Author Archive

Advanced Corneal Surgery Treats Fuchs’

Transplant of cornea’s inner lining followed by PRK procedure to correct vision.

Like the sports cars he tinkers with, Charles Boggess has a few parts that aren’t original. The 61-year-old Florida native and tractor-trailer driver was given a new kidney in 1998. Sixteen years later, he received two corneal transplants to correct a series of vision problems that began years earlier.

Charles is seeing clearly under the hood.

“I started using reading glasses when I was pretty young,” Charles relates. “And I’ve worn regular eyeglasses for nearsightedness since I was 30. Around 2014, my vision became really blurry. I kept getting new glasses prescriptions, but they didn’t clear up my vision. I eventually went to a new eye doctor, and he figured out I had Fuchs’ dystrophy.”

Fuchs’ (pronounced fewks) dystrophy is a condition that causes the cornea, the clear, protective outer layer of the eye, to swell and become cloudy. In a healthy eye, the cells of the cornea’s endothelial layer pump fluid away from the cornea to keep it clear. With Fuchs’ dystrophy, this layer changes and fails, and fluid builds up, causing hazy vision and eye discomfort.

“It was like living underwater, like the filters in my eyes quit working,” Charles describes. “Everything was very blurry. The doctor told me whatever glasses I got weren’t going to work until I got my Fuchs’ dystrophy cleared up. He referred me to Dr. Salinger.”

Clifford L. Salinger, MD, is a cornea specialist and founder of The Dry Eye Spa & V.I.P. Laser Eye Center in Palm Beach Gardens. He has expertise in treating Fuchs’ dystrophy using partial thickness corneal transplants. That’s what he used to address Charles’ diseased corneas.

“The partial thickness corneal transplant procedure we perform is called Descemet stripping automated endothelial keratoplasty, or DSAEK,” Dr. Salinger reports. “This is a newer, more advanced method of performing a corneal transplant that involves removing and replacing only the inner lining of the cornea.

“I noticed a difference right away.” – Charles

“Because it involves transplanting just the inner corneal lining, DSAEK is safer than traditional corneal transplants. There is less trauma to the cornea, so there are fewer risks associated with DSAEK. Healing is faster as well, and patients have fewer limitations to their lifestyle after the procedure.”

Dr. Salinger performed a DSAEK procedure on Charles’ right eye in September 2014 and the left eye three months later.

“After the transplant surgeries, I could see very well in the distance with my right eye, but I had quite a bit of astigmatism in my left eye and still couldn’t see in the distance,” Charles shares.

“I’m a truck driver, and distance vision is very important to me, so Dr. Salinger recommended another procedure to correct the astigmatism. Another reason I wanted both eyes corrected for distance was to keep from having to wear glasses all the time.”

LASEK (With an “E”)

Charles Boggess

“There’s a misconception that if people need glasses following surgery, whether it’s cataract removal or DSAEK, they are stuck wearing glasses forever,” Dr. Salinger notes. “That’s a myth. There are many things we can do, including laser vision correction procedures, that minimize or eliminate a person’s dependence on glasses.”

Generally, when people think about laser vision correction, LASIK® (laser-assisted in situ keratomileusis) comes to mind. LASIK corrects vision by reshaping the cornea, which changes its focusing power on the retina, the light-sensitive nerve tissue lining the back of the eye.

During LASIK, surgeons use a laser to create a thin flap on the corneal surface. Then, the laser removes some of the tissue underneath the flap to reshape the cornea.

But that’s not the procedure Dr. Salinger selected for Charles. Instead, he chose another laser surgery with a slower healing process that he determined would be better and safer for Charles’ left eye.

“Mr. Boggess was looking to become less dependent on glasses,” Dr. Salinger asserts. “Since he had Fuchs’ dystrophy and underwent previous cornea surgery with the DSAEK, we concluded that a procedure without a flap called LASEK was the better option for him.”

With LASEK (laser epithelial keratomileusis), also known as PRK (photorefractive keratectomy), Dr. Salinger first removes the cornea’s surface skin layer, the epithelium, before applying the laser to the corneal surface.

“There’s no cutting, no flap,” Dr. Salinger explains. “We place a bandage contact lens on the eye for better comfort and to assist in healing.

“The cornea’s skin layer then needs time to heal, about a week. The bandage contact lens is then removed and vision continues to improve over weeks to months. For Mr. Boggess, LASEK was safer in the short term and the long term.

“It was essential for Mr. Boggess’ professional life that we perform the laser vision correction to balance his two eyes for distance. If we didn’t, he would feel unsafe on the road, and that feeling would be worse at night and in bad weather. That’s definitely not a good scenario for a truck driver.”

Charles noticed an improvement in his vision soon after the LASEK was completed in August 2020.

“I noticed a difference right away, and after a few weeks, I could see well enough to read road signs,” Charles states. “That’s the main thing I needed. My vision just got better every day.”

Missing Tears

During his 35-year career in law enforcement, Michael Driscoll helped put many dangerous criminals in prison, so he prefers to keep a low profile.

“I’m originally from the Boston area, but I’ve lived in Florida for 33 years,” Michael shares. “I worked for and retired from the Florida Department of Law Enforcement, but I’m a private investigator now so I’m not completely retired.”

As an investigator, Michael relies on his vision to identify individuals and activities of interest in his cases. For more than a decade, Michael’s vision was compromised by symptoms of dry eye disease, a condition associated with a lack of quality tears to lubricate and nourish the eyes.

“I’ve suffered with dry eye for at least 12 years, maybe 15,” Michael reveals. “It became progressively worse over the past few years. I experienced symptoms such as dryness, burning and intense tearing. Early on, I didn’t tear up much, but my eyes teared up excessively over the past couple of years.

“My dry eye never got to the point of being painful. It was just very, very annoying because it wouldn’t go away. I rate the discomfort a five or six on a scale of one to 10. It was very difficult because the symptoms were with me the entire day.”

Much to Michael’s dismay, the treatments recommended by his ophthalmologist had little or no effect.

“My doctor prescribed various medications over the years. Some worked and some didn’t,” Michael discloses. “Treatments such as hot compresses had always helped. However, in the past year or two, nothing helped. No matter what treatments or medication my doctor prescribed, they just did not work for me.

“Then one day, I received a copy of Florida Health Care News in the mail. On the front page was a story about a woman who underwent a dry eye procedure called LipiFlow®. The woman said it was a very good procedure that helped a lot, so I decided to try it.”

The LipiFlow Thermal Pulsation System from TearScience® is a revolutionary, FDA-approved method for clearing the debris that clogs the eye’s oil glands and leads to dry eye. Dr. Salinger offers it at The Dry Eye Spa & V.I.P. Laser Eye Center.

Paradoxical Yet Common

“Mr. Driscoll first came to us on July 23, 2021,” Dr. Salinger explains. “He’s a 67-year-old man with a history of LASIK in both eyes. Years later, he underwent cataract surgery and was fit with intraocular lens implants in both eyes.

“He came to us with symptoms of dry eye that included burning, stinging, irritation and excessive tearing, which is a paradoxical yet common symptom of dry eye disease. Its cause is related to the quantity and quality of the tears. In Mr. Driscoll’s case, he had an adequate quantity of tears, but the tears he was producing were of poor quality. More specifically, there was a lack of balance between the oil and the water in his tears.”

