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A Far Sight Better

Cataract surgery brings back clear, crisp vision.

From teller to manager, Barbara Cherry held just about every job someone can across the nearly 30 years she spent working in the banking industry. Every job, that is, except the position of bank president or vice president.

Barbara Cherry and Rick Wilbur both went to see Dr. Hall for their cataract surgeries and came away with great results.Barbara Cherry and Rick Wilbur both went to see Dr. Hall for their cataract surgeries and came away with great results.Barbara Cherry and Rick Wilbur both went to see Dr. Hall for their cataract surgeries and came away with great results.Barbara Cherry and Rick Wilbur both went to see Dr. Hall for their cataract surgeries and came away with great results.

Arts and crafts are more enjoyable for Barbara following cataract surgery.

“I did everything else but never quite reached that level,” confirms Barbara, who is now retired and living comfortably in St. Petersburg, where the bulk of her activities revolve around a church group performing charity work.

“I like to crochet, and I’m part of a little organization at the church that does a lot of crocheting and knitting for the birthing clinics in the area,” she says. “We also make sleeping mats for the homeless.

“I’m also involved in a couple of Bible study groups. One of them meets at my church on Tuesday mornings. The other gets together on Thursdays at a church out in Seminole. I’ve covered a lot of territory with those two groups the past five years.”

Covering that territory became a little more difficult for Barbara a couple years ago after she learned during her annual vision examination that she was beginning to develop cataracts.

“At the time I learned about the cataracts, the doctor told me they were still too immature to do anything about,” Barbara adds. “I was aware of them, though, and sure enough, as time went on, I began to notice the effects.

“I noticed at first that it was becoming a little bit harder to read. I needed a little more light to read than I had before. Then I began to notice halos around the lights at night when I was driving and a little more glare than I was used to seeing.

“I cut back on my nighttime driving after that, and then, when I went in for my annual eye exam again late last year, the technician said, Wow, your vision has really changed a lot, and he asked me when my next driving test was.

“I told him it was in March, and he said he was concerned that I might not be able to pass the vision test. It was after that that Dr. Hall looked at my eyes and said it was time for me to consider taking those cataracts out.”

Dr. Hall is David E. Hall, MD, of Pasadena Eye Center. The board-certified ophthalmologist has been treating Barbara for many years and has earned her trust to the point where she didn’t hesitate when he suggested the time had come to remove her cataracts.

“I said, Well, let’s go ahead and get it over with,” Barbara explains, “because my husband has vision problems, too, and I was worried that if something happened to him where he couldn’t drive, we’d be in a difficult spot. I knew it was the best thing to do.”

A Matter of Time

Barbara was certainly not alone needing to make the sometimes difficult decision to have cataracts removed. After all, the natural clouding of the eyes’ lenses, known as cataracts, develops naturally in about 90
percent of all people 65 or older.

Cataracts usually develop from a breakdown of the eye’s lens fibers, a clumping of the eye’s proteins, or both and typically cause blurred vision, an increase in sensitivity to light and a reduction in color vibrancy.

Though cataracts tend to develop slowly over a number of years, they can be corrected quickly and easily through an outpatient procedure in which the natural lens is removed and replaced with an artificial intraocular lens, or IOL.

At Pasadena Eye Center, cataract patients are given an array of tests prior to surgery to evaluate the overall health of their eyes and their suitability for surgery. A test is also conducted to determine the most appropriate IOL for each patient.

Standard IOLs correct vision primarily for distance. Patients can also have one eye fixed for distance vision and the other corrected for reading, an option called monovision. A third option is premium IOLs that correct vision for both distance and reading or close-up work, eliminating the need for glasses of any kind.

“With Barbara, it wasn’t that big of a deal for her to continue using reading glasses, so she decided to get standard, or what we call monofocal, implants,” Dr. Hall reports. “For the most part, hers was a very typical surgery.”

The only exception was that Barbara had an astigmatism, which is another common condition that occurs when the cornea is not as perfectly round as it should be. Dr. Hall says about 80 percent of all people have at least a moderate degree of astigmatism.

“Since the majority of people have some sort of astigmatism, that’s something we’re always looking for when we do cataract surgery,” Dr. Hall adds, “because standard lenses don’t correct astigmatism.

“When we put regular implant lenses in, they correct everything else, such as nearsightedness or farsightedness, but they don’t correct astigmatism. We have something called a femtosecond laser that does.

“The femtosecond laser resyncs or reshapes the cornea to make it rounder. That’s one of the big advantages of having and using the laser. Another is that it basically performs the first several steps of the surgery, including the incision.

“It starts by opening up the little lining around the cataract, the capsule. It then divides the hard center part of the cataract, which is known as the nucleus, into tinier pieces that are softer. That makes it easier to suction those pieces out.

“Because they’re smaller and softer, those pieces can also be suctioned out more quickly. That shortens the procedure time. It cuts it about in half, and because we’re in the eye for a shorter period of time, there’s less irritation on the eye.

“The bottom line is that the femtosecond laser allows us to be a little bit more precise during the surgery, and because it eases the irritation on the eye and results in less inflammation, it leads to a better outcome for the patient.

“It’s especially helpful if the patient is diabetic because in some diabetics, healing can be a little slower. With the laser, however, the healing period is a little quicker, so it really is a very nice tool to have in our belt.”

Clockwork Procedure

Cataract surgery is usually performed one eye at a time, with the patient taking a one- or two-week break before having the second eye corrected. Barbara had her first surgery, on her right eye, the first week of November of last year.

