|1
A Look Inside:
A Good Night’s Sleep!
5 tips on how to sleep better without
relying on medications.
Four Local Offices!
Conveniently located in Titusville,
Merritt Island, Pineda and Palm Bay.
New Pain Relief!
Read up on all the latest studies,
treatments, and procedures.
Here’s What
You Will Find...
Contents
7
10
14
4
Relief for Chronic Knee Pain
7
From the Test Kitchen
8
We’re Here to Stay
How Radiofrequency technology can
help relieve chronic knee pain.
A light, summertime, seafood dish to
treat your taste buds to.
Meet our physicians at our new Palm Bay
and Titusville Locations.
10
Florida Pain’s Fresh Face
12
A New Path to Wellness
14
Get Back to Life
17
Be Part of the Future
18
The Supporting Staff
Say hello to Florida Pain’s newest doctor.
Doctor Gayles explains using adult stem
cells for the treatment of pain.
Treat Chronic Tendonitis and Plantar
Fasciitis at the source.
A new study is available for patients who
suffer from Degenerative Disc Disease.
We would not be able to provide our
quality care without our experienced
practitioners.
Across: 1. CASCADE, 4. HEAT, 5. THREE, 6. TENEXHEALTH, 8. KNEE, 11. HEALTHPOLICY, 12. FOUR, 13. OSTEOARTHRITIS, 14. BONEMARROW, 15. MICROTIP, 16. TWO
Down: 2. CLAUSTROPHOBIA, 3. DEGENERATION, 7. DRGOLOVAC, 9. ESPOSITO, 10. HYGIENE
2|
Medical Studies currently
being conducted:
CRPS Type 1
Complex Regional Pain Syndrome
Dr. Gayles
For more info please refer to
www.studyCRPSSnow.com
P: 321-784-8211 F: 321-394-9425
Stanley Golovac, MD
Richard Gayles, MD
Ashish Udeshi, MD
Michael Esposito, MD
Intrathecal Hydromorphone
Safety Study – Dilaudid
Intrathecal Pain Pumps
Dr. Gayles, Dr. Udeshi
For more info please refer to clinicaltrials.gov
Mesoblast
Lumbar Discogenic Lumbar Back Pain,
Dr. Golovac
For more info please refer to clinicaltrials.gov
PRIZM Registry
Prialt Pain Pump
Dr. Gayles
For more info please refer to clinicaltrials.gov
STEPS Trial
Lumbar Spinal Stenosis
Dr. Gayles, Dr. Udeshi
For more info please refer to stenosistrial.com
For more study information, please email
our Clinical Research Coordinator,
Kimberly Colella at: kimberlyc@
floridapaininstitute.net
-or- Susan Clark, ARNP-C at:
susanclarkflp@gmail.com
You may also call 321-784-8211 ext. 1115
Spinal Stenosis
Holding You Back?
leg when walking or standing? It may be Spinal Stenosis
Right now, doctors at
you are 55 or older and think you may have Spinal Stenosis –
but are not yet ready for major spine surgery – this study may
be right for you.
The study is for the Totalis™ System – a minimally-invasive
the same day.
To learn more, please contact us:
Kimberly Colella, Study Coordinator | 321-784-8211 ext. 1115
KimberlyC@floridapaininstitute.net
Dr. Richard Gayles, Florida Pain Institute
595 N Courtenay Pkwy, Merritt Island, FL 32953
321-784-8211 | www.floridapaininstitute.net
|3
ADVERTISEMENT
A New Treatment Provides Relief for
4|
Chronic Knee Pain Sufferers
Osteoarthritis, the most common form of arthritis of the knee, affects approximately 27 million Americans. It
is a degenerative disease that causes a breakdown of cartilage (the tissue that covers the ends of bones where
they form a joint). Healthy cartilage allows bones to glide over one another and absorbs energy from the shock
of physical movement. When the cartilage breaks down, bones under the cartilage rub together, causing pain,
swelling and stiffness. And bone spurs may develop, permanently changing the joint’s shape. For pain relief,
patients typically take medications like aspirin or ibuprofen. When the medications fail to provide relief, over
half of adults in the U.S. diagnosed with knee osteoarthritis will undergo a total knee replacement.1
Total knee replacements can be a good option for some patients, but there are some tradeoffs. Nerve injuries
occur in 1–2% of patients, and more than half of patients who underwent total knee replacement continue to
have pain after the procedure.2
Managing chronic pain
Chronic pain is a uniquely individual, complex
condition that is often difficult to manage. Because
it has many causes and possible treatments, doctors
who specialize in pain management tend to take a
multidisciplinary approach to managing chronic pain.
