Manatee Memorial Hospital opens the freestanding ER at Bayshore Gardens for 24/7 care

COURTESY IMAGES MANATEE MEMORIAL HOSPITAL
Ribbon cutting (left to right): Caleb Grimes, Kevin DiLallo, Tom McDougal, Vern Buchanan, Tara Poulton, Mark Goodson, Jeff Podobnik, Mayor Gene Brown, and Dr. Teresa Rawe

Since 2010, only six Florida counties have experienced a population surge greater than Manatee, which has grown by 31 percent, or more than 100,000 residents, over the past dozen years, according to US census data. 

Meeting the many essentials of the ever-expanding population is challenging, but Manatee Memorial Hospital recently addressed one of the area’s greatest needs by opening the county’s first freestanding emergency department. 

The ER at Bayshore Gardens is an 11,000-square-foot facility that provides emergency care 24 hours a day, seven days a week for all ages. It’s located at 5506 14th St. W. in southwest Manatee, about five miles south of the main hospital in Bradenton. 

“We are honored to be extending Manatee Memorial’s community outreach by opening our first freestanding emergency room for Manatee County,” says Tom McDougal, CEO of Manatee Memorial Hospital. 

“By expanding our emergency services, we can provide access to emergency care where it is needed. No matter the emergency, the new ER at Bayshore Gardens is equipped to handle it, from minor conditions to stabilizing treatment for major conditions such as heart attack and stroke.” 

A twin of Manatee Hospital’s ER at Sun City Center in Hillsborough County, which opened last year, the ER at Bayshore Gardens has 12 treatment areas, including six exam rooms and three rapid medical exam spaces. It also features a full-service laboratory as well as X-ray, CT and ultrasound services. 

Most importantly, a physician and team of certified ER nurses are always on duty to offer the same level of care as a hospital emergency department. 

“Our staff is capable of treating any condition or patient that typically presents to a hospital-based emergency room,” says Tammy Sloas, freestanding emergency department director at Manatee Memorial Hospital. 

The ER at Bayshore Gardens does not have an inpatient option, but patients needing further treatment can be transferred to Manatee Memorial Hospital in Bradenton or have transportation arranged to another hospital of their choice. 

“We can make all of those arrangements right there at the emergency room,” Tammy ensures. “Once the patient has been evaluated by the doctor and all parties are in agreement with the path forward, we call admitting and arrange the transfer.” 

During its first week of operation, the ER at Bayshore Gardens transferred 6 percent of its patients to Manatee Memorial Hospital. Similarly, the ER at Sun City Center has transferred about 6 percent of its patients to primary hospitals since the year began. 

A Growing Trend 

Freestanding emergency departments are nothing new. The concept dates to the early 1970s, when big-city hospitals began opening ER facilities in rural areas that lacked acute care centers. 

At first, the trend developed slowly. However, from 2008 to 2016, the number of stand-alone emergency facilities increased from 222 to 566 across 32 states. Estimates call for more than 2,000 by next year. 

“In growing communities such as Manatee County, there is absolutely a need for facilities like this because it eases the pressure on the primary hospital-based emergency rooms, where volumes are increasing,” Tammy says. 

“Those primary emergency rooms are getting hit all the time, but it’s difficult to add beds or expand those ERs. The better option is to build new facilities out in the community where the people are that provide them with another option for emergency care.” 

COURTESY IMAGES MANATEE MEMORIAL HOSPITAL
To help meet the medical needs in fast-growing Manatee County, Manatee Memorial Hospital has opened the ER at Bayshore Gardens an extension of Manatee Memorial Hospital, an 11,000-square-foot, freestanding

Making a Difference 

Tammy says freestanding emergency departments are “the wave of the future” in hospital care and that it’s no surprise Manatee Memorial is part of the paradigm. It has long been providing advanced treatment options. 

Now celebrating its 70th anniversary, Manatee Memorial opened Manatee County’s first Interventional Radiology Suite with biplane imaging in January 2019 to support advanced stroke care and vascular disease management. 

Biplane radiology uses two rotating cameras, one on each side of the patient, to take simultaneous images, which are combined digitally to form a 3D view. 

Manatee Memorial also became the first hospital in the state to perform 800 cardiac procedures in which the Watchman™ left atrial appendage closure (LAAC) was implanted into atrial fibrillation patients, including 500 by one surgeon. 

More recently, Manatee Memorial was among the first in the region to offer Barostim™ Baroreflex Activation Therapy, which uses neuromodulation – the power of the brain and nervous system – to treat systolic heart failure. 

In recent years, the hospital has also become one of the leaders in the use of the Impella® Heart Pump, a tiny device that allows surgeons to perform complex coronary interventions without opening the heart. 

 The hospital’s range of medical services includes surgery, orthopedics, outpatient and inpatient radiology, rehabilitation, respiratory care, sleep services, oncology and wound care. The hospital also provides specialized care for women and children through the county’s only Level II neonatal intensive care unit. 

The opening of the ER at Sun City Center and ER at Bayshore Gardens are just two more examples of how Manatee Memorial Hospital is working toward its goal of providing the community with advanced care and services. 

“We are proud to be a part of this fast-growing community,” Tammy concludes, “and we’re looking forward to providing the residents here the expanded support and medical care they need.” ■ 

BY ROY CUMMINGS
Florida Health Care News
roy.cummings@ifoundmydoctor.com 

Hearing aids with masking program neutralize maddening sounds

JORDAN PYSZ / FLORIDA HEATH CARE NEWS
As a tinnitus sufferer herself, Dr. Breese relates well to patients such as Audrey.

 The two years that Audrey* spent teaching English at Ramstein Air Base in Germany were easily the most profitable of her career. Not only did she make more money while teaching in German, she also met the man who later became her husband. 

“He was a pilot in the US Air Force,” Audrey gushes. “We’ve traveled all over the Earth together.” 