Oil and water are the two most important components of the tear layer, according to Dr. Salinger. Without oil, the tear layer becomes unstable and fails to spread evenly across the surface of the eye, where the tears evaporate more quickly and cause dry eye.

“If there’s not a good balance between oil and water in the tear layer, it does not stay uniform and stable between blinks, and very quickly it becomes uneven,” the cornea specialist describes. “The tears bead up, overflow and evaporate off the eye.

“The analogy I use for patients is going to a buffet. If there’s one piece of the most exquisite-tasting food you’ve ever eaten, it’s great quality but not enough quantity. You likely won’t go back to that buffet. If there’s a great quantity of food but the quality is poor, you won’t go back either. You want a good balance between quantity and quality.”

An insufficient amount of oil in the tear layer comes as a result of blockages and inflammation in the meibomian glands, the oil glands in the eyelids. As they did with Michael, these blockages compromise the flow of oil through the glands and lead to symptoms.

To correct the problem, Dr. Salinger first used a comprehensive regimen that includes hot compresses, artificial tears, lid cleansing, vitamin supplements containing omega-3 and omega-6, topical steroid drops to reduce inflammation and a topical antibiotic drop.

“I’m very happy with my results.” – Michael

“Mr. Driscoll came back to us a month later because he was experiencing a reaction to the preservatives in the eyedrops he was using, including the artificial tears and the topical steroid,” Dr. Salinger details. “We took him off of those eyedrops and prescribed preservative-free preparations.

“We also performed the LipiFlow procedure, which starts with a thorough deep cleaning using the BlephEx®, a patented hand piece that precisely and carefully spins a medical grade microsponge along the eyelids and lashes to remove debris and exfoliate the eyelids. The BlephEx can do a much deeper cleaning than individuals can do at home.”

Dr. Salinger follows the BlephEx with the LipiFlow procedure. LipiFlow combines the controlled application of therapeutic heat with a gentle, pulsating massage. These functions work to liquefy and remove debris from the eyelid glands, enabling them to function efficiently.

“After the LipiFlow treatment, we performed a manual expression of the meibomian glands to remove any remaining clogging material,” Dr. Salinger details. “This makes room for healthier oil material to populate the glands and flow normally so the tear layer is more stable and uniform, which improves the dryness.”

Following the three-step process, Dr. Salinger maintains dry eye patients on the previous treatment regimen, which helps amplify and extend the benefits of the LipiFlow. His goal is to find the least amount of treatment that can maintain the benefits of the LipiFlow.

He achieved that objective with Michael.

“Mr. Driscoll returned to our office three weeks after his procedure. At that time, he reported 80 to 90 percent improvement in his dry eye symptoms,” the doctor notes. “By then, he had stopped using the steroid and antibiotic drops and prescription medications, and was only using hot compresses, lid cleansing, artificial tears and vitamin supplements.

“That’s What I Wanted”

By the time Michael read about The Dry Eye Spa & V.I.P. Laser Eye Center and its LipiFlow treatment in Florida Health Care News, he had reached a turning point in his life.

“I resolved to do anything to make my dry eye symptoms tolerable, to get them to where I could live with them,” Michael reveals. “That’s why I went to see Dr. Salinger. Since he performed the LipiFlow procedure, I have experienced a great deal of relief. The discomfort in my eyes is down to a two, which is tolerable, and that’s what I wanted. I’m very happy with my results.

“I still have dry eye, but for the first time in years I can live with it. It’s much, much better than it used to be. And I don’t need any medications, just the hot compresses and over-the-counter moisturizing drops, so I’m very happy.”

Michael is equally pleased with the people and care they provided at The Dry Eye Spa & V.I.P. Laser Eye Center.

“Dr. Salinger is very nice and professional,” Michael describes. “He’s knowledgeable and an expert on dry eye. He and his team are excellent. Everyone at that practice is well-trained, accommodating and good at what they do.

“I highly recommend LipiFlow and The Dry Eye Spa & V.I.P. Laser Eye Center. Dr. Salinger is the only doctor I know that does the LipiFlow procedure, so I absolutely recommend him.”

© FHCN article by Patti DiPanfilo Charles’ photos by Jordan Pysz. mkb

Sitting In Chair Halts Urinary Incontinence?

Pulsating BTL Emsella protocol strengthens pelvic muscles, improves bladder control.

The daughter of a western Nebraska wheat farmer, a young Melinda* traveled with some friends to Valentine, Nebraska, seeking work. She found a position as a legal secretary to the county attorney for Cherry County, of which Valentine is the county seat.

She also met her husband, Nathan, there.

“I worked for the county attorney for about four years, then I got married,” says Melinda, now 83. “When I gave birth to our first child in 1960, I decided to stay at home with the baby. I had two more children after that.”

Eventually, Nathan and Melinda relocated from Nebraska to Colorado. The move was precipitated by the weather — and the landscape.

“It’s warmer in Colorado during the winter than it is in north central Nebraska,” Nathan reveals. “And the mountains were calling. We became fans of the mountains. We skied and motorcycled and did a lot of activities in the mountains.”

Alas, the couple eventually wearied of Colorado’s winters and began snowbirding to Florida. Even today, they spend the summers in Colorado and winters on Sanibel Island.

Recently, Melinda also wearied of wearing heavy duty absorbency pads to protect against urinary incontinence, a sudden loss of urine that cannot
be controlled.

“It’s been going on for years,” Melinda says of the condition. “I experienced leakage almost any time I coughed or sneezed or anything like that. On a scale of one to 10, the problem was a 10. I had to wear thick pads and had to change them quite often during the day.”

Melinda attributes her incontinence to childbirth.

“I wasn’t incontinent before I had children,” she insists.

Finally, Nathan and Melinda sought help for Melinda’s condition.

Douglas H. Joyce, DO, FACOS, FACPh, is a board-certified cardiovascular surgeon at Joyce Vein & Aesthetic Institute in Punta Gorda. In addition to treating venous disease, Dr. Joyce also provides therapies to shape and strengthen the abdominal core while also strengthening the muscles of the pelvic floor. These therapies include treatment for urinary incontinence.

“We initially visited Dr. Joyce for treatment of venous disease in Melinda’s lower legs,” Nathan relates. “While we were there, I saw that he treats incontinence, so I asked him about it.”

Building the Pelvic Floor

“The pelvic floor muscles are an underappreciated part of our musculature that serve as a major foundation for the body,” Dr. Joyce contends. “They are extremely important because they support the pelvic organ as well as our posture.

“In women, childbirth can weaken the pelvic floor muscles. Men can experience bladder leakage following prostate removal. And in everybody, the pelvic floor muscles can weaken with age. It’s very important for men and women to perform routine Kegel exercises, which strengthen the pelvic floor muscles and help prevent incontinence.”

For those who do develop urinary incontinence there is help, a noninvasive treatment called the BTL Emsella® chair.

“The Emsella chair is just that, a chair that patients sit on in their street clothes; they don’t have to wear a gown,” Dr. Joyce describes. “They simply sit there. They can read a book or magazine during treatment, which takes about 28 minutes. Our protocol is two treatments per week for three weeks, so six treatments total.”

The Emsella chair uses high-intensity electromagnetic frequencies to stimulate the pelvic floor muscles and strengthen them. The frequencies induce deep pelvic floor muscle contractions, which are the equivalent of doing 15,000 to 20,000 Kegel exercises. In comparison, people are typically instructed by their health care providers to perform three to five sets of eight to 10 Kegels daily.

