Author Archive

An Advanced Repair For Aortic Aneurysm

Endovascular stent procedure typically gets patient home within days.

Jerry Blankenship

Newcomers to the Sunshine State are often lured by the weather or the water. For Jerry Blankenship, it was the Gulf of Mexico that drew him because while living in Arizona for many years, he got plenty of sun and sand, but not enough surf.

“I really wanted to be by the water,” Jerry confirms. “A friend of mine and I came out here about 10 or 11 years ago for the first time and spent some time on Anna Maria Island. As soon as I got here, I said, This is the good life.”

Jerry, 70, made his move shortly after that vacation. He’s been living what he refers to as “the good life” ever since, working part time at a restaurant near his home in Cortez and relaxing near the beach whenever possible.

The only interruption to that idyllic life came about a year ago when treatment for a bad case of appendicitis revealed a far more serious and potentially fatal health issue, an aortic aneurysm.

A juxtarenal thoracic abdominal aortic aneurysm (JAA) is a bulge in the lower part of the aorta (the large artery that runs through the torso), where the arteries that lead to the kidneys branch out.

In Jerry’s case, the bulge was nearly three inches in diameter, which is about two inches larger than the aorta should normally be, and nearly six inches long, beginning near the renal arteries and running downward.

A JAA typically forms as a result of a growing weakness in the artery walls that can be caused by a number of issues, including high blood pressure, high cholesterol or a buildup of plaque inside the arteries.

“Patients recover much faster from this procedure than they do from an open abdominal approach.” – Dr. Mathews.

If an aneurysm of this nature is left untreated, the weakened artery walls can eventually separate, tear or even burst, which can lead to a life-threatening case of internal bleeding.

“I had no idea I had anything like this going on,” Jerry offers. “I had no symptoms of any kind, so I was actually lucky that I had the problem with my appendix because that’s how doctors found the aneurysm, from a CT scan of my appendix.”

Minimally Invasive

In some cases, small slow-growing aortic aneurysms can be treated with medication and lifestyle changes. Larger, faster-growing aneurysms are often considered emergency situations that need to be treated immediately through surgery.

Jerry’s aneurysm fell somewhere in between. Due to its size and location, surgery was required. Jerry’s doctors determined he could wait a few weeks and undergo a minimally invasive form of the surgery called an advanced aortic aneurysm repair. During this procedure, a customized stent is placed inside the aorta where it is bulging to give the patient what is essentially a newer, stronger aortic wall.

In patients who are candidates for the procedure, this endovascular approach replaces the more extensive open abdominal surgery. During the open abdominal surgery, the aorta is clamped to stop blood flow and a synthetic aortic graft replaces the damaged arterial segment.

Manatee Memorial Hospital, located in Bradenton, recently became the first in the area to offer the advanced surgery.

In addition to major advancements in the development of aortic grafts, Manatee Memorial Hospital’s ongoing commitment to leading-edge treatments made this less invasive option a possibility for Jerry.

Manatee Memorial’s Heart and Vascular Team: Front row (from left), hospital CEO Tom McDougal, DSc, FACHE; vascular surgeon Dr. Howard F. Hermans; interventional cardiologist Dr. S. Jay Mathews. Back row (from left), Amy Kimbell, RN; Erica Smith, RN; hospital COO Joseph Hwang; cath lab coordinator Kimberly Chase

The surgery was coordinated and performed by its Heart and Vascular Team, an industry leader that has done more advanced cardiac procedures than any other in the state.

“In the past, patients such as Jerry had to go to Tampa or even Tallahassee to have this procedure done,” says S. Jay Mathews, MD, MS, FACC, FSCAI, who assisted Howard F. Hermans, MD, FACS, during Jerry’s surgery.

“Manatee Memorial Hospital is doing a lot of leading-edge stuff in the endovascular space. The administration has been very forward-thinking about bringing in new technologies and programs, promoting them and allowing physicians access to them.

“As a result, Manatee Memorial Hospital is now doing one of the highest volumes of endovascular procedures in the country. They’re doing stuff that no one else in the area is doing, and that is a big-plus for patients like Jerry.”

The decision to offer Jerry this advanced option was made following his appendectomy. Once Jerry had recovered from that procedure, doctors began preparing him for the advanced endovascular aortic aneurysm repair.

During the earliest stages of preparation, a 3D map of the patient’s anatomy is produced from a CT scan that is used to determine the exact size of the custom-made stent.

“The stent we use is called the Zenith Fenestrated (ZFEN)® aortic stent,” Dr. Hermans states. “Its design includes little openings that line up perfectly with the renal arteries that lead to the kidneys and the mesenteric artery that leads to the intestine. That alignment allows us to place the stent precisely where it needs to be.”

The stents are placed through catheters fed through the femoral arteries, which are accessed through tiny incisions in the groin. X-ray guidance provides the physician with a clear picture of the surgical area.

“Through those little openings, we place stents directly into the arteries to continue perfusing those arteries,” Dr. Hermans continues. “We first deploy the main body of the stent, the one with the openings in it. Once that is properly located, we pass wires through the openings into the renal and superior mesenteric artery, then the stents are deployed for those arteries.”

Rapid Recovery

The surgery is “quite complicated,” and it requires the work of at least two physicians with “very good endovascular skills who work well together,” according to Dr. Mathews, who notes that patients benefit in several ways from this procedure.


“First of all, it’s safer than open surgery,” the doctor reports. “Because we don’t need to put a clamp high up across the aorta where you can run the risk of cutting off the blood supply to the spinal cord, which can lead to paralysis or organ dysfunction.

“Patients recover much faster from this procedure than they do from an open abdominal approach. Following this procedure, most patients go home from the hospital the next day and are saved from a really long operative recovery period.”

Jerry went home the day after the surgery, and despite experiencing a bit of fatigue and back soreness, he resumed his regular daily activities a few days later.
“Now, I feel great,” Jerry exudes. “I told Dr. Hermans recently that I feel so good sometimes that I forget I just turned 70 years old. He and Dr. Mathews did a great job. I’m very fortunate to have had two doctors like that helping me.

“I was pretty shocked and quite scared when I first learned I had this problem, but Dr. Hermans did a great job of explaining the procedure. He even drew it all up on a board to show me where the stents would go and everything.

“He helped put me at ease because he was so confident about what he was going to do. After talking to him, I said, All right, let’s do this. And everyone at the hospital could not have been nicer. They were awesome. Just awesome.”

Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if minimally invasive surgery is right for you.


© FHCN article by Roy Cummings. Jerry’s photo by Jordan Pysz. ZFEN Aortic Stent graphic courtesy of Health and Human Services. Heart and Vascular Team photo courtesy of Manatee Memorial. mkb

Whole-Body Approach Reveals Cause Of Pain

Physical therapists’ comprehensive evaluation goes beyond patient’s primary complaint.

Tina Konrad

It takes a special kind of person, someone who can keep her wits about her amid the most disturbing circumstances, to do the kind of work that Tina Konrad did during the first three years of her six-year stint in the Navy.

“I worked crash rescue,” says Tina, who joined the Navy in 1975 and went on to join the rescue team at Naval Air Station Jacksonville. “We responded to downed planes, put out the fires, rescued the pilots and, when necessary, secured the pilots’ bodies.

“It was rough work, but I’m very good at not letting things bother me in the moment. When it’s all over, you do have to regroup a little bit, but I’ll say this: That was the most memorable time of my life serving our country.”

After her assignment with crash rescue, Tina moved onto the flight line, where she was part of the crew responsible for prepping jet fighters for their missions and inspecting them for damage afterward. Not long ago, Tina was inspected for damage herself.

A long-time runner who gave up that activity after undergoing knee replacement surgery in 2017, Tina recently found it painfully difficult to walk or even stand for any length of time. A muscle disease called dermatomyositis was at the root of that problem.

As with Tina, 65, dermatomyositis (pronounced der-muh-toe-my-uh-si-tis) typically strikes people between their late 40s and early 60s and causes muscle weakness. In Tina’s case, this manifested mainly in her feet.

“I was diagnosed in 2001, and ever since I’ve had to wear very snug shoes or I’ll lose my balance,” Tina relates. “But when you wear snug shoes and have arthritis, which I do, it aggravates the situation and causes even more problems.”

