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At Great Length

Corrective gum procedure brings smile to teen’s face.

Photo by Nerissa Johnson.

Emma is happy to show off her new smile.

Who says playing video games is a waste of time? Emma Subin certainly doesn’t. In fact, this 17-year-old high school senior, currently prepping for her first year of college, is on a path to turn her passion for video games into a paycheck.

“When I was really young, I played a lot of video games, like Mario Kart, Super Mario Bros.® and Pokémon, and when I got a little older, my dad and I would play Guitar Hero® together, and it was always something that made me happy,” Emma explains.

“I decided I’d like to make video games in a way that will make other people happy, too, so I’m going to study video-game design in college. Video-game design is a profession that can be very profitable, so I’m really excited about it.”

Emma’s excitement is evident in her smile. It’s bright and wide, and she’s so proud of it that she shows it off quite often these days. It wasn’t that long ago, though, that Emma was very hesitant to smile, even when she had good reason to.

“For so long, I was very insecure about my smile, and that was because of my teeth,” Emma says. “I had small, short, kind of square teeth that looked almost like what a little child’s teeth look like when they’re first getting their teeth in.

“I was very self-conscious of it, so I didn’t smile very much. You can see why in my senior pictures. When I look at them, all I can see are my gums, and that was very upsetting for me. I couldn’t even stand to look at them sometimes.

“For so long, I thought there was nothing I could do about it, that it was something I was going to have to learn to live with. Then about two years ago, I stumbled across an Instagram post someone put up about their gummy smile transformation.

“At first, I thought, Wow, I didn’t even know this was a thing. Then, I asked my dentist about it and told her that I was really unhappy with my teeth and gums, and she was the one who recommended Dr. DeTure to me.”

Dr. DeTure is C. Nicholas DeTure, DMD, of Stuart Periodontics. He specializes in repairing damaged gums and repairing smiles through a procedure known clinically as anatomical crown exposure, or anatomical crown lengthening.

Overlap Reduction

When Emma first visited him this past December, Dr. DeTure explained that her smile had been negatively affected by altered passive eruption, a condition where the gums greatly overlap the teeth and make them look short, like a child’s teeth.

Some medical professionals believe the condition is hereditary, but Dr. DeTure explains that in many cases, including Emma’s, it also develops as a result of wearing braces that keep the teeth in place for an extended period during their development.

The condition is considered to be a common one, and Dr. DeTure recommended anatomical crown lengthening to correct it. Emma and her parents agreed to the procedure after learning it can be completed during a single, 90-minute visit.

“We call it a gummy smile reduction,” Dr. DeTure says of the treatment. “That’s far less clinical and easier to understand, and the idea behind it is to further expose the natural crowns of the teeth so that the right amount of tooth shows when someone smiles.

“It’s something that instantly makes people more confident because they like their smile better. And a lot of times, if friends don’t know about it, they’ll ask you, Did you get your hair cut or something? because the patient looks better, but they don’t know why.”

The treatment can be performed on any tooth in either arch, upper or lower, and while some periodontists limit it to the teeth in a patient’s smile zone, Dr. DeTure prefers to go back to the patient’s first molars on either side to create a wide beautiful smile.

“We have found that if we only correct the teeth in what some people lovingly call the social six, meaning your six front teeth, then there’s a step down of the gum of the teeth behind those front six teeth, which looks awkward.

“The results of the treatment totally exceeded my expectations. Even now, I sometimes look at my teeth and think, Wow, I had no idea that much tooth was under those gums.” – Emma

“You have all those gummy teeth behind the front six, and that can be unappealing. So we tend to always blend it back to the first molar so that there is a nice, harmonious appearance that looks natural, the way it’s supposed to.”

Patients receiving the treatment, which requires cutting away a few millimeters of gum tissue, reshaping the bone supporting the teeth and suturing the gums, are usually given a local anesthetic. But Dr. DeTure says it is a relatively painless treatment.

“What typically hurts in dentistry is when something is exposed that’s not supposed to be exposed,” Dr. DeTure educates. “In this treatment, we’re not exposing anything that’s not supposed to be exposed.

“We’re exposing the enamel, or the clinical crown, of the tooth. When we remove the gum, all that’s exposed is enamel, and enamel is supposed to be exposed. If we exposed root surface, that would be sensitive afterward, but we don’t do that.

“We typically use a scalpel for the gum removal, but most of the time is spent reshaping the bone supporting the teeth and taking the precise measurements to make sure the teeth are ideally sized.

“Some patients will feel a little bit of discomfort the day we perform the procedure after the anesthetic wears off, but most heal very quickly, and the stitches we use dissolve over a short period of time.”

Merry Christmas

Emma had her surgery on December 23. She considered it an early Christmas present, and that present brought tears of joy to her eyes when her new smile was revealed to her a few minutes after the procedure was completed.

“I took a video of myself when I first saw my teeth, and I just cried happy tears because I was so thrilled,” Emma says. “I cried the whole way home, and I just couldn’t stop looking at my teeth, even though my gums were still a bit battered up.”

Emma says she needed a little more than a week to heal completely from the procedure, in part because it took a little longer than usual for her stitches to dissolve. By the time she returned to school, though, she was healed and smiling more widely than ever.

“My teeth look amazing now,” Emma exudes. “For so long, I smiled with my mouth closed, and I didn’t even want to smile in pictures. Now, I smile all the time, and I’m smiling big and showing my teeth in all my pictures.

“I am ecstatic that I had the procedure done, so if anyone is upset with their teeth or how they look or if they’re uncomfortable smiling, I definitely recommend they get this done. It has really changed the view of how I see myself.

“And I want to say that Dr. DeTure did a great job. I was a little nervous about the surgery at first, but he made me feel very comfortable beforehand because he answered all my questions and took care of all my worries. That was super helpful.

“The results of the treatment totally exceeded my expectations. Even now, I sometimes look at my teeth and think, Wow, I had no idea that much tooth was under those gums. I couldn’t be happier.”


Superb patient care sparks rapid recovery from spine surgery.

Photo by Jordan Pysz.

Robert Long

The quest began just after the turn of the century with a trip to Boston’s legendary Fenway Park. It ended last September with a Texas two-stop in which Robert Long and his wife visited Globe Life Park in Arlington and Minute Maid Park in Houston.

With the homes of the Texas Rangers and Houston Astros scratched off their list, Robert and his wife had completed what baseball fans consider the ultimate road trip – a visit to each of the ballparks that are home to Major League Baseball’s 30 teams.

“It was a great tour, so much fun,” Robert exudes. “We really enjoyed it and liked most all the parks. They all have their own certain charm to them. San Diego was probably my favorite, I guess. It’s beautiful and in such a beautiful setting.

“Oh, and Yankee Stadium is special, of course, and so is Wrigley Field in Chicago. Another one that I really liked is in Kansas City. I felt like I was in a Norman Rockwell painting watching a game in that stadium.

“Now we have do-overs to do because a couple of the teams have moved into new stadiums since we started this. We have to go to the new one in Minnesota and the new one in Miami, and there’s a new one in Arlington now, too, so we’re looking forward to that.”

When he’s not traveling to baseball parks, Robert likes to stay up on the latest movies and play golf, but this retired school superintendent recently had to put his golf clubs away for a while due to some serious back pain.

The pain first flared up while Robert was out golfing one morning this past November. The pain was initially so great, he says, that he had to kneel down to place his ball on the tee. Soon thereafter, he sought medical help for the problem.