“There’s no way people can do 15,000 Kegel exercises on their own,” Dr. Joyce maintains. “But this chair does it for them. Ultimately, it improves bladder control, reduces incontinence and enhances quality of life.

“What’s more, treatment with the Emsella chair is not painful or uncomfortable, and there’s no residual sensation afterward. It’s a great addition to our practice.”

Treatment Success

Melinda completed all the recommended treatments in Dr. Joyce’s Emsella chair protocol. Afterward, she noticed a significant decrease in the severity of her incontinence.

“I underwent six treatments. It didn’t take the problem away totally because I still have some incontinence, but it’s not bad at all now,” she reports. “I still wear a pad but just a lightweight one instead of the heavy duty pads I used to wear.

“On a scale of one to 10, my problem is about a five now, down from a 10, so I’m pretty happy with my results. I’ll be happier when there’s not a drop of incontinence.”

With more control over her bladder and less leakage, Melinda can better enjoy her morning walks and card games with friends. She also likes going to the beach and doing other outdoor activities.

Dr. Joyce notes that results vary from patient to patient and the treatment may be repeated to increase its effectiveness.

Melinda says her visits to Joyce Vein & Aesthetic Institute were a positive experience.

“I really like Dr. Joyce,” she raves. “He’s very knowledgeable, and he’s a good doctor. Also, his staff is very good. I highly recommend Dr. Joyce and his treatment to anyone suffering with incontinence.”

© FHCN article by Patti DiPanfilo. Photo courtesy of Joyce Vein & Aesthetic Institute.
*Patient’s name changed at her request.

Tailored Care For Couple With Cataracts

She also had eye complications. Both now have ‘fantastic’ vision.

Joanne and Richard received individualized cataract surgeries and say they are equally happy with their outcomes.

Richard and Joanne Jacksto will celebrate their 39th wedding anniversary in September, but they’ve been loyal friends far longer than that.

“I’ve known Richard all my life,” explains Joanne, 67. “I was adopted and 3 months old when my parents brought me home. Richard and his parents lived next door. We became friends, and our friendship eventually turned into a romance.”

Richard and Joanne spent the first years of their marriage in New York. Richard worked as a heavy construction mechanic and Joanne was a bookkeeper. But Richard always wanted to live in Florida, so 30 years ago, the couple relocated to the Sunshine State and ultimately settled in Crane Lakes Port Orange.

“I haven’t fully retired yet. I still work part time,” offers Richard, 75. “I live at Crane Lakes and also work there doing landscaping and general maintenance four days a week.”

Nine years ago, Richard’s work-life routine suffered a setback when the vision in his left eye became blurry, and he began to see annoying halos around lights at night.

Blurry vision and halos are common symptoms of cataracts, which is a clouding of the natural lens inside the eye. The only treatment for cataracts is surgery in which the clouded lens is removed and replaced with a synthetic intraocular lens (IOL).

After learning that his cataract required treatment, Richard began searching for a qualified eye surgeon. He found one in the pages of Volusia Health Care News. That’s where he read an article about board-certified ophthalmologist and ophthalmic surgeon Q. Jocelyn Ge, MD, PhD, of Premier Eye Clinic, which has offices in Port Orange and Ormond Beach.

“Richard came to us with a cataract in his left eye,” Dr. Ge recalls. “I performed cataract surgery on that eye in 2013 and implanted the ReSTOR® multifocal IOL. The ReSTOR was the multifocal IOL of choice back then.”

After surgery and follow-up, Dr. Ge referred Richard to Ashley C. Royce, OD, a board-certified optometric physician at Premier Eye Clinic, for ongoing care.

“Three years after I operated on Richard’s left eye, Dr. Royce referred him back to me to have the cataract removed from his right eye,” Dr. Ge recalls. “I implanted the ReSTOR lens in that eye as well, and it was again successful.

“The ReSTOR lens has delivered a very good outcome for Richard in both eyes. He does not require glasses even after all these years. Today, Richard just comes to the clinic for yearly exams with Dr. Royce.”

Unhealthy Eyes

Like her husband, Joanne has trusted her vision to Dr. Royce since 2014. But unlike Richard, whose eyes were healthy aside from the cataracts, Joanne has several conditions that have affected her eye health.

“When I first met Joanne, she had elevated eye pressure as well as ocular surface disease, specifically dry eye,” Dr. Royce reports. “She also has a corneal condition called map dot fingerprint dystrophy (MDF). We tailored Joanne’s treatments to address her specific needs and vision goals.”

MDF is a hereditary disease affecting the epithelium, or outermost layer, of the cornea, the transparent outer covering of the eye. With MDF, recurrent abrasions develop on the surface of the cornea that look like fingerprints on the clear window of the eye.

“As far as Richard and I are concerned, Dr. Ge and Dr. Royce are the best in the business.” – Joanne

“Dr. Royce said the MDF was causing some of the blurriness in my vision, but I also had cataracts forming in my eyes,” Joanne reveals. “Eventually, the cataracts got so bad that I couldn’t see clearly with or without glasses, so Dr. Royce referred me to Dr. Ge for cataract surgery.”

“Joanne came to me thinking it was her chance to have the same clear vision that Richard has enjoyed all these years with the ReSTOR lens,” Dr. Ge recalls. “But because Joanne has eye conditions Richard does not, she is not a candidate for multifocal lens implants.

“Instead, I gave her the option of an accommodating lens implant, which is basically a monofocal lens that moves gently inside the eye using the patient’s own eye muscles and structures to provide a range of glasses-free clear vision, simulating the natural accommodation of the younger eye. I recommended bilateral Crystalens® IOLs for Joanne, and she’s doing great with them. She has almost 20/20 vision and is very happy.”

As part of Joanne’s cataract surgery, Dr. Ge also performed a second procedure aimed at reducing the pressure inside Joanne’s eyes. Known as minimally invasive glaucoma surgery (MIGS), it calls for the implantation of a miniature titanium stent called the iStent® to create a bypass in the trabecular meshwork, which is the main drainage mechanism in the eyes. The iStent improves the eye’s natural ability to drain fluid, decreasing pressure in the eyes.

“I Can See Perfectly”

Joanne underwent cataract surgery on her left eye on November 1. The surgery on her right eye was completed on January 31.

She’s ecstatic about her outcome.

“My vision is great now,” she enthuses. “I don’t need to wear glasses at all. I do use eye drops because I have a very bad case of dry eye, but other than that, I can see perfectly. I’ve worn glasses since I was 11 years old, and I love being able to walk around without them.”

Richard is just as happy with his results.

“When I’m outside, I have the vision of a 25-year-old. It’s really fantastic,” he enthuses. “I’m glad I had the surgery done, and I’m glad I had it done by

Dr. Ge. She’s very professional and very good with follow-up. And she knew how to explain everything so I could understand. Dr. Royce is as nice and as professional as Dr. Ge.”

Joanne agrees with Richard’s assessment of Dr. Ge and Dr. Royce.

“I love both of them and trust them implicitly,” she raves. “They’re very knowledgeable. They know exactly what they’re doing. I wouldn’t go anywhere else. As far as Richard and I are concerned, Dr. Ge and Dr. Royce are the best in the business.”

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

Improve The Appearance Of Your Smile

Digital imagery and 3D printing facilitate in-office restoration.

Geralyn Moulton

A wedding is among the most important moments of a couple’s lives. Geralyn Moulton served as a wedding coordinator for an event planning and catering company for 25 years. During her career, she helped numerous couples organize and celebrate their special day.

