Hea

lth C

are

Patr

on

PRSR

T.ST

D.

U.S

. PO

STA

GE

PAID

Tam

pa

, FL

Perm

it N

o.2

397

Flor

ida

Hea

lth C

are

New

s

Car

rier-

Rout

e Pr

e So

rt

For additional health care information,

visit us on the web at

The online

presence of

Florida Health

Care News

Florida’s Largest Health Care Inform

ation Publications

South Sarasota County Edition Spring 2020

FEATURED ARTICLES

(see Cause and E� ect, page 4)

JEFFREY P. JOHNSON, DC

Dan Sullivan

T wenty years ago, Dan Sullivan got fed up with the 9 to 5 routine of cor-porate America and set

out on a new career path. Initially, he bought and sold income properties but later discovered his niche after pur-chasing four self-storage businesses in northeast Connecticut.

“Before I left the corporate world, I worked in technology and business development for 15 years,” the 68-year-old Boston native shares. “I worked in engineering and manufacturing before that. But I got bored. � at wasn’t what I wanted to be when I grew up.

“After deciding to go o� and do my own thing, I wound up with the storage facilities. I’m kind of semi-retired now. I still have my � ngers in the businesses up north, but I currently reside in Florida. � ere’s a lot I can do with technology to manage the facilities, and I go back to Connecticut a couple of times a year to check in and visit family as well.”

Being semi-retired gives Dan plenty of time for his favorite warm-weather activities, especially gol� ng. He typi-cally plays at least three times a week, but toward the end of last year, increas-ing back pain put a stop to his regular tee times.

“I’ve had a bad back for 10, 12 years,” Dan recalls. “It all started when I hyperex-tended a muscle being stupid about lifting. After that, I started getting muscle spasms, and my back tightened up more and more as I got older. It was solely a soft tissue injury. � ere were no discs involved. But my back muscles were hard as a rock.

“It really got my attention a few months ago when I started having trou-ble golfing. When the muscle spasms � rst started, I took a few days o� . � en I golfed again and was all right for a few days. But the spasms returned, and even-tually, I couldn’t golf at all.

“Then on Christmas morning, I got really bad muscle spasms. I did the usual, used ice and muscle relaxants, which helped, but the pain came back after four or � ve days. � at’s when a friend told me about Dr. Johnson.”

Dr. Johnson is Je� rey P. Johnson, DC, of Johnson Medical Center in Venice. He specializes in a unique treatment protocol for back and neck pain called Sedative Stretching, which is an expanded and comprehensive form of Manipulation Under Anesthesia, or MUA. Dr. Johnson performed a thor-ough evaluation of Dan’s back and reported his � ndings.

“When Dan arrived at our office, his chief complaint was lower back spasms that became debilitating,” Dr. Johnson acknowledges. “He described his back pain as deep and numb with shooting spasms. His back was also stiff and tight. He rated the pain as a nine on a scale of one to 10. Because he likes many physical activi-ties, including dirt bike riding, surfing and golfing, he was a good candidate for Sedative Stretching.”

Before moving to Sedative Stretching, Dr. Johnson typically cares for his patients in a more traditional manner using chi-ropractic treatments and physical therapy. � at was true for Dan as well, but before long, Dan’s symptoms intensi� ed.

“After about two weeks, the back spasms became excruciating, debilitating,”

Stretching protocol halts back spasms, relieves pain

Advanced Orthopedic CenterPhenomenal Results

Physician Partners of AmericaPair Up

Sarasota Foot and Ankle Center Case in Pointe

FHCN Special ReportGaming: Medical

Disorder or Not?

Advanced RejuvenationMedical Breakthroughs

Natural Healing Arts Medical Center

Wave Goodbye to Erectile Dysfunction

Venetian Dental

6Alternative LINX

Secure Foundations

Skin Deep

20,000 Documented Eye Floater Laser Sessions

3David A.

Napoliello, MD, FACS

9Vein

Specialists

South Florida

Eye Clinic

12

Sedative Stretching

L ike a lot of young college stu-dents, Davis* spent his early 20s burning the candle at both ends. He didn’t have much of a

choice. Forced to pay for school himself, Davis chose to work his way through col-lege instead of leaning on student loans.

“I had a part-time job working about 30 hours a week at a shoe store, and I was taking a full load of classes,” Davis explains. “As you might guess, I didn’t get much sleep back then. But when you’re young, you don’t necessarily need a lot of sleep. Or so I thought.”

Davis maintained his hectic pace without issue for about two years. � en, about midway through his junior year, he began to feel sluggish. When the prob-lem persisted, he visited a doctor who told him the cause of his fatigue wasn’t his schedule, it was low testosterone.

“� e doctor told me to exercise more and eat better and that would probably take care of it,” Davis says. “And it did – for a while. A couple years later, I had the same problem again. � is time, the doctor put me on a testosterone booster.

“I’ve been taking that ever since, and for 25 years, all through my marriage, I never had another problem. � en about a year or two after my divorce, another problem developed. It wasn’t fatigue. It was erectile dysfunction.”

Erectile dysfunction is the inability to develop and maintain an erection, which is a condition far more common than many realize. In fact, studies show that some form of erectile dysfunc-tion affects more than half of all men during their lifetime.

The likelihood of a dysfunctional episode is even greater among men suf-fering from hypertension, diabetes and cardiovascular disease. Smoking and the heavy consumption of alcohol and/or drugs (either illicit or prescription) can also cause erectile dysfunction.

Another cause of erectile dysfunc-tion is low testosterone. When Davis � rst experienced it, he naturally thought that was the cause of his struggle. He soon learned the problem was not a lack of tes-tosterone but a lack of su� cient blood � ow to the penis.

DAVID S. ZAMIKOFF, DC

Find them on the web at myo� ceinfo.com and on Facebook at Natural Healing Arts Medical Center

“For the past several years, I’ve been seeing a different doctor, and when I went to see him for this, he told me the blood vessels in my penis were clogged,” Davis recalls. “That was the bad news. The good news was he had something that could fix it.”

The cause of Davis’ erectile dys-function is one that doctors have treated most often with oral medications such as VIAGRA®, CIALIS® and LEVITRA®, all of which can deliver the desired results. So, too, can some surgical procedures.

But there is now a far more prom-ising, nonsurgical, drug-free treatment for erectile dysfunction that many doc-tors, including Davis’ doctor, David S. Zamiko� , DC, of Natural Healing Arts Medical Center in Bradenton, prefer.

Root CauseThe treatment is called GAINSWave® therapy, and it has become the choice of many doctors instead of medica-tions because unlike medications, it addresses the root cause of erectile dysfunction, or ED, which is often a lack of proper blood flow to the penis.

“Of the millions of men who strug-gle to achieve a natural erectile response, approximately 80 percent do so because of poor circulatory issues in which the tiny capil laries in the penis and urogenital area are impaired,” Dr. Za m i k o f f educates.

“The likeli-hood of that kind of impairment inc rea se s d ra -matically as men age and plaque builds up in the blood vessels, but oral medications cannot remove the p laque or open those com-promised blood vessels to allow for a more regular � ow of blood to the penis.

“� e one treatment that can do all that and much more is GAINSWave therapy, which is based on the same tech-nology that’s used to break up kidney stones, meaning it uses sound wave tech-nology to do the job.”

Referred to clinically as extracor-poreal shock wave therapy, or ESWT, GAINSWave uses rapid pulses of high-

frequency acoustic sound waves to break up the plaque and calcium that have built up inside old or damaged blood vessels.

� e result is an increase in blood � ow through the existing, rejuvenated blood vessels, the creation of new blood vessels and the creation of new nerve tissue that improves sensitivity in the penis, which then improves the quality of the erection.

“It’s the newest and most promising treatment yet for ED,” Dr. Zamiko� says of the FDA-approved GAINSWave proce-dure, which has been used as a treatment option in Europe for more than 15 years and was approved for use in the United States in 2015.

GAINSWave can also be used to treat Peyronie’s disease, which is what occurs when scar tissue builds up in the penis and causes an abnormal bend or curvature to the penis that can impede urination and/or ejaculation.

“ By m a k i n g certain adjustments to the machine’s settings, we can treat fibrous tis-sue the same way we t re a t b lood vessels and break down the scar tissue that may be causing the irregular shape,” Dr. Zamiko� states. “The result is a straighter, pain-free erection.”

Using a hand-h e l d d e v i c e , GAINSWave treat-ments are performed in th e doc to r ’s o� ce, where a single

treatment lasts about 30 minutes. A full course of therapy generally consists of six sessions performed twice a week over the course of three weeks.

“� e response in many cases is almost immediate,” Dr. Zamiko� enthuses. “In fact, most patients begin to experience a noticeable di� erence in the quality of their erections as well as an improvement in sex-ual performance after just one treatment.

“Another advantage we’ve found is that there are no side e� ects associated with this treatment. Nor is there any downtime for the patient. Once the pro-cedure is over, the patient can walk out of the o� ce and return to normal activities.”

Remarkable ResultsThe success rate associated with the GAINSWave technology is exceptional as well. One study performed in Europe discovered that the benefits of a single, 12-treatment course of GAINSWave ther-apy can last for as long as two years.

Dr. Zamiko� says that more than a year of continuous bene� ts is the norm for most patients. He also notes that while it’s not necessary, some patients choose to return for once-a-month “maintenance treatments” to ensure sustained bene� ts.

“� is really is the wave of the future for ED treatment because for someone who is young without any medical prob-lems, the success rate is nearly 100 percent,” Dr. Zamikoff adds. “And overall, the success rate is about 75 percent.”

Davis is among those who reported positive results. He says that after just four treatments, he and his girlfriend of about a year both noticed a signi� cant difference in the strength and length of his erections as well as his ability to maintain them.

“Now, I have no trouble getting an erection at all,” Davis reports. “I’m even waking up with an erection every morning. It had been a while since that happened, so I’m doing really well for a 69-year-old guy.

“And that’s all thanks to Dr. Zamiko� . I’ve been with him now for almost 10 years, and I pretty much go to him for all my med-ical problems because he stays current on all the latest technology.

“� at is why I so highly recommend him. He’s on top of everything, he has a great sta� that helps him, and everyone there is very nice and professional. You won’t go wrong with Dr. Zamiko� and the sta� at Natural Healing Arts. I can promise you that.”FHCN article by Roy Cummings. Graphic courtesy of

GAINSWave. mkb *Patient’s name withheld at his request.

The Art of HealingNatural Healing Arts Medical Center is a multidisciplinary offi ce that takes a multi-doctor approach to healing and off ers chiropractic care, massage, physical therapy, acupuncture and medical services provided by an emergency medicine doctor and nurse practitioner. For more information call or visit their offi ce in Bradenton at:

2215 59th St. West

(941) 761-4994

David S. Zamikoff, DC, is a board-certified chiropractor with more than 20 years of experience. He graduated from the Cleveland Chiropractic College in Los Angeles in 1998 and is licensed nationally and at the state level. Dr. Zamikoff holds certification in operating room proto-cols and Manipulation Under Anesthesia by the American Academy of Manual and Physical Medicine. Dr. Zamikoff also holds a diplomate degree from the American Academy of Trauma Professionals and is the director of the Florida Chiropractic Association for Southwest Florida.

Page 2 | Florida Health Care News | Spring 2020 | South Sarasota County Edition erectile dySfunction

DAVID A. NAPOLIELLO, MD, FACS

For more information, please visit www.DavidNapolielloMD.com

LEARN MORE

Dr. Napoliello and his staff look for ward to answering your questions. For more information or to schedule an appointment, call the number below or visit them at one of their two o� ce locations:

Lakewood RanchMedical Offi ce Building 1

8340 Lakewood Ranch Blvd.Suite 101

Venice411 Commercial Ct.