The couple’s travels eventually landed them in Riverview, which became their retirement home. Unfortunately, Audrey’s retirement has been interrupted in recent years by an annoying condition called tinnitus, which is commonly referred to as ringing in the ears. 

“It was awful because it was on both sides of my head, and it was so loud that I just couldn’t think,” Audrey says of the condition, which presented itself as a constant buzzing sound. “It drove me nuts, and believe me, I tried everything to get rid of it. 

“I tried sleeping with a fan on because it was worse at night, but nothing worked. Sometimes it was so bad that I wanted to bury my head in a pillow to get away from it. Of course, that doesn’t work either because that buzzing sound was always there.” 

Been There, Done That 

When the buzzing became unbearable, Audrey began to visit nearby audiologists. After several tries, she finally found one she trusted and felt comfortable with at Hearing Aids of Sarasota, the practice of Kelly Breese, AuD. 

Dr. Breese, who became the proprietor of Hearing Aids of Sarasota in November 2020, is a former competitive and professional percussionist who also has tinnitus. As a sufferer herself, she relates well to patients such as Audrey. 

“Like Audrey, I’ve been through phases where I would try to read something and I couldn’t process what I was reading because the sound in my ears was so loud and bothersome,” Dr. Breese explains. “It’s a very challenging situation to be in.” 

Dr. Breese further explains that tinnitus is a condition that cannot be cured. It can be managed, however, and after learning that Audrey’s tinnitus was a result of age-related hearing loss, she developed a plan to help Audrey do just that. 

 The plan called for Audrey to be fit with hearing aids that included a tinnitus masker, a controllable program that neutralizes tinnitus by providing the wearer with a soothing alternate sound that takes the brain’s focus off the noise caused by the tinnitus. 

Audrey’s masking program was initially set to provide the faint sound of an ocean breeze. During her first week wearing the hearing aids, Audrey found she didn’t need the masker after all. 

“With some patients, the return of natural sound to the brain is enough to neutralize the tinnitus,” Dr. Breese educates. “That’s what happened with Audrey, and it’s been a total game-changer for her.” 

Audrey concurs. She says the hearing aids have not only neutralized her tinnitus, but in doing so also vastly improved her quality of life. 

Those are just two reasons why she thinks so highly of Dr. Breese and gladly recommends her to others. 

“Dr. Breese is so caring and kind; I think the world of her,” Audrey concludes. “She is someone you can trust to do the best for you, and that’s why I travel all the way from Riverview to Sarasota to see her. Because I trust her.” ■ 

BY ROY CUMMINGS
Florida Health Care News
roy.cummings@ifoundmydoctor.com 

Regenerative medicine therapy repairs discs, allowing active snorkeler to enjoy ‘trip of a lifetime’

JORDAN PYSZ / FLORIDA HEATH CARE NEWS
Karen says her symptoms began to improve within weeks of receiving the ReginaSpine protocol. A few months later, most of her pain and spasms were gone and she resumed her active lifestyle.

 When Karen-Astley Moore added snorkeling in the Tobago Cays to her bucket list a few years ago, she did so knowing full well that her chances of scratching off that item stood between slim and none. 

The reason is that the Tobago Cays are an uninhabited archipelago in the Lesser Antilles that can be accessed only by boat from another island, the closest of which is Canouan, which isn’t easy to get to either. 

“It takes three flights just to get to Canouan, and then you have to take a boat to the Tobago Cays,” Karen explains. “It’s quite an undertaking, but when my husband won a trip to Canouan as a reward for his business, we said, This is our chance; we’re not missing it.” 

Karen and her husband made their trip to Canouan in early April. From there they chartered a 43-foot catamaran to the Tobago Cays, where they spent four days living on the boat and exploring the island and its surrounding clear blue waters. 

“We swam with five-foot sea turtles, five-foot stingrays and manatees, and the coral reefs were the most beautiful I’ve seen in the 38 years that I’ve been snorkeling,” Karen exudes. “It was the trip of a lifetime and so worth the long journey to get there.” 

Karen, 61, didn’t devote all her time in the Tobago Cays to snorkeling. An avid kayaker and paddle-boarder, she also engaged in those activities. 

A couple of years ago, agonizing neck and arm pain would have prevented her from taking such a trip. 

“I’ve been dealing with neck pain that radiated into my arms for years,” Karen laments. “I was a gymnast in high school, and that’s probably where it started. But then I worked for 40 years as an oncology nurse, always lifting a lot of heavy patients. 

“That didn’t help me any because I’m not a very big person. I’m just five feet tall and weigh about 115 pounds, so around 1995, all that heavy lifting started to cause some problems for me. That’s when the pain in my neck really started to bother me. 

“But it wasn’t just in my neck that I felt that pain. The pain also radiated down into my arms, which is called radiculopathy. Later I found out that the cause of all this was not just herniated discs but disc desiccation in some of the discs in my cervical spine.”

Desiccation, or dehydration, is a common feature of a condition known as degenerative disc disease, where disc deterioration can cause a range of issues, including pain, numbness and tingling in the neck, arms and back. 

After suffering for four years with the aggravating pain in her neck and arms, Karen underwent neck fusion surgery in 1999. That surgery bought her more than a decade of relief, but her pain returned in 2011 and led to a second surgery in 2012. 

Like the first operation, the second bought Karen years of relief. In 2021, however, the pain returned with a vengeance. What Karen described as a “searing, burning pain” coursed through her neck and arms regularly and disrupted most every aspect of her life. 

“It was so bad that I couldn’t even hold a glass in my hand because I couldn’t feel it,” Karen offers. “But being a nurse, I know that you can’t just keep fusing the spine because once you get to a certain level, you start running the risk of paralysis. 

“So, I said to myself, no more surgeries, and that’s when I started looking for something else. I started by visiting a couple of pain management doctors, but I didn’t feel comfortable with any of them. Then I found Dr. Grana at Regenerative Orthopedic Institute.” 

