Author Archive

Reversing Course

Correct severe shoulder damage.

Never one to waste a lot of time just sitting around, Diane Costa spent the majority of her working years on her feet, first as a waitress and a bar maid, then as a wallpaper hanger and a furniture refinisher and finally as a cake decorator.

Diane Costa had reverse total shoulder replacement surgery and is glad she did.

Diane has regained full range of motion in her left shoulder.

Surprisingly, it was her shoulders that took the brunt of the abuse from that odd array of jobs. As a result of the repetitive nature of the wallpaper hanging, and refinishing, Diane had rotator cuff surgery on both shoulders, the right one in 2005, the left one in 2006.

More trouble developed for Diane a few years later when she stumbled over a poorly fitting drain hole cover in the kitchen where she was decorating cakes and fell, severely injuring her knee, back and left shoulder.

The fall resulted in Diane undergoing a meniscus repair on her knee while receiving radiofrequency treatments on her back. Her shoulder injury was not treated, however, because her insurance company, citing her previous injury, refused to cover the cost.

“After that, I just went to hell in a handbasket,” says Diane, who eventually developed arthritis in both shoulders and lost so much strength in her left shoulder that she could no longer perform even the simplest of household tasks.

“I couldn’t strip the sheets off the bed to wash them or make the bed again when the sheets were cleaned,” she says. “I couldn’t pick up a frying pan, so I had trouble cooking.  And when I drove, I had to keep my left hand at the bottom of the wheel because I couldn’t lift it up to the ten and two position.

“The worst thing of all, though, was that I had a lot of trouble lifting up my husband, who had recently undergone hip and knee surgery and then had a stroke and needed my help getting up out of chairs and getting dressed.”

Diane and her husband were living in North Carolina at the time of her husband’s stroke. Before long, their daughter moved them to Florida, where one of her first tasks was to arrange for her father to undergo rehabilitation therapy at Advanced Orthopedic Center.

It was during one of those therapy sessions that Diane learned that one of the doctors at Advanced Orthopedic Center – Robert P. Stchur, MD – could repair her ailing shoulder by performing what is known as reverse total shoulder replacement surgery.

Transfer of Power

Originally designed in Europe in the 1980s, the reverse total shoulder replacement procedure was approved by the Food and Drug Administration for use in the United States in 2003 as an alternative to traditional shoulder replacement surgery.

It is considered a better option for anyone who has suffered a large tear of a rotator cuff or anyone suffering from severe arthritis in the shoulder because it forces the shoulder to use different muscles than it normally does to lift the arm.

In a healthy shoulder, the muscles and tendons in the rotator cuff work together to keep the ball of the upper arm bone, which is the humerus, in the shoulder socket. They also work to power the process of raising and rotating the arm.

The reverse total shoulder replacement procedure transfers the task of powering the arm to the deltoid muscle through the use of a device that places a metallic ball where the socket was and a socket where the ball was.

Diane Costa had reverse total shoulder replacement surgery and is glad she did.

The DELTA XTEND™  Reverse Shoulder
System is a total semi-
constrained shoulder arthroplasty.

“You’re basically just flipping the joint around,” says Dr. Stchur (pronounced Sure). “Especially with older patients, it’s the best way to go because the failure rates of traditional surgery are much higher in patients with big tears and poor-quality tissue.

“And I’ve seen it happen where someone has gone through a big repair and months of rehabilitation and then they tear the shoulder again, and they have to go in and do the reverse anyway. That’s why we’re favoring the reverse more and more.”

When he first examined Diane in October 2018, Dr. Stchur discovered that her left shoulder was completely devoid of cartilage and that she was indeed a good candidate for the reverse total shoulder replacement surgery.

That surgery took place a few weeks later, and within six weeks of having the surgery, Diane was using her shoulder normally again. Had Diane opted for traditional surgery or even another rotator cuff repair, her downtime would have been three to six months.

“That’s one of the great advantages of this surgery,” Dr. Stchur says. “The recovery time is shockingly fast because we’re not repairing anything. We’re placing metal and plastic components into the shoulder that stick to your bones immediately.”

Patients are often encouraged to begin using their new shoulder immediately as part of their rehabilitation. Diane is among those who began using their shoulders again within a matter of days. She is now back to using it normally.

“For so long, it seemed like I was the one who had the stroke, because I couldn’t use that arm at all,” Diane says. “But now, I can do anything.

“The last time I went to see Dr. Stchur, he had to laugh because he reached out to shake my hand, and I said, No, no, no, give me a high-five instead. I’m telling you, having that reverse shoulder surgery was the best thing I ever did.

“I’m so happy with it that I’m going to have it done on my other shoulder, too, and I’ll have Dr. Stchur do it because he is a fantastic doctor. He has all the qualities you want and expect in a great doctor, and I highly recommend him.”

Two in One

Cardiology and vascular care available at one practice.

When she’s not tending to the patient she cares for three times a day, seven days a week as a private nurse, Nadine Fraser can usually be found teaching health care to medical assistants and patient care technicians at Southern Technical College in Orlando.

Nadine Fraser underwent RFA treatment on her leg and feels better.

Nadine Fraser

If you don’t find her there, then she’s probably administering vaccines to school children, conducting an intake evaluation for someone planning to move into a skilled nursing facility, rehabilitation center or assisted living community or possibly preparing someone’s taxes.

“I do a lot of different things because I don’t like to be bored,” says the 54-year-old registered nurse. “I’m very passionate about health care and about the care people receive, so I stay pretty busy. But I like being busy.”

Looking after her own health is among the many things that keeps Nadine busy. Over the past couple of years, she’s been busier than she would have liked to have been, thanks in part to a cardiac issue that runs through her family.

“Many of the aunts and uncles on my mother’s side have had heart valve replacements due to an insufficiency in the backflow of oxygenated blood, and about a year ago, I was having a few more heart palpitations than usual,” Nadine reveals.

“I needed to have that checked out, and during that process, the doctors asked me if I had any other issues that were bothering me. I said I have very bad varicose veins and told them that I also have this chronic  painful phlebitis that happens.

“I told them that, because of all that, I haven’t worn dresses in years, other than inside the house. I never wear shorts either and mentioned that I’m on my feet all the time and that my legs had become achy and bothersome.

“That’s when they told me their practice is a full-service cardiology and vascular care facility and that they had someone there who could help me with my legs as well. After that, they set me up with an appointment to have my legs looked at.”

Thorough Evaluation

The practice Nadine visited is Heart and Vascular Care, where Pradip B. Baiju, MD, an endovascular specialist and interventional cardiologist, works with Robyn Kempf, PA-C, who specializes in the evaluation and treatment of venous disorders of the legs.

While under the care of Dr. Baiju, Nadine was diagnosed with and treated for atrial fibrillation, which is a quivering of the heart that can lead to the formation of blood clots and cause a stroke, heart attack or other heart complications.