For Tina, the problem was incessant pain, which made it hard for her to perform everyday tasks, where something as seemingly simple as cooking dinner became a chore. It also forced her to abandon walking as an exercise activity.

“My feet hurt 24/7,” Tina details. “There was a constant ache or soreness in them, and the nerves in my feet would get inflamed, and I’d have this burning sensation on top of all that. It was very painful.”

In seeking medical attention, Tina first visited a podiatrist who treated the pain with cortisone injections. These provided only temporary relief, however, so the podiatrist suggested Tina visit Regional Rehab for a more permanent solution.

Assessing Whole Patient

Regional Rehab is the practice of Charles C. Donley, PT, and Paul Ernandes, PT, PhD. Charles and Paul take the concept of comprehensive care to a new level by looking beyond each patient’s primary complaint and individually evaluating each patient as a whole.

“Once we’ve each completed our individual assessments, we share our findings with each other,” explains Charles, founder of Regional Rehab. “One question we always ask each other is, Do you see anything else here besides the primary complaint that requires our attention?

“What we’re doing is putting our 70-plus years of experience together to ensure that we’re doing everything we can to help each patient in every way possible. Those comprehensive evaluations and collaborations are among the biggest keys to our success.”

In taking this approach with Tina, Charles and Paul discovered that poor posture was a major contributor to her foot pain. It’s a problem they have encountered many times.

“It was a whole-body approach, and that is something no one had ever done for me before.” – Tina

“A lot of times, when someone comes in with foot pain, particularly in the forefoot and around the toes, which was the case with Tina, we look at how that person stands, because poor posture can be a cause of foot pain,” Charles explains.

“Tina was standing with her knee hyperextended. She was bending forward from the waist, and that was putting extra pressure on the front of her feet. To alleviate that pressure, we simply had to correct her upper body posture.”

To achieve that, the Regional Rehab staff supervised a series of pelvic tilt exercises that are designed to strengthen the abdominal muscles. They also stretched out Tina’s calf muscles to increase flexibility in her legs.

The staff also sought to erase some of the damage to Tina’s feet by utilizing two of the practice’s signature tools, the Class IV deep tissue therapeutic laser and the HIVAMAT® 200 deep oscillation device.

The laser uses wavelengths of red and near-infrared light to stimulate the body’s natural ability to heal damaged cells. It releases nitric oxide, which removes congestion and swelling, promotes healing, reduces discomfort and increases blood circulation.

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

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

The Class IV laser and HIVAMAT are part of a protocol that typically includes stretching and balance exercises as well as manual therapy. Tina received about eight weeks of treatment at Regional Rehab, where Charles did one other important thing for her.

Kind, Helpful Environment

Tina, a Navy veteran who has fought a long battle with incessant foot pain, finally found a solution for that pain at Regional Rehab in Spring Hill.

“We also put a lift in Tina’s right shoe because the right side of her pelvis was tilted forward more than the left,” Charles adds. “She got immediate relief and a greater sense of relaxation in both hips from that.”

The combination of pelvic exercises, stretches, and laser and HIVAMAT treatments helped Tina’s pain dissipate after just a couple of visits.

“I started feeling relief pretty quickly after we started, and my feet just got continually better after that,” Tina raves. “During the last two weeks that I underwent treatment at Regional Rehab, I had zero pain in my feet. It was incredible.

“What I really liked is that they didn’t just focus on my feet. They looked at my hips, my posture, everything. It was a whole-body approach, and that is something no one had ever done for me before. All anyone had ever done was look at my feet.

“The other thing I like about Regional Rehab is that it’s a work environment where everyone is extremely kind and very helpful. Everybody there wants you to improve. It’s an environment you don’t see in a lot of places, and I can’t tell you how much I appreciated it.”

© FHCN article by Roy Cummings. Photos courtesy of Tina Konrad. mkb

No Recurring Pain Years After MCU Therapy

Multi-Cervical Unit is an advanced device for neck evaluation and treatment.

Patty Annetta

The woman in question had just flown into Miami on an international flight, and when the standard search conducted by two male US Customs agents didn’t reveal what they were sure she was hiding, the agents turned her over to Patty Annetta.

Patty was fresh out of the Federal Law Enforcement Training Center in Georgia, green as a new dollar bill – and, boy, did it show.

“When I first took over that search, I couldn’t find a thing,” Patty remembers. “But the other agents kept telling me, Patty, it’s there; we know it’s there. Go back and look again. So, I went back. Three times I went back. Finally, on the third try, I found it.”

What Patty found was a small stash of cocaine that had been sewn into the woman’s bra. The smuggler was immediately placed under arrest and hauled away. Not long afterward, Patty celebrated her first “bust” as a US Customs agent. It would not be her last.

Patty went on to spend 33 years working as a customs agent. Most of that time was spent searching passengers and luggage for illegal drugs at Miami International Airport, Miami Seaport and Miami cruise terminal.

“It was a very interesting job, and I miss it terribly,” says Patty, now 74. “You learn a lot about people in a job like that. You learn about how bad some people are and how far some are willing to go to protect themselves in situations like that.”

Patty was trained to protect herself in those situations, but during the three decades that she worked in law enforcement, she never quite figured out how to protect herself from some of the job’s hidden dangers.

“I carried a gun on my hip for 30 years as well as a few other things, and when you’re doing that and standing on your feet all day, you eventually feel the effects,” Patty explains. “For me, I eventually began to feel it in my lower back and neck.

“The worst part, though, was the headaches. I started getting them a few years before I retired, and as time went on, they became more and more frequent and more intense. That part was actually quite frightening because I had no idea what was causing them.”

Just as frightening was that the headaches would, at times, come on suddenly, usually as she was getting off a sofa or chair after sitting comfortably for an extended period. In some cases, the rush of pain was so great it made her collapse.

Because of such episodes, Patty became something of a shut-in following her retirement. She did leave the house to seek treatment for the issue, but none of the prescribed medications alleviated it.

As a result, Patty experienced lower back and neck pain and crippling headaches for several years. Finally, about 10 years ago, on the advice of friends, she sought another form of help.

“It was just friends talking to friends about things, and somebody said, Have you tried a chiropractor?” Patty remembers. “I really hadn’t because I was always so busy with work, but after that I did go see a chiropractor, one who was very near where I live.”

The chiropractor Patty went to see was Marc A. Weinberg, DC, founder of Active Health Center. After conducting a thorough examination, Dr. Weinberg began his treatment by performing standard chiropractic adjustments of Patty’s back and neck.

“He was doing the basic stuff because I didn’t tell him about the headaches,” Patty remembers. “I didn’t think they were related, so I only told him about my lower back and neck pain.”

Exclusive Access

Then one day, Dr. Weinberg wasn’t in the office, and Patty was treated by his colleague, Colin O. Behrue, DC, who soon became the chiropractor providing the bulk of her care.
During an appointment, Patty finally mentioned the headaches.

Believing that Patty’s symptoms might be related and that their source might be an issue with her cervical spine, Dr. Behrue opted to test Patty on a unique evaluation/treatment device called the Multi-Cervical Unit, or MCU.

A technologically advanced nonsurgical device that is exclusive to Active Health Center in South Florida, the MCU is an instrument that not only assesses the strength of neck muscles, but also isolates and strengthens those muscles.


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

Once that data is collected, a treatment program is designed that allows the MCU to correct the problems. As such, the MCU is considered the most effective and efficient system for assessment and rehabilitation of the neck.

It has proven so effective that MCU technology is being used by chiropractors and physical therapists worldwide, including those working with athletes in the National Football League and Major League Baseball.

“Starting in the 1990s, a fair amount of research came out that showed neck weakness will lead to neck pain, and you need to address the neck weakness in order to treat the pain,” says Dr. Weinberg.

Each MCU session lasts 20 to 30 minutes, with patients typically going through three sessions a week for nine weeks. During that period, patients are retested at least three times to determine the effectiveness of the treatments.

“We retest the patient every nine visits and compare the results of those tests with the results we received from our original examination,” Dr. Behrue notes. “That shows us how well the patient is progressing. Based on the findings, we make clinical changes that help the patient continue to improve and build strength.

“MCU sessions are painless and there’s always someone available to help you.”