New-Age Specialty 

Founded by Erick A. Grana, MD, Regenerative Orthopedic Institute specializes in regenerative medicine, which promotes growth in tissue ravaged by injury, arthritis or degeneration. 

“Regenerative medicine therapy treats disease and injuries by harnessing the body’s natural healing powers,” Dr. Grana educates. “The natural healing process occurs by combining patients’ stem cells with platelet rich plasma (PRP), a concentration of platelets from their own blood. 

“Unlike surgery, which can result in blood loss, scarring and long, painful recovery periods, regenerative medicine therapy requires only injections into the damaged joint. This advanced process results in a safe, effective treatment.” 

Stem cells are the most basic building blocks of tissues and organs, and they can be collected directly from the bone marrow or fat of the patient. There are no side effects or rejection. 

The procedure to collect tissue is similar to a blood draw. Once the tissue has been harvested, the stem cells and PRP are isolated and injected into the affected areas to spark the regeneration of damaged tissue. 

Regenerative medicine therapy can be used to treat damage in the knees, shoulders, ankles, wrists, hips, back and neck. It can also be used to treat arthritis and peripheral neuropathy, as well as muscle and tendon tears almost anywhere in the body. 

At Regenerative Orthopedic Institute, Dr. Grana developed a system for delivering restorative tissue and PRP into the spine called RegenaSpine™. He also developed a similar system to treat damaged joints called RegenaJoint™. 

Rapid Relief 

Karen spent several months researching regenerative medicine and visiting area physicians who specialize in the treatment. She chose Dr. Grana and Regenerative Orthopedic Institute for two reasons. 

“First of all, Dr. Grana is a pain management specialist,” Karen explains. “I’ve got nothing against orthopedic doctors, but pain management specialists have done thousands of these procedures, and based on volume alone, they’re just better at it. 

“The other thing I like about Dr. Grana is his philosophy. I like the fact that he only uses autologous restorative tissue, which means he only uses tissue taken directly from the patient. I didn’t want bagged restorative tissue or some other person’s tissue.” 

Karen first visited Dr. Grana a little more than a year ago. After determining that she was indeed a good candidate for regenerative medicine therapy, Dr. Grana obtained and processed the restorative tissue, then treated her using his RegenaSpine protocol. 

“After doing all of my research, I figured it would probably take about six months for me to start feeling the effects,” Karen says. “But I can honestly say that I started to feel significantly better within three or four weeks. 

“Then, as time went on, I just continued to improve and get better and better. After a month, most of my pain and spasms were gone, and after a few more months, I was out kayaking, paddleboarding, snorkeling, gardening and even doing Pilates again. 

“At the six-month mark, I was back doing everything that I like to do, and I can tell you that were it not for Dr. Grana and his regenerative medicine therapy, I would not have been able to make that trip to the Tobago Cays. 

“First of all, three plane rides aren’t kind to anybody. And living on a boat for four days is not easy either. But I was able to do all of that as well as snorkel, kayak and paddle board, and thanks to Dr. Grana, I had a great time doing it.” ■ 

BY ROY CUMMINGS
Florida Health Care News
roy.cummings@ifoundmydoctor.com 

Properly placed implant allows summertime farmer to better enjoy the fruits of her labor

JORDAN PYSZ / FLORIDA HEATH CARE NEWS

 In its purest form, farm-to-table dining is experienced at a table on the very farm where the food is produced, a table like the one Shirley Eisenhauer and her husband eat from every day during the summer. 

“We spend our summers on a 22-acre farm in the North Carolina mountains, where we grow all our own vegetables,” Shirley confirms. “We grow just about everything you can think of — tomatoes, asparagus, green beans, peppers, you name it. 

“We even grow strawberries and blueberries, and what I do is go out each morning, find what’s ripe and ready for picking and bring that into the house. Then I go online and find recipes for all the things that were ready that day. It’s a lot of fun.” 

It’s not just on their North Carolina farm that Shirley and her husband literally eat the fruits and vegetables of their labor. They can and freeze a lot of those items and bring them to Florida, where they spend the winters. 

 “I didn’t have to buy hardly any fruits and vegetables the last time we came down, which was good because when I got to Florida and saw the prices at the grocery store, I was shocked,” Shirley offers. “I was really glad we brought most of what we needed.” 

Shirley, 68, has been canning and freezing fruits and vegetables and bringing them to Florida for more than a decade. During one of her first trips to the Sunshine State, a dental issue temporarily forced her to alter her eating habits. 

 “I broke a tooth,” Shirley explains. “It was an upper right molar, and I obviously needed to get it fixed, so I started calling around, looking for a dentist who could see me right away. That’s how I wound up at Port Charlotte Dental Care.” 

Remove and Replace 

Port Charlotte Dental Care is the practice of Joseph H. Farag, DMD. The work he did in reshaping Shirley’s broken tooth and placing a crown on it prompted Shirley and her husband to become regular patients of the practice. 

Shirley says that since her first visit there, she and her husband have turned to Dr. Farag for all their dental care. For Shirley, that recently included another issue with the same tooth, a second premolar that prompted her initial visit. 

“Shirley came back in October 2022 and that same tooth, tooth number 4, had broken off completely,” Dr. Farag reports. “Given the situation, I explained that the best thing I could do for her was to extract that tooth and replace it with a dental implant.” 

Dental implants are root-shaped, screw-like bodies that are surgically placed into the jawbone. Once the implant is in the jawbone, new bone naturally grows around it to form the foundation for an abutment and replacement teeth. 

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

Prior to seating an implant, some patients require a bone graft designed to enhance the volume of the jawbone. By using autologous bone or a synthetic bone substitute, the graft gives the jawbone the strength to support an implant. 

Bone grafts are not always necessary, but for patients who have been missing teeth for many years, they are often required because bone mass deteriorates when there is no pressure from chewing to stimulate natural bone regeneration. 

