Author Archive

Heavenly Intervention

Ongoing treatment for venous disease reveals potentially deadly diagnosis

Still an avid motorcyclist, David often rides with veterans groups for charity events.

David Obermier credits divine intervention for his successful career as a licensed prearrangement adviser with a Punta Gorda funeral home.

“When I moved to Florida from Iowa in 2007, I went to work for a manufactured modular home dealership,” David recalls. “It was a few years after Hurricane Charley, and most of the homes were already sold. After working in the business for about three months, I hadn’t sold a home and was going broke.

“Around that time, I began attending the Lutheran Church of the Cross in Deep Creek. After church one day, the youth group was going on a sailboat as an afternoon activity. I was talking to the group, asking them what they knew about sailing and kind of kidding around with them because I knew more about cornfields than sailboats.

“Two of the children’s mothers came up to me because I was new to the church. One of them asked me what I do for a living. I said, I try to sell manufactured modular homes, but it’s not going so well. I’m going broke.

“She said, The way you help people in our church, you’d be good at helping people with funeral prearrangements. She gave me the name of a funeral director to call. I interviewed and got the job. I’ve been there for more than 15 years, thanks to God.”

David, 67, is also a veteran of the Army’s 101st Airborne Division. He served just as the Vietnam War was ending, so he was spared a tour in Southeast Asia. As a vet, David is part of the Department of Veterans Affairs health care system. Several years ago, he developed a problem and the VA had no solution.

“I had an ulcer on my left ankle that wasn’t healing,” David details. “I also had varicose veins, which is something my dad had, too. Part of those problems, I believe, was due to a motorcycle accident in 1977 in which I suffered four compound fractures of my left leg.

“After the accident, the blood flow in my left leg wasn’t very good, and I’ve worn support stockings to keep the swelling down in my leg ever since. I believe the varicose veins were preventing the ulcer from healing, so the VA referred me to Dr. Joyce.”

Douglas H. Joyce, DO, FACOS, FACPh, is a board-certified cardiovascular surgeon at Joyce Vein & Aesthetic Institute in Punta Gorda. Dr. Joyce specializes in treating venous disease with minimally invasive procedures. He addresses all stages of the disease, from spider veins to venous ulcers.

“The Ulcer Healed”

“We evaluated David using ultrasound and venous mapping and discovered that he had a significant number of incompetent veins in his legs, which caused the ulcer on his left leg,” Dr. Joyce reports. “The affected veins included his saphenous veins and his perforator veins.”

There are two vein systems in the legs: the high-pressure central vein system deep in the muscles and the low-pressure superficial vein system just below the skin. The superficial system drains into the central system through perforator veins and the saphenous vein system.

Leg veins contain one-way valves that prevent blood from flowing backward and pooling. If these valves are weakened or damaged, blood flows back in the veins instead of toward the heart, a condition called venous insufficiency. As a result, blood collects in the legs, causing swelling, discomfort and varicose veins.

Dr. Joyce treated David’s venous insufficiency using two minimally invasive procedures: standard laser ablation and single-needle laser ablation. The latter is a technique pioneered by Dr. Joyce.

“We used standard ablation to close Mr. Obermier’s saphenous veins because they were severely incompetent,” Dr. Joyce reports. “During this procedure, we slide a laser fiber into and along the length of the vein and use laser energy to seal the entire vein. Blood flow is then rerouted to other healthy veins.”

During single-needle laser ablation, Dr. Joyce takes a specifically designed needle and, using ultrasound guidance, places it into the targeted vein, which is usually a perforator vein. He then applies an anesthetic and turns on the laser for 15 to 20 seconds, which spot-welds the area of vein being treated and seals it.

“Dr. Joyce told me that closing the bad veins would heal the ulcer,” David recalls. “And it wasn’t long after the procedures that I started getting results. The ulcer healed rather quickly after that, and now my legs look a lot better. The bulging varicose veins are gone, and my legs are in pretty good shape.

“I no longer experience as much swelling in my legs as I used to either. I still wear support stockings because they keep my legs healthier, but Dr. Joyce checks my legs every year to make sure no varicose veins or ulcers are developing.”

Lifesaving Discovery

Although David was pleased with his treatments, Dr. Joyce wasn’t completely satisfied. He still wasn’t sure that something else might be causing David’s leg vein issues.

“I thought, Something else must be wrong here. So, we started looking for an issue elsewhere, such as in the pelvis or abdomen, that may have caused the problems with drainage from his legs,” Dr. Joyce explains.

An MRI and CT scan confirmed Dr, Joyce’s suspicions.

“They did a scan and discovered seven tumors in my abdomen that turned out to be cancerous,” David reveals. “The diagnosis was non-Hodgkin lymphoma. I went on chemotherapy right away.”

Non-Hodgkin lymphoma occurs when the body makes too many abnormal lymphocytes, a type of white blood cell central to the body’s defense against disease. These lymphocytes lose their infection-fighting ability, making the person highly susceptible to infection.

“Dr. Joyce saved my life, because if it wasn’t for him, I probably wouldn’t have known I had cancer growing inside me until it had really caught hold of me,” David effuses. “Fortunately, I was able to beat it. It’s one of those cancers that’s not entirely curable but is treatable.”

