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Bring Tears To Your Eyes

New treatment ‘melts’ away substance clogging eyelid’s oil glands.

Wilma Kostick and Dr. Alexandra Kostick in the doctor's office

Wilma Kostick and her daughter, Dr. Alexandra Kostick

If you travel a few miles outside of Winnipeg, Manitoba, and look out over the vast horizon on a clear summer night, there’s a good chance you’ll see both the Milky Way and the natural phenomenon known as the aurora borealis.

In the summertime, Winnipeg is a stargazer’s and outdoorsman’s paradise. Unfortunately, Winnipeg summers don’t last very long. The winters, meanwhile, are brutal, with temperatures regularly dipping well below zero and snow falling from September to June.

“And sometimes that snow piles so high you cannot get out of your house,” says Wilma Kostick. “I remember a lot of days when it was 40 below (zero) and there was eight to 10 feet of snow on the ground.”

Days like that are why Wilma, a former psychology teacher, psychologist and longtime Winnipeg resident, finally followed in her daughter’s footsteps and moved to Florida. That was in 1996. Not long thereafter, Wilma developed an aggravating eye issue.

Known as meibomian gland dysfunction, or MGD, the condition is caused by blockages in the eyelid’s oil glands. These blockages limit the secretion of certain oils that help tears moisten the eyes and keep them free of debris.

Similar to dry eye syndrome, where inadequate amounts of tears are produced, MGD can cause stinging and burning of the eyes. It can also make the simple blink of an eye feel like someone is rubbing sand paper across your eyeballs.

“It’s so bad that sometimes you just want to sit with your eyes closed,” Wilma laments. “And that obviously affects a lot of areas of your life.

“I love to read and do crossword puzzles, but you don’t feel like doing that when you have dry eyes. It’s just too painful. Even watching TV or a movie was difficult. I don’t drive very much, but it was very hard to drive, too. It’s just awful.”

MGD and dry eye disease are chronic conditions, but there are a number of treatments that can be used to minimize their symptoms. The objective when treating MGD is to clear the blocked glands. The goal when treating dry eye disease is to produce more tears.

Wilma had tried nearly all of the treatments available for MGD. None provided long-term relief. That’s why her daughter, Alexandra Kostick, MD, FACS, FRCSC, of Atlantic Eye Center recently added a new treatment to her arsenal in the fight against the ailment.

“I liken it to getting your teeth cleaned. You usually get that done twice a year. This treatment is similar in that way.” – Dr. Kostick

The treatment is called TearCare®. It can be used to treat MGD, dry eye disease and blepharitis, an inflammation of the glands of eyelids often caused by allergies, and it can be completed in as little as 15 minutes in the doctor’s office.

“People who have MGD are not producing an oil, they’re producing something that’s more like a cheesy substance or toothpaste,” Dr. Kostick educates. “What TearCare does is liquefy that substance so it no longer clogs the gland.”

Heat and Liquify

TearCare uses a small yet flexible device placed on the eyelids. The device conforms to the eyelid and emits heat that “melts” the substance inside the glands.

“TearCare is the only treatment that reaches a temperature that allows those substances inside the glands to melt and liquefy,” Dr. Kostick explains. “But the temperature is not anything that would cause a burn or discomfort. In fact, patients are quite comfortable with it. The device, meanwhile, stays on the eyelids throughout the procedure. But unlike similar treatments, patients can actually blink and open their eyes.”

Dr. Kostick has treated many patients with TearCare, but Wilma was the first.

“The fact that my own mother was the first patient I used this treatment on tells you just how much I believe in it,” Dr. Kostick notes. “I knew this was something that could help her and others like her, but I was amazed at how well it worked.

“When we completed the treatment, tons of this cheesy material started coming out of her eyelids. That stuff had been clogging her glands for years, and now she’s getting the relief she couldn’t get from all the other treatments she tried.”

Wilma noticed relief immediately following the treatment.

“It was not uncomfortable at all,” she says. “It was quite relaxing.”

The results of the TearCare procedure should last several months.

“Dry eye, MGD and blepharitis are all chronic conditions, so this is not a one-time-and-you’re-done treatment,” Dr. Kostick informs. “I liken it to getting your teeth cleaned. You usually get that done twice a year. This treatment is similar in that way.”

TearCare is not the only new treatment Dr. Kostick offers for dry eye disease, MGD and blepharitis. A trained acupuncturist, she also provides acupuncture for patients not responding to other therapies.

Marisa Melchiorre, who has also struggled for years to find a remedy for dry eye disease, is one such patient.

Marisa Melchiorre standing in a corn field smiling at the camera

Marisa Melchiorre

“Acupuncture is a way of treating dry eye disease that is totally different than all the others, but several research studies show that it actually does help with a certain class of dry eyes,” Dr. Kostick educates. “That’s why I’ve decided to offer it.”

Immediate Relief

Acupuncture is performed using hair-thin needles inserted through the skin at specified points on the body. The points are unique to each patient and their condition. In this case, Dr. Kostick inserted the needles in Marisa’s ankles, hands and above her eyebrows. The treatment lasted about 30 minutes.

Marisa says she experienced immediate relief of her symptoms that lasted about two months. She recently repeated the treatment and is still benefitting from it.

“My eyes used to hurt constantly, like a knife was scratching my eyeball,” Marisa explains. “But ever since I tried the acupuncture, I’ve felt a lot better. I’d say I got about 50 percent relief from it, which is significant for me.

“I found Dr. Kostick while researching ways to treat dry eye disease because nothing else worked for me, and I’m glad I did. She’s great, and I love how she treats everyone like they’re part of her family.”

Dr. Kostick endeavors to create that family atmosphere at Atlantic Eye Center – and you don’t have to be her mother. She is proud to be treating her patients’ parents, spouses, children and grandchildren.

“Our patients become part of our extended family,” Dr. Kostick asserts. “We strive to make them comfortable by creating a very caring environment. They know they are going to be treated with a personal touch whenever they come here.”

© FHCN article by Roy Cummings. Photos courtesy of Atlantic Eye Center and Marisa Melchiorre. js

DRG Stimulation: New Therapy for Nerve Pain

Advanced procedure treats root of the problem.

Pain is a subjective sensation. A level of pain that one person considers tolerable may be deemed excruciating or even disabling by another. It’s no wonder that treating pain, especially chronic pain, has proved to be so challenging.

Man bending over from back pain

One-half of all working Americans admit to
having back pain symptoms each year. – American Chiropractic Association

Though everyday scrapes, bumps and bruises can usually be treated rather effectively with over-the-counter or even home remedies, a safe, effective answer for the kind of aggravating pain that slows someone for weeks, months or even years remains elusive.

The proof is in the numbers.

According to a study conducted a few years ago by the National Institutes of Health, approximately 50 million people in the US suffer from what medical professionals describe as chronic or severe pain.

That’s more than twice the number diagnosed with diabetes, more than three times the number treated for cancer and nearly twice the number known to have heart disease, the NIH states.

Figures such as those are why chronic pain is considered to be an epidemic and why practices such as Jax Spine & Pain Centers remain committed to finding better ways of safely and effectively treating chronic pain.

With offices in Jacksonville, St. Augustine, Fleming Island and Fernandina Beach, Jax Spine & Pain Centers specializes in progressive interventional treatment options for pain. It is also committed to combatting the use and overuse of opioids. As part of that venture, it offers a leading-edge treatment for pain that most other practices don’t.

That treatment is called DRG stimulation. It is an advanced form of spinal cord stimulation, a decades-old remedy for chronic pain in which electrical impulses keep pain messages from traveling to the brain.

By interrupting these messages, the stimulus for pain is not detected, so less pain is felt by the individual. DRG stimulation is a byproduct of the older therapy that allows for the treatment of pain in isolated areas of the lower body.

“DRG stimulation has been around only for about three or four years, but it’s become more mainstream in the last year as more practitioners have become aware of it and have been trained on it,” confirms Claudio Vincenty, MD, of Jax Spine and Pain Centers. “The advantage is that we can target and treat one specific area of the body with it.

