Martin County Edition For additional health care information, visit us on the web at TAKE ME HOME! Winter 2015 www.ifoundMYdoctor.com Featured ARTICLES LASER AESTHETICS NO-SURGERY, 5 Francis J. DuCoin, DMD, M A Stable Smile NO-SWEAT FAT REDUCTION Walk away with less fat after this comfortable and safe laser treatment at Slim Body Laser Spa. 6 10 FHCN PHOTO BY MARC EDWARDS K Health Care Patron Carrier-Route Pre Sort PRSRT.STD. U.S. POSTAGE PAID Tampa, FL Permit No.2397 athleen Dennis was fascinated when she noticed a substantial weight loss in one of her patients at the Robert and Carol Weissman Cancer Center in Stuart. While it isn’t unusual for cancer patients to lose weight, this particular change was different. “She had some lymphedema in one of her arms that she had been carrying around for years that had disappeared,” relates Kathleen. The medical assistant asked the patient how she had achieved the remarkable result. The patient replied that she had gone to Slim Body Laser Spa, owned by Tred Rissacher, DC. The patient then gave Kathleen some additional information about Slim Body. “She told me about the place and I was a little skeptical, but I saw she had lost a considerable amount [of weight],” remembers Kathleen. “I called and set up an appointment for an initial consultation and decided to give it a try.” TRED J. RISSACHER, DC Kathleen’s main problem area was her waistline. She had some areas around her stomach and back that she just could not exercise or diet away. When she had her first session at Slim Body Laser Spa, she was impressed by the ease of the treatment, especially after learning the facts about another fat-reducing procedure about which she had inquired. “It was very comfortable,” she comments, describing the Slim Body laser treatment. “After the first one, I looked forward to going back. You lie there on a comfortable table, and they put the paddles on the areas that you want to have done. The paddles get a little warm. It’s a very comfortable warmth; it’s not even the low setting of a heating pad. Then they wrap you in a sheet, and you just lie there and listen to the nice music. It’s like you’re in a spa. It’s beautiful. I almost fell asleep. “I did investigate another process. I went to a plastic surgeon, and he had a different method by which they grab the skin up into this vacuum-like thing, and I had to lie there for an hour and let this thing go. It just didn’t appeal to me. It was very time-consuming for one thing. You had to go more frequently. This just made more sense to me.” Kathleen was very thankful she chose Slim Body. “They concentrated on my stomach and a little bit on my back,” she shares, “and it was resolved. I was really surprised, just on the first time I went in.” System success Dr. Tred’s Ultimate Laser-Assisted Weight Loss System succeeds when other attempts at weight loss have failed. In fact, over the last four years, his system has helped more than 2,500 people shed thousands of stubborn pounds and inches. The difference is the laser, which acts directly on the problem fat cells. “Laser energy, when applied to the body, safely causes microscopic pores to form in the fat cells,” explains Dr. Tred. “The fat leaks out and is absorbed by the body. It is then burned as energy or removed from the body safely and naturally.” Dr. Tred notes the difference between his laser system and some of the other fat-reducing options available to patients. He stresses the safe, natural process his system uses to rid the body of excess fat. “This procedure shrinks fat cells, whereas many other procedures actually destroy fat cells. They either suck them out or they freeze them and kill them, or (see No-Surgery, No-Sweat Fat Reduction, page 4) Melgen Retina Eye Center Caring for Macular Degeneration Atlas Chiropractic of Palm City Stop Neck Pain and Ease Sinus Infections Also In This EDITION 2 3 8 8 9 10 11 12 RENU Medical Aesthetics Facial Rejuvenation without Surgery Michael C. Solomon, MD, P.A.,FACS Take Control of Overactive Bladder Associated Coastal ENT Physicians Join the Conversation BHRT, Inc. Replenishing Hormones Naturally Vascular Interventional & Vein Associates Surgery without a Scalpel South Florida Eye Clinic Eye Floaters? The Dry Eye Spa & V.I.P. Laser Eye Center Dry Eye Syndrome Relieved Neurology Associates of the Treasure Coast Feeling Faint? For more information, scan the barcode to the right with your mobile device to visit us online. Page 2 | Florida Health Care News | Winter 2015 | Martin County Edition REJUVENATION Facial Rejuvenation without Surgery The RENU Lift™ enables patients to turn back the clock without the risks, scarring or blood loss associated with surgery. A s Bonnie Adams got closer to the latter part of her 50s, she began to find that the signs of aging in her face didn’t reflect her youthful personality. “I was looking to start doing something,” she recalls. “That was about ten years ago.” says: “It’s been a great experience for me over the last ten years. It’s a little different now – there are more things you need to do at 67 than at 57 – but I feel so confident with the way I look right now, and it’s all because of Dr. Barrett. When I started going to her, I looked so much older. I look younger now than I did ten years ago!” Complete treatment PHOTO COURTESY OF RENU MEDICAL AESTHETICS As we age, time, gravity and environmental effects begin to show on our faces as wrinkles and lines. Sun exposure, lifestyle choices such as smoking and dietary habits, weight changes, prior illnesses and heredity can also contribute to the condition of the skin. Bonnie went for a consultation to learn more about facial rejuvenation treatments, but she didn’t like the approach the provider took. “I had gone to someone before, and I wasn’t really happy,” she explains. Then Bonnie met board-certified physician Valerie A. Barrett, MD, of RENU Medical Aesthetics. “I had a consult with her, and when I met her, I was very impressed that she was so conscientious and took a conservative approach,” Bonnie says. “She wants to know what you want, instead of coming in and saying, I think you should do this, I think you should do that. She listens to your concerns, and I liked that about her.” Bonnie began treatment with Dr. Barrett, and ten years later, she is still a patient. More satisfied than ever, she Bonnie Adams Before When you look great, you feel great RENU Medical Aesthetics is a multidisciplinary center offering a e s t h e t i c a n d re j u ve n at i o n treatments, massage therapy and chiropractic care in a spal i ke at m o s p h e re. Fo r m o re information, or to schedule a consultation, please call the office, located at 845 SE Osceola St. in Stuart, at (772) 834-3231. Now open in Tequesta! 304 Tequesta Dr., Suite 3, (561) 406-6123. Call to find out about monthly specials and seminars. FHCN PHOTO BY MARC EDWARDS VALERIE A. BARRETT, MD RENU Medical Aesthetics provides a comprehensive range of aesthetic and rejuvenation treatments in a spalike atmosphere. Services range from BOTOX® Cosmetic, JUVÉDERM®, EndyMed and Sculptra® to laser resurfacing, prescription-grade skincare using the ZO® Skin Health line from Dr. Zein Obagi, and Dr. Barrett’s patented RENU Lift. “Everything I do in the office is minimally invasive and nonsurgical,” explains Dr. Barrett. “We offer a comprehensive variety of procedures, always striving to provide our patients with the widest possible range of options to look and feel good.” Fillers are most often used to lessen deep wrinkles or for replacing volume. The “marionette lines” (located at and below the corners of the mouth) and the nasolabial folds (extending from the corner of the nose down to the chin) respond well to this type of augmentation. Fillers may also be used to replace lip volume. BOTOX or Xeomin® may be used for lines in the upper face (frown lines, crow’s feet). “The lines that go from the edge of the lip to the chin are a common area of concern, and that is actually a symptom of volume loss in the cheeks,” says the doctor. “Over time, everyone loses bone, muscle and fat, and because of that your cheeks drop down. The best treatment for that is to re-volumize the cheeks and re-volumize at the jaw angle. Injectable fillers such as Sculptra, RADIESSE® and VOLUMA™ can achieve that.” Dr. Barrett emphasizes that facial rejuvenation and other cosmetic services are not a “one and done” proposition. For most patients, there will be a natural desire to return for ongoing treatment after a period of months or on an annual basis. “We genuinely treat the whole person,” assures the doctor, “so I think we’re different from other places that offer these types of treatments. As a fullservice rejuvenation center, we don’t try to do everything at once; we typically start with a patient’s area of greatest concern. We always make sure to address the skin as well to treat pigment and sun damage with IPL photo facials and peels.” In Bonnie’s case, Dr. Barrett has used her patented RENU Lift. “The RENU Lift is a new and Bonnie is excited about the results of the RENU Lift. different concept,” says Dr. Barrett. “It’s a personalized approach to determining what combination of products and procedures each patient needs. “Patients are often confused about aesthetic treatments,” she explains. “They think they want one treatment when they really need a different one. So I developed this concept of the RENU Lift. It simply takes the pressure off. “Because I customize the RENU Lift to each patient’s needs and desires, everyone has a different plan. That’s where I think our practice is unique. We always try to offer our patients the widest possible variety of options while advising them on what will be most effective to help them look and feel younger and healthier. My patients always look younger than they did when they first started with me, even if it’s ten years later.” Looking “fabulous” For Bonnie, the RENU Lift has been a revelation. “I would say the last five years that I’ve been with Dr. Barrett, I have been doing the RENU Lift, and it’s amazing,” Bonnie marvels. “No one can ever guess how old I am. In fact, I went out last night and a woman sitting next to me said, You look fabulous. I said, Thank you. At this age, that’s really nice to hear. She said, What do you mean? How old are you? When I told her, she said, I would never have guessed!” She singles out the RADIESSE and Sculptra treatments as being particularly effective. Valerie A. Barrett, MD, is board certified by the American Board of Internal Medicine. After receiving her medical degree from The Chicago Medical School in Chicago, IL, she completed her internship and residency at Rush Presbyterian St. Luke’s Medical Center in Chicago. Dr. Barrett is a member of the American Association of Anti-Aging, the American College of Physicians, the Aesthetic Academy, the Liquid Lift Association, and is a certified Merz Aesthetics Elite and Allergan Platinum provider. “RADIESSE was a great experience,” Bonnie relates. “And I just had Sculptra done today and am very pleased with it, too. As you get older, I think you need a filler that’s a little heavier, and that’s what the Sculptra is,” she adds. For anyone who feels squeamish about the idea of getting injections, Bonnie assures that Dr. Barrett has a gentle, effective technique. “Dr. Barrett has such a good technique that everything is pretty painless, really,” reports Bonnie, “but if she feels that there’s going to be any discomfort, she always has ice packs or numbing cream available. When I first started going to her, I had