Author Archive

‘In Good Hands’

Army vet appreciates provider’s solution for war-begot dental woe.

Connie and Ronald are pleased with Dr. Gaukhman’s solution to Ronald’s denture issues

For 35 years, Ronald Gesell was an outside plant engineer for Illinois Consolidated Telephone Co., now Consolidated Communications, based in Southeast Illinois. Ronald’s job usually involved constructing telephone lines to service rural customers.

“I retired from the telephone company in 1994, then worked for the state of Illinois for three years,” Ronald recounts. “I provided buildings in Chicago and other places with TV service and security monitors. I traveled to all of the prisons in the state and set them up with security cameras and video equipment.”

For most of his life, Ronald, 79, resided in Illinois, although he and his wife, Connie, dreamed of living in the Sunshine State. The bug first bit in 1965 after they visited Daytona Beach for their honeymoon. For years, they returned to Florida’s east coast for summer vacations.

“After Connie’s brother moved to Sarasota, we starting vacationing on this side of the state,” Ronald discloses. “We finally moved to Florida in 1997. We got tired of the snow and ice all winter in Illinois. Besides, it’s gloomy up there most of the time.”

The gloom of Midwestern winters often put a damper on his mood. But a negative experience from his past had already cast a pall on his emotional state. The trauma stems from his Army service in the Vietnam War. Ronald rarely talks about those days except to note their deleterious effect on his health.

“I was exposed to Agent Orange,” Ronald reveals. “I developed diabetes as a result, and it has been tough on my body. It has affected my overall health. I’ve had two strokes due to the diabetes, and the medications I take for it have deteriorated my teeth.”

Consequently, Ronald’s teeth began fracturing and falling out.

“One morning, I was sitting with Connie having a bagel and my front tooth just broke off as I chewed,” he recalls. “At that point, I had only 19 teeth left. I decided to have them all removed and replaced with dentures. We shopped around for a dentist to do the work, and we liked Dr. Gaukhman the best.”

Alexander Gaukhman, DMD, is a skilled general, cosmetic and emergency dentist at Venetian Dental, which has offices in Sarasota, Venice and Osprey. After an examination, Dr. Gaukhman agreed with Ronald’s solution for treating his dental issues.

“By the time I saw Ronald, he had already lost multiple teeth to decay and gum disease,” Dr. Gaukhman reports. “His remaining teeth were full of infection and were unsalvageable. My recommendation was to extract the teeth and create new upper and lower dentures. I further recommended securing his lower denture with two dental implants.”

Connie was impressed with the efficiency and safety protocols of the Venetian Dental staff.

“Because of COVID-19, I wasn’t allowed to go back to the exam room with Ronald,” she relates. “Dr. Gaukhman and his staff got right on Ronald’s case, and they relayed to me what needed to be done. I knew what was going to happen before one tooth was ever removed. I knew Ronald was in good hands.”

Single-Visit Solution

Dr. Gaukhman’s treatment plan called for the placement of dental implants to secure Ronald’s lower denture. But the dentist didn’t suggest implants for Ronald’s upper denture. The reason has a lot to do with the anatomy of the mouth.

“Typically, upper dentures fit securely in the mouth without dental implants because the palate, which serves as the roof of the mouth, creates sufficient suction to hold the appliances in place,” Dr. Gaukhman educates.

Lower dentures are a different story.

“These are often difficult to stabilize because the lower jaw is not designed for dentures,” Dr. Gaukhman asserts. “There’s no palate in the lower jaw due to the location of the tongue, and because of that less suction is produced. Consequently, lower dentures tend to slip and slide.

“It is rare when people can wear lower dentures that don’t bother them or stay tight without help. Securing a lower denture with dental implants is the most effective way to stabilize it. That’s why I recommended using implants to secure Ronald’s lower denture.”

Dental implants are screw-like posts made of titanium alloy that are surgically placed into the jawbone. They serve as the foundation for replacement teeth, such as crowns and dentures. Dentures secured by implants don’t slip or move; they stay in place when patients speak and eat.

In most cases, Dr. Gaukhman treats his denture patients using Dentures in a Day, Venetian Dental’s single-visit smile-restoration technique. As part of the Dentures in a Day process, Dr. Gaukhman places the implants on the same day he extracts the teeth. Typically, temporary dentures are also created that day in Venetian Dental’s on-site laboratory.

“We begin the process by taking impressions of the patient’s teeth,” Dr. Gaukhman describes. “It takes a few hours for the lab to fabricate the dentures, but once they’re ready, we extract the teeth, put in the implants and place the dentures right away. This way, the dentures act as a bandage to minimize swelling and bleeding. Moreover, patients do not need to walk around without teeth.

“The patient wears the temporary denture for three to six months following the implant procedure. The time allows the implants to integrate with the jawbone and for the tissues to heal. At that point, the temporary denture is replaced with a permanent appliance that attaches to the implants. Once the permanent dentures are placed, we make any necessary adjustments to ensure a perfect fit.”

Ronald is currently wearing temporary upper and lower dentures. He will be measured for his permanent appliances during an upcoming visit to Venetian Dental.

“Perfect” Dentures

Ronald says he is pleased with the Dentures in a Day process.

“My treatment went very well,” he enthuses. “Everything was very well planned out, and there was no pain whatsoever. The dentures I have now are perfect. They look nice and fit well, and I have no trouble chewing. I have no problems with these dentures, but I’ll be happy to get my new ones.”

When Ronald and Connie were searching for a dentist to perform Ronald’s mouth restoration, they visited multiple practices. The couple was taken aback when the dental providers quoted prices for Ronald’s treatment without examining him.

“When we got to Dr. Gaukhman’s office, the first thing he said was, Let’s go take some x-rays and see what we have,” Connie reports. “No one else even asked to see what’s going on. They just gave us a quote right off the bat.

“Dr. Gaukhman cared enough to give us the right opinion about what needed to be done for Ronald’s treatment, and that was important to us. We both felt very comfortable because they had everything planned out, right down to the date of surgery.

“Venetian Dental is a well-oiled machine. And Dr. Gaukhman is a very polite young man. I highly recommend him.”

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

Food For Thought

Unique vacuum decompression nourishes pain-relieving repair cells, alleviates back pain.

As a consumer safety officer for the Food and Drug Administration, Anthony Ronga performed unannounced inspections of food manufacturing plants across the country. The inspections were designed to assess compliance with sanitation regulations and ensure the safety of the nation’s food supply.

“I served as an FDA safety officer for the last five years of my career,” Anthony, 79, recounts. “Before that, I was director of quality assurance for IGA, which is a national chain of grocery stores. I worked for IGA for about 20 years.”

Working in the food industry wasn’t Anthony’s first career choice.

“I wanted to be a veterinarian,” he discloses. “I always liked animals and wanted to help them. But I was told I couldn’t be a veterinarian because I was too slight of build; I wouldn’t be able to lift a horse. That’s unbelievable in this day and age. Today, there are many female veterinarians who are slight of build, and they do just fine.”

Anthony was disappointed but moved on. While earning a biology degree from DePaul University in Chicago, Anthony got a part-time job in the laboratory of a national food company. Once he graduated in 1970, the company offered him a full-time position.

“The job involved testing the products that the company manufactured,” Anthony divulges. “I stayed at that company for about 10 years. Around 1985, I went to IGA. I worked in the food industry for close to 50 years in all. I liked the work. I liked helping companies and helping people, making sure their food was safe.”

For most of his career and into retirement, Anthony dealt with chronic back pain. He doesn’t recall any injury precipitating the pain. His back simply began hurting, and the pain became progressively worse as the years went by. Early this year, the pain flared up again. It was almost disabling.

“It was a stabbing pain,” Anthony describes. “It got worse if I sat for more than 20 minutes. But I had to sit or lie down because it hurt to stand and walk, and it caused me to be hunched over. Someone told me I looked like an old man bent over like that.

“I have a treadmill at home, and I can walk on it for 30 minutes without experiencing any back pain.” – Anthony

“I was going to the gym, walking on a treadmill and lifting light weights, but I had to give that up because of the pain, which was about a seven on a scale of one to 10. I tried acetaminophen, but I didn’t want to keep taking pills all the time.

