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Stimulus Package

Out on the sandlot, Gretchen Becker was just as good a baseball player as any of the boys she grew up with. The boys in her neighborhood weren’t any better than her on the basketball court either.

Gretchen’s spinal cord stimulator has her moving pain-free again.

Unfortunately, Gretchen grew up at a time when girls weren’t allowed to play alongside boys on the same youth teams.

That’s all right, though. Gretchen did just fine for herself against the girls. After all, she went on to play softball and basketball in high school and college, at Grand Valley State University just outside of Grand Rapids, Michigan.

“That was back when they first started giving out athletic scholarships to women,” says Gretchen, 67. “It was a great time, and I really enjoyed myself. But I paid a price for playing sports all those years.”

The price came in the form of knee problems that have so far resulted in nine surgeries, including a total reconstruction of her right knee. Gretchen also deals with back trouble, though that’s not a result of her athletic career.

“My back problems go back to 1987, when I was working on the assembly line at General Motors, building cars,” Gretchen reveals. “I was what they classified as a utility person, which means I had to know how to do every job in my department.

“If someone in my department was out sick or on vacation, I would fill their spot on the line.

“One night, I was sent out to a different department that I was not familiar with and they had me securing liners in the trunks of vehicles. I was bending over in the trunk trying to pin this liner in with my thumbs, and I guess I just exerted too much pressure because, all of a sudden, I heard a pop go on in my back. From that point on, I was in excruciating pain.”

As she did often as an athlete, Gretchen trudged on through the pain, literally fighting through it for nearly two years. Finally, after moving to Jacksonville in 1989, she sought medical help.

“I went to a neurosurgeon and had an MRI done,” Gretchen remembers. “The MRI showed that I had a herniated disc, so the neurosurgeon wound up doing a (laminectomy) where you remove part of the (vertebral) bone to relieve pressure on the nerve.”

“I have had absolutely amazing pain relief from this spinal cord stimulator.” – Gretchen

The laminectomy allowed Gretchen to live relatively “pain-free” for about 15 years. Then, in 2005, her back pain returned. This time the pain didn’t stop at her back. It traveled through her buttocks, into both legs and down to her feet.

For help with this problem, Gretchen turned to Jax Spine & Pain Centers, which specializes in the use of progressive interventional treatment options to address chronic joint, neck and back pain.

At Jax Spine & Pain Centers, Gretchen was placed in the care of John Carey, MD, who treated her stubborn back, leg and foot pain primarily with epidural steroid injections until two years ago, when Dr. Carey and an associate suggested another approach.

“Like a lot of patients with this type of pathology, Gretchen became caught in this cycle of receiving interventions and getting some relief, but it wasn’t long-lasting relief,” says Justin D. Mann, MD, of Jax Spine & Pain Centers.

“In October 2018, Dr. Carey and I mentioned to her that there may be a better option. That led to a decision where we all agreed to see how she might do if we gave her a spinal cord stimulator.

Signal Disrupted

A spinal cord stimulator is a small device that alters pain signals running to the brain. It’s powered by a small battery that is implanted under the skin near the patient’s hip, and the technology behind it has improved markedly in recent years, according to Dr. Mann.

The first spinal cord stimulators, developed about 30 years ago, replaced pain signals with a tingling sensation called paresthesia. The latest models work the same way as the old, but advanced technology replaces the pain with no sensation at all.

“We used to think that the pain signals were blocked by distracting the brain,” Dr. Mann educates. “But we now know that we’re actually affecting pain on a cellular level, and that is what is decreasing the patient’s sensation of pain.”

The first phase of spinal cord stimulation therapy is a three- to seven-day trial period during which the stimulator’s effectiveness is gauged. If the patient experiences a significant reduction in pain during the trial, the stimulator is implanted permanently.

“Setting someone up for the trial is a lot like giving them an epidural steroid injection,” Dr. Mann adds. “We do it right in our office, and the only difference is that instead of injecting medication, we thread leads or electrodes through the epidural needle.

“The top end of the electrode is fed into the epidural space of the spine, which is on the inside of the spinal canal but outside of the spinal cord. It’s a unique place anatomically that is especially receptive to this type of therapy.

“The bottom of the electrode is attached to a battery that sits on top of the skin during the trial. The battery is about the size of a half-dollar, and it is that battery that creates the electrical impulses that block the pain signals.”

About 90 percent of patients going through the trial receive enough pain relief to have the stimulator implanted permanently. That implant procedure is similar to the one performed for the trial, except that it is done at a hospital or surgery center.

“During the permanent implant procedure, the patient lies down on their stomach, they’re given intravenous sedation and the process done for the trial is recreated in terms of putting the leads into the spine,” Dr. Mann explains.

“Every time I went to roll over in bed, I would feel that pain. Not anymore.” – Terry

“During the procedure, we actually wake the patient up at one point and ask them if they’re feeling the delivery of energy through the device. We do that to make sure we’re covering the areas where they are experiencing the most pain.

“If they indicate that we’re successful in capturing these painful areas with the electrical signals, we complete the procedure, which includes placing the battery under the skin.

“No bone or muscle is cut during the procedure and the only thing that’s visible afterward is a small incision about an inch long over the lower back and another incision near the hip where we place the battery.”

The battery is charged wirelessly with an external generator that’s attached to a small belt. A non-rechargeable battery is also available, but most patients choose the rechargeable battery that can be recharged in an hour every two days.

100 Percent Relief

After a five-day trial during which she reported receiving “100 percent pain relief,” Gretchen had a spinal cord stimulator permanently implanted in the spring of 2018. She has remained pain-free ever since despite giving her back a rigorous daily workout.

“I’m now a paint associate at Lowe’s, and so I’m on my feet all day,” she says. “That can be pretty tough on your back sometimes, and I have had absolutely amazing pain relief from this spinal cord stimulator. I think it’s a great alternative to pain medications and injections and just about anything else you can try for back pain. That’s why I tell people who complain about back pain to go to Jax Spine & Pain Centers and try the spinal cord stimulator.

“I have always said that nothing beats failure better than a try, which is why I was so willing to try the spinal cord stimulator. I can’t thank the folks at Jax Spine & Pain Centers enough for suggesting it, and for everything they’ve done for me. They’re all great people.”

Road Warrior

There isn’t a major airport in the United States that Terry Kiser doesn’t know as well as her own home. It was through her 23-year career in pharmaceutical sales that Terry gained her intimate knowledge of such places.

Spinal cord stimulation has rid Terry of her “stabbing groin pain.”

“I was the liaison between the medical department at Bayer and some of the top physicians in their field who spoke at conferences all over the country,” Terry relates. “So, I did quite a bit of traveling, especially near the end of my career.”

Despite spending nearly a quarter of a century living out of a suitcase, Terry, 70, still enjoys traveling. Before the coronavirus hit, she usually made at least one trip to Europe each year. In recent years, however, incessant back pain made those trips quite taxing.