(941) 388-9525

David A. Napoliello, MD, FACS, is board cer-tifi ed by the American Board of Surgery and is a Fellow of the American College of Surgeons. He earned his undergraduate degree at Bucknell University, Lewisburg, PA, and his medical degree at Georgetown University School of Medicine. Dr. Napoliello completed his residency in general surgery at Penn State–Geisinger Medical Center, Danville, and a Fellowship in Minimally Invasive and Advanced Laparoscopic Surgery at Mayo

Clinic Jacksonville. He is past chief of surgery for Venice

Hospital and Lakewood Ranch Medical Center. In addition, Dr. Napoliello was voted one of the top general surgeons in

Sarasota and Manatee Counties by his peers

and patients for the Castle Connolly list of America’s

Top Doctors ten years in a row.

Minimally invasive technique resolves acid re� ux disease

T he misery often starts with a burning sensation behind the breastbone that radiates to the neck and throat. In addi-

tion to this pain, known as heartburn, there may be nausea, regurgitation, bad breath and, eventually, tooth decay. These are some of the telltale signs of a common condition known as gastroesophageal re� ux disease, or GERD.

The term gastroesophageal refers to the stomach (gastro) and the esophagus, or food pipe. � e esophagus empties into the stomach through a circular band of muscle called the lower esophageal sphincter (LES). If the LES doesn’t open and close properly, digestive acids from the stomach can � ow back into the esophagus and cause symptoms.

“When this backflow of stomach acids happens persistently, the condition is diagnosed as GERD,” explains David A. Napoliello, MD, who is board-certi� ed by the American Board of Surgery and is a Fellow of the American College of Surgeons. “Over time, GERD can damage the esoph-agus and lead to serious complications.”

Among these complications are esoph-agitis, or in� ammation of the esophagus; and stricture, a narrowing of the esophagus due to scar tissue from acid erosion. Other complications include the formation of ulcers in the esophagus and the develop-ment of precancerous changes in the tissue, a condition called Barrett’s esophagus.

Being obese or pregnant, smoking, overeating, eating late at night, eating certain foods, such as fried or fatty foods, drinking alcohol or coffee, and taking certain medications, including aspirin, can contribute to the weakening of the LES and the development of GERD. Another factor associated with GERD is hiatal hernia.

“There is a natural space in the diaphragm, the thin muscle wall that sepa-rates the chest cavity from the abdomen, that allows the esophagus to pass through to the stomach. It’s called the hiatus,” Dr. Napoliello educates. “� e hiatus can become abnormally large from actions

such as years of coughing or straining. � e stomach can inappropriately slip upward into the chest cavity though that enlarged hiatus. � at is a hiatal hernia.

“� e normal position of the stomach is a major force in reflux manage-ment. When the stomach and its connection to the esophagus are in the wrong anatomical position, the proper food depositing mechanism is broken. � is

contributes signi� cantly to the heartburn and regurgitation associated with GERD.”

With GERD and hiatal hernia, people can experience all of the usual symptoms of GERD and also suffer addit ional symptoms attr ibuted to hiatal hernia. These can include di� culty swallowing and respiratory issues such as chronic coughing and asthma-like symptoms.

LINX

hernia. He is a specially trained re� ux surgeon who completed a fellowship in minimally invasive and advanced laparoscopic surgery at the world-famous Mayo Clinic.

“During the combined GERD/hiatal hernia surgery, we begin by repairing the hiatal hernia,” Dr. Napoliello states. “� at involves � rst putting the stomach back into its appropriate position. � en we sew the defect in the diaphragm closed with or without the use of a biologic mesh patch. After that, we pursue the anti-re� ux procedure.

“� ere has been classically one type of anti-re� ux surgery, called Nissen fundo-plication, during which the surgeon wraps the upper portion of the stomach around

lower part of the esophagus breaks that bond and allows food to pass from the esophagus into the stomach. After that, the magnetic bond quickly reforms, which resists gastric pressures and prevents acids from � owing backward.”

Surgery to install a LINX Reflux Management System can be done as an outpatient procedure or with an over-night stay in the hospital. A standalone LINX procedure takes about one hour to perform. When done as a GERD/hiatal hernia repair, surgery time is slightly longer, about an hour and a half. � e LINX device can be removed or replaced if necessary.

“The LINX device was developed by pioneers in re� ux surgery and studied for more than 10 years,” Dr. Napoliello reports. “� e LINX Re� ux Management System is a safer choice for people whose GERD has not responded to medications, and surgery is the next step in treatment.”

� e LINX technique is also a good option for those who are concerned about the risks and side effects of long-term medication use to manage their GERD symptoms, adds the doctor.

“� ere have been reports recently ques-tioning the standard medical management of GERD, especially the use of proton pump inhibitors,” Dr. Napoliello observes. Proton pump inhibitors are a group of medications that stop production of a protein in the stomach that is necessary for acid secretion.

“� ese medications have been linked to decreased calcium and magnesium, stomach tumors, blood clots and even the development of dementia. Patients who have concerns about these risks now have an answer for treatment of their GERD. It is the less invasive surgery using the LINX device.

“The LINX Reflux Management System is a simpler, more readily revers-ible option that can provide signi� cant GERD relief. The LINX procedure is excellent for GERD, especially for GERD in combination with hiatal hernia.”FHCN article by Patti DiPanfilo. LINX graphics courtesy of Torax. mkb

Anti-Refl ux AvenuesPeople can have GERD without having a hiatal hernia and a hiatal hernia without having GERD, but in most instances, people with hiatal hernia also have GERD. � ey generally co-exist. In some cases of simple hiatal hernia, there may be no symptoms, but symptomatic patients are treated with medication or surgery, Dr. Napoliello notes.

“� ere is a type of hiatal hernia called a paraesophageal hiatal hernia that is dangerous because with it the stomach can get constricted and its blood supply can get cut o� ,” he informs. “With that type of hiatal hernia, surgery is indi-cated upon diagnosis.”

When surgery for GERD with hiatal hernia is warranted, Dr. Napoliello can typically treat both conditions during one surgical session. He performs most of these combined procedures as laparoscopic surgeries with the patients under general anesthesia. Laparoscopic surgery is a minimally invasive technique that uses thin instruments and a camera inserted into the abdomen through tiny incisions. The surgeons view the esophagus, hiatal hernia and surrounding tissue on a video screen.

Fortunately, Dr. Napoliello has expertise in surgically treating GERD with hiatal

the esophagus. � is adds pressure to the LES and lower end of the esophagus. � is procedure, although tried and tested, has some rare pitfalls that would favor a simpler intervention.”

Now, however, there is an option for GERD treatment that is less invasive and proving to be equal, if not more e� ective than fundoplication in reducing GERD symptoms. � is technique uses a re� ux-preventing device called the LINX

Re� ux Management System.

Magnetic Mastery� e LINX system is a drug-free treatment for patients who continue to experience signi� cant GERD symp-toms despite conservative

treatments such as lifestyle changes and acid-suppressing

medications. � e LINX proce-dure is considerably less invasive than

fundoplication because it doesn’t require any surgical changes to the anatomy.

“� e LINX device is a small, � exible, circular band of interlinked magnetic beads made of titanium,” Dr. Napoliello describes. “� e device is placed around the base of the esophagus, and it essentially acts as a new, arti� cial lower esophageal sphincter.

“� e beads in the device form a strong magnetic bond, which holds this arti� cial LES tightly closed. When patients swallow, the movement of food passing through the

LINX DEVICE CLOSED ALLOWING FOOD TO PASS

South Sarasota County Edition | Spring 2020 | Florida Health Care News | Page 3MiniMally invaSive general Surgery

Je� rey P. Johnson, DC, is a member of the National Academy of Manipulation Under Anesthesia Physicians and has performed more than 1,000 procedures to date. He is also a graduate of Life Chiropractic University in Marietta, GA, with additional training through the National College of Chiropractic in Chicago. His training included: Manipulation Under Anesthesia, proprietary substances and chiropractic adjunctive physiotherapy.

He earned his undergraduate degree from the University of South Florida in Tampa. Dr. Johnson holds certifi cation from the National Board of Chiropractic Examiners and is a

member of the American Chiropractic Association, the Florida Chiropractic Association, the American Board of Disability Analysts, and other professional and civic organi-zations. He has been in private practice since 1986.

For more information, please visit www.DRJPJ.com

“I started gol� ng again just 12 days after my

Sedative Stretching procedure”

Dan remembers. “I couldn’t walk, I couldn’t move. I’ve never experienced that much pain before. I couldn’t take a step without feeling like someone was stabbing me in the back. My wife wanted to take me to the emer-gency room, but I said, No, let’s try Dr. Johnson � rst.

“I went to Dr. Johnson on a Tuesday, and he was able to loosen me up and calm the spasms a little, then he sched-uled me for Sedative Stretching on the upcoming � ursday. He performed the procedure at the end of January. It was nothing short of miraculous.”

Stiff and SoreSedative Stretching can bene� t many people with painful mus-cle and joint conditions. Ideal candidates are those with con-ditions such as unresolved neck and back pain, herniated discs, spinal stenosis, sciatica, frozen shoulder, acute and chronic mus-cle spasm, headaches and failed back surgery syndrome. � e proce-dure can also bene� t people who want to regain lost � exibility or those who are “sick and tired of being sti� and sore.”

“ I t ’s b e s t f o r p e o -ple to address the cause of their condition as early a s t h e y p o s s i b l y c a n ,” Dr. Johnson points out. “� e chronic sti� ness, tightness and pain cause excessive wear and tear on the joints of the spine and extremities, resulting in permanent degeneration and arthritis.

“People start losing � exibil-ity after minor injuries incurred during their typical daily activi-ties result in chronic, low-grade in� ammation. Many times, this occurs in early childhood and is a long-forgotten event. But over time, these injuries develop into severe and sometimes debilitat-ing conditions.”

Inflammation is part of the body’s natural healing pro-cess during which a mesh of connective tissue, commonly known as scar tissue, is laid down. Over time, layer upon layer of scar tissue can form in the muscles, tendons and ligaments around the joints, restricting the joints’ ability to move properly. � ese layers of scar tissue are called adhesions.

� e symptoms and warning signs generally associated with adhesions include the slow and insidious loss of flexibility, as well as an increasing achiness and soreness. Most people will attri-bute this to normal aging. While it’s very common to become sti� and sore with age, it’s not normal.

“People will compensate how they move their bodies when this occurs, although they don’t always realize it,” Dr. Johnson notes. “� is is evident everywhere while watching the way people walk, bend, twist and turn.

“Regrettably, many people wait until significant damage from excessive wear and tear has occurred before seeking appro-priate care. Often, people will utilize over-the-counter and prescriptive medications, which help alleviate their symptoms.

“Unfortunately, this gives the patient a false sense of being cured while the underlying scar tissue continues to cause exces-sive damage.”

Mobilizing JointsDuring Sedative Stretching, the patient is put under light sedation, often called twilight sedation. With the patient relaxed, the a� ected joints are brought through their normal full range of motion, freeing the adhesions that have developed between the joints, causing pain.

“We use light, compre-hensive stretching techniques while the patient is sedated,” Dr. Johnson explains. “Since we don’t have to contend with tense, guarded muscles, we are able to

free up the scar tissue and mobi-lize the joints without causing the patient any discomfort. � is would be impossible to do with-out the use of sedation.”

Coordinating the Sedative Stretching procedure is a highly trained team of medical pro-fessionals. Generally, there are multiple health care providers present, including an anesthe-tist and several nurses. Patients usually require only one proce-dure. It is very rare that patients require a second procedure to fully address their condition.

“By following the recom-mended exercises, patients regain the � exibility they had decades before, and they generally return to activities they haven’t done in years,” Dr. Johnson states. “� is is truly correcting the original cause of their conditions.”

“Instant” ResultsDan’s back muscles were extremely tight as a result of the scar tissue adhesions, so Dr. Johnson had to be very aggressive during his Sedative Stretching. The chiropractor warned Dan that he would likely be sore following the pro-cedure. But Dan was pleasantly surprised to � nd that not only was he hardly sore, he also felt immediate pain relief.

“� e results of my Sedative Stretching procedure were instant,” Dan raves. “All of a sudden, my back spasms were gone and I felt very loose. � e tightness was gone. � e pain was gone. I waited for something to happen, for the pain to return, but it never did.

“Having been restricted in my movements and having gone through what I had, I was kind of afraid to move at � rst. I slowly had to get comfortable bending over and moving again. Now, I can bend like I did 10 years ago.