“Doctors told me I have scoliosis, a sideways curve in my spine that probably goes back to my childhood. My back pain was getting worse and worse so I decided to seek help.”

Anthony tried traditional chiropractic treatments, but they didn’t ease his pain. His primary care provider ordered a bone scan to evaluate his bone health, but it revealed no signs of osteoporosis or fractures. Then he learned about a unique spinal treatment called VAX-D® therapy offered by Craig S. Aderholdt, DC, at Back Pain Institute of West Florida.

“I was at the lab getting a blood test and saw a copy of Florida Health Care News,” Anthony recalls. “I read about the VAX-D therapy Dr. Aderholdt offers and thought maybe it could help me. I contacted his office and made an appointment.”

Dr. Aderholdt provides the most advanced treatments for patients in severe pain, including VAX-D therapy, a patented, FDA-approved medical decompression technique for alleviating pressure on the discs of the spine.

“When Anthony came to our practice, he was suffering with a very painful low back condition caused by osteoarthritis secondary to his scoliosis,” reports Dr. Aderholdt, one of the few doctors in the country offering VAX-D. “Based on the physical exam findings, Anthony’s history of symptoms and the results of his x-ray, I recommended VAX-D therapy.”

Targeted Movements

VAX-D, or vertebral axial decompression, is not a traction device, Dr. Aderholdt stresses. It works differently than traction and achieves substantially better results. In addition to alleviating low back and neck pain, VAX-D therapy helps with numbness, tingling and pain that radiates down the arms and legs.

“For many patients, chiropractic adjustments alone can relieve the pain,” Dr. Aderholdt maintains, “but for select people with conditions such as sciatica or herniated, bulging or degenerated discs, VAX-D therapy has proven extremely successful.”

During VAX-D, the patient relaxes on a comfortable, computer-controlled table, secured by a pelvic belt or patented cervical collar, depending on the area being treated. Carefully specified tension and pressure changes guide the use of VAX-D, allowing the therapist to focus decompression at the exact level of dysfunction. Most sessions last about a half-hour.

The computer enables the table to make subtle but targeted movements that create a powerful vacuum within the disc space. This vacuum gently draws the disc back to its proper orientation, pulling nutrient-rich spinal fluid into the disc and stimulating repair cells that effectively mend the disc.

“No other treatment can create such a powerful vacuum,” Dr. Aderholdt contends. “There are imitators, but VAX-D’s vacuum effect is the most powerful. That is what makes VAX-D such a valuable tool for pain relief. Further, VAX-D doesn’t allow the muscles to contract the way other machines can. In fact, it is the only nonsurgical treatment that has been clinically proven to reduce disc pressure to negative levels.

“In my opinion, VAX-D is one of the most effective nonsurgical medical treatments for low back pain, neck pain and sciatica. This innovative technology is one more tool I can offer patients as we work toward relieving pain and maintaining the health of the lumbar and cervical spine.”

Studies show that VAX-D has been effective in treating more than 88 percent of patients. Many report a significant reduction in back or neck pain after only a few treatments. Dr. Aderholdt emphasizes, however, that actual healing takes longer because bulging or herniated discs require a series of sessions to fully reposition.

“Some patients think they will get relief after a handful of sessions and they can just quit, but that’s not the case,” he insists. “Patients must follow through with all of the required treatments to get the full benefit.”

“I Have No Pain”

Like many patients receiving VAX-D therapy, Anthony noticed positive changes to his back condition after just a few treatments. But he followed Dr. Aderholdt’s advice and completed his entire course of therapy.

“After about the fifth treatment, I was able to stand up for longer periods of time,” Anthony relates. “And I got progressively better as the treatments went on. I completed a total of 15 treatments, and they were very effective. I can now stand for a couple of hours without any pain. And I stand up straighter. People have noticed that; even Dr. Aderholdt noticed it.”
Thanks to VAX-D therapy, Anthony can walk and exercise again as well.

“I don’t go to the gym because of COVID, but I have a treadmill at home, and I can walk on it for 30 minutes without experiencing any back pain,” he enthuses. “Before, my pain level was a seven. Now it’s zero. I have no pain.”

Anthony is thrilled with the results of his treatment. He’s also pleased with the providers at Back Pain Institute of West Florida.

“I liked Dr. Aderholdt from the moment I met him,” Anthony raves. “He’s very knowledgeable and explained everything to me. He’s also honest and concerned about his patients. And his staff is wonderful, very friendly and patient. They’re compassionate, understanding, polite and helpful.”

Life-Changing Pain

Dr. Craig Aderholdt at Back Pain Institute of West Florida in Bradenton and Sarasota treated Anthony Ronga and Kechia Hignight for back pain using VAX-D therapy.

After Treatment with VAX-D therapy, Kechia no longer takes medication for her back pain.

Kechia Hignight loved her job as a hospital corpsman in the Navy. She remained in the service for 10 years, which included a year and a half in the Persian Gulf ministering to injured sailors. Following her military discharge, Kechia chose a slightly different career path.

“After being separated from my children for 18 months, I wanted to be more present in their lives,” shares Kechia, 56. “When I returned from the Gulf War, I didn’t want to do hands-on patient care. I learned transcription skills while working as a legal secretary and was familiar with medical terminology. I basically fell into medical transcription.”

Kechia found the work interesting and educational. It also permitted her to spend quality time with her children.

“I transcribed for hospitals all over the country in every discipline,” Kechia muses. “The job let me stay in the medical field and learn about new equipment and procedures. It also allowed me to work from home and be there when my kids needed me.”

Kechia thrived in that profession for 25 years, but she was forced to retire a few years ago when pain from a back injury made it impossible to sit for long periods. Her injury occurred on a hiking trip with her parents in 2004.

“We were stepping off a large rock, and as my father reached up for my hand, I slipped,” the Illinois native recounts. “My feet fell out from under me, and I landed on my right side. I knew my back was injured the minute it happened.”

At first, the discomfort wasn’t terrible, but over time it evolved into severe nerve pain.

“On a regular basis, my pain level sat at a crippling eight,” she details. “It was so bad that I couldn’t run anymore or ride in a car for long periods because my fingers would go numb when I drove. When I sat on the couch, it felt like my legs were full of bees because of the nerve pain. “Everybody’s head weighs approximately 10 pounds, but mine felt like it weighed 50 pounds. It caused the muscles in my neck and shoulders to be extremely tight. It felt like somebody was sitting on top of me. The pain was life-changing because it severely limited me, and I had always been a very healthy and active person. It was horrible to live with.”

Seeking to ease the agony, Kechia tried pain medications as well as physical therapy, massage therapy and chiropractic treatments. Nothing helped.

“The pain relief feels like a miracle to me.” – Kechia

Believing she faced a lifetime of pain, Kechia felt hopeless and depressed. But her fortunes changed in 2020, when her husband discovered Florida Health Care News in his doctor’s waiting room and he saw an article about Dr. Aderholdt and his VAX-D therapy.

He took the publication home to Kechia and said, You should try this. She agreed.

“Kechia was in severe pain when she came to us,” Dr. Aderholdt recalls. “First, we discussed her symptom history in detail. I then performed a physical exam and reviewed her x-rays. Based on the information I gathered, I determined that Kechia was a good candidate for VAX-D therapy.”

“Like a Miracle”

VAX-D’s vacuum effect is highly effective at mending degenerated spinal discs and relieving pain. Another advantage of Vax-D: It can eliminate the need for surgery.

“Many patients with severe back or neck pain want to avoid surgery, and that is something that VAX-D allows,” Dr. Aderholdt observes. “With surgery, there is the potential for serious complications. Because VAX-D is noninvasive, those complications are avoided.”

Kechia is aware of all the complications that can arise from surgery. That’s why she’s grateful VAX-D allowed her to avoid it.

“I used to transcribe reports of back surgeries, and the outcomes were 50-50,” she asserts. “Some people come out of surgery feeling magically better. Others go through the trauma of surgery and get no relief. I don’t want to be in those circumstances. Thankfully, I’m not.”

Kechia received significant benefits from VAX-D therapy. She no longer needs to take opioids for her pain, and she considers that a huge accomplishment.

“My pain level is maybe a three, and I can get by with ibuprofen or acetaminophen,” she beams. “There’s a considerable difference in the discomfort in my head, and the tightness in my neck and shoulders has greatly improved. The pain relief feels like a miracle to me.”