She had surgery on her left eye two weeks later, and she was so pleased with the relative ease of the surgeries themselves and with the outcome that she called the entire procedure an early Christmas present.

“Everything went like clockwork,” she enthuses. “I was afraid at first that I was going to have an anxiety attack or something during the surgery, but they make you feel very comfortable and at ease, and everything went really well.

“I remember seeing so much better after the surgery. It really does make a difference. You don’t realize how bad your vision has become until after the surgery, when you’re seeing so clearly again.

“I was still a little nervous when I went back for my last follow-up because I wasn’t sure if I was going to be able to read the eye chart, but I could read it just fine. I’m confident I’ll pass that driving test now. I’m just tickled to death about the outcome.”

Optical Options

Though immersed in a world of science fiction and fantasy, about which he writes award-winning short stories, novels and novellas, Rick Wilbur also returns to Earth as a professor of journalism, mass media and creative writing. These pursuits necessitate long hours of intense research and reading, so Rick’s vision is precious to him.

“I’ve worn glasses since seventh grade,” he recalls. “I was a heavy reader as a kid, which probably made my eyes worse. Because I read so much, the bottom parts of my glasses were for reading, and the tops had these little half-moons that were more for distance vision, like reading the chalkboard at school.”

Always the storyteller, Rick shares the tale of how his family discovered his need for glasses. His father, a major league baseball player, frequently took his five children to his games. It was at one of those contests that Rick’s poor vision was discovered.

Barbara Cherry and Rick Wilbur both went to see Dr. Hall for their cataract surgeries and came away with great results.Barbara Cherry and Rick Wilbur both went to see Dr. Hall for their cataract surgeries and came away with great results.Barbara Cherry and Rick Wilbur both went to see Dr. Hall for their cataract surgeries and came away with great results.Barbara Cherry and Rick Wilbur both went to see Dr. Hall for their cataract surgeries and came away with great results.

For Rick, cataract surgery proved to be a revelatory moment.

“We were at a game and I asked my father, Why do they even bother with the scoreboard since nobody can read it?” Rick relates. “My father looked at me and asked, Can’t you read the scoreboard?

“I said, No. It’s just a blur, so he took me to an eye doctor and I got my first pair of glasses. The next time I went to a game with my glasses on, I looked through the top of my bifocals so I could see the scoreboard. It was a revelation.”

Many years later, Rick experienced another revelation regarding his vision. This one came during an annual visit to his eye doctor, Dr. Hall, who was unaware at the time that Rick had been experiencing several symptoms of cataracts.

“Dr. Hall said, You know, you have some cataract issues,” Rick recounts. “I didn’t realize that. I had noticed I was cleaning my glasses all the time. I thought they were dirty. It was humbling that it didn’t occur to me that the problem was with my eyes, not my glasses.

“In retrospect, I had other symptoms as well, like trouble driving at night and seeing halos over lights, but the cataracts came upon me so slowly that I didn’t notice I wasn’t seeing colors and details as well as I used to. I forgot how bright colors are.”

Dr. Hall recommended surgery to remove the cataract he found in Rick’s left eye because that cataract had matured and needed to be removed. The cataract Dr. Hall found in Rick’s right eye was not as mature and therefore did not require surgery at that time.

“Since I’m a writer, I work on my computer for hours every day and then read from my Kindle or print books,” Rick discloses. “I needed to see at about fifteen inches and then at ten to twelve inches, so I went ahead with the surgery.

“The surgery itself didn’t take any more than about ten or fifteen minutes. It really is a very easy procedure to go through, and once I was done, I went right home. Almost immediately, I noticed a dramatic change. The vision in my left eye was shockingly better.”

Rick was so impressed with the outcome of his first surgery that he decided to have the surgery done on his right eye as well. The second procedure was completed less than a year after the first.

“The primary idea behind this surgery was to help me see better at a distance,” Rick explains. “This way, my eyes can work together, so I’ll be able to see both near and far. The results have been amazing.”

Measure Twice

Dr. Hall’s initial examination of patients such as Barbara and Rick always includes a test to determine whether they are suffering from macular degeneration, a retinal disease that can also cause blurred vision, particularly in people over 50. Patients are also tested for glaucoma.

“Initially, we perform a routine eye exam during which we check the strength of the eyes and their general anatomy,” notes Dr. Hall. “We then dilate the pupils to examine the backs of the eyes, the retinas and optic nerves.

“If the patient’s eyes are healthy and they decide to go ahead with the cataract surgery, we have them come back for a topography test, which examines the shape of the cornea, or the front part of the eye.

“These test results look similar to the maps you see in National Geographic that are color-coded to mark hills and valleys. During the topography test, we measure astigmatism, which is when the cornea is not perfectly round.”

Another test performed prior to cataract surgery is the OCT retinal scan. The OCT scan checks for any problems that may be hidden under the surface of the retina and are unable to be seen under normal light. The OCT scan exposes conditions such as swelling and scar tissue, which if serious, can interfere with the success of some premium IOLs.

“We obtain the measurements for calculating the lens implant prescriptions two ways,” explains Dr. Hall. “One is with light energy, and the name of the instrument we use is the IOLMaster®. The IOLMaster measures the length of the eye from front to back, from the cornea to the retina.

“We also measure the length of the eye a second way, using ultrasound. The measurements from the IOLMaster and ultrasound tests are fed into a computer program. That takes the curvature of the cornea, which was measured with the topography test, and the length of the eye and tells us which lens implant would work best for an eye that shape and size.”