“I’m doing the follow-up therapy now, which is a three-step process. First, Dr. Johnson exam-ines me and manipulates my lower back and spine, then an assistant does what’s called assisted stretching. � at’s where they stretch me in a way I can’t stretch myself. � en, I get either a laser or electrical stim-ulation treatment.”

Between Sedative Stretching and the follow-up therapy, Dan has recovered su� ciently from his back condition to return to his favorite activities. He recently welcomed the opportunity to get back on the golf course.

“I started gol� ng again just 12 days after my Sedative Stretching procedure,” Dan reports. “I � rst golfed on a Tuesday and then golfed again two days later. And I walked the entire 18 holes. I can work in the yard and walk my dogs without pain as well.”

From the � rst time Dan met Dr. Johnson, he was impressed by the skilled chiropractor.

“Dr. Johnson is a very thor-ough, honest, straightforward guy,” Dan describes. “He earned my con� dence because he knows what he’s doing and solves prob-lems. I’ve recommended him and his Sedative Stretching four or � ve times already. � e procedure took 10 years o� of my back.”FHCN article by Patti DiPanfilo. Photos by

Jordan Pysz. nj

- Dan

Stop the PainFor a consultation

appointment, please contact Johnson Medical Center,

located in Venice at:

401 Johnson Ln., Suite 101

(941) 484-5333

(continued from page 1)

Page 4 | Florida Health Care News | Spring 2020 | South Sarasota County Edition

Barry LevineExecutive Publisher

Gina L. d’AngeloCFO/HR

Roy CummingsEditorial Supervisor

Michelle BrooksCreative Director

Brian LevineProject Coordinator

Patti DiPanfiloLaura EngelEditorial Staff

Laura EngelProduction Assistant

Nerissa JohnsonGraphic Designer

Nerissa JohnsonJordan PyszPhotography

Dominic Donnell Aldy Laracuente

Bob Mize Gary Smith Steve TurkDistribution

Johnson Medical CenterSedative Stretching

Natural Healing Arts Medical CenterErectile Dysfunction

David A. Napoliello, MD, FACSMinimally Invasive General Surgery

Advanced RejuvenationRegenerative Medicine

Venetian Dental General, Cosmetic & Emergency Dentistry

Sarasota Foot and Ankle Center Podiatry

Vein Specialists Vascular Surgery

Physician Partners of AmericaLaser Spine Surgery

Advanced Orthopedic CenterOrthopedic Surgery &

Sports Medicine

South Florida Eye ClinicEye Floater Treatment

215 Bullard ParkwayTemple Terrace, FL 33617

(813) 989-1330

Florida Health Care News

Florida Health Care News is published by Florida Health Care News, Inc.

Florida Health Care News, Inc., reserves the right to decline any advertising/marketing article.

Florida Health Care News is provided for information only and should not be construed as health care advice or instruction. If you have questions concerning articles in this edition, feel free to call our contributing editors.

Florida Health Care News provides a paid forum for health care professionals to present their ideas about various aspects of health care treatment and proce-dures. Florida Health Care News, Inc. is not responsible for the health care delivered by the contributing editors presented in this edition.

Articles reflect the opinion of the sponsoring profes-sional or organization and do not necessarily reflect the opinions of other contributing editors. Contributing editors have approved all text contained within their respective articles.

© 2020 Florida Health Care News, Inc. All rights reserved. The contents of this publication, including articles, may not be reproduced in any form without written permission from the publisher.

FOR ALL health care professionals having

articles in this publication: THE PATIENT AND ANY OTHER PERSON

RESPONSIBLE FOR PAYMENT HAS THE RIGHT TO REFUSE TO PAY, CANCEL PAYMENT OR BE

REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION OR TREATMENT WHICH IS

PERFORMED AS A RESULT OF, AND WITHIN 72 HOURS OF RESPONDING TO, THE ADVERTISEMENT FOR A FREE,

DISCOUNTED OR REDUCED FEE SERVICE, EXAMINATION OR TREATMENT.

All stock imagery that is not marked otherwise is courtesy of istockphoto.com,

Cleanpng.com or pixabay.

Sedative Stretching

Je� rey Sack, M.D., FACC, FCCP, FACA, FASA, FISCI, is a board-certifi ed cardiologist specializing in conservative regenerative cardiology using hyperbaric oxygen, ozone therapy, NAD, vitamin infusions, chelation therapy, stem cells, exosomes and growth factors. These modalities are designed to stimulate the cardio and vascular

system to repair itself. Dr. Sack is working with Advanced Rejuvenation to introduce leading-edge therapies to stimulate the body to recover from heart attack, stroke and peripheral vascular disease.

John Lieurance, DC, RMA, DACNB (board eligible), received his Doctor of Chiropractic degree from Parker College of Chiropractic and his Doctor of Naturopathic degree through St. Luke’s Medical School. He is also a board-eligible chiropractic neurologist through the Carrick Institute of Neurology and a registered medical assistant. Dr. Lieurance is trained in advanced ultrasound techniques through the Gulf Coast Ultrasound Institute. He has practiced alternative and regenerative medicine in Sarasota for the past 25 years.

JEFFREY SACK, MDJOHN LIEURANCE, DC, RMA, DACNB

(BOARD ELIGIBLE)

With Dr. Lieurance (right) by his side,

Je� � nds healing in the CVAC, a pod that

super oxygenates the body and improves

circulation following stem cell therapy.

W hen the list of the biggest earners in network marketing for 2018 came out two years ago, Jeff

Roberti’s name was right there in the mix at ninth overall. � at didn’t come as any great surprise to network marketing insiders.

With more than $85 million in career sales of a whole food supplement product, Jeff is considered a network marketing icon, one who has turned his product into one of the most researched supplements in the world.

“More than 30 years ago, I intro-duced the doctor who had the technology for this product to the manufacturer,” Je� says. “Since then, I’ve become their top rep in the � eld and built distributorships for it in 25 countries.”

In February 2019, serving customers became a bit of a challenge for Je� . A car accident left the 58-year-old entrepreneur with a wrenched back that resulted in a trip to a hospital emergency room, where Je� found little or no relief.

“All they do at the ER, of course, is treat you and street you, so that didn’t do me any good,” Je� reports. “� en the pain started to spread. It went into my right hip and leg. � at’s when I decided to visit Dr. Lieurance at Advanced Rejuvenation.”

Dr. John Lieurance is a board-eligible chiropractic neurologist who has been practicing alternative and regenerative medicine for 25 years. Most of that time has been spent at a Sarasota-based clinic called Advanced Rejuvenation.

State-of-the-Art ClinicA state-of-the-art wellness clinic, Advanced Rejuvenation employs a highly trained team of physicians who specialize in regenerative injection treatments that are considered to be at the forefront of nonsurgical regenerative therapy.

“What we have here is an incredibly powerful group of healers,” Dr. Lieurance says. “� at group includes Dr. Je� Sack, (MD), Dr. Ron Bramson, (DPM), acupuncturist Dr. Alex Smithers, (DOM), Sue Gonzalez, (RN) and Beth Moran, (ARNP), and they all do fabulous work.”

� e injection of stem cells and growth factors, which can be used to regenerate virtually every joint in the body as well as soft tissue, are Advanced Rejuvenation’s signature treatments, but the staff there went beyond using stem cells in treating Je� .

“When Jeff came in, he was in so much pain, he was on crutches,” Dr. Lieurance states. “We evaluated him and discovered the problem wasn’t with his lower back at all. It was his hip.”

A series of tests confirmed the doctor’s belief and prompted him to begin treating Je� with a combination of exosomes and a derivative of platelet-rich plasma known as honey matrix.

Exosomes are the active interior bits that give stem cells their healing e� ect, Dr. Lieurance educates. Platelet-rich plasma, or PRP, is a concentrated source of blood plasma that contains several growth factors and a protein called cytokines.

“� e honey matrix is a more e� ective form of PRP,” Dr. Lieurance notes. “It has more anti-in� ammatory cytokines and more sca� olding material, which is what is needed to hold the position and the space of the tissue we’re repairing.

“Once we have the mixture of exosomes and the honey matrix, we photoactivate it with a special German technology called LumoStem. LumoStem allows us to send a laser through a catheter that energizes the mixture. It’s real next-level stu� that works really well.”

It worked really well for Je� . Within a week, the combination of exosomes and PRP had alleviated Je� ’s back, hip and leg pain, which got him “back to 100 percent.” Je� ’s treatment didn’t end there, though.

In an e� ort to help him keep pace with his busy schedule and active lifestyle, Je� has since delved into a few other treatments at Advanced Rejuvenation, including two that are designed to reinvigorate the body.

Feeling Younger “Je� is a guy who travels a lot, speaks a lot and trains a lot,” Dr. Lieurance says. “To keep his body in peak condition, he likes to do anti-aging treatments. We’ve been doing something with him called 10-pass hyperbaric ozone treatments.”

Ozone is a fast-acting super oxygen. When mixed with blood that is drawn and reinfused into a patient, it can cleanse the blood by killing bacteria, viruses and parasites, improve oxygen utilization throughout the body and enhance energy production.

As its name suggests, the blood draw and infusion process is done 10 times. � at allows for a greater amount of ozone to be delivered to the body in a shorter period of time, which allows the ozone to better saturate the red blood cells and penetrate deeper areas of the body.

“10-pass hyperbaric ozone really ramps up something called mitochondrial function, which is the ability to make

energy from oxygen and glucose, and that is something we all need to do,” Dr. Lieurance states.

“When the immune system starts to fail, you can get a lot of di� erent diseases, fatigue and brain fog at a basic level, and down the road, you get autoimmune conditions, cancer and chronic in� am-matory conditions that are all rooted in mitochondrial dysfunction.

“But this 10-pass treatment is one of the most powerful mitochondrial stimulators. It makes patients feel younger, more robust and it helps them get more restful sleep. It also makes their joints feel better because there’s less in� ammation in the body.

“The other thing we’ve been doing with Je� is we’ve had him spending time in a CVAC, which stands for cyclic variation in adaptive conditioning. It’s a pod you get into, and it closes up like an egg, but there’s a big window that you can look out from.

“What the CVAC does is force a pressure change similar to what you experience when you’re in an airplane that goes up and down. � at drastic pressure change deeply detoxi� es and cleanses the body. It also triggers gene expression in all the cells that simulate exercise.

“What you get is all the improvement you would expect to see from exercise at the cellular level with the CVAC, and we’ve been using the combination of that and the 10-pass with Je� , who says he feels like he’s in his 20s again.”

“I’m 58 years old, and I feel like I’m 27,” Je� con� rms. “And it’s all because of Dr. Lieurance and his medical sta�

working their magic in this world-class facility where the treatments they o� er are so unique and diverse.

“It’s truly state-of-the-art, leading-edge stu� that they o� er here. Like the pod. I’d never heard about that before, but once I tried it, I couldn’t believe how amazing I felt afterward. It’s really incredible what you get out of it.

“Again, this place is extremely diverse. I’m fortunate that I live in Sarasota and am right there, but I can see why people come from all over the world to get some of the treatments they o� er at Advanced Rejuvenation.

“On a scale of one to 10, I’d give the place a rating of 1,000. It’s really spectacular, and I couldn’t be happier with what it’s done for me. I’m a raving fan-customer, and I highly, highly recommend it.”FHCN article by Roy Cummings. Photo by Jordan Pysz.

