Donna, it was important to have all her implant work done at one time, and Dr. Hashemian’s single-visit approach made that possible. Working closely with Donna’s general dentist, they were able to give her a restored smile the same day her teeth were extracted.

Dr. Michael Hashemian of The Dentofacial & Cosmetic Surgery Institute in Lecanto, Spring Hill and Land O’ Lakes placed dental implants in Donna Needham.

“It was perfect. I got all three teeth pulled and
all three implants done in
one appointment.” -Donna

“It was perfect,” Donna enthuses. “I got all three teeth pulled and all three implants done in one appointment. I was also happy I got the temporary front tooth right away while the implant healed. That way, I didn’t look toothless when I smiled or talked.”

While Dr. Hashemian was working on Donna’s implants, he observed a couple of dark spots on her face. As a facial cosmetic surgeon as well as an oral surgeon, he felt obligated to point out the potential dangers if the spots begin to change shape or color.

“When I was in his office for my implants, Dr. Hashemian noticed I had two moles on the side of my face,” verifies Donna. “He explained that I have to keep watching them and make sure they didn’t change or get darker. He said if they do, they must be removed. He told me he does that surgery as well as implants.

“Even though I go to a dermatologist, I really trusted Dr. Hashemian from doing my implants. I had enough confidence in him to have him remove those moles from my face.”

Donna is thoroughly pleased with the results she achieved from Dr. Hashemian’s treatment. She also credits the oral surgeon and his staff for making her time at The Dentofacial & Cosmetic Surgery Institute a very positive experience.

“I really like Dr. Hashemian, the office girls and the assistants who help him,” she says. “They’re all very nice, friendly and considerate. They answered all my questions. I recommend Dr. Hashemian and The Dentofacial and Cosmetic Surgery Institute at any time to anybody. Everything and everybody there is wonderful.”

Vote to Revitalize

Candidate hits campaign trail with healthy, restored smile.

A winning smile is essential to Eugene Kowalski, who is campaigning for election to Seat Four on the DeBary City Council. Eugene has been a resident of DeBary for more than 30 years and is a graduate of the University of Florida.

Richard C. Montz, DDS, of River City Dentistry in DeBary treated long-time patient Eugene Kowalski with restorative dentistry. Sidebar on how bottled water affects the teeth.

Eugene Kowalski

As a businessman and Class A general contractor, Eugene managed, developed and consulted on billions of dollars of construction projects over more than 40 years. The smile he had, however, didn’t match the professional image he
wanted to project.

“I was in Toastmasters International for quite a while,” Eugene shares. “Running for office gives me an opportunity to use my Toastmasters skills and business experience to help the City of DeBary. Unfortunately, I’ve been blessed with bad teeth.”

Eugene’s poor teeth affected his smile and his self-confidence.

“I had some issues with tooth decay,” he continues. “A family member had issues with his teeth and had all of them pulled by the time he was seventy. I’m proactive. I needed a dentist to correct the issues with my teeth and was willing to help with my health issues as well.”

Luckily, Eugene met that dentist on a cruise ten years ago. It was Richard C. Montz, DDS, of River City Dentistry in DeBary. After talking to Dr. Montz casually, Eugene liked the dentist’s personality. He also found Dr. Montz to be highly intelligent, so he decided he wanted Dr. Montz to be his dentist.

Most recently, Eugene counted on Dr. Montz to give him a campaign-worthy smile. The dentist began his work by making sure Eugene’s mouth was healthy. Because of serious dental conditions that could affect other parts of the body, the decision wound up improving Eugene’s general health and wellbeing.

“In one tooth, a root was cracked, and when Dr. Montz pulled the tooth, he found what he said was the biggest abscess he’d ever seen,” relates Eugene. “If he hadn’t pulled that tooth, I would still be living with a serious health issue that was hidden. Now, I’m healing.

“I was having some health issues at the time, but I didn’t realize they were associated with the infection in my tooth. When Dr. Montz found that abscess and corrected it, my health improved dramatically.”