This approach includes working with a team of other
specialists to develop a personalized treatment plan,
which often includes a progression of therapies that
patients will try until they obtain sufficient relief.
Some of these therapies, such as pain medications,
physical therapy and nerve blocks, may work at first
but may not offer lasting pain relief.
Radiofrequency (RF) technology has been used for
decades to help relieve chronic back pain. Recently,
data has shown positive results in using this therapy
to treat chronic knee pain.3 With the use of an RF
generator, electrode and needle, a physician can
create a heat lesion along the nerve pathway. This
heat lesion disrupts the nerve’s ability to send
pain signals to the brain. RF ablation is a minimally
invasive, outpatient procedure.
“As an interventional pain physician, I strive to offer
my patients the full array of treatments short of
surgery,” explains Dr. Stanley Golovac*, a Diplomat of
the American Board of Anesthesiology and the Board
of Pain Management. At Florida Pain Institute, “We
“For me, RF ablation
represents a great choice
for the appropriate patient
to consider when weighing
other options such as
more invasive surgeries
or a long-term
medication regimen.”
— Dr. Stanley Golovac
Florida Pain Institute
595 N. Courtenay Pkwy.
Merritt Island, FL. 32953
321-784-8211
favor a conservative approach whenever feasible.
Many patients have knee pain that is severe enough,
or chronic enough, to warrant more advanced
interventions. For me, RF ablation represents a great
choice for the appropriate patient to consider after
conservative care has failed and when weighing other
options such as more invasive surgeries or lifelong
medication management.”
ADVERTISEMENT
Before the procedure
Before delivering RF, a physician will typically perform
a diagnostic nerve injection. This procedure involves
injecting anesthetic at the site of the nerve pathway.
The physician may also inject steroids into the joint
space in an attempt to alleviate the pain. If the patient
experiences relief as a result of this injection, the
physician can feel more confident in diagnosing the
exact nerve causing the pain. Once the painful nerve
has been confirmed, an RF ablation procedure will
typically be scheduled.
During the procedure
The procedure is performed with the patient in a supine
(face up) position, with the use of local anesthetic
and possibly light sedation. An RF needle is inserted
through the skin and, with the use of fluoroscopy (x-ray)
or ultrasound, advanced until it reaches the target
treatment area. An RF electrode is inserted through
the needle and testing may be used to confirm the
placement of the active tip along the nerve pathway.
Once correct placement is confirmed, additional local
anesthetic may be administered before the heating
profile is activated. The patient may feel the heating
and should alert the physician if the pain becomes
too great. After the heating sequence is finished, the
needle and electrode are removed and the insertion
site is covered with an adhesive bandage.
After the procedure
The patient is typically monitored immediately
after the procedure to ensure no complications or
reactions resulting from the procedure. The patient
should expect pain at the treatment site for 7–10
days following the procedure. After this initial pain
(sometimes described as feeling like a sunburn),
the patient should expect to feel the pain diminish
progressively over the following weeks. The amount
and duration of pain relief varies from patient to
patient and should be closely monitored with the
physician. Typically, relief can last 6–18 months. There
have been cases reporting relief ranging 3–24 months.
The pain may return once the nerves begin to regrow
and reconnect the neural pathways. Fortunately,
RF ablation procedures can be repeated to deliver
continued relief.
“The goal of RF for chronic knee pain for me is simple:
decreased pain, increased functionality and improved
quality of life for 6–18 months,” states Dr. Golovac.
“If we can accomplish this and minimize the need for
additional surgeries or chronic medication with a short
outpatient procedure, then we have met our goal.”
While many patients may be able to manage
their chronic knee pain with RF ablation, not
everyone responds to this therapy in the same way.
Complications are rare, but should be discussed with
a physician. Only a doctor can determine whether
someone is a suitable candidate for this procedure.
If you are interested in learning more about
RF ablation for chronic knee pain and finding
out if it is right for you, contact a pain
management specialist today. To find one in
your area, visit PowerOverYourPain.com**.
1. NIH Fact Sheet on OsteoArthritis.
2. Lundblad H, Kreicbergs A, Jansson KA. Prediction of persistent pain after total knee replacement
for osteoarthritis. J Bone Joint Surg Br. 2008;90(2):166–71.
3. Choi WJ, Hwang SJ, Song JG, Leem JG, et al. Radiofrequency treatment relieves chronic knee
osteoarthritis pain: a double-blind randomized controlled trial. Pain. 2011 Mar;152(3):481–7.
* Dr. Stanley Golovac has experience using St. Jude Medical radiofrequency products in your local area.