her do BOTOX on my forehead and around the eyes and lips, and her technique is just fabulous. “She’s a very nice person, very conscientious and sensitive to a person’s needs,” says Bonnie, “and her follow-up is great. She even calls you at home after your treatment to see how you’re doing. She’s wonderful.” FHCN–Michael J. Sahno Where health and beauty come full circle At RENU, patient care is truly a labor of love. Their goal is to help each patient get to a place in their life where they feel good about themselves and the way they look. Services include: • Laser Body Contouring • EndyMed 3DEEP™ Skin Tightening • BOTOX Cosmetic • JUVÉDERM® XC • BELOTERO BALANCE® • RADIESSE • Sculptra • DOT Fractional CO2 Laser • Chiropractic Care • Laser Hair Removal • IPL • Facials • ZO Skin Health from Dr. Zein Obagi • iS CLINICAL® Products • Peels • Microdermabrasion Visit RENU Medical Aesthetics online at www.renuforyou.com. Martin County Edition | Winter 2015 | Florida Health Care News | Page 3 MINIMALLY INVASIVE UROLOGY Take Control of Overactive Bladder Implantable device gently stimulates the nerves that control urination, resolving the debilitating symptoms of overactive bladder. A simple test ordered by her family doctor sent Pennsylvania native Regina Edwards to the office of urologist Michael C. Solomon, MD, FACS, in Port St. Lucie. At the time, she had no idea just how life-changing that appointment would prove to be. MICHAEL C. SOLOMON, MD, P.A., FACS Leslie calls the InterStim her “best friend.” Time to act Overactive bladder is a very prevalent condition. About 30 percent of all men and 40 percent of all women in the United States live with OAB symptoms. For retired General Motors employee Leslie Muniz, her patience had run out, and she finally decided to do something about hers. “I was having difficulty staying asleep at night,” Leslie shares. “I’d get up two, three, sometimes four times a night to urinate, and after I got my granddaughter off [to school] at eight, I was exhausted, so I would go back to sleep for two hours. It really messed up my day. “I would also have accidents. It was embarrassing seeing as I’m only sixty-one. It was awful. I just got tired of it. I said, This has gone far enough. I need to address this issue.” Leslie made an appointment with her gynecologist, who referred her to Dr. Solomon. The urologist impressed her by how knowledgeable and up-to-date he was. He first attempted to treat Leslie’s OAB with medications. “I tried three different types of medication to help me stop going, and none of them worked,” she reports. “I tried that route and then I said, Dr. Solomon, now what?” Unphased by the medication failures, Dr. Solomon was far from ready to give up. He suggested the InterStim. Calming effect “It is actually sacral neuromodulation, and it is delivered via the InterStim system,” clarifi es Dr. Solomon. “It is an implantable system that sends electrical pulses to an area near the sacral nerve to regulate the neural activity that influences the pelvic floor.” By stimulating the sacral nerves, which are located near the tailbone, sacral neuromodulation is able to control the bladder and muscles related to urination, thus managing the symptoms of OAB. “The difference between oral medication and sacral neuromodulation is that the medications target the muscular component of the bladder,” describes Dr. Solomon. “Sacral neuromodulation controls the symptoms of overactive bladder through direct influence of nerve activity.” FHCN PHOTOS BY MARC EDWARDS “I had gone to my regular medical doctor, and he did a urinalysis,” she relates. “He said there was blood in my urine but I did not have a urinary tract infection, so he asked me to see a urologist. Through referrals, I found Dr. Solomon.” With testing and a thorough examination, Dr. Solomon discovered that Regina had kidney stones. But through that experience, Regina grew very comfortable with the understanding and caring doctor, so she decided to bring up another issue with which she’d been struggling. “I had a hysterectomy in 2005, and since then, when I have to go to the bathroom, I can’t wait,” states Regina. “I have to go to the bathroom. Sometimes, I go and then two minutes later, it’s just coming out more.” Dr. Solomon explained to Regina that she was suffering from overactive bladder (OAB) along with about 33 million other Americans. Common symptoms of OAB include the sudden and intense urge to urinate, urge incontinence (leaking), frequent urination and nocturia, the need to urinate often during the night. Regina could identify with that. “I get up every two hours at night just to urinate, sometimes a little, sometimes a lot.” After nine years of frequent and urgent trips to the bathroom, Regina had had enough. She thought she was too young to start wearing leakage protection. Dr. Solomon gave her a trial of an OAB medication, which is in a class of medications called anticholinergics. Her symptoms improved, but she had side effects of dry mouth and did not desire to continue with medical therapy. So, she asked him for a better option. “At fifty-seven, I really didn’t want to wear those garments and pads,” she notes. “I thought, At my age, there has to be something that can be done. Then Dr. Solomon talked to me about the InterStim®.” Now that she visits the bathroom less frequently, Regina can take Dexter and Woody to play in the park. Before a permanent InterStim is placed, Dr. Solomon has his patients “test drive” the system with a three-day evaluation period using a temporary, non-implanted device. If the patient’s symptoms improve during the evaluation, the permanent InterStim, which is about the size of a pacemaker, is implanted just under the skin. “We put a small lead wire in the skin over the tailbone where the pelvic nerve comes out,” he explains, “and we test it for three days. If their symptoms respond, we will put in a permanent lead and implant the neuromodulator. “The test is done in the office, and the permanent implant is done in a surgery center with very minimal anesthesia.” The FDA-approved InterStim system is especially helpful for those patients who cannot afford the medications or endure their side effects. “I have many patients whose insurances won’t cover the cost of medication,” says Dr. Solomon, “so cost has become a big issue. There are also the side effects. The anticholinergics often cause severe dry mouth and constipation, and patients cannot tolerate the drugs because of that. “The InterStim is usually covered by insurance, and patients are happy because it works and they don’t have to take medication.” A good night’s sleep After Dr. Solomon explained how the InterStim works, Regina was ready for her test drive. The doctor placed the temporary leads, and Regina was sent home to evaluate the device. “I had the one that they do just for the weekend, and within a few hours of it being done, I had no leaking,” she recalls. “It was the first time I slept for almost eight hours. It was magic. “Even just the weekend that I had in it, it changed my life. It was unbelievable.” Leslie was also thrilled to finally get a good night’s sleep. “Sure enough, it worked, because I didn’t wake up one time in a few days straight.” “I can’t wait until I have this done permanently,” states Regina. “I would definitely recommend it. It worked for me.” “I highly recommend Dr. Solomon,” adds Leslie. “He’s a very competent, very, very bright doctor.” Leslie believes that the InterStim is an excellent option for treating OAB because it has been highly effective for her. “It’s my best friend.” FHCN–Patti DiPanfilo Want to know more? Dr. Michael Solomon and his staff look forward to meeting the readers of Florida Health Care News. For more information about this article topic or any of their services, or to schedule an appointment, call the office at (772) 242-9368. The office is conveniently located at 555 NW Lake Whitney Place, Suite 103, in Port St. Lucie. Michael C. Solomon, MD, P.A., FACS, is a diplomate of the American Board of Urology and a fellow of the American College of Surgeons. He completed his undergraduate education at the State University of New York (SUNY) at Binghamton, receiving a Bachelor of Science degree in biology. Dr. Solomon went on to earn his medical degree at New York Medical College and SUNY Health Science Center at Brooklyn. His postgraduate training includes a residency in the Department of Urology at SUNY Health Science Center at Brooklyn, where he served as chief resident. Dr. Solomon also was a research fellow in the Urology Service, Department of Urology at Memorial SloanKettering Cancer Center in New York. Among his professional affiliations, Dr. Solomon is a member of the American Urology Association, the American College of Surgeons and the American Association of Clinical Urologists. Visit them online at www.michaelcsolomonmd.com. Page 4 | Florida Health Care News | Winter 2015 | Martin County Edition LASER AESTHETICS NO-SURGERY, NO-SWEAT FAT REDUCTION 215 Bullard Parkway Temple Terrace, FL 33617 (813) 989-1330 (CONTINUED FROM PAGE 1) Winter 2015 with the results they see.” Barry P. Levine Rewarding experience Executive Publisher As it is for so many people, Dr. Tred’s laser system was successful for Kathleen. She is pleased by what she was able to accomplish with the laser’s help. “After nine treatments, I lost ten inches,” she states, “but I’m actually continuing to get results. I have probably now lost about twelve inches total around the different areas. My clothes fit so much better.” While losing those inches is reward enough, Kathleen thinks the time she spent at Slim Body Laser Spa was in itself rewarding. “The people are pleasant,” she notes. “The girls were so nice there. You almost form a bond with them. I’m planning on going back, but at one of my last treatments, I almost cried. It was kind of sad because you get so friendly. “It’s just a win-win situation. There’s no downtime. There’s no discomfort. It’s relaxing. It was just a very pleasurable experience. “And it works. That’s the big thing.” Doctor commits to his own weight loss program and experiences lasting results. Lasting results BEFORE AFTER FHCN PHOTO BY NERISSA JOHNSON Dr. Tred was pleased with his accomplishments, but he didn’t stop there. He decided to continue with his treatments. As a result, he added to his weight and inch loss totals. “As of the first of May 2014, I lost forty pounds and twelve inches and dropped three pant sizes in less than eight weeks using my own Ultimate Laser-Assisted Weight Loss System,” he describes. “I am also enjoying more energy and better health than I have had in years. “What’s more important is I’m keeping it off,” he adds. “I have not gained back any of the weight or inches because I continue to use the laser and watch what I eat. “I believed in this product before I tried it myself, but now I can say from experience, It really works!” PHOTO COURTESY OF DR. RISSACHER D Gina L. d’Angelo CFO/HR Manager Judy Wade Editorial Manager Kathleen is so happy with how her clothes fit since she lost 12 inches from her waistline at Slim Body Laser Spa. FHCN–Patti DiPanfilo The No-Fail Weight Loss Option r. Tred has devoted his practice to helping people safely lose stubborn pounds and inches. When he started to develop symptoms of pre-diabetes due to his own excess weight gain, he first tried dieting and exercising, but the weight did not come off. The solution, he realized, was the fat-shrinking system he uses with his patients every day. “I decided to really commit to my own laser