“For example, we have a patient who had an amputation and was experiencing phantom limb pain at the point where his leg was amputated. With the old stimulation system, we would have had to provide stimulation in the middle of the spinal column that would have impacted the entire leg. With DRG stimulation, we can target only the nerves that go to the painful part of the leg.”

DRG stimulation does this by affecting the dorsal root ganglion (DRG), which are the cell bodies of sensory neurons that control pain signals. The DRG are located at the side of the spine where the spinal nerve root exits to become a peripheral nerve.

This ability to treat specific areas of the body where pain is experienced is something researchers have sought for decades. The discovery is being celebrated throughout the medical community.

“DRG stimulation is, in essence, the Holy Grail of spinal cord stimulation,” states Justin D. Mann, MD, of Jax Spine & Pain Centers. “It’s something that’s been in the works since spinal cord stimulation was first used way back in the 1970s.

“Prior to discovering DRG stimulation, the areas of the body we could treat through stimulation were very broad. This is a much more targeted therapy that allows us to provide substantial pain relief that gets people feeling better and back to living their life.

“Think of it this way: If you can put a hand on the area that hurts, and your pain is limited to that area, then DRG stimulation is going to be very effective in treating that pain. That’s how targeted it is.”

Addressing Nerve Damage

DRG stimulation is used primarily in the treatment of chronic nerve pain in the lower body – the hips, knees, ankles and feet. It is also used to treat causalgia, which is chronic pain that develops following an injury or an event such as a stroke or heart attack.

Often referred to clinically as complex regional pain syndrome, or CRPS, causalgia is characterized by abnormal inflammation or nerve dysfunction and pain greater than that experienced during the suffering of the injury that caused it.

For example, someone might experience a severe knee injury that requires surgery or undergo surgery for a hernia. However, pain in the region persists weeks or even months afterward, often because nerves are often damaged during surgery. Studies show that between 10 and 40 percent of patients undergoing surgery endure some sort of post-surgical neuropathic pain.

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 suffer with nerve pain for months or years.Dr. Bremer and quote

This pain is sometimes a result of nothing more than a scarring of the nerves, but the scar tissue in scarred nerves can compress a nerve in a way that limits the nerve’s ability to be fed the natural elements that allow it 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.

First Things First

“Treatment of such pain problems typically begins conservatively,” states Nicholas Bremer, MD, of Jax Spine & Pain Centers. “There’s a process we follow that starts with medications, physical therapy or maybe steroid injections. If that doesn’t work, we typically try something more advanced, like ketamine infusions or peripheral nerve blocks. But if you’ve tried all of that and nothing has helped, it usually leads to nerve stimulation.”

As with spinal cord stimulation, DRG stimulation starts with a five- to seven-day trial that begins with the doctor threading two small catheters the width of a strand of spaghetti into the epidural space of the spine.

“We perform this procedure 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®.”

Diagram of the DRG leads placement

The DRG lead lies directly adjacent to the spinal cord.

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 have a trial of the system first, without incisions, and just using needles to place the leads.”

The other end of the electrodes are connected to an external device that creates electrical impulses that block the body’s painful pathway. The pain can be replaced with either a gentle tingling or no sensation at all.

“The device that the bottom ends of the leads are attached to is an externalized pulse generator,” Dr. Bremer details. “It’s a combination battery and pulse generator, and for the duration of the trial, that device is taped to the patient’s back.

“The patient goes about normal daily activities about five to seven days to see how effective the treatment is in relieving pain. If it’s effective, we move ahead to placement of the permanent DRG stimulator.”

Remote Control

During the trial period, patients can control the amount of stimulation they receive by using a remote control that allows for different programs to be locked into it. The remote control also allows the patient to turn the device on or off as needed.

At various points during the trial, the patient will likely be contacted by the doctor or a representative of the device’s manufacturer to see how the trial is going. At the end of the trial, the patient and doctor meet again to discuss the patient’s experience.

“If it didn’t go well, meaning they failed to experience significant pain relief, then we simply remove the leads, knowing that we did as much as we could in that regard,” Dr. Bremer reports. “In those cases, we explore other options.

“But for those who do experience pain relief, and that is the case with a majority of the patients who complete the trial, 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 an increase in function of between 50 and 80 percent. That reduction is measured using a visual analog or numerical scale.Photo of Dr. Hanes and quote

“There are many types of pain and disability scales out there, including some that measure not just pain and function but emotional things as well,” Dr. Bremer educates. “We use different scales, but in general, we’re asking, Did this help you, and if so, how much?”

The implant procedure is similar to the one used for the temporary device, except that it takes place at an outpatient surgery center.

“In that setting, the patient is put to sleep and we implant the system underneath the skin, usually in the flanks,” Dr. Mann discloses. “When the patient wakes up, the system is in place and it gets programmed over the coming days and weeks.”

Longer Lasting Battery

The battery powering the system is a technological marvel in and of itself. According to the doctors at Jax Spine & Pain Centers, the battery can maintain a charge for at least seven years and in some cases up to 10 years.

“With the more traditional devices, patients would have to recharge the battery every couple of weeks or so,” Dr. Vincenty notes. “But as it is with almost everything these days, the technology in the battery has improved tremendously.”

Dr. Hanes adds: “The fact that you hardly ever have to charge the device is one reason this is considered a very convenient therapy. Another is that you don’t feel the stimulation. It’s always running but you don’t know it’s there.”

The patient will know it’s working by the reduction in pain it provides. According to the team at Jax Spine & Pain Centers, most patients who have received the DRG stimulator report a reduction in pain of at least 50 percent.

“Among my patients, it’s somewhere in the neighborhood of 85 to 90 percent received enough relief from it to have the permanent system implanted,” Dr. Mann reveals. “So, it’s an effective treatment that we are thrilled to provide.”

© FHCN article by Roy Cummings. Photos by Jordan Pysz.Graphic courtesy of Jax Spine & Pain Centers. mkb

In A Class By Itself

Pre-surgery education program improves patient experience, outcomes.

The vast majority of the nearly 1 million Colombians living in the United States emigrated during the 1980s and ’90s. Beatriz Irvin was part of that wave.

Beatriz Irvin poses with the equipment at Manatee Memorial Hospital

Beatriz Irvin

“I was always interested in the United States, and when we started studying it in high school in my social studies class, I fell in love with it,” Beatriz discloses. “It became my dream to move here, and I finally did that in the ’80s after living in London for a while.

“The thing I love most about living in America is the freedom we have here. I love all the things we have here that we didn’t have in Colombia. It’s a great country, and I’m fortunate to be living out the dream I had as a little girl.”

Beatriz’s childhood dream also included marrying and raising a family. She realized that in the US as well, marrying after five years of residency and raising a daughter who recently graduated from college and is now rearing children of her own.

About five years ago, while her daughter was wrapping up her education, Beatriz began to feel discomfort in her left knee. At first, she was bothered only occasionally by the pain. Before long, though, she was forced to alter her routine at work.

“I was working as a supervisor at a hotel, and I was on my feet a lot in that job, constantly moving,” Beatriz relates. “Instead of taking the elevator, I often took the stairs when moving from one floor to another. But that became a problem for me. Whenever I went up and down the stairs, my knee would hurt something terrible.”

So, she stopped taking the stairs. That helped, but one day she sat down to do paperwork “and my knee hurt so bad I could hardly bend it to sit down.”

Another problem developed while driving.

“My drive to work was about 20 minutes long, and by the time I got to work and had to get out of the car, my knee was so stiff that I could hardly move it,” she explains.

“The best thing about the class is that they go over so many things that you would never really think of.” – Beatriz

Beatriz fought through the pain for a couple of years. When she finally sought medical help, she was diagnosed with arthritis and given injections to alleviate the pain. The injections provided only temporary relief.

“Then the coronavirus pandemic came, and I don’t know what happened, but my knee just got worse,” Beatriz laments. “The pain was like nothing I’d ever felt before. It was like it was burning, and it didn’t matter whether I was walking or not, it was always like that.