David receives routine checkups to make sure his cancer stays in remission.

“Dr. Joyce is a fabulous doctor,” David offers. “He’s very knowledgeable and cares about his patients. He’s always studying to stay on the leading-edge of his field. I wouldn’t trust my legs to any other vein surgeon. He’s got a great office staff as well; very nice and very knowledgeable. A great staff reflects the strength of Dr. Joyce’s leadership. I highly recommend him.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz.

As seen in Charlotte County Edition of
Florida Health Care News

As A Matter Of Facets

Regenerative therapy reduces pain, rebuilds cushion in degenerated spinal joints

On May 4, 1970, members of the Ohio National Guard fired into a crowd of anti-war protestors at Kent State University, killing four students and wounding nine others.

The event, which became known as the Kent State massacre, triggered a massive student strike across the nation that forced hundreds of colleges and universities to temporarily cease operations. It was also instrumental in turning the tide of public opinion against the war in Southeast Asia.

Janet Goff was just a teenager then, but nearly 53 years later, she can still recall the anxiety she felt as a Kent resident during those events and their aftermath.

“We moved around because my dad was in the military, but he chose to retire in Kent,” recounts Janet, 68. “I was in high school at the time. My sister was actually working in the university’s ROTC building when all that broke out. It was a pretty scary time.”

When Janet became an adult, she left Kent, married and began traveling again, this time with her husband. Initially. Janet was a stay-at-home mom to their son. When her son got older, Janet began working outside the home to help with the family finances.

“I mostly did administrative-type work,” Janet relates. “I was a pharmacy technician for a while, and I worked in different offices. I worked for an engineering company and a brand development company. I was also a certified aerobics instructor. Of all my jobs, I liked teaching aerobics the best. It was fun helping women get in shape.

“I taught aerobics at the YMCA, at an after-school program for teachers and at several churches. I taught at a women’s fitness camp every summer. I also taught after-work classes for various corporations including Ohio Bell, the telephone company. I went to the jobsite, where a room was set up for the class.”

Now retired, Janet remains active. She fills her days with gardening, working out, biking and running. She also volunteers at church and at a nursing home. Several years ago, her active lifestyle took a hit when low back pain flared and grew progressively worse.

“I fought the pain for quite a while,” she says. “I think a lot of the problem was overuse and physical strain. I cut down a lot of trees, did a lot of yardwork and lifted a lot of things. For years, nothing stopped me, but I think that’s how I hurt myself.

“The pain was mostly in my hips, lower back and buttocks, and it was a sharp, shooting pain that eventually got so bad that I couldn’t get up or down or even stand because it felt like my leg wouldn’t hold me up.

“I had to quit exercising and doing yardwork and even had trouble cleaning my house at times. I was always hurting, and when you’re in pain like that, you don’t want to do anything but lie around. That’s what happened to me, and I put on a lot of weight because of it.”

Over the years, Janet visited several chiropractors who tried to alleviate her pain with physical therapy, massage therapy, and ice and heat treatments, but those provided only short-term relief.

Then her massage therapist recommended Dr. Jeffrey P. Johnson, lead provider at Johnson Medical Center in Venice. After a thorough examination, Dr. Johnson determined that the primary source of Janet’s pain was the facet joints in her lower spine.

The facet joints are pairs of small joints at each vertebral level of the spine. They connect the vertebrae and allow the spine to bend forward and backward. They are also a common cause of back pain.

“Those joints were degenerated and arthritic,” Dr. Johnson reports. “As a result of the degeneration, the material that cushions the bones of those joints had worn away, which allowed the bones to rub against each other, causing pain.”

Dr. Johnson first tried treating Janet with chiropractic and physical therapy. When those approaches alone failed to provide long-term relief, Dr. Johnson recommended another treatment called regenerative therapy.

Alternative to Surgery

Regenerative therapy is a nonsurgical option in which renewing substances are injected into the joint to stimulate the body’s ability to heal itself.

Because injections are less invasive than surgery, patients recover much faster and there is less risk for complications such as bleeding and infection, which can occur with joint replacement and other types of surgery.

“Regenerative therapy provides an option for patients with conditions that I would have previously referred for surgery,” Dr. Johnson affirms. “It’s been a terrific addition to our practice, where we also use rehabilitation therapy, laser therapy, chiropractic and other modalities to assist with the process of rehabilitating damaged joints.

“The goal is for the treatment to be a long-term restorative event, not just a short-term fix. And best of all, it works. We’re seeing tremendous results with our regenerative therapy protocol.

“Within weeks of beginning treatment, patients are experiencing terrific relief from their joint pain. In a matter of months, we’re seeing an increase in the joint cushioning and true healing of the joint. You don’t see that level of healing with joint replacement or other surgery.”

Janet was deemed an excellent candidate for Johnson Medical Center’s regenerative therapy protocol, which begins with a simple blood draw. The blood is placed in a centrifuge, where it’s spun to create enriched plasma, which contains healing and growth factors that help regenerate damaged tissue.

At Johnson Medical Center, a typical course of regenerative therapy calls for the patient to receive three weekly injections of enriched plasma.

“We then inject another material called micro human tissue, which c o n t a i n s even more of the vibrant s u b s t a n c e s that promote the body’s healing ability,” Dr. Johnson relates.