Like Anthony, Kechia has high regard for the doctor that cared for her.

“I love Dr. Aderholdt,” Kechia raves. “He explained the reasons for some of the other symptoms I was experiencing, such as why I felt tingling in my legs, but only in my calves. He told me it’s because a disc in my lower back was compressing the nerve going down the side of my calves.

“And I never knew it at the time, but it turns out that this constant sinus pressure I had was actually because a cervical disc had slid to one side and onto the nerve that services my sinus cavity. Knowing the cause of my symptoms actually made me feel better. At least I understood why they were occurring.”

Kechia wholeheartedly agrees with Anthony who says, “I highly recommend VAX-D therapy and Dr. Aderholdt to anyone with back pain.”

© FHCN article by Patti DiPanfilo. Kechia photo by Jordan Pysz. mkb

Waves of Relief

Sanexas pulsed energy treatment eases neuropathy pain without meds.

Eight years ago, Jeff Barnhart retired from his position as a tugboat captain. Throughout his career, Jeff was based in Tampa. He traveled with the boat for three weeks at a time and was then off duty for three weeks, an arrangement that lasted nearly 35 years.

Jeff enjoyed the free time his job afforded him. He liked the salary as well.

“The best thing about being a tugboat captain is the money,” admits Jeff, 75. “It’s a lucrative profession. I got the job through my brother, who was in the Merchant Marine. I started out as a deckhand and worked my way up.

“My boat was an ATB, an articulated tug and barge. It was about 600 feet long and attached itself to the big barges. I mostly picked up oil barges and took them to different locations. We went everywhere, from Canada to Costa Rica. Before I retired, I had a run from New York to Texas.”

Since retiring in 2013, Jeff has worked a few hours a day doing general maintenance for the housing community where he lives. For fun, he often plays golf and pickleball, but those activities became difficult a few years ago after Jeff developed uncomfortable issues with his feet.

“There was awful tingling, burning, pain and tightness in my feet,” Jeff elaborates. “Those symptoms advanced over a period of two to three years and made it hard for me to walk, so I had to give up golf. My pain hovered around a five or six on a scale of one to 10.”

Seeking an explanation for his discomfort, Jeff visited a neurologist who told him his problem was peripheral neuropathy. It’s a condition that affects more than 20 million Americans and is the result of damage done to the nerves that run from the brain and spinal cord to the rest of the body.

Common causes of peripheral neuropathy include diabetes, autoimmune diseases and inflammatory infections. But Jeff suffered with none of these disorders.

“The neurologist told me that in 30 percent of cases doctors have no idea what causes the neuropathy,” Jeff reveals.

Eager to rid himself of the pain and tingling, Jeff underwent LED therapy, a treatment that purports to improve neuropathy symptoms by increasing blood flow to the affected limbs by exposing them to infrared or red light.

“The LED lights didn’t really do anything for me,” Jeff corroborates. “Then I saw an article in Florida Health Care News about Dr. Lupo’s treatment, so I called and made an appointment.”

Harmonic Vibrations

The article Jeff read highlighted the work of Robert C. Lupo, DC, a chiropractic physician who offers primary, chiropractic and holistic care at his Tampa-based practice, Physical Medicine Center.

“The symptoms Jeff described are consistent with neuropathy, and I ran some tests to confirm the diagnosis,” Dr. Lupo recalls. “Those tests showed that Jeff was a good candidate for a unique treatment protocol we offer.”

That protocol is called Sanexas electrotherapy. It’s a noninvasive form of electric cell signaling therapy, or ECST, that uses pulsed energy waves to treat painful areas of the body.

Traditional treatments for neuropathy include medications such as gabapentin, LYRICA® and antidepressants, but Dr. Lupo says those only mask symptoms. They don’t treat the underlying problem.

“After three months, there was less pain, burning and tingling in my feet.” – Jeff

“With Sanexas electrotherapy, we can repair the damage done to the nerves by whatever causes the neuropathy,” Dr. Lupo asserts. “And we do it without medications. That’s especially important given the concern we all have with the overuse of pain medications.”

In addition to treating chronic pain and discomfort, Sanexas electrotherapy can also relieve the symptoms associated with conditions such as fibromyalgia because it decreases inflammation, increases blood circulation and heals the body’s damaged nerve pathways.

It does this through a form of natural electric nerve stimulation that goes beyond transcutaneous electrical nerve stimulation (TENS) by using electronic signal energy waves produced by a digital UHF generator.

“The energy waves stimulate the body at the cellular level by delivering energy to the affected areas of the body in varying wavelengths that include low-frequency and middle-frequency signals,” Dr. Lupo divulges.

“That’s what allows this system to affect the nerve cell membranes as well as the surrounding tissue and produce a harmonic resonant vibration that promotes repair and healing. And it does this without causing any discomfort for the patient.

“Most importantly, it allows patients to decrease their reliance on pain medications and greatly increases their mobility. That in turn allows some to begin exercising again and just leads to a much better overall quality of life.”

Sanexas electrotherapy is painless, and benefits of the treatments include the normalizing of pH levels, which helps with food digestion and the destruction of germs in the gut. It also stimulates the production of serotonin.

“Serotonin is a chemical in our bodies that is sometimes called the happy chemical,” Dr. Lupo points out. “It contributes to happiness and well-being and eases most kinds of pain, so the increase in serotonin is just another positive result of this treatment.”

Many patients also report sleeping better and having less anxiety after beginning Sanexas electrotherapy treatments. More than 80 percent of all patients treated through this protocol gain enough relief from it to resume normal activities, studies show.

Back on Course

Jeff has been receiving Sanexas electrotherapy treatments twice a week for the past six months. He says he feels no pain during the treatments, only “a little tingling,” and noticed a difference in his symptoms not long after beginning the therapy.

“After three months, there was less pain, burning and tingling in my feet,” Jeff enthuses. “And two months ago, I started golfing again. Instead of a five or six, my pain level now is maybe a two or three. Our goal is to decrease it even further.

“Right now, I’m about 75 percent recovered. But I’m still in treatment, so I expect to recover even more. I’m very satisfied with my treatment so far. I highly recommend Sanexas electrotherapy. And I recommend Dr. Lupo and Physical Medicine Center as well.”

© FHCN article by Patti DiPanfilo. js

“A Whole New World”

Surgery combination produces 20/10 vision for longtime glasses wearer.

Gary Northrup was born and raised in Dubuque, Iowa, a small industrial town on the Mississippi River. Dubuque is 25 miles east of the Field of Dreams, the baseball park and tourist attraction built for the eponymous 1989 sports fantasy movie.

Greg regularly travels in his RV with Kathy Reid and their three dogs, from left, Ginger, Joy and Chase.

Once Gary became an adult, he left Iowa to pursue his own dreams.

“When I got married and started my family, we lived in the Chicago area, in Naperville, Illinois,” recounts Gary, 61. “We moved to Florida in 2000. We moved for the sunshine and the beaches, and so we wouldn’t have to shovel snow anymore.”

In Florida, Gary got a job as a store manager for The Home Depot®. He started in Sarasota, moved to Venice, then Sun City Center and eventually to Lakeland. He retired from The Home Depot after 16 years and now sells real estate part time. Gary spends the rest of his time traveling the country in his 38-foot Class A motor home.

“We mostly use the RV to go back and forth to Michigan, Iowa and Ohio visiting family,” Gary elaborates. “We got it so we could travel with our three dogs because my son was no longer available to stay at the house and watch them. We had the choice of not going anywhere or getting the RV and taking the dogs with us everywhere, so that’s what we did. The RV has seating for eight, dining for four and sleeps two. It’s perfect for our needs.”

Gary has other needs as well, especially where his vision is concerned. He’s had vision problems since he was very young and has worn glasses since his early years in elementary school. As Gary’s aged, his eye problems have multiplied.

In recent years, he developed iritis, an inflammation of the iris that spontaneously occurs in otherwise healthy people, and was diagnosed with a corneal disease that prompted his eye doctor to issue a stark warning.

“He said that if I didn’t have it treated I would be blind in five years,” Gary remembers. “He immediately referred me to a specialist, whom I visited a few years ago. But then the specialist moved. While looking for a new eye doctor covered by my insurance, my agent said, You need to see Dr. Berger.”