For Health and Comfort

The staff of Advanced Rejuvenation looks forward to meeting the readers of Florida Health Care News. To learn more about hyperbaric oxygen therapy, exosome and LumoStem Activation or other regenerative options, contact the holistic health and chiropractic center. Their offi ce is located in Sarasota at:

2033 Wood St., Suite 210

(941) 330-8553To learn more about all the treatments available at Advanced Rejuvenation, visit them on the internet at advancedrejuvenation.us

South Sarasota County Edition | Spring 2020 | Florida Health Care News | Page 5regenerative Medicine

Please visit Dr. Gaukhman’s website at www.VenetianDentalCare.com

• Dental implants• Extraction of

teeth• Crowns• Deep cleaning

• Bleaching• ZOOM!®

whitening• Root canals• Laser surgery

• Invisalign®• Dentures• Partials• Bridges

Venetian Dental specializes in all aspects of dentistry, including but not limited to:

Venetian Dental Services

ALEXANDER GAUKHMAN, DMD

Implant denture advantages over traditional lower dentures

Alexander Gaukhman, DMD, earned his den-tal degree at Nova Southeastern University College of Dentistry, Ft. Lauderdale. He com-pleted his undergraduate studies at Florida Atlantic University, Boca Raton. Dr. Gaukhman

is a diplomate of the International Congress of Oral Implantologists and a member of the American Academy of Implant Dentistry, Academy of General Dentistry,

Florida Dental Association, Sarasota Dental Association and

American Dental Association.

Peter says he made the right choice in choosing Venetian Dental.

Donna is thrilled with

her new smile.

infection also a� ected his bone. Peter’s teeth were not worth saving, so I recommended extracting them and replacing them with a lower denture secured by dental implants.”

“Dr. Gaukhman told me it wasn’t healthy for my teeth to be in the condition they were in and that, because of their poor condition, there wasn’t much he could do with them,” Peter recalls. “He recommended removing them and doing the implants and denture. At that time, I already had an upper denture for going on 15 years.”

Not Designed for DenturesDentures are often used to replace natural teeth that are lost due to tooth decay, gum disease, infection or injury. In most cases, upper dentures � t securely because the palate enables the creation of su� cient suction to hold the appliance in place. � at was the case with Peter, whose upper denture � ts just � ne and does not wobble or move.

“Lower dentures are often more difficult to stabilize,” Dr. Gaukhman observes. “� e lower jaw is not designed for dentures because there is no palate, due to the location of the tongue, and less suction is produced. As a result, lower dentures tend to slip and slide.

“It is rare when people can wear lower dentures that do not bother them or stay tight without help. � at is why securing a lower denture with dental implants is the most e� ective way to stabilize it and why I recommended two implants to secure Peter’s lower denture.”

Dental implants are screw-like posts that are surgi-cally placed into the jawbone to serve as the foundation for replacement teeth, such as crowns and dentures. When secured by implants, dentures don’t slip or move; they stay in place when people speak and eat. � ere are other advantages of implant dentures over traditional dentures.

Dentures secured by implants have stronger chewing capability than tradi-tional dentures, so patients can eat foods they could not eat previously, improving their quality of life. In addition, the added stability provided by implant dentures o� ers patients better speech, better aesthetics and greater self-con� dence.

Implants are made of a titanium alloy that fuses with the patient’s jawbone to become

a solid unit. For most patients at Venetian Dental, implants are placed on the day of tooth extraction. Temporary dentures are also created at that time, typically at Venetian Dental’s in-house dental laboratory.

“ I n g e n e r a l , once the patient’s problem is diagnosed and the treatment is determined, I take impressions of their teeth,” Dr. Gaukhman informs. “When the temporary dentures are ready, which is usually on the same day or the next day, I extract the teeth and put the dentures in right away.

“� e dentures act as a bandage to stop bleeding and limit swelling, and for the next three to six months, I keep the patients in temporary dentures until the implants fuse and the gums heal. � en, I replace the temporary dentures with the permanent appliances. Using temporary dentures means patients are never toothless while waiting for their � nished dentures. All in all, it is a relatively easy, painless process.”

Quality of LifeTo be � t with dental implants, patients must have su� cient bone mass in their jaw to hold the implants securely. But bone mass can become depleted when teeth are missing because there is no longer pressure on the

jaw from chewing to keep it actively building new bone.

For patients with depleted bone, Dr. Gaukhman has two options. One is to use mini implants, which are smaller in diameter than standard implants, to secure the lower dentures. The other is to perform a bone graft, which is what he did for Peter.

“� e advantage of using mini implants is that the

patient heals faster, so treatment can be � nished quicker,” Dr. Gaukhman relates. “In addition, we can use mini implants in patients who are medically compromised.

“Implant-retained lower dentures are generally secured with two implants,” Dr. Gaukhman adds. “When we secure upper dentures with implants, which we recommend in certain cases, we typically use four implants because they have to work against gravity.”

Implant dentures can be fabricated to � t one of two ways: to be � xed or removable.

� ere are pros and cons to both options, Dr. Gaukhman states.

“Removable dentures snap on and o� the implants,” he describes. “� ey can

be made and � t rela-tively quickly. The patient can remove the teeth, clean them with a toothbrush and put them back in the mouth within minutes. They are easier to maintain

than � xed dentures. I made a removable denture for Peter.

“Fixed dentures, on the other hand, stay in the mouth at all times. � ey take much longer to fabricate and are harder to clean. � ey must be cleaned by professionals. But because they can only be removed by a dentist, they are more secure.”

Adjustment Period� e process of restoring Peter’s lower jaw began in September, and by February, he had his permanent lower denture. He recently went to Venetian Dental to receive a slight adjustment to the denture so it � ts as comfortably as possible.

“It takes some time for the denture to settle into the gums,” Peter states. “When it was � rst � t, it rubbed a little, so I went back to Venetian Dental and Dr. Gaukhman adjusted it, and the rubbing went away. Now, I just snap it into place and I’m good to go.

“I’m very happy with my new lower denture. It’s a lot better than a denture without implants. One of the best things about it is that, with this denture, I’m not afraid to smile, because there are no more gaps in my teeth.

“Before, I made the most I could of my smile. I always thought, It is what it is. But now, I don’t even think about not smiling. And my wife is quite happy with the way the denture looks, too. She says it’s a de� nite improvement over what I had, and I’m a lot nicer to look at.”

Tropical ParadiseDonna Kiehl and her husband built a successful nursery business from a collec-tion of bromeliads just large enough to � ll a kitchen table. Today, they � ll orders for the tropical � owering plant from all over the world via mail order and sell them from a store on the couple’s Venice property.

“We’ve been selling bromeliads and other tropical plants for about 35 years

total,” Donna shares. “We started the busi-ness in St. Petersburg but moved it to Venice when we went there to purchase a bromeliad collection. As it turned out, the property in Venice was also for sale, and we ended up buying it as well.

“It all started because my husband has had a love for bromeliads since he was young. He saw one on his parents’ property and was fascinated with the plant and its bloom. He researched bromeliads and how to grow them, then started collecting them.”

Donna, 63, who hails from Warminster, Pennsylvania, about 13 miles north of Philadelphia, relo-cated to Florida when she was 12. As an adult, Donna was diagnosed with Sjögren’s syndrome, an autoimmune condition where the immune system attacks the body’s own cells. � e most common symp-toms of Sjögren’s syndrome are dry eyes and dry mouth. � e dry mouth negatively a� ected Donna’s oral health.

“Because of the dryness in my mouth, my teeth started to go bad, and I started to lose them,” she relates. “That’s pretty much what happens with Sjögren’s. I didn’t have enough saliva to protect my teeth. I was told that, eventually, all of my teeth would go bad.

“My gums were receding as well, and it looked awful. My teeth were turning color, and I hated looking in the mirror and hated smiling because my smile was horrible. So, I looked into getting a dentist who would remove my teeth and give me dentures.

“I received a copy of Florida Health Care News in the mail, and in it were a couple of interviews with people telling their stories about working with Dr. Gaukhman. � at’s how I found him and decided to go to him.”

“Donna came to us believing that her teeth were unhealthy and probably not salvageable,” Dr. Gaukhman remembers. “I con� rmed that it was not worth the time and expense to try to save them. We agreed that the best option was to extract her failing teeth and replace them with dentures. After that, she would not have to worry about her teeth for at least � ve years.”

“Initially, Dr. Gaukhman pulled my upper teeth and made a denture for the top,” Donna recalls. “We did the top in January 2018. We waited to do the bottom because

those teeth weren’t quite ready to come out. But they were starting to turn as well.

“And before long, my bottom teeth began to break. Having no saliva made them go bad sooner than anticipated. But we waited to do the bottom until I got a cavity in the front and it started hurting. � at was in July of last year.

“When Dr. Gaukhman created my bottom denture, he put in the dental implants and � t me with the tempo-rary denture right away. I got my permanent denture in November. I just snapped it in.”

“They Look Awesome”With her treatment completed, Donna relates that she’s thril led with the dentures Dr. Gaukhman created for her at Venetian Dental.

“I love them, absolutely love them,” she raves. “� ey look awesome, and my smile is great. I get compliments all the time on my teeth, my smile and how happy I look now. And the Sjögren’s doesn’t bother the dentures at all.

“My treatment was successful, and I recommend implant dentures to others in situations similar to mine. And I most de� nitely recommend Dr. Gaukhman. In fact, I have already recommended him to a friend who was having issues with her teeth.”

Peter’s treatment was successful as well. He’s extremely pleased with the outcome of his treatment at Venetian Dental. He’s also pleased that the treatment process met his � nancial requirements.

“It came down to what was a� ordable for me,” Peter says. “I could have gotten a full set of implants with an implant for each tooth, but a lower denture with two implants was more a� ordable. I have no regrets.”

Although Peter met Dr. Gaukhman in an emergency situation, he was impressed enough to stay with the dentist to receive his implant treatment and lower denture.

“Dr. Gaukhman and his staff were very good and caring,” he reports. “I’m very happy with the choice I made to go to Venetian Dental. I absolutely recommend them to others with dental needs.”

“I’m very happy with the outcome of my treatment at Venetian Dental,” Donna concurs. “On a scale of one to 10, I would rate my experience a 20!”FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

Peter Benbow, 67, emigrated f r o m h i s

native England to the United States in 1991. He originally settled in Fort Lauderdale but later relocated to Port Charlotte. He moved after retiring from his construction and home remodeling business. � ere were good reasons Peter chose Florida as his new home.

“I decided to move to the States because I was ready for a life change,” he acknowl-edges. “� e weather in Florida was a huge factor in my choice of place to live and, of course, there was no language barrier.

“I spent most of my time in the Fort Lauderdale area, but then it became too over-populated. My wife and I decided we wanted a more quiet and relaxing atmosphere, and Port Charlotte � t that description. Plus, my wife had family here, so we made the move.”

Peter always liked to work with his hands. In England, he labored in the elec-trical and plumbing business, so when he came to the US, it seemed a natural progres-sion for him to move into construction.

“Obviously, I wasn’t going to be doing much work in the heating business in Florida, so my business just morphed into interior remodeling,” Peter describes. “Now, in retirement, I’m doing some remodeling and redecorating of our house in Port Charlotte. � e house was built in 1989, so it’s a little dated and needs some work.”

Having always been self-employed, Peter found health and dental insurance too costly for his bottom-line point of view. As a result, Peter tended to neglect his health, especially his teeth. His neglect caught up to him last September.

“My teeth were de� nitely su� ering,” Peter admits. “� en one day, I woke up with a severe toothache. � e pain was terrible, so my wife said, You’re going to the dentist. She went online to � nd an emergency dentist that would see me and found Dr. Gaukhman. His o� ce was a good 30-mile drive, but he could get me in, so o� we went.”

Alexander Gaukhman, DMD, at Venetian Dental in Venice, o� ers exceptional general, cosmetic and restorative dentistry as well as emergency dentistry. He also has o� ces in Sarasota and Osprey.

“When I first examined Peter, he already had an upper denture,” the dentist reports. “But his lower teeth were decayed and infected by periodontal disease. � e

Page 6 | Florida Health Care News | Spring 2020 | South Sarasota County Edition general, coSMetic & eMergency dentiStry

Please visit Dr. Gaukhman’s website at www.VenetianDentalCare.com

• Dental implants• Extraction of

teeth• Crowns• Deep cleaning

• Bleaching• ZOOM!®

whitening• Root canals• Laser surgery

• Invisalign®• Dentures• Partials• Bridges

Venetian Dental specializes in all aspects of dentistry, including but not limited to:

Venetian Dental Services

ALEXANDER GAUKHMAN, DMD

Implant denture advantages over traditional lower dentures

Alexander Gaukhman, DMD, earned his den-tal degree at Nova Southeastern University College of Dentistry, Ft. Lauderdale. He com-pleted his undergraduate studies at Florida Atlantic University, Boca Raton. Dr. Gaukhman

is a diplomate of the International Congress of Oral Implantologists and a member of the American Academy of Implant Dentistry, Academy of General Dentistry,

Florida Dental Association, Sarasota Dental Association and

American Dental Association.