“Those problems go back many years,” Terry confides. “I think all the traveling I did for work was one reason for them. But as a kid growing up, I played every sport offered in high school, and after school I played a lot of golf, tennis and I also water-skied.

“It all started to catch up to me when I was 47 and had to have vertebrae restructured in my neck. Then, three years ago, I had to get fusions done on my lumbar spine. A year later I had more work done on the vertebrae above that. Then things really went south. My back pain was so bad that I had to give up all sports. Even walking became difficult. I was at a point where this pain I was dealing with was majorly impacting my quality of life.”

As it often does, Terry’s back pain traveled to other parts of her body, including her left groin area. At its worst, Terry could barely take a single step or even roll over in bed at night without feeling its debilitating impact.

“It was like an icepick stabbing me, and believe me, I threw everything I could think of at it,” Terry explains. “I tried chiropractic care, massage therapy and supplements. I even tried a personal trainer, thinking that strengthening the muscles in that area might help. It didn’t. In fact, it made things worse.

“After that I went to Jax Spine & Pain Center. They gave me epidural injections. After a while, though, epidurals stop helping.

“I consulted with a neurosurgeon, but at the same time, I was talking with my niece, who works for Abbot, the company that makes the spinal cord stimulator. She thought I might be a candidate for it and suggested I talk with Dr. Hanes.”

Michael Hanes, MD, of Jax Spine & Pain Centers, specializes in neuromodulation. He is considered one of the country’s leading experts in the field, which includes spinal cord stimulation and intrathecal drug delivery.

“Terry first came to see us in the summer of 2019,” Dr. Hanes reports. “She came to us on the advice of her niece, who knew of me because I also teach courses nationally about spinal cord stimulation and have had several articles on it published in
medical journals.

“From the very start, I looked at Terry as a classic candidate for spinal cord stimulation because she already had multiple back surgeries, but she still had chronic back and leg pain despite having tried other therapies.

“A lot of people view spinal cord stimulation as a last-line therapy, but I don’t consider it a last-line therapy anymore. Sometimes, spinal cord stimulation is the first thing I’ll offer a patient because I know it’s going to be the best thing for them.

“With most patients, we do try a couple of injections first, but Terry is one of those patients I thought we should go straight to spinal cord stimulation before trying anything else because I thought it was going to be more effective.

“With patients like that, my thinking is, Why do six injections before trying spinal cord stimulation when you know that most likely spinal cord stimulation is going to give them the long-term relief they want? That’s how I viewed Terry.”

Long-Lasting Relief

Terry agreed and has had her spinal cord stimulator for a little more than a year. Just as Dr. Hanes suggested, it has given her the long-lasting pain relief she couldn’t get from epidural injections or other therapies.

“It has helped me tremendously,” Terry raves. “That stabbing nerve pain I had in my groin? Gone. And that was the worst problem I was dealing with because it was affecting so many areas of my life.

“Every time I went to roll over in bed, I would feel that pain. Not anymore. It’s even helped alleviate some of the arthritis pain I have. That’s why I’m so thrilled to have met Dr. Hanes and to have found Jax Spine & Pain Centers.

“Dr. Hanes is wonderful. He’s so kind and professional and informative. In fact, I only have good things to say about him and the people at Jax Spine & Pain Centers. They’re all just awesome and so helpful. They really are top-notch professionals, and I have no trouble recommending them or spinal cord stimulation to anyone.”

Didn’t See That Coming

Cataract surgery perfects fast-fading vision, eliminates need for glasses.

During the 41 years he piloted the gymnastics program at Southern Connecticut State University, legendary US Olympic coach Abie Grossfeld produced 29 individual NCAA champions, 126 All-Americans and hundreds of gold medalists.
Jean Rodenbaugh is among those who made it into the latter category.

Jean’s vision is
“absolutely perfect now” that she’s seeing the world through
PanOptix lenses.

Though the floor exercise and uneven bars were her favorite gymnastics events, the balance beam is where Jean won gold for Southern Connecticut State under Grossfeld’s tutelage. The medal she won is a prize Jean will never let go of.

“Yes, I still have the medal,” says Jean, now 73. “I have it locked up in a safe-deposit box. I’m very proud to have won it and very proud to have been coached by Abie Grossfeld. He and his wife, Muriel, were very good coaches – the best.”

A gymnast all through her youth, Jean ended her athletic career after college, where her love of numbers paved the way for a career in accounting. Her career as an accountant peaked when she became the chief financial officer for Ocean Pacific Apparel.

Since then, Jean has slowly migrated south, eventually landing in Florida, where she retired a few years ago. Jean has largely enjoyed her retirement, save for a stunning diagnosis she received last June that she literally did not see coming.

“I’m prediabetic, and because of that my doctor has me get my eyes checked about every three months,” Jean explains. “I was doing that regularly through last September, but when the coronavirus hit I had to miss one of those appointments.

“I didn’t get back to the eye doctor until June, and when I did I could not read the eye chart. I said, Read it? I can’t even see it. That was with my left eye. Then they checked the other eye, and it was pretty much the same thing.

“I was shocked. I didn’t know what to think because as far as seeing everything around the house and reading, I wasn’t really having any problems. Of course, the eye doctor knew right away what was wrong.”

Jean’s eye doctor is Alexandra Kostick, MD, FACS, FRCSC, of Atlantic Eye Center in Palm Coast. During her examination, Dr. Kostick discovered that the cause of Jean’s suddenly poor vision was the rapid development of cataracts.

A Common Occurrence

Cataracts are a natural clouding of the normally clear lens of the eye, typically caused by aging. They usually result in blurred vision, an increase in the eye’s sensitivity to light or a reduction in the vibrancy of colors.

It is estimated that more than half of all people between the ages of 75 and 85 will develop cataracts, however, surgery to remove them is among the most common medical procedures.

Cataract surgery is typically performed on one eye at a time in an outpatient setting, with a break of a week or two in between. During such procedures, the clouded natural lens is removed and replaced with an artificial intraocular lens, or IOL.

IOLs are made of acrylic or silicone and are coated with special material to protect the eyes from the sun’s ultraviolet rays. During surgery, the IOL is rolled up and placed in the eye, where it unfolds and is held in place by two side structures called haptics.

Like contact lenses, IOLs are available in different focusing powers. Standard IOLs typically correct distance vision, while multifocal IOLs can correct distance and near vision in much the way bifocal glasses or contacts do.

Recently, the most advanced IOL yet, the trifocal PanOptix lens that corrects distance, intermediate and near vision, was made available in the United States. Dr. Kostick believes there is no other like it.

“Most multifocal lenses correct only distance and near vision, or distance and intermediate vision,” she explains “With the PanOptix lens, you can see in the distance clearly, you can read clearly and you can see things in the intermediate range clearly, such as a computer screen.