Craig E. Berger, MD, is a board-certified, fellowship-trained ophthalmic surgeon at Bay Area Eye Institute in Tampa. In addition to his practice, Dr. Berger spent 15 years working as an adjunct assistant professor of ophthalmology at the University of South Florida Eye Institute.

During his initial visit with Gary, Dr. Berger discovered that Gary also had cataracts in both eyes. The diagnosis came as a surprise to Gary, who was not experiencing any of the obvious symptoms of cataracts, including glare, loss of color intensity and seeing halos around lights. All he noticed was a slight drop in the clarity of his vision.

“I saw fine in general, but I couldn’t see sharp detail,” he expounds. “It was like someone was taking a picture but dialed out the camera’s focus just a little bit. I thought the distortion was due to the corneal disease.”

Selective Replacement

Cataracts develop as a result of protein buildup in the natural lens of the eye. This buildup prevents light from passing through the lens, makes the vision look cloudy and can sometimes cause double vision.

Cataracts are a common problem typically related to aging. More than half of all Americans will develop a cataract by age 80. But other factors, such as diabetes, sun exposure, smoking and family history can cause the condition to develop at a younger age.

“Generally, cataracts become a problem later in life, but they actually start around the age of 40 and progress at different rates in different people,” Dr. Berger educates. “For this reason, they can occur in younger people as well.”

Treatment for cataracts involves the surgical removal of the affected natural lens and its replacement with a clear, synthetic intraocular lens, or IOL. Cataract surgery is generally performed on an outpatient basis on one eye at a time, typically a few weeks apart.

“In addition to cataracts, Gary also had a condition that affects the innermost layers of the cornea and causes blurred vision,” Dr. Berger reports. “It was necessary to treat the corneal condition with separate procedures before we removed his cataracts and implanted the IOLs.”

The treatment for Gary’s corneal condition was an advanced partial corneal transplant called Descemet membrane endothelial keratoplasty, or DMEK, Dr. Berger reveals. The Descemet membrane is the basement membrane deep within the cornea. The endothelium is the lining tissue.

“During DMEK, the patient’s Descemet membrane and endothelium are selectively removed and replaced with donor tissue,” the ophthalmic surgeon describes. “I am one of only three doctors in the area offering this procedure.”

It was necessary for Gary to have DMEK if he wanted to be free of glasses after cataract surgery. Without the DMEK procedure, he would not be a candidate for multifocal IOLs, which can reduce the need for glasses after surgery.

“If Gary did not undergo DMEK, he would have had to settle for standard monofocal IOLs,” Dr. Berger elaborates. “With monofocal lenses, Gary would need to use glasses for distance and up-close vision for the rest of his life.

“But Gary was very motivated to be glasses-independent after surgery, so I performed DMEK and recommended a new trifocal IOL called the PanOptix®. This lens provides clear vision at all three focal points: near, far and intermediate. It virtually eliminates the need for glasses following cataract surgery.”

“Absolutely the Best”

“Dr. Berger performed four surgeries on me in four months,” Gary recalls. “He performed two corneal transplants, first on the left eye and then on the right. Then he performed cataract surgery, again on my left eye first and then on the right.”

Just as Dr. Berger intended, Gary achieved excellent vision after DMEK and cataract surgery with the PanOptix. He is now out of glasses after more than 50 years of dependence on spectacles.

“The PanOptix lens is absolutely the best,” Gary enthuses. “It’s added a whole new aspect to my life because I can run around without glasses. I use cheaters occasionally if I’m looking at something small, like fine detail, or if I need to look at something close. Otherwise, everything is crystal clear. This is a whole new world for me because I’ve always worn glasses.

“Dr. Berger says my vision is 20/10, so it’s better than 20/20 without glasses. I’m very happy with the procedures and my results. I wish I could’ve had the surgery sooner.”

Gary is happy with the eye doctor that performed those procedures as well.

“Dr. Berger is awesome,” he raves. “I wanted the most qualified doctor available so I can be confident in his abilities. Dr. Berger is absolutely the most qualified, if not the best, eye doctor in this area.”

© FHCN article by Patti DiPanfilo. Photo courtesy of Gary Northrup. mkb

A Lesson In Hope and Survival

Chemo adjustment brings lifesaving results after grim prognosis.

For as long as Brenda Badger can remember, she has been drawn to children and aspired to care for them. At age 11, she worked her first full-time summer job babysitting for a woman with six children, ages newborn to 7 years.

Brenda Badger

Brenda fashioned that early experience into a 45-year career in childcare, including 18 years at a day care center located in her home.

“I was working at a hospital-based childcare center in Montpelier, Vermont,” Brenda recounts. “I have a degree in early education and was teaching the 2-year-old toddler group. The hospital decided to close its center, so I decided to open my own. My husband built a huge addition onto our house, which became our day care. We were licensed and registered in the state of Vermont.

“When the hospital center was closing, people asked where they could send their children. The hospital staff referred many of them to me. I took care of children from 6 in the morning to 6 at night. I cared for children ranging in age from 6 weeks to 12 years.”

Once the children turned 12, Brenda invited them to return to her center to help care for the younger children. She also encouraged the older children to attend a babysitting class she taught so they could become registered babysitters.

“There’s something about children; I just love being around them,” Brenda muses. “I’ve actually helped the children of children I cared for.”

In 2016, Brenda and her husband became snowbirds, traveling from Vermont to an RV park in Florida. Two years ago, they purchased a home in Inverness and became permanent residents, but they still travel to Vermont each summer to visit their children and grandchildren. While in Vermont last year, Brenda received some disturbing news.

“Eleven years ago, I was diagnosed with breast cancer. It was invasive ductal carcinoma,” Brenda shares. “I went through chemotherapy and radiation and then started taking tamoxifen. I did the hormone therapy for 10 years but started worrying about its effects on my body. I stopped taking tamoxifen last summer and started getting sick.

“My lungs kept filling up with fluid and nobody could figure out what was causing it. This was happening during the surge of COVID-19 and everybody was worried that I had the coronavirus. But all the tests came back negative. The doctors tried just about every diagnostic test they could think of, but they all turned out negative.”

In time, Brenda visited a pulmonologist who recommended positron emission tomography (PET scan). The test revealed the breast cancer had metastasized into her lymph nodes, liver and bones.

“When people don’t get screened at the appropriate time, we see the consequences.” – Dr. Apuri

While still in Vermont, Brenda was hospitalized several times. She was referred to a thoracic surgeon, who placed a sticky substance in her chest to hold open the pleura, the sheet of tissue surrounding her lungs. This way, her lungs, which continued to fill with fluid, wouldn’t collapse. Following surgery, Brenda found an oncologist and began chemotherapy.

When Brenda was finally well enough to travel, she returned to Florida and immediately visited Florida Cancer Specialists & Research Institute in Inverness for follow-up care. At Florida Cancer Specialists, Brenda met with medical oncologist Susmitha Apuri, MD.

“Brenda was diagnosed with stage 4 breast cancer in Vermont, was started on treatment and received several cycles of chemotherapy,” Dr. Apuri reports. “There are many types of breast cancer. Brenda has a common type, hormone receptor-positive breast cancer. We talked about available treatments for this type of cancer.”

Approach Adjustment

As part of her chemo regimen, Brenda was taking Taxol, an antimitotic drug that blocks cancer cell growth by disrupting mitosis, or cell division. But over time, that medication became less effective for her.

“I began experiencing more cancer progression, especially in my lungs,” Brenda elaborates. “In fact, my doctor in Vermont said there wasn’t anything more he could do for me. He wanted to send me home with hospice. I was devastated and so was my family.”

That devastating news was delivered to Brenda and her family last October, not long before she was scheduled to go back to Florida. By the time she returned, her health had declined significantly, according to Dr. Apuri.

“She’d lost weight and was on oxygen,” the doctor details. “She was also under the impression that nothing more could be done for her. We have come a long way in breast cancer treatment, so I thought, It’s too early to say there’s no hope. We talked about some other treatment options and agreed to make changes to her chemotherapy regimen.”

Dr. Apuri switched Brenda’s treatment to a combination chemotherapy consisting of two medications, Gemzar and carboplatin. Brenda received therapy on a schedule of two weeks on and one week off and responded wonderfully.

