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FEATURED ARTICLES

treat painful, arthritic knees. One treat-ment that caught her attention was the use of a patient’s own cells to rebuild damaged tissue. � e provider she found who o� ered this treatment is Regenerative Orthopedic Institute in Tampa.

Regenerative Orthopedic Institute is where Erick A. Grana, MD, specializes in regenerative medicine. He treats patients with a nonsurgical regenerative technique called stem cell therapy. � is therapy uses the patient’s own specialized stem cells to promote the growth of new tissue in joints ravaged by arthritis or injury.

“Today, there are options that we can o� er to osteoarthritis patients that allow them to avoid taking on the risks of a surgical procedure before they get to the stage where they need joint replacement,” Dr. Grana reports.

“Not only can we relieve the pain, we can also reverse some of the damage done by the osteoarthritis. � is is accomplished by regenerating the cartilage and connec-tive tissues in and around the joint area.

“Regenerative medicine treats disease and injuries by harnessing the body’s own healing powers. � e natural healing process is accelerated by a combination of growth factors and bioactive cells in the form of stem cells and platelet-rich plasma (PRP).

“� is process results in a safe, e� ective, nonsurgical treatment, and unlike tradi-tional invasive surgery, which can result (see Joint Investment, page 4)

Joint Investment

ERICK A. GRANA, MD

Regenerative technique relieves severe knee pain without surgery

H igh-flying airline pilot Raymond* made a career of defying gravity and soaring through the open

skies. He did that for 28 years, then took a job as a building-code examiner for Pasco County. � at job meant long hours on his feet, which aggravated the arthritis pro-gressing in his knee.

“My right knee was the one giving me problems,” Raymond clari� es. “I went to a doctor, who took x-rays and discovered my knee joint was bone-on-bone. I felt a sharp pain in that knee every time I moved the joint. One bone would grind over the other, and that caused the pain, which was usually so intense, I could hardly walk. I had to give up gol� ng because I could barely move. � e pain averaged nine on a scale of one to ten.”

At his doctor’s recommendation, Raymond tried a couple of different avenues for pain relief, including corti-sone shots and wearing a knee brace, but received little or no lasting relief from them. Mired in agony as a result of the failed treatment attempts, Raymond didn’t feel any better after learning the follow-up option his doctor suggested.

“� e brace helped because it sepa-rated the bones, but it was cumbersome and difficult to wear all the time,” Raymond explains. “� e brace also cut o� the circulation in my leg, so I wasn’t happy about wearing it. � en the doctor told me the next step was a knee replace-ment. I wasn’t ready to do that yet, so I told the doctor, No, a knee replacement is my last alternative.”

Hoping to help her husband avoid surgery, Raymond’s wife, a registered nurse, researched nonsurgical options to

in blood loss, scarring and long, painful recovery periods, stem cell therapy requires only injections into the damaged joint and o� ers a much quicker recovery than surgery. Typically, patients begin to feel a noticeable decrease in pain after six weeks.”

“Tremendous Potential”Stem cell therapy is autologous, meaning it utilizes stem cells, PRP and growth factors from the patient’s own body. Using the patient’s own cells eliminates the chances of reactive side e� ects or rejection.

Stem cells are extracted from the patient’s bone marrow or fat, and PRP is taken from the patient’s own blood. � e harvested cells are then injected into the painful area to stimulate regeneration of damaged tissue and the healing of ten-dons, ligaments, joints or spinal discs.

“When I was � rst introduced to stem cell therapy, I recognized its tremendous potential for patients who would other-wise have limited treatment options for pain relief,” Dr. Grana discloses.

“Patients with osteoarthritis, such as Raymond, have very few choices other than surgery when the condition advances and damages the joint. Since surgery has potential complications, when we treat arthritic joints without surgery, patients do much better.”

Dr. Grana has developed a system for the delivery of stem cells and PRP into the pain generators in and around joints such as the knees, shoulders and hips. It’s called RegenaJoint™.

He developed a similar system to treat the spine. That process is called RegenaSpine™. RegenaJoint and

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L. Amarchand, MD, FACPBypassing Blockages

Stem Cell therapy/pain management

EECP may be the nonsurgical alternative for you! For more

information or to schedule an appointment, please contact

Dr. Amarchand’s o� ce in Brooksville at:

750 Desoto Ave.(352) 796-6721

L. AMARCHAND, MD, FACP

L. AMARCHAND, MD, FACPDR. TONG GUO

L. Amarchand, MD, FACP, is board certi� ed by the American Board of Internal Medicine. He completed a residency in internal medicine and a two-year fellowship in cardiology and cardiac nuclear imaging at

St. Barnabas Medical Center in Livingston, NJ. His third year of fellowship training included a clinical and research fellowship in cardiology and a cardiac nuclear imaging fellowship at Massachusetts General Hospital in Boston, MA, as well as a research fellowship in medicine at Harvard Medical School. Dr. Amarchand is for-mer chief of sta� (2001-2005) at Brooksville and Spring Hill Regional Hospitals. He has served as a medical expert for the Florida Agency for Health Care Administration. He is a Fellow of the American College of Physicians and a member of the American College of Cardiology and the American Medical Association.