Seeing Is Believing

Much like Barbara, Rick is thrilled with the results of his cataract surgeries. He says he was initially overwhelmed by the improvement in his vision.

“After my second cataract surgery, I had the same kind of revelation I did seeing that scoreboard at the baseball game,” he states. “I’d forgotten what really clear vision can be, and now, there it is. The surgery gave me back vision I haven’t had since my youth.

“Now, I see well both up close and at a distance with my two eyes working together. That’s a very welcome change. And I’m fine when I drive at night. I see very clearly. I do wear glasses for reading, but I’m not sure I even need them.

“I know people say this all the time, but I really wish I had this done sooner because the difference is remarkable. And I owe it all to Dr. Hall and the amazing staff at Pasadena Eye Center.

“Dr. Hall is truly terrific. He’s very personable, and he’s an expert at the same time, which is of course what everybody wants their doctors to be. He and his staff are a fantastic group of professionals.”

Barbara learned that about 35 years ago when she and her husband first started seeing Dr. Hall.

“We really couldn’t ask for more professional and skilled people,” she exudes. “The whole staff is trained in all aspects of eye care, so they have a good backup system and they all know what they’re doing and how to do it.

“You go in knowing you’re going to get the best care possible and come out feeling confident and assured that everything went just as you hoped. That’s why I highly recommend Dr. Hall and Pasadena Eye Center.

“I can’t imagine there’s a better place to go for eye care.”

Reverse Osteoporosis

Once-a-week, 15-minute workouts increase bone density.

Since discovering her life’s purpose and moving to the United States some 35 years ago, Noa Spector-Flock has not only become a licensed massage therapist but written three books on body movement, wellness and injury prevention.

Noa Spector-Flock has experienced an increase in bone density levels since beginning OsteoStrong® workouts a year ago.

Noa found the OsteoStrong workouts easy and effective.

Her books and the videos that go with them explain how a specific set of exercises and the use of a large elastic band such as those used for resistance training allow certain muscles in the body to lengthen while they contract.

Known clinically as eccentric contraction, the goal of Noa’s exercise regimen is to improve overall strength and decrease the chances of injury. Unfortunately, Noa’s workout regimen doesn’t work for every part of the body.

Noa learned a couple years ago that while her workouts do indeed have the ability to improve the strength of certain muscle groups and therefore decrease a person’s chances of injury, they do nothing to ward off the onset of osteoporosis.

Found most often in post-menopausal women, osteoporosis is a potentially severe condition in which new bone growth does not keep pace with degeneration, and the bone mineral density becomes so low that the risk of fracture is markedly increased.

About 54 million Americans have osteoporosis and low bone mass, which places them at increased risk for osteoporosis. Breaking a bone is a serious complication of osteoporosis, especially as people age.

Osteoporotic bone breaks are most likely to occur in the hip, spine or wrist, but other bones can break too. Osteoporosis can also cause some to lose height as it can also affect the vertebrae, which are the bones in the spine, and often leads to a stooped posture.

Considered a silent disease by many physicians, osteoporosis often goes undetected until a person suffers a bone fracture or change in posture, but statistics show one in two women and one in four men will suffer an osteoporosis-related fracture at some point in their lifetime.

After first being diagnosed with osteoporosis, Noa began taking an oyster-shell-based calcium supplement to improve her bone density. She learned six months later that wasn’t working for her. She then chose to get more aggressive in her fight against osteoporosis.

“The first thing I did was start taking a different and hopefully more effective supplement that is made with algae,” Noa explains. “But I wanted to speed up the healing process, so I also decided to start doing the OsteoStrong workouts as well.”

Revolutionary Program

A revolutionary program that has helped more than 25,000 people reverse the negative effects of osteopenia and osteoporosis, OsteoStrong helps rebuild bone through once-a-week, 15-minute sessions using specialized strengthening equipment.

Noa Spector-Flock has experienced an increase in bone density levels since beginning OsteoStrong® workouts a year ago.

“The workouts are definitely making a difference, and one of the things I really like about them is they’re very easy.” -Noa

This specialized equipment includes four bio-mechanical machines that allows the user to perform resistance-based pushing and pulling exercises with their arms and/or legs. During these exercises, the user can safely exert pressure four to 12 times their body weight.

“The difference between our exercise equipment and that used at a traditional gym is that our equipment is isometric, which means tension is developed without contraction of the muscle,” states Mark Brady, president of OsteoStrong in South Pasadena.

“There is no force pushing against you, which means you create the force. On the leg press, for example, I’ve had ladies in their eighties weighing one hundred pounds who can press a thousand pounds. That’s because it’s isometric.

“For a person who weighs one hundred pounds to develop new bone working out on traditional equipment, they would have to create a resistance of well over four hundred pounds,” Mark continues.

“That simply can’t be done for ninety-nine percent of all people in a gym environment because it involves weights that they couldn’t physically move or, if they could, they’d be at high risk of injury.”

To understand the difference, Mark invites people to come in and try the equipment for themselves, noting that his facility in South Pasadena offers two free sessions that allow newcomers to experience the OsteoStrong workout.

“This is an amazing concept that is the culmination of twelve years of research that looked into the body’s own adaptive response to growing new bone and muscle structure and improving the density of the bones we have,” Mark says.

“As a result of that research, it is now a known medical fact that when you put certain forces on the bones, the body responds by growing new bone tissue. And the results of these short workouts is absolutely amazing.

“On average, our studies have found that OsteoStrong improves people’s bone density from three to seven percent a year. Also, people will increase their strength by an average of seventy-three percent over their first year at OsteoStrong.”