“Dr. Apuri ordered a PET scan at the end of December and it showed that things were improving,” Brenda enthuses. “The tumors were shrinking.”

Brenda continues to respond to her updated chemotherapy regimen.

The oncologist added another medication to Brenda’s regimen called XGEVA® to help battle the metastasis in her bones. Dr. Apuri also recommended that Brenda continue taking calcium supplements to further strengthen her bones.

Brenda’s cancer continued to respond to treatment, but she did suffer a minor setback: an allergic reaction to carboplatin. In response, Dr. Apuri made another adjustment to Brenda’s regimen.

“I changed how Brenda’s medications were administered to minimize the side effects, and we talked about what else we could do in the future,” Dr. Apuri remembers. “We reviewed and discussed all treatment options again, including clinical trials. I believe our discussion gave her a lot of hope.”

Brenda spent the summer in Vermont, where she attended the graduation ceremonies of three of her grandchildren. Throughout Brenda’s stay, Dr. Apuri continued to be involved with her day-to-day care from afar.

“Dr. Apuri shared all of my information and test results with my new oncologist in Vermont,” Brenda elaborates. “She also told me to contact her if I have any questions or concerns. I’ve called Dr. Apuri a few times, and she’s been very supportive.

“I absolutely love Dr. Apuri. She’s great. She’s very good at explaining things I don’t understand. She’s caring and compassionate, and I feel comfortable with her. She just knows what she’s doing. I wouldn’t go to anybody else.”

© FHCN article by Patti DiPanfilo.Photos courtesy of Brenda Badger. js

Concerning Sudden Cardiac Arrest

October 19th, 2021

A sudden cardiac arrest, or SCA, is sometimes referred to as a “massive heart attack,” but that moniker is not quite accurate. It’s true that SCA affects the heart, but it’s not a true heart attack. A heart attack occurs when blood flow to a part of the heart is stopped or slowed, generally due to a blockage in the coronary arteries, causing the death of heart muscle tissue.

Generally, there are signs and symptoms signaling a heart attack, and in most cases those hearts continue to beat after the event. But with SCA, people just collapse and discontinue breathing, and their hearts simply stop beating. A very serious heart attack can lead to SCA, but most SCAs are caused by problems in the rhythm of the heartbeats.

Most of the body’s electrical activity is handled by nerves, but the heart has its own unique electrical system. In the heart, electricity is generated in special pacemaker cells in the atrium, or upper chamber, and is then carried through designated pathways to the heart muscle cells. The cells then all contract at once to produce a heartbeat.

If there is an interruption anywhere along that electrical pathway, the heartbeat can become faster, slower or erratic. The most common cause of SCA is ventricular fibrillation, a very fast or chaotic heart rhythm, or arrhythmia. While ventricular fibrillation is most common, any arrhythmia can cause the heart to stop beating.

Most people at risk for SCA have coronary artery disease (CAD), although some don’t even know they have it. There are other pre-existing heart conditions that can lead to SCA, including cardiomyopathy, or an enlarged heart, valvular heart disease and a congenital heart condition, a problem that is present since birth.

Some other factors that put you at risk for SCA include the risk factors for CAD. These include being a smoker; having diabetes, high blood pressure and/or high cholesterol; being overweight or obese; and living a sedentary lifestyle. Drinking more than two drinks a day is another CAD risk factor, as is having a family history of the disease.

Other risk factors for SCA include having had a previous SCA or having a family history of SCA. If you’ve had a heart attack or have a family history of heart disease, your risk for SCA increases. The risk also goes up with getting older, being male, using recreational drugs like cocaine and amphetamines, and having low levels of potassium or magnesium in your system.

Blunt force trauma, like what can occur in a car accident or after taking a direct blow to the chest, can also trigger SCA. This is called commotio cordis. Strenuous physical activity can trigger SCA, but in most cases, there is an underlying heart problem that the people doing the activity may or may not be aware of. This is often the case when athletes in top physical condition experience SCA.

Most people with SCA, about 95 percent, die, often within minutes. Rapid treatment of someone suffering SCA is critical not only for that person’s survival, but also to minimize damage to the brain from being without oxygenated blood. Because when the heart stops beating, blood flow to the rest of the body ceases.

The chances of a positive outcome increase dramatically if the person’s receives CPR and treatment with a defibrillator within minutes. Automated external defibrillators (AEDs) are available in more and more public places, including shopping malls, busses, parks and schools. You can even get an AED for your home, but talk to your doctor before you buy.

AEDs are devices that analyze the heart and if they detect a problem deliver an electrical shock to restore the heart’s normal rhythm. They are designed for use by laypeople and provide visual and voice prompts. They will only shock the heart when necessary to restore normal rhythm.

If you witness someone experiencing SCA, call, 911 immediately, then check to see if the person is breathing. If they’re not, begin chest compressions. If an AED happens to be available, use it on the unconscious, unbreathing person. Follow the instructions and prompts provided with the AED. Use the AED once, then continue chest compressions until emergency personnel arrive.

SCAs happen without notice, so they can’t be diagnosed until after they occur. There are, however, tests to diagnose contributory disorders and steps to reduce the impact of some risk factors. Having routine appointments and physicals with your doctor and getting appropriate screenings when required can help alert you to potential risk factors for SCA.

If you survive SCA or are at very high risk for SCA, your doctor may choose to place an implantable cardioverter defibrillator (ICD). An ICD is placed under the skin in your chest wall, with wires that attach to the heart. The ICD works like a pacemaker. When it detects a dangerous arrhythmia, it sends a shock to the heart to restore the natural rhythm.

Your doctor may also prescribe medication, especially if you’ve had a heart attack or if you have heart failure or an arrhythmia. Types of medications include ACE inhibitors, beta blockers, calcium channel blockers and other anti-arrhythmia drugs. If you’ve got high cholesterol and CAD, your doctor may also prescribe a statin medication for lowering your cholesterol levels.

If you’re aware of a heart condition or other risk factors for SCA, you can help yourself by making some lifestyle changes to reduce your risk of CAD and SCA. Lifestyle behaviors to put into practice in your life include quitting smoking, maintaining a healthy weight, exercising regularly, eating a low-fat diet and managing diabetes, high blood pressure and other chronic conditions.

For the best outcome in the case of SCA, treatment must be started within minutes of the event. If someone you love is at high risk for SCA, do them a favor and learn the proper techniques for CPR. The American Heart Association and many hospitals and health organizations routinely offer classes you can sign up for.

Think about learning CPR. You can save someone’s life.

Father Of Invention

New Generation Laser Is Gold Standard For Skin Rejuvenation.

Google the name William B. Rife and the first result that pops up is a document detailing his various inventions for dissipating heat from electronic devices. William’s name is associated with multiple patents earned while he was employed by Chip Coolers Inc. of Warwick, Rhode Island.

William B. Rife

“I’m the inventor of about 10 patented products,” William elaborates. “I don’t hold the patents personally; my company does. But I’m the inventor of record for them.”

His inventions have been used primarily to cool computer components. His innovations helped facilitate rapid advancements in computer technology that began in the 1980s.

“As computers expanded, their microprocessors got hotter and hotter, and the only device that was available to cool them had to be glued on,” William discloses. “But the glue eventually hardened, and that slowed further development of the computer.

“I invented a device that is essentially a piece of aluminum that is mounted onto the microprocessor to transfer heat away from it. I also invented various types of clips to snap onto that cooling device, as well as other products that can be screwed onto the microprocessors.”

As time went on, William developed heat-transfer devices for other computer parts that get hot with use, such as motherboards. He attended computer shows around the world, demonstrating his products to other companies and displaying what was available to cool overworked components.

“If a company had a specific need, we could adjust our products to meet that need,” William reports.

During the home computer boom of the 1980s, William was working in the trenches to help make equipment more efficient. He was in tune with the work of the nation’s leaders in computer technology as well.

“Go into any computer store, and the name ‘Dell’ is imprinted on most of the computers,” he notes. “That company (Dell Technologies) was started in 1984 by Michael Dell in Texas.

Being in the business I was aware of little things that were happening in the background of that company’s development, what was going on and where Michael Dell was with things at different times.”