After being informed at an urgent care clinic that he was suffering from sciatica, a condition caused by problems with the sciatic nerve, which runs from the lower back and down the back of each leg, Robert decided to trudge on.

He did, at least, until the pain intensified. Then, and largely because he had a weeklong cruise to the Mexican Riviera coming up, Robert visited orthopedic surgeon Patrick G. Dermarkarian, MD.

“Dr. Dermarkarian didn’t say I couldn’t go on the cruise, but I probably shouldn’t have,” Robert says. “I was in so much pain that I had to go to the emergency room the night before we got on the boat, and then, during the cruise, it was really tough.

“It was while I was on the cruise that I got my first cane because the pain was like nothing I’d ever felt before. It ran through my left buttock and all the way down my leg, so as soon as we got back from the cruise, I went back to see Dr. Dermarkarian.”

Time to Decompress

Photo by Jordan Pysz.

Robert points to a
display of all the
major league ballparks he’s visited.

During his previous visit with Dr. Dermarkarian, Robert learned that the root cause of his pain was a severe case of stenosis, which is a narrowing of the spinal canal that results in a pinching of the nerves in the spine.

Dr. Dermarkarian initially suggested treating the problem with physical therapy or epidural injections, but upon seeing Robert in the condition he was in following the cruise, Dr. Dermarkarian suggested a more aggressive fix.

“We had talked about watching this and seeing if it got any better, but at that point, Robert’s gait was changing,” Dr. Dermarkarian reports. “He was barely able to walk because of the pain, so I recommended surgery, and Robert agreed.”

For patients such as Robert, there are two forms of spine surgery that can alleviate their pain. One is a decompression procedure where the objective is to alleviate the pain by removing any bone or tissue that may be compressing the nerves. The other is a fusion-type procedure which may be needed in order to realign or reconstruct the spine in order to adequately alleviate the pressure on the nerves. The decision between the two is dependent on what is seen on x-rays and advanced imaging, such as MRI and/or CT.

For Robert, Dr. Dermarkarian performed the decompression procedure, and he chose to perform that procedure at Manatee Memorial Hospital, which offers a comprehensive range of surgical services for joints and the spine.

“Manatee Memorial Hospital has a great staff that is well-versed in spine surgery,” Dr. Dermarkarian observes. “They have both orthopedic spine surgeons and neurosurgeons and a dedicated nursing staff that understands the procedures surgeons perform.

“The whole process of getting the patient prepped and to the operating room is very seamless there, and when it comes to postoperative care, Manatee Memorial’s Nurse Navigator, Andrew Stritzl, RN, BSN, is a huge asset.

“He looks after all the orthopedic-type patients and spine patients and knows exactly what the best process for taking care of them postoperatively is. He’s an incredible resource for us.”

Clean Sweep

Robert had his surgery on December 17. The procedure, which begins with the physician making an incision about five centimeters long in the patient’s lower back, takes about 90 minutes to complete.

“Through that incision, I gently elevate the musculature off the spinous process [a bony projection on each vertebra],” Dr. Dermarkarian explains. “The spinous process connects to the lamina, and you take out part of that bone and the ligament in between on both sides.

“That decompresses the canal, and then an instrument is used to sweep around in there and make sure the nerve is completely free of anything that might be pushing on it or any large disc herniations that could result in impingement.

“I typically do this as an outpatient procedure where the patient goes home later that day, but with Robert, I wanted to keep a close eye on his respiratory and cardiac status, so we had him stay overnight, and he went home the next day.”

Robert’s stay wound up lasting less than 24 hours, but he was pain free shortly after coming out of surgery. He has remained that way since and says his activity level is increasing all the time now.

“They have you follow the BLT order, which is no bending, lifting or twisting, for a while, but I was back walking right away, and by January, I was driving again, which is something I hadn’t done since I first hurt my back in November,” Robert says.

“So the recovery went very well for me, and the surgery was wonderful. In fact, the whole experience was topnotch. I could not be happier with Dr. Dermarkarian and the folks at Manatee Memorial Hospital.

“Dr. Dermarkarian did a great job explaining everything, and the Manatee Memorial Hospital staff was really top-of-the-line. If you’re assigning a number grade to them, with ten being the highest, they get a ten from me, for sure.”

A Touch of Class

Advanced laser, massage therapies trigger successful recoveries.

Photos by Jordan Pysz.

Madeline Bugeja

Few were happier to ring out the old year and ring in a new one this past January than Madeline Bugeja. A retired administrative assistant for a global insurance company now living in Spring Hill, 78-year-old Madeline aptly described her 2019 as a year to forget.

“My problems started in January, when I suffered a brain hemorrhage,” Madeline reveals. “The folks at Oak Hill Hospital picked up on it and immediately rushed me by ambulance to the hospital in Bayonet Point. That’s where I had brain surgery on January 6.

“I then spent the next six months recovering at a health care center in Brooksville, but about three days after finally returning home, I suffered a bad fall. I was rushed to the hospital yet again, and after that, I was sent to another rehab center.”

Despite all the months she spent in rehab, Madeline’s physical condition only worsened over time. As a result of the brain hemorrhage, she eventually lost most of the strength she once had in her right arm and leg, a condition known as hemiplegia.

“My leg was so weak that I could not get out of bed without help,” Madeline reports. “I couldn’t get out of a chair by myself or get in a car, much less drive a car. And my right arm was so weak that I couldn’t even pick up a pencil.

“I’m usually a very active person, but this kept me from doing anything. I even had to have the visiting nurses come in and help me, and then one day, a friend told me I should go see the people at Regional Rehab in Spring Hill.”

Madeline first visited Regional Rehab last September. That’s when she met Charles Donley, PT, whose initial evaluation of Madeline revealed more than the hemiplegia that came as result of her brain hemorrhage.

The people at Regional Rehab do great work…I recommend them in a heartbeat. – Madeline

“She also had pretty significant lymphedema, or swelling, in both lower extremities,” Charles notes. “The bigger issue, though, was the weakness from the hemorrhage, because that can prevent nerve cells from communicating with other parts of the body.

“That disrupts normal function, so what we had to do was restore that communication and function, so what I recommended was a combination of treatments using the Class IV deep tissue therapeutic laser and the HIVAMAT® 200 deep oscillation therapy device.

Dynamic Duo

Photos by Jordan Pysz.

Robert Hilker

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

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

“The Class IV laser in particular is an impressive and versatile tool,” says Charles, the director of Regional Rehab. “We use it for burn and wound patients as well as for all the different musculoskeletal issues we typically treat such as acute, chronic and postoperative pain.”

The Class IV laser and HIVAMAT 200 treatments are part of a protocol that typically includes manual therapy consisting of stretching and balance exercises. Together, those treatments finally got Madeline up and moving independently again.

“The people at Regional Rehab did more for me in three months than all the other rehab facilities did in more than six,” she says. “Now, I can zip in and out of bed, walk around the store and even drive myself to the store. They really know what they’re doing there.”

Robert Hilker, 82, doesn’t argue that point. After reading about the practice in Florida Health Care News, he visited Regional Rehab last December following treatment for a hematoma that damaged the nerves in his left hip.

“The damage to the nerves caused my left leg to feel numb and weak, and there was a lot of pain, too,” Robert explains. “The pain is like a bunch of constant bee stings, and it’s had me pretty much living in a lift chair for almost a year.”