“I met with the brides and mothers and then put everything together,” Geralyn describes. “My company offered full-service event planning. We made the food, hired the entertainment, arranged for the limousine. We did everything except match the gowns and tuxes. I was always present during the event to help the bride and family with anything they needed.”

The Tennessee native, who relocated to Florida in 1979, immensely enjoyed her work with the Daytona Beach company.

“I loved the feeling when the wedding was over and everybody was happy,” Geralyn admits. “I loved knowing I helped make someone’s wedding day very special and that they’ll remember that day for the rest of their lives. It was very exciting.”

Geralyn, 65, retired as a wedding coordinator in 1999. She worked for a few years alongside her husband, who sold vacations and hotel timeshares. In 2006, she retired again, mainly so she could stay home and care for her grandchildren. Geralyn loves that job as well, but at the same time hated her failing teeth and anemic smile.

“My teeth had been deteriorating for years,” she shares. “I was also in a car wreck, and the impact of the airbag caused my front four teeth to turn sideways. There were big gaps where they were turning and crossing over.

“I’ve got a movie star smile now thanks to Dr. Aljonaidy.” – Geralyn

“I was embarrassed of my teeth. When I smiled, I tried to keep my lips over my teeth. I didn’t smile often because I didn’t want people to see my teeth. I didn’t even like looking in the mirror. I was depressed because of my teeth.”

Her situation worsened last fall.

“I was eating dinner one night and a cap fell out of my mouth with the tooth still in it,” Geralyn recounts. “There was significant pain where that tooth came out, and that was the only chewing side I had left. I lost several teeth on the other side a long time ago.”

Geralyn went immediately to a local dental office. She was exasperated by the experience because for a week the staff told her nothing could be done. She was in pain and couldn’t eat, so she left that office upset and crying. Seeing her in distress, her husband went looking for a dental practice that could help.

“The next thing I knew my husband calls and says, Get to Blossom Dental and Facial Aesthetics right now. They’ll see you right away,” Geralyn remembers. “I went right over there, and I’ve never had a more wonderful experience.”

Position and Shape

Blossom Dental and Facial Aesthetics is the Ormond Beach practice of Huda Aljonaidy, DDS. Upon examination, Dr. Aljonaidy discovered that Geralyn’s broken tooth and intense pain were associated with an infection. The dentist treated the infection and Geralyn’s pain subsided.

“Because we eliminated Geralyn’s pain, trust was built,” Dr. Aljonaidy relates. “At that point, I asked her, How do you feel about a full exam? She agreed to proceed, and that started an in-depth assessment of her mouth and facial aesthetics.

“During the assessment, we discussed issues such as her occlusion (the way teeth touch when the mouth is closed), cavities and gum disease. She wanted all those issues handled, which we did. Then, we discussed her smile, including her teeth position and shape. I told her, Every tooth in your mouth needs to be crowned to restore your smile.

Geralyn gave Dr. Aljonaidy the freedom to alter the shape of her teeth slightly to improve the appearance of her smile. The dentist relied on advanced digital technology and 3D printing to design and fabricate Geralyn’s crowns to exact specifications.

“While Geralyn sat in the dental chair, we took pictures of her teeth, analyzed her facial profile and lip thickness, and entered those ratios into our computer system,” Dr. Aljonaidy explains. “We chose the teeth shape from our digital library of human teeth and customized the design with our CAD/CAM (computer-aided design and manufacturing) software.

“The software is connected to our 3D printer, which creates temporary crowns. Their shape was chosen from examples of attractive teeth in nature, including celebrity teeth. The teeth were then printed and placed in Geralyn’s mouth. They are not simulations. They’re real teeth that she wore home and used. They serve as the backbone for the final restorations.”

After Geralyn’s mouth was healed from the preparatory dental work, Dr. Aljonaidy created a second set of 3D teeth to verify the bite, fit and appearance.

When everything was finalized, the dentist milled the permanent crowns out of a block of porcelain. That step was also completed in Dr. Aljonaidy’s office using her CAD/CAM equipment.

“With Geralyn, I restored one arch at a time starting with her lower arch,” the dentist explains. “Once the swelling was gone, I removed the 3D temporaries and fit the permanent teeth to sit perfectly on the gumline. Her top arch required more than one visit because she had more teeth on top, so I completed it in two phases. Now, her smile fits her charismatic personality.”

A Lifesaver

In addition to crowning all of Geralyn’s teeth, Dr. Aljonaidy finished off the smile restoration with injections of hyaluronic acid fillers in her lips and cheeks. The dentist also injected BOTOX® Cosmetic into Geralyn’s face to eliminate the lines created when she smiles. Geralyn is thrilled with her rejuvenated appearance.

“When I first met Dr. Aljonaidy, she asked me what my goal was, and I told her it was to smile again,” Geralyn recalls. “Ever since she restored my teeth, I’ve done nothing but smile. People who know me are amazed by how much I’m smiling now. And now that I’m smiling, I’m a lot happier than when I was self-conscious and trying to hide my teeth.

“I’ve got a movie star smile now thanks to Dr. Aljonaidy. My teeth are beautiful. I’m loving them. She did a beautiful job. And she’s got amazing, state-of-the-art equipment. I’ve never been to a dentist that can scan your mouth and immediately know what’s going on with your teeth.”

Geralyn has more praise for the dentist who restored her smile.

Geralyn Before and After

“Dr. Aljonaidy is a lifesaver,” she raves. “She got me into the office right away. She capped every tooth in my mouth and got me back to where I could eat. I can eat anything with the teeth she gave me, including corn on the cob and ribs on the bone. She’s given me my life back.

“She’s absolutely wonderful and efficient. She never stops and is on top of new technology. She’s also very personal and jokes around with me. It’s like I’m visiting one of my best friends every time I go into her office. I look forward to my dental appointments now. Dr. Aljonaidy changed my entire life.”

© FHCN article by Patti DiPanfilo. All photos courtesy of Blossom Dental and Facial Aesthetics. mkb

Physical Therapist Gives Tendon Loving Care

Softball warrior feels head over heels after rehab for torn Achilles.

Bob’s playing competitive softball again after physical therapy on his surgically repaired Achilles tendon.

At age 55, Bob Daniels retired as a quality engineer for the US Postal Service in Maryland. Two years later, in 2007, he relocated to the Sunshine State to escape the frigid winters. Before long, he became involved in the local sports scene in Florida.

“When I first moved to Ormond Beach, I umpired for a gentleman who talked me into taking the job as sports coordinator for the city’s youth athletic program,” recounts Bob, now 72. “I’m 12 years into that job at this point. I work evenings at the city’s sports complex as well.

“My job includes managing the fields, making sure they’re set up for the youth and adult programs we offer. I also teach sports skills — baseball, flag football and softball — to kids in the evenings. When I first started working there, I coached the sports teams my granddaughter played on. She’s in college now, so I don’t coach anymore.

“I’m also commissioner for the senior softball league in Flagler County, and I play competitive softball on a team called The Old Timers. I have a lot of fun.”

Bob’s fun was interrupted last July when he was injured playing softball.

“I hit a ball that went deep to the fence,” he remembers. “As I ran across first base and turned the corner to head for second, I collided with the first baseman. During the collision I felt something pop and then the pain came.

“I have a very high pain tolerance, but this hurt bad enough for me to stop playing. As I limped off the field, the pain was a 10 on a scale of one to 10. After I sat for a while, the pain subsided some, but it was still about an eight.”