William, now 80, worked for Chip Coolers from 1978 to 2001. He eventually became a minority owner and general manager until the principal owner decided to sell the company.
“He took care of me, and I was able to retire at 60,” William reveals.

An active retiree, William golfs once a week and lifts weights to maintain his strength. Each Wednesday, he also volunteers at a local food pantry, where he unloads trucks, stocks shelves and carries boxes of food to clients’ cars. Thankfully, he’s remained healthy. He did, however, suffer a health scare at the beginning of this year.

“There was a black spot on my right leg,” William describes. “At first, I thought it was just a scab or something. Then I became concerned that it might be cancer. I asked my wife to get me an appointment with her skin doctor.

“Then one day, I was taking off my sock and I hit the spot with my fingernail. It broke open and blood shot out. My wife called an ambulance and they took me to the emergency room. The doctor there said, It’s not cancer. It’s a vein problem. My son-in-law’s neighbor had gone to Premier Vein Centers and recommended Dr. Sharma.”

Seen and Felt

Ravi Sharma, MD, is a board-certified cardiovascular surgeon at Premier Vein Centers in Homosassa and The Villages®. He specializes in the treatment of blood vessel disorders affecting the legs.

During his first visit with William, Dr. Sharma began his evaluation by ordering an ultrasound examination of William’s right leg. The ultrasound showed that a number of William’s deep leg veins were leaking and restricting blood from flowing back toward his heart, a condition called venous insufficiency.

Chronic venous insufficiency has multiple causes.

“Long periods of sitting or standing can cause the blood in leg veins to pool,” Dr. Sharma explains. “This increases the venous blood pressure and weakens the vein walls and valves, thereby damaging the valves. Damaged valves prevent proper blood flow back to the heart.”

“Everything’s great now. Both legs are just fine.”-William

Venous insufficiency has many signs and symptoms. Signs, which can be seen, include bulging varicose veins as well as swelling, thickening and discoloration of the skin of the ankles or legs. Symptoms, which are felt, include throbbing, aching, stinging, burning, itching, nighttime leg cramps and restless legs.

“It is critically important that patients experiencing any of these signs and symptoms have their leg veins assessed,” Dr. Sharma underscores. “Leaving the condition untreated can lead to more serious complications, including leg ulcers, infection and a breakdown of the skin. In William’s case, the problem vein began to bleed externally.”

Dr. Sharma has some advice for people seeking care for any of these signs or symptoms.

“It is crucial that people choose surgeons who specialize in venous diseases and only venous diseases,” he declares. “I recommend staying away from physicians in large practices that offer a variety of services and perform venous treatment as a side service. Vein treatment must be tailored to the individual. There is no one-size-fits-all approach.

“In addition, the physicians people choose should be experienced in the advanced procedures available to treat venous diseases. They must also express genuine concern and compassion for their patients. Physicians with these qualifications achieve the best outcomes.”

Minimally Invasive Options

Premier Vein Centers offers a full range of advanced, minimally invasive treatments for patients with venous insufficiency. These options include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections, VenaSeal and Varithena®.

Microphlebectomy has replaced vein stripping, an outdated, more invasive procedure during which doctors removed the large veins by making big gashes across the leg, often leaving sizable scars.

“With microphlebectomy, the incision is tiny – about the size of the tip of a scalpel – and we can do much more through that small incision,” Dr. Sharma asserts. “And with this procedure, patients end up with tiny marks on the skin or no scars at all.”

EVLA is performed using a sterile laser fiber that is introduced into the incompetent vein through a small puncture in the leg. Laser energy is then delivered through the fiber, painlessly closing the vein in less than an hour, using local anesthesia.

Sclerosing injections are used to treat spider veins, which are small twisted veins that are visible through the skin. Dr. Sharma uses ultrasound-guided sclerotherapy (UGS) to guide the injections that gently close the problem vessels.

VenaSeal is a non-thermal closure system that relieves symptoms by delivering small amounts of a specially formulated medical adhesive, or “super glue,” to the diseased vein. This permanently seals the vein. This procedure does not require multiple needle sticks, and in some cases support stockings are not necessary. After treatment, blood that used to flow through the faulty veins is diverted to healthy veins in the leg.

Varithena is a microfoam that is injected into the diseased vein section, treating the vein wall and collapsing the vein. Blood flow is then rerouted to healthy veins.

Premier Vein Centers provides a free initial consultation and accepts most insurance, including Medicare. All advanced treatments offered at Premier Vein Centers are performed in a comfortable office setting and result in little or no downtime and discomfort.

William has returned to his activities,
including golfing, with no worries that his leg vein will bleed again.

“Our patients are often very relieved to discover that there is no general anesthesia involved in our minimally invasive treatments,” Dr. Sharma observes. “And they are happy to learn that they can resume activities right away following the procedure.”

Return to Form

In determining which procedures will work best, Dr. Sharma relies on his expertise and assessment of each patient’s symptoms and health status. To seal William’s leg veins, Dr. Sharma decided that VenaSeal and microphlebectomy would work best.

“After he performed some tests and detected the problems with the veins in my right leg, Dr. Sharma went in and chemically shut down the main vein between my ankle and knee and also above my knee,” William reports. “He totally shut down the vein so there’s no blood in it, then he rerouted the blood to other veins in my leg.

“Later, Dr. Sharma examined my left leg and found some potential problems there as well. Instead of chemically closing those veins, he performed a surgical procedure. He made small cuts and pulled out the main vein in both my thigh and below my knee.”

The treatments Dr. Sharma performed were highly effective in eliminating the signs and symptoms of venous insufficiency that William was experiencing.

“Everything’s great now,” William raves. “There’s no pain or anything; both legs are just fine. I’m thrilled with Dr. Sharma’s procedures and with the results. I’m amazed by how quick the procedures were and how well they worked.

“The spot on my right leg is pretty much gone now. It’s tiny, and it’s not sticking out or dark like it was before. It looks almost like a scar now. And I know there’s no blood in that vein, so I don’t have to worry about that spot bleeding again.”

William gives kudos to Dr. Sharma for his expertise, attitude and approach to his patients.

“My son-in-law’s neighbor had a good experience with Dr. Sharma, and I’m impressed with him as well,” William states. “He took time to sit down with me and explain things. He presented my options and what he recommended as a solution for me. He made me feel confident that everything was going to work out fine, and it did.”

Since receiving the treatments, William has returned to golfing, lifting weights and working at the food pantry with no worries about bleeding from his leg.

“I’m very pleased with the work Dr. Sharma did on my legs because it allows me to do my activities,” William says. “I get kind of tired at the end of the day, but I’m still in pretty good shape.”

© FHCN articles by Patti DiPanfilo. Photos by Jordan Pysz. js

Come Up Smiling

Lifelong dental problems remedied in a day with unique implant protocol.

Mari Guarneri always wanted to help others. She achieved that goal by pursuing a career in mental health. In Mari’s eyes, mental illness was stigmatized, and people suffering with mental illness weren’t getting the services they required.

Mari enjoys the blooms that flourish in her yard and garden.

“That’s what drove me into mental health as a career,” Mari shares. “Also, the brain is a fascinating organ. I entered the field in the early 1980s as a secular clinician. I earned a PhD from Columbus State University in Georgia and worked as a secular counselor for 25 years.”

During those years, Mari worked with at-risk youth facing social and legal challenges due to their behaviors, addictions and mental illnesses. She assisted her patients as best she could, but she was convinced something was lacking.

“I felt there was a component missing,” Mari confirms. “So, about 10 years ago, I went back to school at Omega Bible Institute & Seminary in Monroe, Louisiana, and earned a second PhD in Christian counseling. As a Christian counselor, I can use my therapy skills but add faith-based approaches as well.

“I retired from the South Carolina Department of Mental Health before moving to Florida five years ago. I’m currently a Christian counselor at my church, Shepherd of the Hills Episcopal in Lecanto.”

Mari wanted to help people with mental illness since she was a young girl. She also suffered with dental complications from a young age.

“I’ve had problems with my teeth since I was 15,” Mari elaborates. “My jaw was unstable, so my teeth were prone to breaking and chipping. I’ve been in and out of dental offices almost my entire life. I’ve had root canals, extractions, oral surgeries, crowns, bridges, you name it. I’ve had multiple abscesses and been on antibiotics many times.