The Road to Recovery

As he did with Madeline, Charles recommended treatment using the Class IV laser and HIVAMAT 200. Robert worked most closely with Glenn Guterman, PTA, and that work has put Robert on a path to what he hopes will be a full recovery.

“Glenn is great,” Robert exudes. “He spent a lot of time with me and worked really hard with me. I know that I’m a very unusual case, because, quite frankly, I don’t think a lot of the doctors knew what to do with me.

“I’ve been told that some of the damaged nerves will never grow back, so right now, there is still some numbness and weakness, but the treatment I received from Regional Rehab has helped quite a bit. There has definitely been some improvement.

“The pain I was experiencing isn’t as bad as it was, and it’s actually changed locations, so something is happening with those nerves. I have good days and bad days, but I still have more rehab to do, and I’m expecting I will continue to feel better.”

He already is better. Robert’s lift chair is now a thing of the past and he is now ambulatory with the assistance of a walker. He can exercise independently and is once again self-sufficient at home with activities of daily living and only requires minimal assistance with household upkeep.

Renewed Hope

Like Robert, Madeline once thought all hope of feeling better was lost, but visiting Regional Rehab changed all that. The treatment she received there helped restore mobility and strength in her right arm and leg and eliminated the swelling in both legs.

Madeline is now in the maintenance phase of her rehab program. She says she “religiously” performs the home exercises Charles showed her and doubts that she’d be feeling as well as she does had her friend not told her about the practice.

“That was one of the best things my friend ever did for me,” she states. “The people at Regional Rehab do great work, and they’re so compassionate. You can absolutely feel the compassion in that building; that’s how caring everyone is there.

“I could not be more pleased with what they’ve done for me, and I recommend them in a heartbeat to anyone. That place is fantastic. Honest to goodness, the people and the treatments – they’re all great.”

Pain Eraser

Unique therapy nullifies debilitating neck, shoulder and back pain.

When driving through Palm Beach Gardens, it’s easy to spot Cathy Mitchell’s house. It’s the one with all the sunflowers rising up from the beautifully landscaped and manicured front lawn that is Cathy’s pride and joy.

Photo by Nerissa Johnson.

Cathy Mitchell

“My sunflowers range in size from six inches to several feet high,” Cathy gushes. “But it’s not just sunflowers that I have. I have all kinds of flowers. I have zinnias, marigolds and impatiens. I have lavender plants, hibiscus and palm trees.

“It’s a beautiful yard, and I’m always getting compliments from people who drive by, or walk by with their dogs. I also love to take some of my flowers and make bouquets out of them for people. I really love to garden and share with others what I’ve grown.”

Cathy’s garden is the result of years of dedication and toil, much of which was performed under duress while she fought neck and shoulder pain stemming from the injuries she sustained in a series of car accidents, the last of which occurred in 2013.

Those injuries forced Cathy to undergo triple neck-fusion surgery in 2015, but Cathy, now 56, only reaped the benefits of her surgery for about two years before her discomfort returned and eventually intensified.

“At its worst, I felt like my whole body was just falling apart on me,” Cathy laments. “I was having a lot of trouble raising my arms, and by the end of the morning every day, my back was always hurting.

“I couldn’t turn my head to the left, and I was getting severe migraines, which were keeping me from going to work. The migraines were so bad that when I got one, I had to be in complete darkness and not see or talk to anybody.

“My neck hurt so bad that at times, I couldn’t even look up, like to see the stars or the moon. The pain even went into my back and hip. Sleeping became a problem for me, too. I was going for days without sleep.”

Cathy suffered through her pain for more than a year. It wasn’t until this past spring, after her pain intensified following a bad fall at home, that she finally relented and sought medical help.

On the advice of her brother, who had found relief for his own neck pain at the North Palm Beach practice, Cathy sought that help from Active Health Center, where she soon found herself in the care of Colin O. Behrue, DC.

“Cathy thought that after she had the neck-fusion surgery, a lot of her pain would go away,” Dr. Behrue says. “But since having that surgery, her pain had only gotten worse. She had pain and burning in her shoulders and ribs and in her collarbone on one side.

Photo by Nerissa Johnson.

MCU therapy has allowed Cathy to return to her garden and resume her active lifestyle.

“She also became a fall risk because her legs were getting weak as well. So we looked back at all her old x-rays and took some new ones and really honed in on what happened with the surgery and why it was that she was still in pain.

“What we found was that, before doing anything conservative, the surgeons just did the fusion surgery. What happens when you do that is all the muscles around those fused joints suddenly shut down because those joints don’t know how to work anymore.

“And because those joints are no longer working, the rest of the joints in the neck have to compensate for that. So she had just four joints doing the job of seven, and that put added pressure and stress on those four joints, which caused her increased pain.

“Obviously, those four joints were not designed to do the work of seven, so what we had to do treatment-wise was isolate those joints, rebuild the neck and retrain those joints so that they could handle the extra work. We did that using the MCU machine.”

MCU file photo.

The MCU machine provided both women with lasting relief.

Unique, Nonsurgical Device

The MCU, or Multi-Cervical Unit, is a unique, nonsurgical device that not only isolates and strengthens the muscles around the neck but provides a comprehensive assessment of the patient’s physical progress while the patient is receiving the therapy.

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

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

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

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

“We re-test the patient every three weeks, or nine visits, and compare the results of those tests with the results we received from our original examination of the patient,” Dr. Behrue explains.

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

After nine weeks of therapy, patients are typically given a maintenance program that includes exercises they do at home to maintain their strength. Cathy is in the maintenance program now, and thanks to the MCU machine, she’s back to normal.

Back to Normal

“When I first went into Dr. Behrue’s office, I could barely move,” Cathy recalls. “I couldn’t lift a gallon of milk or even hold a cup of coffee in my right hand, and I couldn’t sit for long periods of time because my leg would go numb.

“I couldn’t walk or stand for very long either, which meant I couldn’t go walking on the beach, which is something I love to do. I couldn’t drive for long periods either, so it was hard for me to go the grocery store and things like that.

“I have a stack of business cards from Active Health Center, and I hand them out everywhere I go.” – Cathy

“But that MCU machine is amazing, and it changed everything for me. Now, the migraines are gone, I can walk on the beach again, and I’m even riding my bike again, which is something I hadn’t done in years.

“And when I walk, I often needed to realign myself and take these little baby steps when I started, but now, I can get up and walk like normal again, which is great. And I’m gardening again because I can finally move my arms and lift a shovel.

“I’m exercising, too. I was actually gaining some weight before because I couldn’t do anything. I couldn’t even walk my dog, but now, I’m back doing those things, and I feel so much better. It’s like I’m finally back to normal again.”

Active and Strong

Even at the age of 75, Judi Johannsen’s weekly, normal routine includes playing a few rounds of golf, participating in a couple of spin classes, doing Pilates and working out with a personal trainer.

Judi’s photo courtesy of Judi Johannsen.

Judi Johannsen

“I stay pretty active,” says Judi, a former business manager who has maintained her active lifestyle through a decades-long battle with neck pain, the genesis of which remains a mystery to her.

“I have no idea how it started,” Judi confirms. “I once even asked my ex-husband if he could remember anything happening to me in the past thirty or forty years that might have triggered this, but he said, No, nothing.