Micro human tissue is obtained from women who donate their babies’ umbilical cords following healthy births. The umbilical cord has protective tissue that surrounds the arteries and veins and is a vital component of fetal development.

“The enriched plasma gets the joint ready for the micro human tissue, which is the last injection of our protocol,” Dr. Johnson informs. “Micro human tissue is the most effective tissue we use to promote healing.”

At Johnson Medical Center, all regenerative therapy injections are administered by Mahendra Poonai, RN, APRN, FNP-BC, under ultrasound guidance, which ensures appropriate placement at the site of the degeneration and/or injury.

“Mahendra has traveled across the country to receive the best training in regenerative therapy techniques,” Dr. Johnson assures. “He has developed expertise in using ultrasound to get the enriched plasma and micro human tissue exactly where it needs to be for the treatment to be most effective. It’s a very precise technique, and Mahendra does it well.”

As part of her treatment, Janet also received trigger point injections. This involves injecting a local anesthetic, sometimes combined with a steroid medication, into a trigger point, which is a sensitive area of tight muscles, to relax the muscles and relieve pain. Mahendra delivers these injections, too.

“Just Amazing”

After Dr. Johnson explained the regenerative therapy protocol to Janet, she was enthusiastic about giving it a try. Once she did, she was amazed by how rapidly she noticed a difference in her pain level.

“The therapy started working really quickly, within a couple of days of getting the micro human tissue injection,” Janet enthuses. “It alleviated the pain in my lower back, which is now gone. I have zero pain, which is just amazing.

“Thanks to that, I’m moving around again. I’m very active. I’m running, biking, exercising and gardening. I’m running around like I used to. I feel like I’m 20 years younger, and because I’m stronger and more active, I’ve lost 12 pounds.”

Janet says she is delighted with the work and manner of Dr. Johnson as well as Johnson Medical Center’s staff.

“Dr. Johnson is a very nice man,” she raves. “He is very personable. He likes to talk to you about stuff, and he checks up on you during your treatment. The staff at Johnson Medical Center is also super nice and helpful. I definitely recommend them and have already given their number out to several people. I always tell people about them.”

© FHCN staff article. Photos by Jordan Pysz.

As seen in Charlotte County Edition of
Florida Health Care News


A Gut-Wrenching Feeling

Tension-free repairs for painful inguinal hernia include laparoscopic surgery

For 39 years, David Napoli, DC, has been providing chiropractic care at his Broward County practice, where he specializes in treating sports injuries, personal injuries and injuries suffered by workers on the job.

It was his personal experience with chiropractic that influenced Dr. Napoli’s decision to pursue a career in the field.

“In high school, I injured my back playing football,” the Pittsburgh-area native relates. “I was told I needed surgery on one of my discs, but I ended up seeing a local chiropractor instead. Within four or five months of treatment and rehab, I was playing ball again.”

“After high school, I attended Palmer College of Chiropractic in Davenport, Iowa, and earned my doctorate in 1982. That’s the original chiropractic college in this country. It’s considered the Harvard of chiropractic educational institutions. It was founded in 1897 by Daniel David Palmer, and I had the pleasure of graduating from there.”

Dr. Napoli, 63, also enjoyed the pleasure of never needing any type of surgery — until a couple of years ago, when he was injured during an automobile accident.

“My car was hit, went off the road and landed on its side,” Dr. Napoli recalls. “I tried to open the driver’s side door to get out, but the doors are very heavy when the car is on its side. I strained to get the door open, and I felt a pop in my left groin. Then I felt pain on my left side.

“The pain wasn’t excruciating, but after a while it started to really bother me when I was on my feet for extended periods of time. Gradually, it got worse to where I was experiencing a throbbing, aching pain at night. When it got bad, it was an eight or nine on a scale of one to 10.”

Dr. Napoli soon learned that the cause of his pain was a hernia triggered by his attempt to open the car door. A hernia occurs when an internal organ or other body part protrudes through the wall of muscle or tissue that normally holds it in place.

Seeking a remedy, Dr. Napoli began interviewing local physicians about the surgical interventions available. He came away quite discouraged.

“I know many doctors on the state’s east coast because I practice there, but I wasn’t very impressed with any of the doctors I visited,” he laments. “So, I went on the internet and Googled doctors who did hernia surgery and the techniques they use. I picked three physicians on the west coast to interview. One was Dr. Napoliello.”

David A. Napoliello, MD, is certified by the American Board of Surgery and is a fellow of the American College of Surgeons. He has offices in Bradenton and Venice.

“When I first called Dr. Napoliello’s office, I talked to his staff and left a message,” Dr. Napoli explains. “Unbelievably, Dr. Napoliello called me back and spent an hour and 15 minutes on the phone explaining the procedures he offers. I was very impressed.”

Bulging Tire

Dr. Napoliello explained that hernias can develop in adults and children as a result of heavy lifting, straining, coughing or any unusual stress that causes a sudden increase of intra-abdominal pressure.

Some hernias are congenital, meaning they are present at birth, whereas others develop as a result of a predisposition for hernia. Also, anyone who has had surgery may experience a weakening of tissue at the incision site that could result in a hernia.