“The only thing that made it feel any better was if I put ice on it or if I fell asleep. I went back to my doctor, and he said I needed to have surgery to replace my knee. That’s how I wound up seeing Dr. Retino.”

Out With The Old

Beatriz works out on machines as Monica watches.

At the Rehabilitation and Sports Medicine Center, a service of Manatee Memorial Hospital, Beatriz rehabs under the watchful eye of Monica Reid, PT (right).

Michael A. Retino, DO, is an orthopedic surgeon on staff at Manatee Memorial Hospital. He first saw Beatriz in February, when he ordered an MRI that revealed the true extent of her arthritic disease.

“Beatriz had a badly arthritic knee, and she was at the point where it was interfering greatly with normal activities of daily living and causing functional limitations,” the doctor reports. “She was no longer responding to conservative measures and when we talked about knee replacement surgery, she committed to it.

“Our plan was to do a total knee arthroplasty, which means you’re resurfacing all three compartments: the medial, or inside, part of the knee; the lateral, or outside, compartment; and the patellofemoral, which is the front or anterior aspect of the knee.”

To provide the patient with optimum stability and mobility following surgery, Dr. Retino prefers to use the ATTUNE® Total Knee System. Made by DePuy, the ATTUNE knee allows for improved stability and kinematics, creating a more naturally feeling joint replacement.

Dr. Retino typically performs such surgeries at Manatee Memorial Hospital, where joint replacement surgery patients are encouraged to participate in a pre-surgical education program designed to ensure better experiences and outcomes.

“In the past, when the patient came in ready for surgery, we simply placed them on the schedule,” Dr. Retino relates. “Now, we go well beyond that and try to get the patient into the best possible shape, both physically and mentally, before putting them through surgery.”

In With The New

The coordinator of Manatee Memorial Hospital’s joint replacement pre-surgical education program is Andrew Stritzl. His official title is orthopedic nurse navigator, and his primary goal is to ensure the patient remains safe leading up to surgery, during their stay and through their recovery.

“Undergoing surgery is like running a marathon,” Andrew offers. “My job is to make sure each patient is as prepared as they possibly can be to run that marathon, finish it and not suffer from any complications afterward.

“Our first touch point with the patient is during our pre-surgery educational classes for total knee, hip and shoulder replacements. The classes I offer are held on Mondays and Wednesdays, and our focus is on pre- and post-surgery preparedness.”

“The focus is on functional safety and safety awareness.” – Andrew

One of the primary objectives of the pre-surgical education program is to avoid complications following the procedure. Among the most serious possible complication is infection of the surgical site. It’s a concern Andrew covers in great detail in his class.

“A surgical site infection can be a life-changing event,” Andrew warns. “That’s why our pre-surgery education class puts such great emphasis on it. We go over what patients need to do before and after surgery to help reduce the risk of getting an infection.”

The regimen to reduce the risk of infection begins several days before the procedure, when patients are asked to make simple, but important changes to their home environment and to their bathing habits.

“Everybody has heard about the horrors of staph infections,” Dr. Retino explains. “The problem is that everybody is walking around with what we call MRSA (methicillin-resistant Staphylococcus) on their skin. There’s just no way around it. That’s why I ask the patients to bathe up to a week prior to surgery using a special soap that removes harmful flora on the skin. It’s a way to be proactive and decolonize the skin to further reduce the risk of infection.”

Andrew suggests that before surgery patients “bust out the disinfecting wipes” and clean all kitchen countertops and other surface areas in their homes to ensure they’re recovering in an aseptic environment.

Changing the bed sheets prior to surgery, ensuring pet care is planned for and emphasizing proper hand hygiene habits are maintained all go a long way toward reducing the possibility of infection.

So does eating properly before and after surgery. Andrew encourages patients to adopt a high-calorie, high-protein dietary regimen to reduce the possibility of surgical site infections and expedite the healing process.

Also, as part of the preop educational program, additional information is provided by a registered dietitian on healthy high-protein diets in preparation for surgery and after to enhance healing and recovery.

“It’s an example of old-fashioned caring.” – Dr. Retino.

“We also ask that patients enjoy a good pasta dinner the night before surgery because long-lasting carbs will help them get through the day of surgery and reduce the surgical stress of the process,” Andrew notes.

“Again, it’s like a marathon runner or any athlete who’s preparing for an event the next day. By eating that spaghetti dinner, you’re increasing the glycogen storages in the muscles that help provide the body with energy when needed during and after the surgery to reduce surgical stress on the body. It gives the body the energy it needs so the patient has a better outcome and feels more comfortable and more at ease after surgery. It also helps decrease postoperative nausea and vomiting and preserves
muscle mass.”

The benchmarks of recovery times and what to expect after surgery are also among the topics discussed by Andrew during the preoperative educational program.

“For knee and hip replacement patients, I talk about making sure they have a way to elevate their leg properly to limit swelling,” Andrew explains. “I also talk about creating an ambulation regimen within the home that incorporates frequently moving, in balance with icing, elevation and specific exercises.

“This regimen is to help limit pain and swelling, reduce inflammation, and to get reasonable range of motion during the first week or two after surgery. In preparing the home to receive you, patients are instructed to remove from high traffic areas anything that could cause the patient to stumble, trip or fall such as throw rugs, extension cords or cables.

“We also talk about pain management quite a bit. Each patient is different, so I go over the broad pain management regimen that has an emphasis on a layered multimodal pain management approach. Using scheduled acetaminophen as well as NSAIDs (non-steroidal anti-inflammatory drugs) when possible can help patients use fewer narcotics, which tend to have more side effects.

“We cover what to expect in the hospital before and after surgery with a focus on rehab and the goals of functional safety. The roles of physical therapy and occupational therapy are discussed as well as individualized discharging planning. Discussions of equipment needs and family involvement and their role are also explained in detail.”

The Team Dynamic

Monica evaluates the condition of Beatriz left knee.

With the help of Monica Reid, PT, Beatriz (right) is making a full recovery from her knee surgery.

Andrew’s job doesn’t end when class is dismissed. He follows patients through their hospitalization and remains the point man for the collaboration between the interdisciplinary team that consists of the surgeon, nursing, physical therapist and case managers. Andrew literally takes a hands-on approach to patient care and collaborates with the team on when the patient is meeting the functional safety goals to get home safely.

“With most joint-replacement patients, it’s a next-day, if not same-day discharge to home, and as we are working with patients by ambulating them, we’re deciding if they’re functionally safe to go home,” Andrew relates.

“Collaboration with the surgeon and case managers ensures we have a clear plan of care when the patient is ready for discharge, either with home health care services or straight to outpatient physical therapy. I complete the discharge process for each patient, ensuring prescriptions, instructions and any last-minute questions are answered.

“But even after the patient has returned home, I always tell them, I’m only a phone call away so don’t hesitate to call me. Just like your surgeon’s office is there if you have questions or concerns, so am I. It’s just an added safety net of communication.”

Andrew says the tremendous support the program gets from surgeons such as Dr. Retino is one reason Manatee Memorial Hospital is achieving its goal of creating better patient outcomes. Dr. Retino says he’s happy to be a part of the program.

“It’s an example of old-fashioned caring,” Dr. Retino concludes. “We’re very thoughtful about the surgical process, so we’re always looking for ways to fine-tune that process so we can get good solid outcomes. One way to do that is by doing more with preop education.”

“Doing Great”

Beatriz wasn’t surprised to learn that her knee required surgery, but she had no idea what she needed to do to prepare or what needed to be done to ensure a good recovery.
She learned all that and more in the pre-surgery education class.

“I thought the class was very helpful,” she shares. “They did a great job of explaining how the surgery would go and how the recovery would be, but the best thing about the class is that they go over so many things that you would never really think of.

“The parts about how to prepare for the day of surgery and how to prepare your home for the day you come home from surgery are very important, so the class was very informative. They give you lots of good tips to help you get through it all.”

After attending the class, Beatriz had surgery in February. Following an overnight stay at the hospital, she began her recovery the next day. She’s well on her way to a full recovery now.