Mark also points out that similar studies show that doing an OsteoStrong session more than once a week does not promote any additional benefit. As a result, the workouts are not only impactful, but time efficient.

Mark encourages men and women of all ages to accept his invitation to try out the OsteoStrong equipment, because he says it’s important to know that osteoporosis is not a disorder that is exclusive to a specific age group or gender.

“Osteoporosis is not something that only happens to old people,” he notes. “We have clients from young to old and everything in between. And men are not immune. When they start losing their testosterone, their bone loss becomes more rapid.

Noa Spector-Flock has experienced an increase in bone density levels since beginning OsteoStrong® workouts a year ago.

Before & After treatment

“In addition to helping them recover from it, OsteoStrong wants to help educate people about bone loss. The skeletal framework is the most important part of the body and you need to take care of it and be aware of changes to it.”

Noa is among those who have experienced a significant increase in bone density levels since beginning the OsteoStrong program. She says a very recent density scan showed that she made the right call by beginning OsteoStrong workouts.

“The workouts are definitely making a difference, and one of the things I really like about them is they’re very easy,” Noa says. “I also like that if you are ambitious, you can track your improvement in terms of how much weight you push.

“And there’s always someone there to guide you and watch you and make sure that you’re doing the exercises right and getting the maximum benefit. Everyone there is very personable and helpful. I’m a big fan, and I highly recommend it.”

Like Father, Like Son

Manipulation therapy relieves debilitating shoulder pain.

It wasn’t all that long ago that popcorn ceilings were all the rage in homebuilding. They have fallen well out of favor over the course of the past 30 years, and Gary Cummings, 73, is among those who have good reason to despise them.

Gary and Gregg Cummings both found relief for their sore shoulders by visiting Dr. Minafri at Riverview Chiropractic Center.

Gary (right) and Gregg are
now pain free.

A do-it-yourselfer, Gary was remodeling two homes – his and his daughter’s – a couple years ago when his attempt to scrape away the popcorn ceilings in both homes resulted in Gary severely injuring his right shoulder.

“That’s all overhead work, and after about three weeks, my shoulder got so sore that I couldn’t even lift my arm up,” Gary explains. “I figured that all I needed to do was rest it for a week or so and I’d be fine, but rest didn’t do it much good.”

Gary eventually learned from his son, a contractor, that his injury was likely a tear of the tendons surrounding the shoulder, or rotator cuff. Such injuries usually require surgery to repair, but Gary was in no hurry to have surgery.

He opted instead to continue fighting through the pain, which often interrupted his sleep. Finally, last summer, he visited his chiropractor, Steven J. Minafri, DC, at Riverview Chiropractic Center, to see if he could provide any relief.

No Need for Surgery

“I’ve been treating Gary for neck and back problems for years, but I am also trained in extremity manipulation,” Dr. Minafri reports. “Some chiropractors are trained in that area, but most prefer to work only on the spine.

“I like to work on both the spine and the joints, and the MRI we ordered showed Gary did have a torn rotator cuff. Most people believe rotator cuff tears can only be repaired through surgery, but rotator cuffs can be treated with a form of manipulation.

“I refer to it as an intermediate step between doing nothing and having surgery, and what I do is reseat the structure of the joint so that there is less tearing and pulling on the rotator cuff. That allows the tissue to heal up.”

Dr. Minafri’s intermediate intervention had the intended positive effect on Gary. He avoided surgery and now has full range of pain-free motion throughout a fully functional right shoulder.

“I have to watch myself, but I can do everything I need to with that shoulder,” Gary says. “Dr. Minafri did a great job, and I was so impressed with him that I even had my son Gregg go see him after he injured his shoulder in a car accident last summer.”

“Gregg suffered the kind of injury we often see with people in car accidents, where the seatbelt holds the collarbone in place but permits the rest of the shoulder to move forward at the moment of impact,” Dr. Minafri explains.

“Without the additional movement of the shoulder blade and scapula, there is a shearing or tearing action that goes on that can cause the rotator cuff or labrum to tear, and often, there is a disarticulation or a misalignment of the shoulder itself.”

When Gregg first visited Dr. Minafri, he had no use of his arm. “It just hung there by his side,” Dr. Minafri describes. After a few manipulative treatments, Gregg regained full range of motion and full use of his arm.

“After the way he helped me, I knew Dr. Minafri could help Gregg,” Gary exudes. “He doesn’t just crack backs. He does more than that, and I’d recommend him to anyone because he’s as good as there is.”

Nature’s Way

Natural healing techniques relieve chronic pain, fatigue.

The days of riding her own motorcycle alongside her husband, playing competitive volleyball and doing water aerobics to stay in shape are little more than faint memories for Lisa Lovelace. Fibromyalgia is the reason.

For more than 20 years, the condition has caused Lisa so much pain, suffering and fatigue that she was forced to give up not only her active lifestyle but her job as a pharmaceutical sales rep.

Lisa has suffered from fibromyalgia for years, but her symptoms have started to fade since she started receiving a mixture of therapies from the Holistic Medical Care Clinic.

Lisa Lovelace

“I reached a point where I couldn’t even get out of my car,” Lisa reveals. “There were days where it was all I could do just to take a shower and wash my hair.”

Lisa, 52, spent years searching for a remedy, but it wasn’t until she visited the Holistic Medical Care Clinic that she found relief.

The objective of the Holistic Medical Care Clinic’s founders, Nataliya Sia, ARNP, and Sunny Sia, PMHNP-BC, is to treat patients with a blend of conventional/Western medicine and complementary natural therapies. This treatment philosophy is also called integrative medicine.