“Dr. Napoli had an inguinal hernia, which is the most common,” Dr. Napoliello reports. “Inguinal hernias occur due to a defect or weakness in the abdominal muscle wall through which intestine and fat layers protrude and form a visible bulge in the groin area.

“To visualize the dynamics of it, think of an automobile tire. The abdominal wall is like the thick outer wall of the tire. Should the tire get damaged, the inner tube can push through the weakened area or crack, forming a small bubble.

“If the abdominal wall becomes weakened, the tissue that lines the inside of the abdomen and holds the intestines in place, called the peritoneum, can bulge into the outer wall. In the tire, the inner tube can become strangled by the pressure of the edges of the crack through which it protrudes. It’s the same with a hernia.”

The first sign of a hernia is a bulging under the skin. Additional symptoms may include discomfort while lifting heavy objects, sneezing or coughing, straining while using the toilet, or pain while standing or sitting.

Because delayed treatment can sometimes lead to the intestine being trapped inside the hernia sac, resulting in gangrene, any bulge should be brought to a physician’s attention immediately so that diagnosis and treatment can begin.

If left untreated, certain complications from hernias can be fatal.

Repair Techniques

To repair hernias, surgeons have the option of several techniques. Surgeons typically choose the best option depending upon the patient and the size of the hernia.

“Formerly, the only hernia repair option available was an open surgical procedure called a tension repair,” Dr. Napoliello observes. “The physician makes an incision, pushes the protruding tissue back into place and stitches the tissue layers together. The potential disadvantages of this type of surgery include relatively long recovery periods, high recurrence rates and discomfort following surgery.

“Today, we can offer a variety of minimally invasive open procedures, as well as laparoscopic and robotic procedures. Unlike a tension repair, these are tension-free because the stitches or sutures used do not put tension on the sides of the defect to keep it closed.

“Instead, we use special mesh patches that limit the size of the required incision. These procedures offer lower recurrence rates, quick recovery and only minor discomfort. The minimally invasive open approach can also allow the patient to avoid general anesthesia.”

There are two main options for robotic and laparoscopic surgery, the skilled surgeon continues. “In the transabdominal approach, the physician makes a small incision and slides a laparoscope, which is a thin telescope, through the abdominal wall. For the preperitoneal approach, the laparoscope slides between the tissues of the abdominal wall, never entering the abdominal cavity. With both approaches, surgeons view the hernia and surrounding tissue on a video screen.

‘I Feel Fantastic”

Dr. Napoliello repaired Dr. Napoli’s inguinal hernia using the preperitoneal laparoscopic approach in February 2021.

“He made three small incisions and performed the surgery through those,” Dr. Napoli describes. “He inserted air around the hernia and worked within that space. He did a great job. It took care of my problem, and I healed up nicely.

“I have a clean bill of health. The pain is gone, and I feel fantastic. I’m playing golf again, swimming and even doing some light weightlifting. I couldn’t do those activities before the procedure; the pain was too great. My hernia surgery was one of the smoothest procedures I ever went through as far as my health is concerned.”

The chiropractor says the surgeon is a fantastic medical colleague.

“He’s very cordial and professional and knew exactly what needed to be done,” Dr. Napoli raves. “He’s also very efficient and did everything correctly.

“I drove three hours from Fort Lauderdale to Sarasota to have my hernia procedure done. That’s how confident I was in Dr. Napoliello. And it was a great experience.”

© FHCN article by Roy Cummings. Photo courtesy of Dr. David Napoli.

As seen in Charlotte County Edition of
Florida Health Care News

Never Sounded Better

Patient appreciates benefits of prescriptive hearing aids from audiologist

There are plenty of people who don’t interact with their closest neighbors or even some family members as often as Richard Jones has with the US Patent and Trademark Office.

Richard, a 79-year-old retired electrical engineer, holds nine US patents for the innovations he’s created while modeling and designing microprocessor-controlled air-conditioning, refrigeration and heat-transfer systems.

Most of those patents were awarded while Richard was working for a major air-conditioning manufacturer, a well-known electronics maker and a Virginia-based energy company that supplies power to parts of Virginia, North Carolina and South Carolina.

“More recently I’ve been producing works on climate change,” Richard offers. “I’ve studied the subject for 2½ years and have already written one book on the subject. I’m in the process of writing a second.”

Long before turning his attention to climate change, Richard was forced to turn his attention to a far more personal issue, one with roots in a congenital condition that has caused him suffering and discomfort since childhood.

“I have very small eustachian tubes,” Richard says of the passageways between the middle of each ear and the upper throat that are responsible for equalizing ear pressure and draining fluid from the middle ear.

“This issue has caused me problems since I was 5 or 6 years old because the eustachian tubes get all plugged up and harbor bacteria, which can cause earaches, infections and things like that.

“Then about 15 years ago, I contracted a cholesteatoma (middle ear cyst) that had to be operated on. I was fit with a prosthesis after that, but that eventually failed, and when it did my hearing went to hell in a handbasket.”

I Blame Myself

Richard was already severely hard of hearing in his right ear before the left ear became compromised following the surgery. However, his initial attempt to resolve the issue failed as badly as the prosthesis.

He admits he has only himself to blame for that.