Peter says he made the right choice in choosing Venetian Dental.

Donna is thrilled with

her new smile.

infection also a� ected his bone. Peter’s teeth were not worth saving, so I recommended extracting them and replacing them with a lower denture secured by dental implants.”

“Dr. Gaukhman told me it wasn’t healthy for my teeth to be in the condition they were in and that, because of their poor condition, there wasn’t much he could do with them,” Peter recalls. “He recommended removing them and doing the implants and denture. At that time, I already had an upper denture for going on 15 years.”

Not Designed for DenturesDentures are often used to replace natural teeth that are lost due to tooth decay, gum disease, infection or injury. In most cases, upper dentures � t securely because the palate enables the creation of su� cient suction to hold the appliance in place. � at was the case with Peter, whose upper denture � ts just � ne and does not wobble or move.

“Lower dentures are often more difficult to stabilize,” Dr. Gaukhman observes. “� e lower jaw is not designed for dentures because there is no palate, due to the location of the tongue, and less suction is produced. As a result, lower dentures tend to slip and slide.

“It is rare when people can wear lower dentures that do not bother them or stay tight without help. � at is why securing a lower denture with dental implants is the most e� ective way to stabilize it and why I recommended two implants to secure Peter’s lower denture.”

Dental implants are screw-like posts that are surgi-cally placed into the jawbone to serve as the foundation for replacement teeth, such as crowns and dentures. When secured by implants, dentures don’t slip or move; they stay in place when people speak and eat. � ere are other advantages of implant dentures over traditional dentures.

Dentures secured by implants have stronger chewing capability than tradi-tional dentures, so patients can eat foods they could not eat previously, improving their quality of life. In addition, the added stability provided by implant dentures o� ers patients better speech, better aesthetics and greater self-con� dence.

Implants are made of a titanium alloy that fuses with the patient’s jawbone to become

a solid unit. For most patients at Venetian Dental, implants are placed on the day of tooth extraction. Temporary dentures are also created at that time, typically at Venetian Dental’s in-house dental laboratory.

“ I n g e n e r a l , once the patient’s problem is diagnosed and the treatment is determined, I take impressions of their teeth,” Dr. Gaukhman informs. “When the temporary dentures are ready, which is usually on the same day or the next day, I extract the teeth and put the dentures in right away.

“� e dentures act as a bandage to stop bleeding and limit swelling, and for the next three to six months, I keep the patients in temporary dentures until the implants fuse and the gums heal. � en, I replace the temporary dentures with the permanent appliances. Using temporary dentures means patients are never toothless while waiting for their � nished dentures. All in all, it is a relatively easy, painless process.”

Quality of LifeTo be � t with dental implants, patients must have su� cient bone mass in their jaw to hold the implants securely. But bone mass can become depleted when teeth are missing because there is no longer pressure on the

jaw from chewing to keep it actively building new bone.

For patients with depleted bone, Dr. Gaukhman has two options. One is to use mini implants, which are smaller in diameter than standard implants, to secure the lower dentures. The other is to perform a bone graft, which is what he did for Peter.

“� e advantage of using mini implants is that the

patient heals faster, so treatment can be � nished quicker,” Dr. Gaukhman relates. “In addition, we can use mini implants in patients who are medically compromised.

“Implant-retained lower dentures are generally secured with two implants,” Dr. Gaukhman adds. “When we secure upper dentures with implants, which we recommend in certain cases, we typically use four implants because they have to work against gravity.”

Implant dentures can be fabricated to � t one of two ways: to be � xed or removable.

� ere are pros and cons to both options, Dr. Gaukhman states.

“Removable dentures snap on and o� the implants,” he describes. “� ey can

be made and � t rela-tively quickly. The patient can remove the teeth, clean them with a toothbrush and put them back in the mouth within minutes. They are easier to maintain

than � xed dentures. I made a removable denture for Peter.

“Fixed dentures, on the other hand, stay in the mouth at all times. � ey take much longer to fabricate and are harder to clean. � ey must be cleaned by professionals. But because they can only be removed by a dentist, they are more secure.”

Adjustment Period� e process of restoring Peter’s lower jaw began in September, and by February, he had his permanent lower denture. He recently went to Venetian Dental to receive a slight adjustment to the denture so it � ts as comfortably as possible.

“It takes some time for the denture to settle into the gums,” Peter states. “When it was � rst � t, it rubbed a little, so I went back to Venetian Dental and Dr. Gaukhman adjusted it, and the rubbing went away. Now, I just snap it into place and I’m good to go.

“I’m very happy with my new lower denture. It’s a lot better than a denture without implants. One of the best things about it is that, with this denture, I’m not afraid to smile, because there are no more gaps in my teeth.

“Before, I made the most I could of my smile. I always thought, It is what it is. But now, I don’t even think about not smiling. And my wife is quite happy with the way the denture looks, too. She says it’s a de� nite improvement over what I had, and I’m a lot nicer to look at.”

Tropical ParadiseDonna Kiehl and her husband built a successful nursery business from a collec-tion of bromeliads just large enough to � ll a kitchen table. Today, they � ll orders for the tropical � owering plant from all over the world via mail order and sell them from a store on the couple’s Venice property.

“We’ve been selling bromeliads and other tropical plants for about 35 years

total,” Donna shares. “We started the busi-ness in St. Petersburg but moved it to Venice when we went there to purchase a bromeliad collection. As it turned out, the property in Venice was also for sale, and we ended up buying it as well.

“It all started because my husband has had a love for bromeliads since he was young. He saw one on his parents’ property and was fascinated with the plant and its bloom. He researched bromeliads and how to grow them, then started collecting them.”

Donna, 63, who hails from Warminster, Pennsylvania, about 13 miles north of Philadelphia, relo-cated to Florida when she was 12. As an adult, Donna was diagnosed with Sjögren’s syndrome, an autoimmune condition where the immune system attacks the body’s own cells. � e most common symp-toms of Sjögren’s syndrome are dry eyes and dry mouth. � e dry mouth negatively a� ected Donna’s oral health.

“Because of the dryness in my mouth, my teeth started to go bad, and I started to lose them,” she relates. “That’s pretty much what happens with Sjögren’s. I didn’t have enough saliva to protect my teeth. I was told that, eventually, all of my teeth would go bad.

“My gums were receding as well, and it looked awful. My teeth were turning color, and I hated looking in the mirror and hated smiling because my smile was horrible. So, I looked into getting a dentist who would remove my teeth and give me dentures.

“I received a copy of Florida Health Care News in the mail, and in it were a couple of interviews with people telling their stories about working with Dr. Gaukhman. � at’s how I found him and decided to go to him.”

“Donna came to us believing that her teeth were unhealthy and probably not salvageable,” Dr. Gaukhman remembers. “I con� rmed that it was not worth the time and expense to try to save them. We agreed that the best option was to extract her failing teeth and replace them with dentures. After that, she would not have to worry about her teeth for at least � ve years.”

“Initially, Dr. Gaukhman pulled my upper teeth and made a denture for the top,” Donna recalls. “We did the top in January 2018. We waited to do the bottom because

those teeth weren’t quite ready to come out. But they were starting to turn as well.

“And before long, my bottom teeth began to break. Having no saliva made them go bad sooner than anticipated. But we waited to do the bottom until I got a cavity in the front and it started hurting. � at was in July of last year.

“When Dr. Gaukhman created my bottom denture, he put in the dental implants and � t me with the tempo-rary denture right away. I got my permanent denture in November. I just snapped it in.”

“They Look Awesome”With her treatment completed, Donna relates that she’s thril led with the dentures Dr. Gaukhman created for her at Venetian Dental.

“I love them, absolutely love them,” she raves. “� ey look awesome, and my smile is great. I get compliments all the time on my teeth, my smile and how happy I look now. And the Sjögren’s doesn’t bother the dentures at all.

“My treatment was successful, and I recommend implant dentures to others in situations similar to mine. And I most de� nitely recommend Dr. Gaukhman. In fact, I have already recommended him to a friend who was having issues with her teeth.”

Peter’s treatment was successful as well. He’s extremely pleased with the outcome of his treatment at Venetian Dental. He’s also pleased that the treatment process met his � nancial requirements.

“It came down to what was a� ordable for me,” Peter says. “I could have gotten a full set of implants with an implant for each tooth, but a lower denture with two implants was more a� ordable. I have no regrets.”

Although Peter met Dr. Gaukhman in an emergency situation, he was impressed enough to stay with the dentist to receive his implant treatment and lower denture.

“Dr. Gaukhman and his staff were very good and caring,” he reports. “I’m very happy with the choice I made to go to Venetian Dental. I absolutely recommend them to others with dental needs.”

“I’m very happy with the outcome of my treatment at Venetian Dental,” Donna concurs. “On a scale of one to 10, I would rate my experience a 20!”FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

Peter Benbow, 67, emigrated f r o m h i s

native England to the United States in 1991. He originally settled in Fort Lauderdale but later relocated to Port Charlotte. He moved after retiring from his construction and home remodeling business. � ere were good reasons Peter chose Florida as his new home.

“I decided to move to the States because I was ready for a life change,” he acknowl-edges. “� e weather in Florida was a huge factor in my choice of place to live and, of course, there was no language barrier.

“I spent most of my time in the Fort Lauderdale area, but then it became too over-populated. My wife and I decided we wanted a more quiet and relaxing atmosphere, and Port Charlotte � t that description. Plus, my wife had family here, so we made the move.”

Peter always liked to work with his hands. In England, he labored in the elec-trical and plumbing business, so when he came to the US, it seemed a natural progres-sion for him to move into construction.

“Obviously, I wasn’t going to be doing much work in the heating business in Florida, so my business just morphed into interior remodeling,” Peter describes. “Now, in retirement, I’m doing some remodeling and redecorating of our house in Port Charlotte. � e house was built in 1989, so it’s a little dated and needs some work.”

Having always been self-employed, Peter found health and dental insurance too costly for his bottom-line point of view. As a result, Peter tended to neglect his health, especially his teeth. His neglect caught up to him last September.

“My teeth were de� nitely su� ering,” Peter admits. “� en one day, I woke up with a severe toothache. � e pain was terrible, so my wife said, You’re going to the dentist. She went online to � nd an emergency dentist that would see me and found Dr. Gaukhman. His o� ce was a good 30-mile drive, but he could get me in, so o� we went.”

Alexander Gaukhman, DMD, at Venetian Dental in Venice, o� ers exceptional general, cosmetic and restorative dentistry as well as emergency dentistry. He also has o� ces in Sarasota and Osprey.

“When I first examined Peter, he already had an upper denture,” the dentist reports. “But his lower teeth were decayed and infected by periodontal disease. � e

South Sarasota County Edition | Spring 2020 | Florida Health Care News | Page 7general, coSMetic & eMergency dentiStry

Dawn Chiu, DPM, AACFAS, is a board-qualifi ed podiatric surgeon and associate of the American College of Foot and Ankle Surgeons. She grad-uated from the University of California, Davis, with a degree in zoology and received her Doctor of Podiatric Medicine degree from the California College of Podiatric Medicine in San Francisco. Dr. Chiu completed her podiatric surgical residency at Frankford Hospital in Philadelphia.

Arthur D. Clode, DPM, AACFAS, is a board-qualified podiatric surgeon and associate of the American College of Foot and Ankle Surgeons. He earned a degree in biological sciences from Florida International University and a Doctor of Podiatric Medicine degree from the California College of Podiatric Medicine in San Francisco. He completed his podiatric surgical residency at Golden Glades Regional Medical Center in Miami.

SARASOTA FOOT AND ANKLE CENTER

DAWN CHIU, DPM, AACFASARTHUR D. CLODE, DPM, AACFAS

Makethe Call

To learn more about the PinPointe FootLaser, visit www.sarasotafoot.com

There’s no need to drive to Fort Myers or Tampa for laser toenail fungus

treatment. FDA-approved PinPointe FootLaser is available at

Sarasota Foot and Ankle Center, which has three locations:

Sarasota3428 17th St.