As it turns out, Bob tore his left Achilles tendon. The tendon, which connects the calf muscles to the heel bone, is named after the warrior hero in Greek mythology who was killed by a poisonous arrow to his heel.

After undergoing surgery to repair the tendon in August, Bob was scheduled to begin physical therapy in September. Based on previous experiences, he chose to do his rehab at Barr & Associates Physical Therapy in Ormond Beach, working with Jacob Barr, PT, DPT, MTC, CEAS, CHT.

“My ankle feels strong, now. I’m able to run and play softball and be competitive when I play.” – Bob

“I first met Dr. Barr on the softball field at Ormond Beach Sports Complex with the adult co-ed league several years ago,” Bob reveals. “I got to talking with him, and he told me he was a physical therapist.

“When I underwent shoulder surgery years ago, I turned to Dr. Barr to rehab my shoulder. Then four years ago, I had my right knee replaced, and he rehabbed my knee. Dr. Barr did a great job with those conditions because he helped get me back on the softball field, so I turned to him again.

“My goals this time, though, were a bit different. In addition to getting back on the softball field, I wanted to be able to walk an hour and a half with my wife, which is something we were doing before I got injured. That was my primary goal.”

Therapy Protocol

To help Bob attain those goals, Dr. Barr followed a rehab protocol provided by Bob’s surgeon. The first order of business was to increase flexibility in Bob’s ankle.

Bob Daniels

“When Bob arrived, he was wearing a protective boot on his left foot and couldn’t perform any exercises while standing without the boot,” Dr. Barr informs. “We began with some range of motion exercises, soft tissue mobilization and passive range of motion techniques. We then progressed gradually through the protocol to performing strength exercises. Eventually, we worked on balance and walking without the boot.

“To assist with walking and gait training, we had Bob walk on our AlterG® Anti-Gravity Treadmill. The AlterG uses differential air pressure to ‘unweight’ the patient. We can take off as much as 80 percent of the patient’s body weight in as little as 1 percent increments. It’s like being in a pool but without the water.

“Because the AlterG is not full weightbearing, Bob was able to walk on the treadmill and recover a normal gait at an earlier stage in the rehab process.”

During his tenure at Barr & Associates, Bob also worked with Jonathan Wright, a physical therapy assistant.

“Jonathan has a baseball background, so he and Bob had a mutual interest in baseball and softball,” Dr. Barr reports. “Jonathan helped Bob regain the skills to return to playing competitive softball, which was one of his main goals.”

Bob received four months of therapy, completing on January 24.

“That’s typical for someone with that type of injury who desires to return to a high level of activity, such as playing sports,” Dr. Barr maintains. “If Bob didn’t want to do that, if he just wanted to be able to perform his everyday activities, the rehab would likely have taken less time.”

“Very Worthwhile Trip”

Bob continues to faithfully perform the exercises he learned at Barr & Associates to further strengthen his repaired Achilles tendon. He’s delighted with the results of his therapy, which eliminated his pain and allowed for a return to his active lifestyle.

Achilles Tendon

“My rehab went really well,” Bob enthuses. “My ankle feels strong now. I’m able to run and play softball and be competitive when I play. At this point, my ankle is about 95 percent healed. Both my surgeon and Dr. Barr told me it will probably take a year from my surgery for it to be 100 percent. That’s the main reason I continue with the exercises.”

Bob is pleased with the physical therapist that treated him and his staff as well.

“Dr. Barr is great,” he raves. “He’s very knowledgeable. And he knows me, so he knows my goals. I know other physical therapists; there are two or three others that play in the league. But I prefer going to Dr. Barr over anybody else.

“All the folks at Barr & Associates Physical Therapy are really good people. They taught me what to do when I leave the clinic. We spent an hour three days a week. The rest of the time I practiced the things they taught me.

“It’s been a long but very worthwhile trip. I reached the walking goal first and then I reached the softball goal. Anytime I talk to someone that’s injured, needs rehab or just wants to talk to a physical therapist, I always recommend Dr. Barr and Barr & Associates Physical Therapy.”

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

Eye Injections Manage Retinal Vein Occlusion

Anti-VEGF medications halt vision loss and reduce other complications.

Russ Williams played football and baseball while attending the University of Dayton in Ohio. Upon graduation in 1981, he acknowledged what most college athletes do — that he would never play either sport professionally. So, he went into broadcasting, which he studied as an undergrad. His career spanned nearly four decades.

Russ’ vision, with glasses, is now 20/20 in both eyes, which he considers a “blessing.”

“I was primarily an outside sales associate in radio and cable TV advertising. However, I did just about everything for the stations except climb the towers,” shares Russ, 66. “I performed a lot of promotional and sales duties, but I also recorded voiceovers and commercials. I broadcasted sports and special events as well.”

For the most part, Russ worked for stations in small and medium markets, beginning in Dayton. Eventually, he relocated to Florida and worked for radio stations and cable companies in various small markets.

“A cable company I worked for in Central Florida was instrumental in getting Daytona Beach hooked up with MTV’s spring break promotion in 1986,” Russ reveals. “I was very involved with that. I provided a lot of the legwork and background work. It was a trailblazing event to link a local cable company and an international cable network on the road.”

After Russ retired, he took on a new role at home: full-time caregiver. He helped his wife manage multiple hospital and specialists visits and deal with fluctuating symptoms until her death from metastatic breast cancer in February 2020. Being a caregiver heightened Russ’ awareness of his own health.

“About six years ago, I noticed a problem with the eyesight in my left eye,” he remembers. “My vision was blurry. I had a difficult time seeing. I didn’t have any trouble driving and I didn’t have any accidents or anything, but it was a challenge to clearly see what was going on in front of me. There was no pain, but when I read, my eyes got extremely tired, and my left eye got a little red and irritated.

“I thought perhaps my vision was being impaired by a stye growing on the outside of my eye. I visited a specialist to have it looked at, but it turned out the growth had nothing to do with my vision difficulties. The specialist determined that something more serious was going on and directed me to Florida Retina Institute.”

At Florida Retina Institute, Russ met with Jaya B. Kumar, MD, FASRS, a board-certified, fellowship-trained retina specialist.

“Mr. Williams initially came to us in 2016,” Dr. Kumar recalls. “He suffered a sudden, painless loss of vision in his left eye. His vision was blurry and distorted. After an exam and testing, we discovered he had a retinal vein occlusion.

Inflammation Cascade

A retinal vein occlusion is a blockage in the small veins that carry blood away from the retina, the light-sensitive layer of nerve tissue lining the back of the eye. Retinal vein occlusion is a common cause of vision loss.

“Think of it like someone stepping on a firehose and causing a backup of blood and fluid in the vein,” Dr. Kumar describes. “There are several complications when this backup occurs. For one, blood is not able to drain out of the eye. As a result, the blood vessels begin to leak, causing swelling of the tissues around the vein.

“Cholesterol deposits and blood leak from the vessels, which damage the retinal tissues. In addition, the eye releases vascular endothelial growth factor, or VEGF. This triggers a cascade of inflammation that causes swelling in the eye, bleeding and the creation of scar tissue.”

VEGF also signals the formation of abnormal blood vessels, which can leak and cause swelling and vision loss. The main treatment for retinal vein occlusion is the injection into the eye of anti-VEGF medication to halt the progress of these vessels.