“I decided I needed to get a hearing aid,” Richard reveals. “But what I did was get what amounts to an amplifier from a big-box retailer.”

The device did little to improve Richard’s hearing. It made the sounds he heard louder, but it didn’t make them clearer or more intelligible. Despite the aggravation that caused, Richard waited almost a year to rectify the problem.

“There was a lot of turning my head to the left to hear somebody during that time,” Richard relates. “I was given a recommendation by my ear, nose and throat physician, who said I should go see Dr. Duran.”

Dr. Duran is Drianis Duran, AuD, of Gulf Coast Audiology. She first saw Richard about a year ago. It was not the first time she’s treated a patient who failed to resolve a hearing issue by obtaining nonprescriptive hearing aids.

In most of those case

s, she says, the failure stems from the provider’s inability to properly test and evaluate the patient’s hearing loss. That is never a problem at a practice such as Gulf Coast Audiology, according to Dr. Duran.

“You’re visiting a team of professionals who have the knowledge and experience to accurately test your hearing, evaluate your needs and determine the treatment option that’s best for you,” she says.

“That is all a part of our recipe for personalized care, and you need to take that personal approach to care when treating someone with hearing loss because there is no one-size-fits-all approach to treating hearing loss.

“Hearing is a very dynamic sense because people are not always in the same environment. We hear differently depending on where we are and what’s happening around us, and correcting that starts with a very thorough audiological evaluation.

“Beyond that, the provider needs to make a commitment in time and effort to resolving someone’s hearing issues because there’s a lot of fine-tuning, even a lot of handholding involved in fitting someone with the proper hearing device.

“And finally, depending on the hearing device the patient receives, the provider may need to spend time explaining the various features and applications that make it the right fit for t h e wearer and allow them to get all that they can out of it.”

“A Substantial Difference”

Richard realized the difference between a big-box provider and a board-certified audiologist within minutes of meeting Dr. Duran. The hearing test alone, he says, was on a level he had not experienced before.

“There’s a substantial difference between the two,” Richard confirms. “The difference is that Dr. Duran has the ability to make sure the hearing aid I have is actually amplifying the frequencies that I’m deficient in.”

Dr. Duran did that by fitting Richard with a hearing device that includes a feature known as CROS, which stands for contralateral routing of signals. A CROS device allows a person with unilateral, or single-sided deafness, to hear and comprehend all necessary sounds.

The system includes a transmitter that is placed in the most compromised ear and a hearing aid that is placed in the better ear. The transmitter sends signals that can’t be heard in the poor ear to the better ear so that hearing becomes more natural.

The CROS device has done wonders for Richard.

“There is a substantial difference in the quality of the sound that I receive now,” Richard details. “It’s a much better sound, much crisper. And it’s eliminated the need for me to turn my head toward the person I’m listening to.

“The bottom line is that through the hearing aids she’s fit me with, Dr. Duran has made my life significantly better. There is no question about it, and because of that, I absolutely recommend her to anyone with hearing issues.

“The difference between Dr. Duran and the people I was dealing with before is like apples and oranges.”

© FHCN article by Roy Cummings. Photo courtesy of Richard Jones.

As seen in Charlotte County Edition of
Florida Health Care News

Hip, Hip Hooray

Outpatient replacement procedure results in rapid recovery

Seven years ago, Gene Cooley and his wife took a sabbatical from the bustling lives they had come to know here in the US and moved to a small, Spanish seaside town 20 miles southwest of Barcelona called Sitges.

Often referred to as the Saint- Tropez of Spain, Sitges offered the couple a chance to unwind. While they continued working, they explored the continent they fell in love with on a cruise a few years earlier.

“That was the whole point of going over there,” Gene says. “We wanted to see Europe. And believe me, we made the most of it. In the time we were there, we visited 18 countries and more than 100 cities.

“Another thing we loved there was the lifestyle. It’s totally different from what it’s like here in America. I mean, there’s a break for every holiday. And they have a lot of holidays. I had 40 paid holidays a year over there. That’s unheard of here.”

It is when you work in the restaurant business, which Gene has done for 35 years. Now a chef at Hurricane Charley’s in Punta Gorda, Gene was accustomed to working most holidays. He got a break while in Europe but began to pay a price for it.

“We didn’t have a car over there, so we walked most everywhere we went,” Gene says. “After a year or two, that caught up to me and I started to feel a lot of pain in my hips. I also lost a lot of flexibility, so much that I couldn’t even bend to pick up something.”

After a couple of uncomfortable years, Gene finally visited a doctor. The diagnosis was arthritis brought on by the years of standing at work.

“Weight was a factor, too,” Gene admits. “I was close to 400 pounds at the time. That and spending nearly 14 hours a day on my feet contributed to the problem, which was that my hips were just wearing out.”

After Gene and his wife returned to the US two years ago to be closer to family, his hip pain began to affect his work. When it forced him to start relying on others to do tasks he used to do, he sought medical help again.

Based on a recommendation from his insurance company, Gene went to Advanced Orthopedic Center, which has locations in Port Charlotte and Punta Gorda. That’s where he was placed in the care of Jacob M. Pennington, DO.

Front and Back

During the initial appointment, Dr. Pennington conducted a thorough examination that included taking x-rays of Gene’s aching hips. Those images showed that Gene was suffering with end-stage arthritis, the most severe stage of the condition.