(941) 366-4888Englewood

693 Old Englewood Rd.(941) 366-4888

Sun City Center1601 Rickenbacker Dr.

(813) 634-8980

Case in Pointe

W hen a two-liter bottle of soda fell out of a grocery bag and onto her right big toe one summer day

several years back, Sandy Oliver knew it would take a while for the resulting cracked toenail to heal and look normal again.

She just didn’t expect the healing pro-cess to take more than 20 years.

“� is all started at a water park in Texas,” Sandy relates. “I had taken my kids there for the day, and when this bot-tle of soda fell out of the sack, I wasn’t wearing anything on my feet, so my toe wasn’t protected at all. Let me tell you, that really hurt.

“What happened later is that a fun-gus got in there, so even after that big toe healed, it still wasn’t right. It became all black and then the fungus spread to some other toes. It got so bad that it hurt to wear shoes, which made it hard to walk.”

� e situation eventually forced Sandy to visit a podiatrist, who prescribed an oral antifungal medication. � e medi-cation eliminated the fungus, but it also

made Sandy feel ill. She felt worse when the fungus returned a few months later.

Reluctant to try another medication, Sandy tolerated the fungus and its e� ects for years. It wasn’t until after she moved to Florida and read about a laser treatment per-formed at Sarasota Foot and Ankle Center that she once again sought medical aid.

Weapon of Choice“Sandy � rst came to us a little more than a year ago wanting to try our PinPointe™ FootLaser® therapy, which is my preferred weapon of choice in the battle against toe-nail fungus,’’ says Dawn Chiu, DPM, at Sarasota Foot and Ankle Center.

“I prefer it because unlike oral med-ications, which can upset a person’s stomach the way they did with Sandy, the laser treatment kills the under-lying fungus without caus-ing side e� ects, and there’s no need for the patient to take a blood test beforehand.”

� e in-o� ce laser treatment lasts only a few minutes, during which time the laser is passed over the nail in a crisscross pattern to ensure full coverage. Patients

usually feel a warm sensation on their toe while the laser treatment is in progress, but no pain.

Afterward, patients can resume nor-mal activities. When combined with topical ointments, the laser treatment has an 80 percent success rate. Sandy, who had the treatment performed on all of her toes in November 2017, is factored into that success rate.

“My toes look and feel great again, and I’m really happy about that because I moved to Florida to be near the beach,’’ Sandy exudes. “I love the white sand beaches and the blue water of the west coast, and now, I can really enjoy them.

“I’m so glad I found this treatment because I was thinking I was going to have to put up with that fungus prob-

lem forever. D r . C h i u and her staff cou ldn’t be more profes-s i o n a l a n d kind. They’re

all great, and I highly recommend them and the laser treatment.”FHCN article by Roy Cummings. Photo by Jordan Pysz.

Before and after images courtesy of Sarasota Foot and

Ankle Center. mkb

Painless, in-o� ce laser treatment corrects toenail fungus

Sandy Oliver

T here’s no debating it. Internet and video games are popular in this country. A recent Pew survey found that 97 percent

of teen boys and 83 percent of teen girls play games on some type of device. But it’s not just kids who are playing. Research shows that about 160 million American adults play some kind of video game as well.

� e question is, are kids and adults playing too many video and internet games and has this pastime become a disease or an addiction?

One answer comes from the World Health Organization (WHO). WHO o� cially recognized gaming addiction as a disease in 2019, when it agreed to include gaming disorder, which includes internet and video gaming, as a condition in its International Classi� cation of Diseases (ICD) 11th Revision.

MEDICAL DISORDER

to change the behavior of a habit. � ese specialists also argue that labeling someone an addict and saying they have a chronic disease can have lasting consequences on that person’s life and self-esteem. � is is especially true for teens who are in the process of forming their identities.

Whatever you call it, overdoing it on the games to the point of ignoring everything else is not okay. If that’s you and you can’t stop, seek a qualified professional’s help to reduce your urge to play and modify your behavior. Don’t be afraid and don’t wait. After all, life is not a game. FHCN staff article. mkb

Three-fourths

of all Americans

have at least one gamer

in their household

� e ICD serves as the international standard for diagnosing and treating health conditions. It’s used by health care professionals across the globe. � e WHO based its decision to include gaming disorder in the ICD on available research and a consensus among a group of international experts in the � eld.

The ICD describes people with gaming disorder as having a “pattern of gaming behavior characterized by impaired control” that also involves prioritizing gaming over other daily responsibilities, including school, work and social appointments.

Another comes from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders � fth edition (DSM-5). Considered the bible for American mental health prac-titioners, the DSM-5 doesn’t recognize gaming disorder as a condition, but in 2013 it did list internet gaming disorder in a section recommending conditions for further research.

The DSM-5 notes that internet gaming must cause

“signi� cant impairment or distress” in several aspects of a person’s life and proposed a set of symptoms

that includes preoccu-pation with gaming: withdrawal symptoms when gaming is taken

away or not available; the need to spend more time gaming to satisfy the urge; giving up other activities; loss of interest in activities previously enjoyed; having jeop-ardized or lost a job or relationship due to gaming; inability to reduce gaming or unsuccessful attempts to quit; deceiving others about the amount of time spent gaming; and using gaming to relieve negative moods, such as guilt or hopelessness.

According to the DSM-5, a person must have � ve or more of these symptoms within a year to be diagnosed with internet gaming disorder. But not all experts agree that gaming, internet or otherwise, should be considered a disorder. Some argue that gaming can’t be separated from general screen overuse, which includes social media use as well. Others suggest that intense gaming is a symptom of another disorder such as anxiety, depression or ADHD.

And there’s research to back that up. One study found that children who had problems with video games were more likely to also have a diagnosis of ADHD or autism spectrum. � ose who struggled with social media use often also struggled with depression or anxiety.

Another group of specialists recom-mends referring to gaming as a habit rather than a disorder or addiction. � ey explain that people feel more empowered

Page 8 | Florida Health Care News | Spring 2020 | South Sarasota County Edition Podiatry

Mental health

Smooth Out Your Problem Veins

Dr. Magnant welcomes all questions regarding this article as well as other topics related to veins. Call or visit one of the two Vein Specialists locations:

Fort Myers1500 Royal Palm Square Blvd., Suite 104

Bonita Springs3359 Woods Edge Cir., Suite 102

(239) 694-VEIN (8346)

InstaInsta

Follow them on:

Visit their screening website,

eVeinscreening.com

Allison Ferguson

Skin DeepStasis dermatitis: a sign of advanced vein disease

O riginally from Texas, Allison Ferguson, 42, grew up in the Houston area but relocated to Florida in June 2017. Her

life is now devoted to her dual careers as the mother of a 12-year-old son and 14-year-old daughter and as a computer professional.

“I work in store � nance at the corpo-rate headquarters for Chico’s clothing stores,” Allison shares. Living in Florida, Allison likes to spend her free time at the beach with her family and friends. She loves to swim and walk and enjoys other outdoor activities, but in early 2018, a strange rash appeared on her leg that made her favorite pastimes less enjoyable.

“� at February, I noticed these red dots on the ankle of my right leg,” Allison relates. “� ey bothered me, but I didn’t think that much about them at � rst. � ey just came and went, and I let it go.

“My leg was extremely itchy, so it felt good to scratch it. But the more I scratched, the more red and in� amed it got, and it became a situation. At Chico’s, we have a health clinic on campus, so I went there. � e nurse gave me a steroid cream to put on my leg, but the rash didn’t get any better. � en the nurse suggested I see a dermatologist.”

� e dermatologist diagnosed Allison’s condition as eczema and prescribed another medicated cream, but the condition of Allison’s leg got worse instead of better. Her leg started swelling, and she broke out in hives. � e redness, in� ammation and itching became more intense as well.

“The itching was terrible,” Allison shares. “It was like poison ivy. It was truly consuming. And the rash was getting redder with bleeding and scabbing, so I worried about it getting infected. In May, the dermatologist tested me for skin mites and shingles, but the results came back negative.”

When nothing the dermatologist suggested helped, the doctor recommended Allison visit a rheumatologist to determine if an autoimmune disease might be the cause of her skin condition. � e rheuma-tologist couldn’t � nd a link but wanted her to see a specialist at � e Mayo Clinic in Jacksonville. � at was a long drive from Allison’s Fort Myers home.

“Before I did that, I thought, Let me try an allergist,” Allison recalls. “I had allergies as a child and took allergy shots in the past. But as soon as I walked in, the allergist said, � is is not an allergy issue. You need to go to the University of Miami Center for Dermatology. I � gured that was closer than � e Mayo Clinic in Jacksonville.”

Doctors in Miami ran a slew of tests and told Allison her problem

was stasis dermatitis caused by a problem with her leg veins. � at’s when she found Joseph G. Magnant, MD, of Vein Specialists in Fort Myers and Bonita Springs. Dr. Magnant, a board-certi� ed vascular surgeon, is dedicated to the most modern and comprehensive evaluation of leg vein disorders and the most-advanced mini-mally invasive treatment of those disorders.

Dr. Magnant explained that Allison’s problem was venous insu� ciency, a disease that occurs when the valves in the leg veins that keep blood � owing toward the heart begin to fail.

As a result of the failure, blood leaks backward, or re� uxes, and pools in the legs and ankles. � is pooling can result in varicose veins, swelling, heaviness, itchiness and in� ammation of the skin of the legs and venous ulcerations.

Unseen SymptomAllison did not have varicose veins, the most commonly recognized sign of venous insu� ciency. What she did have was the more-subtle, more-advanced skin-related sign of venous insu� ciency called stasis dermatitis.

“Patients can have stasis dermatitis that doesn’t show through the skin,” Dr. Magnant stresses. “In those cases, the patient’s legs may get very itchy as their day wears on. � e itch occurs primarily in the lower half of the calves. Patients expect to see something there when they look down, such as red spots or a red area, but those signs may not be present.

“Even in the absence of that physical sign of in� ammation, the patient may still have stasis dermatitis because that’s how it starts. For example, Allison’s stasis derma-titis essentially began with intense itching on her leg that became a full-blown rash after she scratched it.

“Patients such as Allison will really bene� t from a thorough vascular evalua-tion, including a pulse check and a special Doppler ultrasound, because that evaluation will often disclose the underlying problem.”

One reason Dr. Magnant recommends visiting an accredited vein center and receiving a thorough vascular evaluation is because some physicians fail to attribute stasis dermatitis as a sign of venous insu� ciency

and treat it simply as a “skin condition.” � at’s what happened to Allison.

“When the diagnosis of stasis dermatitis due to venous insu� -ciency was � nally made, Allison was already eight months into her ordeal,” Dr. Magnant relates. “By that time, she felt like she had been bounced around, been prescribed a variety of di� erent medications and not found anyone who could really help her until she made it to Vein Specialists. We were able to establish the underlying cause of her skin problem.”

� at help began with an ultra-sound examination to determine the presence of leaking vein valves, the exact veins a� ected and the severity of the leaks causing Allison’s discomfort. � e results brought the issue into focus and led to a recommendation for a solution to the problem.

“When Dr. Magnant gave me the results, he showed me pictures of the veins in both legs that weren’t working properly and said he could � x them with an endovenous ablation procedure called ClosureFast™,” Allison states.

ClosureFast is a thermal vein-sealing treatment that uses radiofrequency heat to seal the damaged leaking leg veins. By sealing the diseased veins, blood � ow is naturally redirected to healthier veins, which alleviates a patient’s symptoms.

Dr. Magnant begins the ClosureFast procedure by inserting a small needle into the abnormal vein through which a heating catheter is inserted and advanced into the vein. Liquid with local anes-thesia is then injected around the vein to collapse it around the catheter and to absorb the heat from the vein wall during the heating process. � e local anesthetic in the liquid helps prevent the patient from feeling pain. � e vein is then heated with radiofrequency, which causes it to eventually shrink into scar tissue.