“One thing I learned in the class is that you have to be patient. The recovery is going to take some time, and you have to go through the therapy and rehabilitation and do everything they ask,” Beatriz reports. “But I’m feeling better and moving better. I’m still recovering, but I always feel better after physical therapy.

“I think Dr. Retino did a very good job. He’s a good surgeon and he helped me a lot. Attending the class helped me a lot, too. It’s a good class, and having it is a good idea.”

© FHCN article by Roy Cummings. Photos courtesy of Manatee Memorial Hospital. mkb

Timing is Everything

Weekly slow-cadence workouts improve balance, add strength.

For the majority of her 30-plus years working as a clinical psychologist, Lillian Miller resided overseas aiding English-speaking individuals in some of Europe’s most picturesque locales.

headshot of Lillian Miller

Lillian Miller

“Heidelberg, Germany, and Naples, Italy, were the two places I worked in the most, and they were both wonderful,” Lillian says. “I worked primarily with children and families, and I would see them for any reason they saw fit to see a psychologist.

“Sometimes with the children it was school-related, and sometimes it was to help them make the adjustment to living in a foreign country. It was a very flexible job, and I was happy to be helpful in any way that I could.”

A native of Milwaukee, Lillian, 74, spent the last leg of her career in Tacoma, Washington. When she retired six years ago, she took the advice of a psychologist she worked with overseas who told her she should retire in Sarasota.

“She told me, Sarasota is just like Europe; you’ll love it,” Lillian remembers. “So I came to Sarasota. But it’s not like Europe. I do like it here, though, because I love to bicycle and garden. In fact, gardening is probably my major form of exercise.”

Not exactly. Lillian also gets out for at least two daily walks with her dogs, and since she made the move to Florida, she has also incorporated a modern form of exercise into her weekly routine.

She was attracted by a need to improve strength and balance.

“I have a genetic disease called neurofibromatosis type 2 that causes benign tumors to grow on the brain,” Lillian reveals. “These tumors are mostly around my ears, on the acoustic nerves, and they’ve pretty much destroyed my hearing and balance. I wear hearing aids to improve my hearing, but I needed something to help me with my balance because I became very prone to falls.

“I first tried a gym program, but that lasted just one session because I hated the atmosphere and had no idea what I was doing. Then one day I noticed that 20 Minutes to Fitness was right across the street from my bank. After reading a brochure about it, I became very intrigued.”

Because 20 Minutes to Fitness offered a free trial session, she decided she had nothing to lose by checking it out.

Tailored Training

At 20 Minutes to Fitness, clients work out one-on-one with a nationally certified personal fitness coach, who creates and supervises an individualized workout program designed to do what the business name implies: achieve results through a weekly 20-minute session.

The workouts are structured around an exercise method known as slow-cadence training. The coach guides each client’s pace and form as weights are lifted in ultraslow movements on highly specialized equipment. Repetitions during each workout take approximately 20 seconds, thereby maximizing muscle performance.

The slow-paced movements create continuous tension on muscle fibers. This generates more physical benefits than a traditional workout program with three or four sessions per week.

“While each repetition in a traditional workout lasts for one or two seconds up and then one or two seconds down, we stretch that out to a 10- to 12-second count. It’s a big, big difference that achieves far better results,” says Blake Weinstein, general manager of the 20 Minutes to Fitness in downtown Sarasota.

Each workout consists of five to seven exercises lasting two minutes each, with the goal being to reach what is known as “peak performance.” When muscles reach this level during strength training, blood flows to the site. That supercharges the body and helps it burn fat while it rebuilds and strengthens the muscle naturally.

“Participants get the maximum benefit through one 20-minute workout per week,” explains Angela Begin, part-owner of 20 Minutes to Fitness. “By going slowly, we get down deeper into the muscle fibers and force them to work at their peak performance. We work the entire body to keep it strong.”

The program has years of research and plenty of science behind its success. The weight-training equipment feat­ures a patented double-stacking system, where weight can be increased in increments of 2 pounds instead of the traditional 5, 10 or 20. The equipment is calibrated to work specific muscle groups without putting undue stress on joints or ligaments.

“I felt a difference after just six weeks or so. I felt stronger and healthier, and my attitude was better. ” – Lillian

Research has shown that in addition to improving strength and balance, weekly 20-minute slow-cadence training sessions help increase energy, control arthritis, increase bone density, fight symptoms of diabetes and reduce back pain.

“We have clients who are planning to have hip or knee replacement surgeries, and their doctors refer them to us because they know we can help them build the muscle around those joints prior to surgery,” Angela points out. “This allows for a quicker recovery after surgery.”

The program even has people who have delayed surgeries because they’ve built up the muscle around the joint, Angela informs.

“Most of our clients, though, are people who want to stay fit and don’t have the time or don’t want to spend hours in a gym and possibly risk injury. They want a safe, quiet, private studio environment, and that’s what we offer, in addition to building back the muscle people lose as they age,” she states.

“The other thing is, you’re never too young or too old to do this. We have teenagers who come in, in addition to clients who are in their 90s. We have clients who have never worked out as well as athletes. We build your strength from where you are today.”

Confidence Builder

In addition to improving her balance, Lillian wanted to stay ahead in her fight against k, a disorder that can increase the risk of bone breaks.

Lillian Miller doing her workout at 20 Minutes to Fitness.

Lillian’s weekly 20-minute workouts have given her added strength, balance and confidence.

“I don’t have osteoporosis, but I’m on the borderline,” Lillian explains. “So, I joined and started doing 20 Minutes to Fitness workouts as a preventive measure for that and to build the strength and balance I needed. But I soon found it did that and more.

“I loved the session from the very start and soon found that they also improve my mood. And because I feel healthier, stronger and surer of myself, they’ve given me increased confidence when I do things like walk my dogs or go for a bike ride.

“Thanks to 20 Minutes to Fitness, I’m not so afraid of falling anymore. And I love how convenient the sessions are and that the trainers track you so carefully, so you know you’re actually making progress. In fact, it’s almost impossible not to make progress with these workouts if you stick with it.”

Lillian says she looks forward to every workout and greatly appreciates the assistance she gets from her trainer, SarahJane. “She’s great. She’s always helpful,” Lillian says.

“Everyone there does a great job making people who have never done this kind of thing feel very comfortable,” Lillian adds. “Some older people might be a bit intimidated going to a place like 20 Minutes to Fitness because they think it’s a gym, but everyone is incredibly professional, and the workouts don’t feel like work at all. They feel like an accomplishment.

“I felt a difference after just six weeks or so. I felt stronger and healthier, and my attitude was better. I enjoyed it so much that I invited a friend to come along with me, and she enjoyed it as much as I did. I recommend it to anyone.”

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

Alleviate Neck And Back Pain

Nonsurgical stem cell therapy provides long-lasting relief.

Darlene Fisher walking thru a park.

“Stem cell therapy was exactly what my body needed.” – Darlene

It’s a stretch to say that everyone enjoys a love story, but with romance novels accounting for nearly one-third of all marketed fiction sales each year, it’s safe to say there is a hefty appetite for affairs of the heart.

For some, that craving is nothing short of insatiable. According to one marketing study, about 15 percent of romance readers buy a story of desire every week.
Darlene Fisher, 66, is hoping that, one day soon, someone will buy her romance novel.

“I’m officially retired, but I’ve worked as a publicist for a group of romance novelists since 2015, and I’m actually an author myself,” Darlene explains. “I’m not published yet, but I’m hoping that happens sometime in the near future.”

Darlene’s foray into the literary field came after working for four government agencies. She spent the last several years of that career and the first few of her retirement romanticizing about the day she’d be free of her debilitating neck and back pain.

Darlene’s neck and back pain stemmed largely from damage done nearly 40 years ago when she was involved in a car accident. Though surgery to repair her injuries allowed her to live comfortably for many years, Darlene’s pain eventually returned. And with a vengeance.

“It was downright disabling, and it didn’t just stop at my neck and low back,” Darlene laments. “These gripping spasms of pain went all through my shoulders and into my hands and even down into my hips. They were so bad that I couldn’t do anything normal.