“With end-stage arthritis, patients are not only suffering from a great deal of pain, they have also lost a lot of function and mobility,” Dr. Pennington educates. “That’s where Gene was, and the only way to help patients like that is through hip replacement surgery.”

Dr. Pennington recommended that Gene undergo an advanced version of the procedure called an anterior direct hip replacement. The doctor typically suggests this outpatient surgery. This approach causes less trauma to the muscle surrounding the joint than the traditional procedure because the surgeon enters the body from the front of the joint instead of the back.

“When you’re approaching the hip joint from the front, you can simply retract the two main muscle groups that are in the way of the joint itself,” Dr. Pennington explains. “You don’t need to cut any muscle to get to that joint.

“This is a muscle-sparring approach, and because you’re doing only bone work and not cutting any muscles or tendons, patients recover more quickly than they do from traditional replacement procedures.”

Further aiding the patient is the type of artificial joint implanted by Dr. Pennington. That joint is a smaller implant that has a bit more curve. The size and shape make it easier to slip beneath the muscle without doing damage.

As a result, patients typically go home a few hours after surgery. They also recover much faster than patients undergoing traditional replacement surgeries. Gene went home the same day as the procedure and was amazed at how quickly he recovered.

Do It Again

“Dr. Pennington replaced my left hip first, and two days after surgery, I no longer needed the walker they gave me for stability,” Gene says. “And three days after that, I no longer needed the cane they gave me. That’s amazing, just amazing.”

The quick recovery was aided in part by Gene taking off 150 pounds in the 18 months prior to visiting Dr. Pennington. His recovery from surgery was so quick that soon after he decided to have his right hip replaced as well.

“Gene initially wanted to wait a year before having the second hip replaced, but he recovered so well and so quickly from the first surgery that he had the second hip replaced just six weeks later,” Dr. Pennington offers.

That second hip replacement procedure was performed late last summer.

“Within a few months of undergoing the second surgery, I was walking around and feeling like a different person,” Gene enthuses. “It’s amazing what this surgery has done for me. I am doing all the things I could not do before.”

Gene is exercising regularly again in an effort to keep his weight in check and living the active, independent life he was forced to give up a few years earlier.

“I can actually get down on my hands and knees and clean baseboards, which is something I was doing just the other day. And at work, I can walk and be on my feet all day”, Gene says. “And at work I don’t need to ask for help lifting or doing anything.”

“I’m more careful with how I use my hips, but I’m living the life I want to live. I cannot thank Dr. Pennington and his staff at Advanced Orthopedic Center enough for giving that life back to me.

“They’re all great people, and I highly recommend them.”

© FHCN article by Roy Cummings. Gene’s photo by Jordan Pysz.

As seen in Charlotte County Edition of
Florida Health Care News

Treatments Will Sculpt A Better Looking You

Emsculpt NEO, microneedling with PRP combine to trim, tighten and take years off appearance.

The pork rub recipe that has been passed down through three generations consists of 17 ingredients, five of which Madison* will not reveal under any circumstance.

“Most of the ingredients are foundational things that are found in every rub recipe,” Madison offers. “I’m talking about things like paprika, brown sugar, chili powder, salt and pepper. The five I can’t reveal are the ones that make the rub special.”

Originally concocted by Madison’s grandfather, this recipe has helped Madison’s family win four blue ribbons at barbecue festivals around the country the last eight years.

“That’s our thing,” Madison offers. “In the spring and summer, my family spends almost every weekend at a county fair, state fair or barbecue festival barbecuing ribs and competing against other pit masters. It’s a lot of fun.

“The only drawback is that you’re on the road a lot, which makes it hard to eat healthy. Throw in the fact that you spend your weekends tasting barbecue ribs to make sure they’re just right, and it’s hard to keep your weight in check.”

Madison, 42, has been fighting such a battle for about three years. She was convinced she was winning after losing 28 pounds — until a year ago, when her weight plateaued while trying to lose the final seven to reach her goal.

“I was really proud of myself for what I’d done,” Madison offers. “I started working out and worked really hard at eating right, and it paid off big time. But no matter what I did, those last seven or eight pounds just wouldn’t come off.

“And, of course, those seven or eight pounds were all right around my tummy and sides. I’m at an age where I can still look good in a bikini, and I wanted to look that way again, but I needed some help. So, I went to see Dr. Dean.”

Hitting the Target

Melissa Dean, MD, is the founder of the Dean Wellness Institute in Vero Beach, where she practices traditional medicine, offers a holistic approach to wellness and specializes in the treatment of menopause and andropause.

Dr. Dean also specializes in bioidentical hormone replacement therapy (BHRT), which is considered the most natural and effective solution for hormone-related issues such as insomnia, vaginal dryness and lack of focus.

Madison has been a patient of Dr. Dean’s for several years, with appointments for regular checkups the way many would see a primary care physician. Last year, she went to Dr. Dean seeking help with those unwanted pounds.

“I look better than I have in years.” – Madison

Dr. Dean recommended Emsculpt NEO®, an FDA-approved, nonsurgical body-contouring treatment that she says burns stubborn fat, tones muscle and tightens skin.