program that I recommend to others,” he observes. “I began the laser program, and within four weeks I dropped ten inches.” He also lost 30 pounds in less than six weeks, and his health issue disappeared. “My diabetes responded beautifully to my weight loss. It resolved as soon as I lost weight and got rid of the inches.” Gail Goldy Senior Associate Publisher FHCN PHOTO BY MARC EDWARDS they blast them with ultrasound or heat them up with radio waves. Our laser procedure simply causes the fat cells to empty their contents, and then the body absorbs that fatty acid naturally through the lymphatic system. It is burned as fuel for the body. It is congruent with how the body normally processes energy, which is why it is so safe. “This laser treatment is an effective method that doesn’t take long,” continues the doctor. “In a series of nine, thirty-minute sessions, patients can lose three to nine inches of belly fat, and their health can improve dramatically, allowing for a long-term solution to keeping the weight off.” Dr. Tred’s laser system can effectively treat many different areas, such as chin fat and muffin top (see Treatment Areas special box). Dr. Tred does mention, however, that diet modification and some exercise can help the process to be more sustaining for some patients. “Patients do need to eat right and exercise in order for the results from these treatments to be long-lasting,” he says. “If a person follows the entire plan, they will be more than happy Florida Health Care News Tred J. Rissacher, DC, completed his undergraduate studies at Indian River Community College and earned his Doctorate degree in Chiropractic from Cleveland Chiropractic College in Kansas City. He attends postgraduate seminars on the diagnosis and treatment of spine disorders. Dr. Rissacher can administer low-level, or “cold,” laser therapy, a new, FDAcleared, noninvasive, effective therapy that can relieve pain caused by arthritis, tendonitis and carpal tunnel syndrome. The Lapex BCS is being used “off label” for spot fat reduction and laser-assisted weight loss. Michael J. Sahno Senior Writer Patti DiPanfilo Melanie Casey Editorial Staff Michelle Brooks Creative Director Nerissa Johnson Graphic Designer Marc Edwards Nerissa Johnson Photography Brian Levine Project Coordinator Laura Engel Treatment Areas* Production Assistant Dr. Tred’s Ultimate Laser-Assisted Weight Loss System can effectively treat the following problems in both men and women: Steve Turk John Gnibus Vincent Ortiz Aaron Ogden • • • • • • Belly fat Chin fat Upper arm fat Muffin top Thigh fat Bra bulges And more * Information supplied by Slim Body Laser Spa Distribution Contributing Editors Slim Body Laser Spa Laser Aesthetics RENU Medical Aesthetics Rejuvenation Michael C. Solomon, MD, P.A., FACS Minimally Invasive Urology Here’s where you can find us: Francis J. DuCoin, DMD, MS 2311 SE Ocean Blvd., Suite A Retina Specialist Stuart Associated Coastal ENT Physicians (772) 223-5885 or call 1-800-MY-SLIMBODY VIP Priority Scheduling The first 20 people to schedule an appointment may begin their treatments right away. These VIP priority-scheduling times are the most sought-after times available, so call today for your “VIP” time. Advanced Dentistry Melgen Retina Eye Center Audiology BHRT, Inc. Hormone Replacement Therapy Vascular Interventional & Vein Associates Vascular Surgery Atlas Chiropractic of Palm City Chiropractic South Florida Eye Clinic Ophthalmology The Dry Eye Spa & V.I.P. Laser Eye Center Dry Eye Treatment Neurology Associates of the Treasure Coast B&As of Dr. Rissacher’s patients Neurology and Pain Management PHOTOS COURTESY OF SLIM BODY LASER SPA For all health care professionals having articles in this publication that offer free or discounted services: 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. 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. 9 treatments/3 weeks’ time Total inch loss = 8 1/2” 9 treatments/3 weeks’ time Total inch loss = 7” For more information, please visit www.slimbodylaserspa.com. Results may vary from person to person based on different factors, and there is no guarantee for specific results. Testimonials and examples found in this publication, in our article from the Slim Body Laser Spa of Stuart, are verified results that have been actually achieved by our clients as described. However, these results may not apply to the average person and are not intended to represent or guarantee that anyone will achieve the same or similar results. FDA indications for use FDA 510(k) The Lapex is intended to emit energy in the visible and infra red spectrum to provide topical heating for the purpose of elevating tissue temperature for the temporary relief of minor muscle and joint pain and stiffness, minor arthritis pain or muscle spasm, the temporary increase in local blood circulation and/or temporary relaxation of muscle. Florida Health Care News provides a paid forum for health care professionals to present their ideas about various aspects of health care treatment and procedures. 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 professional or organization and do not necessarily reflect the opinions of other contributing editors. Contributing editors have approved all text contained within their respective articles. © 2015 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. Martin County Edition | Winter 2015 | Florida Health Care News | Page 5 ADVANCED DENTISTRY A Stable Smile Dental implants change lives by providing security, comfort and renewed confidence. C arol Yates learned the hard way that not all dentists are created the same. Ye a r s a g o , C a r o l underwent extensive dental work that included several crowns and a bridge. In recent years, a couple of those crowns and the bridge became loose and were painful at times. “Dr. DuCoin was very patient and understanding about my concerns,” she says. “He didn’t push me to make a decision right away. I asked him what my options were, and he told me there were three options, and in the end, he let me make my own decision. He didn’t try to push me in any one direction. He was very patient with me and answered all of my questions. He has been wonderful to work with.” What are dental implants? FRANCIS J. DUCOIN, DMD, MS Dental implants serve as the base for many tooth replacement options, including bridges, dentures and individual artificial teeth. Implants are surgically implanted in the jaw to provide a comfortable, secure fit and a natural appearance. Benefits of Dental Implants: • • • • • • Function and feel like natural teeth, allowing you to eat and speak comfortably Are restored to look like natural teeth, so you can smile with confidence Maintain the bone structures of the jaws and face, preventing the premature aging process often associated with tooth and bone loss Suppor t dental work securely, eliminating the need for bulky, plastic dentures or adhesives Help prevent decay in the jawbone Dental implants have a very high success rate The benefits of implants “For people with loose dentures, implants can provide a tremendous benefit because they can confidently chew their food again,” explains Dr. DuCoin, who is board certified by the American Board of Oral Implantology. “The term I like to use is social security, because patients can smile and talk and no longer have to worry about what they can eat or their dentures coming out.” Th e benefi ts of an implant, compared to another prosthesis, like a partial denture or full denture, include FHCN PHOTO BY MARC EDWARDS “I felt like my whole mouth was just uncomfortable all the time,” she explains. “I knew then that I wanted to get dental implants, but I had so much difficulty with dentists in the past that I kind of sat on the idea for a long time. I prayed to God to give me a sign. I asked Him to help me find the right path to take with my dental needs because I had lost so much faith in dentists at that point.” About a year ago, Carol started searching the internet for a new dentist. After reading several online patient reviews, she decided to give Francis J. DuCoin, DMD, a try. “I read a lot of good things about him, and I decided I would make an appointment,” she says. “I knew I had to do something, quickly.” After an initial consultation, Dr. DuCoin suggested three dental implants, as well as bone grafting, for Carol. “I have been doing implants for thirty years now, and I have seen things reinvented numerous times as far as what options are available for patients,” shares Dr. DuCoin. According to Dr. DuCoin, implants were originally devised in the 1940s and have since become increasingly mainstream. “Implants are a standard part of our operating procedures, and a tool that helps provide the results a patient needs and wants,” describes Dr. DuCoin. “There are many benefits to dental implants. They can really change a patient’s entire life.” The implant itself is an artificial tooth root that he can utilize to either replace a single tooth or use as a foundation to replace a couple of teeth with new porcelain teeth that are cemented in place and don’t come out. When appropriate, he can also use implants to provide support for a loose denture. The implant procedure is completed right in his office. First, he replaces the missing natural tooth root with a titanium implant, which is inserted under the gum. He then connects a post called an abutment, which fits over the part of the implant protruding from the gumline. Later, after the gum has healed, a crown or other prosthesis is crafted and placed onto the integrated implant. “In order for implants to be successful, it requires both a financial investment and a time investment from the patient,” Dr. DuCoin emphasizes. “We have all seen the advertisements that offer dental implants in a day, but here, while we can do that, we usually place implants in a more traditional manner. We use stateof-the-art techniques, of course, but also time-tested protocols,” he adds. “If a patient is going to invest financially in implants, then they must also understand that an implant may take time to craft and place properly, especially when you are talking about an implant that the patient would like to last for many years.” Carol can smile once again thanks to the dental implants she received from Dr. DuCoin. increased stability, a more natural look, improved comfort and confidence, and increased longevity because patients can eat comfortably again. “When they go to a restaurant, they don’t have to look at the menu to see what they can eat, but they can look at the menu to see what they want to eat,” Dr. DuCoin says. “Unfortunately, Carol was afraid, or hesitant, to eat many foods because of her old, failing dental work. “Because of the insufficient quantity and poor quality of her bone, placing dental implants was a procedure that really couldn’t be rushed. We did bone grafting first in order to preserve what bone was left and her facial structure. Once the implants were placed, we gave them enough time so that they could integrate adequately into the bone.” Prayers answered Since day one, Carol has been satisfied with the care she receives at Dr. DuCoin’s office. “From the minute that I left there, I have felt fantastic about my teeth,” Carol raves. “They’re just like natural teeth and they feel natural. When I came to Dr. DuCoin, I was very hesitant about having more dental work done after everything else I had been through. But he eased my fears and things went very smoothly, as they should.” In addition to providing exceptional dental care, Dr. DuCoin