** St. Jude Medical maintains a list of physicians who have experience with St. Jude Medical products. The listing of pain management specialists is compiled as a reference tool
for locating certain physicians. No physician has paid or received a fee to be listed there. St. Jude Medical does not verify or monitor the license, credentials, or qualifications
of any physician listed in the database and is not responsible for the medical advice of the physicians included in this database. The decision whether, and when, to contact a
physician is yours alone. When choosing a physician, we encourage you to weigh various factors, such as level of experience, educational background, personal rapport and
local proximity.
Unless otherwise noted, ™ indicates that the name is a trademark of, or licensed to, St. Jude Medical or one of its subsidiaries. ST. JUDE MEDICAL and the nine-squares symbol
are trademarks and service marks of St. Jude Medical, Inc. and its related companies. © 2015 St. Jude Medical, Inc. All Rights Reserved.
SJM-NET-0615-0016 | Item approved for U.S. use only.
|5
New Sleep Habits
6|
Dr. Udeshi’s
5 Tips for
Sleeping
Better with
Back Pain:
One of the most common complaints people with
back pain have is difficulty sleeping at night. The back is
a complicated structure of bones, joints, ligaments and
muscles, and having proper rest can help these structures
function. Proper sleep hygiene is crucial in improving
pain conditions and quality of life.
Below is a list of five tips on how to get a good night
sleep without relying on medications:
1. Proper Sleeping Positions
SIDE SLEEPER:
If you sleep on your side, draw your legs up slightly
toward your chest and put a pillow between your legs.
Use a full-length body pillow if you prefer. This will align
the structures of the pelvis, spine, and head/neck.
BACK SLEEPER:
If you sleep on your back, place a pillow under your
knees to help maintain the normal curve of your lower
back. You might try a small, rolled towel under the small
of your back for additional support. Also, its important
to support your neck with a pillow.
STOMACH SLEEPERS:
This flattens the natural curve of the spine, and puts
more strain on your back muscles, and is the WORST
position for you. However, if you must sleep on your
stomach do the following: reduce the strain on your
back by placing a pillow under your pelvis and lower
abdomen. Use a pillow under your head if it doesn’t
place too much strain on your back. If it does cause
strain, try sleeping without a pillow under your head.
2. Proper Mattress Selections
A good mattress should provide support for the
natural curves and alignment of the spine. This helps you
avoid muscle soreness in the morning. Unfortunately
there is not much clinical data concerning mattresses,
however one study found that medium-firm mattresses
usually provide more back pain relief than firm
mattresses. I suggest trying different mattress to find
which one fits you best.
3. Relax the BACK
Heat relaxes muscles and improves blood circulation.
Consider taking a hot shower before bed, applying
topical ointments, using a warm compress or TENS
(Transcutaneous Electrical Nerve Stimulation) device.
These techniques can help improve blood flow and
reduce pain right before bedtime.
4. Reduce Stress
Emotional stress or psychological factors can make
any back pain problem worse. Thus, it is extremely
important to limit stressful activities around bedtime.
I recommend stop working at least 2 hours before bed
(stop checking work email or text messages), and create a
dark and completely cool room.
5. Avoid Late Night Snacks
Avoid sugar and heavy meals at least 2 hours before
sleep. Do not drink alcohol or caffeine 2 hours before
bedtime. Caffeine and sugar act as stimulants making
sleep difficult. While alcohol and heavy meals can affect
the central nervous and gastrointestinal systems and
cause sleep interruptions.
These are just a few simple tips to help with chronic
low back pain and sleep. However, its extremely
important you take the time to find out what is actually
causing your back pain and correct the real problem.
Getting the right diagnosis and treatment can help you
get long lasting relief from the pain in your lower back,
develop normal sleep patterns, and enjoy quality sleep.
New Tastes
Chipotle Shrimp Tacos
on Cayenne Pepper Cabbage Slaw
by Alexandra Golovac, Fitness Nutritionist - Chef
Makes: 4 Servings
This great tasting light meal is great
for those hot summer days.
Ingredients
Directions
•
•
•
•
•
•
1. Clean shrimp, season with chipotle powder, a little salt and
pepper.
1 red bell pepper, sliced
1 yellow bell pepper, sliced
1 green bell pepper, sliced
1 small yellow onion, sliced
1/2 purple cabbage head, sliced
1 lb (31-35 shrimp), peeled and
deveined
• 1 teaspoon chipotle powder
• 1/2 teaspoon cayenne pepper
(optional)
•Salt
•Pepper
• Olive oil
• Corn Tortillas
• Limes, quartered
2. Slice all vegetables.
3. Heat olive oil over medium heat in a large saute pan. Add
onions and sweat for 3 minutes with salt.