“Another great thing is that the patient’s visual recovery from surgery comes quicker when implanting the PanOptix lens. That’s why the PanOptix lens is now the lens I recommend for all my cataract patients who want multifocal lenses.”

Part of the Family

Recognized as one of the most accomplished surgeons in the ophthalmologic field, Dr. Kostick first noticed that cataracts were forming in Jean’s eyes in 2019. By June 2020, Jean’s cataracts had developed to a point where they needed to come out.

After reaching that conclusion, Jean and Dr. Kostick had a discussion regarding replacement lenses. Accepting Dr. Kostick’s recommendation, Jean opted for the PanOptix lenses. She says it was one of the best decisions she’s ever made.

“I’m truly amazed at the difference in my eyesight,” Jean raves. “My vision is absolutely perfect now. It’s 20/20, and before I got these PanOptix lenses, I never had 20/20 vision in my life. I mean it when I say these PanOptix lenses are fantastic.

“Not only can I read the bottom line on an eye chart now, I can read the fine print on absolutely anything. And colors – oh, the difference in colors is absolutely astounding. What was once a pale yellow or orange or red is now a bright yellow, orange or red.

“And you know what one of the best things about this is? I will never have to buy or wear another pair of glasses or contact lenses again. That’s a great feeling, so I could not be happier with the outcome of my cataract surgery or with Dr. Kostick.

“She is a true professional, and her staff is fabulous. I recommend them to anyone because they explained everything and answered all my questions, and I love that they treat every one of their patients like they’re a member of their own family.”

A family-like atmosphere is what Dr. Kostick strives for at Atlantic Eye Center. She also treats Jean’s husband and is proud to be treating not just patients’ spouses, but also their children and grandchildren.

“Our patients become part of our extended family,” Dr. Kostick asserts. “We strive to make them comfortable by creating a very caring environment. They know they are going to be treated with a personal touch whenever they come here.”
A strong reputation in the community is also something the Atlantic Eye Center staff strives to maintain.

“I think word of mouth is very important for doctors, and we pride ourselves on the referrals we get,” Dr. Kostick adds. “I can honestly say that my staff members go out of their way to ensure that people are cared for to our utmost capability.”

Keeping Watch Over Your Heart

Implant blocks clots in AFib patients, helps reduce risk of stroke.

The US petroleum industry got its start in the 1860s after the first modern oil well was drilled near a bend in the Allegheny River in northwestern Pennsylvania. The small town around the river came to be known as Oil City.
A little less than a century later, Judy Espy got her start in Oil City as well.

Judy Espy

Judy went on to marry a baker, and the couple raised three boys and a girl they adopted from Korea. Most of Judy’s work as a homemaker was done in Oil City, but for years the family spent its summers elsewhere.

“My best friend since I was 9 years old moved to Bradenton during her senior year of high school, and for years after that I would always go down for visits,” Judy says. “I pretty much raised my children in Florida in the summertime.

“We would stay in Florida most of the summer, and I always wanted to make it a permanent move. I finally bought a house here in 1998. It was after both of my parents had passed and the children were grown that I made the move.”

Long before that, Judy began experiencing random moments during which her heart would beat at an accelerated pace. They usually lasted only a few minutes, but after she moved to Florida the time span increased.

“One of them lasted for five or six hours,” Judy remembers. “That was pretty bad. That’s when I realized I probably needed to do something about this because I had never really been all that bothered before.

“I barely even paid any attention to them when I lived in Pennsylvania, but after I moved to Florida, I started to have these little episodes five or six times a day. And I couldn’t do anything when they happened because I had to lie down and relax.”

Upon first seeking medical attention for the problem, Judy was told she had a classic case of atrial fibrillation, an irregular or rapid heart rate that can lead to the formation of blood clots and cause a stroke or heart failure.

Studies show that people with atrial fibrillation, or AFib, are approximately five times more likely to suffer a stroke than those who do not have it and that by 2030 approximately 12 million people in the US will have AFib.

AFib is considered to be the most common form of irregular or rapid heart rate, and while some who have it may experience no symptoms at all, others could experience dizziness, shortness of breath, lightheadedness and chest pains.

After first diagnosing Judy with this condition, her doctors chose to simply “keep an eye on” her situation. As Judy’s symptoms worsened, her doctors felt the need to monitor her situation more closely.

“They gave me a monitor to wear, and as soon as one of those episodes would start, I pressed a button on it, and the monitor kept track of how long the episode lasted and what my heart rate was,” Judy explains. “It would then send the information to the hospital.”

The monitor allowed Judy’s doctors to keep tabs on her AFib, but it did nothing to resolve it. For that she was soon placed on blood thinners and underwent an ablation procedure, where scar tissue is created within the heart. The scar tissue blocks the abnormal electrical signals and reduces the chances of the irregular or rapid heartbeat occurring again. Before long, though, Judy’s doctors offered her a better option: the Watchman™ left atrial appendage closure (LAAC).

Best of Both Worlds

“The Watchman is a device that gets placed into the heart, where it mechanically blocks the blood clots that form in response to atrial fibrillation,” educates Daniel E. Friedman, MD, FACC, FHRS, a board-certified clinical cardiac electrophysiologist and the medical director of the Watchman program at Manatee Memorial Hospital.

“Those blood clots can travel through the heart, up to the brain and cause a stroke,” Dr. Friedman adds. “But the Watchman prevents those strokes from happening by literally catching the blood clots, which are essentially reabsorbed by the body over time.

Watchman FLX™ Implant

“Candidates for this procedure are patients who have atrial fibrillation, whether it be intermittent or all the time, and have risk factors for stroke with their atrial fibrillation such as diabetes, high blood pressure or previous stroke. The best candidates are patients who cannot take blood thinners safely long term or someone who has major bleeding problems with blood thinners.”

The Watchman is larger than a nickel but smaller than a quarter with a fabric top. It’s inserted into a small pouch in the heart called the left atrial appendage through a catheter during a procedure typically completed in about an hour.

The device received its approval from the Federal Drug Administration in 2015. Almost immediately, Manatee Memorial Hospital began its Watchman program. Since then, Dr. Friedman has implanted more than 400 at the hospital.

“We wanted to be the first to do this procedure because we had so many patients who could not take blood thinners long term and therefore were at great risk for a stroke,” says Dr. Friedman, a member of the Structural Heart Team at Manatee Memorial.

“Another reason we wanted to do it is because it represents a paradigm shift in the treatment for AFib. The Watchman not only prevents a stroke, it also prevents bleeding, in essence because patients receiving it no longer need to take the blood thinners.

“It offers AFib patients the best of both worlds. There’s also a cost-effectiveness aspect to it, because research shows that within a few years, patients break even in terms of the cost of getting the Watchman versus taking blood thinners.

That’s why this is something that’s going to be done more and more as time progresses. At Manatee Memorial Hospital, we have a great team involved in the implantation of the Watchman device.