Once Eugene’s infection was resolved, Dr. Montz concentrated on improving his smile using restorative dentistry techniques. As part of that, he recommended dental implants in some instances where Eugene’s teeth were simply
not salvageable.

“Eugene had a few failed root canals and breakdowns in other teeth,” reports Dr. Montz. “He broke a couple of teeth, one I’ve never seen broken in that manner. Several of his teeth failed and required extraction, so he’s had five dental implants placed to date.”

“Having some of my teeth pulled caused me to rethink my overall strategy,” offers Eugene. “So, Dr. Montz and I came up with a proactive approach to improve my dental health and my smile.”

Dr. Montz recommended restoring Eugene’s smile with new crowns, which impressed Eugene. He also admired Dr. Montz’s straightforward style when it came to recommending the appropriate dental procedures for him. The dentist suggested the best options for Eugene’s oral health and budget.

“Sometimes, a person goes to the dentist and is told a tooth can be saved, so they make an investment in dental work and eventually the tooth has to be pulled anyway,” Eugene comments. “I appreciate that Dr. Montz was upfront and honest. He told me that under the circumstances, I’d be better off with an implant instead of making an investment I’ll never recover. The tooth was just going to get worse.”

Functional and Cosmetic

Dr. Montz points out that in dentistry, there’s a distinction between restorative and cosmetic dentistry. Restorative is done to restore form and function, while cosmetic concentrates on improving aesthetics. He argues, however, that all dentistry today is designed to be cosmetic.

“Restorative and cosmetic are essentially redundant, because anyone who does any kind of dentistry should be concerned about cosmetics,” he asserts. “Restorative dentistry can be functional, but it also improves the patient’s appearance, even when it’s done in the back of the mouth.

“Patients don’t want shabby smiles, which is why we use techniques that are both functional and cosmetic. It used to be amalgam was the standard treatment for fillings, but today we use a tooth-colored material that’s more aesthetic. We also use crowns without metal bases so there are never dark lines showing up when the gums recede.”

Dr. Montz used these technologies to restore Eugene’s weak smile. First, however, the dentist noted that a major contributing factor to Eugene’s dental issues was his ongoing problem with clenching and grinding his teeth.

“Clenching and grinding put a great deal of pressure on the teeth,” explains Dr. Montz. “Over time, dental work starts breaking, things steamroll and pretty soon the person loses a tooth here, a tooth there. After that, the same amount of pressure is placed on fewer teeth, which intensifies the process.

“I don’t know why it started, but Eugene developed a clenching and grinding problem, and some of his teeth started separating. That allowed debris to get down between his teeth, so decay developed and those were the teeth that were replaced with implants.

“As we get him stabilized, we’ll create a custom-made occlusal guard for him to wear over his teeth, especially at night. The guard will help temper some of the forces and protect his teeth and the implants.”

To replace the teeth over Eugene’s implants, Dr. Montz chose all-porcelain crowns. In addition to being more aesthetically pleasing, they are stronger than traditional porcelain-fused-to-metal crowns. The dentist also chose individual crowns for Eugene rather than a bridge for the restoration.

Richard C. Montz, DDS, of River City Dentistry in DeBary treated long-time patient Eugene Kowalski with restorative dentistry. Sidebar on how bottled water affects the teeth.

Eugene takes to the campaign trail feeling more
confident about his smile.

“I generally don’t use bridges on implants, especially if the patient is a clencher or grinder,” states Dr. Montz. “Implants don’t respond as well as natural teeth to those forces because of certain structural dissimilarities.

“When you use bridges to restore missing teeth, the bridges are essentially all there is absorbing the forces of clenching and grinding. Therefore, the bridge is more likely to break due to those forces.”

Campaign Confident

Calling upon his years of expertise, Dr. Montz selected the exact procedures to effectively restore Eugene’s dental health and revitalize his smile. Eugene agrees with Dr. Montz’s choices and is excited by their positive outcome.