They are also effective. Studies show that following MCU therapy, pain levels decrease by 66 percent while strength levels increase more than 70 percent, with more than 90 percent of patients making a full recovery, according to Active Health Center.


“Amazing” Results

“This is a treatment that lasts for a long time. A real long time,” says Patty.

The evaluation conducted with the MCU machine confirmed Dr. Behrue’s suspicions: Patty’s symptoms were a result of deficiencies in the strength and structure of her neck.

“The upper part of the neck is not supposed to bear weight,” Dr. Behrue educates. “That’s the job of the lower part of the neck. With Patty, however, the lower neck was so weak and out of alignment that it was recruiting the upper part to help it do its job.

“When that happens, or if you hurt your upper spine in some way, you can get weird symptoms. You can get vision changes, headaches, TMJ (temporomandibular joint) changes, and it’s all because the upper part of the spinal cord is suddenly doing something it’s not supposed to do.”

To correct the problem, Dr. Behrue recommended a full regimen of treatments using the MCU. Patty agreed, and more than 10 years later, she’s still glad she did.

“There was one day not long after I’d finished up all my treatment sessions where it suddenly dawned on me that I was no longer experiencing any more of those awful headaches,” Patty marvels.

“Those headaches sometimes put me out of commission for the day, but all of a sudden they disappeared. Same with my neck pain. My neck used to bother me all the time, but after my treatment on the MCU, that pain is gone, too.

“And what’s amazing is that it’s been 10 years since I got those MCU treatments. Now, I did go back for a maintenance treatment a couple of years later. But it wasn’t like I really needed it or anything. Dr. Behrue suggested it.

“The point is, ever since I completed the MCU treatments, my neck pain has gone away, my headaches have gone away and my back pain has gone away. So this is a treatment that lasts for a long time. A real long time.”

Patty still visits Active Health Center for standard adjustments on her back but has been living pain-free for years. That’s why she gladly recommends Active Health Center to others.

“I tell everybody I can about the great doctors there and the MCU machine,” she says. “I really do because I’m so grateful for what they did for me. To not have to deal with that neck pain and those headaches is an absolute blessing.”

Patricia “Tish” Kern

A League of Its Own

It’s safe to say that Patricia “Tish” Kern’s love of sports knows no bounds. A former high school cheerleader, Tish was a competitive swimmer, diver and volleyball player who also played a little bit of “social” tennis on the side.

In time, Tish channeled most of her energy toward her greatest love, which is tennis. Now 73, she plays almost every day. It’s been that way since she retired from her job as an English and journalism teacher several years ago.

“I was probably about 60 when I took up tennis again, and I got right back into it,” Tish explains. “I’ve been playing ever since. I’m in a league where I play competitively, mostly against people who are younger than me.”

Tish seldom feels her age on the tennis court. There was a time not long after she’d taken the game up again, when a sore neck left her struggling with one of the most important elements of the game.

“Because of this neck problem, I had a hard time serving,” Tish relates. “I was struggling because of tingling and numbness in my arm and hand, but that wasn’t the only problem. I also had this horrible itch in both arms.

“The itching was the worst thing. I’d wake up during the night with it sometimes and nothing would help except putting ice on it. I finally went to a dermatologist who prescribed an epidural steroid injection, but when the injection wore off, the itching returned.”

Thinking that the root of her itching might lie somewhere else, Tish next visited with a neurologist who failed to find the cause and suggested she see a chiropractor. When Tish asked for a recommendation, the neurologist pointed her toward Active Health Center.

Before Tish visited Active Health Center, she was also prescribed physical therapy. Like the steroid injection, however, that provided only temporary relief.

Dr. Behrue soon discovered why.

During an extensive examination that included an evaluation of her neck on the MCU, Dr. Behrue determined that the likely cause of Tish’s neck pain, tingling, numbness and even her itching was a pinched nerve in her neck.

“There are different components to every nerve,” Dr. Behrue explains. “When under pressure, some of those components can cause pain, numbness and tingling. Others can cause burning or itching. It all depends on where the nerve is being pressured.

“In Tish’s case, she was feeling all those sensations because weakness in her neck was causing nerve impingement. She also had an imbalance of the muscles in her neck, which is why the other treatments weren’t providing long-lasting relief.

“She would get an injection or some other form of treatment, then go back and repeat the same muscle pattern. As a result, she never felt a true change in her symptoms because the nerve that was pinched was the one that was always overworked.”

To correct the problem, Tish needed to strengthen the muscles in her neck so the nerves were no longer under pressure. To do that, Dr. Behrue recommended a full regimen of treatment on the MCU.

“This treatment … gave me a new lease on life, and I’m still reaping the benefits,” says Tish.

“The problem that Tish and a lot of other people with neck issues suffer from is not just a lack of strength in the neck muscles, but also a lack of balance,” Dr. Behrue adds. “That’s why generic physical therapy often is not enough to rectify these problems.

“I say that because you have about 26 muscles in the neck. But during generic physical therapy, you may only use or strengthen 10 of them. As a result, those 10 become overworked. That’s why you need both strength and balance in the neck muscles.”

Because of the extent of her issues, Tish required two rounds of MCU therapy. Within a matter of weeks, though, she began to feel the positive effects of the treatments as her symptoms slowly disappeared, and they have not returned.

“It’s been six or seven years since I had the MCU treatments and I am really doing quite well,” Tish enthuses. “I have not had any recurring issues with my neck, and that is all thanks to Dr. Behrue and everyone at Active Health Center.

“Dr. Behrue and Dr. Weinberg are dedicated to getting people back on their feet and doing as much as they possibly can for them. It’s not just a business to them. They want you to feel better. They’re empathetic, compassionate and dedicated.

“What they did for me is like a miracle, and because of that I have recommended them to many people. This treatment really works, and it’s a treatment that lasts. I’m proof, because it gave me a new lease on life, and I’m still reaping the benefits.”

© FHCN article by Roy Cummings. Patty’s photos by Jordan Pysz. Tish’s photos courtesy of Patricia Kern. mkb

Referrals Prompt A Pair Of Smile Makeovers

Treatment plan results in shiny restoration. Diligent home care keeps it beaming.

Once the most popular getaway destination for Hollywood stars and the rest of the world’s most rich and famous, Acapulco, Mexico, has slowly deteriorated to a point where it is now considered one of the world’s most dangerous cities.

Medardo Vazquez with Dr. Ortiz

Somewhere in the middle of that Pacific beach town’s decline, Medardo Vazquez’s family packed up and moved cross-continent to Lake Worth, an hour’s drive from one of the Atlantic’s most popular beach towns.

Medardo was just a child when his family made that move, so he considers himself a Floridian, one who went on to raise a family of his own. Recently, one of those relatives gave Medardo a life-changing recommendation.

“I needed a teeth cleaning, but I didn’t want to go back to the dentist that I was going to before,” Medardo explains. “I didn’t like the way that dentist cleaned my teeth, so I asked my daughter about her dentist.”

Medardo’s daughter goes to Julian R. Ortiz, DMD, of Lake Worth Dentistry, which is part of the Health and Wellness Dentistry group that also has locations in Boynton Beach (Town Square Dentistry) and Boca Raton (Regency Court Dentistry).

Dr. Ortiz conducted a thorough oral evaluation during his initial visit with Medardo, who soon learned he was in need of much more than a cleaning.

Though he was not in pain, Medardo had a number of cracked or broken teeth along the front of his upper arch. He was also missing two molars, one on top and one on the bottom, which Dr. Ortiz pegged as the cause of the damage to the front teeth.

“When you lose teeth in the back, your body naturally adapts to those losses by using the teeth that are left to do the job of the back teeth,” Dr. Ortiz explains. “So, instead of chewing normally with his back teeth, Medardo had been chewing with his front teeth.

“The front teeth are not built for that purpose, so the pressure he was putting on those teeth by chewing with them had caused several of those front teeth to break down. One of them, a lower right incisor, had broken so badly it was missing.”

Repair and Replace

In addition to that missing lower incisor, Medardo also presented with extensive damage to his upper left lateral incisor and both of his upper central incisors, meaning three of his upper front four teeth were in desperate need of repair.