 X Marks the Spot 

Though Shirley had her tooth extracted, Dr. Farag determined through a CT scan that she would still require some grafting prior to seating the implant, which was done with the help of a digital 3D planning platform called X-Guide®. 

“The X-Guide system is a tremendous tool that allows us to do all the planning for a dental implant virtually on a computer,” Dr Farag states. “It also helps us determine the precise size of the implant that’s needed and how to place it. 

“It gives us all the angles that we need for proper alignment of the implant and even shows us how the implant will line up with the opposing jawbone and teeth that we’re keeping. Like I said, it’s an invaluable tool.” 

In Shirley’s case, the X-Guide system helped Dr. Farag determine that the root of the damaged tooth was so similar in size to the required implant that Dr. Farag was able to remove the tooth and place the implant on the same day. 

“That’s not very common, but when it happens it’s great because it saves a lot of time,” Dr. Farag educates. “We usually need to wait about three months for the extraction area to heal before placing the implant, but with Shirley, that was all done at once.” 

Following placement of the implant, patients typically need to wait three to four months for new bone to grow around the implant and provide the strength it needs to support the abutment and crown that finishes it off. 

During that time, patients are sometimes fit with temporary crowns, but Shirley was not. She returned to Dr. Farag in February for placement of her permanent crown. 

Crown Jewels 

Depending on the tooth and color desired, a variety of materials, including lithium disilicate and zirconia, can be used to create crowns. In all cases, though, new crowns are monolithic, meaning they are formed from a single block of material. 

That creates several natural advantages over older crowns that were made of porcelain fused to metal. For starters, monolithic crowns are stronger. They are also more aesthetically pleasing with no metal collar at the top. 

“These new materials also mimic the enamel translucency of natural teeth because they allow light to transfer in and out of the tooth,” Dr. Farag notes. “And people like that because it looks more like a real tooth, even up close. 

“With the old porcelain-fused-to-metal crowns, your teeth might look good from far away. But if you get close, you start to notice that there’s something different about them. They don’t look as real or as good.” 

Shirley says the match on her replacement is so perfect that she can’t tell the difference between that tooth and the one she lost. She also says there was “no pain whatsoever” during the implant placement process. 

“The work that Dr. Farag does is just amazing,” Shirley enthuses. “He’s so gentle. I lived in Dallas for 20 years and in Dayton, Ohio for a while, so I’ve been to dentists all over, and I’ve never had a dentist who is as good and efficient as Dr. Farag. 

“He’s really special, and I have absolutely recommended him to others. I’ve sent a lot of people his way, and I’ll keep doing it. 

“Dr. Farag is a great dentist, and his staff is exceptional. I wouldn’t want to go anywhere else for my dental care.” ■ 

BY ROY CUMMINGS
Florida Health Care News
roy.cummings@ifoundmydoctor.com 

Say no to surgery; let injection of healing factors rebuild degenerated cushion

 Tom DeLaura is about to live a dream. The avid golfer is delaying his return to New Jersey for the summer to travel across the pond to play the world’s oldest — and most celebrated — golf course. 

“We usually stay in Florida until the middle of May, but this year I’m going on a bucket list trip with both my boys to Scotland to play St. Andrews Links, the ‘Home of Golf,’ ” Tom enthuses. “I’m really looking forward to it. 

“We’ve been to Pebble Beach in California and some other famous courses in Arizona, Texas and Florida. One of my sons is the head pro at the Crestmont Country Club in New Jersey, so he makes all the arrangements.” 

His other son runs the family business for Tom, 72, a semi-retired restaurateur.

“I’ve owned a restaurant in New Jersey for 34 years, since 1989,” Tom elaborates. “I live in Florida seven months of the year and then go up north in the summer. My son manages the restaurant, and when I’m in New Jersey for the summer, I still help out.

“The restaurant is a bar and grill called Grant Street Cafe. We’re famous for our thin-crust pizza, mussels, burgers and sandwiches. We also serve Italian dishes. And for three straight years, we’ve been voted Bergen County’s best craft beer bar in a local magazine’s reader poll.”

Credit Tom’s vast experience for the success of Grant Street Cafe. He’s been in the restaurant business for most of his life.

“It’s all I’ve ever done, and I love it,” he states. “I started out parking cars, and then I became a bartender. I always wanted my own place, and I was fortunate enough to make that happen and succeed at it.”

When he’s not busy with the restaurant, Tom spends most of his free time golfing, fishing and visiting the beach with his wife. A few years back, however, a health issue began to slow this active septuagenarian.

“I’ve exercised all my life,” Tom relates. “I’ve done a lot of weight training, running and swimming. Then, about four years ago, my right shoulder started hurting, and it was progressively deteriorating. I visited an orthopedic surgeon in New Jersey who said I was a candidate for shoulder replacement. I said, That’s not going to happen. Only as a last resort.”

Revealing Evaluation

By November 2020, Tom’s shoulder had grown extremely painful, and the discomfort was interfering with his everyday activities and many of his leisure pursuits.

“The pain was both sharp and aching, and it rated an eight on a scale of one to 10,” Tom reveals. “It was constant and getting worse. I 

could only lift my arm a little bit. I couldn’t ride my bike because leaning over hurt my shoulder. Worst of all, it kept me from sleeping. Let’s face it, we can go without a lot of things, but not without sleep.

“Believe it or not, I could still golf. Apparently, the downward swing doesn’t affect your shoulder that much. But I’d be really sore the following day. And I knew my shoulder was getting to the point where soon I wouldn’t be able to golf at all.

“Fishing was painful. It bothered me to cast my line. The next day, I’d wake up with that shoulder aching. The motion of throwing out the line or reeling in a fish would cause my shoulder to hurt.”

With Tom in severe pain and adamant about avoiding shoulder surgery, his wife recommended he visit her physician, Dr. Jeffrey P. Johnson, the principal provider at Johnson Medical Center, a comprehensive medical practice in Venice.