Dr. Tong Guo, a pioneer in obtain-ing FDA approval of EECP for use in the United States, assists Dr. Amarchand in overseeing EECP, ensuring the delivery of optimal treatment with excellent outcomes

for patients. Dr. Guo worked as a research fellow in the cardiology division at Stony Brook Medical Center School of Medicine, NY, helping to set up the � rst EECP treatment centers.

Bypassing BlockagesNoninvasive therapy boosts collateral circulation in heart

A fter re t i r ing f rom the United States Navy in 1983 following 26 years of ser-vice, Daniel Segovia, 78,

worked for a while for the US Postal Service, then joined his brothers in a business venture. Unfortunately, the Michigan native then experienced a series of health challenges that eventu-ally brought his working life to a halt.

“I retired for good when I fell down my steps and broke an arm and a leg,” Daniel shares. “I fell again and broke an ankle and the other arm. After that, I suf-fered a heart attack, then I had a stroke, actually two strokes. I also have diabetes.”

While these issues put a stop to Daniel’s professional life, they didn’t stop him entirely. He continued to work around the house, keeping himself busy and active. He became concerned, how-ever, when everyday activities became di� cult to manage.

“One day, I realized I couldn’t walk from one side of the room to the other without hu� ng and pu� ng,” he recalls. “Outside in the yard, I’d work about � ve minutes, and I’d be hu� ng and pu� ng. I was short of breath all the time.

“I didn’t have any chest pain, but I didn’t have any energy. I didn’t want to do anything because I knew I was going to be tired out. No matter what I tried to do, I just didn’t have the energy to do it.”

� ese symptoms, caused by prob-lems related to Daniel’s heart attack, left him physically and emotionally de� ated. He was open to new ways to get his energy and breathing back to normal. He discovered a new way in the pages of a newspaper he found in the o� ce of one of his doctors.

“I like to read, and when I went to see my diabetes doctor, there was a copy of Florida Health Care News in the waiting room,” Daniel confirms. “I got interested in an article about Dr. Amarchand and his procedure, and I wanted to learn more about it.

“I talked to my diabetes doctor and said, I’ve been feeling a loss of energy like the person in this article, and I think I want to see this doctor. My diabetes doctor said Dr. Amarchand was a good doctor, so I went to see him.”

Daniel’s doc-tor recommended L. Amarchand, MD, a board-certified cardiolo-gist and internist in Brooksville. � e article Daniel read was about the unique treatment protocol and surgi-cal alternative that Dr. Amarchand o� ers his patients. � e treatment is a safe, noninva-sive, circulation-boosting technique called enhanced external counterpulsation (EECP).

Dr. Amarchand uses nonsurgical EECP to treat patients with heart dis-orders such as congestive heart failure, blocked coronary arteries and angina pain, all of which can cause the lack of energy and shortness of breath Daniel experi-enced. Using EECP, Dr. Amarchand has an impressive record of success in main-taining his cardiac patients’ heart health and independence.

Timed RhythmsIn addition to shortness of breath and loss of energy, a tightening or pressure in the chest, weakness and other symptoms can all be caused by a lack of oxygenated blood � owing through the heart.

As these symptoms get progressively worse, it’s not unusual for people to

restrict their activities in order to reduce their discomfort. As a result, their qual-ity of life quickly diminishes. EECP can reverse these symptoms by working like a natural bypass procedure.

“More than twelve million Americans have found relief from their symptoms and had their energy restored while also receiving other bene� ts through the use of EECP,” declares Dr. Amarchand.

Typically, EECP is delivered through a series of 35 hour-long sessions over the course of seven weeks. During an EECP session, the patient reclines, fully clothed, on a cushioned table while listening to music or watch-i n g a m ov i e . C o m p r e s s i o n cu� s are wrapped a r o u n d t h e

patient’s calves, thighs and buttocks to apply pressure in rhythms carefully timed to the patient’s heartbeat.

“The pressure propels more blood upward and into the coronary arteries, enlarging the arteries and improving collateral circulation,” informs Dr. Amarchand. “It helps the patient’s own circulatory system bypass coro-nary artery blockages and opens up the underused collateral blood vessels.”

“It felt like a comical situation because there I was in a funny out� t, all hooked up and lying on a table,” Daniel relates. “� en they turn on the machine, and I start bouncing up and down, a little to the left and a little to the right. � e treatment didn’t hurt; it relaxed me. It made me feel better.”

EECP is the perfect option for indi-viduals who want to try a noninvasive procedure before resorting to open heart surgery, notes Dr. Amarchand. It’s also

good for those who have not achieved relief with prior surgical procedures such as bypass and angioplasty, and for patients who aren’t candidates for surgery.

“According to studies done on the procedure, eighty-� ve percent of patients completing EECP treatments obtain sub-stantial and sometimes dramatic relief from their heart-related symptoms,” states Dr. Amarchand. “The same percent-age realizes increased exercise tolerance, mental alertness and reduced need for nitroglycerin to relieve angina pain.