Just taking a shower in the morning was an ordeal for her. So was preparing lunch or dinner, or simply sitting down to eat.

“I was so miserable that some nights, I would lay in bed and cry,” Darlene laments. “One night, I told my husband, I can’t take this anymore. I realized my pain was telling me there was something that needed to be fixed, so I started doing research because I didn’t want to have surgery again or have to take medications. That’s why I decided to call Dr. Grana.”

New-Age Specialty

Erick A. Grana, MD, of Regenerative Orthopedic Institute in Tampa, specializes in regenerative medicine, which promotes new growth in tissue ravaged by injury or arthritis using a nonsurgical, noninvasive technique called stem cell therapy.

Dr. Grana first saw Darlene in February. At that time, he conducted a thorough examination that revealed her pain was being caused largely by compressed discs and the advanced deterioration of discs throughout her spine.

“Dr. Grana performed imaging right there in his office and could see that some of the nerves were being pinched by the vertebrae, including the nerve that actually controls the movement of your fingers,” Darlene reports. “That’s why I was feeling the pain all the way into my hands.”

To correct the problem, Dr. Grana suggested stem cell therapy.

“Stem cell therapy treats disease and injuries by harnessing the body’s own healing powers,” Dr. Grana educates. “The natural healing process occurs by combining a patient’s own stem cells with their own platelet rich plasma, or PRP.

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

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

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

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

Stem cell therapy is a convenient treatment, Dr. Grana notes. It’s an in-office procedure and requires no anesthesia. The simple injection of the cells completes
the process.

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

“RegenaJoint and RegenaSpine are both minimally invasive procedures that are performed right in my office using a local anesthetic,” Dr. Grana points out. “Patients typically resume normal activities immediately following the procedures.”

Marvelous Outcome

Dr. Grana used RegenaSpine to treat Darlene. During one office visit, he injected stem cells and platelets into areas of her cervical, thoracic and lumbar spine. The results have been life-changing.

Darlene says that shortly after she received the injections, she began to feel a warm sensation that she believes was the stem cells working to make her
body stronger.

“Stem cell therapy was exactly what my body needed,” Darlene raves. “Before I visited Dr. Grana, I felt like an invalid. But now that I have this new cushion developing in my spine, I feel like a different person.

“I’ve actually been on a health journey of late. I’ve been going to physical therapy three days a week, but I’m also swimming, going to the gym, lifting weights and walking on the treadmill. These are all things I wasn’t able to do before I visited Dr. Grana and received the stem cell injections, so it has made a huge difference in my life. Every day I feel a little bit better. That would not be happening were it not for stem cell therapy.”

The improvement she has experienced has been “really exciting.”

“I was lying in bed one night, thinking to myself, I can actually feel this working,” she exclaims. “I really didn’t know what to expect, but the results have been tremendous.

“And I could not be happier with Dr. Grana. He’s such a wonderful human being. He’s so dedicated to helping people and getting them out of pain. When I first visited with him, he picked up my hand and said, I’m going to fix this for you. That’s how incredibly compassionate he is.

“Everyone in his office is the same way. They’re just great, and being treated and helped by them all has been such a wonderful experience that I wholeheartedly recommend Regenerative Orthopedic Institute to anyone.”

© FHCN article by Roy Cummings. Photo by Jordan Pysz. js


Look Good, Feel Great & Live Happy

Celebrating 10 years of helping clients save their skin.

Like many women, Janie Rushnell first noticed a few signs of aging in her face while she was in her late 30s. Staying one step ahead of that dreaded aging process soon became her passion. In time, that passion became a business.

The Staff of Skinfastc celebrating the 10th anniversary.

Back Row left to right: Tracy Burke, Brianna Lebkey, Unjen Sin, Janie Rushnell, Emily Zielinski, Alexis Sunderland, Alex Messier Front row left to right: Katie Schultz, Isabel Langdon, Jessica Estrada, Jamie Johnson

“That’s how Skintastic was born,” Janie says of the boutique med spa celebrating its 10th year in Spring Hill. “I wanted to turn my passion into more than a hobby, but I never imagined Skintastic would become what it is today.”

When Janie first opened Skintastic — in a much smaller building than the current location — she had recently earned her facial specialists license and planned to offer a modest menu of services.

“We offered only some of the most basic services, things like BOTOX® Cosmetic and JUVÉDERM® injections,” Janie remembers. “Then I got into my 40s, and I started researching nonsurgical treatments for lifting and tightening. I was actually looking for something for myself but didn’t want plastic surgery.”

Through her research she found Ultherapy®, an FDA-approved, noninvasive treatment for lifting and tightening.

“So, I got an Ultherapy machine,” she confesses. “We’ve been adding services ever since.”

Facials and More

By doing so, Skintastic has grown into a med spa unlike any other in the area. With more than 50 treatments, Skintastic offers the most extensive menu of health, wellness and aesthetic services in Hernando County.

“We’re like a Tampa med spa but with Spring Hill pricing,” Janie says. “In addition to BOTOX, JUVÉDERM and Ultherapy, we also offer intravenous vitamin therapy, wellness shots and body scrubs, even hormone replacement therapy.

“We offer CoolSculpting, laser skin and acne treatments, massage therapy and every injectable on the market. It’s the same with facials. I like to say, No one outfacials Skintastic. We offer European facials, clinical facials and everything in between.

“We offer all these services because we want our customers to live the happiest, best life possible. We do that by offering services your typical med spa simply doesn’t have. And we guarantee natural-looking results. That is my promise to our customers.

“Your husband, boyfriend or other friends may ask you if you recently got your hair done or if you’re wearing a new lipstick. They’ll tell you things like, You look really well rested, or You look great, and that’s our goal. To make you look good, feel great and live happy.”

Helping Janie achieve that goal is a staff that’s nearly as vast as Skintastic’s product line. It includes medical director Cynthia Brooks, MD, four nurse practitioners, three medical aestheticians, a physician’s assistant and a massage therapist.

In addition, Janie is a master aesthetician who recently became a Comité International d’Esthétique et de Cosmétologie (CIDESCO) diplomat, a title recognized internationally as the most prestigious qualification for aesthetic and beauty therapists.

It’s that world-class expertise that allows Skintastic to provide customers with the “naturally looking results” Janie promises. The key to producing such results is simple, Janie reveals. It’s just a matter of not overdoing it.

“I believe in doing the right thing at the right time in the right way,” Janie explains. “For example, Galderma, the manufacturer of Dysport®, an injectable we use to erase and prevent wrinkles, recommends getting treated once every four months. Following that recommendation is the key to getting the natural-looking result customers want from that treatment, or any other treatment.

“We have customers come in all the time who say they want something done, but they’re afraid they won’t look natural or won’t look like themselves afterward. Sometimes I have to tell the person, You already don’t look like yourself, and that’s not because of anything we’ve done. It’s because of the aging process.

“If someone who is older looks at a photo of themselves when they were in their 30s or 40s and then compares it to a photo of themselves when they’re in their 60s, there’s going to be a difference. That’s because of the aging process. So what we do here is help you look more like yourself. And that starts with a free private consultation with me.”

Self-Care, Self-Love

That consultation includes having photos taken using a Reveal® Imager, a special camera that can see beneath the skin’s surface and display in great detail the skin’s health. Those images can then be used to develop a treatment plan aimed at alleviating the fine lines, wrinkles and age spots that make a person look older.

“There’s a lot that this industry has to offer, and it can be confusing, overwhelming and, yes, even scary,” Janie acknowledges. “But there’s no reason to be fearful. When these treatments are done the right way and at the right time, the results are marvelous.

“And I’m proof of that. I’ve been getting these services done since I was 36, and when I tell people that, some can’t believe it. They say, Really? But you look so natural. And I say, I look natural because this is what it looks like when a med spa does it right.”

Janie notes that a free consultation is the best way to start the process of looking more like yourself. It’s also the first step in what she describes as a self-care, self-love approach to customers finding their happy place.