“During the past three years, my teeth started getting really unstable and breaking even more, which caused significant pain. I carried Orajel® and ibuprofen around with me everywhere. I couldn’t eat and I couldn’t go to restaurants because I never knew when one of my teeth was going to snap off. The situation with my teeth impacted my health and my self-esteem. I was embarrassed to smile.”

Her dentist in Lecanto suggested that she see Michael A. Pikos, DDS, a board-certified oral and maxillofacial surgeon and the founder of Coastal Jaw Surgery.

“My dentist attends many seminars led by Dr. Pikos and is very knowledgeable about his work,” she points out.

Better Option

Dr. Pikos is a global leader in dental implants and surgical reconstruction known for developing the smile restoration process called Same Day Teeth®.

Same Day Teeth is an innovative treatment that allows for the placement of dental implants and new teeth on the same day, he details. It restores the aesthetic appearance of the smile and provides optimal functionality.

“When patients like Ms. Guarneri come to us, they typically have ongoing problems with their teeth, such as decay and gum disease,” Dr. Pikos explains. “As a result, it is often not practical to save the teeth. Whenever possible, we try to save the teeth, but many times, the better option is to extract them, and at the same time place implants and permanent teeth, which is the Same Day Teeth protocol.”

That was the case with Mari.

“Dr. Pikos recommended I undergo the Same Day Teeth process,” Mari recalls. “He felt very confident it would solve my problems and I would be healthier and happier afterward.”

During her evaluation, Mari also met with prosthodontist Philip J. Hedger, DMD, Coastal Jaw Surgery’s tooth-replacement specialist and “smile architect.” Dr. Hedger creates the permanent teeth that patients receive as part of the Same Day Teeth protocol.

“I’m very happy with my new teeth.” – Mari

“Dr. Pikos and Dr. Hedger did a good job explaining what they wanted to do, what the results might be and some alternative treatments as well,” Mari reveals. “After considering everything, my husband and I decided to move forward with the Same Day Teeth process.”

As part of his initial evaluation, Dr. Pikos thoroughly examines the patient’s mouth, head and neck area. He also takes a cone beam CT scan to assess the quantity and quality of the existing jawbone. Sufficient bone is necessary to accommodate dental implants.
Along with measurements of the teeth taken by Dr. Hedger, the data gathered from the evaluation and CT scan are then sent digitally to a dental laboratory. The lab uses complex computer software to help Dr. Pikos create a customized treatment plan for each patient.

“Using the information returned to us from the lab, we can determine exactly where to place the implants in advance of the surgery,” Dr. Pikos discloses. “We can simulate the exact surgery to be performed on the patient. This is called guided surgery.

“We customize all aspects of the treatment, including the number and types of implants to use. There’re two main types of implants. Axial implants vary in length from 10 to 12 or even 13 mm in height. Zygomatic implants are anywhere from 40 to 55 mm, or approximately two inches.”

Zygomatic implants are anchored in the cheekbone. They are generally used for patients that don’t have enough bone in their upper jaws to support axial implants.

“My Life is Great”

Dr. Pikos and Dr. Hedger worked as a team to give Mari a new smile using the Same Day Teeth protocol, and Mari is thrilled with the results.

“My new teeth are very bright and straight,” she enthuses. “They look very natural. People can’t tell that they aren’t real teeth. They look great, so I’m smiling with an open mouth again, which is something I hadn’t done in quite a few years.

“I’m very happy with my new teeth. I can eat whatever I want. I can smile and I can sing in the church choir. I can be out in public and I don’t have to worry about my teeth at all.”

Mari also isn’t worrying about her teeth hurting or becoming infected anymore. Since receiving her new teeth, she has consistently followed an oral hygiene program that was designed by Dr. Pikos to eliminate those concerns.

Mari Guarneri

“I don’t have pain or get abscesses or breakage,” she raves. “I don’t have any of that. I just have to continue with good oral hygiene to keep my gums and the implant posts healthy, and that’s no problem at all.

“My self-esteem is really high now. During the last year, I took off some weight, so now I’ve got a new smile and a new figure. And I’ve become very active. I’m swimming a lot and trying to keep up with my 13-year-old. My life is great.”

Mari is impressed by the Same Day Teeth protocol. She’s also impressed by the providers.

“Dr. Pikos, Dr. Hedger and the Coastal Jaw Surgery team were with me every step of the way, even after I healed from the procedure,” she states. “They called to check up on me to make sure there were no problems.

“And Dr. Pikos and Dr. Hedger are perfectionists. They make sure you have exactly what you want and exactly what you need. I highly recommend them.”

1© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz.Before and after images courtesy of Coastal Jaw Surgery. js


His Heart Sings Again

After serving as a firefighter in Florida for 22 years, Robert* retired in 1996 and shifted his attention full time to music. He’s had a passion for the latter since he first heard someone strum a guitar.

“When I was 8, I went to a rodeo where they had live music,” Robert recalls. “There were two brothers playing instruments, and one was a guitar. I fell in love with the sound and thought, I want to do that someday.

“Now, I play guitar, banjo and mandolin. I started playing guitar when I was 12, so I’ve been playing that for 58 years. I’ve been playing the banjo for about 20 years, and I’ve played the mandolin
for three.

“I play music mostly for myself, but I also jam with friends. Playing the instruments didn’t come naturally to me. I had to work very hard to learn them. It’s difficult to say which instrument is my favorite; it’s either the guitar or banjo, but I love all of them.”

In addition to music, Robert concentrates on staying healthy and enjoying life. But those aims have become more difficult to achieve. For the past 15 years, Robert has struggled with a heart condition.

“I’ve always had a problem with the circulation in my heart,” Robert shares. “I experience hills and valleys as far as my energy and discomfort, including chest pain and tightness. I’ll be all right for a couple of weeks, and then the symptoms will come back and slow me down.

“When I get too slow, I know that the arteries in my heart are blocked. Typically, the only treatment options are stents or open heart surgery. But there’s also a therapy called EECP that I learned about and have taken advantage of.”

Enhanced external counterpulsation, or EECP, is a safe, noninvasive, circulation-boosting technique for easing uncomfortable cardiac symptoms. Robert underwent EECP for the first time in 2006 and again seven years later. He experienced significant benefits from the procedures, but a year ago, Robert’s symptoms returned.

“I was feeling very sluggish, very tired all the time,” Robert describes. “I was also experiencing minor pain and tightness in my chest, as well as shortness of breath. I had to do something.

“My doctor placed three stents in my coronary arteries, but I felt that wasn’t enough. I wanted to be healthier and more active. I already had EECP twice at Citrus Memorial Hospital and decided to have the treatment a third time.”

Citrus Memorial had discontinued the treatment, so Robert searched the internet for providers offering EECP. He discovered L. Amarchand, MD, a cardiologist and internist in Brooksville.

Dr. Amarchand uses EECP to treat patients with heart disorders such as congestive heart failure, blocked coronary arteries and angina pain. Using EECP, Dr. Amarchand has a record of success in maintaining his cardiac patients’ heart health and independence.

Collateral Enhancement

Robert’s problems, Dr. Amarchand knew, were the result of a lack of oxygenated blood flowing through his heart. That can cause symptoms such as a loss of energy, shortness of breath, a tightening or pressure in the chest and weakness.

“It is not unusual for people to restrict their activities to reduce their discomfort as these symptoms get progressively worse,” Dr. Amarchand maintains. “As a result, their quality of life quickly diminishes. EECP can reverse these symptoms by working like a natural bypass procedure.

“Through the use of EECP, more than 12 million Americans have found relief from their symptoms, had their energy restored and received other benefits.”

EECP is delivered through a series of 35 hour-long sessions over seven weeks. During an EECP session, the patient reclines, fully clothed, on a cushioned table while listening to music or watching a movie.

Compression cuffs are wrapped around the patient’s calves, thighs and buttocks to apply pressure in rhythms carefully timed to the patient’s heartbeat.

“The pressure propels more blood upward and into the coronary arteries, enlarging the arteries and improving collateral circulation,”  Dr. Amarchand explains. “It helps the patient’s circulatory system bypass coronary artery blockages and opens up the underused collateral blood vessels.”