“I’m very pleased with the results,” enthuses Eugene. “Now, I look and feel more confident, which will help me during my campaign. I’m also proud of my smile now, and I smile all the time. Dr. Montz’s excellent work is instrumental in
making that happen.”

Not only is Eugene pleased with the way his dental work turned out, he’s also happy with his visits to River City Dentistry. He’s grateful for everyone he encounters there. He especially appreciates the deep care and concern that are natural aspects of Dr. Montz’s chairside manner.

“My experience getting work done at River City Dentistry is very positive,” Eugene says. “Dr. Montz and his staff are incredible. They’re very friendly, kind and helpful. I always feel comfortable working with them. I recommend them to anyone.

“I have a lot of trust and confidence in Dr. Montz. I value his experience and appreciate the fact that he really cares enough to want to make me look and feel better. I didn’t realize how bad my teeth were and how much the corrections Dr. Montz implemented improved my life.”

School of Thought

While caring for their family’s health, parents can’t forget their own.

There’s much to be done to prepare the kids for going back to school, including getting all the items they’ll need: new clothes, new shoes, new backpacks and new school supplies. There’re generally good deals on all of these items during the summer months. Summer’s also a good time to catch up on the kids’ health needs.

LAD imaging Interim Center Director Barbara Borden and patient Cara Burgess discuss getting your kids’ health checked for back-to-school and keeping yourself healthy.

While ramping up for the new school year, Cara reminds parents to take care of themselves as well as their children.

“We do all of the normal things as far as getting new school uniforms and supplies,” relates Cara Burgess, a local mother of two. “We also take time during the summer months to get any immunizations and any school or sports physicals that are required.

“If the kids have dental appointments or other doctor visits that need to be done, summer’s a good time to do them when the kids aren’t in school.”

Cara takes advantage of the summer months to update her kids’ health status. She also uses the season to help her children prepare for returning to the school environment.

“I’m able to spend more quality time with my kids when they’re not in school, while also getting the necessary things done to help them get ready to go back,” she confirms. “That way, the school year is a little less hectic for everyone when it starts.”

In their efforts to get their children prepared for going back to school, as well as keeping up with all their after-school activities, many parents neglect themselves and their own health needs. This includes overlooking the recommended screening exams. Cara believes these are critical to maintaining good health.

“I make them a priority,” she states. “To screen for cancer, I get an annual mammogram and Pap test. I’m also careful to keep up with my dental exams and annual physicals from my doctor. If I’m healthy, I can take care of my family.

“Parents can’t forget about taking care of their own health. Many of us are inclined to take care of our kids first and forget about ourselves, but we have to think about ourselves, as well, for our families’ wellbeing.”

Cara gets her mammograms done at LAD imaging, a fully accredited, outpatient imaging center in Deltona. LAD imaging serves the community with a wide range of diagnostic imaging tests, notes Barbara Borden, Interim Center Director.

“LAD imaging’s singular mission is to produce high-quality diagnostic images so doctors have the best information available in designing treatment plans for their patients,” Barbara clarifies. “Our vision is to create a pleasant, convenient
experience for both patient and prescriber.”

“I’ve been going to LAD imaging for five years, and have had my annual mammograms done there,” discloses Cara. “It’s nice to see the same people every year and have a history with them. It’s also comforting to know all of my records are in one place, and the staff can easily tell if there are any changes in my scans.”

Cara believes some people, especially women, are more attentive to the day-to-day functioning of their bodies and more attuned to any irregularities when they occur. She urges people with this intuition to act as soon as they notice anything out of the ordinary.

“I think as women, we know our bodies and when something doesn’t feel right,” she asserts. “Whenever we feel something’s wrong, we need to trust our instincts and get checked out, not just let it go. That way, we can be healthy and take better care of our families.”

Diagnostic and Screening

The tests available at LAD imaging include traditional x-rays, computed tomography (CT), mammography, dexa scans (bone density), high-field MRI and magnetic resonance angiography (MRA), ultrasound (including four-dimensional OB images), and vascular studies.