and his staff go above and beyond for patients. “As I mentioned, I was very hesitant and somewhat apprehensive at first,” Carol emphasizes, “but I was able to tell rather quickly that they were willing to take the time to make it right. And they certainly did that. The staff is very professional and courteous, and Dr. DuCoin is tremendous. His concern for his patients is evident, and he really listens. I am so happy I found him. God answered my prayers.” FHCN–Judy Wade Francis J. DuCoin, DMD, MS, is a graduate of the School of Dental Medicine at the University of Pennsylvania in Philadelphia. He received his undergraduate degree from Drexel University in Philadelphia, where he also earned his Master of Science degree in biomedical engineering. Dr. DuCoin is a Diplomate of the American Board of Oral Implantology/Implant Dentistry and is an Honored Fellow of the American Academy of Implant Dentistry. He is also a Master of the American Academy of Implant Prosthodontics. He served as president of the American Academy of Implant Dentistry from 2003 to 2004 and the board of trustees of the American Academy of Cosmetic Dentistry Charitable Foundation from 2006 to 2009. He currently serves on the Board of Trustees of the American Academy of Implant Dentistry. Dr. DuCoin has earned more than 2000 hours of continuing education and has lectured nationally and internationally on dental implants. For that healthy smile Dr. DuCoin and his staff look forward to meeting the readers of Florida Health Care News. For more information or to schedule an appointment, please call (772) 419-9767 for his office, located at 808 SE Ocean Blvd., Suite 1, in Stuart. For more information, visit www.fducoindmd.com. Page 6 | Florida Health Care News | Winter 2015 | Martin County Edition RETINA S CARING FOR MACULAR DEGENER At this practice, expertise and empathy make for a powerful combination that helps restore patients’ vision…and even their fa B efore retiring from her position as assistant director of nursing at a large hospital, Nancy L. Rice was involved with helping patients with life-threatening conditions. “We set up for open heart surgery and acute and chronic dialysis,” she explains. More recently, Nancy had to deal with another kind of danger: macular degeneration, which threatened her vision. “Just imagine being born with eyesight, and one day you go to the ophthalmologist to have your eyes checked and he suddenly says you need laser treatment. Well,” continues Nancy, “I knew the doctor because he worked at the hospital where I worked. So he gave me the treatment and then afterward, he said, You may have problems with your eyesight for a while. “It was okay for several years, but then I did start having problems,” she explains. “I went to several different physicians, but they all said that there was nothing they could do. I panicked. I proceeded to look for a specialist, but after I had exhausted all my efforts, I felt helpless.” Nancy finally found someone who was able to help save her vision when she visited Salomon Melgen, MD, the founder of Melgen Retina Eye Center. “The other doctors never said anything about macular degeneration. But then I went to the finest physician, Dr. Salomon Melgen, and he gave me the truth,” she says. Age-related macular degeneration is the most common cause of blindness, and in approximately ten percent of patients, the dry form of macular degeneration gives way to the wet form. Wet macular degeneration develops when new blood vessels form beneath the retina and begin to leak or bleed. Eventually, they develop scar tissue that distorts and can damage the retina. In Nancy’s case, the problem had already led to a loss of central vision in her right eye by the time she reached Dr. Melgen. “My left eye is my good eye,” she clarifies. “I’ve been going to Dr. Melgen for three and a half years, and he took me through the steps of macular degeneration and told me how he could treat it. He’s wonderful.” Owen Shilletto had major eye health concerns as well. “Back in the late 1990s, I developed some small swellings the size of a pinhead in the back of my eye, and I was going to an ophthalmologist for treatment for several weeks,” he remembers. “However, these treatments were not successful. I spoke with my personal physician about it, and he said, Why don’t you see Dr. Melgen? Now, he has been taking care of my eyes for years.” Owen found that he immediately felt at ease in Dr. Melgen’s office. “He and his staff are the most conscientious and caring bunch of people,” he continues. “At the onset, Dr. Melgen explained to me that there was leakage in the eye, and in order to prevent it from getting any worse, I would need treatment. “I’ve been associated with Dr. Melgen and his staff ever since then, approximately fourteen years.” About macular degeneration For conditions such as macular degeneration and diabetic retinopathy, Dr. Melgen has successfully treated hundreds of patients in the Palm Beach County area, with four convenient clinic locations. Dr. Melgen founded Melgen Retina Eye Center in 1988. While much clinical research was being conducted, his was one of the first private practices in Florida to use the scanning laser ophthalmoscope (SLO), which helped tremendously in understanding macular degeneration. “Our center was one of the first in Florida to implement laser therapy for this disease,” he reports. “When nothing was being offered to treat patients suffering from macular degeneration, I was able to help them.” Dr. Melgen notes that until they visit him, many of his legally blind patients feel hopeless about retaining some of their vision. “People frequently come to me after having been told that nothing can be done for them,” he explains. “I see it in my practice every day. Fortunately, there are things that can be done. Our goal is to make a macular degeneration patient’s blind spot smaller and lighter, thereby improving their peripheral vision. And even if the change is so small that it cannot be measured on a chart, many patients report that their vision has improved.” The macula is the central area of the retina that makes it possible to distinguish fine details and colors. When retinal tissue in the macula degenerates – either because the tissue itself begins to deteriorate or because new blood vessels form beneath the tissue and threaten its integrity – it can have a significant impact on vision. SALOMON MELGEN, MD, P.A. “Nancy is one of our age-related macular degeneration patients, but she also has retinal vein occlusion, which is like a circulation problem in the eye,” observes Dr. Melgen. “There are many diseases of the eye that patients may not be aware of, and retinal vein occlusion is one such condition. Thanks to laser and injections, her treatment has gone very well. “Owen has been very cooperative in his treatment plan, and as a result, his vision is 20/15. He is a great example of how patient compliance is extremely important. His compliance with his treatments has resulted in his having excellent vision today.” Customizing care In the presence of macular degeneration, some people will notice a gradual loss of their ability to see objects clearly, especially noticing a blurring of areas of type on a page of print, or dark or empty spaces that may block the center of the field of vision. Some patients may notice that straight lines in the landscape – such as telephone poles, the sides of buildings or streetlight posts – appear wavy, crooked or distorted. Some may notice the need for brighter light when reading or a gradual loss of color intensity in everything around them. Leading-edge treatments “Today, there are medications that have tremendously helped patients with macular degeneration and other retinal diseases that we didn’t have in our arsenal in years past,” assures Dr. Melgen. “Drugs such as Lucentis® and Avastin® can help to arrest the further progression of the disease and, in most patients, improve their vision. “The dry form of macular degeneration is like a wearing out of the retina,” explains Dr. Melgen. “It’s like when the skin wrinkles and hair goes grey. It’s a part of aging; it’s the golden years of the eye. “With the wet form of macular degeneration, however, people develop abnormal, leaky vessels and they bleed easily. As they grow, these leaky vessels destroy the retina and create scar tissue, which causes the loss of central vision.” For Owen and Nancy, the aggressive treatment proved beneficial right from the start. “I’m very pleased with how I am taken care of by Dr. Melgen,” says Owen. “Thanks to his continuous treatment, I’m able to see very well.” “I see one or two patients almost every day with this condition who have been told by other doctors that they cannot be helped,” continues Dr. Melgen. “These patients need treatment, and I have had great success in treating them. I explain to them that what I can do is decrease the size and density of their central ‘black spot,’ so they can function better. They may or may not be able to read or drive, but they can see their grandchildren better and function better because they gain better peripheral vision.” He adds that it’s important to customize treatment to each individual patient, not just to what it says in their chart. “The truth is that there are many different degrees of legal blindness. In the chart, they all look the same, but we’re not treating charts; we’re treating patients. “In Florida, there are many people who are legally blind,” explains the doctor, “and they need frequent visits to the doctor because those leaky blood vessels in the eye tend to recur. As they recur, they grow, and as they grow, they destroy more healthy retinal tissue. “A comprehensive treatment plan prevents the progression of the disease, and that is essential. By stopping a patient’s blind spot from growing – and, in many cases, making it lighter and smaller – we can improve that person’s vision, even though they had been told that their case was hopeless. Many of our patients are now more independent, more confident in their daily activities and they manage much better at home. Four convenie Port St. Lucie 1751 SE Port St. Lucie Blvd. (772) 337-4800 Delray Beach/Boca Raton 6290 Linton Blvd. Suite 103 FHCN PHOTOS BY MARC EDWARDS (561) 495-5333 Se habla For more information, vi Martin County Edition | Winter 2015 | Florida Health Care News | Page 7 SPECIALIST RATION aith in the medical profession. “This is an aggressive, chronic disease, so it has to be treated aggressively. I want to maintain what vision the patient has or make it better, if I can. For a person who is in the dark, a little bit of light is an improvement,” concludes Dr. Melgen, “and if we can provide that for our patients, then we have been successful.” “I thank God every day for giving Dr. Melgen the skill and ability to help us with our vision,” says Nancy. Thankful patients Nancy is thrilled with Dr. Melgen and his staff, and says that they combine a strong ethical approach with empathy for every patient. “Ethics, expertise, compassion, kindness, loyalty and integrity: those are the words that describe Dr. Melgen,” she lists. “This is not just my opinion; many other patients express the same feelings. When sitting with others in the waiting area, I have heard patients share about having debilitating experiences with other doctors before going to Dr. Melgen for their treatments. Once those treatments were performed, it was like hitting the lottery. What separates Dr. Melgen from the mediocre is that he strives for perfection and never gives