To correct those problems, Dr. Ortiz recommended a complete smile restoration that would start with the cleaning Medardo came for in the first place. Due to extensive gum disease, Dr. Ortiz explained that what Medardo needed was a deep cleaning.

“I love my smile. My teeth look and feel great.” – Medardo

After discussing the matter with his family, including a niece who is also a patient of Dr. Ortiz, Medardo agreed to the smile makeover. The work began in September 2021 with the deep cleaning.

That cleaning helped develop a strong foundation for the rest of the work proposed by Dr. Ortiz, whose treatment plan called for two of Medardo’s three missing teeth to be replaced with dental implants and the repair of all the damaged teeth.

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

The replacement teeth can be a crown that is cemented or screwed onto an 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.

Some patients require a bone graft designed to enhance the volume of the jawbone so it can properly support the implant. Following the grafting procedure, it takes about three months for new bone to develop.

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

As with Medardo, the bone grafts can be done when the implants are seated. The graft and implants then need three to six months to heal before they are strong enough to support a prosthetic.

Medardo waited five months to receive his prosthetics, which were crowns placed atop the implants replacing his lower right incisor and a lower left molar. Because of the shifting of other teeth, no implant was needed to replace Medardo’s missing upper molar.

While Medardo waited for the implants to heal and the prosthetics to be placed, Dr. Ortiz concentrated on repairing his other damaged teeth. In the end, he restored and placed crowns on the six upper teeth in Medardo’s smile line.

All Due Credit

Medardo now has a functionally sound smile that is also aesthetically pleasing.

Dr. Ortiz is largely responsible, but he says the bulk of the credit for the positive change has to go to Medardo.

“The biggest change is the change Medardo made in terms of oral hygiene,” Dr. Ortiz explains. “At home, he’s doing everything we instructed him to do regarding proper flossing and brushing. He’s even using an electric toothbrush.

“As a result, the amount of spacing and recession that he had due to his periodontal disease has all been corrected. The restorative work we did is like the icing on the cake because all that work would be for naught without that good foundation.

“We explained that to him before we started. We made it clear that for this treatment plan to work, he would need to do his part. He would need to be very diligent about flossing and brushing twice a day, and he’s done that.”

Medardo is happily reaping the rewards of his commitment to improved oral hygiene. For the first time in years, he can eat anything he wants and smile with confidence, he says.

“I used to have to eat a lot of soft foods because it was hard to chew, and yes, I was very hesitant to smile,” he says. “But now I love my smile. My teeth look and feel great, and I can’t thank Dr. Ortiz enough for all that he’s done for me.

“Dr. Ortiz is a great dentist. Throughout the entire process, I never felt any pain and the results are great. I see now why my daughter and niece see Dr. Ortiz, and just as they did with me, I gladly recommend him to anyone.”

Caring for Community

Whether it’s due to increased awareness, changes in the way the condition is diagnosed or both, the prevalence of autism spectrum disorder is on the rise. That has sparked an increase in the need for people who can teach and work with autistic children and adults.

For 16 years, Marie Orelus accepted that challenge. In addition to being a certified nursing assistant, Marie works with adults on the spectrum, including some who receive care and instruction at home.

Marie shows off her new smile with Dr. Ortiz, along with dental assistant Patrick Brady, left, and dental hygienist Sophia Zapata, right.

“In some cases, we actually cook for them and teach them how to clean and shower,” Marie explains. “We help them in any number of ways that are necessary because some cannot help themselves.”

Several years ago, Marie required specialized help herself after an accident left her with four broken front teeth. Those teeth were saved during an emergency trip to her dentist, who performed root canals on her two front teeth on the top and bottom.

But Marie’s dentist, who would soon sell his practice and retire, never recommended crowning the repaired teeth. As a result, those teeth soon became brittle, worn and discolored. Recently, Marie resolved to rectify that problem.

Crowning Achievement

After a few years of encouragement from Naved Fatmi, DMD, who purchased the practice and made it part of the Health and Wellness Dentistry group, Marie agreed to have those teeth crowned. There was just one problem.

By the time Marie agreed to the crowns, the two bottom front teeth were so worn that they were no longer salvageable. As a result, Dr. Fatmi had to pull those teeth and replace them with a dental implant.

Prior to receiving that implant, Marie required a grafting procedure, which was performed by Dr. Fatmi. While she waited for the implant to fuse and new bone to develop in her bottom jaw, Marie was placed in the care of Dr. Ortiz.

Marie was among the first patients treated by Dr. Ortiz as a part of Dr. Fatmi’s Health and Wellness Dentistry group, and one of the first things he did for her was rectify a fast-growing issue with her wisdom teeth.

“She had some inflammation around the gums, and the bone had started to die around those teeth because of calculus buildup,” Dr. Ortiz relates. “That’s not unusual because it’s hard to keep those back teeth clean, so we pulled all four wisdom teeth.”

After verifying a healthy foundation and stable gum health, Dr. Ortiz turned his focus to restoring Marie’s smile. He did that by placing a crown on each of her two top front teeth and a single crown made to look like two teeth on top of the implant on the bottom.

Same-Day Service

All three crowns were created and placed during one visit in which Dr. Ortiz made extensive use of the advanced technology available at Health and Wellness Dentistry, which has the ability to create crowns in its on-site laboratory.

That process starts with the dentist taking a digital impression of the teeth, eliminating the need for gooey molds. The digital impression is used as a guide to create permanent crowns, which can be seated immediately.

“I walked into their office and walked out a couple of hours later with a beautiful new smile.” – Marie

“We have our own in-house lab manager, and he works side-by-side with us,” Dr. Ortiz explains. “He makes sure that the shape, size and shade of the crown matches all the patient’s other teeth, and the resulting bite is ideal so that the smile looks completely natural and has lasting results that will prevent any complications in the future.”

This technology at Health and Wellness Dentistry also eliminates the need for temporary crowns, which can fall off or break, and saves the patients’ time because it allows to have extensive damage repaired in one visit.

“What Dr. Fatmi and Dr. Ortiz did for me is absolutely amazing,” Marie raves. “And it was done so quickly. I walked into their office and walked out a couple of hours later with a beautiful new smile that everybody complements.

“The dentists are very, very good, and they are exceedingly kind. Everyone treats you with so much respect that I only have wonderful things to say about them.”

© FHCN article by Roy Cummings. Photos courtesy of Health and Wellness Dentistry. mkb

Ormond Beach Gains Pain Relief Experts

Welcome an affiliate of a leading provider of progressive interventional treatments.

Kassia Silva, MD meeting with a patient

Kassia Silva, MD

A recent study from the Mayo Clinic revealed that, after skin disorders, doctor visits are most often prompted by joint pain, back pain and pain associated with osteoarthritis. Many of these patients complain of chronic pain, described as lasting three or more months.

Now open in Ormond Beach, Centurion Spine & Pain Centers specializes in the use of progressive interventional treatment options to address chronic joint, neck and back pain.

“We don’t stop at treating the pain that brings someone to us in the first place,” says Kassia Silva, MD, the lead physician at Centurion Spine & Pain Centers. “Our goal is to find the cause of that person’s pain and to treat the cause.

“We’re specialists and when someone is in pain, the best thing they can do is see a specialist because we can find the root cause of their pain and treat the cause instead of just putting a band-aid on it or treating it with pain medications.”

Centurion Spine & Pain Centers is an affiliate of Jax Spine & Pain Centers, which has six other locations in Northeast Florida.

“Our expectation is to serve the entire community with the best care possible, and by expanding to Ormond Beach, we’re hoping we can help more people in pain,” Dr. Silva says.

From weekend warriors nursing minor muscle strains to senior citizens crippled by spinal compression fractures, the staff of Centurion Spine & Pain Centers is highly trained and experienced in the diagnosis and treatment of all causes of pain.

Those causes can include degenerative disc disease, arthritis, sciatica, sports-related injuries, or injuries suffered at work, home or while participating in a favorite activity. No matter the trigger, Centurion Spine & Pain Centers has a solution.

“We usually begin conservatively when treating our patients, but the pathology ultimately dictates the direction we take,” Dr. Silva adds. “If someone comes to us who has already tried a slew of conservative treatments, we can move on to advanced procedures.”