While these tests are primarily diagnostic, part of LAD imaging’s role is to provide the community with health screening exams such as bone density testing and mammography. Barbara notes that the center offers other, less common screenings and exams as well.

“Physicians routinely perform scoliosis screenings on children as part of their annual physicals,” she observes. “The physicians have the children bend forward, and they check the curvature of the spine. If there’s any question or hesitation about the diagnosis, the children are sent to us for screening x-rays.

“In addition, sometimes physicians order low-dose CT scanning for people who smoke as a cancer screening. The scans look at the patients’ lungs to see if they are clear and free of cancer.”

Barbara agrees that the summer months are a good time for parents to tend to their children’s medical and dental appointments. She also concurs that parents must not neglect their own health needs. LAD imaging makes it easy for them to get any necessary diagnostic and screening exams performed.

“It’s difficult for parents to take care of their children if they’re sick,” she says. “So, it’s very important that they take care of themselves and make time to see to their own health. When it comes time for annual screenings and physicals, parents often put them off because they’re busy with the kids or working.

“LAD imaging is open six days a week, including Saturdays, and has late hours to accommodate those with busy schedules. We take walk-ins for x-rays, which are the most common tests requested. Exam reports are sent to the prescribing physician within twenty-four hours for a stat exam or within twenty-four to forty-eight hours for a traditional exam. That way, any necessary treatment can begin right away.”

In addition to her mammograms, Cara has received other services at LAD imaging during the five years she’s been a patient there. These services include MRIs and CT scans. She’s very pleased with her experiences every time she’s used the center.

“I always get great service and have always been treated with professionalism,” she reports.

Positive Policy

Parents are often quick to take their children to see a physician when they’re not feeling well, but they hesitate when it comes to going themselves. In some cases, work gets in the way, although some employers are more flexible than others about allowing employees to take time off to go to physician appointments.

Cara works as a human resources manager at the City of Deltona. She says they have an excellent strategy for promoting employee wellness and proper use of sick time.

“The city has a very good sick time policy that lets employees take time to care for ill family members as well as themselves,” she describes. “We also have a very strong wellness program that encourages employees to get their annual screenings and see their doctors on a regular basis.”

Not all employers are this way, however, and difficulty getting away from work to go to the doctor can cause further hesitation for parents who need to see a physician.

“Unfortunately, hesitating to go to the doctor can sometimes result in negative consequences,” comments Cara. “Parents must keep in mind that they have to take care of themselves to be there for their families.

“So my message to parents is: Make it a priority if you’re not feeling well to get checked out. It can’t hurt.”

Say “So Long” to Symptoms

Revolutionary therapy defeats dry eye.

After years of compensating for her increasingly blurry eyesight, Diana* finally accepted the need for cataract surgery early in 2018. At the same time, the New Zealand native and former snowbird from Upstate New York was also experiencing other issues with her eyes that further compromised her vision.Diana (alias) is treated for dry eye disease with the LipiFlow® system by Dr. Clifford Salinger at The Dry Eye Spa® & V.I.P Laser Eye Center in Palm Beach Gardens.

“My eyes were really bothering me, and not just from the cataracts,” she reflects. “There was also terrible itchiness, redness, grittiness and a feeling there was something stuck in my eyes all the time. All of these symptoms were related
to my dry eye disease.

“I was also having a lot of difficulty with my vision. Some of that was because of the cataracts and some of it was due to the dry eye. They both contributed to my vision being blurry and not as good as it should be.”

According to Diana, dry eye disease is a nasty disorder to have. She tried treating hers with popular, over-the-counter eye drops, but never got lasting relief from them. The symptoms always returned.

“People can’t treat dry eye with over-the-counter drops and live normally with it,” she shares. “It doesn’t work that way. The dryness, redness, burning and feeling of something in my eyes never went away with the over-the-counter medications. They were just a temporary fix.”