up. “Furthermore,” adds Nancy, “Dr. Melgen is not partial to a particular class or culture. He treats everyone with dignity and respect. The staff there are wonderful as well. They make you feel at ease and they have a good relationship with the patients. Sometimes, I sit and talk to other patients who have been coming to Dr. Melgen for years, and they tell me their experiences and how they feel about him, how he’s helped them so much to have eyesight where other doctors had told them, We don’t know what we can do for you.” She stresses that the results of the treatment have been uniformly excellent. “My vision in my right eye was poor before I saw Dr. Melgen,” reminds Nancy, “but after I had several treatments, I began to see. It was as if I had new glasses, or even a new eye. I could see so much better, because he made my peripheral vision in my right eye so much clearer. I can see everything better. He saved my eyesight.” For his part, Owen is thankful for all the help he has received from Dr. Melgen and the staff. “I have always gone for my regular appointments over the years,” he confirms, “and during that time, my vision has gotten better and better. I’m very pleased with how I am taken care of by Dr. Melgen. Thanks to his continuous treatment, I’m able to see very well.” Having had a relationship with the practice for so many years, Owen knows well how the doctor and staff interact with all of their patients. “They’ve made me feel so comfortable, I could describe them as family,” he says. “Even though there are patients lining up to go in and see him, he’s not going to rush. He’s always there lending an ear. “In fact, when I lost my dad, which was about eight years ago, Dr. Melgen embraced me in such a way and reminded me to think of the good things in life. There was just so much compassion in his feeling toward me when I lost my dad, and I will never, ever forget it. “Sometimes when I sit there in the waiting area with other patients, I hear them talking among themselves about the type of person he really is. As the kids would say, He’s awesome!” FHCN–Michael J. Sahno Dr. Melgen treats a variety of ocular conditions, including: Macular Degeneration Diabetic Retinopathy Retinal Detachment Macular Puckers/Macular Holes Retinal Vein Occlusions Macular Edema ent locations West Palm Beach 2521 Metrocentre Blvd. (561) 687-0007 Wellington 3319 State Rd. 7, Suite 207 (561) 753-0873 a Español Flashers and Floaters Salomon Melgen, MD, is a Diplomate of the American Board of Ophthalmology and a Fellow of the American Academy of Ophthalmology. After completing an internship at Danbury Hospital affiliated with Yale University and residency at the University of MissouriKansas City, he became the Chief Resident of the Ophthalmology Department at the University of MissouriKansas City. Dr. Melgen went on to complete a VitreoRetinal Fellowship at Harvard Medical School, where he became the Chief Fellow for the Massachusetts Eye and Ear Infirmary. He is a former Chief of Ophthalmology at St. Mary’s Hospital in West Palm Beach. Dr. Melgen is a founding donor of the American Retina Foundation and a member of the American Society of Retinal Specialists, American Board of Eye Surgery, and Florida Society of Ophthalmology, by whom he has been awarded for his service to the community. Dr. Melgen has received numerous awards for excellence in his field, including the Patients’ Choice Award for six consecutive years and the Patients’ Choice Award as one of America’s Most Compassionate Doctors for four consecutive years. He is a Castle Connolly Top Doctor, and was recognized as one of America’s Top Ophthalmologists by the Consumers’ Research Council of America. isit Melgen Retina Eye Center at www.melgeneyecenter.com or www.facebook.com/melgeneyecenter. Page 8 | Florida Health Care News | Winter 2015 | Martin County Edition AUDIOLOGY Join the Conversation W Being properly fit for hearing aids is a task you should entrust to a board-certified audiologist. RICHARD B. ALLEN, MD CHRISTOPHER L. SLACK, MD MICHELE L. RICHARDS, MD JONATHAN M. OWENS, MD NICOLE THOMPSON, ARNP LORI K. GIROUARD, AUD ERIN E. ANDERSON, AUD “There was a lot of background noise,” Harold explains. “If I was in a crowded place, like a restaurant, and I was having a conversation, I had a hard time tuning out the background noises and focusing on the person I was talking to. It was hard to pick out the words.” His work as an attorney requires Harold to speak to his clients often, both on the phone and in person. “I am always talking, one way or the other,” Harold says and laughs. “And it got to a point where it was not only affecting my social lifestyle, but it was also affecting my work with my clients. Hearing is a very important gift that we can easily take for granted.” Anyone seeking a complete hearing evaluation should seek the help of a board-certified audiologist. Thankfully, Harold knew where to turn for help. A longstanding patient at Associated Coastal ENT Physicians, he gave them a call to schedule a hearing test. “My entire family has been seeing the otolaryngologists there for years, so I was already familiar with the practice and the doctors. I was comfortable with them,” Harold says. An audiologist knows best “As doctorate-level audiologists, we perform comprehensive audiological evaluations on each patient,” explains Lori K. Girouard, AuD. “Our high level of training allows us to diagnose and treat various types of hearing loss and balance disorders. Our audiologists and ENT physicians work as a team to provide the best possible hearing health care to our patients. If a patient has wax build-up or a medical condition requiring medication or surgery, we are able to have them see one of our physicians the same day (like a one-stop shop for hearing health care).” Hearing loss can result from a variety of factors and can present itself at any age. “Studies have found there is a direct correlation between hearing loss and dementia. It is important to keep the auditory system and hearing centers of the brain stimulated. With hearing loss, this pathway is disrupted. The brain relies on incoming sound, and the advanced technology offered in our hearing aids allows patients to hear in noise as effortlessly as possible.” FHCN PHOTO BY MARC EDWARDS hile in his early 20s and serving in the US Army, Harold Melville lost the hearing in his right ear. Advanced technology “When it comes to hearing aids, technology is constantly changing and improving,” Erin E. Anderson, AuD, also a doctorate-level audiologist in the practice, explains. “We fit our patients with state-ofthe-art hearing aids which offer Bluetooth® connectivity, allowing phone calls, TV and music to stream directly into the hearing aids via a streaming device. There is even an iPhone® app for certain hearing aids. “Signs of hearing loss include ringing, or tinnitus; asking for repetition, having the TV louder than normal and often Lori K. Girouard, AuD, is a doctorate-level audiologist. She received her undergraduate degree from Worcester State College, Worcester, MA, her Master’s degree in Audiology from the University of Massachusetts and Doctorate in Audiology from Salus University. She is a fellow of the American Academy of Audiology and a member of the American Speech-Language-Hearing Association. Erin E. Anderson, AuD, is a doctorate-level audiologist. She received her undergraduate degree from the University of New York at Geneseo and her Doctorate in Audiology from Nova Southeastern University in Fort Lauderdale. She is a fellow of the American Academy of Audiology. Harold can have meaningful conversations with his clients again after receiving his hearing aid. withdrawing from social situations.” Harold says life has changed dramatically since he received his hearing aids. “I am hearing sounds now that I had not heard in forty years,” he says. “I would just sit in my car and listen to songs on the radio because I was actually hearing the words. It has opened up a whole new world for me. It’s great!” FHCN Hearing aid expertise Associated Coastal ENT Physicians takes great pride in providing comprehensive and compassionate ear, nose and throat care in the heart of the Treasure Coast. Offices are located at 1731 SW Gatlin Blvd., Port St. Lucie, and 4632 S. 25th St., Fort Pierce. For more information, or to schedule a consultation, please (772) 464-9595. Visit Associated Coastal ENT Physicians on the web at www.coastalent.org. HORMONE REPLACEMENT THERAPY Replenishing Hormones Naturally Pellet therapy provides steady relief from menopausal symptoms through bio-identical hormone replacement. FHCN PHOTO BY MARC EDWARDS S Sophia is happier and healthier now, thanks to Dr. Berman and BHRT. Mikhail Berman, MD, is a general practitioner who focuses on holistic and anti-aging medicine. Dr. Berman earned his medical degree from the Leningrad Pediatric School of Medicine in St. Petersburg, Russia. He completed his internship and residency at the Second Hospital of Leningrad and completed residencies at the Institute of Trauma and Orthopedics and the Urology Second School of Medicine in St. Petersburg, Russia. More recently, Dr. Berman has received board certification and is a fellow of the American Academy of Anti-Aging Medicine. Dr. Berman is a board member of the National Science Foundation University-Industry Cooperative Research Center. ophia Rekblatt always led what she considered to be an active lifestyle between her job in the home health industry and her personal and married life. “I work a lot of hours and I burn a lot of energy all day long at work,” Sophia relays. “I have always been a morning person and never had an issue getting out of bed and going to work, then one day I felt like my body just crashed. I just had no energy, even after a good night’s sleep. I was tired all the time.” Then, the menopausal symptoms seemed to settle in, Sophia recalls. “I started having hot fl ashes and mood swings,” she says. “I remember that my mother had a really diffi cult time with menopause, and I just did not want to go through those same things. She was depressed a lot. Every woman is different, but I knew I did not want to go through that.” Married for 27 years to her husband, George, Sophia recalls confiding in him about her physical condition. “I talked to my husband and he said, Let’s find some options,” she says. That’s when she turned to Mikhail Berman, MD, at BHRT, Inc. in Palm Beach Gardens. Feel good again After an initial consultation, it was determined that Sophia needed hormone replacement and Dr. Berman recommended bio-identical pellet hormone replacement therapy (BHRT). “Hormones are messenger molecules,” explains Dr. Berman. “They are responsible for making all systems of the body work in unison. Estrogen, progesterone and testosterone are important hormones that are produced in ovaries, testicles and adrenal glands. As we age, they decline and this negatively affects not only sexuality, but also mood, sleep, energy and many other functions. BHRT, INC. MIKHAIL BERMAN, MD “When delivered by pellets,” he continues, “which are the size of a grain of rice, hormones provide superior relief of menopausal symptoms. The oldest method of hormone replacement, pellets have been used for decades and are the safest and most thoroughly studied way to replace hormones. Pellets also prevent hormone transmission to others, which can occur when using creams.” Dr. Berman worked closely with Sophia and after detailed testing and thorough examinations, they determined the proper dosage that worked best for