4. Add the bell peppers and saute for another 2-3 minutes,
leaving the bell peppers al dente. Remove from saute pan.
5. Heat some more olive oil in the pan and add the shrimp.
6. Cook shrimp until pink and the shrimp slightly curl. Remove
from saute pan.
7. Add a little more olive oil to the saute pan and add the sliced
cabbage with a splash of broth or water.
8. Add the cayenne pepper, if using.
9. Saute cabbage just until al dente, about 3 minutes over
medium heat.
10.Assemble the tacos and finish with a squeeze of fresh lime.
|7
New Facilities Now Open in
8|
Ashish Udeshi, MD
Your Palm Bay Physicians...
•B.S. degree in Biology with Honors in 2004 and a
graduate of the University of Miami Miller School
of Medicine in 2008.
•Residency in Anesthesiology, Fellowship for
Interventional Pain Medicine, and Board Certified
in Anesthesiology.
•Speaks fluent English and Spanish.
Michael Esposito, MD
•Graduated from Georgetown University School of
Medicine in 2010.
•Residency in Anesthesiology and Critical Care at
Chicago Hospital where he served as Chief resident.
•Interventional Pain management fellowship at
Massachusetts General Hospital.
•Board certified in Anesthesiology.
New Locations, Same Dedication to You!
Exit 176
Pkwy
rfolk
No
5
I-9
Palm Bay Rd NE
it
Ex
17
5
6
I-9
Culver Dr NE
Centre Lake Dr NE
Palm Bay Location:
NOW OPEN!
490 Centre Lake Drive NE
Suite 200B
Palm Bay, FL 32907
Palm Bay and Titusville
US 1
n
cisiyo
PreW
a
• Doctor of Medicine Degree in 1991 from the University
of Michigan School of Medicine and residency in the
Department of Anesthesiology and Critical Care Medicine
at Johns Hopkins in Baltimore.
• Certified for three elite boards and ABA Special
Qualifications in Pain Management
1
Richard Gayles, MD
Kings Hwy
|9
US
Dr. Richard Gayles,
Your Titusville Physician.
St
ood
w
l
l
Be ita St
Bon
ay
ed WBlvd
d
u
l
Sec r Park
ir
Rive tthew C
Ma
Titusville Location:
South Titusville Medical Center
7455 South US Highway 1
Titusville, FL 32780
How to Arrange an Appointment:
•Ask your Primary Care or Treating Physician
to refer you to Florida Pain Institute.
•Referrals can be faxed to 321-336-7656.
*Include: referral, patient demographics,
current insurance information, current office
notes, and diagnostic testing reports that
pertain to the area to be treated.
•We accept the majority of area insurance
plans. Please call to check coverage
availability: 321-784-8211.
Call: 321-784-8211 or Visit: www.FloridaPainInstitute.net
404
N Wickham Rd
Outlook Dr
Hoofprint Dr
Cloudberry
Pl
Outlook Dr
Merritt Island Location
595 N Courtenay Pkwy., Ste #101
Merritt Island, FL 32953
Co Rd 509
Hoofprint Dr
Dr
Needle Blvd
s
ke
La
er
De
High Pasture
Way
N Courtenay Pkwy
Aster Ct
Hurtwood Ave
Kurek Ct
Minna Ln
404
Pineda Causeway
Pineda Location
5545 N Wickham Rd., Ste 104
Melbourne, FL 32940
WE’RE HERE FOR YOU.
With 2 Other Convenient
Locations in:
Merritt Island and Melbourne
10 |
New Doctor
Dr. Michael Esposito is happy to finally call Florida home
after having spent family vacations in Melbourne Beach annually
while growing up. Dr. Esposito grew up in New Jersey and received
a Bachelor of Arts with Honors from the University of Pennsylvania
in Philadelphia in 2006. Upon graduation Dr. Esposito attended
Georgetown University School of Medicine in Washington, DC,
graduating in 2010. He completed residency in Anesthesiology in
the Department of Anesthesia and Critical Care at The University of
Chicago Hospital in Chicago, IL where he also served as Chief Resident.
He went on to complete an Interventional Pain Medicine Fellowship
at Massachusetts General Hospital,
a Harvard Medical School Teaching
Hospital. While in Boston, he
worked as an Anesthesiologist at
Massachusetts General Hospital and
at the Veterans Affairs West Roxbury
Hospital.
During his education and
training, Dr. Esposito received
the Arnold P. Gold Foundation
Humanism and Excellence in
Teaching Award in 2010-2011. He
was also recognized as the University of Chicago
Department of Anesthesia and Critical Care Resident
of the Year in 2013-2014.
Dr. Esposito has devoted his time to various
local, state, national, and international organizations.