“When I put on my glasses I can see like I used to when I was half my age.” – Russ

An occlusion often occurs when the vein is “pinched off” due to the pressure of the retinal artery on top of it or when a blood clot interrupts blood flow. Certain factors increase a person’s risk for developing the condition.

“The main risk factor for retinal vein occlusion is high blood pressure,” Dr. Kumar warns. “Other risk factors include having diabetes, glaucoma, and certain types of cancer or vascular conditions that increase the likelihood of developing a blood clot. Retinal vein occlusion is more common in people over 50.”

To diagnose an occlusion, retina specialists begin with a dilated eye exam, which provides a clear view of the retina. It can reveal abnormal blood vessels as well as bleeding and swelling in the retina and macula, the center portion of the retina. This bleeding and swelling cause blurry vision.

“We may also use certain tests to assist in making the diagnosis,” Dr. Kumar observes. “One is optical coherence tomography, or OCT, which in an imaging exam that details the layers of the retina.

“Sometimes, we perform a fluorescein angiogram. During this test, we inject a plant-based dye called fluorescein into a blood vessel in the arm. We then take pictures of the blood vessels in the back of the eye as the dye passes through them. Certain patterns on the images suggest a diagnosis of retinal vein occlusion.”

“A Definite Blessing”

There is no cure for retinal vein occlusion, but it can generally be managed successfully with ongoing treatment, Dr. Kumar assures.

One of the FDA-approved anti-VEGF medications used for treating retinal vein occlusion is bevacizumab, trade name AVASTIN®. Others are ranibizumab, brand name LUCENTIS®, and aflibercept (EYLEA®).

“In 2018, I switched Mr. Williams’ anti-VEGF medication from AVASTIN to EYLEA, which is a little stronger and can last a little longer than AVASTIN,” the doctor reports. “Today, we are treating him with EYLEA injections every three months. And he is doing well. His vision is excellent.”

Russ elaborates.

“My condition has gotten remarkably better,” he enthuses. “Before the injections, my eyesight, even with glasses, wasn’t anywhere near what it is now. My vision right now is great. With my bifocal prescription, I’ve got 20/20 vision in both eyes. I consider that a definite blessing. When I put on my glasses I can see like I used to when I was half my age.”

Not only is Russ amazed by his outcome, he’s also impressed by the retina specialist that helped him achieve it.

“Dr. Kumar is an incredible doctor,” Russ raves. “She’s very knowledgeable and up to date with all the treatments. And she has a very good doctor-patient philosophy. Having a good relationship with your doctor is critical when you’re dealing with your eyesight. I have that with Dr. Kumar.”

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

Chair-Side Philosophy Eases Dental Anxiety

Dentist creates a beautiful new smile, plus he “caters to chickens.”

Cathy is no longer a “chicken” about going to the dentist.

A Florida native, Cathy Thompson grew up in Orlando, lived for a while in Miami and eventually relocated to New Smyrna Beach. She’s worked as a real estate agent for the past 11 years, a job she thoroughly enjoys. However, her real enthusiasm lies with protecting the sea turtles that nest on the beach.

“This is my 23rd nesting season working with the New Smyrna Beach Marine Turtle Conservancy,” Cathy elaborates. “We call ourselves the Turtle Trackers for short. It’s a group that started in 1984. I happened to see them putting a protective barrier around a turtle nest one day and decided to get involved.

“Before I joined the group, I didn’t know much about sea turtles. But once I got involved, they became one of my passions.”

Cathy, 70, explains that sea turtle nesting season runs from May 1 through October 31. The Turtle Trackers drive the 13 miles of beach every morning during that period looking for turtle tracks that may indicate a nest has been built in the sand.

“If we discover a nest, we place a protective barrier around it and watch it closely until the hatchlings emerge,” Cathy describes. “Then we do an excavation, where we carefully dig up and count everything to determine the success of the nest. There’s an average of about 100 eggs in each nest.

“All the information we gather is sent to Volusia County and eventually to the state and federal government. The statistics our group and all the other turtle groups collect are what determine the status of the species, whether it’s threatened, endangered or doing fine.”

Sadly, all five Florida species of sea turtle are listed as threatened or endangered, making the work of the Turtle Trackers critical to their survival.

Cathy’s devotion to protecting the health of sea turtles is exemplary. Unfortunately, she spent years neglecting her own health, particularly her dental health. That disregard was due primarily to a deep-seeded fear of dentists that came back to haunt her a few years ago, when she realized she had some loose teeth that needed attention.

In dire need of a solution, Cathy visited Stephen P. Lester, DDS, a skilled and experienced general and cosmetic dentist at Park Avenue Dentistry in Edgewater. She initially met Dr. Lester at a business expo she sponsored as a Realtor®.

“I really liked Dr. Lester and his philosophy of patient care. He told me, We cater to chickens,” Cathy remembers. “He’s very gentle and kind. His office staff is the same way. Dr. Lester explains everything and is a wonderful dentist. He fit the bill for me, so I called him up and made an appointment.”

Avoiding Horse Teeth

“Cathy originally came to us in 2018 with some loose teeth due to moderate to severe gum disease,” Dr. Lester recalls. “There are several solutions for that. One is to remove the teeth. That’s a cure for gum disease.

“Another solution is traditional gum surgery.”

Dr. Lester offers an alternative to traditional gum surgery at Park Avenue Dentistry: nonsurgical laser gum therapy. It is effective at treating moderate gum disease, so he recommended the therapy for Cathy.

“We performed a combination of procedures on Cathy,” Dr. Lester elaborates. “We extracted several teeth that were hopelessly involved with gum disease. We did the laser therapy on the others.

“Laser gum therapy is much easier for the patient and is not painful. There’s no downtime and no healing discomfort. It’s as easy as getting your teeth cleaned. And it’s much less expensive than traditional gum surgery.”

During the therapy, Dr. Lester uses a special type of laser to access and remove inflamed gum tissue around the tooth root. He also removes tartar and plaque buildup from below and around the gumline. The procedure results in cleaner, healthier, more attractive gums.

“Superior Option”

Happy with the outcome, Cathy recently returned to Dr. Lester when an aging bridge became endangered.

“It was a bridge on the top left side of my mouth,” Cathy details. “It was old and deteriorated, and one day it just fell out and I couldn’t put it back in.”

During a brief examination, Dr. Lester discovered that Cathy could no longer keep the bridge in place because the teeth that were anchoring it had broken.

To correct the problem, Dr. Lester extracted the broken teeth that were anchoring the bridge and replaced them and the bridge with dental implants.

Dental implants are root-shaped, screw-like bodies that are surgically placed into the jawbone. New bone naturally grows around implants to form the foundation for an attachment piece, called an abutment, and the replacement teeth.

Cathy Thompson

The replacement teeth can be a crown that is cemented or screwed onto the abutment, a partial denture that can be affixed to one or more implants, or a full denture that can be fastened to a series of implants.

Some patients require a bone grafting procedure to enhance the volume of the jawbone so it can properly support the implant. The amount of time needed for the bone development is about three months.

“I’m a very satisfied patient.” – Cathy

Patients who have been missing teeth for many years may require a graft because bone mass deteriorates when there is no pressure from chewing to stimulate natural regeneration.

Bone grafts are sometimes done when the implants are seated. The implants then need three to six months to heal to a point where they can support a prosthetic. During the healing period, patients are usually fit with temporary replacement teeth.