“I look natural because this is what it looks like when a med spa does it right.” – Janie

“It’s rare that someone calls up and says, I’d like to make an appointment for your ResurFX™ laser to treat my acne scars,” Janie shares. “Most people call and ask what we can do about a specific problem, and we always say, Come in and let’s talk about it. And once they come in, we’ll sit down together and discuss goals.”

Based on that, a treatment plan is developed that is unique to a person’s needs and wishes.

“The beauty about Skintastic is that we service most any need,” she points out. “If you want to look and feel more refreshed, we can help you do that. If you’re someone who has looked in the mirror recently and said, Gosh, my eyes never used to look like this or Where did this droopy, heavy skin come from? we can help with that.

“The bottom line is we have something for everyone. If you’re 18, you can come in and get a facial and maybe get your lips injected. If you’re 81, you can come in and get a facial and IV therapy and everything in between.

“We have the most extensive service menu you’re going to find, so no matter what it is that you’re looking for, we’ve got you covered. We’ve got the treatments, the staff and the equipment to provide the best treatment available for self-care.”

© FHCN article by Roy Cummings. Photo courtesy of Skintastic. js

‘Lucky To Be Alive’

Rescued crash survivor grateful for pain-relieving therapies.

The details of “the crash” are important, but not as important as this: Andrew Biggart is alive. In his words, he’s “lucky to be alive,” and there is nothing hyperbolic about those words or the horrific events that lay at the root of them.

Headshot of Andrew Biggart

Andrew Biggart

On the afternoon of Nov. 29, 2018, Andrew was driving to his mother’s house in Hernando Beach. As he turned his car onto Shoal Line Drive, control of the accelerator and brakes was suddenly and inexplicably wrested from him.

In a matter seconds, the car was hurtling down the two-lane road at more than 90 miles per hour. After striking the back of a van, the car careened into the opposite lane, where it was about to crash head-on into another car when Andrew pulled left on the steering wheel.

That sent the car nose first into a tree in front of Nature Coast Marina, where the car burst into flames. Within four minutes, though, a group of fishermen ran to the scene and with nothing more than muscle and adrenalin rescued Andrew from the burning wreck.

“Those fishermen are the reason I’m alive,” Andrew reasons. “On any other day, they would have been out fishing at that time. But it was too cold to go out that day, so they were just hanging out and talking at the marina when my car hit the tree.”

Since his rescue, Andrew has spent every day traveling a slow path to recovery from his injuries, which included losing his right foot, breaking both his legs, two vertebrae, all 24 ribs and suffering third-degree burns on his legs and arms.Lucky to be alive, indeed.

“I spent three months in the severe burn ward at Tampa General Hospital, where the doctors and nurses were amazing,” Andrew exclaims. “After that, I started my rehab. But for a year, I felt like the facility I was visiting was running me around in circles.

“COVID-19 was a big part of it because there was a long pause where I couldn’t do much of anything. I was very discouraged. Eventually, my mom, who knows Charles Donley, sent me to Regional Rehab. The way I feel since I started going there is like night and day.”

Assessing the Whole Patient

Regional Rehab is the practice of Charles C. Donley, PT, and Paul Ernandes, PT, PhD. When Andrew first arrived there late last year, he was still so riddled with pain that, by his own admission, he had become quite ornery and difficult to be around.

That has all changed in the months since Andrew began treatment at Regional Rehab, where the staff’s penchant for looking beyond each patient’s primary complaint sparked discoveries that accelerated Andrew’s recovery and slowly erased his pain.

“Once we have each evaluated a patient, Paul and I will collaborate and discuss the findings of our individual comprehensive assessments,” Charles explains. “We believe those comprehensive evaluations and collaborations are the keys to our success.”

“I’m back up to 85 or 90 percent, and I owe so much of that to Paul, Charles, Brandi and everyone at Regional Rehab.”- Andrew

They were for Andrew, who arrived at Regional Rehab complaining mostly of excruciating pain in his right hip, right leg and left ankle, which had been crushed in the crash, and “phantom pain” throughout the rest of his body.

“The pain in his right leg was stump pain, meaning he was experiencing pain at the point where his leg was now fitting into his new prosthetic foot,” Paul discloses. “The left ankle pain was because he had all kinds of plates and screws in there.”

Like the “phantom pain,” Andrew’s hip pain was a bit of a mystery. Paul eventually solved that mystery by performing a gait assessment that revealed an adverse rotation in Andrew’s hips. Following the gait adjustment, the pace of Andrew’s recovery began to increase.

Helping to expedite the team’s progress was its extensive use of two advanced modalities at the core of Regional Rehab’s treatment protocol. One is the Class IV deep tissue therapeutic laser. The other is the HIVAMAT® 200 deep oscillation therapy device.

The laser uses specific wavelengths of red and near-infrared light to stimulate the body’s natural ability to heal cells. It works by releasing nitric oxide, which removes congestion and swelling, promotes rapid healing and reduces discomfort while increasing blood circulation.

The HIVAMAT 200 creates gentle impulses that relax muscles and penetrate all tissue layers to remove the inflammatory byproducts that cause pain in cells. In addition to those modalities, Paul used a third treatment in addressing Andrew’s stump, ankle and leg pain.

“We put both of his legs in a foot bath and ran an electric current through the bath, so the current went through both legs,” Paul informs. “By placing the electrode in the water, the whole bath becomes an electrode that allows us to treat a bigger surface.”

A Walk in the Park

The treatments on his lower extremities were nothing short of life-altering for Andrew. In addition to alleviating much of his pain, they allowed for even more therapy aimed at normalizing Andrew’s balance and mobility.

Andrew Biggart in his yard throwing a frisbee to his dog.

Playing with his dog is one of the many life pleasures that Andrew has regained in recent months.

Those therapies included walking on uneven ground, walking up and down hills, and even participating in baseball batting practice. Those are activities Andrew could not do just a few months earlier.

“When we first started working with Andrew, he could not stand for any more than four or five minutes,” reports Brandi Girard, PTA. “Now he can stand and walk for as much as 45 minutes before he needs to rest. He can also do a lot of other dynamic activities as well.

“But it’s not just his balance and mobility that have improved. Andrew was pretty down when he started with us. Now, he’s got a whole new outlook on life. He’s very driven and motivated, and that’s what’s brought him to this point.”

“This point” is not yet what most would consider normal. But it’s close. Andrew’s pain levels – including the phantom pain, for which he acted on Paul’s advice to receive acupuncture – are now tolerable and continue to diminish.

“I’ve gone from sweating my way through each day because I was in so much pain that I couldn’t stand it, to walking my dog and even taking him to the dog park to play with him,” Andrew shares.

“I can stay on my feet all day now and go to bed relatively pain-free. I can’t tell you what a relief that is. After a few months of working with everybody at Regional Rehab and doing all the home exercises they’ve given me, I’m feeling better than I have in two years.

“I’m back up to 85 or 90 percent, and I owe so much of that to Paul, Charles, Brandi Girard and Leanna Ramirez (laser technician). The people at Regional Rehab changed my life. They’ve saved me and have been so good to me that there isn’t anything I wouldn’t do for them.”

© FHCN article by Roy Cummings. Photo by Jordan Pysz. js

No Bones About It

Innovative once-a-week, 15-minute workouts reverse osteoporosis.

Lyn Foley putting away dishes in her cabinet.

Lyn has gained balance and strength through OsteoStrong.

If you watched television at all during the 1980s and ’90s, there’s a good chance you saw Lyn Foley. Not necessarily on a TV show or in a movie, but in a commercial. Lyn appeared in nearly 100 during a 30-year acting career.

“Some of the more notable commercials I did were for Burger King, McDonald’s and Toyota,” Lyn relates. “I also did a Gain detergent commercial that ran for quite a while.

“I even did a hemorrhoid commercial once. With that one, my son was living in California at the time and he called me up one day and said, Mom, a friend of mine in San Francisco just called and told me he saw you in a hemorrhoid commercial. I said, Yep, that’s me.

Now 74, Lyn has retired from her acting career, which included a somewhat regular gig on a Swedish TV series, Ocean Ave., in 2003 and a cameo on an episode of A&E’s The Glades in 2010.