Conservative treatments offered by Centurion Spine & Pain Centers include epidural steroid injections, which are used largely to alleviate debilitating back, leg or neck pain, and cortisone injections, which can alleviate joint pain.

The practice also performs medial branch nerve blocks, which are injections of anesthetic into a targeted nerve that is often used as a precursor to a more advanced treatment called radiofrequency ablation.

During radiofrequency ablation, radio waves produce heat that is delivered through a probe to the targeted nerves. The heat creates a spot on the nerve that impedes the transmission of pain signals to the brain.

As with steroid injections, cortisone injections and nerve blocks, radiofrequency ablation can alleviate pain for as much as six months or more, and these conservative treatments can be repeated.

But for patients seeking more permanent fixes or those whose pain returns or becomes so prolonged and agonizing that it adversely affects their lifestyles, the providers at Centurion Spine & Pain Centers turn to advanced treatment options.

Spinal Cord Stimulation

One such option is neurostimulation. Jax Spine & Pain Centers has been deemed a Center of Excellence for neurostimulation, which includes spinal cord stimulation, dorsal root ganglion (DRG) stimulation and peripheral nerve stimulation.

These therapies have proven effective with a variety of ailments, including sciatica, neuropathy, complex regional pain syndrome, failed back surgery syndrome and other neuropathic pain syndromes.
These therapies use a small device that alters pain signals running to the brain. The device is powered by a small battery that is typically implanted under the skin.

While these are considered advanced treatments, the technology is not new.

The first spinal cord stimulator, for example, was developed about 30 years ago. That device replaced pain signals with a tingling sensation called a paresthesia. The latest models are similar but advanced technology allows the pain to be replaced with no sensation at all.

“We used to think that the pain signals were blocked by distracting the brain,” says Justin Mann, MD, of Jax Spine & Pain Centers. “We now know that we actually affect pain on a cellular level, and that is what is decreasing the patient’s sensation of pain.”

Stimulation therapy typically begins with a three- to seven-day trial period during which the stimulator’s effectiveness is gauged. If the patient experiences a significant reduction in pain during the trial, the stimulator is implanted permanently.

“With spinal cord stimulation, the trial is similar to receiving an epidural steroid injection,” Dr. Mann adds. “We do it right in our office, and the only difference is that instead of injecting medication we thread leads or electrodes through the epidural needle.

“The top end of the electrode is fed into the epidural space of the spine, which is on the inside of the spinal canal but outside of the spinal cord. It’s a unique place anatomically that is especially receptive to this type of therapy.

“The bottom of the electrode is attached to a battery that sits on top of the skin during the trial. The battery, about the size of a half-dollar, creates electrical impulses that block the pain signals.”

About 90 percent of patients going through a spinal cord stimulation trial receive enough pain relief to have the stimulator implanted permanently. That procedure is similar to the one performed for the trial, except that it is done at a hospital or surgery center.

“During the permanent implant procedure, the patient lies stomach down, is given intravenous sedation, and the process done for the trial is recreated in terms of putting the leads into the spine,” Dr. Mann explains.

“During the procedure, we actually wake the patient at one point and ask if they’re feeling the delivery of energy through the device. We do that to make sure we’re covering the areas with the most pain.
“If the patient indicates that we’re successful in capturing these painful areas with the electrical signals, we complete the procedure, during which no bone or muscle is cut even while we’re placing the battery under the skin.”

The battery is charged wirelessly with an external generator that’s attached to a small belt. A nonrechargeable battery is also available, but most patients choose the rechargeable battery that can be recharged in an hour every two days.

DRG Stimulation

DRG stimulation is an advanced form of spinal cord stimulation that affects dorsal root ganglion, which is a body of sensory neurons at the side of the spine where the spinal nerve root exits to become a peripheral nerve.

This therapy treats specific areas such as the hips, knees, ankles and feet.

It is also used to treat causalgia, which is chronic pain that develops following an injury or event such as a stroke or heart attack. Often referred to as complex regional pain syndrome, or CRPS, causalgia is characterized by inflammation or nerve dysfunction and pain greater than experienced during the suffering of the injury that caused it.

That is especially true with amputations and paralysis, but doctors have found that people with severe diabetes as well as women who gave birth through cesarean section experience nerve pain for months or years.

This pain is sometimes a result of scar tissue that compresses a nerve in a way that limits the nerve’s ability to be fed the natural elements needed to remain healthy.

In addition to pain, damaged nerves can cause numbness, tingling, burning, muscle weakness and atrophy. When those symptoms last longer than a few months, they are considered permanent and in need of treatment.

As with spinal cord stimulation, DRG stimulation starts with a short trial that begins with the doctor threading two catheters the width of spaghetti.

“We perform this in our office, and it’s done while the patient is under light sedation,” states Michael Hanes, MD, of Jax Spine & Pain Centers. “Sometimes we can even get away with just having the patient take a Valium®.”

The catheters contain leads or electrodes that are placed on the dorsal root ganglion. The spinal column contains several ganglia, each of which is associated with a different area of the body. Physicians know which DRG to stimulate based on the location of the pain.

“These areas are pretty well mapped out, although there can be some variation from person to person,” Dr. Hanes educates. “That’s why we perform a trial of the system first, without incisions, just using needles to place the leads.”

As with spinal cord stimulation, the other end of the electrodes are connected to an external device that creates electrical impulses to block the body’s pain pathways. The pain can be replaced with a gentle tingling or no sensation.

Patients can control the amount of stimulation they receive by using a remote. The remote also allows the patient to turn the device on or off.

At various points during a trial, the patient is contacted by the doctor or a representative of the device’s manufacturer for updates. At the end of the trial, the patient and doctor meet again to discuss the patient’s experience.

With peripheral nerve stimulation, the leads are typically placed over the painful area of the body instead of near the spine, where the pain signals are generated.

“If the patient fails to experience significant pain relief, then we simply remove the leads knowing that we did as much as we could in that regard,” says Nicholas Bremer, MD, of Jax Spine & Pain Centers. “In those cases, we explore other options.

“But for those who do experience relief, and that is the case with a majority of the patients who complete the trials, we move on to get insurance approval for placement of the permanent device.”

To gain approval, a patient must experience a reduction in pain and increase in function of between 50 and 80 percent, measured using a visual log or numerical scale.


Another advanced treatment offered at Centurion Spine & Pain Centers is kyphoplasty (pronounced ki-fo-plas-tee), a painless, injection-like procedure that relieves pain associated with a spinal compression fracture.

A spinal compression fracture occurs when a vertebra weakens and either breaks or collapses, affecting nerves of the back. If left untreated, the fractures can cause severe pain, deformity and often a stooped posture.

These fractures most often affect the lower portion of the thoracic, or middle, area of the spine. Kyphoplasty, performed in an outpatient setting, can repair that damage.

“Prior to the development of this procedure, patients with a spinal compression fracture would usually be placed in a brace before being sent home in the hope that the fracture would heal on its own,” Dr. Silva reports.

“The brace was very uncomfortable, and the patients sometimes had a hard time breathing and ambulating. As a result, it wasn’t unusual for some patients to wind up in the hospital with pneumonia or blood clots that could go to their lungs.

“That’s why kyphoplasty is considered by many to be a lifesaver. It repairs the fracture and prevents patients from suffering some of these other issues. It actually reduces the risk of mortality.”

One study of more than 2 million compression fracture patients showed that those undergoing kyphoplasty were 22 percent less likely to die from complications associated with the fracture than those who did not go through the procedure.

Kyphoplasty is performed through a small incision in the back. The physician uses a needle and x-ray guidance to insert a balloon into the fractured vertebra. By inflating the balloon, the compressed vertebra returns to its original height.

The cavity created by the expansion of the balloon is filled with a fast-drying cement that immediately stabilizes the fracture, alleviating pressure on the nerves and eliminating the pain. The minimally invasive procedure takes about 30 minutes.

At Centurion Spine & Pain Centers, a kyphoplasty can be done within 24 hours of the diagnosis. And the results are immediate because the cement is dry before the patient leaves the office.

“The only reason we don’t say, Go home, and do everything you normally would is because they received sedation,” Dr. Silva notes. “We tell our patients, Go home and be careful for 24 hours. After that, they are usually good to go. Even if the patient is in their 80s who walks two miles a day, they can resume those walks within 24 hours.