She was then handed over to Robyn for a thorough examination of her legs, where there are two systems of veins – the deep veins in the middle of the leg and the superficial veins near the skin’s surface.

These deep and superficial veins are low pressure systems. The exam uses ultrasound to evaluate the competence of the deep and superficial veins. After treating the superficial veins, the deep veins take over the return blood supply from the extremities.

That examination revealed insufficient valves and bloating in two of the superficial veins in Nadine’s right leg and a blood clot that ran the entire length of the longest superficial vein in Nadine’s left leg.

Out of fear the clot might travel to the heart or lungs, which could prove fatal, Robyn immediately prescribed a blood thinner called COUMADIN® that treats and prevents blood clots and is often prescribed for patients diagnosed with atrial fibrillation, or A-fib.

Robyn then treated the problem veins in Nadine’s right leg, both of which had become enlarged due to a breakdown of the one-way valves that open and close and assist with the flow of blood through the vein and to the heart.

When these valves break down, the result is a condition called venous insufficiency, which allows blood to reflux, or leak, backward down the vein, where the excess blood causes swelling and interferes with the proper circulation in the legs.

Modern Medicine

At Heart and Vascular Care, Robyn uses modern, advanced techniques to treat venous insufficiency, the most common being a minimally invasive technique called radiofrequency ablation (RFA) that shrinks and permanently seals the affected vein from the inside.

“We begin RFA by applying a local anesthetic, then make a small puncture, usually below the knee, and insert a small tube called a sheath into the vein,” Robyn describes. “We then insert a specialized ablation catheter and advance it to the affected area.

“We put fluid and numbing medicine all along the vein and apply controlled heat to the affected sections down along the vein. The heat results in ablation of the vein, where the vein thickens, collapses and seals permanently.

“When we’re finished, we withdraw the catheter and place a small bandage over the puncture site. The leg is then wrapped in a compression bandage, and patients typically return for a follow-up ultrasound exam two days later.”

This follow-up is done to ensure the problem veins are sealed and that there are no blood clots in the deep veins of the legs. The bandages are removed, and patients are instructed to wear compression stockings during the day for two weeks.

Robyn treated only Nadine’s right leg because it’s relatively dangerous to perform an ablation on a leg that has a fresh clot in it. Nadine’s plan is to return this year for another ultrasound evaluation of the left leg. If the clot has resolved, she will proceed with treatment.  Meanwhile, she’s enjoying the results of the treatment on her right leg.

“They started with the great saphenous vein on the right leg, and they ablated that,” Nadine says. “The healing on that one was a little slow because of the Coumadin, but otherwise, I had no great issues with the treatment.

“Then we went back in and did the shorter saphenous, which runs from about the knee down into the back of that right leg. I’ve had great success with that, and now, my right leg feels amazing. I have much less swelling, and there’s no discomfort or pain.”

Nadine says she was fortunate to have found a practice that treats patients for both cardiology issues and vascular problems and was extremely pleased with the care she received for her conditions.

“Everyone there is great,” Nadine exudes. “And Robyn does a great job in her specialty. She’s really good with the ablation treatments. I also like her demeanor. She’s very casual and personal and makes a point to really get to know you.

“At the same time, she tells it to you straight and in language that anybody can understand, and she’s not in a hurry to jump into doing some procedure that may not benefit the patient and might cause them further problems down the road.

“She’s willing to be patient and takes her time with everything, which is great. Some physicians are more about getting the procedures done and getting patients in and out, but they’re not like that at Heart and Vascular Care. They do exactly what’s right for each client.”

Are Men More Likely To Develop Osteoporosis Than Women?

June 9th, 2019

New Study Reveals Stunning Trend

The precursor to osteoporosis, a silent yet potentially disabling disease that can cause bones to weaken and break unexpectedly, is osteopenia.

Like osteoporosis, osteopenia is a disease most often found in women, but new research suggests middle-aged men may be more likely to develop the disease.

That is the conclusion drawn from a recent study of the bone mineral density in the necks and hips of 173 men and women between the ages of 35 and 50.

The study found that 28 percent of the men studied showed significant signs of osteopenia while 26 percent of the women studied showed those signs.

Osteoporosis is defined clinically as a potentially severe condition in which new bone growth fails to keep pace with bone degeneration.

About 54 million Americans have osteoporosis, and according to the study, a fracture caused by osteoporosis occurs every three seconds.

Osteopathic fractures are also on the rise, per the study, with the worldwide incidence of such fractures expected to increase by 310% in men and 240% in women by the year 2050.

Osteopathic fractures occur most often in the spinal vertebrae and femoral head or hip, but other bones, such as the wrist bone, can break as well. But fractures are not the only damaging result of osteoporosis.

Osteoporosis can also result in a loss of height as the effects on the vertebrae, or the bones of the spine, often lead to a stooped or hunched posture.

According to the study, published in The Journal of the American Osteopathic Association, osteoporosis can drastically decrease mobility, lessen the quality of one’s life and even lead to death.

Given the dangers associated with this growing health concern, it’s no wonder doctors have sought to find ways to halt or reverse the effects of osteoporosis.

One such solution is a revolutionary exercise program called OsteoStrong, which helps rebuild bone through once-a-week, 15-minute workout sessions using specialized equipment that includes four bio-mechanical machines.

These machines allow the user to perform resistance-based pushing and pulling exercises with their arms and/or legs. During these sessions, the user can safely exert pressure four to 12 times their body weight.

The concept is the culmination of twelve years of research that looked into the body’s response to growing new bone and muscle structure and improving the density of the bones,” says Mark Brady, president of OsteoStrong in South Pasadena.

“As a result of that research, it is a known medical fact that when you put certain forces on the bones, the body responds by growing new bone tissue. We do this through our short sessions on bio-mechanical equipment, and the results are absolutely amazing.

“Our studies show that on average, OsteoStrong workouts improve people’s bone density levels from three to seven percent a year. In addition, people typically increase their strength by an average of seventy-three percent during their first year at OsteoStrong.”

OsteoStrong has already helped more than 25,000 people reverse the negative effects of both osteopenia and osteoporosis and should remain a critical tool in the fight against this silent disease for years to come.



Tailor Made

Long before computers became small enough to sit on your lap, Elena Fontanazza worked for IBM, testing and developing many of the systems that allowed Big Blue to become one of the worldwide leaders in modern information technology.

Elena Fontanazza needed special dental care following her oral cancer surgery. She got it from Dr. Fatmi.

Elena is very happy with the personalized care she receives from Dr. Fatmi

“I was a supervisor working with all the older IBM machines, and I really enjoyed it,” says Elena, a Brooklyn, New York native who later married and moved to Fort Lauderdale, where she became a beautician and eventually a homemaker.