Dr. Johnson performed a complete workup on Tom. Those tests revealed that Tom was suffering from what Dr. Johnson described as “nearly bone-on-bone arthritis” in his right shoulder.

“Fortunately, Tom still had some natural tissue left in the joint that we could build on,” Dr. Johnson adds. “That made him an excellent candidate for our regenerative therapy protocol.”

Body, Heal Thyself

A novel treatment in Dr. Johnson’s arsenal against pain is regenerative therapy. It works by harnessing natural healing factors in the body to provide cushioning to degenerated and injured joints to help relieve pain and improve function. These healing factors, which can help stimulate the body’s ability to heal are either extracted from a younger person’s own blood or supplemented by utilizing amniotic fluid collected during healthy baby deliveries.

“With the growth factors, we inject another material called micro human tissue, which contains a high concentration of the vibrant substances that promote the body’s healing ability.”

The micro human tissue is obtained from umbilical cords donated by mothers following healthy births. The umbilical cord has protective tissue that surrounds the arteries and veins and is a vital component of fetus development. 

Johnson Medical Center’s regenerative therapy protocol begins with a thorough evaluation to determine if the patient is a good candidate and to identify any other contributing conditions which may need to be addressed to ensure favorable outcomes.

“A mixture of purified amniotic fluid and micro human tissue requires a single injection with our protocol,” Dr. Johnson explains. “These are the most effective tissues we use to treat these conditions and promote healing.”

“Depending on the patient, our protocol may also include physical medicine to help improve their function and IV nutritional and/or IV ozone therapy to help boost the immune system and improve their ability to heal faster. Injections are less invasive than surgery and patients recover much faster, Dr. Johnson points out. Further, there is a very low risk for complications such as bleeding and infection, which can occur with joint replacement and other types of surgery. 

“Regenerative therapy provides an option for patients with conditions that I would have previously referred for surgery,” Dr. Johnson declares. “It’s been a terrific addition to our practice, where we also use rehabilitation therapy, laser therapy, chiropractic and other modalities to assist with the process of rehabilitating damaged joints. The goal is for the treatment to be a long-term restorative event, not just a short-term fix.

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

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

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

Lasting Results

Tom underwent the regenerative therapy protocol at Johnson Medical Center in March 2021. He noticed some improvement in his condition while receiving the treatment. Its full effect was realized within two months of completing the therapy.

“After the enriched plasma injections, I told Dr. Johnson that my shoulder was already feeling a little better,” Tom reports. “Then, after I received the micro human tissue injection and started physical therapy, my shoulder got progressively better.

“A couple of months later, I had no problem lifting my arm. I could raise it like a kid in class. I was back riding my bike. And where I used to hurt the day after golfing, I felt like I could play again the next day. Fishing didn’t bother me, either.” 

Best of all, Tom was able to sleep. 

“That’s pretty much where I am right now,” he says. “Sometimes, my shoulder aches a little bit, but the pain is only about a two, if that, on a scale of one to 10. But I’m 72 years old. I can’t expect to feel like a 25-year-old anymore. Still, I’m not restricted. I can do almost anything I want.”

For Tom, the physical therapy component of the protocol proved critical to his continuing success.

“During the treatment process and afterward, I was doing physical therapy,” he confirms. “Even now, when I go home in the summertime, I do physical therapy every day. Whenever you have any kind of injury, or if you just want to keep yourself in shape, you’ve got to work at it. And that’s what I do.”

He has great respect for his primary provider at Johnson Medical Center.

“Dr. Johnson is great,” Tom raves. “He knows how to manipulate my shoulder for the best results. The problem is that when I go home to New Jersey I can’t find anybody who can do the same process. 

“He told me, Find somebody and have them give me a call. Sometimes, though, doctors don’t want to get on the phone and ask, What are you doing for him? They’ve got their own ideas. But when I’m in Florida, I wouldn’t consider anybody other than
Dr. Johnson.”  ■

BY Roy Cummings
Florida Health Care News
roy.cummings@ifoundmydoctor.com 

Total ankle replacement surgery ends painful bout with post-traumatic arthritis

Arthritis invaded Diane’s ankle, leaving little cartilage in the joint. After replacement surgery, she’s ecstatic to be walking pain-free again.

Though she claims to have a great affection for it, the singer Madonna once referred to her hometown of Bay City, Michigan, as “a smelly little town” tucked between the thumb and fingers of the state’s mitten-shaped lower peninsula. 

Diane Petee, another Bay City native, echoes those sentiments. 

“Bay City is about a two-hour drive north of Detroit, and it’s always cloudy, cold and dreary there,” she says. “It gets very little sun, which is one of the reasons why we moved to Florida.” 

“We” is a reference to Diane and her husband. Together, they made their escape to Florida in 2014, not long after both retired. They “love it here in Florida,” according to Diane, who says she’ll never forget “the worst winter” she ever experienced in Bay City. 

“It was about 11 years ago,” she recalls. “We had terrible snowstorms that whole winter, and one day, while I was taking my dog, Arizona, a little Shih Tzu, out for a walk, I slipped on the snow on my porch and fell and broke my left ankle.” 

That’s the bad news. The good news is that Diane was then working for an orthopedist as a licensed practical nurse. Two days later, that orthopedist put Diane’s ankle back together with plates and screws. 

He then issued an ominous warning. 

“He told me that I already had some arthritis in that ankle, and that eventually I was going to have a lot more and it would be a problem for me,” Diane recalls. “And that’s exactly what happened. About 10 years later, arthritis took over my ankle. 

“I can even remember the day I realized it happened. It was one day last fall. A friend and I were out antique shopping and, all of a sudden, my ankle just started aching real badly. It was killing me. 

“I tried toughing it out for a while, but the pain wasn’t going away. It got so bad, I had to stop walking the dog. I gave those duties to my husband. He even did the grocery shopping for us for a while. It was after that that I went to see Dr. Anthony.” 