her. “Pellets deliver a steady stream of hormones into the blood because they are introduced under the skin into fat tissue and they slowly dissolve over a period of four to five months,” he explains. “This ensures their levels remain stable and do not fluctuate.” Renewed energy Sophia says she started feeling better within days of receiving the pellet treatment. “In a few days, I felt like myself again,” Sophia notes. “I was just full of renewed energy, hot flashes and mood swings were gone and the desire for intimacy returned.” Sophia now has more energy than ever before and can maintain her active lifestyle. “I’m very happy with the choice I made,” she confides. “Any time I have a concern, I know I can call Dr. Berman and he is available to take any questions,” she adds. “He’s very passionate about what he does and very knowledgeable. I am thrilled with the results.” FHCN Correct Your Hormones Today! If you are interested in hormone replacement, visit Dr. Berman’s office at 8295 North Military Trail, Suite G, in Palm Beach Gardens or call his office at (561) 626-3205. For more information, visit his website at www.hormonecorrection.com. Martin County Edition | Winter 2015 | Florida Health Care News | Page 9 VASCULAR SURGERY SURGERY WITHOUT A SCALPEL With less pain and quicker recovery, revolutionary new PEVAR procedure offers less invasive abdominal aneurysm repair option. F rank Roach was only two weeks into his recovery from triple bypass surgery last September when he experienced a pain he couldn’t explain. “I was at home, and all of a sudden I had this tremendous pain,” he recalls. “I almost passed out. It was so intense in my lower left abdomen, and I told my wife, Something’s seriously wrong.” VASCULAR INTERVENTIONAL & VEIN ASSOCIATES PRANAY T. RAMDEV, MD, FACS About aneurysms GRAPHIC COURTESY OF VASCULAR INTERVENTIONAL & VEIN ASSOCIATES An abdominal aneurysm is a bulge in an artery caused by a weakening of the blood vessel wall. Left untreated, the condition can be fatal. “It’s like a balloon that’s too full of water,” explains Dr. Ramdev. “The PEVAR technique BEFORE: AFTER: An aortic With the aneurysm looks aneurysm fixed, like a balloon that the risk of is ready to pop rupture is gone Pranay T. Ramdev, MD, FACS, is a Fellow of the American College of Surgeons and is board certified by the National Board of Medical Examiners – Parts I, II, III, and by the American Board of Surgery with a certificate of added qualification in vascular surgery. He earned his medical degree from Dartmouth Medical School in Hanover, NH and served five years of general surgery residency at the University of Rochester Strong Memorial Hospital. Dr. Ramdev went on to complete a fellowship in vascular and endovascular surgery at Harvard University in Boston. Following his fellowship, he joined the faculty at the Division of Vascular and Endovascular Surgery at the University of Miami Miller School of Medicine. Dr. Ramdev has been practicing vascular surgery for more than 12 years. Until a few years ago, patients needing repair of an abdominal aneurysm would have an operation requiring “a big incision in the belly,” reports Dr. Ramdev. “Patients often stayed a week to ten days or more in the hospital. The next evolution was minimally invasive, with incisions in the groin and relining the aorta. Now, it’s almost like Welcome Dr. Galovich Vascular Interventional & Vein Associates welcomes Justin M. Galovich, MD, to the practice. A fellowship-trained vascular surgeon, Dr. Galovich earned his Bachelor of Science degree in biochemistry and molecular biology at the University of California Santa Cruz and his medical degree from St. George’s University School of Medicine, Grenada, West Indies. He completed his internship at Harbor UCLA Medical Center followed by a residency at the University of California Irvine, where he was named chief resident. He completed a fellowship in vascular surgery at Harbor UCLA Medical Center in 2014. A California native and avid surfer, Dr. Galovich is married and the father of two PHOTO FROM ISTOCKPHOTO.COM His wife, Carol, called 911, and Frank was whisked to the emergency room. Doctors determined that he was suffering from an abdominal aortic aneurysm and needed immediate emergency surgery. Pranay T. Ramdev, MD, FACS, a board-certified vascular surgeon at Vascular Interventional & Vein Associates, was the surgeon on call at the hospital that night. “He came in and told me that I had a leaking aneurysm and I needed to be operated on,” remembers Frank, a retired banker who is originally from New York. “I said, Okay. What we gotta do, we gotta do.” “We were able to get in very quickly using percutaneous [through the skin using a needle] access,” explains Dr. Ramdev. “I put the graft into the aorta all percutaneously and closed it percutaneously. He did extremely well.” balloon will eventually explode, and that’s essentially what happened to Frank.” Though genetics can play a role in the development of aneurysms, smokers are at higher risk because smoking accelerates aneurysm growth, explains the doctor. “The chemicals in the smoke cause the breakdown and weakening of the artery wall,” offers Justin Galovich, MD, a fellowship-trained vascular surgeon who recently joined Vascular Interventional & Vein Associates. Other causes of aneurysm include high blood pressure, atherosclerosis and certain connective tissue disorders. No matter the cause, an abdominal aneurysm is a serious condition that requires treatment. Unfortunately, aneurysms don’t always cause noticeable symptoms unless they start to leak or rupture – situations that require immediate emergency medical treatment. When an abdominal aneurysm ruptures, “the mortality can be quite high,” Dr. Ramdev reports. “If it’s a free rupture, meaning your entire blood volume is being dumped into your belly, it can be exceedingly high. But if it’s a contained rupture, which is what Mr. Roach had, it is contained in an area called the retroperitoneum, and you have a little bit more time, a few hours.” Unfortunately, unless they rupture, aneurysms often go undetected. Frank, 63, says he didn’t notice any overt symptoms. “I might have had little twinges down there,” he admits, “but I didn’t really pay a whole lot of attention to them. But this one just doubled me over. I went down on one knee on the floor. That’s how painful it was.” Fortunately, an ultrasound scan can detect an aneurysm well before there is a risk of rupture. Moreover, when individuals begin Medicare coverage at age 65, they are entitled to receive an aneurysm screening, stresses Dr. Ramdev. “They can come in, get an ultrasound test and Medicare will cover the cost,” he says. Severe abdominal pain can be a sign of an aneurysm, which requires emergency medical treatment. a heart catheterization with bigger devices that go in the groin, and we now have almost no incisions.” “It was like I wasn’t even operated on. The incisions were minor, and the day after the surgery I was up and walking around.” - Frank Roach This leading-edge technique, which was FDA approved in 2013, is known as percutaneous endovascular aneurysm repair (PEVAR). It involves a series of catheters that are directed to the aorta through tiny, pinkie finger-sized punctures in the groin. Once in position, a stent graft (a long, cylinder-like tube) is threaded through the catheters and into the affected area to repair the aneurysm. “It’s more of a new procedure, and I’m not aware of anyone else in the area doing it,” notes Dr. Galovich. PEVAR offers an array of benefits for the patient, including reduced groin complications, less blood loss, less pain, a shorter hospital stay and a quicker return to normal. The day after Frank’s emergency active, young sons, ages 5 and 8. One of the reasons the family chose to relocate to Vero Beach is because of the wide array of available outdoor activities. “There’s a good family lifestyle here,” he says. Professionally, Dr. Galovich “was looking for someone who is going to be a mentor,” he explains. “Dr. Ramdev is someone who knows a lot of the procedures I was trained to do and does those procedures. I was looking for someone who would help me grow.” Dr. Galovich is a member of the Peripheral Vascular Surgical Society, the Society for Clinical Vascular Surgery and the American College of Surgeons. He practices out of the Sebastian office. Please visit www.VIVAMyVeins.com for more information. surgery, he woke to find he “had no pain,” he marvels. “No discomfort whatsoever. It was like I wasn’t even operated on. The incisions were minor, and the day after the surgery I was up and walking around.” “He did extremely well,” observes Dr. Ramdev. “The aneurysm is essentially repaired, with very minimal morbidity and minimal discomfort sensation. His prognosis is really good. He’ll have ultrasounds and a follow-up, but he should do really well.” Enjoying life Frank had never even been in a hospital prior to his triple bypass surgery last summer. Now, after two life-threatening events in the span of a month, he has a new lease on life and is well on the road to recovery. He is looking forward to spending time with Carol, his wife of 39 years; playing golf and cards with friends and visiting his two sons and two grandsons. Though last September was “kind of a rough month,” he admits, Frank is glad that Dr. Ramdev was the doctor on call the night his aneurysm ruptured. “He is very confident,” Frank observes. “He was very clear as to what he was going to do and why he had to do it.” FHCN–Melanie Casey Find Help Dr. Ramdev, Dr. Galovich and Physician Assistant Robyn Ronzio welcome all calls regarding this article as well as other topics related to vascular issues. Offices are located at 955 37th Place in Vero Beach, (772) 5678482; 7925 Bay Street in Sebastian, (772) 646-4626 and 2215 Nebraska Avenue, Suite 1A, in Ft. Pierce, (772) 801-2108. Page 10 | Florida Health Care News | Winter 2015 | Martin County Edition CHIROPRACTIC Stop Neck Pain and Ease Sinus Infections Treatment also brings relief from headaches and other symptoms simultaneously. L aura Vinci was suffering with multiple symptoms. “I had severe, chronic neck pain, and I mean chronic,” describes the Real Estate of Florida realtor. ATLAS CHIROPRACTIC OF PALM CITY THOMAS D. KLEINMAN, DC The Atlas procedure Dr. Kleinman, a local chiropractor, has used a protocol known as the atlas orthogonal procedure for more than 25 years. This procedure is based on maintaining the precise alignment of the first cervical, or atlas, vertebra. It is called the atlas because it holds up the head, just as the titan Atlas holds up the world in Greek mythology. According to Dr. Kleinman, it is the balance of the head on the neck that controls the body’s posture and is the key to good health. Misalignment of the atlas vertebra causes the spine to twist in order to maintain its balance. This twist can pinch nerves and put pressure on the spinal cord or the brain stem itself. This can cause a myriad of symptoms sometimes not even thought to be associated with the spine. “The human body is an incredible healing mechanism,” observes the doctor. “However, the trick to health care is to find the cause of the symptoms and correct it. Just treating the symptoms will have little long-term effect. “In Laura’s case, as in so many like hers, the problem of misalignment of her atlas vertebra caused a constellation of symptoms, but the focus was fi rst, of course, on her pain. Once the pain was correctly addressed, everything else functioned better.” Laura is now approximately