Now 76, Elena also spent some time helping her husband run their family’s jewelry store before retiring about 16 years ago. It wasn’t long after she settled into retirement that Elena found herself back at work, this time fighting oral cancer.

“I had this tiny lump under my tongue, and I had to have surgery to remove it,” Elena says. “But they also had to remove some of my jaw bone, the back four teeth on the bottom left side of my mouth and a portion of the left side of my tongue.”

The portion of Elena’s tongue that was removed included the small membrane that attaches it to the floor of the mouth. To compensate for that loss, Elena’s tongue was attached to the left side of her jaw in a fixed position.

In the wake of her surgery, Elena underwent extensive radiation therapy to ensure the cancer did not return. It hasn’t, but the radiation treatments have greatly compromised the structural integrity of her jaw bone and remaining teeth.

Those issues have combined to make Elena a challenging case for any dentist to do even the most routine work on her. She learned just how challenging when the passing of her dentist forced her to look for a new one shortly after she recovered from her surgery.

After visiting with several potential replacements, Elena discovered that she would need “something of a specialist” going forward. The specialist she eventually chose is Naved Fatmi, DMD, of Regency Court Dentistry in Boca Raton.

Outside the Box

“With someone like Elena, you just have to think outside the box a little bit because you are limited in the number of extractions and procedures you can perform. You need to be very careful not to cause the patient any more harm,” Dr. Fatmi explains.

“You can’t just pull a tooth, for example, because the density of the jaw bone is much less than normal as a result of the radiation. Not only that, but her teeth are a little more brittle than usual as well, so all that has to be taken into account.”

Dr. Fatmi did take all of those issues into account immediately upon meeting Elena, who at the time needed to replace a failed upper left second bicuspid and needed crowns on her upper left lateral incisor, her upper right first molar and her lower right second bicuspid.

She also needed a filling in her lower right wisdom tooth, which Dr. Fatmi chose to keep in an effort to avoid doing further damage to her jaw, as well as a heavy fluoride treatment to reduce the chances of further cavity development.

The biggest challenge Dr. Fatmi faced was in replacing the failed upper left second bicuspid because it required removing the failing tooth – which could cause damage to the already weakened jaw bone – and replacing it with either a bridge or implant.

Implants are screw-like bodies that are surgically placed into the jaw bone. Over time, the implant fuses with the bone and becomes a solid unit upon which an abutment and eventually a crown are placed to give the patient a new tooth.

Dr. Fatmi’s recommendation, which Elena agreed to, was to replace that tooth with an implant. The implant, he reasoned, would provide more biting power than a bridge, which could damage the support teeth because it would have to be removed regularly for cleaning.

Depending on the patient, an implant needs three to six months to fuse with the bone. That’s why Dr. Fatmi chose to do that procedure first. While Elena’s implant fused, he repaired her other teeth, eventually completing the restoration in about a year.

Since finishing that initial round of work in 2013, Dr. Fatmi has continued to treat Elena regularly, about every three months, providing mostly cleanings and fluoride treatments. He reports that her overall oral health has improved markedly since then and is now sound.

“One of the things we wanted to make sure of with Elena is that she can smile and speak and chew her food properly so that she can feel confident leaving the house and being in a social atmosphere,” Dr. Fatmi states. “We achieved that goal.

“She’s not insecure about leaving the house or speaking to people or about the aesthetics of her situation at all. She’s very happy and in control and says she’s grateful she met us because she was being pushed from doctor to doctor after having her surgery.”

An “Excellent Job”

Happy may be an understatement. Elena says Dr. Fatmi has done an “excellent job” of keeping her teeth and gums healthy and has proved to be very conscientious and considerate of her special needs.

“I’d recommend him to anyone because when I first went to see him, he knew everything my surgeon had done and exactly how to proceed from there,” she says. “And he was very confident he could take care of my situation because he has the right tools and know-how to do it.

“For example, with me, he uses this special x-ray machine that doesn’t give off a lot of radiation. That’s very helpful for me, and it’s things like that that make me feel very comfortable with him. Dr. Fatmi is so good, even my husband is impressed with him.”

“That’s true,” confirms Paul Fontanazza. “Dr. Fatmi is a phenomenal dentist. He’s already saved two of Elena’s teeth, and he completely understands and provides the special care she requires as a result of her surgery.

“After we first met Dr. Fatmi, I said to my wife, You’ve got to stick with this guy, and now, she won’t go anywhere else. Her needs are met above and beyond with Dr. Fatmi.

“She’s absolutely enamored with him, and I see why, because he’s exceptional.”

Double Duty

Magnetic stimulation therapy relieves pain, alleviates depression.

Brian Morgan had crippling back pain successfully treated with magnetic waves. Brian Covins had a great response to both TMS and TBS treatments provided by Dr. Kawliche at Brandon TMS & Psychiatry.

Brian Morgan is pain free at work and at home after treatment.

One of the strangest sports injuries ever documented occurred in May 2004 when then Chicago Cubs slugger Sammy Sosa strained a ligament in his back while sneezing. It was an injury that eventually forced Sosa to miss two weeks of games.

Police officer Brian Morgan, who played college and minor league baseball before retiring from the game and joining the force, can relate.

“I was sitting on the couch one day and reached over to get the remote control.

I sneezed at the same time, and something bizarre happened that I can barely explain,” Brian recalls. “I felt a sharp, stinging pain in my lower back and both of my feet went numb.

“I wound up missing a few days of work because I couldn’t bend down. I couldn’t even walk. The pain would start in the lower left side of my back and shoot down through my hip and into my leg and foot.

“When I finally went back to work, I was in pain off and on most days, but I struggled through it. I would apply heat and then ice throughout the day when I was able to, but it was a rough ride, that’s for sure.”

Prior to becoming a police officer, Brian always led an active lifestyle. He was a basketball player and baseball player in high school, and when his baseball career ended, he became an avid runner. But his back pain forced him to the sidelines.

“I really missed my long runs and being active,” he remarks. “Even during all the years I played sports, I never had an injury that caused the kind of pain this one did. Just getting out of bed was painful.

“Most mornings, it would take me twenty-five minutes to get out of bed and get moving. At the time, my son was three and my daughter was five. I couldn’t pick them up without painful consequences. That went on for over a year.”

On a scale of one to ten, Brian’s pain level escalated to an eight or nine. At his wife’s urging, he consulted with a chiropractor who sent him for an MRI. The results, Brian says, indicated he had a slipped disc in his lower back.

“I underwent several chiropractic treatments, but nothing worked long-term to alleviate the pain,” he says. “Then, on Easter Sunday, I overheard someone in the family talking about an experimental treatment a doctor at her clinic was using to alleviate pain through electromagnetic induction.