Post-Traumatic Arthritis 

Diane, who also has arthritis in her knees, has long been a patient of Nicholas J. Connors, DO, of Advanced Orthopedic Center. Upon learning of Diane’s ankle pain, Dr. Connors referred her to his colleague at the practice, Steven R. Anthony, DO. 

Upon first visiting with Diane, Dr. Anthony ordered a series of x-rays of her ankle that showed she was suffering from post-traumatic arthritis, which Dr. Anthony describes as “the most common form of arthritis of the ankle.” 

“This is what we typically find in someone who has broken their ankle or sprained it severely several times in the past,” Dr. Anthony details. “Through those injuries, the cartilage and joint are damaged, and that’s what happened with Diane.” 

As it is with damaged knees and hips, the degree of arthritis in the joint determines the course of treatment. In Diane’s case, there was virtually no cartilage left in the ankle, so Dr. Anthony suggested total ankle replacement surgery. 

“There are several surgeries that can be performed on someone with ankle arthritis,” Dr. Anthony explains. “Total ankle replacement is the largest one and is typically reserved for patients over the age of 60 who are not obese or overly active. 

“This is not a surgery you’re going to perform on someone who still wants to run a half-marathon or manage a 2,000-acre ranch in Arcadia. Like tires on a car, the joint is going to wear out pretty quickly in someone like that.” 

Diane had no plans to put excessive stress on her ankle, and because it had been surgically reconstructed already, she agreed to have the replacement surgery, which begins with the surgeon ordering a CT scan. 

From the CT scan, a 3D model of the ankle is constructed. The CT scan and 3D model are used as guides to “pre-size the implant” ahead of surgery and show the surgeon where to cut the bones before fitting the implant. 

“The incision is made right down the middle of the front of the ankle,” Dr. Anthony describes. “Through that incision, we flatten out the round top of the talus, which is a very small foot bone with a round top, and shave it to make it a square top. 

“We then take a square cut off the bottom of the tibia, or shin bone. A square metal plate is placed on the bottom of the shin bone and a flat metal plate with a rounded metal top is placed on top of the talus. Then, a piece of plastic goes in between.” 

Pain-Free Again 

The procedure can typically be completed in less than 90 minutes and allows for normal, painless up-and-down movement of the ankle. 

Diane underwent the surgery in February 2022. By summer, she was walking pain-free again. 

“I still had some pain on and off for a couple of months after the surgery, but it’s fine now,” Diane relates. “I’m doing great, and so the bottom line is, I’m really glad I had the surgery. 

“I have to admit, I was a little hesitant at first, partly because I’d never heard of anyone getting a total ankle replacement. But Dr. Anthony did a great job explaining the procedure, and he did a great job. 

“He’s a wonderful doctor. I spent years working for what I consider to be one of the best doctor’s I’ve ever known, and Dr. Anthony is right up there with him. They’re neck and neck.” ■ 

BY ROY CUMMINGS
Florida Health Care News
roy.cummings@ifoundmydoctor.com

Painless laser tool ends toenail fungus, so you can sink your feet in the sand

 For six years, the page cut from a magazine listing the top five beaches in the U.S. was held against the door of Mary Anne’s* refrigerator by a couple of magnets. One by one, the suburban Montreal native checked off each as she visited them until one remained. 

“Siesta Key Beach,” Mary Anne offers. “That was the last one I needed, and I saved it for last because a friend of mine visited there and loved it so much that she wound up moving there. I thought I might do the same.” 

Mary Anne did follow her friend to Siesta Key. She made the move two years ago with plans to spend as much time as possible digging her toes into the sand. And that’s exactly what she did. But for all the wrong reasons. 

“I was here about a month, when out of nowhere, my left big toe and the one next to it started looking all brown and crusty,” Mary Anne laments. “They looked so nasty that I was embarrassed to walk around without shoes on. 

“My friend told me it was toenail fungus. She said she had it, too, and that after a year she finally went to see a doctor in Sarasota who took care of it. I waited about a year, too, then finally asked my friend for the doctor’s name.” 

The doctor is Dawn Chiu, DPM, AACFAS, of Sarasota Foot and Ankle Center. During her initial visit with Mary Anne, Dr. Chiu confirmed the presence of a fungus and recommended PinPointe™ FootLaser® therapy as a treatment. 

Dr. Chiu calls PinPointe FootLaser therapy her “weapon of choice” in the battle against toenail fungus because it’s a quick, easy, painless, in-office treatment that kills the fungus without side effects and does not require patients to take a blood test beforehand. 

“PinPointe FootLaser treatments last only a few minutes, during which time the laser is passed over the nail in a crisscross pattern to ensure full coverage,” Dr. Chiu explains. “Patients usually feel a warmth on their toe during the treatment but no pain.” 

 After each treatment, patients can return to normal activities immediately. When combined with topical ointments, the laser therapy has an 80 percent success rate, according to Dr. Chiu, who counts Mary Anne among her successes. 

“The treatment worked incredibly well,” Mary Anne confirms. “I received a laser treatment the first day I visited Dr. Chiu and another three months later. That was it, and after the second treatment, the fungus started to disappear. 

“Now, my toes look great, just like normal. I was really pleased with the treatment, and it was so easy. It didn’t hurt at all, and most importantly, it worked. 

“I would recommend Dr. Chui and Sarasota Foot and Ankle Center in a snap because they do great work.” ■ 

* Patient’s name changed at her request 

BY ROY CUMMINGS
Florida Health Care News
roy.cummings@ifoundmydoctor.com 

Comprehensive protocol regenerates nerves damaged by peripheral neuropathy

JORDAN PYSZ / FLORIDA HEATH CARE NEWS
Ed receiving treatment for his peripheral neuropathy that has helped him gain relief from his symptoms.