“However, according to the doctors I saw, something traumatic must have happened, because I had disc issues, bone spurs and some arthritis in my neck, and it was always merely there until early last year, when all of a sudden, I couldn’t lift my head off my pillow.

“I literally had no strength in my neck and very little range of motion. And the pain was constant. It was so bad that I could barely move my head a quarter of the way around without it hurting, and driving became a real problem. I was very cautious about that.”

The restrictions the pain placed on Judi prompted her to seek medical attention. When two neurosurgeons suggested she needed surgery to repair the problem and a third said surgery would do her no good, she opted for a different treatment method.

“I tried acupuncture, cupping therapy and even cervical nerve block injections, but none of that helped,” Judi laments. “Then a friend of mine who had actually been there and tried the therapy told me about Active Health Center and the MCU machine.”

“Absolutely Amazing”

Mostly because she found no relief through the other therapies she’d tried, Judi was a bit leery of trying the MCU machine. But after hearing Dr. Behrue’s explanation of how it worked and what it was designed to do, she agreed to give it a try.

“When I looked at the machine, I thought it looked kind of weird, and I even took some pictures of myself on it and sent them to my friends,” Judi admits. “But I have to say, the results were absolutely amazing.

“After about three sessions, the strength came back in my neck, and my range of motion was almost normal. I had only a little bit of restriction after that – not much at all, really – and I just kept getting better and better.

“I was a little concerned that after I completed the treatment, I would go back to the way I was and have to go through another process like this again, but Dr. Behrue said, No, this should be it for you.

“It’s a great practice, and everyone there is amazing. I would literally stand on a corner and wave flags for them.” – Judi

“He was right. Now, I’m back doing Pilates again and going to the gym. And I’m playing golf again as well. I recently joined a ladies nine-hole group to get back into it, and at first, I was a little concerned. But Dr. Behrue said, No, go ahead and play; you have no restrictions.

“So needless to say, I’m thrilled. I’m thrilled with the results of the MCU therapy, and I couldn’t be happier with Dr. Behrue and Active Health Center. It’s a great practice, and everyone there is amazing. I would literally stand on a corner and wave flags for them.”

Cathy’s praise for the practice echoes Judi’s. She adds that she received a great education from Dr. Behrue regarding the anatomy of the neck that made it easier for her to understand why her surgery didn’t work and why another would not have worked either.

“All the nerves and everything that start at your neck go all the way down your back, and because of that, the MCU therapy helped my back as well as my neck,” Cathy says. “Now, I just need to get adjusted every once in a while, and I feel great.

“That’s why I have a stack of business cards from Active Health Center, and I hand them out everywhere I go. Anytime I meet up with someone who has neck or back problems and they tell me their story, I tell them mine and I tell them, Go to Active Health Center.

One for All

Revered practice is one-stop shop for all dental needs.

Stock photo from iStockPhoto.Like the tail on a kite, a team of black Labrador Retriever puppies follows Karen* out the back door of her DeLand-area home and into the backyard, where half a dozen older Labs are now excitedly awaiting Karen’s arrival.

“It’s dinner time; that’s why they’re so excited,” explains Karen, a 58-year-old dog breeder who has been breeding and showing Labradors since her family moved to Florida from South Dakota 34 years ago.

“My father bred Labs as just sort of a side job back when I was a kid,” Karen continues. “He was planning to give it up after we moved to Florida, but shortly after we got here, one of the two dogs we brought with us had a litter.

“I was just out of college and looking for work at the time, so I took care of the puppies until we sold them and decided after that to keep on breeding them. I started showing them a few years later, and it was at a show that I met my husband.”

One of Karen’s prize dogs, a yellow Labrador named Cleo, served as the ring bearer at her wedding, carrying the rings in a small basket dangling from her collar. The beaming smile that Karen wore that day has since faded a bit.

“I’ve had a lot of trouble with my teeth over the years, the back ones especially,” Karen reveals. “I lost a lower left molar when I was in my teens and had to have another one right next to it pulled when I was in my thirties.

“I was fit with a bridge, and for years, the bridge was fine, but then one of the teeth that supported the bridge got infected. I wasn’t very happy with the dentist I’d been seeing, so I decided instead to go see this dentist I read about in Volusia Health Care News.”

The Implant Option

The dentist Karen read about is Rajiv Patel, BDS, MDS, the founder of DeLand Implant Dentistry. Upon first seeing her in March 2017, Dr. Patel performed a thorough examination of Karen and presented her with two options as solutions for her problem.

The first was to fashion a new bridge. The second, which Dr. Patel recommended because the supporting teeth were no longer strong enough to properly support a bridge, was to replace the missing teeth with dental implants.

Dental implants are screw-like posts that are surgically placed into the jawbone. After an implant is seated in the jaw, bone naturally grows around it to create a solid foundation for replacement teeth.

A single implant supports an abutment and a crown for a single tooth, while two or more implants can support a fixed bridge or a full denture. Karen accepted Dr. Patel’s recommendation and was eventually fit with two implants and a fixed bridge.

Prior to doing that work, however, Dr. Patel had to perform a bone graft because Karen’s jaw bone had deteriorated in the area where she had long been missing the two lower molars. That type of deterioration, Dr. Patel informs, is natural.

“Bone mass diminishes with tooth loss because there is no longer anything there to stimulate bone regeneration in the jaw,” Dr. Patel educates. “That’s why we often need to perform bone grafts for patients who have been missing teeth for a long time.”

Bone grafts can be performed using residual bone collected from the patient while preparing the jaw for implant placement, a bone substitute material or a combination of the two. No matter the choice, it takes between three and six months for new bone to grow.

In some cases, however, the bone graft can be performed at the same time the implant is seated. That is what Dr. Patel did with Karen, who was immediately fit with a temporary bridge that she wore for about four months. She then received her permanent bridge.

In the meantime, Dr. Patel found another problem that needed his attention. This one revolved around Karen’s upper right bicuspid, which had once received a failed root canal and was now the site of an area of abscess.

The poor condition of that tooth required that it be removed, but when Dr. Patel removed it, he found that the deterioration of supporting bone extended all the way into the sinus cavity. Once again, he recommended a bone graft and a dental implant.

“In this case, we needed to perform a lot of bone grafting to close the sinus,” Dr. Patel informs. “We also used platelet-rich plasma and platelet-rich fibrin, which are blood products derived from the patient’s own blood, during the bone grafting procedure.”

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are regenerative blood products that are produced by first drawing blood from the patient. The blood is then placed into a centrifuge, where the growth factors are separated. Growth factors are specialized proteins that control essential activities in many types of cells.

In the final stage of the process, the growth factors are reintroduced into the patient’s body, where they accelerate healing of both soft and hard tissue. Dr. Patel can produce PRP and PRF right in his own office, which is certainly a major advantage for his patients.

Worth the Wait

“We’re like a one-stop shop for all your dental needs,” Dr. Patel says, “and Karen is a good example of what that means for patients. She needed a lot of advanced dental work done, and we were able to accommodate her without sending her somewhere else.

“She came in here with a complaint about an old, failing bridge and had an abscessed tooth. We were able to correct those issues by performing the bone-grafting procedures with the PRP and fitting her with dental implants.”

Karen received her permanent fixed bridge and the permanent crown for her failed upper bicuspid in the summer of 2017. She was so thrilled with the outcome that she has since made Dr. Patel her permanent dentist.