“I heard them talk about how these electromagnetic waves can eliminate pain in certain areas of the body, and I said, I’m willing to try it, no questions asked. I made an appointment the next morning, and by that afternoon, I was undergoing
my first treatment.”

Wave of the Future

The doctor Brian’s family member was referring to is Boris Kawliche, MD, a board-certified psychiatrist at Brandon TMS & Psychiatry who specializes in the administration of Corporal Theta Burst, or CTB, therapy.

CTB is an experimental treatment for back pain that uses short bursts of magnetic pulses to stimulate the part of the body where the patient is experiencing pain. In administering the treatment, Dr. Kawliche uses the same Danish-made MagVita R30 machine that he uses when treating patients with depression with transcranial magnetic stimulation, or TMS, just in a different way.

The Food and Drug Administration approved TMS therapy in 2008 for people with treatment-resistant depression. In most cases, those who failed treatments with antidepressants respond very well to TMS, and there are essentially no side effects.

While approved to treat depression, TMS has not yet been approved by the FDA to relieve chronic pain. Dr. Kawliche is the only provider in the area who has equipment that can handle the Theta Burst protocol, which he dubbed CTB.

“I made it clear to Brian that using CTB to treat pain is strictly experimental,” Dr. Kawliche emphasizes. “I told him that he would be part of a study of its effects on pain, and he had absolutely no hesitation in trying it.”

Brian’s willingness to try the experimental treatment paid off. After completing five sessions equaling a total of 60 minutes of therapy, Brian says he went from not being able to get out of bed in the morning to resuming a physical lifestyle.

“After the fourth day of treatment, I went into work and I said, Man, I feel great.

In the months that followed, Brian went on to train for a decathlon.

Dr. Kawliche says results as dramatic as those experienced by Brian cannot be expected with every patient, even if they are what he strives for.

Personal Results

Much like Brian, Dr. Kawliche says he considers himself a guinea pig in the
experimental use of CTB.

“I enjoy running in my spare time, and I developed Achilles tendonitis in my left ankle,” Dr. Kawliche shares. “For fifteen years, it had been impossible to run for more than ten minutes. If I attempted to run, I would be paying the price for a couple of weeks afterward. I would be limping around. I tried everything, from massages to heat and cold packs to TENS units – nothing seemed to work.

“Then one day, I thought to myself, If TMS can be used on the brain so effectively, and more specifically Theta Burst protocol can give results so quickly, why can’t it be used on other parts of the body?

After a handful of sessions to treat his own ankle, Dr. Kawliche says he found he was able to run for an hour or two without any pain. Dr. Kawliche says that success prompted him to expand his experiment.

“I knew I was onto something, and I wanted to conduct a study with real-life
participants in order to further prove its effects,” he explains. “We gathered forty volunteers to be in a study that we presented in Berlin at Biospine last April.

“Those participants had very positive results. Some of those patients came off of opioid medications. Others were able to cancel invasive procedures such as spinal fusions, stem cell injections, spinal cord stimulation implantations and morphine pumps after this treatment.

“After one ten-minute session, the effects of the MagVita machine are comparable to someone being given the energy to lift a parking lot of cars. The amount of power that is radiated has effects at the atomic level. It is restorative energy.”

Dr. Kawliche hopes to see the FDA approve pain-related magnetic treatments so more people suffering from chronic pain can reap the benefits. The treatment is a safer, more cost-effective and more effective way to treat pain without the risks associated with surgery or medications.

“I could see this being effective in treating patients with arthritis, fibromyalgia, even migraines,” he says.

Living Life Again

Brian says not having to take more than 20 minutes to get out of bed every day took some getting used to.

“I would wake up and start doing my old morning stretch routine to get out of bed, and my wife would say, I thought that your back wasn’t hurting anymore?” he recalls. “And I’d say, It’s not. And then I’d remember and think, Oh my God, I’ve been doing this so long, I forgot I don’t need to anymore. Now, the alarm goes off, I get out of bed and I’m immediately in motion.

“I’ve been telling everybody I know about the treatment. I can lift my kids without problems. I’ve started running again. The CTB treatment truly has been life-changing for me. I was willing to try anything to get my life back, and this has definitely done that for me.”

On the Fast Track

After working for more than a decade in the technical support field for a variety of different companies, Brian Covins ventured out on his own a few years ago and became a one-man Geek Squad®, creating the company he now calls Lighthouse Computer Services.

“I mainly go around to homes and small businesses and do computer maintenance and troubleshoot any problems people might have,” Brian says. “I teach them about any changes that have been made in their systems, clean up viruses, that sort of thing.”

Brian, 47, uses his tech support company to supplement his income, a portion of which comes from the disability payments he’s been receiving since he was deemed permanently disabled because of anxiety and depression several years back.

“The depression made me feel like I was fatigued all the time, and the anxiety made me make mistakes on paperwork and that sort of thing,” Brian explains. “Unfortunately, that’s been a long-running theme.”

Brian’s personal bout with depression and anxiety dates back to his late teens, when his inability to concentrate on his studies forced him to abandon his early attempt to earn some college credits. It also cost him a part-time job.

Brian’s struggles eventually led to a diagnosis of major depressive disorder for which he was initially treated with antidepressants. When those proved ineffective, Brian took advantage of an opportunity to undergo TMS therapy.

Brian says he had a “very good response” to his initial TMS treatments. The response was so good, in fact, that when the psychiatrist who administered his first TMS treatments retired, Brian sought out a new psychiatrist who offered the same treatment. That psychiatrist he chose is Dr. Kawliche, who offers not only the noninvasive, pain-
relieving, experimental CTB treatments but also TMS and an “express” version of TMS treatments called theta-burst stimulation, or TBS.

Intermittent or Continuous

The biggest difference between standard TMS treatments and the similarly noninvasive TBS treatments is the amount of time required for each treatment session to be completed.

Brian Morgan had crippling back pain successfully treated with magnetic waves. Brian Covins had a great response to both TMS and TBS treatments provided by Dr. Kawliche at Brandon TMS & Psychiatry.

Brian Covins says he can feel the effects of TBS treatments even as he receives them.

A single TMS treatment session lasts approximately 19 minutes, and a typical TMS treatment protocol calls for patients to receive five such treatments each week for six to eight weeks for a total of 36 treatments.
TBS treatments, which were approved for use by the FDA just last summer, can be delivered in an intermittent form that takes about three minutes per session or a continuous form that can be completed in about a minute.

When Dr. Kawliche first began treating Brian in 2017, he treated him for depression using standard TMS. Since then, he has treated him for both depression and anxiety, the latter through TBS treatments, which he recently changed from intermittent to continuous.

“When they do the TMS treatments for my depression, they place the paddle on the left side of my head,” Brian explains. “When they do the TBS treatments for my anxiety, the device is placed on the right side of my head.

“Both have worked really well for me. The treatments for my depression have really helped improve my moods, to the point where I have actually been getting out more and have become more socially active.