Ideally suited for people who have a body mass index (BMI) of less than 35, Emsculpt NEO delivers rapid pulses of high-intensity electromagnetic and radiofrequency energy.

“The energy is emitted through an applicator that is applied to the area of the body to be treated,” Dr. Dean educates. “The energy heats the fat cells to a degree where they simply can’t survive. Once the fat cells die, the lipids inside them are released into the lymph system, and they’re excreted over time.

“At the same time that the fat cells are being targeted, the muscles are heated, and there’s a contraction device on the applicator that, when working the abdomen for instance, simulates the body doing about 20,000 stomach crunches in half an hour.”

Emsculpt NEO treatments are performed while the patient lies comfortably on a table and typically last about 30 minutes. They can be used to treat multiple areas where stubborn fat remains or a need for increased muscle tone is desired.

Clinical studies show that within weeks of completing four Emsculpt NEO sessions, patients report a 30 percent decrease in fat and 25 percent increase in muscle growth.

Madison is among those who achieved the results she was seeking.

“I did six sessions targeting my tummy area, the front and back of my arms, and my thighs and buttocks,” Madison offers. “The results were incredible. I lost three inches around my arms and three inches around my waist.

“The best way for me to explain how happy I am is to say that for the first time in years I can walk by a mirror and smile. I feel sexier than I have in years because Emsculpt NEO gave me a huge boost in confidence.”

Liquid Gold

Madison received a further confidence boost through microneedling with platelet rich plasma (PRP), a skin-rejuvenation treatment in which a trained technician uses a small handheld device to induce microtraumas to the skin that are then treated with PRP.

Treatments begin with a blood draw from the patient’s arm. The blood is placed in a centrifuge and spun down. Afterward, a special kit is used to separate red blood cells from the plasma and PRP.

“What you’re left with is what we refer to as liquid gold,” Dr. Dean explains. “That’s the plasma with all the growth factors, or PRP. We put that into a syringe and disperse it like a lotion across the targeted area while performing the microneedling.

“When performing microneedling, the body responds naturally by sending growth factors from inside the body to the site of the microtraumas. With PRP, we’re also applying growth factors to the outside of those microtraumas.

A typical microneedling session, including prep, blood draw and procedure, lasts about an hour. It can be used to smooth out fine lines and wrinkles, tighten skin and even reduce or eliminate scarring.

“There’s no downtime with this treatment,” Dr. Dean concludes. “The effects are like that of a slight sunburn, so you can leave our office following a treatment and go right back to work or whatever you’d like without any concerns.”

Madison received three microneedling treatments across a three-month period and says they left her with a “very refreshed complexion” that has earned many compliments. As a result, she plans to continue the microneedling and Emsculpt NEO treatments.

“I really love what Emsculpt NEO and the microneedling with PRP have done for me,” Madison enthuses. “I look better than I have in years, my husband can’t stop complimenting me, and it was all so easy to do.

“The treatments are very relaxing and not painful at all, so I gladly recommend them to anybody. And I strongly recommend Dr. Dean and her staff. I love that crew to death. They’re the best.”

© FHCN article by Roy Cummings. Before and after images courtesy of BTL. mkb
*Patient’s name changed at her request.

Time Is Of The Essence

Early detection of macular degeneration key to preserving vision.

For many years, Olivia* and her husband owned an automotive radiator and air-conditioning business in Miami. When business there began to decline in 2002, the couple took their entrepreneurial spirit and moved 200 miles north to Titusville.

“We had friends who lived in the Titusville area that we visited frequently, and we really liked the area,” Olivia shares. “Our children were all grown up and had moved out, and we thought Titusville would be a nice place to relocate and eventually retire.

“Some people we know own a self-service car wash in Port St. Lucie. We figured that would be a good business to have to keep us busy, so we opened a self-service car wash in Titusville. We’ve had it for about 18 years.”

Olivia, 62, says there are benefits and drawbacks to being self-employed.

“It’s nice not having to answer to a boss, but your business becomes your boss,” she reflects. “It dictates when you work, and it doesn’t care what the hours are. Because our car wash is self-service, people come at all hours of the day and night.

“It’s our job to make sure the equipment works properly and the place is clean, so we have to empty the garbage cans and things like that. It’s actually a 24/7 job. Still, we’re OK with it. It keeps us busy, and we’re making enough money to survive.”

Ten years ago, Olivia started experiencing a serious threat to her security. She developed an issue with her eyes that affected her ability to perform many everyday tasks.

“I was having problems with my vision; it was blurry,” Olivia discloses. “The problem started in my left eye. Then five years later, my right eye was affected as well. I didn’t have any other symptoms, such as headaches or black spots, just the blurry vision.

“I went to my regular ophthalmologist, who ran some tests and discovered that I had macular degeneration. He advised me to go to Dr. Barnard.”

Thomas A. Barnard, MD, is a board-certified, fellowship-trained retina specialist at Florida Retina Institute. After thoroughly evaluating Olivia’s left eye, Dr. Barnard confirmed the diagnosis of macular degeneration, a progressive breakdown of the macula, or center portion of the retina responsible for central vision. The retina is the light-sensitive layer (or wallpaper) of nerve tissue that lines the back of the eye.