“I reached a point a few years ago where I felt like I had done enough,” Lyn explains. “Besides, it’s hard to get the work. You have to go through a lot of auditions before you get a job, and that can be frustrating. It is great when you get one, though.”

Since moving from Miami to Deerfield Beach a few years ago, Lyn has focused largely on maintaining good health in an effort to enjoy her downtime. Recently, her efforts had to be intensified after she was diagnosed with osteopenia.

Osteopenia is the precursor to osteoporosis. These conditions develop when new bone growth fails to keep pace with natural bone degeneration to the point where bone mineral density becomes dangerously low.

About 54 million Americans, most of them postmenopausal women, have osteopenia, osteoporosis or low bone mass, all of which places them at increased risk for hip, spine, wrist and other bone breaks. Statistics show that half of all women and one-fourth of all men will deal with an osteoporosis-related fracture.

These conditions often cause some to lose height, as they can affect the bones in the spine and lead to a stooped posture.

Low bone density can be treated with medications, but Lyn first tried beating the disorder by increasing her activity level and walking her dog more often. When that didn’t make an impact, she checked out OsteoStrong.

Revolutionary Program

OsteoStrong is a revolutionary, integrative health, wellness and fitness program that has helped more than 25,000 people reverse the negative effects of osteopenia and osteoporosis and improve skeletal strength.

At the core of the program is a once-a-week, 15-minute workout session that has proved effective in helping people rebuild bone by using proprietary equipment designed to achieve osteogenesis.

“I also suffer from scoliosis, so when I first became aware of OsteoStrong I thought it would help me strengthen my spine and be a worthwhile thing to do,” Lyn reveals. “I started in November, and I’ve been doing it every week ever since.”

The workouts are performed using four biomechanical machines that allow users to perform resistance-based pushing and pulling exercises with their arms
and/or legs. During these sessions, users are able to safely exert pressure four to 12 times their body weight.

“The difference between our biomechanical equipment and that used at a traditional gym is that our equipment creates an osteogenic load, which means tension is developed without contraction of the muscle,” states Oxana Voinarevich, owner of OsteoStrong Boca Raton.

“There is no force pushing against you, which means you create the force. On the lower-body exercise equipment, for example, I’ve had ladies in their 80s who weigh 100 pounds produce 1,000 pounds of force.

“For a person who weighs 100 pounds to develop new bone using traditional weight equipment, they would need to lift more than 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.”

Oxana invites people to come in and try out the equipment at the Boca Raton location that recently opened, noting that her facility offers a free session for newcomers to experience the OsteoStrong workout.

“This is an amazing concept that is the culmination of 12 years of research that looked into the body’s adaptive response to growing new bone and muscle structure, and improving the density of the bones we have,” Oxana says. “As a result of that research, it is now a known medical fact that when you put certain forces on the bones, the body responds by growing new bone tissue. And the results of these short workouts are amazing.

“On average, our studies show that OsteoStrong improves people’s bone density from 7 to 14 percent a year. In addition, people will increase their strength by an average of 73 percent during their first year on the program.”

Similar studies show that completing an OsteoStrong session more than once a week does not promote any additional benefit. As a result, the workouts are not only impactful, but also time efficient.

Oxana encourages men and women of all ages to accept her invitation to try the OsteoStrong equipment and further notes that it’s important to know that osteoporosis is not a disorder exclusive to any age group or gender.

“Osteoporosis is not something that develops only when we get older,” she explains. “We have clients from young to old. And men are not immune; when they start losing their testosterone, their bone loss becomes more rapid.”

Added Benefits

In addition to helping people recover from bone loss, Oxana wants to help educate them about the body’s skeletal framework. She says that framework “is the most important part of the body, and people need to take care of it and be aware of changes to it.”

Lyn has not had a bone density scan since she began the OsteoStrong program, so she’s not sure of the effect the workouts have had on her osteopenia. She is certain, however, that the workouts are improving her health in other areas.

“I’ve noticed that my balance is better and that I’m a bit stronger, especially in my ability to lift things,” she says. “For example, when I first moved, I was unpacking and needed to put my dinner plates in the cabinet. I have eight and I wanted to put them all up at once, but they were too heavy. So, I did four at a time. Well, recently, I was unloading the dishwasher and picked up all eight plates and put them in the cupboard without any effort.

“I thought to myself, That’s the OsteoStrong program working for me. And I’m confident that if it’s making me stronger in those areas, it’s making my bones
stronger, too.

“It’s a program I’m really happy to have found because I was never a gym person. I tried going to the gym, but it always became drudgery. With OsteoStrong, it only takes a short time to do the workout once a week and you get great benefits. That is very appealing.

“And the coaches are all wonderful. They’re with you the whole time to make sure you have the proper posture on the machines, so you get the full benefit. The entire experience is just a pleasure.”

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

Evolution Of A Smile

Compassionate dentist succeeds in erasing effects of genetic deformity.

Joshua and Annie Bundyposing in front of a lake and mountains

Joshua and Annie Bundy

The shimmering dance of green and purple light that is the aurora borealis is a phenomenon relatively few people see even once in their lifetimes. For Annie Bundy and her family, that magical light show is visible most every night.

Since graduating from college 12 years ago, Annie, 33, has lived in six states. She’s currently living in Alaska, where an opportunity to view the mesmerizing northern lights is just one of a long string of benefits.

“The winters are obviously quite long, and those days when you only get three or four hours of sunlight can be tough,” Annie reports. “But the culture and the sense of community are really special.

“Everybody is like family, and as a parent, you want a nice wholesome place to raise your kids. We found that here. My husband and I moved from Idaho a few years ago when a job opportunity opened for him, and we just love it.”

Annie’s migration to Alaska began in Pennsylvania and included a stop just after college in Guatemala, where she taught school for a year. All along the way, she has endured the difficulties that come from being born with Van der Woude syndrome.

A genetic disorder that results in structural deformities of the mouth, Van der Woude syndrome left Annie with a cleft lip and palate and virtually no teeth along her upper arch. That laid the foundation for a distressing childhood.

Meals From a Blender

“I was never the skinny kid either, so the cleft lip and palate were just two more things for kids to pick on and make fun of,” Annie laments. “The other thing was that I was always in surgeries to try to correct these things, so I was always in a lot of pain as a kid.

“The surgeries were to fill in the gaps in my lips and the roof of my mouth. Because of those surgeries, I mostly had to be on a liquid diet. I came to hate the fact that my meals came from a blender. Even later on, I could never eat like normal people.

As a teenager, she was fit with what amounts to a denture.

“But it was done rather carelessly, and so I’ve never bit into an apple in my life,” Annie laments. “Things like hamburgers and sandwiches, I could never bite into them either. I always had to cut them up. And it was still hard to chew because I only had five teeth on the upper left side of my mouth, and they were all compromised. Some only had partial roots, and none of them had enamel, so they were always weak and yellow.”

All through her school years, Annie’s appearance caused her to withdraw socially. She compensated by pouring herself into her studies, which paid off handsomely. After being named valedictorian in high school, she earned a bachelor’s degree at the age of 20.

Her appearance and poor dental function remained a concern, however, until she moved to Florida three years later and decided to visit the eventual founder of Health and Wellness Dentistry, Naved Fatmi, DMD, for a general consultation.

“Dr. Fatmi has given me a confidence that I never had before” – Annie

At the time of that 2011 appointment, Annie was missing 12 teeth across her upper arch and was wearing a rather crude-fitting bridge that attached on each side to one of the few teeth she had in the back of that arch.

“She came in asking about an aesthetic result that other dentists she’d visited would not commit to or promise,” Dr. Fatmi explains. “We took a pretty big chance committing to her case, but I was confident we could give her a result that would make her feel as if she wasn’t out of the norm.”

The lack of bone in Annie’s upper jaw ruled out replacing her missing teeth with dental implants, so to achieve his goal, Dr. Fatmi proposed creating a new bridge that he would fashion with the aid of digital technology.

“It sounds pretty simple, right? Just create a bridge,” Dr. Fatmi reasons. “The problem was that the teeth she does have were all misaligned, and so we had to add and subtract porcelain to make sure all the teeth in the bridge were in proper alignment.