“Defi nitely Working”“I had the ClosureFAST™ [radiofrequency] procedure done on my right leg on April 7, 2019,” Allison reports. “It was pretty effortless and painless. It was performed right in the office with a little numbing medicine, and I was able to drive home afterward. It was very convenient; it only took about an hour. Two weeks later, I had the procedure done on my left leg.”

Allison is quite pleased with the outcome of her ClosureFAST procedures.“I really noticed a di� erence in my legs about nine months after the procedures were completed,” she states. “And today, I feel 100 percent better. � e itching is gone and there’s no more swelling. My legs look 95 percent better.

“I would definitely have the ClosureFAST endovenous ablation proce-dure again if I had to. And I de� nitely recommend getting that treatment from Dr. Magnant at Vein Specialists.”FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb

Joseph G. Magnant, MD, FACS, RPVI, is a fellow of the American College of Surgeons and is board-certifi ed by the American Board of Surgery in

vascular surgery. He earned his medical degree from Medical College of Virginia. He completed a general surgery residency at Medical

College of Virginia Hospitals and a fellowship in vascular sur-gery at Dartmouth-Hitchcock Medical Center, Lebanon,

NH. Dr. Magnant focuses exclusively on vein evaluation and modern treatments in a dedicated, outpatient, vein-centered facility. Dr. Magnant is an active member of the American Vein & Lymphatic Society, Society for Vascular Surgery and Society of Vascular Ultrasound.

South Sarasota County Edition | Spring 2020 | Florida Health Care News | Page 9vaScular Surgery

L arry Solie grew up on a ranch, so he’s no stranger to responsibility and hard work out-doors. Every day, he toiled in the garden and cared for the horses. It was a natural transition

when he became executive director of a wilderness pro-gram for troubled teens.

“Minimally invasive laser laminotomy is per-formed through a half-inch incision in the back,” Dr. St. Louis explains. “The incision is carefully placed with the help of a special x-ray called C-arm fluoroscopy. Laminotomy is carried out using a scope with a camera, and the surgeon operates while visual-izing images from the camera on a computer screen.

“Once the incision is made, we insert a series of tubes to dilate the muscles that sit on top of the bone and create an opening in the lamina using a laser, small drill and a kerasin. We use rongeurs to remove the pieces of bone that were in the lamina.”

To relieve pressure on spinal nerves, Dr. St. Louis uses the kerasin to remove some of the bone sur-rounding the foramen where the nerves exit the spinal cord. This is a foraminotomy. Because laminotomy and foraminotomy are performed minimally inva-sively, recovery is short and complications are rare.

“I typically instruct patients to walk for an hour the day after surgery in three 20-minute intervals,” Dr. St. Louis informs. “Total recovery time depends on the patient’s degree of activity. If they’re return-ing to a desk job, they can go back within a week. If they do manual labor, they must wait anywhere from two weeks to a month.”

Dr. St. Louis makes a point of noting that Physician Partners of America accepts Medicare, so

patients with Medicare don’t have to pay large out-of-pocket sums for their laser surgery. This is important because many of the conditions that require procedures such as laminotomy and foraminotomy are common in older adults.

“As people age, they often develop bone spurs that can pinch the spinal cord or spinal nerves and cause pain,” the doctor observes. “In addi-tion, every nerve travels through a tunnel, and over time, that tunnel shrinks and puts pressure on the nerve. Laminotomy and foraminotomy remove the bone spurs and open up the tunnels, freeing the nerves and relieving pain.”

“Immediate Relief”Dr. St. Louis thoroughly explained what was caus-ing Larry’s back and leg pain, and detailed how laser laminotomy and foraminotomy would repair the problem. Larry agreed to undergo the proce-dures and was amazed by how quickly he noticed a difference in his condition.

“I felt immediate relief,” Larry enthuses. “And my recovery was very quick. I walked out of sur-gery with no pain in my back or down my legs. At first, I attributed most of the relief to the anesthe-sia, but the pain hasn’t returned. There’s zero pain now, when before it was a 10.”Larry no longer suffers with discomfort in his

back or legs, so he’s able to perform his favorite activ-ities. Those include working in the garden, shades of his days on the ranch.

“My wife doesn’t call me a gardener,” Larry relates. “She calls me a landscaper because what I do requires a lot of physical activity. We walk daily as well. And I recently picked up an airbrush. I’ve been an artist all my life, so I’m moving into a different level of art.

“I’m looking forward to getting back to boating and traveling. I had to cancel a couple of trips due to my back pain, but that’s all behind me now. I highly recommend Dr. St. Louis and his team at Physician Partners of America. They provided me with pain relief and in turn gave me my life back.”FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. ke

JAMES ST. LOUIS, DOKEITH GIRTON, MD

James St. Louis, DO, earned his Bachelor of Science and Masters of Science degrees from the University of Wisconsin, La Crosse. He received his osteopathic medicine degree from the Kansas City University of Medicine and Biosciences, and completed

his surgical training in the US Army and at Kennedy Medical Center in Cherry Hill, NJ. Dr. St. Louis is a member of many medical organizations including the American Osteopathic Association, American Osteopathic Academy of Orthopedics, American Medical Association and American Association of Physician Specialists.

Larry already had an idea where he’d go for help with his bad back. His daughter worked for Physician Partners of America, and Larry knew their surgeons performed minimally invasive laser spine surgery. Larry made an appointment and met with Dr. James St. Louis, director of the practice’s Minimally Invasive Spine Group.

Attachment Point “Upon evaluating Larry, I discovered that a dam-aged disc in his lower spine was pinching the nerves exiting through the openings in the spinal column, which are called foramen,” Dr. St. Louis explains. “Pressure on the nerves caused the pain in his back and numbness down his legs.

Leaders in Interventional Pain Management and Minimally Invasive Laser Spine Surgery

877-331-6603

Physician Partners of America is committed to providing the highest levels of compassionate, patient-centered care possible. They have 20 locations across Florida to serve you. To schedule a consultation with one of their pain management or minimally invasive laser spine specialists, call or visit one of their offices:

Keith Girton, MD, is board-certifi ed by the American Board of Orthopaedic Surgery. He is a native of Columbus, OH, and earned his medical degree from The Ohio State University College of Medicine. Dr. Girton completed a residency in family medicine at Miami Valley Hospital in Ohio and a residency in orthopedics at Fort Worth Affi liated Hospitals in Texas. During his second residency, he joined the US Air Force and was stationed at Scott Air Force Base near Belleville, IL. He was honorably discharged.

To learn more, visit them online at PPOASpine.com

“� e program operated over a 50,000-acre spread in Central Oregon,” Larry describes. “We worked with 300 teens a year. � ey learned tracking and naviga-tion skills, how to build � res without matches and many Native American-style ways of living in the wilderness.

“Before I took over that program, I was head-master at a school for troubled boys. During that time, I met the founder of the wilderness program – an ex-ranger who wanted help with his business. We formed an alliance to cross-train our kids, and I eventually bought his program.”

Larry expanded the program, which was featured on a television series in 2003. � e show garnered national recognition for Larry’s program as well as the attention of larger organizations doing residential and wilderness-based programming. Larry left his program in the capable hands of one of those organizations and retired in 2006.

Unfortunately, all those years of working on the ranch, hiking, and sleeping on the hard ground in the wilderness took a toll on Larry’s back. � at distress was compounded by damage done to his back during his military career.

“I served during the Six-Day War, and we got banged around on my ship quite a bit,” Larry recalls. “When my ship was torpedoed, I su� ered an injury to my spine that didn’t show up until later. Couple that with the walking and lifting I did, and the strain on my back really got bad.

“� e � rst symptom I noticed was weakness in my right leg, followed by numbness and cramping in both legs. I also experienced pretty intense pain in my back and down my left leg. � ere were stabbing, sharp pains, then there were dull pains. It ran the gamut, but the pain was a 10 on a scale of one to 10. If I lifted something, I could guarantee I’d be in pain for days. I’m a very active person. It was di� cult for me to just sit still.

“My wife and I like to go boating and travel, and I draw and paint outside, but with a bad back, I didn’t do much but sit on ice and take pain pills. It got to the point that my wife said, Look, I want to travel, but if you want to sit here in pain, I’ll get you a subscription to the newspaper. � at prompted me to seek treatment.”

The affected nerve is identified after evaluating the patient’s symptoms and using MRI to pinpoint the specific nerve.

“To address Larry’s condition, I chose to perform two minimally invasive laser spine procedures, a lami-notomy and a foraminotomy,” Dr. St. Louis continues. “The goal of performing those procedures was to ease the pressure on Larry’s nerves and relieve his painful symptoms.”

A lamina is a part of the vertebral arch. A pair of laminae join with the bony projections that jut from the middle of the vertebrae, called spinous processes, to provide a point of attachment for the spine’s mus-cles and ligaments. A laminotomy is the removal of some of the lamina to relieve pressure from the bone pressing on the spinal cord.

Lakewood Ranch(pain management)

6310 Health Pkwy., Suite 320

St. Petersburg (pain/spine)

5767 49TH St. North

Tampa (pain/spine)

4730 N. Habana Ave., Suite 202

Orlando(pain/spine)

1736 33RD St.

Page 10 | Florida Health Care News | Spring 2020 | South Sarasota County Edition laSer SPine Surgery

KENNETH D. LEVY, MDRONALD M. CONSTINE, MD

DALE A. GREENBERG, MDNICHOLAS J. CONNORS, MD

ROBERT P. STCHUR, MDGREGORY P. GEBAUER, MD

JASON E. REISS, DOSTEVEN R. ANTHONY, DO

LEE M. JAMES, DOJASON M. MLNARIK, DO

Advanced Orthopedic CenterREPAIR RESTORE RECOVERY

Lee M. James, DO, received his undergrad-uate degree from the University of South Florida. He earned his medical degree at Nova Southeastern University. Dr. James is board-certified in physical medicine and rehabilitation, and pain medicine. He completed his physical medicine and rehabilitation residency at the University of North Carolina Hospitals in Chapel Hill. He completed his pain medicine fellow-ship in the department of anesthesiology

at the University of North Carolina Hospitals in Chapel Hill. He is a member of the Spine Intervention Society, International Neuromodulation Society,

A m e r i c a n A c a d e m y of Pain Medicine and

American Academy of Physical Medicine

The staff of Advanced Orthopedic Center welcomes new patients and is happy to answer questions about

joint replacement, joint revision, sports medicine and surgery of the spine. To schedule an appointment, please visit

or call one of their offi ces.

Port Charlotte1641 Tamiami Trail, Suite 1

(941) 629-6262

Punta Gorda350 Mary St., Suite F

(941) 639-6699Visit Advanced Orthopedic Center on the web at www.advancedorthopediccenter.com

Give Them a Call!

• Pain with motion• Pain that fl ares up with

vigorous activity• Tenderness when pressure is

applied to the joint• Diffi culty walking

• Joint swelling, warmth and redness

• Increased pain and swelling in the morning, or after sitting or resting

Serving patients in the Southwest Florida area since 1980, Advanced Orthopedic Center’s top-notch surgeons offer comprehensive orthopedic care to all ages. The courteous and caring staff is ready to assist and ensure your satisfaction.Our Specialties Include:• Spine surgery• Sports medicine• Total and partial joint

replacement• Foot and ankle care• Hand care• Upper extremity fracture care• General orthopedics• Interventional pain

management• Trauma surgery

Welcome to Advanced Orthopedic Center

Do You Have Arthritis?The symptoms of arthritis vary depending on which joint is aff ected. In many cases, an arthritic joint will be painful and infl amed. Generally, the pain develops gradually over time, although sudden onset is also possible. Other signs can include:

The dream of every artist is to sell a piece of their art. Karen Close, who didn’t become an artist until after she retired

a few years ago, has experienced that dream on a few occasions, but one such experience stands out above all the rest.

Karen is painting pain-free following SI joint fusion surgery.

Phenomenal Results Leading-edge fusion procedure eliminates chronic sacroiliac joint pain

A dowel-shaped cadaver bone like those shown here are used during the SI joint fusion procedure

“I couldn’t even pick up my cats or bend over to clean their litter boxes. And if I sat, I had to sit with a pillow behind my back and with my feet up. � e pain even kept me from sleeping. It was very debilitating.”