When Diana consulted with the ophthalmologist who was to perform her cataract surgery, he suggested she have her dry eye treated before surgery. He told Diana about a new treatment for dry eye called LipiFlow®, then referred her to Clifford L. Salinger, MD, founder of The Dry Eye Spa & V.I.P. Laser Eye Center in Palm Beach Gardens.

Dr. Salinger specializes in dry eye disease, which afflicts millions of Americans. He provides extensive education and testing, as well as comprehensive treatment for the disorder. Among the treatments he provides is the LipiFlow Thermal Pulsation System from TearScience®.

“Dry eye disease, also called ocular surface disease, is caused by a combination of factors,” Dr. Salinger points out. “Among those are a reduction in the quantity of tears on the surface of the eyes and a decrease in the quality of the tears produced. Tear quality includes the composition and amount of oils in the eye’s tear layer.

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

“I spoke to my ophthalmologist about LipiFlow, then did some research,” states Diana. “I also read an article about Dr. Salinger in Florida Health Care News and saw that he also expresses the oil glands in the eyelids. I wanted to do whatever would make my eyes better, so I called and made an appointment.

“I told Dr. Salinger I wanted to have the LipiFlow as soon as possible. I believed it was going to be a good solution for me.”

The Finish Line

“Diana came to us in mid March of this year with significant dry eye disease in both eyes,” notes Dr. Salinger. “Her cataract surgeon was savvy enough to understand that significant dry eye disease affects the cataract surgery in several critical ways.

“First, it makes the surgery more challenging. Second, healing after surgery is slower. Third and most important, dry eye alters the measurements and calculations necessary to determine the appropriate lens implant strength for the best uncorrected vision following surgery.Diana (alias) is treated for dry eye disease with the LipiFlow® system by Dr. Clifford Salinger at The Dry Eye Spa® & V.I.P Laser Eye Center in Palm Beach Gardens.

“The ophthalmologist rightly told Diana to treat her dry eye first to improve the condition of her eyes’ environment and stabilize the disease. Then her surgery, healing and choice of implant would be more straightforward.”

After doing several tests to determine the extent of Diana’s condition, Dr. Salinger began her on a comprehensive therapy for her dry eye disease. For Diana, this included hot compresses, lid hygiene with special cleaning agents, vitamin supplements, a mild steroid drop for inflammation, and antibiotic drops and ointment.

“After two weeks of treatment, Diana was still having quite a bit of discomfort because the surfaces of her eyes were so dry,” reports Dr. Salinger. “So, on April third, we did the LipiFlow treatment, and she did very well with it.”

The three-step LipiFlow treatment takes about an hour, with cleaning of the
eyelids before the procedure and expressing the oil glands in the eyelids afterward.

“During the LipiFlow procedure, an eyepiece contacts the outer eyelid and contains a soft, flexible bladder that intermittently inflates to provide controlled pressure and massage,” explains Dr. Salinger. “Heat is also applied to the inner surface of the lid because of its proximity to the glands.”

Both of these functions work to liquefy then remove clogging debris from the oil glands.

“Other doctors don’t typically do the expression of oil glands, but we find that adding this step enhances the benefits of LipiFlow more rapidly, and they last longer,” observes Dr. Salinger. “This step can double or triple the duration of the
treatment’s benefits.”

Dr. Salinger saw Diana three weeks after her LipiFlow procedure for a follow-up appointment. When he examined her eyes, they showed a great deal of improvement already.

“Diana was experiencing less redness, burning, tearing and overall discomfort,” he offers. “She returned to the office at five weeks post-treatment and said she was thrilled with the comfort in both eyes.”

With this substantial improvement in Diana’s dry eye symptoms, Dr. Salinger was able to cut back on some of the other treatments in her comprehensive therapy plan.

“We’re finding that eighty to ninety percent of our patients are getting significant improvement of their dry eye disease, although many don’t reach it as quickly as Diana,” Dr. Salinger asserts. “She was more motivated than the average person because she saw the finish line as the chance to have vision-correcting
cataract surgery.”