“We worked hand in hand with a very good lab in doing that. It took us a little more than two months to make sure everything looked symmetrical and natural, but we got the result we wanted. And now, 10 years later, that bridge still looks perfect.

“There’s been no decay and no recurrent infection in her mouth at all. And part of that is because Annie has done such a great job practicing good dental health care. When patients do that, there’s no reason to redo anything or change anything.”

Compassionate Care

Annie typically returns to Florida once a year, in part to visit Dr. Fatmi. She says the work Dr. Fatmi did in fashioning the bridge has done as much to make her look and feel “normal” as any of the doctors she’s seen over the years.

“Dr. Fatmi has given me a confidence that I never had before,” she beams. “When I smile now, most people can’t even tell that I had a cleft lip and palate. And no one knows that my teeth aren’t real. I would say that Dr. Fatmi literally changed my life.”

Annie’s care recently included replacing a failing lower molar with a dental implant. Annie says that even when providing general maintenance, Dr. Fatmi displays a level of compassion beyond anything she has experienced from other health providers.

“Dr. Fatmi was the first dentist who ever put himself in my shoes and asked, If I was her, how would I want to look?” Annie relates. “Everybody else treated my situation as a job. He looked at me and asked, What’s the best possible scenario I can give her?

“After all this time, he still calls to check up on me and make sure everything is OK. That’s a part of dentistry you can’t teach. But Dr. Fatmi has that in him and so does everyone on his staff. They’re all truly top-notch.”

© FHCN article by Roy Cummings. Photo courtesy of Annie Bundy. js


Pain In The Neck

Evidence-based rehab machine alleviates aggravating pain.

Anne Marie Rose headshot

MCU treatment alleviated Ann Marie’s neck pain

If you had a choice between spending your weekends working an Italian ice truck at a nearby flea market or cruising the Treasure Coast in a 31-foot Sundancer and stopping for lunch, dinner or drinks at marinas along the way, which would you opt for?

After two years of trying the former, Anne Marie Rose and her husband eventually chose the latter. They’re glad they did.

“The Italian ice thing was something my husband and I really wanted to do, and we put a lot of time and effort into it,” Anne Marie explains. “But we got to a point after two years where we felt like nomads and just didn’t want to do it anymore.

“It was mostly a weekend thing, and we were constantly making the Italian ice, so it seemed like we never had any time off. We decided it wasn’t for us anymore.”

For Anne Marie, who works full time in the marketing department for a national banking firm, the decision to abandon the Italian ice venture opened a new world of possibilities, and she and her husband planned to take full advantage.

Later this year, they plan to cruise down to the Florida Keys. Similar trips are in the works for the weekends and months ahead, and Anne Marie, 48, is looking forward to them now that a painful and longstanding neck issue has been resolved.

“My neck problems started when I was 16. I was in a car accident and got really bad whiplash,” Anne Marie relates. “I’ve been seeing chiropractors ever since, and they have helped, but the problem never really went away. In fact, from doing a lot of activities when I was younger such as wakeboarding, skiing and things like that over the years, it only got worse. Then the pain moved to my lower back.

“But the neck pain was the worst. It was like having a charley horse that would never go away. There were times when I was lost in concentration on something for a few minutes that I didn’t think about it, but other than that it was always bothering me.”

Her pain became especially agonizing when waking up in the morning.

“As the day dragged on, the pain would go into my shoulders, and my neck would start to creak and feel heavy,” she recalls. “It felt like I was carrying a bowling ball on my head.

“I have a very high tolerance for pain so I fought through it all the time, but I’m a big cyclist, and whenever I went for a ride, my neck would seize up and become stiff and sore.”

About five years ago, Anne Marie and her husband moved from the Orlando area to North Palm Beach. Shortly after, her husband met Marc A. Weinberg, DC, of Active Health Center.

When Anne Marie’s husband mentioned her struggles with chronic neck and lower back pain, Dr. Weinberg suggested she visit his practice. Since her first appointment, Anne Marie has been getting adjustments for her back and neck, although she hasn’t always heeded the doctor’s advice. She hesitated getting a specific treatment for her neck that Dr. Weinberg and another doctor at the practice, Sandy McLean, DC, recommended.

“Despite all the adjustments, the problem Anne Marie had with her neck wasn’t going away,” notes Dr. McLean. “I told her that we have a machine that would take care of it, but I couldn’t get her to commit to it.”

Nonsurgical Device

The machine that Dr. Weinberg and Dr. McLean spent years trying to get Anne Marie to accept treatment on is called the Multi-Cervical Unit, or MCU. It’s a tool designed to alleviate the type of neck pain afflicting Anne Marie.

Active Health Center is the only provider in South Florida offering treatment on the MCU, which is a nonsurgical device that isolates and strengthens muscles around the neck.

An instrument 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.

“You don’t have to live with neck pain. The MCU can get rid of that for you.” – Anne Marie

Once that data is revealed, a program is designed that allows the MCU to correct those problems. It is considered the most complete, efficient system for assessment and rehabilitation of the neck. Studies show that following MCU therapy, patient pain levels decreased 66 percent while strength levels increased more than 70 percent, with more than 90 percent of patients making a full recovery, according to Active Health Center.

An MCU session lasts 20 to 30 minutes, with patients 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,” says Colin O. Behrue, DC, at Active Health Center. “That shows us how well the patient is progressing. Based on those findings, we make clinical changes that help the patient continue to improve and build strength.”

Sooner or Later

Anne Marie’s MCU hesitance stemmed in large part from her busy work schedule. She explained on numerous occasions to Dr. Weinberg and
Dr. McLean that she simply didn’t have time to commit to it.

Anne Marie Rose holding a long board

Anne Marie Rose

A year ago, however, after the onslaught of COVID-19 forced her to work primarily from home and created a window of opportunity in her daily schedule, she agreed to give the MCU a try. She soon found it to be the panacea she’d long desired.

Anne Marie’s care began with a session on the MCU that assessed the strength of her neck muscles and created a program to correct her weaknesses.

“It took me a couple of sessions to build up some strength in my neck. After about five sessions, I was already feeling a lot better,” Anne Marie reports. “I remember sitting at my desk working and suddenly realizing I didn’t have that creaking in my neck anymore.

“That was after only a couple of weeks of treatment on the MCU, and it only got better after that. Pretty soon, my head didn’t feel as heavy on my shoulders. It definitely felt lighter, and the pain was far more manageable.

“Now, I feel amazing. I still go for adjustments, but the way my neck feels is like night and day compared to what it was. It’s not stiff all the time. I have normal mobility, and I don’t get those twinges of pain in my neck and shoulders that I used to get.”

Anne Marie’s results are typical of what most patients receive from treatment on the MCU. She now wishes she had taken the doctors’ advice much earlier. She’s not the first to express that opinion.

“Anne Marie finally reached a point where she said, That’s it; I’m done being in pain,” Dr. McLean elaborates. “That’s how it is with a lot of people.

“For many, making that commitment is the hardest part because it’s never convenient, right? Our two most precious commodities are time and money. And because we don’t want to give that away, we just continue to spiral downward.

“That’s why so many people like Anne Marie go around for weeks, months, even years with a problem that can be corrected rather quickly if they’re just willing to commit to it. Once Anne Marie did that, before she knew it, her pain was gone.”

And for that, Anne Marie is grateful. She says that finally agreeing to receive treatment on the MCU was “one of the best decisions” she’s ever made.

“The bottom line is you don’t have to live with neck pain,” she concludes. “The MCU can get rid of that for you. That’s why I so highly recommend that people with neck pain look into this therapy and visit Active Health Center.

“I’m thrilled to be a patient there because the entire staff is truly dedicated to making you feel better. They have a wonderful team, and they’re very accommodating. I was there during the whole COVID thing, too, and I can tell you I always felt very safe there. They’ve taken all the protocols necessary to make sure everyone is safe.

“And, of course, their treatment, whether you’re getting a standard adjustment or receiving treatment on the MCU, is just exceptional.”

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