He has served on two hospital Graduate Medical
Education Committees which oversee resident and
fellow education. He has also served as an instructor
for conference workshops, teaching physicians from
all over ultrasound guided procedures. He developed
an educational web-based lecture series and helped
implement annual conference educational programs
while serving as the Resident Section Chair for the
Society for Ambulatory Anesthesia. Dr. Esposito has
also spent some time in our nation’s capital, discussing
health policy with U.S. Congressmen and advocating
for patient safety while working with the American
Society
of
Anesthesiologists’
Advocacy Division.
He has presented at numerous
national Anesthesia and Pain Medicine
conferences. Dr. Esposito has been
affiliated with the American Society
of Anesthesiologists, American
Society of Regional Anesthesia and
Pain Medicine, American Academy
of Pain Medicine, American Society
of Interventional Pain Physicians,
American Pain Society, North
American Neuromodulation Society, and the Society
for Ambulatory Anesthesia.
Dr. Esposito is extremely thrilled to be part
of the Florida Pain Family. He is a Board Certified
Anesthesiologist (Diplomate of the American Board
of Anesthesiology) and will sit for the Pain Medicine
Boards in September 2015.
• Graduated from Georgetown University School
of Medicine in 2010.
• Residency in Anesthesiology and Critical Care
at Chicago Hospital where he served as
Chief resident.
• Interventional Pain management fellowship at
Massachusetts General Hospital.
• Board certified in Anesthesiology.
| 11
Adult Stem Cells For The Treatm
12 |
Discovering A New Path
To Wellness
REGENERATIVE MEDICINE
Through regenerative medicine, a person can take
advantage of their body’s ability to heal itself by
using the healthy adult stem cells that can be found
throughout the body. Laboratory and clinical research
has shown that it is possible to use adult stem cells
to restore lost, damaged or aging cells and effectively
regenerate tissue in the body. Regenerative therapies
are showing promise in the treatment of pain.
Adult stem cells were discovered over 40 years
ago when researchers found that cells derived from
bone marrow had the ability to form various tissues.
Adult stem cells are early stage cells and under the
right conditions, are capable of developing into
other types of cells with the potential to regenerate
damaged tissue.
Adult stem cells are being used to treat many types of
chronic pain and degeneration. Currently doctors are
treating shoulder, knee, hip, and spine degeneration,
in addition to soft tissue (muscle, tendon, ligament)
and other bone related injuries.
FREQUENTLY ASKED QUESTIONS
Where Do Adult Stem Cells Come From?
In adults, stem cells are present within variety of
tissues and organs, the most common sources being
bone marrow and fat (or adipose) tissues.
How Do Adult Stem Cells Know What
Type of Tissue to Develop Into?
The differentiation of adult stem cells is dependent
on many factors, including cell signaling and
microenvironmental signals. For example, adult
stem cells delivered to damaged bone can develop
into bone cells to aid in tissue repair.
What is the Difference Between Adult
Stem Cells and Embryonic Cells?
Adult stem cells are found in mature adult tissues
including bone marrow and fat, while embryonic
cells are not found in the adult human body.
Embryonic cells are obtained from donated in vitro
fertilizations which raises many ethical concerns.
ment Of Pain
How Are Adult Stem Cells Obtained,
Prepared, and Delivered?
One of the richest sources of adult stem cells is
bone marrow, and the hip (pelvis) is one of the best
and most convenient locations for obtaining bone
marrow. In the harvesting procedure, the doctor
typically removes (or aspirates) from the pelvis. A
trained nurse or technician then uses specifically
designed equipment to concentrate the adult stem
cells in the bone marrow and provides the cells
back to the physician for implantation at the site of
injury at point-of-care.
POTENTIAL APPLICATIONS
There are many potential applications where stem
cell treatments can be very effective. The following
are the most common:
Will My Body Reject the Adult Stem Cells?
No, since they are cells collected from your own
tissue, there is little threat of rejection.
Who is a Good Candidate for a Stem
Cell Procedure?
The ideal candidate for a stem cell procedure
is a patient that wants to use their body’s own
regenerative potential as an option to possibly
delay or avoid invasive surgery.
ABOUT DR. RICHARD GAYLES
• Doctor of Medicine Degree in 1991
from the Michigan School of Medicine
and residency in the Department of
Anesthesiology and Critical Care Medicine
at Johns Hopkins in Baltimore. Fellowship
completed at the Cleveland Clinic in Ohio.