“We avoid prescribing medications as much as possible and look to heal patients a more natural way,” Nataliya says. “We specialize in treatments such as intravenous vitamin (IV) therapy, ultraviolet blood irradiation (UBI) intravenous therapy, stem cell and PRP therapy, and hyperbaric oxygen therapy (HBOT).”

Intravenous (IV) vitamin therapy uses a mixture of vitamins and minerals that are delivered directly into the bloodstream to fight fatigue as well as a variety of potential vitamin deficiencies.

Ultraviolet blood irradiation is a procedure where blood is exposed to ultraviolet light. The light exposure helps regulate the body’s immune system, which helps it fight off infection and manage autoimmune conditions such as lupus and rheumatoid arthritis.

Stem cell therapy promotes the repair of diseased, dysfunctional or injured tissue using stem cells or their derivatives. PRP/Prolozone therapy is similar to stem cell therapy but it utilizes your own blood platelets and/or ozone to repair injured muscles or tissues.

Hyperbaric oxygen therapy oxygenates the body, calms the central nervous system and increases energy. It complements well with stem cell and PRP therapy as the oxygenation helps expedite healing and recovery through cell regeneration.

After examining Lisa and discovering that she also suffered from an inability to absorb vitamins, Nataliya prescribed intravenous IV therapy, ultraviolet blood irradiation therapy and hyperbaric
oxygen therapy.

Lisa reports that after the very first round of treatments, a longstanding nagging pain in her hip and foot disappeared. Since then, the therapies have continued to have a positive impact on Lisa’s wellbeing.

“Almost everything has resolved itself,” Lisa exudes. “I have a lot more energy now, and I’m planning to get back into exercising soon. There’s a world of difference between how I felt before and how I feel now, and I can’t thank Nataliya enough. She’s just great.”

Three Cheers for TMS

Alternative to antidepressants shows promise for eating disorders.

Many kids grow up wanting to be doctors, teachers or professional athletes. Not Samantha Wynimko. For the longest time, she says, she has wanted to be an autopsy technician. A recent trip to the morgue only strengthened her conviction.

Alternative to antidepressants shows promise for eating disorders

Samantha Wynimko

“I was able to observe six autopsies at the Pinellas County Morgue, and that really confirmed to me that this is what I want to do,” the 25-year-old Riverview resident says. “I know it’s not for everyone, but it’s something I’m excited about.

“And I’m almost there. I already have my Bachelor’s degree in Health Science from the University of South Florida, and I have just one more class to complete before I can take the state exam and get certified.”

If all goes as planned, Samantha will be working in a morgue sometime in the very near future, which is now very promising. It wasn’t long ago that Samantha’s future was quite uncertain because of a bout with depression, anxiety and an eating disorder.

“The problems all started when I was in high school,” Samantha relates. “I was a varsity cheerleader, and there’s this belief among a lot of people that cheerleaders are all supposed to be small or a certain size. Well, I wasn’t.

“I was probably the biggest girl on my team. I’m five foot ten, and I weighed around two hundred twenty pounds back then. Because of that, I was bullied and tortured just about every day about my weight, by one person in particular.

“One day, I finally said, Enough, and decided to do something about it. I started off dieting, but it turned into purging and over-exercising. I would work out at the gym for three hours or more and then not eat. I was obsessed with my weight.”

Samantha carried that obsession for more than two years, during which time she dropped approximately 130 pounds. But it was not a healthy weight loss. By the time her 19th birthday rolled around, Samantha had become anorexic.

Fortunately, a friend noticed and took Samantha to the hospital. Samantha stayed there for four weeks, then moved to a treatment center, where she spent three months. During that time, she was diagnosed with depression and anxiety and prescribed medications.

The medications never really worked. In fact, it wasn’t until a few months ago, after she began seeing Boris Kawliche, MD, at Brandon TMS & Psychiatry, that Samantha found a treatment that really worked for her. That treatment is transcranial magnetic stimulation, or TMS.

The TMS Era

Sparking a new era in depression treatment, TMS therapy was developed in the 1980s when a researcher at the University of South Carolina learned that magnetic pulses can stimulate the part of the brain that is underactive in people who suffer with depression.

These short pulses are delivered through a paddle-shaped device that is placed on the prefrontal cortex, which is the part of the brain associated with mood regulation and cognitive function. This area can be underactive in those who are depressed.

The Food and Drug Administration approved the noninvasive therapy in 2008 for patients who have not responded favorably to traditional treatments such as talk therapy and antidepressants, as well as those who cannot tolerate the side effects of antidepressants.

TMS treatments last approximately 30 minutes, and patients typically receive a total of 36 treatments over a period of six to eight weeks. Patients are treated five times per week for the first six weeks and are gradually weaned off the treatment in the final weeks.

“This form of treatment does require a commitment on the part of the patient, because at the beginning you do have to come every day, five days a week, and spend about a half hour with us,” Dr. Kawliche notes.

“If you’re in school or working, those are factors that can be hard to surmount. In that way TMS treatment can be a little complicated, but it is effective. And for those who fear it may be like electroconvulsive therapy, which some refer to as shock therapy, I can assure you it is not. This is totally different.”

One of the biggest differences between electroconvulsive therapy (ECT) and TMS is that TMS is done in the doctor’s office while the patient is awake. ECT must be done in a hospital or surgery center because the patient must be anesthetized. There is also a difference in what the two treatments deliver.