“Not only do we have the nurses and the nurse practitioners we need to perform this procedure, but we also have at least three cardiologists who perform this procedure on a routine basis. Manatee Memorial Hospital is perfectly outfitted with everything we need.

“In fact, I would say that if someone is going to have this procedure done, Manatee Memorial Hospital is the place to go. It’s an effective procedure, and Manatee Memorial Hospital’s complication rate is less than the national average, which is less than half of 1 percent.”

Reducing Stroke Risk

Like blood thinners, the Watchman doesn’t correct the heart’s electrical malfunction, which hinders its ability to pump blood, allowing blood to pool and clot in the left atrial appendage. The Watchman’s purpose is to take away the increased risk for stroke that the blood clots create. As a result, patients still need to take medication to control irregular heart rhythm, and many are also advised to take an aspirin a day.

“I read up on it before I had the procedure done, so I was confident it was going to work well for me, and it has,” Judy exudes. “I’d say it’s one of the best things I ever did for myself because it works great.

“I have had maybe three episodes of rapid heartbeat since the Watchman was implanted by Dr. Friedman. But none of them have been like they were before. They lasted just a few seconds, and that was it, so I’m very happy with how
it’s all worked out.

“And I’m very happy with the work that Dr. Friedman and everyone at Bradenton Cardiology and Manatee Memorial Hospital did. They’re all exceptional people, and Dr. Friedman is very persistent.

“He’s very friendly, and I really appreciate that he answered all the questions I had about how the Watchman worked and how the surgery was done. He’s a great doctor I gladly recommend. I think he’s great.”

It’s All In The Details

Comprehensive, proper physical assessment reveals cause of disabling leg pain.

Back in the fall of 1964, when General Motors rolled out its 1965 line of Pontiacs, a small number of the GTO and LeMans models were finished off with an iridescent lavender-like exterior paint color known as iris mist.

Treatment at Regional Rehab has John walking on his own two feet again.

Also called Paint Code P, that purplish hue was never used again on any other model produced by Pontiac. That’s why the factory-painted iris mist 1965 LeMans that John Finan owns is considered a collectors’ item.

“It’s a stock LeMans, but the motor, the transmission, the interior and that iris mist paint color are all original,” John explains. “That car also has about 105,000 miles on it, but if you take it out and drive it, it’ll keep up with traffic just fine. It’s a really great car.”

A self-proclaimed “car nut,” John also has a silver 1965 GTO that he rebuilt himself. He says he’s “put a fortune” into that restoration project, which he completed while suffering through some disabling health issues.

Among them was a back injury so severe that it required major spine surgery. And while that 2010 procedure alleviated John’s pain, it left him with a pinched nerve that all but disabled his right leg.

“At first, I was in a lot of pain with that leg,” John remembers. “But after a while that leg got so bad that I could only walk short distances on it. If I tried to walk too far, my leg would get weak, give out on me and cause me to fall.

“The doctor wanted to put me in a wheelchair, but I didn’t want that, so I started walking with a cane. The thing is, I’m 79 years old, but I don’t see myself as 79. I’ve got a life to live, so I’ve been hobbling around with this cane for 10 years.

“I’ve tried for about eight years to get help for this problem. But none of the physical therapy places I tried were able to do anything for me. They tried all kinds of treatments, but nothing ever made it any better.”

John’s health worsened recently when his weakened leg sparked a fall that damaged his right shoulder. Ironically, it was while treating John’s shoulder that someone finally resolved his leg problem.

That remedy was found at Regional Rehab in Spring Hill, where Charles C. Donley, PT, and Paul Ernandes, PT, PhD, thoroughly assess each patient’s entire well-being, not just the specific complaint for which the patient seeks treatment.

Assessing the Whole Patient

“What Paul and I and our entire team do here is collaborate to make sure we’re reaching the whole issue of the patient,” Charles explains. “Sometimes the patient brings those issues up and sometimes we bring it up because we’re seeing the deficit in them.

“That’s how it was with John. After our individual evaluations, Paul and I collaborated like we always do, and we asked each other if there was anything else we could be doing for him. We both mentioned the issue we saw with his gait.”

What Charles and Paul noticed immediately was John’s significant limp while walking. They also noticed he struggled to push off his right leg and was very unstable, even with a cane.

After learning the history behind John’s problem, Paul discovered a severe muscle weakness in John’s right leg; “laziness” in the nerves, which were not functioning optimally; and a lack of balance.

To correct those problems, Paul recommended treatment using three advanced modalities: the Class IV deep tissue therapeutic laser, the HIVAMAT® 200 deep oscillation therapy device and electronic muscle stimulation (EMS).

“Everyone there works as a unit to make sure they’re doing as much as they can for people.” – John

The laser uses specific wavelengths of red and near-infrared light to stimulate the body’s natural ability to heal cells. It works by releasing nitric oxide, which removes congestion and swelling, promotes rapid healing and reduces discomfort while increasing blood circulation.

The HIVAMAT 200 creates gentle impulses that relax muscles and penetrates all tissue layers to remove inflammatory byproducts from cells that cause pain but are not part of the cells’ natural makeup.

EMS stimulates, or “wakes up,” the static muscles and nerves, allowing patients such as John to exercise their legs and rebuild strength, balance and function.

When John first started treatment in August, he could not stand on his toes, walk heel-to-toe or push off his right foot. As a result, he was falling several times a day, despite using a cane for stability.

After six weeks of balance therapy and treatment geared toward waking up the nerves in his right calf, foot and toes, John regained the ability to stand and push off his right foot. In addition, he was able to safely walk short distances without a cane for the first time in years.

Walk This Way

“John lives alone on a large piece of property, and his primary goal was to get to a point where he’s safe, can work on his cars, care for his lawn and do different activities without a fear of falling,” says Brandi Girard, PTA, a physical therapist assistant at Regional Rehab. “He’s there now. He can now walk on uneven surfaces such as the grass without his cane and walk longer distances without pain and without a cane. That’s because he’s able to push off properly and bear weight with that foot again.”

“I have definitely come a long way from where I was,” John concurs. “This is not something where two or three treatments heal you. I went almost 10 years without being able to use that leg, so the recovery is slow. But it’s working.

“That’s because the people at Regional Rehab took the time to investigate the real cause of my leg problem. Everywhere else I went, all they wanted to do was address the problem, not the cause. That’s why I never got better.

“There’s a noticeable difference in what I can do with my feet and legs now. I can actually curl my toes again, which is what allows me to walk heel to toe the way I’m supposed to. That’s why I say the people at Regional Rehab are just fantastic.

“Everyone there works as a unit to make sure they’re doing as much as they can for people, and they all have such great attitudes. It’s a great place to go for treatment because they do a great job and they always make you feel very comfortable.”