“As for the anxiety, my biggest problem there has always been sleeping. Because I would lie awake all night worrying about anything and everything, I’d only get about four to six hours of sleep a night.

“That may not seem that bad, but when you do that for days on end, you eventually reach a point where you’re so tired, you just have to crash for about twelve hours. That’s what was happening to me.

“Ever since we started doing the continuous TBS treatments, I’ve been sleeping a lot better. I’ve been sleeping a good eight hours or nine hours, which is what I need to feel more refreshed. I also feel a lot more alert and aware of things.”

Safe, Easy and Effective

Brian had what Dr. Kawliche refers to as a “typical response” to the two therapies, which have proven to be extremely effective. Studies show that 40 percent of patients receiving TMS or TBS treatments become completely asymptomatic, while 60 percent feel better but do not reach a level where they consider themselves to be completely asymptomatic.

In addition to their effectiveness, TMS and TBS treatments are also safe and easy on the body. The most common side effect is some mild to moderate scalp discomfort stemming from the treatment applications.

“The TBS treatments have really made a difference for me,” Brian exudes. “With the theta-burst treatments, I can feel them working even while I’m getting them. I can feel my mood changing and getting better.

“It’s a therapy I absolutely recommend for anyone who’s fighting depression or anxiety like me, and I definitely recommend Dr. Kawliche. I love that guy because he’s so open-minded and willing to try new things.

“He’s traveled all over the world to do research on TMS and TBS, and because of that, he’s on the leading edge of this.”

The da Vinci Debate

June 6th, 2019

Medical theories abound over what caused the great master to leave so many works, including his most famous, undone?

For all of its beauty, mystery and technical expertise, the Mona Lisa has long been considered an unfinished masterpiece. It remains a subject of debate even today, and not just among artists and art historians, but among medical professionals as well.

In early May, as the art world began to recognize the 500th anniversary of the death of the Mona Lisa’s creator, Leonardo da Vinci, several doctors began questioning the long-standing beliefs regarding da Vinci’s failure to complete the work, which was first discovered in his studio immediately after his death.

One of those beliefs is that da Vinci suffered a stroke that robbed him of the use of his right hand, which is the hand the ambidextrous artist painted with. Another suggests da Vinci’s right hand became deformed as a result of a condition known as Dupuytren’s contracture.

Two Italian physicians – one a plastic surgeon, the other a neurologist – were the first to question those theories, arguing in The Journal of the Royal Society of Medicine that da Vinci may have simply suffered a fall that resulted in nerve damage to his right hand.

They based their theory on a drawing created by a contemporary of an elderly da Vinci in which da Vinci’s right arm is wrapped in “folds of clothing, as if it was a bandage, with his right-hand suspended in a stiff, contracted position.

The doctors go on to say that, in the drawing, da Vinci’s right hand does not appear to be gnarled or clenched in the way that it would have been had it been disabled by a stroke and otherwise suggest the disabling cause may have been a palsy known as claw hand.

The authors used another drawing, this one a 1505 depiction of a man identified as an older da Vinci playing a lyre, to rule out Dupuytren’s contracture as the cause of the late-life disability in da Vinci’s right hand.

Dupuytren’s contracture is a progressive disease that gnarls the hand slowly over time. The authors argue that if da Vinci suffered from the disease, its symptoms would have been present in the 1505 drawing, which they are not.

The art world was still digesting the two Italian author’s findings when, in late May, a paper published in the journal Brain suggested yet another reason why da Vinci continued to teach and draw until his death but left many paintings unfinished.

According to Marco Catani, a King’s College of London psychiatrist, and Paolo Mazzarello, a medical historian at the University of Pavia, da Vinci suffered from attention deficit and hyperactivity disorder, or ADHD, and was a chronic procrastinator who struggled to finish projects.

“Even when Leonardo was finally commissioned with the important project of building a bronze statue of Ludovico’s father, the future Duke asked his allied Lorenzo il Magnifico if he could indicate a more apt Florentine artist for the project because he ‘doubted Leonardo’s capabilities to bring it to completion.’”

Catani and Mazzarello used accounts of da Vinci’s behavior and work habits culled from writings about da Vinci in reaching their conclusion, noting that da Vinci struggled to remain focused on tasks from early childhood on.

They refer to stories of how da Vinci regularly wowed people with his ambitious ideas and projects but often disappointed them because he failed to complete the project he was hired to do. A statue of the father of Ludovico il Moro, the future Duke of Milan, was one such project.

“Even when Leonardo was finally commissioned with the … project … the future Duke asked … if …  a more apt Florentine artist (could be found) because he doubted Leonardo’s capabilities to bring it to completion,” Catani and Mazzarello wrote.

The authors go on to suggest that evidence of ADHD can be found in the history behind the creation of other great works by da Vinci, including The Last Supper, which is painted on a wall in the dining hall of the Santa Maria delle Grazie in Milan, Italy.

They also suggest that ADHD negatively affected da Vinci’s relationships, career and income, but they note that it may have been at the root of his virtually unsurpassed creativity and imagination.

The difficulties linked to his extraordinary wandering mind caused him deep regrets but did not prevent him from learning and exploring the wonders of human life and nature,” the authors wrote.






Back from the Brink

Immunotherapy provides healthy, new path for lung cancer victims.

The promise of better weather, better schools for his sons and a better overall lifestyle in retirement prompted George Koehler to uproot his family and move from Long Island, New York to Florida 11 years ago.

Lung cancer survivor George Koehler is living a normal life now, thanks to immunotherapy and Dr. David Wenk.

Immunotherapy has George not only living, but enjoying life.

The relocation came as part of a complete lifestyle change for George, who had recently quit the smoking habit he’d started decades earlier. George learned a few years ago his decision to quit smoking came a bit too late to avoid any consequences.

An in-home service technician for Sears® at the time, George first detected trouble in 2014 when he began to experience sharp chest pains. Thinking at first that his chest pains were the result of a pulled muscle, he all but ignored the pains for nearly a year.

When the pains persisted, George eventually visited a doctor, who prescribed antibiotics. Dissatisfied with that doctor’s diagnosis, George’s wife insisted that George visit another doctor. This one ordered a chest x-ray that revealed the cause of the problem: cancer.

“That was a very, very hard pill to swallow,” says George, now 66 and retired. “I immediately thought the worst. We went to see a couple of other doctors to get their opinions on what to do next. They all gave us the same recommendation.”

That unanimous recommendation from the doctors George met with was to see David Wenk, MD, a board-certified specialist in medical oncology with Florida Cancer Specialists & Research Institute. George’s decision to heed the doctor’s advice proved to be a life-saving one.

Upon first visiting Dr. Wenk, George learned that what he actually had was Stage IV non-small cell lung cancer. It is the most common lung cancer discovered in patients in the United States, but at Stage IV, it is considered incurable.