“I’m so glad I chose to get the implants instead of a new bridge for my bottom teeth because having implants is just like having real teeth,” Karen exudes. “They don’t move at all, and you don’t have to take them out to clean them.

“The implant process is a long one, but it’s worth it in the end, and I love it. I can’t tell you how happy I am with what Dr. Patel did for me. I’m so thrilled with him that I even recommended him to a cousin of mine.

“She just came down here from Minnesota for college and needed a dentist. I told her to go to Dr. Patel, which she did, and she’s as happy with him as I am. He’s very good and very friendly, and his whole staff is the same way.

“This may sound kind of funny, but I’ve always hated getting my teeth cleaned. There’s just something about it that bothers me, but now that I’m going to DeLand Implant Dentistry for cleanings, I don’t mind them at all.”

*Patient’s name withheld at her request.

Say What?

Speech therapy resolves persistent cough, scratchy throat.

Most retirees move to Florida for the weather. Not Susan Robertson. When she retired from her job as a communications consultant a few years ago, she moved to Florida to be closer to her daughter and two grandchildren.

Photo by Jordan Pysz.

Susan Robertson

“I just wanted to be closer to those kids,” says Susan, a Memphis, Tennessee native who, despite waging a year-long battle with an aggravating throat issue, has greatly enjoyed the time she’s spent with her family.

“The medical problem I had was this very annoying, little cough and scratchy throat. I was always having to clear my throat,” Susan says. “Because of that, I was very hoarse and hard to understand.”

Susan battled the issue for several months before seeking medical attention, but the first two doctors she visited couldn’t resolve the problem. She then visited Atlantic Ear, Nose & Throat in Lake Mary, where she was seen by Devang Shah, MD.

Dr. Shah started his work with Susan by performing a sinus scan, which showed her sinuses were clear. He then examined her larynx using a fiberoptic scope. Like the sinus scan, that too showed no abnormalities.

Dr. Shah then conducted a videostroboscopy, which uses a strobe light to examine the vocal cords. The videostroboscopy, which allows physicians to see the vocal cords in motion and detect abnormalities in them, revealed the cause of the problem.

“It was a strain,” Dr. Shah reports. “The strain causes inflammation and irritation on the vocal cords, and that’s what was making Susan cough. It’s a problem that is more common than people think because it comes out of habit.

“If someone keeps clearing their throat, it irritates the larynx and actually makes things worse. That’s why we recommend that, instead of clearing your throat, you just take a sip of water or swallow.”

In Susan’s case, sipping water or swallowing would not resolve the problem. As a result, she was advised to undergo six 30-minute speech therapy sessions. She found the prescription odd at first, but soon learned why it was recommended.

“They had me do some exercises that seemed rather silly at first, like holding up a card and blowing on it so that it vibrates and reading paragraphs and sentences and emphasizing certain letters in the words,” she says.

Susan says her scratchy throat and cough began to dissipate after just two sessions. She is speaking normally again. She says that might not be the case had she not found Dr. Shah.

“It’s unbelievable to me that I went to all these other doctors and never got any relief, and then I go to Atlantic Ear, Nose and Throat, and they do this simple thing, and I had relief almost immediately,” she raves.

“Dr. Shah is a very practical doctor. He starts simply and builds up, and I appreciate that. That’s why I’ve already sent my daughter and two friends to Atlantic, Ear, Nose and Throat, because I highly recommend them.”

Out With the Old

New-generation technology delivers better results.

Photos by Jordan Pysz.

Shirley Ladd

Like a bird in winter, Shirley Ladd has slowly migrated south across her lifetime. A native of the Canadian providence of Newfoundland, Shirley first moved to Montreal during early adulthood and then to New York.

From New York, the one-time nurse moved to Athens, Georgia, and from Athens, she moved to Port Charlotte following retirement. Oddly, her migration was not a prolonged quest to find warmer weather.

“I like the warmer weather, but it can be a bit much sometimes,” says Shirley, who has been living in Florida for the past 12 years. “I actually enjoy cool weather. But I don’t miss shoveling snow. I’m really glad I don’t have to do that anymore.”

With plenty of family members and friends still residing in Newfoundland, Shirley occasionally travels back home for extended visits. It was during one such visit recently that a dental problem arose that needed immediate attention.

“I was having breakfast one morning when the stud inside one of my crowns broke,” Shirley says. “I ended up going to a dentist there, and he put a temporary on, and when I came back to Florida, I went looking for a dentist.

“Prior to my crown breaking, I’d only had about three dentists in my life, and I’d been looking for a new one for a while because I just had this feeling that I needed to get things checked out and make sure everything was okay.

“In doing that, I’d been to two dentists. One told me I had decay underneath these six crowns I have on my top front teeth, but the other told me everything was fine and that I didn’t have any problems. Then I had the one tooth break in Newfoundland.

“When I came back, I did what I should have done in the first place, which was go see this dentist that I read about in Florida Health Care News. I wanted to go to that dentist, but for some reason I don’t remember anymore, I didn’t. But this time, I did.”

The dentist Shirley had read about and finally went to see is Joseph H. Farag, DMD, of Port Charlotte Dental Care. During his initial examination of Shirley, Dr. Farag found issues with several of the crowns she had on her front upper teeth.

Signs of Aging

“All six of her anterior teeth, which are essentially the upper teeth in her smile line, had been crowned previously,” Dr. Farag reports. “That work had been done years ago, and the thing about these restorations is that they only last a finite amount of time.

“Eventually, and this is especially true with older restorations, the gums recede and the old materials, which have metal in them, start to show. For someone like Shirley, who has those crowns in her smile line, that can become a problem.

“She wasn’t happy that the old material was starting to show and that her gums were receding around them. She wasn’t happy with the way those old crowns felt and the fact that they had become a little discolored and yellow.

“What I also discovered was that, in addition to the aesthetic issues she had with them, those crowns were not really sitting down all the way on her teeth. The margins were not sealed around them, giving her a bit of a problem with the feel of them as well.

“I also found that her gums were quite irritated, which is a sign of the margins between the teeth and gums being opened, allowing bacteria to accumulate in that space. When I explained all this to her and suggested we clean everything up and refresh the crowns, she agreed.”

Dr. Farag’s treatment plan for Shirley called for him to remove her old crowns, treat her gums to rid them of any bacteria and disease, and seat new crowns that would provide Shirley with improved function and aesthetics.

“Her old crowns were made of an older generation of dental ceramic,” Dr. Farag explains. “It’s a very brittle porcelain, and the shade she was given was much more yellow than her other teeth, and as I said, the fit wasn’t really good.

“The material we use to make crowns now is zirconia, and the crowns are actually made of that one material throughout. There’s no layering anymore, and it’s a much stronger material, so there’s no chance of fracture or chipping.

“You can literally hit this material with a hammer, and it can withstand the impact of the hammer. Racecars now use something called ceramic brakes, and that hard, ceramic brake, that’s that kind of utility you get from the material in these zirconia crowns.”

Airtight Fit

Dr. Farag creates some crowns – mostly those used for posterior teeth – in his office. But in a cosmetic case such as Shirley’s, he typically employs a lab technician to build the permanent crowns so that the patient is guaranteed the best look possible.

In creating Shirley’s permanent crowns, Dr. Farag and Shirley settled on a whiter shade of material than she had before. Her new crowns also fit better than the old ones, giving her vastly improved function and aesthetics – “airtight, like a glove,” Dr. Farag brags.