Feeling Fantastic Again

Hormone replacement pellet therapy targets menopausal symptoms.

Though the majority of the old masterpieces are primarily on canvas, a true artist can paint on just about any surface, be it a pane of glass, piece of wood or concrete wall. Cindy McDonald is such an artist. Her canvas is the face.

Cindy McDonald

“I’m a permanent makeup artist,” says Cindy, owner of the Leopard Lily Permanent Makeup Studio in Spring Hill. “I paint eyebrows, eyeliner and lip color. I’ve been doing it for about 20 years now, ever since I tried it for myself.

“I had my lips done but had a bad experience. To fix things, I took a permanent makeup class and wound up falling in love with this personalized art. One procedure can sometimes take up to three hours to complete, but that’s because I’m a perfectionist.”

Cindy’s pursuit of perfection is not limited to her work. She seeks that high standard in her personal life, where she always strives to look and feel her best. The latter objective is one Cindy was struggling to achieve not long ago.

“I was about 52 years old when all of a sudden I started to experience hot flashes,” Cindy recalls. “Then came the night sweats, and along with that I started to have trouble sleeping. Oh, and low libido as well. That was another issue.”

Those issues are all signs of menopause, which can affect women beginning in their late 40s and early 50s. There is no medical treatment, but some symptoms can be relieved through hormone replacement therapy.

Cindy chose such a treatment in the hope it would alleviate her hot flashes and night sweats, but she soon grew frustrated with the daily inconvenience of taking pills and applying the hormone creams she was prescribed.

“The creams helped, but it was a lot of work keeping up with all the different ones I had to use,” Cindy laments. “I needed to take testosterone in a cream form and then take a progesterone pill on top of that.

“I committed to doing it every day, but then I went on a trip and got out of the habit of applying the creams, which were always a little messy anyway. After that I had a hard time getting back on track with all of that.”

Cindy soon discovered the availability of a more advanced type of hormone treatment, one that her friend Janie Rushnell, CME, now offers at Skintastic Med Spa, Rushnell’s natural wellness boutique in Spring Hill.

No One Outfacials Skintastic

Skintastic has been in business for 10 years and offers more than 50 health, wellness and aesthetic services, including injectable treatments such as BOTOX® Cosmetic, rejuvenation treatments such as Ultherapy®, massage therapy and intravenous vitamin therapy.

“We focus not only on making our customers look good, but also on making them feel good,” Janie explains. “We want our customers to live their best life possible, and we do that by offering services your typical med spa simply doesn’t have.

“When it comes to aesthetics, for example, no one outfacials Skintastic. I am a CIDESCO diplomat, which means I am a true master aesthetician. And I am all about facials. From European facials to clinical facials and everything in between, we offer it all.

“And we guarantee natural-looking results. A lot of women who come in are scared, or their husbands are afraid they won’t look like themselves or look natural after their treatment. That won’t happen here, and we guarantee that.”

Cindy first visited Skintastic to take advantage of some of its facial treatments. She soon learned of all the other services they offer, and when she discovered that BioTE® Medical hormone pellet therapy is among them, she asked more about it.

What she learned from Janie is that the BioTE pellet therapy is considered the most natural and effective solution for hormone-related issues, which can also include mood swings, vaginal dryness, an inability to focus and a loss of energy.

“It’s a great place for anti-aging because I can get those treatments and still look natural, and I love that.” – Cindy

A treatment that has also proven to be effective in preventing diabetes, osteoporosis, and cardiovascular disease, BioTE hormone therapy uses pellets that are derived from plants and are molecularly identical to the hormones produced by the human body.

Unlike creams or pills, which can produce inconsistent hormone levels and result in mood and energy fluctuations, a BioTE treatment releases a consistent level of hormones throughout the day for up to five months.

“Dosing for hormone replacement therapy is unique to each patient’s needs using the BioTE method. BioTE has completed over a million pellet insertions, and with that experience comes a lot of knowledge,” Janie adds. “We are a proud, certified BioTE clinic.

“They have studied hormones extensively. And as a BioTE provider, we have access to all the information in its database at any time. The other feature is the BioTE method is proven and very accurate.”

“A World of Difference”

BioTE pellets are about the size of a grain of rice and are inserted beneath the skin into the fatty tissue in the buttock or flank area of the patient. The first phase of that insertion process is a blood test to determine the true nature of each patient’s hormone deficiency.

“We’re not just asking patients how old they are and what their symptoms are,” Janie emphasizes. “The BioTE method is very science-based, and the treatment is determined by what we find in the lab values we get from the patient’s blood work.”

Once a patient is determined to be a candidate for the treatment, the customized pellets are created at BioTE Medical. They are then inserted through a small incision by a physician’s assistant during an in-office procedure that takes about 15 minutes using a local anesthetic.

About a month after the initial insertion, patients typically return for a follow-up to determine the effectiveness of the pellets. Adjustments can then be made, and the process is repeated every three to five months.

“I usually go back about every five months, or if I feel like I’m not as bubbly as I usually am or maybe need a bit of an energy boost,” Cindy says. “And then, about three weeks after the insertion, I can feel the pellets start to kick in. When that happens, it just makes a world of difference with everything I do. I sleep more soundly, my mental clarity is better and my memory is sharper. I also have a lot more energy.

“I didn’t know I was losing energy until I tried the pellets and realized how much more energy I had after the treatment. I’m a pretty happy person anyway, but after I get the pellets, I’m typically in a great mood and feeling good all the time.

“Overall, it’s a great therapy. It’s wonderful to have that energy and not have any hot flashes, night sweats or anything like that. I’m so grateful that Janie suggested it, and I’ve recommended it to some of my own
clients as well.

“I’ve shared my story about the pellets with them, and a few have received them at Skintastic. They’ve reported back and said that they’re feeling great and want to get their husbands onboard as well.

“I highly recommend Skintastic’s other treatments as well. They have a number of services that I receive regularly, and it’s a great place for anti-aging because I can get those treatments and still look natural, and I love that.”

“It’s a Wonderful Place”

Retirement community provides all levels of personalized care.

To get an idea of all the places Betty Pantuso has visited, imagine a refrigerator door covered with souvenir magnets representing each stop across the globe. Now imagine that refrigerator isn’t large enough for all those magnets.

Betty Pantuso

“I’ve traveled to so many places and collected so many magnets that I ran out of room for them on the refrigerator and had to start putting them on a magnet board,” Betty confirms. “Now the magnet board is almost full.

“Other people collect tchotchkes from the places they visit, but I like collecting the magnets. You don’t have to dust them and when I look at them, I can remember almost everything that happened on that particular trip.

“It’s great to reminisce like that, and I’ve been all over. I’ve been to Russia, Denmark and Sweden. I’ve been to Paris, Amsterdam and Switzerland. The place I loved the most, though, is Bali. And as far as I’m concerned, cruising is the best way to travel.”