“Historically, even if they are treated with a very aggressive form of chemotherapy, the survival rate for patients with Stage IV non-small cell lung cancer is about a year – and it’s not always a good year,” Dr. Wenk explains.

“With most patients, the chemotherapy usually just beats them up and weakens them to the point where they have to wonder just how much good the chemotherapy is doing, because the decline in the quality of life is so great.”

Change of Course

George was facing just such a set of circumstances when he first began to be treated by Dr. Wenk, who initially followed the standard treatment protocol for lung cancer by prescribing an aggressive form of chemotherapy designed to shrink the tumor.

George then had surgery to remove the tumor and underwent several weeks of radiation treatments. It was in the wake of the radiation treatments that Dr. Wenk decided to alter the traditional course of therapy for George.

The alteration came as a result of the advent of immunotherapy, which is the treatment of diseases such as cancer with drugs that either suppress or boost the immune system, and the development of the drug known as KEYTRUDA®.

Famous in part because it has effectively aided former President Jimmy Carter in his fight against advanced melanoma, KEYTRUDA was recently approved by the FDA as an agent to fight lung cancer.

At the time of George’s diagnosis, KEYTRUDA was considered an experimental drug and was being used only on a trial basis. That didn’t dissuade Dr. Wenk, who nevertheless prescribed a combination of chemotherapy and immunotherapy using KEYTRUDA for George.

“In my line of work, the evidence is changing on almost a daily basis,” Dr. Wenk says. “You have to adapt as new data is presented and make real-time decisions because if you wait for drug approvals to come, a lot of times, it’s too late.

“The regulatory approval process takes a long time, so if you can make decisions once the data is presented and not wait until an application is filed, your patients can start getting the benefits of these therapies right away.

“That’s how I approached the situation with George. I said to him, Look, this is not yet the standard, but it looks very promising based on clinical research, and together, we made the decision to go with the combination of chemotherapy and immunotherapy.

“George has now been on KEYTRUDA alone for about two years, and incredibly, he has no evidence of disease. And this is a disease that should have killed him after a year. Instead, he’s living a normal life and looking like someone you’d never suspect had incurable Stage IV lung cancer.

“That’s why we call him the poster child for what immunotherapy can do for patients with lung cancer. It can literally turn cancer into a chronic disease like diabetes or high blood pressure that you can just treat, so that it’s not the death sentence that it once was.

“The reason immunotherapy works is because the immune system is the most powerful anticancer defense we have. It not only kills bacteria and viruses and keeps us healthy on a regular basis, but it also kills cancer cells.

“The problem is that certain cancers make proteins that help them hide from the immune system. What immunotherapy does is it allows the immune system to see those cancer cells and attack them. And it’s proving to be effective in fighting a lot of different cancers.

“It has recently been shown to be very effective in fighting certain types of breast cancer, liver cancer, kidney cancer, neck and head cancer and Hodgkin’s disease. You can pretty much run the gamut with it.”

A Small Price to Pay

George receives his KEYTRUDA treatments once every three weeks in the form of an intravenous drip that lasts about 30 minutes. The drug leaves him a bit fatigued, but he says that’s a small price to pay, considering the alternative.

“I don’t have the energy I used to have, but overall, I feel pretty good,” George says. “I have to fight through the fatigue a bit and sometimes force myself to get up and get involved in things, but that all comes with staying alive.”

George says he feels fortunate to have been directed to Dr. Wenk and the staff at Florida Cancer Specialists & Research Institute. Without them, he says, there’s no telling where he’d be today.

“Dr. Wenk and his nurse practitioner Patty Rogers are my two saints,” George exudes. “They’ve been there with me the whole way and are always just a phone call away. If ever I need anything, they take care of it.

“And Dr. Wenk is just amazing. Every time I sit down with him, I’m astonished by how much he knows about what’s available in cancer treatment today, about what works and what doesn’t work and what plan of action we should take.

“I’m in great hands with Dr. Wenk, and in great hands with everybody at Florida Cancer Specialists and Research Institute. They all know you by name and when you walk in there, they treat you like family. The whole place and everything they do there is absolutely fabulous.”

Get Back in the Game

Revolutionary acoustic wave therapy boosts sexual performance.

Outside of being about four or five pounds overweight, Elliott* says he’s in great shape for a man who will soon celebrate his 70th birthday.

“I’m in excellent health,” the now retired civil engineer exudes. “The only problem I’ve had has been in the bedroom, if you know what I mean. That’s the only place where I’ve had a tendency to feel my age on occasion.”Stock Photo from
On those occasions when Elliott has actually felt his age, it was erectile dysfunction, or the inability to either achieve or maintain an erection satisfactory for sexual intercourse, that robbed him of his vim and vigor.

“I used to get early-morning erections all the time,” Elliott says. “I used to wake up with one. Then, a few years ago, they started going away or decreased in time or just weren’t as hard. After a couple years of that, I couldn’t get a good, hard erection at all.”
Elliott is not alone in his plight. Studies show that more than half of all men will experience some form of erectile dysfunction during their lifetime and that men suffering from hypertension, diabetes or cardiovascular disease are even more likely to experience dysfunction.

Smoking, heavy consumption of alcohol and drugs (either illicit or prescription) can also cause erectile dysfunction, which is typically the result of circulatory impairment in the blood capillaries or urogenital areas of the penis.

For years, medications such as VIAGRA® and CIALIS® have been the first line of defense against erectile dysfunction, or ED. If those proved unsuccessful, the next treatment option has generally been injections into the penis. If that failed, the last resort has long been a penile implant.

There is now a revolutionary, noninvasive and highly effective treatment called GAINSWave® therapy that treats erectile dysfunction through the use of acoustical waves that is performed in Clearwater by Rene M. Reed, DC, DABCO, NMD.

Acoustic Wave Technology

Dr. Reed is a practicing chiropractic orthopedic specialist and naturopathic medical doctor who specializes in alternative medicine. He recently added GAINSWave to his menu of treatment options because of the great need he sees for it.

Graphic courtesy of GAINSWave.“I do hormone treatments, genetic testing, stool studies for digestive issues and treat autoimmune diseases. Now, I do GAINSWave treatments because I’ve seen erectile dysfunction destroy relationships and devastate men,” Dr. Reed explains.

“It doesn’t matter how educated you are or how rich you are. When that ability to express yourself in the area of romance wanes, it tears men apart. I’ve literally had grown men cry in front of me over it.

“Most men won’t even admit they have this kind of a problem. But all they’re doing is letting themselves down and letting their wives down. What they need to know is that it’s okay to let somebody know they have an issue, because we can fix it.”

GAINSWave fixes the problem through the use of a small, handheld device that delivers acoustical waves in a series of short, painless pulsations that break up the plaque and calcium that have built up inside the blood vessels in the penis.