Knee
Shoulder
Osteoarthritis
Partial ligament tears
Partial meniscal tears
Augmented ACL or PCL
reconstruction
Partial rotator cuff tears
Labral tears
Mild to moderate
osteoarthritis
Foot and Ankle
Osteoarthritis
Labral tears
Articular cartilage injuries
Congenital deformities
Mild to moderate
osteoarthritis
Tendon inflammation
Partial Achilles
Hip
• American Board Certified in
Anesthesiology with qualifications
in Chronic Pain Management.
Diplomate American Board
of Pain Management.
• Certified for three elite boards and
ABA Special Qualifications in Pain
Management
| 13
New Pain Relief
14 |
Tenex Health TX Treats
Chronic Tendonitis and
Plantar Fasciitis at
the Source.
You. Are. In. Pain.
It’s in your shoulder, elbow, knee, ankle or foot.
It’s with you always and takes a toll on the activities
you love and need to do.
You’ve tried everything: over-the-counter pain
medication, rest, ice, compression, elevation,
physical therapy, even cortisone injections—and
nothing works. Nothing. It’s been at least 3 months
now and you don’t know what else to do.
YOU are one of the millions of people suffering
from chronic tendon pain.
How did this happen? Chronic tendon pain
comes from performing activities over and over
and over again. Repetitive motions, no matter how
ordinary, are causing
you injury.
Maybe it feels like
burning, cutting, or
stabbing. However you
describe it—it hurts
when you perform even
the simplest tasks and
that pain is interfering
with your life.
Sound like you?
You may be a candidate for a minimally invasive
procedure, using Tenex Health TX™ technology,
that may provide relief for your chronic tendon
pain with a one-time ultrasonic treatment.
With Tenex Health TX™, you could return to
doing what matters most to you quickly without
surgery, stitches or physical therapy. Just one
simple procedure.
Tenex Health TX is designed to use precise
ultrasonic energy to end your frustration
with chronic tendon pain that has lasted 3
months or longer despite trying rest, injections,
or medications.
Unlike these treatment options, Tenex Health
TX removes the source of your pain, the damaged
tissue, and in so doing stimulates a healing response.
Using ultrasound imaging technology, the same
kind used to see babies in the womb, your doctor
identifies the specific location of your damaged
tissue. He or she then creates a microincision
and inserts the TX MicroTip through this
microincision.
The TX Micro Tip uses ultrasonic energy to
precisely remove only your damaged tissue,
breaking it down; without removing or hurting any
healthy tissue. With this accuracy, Tenex Health
TX accelerates your
pain relief allowing you
a rapid return to the
things you love.
There is no general
anesthesia, you are
awake the entire time,
and, most people feel
nothing once the area
is numbed, possibly a
slight pressure.
Get Back: To Quality Time
| 15|
15
Using ultrasound imaging technology, the same
In most
cases, you should be back to your
kind used to see babies in the womb, your doctor
normal
everyday activities within a few
identifies the specific location of your damaged
weeks.
There
nothen
need
for any
additional and
tissue. He or is
she
creates
a microincision
treatment
like
Though
inserts the
TXphysical
MicroTip therapy.
through this
microincision.
recovery is rapid, those with extensive tendon
The TXmay
MicroTip
ultrasonic
energy
to precisely
damage
takeuses
slightly
longer
to heal
and
remove only your damaged tissue, breaking it
results will vary.
For 3 days after the procedure, you should take
Ask about Tenex Health TX today!
In most cases, you should be back to your
normal everyday activities within a few weeks.
There is no need for any additional treatment
like physical therapy. Though recovery is rapid,
those with extensive tendon damage may take
slightly longer to heal and results will vary.
down; without removing or hurting any healthy
tissue. With this accuracy, the Tenex Health TX™
procedure accelerates your pain relief allowing you
a rapid return to the things you love.
Is Tenex Health TX™ Right for You?
• Do you have pain in your shoulder,
There is no general anesthesia, you are awake the
elbow,
knee, ankle or foot?
entire time, and, most people feel nothing once the
area is numbed, possibly a slight pressure.
• Have you been in pain for
3 months or longer?
005_Tenex_PodiatryBrochure_05072014.indd 6-8
Desc
Rest or
R.I.C.E
of the yes
area.to any of these questions,
Ifextra
you care
answered
Tenex Health TX could be the answer to your
For 2 weeks after the procedure, you should not
tendon
painany
problems.
perform
weight bearing exercise or activities.
Medication
For 2 weeks after the procedure, you should
not perform any weight bearing exercise or
activities.
• Would you prefer a relatively
painless procedure versus the well
known challenges of traditional
surgery?
Physical
Therapy (PT)
For 3 days after the procedure, you should
take extra care of the area.
• Have you already tried to manage
your discomfort with rest, ice, medicine
and/or cortisone shots?
Open surgical
procedure
After your procedure, you can simply go home.