“They’re really nice,” Shirley says of her crowns. “I really like them a lot, and so do my family and friends. They all tell me, Oh, your teeth look really good, so I’m thrilled with the outcome and glad that I chose to see Dr. Farag.

“I like him. He’s very professional and very knowledgeable. I like that he has a lot of high-tech equipment he uses in his work. I was very impressed with him, his work and with everyone in his office.

“Everybody there is so professional, and they all treated me so very kindly. They were helpful in explaining everything that was being done for me. They were all great, and I highly recommend them to anyone.”

Periodontal Do-Over

Of all the positions she filled during her long career in the health care industry, the one that 69-year-old Pam Bicking found to be the most rewarding was the position she held while working for a nonprofit organization called Healthy Start.

“Healthy Start is a program that helps women with their pregnancies,” Pam explains. “It especially helps women who are on Medicaid, and what we try to do is improve pregnancy outcomes. I was what they call a Mom Care Advisor.

“I loved the job because it made me feel like a mom myself. A lot of the women I dealt with were younger, had never been through a pregnancy and didn’t know which way was up. I helped them get through it all.”

The mother of two grown children of her own, Pam had to get through a medical issue herself a couple years ago when a toothache prompted a trip to the dentist while visiting a daughter in Atlanta. During that visit, Pam learned her toothache wasn’t her only dental issue.

In addition to that bothersome tooth, one that the dentist said would likely need to be extracted because it was on the brink of failing, Pam learned she was also suffering from a severe case of periodontal disease, or gum disease.

“I wasn’t surprised to hear about the gum disease,” Pam admits. “My mother had problems with her gums and so did my sister. And when I brushed, my gums would bleed. Not a lot but enough that I knew there was probably a problem.”

Pam soon learned that her gum disease was bad enough that in addition to affecting her fast-failing tooth, it was also endangering her other teeth. Resolving the problem long-term, the dentist said, would require periodontal flap surgery.

Armed with that information, Pam returned to Florida, where she soon visited a dentist who confirmed the original diagnosis and agreed that a periodontal flap procedure, in which the gums would be repaired surgically, was indeed her best option.

Despite being a bit apprehensive, Pam agreed to have the surgery. She changed her mind just a day or two before the scheduled surgery, though, after reading an article in Florida Health Care News about a more modern fix for severe gum disease.

“The dentist in Atlanta had mentioned this procedure, but I thought there was no way it was available in Port Charlotte,” Pam reveals. “Then I read this article about a dentist who did the procedure here, so I went out and called him right away.”

Regenerative Procedure

Photos by Jordan Pysz.

Pam Bicking

The dentist Pam called is Dr. Farag, and the procedure she read about in the paper is a revolutionary gum treatment called LANAP®, which stands for laser-assisted new attachment procedure.

“Pam first came to me primarily because she wanted to learn about LANAP, so I told her all about it; then, I examined her,”
Dr. Farag remembers. “It was after the examination that I told her I thought LANAP would work very well for her.

“One reason for that conclusion was because she told me she was going to have a tooth extracted during her visit with the other dentist. I could see why someone might want to extract that tooth, but I also thought that, with LANAP, we might be able to save it.

“It wasn’t a dead tooth. She just had a periodontal infection and not necessarily an abscess. If we do the LANAP, we can wait and see how that tooth looks after the procedure and decide whether it really needs to come out or not.”

Encouraged by what she learned of LANAP, which would not only rid her of her periodontal disease but offer her a chance to salvage her failing tooth, Pam agreed to undergo the LANAP procedure.

Dr. Farag considered it a wise choice, largely because he strongly believes that LANAP provides far better results than the traditional flap procedure, during which a dentist uses a scalpel to remove the diseased tissue.

“With the flap procedure, you cut the gums open and then you scrape the diseased tissue out, clean the roots, scrape the bone, and when you’re done with all that, you sew it back together,” Dr. Farag explains.

“It works, but the result is usually a very high gumline, a lot of recession, gum loss and sensitive teeth. With LANAP, we get even better results without that gingival recession because we’re not cutting the tissue.

“What we do instead is use the laser to make small troughs that are three hairs thick between the gum and bone. We then put our instruments into that gap and debride, disinfect and sanitize all the way to the bone and flush all the bad stuff out of there.

“The gums actually stay where they are, so it’s a nice way of getting up in there and cleaning things out and disinfecting and sanitizing the periodontal pockets without cutting everything open.”

In addition to healing gum tissue, LANAP can also improve bone quality and density. In some cases, it can even spark the regeneration of bone, according to Dr. Farag, who treats a patient’s entire mouth in three phases during a visit that lasts about two hours.

Dr. Farag explains that during the first laser pass, the energy from the laser kills any bacteria in the gums, vaporizes the diseased gum tissue and dehydrates the tartar on the teeth, making it brittle and easy to remove.

During the second step, the tartar is removed with a fine-tipped, vibrating, ultrasonic instrument. The teeth are then rinsed with an antimicrobial substance that halts the growth of new bacteria. During this step, the diseased lining of the tissue is removed, and the bone surrounding the teeth is debride of infected tissue.

Finally, during a third pass of the laser at a different setting than the first, an antimicrobial seal is created that prevents re-infection and releases growth factors from blood cells that help regenerate the attachment between the gums and the teeth.

“The patient doesn’t have any sensation of what we’re doing during the procedure because we use a local dental anesthetic, just as we do if we’re doing a filling,” Dr. Farag says. “That’s how patients stay comfortable during the process.

“And there’s no post-op discomfort because we’re not traumatizing anything. The gums are not inflamed, so they’re not painful. Afterward, we simply ask patients to briefly stay on a softfood diet to prevent any tearing of the new tissue that’s forming.”

More Brushing

Pam says that sticking to a soft-food diet for a few days following the procedure was a small sacrifice that she was more than willing to make to avoid the invasive nature of the periodontal flap procedure.

“What I really liked about the LANAP procedure was that it didn’t involve any cutting or stitches and all that recuperative time afterward,” Pam says. “And this procedure takes care of your whole mouth in one visit.

“It wasn’t painful at all, and now, when I brush my teeth, there’s no bleeding. I brush my teeth and floss more than ever now because it doesn’t hurt to brush, and I really want to take care of my teeth.”

One of those teeth that Pam is now taking better care of is the molar she was in danger of losing. Just as Dr. Farag suggested, the LANAP procedure allowed her to save that tooth while improving the status of several others.

“That tooth was such a bother because the pockets were so big around it that food would get stuck in it sometimes,” Pam says. “But I haven’t had a problem of any kind with that tooth since the LANAP procedure.

“I am very pleased with the results of the procedure. And I couldn’t be happier with Dr. Farag and his staff. I get regular cleanings from them every three months now, and they take such good care of me.

“I really appreciate everything they’ve done for me. And if it weren’t for Florida Health Care News, I wouldn’t have found them. I don’t know how my teeth and gums would be had I not read that article, but I doubt they’d be as healthy as they are now.”

Phenomenal Results

Leading-edge fusion procedure eliminates chronic sacroiliac joint pain.

Photo by Jordan Pysz.

Karen is painting pain free following SI joint fusion surgery.

The dream of every artist is to sell a piece of their art. Karen Close, who didn’t become an artist until after she retired a few years ago, has experienced that dream on a few occasions, but one such experience stands out above all the rest.