“It works like a little pneumatic hammer except you don’t feel it because it doesn’t touch your skin,” Dr. Reed explains. “And once that plaque and calcium are broken up, you get better blood flow. It’s that improved blood flow that leads to better, longer-lasting erections.”

Along with providing better blood flow through existing blood vessels, the GAINSWave treatment also stimulates the growth of new nerve tissue, which is vital for achieving and maintaining healthy erections.

In addition, GAINSWave causes the growth of new blood vessels to occur. That process typically takes three to four months to complete and leads to larger girth and firmer erections that are totally natural.

GAINSWave treatments can also be used to treat Peyronie’s disease, which is what occurs when scar tissue builds up in the penis and causes an abnormal bend, or curvature, to the penis that can impede urination and/or ejaculation.

“By making certain adjustments to the machine’s settings, we can treat the fibrous tissue the same way we treat blood vessels and break down the scar tissue that may be causing that irregular shape,” Dr. Reed informs.

“Women can benefit from this treatment, too, because the anatomy and physiology of the female genitalia is the same as the man. And just like men, when women get older, their labia shrink up, and their clitoris shrinks up just like the man’s penis shrinks up.

“But, just as it does with men, GAINSWave can improve that blood supply and reinvigorate the nerves and put some spice back into their lives and their relationships so that they’re not one of two people just living together anymore.”

Remarkable Results

Elliott’s relationship was nearing just such a stage when he sought out Dr. Reed, who had previously treated him for a vitamin deficiency. After discussing the matter, Elliott and Dr. Reed agreed that Elliott would benefit from the GAINSWave treatments, which he began last spring.

Patient photo by Jordan Pysz.

Dr. Rene M. Reed

GAINSWave treatments last about 30 minutes, with patients typically receiving two such treatments per week for a span of six weeks. Some patients, such as those with high blood pressure or diabetes, may require more sessions to achieve the desired response.

“For those patients as well as anyone who has been a heavy smoker, as many as twenty treatments may be needed to see a result,” Dr. Reed confirms. “But the therapy does work. More than seventy percent of men who undergo GAINSWave therapy respond to it.”

Dr. Reed says most patients begin to experience a response after about six sessions and notes that they typically experience the effects for more than a year. Elliott is among those who reported positive results after his first course of treatment.

“It wasn’t all that long after I started the treatments that my erections started to become bigger and stronger, and my wife can attest to that,” Elliott says. “It’s been about a year now since I completed my treatment, and I’m still going strong.

“But I’m not stopping there. This treatment has made such a difference in my life and in my relationship with my wife that I’m going back in the summer for a tune-up. And let me say that everyone in Dr. Reed’s office is very professional.

“Dr. Reed is a fascinating guy. He shows a great deal of concern for his patients, and his staff does a great job. I don’t hesitate to say that Dr. Reed has not only changed my life, but he’s made it better. A lot better.”

*Patient’s name withheld at his request.

Freedom from Glasses

Graphic from kisspng.Cataract surgery alleviates need for glasses, improves vision.

As military tours of duty go, the 23-month stint that John Clark served overseas with the 1st Cavalry Division and 173rd Airborne during the Vietnam War was about as manageable as any soldier could possibly hope for.

As a communications expert working in the small town of An Khê in the Central Highlands, John saw no combat and worked in a secured, air-conditioned communications facility.
“I don’t brag about it, but I definitely lucked out,’’ says John, whose three-decade-long career in communications continued in similar comfort. It wasn’t until after he retired that John’s good fortune began to wane as some medical issues, including a very significant one associated with his eyesight, crept up on him.

“I’ve always been very good about getting my eyes checked regularly, and for a few years, the eye doctors had been telling me, You’ve got a nice cataract growing there,’’ John reveals. “At first, I really didn’t notice it, but that changed the last year or so.
“I eventually began to notice that I wasn’t seeing as well as I had before, especially driving at night. Whenever I would drive somewhere, it was like the lights were exploding. The glare would fill the whole windshield of my car.

“At home it was just the opposite, everything was dim. I had to start leaving lights on all over the house because I wasn’t seeing as well. I didn’t need the light to get to the room, but I needed the light on once I got into the room, so I just left them on.”
John, who had worn glasses all his life, put up with the inconveniences for several months. Finally, during his annual eye exam last year, he was told his cataract needed to be removed and was advised to have his surgery done at The Eye Institute of West Florida.

That’s where he met Robert J. Weinstock, MD, a board-certified, fellowship-trained cataract and refractive surgeon who is in his 18th year of service at the institute and is now the institute’s director of cataract and refractive services.
During his initial examination of John, Dr. Weinstock learned that John had cataracts in both eyes and that they had matured to the point where they were affecting his vision. He then scheduled John for cataract surgery.

A Common Occurrence

As they did with John, cataracts develop naturally in about 90 percent of all people 65 or older and more often than not as a result of either a breakdown of the eye’s lens fibers, a clumping of the eye’s proteins, or both.

Patient photo by Jordan Pysz.

John had one eye corrected for distance and the other for reading,
which is known as monovision.

They most often cause blurred vision, an increase in sensitivity to light and/or a reduction in color vibrancy, and while they usually develop slowly, they can be corrected quickly, easily and painlessly through a brief, outpatient surgical procedure.

With a break of a week or two in between surgeries, physicians usually correct one eye at a time using an ultrasonic device that breaks up the cloudy, natural lens. Once that old lens is removed, it is replaced with an artificial intraocular lens or IOL.

Standard IOLs correct a patient’s vision for distance only, meaning the patient would still need to wear glasses for reading. Multifocal IOLs correct vision if any present astigmatism is corrected simultaneously for both distance and close-up needs, such as reading, the way bifocal glasses or multifocal contact lenses do.

Patients can also have one eye fixed for distance and one fixed for reading. That process is called monovision. That was the correction Dr. Weinstock recommended for John, who first went through a natural monovision trial, at Dr. Weinstock’s recommendation.
“During a natural monovision trial, we give the patient about a week to see how their brain will tolerate one eye being set for distance and the other being set to see up-close vision,’’ Dr. Weinstock informs. “John was one who actually adjusted very well to that.

“We corrected his left eye first, for distance, and when he looked in the distance following the surgery, his brain automatically used the distance-corrected eye. At the same time, when he looked at his cell phone, his brain automatically used the noncorrected eye, set for near.

“That eye was still blurry and hazy because we had not yet removed the cataract from it. We could tell by the way he responded to that first surgery that once we corrected the second eye, his brain would adjust very well with monovision.

“When we corrected the second eye, we purposely left him nearsighted in that eye because we want that eye to continue reading for him without glasses. Now, it’s like he has a built-in pair of reading glasses in that one eye, so he doesn’t need reading glasses at all and has crystal-clear distance vision as well from the first eye.”