EECP is the perfect option for individuals who want to try a noninvasive procedure before resorting to heart surgery, Dr. Amarchand contends. It’s also good for those who have not achieved relief with prior procedures such as bypass and angioplasty, and for patients who aren’t candidates for surgery.

“According to studies, 85 percent of patients completing EECP treatments obtain substantial and sometimes dramatic relief from their heart-related symptoms,” Dr. Amarchand discloses. “The same percentage realizes increased exercise tolerance, mental alertness and reduced need for nitroglycerin to relieve angina pain.”

“If I start to feel pressure in my chest, I take nitroglycerin, and that kicks it,” Robert reports. “But my chest pain is minimal now, so I don’t take nitro that often, just once in a great while. Before EECP, I was taking it three or four times a week.”

Because it’s noninvasive, EECP can be repeated as often as needed, Dr. Amarchand says of the treatment that is FDA-approved and Medicare-reimbursed. But its beneficial effects can last from three to five years, the doctor stresses.

“It Rejuvenates Me”

Dr. Amarchand explained how EECP refreshes the heart with new blood flow from its collateral blood vessels. Robert just knows that it helps him.

“It rejuvenates me,” he enthuses. “After my first EECP, I felt like I was 20 years younger. I completed my third treatment a year ago, and I’ve been doing pretty well ever since.

“Now, I go to the gym three times a week and walk three-quarters of a mile around my neighborhood twice a day. I still get a little tired, but I think that has to do with my age as much as my heart. I’m feeling pretty good now and I’m happy about that.”

Robert is pleased with the providers he encountered at the Brooksville practice as well.

“Dr. Amarchand is very nice and quite knowledgeable,” the musician describes. “He explained everything and answered all my questions. My main contact was Dr. Tong Guo, who actually performed the treatments.

Dr. Guo is a very smart guy. He’s worked with EECP for years and helped start an EECP program in another state. I highly recommend them.

“EECP is wonderful. If you don’t want open heart surgery, and who does, you ought to try EECP because it’s fantastic therapy. I tell everyone with heart problems to try it because it’s noninvasive and it works.

“It takes a while to complete the EECP treatments. It takes five days a week for seven weeks; that’s 35 trips from my house in Homosassa to Brooksville. But we’re talking about your life. We’re talking about better heart health. It’s definitely worth it.”

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

A New Spin For Your Skin

Centrifuged from patient’s blood, PRF delivers next-generation rejuvenation

Jessica Caldwell is a master at juggling responsibilities. A 38-year-old working mother, she successfully synchronizes the daily care of her children with a full-time job.  

Jessica Caldwell

“My eyes have a full, plump, youthful appearance. I’m super happy with my results.”

“I’m a financial wellness consultant at a bank,” Jessica reveals. “I offer fantastic financial solutions to basically add benefits to companies for their employees.”

Jessica’s banking career began when she was 19. Besides motherhood, it’s the only job she’s held since high school.

“I graduated in 2001 and started with the bank in 2002,” she elaborates. “I’ve been with the bank for 19 years and with the wellness consulting team for 12. It’s definitely my favorite division, so far. I really like what I’m doing now.”

In Jessica’s line of work, exceptional customer service is a requisite. Jessica expects the same from the companies she does business with and her health care providers. Recently, one such provider failed to deliver in that area.

“I had visited my dentist for a BOTOX® treatment in my jaw, but the dentist didn’t administer it properly,” Jessica shares. “Another thing I struggled with during my dental experience was their bedside manner. They took little time to answer my questions. It was nerve-racking not knowing what was going to happen.”

After sharing her experience with a friend, Jessica was advised to visit GaliDerm Aesthetics & Plastic Surgery in Royal Palm Beach. During her first meeting there with Cigdem Gali, MSPA, PA-C, a physician assistant specializing in aesthetic medicine, Jessica was immediately taken by the difference in approaches.

“Cigdem and her team took time to answer all my questions, so I was comfortable not only with what was going to happen, but also with my budget,” Jessica recalls. “After Cigdem properly administered the (BOTOX) injection, we just naturally got into a conversation about some other concerns I had around my eyes.”

Specifically, Jessica was concerned that her eyes made her look tired.

“I started to recognize some aging in that area,” she explains. “There was a lot of creping, wrinkling and thin skin under my eyes.”

 Cigdem suggested she try an injection under the eyes called platelet rich fibrin, or PRF, rather than a hyaluronic acid filler alone.

“It was clear that she experienced significant volume loss in her tear trough, the area between the lower eyelid and upper cheek,” Cigdem points out. “When she smiled, there were deep creases in her tear trough. I recommended PRF combined with a hyaluronic acid filler. We blended the constituents and injected them into Jessica’s tear trough.”

Advanced Technology

Cigdem and her team’s use of the combination of PRF and hyaluronic acid represents a step forward in the technology used for aesthetic treatment. In the past, GaliDerm Aesthetics & Plastic Surgery treated facial flaws using platelet rich plasma, or PRP.

The PRP is obtained through a draw of the patient’s blood. The blood is spun down in a centrifuge. After it has been isolated, the platelet rich plasma is injected back into the patient, where the PRP’s healing and growth factors restore the damaged skin.

“Six or seven years ago, PRP was the best technology available,” Cigdem asserts. “PRF is PRP 2.0: the next generation. With PRF, we spin the patient’s blood at a slightly different angle and at a slower speed, which causes less damage to the cells. As a result, we obtain a higher quality of healthy platelets, stem cells, growth factors and healing factors. Higher quality cells lead to superior and longer lasting results compared to PRP.”

PRP treatments required the addition of an anticoagulant, or blood thinner, to keep the blood from clotting before the PRP could be injected. That isn’t necessary with PRF, which studies show to be more effective without an anticoagulant.

“Once PRF is injected, a natural fibrous thickening forms that consistently releases healing and growth factors into the skin over time,” Cigdem explains. “Consequently, patients’ results continue to get better over an extended period.

“Patients generally see a difference immediately after their first PRF injection. After that, 75 percent of the PRF reabsorbs into the body. Patients typically see the full effect of the injections six to eight weeks after treatment is completed.”

A typical course of PRF involves two to four injections given four to six weeks apart. According to Cigdem, this course most effectively stimulates the skin to ensure the best results possible.

“When patients require more volume and skin tone correction than PRF alone can provide, we often combine PRF with a hyaluronic acid filler,” Cigdem observes. “This is commonly done when treating the tear trough, which is what we did in treating Jessica.

“If we inject a filler alone, patients won’t receive the immediate glow that appears with PRF. Fillers are also not going to improve the tone and texture of the skin. Fillers will volumize but won’t help if patients have dark circles or irregular texture due to thin skin under the eyes. But PRF will. It is the body’s natural filler.”

PRF serves many purposes at GaliDerm Aesthetics & Plastic Surgery. Cigdem may utilize it during microneedling to help improve skin texture while the microneedles generate collagen for smoother, firmer, more toned skin.

“We use PRF to treat acne scars,” Cigdem discloses. “It is effective for volumizing the cheeks, nasolabial folds and jawline, as well as the chin, neck, hands and décolleté, with beautiful results. We use it to revitalize fine, thinning hair; enlarge breasts; enhance the buttocks; and treat cellulite as well. It is very versatile.”

“It Was Amazing”

After Cigdem recommended PRF, Jessica did some research before agreeing to the treatment. She received the injection on June 14. She saw results immediately.

“It was amazing,” Jessica exclaims. “The fullness was back under my eyes, which took away that aging look. The wrinkles were nearly gone as well. My eyes have a full, plump, youthful appearance. I’m super happy with my results.”

Jessica’s excitement extends to Cigdem and her staff at GaliDerm Aesthetics & Plastic Surgery.

“I love Cigdem,” she raves. “She really knows what she’s doing and wants to make sure I’m happy. Cigdem’s staff is great and her team is growing. She must be good at picking team members because no matter who I deal with, they’re very knowledgeable and friendly. 

“I very much appreciate the service provided by everyone at GaliDerm Aesthetics & Plastic Surgery. I absolutely recommend them.”

© FHCN article by Patti DiPanfilo. Photo courtesy of Jessica Caldwell. Before and after images courtesy of GaliDerm Aesthetics & Plastic Surgery. mkb
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