So debilitating that after a month of trying basic home remedies that failed to resolve the problem, Karen � nally paid a visit to Advanced Orthopedic Center, where her husband had once been treated for a knee problem by Dale A. Greenberg, MD.

Root Cause Dr. Greenberg performed an initial examination of Karen and ordered a set of x-rays and an MRI of her back. � e MRI showed that the cause of her pain was damage to the sacroiliac, or SI, joint, which is found between the hip and spine.A t t h a t p o i n t , Dr. Greenberg handed Karen’s case over to his asso-ciate, Lee M. James, DO, who began his treatment of Karen in a conservative manner by giving her a therapeutic sacroiliac joint steroid injection.

“ I t ’s a s t a n d a r d protocol,” Dr. James says of the injections, “but the problem with them is that they wear o� after a while. With Karen, the � rst injection wore o� after about a year. So, we gave her another. � at one lasted about six months. � en she needed another.

“At that point, we decided we needed to take a different approach with her because the e� ect of the injections was wearing o� more quickly each time we did it. � at’s when I suggested doing the SI joint fusion surgery.”

SI joint fusion surgery is a low-risk, minimally invasive procedure that is performed under intravenous sedation or general anesthesia and begins with the surgeon making a small incision of less than an inch in the patient’s lower back.

Using fluoroscopy, which creates a continuous x-ray image on a monitor, the surgeon then inserts a small piece of cadaver bone that is shaped like a dowel

through the incision and into the joint. � e incision is then sewn up, and the patient typically returns home that day.

“This is the closest thing we have to a � x for the kind of problem Karen had,” Dr. James says of the procedure, which is completed in about 20 minutes. “And once we’re done, over time, new bone grows around the dowel, or cadaver bone.

“That’s why we call it fusion surgery, because the bone and the cadaver bone fuse together. We

then check with the patient again after two weeks and again four weeks after that, and so far, we’re getting about 80 percent success with this procedure, which is amazing.

“� e only thing we’re not quite sure of just yet is how long the e� ects of the procedure can actually last once the bone has fused with the cadaver bone. We don’t know if it will last three years or � ve years, because it’s a new procedure.”

Active AgainKaren had her surgery this past September. � ough she has no idea what the long-term e� ects of it will be, she is greatly encouraged by the short-term results, which she describes as phenomenal.

“I’m feeling pretty good because I no longer have that aching and burning pain that was in my back and hip and going down my legs,” she says. “� at tells me that we hit the nail right on the head with this procedure.

“And as far as activities go, I wouldn’t say that I’m ready to dance with the Rockettes, but the pain that was keeping me from doing things is gone and so that part of my life is back. I’ve even gone bowling since I had the surgery.

“� ere’s no way I would have been able to do anything like bowling before I went to Advanced Orthopedic Center, so I just can’t say enough about what Dr. Greenberg and Dr. James have done for me.

“My husband and I think the world of them. Dr. Greenberg gave my husband two new knees, and now, he and Dr. James have helped me with my back problem. We love the entire Advanced Orthopedic family. Everybody there is just great.”FHCN article by Roy Cummings. Photo by Jordan Pysz.

Cadaver bone graphic courtesy of SI-BONE®. mkb

“� ere’s an art group that I belong to, and we have a show every couple of years in the Visual Arts Center,” the Port Charlotte resident explains. “At the last show we had this past March, I actually sold a piece.

“To sell a piece out of a gallery, well, I was walking on air after that. It’s really a great feeling. I’ve sold other pieces from a booth in a consignment shop in Englewood, but selling that piece out of the gallery was really special for me.”

Karen’s passion for art developed rather by chance. Shortly after retiring from her job as an administrative assis-tant, she took an art class and found it to be therapeutic for her as she battled through some health issues.

Among those health issues was a back problem that � rst manifested itself a couple years ago as pain in her right hip. Before long, the pain moved to her lower back and radiated into her legs, which made performing even some of the simplest tasks virtually impossible.

“It got to the point where I couldn’t even stand in the kitchen and prepare dinner,” Karen laments. “I couldn’t stand long enough to even make a salad. I had to put everything on a tray and go sit down somewhere else and make it there.

“And I couldn’t walk any distances at all. If I went to the grocery store, even if it was just a 10-minute trip to pick up a few things, I had to get a cart and lean on the cart and walk behind that. And later, after I came home, the pain was 10 times worse.

South Sarasota County Edition | Spring 2020 | Florida Health Care News | Page 11orthoPedic Surgery & SPortS Medicine

20,000 Documented Eye Floater Laser Sessions

Patients often ask Scott Geller, MD, “Why can’t my local doctor laser eye � oaters?”

“Because this is a niche area of interest and most ophthalmologists will not take the time to really get into it,” Dr. Geller states. “It’s a bit like plastic surgery. Any intern can make an incision and stitch skin, but it takes years of expe-rience to size up a patient, know exactly how to modify a technique and get the absolute best result possible.”

Dr. Geller has that experience. He has performed more than 20,000 eye � oater laser procedures. He also has given an impressive mumber of lectures around the world on his research and technique.

“Florida has some great ophthalmic centers, including the schools in Tampa, Gainesville, and the Bascom-Palmer Eye Institute in Miami,” says Dr. Geller, “But their interests lie elsewhere. So, all the advances have been done here, outside academia, by private clinics.”

Understanding the PatientMany ophthalmologists don’t understand what a patient with eye � oaters is expe-riencing, Dr. Geller says. As a matter of routine, he adds, they measure the patient’s best vision, which is typically normal, check for a retinal tear or detachment and, barring anything unusual, tell the patient he or she will be � ne, because the retina looks � ne and the � oater will either fade or the patient will get used to it.

To which the patient responds, “But doctor, I can’t see.”

“It is true that, for the majority of patients, floaters do seem to fade, or the patient does get used to them,” Dr. Geller notes. “But that’s not always the case. � at’s why ophthalmologists need to listen to the patient’s problem and thoroughly

examine the vitreous gel, where eye � oaters are formed.

“If the ophthalmologist measures only the patient’s best vision on an eye chart, they may not correctly diagnose the problem and might dismiss the patient out of hand, telling them that nothing needs to be done, which may leave the patient bewildered and frustrated.

“� is is one of the areas of ophthalmology that is routinely ignored by many ophthalmologists, and the reason for this is simple: � ey don’t take the patient’s visual acuity with the � oater in the visual axis.

“We have seen patients reporting improvement of overall vision even with macular degeneration and Lazy Eye [amblyopia], where the floater causes interfering noise with the good eye.

Japan, the People’s Republic of China, Russia and almost every European country,” the doctor notes.

Recently, Dr. Gellerwas a featured lecturer for the fourth year in a row at an International Ophthalmology Meeting in Taormina, Sicily, Italy. Other experts from the Netherlands

and Italy presented papers on their experiences treating eye floaters with the laser as well as traditional surgery. Patients from other areas of Italy came to Sicily to be examined and treated by Dr. Geller.

“I have quite a reputation in Europe and have treated patients in Italy with the Ellex Laser, but in the US I � nd the Swiss made LASAG laser to be the best,” states

tell them they need vitrectomy surgery,” Dr. Geller notes. “But the problem with vitrectomy surgery, which is the surgical removal of the entire vitreous gel, where � oaters begin, is that it is not without its own problems.

“Most patients over the age of 40 will develop an early cataract and will need another operation as early as six months to a year later. � is is due to the physiology of the eye, not the skill of the surgeon. 

“In my hands, with my years of expe-rience, complications are rare,” assures Dr. Geller, who presented his results at the American Academy of Ophthalmology in 2012, and other meetings worldwide.

Finding Dr. GellerDr. Geller con� des that patients often � nd him in a roundabout way.

“Recently, a man in West Palm Beach went to the satellite clinic of a world-famous Miami eye institute,” the doctor reports. “� ey told him they couldn’t do anything for him except vitrectomy, but they also told him, there’s an ophthalmol-ogist on the west coast of Florida who can treat your eye with a laser.

“It wasn’t a direct referral, but the patient managed to � nd me and was ecstatic with his results. Subsequently, I uploaded a video of his procedure to YouTube.com and Vimeo.com, which can be found among dozens of videos I’ve posted.”

Dr. Geller cautions that not all patients can be helped with his laser procedure, though he is pleased to report that, partially due to his meticulous patient selection process, his patient results are excellent.

Laser SelectionDr. Geller also welcomes colleagues to observe or just call if they need to re� ne their own technique.

“Laser treatment of eye floaters is fascinating,” Dr. Geller says. “I look forward to doing this every day.”

Dr. Geller says that, while his greatest satisfaction comes from helping patients who have been told by their own ophthal-mologists that nothing can be done, he actually welcomes the opportunity to share his technique with others in his � eld.

“Other ophthalmologists need only call me, or ask one of my patients about their results,” he says. “I’m proud of our track record and of the patients we’ve helped.”Article submitted by Scott L.Geller, MD. FHCN file photo. mkb

SOUTH FLORIDA EYE CLINICSCOTT L. GELLER, MD

Scott L. Geller, MD, is board-certified by the American Board of Ophthalmology. He is a graduate of Ohio Wesleyan University and Rush Medical College. While in medical school, he was awarded a student fel-

lowship to study tropical medicine at a missionary hospital in India, and pursued additional studies at the famous Brompton Hospital

in London. He interned at Presbyterian Hospital, Pacifi c Medical Center, San Francisco, and completed his residency in oph-thalmology at Sinai Hospital of Detroit, which was affiliated with Wayne State Medical School and Kresge Eye Institute. Dr. Geller was fellowship-trained in anterior segment and refrac-tive surgery with Dr. William Myers of the Michigan Eye Institute. Dr. Geller is a fellow of the American Academy of Ophthalmology and has presented papers on eye fl oater laser treatment at the International Congress of Ophthalmology, European Congress of Cataract & Refractive Surgery, European Congress

of Ophthalmology and the Florida Society of Ophthalmology.

See what patients say about the Eye Floater Laser at www.vimeo.com/eye� oaters and on the Scott Geller MD YouTube channelwww.vitreous� oaters.com

For Eye Floater Solutions

South Florida Eye Clinic is located in Fort Myers at:

4755 Summerlin Rd. Call Dr. Geller at:

(239) 275-8222or toll-free at:

877-371-3937

SCAN THIS WITH YOUR SMART PHONE

TO SEE SCIENTIFIC PRESENTATIONS BY

DR. GELLERwww.vitreous� oaters.com

SCAN THIS WITH YOUR SMARTPHONE

TO SEE ACTUAL PATIENTS

www.vimeo.com/eye� oaters

South Florida Eye Clinic sta� are the experts with a worldwide patient base

“At South Florida Eye Clinic, we always measure the patient’s worst vision on the eye chart to see exactly how bad the vision gets with the � oater obstructing it.”

Laser TreatmentDr. Geller has performed more than 20,000 documented eye floater laser procedures across more than 30 years of service to patients from all over the world.

“We have a worldwide patient following and have helped people from

Dr. Geller. “And we are the only facility using it in the US.”

“My � rst scienti� c presentation was at the 1989 International Congress of Ophthalmology in Singapore,” he adds. “It was followed by lectures at several conferences in China, including the pres-tigious Shanghai Eye and Ear Institute.

“Other major meetings included the 1997 European Congress of Cataract and Refractive Surgery in Prague; the 1999 Florida Society of Ophthalmology; the 2001 European Congress of Ophthalmology in Istanbul; the 2010 World Congress of Ophthalmology in Berlin; and the 2010 American Society of Cataract and Refractive Surgery in Boston. � ere was also a peer-reviewed presentation at the American Academy of Ophthalmology in Chicago in 2012.”

Dr. Geller’s latest presentations were at the prestigious Florida Society of Ophthalmology and the Orione Ophthalmic Congress in Italy, where he performed eye � oater laser sessions on selected patients.

“Many doctors tell their patients, Live with it, nothing can be done, or they

Page 12 | Florida Health Care News | Spring 2020 | South Sarasota County Edition eye floater treatMent