onethird of the way through her treatment. “I feel fi fty million times better,” she marvels. “I knew from the results of my first treatment that I was in the right place, and now my neck pain is already ninety percent better. My ears feel much less stuffed up and are improving, the Whole Food Nutrition Offered Dr. Kleinman has incorporated whole food nutrition from Standard Process® as part of his wellness program. He invites you to learn more about the role of whole food nutrition in reversing disease. Workshops are held at Atlas Health and Wellness, located in the Palm City Professional Center, 1516 SW Mapp Road. Please call (772) 781-9987 for further information. FHCN FILE PHOTO Following a couple of childhood incidents involving her neck, Laura was a passenger in a motor vehicle accident in 1998, she recounts. “It was pretty bad; when I regained consciousness, I was shocked that I hadn’t broken my neck. However, the pain did get significantly worse. If I turned my head to the right or left, or tried bending it back, the pain was excruciating. I had a lot of headaches, and was always getting sinus infections. I could feel that my posture was no longer correct. Plus, since 2006, my ears had been consistently stuffed up, I was having dizzy spells and I was plagued with fatigue.” Laura says she sought help on several fronts: “I was diagnosed with a herniated disc and went through physical therapy. I was treated by a chiropractor in Connecticut, which helped somewhat, but I still suff ered neck pain every day. I saw a couple of different allergists about my ears. They talked about treating the symptoms, but didn’t address the underlying problem. “I’m living with all of this, thinking that I would be like this for the rest of my life. I thought, What’s going to happen to me when I’m older? “Th en I saw an article in Florida Health Care News about another patient with multiple symptoms similar to mine who found help. I thought, If someone can help me after all of these years, it would be a miracle.” Laura scheduled an appointment with Dr. Thomas Kleinman. Laura says the change in her health has been dramatic. headaches are much better, the episodes of dizziness are regressing and I have much more energy. “It’s been the biggest blessing of my life, and it happened within such a short time period.” Laura says Dr. Kleinman is wonderful to work with: “He’s phenomenal. He has such compassion for his patients, and the staff makes you feel so welcome. “The entire place emits a positive light.” FHCN Thomas D. Kleinman, DC, is board certified by the National Board of Chiropractic Examiners. He is on the board of the Spinal Orthopedic and Neurological Advancement and Rehabilitation Foundation and the board of the Carpal Tunnel Relief Foundation and assists in the development of nonsurgical protocol for relief of this debilitating syndrome. OPHTHALMOLOGY Eye Floaters? E ye floaters − those tiny specks or strings that float into your field of vision periodically − can be concerning. Typically caused by age-related changes to the vitreous humor, the thick fluid inside the eye, eye floaters become more common with age. But can they cause blindness? SOUTH FLORIDA EYE CLINIC SCOTT L. GELLER, MD FHCN PHOTOS BY MARC EDWARDS “By our usual definition, of course not,” says Scott Geller, MD, a boardcertified ophthalmologist at South Florida Eye Clinic in Fort Myers who has a special interest in the treatment of eye floaters. “But imagine if you only had one good eye. Imagine that the floater in it was so large that when it came across your field of vision, you could not even see the big E on the eye chart. Imagine if it were a car on the highway or a road Laser treatment for eye floaters is safe and effective. sign. By the statutory definition of legal word to more ophthalmologists that this blindness, that would qualify, if only for is a safe technique,” he explains. “And the short period of time the floater was even more than that, we need to educate in your field of vision.” ophthalmologists that in many instances, Patients with eye floaters of this size − eye floaters can disable. even if their vision is perfect − are actually “The current ophthalmic dogma is quite disabled, stresses Dr. Geller. “Most that an ophthalmologist will say, Well, I ophthalmologists don’t seem to under- have floaters; what are you complaining stand that when a patient is complaining about? So they write off the patient and of serious eye floaters, but their vision is tell them it will go away. In most cases, 20/20, they are actually having a real prob- this is true, but the patients that come to lem,” he says. “It’s not something that’s me have serious problems.” only in their mind.” When eye floaters are severe, some Dr. Geller should know: he is one ophthalmologists may offer a vitrecof the most recognized eye floater laser tomy, the surgical removal of the gel specialists in the United States and where the floaters reside. However, this around the world. is rare because the “We have had has some “THE LARGEST SERIES operation patients come from serious drawbacks all over the world to and complications, OF EYE FLOATER our facility in Fort and it is an expensive, LASERS WORLDWIDE” invasive Myers for treatment,” procedure. says Dr. Geller. www.vitreousfloaters.com However, the com“Many patients come plication rate for laser from countries where medicine is social- treatment of eye floaters is very low. ized, and there is a lack of training and Furthermore, there is no risk of infecproper equipment. During the past tion with laser since there is no cutting twenty years, we have treated thousands with a scalpel. of patients and have performed nearly Dr. Geller has treated many meditwenty thousand laser sessions.” cal doctors for their eye floaters as well. “When other doctors and ophthalMaster of floater treatment mologists come to you for their own Dr. Geller is a master of this treatment problems, I would say that speaks for modality. He has trained doctors from itself. We love doing laser surgery on Holland, Italy, the United States and eye floaters, and love dealing with our Central America. “We need to spread the patients on a personal basis.” FHCN 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 fellowship to study tropical medicine at a missionary hospital in India, and pursued additional studies at the famous Brompton Hospital in London, England. He interned at Presbyterian Hospital, Pacific Medical Center, San Francisco, CA, and completed his residency in ophthalmology 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 refractive 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 floater laser treatment at the International Congress of Ophthalmology, European Congress of Cataract & Refractive Surgery, European Congress of Ophthalmology, and the Florida Society of Ophthalmology. For eye floater solutions... Call Dr. Geller at (239) 275-8222 or toll-free at (877) 371-3937. South Florida Eye Clinic is located at 4755 Summerlin Rd. in Fort Myers. www.vitreousfloaters.com Martin County Edition | Winter 2015 | Florida Health Care News | Page 11 DRY EYE TREATMENT Dry Eye Syndrome Relieved The revolutionary LipiFlow technology from TearScience provides a long-lasting solution to the pain, itching and blurriness of dry eyes. L ynne Parent has gone through a major challenge with dry eye syndrome. She says that long-term use of contact lenses played a role in either causing or exacerbating her dry eye symptoms. “I was a contact user for many, many years. I enjoyed wearing contacts, so I very seldom wore my glasses,” explains Lynne, adding that the dry eye problem actually forced her out of her contacts and back to glasses. THE DRY EYE SPA & V.I.P. LASER EYE CENTER CLIFFORD L. SALINGER, MD Evaporative tear deficiency When addressing dry eye syndrome, there are four factors to consider: exposure to the elements, inflammation, the quantity of tear production and, most importantly, the quality of the tears. “Dry eye is a chronic, progressive condition that requires some maintenance treatment,” emphasizes Dr. Salinger. “Exposure to the elements happens to some degree whether we are awake or asleep, because the eyelids do not close completely. Even when we are sleeping, there is some exposure of the surface of the eye, so a ceiling fan or air conditioning unit blowing directly on you will exacerbate the problem.” The quality of tears is the most significant component that can be treated medically, and LipiFlow directly addresses the balance between the oil layer and the water layer, thereby improving tear film stability. “Oftentimes, dry eye patients are treated for aqueous deficiency, or not enough of the water layer,” clarifies Dr. Salinger. “What we now know, however, is that the majority of the dry eye condition is typically caused by evaporative tear deficiency, not aqueous deficiency. This problem is primarily due to the dysfunction of the oil glands.” Revolutionary treatment The LipiFlow Thermal Pulsation System from TearScience provides a more targeted treatment, even for seemingly hopeless cases of dry eye syndrome that have persisted in spite of traditional comprehensive care. Dr. Salinger has offered the LipiFlow treatment since April 2012. The LipiFlow system relieves blockages of the eyelid’s oil glands during a short office visit. Opening and clearing these blocked glands enhances the natural production of the oils that are needed for a healthy layer of tears on the surface of the eye. “The dysfunction within the oil glands is not particularly noticeable,” says Dr. Salinger, “and most eye doctors are Signs and Symptoms of Dry Eye Syndrome • • • • Dryness or itching Excess tear production Burning, stinging sensation “Foreign body” or scratchy sensation • Blurred vision • Eye fatigue • Pain and redness The System Fast • Noninvasive • Painless Effective • Long-lasting LipiFlow treatment jumpstarts the oil glands, emptying them of a lifetime of blocked-up material so that the new oil being produced is healthier and flows more naturally from the evacuated gland. “Lynne came to us with significant dry eye problems that were unable to be improved by other physicians. We were able to improve her symptoms of the dry eye disease, as well as her ocular signs of dry eye, sufficiently enough to then make her a candidate for LASEK laser vision correction. “There is a widespread belief that you’re not a good laser vision candidate if you have dry eye,” adds Dr. Salinger, “and that is true for the standard, conventional LASIK. But for the surface laser vision correction procedure, LASEK, although it FHCN PHOTO BY MARC EDWARDS “It was at the point where I was down to only a few hours per day where I could wear my contacts before I would have to change into glasses – my eyes were so dry that the contacts were irritating them.” Dry eye syndrome, also known as keratoconjunctivitis sicca, is a problem that affects millions of Americans like Lynne. Symptoms of dry eye syndrome can include intermittent blurry vision, excess production of tears, itching, or burning and stinging. Once the problem became severe, Lynne suffered for a long time with her painful dry eyes. “I was experiencing pain in my eyes for almost a year, waking up so dry every morning,” she recalls. “I was always blinking to try to moisten my eyes. It just got so painful for me.” Lynne finally found help after consulting Cliff ord L. Salinger, MD, the founder of The Dry Eye Spa & V.I.P. Laser Eye Center in Palm Beach Gardens. Dr. Salinger is a board-certified ophthalmologist, cornea and