Better Than Ever

John underwent cataract surgery on his left eye in January. During that surgery, Dr. Weinstock also corrected the astigmatism in John’s left eye using a special laser. He also fine-tuned the power of his lens by using a special device called the ORA System.
ORA stands for Optiwave Refractive Analysis. It allows eye surgeons to obtain accurate measurements of the shape of the eye after the cataract has been removed so the newly implanted IOL gives the patient the clearest vision possible.

Patient photo by Jordan Pysz.

John Clark

“By correcting his astigmatism and using the advanced technology ORA System to measure the shape of the eye, we were able to get the perfect matched lens for John, which gave him perfect 20/20 distance vision in that eye,’’ Dr. Weinstock reports.
“All of a sudden, he could drive again, even at night, without glasses. He could see street signs and watch TV. He had surgery on his right eye a week after he had the surgery on his left, and he began to notice a drastic improvement in his reading vision as well.”

“After the first surgery, I would close my right eye and look only out of the left, and everything was bright and clear,’’ John says. “But when I looked only out of my right eye, the one that hadn’t been corrected yet, everything was yellow and blurry.

“That’s when I realized that I never knew just how bad my eyesight had become. I naturally just got used to seeing poorly, I guess. Now that I’ve had both eyes done, I can see everything perfectly in the distance and up close.”
John adds that he’s extremely happy he was advised to visit Dr. Weinstock for his surgery. He says the entire staff at The Eye Institute of West Florida deserves high grades for its care and compassion.

“They’re all just aces,’’ John says. “Dr. Weinstock is very personable, and he made sure I knew everything that was going to happen all along the way. They even called me the very next day after the surgeries to make sure everything was all right. They’re all great.”

Nurse Peggy

Like John, Peggy Hall learned a couple years ago that cataracts were developing in her eyes. Sometime last summer, the cataract in her right eye began to develop rapidly, causing her to make a couple of changes in her contact lens prescription.

Patient photo by Jordan Pysz.

Peggy Hall

“All of a sudden, the vision in my right eye began to get progressively worse,’’ explains Peggy, a 61-year-old registered nurse who has spent the past 38 years of her 40 years in nursing serving patients at Clearwater’s Morton Plant Hospital.

“At first, I was just having a lot of blurred vision. But then I started to see halos around lights at night. And they were pretty pronounced. It was like there was a rainbow around the street lights, which made me a little anxious.

“I quickly reached a point where I wasn’t all that crazy about driving at night anymore, so I would only drive at night if I absolutely had to. Over time, the problem eventually started affecting me at work a little bit, too.

“I’m a triage nurse, and I’d worn multifocal contact lenses for years, but I still used readers at the desk and when I would work with patients, reading their monitors and charts. After a while, I had to get a little closer to the monitor to read it clearly.”

Peggy’s growing vision problems prompted her to visit her eye doctor, who twice prescribed new contact lenses. When the problem persisted, Peggy’s eye doctor suggested she see Dr. Weinstock at The Eye Institute of West Florida.

“When I first saw Dr. Weinstock in November of last year, my contact lens prescription had changed even more,’’ Peggy says. “That’s how fast the cataract was developing, so I knew I needed to have it taken care of.”

During her initial visit with Dr. Weinstock, Peggy made plans to have her cataract surgery done in January. Because she was accustomed to wearing multifocal contact lenses, she chose to have multifocal IOLs implanted during that surgery.

“The multifocal implants are very similar to the optic design of the multifocal contact lenses,’’ Dr. Weinstock informs. “That made them a good choice for Peggy because her brain was already accustomed to the use of the multifocal contacts.

“That’s a very important factor that has to be taken into consideration, because cataract surgery is no longer a one-size-fits-all type of procedure. There’s a big difference now between what you get from customized refractive cataract surgery and basic cataract surgery.

“Standard IOLs are going to be fine for a lot of people, depending on their lifestyle. But because of the advances that have been made in technology and training, there’s another level we can go to that can leave you completely glasses free and with exceptional vision.”

Amazing Outcome

Peggy reached that level after undergoing a surgical procedure similar to John’s, one in which Dr. Weinstock corrected her astigmatism and used the ORA System to ensure the implanted IOLs gave her the clearest, sharpest vision possible.

Patient photo by Jordan Pysz.

Peggy received multifocal implants, which allow her to see all distances clearly

The surgery, and Peggy’s choice of multifocal IOLs, proved a perfect combination for her as she is now living a glasses-free and contact-lens-free lifestyle for the first time since she was eight years old.

“The outcome was absolutely amazing,’’ Peggy exudes. “I wore glasses and contact lenses for fifty-three years, and the first morning I woke up and was able to see the alarm clock without reaching for my glasses was a very emotional moment for me.

“That sort of thing has been very cool. It’s also been a little hard to get used to. I mean, I’ve been in the habit of taking out my contact lenses every night and putting them in every morning for so long that I still think to do it sometimes. But I don’t have to.

“The best part, of course, is that my vision is perfect. Actually, it’s better than perfect. My vision is 20/15 now, so I’m very lucky. I don’t need to wear readers or anything anymore, and I see in the distance very clearly and crisply.”

Like John, Peggy’s vision improved dramatically after she had just one eye corrected. In her case, that was the right eye. The procedure Dr. Weinstock performed on both her right and left eye was
“completely uneventful.”

“It was so easy,’’ she raves. “And the way they do everything is so organized. They have it down to a science how they get you in and out of there. It doesn’t take any time at all, just a few minutes for the surgery itself, which is great.

“And everyone there is so professional, yet they treat you like family. Everybody greets you and is very courteous.
Dr. Weinstock is just amazing. Even though he’s treating so many people, he treats you like you’re his only patient.

“The reason I went to him is because so many of the surgeons and anesthesiologists I work with have been to him and recommended him. I figured that if they trusted him with their eyes, then that’s who I’m going to trust my eyes to, and I’m glad I did.”

Implants Now The Gold Standard For Replacement Teeth

May 22nd, 2019

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.

The advantages to dental implants include a more natural feel and look but they don’t end there. Because a full implant-supported upper arch doesn’t cover the palate the way traditional dentures do, they don’t negatively affect a person’s sense of taste.

Another issue associated with traditional dentures that is avoided through implant-supported dentures is the gag reflex that some patients experience because the denture extends over the back of the palate. Implants also aid the digestive process.

That process begins in the mouth with the way we chew our food. Implants allow a person to chew their naturally and properly, which is an important health factor. If certain foods are not chewed properly, some nutrients may not be absorbed into the body.

Implants even have an effect on the foods we eat. People missing teeth or those wearing bridges or traditional dentures may be prohibited from eating certain foods. That’s not the case with dentures, because their natural form eliminates all restrictions.

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