“Last fall, we placed two dental implants in Cathy’s upper left jaw,” Dr. Lester reports. “We made a temporary partial denture for her to wear while we waited for the implants to bond with the jawbone. Then in March, we placed the permanent replacement teeth — two crowns — on top of those implants.

“We couldn’t make Cathy another bridge because she no longer has anchoring teeth in the appropriate places. She had to decide between nothing, implants or a removable partial denture. She chose the implants and is very happy with her decision.”

According to Dr. Lester, implants are a good alternative to partial dentures and bridges.

“Dental implants are the closest reproduction to God-given natural teeth that dentistry has been able to create to this point,” the dentist contends. “They look and feel like natural teeth. They chew like natural teeth, brush like teeth and, oftentimes, floss like teeth. But they don’t decay like natural teeth.

They’re a superior option for replacing missing teeth.”

“Just Like Real Teeth”

To date, Cathy has received two implants to replace the teeth that were once anchoring her old bridge. She will soon be fit with two more to replace her other missing teeth.

Unlike Cathy who only needed two implants, pictured above is an example of a major restoration supported by implants.

“I love the implants,” she enthuses. “The restorations Dr. Lester attached are just like real teeth. They look like real teeth; you would never know that they weren’t my natural teeth.

“And I can eat anything I want with them. I have no problems whatsoever. My bridge is long gone, and I didn’t want a partial denture, so I’m a very satisfied patient.”

Cathy is also happy she ran into Dr. Lester at the expo. Because of him, she’s conquered her fear of dentists and no longer neglects her dental health.

“Dr. Lester is very knowledgeable, he’s up to date on all the latest dental techniques, and I love his philosophy of patient care,” Cathy raves. “He told me, We cater to chickens, which he does very well. He’s very gentle and kind, so I don’t avoid the dentist like I used to.

“I love his staff, too. Everyone is kind and gentle just like he is, and instead of working on Fridays, they do continuing education, which I think is great. They’re all awesome, and that’s why I highly recommend Dr. Lester and Park Avenue Dentistry.”

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb



Venous insufficiency Without Visible Veins

After ultrasound reveals painful ailment, repairs done with minimally invasive procedures.

For 18 years, June Krippner worked as an administrative assistant in several departments of the University of Hartford in Connecticut. She spent eight years in the athletics department and eight years in financial aid. Ultimately, she served as an administrative assistant to the university’s president.

June has no trouble walking now that her leaky leg veins have been treated.

June was also a student at the university. She earned a bachelor’s and a master’s degree in education from the institution. Her goal was to become a teacher, a profession common among the women in her family.

“My mother was a teacher; my sister was a teacher; and my grandmother was a teacher,” June reveals.

Family responsibilities curtailed her career ambitions, however.

“At the time I received my master’s degree, my daughter had two children, and she asked me to babysit,” June recounts. “So, I didn’t get to use my degree as a full-time teacher, but I got to use it as a substitute teacher.

“I substituted for various grades at the elementary level in a little town called Simsbury. I’ve been retired since I started watching my grandchildren, about 15 years. We moved to Florida five years ago because the taxes and other expenses in Connecticut were too high, and the weather in Florida is much nicer.”

June, 69, now lives in a vibrant 55-and-over community in Punta Gorda and maintains an active social life.

“I belong to about 10 different clubs, including those for quilting, knitting and playing mahjong,” she relates. “I also create artwork at the visual arts center and go to many concerts and shows with friends. Every single day, there’s something going on, so I stay pretty busy.”

Two years ago, June developed a troubling issue with her legs that put a cramp in her active lifestyle. She experienced intense heaviness in both legs that limited her ability to get around.

“My legs felt like they weighed 50 pounds each,” June elaborates. “I couldn’t move my legs, and my feet were numb. It didn’t disturb me until I physically couldn’t walk. I got up at night, and I had to slap my feet on the ground to get the circulation going.

“There was not a lot of swelling, although my ankles swelled a little. I wore compression socks at night. There were no varicose or spider veins visible on my legs. I just had the heaviness in my legs and the numbness in my feet. I didn’t notice the problem coming on. It developed gradually over time.”

One of June’s friends is an administrator at Joyce Vein & Aesthetic Institute, the Punta Gorda practice of Douglas H. Joyce, DO, a board-certified cardiovascular surgeon. Dr. Joyce specializes in treating venous disease with minimally invasive procedures and addresses all stages of the ailment from spider veins to venous ulcers.

“My friend said, You should have Dr. Joyce check out your legs,” June remembers. “I followed her advice, and after the examination, Dr. Joyce said, June, your legs look good, but your veins are a mess. He told me I could potentially develop ulcers on my legs if I didn’t take care of the vein problem right away.”

Invisible Symptoms

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 and discomfort.

“June did not have bulging varicose veins or spider veins, swelling or discoloration, which are the common outward signs of venous insufficiency,” Dr. Joyce recalls, “but the disease doesn’t always have external signs.

“That was the case with June, who did have heaviness in her legs, numbness and some difficulty with balance. Venous disease sometimes presents that way, and sometimes it comes with aching, restless legs at night or an antsy feeling in the legs. Some say it feels like bugs are crawling on their legs when they’re sitting in a chair or trying to sleep at night.”

Recognizing June’s invisible symptoms, Dr. Joyce ordered a venous ultrasound mapping of her legs.

“It’s been about a year since my vein treatment, and my legs feel great.” – June

“The ultrasound showed significant venous insufficiency in her long veins — the great and small saphenous veins — and in her perforator veins,” Dr. Joyce reports. “She had the picture of what we would expect to see on someone that has visible signs of venous insufficiency, but she didn’t have those signs. We advised treating her venous dysfunction.”

Dr. Joyce performed two minimally invasive procedures to close them: standard laser ablation and single-needle laser ablation, the latter a technique he developed.

“During standard ablation, we slide a laser fiber along the length of the vein and use laser energy to seal the entire vein,” Dr. Joyce explains. “Blood flow is then rerouted to other healthy veins.

“During single-needle laser ablation, which we typically use to treat abnormal perforator veins, we take a specially designed needle and, using ultrasound guidance, place it into the target vein. We insert a laser fiber, apply anesthetic, then turn on the laser for 15 to 20 seconds to spot-weld the area of vein being treated.”

Dr. Joyce performed 14 procedures on June, seven on each leg.

“Once we’re done, we perform another ultrasound to make sure all the blood is flowing the correct way and there’s no more abnormal venous flow. That’s our ultimate goal,” the doctor says.

“World of Difference”

June is extremely pleased with the outcome.

“It’s been about a year since my treatment, and my legs feel great,” she enthuses. “The heaviness is gone, and I have no trouble walking. I also bike and do water aerobics. My legs are very comfortable now. I don’t have any issues, and I sleep through the night.”

June is just as delighted with her experience at Joyce Vein & Aesthetic Institute.

“Dr. Joyce is very knowledgeable,” she raves. “He’s excellent. After the initial ultrasound, he showed me a diagram of my legs and explained very thoroughly what had to be done. I understood exactly what he was saying.

“I’m very happy with Dr. Joyce’s professionalism and the professionalism of the people in his office. They’re kind people. I can tell they care. I’ve been to a lot of different doctors during my life, and Joyce Vein & Aesthetic Institute is the most kind and considerate office I’ve ever been to.

“I recommend Dr. Joyce and his procedures 110 percent. They made a world of difference in my life.”