Really. You may even drive yourself if your doctor
approves. There are none of the stitches or general
anesthesia you would need with open surgery, so
there isGet
minimal
downtime. Best of all, the pain
Back:
relief can be nearly instant. So you can get back to
To Giggles
the things you miss significantly faster than with
open surgery. Your individual results may vary.
Don’t let wait and see
turn into wait and suffer
Diseased Achilles tendon
Icing, h
avoiding
Anti-infla
Cortison
Usually
with rest
or s
Remove
tissue w
(k
Healthy Achilles tendon
Before your procedure, your doctor can visualize the
Before
your
procedure,
your ultrasound
doctor canimaging.
visualizeAfter
the
damaged
tendon
tissue using
the
procedure,
you
can
see
the
damaged
areas
are
gone
damaged tendon tissue using ultrasound imaging.
leaving healthy tendon tissue.
After the procedure, you can see the damaged areas
are gone leaving health tendon tissue.
Tenex
Health TX
Get Back: To Giggles
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en
Treatment options
New Study
16 |
Be Part of the Future
of Degenerative Disc
Disease Research
If you are an adult with degenerative disc disease,
you may be eligible to take part in a clinical research
study.
The CASCADE Study is looking at the impact of an
investigational product for people experiencing
chronic low back pain caused by degenerative
disc disease. The investigational product aims to
potentially reduce pain and improve disability
that results from the disease. You may be eligible
to participate in this study, if you:
• are 18 years of age or older
• have a diagnosis of degenerative disc disease
• have had chronic low back pain for at least
6 months
• are still experiencing low back pain, despite trying
other treatments for at least 3 months.
ABOUT DR. STANLEY GOLOVAC
• Medical degree from UTESA
University in 1985 and
residency in the Department
of Anesthesiology at Jackson
Memorial in Miami.
• American Board Certified in
Anesthesia with an emphasis in
Pain Management.
• Speaks fluent English, Spanish, and
Portuguese.
CASCADE
If you decide to take part in the CASCADE Study,
your participation will last approximately 1 year. You
will be required to attend the study center a number
of times so that the study doctor can assess your
degenerative disc disease and overall health. After the
start of the study when you receive the investigational
product, you will be required to visit every 3 months.
The CASCADE Study is looking at a potential new
treatment (an investigational product) for people with
degenerative disc disease. The investigational product
is made from a certain type of adult stem cell. Stem
cells are immature cells produced by the human body
that have the ability to develop into many different
types of cells.
The stem cells being looked at in this study are called
mesenchymal precursor cells. The cells being used
in the study have been carefully collected from bone
marrow samples from healthy human adult donors
and grown in a laboratory under strict conditions.
The CASCADE Study will involve approximately 330
adults with degenerative disc disease. The main study
will last about 1 year; however, study participants will
be asked to be followed up for a total of 3 years.
Everyone who takes part in the study will receive a
single injection into their painful disc of either: the
investigational product the investigational product
combined with a carrier material called hyaluronic acid,
or a saline solution, which looks like the investigational
medication but contains no active ingredient.
There is a two in three chance of receiving the
investigational product and a one in three chance
of receiving a saline solution. The injections will be
assigned randomly (like flipping a coin) and neither
the study participant nor study doctors performing
the follow-up assessments will know who is receiving
what.
Meet Your Practitioners
| 17
Susan Clark, ARNP,
Eric Cole, PA-C,
Patricia (Tricia) Dunn,
DNP, ARNP-BC,
is Board Certified as an Adult Nurse
Practitioner as well as Acute Care
Nurse Practitioner. Her professional
memberships include American
Nurses Association, Florida Nurses
Association, American Academy of
Nurse Practitioners, Association of
Clinical Research Professionals, Space
Coast Clinicians, North American
Spine Society and American Academy
of Pain Management. She is also a
Certified Research Coordinator.
began his career as a Medical
Technologist while in the Army and
decided that becoming a Physician
Assistant was his calling. After
graduating in 1992 Eric spent the bulk
of his career in surgery and in 2008 he
began working in Pain Management.
Beth Holtham, PA-C,
Michael Thomas, PA-C,
John Welch, PA-C,
obtained initial certification by the
National Commission of Certification
of Physician Assistants in 1998 and
has maintained certification. She is a
member of The Florida Academy of
Physician Assistants, The American
Academy of Physician Assistants, and
Space Coast Clinicians Group.
began his training as an US Navy
Hospital Corpsman. He is currently a
Board Certified member of the Florida
Academy of Physician Assistants as well
as the American Academy of Physician
Assistants. He is also the President of
Space Coast Clinicians educational and
networking group.
is Board Certified through the
American Nurses Credential Center
as an Adult Nurse Practitioner. His
professional memberships include
American Nurses Association, Florida
Nurses Association, and Space Coast
Clinicians. His focus is on Primary
Care, Urgent Care, Physical Medicine,
Cosmetics, and Interventional Pain
Management.
is Board Certified by the America
Nurse Credential Center as an
Advanced Registered Nurse
Practitioner- Family Nurse Practitioner.