ECT causes the patient to go into a seizure. TMS, through electromagnetic induction, emits a magnetic field in short pulses in computer generated sequences that stimulate the brain. This process is similar to a workout for the brain that is restorative and brings about positive changes.

The most common side effects of TMS are mild scalp discomfort, headaches and dizziness, all of which stem from the treatment coil. And Dr. Kawliche proudly declares that TMS therapy often proves to be more effective in helping patients than antidepressants.

“Sadly, after someone has tried three antidepressants, there is only a seven percent chance they will get well by trying a fourth,” Dr. Kawliche educates. “Those are really miserable odds.

“With TMS, we get about forty percent remission rates, where the patients are completely asymptomatic, and about sixty percent response rates, where the person is better but still not at a level where everything is completely where it needs to be.”

A Difference Maker

Samantha went to see Dr. Kawliche thinking he would continue treating her with antidepressants. It wasn’t long before he suggested she try TMS therapy. Now, Samantha is glad he did because it has changed her life.

“After more than five years of trying so many different antidepressants, I was at a point where I was willing to try anything that was different,” Samantha concedes. “So I figured, Why not give it a shot.  Almost immediately I noticed a difference.

Alternative to antidepressants shows promise for eating disorders

Samantha is living a happier and healthier lifestyle since receiving TMS treatments

“After my very first TMS session the things I was struggling with the most – the depression and anxiety – really just disappeared to a point where I was able to decrease my medications. I stopped the binging and purging and just started feeling a lot better.”

Samantha was the first patient with eating disorders that
Dr. Kawliche has treated with TMS therapy. She is not, however, the first person with a disorder other than severe depression who found relief from TMS treatments.

“We’ve encountered a lot of different people experiencing anything from pseudo seizures to real seizures and even people suffering from post-traumatic stress disorder that we have observed improvement in,” Dr. Kawliche says.

“In Samantha’s case it was an eating disorder. She was binging and purging on a regular basis pretty much daily and sometimes several times a day. But gradually, after we began the TMS treatments, that behavior went away, and she did very well.”

She did well for a while. Samantha completed her initial round of TMS treatments this past summer. After a couple of months, however, she suffered a relapse that resulted in her falling back into some old habits.

“I started slipping back into old behaviors again,” she says. “It started with me restricting what I was eating during the day and being very focused on my calorie intake, my fat intake and my carb intake.

“And just like I did before, I began obsessing over my body image the way I did when I first got out of high school and in college, and I didn’t want to eat. And when I did eat, I’d make myself throw up, so I was purging again.”

The relapse prompted Samantha to go back to Dr. Kawliche, who recommended a second round of TMS treatments. Just as they did the first time, the treatments had the desired effect on Samantha’s depression, anxiety and obsession.

“After only a few days of treatment the second time around, I started feeling a whole lot better,” Samantha says. “My anxiety went away almost immediately, and I noticed I had a lot more energy. I was no longer just sitting around by myself all the time.

“And after a couple of weeks, I was no longer restricting my diet and worrying about what I was eating. I stopped the purging, and now my weight is back to what is normal for a woman my height, and I’m happy with that.

“TMS has made a huge difference in my life. I’m so glad I did this. It has helped me more than I could have ever imagined. I probably never would have done it had I not found Dr. Kawliche.

“He’s just great. And so is everybody in the office. Everyone is nice and welcoming. The atmosphere there is so relaxing and comforting that I actually enjoy my appointments, and I used to hate going to doctors.

“I don’t know where I’d be had I not found Dr. Kawliche. I recommend him and everyone else at Brandon TMS one hundred and fifty percent. They’re the best. They helped me get my life back, and I can’t thank them enough for that.”

Quick, Easy and Effective

Safe, nonsurgical treatment relieves hemorrhoids.

For the better part of the ten years he suffered from hemorrhoids, Jason* told no one of the condition, not even his wife or his doctor.Safe, nonsurgical treatment relieves hemorrhoids

“I guess like a lot of people I was too embarrassed to talk about it,” Jason confides. “It was definitely a problem, though. I’d wake up in the middle of the night, itching like crazy,” he confides. “I tried hemorrhoid cream, but it didn’t do anything. It was horrible.”

Now retired, Jason spent his working years in the broadcasting industry, where he managed radio and television stations. One day, he heard an advertisement for HemRelief that included the question Why suffer in silence? and had a revelatory moment.

“I said to myself, that’s me. I’m not telling my wife. I’m not telling anybody,” recalls Jason. “I went home and told my wife, I’m having a little problem down there. I’m going to make an appointment.”

Outpatient Procedure

“Hemorrhoids, which are swollen veins in the rectum or anal canal, are extremely common,” notes Linh B. Nguyen, MD, of HemRelief. “In fact, more than fifty percent of people age fifty or older have them to some degree.”

Most sufferers are understandably reluctant to try the available treatment options, some of which have traditionally been both painful and inconvenient.

Fortunately, Dr. Nguyen offers microcurrent electrolysis (MCE), an FDA-approved, nonsurgical method for treatment of hemorrhoids. The noninvasive, relatively painless outpatient procedure has been helping patients for more than 20 years and is completed right in the doctor’s office.

“A low current is applied to the base of the hemorrhoid, causing a chemical reaction that induces the hemorrhoid to shrink,” explains the doctor. “The procedure is well tolerated by patients and does not require anesthesia.

“The MCE method is considered revolutionary because it is highly effective, safe and convenient. Up to ninety percent of people who have it done get relief from their hemorrhoids.

“It doesn’t cause the agonizing pain often associated with traditional hemorrhoid surgery and is also covered by most insurances and Medicare.”