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

Body Sculpting With The Emsculpt NEO

Treatment uses electromagnetic frequencies to stimulate muscles, eliminate excess fat.

A recent body-sculpting addition at the Joyce Vein & Aesthetic Institute is Emsculpt® NEO, a device that stimulates muscle groups using electromagnetic frequencies as well as radiofrequency energy. It can be used on the abdomen, buttocks, thighs, calves, triceps, biceps and other muscle groups.

“Emsculpt NEO is another life-changing treatment offered at Joyce Vein & Aesthetic Institute,” says Douglas H. Joyce, DO, FACOS, FACPh, a board-certified surgeon.

“One of our staff had a very difficult time with weight around his lower abdomen,” the doctor relates. “He worked out with a trainer weekly and tried everything over the years to get rid of it.

“When the Emsculpt NEO arrived, he was our first patient. He underwent five treatments one week apart. Then, we waited eight weeks over the holidays and took pictures. The results speak for themselves.”

Emsculpt NEO is very effective at slimming the abdomen, Dr. Joyce observes.

“The treatment continually contracts the abdominal muscles, so it’s the equivalent of doing 15,000 crunches during a 30-minute treatment,” he reports. “In addition, the radiofrequency energy heats up excess fat and disrupts it, and the body then absorbs the displaced fat over time.

“During an Emsculpt NEO treatment, we place a conduction paddle on the area to be treated and secure it with a strap. Patients simply sit back and watch TV for a half-hour while the equipment does its thing. And the results are amazing.”

Emsculpt NEO treatments are not painful, nor do they result in any residual sensations. The two treatments are noninvasive and require zero recovery time.

“Both utilize a specific series of pulses that remove lactic acid from the targeted muscles, so patients don’t experience the tiredness and soreness associated with intense exercise,” Dr. Joyce explains. “Emsculpt NEO strengthens the core, and when we combine it with the Emsella chair, we get total core-to-floor strengthening.

“These technologies build up the core, and core strength is massively important as we get older. People need core strength for everyday activities, such as getting in and out of a car and for catching themselves if they start to fall.”

© FHCN article by Patti DiPanfilo. Before and after images courtesy of Joyce Vein & Aesthetic Institute. mkb

Electrotherapy Reduces Need For Pain Meds

Noninvasive Sanexas protocol treats underlying cause of  peripheral neuropathy.

Mike has received six months of Sanexas therapy so far and experienced a noticeable improvement in his symptoms.

Mike Merino is an Army veteran who spent many years in the restaurant business, owning and operating eateries throughout the Tampa Bay area. Toward the end of his career, Mike shifted his focus and became a journalist, writing primarily for the Tampa Bay Times.

“One day, I was having a debate with a friend, and he said, You never get off the fence. Make a decision. Be on one side or the other,” Mike remembers. “That prompted me to start making decisions about all kinds of issues: politics, lifestyle, all forms of human interaction.

“I started writing letters to the editor and, for whatever reason, the newspaper was publishing them. Before I was done, more than 200 of my letters to the editor were published, and I won Letter of the Day, Letter of the Year, all sorts of accolades.

“Eventually, I came up with a story and submitted it to the paper. The editor liked it so much, he said, If you keep coming up with stories, we’ll keep printing them and paying you for them. Over about a two-year period, I wrote more than 30 stories for the Tampa Bay Times and Tampa Tribune.”

Before he retired completely, Mike also worked at the James A. Haley Veterans’ Hospital in Tampa for 10 years. Toward the end of his tenure, Mike developed a painful condition in his feet.

“My feet felt very cold, and they were numb and tingly,” discloses Mike, now 69. “It was painful to be on my feet for long periods. I couldn’t walk around the block without pain. I could stand, but my balance was seriously impaired. At one point, my discomfort rated an eight or 10 on a scale of one to 10. My neurologist at the veterans’ hospital diagnosed the problem as peripheral neuropathy.”

Peripheral neuropathy is a condition that affects more than 20 million Americans. It is the result of damage done to the nerves that run from the central nervous system (the brain and spinal cord) to the rest of the body.

Common causes of peripheral neuropathy include diabetes, certain autoimmune diseases and inflammatory infections. Mike’s neurologist could not determine the cause of his neuropathy, which worsened over time.

“Once I retired, my neuropathy really accelerated and became severe,” Mike reveals. “I tried LYRICA® and other similar medications in an attempt to ease the pain and numbness. But there’s really no cure for neuropathy at this time.

“My condition became so bad that the neurologist ran out of things to do for me. He had me try every treatment, concept and prototype in his arsenal with no results. After that, I took it upon myself to search for an alternative.”

While researching new therapies for neuropathy, Mike discovered a leading-edge technology called Sanexas electrotherapy. It’s a noninvasive form of electric cell signaling therapy, or ECST, which uses pulsed energy waves to treat painful areas of the body.

“Initially, I found the Sanexas equipment, the actual machine, then I read all the research that’s been done on Sanexas electrotherapy,” Mike recounts. “I reached out to the main company in Nevada, and they directed me to Dr. Lupo. They told me he has the Sanexas equipment in his office.”

Robert C. Lupo, DC, is a chiropractic physician who offers primary, chiropractic and holistic care at his Tampa-based practice, Physical Medicine Center. Dr. Lupo also provides Sanexas electrotherapy for neuropathy as part of his specialty services.

Harmonic Vibrations

“Mike came to us complaining of coldness, tingling, numbness and pain in his feet,” Dr. Lupo recalls. “Those symptoms are consistent with neuropathy, and I ran some tests to confirm the diagnosis. Those tests revealed that Mike was a good candidate for our Sanexas electrotherapy protocol.”

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.

“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 relieve 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 tingling and numbness in my feet have decreased significantly.” – Mike

“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 says.

“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, which leads to a much better overall quality of life.”

Sanexas electrotherapy is painless and benefits 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 observes. “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. Studies show that more than 80 percent of patients gain enough relief to resume normal activities.

“Positive Results”

Because Mike’s neuropathy was so severe, Dr. Lupo planned a course of Sanexas electrotherapy that included treatments twice a week for at least one year. Mike has received six months of treatment so far and experienced a noticeable change in his symptoms.

“I’ve already received positive results from the treatment,” Mike confirms. “My feet used to be ice cold. I’d have to wear double socks at night just to keep them from freezing. That has subsided greatly.

“The tingling and numbness in my feet have decreased significantly. As a result, my walking and standing have improved. I can now walk around the block if I want to, but at age 69 I’ve got to keep my activity level at a low roar. And instead of an eight or 10, my discomfort has been reduced to a four.”

Mike says he has faith in the technology.

“I believe Sanexas electrotherapy will ultimately give me the best results of any device or treatment for neuropathy that’s in the marketplace today,” he shares.

The retired restaurateur and journalist also has faith in the physician who treated his peripheral neuropathy.

“Dr. Lupo is incredibly knowledgeable and always explains what he’s doing to me,” Mike enthuses. “I always describe to him how I reacted over the weekend following a treatment, and he works very closely with me on a one-on-one basis to try to understand my condition.

“Not everybody has severe peripheral neuropathy or the intense issues that I had. The best time to treat neuropathy is at the beginning, at the onset of symptoms. I urge people to go to
Dr. Lupo as quickly as possible once they begin to feel symptoms.

“For people who have any type of neuropathy pain, numbness or tingling in their feet, I highly recommend Sanexas electrotherapy. And I absolutely recommend Dr. Lupo.”

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