“The ability to treat more patients with these advanced options is why I’m so excited to be opening this new sister practice to Jax Spine & Pain Centers. We strongly believe Centurion Spine & Pain Centers will be a welcomed addition to the community.”

An additional benefit of having the treatment done at Centurion Spine & Pain Centers is that it is less costly, says Mike Bergantino, chief operating officer of Jax Spine & Pain Centers.

“If you go to a hospital or surgery center, you’ll pay significantly more because you also need to pay professional and facility fees,” Bergantino points out. “At our office, your regular office copay covers the cost.”

© FHCN article by Roy Cummings. Photo by Thom Giordano. mkb

Solutions For Cellulite, Stubborn Belly Flab

Taut and Toned package trims fat, tightens lumpy skin using Emsculpt NEO, BTL Emtone.

Though they can also be found anywhere along the East Coast, there’s no better place to hunt for spiny Florida lobster than the Keys. And to hear Tina Appel tell it, there’s no better time to hunt for lobster in the Keys than September.

“During the whole month of September, after the kids have all gone back to school, you can pretty much have the open waters of the Keys all to yourself,” Tina reports. “It just seems there aren’t that many boats out there at that time of the year.”

Tina would know. Like birds heading south for the winter, her family migrates south to the Keys every September. The primary objective is to flush out, catch and eat as many lobsters as the law allows.

“My husband and I are a real good team,” she insists. “He tickles the lobsters out with a tickle stick, and I plop a bully net on top of them. If they’re legal size, we put them in the boat, and they become our dinner for the night. We love it.”

A retired nurse, Tina also loves to fish for grouper, and at age 63, she remains a self-proclaimed “gym rat” who eagerly starts each day early and works out regularly — twice a week with a personal trainer.

“Exercise has always been a big part of my life,” Tina contends. “I’m a big advocate of keeping fit. And I feel like I’m in pretty good shape for someone my age. But even with all that exercise, I still had some problem areas that needed extra attention.”

Those areas were her tummy, where she could never seem to shed those last few pounds of flab, and her legs, where cellulite sometimes made her think twice about wearing shorts or her favorite bathing suit.

Despite her years in the medical field, Tina never thought she’d find a solution at a doctor’s office. She did just that, though, during a visit to Family First Health Center, the practice of Delicia M. Haynes, MD.

Join the Club

Based on the Direct Primary Care model, Family First Health Center is an integrative, membership-based primary care clinic where Dr. Haynes empowers patients to look and feel their best from the inside out through a lifestyle medicine approach.

Unlike many traditional primary care offices, Family First offers members prompt appointments, expanded one-on-one time with the doctor, virtual visits and more benefits through a monthly membership. There are no copays, deductibles or insurance hassles.

“It’s like having a gym-style membership to your doctor,” Dr. Haynes relates. “But the membership is secondary because care is our primary focus, and what I promote is personalized health care. I’m like an old-time family doctor with modern technology.”

The model followed by Family First Health Center is one of the fastest-growing movements in primary care, and Dr. Haynes is among those who have helped other physicians make the transition.

“Most doctors really love practicing medicine, but they hate the way it’s being practiced,” she says. “This model is all about getting third parties out of the exam room and going back to emphasizing the doctor-patient relationship.”

On Target

It’s that deeper, more personal relationship that attracted Tina to the practice. She initially pegged it as a good fit for her mother, who was looking for a new primary care physician, but she soon found something there she could benefit from as well.

“We got the membership and made an appointment, and while I was there, I noticed some of the signage they have for Emsculpt® NEO and BTL Emtone,” Tina explains. “I’d never heard of either one, but I was intrigued, so I asked Dr. Haynes about it.”

At Family First Health, those treatments are offered together to members and the general public through what Dr. Haynes calls the Taut and Toned package.

Emsculpt NEO is an FDA-approved, nonsurgical body-contouring device that uses rapid pulses of high-intensity electromagnetic energy and radiofrequency to simultaneously burn stubborn fat, tone muscle and tighten skin.

“I thought this could be a win-win for me, and it absolutely has been.” – Tina

Delivered through an applicator placed on the treatment area, the radiofrequency component heats the fat cells to a degree where they break down and become permanently damaged. At the same time, it heats the muscle in the target area.

As that happens, the NEO’s electromagnetic component creates what amounts to thousands of supramaximal muscle contractions, which is more than any individual can do alone.

“Think of it like this,” Dr. Haynes explains. “At best, a nonathlete might get 30 percent muscle engagement during a workout. Even an Olympic athlete will only get 50 percent engagement. This technology gets you between 90 and 100 percent engagement.

“That’s why Emsculpt NEO is so effective in building muscle. And in terms of losing fat, once those fat cells are permanently damaged and die, they go through a process called lymphatic drainage in which they slowly exit the body through the lymph system.”

Ideally suited for people with a body mass index (BMI) of less than 35, Emsculpt NEO treatments last about 30 minutes, and FDA-approved studies show that a four-treatment regimen will result in a 30 percent reduction in fat and a 25 percent increase in muscle.

Similar studies show that treatments can lead to a 14.3 percent reduction of visceral fat. Visceral fat is the dangerous fat that surrounds abdominal organs and increases the risk for Type 2 diabetes, high cholesterol, high blood pressure, stroke, fatty liver disease and more.

“While it’s nice to have sculpted abs and glutes, these treatments improve health and core strength, and they allow patients to resume or enjoy an active lifestyle as they continue to celebrate more and more birthdays,” Dr. Haynes says.

BTL Emtone uses a device similar to that used during an Emsculpt NEO treatment to deliver thermal and mechanical energy that treats all of the contributing factors to cellulite, which only affects women.

“Unlike men, who have rectangular fat chambers, fat chambers in women are oval,” Dr. Haynes educates. “Because of that oval shape, dimples form on the skin when collagen fibers pull down on the fat chambers.

“In addition to causing that dimpling on the skin that women hate, the pull on the collagen fibers causes the skin to lose elasticity and slows blood flow. That leads to an accumulation of metabolic waste, but BTL Emtone treats all of those issues.

“It helps diminish the fat chambers. It helps remodel the collagen, so those ties don’t pull down and cause the dimpling of the skin; and it restores elasticity and improves blood flow, which helps with the removal of metabolic waste.”

Emsculpt NEO and BTL Emtone treatments can deliver results you can feel almost immediately after the first treatment, but most visible changes occur gradually over two to four weeks, according to Dr. Haynes.

Confidence Builder

As she does with Emsculpt NEO, Dr. Haynes typically recommends patients receive four 20-minute BTL Emtone treatments across a two- or three-week period. After learning about the treatments, Tina agreed to such a plan and is elated with the results.

“Even though I work out a lot, I had that little tummy pooch that I could never get rid of, but I saw a big difference after doing the Emsculpt NEO treatments,” she says. “And the Emtone treatments really smoothed out my skin where the cellulite was.

“I’m on a maintenance package now where I get a treatment once every month or six weeks, and I’m continuing to see results. The confidence level I have in my appearance now, whether I’m wearing a bathing suit, shorts or whatever, has definitely improved.”

Tina tried the Emsculpt NEO and BTL Emtone treatments hoping they would complement the work she does at the gym. She says she got exactly what she was hoping for.

“I thought this could be a win-win for me, and it absolutely has been,” she confirms. “I gladly recommend Emsculpt NEO and BTL Emtone, and I highly recommend Dr. Haynes and Family First Health Center. She’s a great doctor, and her staff is terrific.”

© FHCN article by Roy Cummings. Photo courtesy of Tina Appel. mkb

Regenerative Medicine Erases Arthritic Pain

85-year-old biker finds a nonsurgical solution to crippling knee agony.

For their 63rd wedding anniversary two years ago, Clarence Gill bought his wife, Lorraine, a shiny, electric blue Harley-Davidson® Fat Boy® motorcycle to match the one he had been riding for years. Lorraine’s bike was quickly modified, however.

Lorraine riding her blue Harley Fat Boy

Lorraine Gill turned her Harley into a motor trike to make it easier to ride. 

“I had it turned into a trike to make it easier for me to ride,” Lorraine says.