“Just like the rest of the body, the retina undergoes changes over time that can eventually affect vision,” Dr. Barnard describes. “These changes generally occur in people over 40 years old, so the condition is also called age-related macular degeneration, or AMD. 

“The changes associated with AMD are primarily genetic. People who have family members with AMD have a much higher risk for developing it. Genetics accounts for at least half of all cases of AMD, although certain lifestyle factors affect risk as well. These factors include sun exposure, diet, activity level, cholesterol and blood pressure.” 

Wavy Lines  

There are two types of AMD: dry and wet. Dry AMD occurs due to natural degenerative changes to the retina. The most common symptom of dry AMD is blurry or distorted vision; straight lines may appear wavy, for example.

“With wet AMD, the body tries to grow new blood vessels to help nourish the degenerating tissue in the back of the eye,” Dr. Barnard explains. “However, these blood vessels are abnormal and leak into the retina, destroying central vision. In addition to blurry or distorted vision, wet AMD can also cause dark spots to form in the field of vision.

“The majority of people with AMD have the dry type. Only about 15 percent develop wet AMD. We do not know why some people develop dry AMD and some develop wet AMD. Generally speaking, dry AMD does not progress to wet.”

There are no treatments for dry AMD, other than taking a special formulation of eye vitamins called AREDS2.  If wet AMD is caught early, there are treatments that are effective at halting progression and further vision loss.

“For the most part, treatment for wet AMD involves medications that block vascular endothelial growth factor, or VEGF,” Dr. Barnard educates. “VEGF is a protein made by the body that causes new blood vessels to grow. Anti-VEGF medications suppress the formation of blood vessels that become abnormal with wet AMD.

“These medications only stay inside the eye for a certain amount of time before the body flushes them out. Therefore, anti-VEGF injections must be given continually at certain intervals. Each patient is different, so the interval between injections is specific to the patient.”

There are three FDA-approved anti-VEGF medications used by the specialists at Florida Retina Institute: bevacizumab (brand name AVASTIN®), ranibizumab (LUCENTIS®) and aflibercept (EYLEA®).

“Olivia first came to us 10 years ago with symptoms of wet AMD in her left eye,” Dr. Barnard recalls. “We treated that eye, but unfortunately, we caught the AMD too late and she lost significant central vision in that eye.

“Fortunately, we caught the wet AMD in her right eye very early, and we are treating it with injections of AVASTIN every eight weeks. She is doing very well with the treatment. She has been able to stay independent and do everything she wants to do.”

“I Love Them”

“The injections aren’t painful at all because Dr. Barnard numbs my eye first,” Olivia describes. “And within a matter of minutes it is done. And thanks to those injections, my vision now is very good. Depending on the day that I visit Florida Retina Institute, sometimes my vision is 20/20 and sometimes it’s 20/30. God bless Dr. Barnard. He’s done a fabulous job of helping me keep my vision.”

Olivia is thrilled with the outcome of her treatment at Florida Retina Institute. She’s also pleased with the retina specialist providing that treatment.

“Dr. Barnard is a very nice man,” she describes. “He’s very polite and has a very good bedside manner. He’s good at explaining things to me, and I feel very comfortable going to him for my eye care.”

She appreciates the institute’s staff as well.

“I love them,” Olivia raves. “There’s not one person that works there that I don’t love. They’re very nice people and very friendly and compassionate. Dr. Barnard has a great staff.

“I recommend Dr. Barnard and Florida Retina Institute to anyone who has any kind of macular degeneration.”

© FHCN article by Patti DiPanfilo. js
*Patient’s name changed at her request.

Bye-Bye Vertigo!

August 28th, 2018

Living in Florida can be brutal for an allergy sufferer. I know, because I’ve lived in Florida since I was three and can’t remember a time when I didn’t suffer from allergies and ear and nasal infections. I’m allergic to the world so I’m always having to make trips to the doctor for antibiotics and allergy treatments.Photo from

Recently, I started getting frequent dizzy spells as well. I assumed at first that they were the result of another infection and put off doing anything about it. But then the dizzy spells became more severe and quite random. They would occur almost anytime, anywhere.

At first, they lasted only for a few seconds. But then, about a month ago, I woke up one morning feeling very dizzy, and as I started to move around, the dizziness did not let up at all. In fact, it only got worse, to the point where I didn’t feel safe driving myself to work.

I struggled through that entire day, literally using the walls in the hallway to hold me up because my balance was terrible, and I didn’t trust myself not to fall. After another couple days of feeling like this, I ended up having to miss a day of work.

It was at that point that I finally gave in and went to see a doctor. I was feeling anxious before my appointment, not knowing exactly what was going on at this point or how it would be diagnosed or treated, but then, after the doctor did a few maneuvers on me, he said, You have vertigo.

He explained briefly what vertigo is and provided a video for me to watch. At first, I thought, A videoHow is a video going to help me? But he was right. The video was extremely informative and explained in detail what vertigo is while also providing a detailed demonstration of how to treat it.

I went home and started following the protocol from the video right away. By the next morning, I was feeling much better. The treatment helped rid me of the dizziness and changed my life. If it ever comes back again, I will know exactly what to do. I hope this video helps you as much as it did me.


Page 1 of 1