A Tennessee native, Betty has traveled extensively across the U.S. as well. After marrying her husband, who passed away many years ago, they moved to Connecticut. She later followed her daughter to Arizona and then to Florida.

Betty lived alone in a condominium after first moving to the Sunshine State. For health reasons, she later moved to an assisted living facility. In time, she required more assistance than could be provided.
“I reached a point where I was falling a lot,” Betty reveals. “I’m doing a lot better now, but I can only walk for short distances, so I need help getting to the bathroom and taking a shower, and sometimes I need help getting dressed.”

Betty’s condition requires what is known as extended congregate care, or ECC. Because her assisted living facility was not licensed to offer such care, she had to find one that was. She discovered what she was looking for at Weinberg Village in Tampa.

All Are Welcome

Amid a warm environment where the independence of private living is combined with the security of knowing that assistance is always available, Weinberg Village offers residents a blend of assisted living, memory support and respite care.

The community is situated on a beautiful 21-acre campus, with a pond and 75 spacious private apartments, where residents can celebrate the best in Jewish heritage, culture, traditions and values. But Weinberg Village is not exclusively a Jewish community.

“We welcome diversity,” says Dan Sultan, executive director at Weinberg Village. “About 35 to 40 percent of our residents, including Betty, are not Jewish. They chose us for the quality of care we provide.
“That quality of care includes a rehabilitation facility that we have right on site,” Dan adds. “But it’s the ECC license that allows us to provide care at virtually every stage of a resident’s life using different health disciplines, including hospice care.

“We also have the ability to help residents transition into memory care. That is a transition that is made over time. It’s not as though one day you’re in assisted living and the next day you’re in memory care. That’s a plus for the resident and family.”

Helping to make those transitions is a nurturing staff of more than 50 employees with a total of more than 325 years providing senior care. Many have been with Weinberg Village since it opened in 1995, Dan notes.
No matter the level of experience, each staff member’s objective is to help residents enjoy the fullest, most active and meaningful lifestyle possible. They achieve that by creating a friendly, engaging atmosphere and by providing care in a dignified manner.

Those efforts are enhanced by an array of amenities that includes multiple activity/lounge areas, two dining rooms, reading alcoves, a well-stocked library, hobby and craft rooms, a beauty/barber shop, therapy/exam rooms and a sanctuary.

“One of the qualities that makes Weinberg Village truly unique and sets us apart from other senior living communities is our campus is multi-generational,” Dan notes. “By that I mean we have a preschool here as well as Jewish Community Center.

“Before COVID-19, the preschoolers would come over and do activities with the residents, and the residents took advantage of the programs going on at the JCC. That way, it’s not all about seniors all day every day.
“We’re eager to get back to our normal activities schedule because it’s very robust. We regularly have entertainers of different kinds, including piano players, guitar players and opera singers who come and perform for our residents.

“Every month we have painters come in or people who do portrait drawings. And of course, we have a community bus that takes our residents to places and events outside of our community, such as the mall or the Straz Center.”

Happy to Help

The coronavirus has not forced Weinberg Village to abandon all of its activities. Many events are now offered through the community’s television channel, which allows residents to stay in their rooms and still participate. Since her arrival at Weinberg Village this year, Betty has come to enjoy that and many other aspects of community life.

“The apartments are very spacious and comfortable, and I really like that they have the TV mounted on the wall for you,” Betty says. “There are some very beautiful outdoor areas where I love to go to for a walk.

“The best thing about Weinberg Village, though, is the people. I have met some very nice ladies that I’ve become good friends with. And the care is exceptional. That part is absolutely wonderful, and they all take such good care of me. They treat me so well, and what’s really nice is that no matter what they have to do for me, it never seems like it’s a burden. I can tell that they really want to help people like me as much as they can.

“It’s because of all that help that I feel I’m improving. I feel I’m actually getting better because of how well they treat me and how they do it with a smile. Weinberg Village has been very good to me, and I recommend it highly to anyone. It’s a wonderful place.”

Starting From Scratch

Full-mouth restoration returns brilliant new smile.

When she was 10 years old, Molly* spent the bulk of her summer vacation visiting her grandparents in Orlando. Thirty-two years later, Molly still says the best part of that vacation was learning how to bake with her grandmother.

“I enjoyed that even more than going to Disney World and SeaWorld,” Molly remembers. “We baked cookies, pies, cakes, all kinds of things. I literally fell in love with baking that summer, and my passion for it has never died.”

Molly’s passion for baking is so great that it’s no longer just a hobby that fills her weekends. She bakes full time now for a Palm Beach caterer and, if all goes as planned, she hopes to open her own bakery within the next year or two.

“I was hoping to open the bakery in early 2021, but I’ve lost a lot of work because of the coronavirus and haven’t been able to save as much money as I needed to get that done,” Molly reveals. “I’m not worried, though; that bakery is going to happen.”

When it does happen, Molly will go from working in the back of the house to the front of the house. She’ll be dealing with customers and clients on a daily basis. To prepare for that change, Molly recently underwent a smile makeover.

“That’s something I needed to do no matter what,” Molly confides. “I’ve never had the best of teeth, mostly because I never kept up with regular cleanings and dental visits, and it had really become a problem for me.

“I had reached a point where it was painful for me to chew because I had a lot of broken teeth and I couldn’t use my whole mouth to chew. I had to chew in certain parts, where it wasn’t too uncomfortable.

“And again, that’s all my fault. I was never really a fan of going to the dentist, and I eventually paid a price for it. So the bottom line was, I really needed to clean up my smile, and that’s why I started looking for a good dentist.

“The first thing I did was visit a couple of dentists to get an idea of what really needed to be done. Then I asked some friends and even some clients who they would recommend. The name I kept hearing over and over was Regency Court Dentistry.”

Three In One

Regency Court Dentistry in Boca Raton is part of Health and Wellness Dentistry, which was founded by Naved Fatmi, DMD. In addition to its Boca Raton office, Health and Wellness Dentistry has two other locations: Town Square Dentistry in Boynton Beach and Square One Dentistry in Jensen Beach.

Molly first visited Regency Court Dentistry in the spring of 2020. It was then that she met Aurelie Huyghues-Despointes, DMD, and expressed her desire for a new smile. Dr. Huyghues-Despointes remembers the visit well.

“Molly came in and the first thing she said was that she hated her smile and needed someone to fix her teeth,” Dr. Huyghues-Despointes recalls. “The other thing she said was that she wanted a Hollywood smile.

“After learning her objective, the first thing I did with Molly was give her a thorough examination. It was obvious right away that she had not taken good care of her teeth because they were all very stained, decayed and broken down.

“The other problem I found was that her bite had collapsed. It almost looked sunken, so I knew I was going to need the help of the prosthodontist who works with us as well. The first thing we did in terms of treating her was to give her a deep cleaning.”