Wonderful Feeling

Immediately after getting the LipiFlow treatment, Diana’s eyes started feeling better little by little. Then, all of a sudden, she realized a burst of relief. She was amazed by the experience and by the treatment’s ultimate results.

Diana (alias) is treated for dry eye disease with the LipiFlow® system by Dr. Clifford Salinger at The Dry Eye Spa® & V.I.P Laser Eye Center in Palm Beach Gardens.

LipiFlow is a revolutionary breakthrough for treating chronic dry eye disease.

“My eyes feel wonderful,” she marvels. “Dr. Salinger always asks me how I’m doing on a scale of one to ten, with ten being the best. When I last saw him, I said, Dr. Salinger, you get a ten plus! The difference in my eyes is remarkable.”

The comprehensive therapy plan created by Dr. Salinger, which included the LipiFlow procedure, eased the uncomfortable dry eye symptoms Diana suffered. She notes how extensive they were prior to treatment and how much better they are now.

“The redness I had wasn’t just in the eyes,” she describes. “It was all along the edges, too, but it’s all gone now. The itching, grittiness and feeling of something in my eyes are all gone. I have no symptoms whatsoever since LipiFlow treatment. It’s wonderful.

“I know my vision will improve more after cataract surgery, but I got some improvement since the LipiFlow. Now, my eyes don’t get as tired as they used to when I’m reading or watching television. My vision is better in that respect.”

As Diana prepares for her cataract surgery, she knows it will go more smoothly now that she’s had her dry eye treated. She’s pleased with the difference the treatment has made in her daily life already.

“With the dry eye, my eyes were uncomfortable all the time; it was a twenty-four-hour thing,” she relates. “Now that I’ve had the LipiFlow with Dr. Salinger at The Dry Eye Spa and V.I.P. Laser Eye Center, it’s a really, really good feeling.”

*Patient’s name withheld at their request.

From Near Blind to Brilliant

Cataract surgery an excellent option for vision correction.

In North Carolina, Andrea Levinson, 64, was recognized as a doctor of natural medicine. She had a great practice, loved her work and achieved good results for her patients. When she moved to Florida in January 2017, she had to give up the title “doctor,” but not the care she delivered. Her title doesn’t matter much to her; she has something bigger in mind.

Dr. Q. Jocelyn Ge of Premier Eye Clinic in Port Orange and Ormond Beach performed cataract surgery on Andrea Levinson and used a sophisticated intraocular lens implant so she no longer is dependent on eyeglasses.

Crystalens implants have given Andrea the crystal-clear vision she always wanted

“I’m getting ready to purchase a cruise ship that I’m going to convert into a state-of-the-art, sustainable, holistic center and travel the world helping people,” she announces.

Although Andrea’s vision of a floating natural health center was clear in her mind, her actual vision was less than crystalline. Poor eyesight was a problem she’d dealt with for most of her life, one that got increasingly worse over the years.

“I’ve been wearing glasses since I was six years old,” she shares. “Thirty years ago, I went on a group hike and it started to rain torrentially. Since my glasses were wet, I couldn’t see, so I endangered everybody. I decided then to get RK surgery.”

RK, or radial keratotomy, is a refractive surgery to correct nearsightedness. For ten years, that surgery provided Andrea with what she described as “great vision.” After that, she reports, her vision began to decline.

“It began changing during the day,” Andrea explains, “My prescription in the morning was different than it was in the afternoon, so I had to wear two different pairs of glasses.”

Andrea’s vision remained that way for many years. She became accustomed to the accommodations she had to make to see clearly. About two years ago, however, Andrea’s vision began to deteriorate substantially, and she started looking for an eye doctor who could help her.

“My vision got considerably worse – to the point where I couldn’t even tell there were letters on the eye chart,” she describes. “Where people read the big ‘E,’ I didn’t see anything. All I saw was white paper. I couldn’t see near, medium or far. I was wearing trifocals and was close to becoming legally blind.