“There’s an art group that I belong to, and we have a show every couple of years in the Visual Arts Center,” the Port Charlotte resident explains. “At the last show we had this past March, I actually sold a piece.

“To sell a piece out of a gallery, well, I was walking on air after that. It’s really a great feeling. I’ve sold other pieces from a booth in a consignment shop in Englewood, but selling that piece out of the gallery was really special for me.”

Karen’s passion for art developed rather by chance. Shortly after retiring from her job as an administrative assistant, she took an art class and found it to be therapeutic for her as she battled through some health issues.

Among those health issues was a back problem that first manifested itself a couple years ago as pain in her right hip. Before long, the pain moved to her lower back and radiated into her legs, which made performing even some of the simplest tasks virtually impossible.

“It got to the point where I couldn’t even stand in the kitchen and prepare dinner,” Karen laments. “I couldn’t stand long enough to even make a salad. I had to put everything on a tray and go sit down somewhere else and make it there.

“And I couldn’t walk any distances at all. If I went to the grocery store, even if it was just a ten-minute trip to pick up a few things, I had to get a cart and lean on the cart and walk behind that. And later, after I came home, the pain was ten times worse.

“I couldn’t even pick up my cats or bend over to clean their litter boxes. And if I sat, I had to sit with a pillow behind my back and with my feet up. The pain even kept me from sleeping. It was very debilitating.”

So debilitating that after a month of trying basic home remedies that failed to resolve the problem, Karen finally paid a visit to Advanced Orthopedic Center, where her husband had once been treated for a knee problem by Dale A. Greenberg, MD.

Root Cause

Upon first seeing her, Dr. Greenberg performed an initial examination of Karen and ordered a set of x-rays and an MRI of her back. The MRI showed that the cause of her pain was damage to the sacroiliac, or SI, joint, which is found between the hip and spine.

Graphic courtesy of SI-BONE®

A dowel-shaped cadaver bone like those shown here are used during the SI joint fusion procedure.

At that point, Dr. Greenberg handed Karen’s case over to his associate, Lee M. James, DO, who began his treatment of Karen in a conservative manner by giving her a therapeutic sacroiliac joint steroid injection.

“It’s a standard protocol,” Dr. James says of the injections, “but the problem with them is that they wear off after a while. With Karen, the first injection wore off after about a year. So, we gave her another. That one lasted about six months. Then she needed another.

“At that point, we decided we needed to take a different approach with her because the effect of the injections was wearing off more quickly each time we did it. That’s when I suggested doing the SI joint fusion surgery.”

SI joint fusion surgery is a low-risk, minimally invasive procedure that is performed under intravenous sedation or general anesthesia and begins with the surgeon making a small incision of less than an inch in the patient’s lower back.

Using fluoroscopy, which creates a continuous x-ray image on a monitor, the surgeon then inserts a small piece of cadaver bone that is shaped like a dowel through the incision and into the joint. The incision is then sewn up, and the patient typically returns home that day.

“This is the closest thing we have to a fix for the kind of problem Karen had,” Dr. James says of the procedure, which is completed in about 20 minutes. “And once we’re done, over time, new bone grows around the dowel, or cadaver bone.

“That’s why we call it fusion surgery, because the bone and the cadaver bone fuse together. We then check with the patient again after two weeks and again four weeks after that, and so far, we’re getting about eighty-percent success with this procedure, which is amazing.

“The only thing we’re not quite sure of just yet is how long the effects of the procedure can actually last once the bone has fused with the cadaver bone. We don’t know if it will last three years or five years, because it’s a new procedure.”

Active Again

Karen had her surgery this past September. Though she has no idea what the long-term effects of it will be, she is greatly encouraged by the short-term results, which she describes as phenomenal.

“I’m feeling pretty good because I no longer have that aching and burning pain that was in my back and hip and going down my legs,” she says. “That tells me that we hit the nail right on the head with this procedure.

“And as far as activities go, I wouldn’t say that I’m ready to dance with the Rockettes®, but the pain that was keeping me from doing things is gone and so that part of my life is back. I’ve even gone bowling since I had the surgery.

“There’s no way I would have been able to do anything like bowling before I went to Advanced Orthopedic Center, so I just can’t say enough about what Dr. Greenberg and Dr. James have done for me.

“My husband and I think the world of them. Dr. Greenberg gave my husband two new knees, and now, he and Dr. James have helped me with my back problem. We love the entire Advanced Orthopedic family. Everybody there is just great.”


An Ideal World

For as long as Glenn Martin can remember, he has had a passion for fishing. And for years, fishing in Alaska was an item near the top of Glenn’s bucket list. The 77-year-old native of South Jersey happily scratched that item off that list a few years ago.

“It was an absolutely awesome trip,” Glenn raves. “We rented a camper in Anchorage, went to the Kenai Peninsula and spent the better part of two weeks camping and fishing. Any place that looked like it might be fishable, we fished there, and it was great.

“The highlight came when I caught two one-hundred-pound halibut. That was fun, and they were keepers. We eventually shipped back home a bunch of the halibut and a bunch of salmon and what we didn’t give away to friends and neighbors we ate for months.”

A former business executive who later owned and operated a couple of shipping stores before retiring in 2012, Glenn’s fishing trip came as he began to fight the same malady that had afflicted both his mother and his grandmother previously.

“I had begun to put on some weight and soon developed diabetes,” Glenn shares. “I eventually got to the point where I weighed two-hundred-forty pounds and was spending twelve-hundred dollars a quarter on insulin, which I really hated doing.

“So I said to myself, Self, it’s time to do something about this and lose some weight. I started looking around for a good weight- loss program. I tried a couple of them, including one that you see on TV all the time, but they didn’t work for me.

“So, long story short, I eventually started looking around for a medically-supervised weight-loss program, and one of the places I called is DeLand Chiropractic and Spinal Decompression, which has this program called Ideal Protein®.”

Complete, Customized ProgramIdeal Protein

Ideal Protein enables quick weight loss while boosting energy, fostering better appetite control, improving blood sugar and cholesterol levels, and reducing blood pressure. It is an easy-to-follow, comprehensive, customized program that helps people such as Glenn achieve and maintain a healthy weight in a way that becomes second nature.

“Ideal Protein helps limit the amount of sugars and dietary fats you take in while providing a high-quality form of protein that’s easily absorbed,” explains Dr. Gordon. “Some other plans merely restrict caloric intake, so the body burns fat as well as muscle. Ideal Protein burns stored fat while preserving lean muscle.”

Dr. Gordon recommends Ideal Protein over other diet plans and surgery largely because it is more than just a diet plan. Ideal Protein fosters changes in eating habits that allow people to keep the weight off long term.

“While people can lose weight by cutting back on calories, most can’t sustain that long term,” Dr. Gordon reports. “And it’s not healthy to keep that lower level of caloric intake for an extended period.”

Dr. Gordon further warns that appetite suppressants are not the answer, because they carry a risk of dangerous side effects and “don’t address the underlying issue, which is that patients are eating unhealthy foods or excessive quantities of healthy foods.

“That doesn’t happen with people who are on Ideal Protein, because we make sure our patients learn healthy eating habits, so they can maintain their weight in a healthy range for the long term.”