And ride she does. Though Clarence has since passed away, 85-year-old Lorraine still rides regularly. In fact, she recently returned from a rally of the Eastern Pennsylvania Retreads Motorcycle Group, which bestowed quite an honor upon her.

“We rode from the Pocono Mountains out to Lancaster, which is about a 2½-hour drive,” Lorraine details. “After we got back, the group gave me a trophy and a plaque for being the oldest female in the group.”

Following the Pennsylvania rally, Lorraine and her son and daughter-in-law loaded their bikes onto a trailer and traveled south to North Carolina, where they joined another group riding the Blue Ridge Parkway. This trip wasn’t quite as rewarding as the first.

“The first day we were there, my left knee started hurting really bad,” Lorraine laments. “It was killing me, so I didn’t ride that day. I went out the next day, though, and we wound up riding 120 miles before we even stopped for lunch.

“By the time we got back, my left knee was really hurting, so I took it easy for the next day or so. Then, a few days later, a group was going out and I decided to go with them. This time, we rode 101 miles. When we stopped, my knee hurt so bad I couldn’t walk.

“A bunch of people went hiking, but I stayed back, which turned out fine because a lot of people stopped to chat with me and take pictures with me and my bike. But I knew I had to do something about my knee.”

Lorraine knew exactly what to do because two years earlier she addressed a similar problem with her right knee. This after her family doctor told her there was nothing he could for the arthritis pain that was crippling her.

“My doctor told me I was just going to have to live with it, but I didn’t want to live with it, so I started looking around to see what was out there,” Lorraine recalls. “Then one day I saw some information for this place that did stem cell injections.”

Body’s Building Blocks

The place Lorraine found is Coastal Integrative Healthcare. It’s a medical center dedicated to serving the community and providing pain relief through advanced chiropractic equipment, advanced technology and regenerative medicine.

Regenerative medicine uses the foundation cells that grow tissue throughout the body. When these cellular products are injected into damaged tissue, they support the natural healing process by regenerating that tissue and stimulating the body’s repair mechanisms.

Because of this regenerative nature, many in the medical community, including those at the National Institutes of Health and the Institute of Medicine, consider regenerative medicine to be the future of medicine.
Timothy Steflik, DC, clinic director and president of Coastal Integrative Healthcare, is right there with them.

“I have no pain in either of my knees now.” – Lorraine

“Regenerative medicine is definitely on the leading edge of medical technology,” Dr. Steflik affirms. “It’s a great alternative to surgery because it regenerates the body instead of trying to fix it or cover up a problem with surgery. The real beauty is that it’s a one-and-done, in-office procedure that takes about 15 minutes and needs no anesthesia. It’s a simple injection of the cells that are cryopreserved in our office.

“For some patients, we administer the injections using color ultrasound to help guide us. We do that because we need to be very specific where the cells are placed. Once the cells are injected, patients can return to normal activities right away.”

Regenerative medicine can be used to treat arthritis, muscle or tendon tears, and peripheral neuropathy almost anywhere in the body, including the knees and shoulders, ankles and wrists, hips, back and neck, Dr. Steflik details.

Not all patients are candidates for regenerative medicine. Someone with a complete tear of the rotator cuff, for example, would be encouraged to try other options first. Lorraine, however, was twice deemed a good fit for the advanced therapy.

Worth a Shot

“The first time was after I went to see them about my right knee,” Lorraine confirms. “The first thing they did was take an MRI of my knee, but not long after that, my husband passed away, and I didn’t stay in contact with them.

“A little while later, my son came down to help me with everything, and when he asked what I was doing for my right knee, I told him I hadn’t gotten back to the doctors. He said, Well, you need to get it taken care of, so let’s give them a call.”

Lorraine’s call led to a meeting with Dr. Steflik and his staff. A few days later, Lorraine received the injections into her right knee. Since then, Lorraine has had no problems with what she used to refer to as her “bad knee.”

“That knee hurt so bad that I couldn’t put pressure on my right leg and lift my left leg up to get onto my bike,” Lorraine details. “I couldn’t even walk sometimes, and when I went to the grocery store, I had to lean on the cart and just kind of drag that leg along.

Lorraine Gill looking in the rear view mirror of her bike.

Lorraine has no pain in her knees after her regenerative medicine injections. 

“Ever since I received the injections in that knee, everything has been fine. That knee was so strong that my son was afraid I was going to ruin it again by babying the other one, which is why I got the injections in my left knee.”

Lorraine received those injections in June. She says she believes her left knee is responding to the injections even faster than her right knee did because she was doing things she had been avoiding for years.

“I have no pain whatsoever in either of my knees now, so I can get up in the morning and go for a walk or get on my bike and go for a ride. I can do anything,” she adds. “I feel great, and I can’t tell you how long it’s been since I felt that way.

“I used to wake up every morning with pain in at least one of my knees, and I’d go to bed the same way. And for so long, nobody seemed to know what to do about it, so I can’t tell you how happy I am that I found Coastal Integrative Healthcare.

“I love the people there. They’re like family to me now because they’re all so nice and caring, and the injections weren’t painful at all. I appreciate what they’ve done for me so much that I’ve already recommended some friends to them.

“I gladly recommend anyone to them. They definitely get two thumbs up from me.”

© FHCN article by Roy Cummings. Photos by Jordan Pysz. mkb


Ideal Protein: Healthy Path to Weight Loss

A medically supervised program changes lives (and the “food is great”).

Dr. Gordon, Barbara and Ideal Protein coach Jennifer

Dr. Jeremy Gordon, Barbara Anderson (center) and her Ideal Protein coach Jennifer Gordon.

Music is Barbara Anderson’s life. For years, she taught music at the elementary school and university levels, and she still sings in her church choir. For a while, she also directed that choir. She even sang professionally for a time.

“I was a soloist with The Phoenix Symphony,” the Arizona native reveals. “I was also a soloist with the Huntsville Symphony in Alabama, in connection with the Methodist church there, and a soloist in Wilmington, North Carolina.”

Barbara, 73, prefers to sing “God’s music.” For years, she did so despite suffering from severe neck and back pain, the result of damage to three discs in her back and neck. When that pain became severe, she sought relief from Jeremy M. Gordon, DC, at Deland Chiropractic & Spinal Decompression.

“I used to get regular chiropractic adjustments from Dr. Gordon, but then I went a long while without any care at all,” Barbara explains. “That’s something I probably should not have done because I wound up in a great deal of pain again.

“I was in so much pain that I didn’t feel like doing anything in terms of physical activity. I used to jog, but my pain made it uncomfortable to do anything like that, so I got away from jogging and exercising, and that wasn’t good for me either.

“I’m amazed that you can lose weight while eating some of the food that’s allowed.” – Barbara

“Because I wasn’t exercising as much as I used to, I started to put on weight. And the more weight I put on, the more uncomfortable I felt. I was stuck in a bad cycle, so I went back to Dr. Gordon to see if he could help.”

Dr. Gordon’s renewed treatment of Barbara was centered around a regimen of standard chiropractic adjustments. But there was another suggestion Barbara agreed to try.

“He wanted me to get on the Ideal Protein® program,” Barbara reveals. “He told me that the chiropractic adjustments would help but that it would also help me to lose some weight. So, I decided to give Ideal Protein a try.

Ideal Protein is a customized, easy-to-follow four-phase, ketogenic lifestyle program that helps participants boost energy levels, foster better appetite control, improve blood sugar and cholesterol levels, and reduce blood pressure.

“Some plans merely restrict caloric intake, so the body burns fat as well as muscle,”
Dr. Gordon explains. “By limiting the sugars and fats you take in and providing protein that is easily absorbed, Ideal Protein burns stored fat while preserving lean muscle.”

One of the biggest advantages of Ideal Protein is that it helps participants develop and maintain good eating habits that become second nature. The typical result is a loss of about 12 to 15 pounds per month, according to Dr. Gordon.

At DeLand Chiropractic & Spinal Decompression, those results are achieved with the help of the clinic’s Ideal Protein coach, Jennifer Gordon, who has helped Barbara lose more than 60 pounds since she began the program early in 2020.

“I love the Ideal Protein program,” Barbara enthuses. “I love the food. It’s the only weight-loss program I’ve been on that lets you have a treat. I’m amazed that you can lose weight while eating some of the food that’s allowed.”