The treatment is quick, convenient and can be safely repeated as needed.

“There’s no need to take any special preparation to clear the bowels,” Dr. Nguyen notes. “Patients can have the procedure done and go back to work immediately, so there is no downtime. The entire procedure takes approximately twenty minutes.”

“Feel Like New”

Jason appreciated how Dr. Nguyen helped him feel at ease. “Dr. Nguyen makes you feel very comfortable,” he reports.

The procedure was painless, he says, and results were evident right away. The constant itching was gone.

“I felt like a new person when I walked out of the doctor’s office after the procedure.”

Jason is no longer embarrassed to talk about hemorrhoids. In fact, he talks about them freely now, in case it helps others.

“I tell people that this is the most comfortable treatment and it’s not an embarrassing situation,” he notes. “If you’re putting treatment off because of embarrassment, don’t wait another second. Pick up the phone and get it done because it’s not embarrassing at all.”

* Patient’s name withheld at his request.

An Ideal Solution

In addition to anti-aging treatments such as those utilized by Deepa, L.I.V. endorses a medical weight loss program known as Ideal Protein®. A four-phase ketogenic and lifestyle program, Ideal Protein is designed to help patients lose weight safely and effectively while improving their health and vitality.Deepa Saha dove into the facial aesthetic treatment pool by having a dermaplaning procedure done at L.I.V.

In addition to fostering better appetite control, improving blood sugar and cholesterol levels and reducing blood pressure counts, Ideal Protein also helps patients develop and maintain eating habits that become second nature to them.

Those goals are achieved through customized meal plans that help to burn stored fat and preserve lean muscle by emphasizing high-quality proteins that are easily absorbed and limiting the amount of sugars and dietary fats that are taken in.

“Most patients do like to eat protein more than carbs or sugars,” Dr. Ravi explains. “And with Ideal Protein, they can eat all kinds of proteins, including eggs, white fish, turkey and chicken, and they eat four ounces of whatever that protein is at each meal.

“They eat that in association with some vegetables and some selected fruits that they can also have as a snack. That gives the participant enough calories to make them feel as if their stomach is full, which helps them get through their day.”

Because the program removes most of the dairy, grains and a lot of fruits from their diet, Ideal Protein participants need to take a multivitamin and also potassium, fish oil and calcium supplements to ensure they receive an adequate amount of minerals each day.

Participants in the Ideal Protein Protocol are also encouraged to exercise regularly. To aid them in that endeavor, participants are given a booklet that shows them a variety of exercises that can be done to help them burn more calories.

“Some of the exercises can even be done while someone is sitting down and watching TV,” reports Dr. Ravi, who has been recommending Ideal Protein for patients looking to lose weight for more than a dozen years.

“It’s an active management of diet, exercise and healthy behavioral changes, and with the exception of the home exercises, everything is done in the office, including the initial blood work. Even the prescriptions are dispensed in our office.

“We’ve set it up so that the patient can just walk in and take the bag that he or she needs to go along with their weight loss program and go about their day. It’s a great program, and my patients have had lots of success with it.”

Age Eraser

Aesthetic treatment returns youthful glow.

All through her 20s and 30s, Deepa Saha proudly maintained a natural youthful appearance that belied her age. Then the pediatrician and mother of two turned 40. Suddenly, Deepa’s age-defying glow disappeared.

“I was always told, You look so much younger than your age, and then the kids came, and I was working more, and I don’t know if it was all the stress associated with that or what but when I turned forty, I really looked forty,” Deepa explains.

Deepa Saha dove into the facial aesthetic treatment pool by having a dermaplaning procedure done at L.I.V.

Dermaplaning gave Deepa’s skin back its soft, natural glow.

“And that’s okay. I’m not saying that’s a bad thing necessarily. But it suddenly hit me that, I’m getting old, and so out of curiosity I started taking more notice of some of the anti-aging products and services that are available.”

Two services in particular piqued Deepa’s interest. One is dermaplaning, an exfoliation technique designed to scrape away dead skin and remove fine facial hair. The other is microneedling, which is a slightly more invasive collagen-induction treatment.

To learn more, Deepa attended a demonstration event at L.I.V. Medical Weight Loss & Aesthetics. It is the practice of Himagiri Ravi, MD, a weight loss management specialist who recently renamed her practice and moved it from Lakeland to Boynton Beach.

At L.I.V. Dr. Ravi focuses on improving each patient’s individual wellness through an array of services, including medically supervised weight loss, hormone replacement therapy and anti-aging treatments.

Introductory Procedure

“Deepa came in last fall looking for something that would give her a fresh clean look and remove the fuzzy hair she had on her face,” Dr. Ravi explains. “Her primary goal was to prevent any further damage to her skin.”

After learning more about the two procedures, Deepa decided that dermaplaning would be best for her, in part because she has very sensitive skin and sometimes suffers from eczema, a condition that leaves the skin red and itchy.

“Dermaplaning seemed like it would be great for me because it’s like an introduction to all the aesthetic procedures that are available at L.I.V.,” Deepa says. “It was a way for me to dip my toe in the water.”

Dermaplaning is a safe, simple procedure during which a trained esthetician uses a surgical blade to shave off the top layer of dead skin as well as any fine hair. A single session typically lasts about 30 minutes and leaves the skin softer and smoother.

“I had the dermaplaning done and followed up with a facial peel and the results were absolutely amazing,” Deepa explains. “It didn’t agitate my skin at all and neither did the peel that followed.”