refractive surgeon and dry eye specialist. Lynne says she is “thrilled” with the results of her LASEK procedure and the comprehensive dry eye treatment that preceded it. not accustomed to searching for it. You have to actively look for it with specialized diagnostic equipment that most practices do not have. In fact, our office is one of very few in the state of Florida to have the technology, which uses infrared light to view the oil glands directly.” heals somewhat more slowly than LASIK, it is not associated with making preexisting dry eye syndrome worse. As a result, once dry eye treatments are improving the patient enough and the condition is under sufficient control, then he or she may be a candidate for LASEK.” LASEK success When Lynne was ready, she also had the LASEK procedure, and she chose to return to Dr. Salinger’s office for it. “Like I would with any doctor, I really researched his background,” adds Lynne. “I talked to people who have gone to him, and he has a very good reputation here. When it comes to your eyes, you just don’t settle. There were plenty of doctors who would do the laser vision correction, but I wasn’t going to trust my eyes to just anyone.” After the LASEK correction, she was absolutely thrilled with the results, particularly as she was able to eliminate wearing glasses for most tasks. “Because of my dry eye, I could not wear contacts any longer,” reminds Lynne, “because they made the dry eye more severe. So with the laser vision correction, of course I don’t need the contact lenses anymore, and I’m definitely more comfortable. I’m having less dry eye issues – the scratchiness and pain has been relieved. “I never did want to wear glasses all the time, so I guess you could say Stop suffering! Dr. Salinger is proud to present the latest breakthrough medical technology for dry eye syndrome. For more information, or to schedule a consultation, please call (561) 624-7878. The Dry Eye Spa & V.I.P. Laser Eye Center is located in Palm Beach Gardens. Also offering consultations in Stuart and Vero Beach. there was a little vanity there, too,” she adds with a chuckle. “I still need glasses for reading and computer work, but that doesn’t really bother me. I’m in my fifties, and most people in their fifties have reading glasses.” NOW AVAILABLE, DNA TESTING FOR LASIK SAFETY Lynne suggests anyone pondering LASEK surgery or suffering with a dry eye problem follow her lead and consult The Dry Eye Spa at V.I.P. Laser Eye Center and Dr. Salinger. “He has a great staff and they are very well educated in everything,” she emphasizes. “The nurses are so helpful and just explain things so well,” she adds. “If I had a question, all I had to do was call them and they would get right back to me. I think they’re the best medical practice that I have dealt with here in South Florida. I can’t say enough about them. I am just thrilled, and I definitely recommend them to anyone and everyone I talk to!” FHCN–Michael J. Sahno Clifford L. Salinger, MD, recipient of the “Heroes in Medicine” 2014, awarded by the Palm Beach County Medical Society, is a board-certified ophthalmologist with subspecialty certification in corneal and refractive surgery, and dry eye. After completing his undergraduate degree at The Johns Hopkins University in Baltimore, he received his medical degree from UMDNJ-Rutgers Medical School, New Brunswick, NJ. Dr. Salinger completed an ophthalmology residency at UMDNJ-New Jersey Medical School. He is a member of the American Academy of Ophthalmology, the Cornea Society, and the Florida Society of Ophthalmology. He is a past associate professor at the University of Rochester and has lectured extensively nationally and abroad. In addition to his volunteer work, traveling overseas on many occasions, he has been the education chairman for the Florida Society of Ophthalmology for more than ten years. Visit The Dry Eye Spa & V.I.P. Laser Eye Center on the web at www.TheDryEyeSpa.com. Page 12 | Florida Health Care News | Winter 2015 | Martin County Edition NEUROLOGY AND PAIN MANAGEMENT Feeling Faint? A condition called syncope can be the cause of fainting or passing out. However, the cause of the syncope condition itself can be varied. Find out more. S “ yncope, also known as fainting spells, may not be cardiac-related,” notes Hal M. Tobias, MD, of Neurology Associates of the Treasure Coast. “Although people typically think that this problem is due to a cardiac arrhythmia, it may be neurological.” Recurring dizziness, lightheadedness or passing out spells (syncope) are often symptoms of an underlying neurological condition, explains the doctor. “Syncope is one of those conditions that can actually be caused by any one of a variety of factors, from diabetes to dehydration. Other causes may include medications, pregnancy or anemia. However, it’s crucial that a neurological workup be performed in order to rule out something more serious.” FHCN Do You Have Fibromyalgia? F Has your physician told you, “It’s all in your head”? “ ibromyalgia patients may fibromyalgia, for example, cannot be have lower pain thresholds found because there is no test for it. We than people without fibro- infer the presence of fibromyalgia by rulmyalgia,” says Dr. Tobias. ing out other diseases. The problem is, sufferers often look “In fact, research shows that compared healthy, giving rise to people without to a feeling of hypochondria that further fibromyalgia, fibroinhibits their chances myalgia patients HAL M. TOBIAS, MD tend to process pain of arresting the pain.” differently and to be particularly sensiEqually frustrating, the symptoms of tive to pain. That heightened sensitivity fibromyalgia vary from patient to patient: to pain likely stems from pain-processing “Sufferers may have trouble sleeping because of general discomfort, persistent problems in the central nervous system. “Traditionally, medical science has leg or arm pain, soreness on the skin with difficulty giving credence to something the lightest touch, or with no touch at all. “Fibromyalgia frequently overlies that can’t be quantified,” observes Dr. Tobias. “Little wonder. Conditions like other conditions, too,” adds Dr. Tobias, “so it takes some detective work to determine symptoms caused by other, more easily identifiable disease processes.” Other conditions frequently accompanying fibromyalgia include irritable bowel, migraine, TMJ (temporomandibular joint disorder), multiple chemical sensitivities, numbness and tingling, cognitive or memory deficits, muscle twitching and chronic fatigue. Dr. Tobias addresses both the pain that disrupts a patient’s life and the underlying damage generating the pain signals. “When people come to the office and I ask what’s wrong, sometimes they say, Everything hurts. Some physicians might say, I can’t deal with that; go see somebody else, but we can deal with that here. The problem may be fibromyalgia, and there is a treatment for it now. We take time to sit with the patient, listen to their history and diagnose the cause of their pain.” Emotional Symptoms Associated with Neurological Problems Now there may be medication available to treat uncontrolled emotions associated with certain neurological symptoms. S “ PHOTOS FROM ISTOCKPHOTO.COM ome secondary symptoms of neurological disorders, such as Parkinson’s disease, Alzheimer’s, dementia, memory loss, and so on, may include problems with overwhelming emotions,” reflects Dr. Tobias. “Not all emotional problems are depression. If your anti-depressants are not working, you or a loved one may find yourself feeling fine one minute then crying the next over something small or nothing at all; crying easily or something not appropriate for the situation; or exhibiting symptoms of emotional ups and downs. These symptoms, due to no fault of your own, can be embarrassing. We may be able to give you ways to deal with these symptoms.” Neuropathy? B “ etween ten and twenty million Americans suffer from neuropathy, experiencing seemingly causeless sensations of tingling, numbness, heat, cold and even stabbing pain,” notes Dr. Tobias, “yet the Neuropathy Association estimates that only seven percent of Americans have even heard of this sometimes debilitating condition. “Consequently, many patients don’t even realize that their phantom sensations are symptoms of a recognized medical condition. They fail to seek help, suffering needlessly while their condition deteriorates and their symptoms intensify.” Neuropathy may also present as sudden, involuntary movements of the extremities, weakness in the arms or legs, lack of coordination or sensation, or both. It is a neurologic condition, so it will be most effectively addressed by a neurologist, who can identify treatable medical conditions, which, when addressed, may result in significant relief from neuropathy’s painful and sometimes debilitating effects. Dr. Tobias advises patients to select a neurologist who is also well versed in pain management techniques because fully 30 percent of patients suffering from neuropathy demonstrate no identifiable cause for their discomfort. Another 30 percent of cases can be traced to nerve damage that results from diabetes. Neuropathic symptoms may also result from trauma, infections, autoimmune disease, tumors, heredity, compressed nerves, and drugs or toxins. Dr. Tobias is board certified in both neurology and pain medicine, so even if the underlying cause of a patient’s neuropathy is not identifiable, Dr. Tobias can still turn his efforts to relieving that patient’s discomfort quickly. Patients of all ages can develop neuropathy, but it occurs more frequently with age. Neuropathy results from damage to the peripheral nervous system, the system of sensory, motor and autonomic (organ) nerves that branch off from the central nervous system comprising the brain and spinal cord. Most cases of neuropathy involve all three types of nerves, although patients may only be aware of one or two. Depending on which nerves are affected, the symptoms of neuropathy can appear suddenly or may increase gradually over a period of years. Early indications are persistent numbness or weakness and unexplained pain. Damaged sensory nerves can generate a variety of symptoms. They often begin with sporadic sensations of pain, electric shock, numbness, tingling, heat or cold. These sensations are usually more frequent and pronounced at night. Abnormal and unpleasant sensations can be triggered by a touch, or the patient may experience a lessening of sensation in the affected area. Sensory nerves can also give an inaccurate perception of body position. Patients may find themselves unsteady or uncoordinated while walking because they cannot accurately gauge the placement of their feet. These sensory misperceptions may cause them to walk with a widened gait to maintain balance or to drag their feet while walking to maintain awareness of positioning. Dr. Tobias urges anyone who experiences any of these symptoms to seek the advice of a skilled neurologist and pain specialist. Gaining on pain Dr. Tobias welcomes your questions regarding this ar ticle or any issues involving pain management and neurological disorders. To schedule an appointment, please call (772) 283-3414. Neurology Associates of the Treasure Coast is located at 901 SE Monterey Commons Blvd., Suite 200, in Stuart. Hal M. Tobias, MD, is board certified in neurology and pain medicine by the American Board of Psychiatry and Neurology and in pain medicine by the American Academy of Pain Medicine. He completed his neurology residency at Jackson Memorial Hospital, Miami.