She is a member of the American
Association of Nurse Practitioners, The
American Association of Heart Failure
Nurses, Florida Nurse Practitioner
Network, American Academy of
Pain Management, and Space Coast
Clinicians.
NEED AN MRI? GO TO NSI.
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 Highly Specialized Radiologists
18 |
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Melbourne, FL 32901
(321) 409-9990 • Fax (321) 409-9989
NSI of Merritt Island
255 N. Sykes Creek Parkway
Suite 102
Merritt Island, FL 32953
(321) 454-6335 • Fax (321) 454-4897
NSI Orlando
1315 S. Orange Avenue
Suite 1B
Orlando, FL 32806
(407) 999-9977 • Fax (407) 999-9988
New Knowledge
Test to see how much you’ve learned.
1
2
| 19
3
4
5
6
7
9
8
10
11
12
13
14
15
Across
1. What study is looking at the impact of an investigational
product for people experiencing chronic low back pain
caused by degenerative disc disease.
16
15. The TX ______ ____ uses ultrasonic energy to
precisely remove only your damaged tissue; without
removing or hurting any healthy tissue.
16. How many hours before sleep should you avoid sugar
and heavy meals?
4. What relaxes muscles and improves blood circulation?
5. NSI is serving all of Central Florida with ___ convenient
locations.
7. ______ _______ TX Treats chronic Tendonitis and
plantar fasciitis at the source.
8. The St. Jude article discusses the benefits of using
Radiofrequency Ablation to relieve chronic _____ pain.
11. Dr. Esposito spent time in our nations capital, discussing
_____ ______ with U.S. Congressman and advocating
for patient safety.
12. How many locations does Florida Pain currently have?
13. What is the most common form of arthritis in the knee?
DOWN
2. NSI offers highfield open MRI’s for ____________ .
3. Adult stem cells are being used to treat many types of
chronic pain and ________ .
6. Which Florida Pain Physician is currently enrolling
patients in the Cascade study?
9. The newest Physician to join Florida Pain Institute is
Dr. ________ .
10. Proper sleep ______ is crucial in improving pain
conditions and quality of life.
14. In adults, stem cells are present within a variety of tissues
and organs, the most common being _____ _______ and
fat(or adipose) tissues.
See page 2 for answers.
BREVARD COUNTY’S
LEADING INTERVENTIONAL
PAIN MANAGEMENT GROUP
| 20
Dr. Stanley Golovac
•
Dr. Ashish Udeshi
•
Dr. Richard Gayles
Dr. Michael Esposito
•
Specializing in Neck,
Back, & Cancer Pain
FLORIDA PAIN INSTITUTE is a multi-service facility that offers interventional pain management for
acute and chronic pain. Florida Pain Institute has offices in Merritt Island, Pineda, Palm Bay, and Titusville.
Merritt Island Location
595 N Courtenay Pkwy., Ste 101
Merritt Island, FL 32953
Fax: (321) 394-9425
Pineda Location
5545 N Wickham Rd., Ste 104
Melbourne, FL 32940
Fax: (321) 775-0535
404
Outlook Dr
Dr
Cloudber
ry Pl
N Wickham Rd
Hoofprint Dr
Co Rd 509
s
ke
La
er
De
High Pasture
Way
Needle Blvd
Hoofprint Dr
Outlook Dr
US 1
Exit 176
Pkwy
rfolk
No
n
cisiyo
PreW
a
5
I-9
Merritt Island
Pineda
Palm Bay
Titusville
Hurtwood Ave
Aster Ct
Serving all of
Brevard with
4 Convenient
Locations in:
N Courtenay Pkwy
Kurek Ct
Minna Ln
404
Pineda Causeway
Palm Bay Rd NE
d St
woo
Bell ita St
Bon
ay
dW
lude rk Blvd
c
e
S
ir
r Pa
Rive tthew C
Ma
76
it 1
Ex
5
I-9
1
Palm Bay Location
490 Centre Lake Drive NE, Ste 200B
Palm Bay, FL 32907
Fax: (321) 265-5120
US
Culver Dr NE
Kings Hwy
Centre Lake Dr NE
Titusville Location
7455 South US Highway 1
Titusville, FL 32780
Fax: (321) 394-9425