Barbara is currently in the program’s weight-maintenance phase.

Barbara showing her before photo on cellphone

Barbara has lost more than 60 pounds on the Ideal Protein program.

“I’m not having a hard time doing that because the food is great. I could eat it for the rest of my life and be very content,” she says.

“The other thing this program has done is it’s made me feel better. I’ve lost 60 pounds, but the difference in how I look is nothing compared to the difference in how I feel. I’m amazed at how comfortable I feel, and that was my ultimate goal.

“I tried the Ideal Protein program because I was hoping it would help relieve me of some of my back pain and help me to feel better. Dr. Gordon said it would, and he was right, because for someone 73 years old, I feel great.”

© FHCN article Roy Cummings. Photos by Jordan Pysz. mkb

Maintenance Is Key To Smile Restoration

His new teeth look “awesome” and function properly. But patient education is critical.

George Phillips ready to throw a football

George Phillips

The DeLand Bulldogs of the DeLand Pop Warner Youth Tackle Football and Cheer Association lost far more games than they won in 2021. The 10-and-under team did, at least. At the Pop Warner level, though, winning is not a top priority.

“First and foremost, we try to teach sportsmanship, good behavior and respect for the game, officials and other athletes,” says George Phillips, the coach of that 10-and-under team. “At this level, every kid gets a chance to play.”

George, 47, didn’t play much football during his youth. He gravitated more toward soccer and proved to be pretty good at it. Good enough, in fact, to play for the Army during a four-year stint of active service and afterward at a higher level.

“I tried out for a couple of development league teams and landed a spot with one, but I wasn’t going to get paid,” George relates. “Being married and all, I chose another career over soccer and went to work for a living.”

“Finding Dr. Patel was definitely a blessing.” –George

George went on to become a regional manager for a communications company, where he coordinates the installation of infrastructure.

He recently needed some work on his own infrastructure – involving his dental health.

“I had a bridge break,” George says of a dental bridge that spanned his six upper front teeth and was held in place by four upper teeth. “The dentist I was seeing gave me a recommendation for another dentist to do the work, but I decided to look elsewhere.”

George’s search was exhaustive. He visited six dentists, each of whom recommended replacing the broken bridge with a bridge supported by dental implants, before choosing Jayraj J. Patel, DMD, of DeLand Implant Dentistry.

“I chose Dr. Patel because of his attention to detail,” George explains. “He said, To do this right, we’ll need to take our time. All the other dentists said they could do the work in a couple of visits, which seemed like a quick fix. That was the last thing I wanted.”

Balancing Act

George first visited Dr. Patel a little more than a year ago. As with all patients, Dr. Patel began with a short meeting during which he learned of George’s primary concerns. He then conducted a comprehensive oral health examination.

“We always start with a comprehensive exam that looks beyond the patient’s primary complaint because we want to be sure our patients have balanced bilateral occlusion, which means they have healthy teeth and support on all sides in both arches so that they can properly maintain their teeth,” Dr. Patel informs.

“If you’re missing teeth or have other problems that affect your bite, the other teeth are going to suffer. That’s why we always do a comprehensive exam and provide a treatment plan that addresses all the patient’s needs.”

That proved critical in treating George, who presented with only two teeth— the eye tooth and middle front tooth — on each side of his upper arch. He was also missing three teeth — a molar and premolar on the left side and a molar on the right — in his lower arch.

To correct those issues and the occlusal imbalance they caused, Dr. Patel recommended pulling the remaining four upper teeth and fitting George with a full implant-supported upper bridge. He also proposed replacing George’s missing lower teeth with dental implants.



Dental implants are root-shaped, screw-like bodies that are surgically positioned into the jawbone. After placement, new bone naturally grows around the implant to form the foundation for an abutment and replacement teeth.

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

Some patients require a bone graft designed 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 to six months.

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

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

A 20-Year Fix

George holding football

George’s bright new smile makes him feel like a winner.

Dr. Patel’s work on George began with a thorough cleaning of his lower teeth and a gum treatment to ensure he had a healthy foundation for the implants and restorations.

Dr. Patel then pulled the four upper teeth that held the failing bridge.
Following the extractions, Dr. Patel grafted the upper arch, which received six implants. He then fit George with a temporary denture. While the upper implants healed, Dr. Patel placed three implants in George’s lower arch where the molars and premolar were missing.

George wore the temporary denture until all his implants were strong enough to support prosthetics, which was a few months. He was then fit with a permanent 12-unit upper bridge and had crowns placed on the three implants on the lower arch.

“The last thing we did with George is another thing we do with all our patients,” Dr. Patel adds, “and that is to educate them on proper home health care and maintenance. That is something that I believe sets us apart from other practices.

“We not only do the surgery to grow bone and gums, and place implants, we also help you maintain the implants, so you don’t have future problems. That part is critical because without proper maintenance, just like a car, your implants will break down.”

That kind of care is what George was looking for when he selected Dr. Patel. He’s confident he made the right choice because he has what he refers to as an “awesome” smile that looks great and functions properly.

“Finding Dr. Patel was definitely a blessing,” George enthuses. “His attention to detail is just amazing. He said this will be a 20-year fix, and that was what I was looking for, something that would last. I definitely made the right call in choosing Dr. Patel.”

© FHCN article by Roy Cummings. Photo by Jordan Pysz. Before and after images courtesy of DeLand Implant Dentistry. mkb

Modern Hearing Aids Help With Tinnitus

Digital program produces a more soothing sound to the brain.

After working for 40 years as a legal secretary in the Big Apple, New York native Jillian* was beginning to settle into retirement at her home near West Point when her daughter convinced her to move south.

“My daughter and son-in-law moved to Florida about five years ago,” Jillian explains. “After I retired, my daughter said, Mom, there’s no need to stay up there anymore. Sell the house, lighten the load and come on down.

Jillian arrived in Florida this past fall just in time to enjoy Thanksgiving, Christmas and New Year’s with her family. It was during those holiday gatherings that Jillian’s daughter expressed concern about her mother’s hearing.

“I knew I had some hearing loss because I had seen an audiologist in New York a couple of years earlier who told me about it,” Jillian explains. “When my daughter suggested I should have my hearing rechecked, we started looking for an audiologist around here.”

The audiologist that Jillian decided to see is Dana Jickell, AuD, proprietor of Professional Hearing Solutions in Port Orange. Dr. Jickell, who is in her 25th year of providing care for patients with hearing loss, purchased the practice in January.

“Something our patients will notice is that we strive to maintain a family-like atmosphere here,” says Dr. Jickell, who has her daughter, Raegan Jickell, working as an audiology assistant.

Dr. Jickell and Raegan first saw Jillian in May.

That’s when Dr. Jickell discovered that, in addition to a loss of high-frequency hearing – which can prevent someone from hearing a doorbell, a child’s voice or a person talking to them in a crowded environment – Jillian also suffers from tinnitus.

Tinnitus is a symptom associated with age-related hearing loss that presents itself as a ringing or buzzing in the ears. In Jillian’s case, it created a constant cricket-like sound. There is no cure for tinnitus, but it can be managed.

The most common tinnitus management is found with hearing aids. These devices include a digital program that produces a more soothing sound to the brain. One device is the ReSound LiNX Quattro, which Dr. Jickell recommended for Jillian.

“I first wanted to see if simply fitting Jillian with hearing aids and bringing back the high frequencies would help her manage her tinnitus, because that does do it sometimes,” Dr. Jickell explains. “But after two weeks, her tinnitus had not improved.

“She still needed a little more help, so that’s when I set up what is called the tinnitus sound generator. What that does is present a more soothing sound that the brain can focus on instead of the sound that is actually presented by the tinnitus.”

For Jillian, the doctor created a subtle sound that covers the high-pitched cricket sound. It made an immediate impact on Jillian, who says she now hears things she hasn’t heard in years, such as birds and even the turn signal in her car.

“I’m a lot more engaged in conversations,” Jillian says. “I’m very thankful I found Dr. Jickell. She’s very professional and did a great job explaining everything to me. I really appreciated that and the fact she was never pushy. I definitely recommend her.”

© FHCN article by Roy Cummings. mkb
* Patient’s name changed at her request.
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