The deep cleaning helped restore the health of Molly’s gums, which were infected in some areas. The next step was to begin the restoration of Molly’s teeth. The restorative work was performed by Dr. Huyghues-Despointes under the guidance of the practice’s prosthodontist, Ronik Seecharan, DMD.

With the exception of one tooth, an upper left second molar that had to be extracted, all of Molly’s teeth were salvageable. Three needed root canals, but the rest were restored through the placement of individual crowns that served more than one purpose.

“By placing the temporaries, we were able to build back her facial structure and bite, which was unstable due to excessive wear on the teeth,” Dr. Huyghues-Despointes explains. “We had to use crowns because her tooth structure was compromised.”

“Ecstatic Over The Results”

Working through one quadrant at a time, Dr. Huyghues-Despointes followed Dr. Seecharan’s guidance and eventually crowned 26 of Molly’s teeth. In each case, Molly was fit with temporary crowns that she wore for about two weeks before being fit with the permanent crowns.

“It was a full-mouth reconstruction,” Dr. Huyghues-Despointes adds. “Every tooth received a crown. She also had some implants placed prior to seeing us and we utilized those as well in our reconstruction because she never had them restored.”

Molly says the implants were initially placed 12 years ago. It was largely because of her reluctance to visit a dentist that she never had them crowned, but now that she has, she’s thrilled with the look and function of her new smile.

“It’s been a long journey, but I’m ecstatic over the results,” she raves. “I could not be happier with how this all turned out. Once I went into this, I wanted to get all my teeth done at once, and I was able to do that, and it’s just worked out great.

“I definitely made the right choice visiting Regency Court Dentistry because Dr. Huyghues-Despointes and Dr. Seecharan are just great. They did a great job, and they always made me feel comfortable and relaxed and confident.”

*Patient’s name changed at her request.

In The Neck Of Time

Advanced rehab device alleviates maddening headaches and neck pain.

When their children were young, Jill Weinberg would drop by her husband’s chiropractic practice whenever she had free time and help with billing, scheduling or any other clerical task that needed to be done. With a degree in accounting, three years of experience as a public auditor and seven years of experience as operations manager for a national health care company it was a seamless transition.

Photo by Nerissa Johnson.

Jill Weinberg and Maggie

As their children grew older, Jill’s visits became more frequent, and she more or less became a part-time fixture at the practice. Now, with the children out of the house, Jill works full time at Active Health as its practice manager.

“It’s about 10 years now that I’ve been full time in the office,” notes Jill, 57. “I co-manage with my husband and am responsible for most aspects of human resources, accounting and managing the non-clinical staff.”

Jill’s life away from work is as varied as her job. She exercises, loves to read, does puzzles for relaxation, and is always willing to try out new recipes in the kitchen. Like her husband, Marc A. Weinberg, DC, she’s an avid hiker and her favorite getaway is their second home in North Carolina.

“We love it there,” Jill says of their Carolina escape. “The weather’s awesome. Originally from the Northeast, I really miss the fall weather. It’s been our family’s place to just kind of get away, rest, relax and decompress.”

For several years, neither rest, relaxation nor the occasional chiropractic adjustment were enough to alleviate Jill’s bothersome headaches and aggravating upper-body discomfort.
She believes those issues stem in part from her lifelong habit of sleeping on her abdomen, a practice that keeps her head turned at a 90-degree angle for hours each night, but she notes that even light workouts simply made them worse.

“I think a lot of the problem was from normal wear and tear because, as I got older, I would work out and eventually get these horrible headaches,” Jill explains. “Along with that, I would get this feeling of an awful weight on my shoulders.

“Even though my husband (and my first pregnancy) cured me of my belly sleeping, I was still having headaches. I tried using different pillows and they helped. I was also receiving chiropractic adjustments, and that helped, too, but I was still getting the headaches and Marc said I was having major weakness in my neck.”

From the very beginning, Dr. Weinberg suggested treatment using an advanced, evidence-based chiropractic tool called the MCU. He’d been saying for years that neck strength was the missing link for neck pain. For years, though, Jill passed on that advice. When her symptoms became acute, however, she had no choice but to relent.

“My husband kept urging me to get on the MCU, but I didn’t want to bother anyone at the practice with taking care of me,” Jill states. “I always put our patients first, and I didn’t want to ask anyone to skip their lunch break or stay late for me.

“But my problem wasn’t getting any better. It got to a point where I was at the end of my rope, so I finally decided that I had to take the time and ask someone for help and get tested on the MCU because I know it works.”

Nonsurgical Device

Available exclusively at Active Health in North Palm Beach, the MCU, or Multi-Cervical Unit, is a nonsurgical device that isolates and strengthens muscles around the neck and provides a comprehensive assessment of physical progress during therapy.

A tool in what doctors refer to as evidence-based medicine, the MCU records 16 ranges of muscle movement for strength to determine the areas of the neck where there are weaknesses, imbalances or a loss in range of motion.

Once that data is revealed, a treatment program is designed that allows the MCU to correct those problems. Considered the most complete, efficient system for assessment and rehabilitation of the neck, the MCU has proven to be a highly effective instrument.

According to Active Health, studies show that after receiving MCU therapy, patient pain levels decreased by 66 percent while strength levels increased by more than 70 percent, with more than 90 percent of patients making a full recovery.

A single MCU session lasts between 20 and 30 minutes, with patients typically going through three sessions a week for nine weeks. During those nine weeks, patients are retested at least three times to determine the effectiveness of the treatments.

“We retest the patient every three weeks, or nine visits, and compare the results of those tests with the results we received from our original examination of the patient,” says Colin O. Behrue, DC, at Active Health.

“That shows us how well the patient is progressing. Based on the findings, we make clinical changes. The change could be different exercises, different angles or different weights that help the patient continue to improve and build strength.”

After nine weeks, patients are typically given a maintenance program that includes exercises they do at home to maintain strength. Jill is in that phase now, and her only regret is that she didn’t seek treatment on the MCU sooner.

Do As I Do

“I know it helps because I’ve seen it help people like me a thousand times before,” she shares. “They’ll come in here with sore necks and shoulders and they’re in agony, and we put them on the MCU and they’re better.

Photo by Nerissa Johnson.

Treatment on the MCU machine alleviated Jill’s aggravating neck pain.

“That’s how it was for me. Like I said, I wasn’t getting any better. My headaches and shoulder pain were getting worse, so I finally got on the MCU and now I feel so much better. It’s incredible the difference that machine can make.

“I’m no longer getting the headaches I was getting when I worked out, and that heavy feeling I had in my neck and shoulders is gone. I knew it would be that way once I agreed to the treatment, which is why I should have done it a lot sooner.”

The time commitment was one reason Jill waited. She soon learned, however, it was time well spent.

“One thing people need to realize is that you’re actually hurting yourself more by not taking the time to get the treatment than you are by taking the time to get treated,” she offers. “It’s one of those, Do as I say, not as I did, kind of things.