For years, Ed Marano devoted the bulk of his free time to athletics, weight training and physical fitness. That devotion never earned him the college scholarship or the professional contract he once dreamed of, but it provided a payoff, nonetheless. 

“It saved my life,” Ed says. “I played high school football, college soccer, got into karate later in life, and worked out and weight-lifted my entire life. If I hadn’t, the heart attack I had a few years ago would have killed me. 

“That’s what the doctors told me, because all four of the main arteries to my heart were blocked 100 percent. They said that because I was an athlete all my life, the peripheral vascularity in my heart was sufficient to save me. So, I was pretty fortunate.” 

Fortunate indeed because Ed, 76, suffered his heart attack just as he was completing the task of helping his son establish the Marano Animal Hospital in Venice. Ed still works at the hospital on occasion, doing “a lot of nonmedical stuff.” 

Beyond that, he devotes most of his free time to watching his granddaughter’s karate and gymnastics competitions. 

A few years ago, numbness, tingling and stiffness in his right foot and right big toe made that experience and many others a lot less enjoyable. 

“This was in 2018, and the situation got worse and worse as time went on,” Ed explains. “So, I went to the doctor, and he said, I think you have the beginnings of peripheral neuropathy. I was like, What? I’d never heard of peripheral neuropathy before.” 

Peripheral neuropathy is a condition that results when the nerves outside the brain and spinal cord are damaged. As with Ed, it can cause numbness, tingling and stiffness as well as weakness, burning and pain in the feet, hands and arms. 

The condition can be triggered by an injury, regular exposure to statin drugs and chemotherapy, but it is most often caused by diabetes, which Ed was diagnosed with not long after his heart attack. 

“I went from being prediabetic before the heart attack to having flaming diabetes after the heart attack,” Ed confirms. “And with that came this neuropathy, which for me was bad. But it wasn’t as bad as it is for some people. 

“Some people get severe stinging, burning and pain, and they just can’t take it. I had mainly numbness and discomfort. On a scale of one to 10, my pain level was probably a five at its worst, and on most days it was a two or three. 

“But the numbness caused my balance to be off, so I had trouble walking. If a cop had asked me to do a field sobriety test where they ask you to walk a straight line, I would have failed. And I don’t drink. I just didn’t have the mobility in my foot.” 

Ed’s symptoms worsened over several months. Then one day, while visiting his chiropractor, he read a pamphlet he picked up in the office that detailed a comprehensive treatment plan for peripheral neuropathy. 

“I’m reading this pamphlet, and it’s explaining how peripheral neuropathy can lead to amputation of toes and feet if it’s not treated,” Ed remembers. “I said to myself, This isn’t happening to me. So, I asked my chiropractor about the treatment.” 

 Stage Presence 

Ed’s chiropractor is Kenneth D. Carle, DC. He is the founder of Renewed Life Wellness Center, which is committed to offering the best in chiropractic care, medical weight-loss solutions, regenerative medicine therapy and treatment for peripheral neuropathy. 

Peripheral neuropathy has four stages. Patients in Stages 1, 2 and 3 have various amounts of pain, numbness and burning. As those symptoms grow in severity, many patients may lose their balance, which can lead to a loss of independence and the need for walking assistance with a cane, walker or motorized chair. 

“In Stage 4, patients are too far gone, and some cannot be treated,” Dr. Carle explains. “That’s the stage where people need to have toes amputated and are totally reliant on others to take care of them. Thankfully, Ed was not at that stage.” 

Following a thorough examination and evaluation by Dr. Carle, Ed was diagnosed with Stage 1 peripheral neuropathy in his left and right foot, although the condition was far worse in the right foot, where it was on the brink of Stage 2. 

Dr. Carle has about a dozen tools that he uses to stop peripheral neuropathy and restore damaged nerves. The severity of each patient’s condition determines which tools he uses, but one is almost universal: the ReBuilder, an FDA-approved device that uses neuro-electrical therapy to repair and regenerate damaged nerves. Dr. Carle also uses red-light therapy, which produces waves of infrared light that is known to stimulate new growth in damaged blood vessels. 

The new growth improves the overall function of the blood vessels, which allows for greater blood and oxygen flow in the affected area. The improved blood and oxygen flow promotes healing, which leads to a decrease in pain and an increase in function. 

Those devices and another that Dr. Carle recommends called a vibration plate can be used at home. In addition, Dr. Carle recommends a cocktail of nutritional supplements that are designed to further advance the healing of the damaged nerves. 

“One of the supplements is a pill,” Dr. Carle says. “The other is a powder you mix with water. Both are vasodilators that increase the production of nitric oxide, which increases the diameter of the blood vessels and helps with blood flow. 

“And when combined with the other treatments, they work. One hundred percent of our patients experience some level of improvement in their symptoms. We don’t get 100 percent improvement in 100 percent of our patients, but most improve between 30 and 75 percent.” 

Rapid Recovery 

Dr. Carle used all of the medical devices in his tool kit in treating Ed, who says he religiously followed the doctor’s recommendations and was amazed at how quickly his symptoms improved. 

“When I started these treatments, I had maybe 10 percent flexion in the toes in my right foot and no flexion at all in the big toe on my right foot,” Ed reports. “Now, I have about 90 percent flexion in all those toes. 

“That feelings of pins and needles that I had in my feet is gone, too. There’s still a little stiffness in the right big toe, but it’s a lot better than it was, and I don’t wake up in the middle of the night with cramps in my feet anymore. 

“What’s really amazing is how quickly I started to feel a difference after starting these treatments. It wasn’t any more than two weeks after Dr. Carle started me on this program that I began to feel better. That’s like five or six treatments.” 

The opportunity to do the treatments at home makes the protocol a convenient remedy for neuropathy, Ed notes, and he says you won’t find a better doctor to evaluate and treat your condition than Dr. Carle. 