Deepa was so pleased with the results that she recently had a second combo treatment done. She says she hasn’t ruled out turning to microneedling in the future but is very happy with the dermaplaning and facial peel approach.

“The bottom line is, I look so much better overall,” Deepa raves. “Between the procedures and post-procedure products they gave me, they even helped clear up the acne scarring that I had that never went away. I have that glow back that I was looking for.”

Custom Fit

Assisted living facility proves to be the right choice.

When gastroenterologist Jeff Breiter, MD, closed up his practice, retired and moved from Connecticut to Florida three years ago, he didn’t stop caring for others. He simply shifted the bulk of his focus to his mother, Geraldine.

Jeff Breiter, MD, chose Sabal Palms Assisted Living & Memory Care for his mother.

Jeff Breiter, MD, and Geraldine Breiter

Now 92, Geraldine was residing in an independent living community in Palm Beach at the time, but she recently became a widow and suffered a couple of falls, including one that resulted in a brief hospital stay.

“Because of the falls and everything, I thought it would be better for my mother to live closer to me,” says Dr. Breiter, who moved to the Palm Coast area. “She agreed to that, so I moved her to another independent living facility here in Palm Coast.”

That was in May of 2016, and despite losing some stability in her gait, Geraldine adjusted well to her new surroundings. She made new friends easily and remained very active, participating regularly in community activities, events and outings.

As the end of her second year in her new home approached, Dr. Breiter began to notice some changes. Geraldine was interacting with others less than before and had become forgetful of things, most notably her prescribed medications.

As he monitored those changes over the course of the next few months, Dr. Breiter became convinced that his mother needed more care, so he began to look for an assisted living community that also provided memory care.

Five Levels of Care

His choice was Sabal Palms Assisted Living & Memory Care, a newly opened, pet-friendly senior living community that offers studio and one and two-bedroom suites as well as five levels of customized care for residents such as Geraldine, who moved there last fall.

“Our levels of care begin with minimal assistance, such as medication management, and move up to include incontinence care, shower assistance, housekeeping and maintenance,” explains Sandra Davis, Executive Director of Sabal Palms Assisted Living & Memory Care.

“We also have a full gym complete with exercise equipment, and we conduct yoga classes, cooking classes, painting classes and music classes as part of our vast array of daily activities that includes a movie every night with popcorn in our beautiful movie theater.

“We all gathered in the movie theater to watch the Super Bowl this year, and of course we provide three delicious Chefprepared meals a day that include an assortment of homemade soups, entrees, desserts and breads.

“It’s really a gorgeous community, and we are actually quite honored that Dr. Breiter, being a physician himself, chose us for his mother’s care. He’s very involved in her care, and she seems to be very happy with the care she’s been receiving.”

Dr. Breiter agrees. He said he chose Sabal Palms in part because it is located close to his home, but also because he was impressed by the array of amenities and the fact that it’s a new community. The real draw, however, was the customized levels of care that are offered.

“The staff is very attentive, and my mother needs that because things are changing with her,” Dr. Breiter confides. “For example, she has some incontinence issues now, but they look after that and do a good job of making sure she gets her medicines.

“She’s quickly become very comfortable and happy at Sabal Palms. She knows all the staff members by name and goes on a lot of the outings that they have for the residents. She’s doing very well there.

“I’d say she is definitely more comfortable there than she was at the independent living facility, and there’s no question I’d recommend Sabal Palms for others. There’s a huge need for facilities like it, given that people are living longer and sometimes need more care as they age, and this is one of the best.

The Gold Standard

Dental implants are best choice for replacement teeth.

The loss of a tooth may be a bit traumatic for a five- or six-year-old child, but it’s all part of the natural growing process, one that adults usually find rather cute. There is nothing cute, however, about adults losing a tooth.

When someone past the age of seven or eight loses a tooth, it’s gone for good, and studies show that more than 178 million Americans have suffered just such a loss while more than 35 million Americans have lost not just one or two teeth but all their teeth.

Most consider tooth loss to be an aesthetic problem, and for those who lose a tooth in their smile line it is. But there are physical problems that develop as a result of tooth loss that are even more concerning.

Over time, the loss of a tooth can lead to a loss of bone in the jaw area where the missing tooth used to be, which can result in changes in a person’s facial appearance, odd shifts in the remaining teeth and a collapse in the person’s bite.

Replacement options for missing teeth include bridges and dentures, but dental implants have become the gold standard for tooth replacement because they prevent further bone loss and look and function just like natural teeth.

At Dental Specialists of North Florida, John W. Thousand IV, DDS, MSD, is a specialist in implant dentistry, which is the surgical placement into the jawbone of a screw-like post that serves as the foundation for replacement teeth, bridges or dentures.

The Right Choice

The implant itself is a titanium root-shaped body that is surgically placed into the jaw bone. A single implant supports an abutment and a crown, which creates a new tooth. Several implants can be used to support a fixed bridge or even a full denture.

Because implants require a certain amount of bone to attach to, the implant procedure always begins with an examination to determine whether the patient has enough jaw bone to adequately support an implant.

For those who don’t, a bone grafting procedure can be done in which bone from another part of the body or a special bone grafting material designed to enhance new bone growth is seated in the jawbone where the implant is expected to go.

It typically takes between four and six months for the jaw bone to heal to a point where it is strong enough to support implants. During that healing period, patients usually wear temporary, or removable, dentures or bridges.

Once the implants are placed, patients usually need between three and six months for the implants to heal to the point where they can support the abutment and the crown. As with bone grafting, patients typically wear temporary crowns or bridges during that time.

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