“The Ideal Protein program was totally successful. In fact, it’s been so successful that even my family doctor is now recommending it to some of his patients.” – Glenn

And while Dr. Gordon agrees that surgery to reduce stomach size does decrease the amount of food a person can eat at a sitting, he notes that some surgery patients still don’t achieve the results they expect and end up turning to Ideal Protein.

Rigorous physical activity isn’t necessary to lose weight while on Ideal Protein, but participants are required to take a multi-vitamin and ensure that potassium, fish oil and calcium supplements are part of their diet.

“We supplement because most of the dairy, grains and fruits are removed from the patient’s diet while they’re on the program,” Dr. Gordon informs. “Those food groups have lots of minerals, so the supplements ensure they get an adequate, balanced amount of minerals.

“But there are no diet pills or stimulants in Ideal Protein. The program teaches people to eat healthy, because all of the plan’s food is designed to be low-carb, low-fat, with a moderate amount of protein and typically high in fiber.

“They help satisfy your cravings and hold you over until your next meal. One thing we don’t want is for people to be hungry.”

Dr. Gordon observes that what really sets Ideal Protein apart is the program’s one-on-one coaching and support system. The clinic’s Ideal Protein coach, Jennifer Gordon, meets individually with Ideal Protein clients to guide them on their journey to better health and wellness.

No Pills, No Stimulants

Glenn can attest to the great impact the Ideal Protein coach has on clients of the program. He first visited DeLand Chiropractic & Spinal Decompression in early 2019 and began the four-phase ketogenic lifestyle program shortly thereafter.

From the very beginning, he worked directly with Jennifer, the practice’s lead Ideal Protein coach, who proved to be an invaluable resource during the nine months he spent on the program.

Photo by Jordan Pysz.

Glenn Martin

“Early on in the program, there are times when you’re not quite sure what you can and can’t eat. Having access to a live person really helps,” he says. “She even gave me her personal cell phone number so that if I had a question, I could call her directly.

“The other thing that happened was, after I started the program, I began looking more closely at the contents of foods, I found there are certain ingredients in some foods that I had no clue about and Jennifer was really helpful with that, letting me know what I could and could not eat.”

Thanks in part to Jennifer’s help, Glenn wound up losing more than 60 pounds in nine months on the Ideal Protein program. Even better, his weight loss completely eliminated the need for him to take insulin shots, which he has not done since April 2019.

Glenn is confident that trend will continue, because Ideal Protein also helped reshape his eating habits to the point where even when he craves a late-night snack, he now satisfies that craving in a healthy manner that allows him to keep the weight off.

“The Ideal Protein program was totally successful,” Glenn enthuses. “In fact, it’s been so successful that even my family doctor is now recommending it to some of his patients. And I recommend it too, of course.

“Remember, I tried a lot of other programs and even tried one of them twice before I discovered the Ideal Protein program, but none of them worked. This one definitely did work, and thanks to the folks at DeLand Chiropractic, it worked terrifically.”

The Future Is Now

Technological upgrades result in more accurate dental diagnoses.

Photo courtesy of Jack Varsalona.

Dr. Jack Varsalona

When Jack Varsalona stepped in as the third president of Wilmington College in 2005, the private, nonprofit, doctoral research institute was still in its infancy. That place of higher learning grew in a hurry under Dr. Varsalona’s direction.

During his first two years in office, Dr. Varsalona orchestrated the transition of the small New Castle, Delaware academy into Wilmington University. He then watched as the campus expanded and its enrollment doubled to more than 20,000 students.

The expansion of the school was the highlight of Dr. Varsalona’s career in education, which came to an end when the now 71-year-old retired and moved to Delray Beach a little more than two years ago.

At the time of his move, Dr. Varsalona harbored concerns about the status of two crowns that, according to his previous dentist, needed to be replaced. His arrival in Florida was followed almost immediately by a search for a new dentist.

His eventual choice, based on referrals from friends and associates he knew in the area, was Naved Fatmi, DMD, of Town Square Dentistry in Boynton Beach. It didn’t take long for Dr. Varsalona to learn why Dr. Fatmi came so highly recommended.

“Keep in mind that I went to him because I was concerned about these two crowns that my previous dentist had told me needed to be replaced,” Dr. Varsalona explains. “Well, after my initial examination with him, Dr. Fatmi said those crowns were fine.

“I found it rather amazing that dental work I had been told I needed, I didn’t really need at all. I remember Dr. Fatmi saying to me, No, we try to preserve the teeth as long as possible, so you really don’t need to have those crowns replaced.

“That was two years ago, and I have not had any problems with those crowns or those supporting teeth at all since then, and I still don’t need new crowns. I was very happy to see that Dr. Fatmi was not looking to do additional work.

“He just wanted to do what was the best for me, and I can’t tell you how much I appreciate that he is that way. In fact, he treated me in a similar way just recently when I went to see him after an old filling came out.

“I thought for sure that I would need a crown there, but he said, No, you’re not in pain, and we can treat this another way. Once again, his whole objective was to preserve the original tooth as long as possible, which I appreciate.”

Dr. Fatmi was able to make the sound, cost-saving judgments he made regarding the status of Dr. Varsalona’s teeth in part because he has at his disposal some of the most advanced dental technology available.

That technology includes intraoral digital radiography, or digital x-ray technology, which is lauded universally because the images taken from inside the mouth produce a far more detailed dental x-ray in a much faster and safer way than traditional dental x-rays do.

“With the old way of taking x-rays, you had a little sheet or piece of cardboard, and you had to hold that up to the patient’s mouth and then snap the picture,” Dr. Fatmi explains. “It was very clunky.

“It was also very easy to misdiagnose or misinterpret what you saw on those old x-rays because you couldn’t see some of the harder areas on them very well. Digital x-rays are far superior because the image can be looked at immediately on your computer screen.

“It’s a lot easier to help the patient because you can see things better and, of course, that helps us to properly diagnose any problem and come up with the right treatment and outcome, just as we did with Dr. Varsalona.”

Another advantage of digital x-rays is that they reduce the exposure of the patient to radiation by approximately 90 percent. That can be critical for some patients, especially those who are concerned about radiation exposure.

Making a Positive Impression

Dr. Fatmi also has the equipment necessary to produce digital impressions, which eliminate the need to create molds for crowns, bridges and dentures out of that foul-tasting, gooey putty that patients can gag on if too much is used.

Digital impressions are produced using a wand-like tool that is connected to a computer loaded with advanced software. After the mouth is scanned, a virtual model of the hard and soft tissue in the mouth is created that is then used for a variety of purposes.

Those purposes include producing immediate images of what a patient’s mouth will look like following the kind of extensive changes that come as a result of a patient being fit with partials, dentures or dental implants.

Town Square Dentistry also offers cosmetic dental services such as teeth whitening, as well as teeth straightening through Invisalign® clear braces, which provides most patients with a beautiful smile within a year.

“We recently purchased this practice from a previous owner, and when we did, we made sure to upgrade it with all the latest technology available so that we can better serve our patients, such as Dr. Varsalona,” Dr. Fatmi says.

Dr. Varsalona is among those who have greatly benefitted from the upgrades. Were it not for the advanced technology Dr. Fatmi brought in, Dr. Varsalona might have unnecessarily gone through some major dental revisions.

“I’ve had a few little problems here and there that I thought were bigger problems until I saw Dr. Fatmi,” Dr. Varsalona says. “In my opinion, he’s the best. He’s the best dentist I’ve ever had, and I’ve happily referred friends to him.”

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