“I’ve touted the MCU and its benefits for years because I’ve seen what it does for people. But sometimes, you need to get out of your own way and make the time to get yourself better.

“In the long run, you’re going to get more quality time back than you put into getting the treatment because, again, it’s 20 or 30 minutes three times a week, and it gets you better. But if you never put in that time or keep putting it off, you never get better.

“So, I’m speaking from experience now when I say: If you’ve got a problem with your neck, if you’re just not feeling right or you’re getting headaches the way I was, give the MCU a try because it’s amazing. It’s incredible what it can do for you.”

Breathe Easier

The dedicated team of physicians and specialists at Atlantic Ear, Nose & Throat provide comprehensive, state-of-the-art care for a range of disorders and conditions, including a nasal valve collapse and deviated septum.

A nasal valve collapse comes as a result of the nostrils collapsing when taking a deep breath. When the nostrils collapse in such a manner, breathing is more difficult and the sinuses can become blocked.

With a deviated septum, breathing naturally through the nose is compromised by irregularities in the septum, the bone and cartilage that divide the nasal cavity.

As Dr. Shah explains, both conditions can be corrected through an effective outpatient procedure that calls for the insertion of a cartilage alternative known as the LATERA® Absorbable Nasal Implant.

“The technology has evolved to the point where this procedure is more widely available and easier for patients to tolerate than traditional surgery, where you have to harvest the cartilage and make a wider opening to get that cartilage in there,” Dr. Shah reports.

During the implant procedure, which can be done in a doctor’s office under IV sedation or in a surgery center in association with another procedure under general anesthesia, the LATERA implant is inserted into the nasal wall or cartilage through an insertion tube.

Similar to dissolvable sutures, the LATERA nasal implant is made of special materials that are naturally absorbed into the body over about 18 months. Its impact is immediate, and following completion of the absorption period, its effects continue to be felt for approximately six more months.

Because the implant is placed inside the nasal wall, it cannot be seen and does not alter the patient’s appearance. Some patients sense the awareness of the implant during the healing stage but generally do not notice it after a few days or a couple of weeks.

Cross Out That Bridge

Dental implants provide better stability, function than ill-fitting partials.

When Fran Malinowski was 2 years old, her mother plopped her down on the back of a pony for a short ride around a stable. Fran still has a picture of herself from that moment, which sparked a unique bond between Fran and horses that remains strong.

Photo by Nerissa Johnson.

Thanks to IV sedation, Fran “didn’t feel a thing” during her dental implant procedure.

“My mother once asked me, What is it with you and horses? because she and my dad were city people and I grew up in a subdivision,” Fran remembers, “I told her, I think it goes back to that day you put me on a horse for the first time.

“Something must have clicked there because, as my mother used to say, It’s horses, horses, horses with you all the time. And it really has been that way all my life. I bought my first horse when I was 20, and they have been a big part of my life ever since.”

Fran, 63, currently owns two horses, a pinto named Apache and a miniature named Biscuit. She says she’ll never give them up because they’re great companions and constantly bring her pleasure and joy.

“Even as an adult, when things aren’t going your way, that four-legged creature with the kind eyes has a way of looking at you that just melts your heart and makes all your problems go away,” Fran says. “That’s how it is with me anyway.”

One such problem materialized a couple of years ago when Fran developed a bad toothache. What made the problem worse was that the dentist who cared for Fran for years had recently retired.

“I was searching for a dentist, and I found one who was going to give me an exam and an estimate,” Fran says. “While I was waiting to see him, though, I saw a copy of Volusia Health Care News in the waiting room and started looking through it.

“It was in there that I read about another dentist in the area. I wasn’t all that comfortable with the dentist I had seen, so after my appointment I took a copy of the paper home and later called to make an appointment with the other dentist. I’m glad I did.”

A Bone To Pick

The dentist Fran read about is Rajiv Patel, BDS, MDS, founder of DeLand Implant Dentistry. During her initial visit, in 2018, Dr. Patel discovered the cause of Fran’s problem was advanced decay in two teeth beneath an existing bridge.

“Fran mentioned the bridge was not working very well for her,” Dr. Patel reports. “One of the reasons is because she has what is known as bony exostosis, which is extra bone growth or bone spurs all around her mouth. When someone has this extra bone growth, the fabrication of any removable prosthesis is tricky and usually not successful. That is, unless you go through major surgery to remove that extra growth, which she had not.

“My suggestion was to extract the two decaying teeth, get rid of the partial and replace her missing teeth with dental implants. She was very much open to the idea because she had received some implants before and was very happy with the result.”

Dental implants are root-shaped, screw-like bodies that are surgically placed into the jawbone. Once the implant is in the jawbone, new bone naturally grows around it to form the foundation for an abutment and replacement teeth.

“I could not be more pleased that I found DeLand Implant Dentistry.”

The replacement teeth can be a single crown that is cemented or screwed onto the abutment, a partial bridge that can be affixed to one or more implants, or a full denture that can be fastened to a series of implants.

Prior to placing an implant, some patients require a bone grafting procedure that is designed to enhance the volume of the jawbone so that it can properly support the implant. The amount of time needed for the bone development is about three months.

Bone grafts are not always necessary, but with patients who have been missing teeth for many years, a graft is sometimes required because bone mass deteriorates when there is no pressure from chewing to stimulate natural bone regeneration.

Bone grafts are typically done at the time the implants are seated. The implants then need three to six months to heal before they can support a prosthetic. During the healing period, patients are usually fit with temporary replacement teeth.

Fran did not require bone grafts.

A Great Tool

Fran gets quite anxious when visiting a dentist, so she required another treatment that Dr. Rajiv Patel and his partner at the practice, Jayraj J. Patel, DMD, are certified to offer: intravenous sedation.

This is a monitored form of anesthesia delivered intravenously that allows the patient to remain in a state of twilight sleep during intense procedures. Dr. Rajiv Patel says it is a great tool that benefits the patient and the dentist.

“With intravenous sedation, we can control the depth of conscious sedation that is desired, and that allows us to get a lot of work accomplished in a short period of time,” the doctor educates. “That results in fewer appointments for the patient.”

Fran calls IV sedation a “wonderful” tool. She says it allowed her to remain calm and relaxed throughout her procedure, in which three implants were placed in the back of her lower left arch. Fran was later fit with a couple of new crowns and two other implants. Dr. Jayraj Patel performed the latter work, which Fran says was absolutely pain-free.

“Because of the IV sedation, I didn’t feel a thing,” she raves. “And I have to tell you that I could not be more pleased that I found DeLand Implant Dentistry, because they got me out of my old partial that always hurt.

“I really appreciate the work they do and how caring they are. They even call to check up on you the night after a procedure. They’re just great, and that’s why I’ve already recommended them to several of my friends and even my lawyer.”

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