“He’s phenomenal,” Ed raves. “He’s a true professional, and he’s got an incredible personality and bedside manner. There are a lot of doctors who are good, but talking to them is like talking to sandpaper. They’re gritty. Dr. Carle isn’t like that. He’s great.” ■ 

 BY ROY CUMMINGS
Florida Health Care News
roy.cummings@ifoundmydoctor.com 

Regenerative medicine treatments help Masters simmer get back into the poo

Once-a-week workout program helps improve balance, bone density

“I’m getting around really well, and I’ve got lots of energy. And I believe OsteoStrong is one of the reasons for that.”
— Rochelle

A growing number of countries no longer stamp passports to mark a traveler’s arrival, but Rochelle Helm has journeyed so far and so often in recent years that her passport has become a colorful keepsake, nonetheless. 

“My husband and I have easily been to 30 or 40 countries,” Rochelle reports. “Our last trip was to Greece and Italy, where we’ve been to many, many times. We took our grandchildren with us this time, so we spent a lot of time showing them all the highlights. 

“I love Italy, but my favorite of all the places we’ve been is New Zealand. The people there are delightful, the prices are reasonable, and they have beautiful white sandy beaches up north and skiing down south. What more could you ask for?” 

At age 80, Rochelle doesn’t do much skiing anymore. She does walk a lot, however; five miles on most days. She also works out at a gym regularly and attends aerobics classes. 

“I’m trying to stay in the game,” says Rochelle, who literally fell out of the game a few years ago after a confounding battle with her balance left her with a broken left elbow, a broken left shoulder and a broken nose. 

“I was just clumsy,” Rochelle offers. “I’ve probably had 10 different fractures in my life because of my balance issues and falls and being so clumsy. After the last fall that I had, I was in such bad shape that at one point I had to use a walker to get around.” 

In addition to her balance issues, Rochelle was also suffering from osteopenia, which is the precursor of osteoporosis. Both diseases develop when bone growth fails to keep pace with bone degeneration and increases the risk for hip, spine and wrist fractures. 

Found most often in postmenopausal women, osteopenia and osteoporosis can also lead to a stooped posture, which can result in the kind of balance disorders causing many of Rochelle’s falls. 

Determined to “stay in the game,” Rochelle ditched the walker shortly after recovering from her elbow and shoulder injuries and started walking. Her goal was to increase balance and strength. To augment that, she joined OsteoStrong. 

“I remember reading about OsteoStrong somewhere and seeing that something like 70 percent of the people who try the program improve their balance and strength,” Rochelle recalls. “That was exactly what I needed, so I went there and signed up.” 

Resistance-Based Program 

OsteoStrong is a revolutionary exercise program that has helped more than 25,000 people reverse the effects of osteoporosis and osteopenia by using specialized biomechanical equipment once a week for about 15 minutes. 

The equipment is designed for resistance-based pushing and pulling exercises with the arms and legs. During thsee resistance motions, a pressure many times the user’s body weight can be safely applied. 

“The difference between the equipment used at OsteoStrong and the equipment you find at a traditional gym is that our equipement does not involve a counter force,” states Mark Brady, president of OsteoStrong in South Pasadena. 

“Because there’s no force pushing against you, you create a force within your comfort zone, and you’re in control at all times. For example, on our lower body machine, I’ve had women in their 80s who weigh 100 pounds exert forces in excess of 1,000 pounds. 

“For a 100-pound person to develop new bone working out on traditional weight equipment, they would need to create a resistance of over 400 pounds. That simply can’t be done by 99 percent of all people in a gym environment because it involves weights they couldn’t physically move. Or, if they could move them, they’d be at high risk of injury.” 

To understand the difference, Mark invites people to come in and try the OsteoStrong equipment during a free orientation session that will allow them to learn more about the science behind the program. 

“This is an amazing concept that is the culmination of 12 years of research that looked into the body’s adaptive response to growing bone and muscle to improve the density of the bones,” Mark says. 

“Medical research has shown that when you put certain forces on the bones, the body responds by growing new bone tissue. That’s what OsteoStrong does, and the results of these short sessions are absolutely amazing.” 

According to Mark, studies have found that OsteoStrong improves bone density 3 to 10 percent per year. In addition, people will increase their strength by an average of 73 percent over their first year at OsteoStrong. 

Mark also points out that doing an OsteoStrong session more than once a week does not promote additional benefit. As a result, OsteoStrong workouts are effective and time efficient. 

Noting that osteoporosis is not a disease that is exclusive to any particular age group or gender, Mark encourages people of all ages to accept his invitation to try the equipment. 

“Osteoporosis is not something that only happens to old people,” he explains. “As a result, we have clients from young to old. And men are not immune. When men start losing their testosterone, their bone loss becomes more rapid. 

“At OsteoStrong, we also offer people an opportunity to learn more about osteopenia and osteoporosis and why the OsteoStrong program is so effective at fighting them.” 

“Marvelous” Results 

It was nearly three years ago that Rochelle first started working out at OsteoStrong. Since then, she says she has gained a significant amount of strength throughout her body and completely rid herself of those dangerous balance issues. 

“I was looking at my elbow the other day and suddenly realized that I have not fallen once since I started the OsteoStrong program,” Rochelle exudes. “That is amazing because, I’m telling you, I’ve fallen like that my whole life. 

“I’m much stronger now, too, and I can tell you this, I wasn’t walking five miles a day before I started OsteoStrong. I was walking, but I wasn’t walking five miles a day, and part of that was because I was afraid I might fall. 

“OsteoStrong has been a great thing for me. For someone who is 80 years old, I’m getting around really well, and I’ve got lots of energy. I believe OsteoStrong is one of the reasons for that. That’s why I’ve recommended it to so many people. 

“I tell them, It’s once a week and you’re done, and I tell them that not only has it made me stronger, but it’s also helped me with my balance because the fact that I haven’t fallen since I started the program is a miracle. It’s an absolute miracle.” ■

 BY ROY CUMMINGS
Florida Health Care News
roy.cummings@ifoundmydoctor.com