“My eye doctor told me I also had the beginnings of cataracts, so I looked for doctors who specialized in that. I went to many doctors who said I was a tough case because of my previous RK surgery and refused to treat me. Then, one of the doctor’s suggested I see Dr. Ge.”

The eye surgeon the doctor recommended was board-certified ophthalmologist Q. Jocelyn Ge, MD, PhD of Premier Eye Clinic. Even with Andrea’s complications, Dr. Ge took on the challenge of treating her.

“When Andrea first came to see me, she was wearing trifocals, which meant she needed eyeglasses for distance, reading and everything in between,” reports Dr. Ge. “She was looking for help to do away with the glasses she had to wear on a daily basis.”

A Second Option

During Andrea’s initial examination, Dr. Ge noted Andrea’s cataracts had not yet reached the point where surgery was medically necessary. Dr. Ge also noted Andrea’s history of having had RK surgery, which was the refractory surgery used prior to LASIK®.
Dr. Ge considered both factors before recommending a treatment plan for Andrea.

“Andrea’s eyes were otherwise healthy,” states Dr. Ge. “That gave us options for correcting her vision, even with her RK history. We could perform LASIK to treat her prescription, but there are drawbacks to that option.

“With LASIK, we cannot correct both eyes for near and far. Instead, we correct one eye for distance and the other eye for near vision. This is called monovision, which means Andrea would have a big difference in focus between the two eyes and with each individual eye. She would see clearly at distance or near, but not both.”

The greater factor was Andrea’s existing cataracts. Because they would continue to grow with age and would eventually cause her vision to become limited again, Andrea was facing the virtual certainty of needing to undergo cataract surgery down the road.

“For these reasons, I recommended going ahead with cataract surgery over LASIK for Andrea,” Dr. Ge explains. “Cataract surgery removes the natural lens of the eye and replaces it with a clear artificial lens implant. By using a premium implant that offers a range of vision, we can correct Andrea’s vision at all distances and free her from dependence on glasses.”

Dr. Ge began Andrea’s treatment in February with surgery on her left eye and completed her right eye a month later. In both eyes, the doctor implanted a sophisticated lens implant called Crystalens®.

“Andrea’s vision is now 20/20 for distance, 20/20 for near and 20/12 for intermediate range with both eyes,” notes Dr. Ge. “She has normal near and far vision in each eye and, at 20/12, really sharp intermediate vision, and that’s without glasses.”

When thinking of surgery to correct vision problems, most people naturally think of LASIK, asserts Dr. Ge. “However, cataract surgery with the current technologies works just as well. And in some cases, it’s even better than LASIK to help people become free of the burden of glasses and contact lenses. That was our goal with Andrea.”

Miraculous Vision

Since Dr. Ge performed surgery on Andrea’s eyes earlier this year, Andrea’s vision is brilliant. She’s thrilled with the results of her treatment.

“I’m just ecstatic,” she marvels. “I can see things across the street, and I can read words on the television. When I sit in the living room, I can see the clock on the kitchen wall. I can see leaves on a tree that’s fifty yards away. I can actually read the newspaper and my cell phone. It’s going to take me a while to adjust to the fact that I can see now, but every moment is a miracle for me.”

The clarity of her vision since surgery amazes Andrea. It’s also amazing to Andrea that Dr. Ge’s surgery ended her dependence on prescription eyewear.

“I don’t wear glasses at all anymore,” she says. “Now, when I swim and boat, which I do a lot, I don’t worry about not seeing or having wet glasses on the water.”

Andrea describes Dr. Ge and her staff at Premier Eye Center as being wonderful. She adds that she’s grateful for everything they did to make her experience as easy and comfortable as possible.

“Dr. Ge is excellent, was really knowledgeable about my complications and took extra time with me,” she relates. “Knowing that my vision changed during the day, she had me come in at different times to take measurements before she decided which lens to use. The Crystalens she chose works for me.

“I feel Dr. Ge and her team at Premier Eye Clinic went above and beyond. That’s the kind of practitioner I was, and that’s exactly what I was looking for in a provider.”

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