“EECP can be repeated as often as needed because it is noninvasive,” adds the doctor. “However, its bene� cial e� ects can last from three to � ve years.”

EECP treatment is FDA-approved and Medicare-reimbursed.

Feeling Young AgainWhile all 35 treatment sessions are needed to get the full bene� ts of EECP, many patients begin to feel relief of their symptoms after just a few sessions. Daniel started to feel better early in the course of his therapy.

“After two or three EECP treatments, I knew it was doing me good,” he reports. “My legs weren’t tired. My body wasn’t tired. I had energy, and I could breathe better. I got home and I walked back and forth from room to room with no prob-lem. After supper, I walked around the house, and it felt good.”

Daniel is amazed by the improve-ment in his condition. He’s happy he no longer su� ers with the symptoms he experienced before EECP therapy. � e treatment has him feeling young again. He tells everybody he knows about his miraculous turnaround.

“Everything’s come back, my breath-ing and my energy,” Daniel enthuses. “I joke around with my family and say I’m like a sixteen-year-old guy. I feel like I did when I used to play around with my kids when they were � ve and six years old. I have all of the energy, all of the get-up-and-go. I’m even going to the gym.

“Every chance I get, I tell people about Dr. Amarchand and EECP. If I hear somebody say they’re having trouble, I tell them to read up on the procedure, and if they have any questions, call Dr. Amarchand. I’m a � rm believer in him and his EECP therapy.”FHCN article by Patti DiPanfilo. Photo by Jordan Pysz.

Header graphic from Pixabay. mkb

EECP has Daniel feeling like a kid again.

Page 2 | Florida Health Care News | Spring 2019 | West Citrus County Edition Cardiology

KASIM MANZUR, DMD

Visit them online at www.naturecoastdentistry.com

A Trusted Tradition of Personalized and

Comfortable CareDr. Manzur and the sta� at

Nature Coast Dentistry look forward to serving the readers of

Florida Health Care News and their families and friends.

For an appointment, call the number below or visit the o� ce in

Beverly Hills at:

3835 N. Lecanto Hwy.(352) 746-3525

Kasim Manzur, DMD, received a Bachelor’s degree in Biology from Georgia State University in Atlanta, then did post-graduate work at Barry University in Miami and Nova Southeastern University in Ft. Lauderdale. He earned his Doctor of Dental Medicine degree at Nova Southeastern University School of Dental Medicine, also in Ft. Lauderdale. While in dental school, Dr. Manzur was a dental anatomy and operative dentistry tutor and worked with Kids in Dentistry, the North Miami Beach Dental Clinic, Nova Southeastern Oral Surgery Clinic and Joe DiMaggio Children’s Hospital. He is a member of the American Dental Association and Florida Dental Association.

Follow the LeaderGet crowns and bridges in one day with CEREC®

N ature Coast Dentistry in Beverly Hills is a leader, not a follower.

The dental practice was among the � rst in the area to o� er both in-house, high-tech CT scans and digital x-rays that require 70 percent less radiation exposure. � e goal of being at the forefront of technology is prominent under the leadership of Kasim Manzur, DMD. He and his sta� are committed to keeping Nature Coast Dentistry on the leading edge of dental practice.

Dr. Manzur prepares the

milling machine for a same-day

crown

The CEREC milling machine fabricates crowns from a solid

piece of ceramic in minutes.

“We continually upgrade our practice with the most up-to-date equipment, techniques and technolo-gies,” Dr. Manzur con� rms. “We want to provide our patients with the best, most advanced dentistry we possibly can.”

Committed to advanced tech-nology, Dr. Manzur recently added digital dentistry using innovative CAD/CAM technology. CAD/CAM stands for computer-aided design/computer-aided manufacturing. It has been used for many years to design and manufacture products such as tools and auto parts.

Mo re r e c e n t l y, C A D / C A M technology was retooled for use in dentistry to meet the growing need for comfort and convenience in the dental office. That fueled the devel-opment of office-based CAD/CAM restoration-fabricating equipment such as the CEREC in-office system.

“CEREC is a technology that creates tooth restorations quickly and easily in our o� ce, most often in a single visit,” Dr. Manzur elabo-rates. “It can make dental crowns, inlays, onlays, veneers and even bridges.

“ T h e m o s t common res to-rations we make with CEREC are crowns and bridges. Crowns are restorations that cover the entire tooth. Bridges are just what their name suggests. � ey bridge the gap where one or more teeth are missing.”

CEREC, which is an acronym for Chairside Economical Restoration of Esthetic Ceramics, uses state-of-the-art optical imaging and CAD/CAM technology to design and mill a cus-tomized restoration that � ts perfectly and matches the color of the patient’s surrounding teeth.

“CEREC enables us to make the all-ceramic dental restorations right here in our o� ce,” Dr. Manzur stresses. “With CEREC, creating a restoration is a one-appointment process. � ere are no temporaries involved. In most cases, we can have a patient’s restoration com-pleted in a single visit.”

Doing Dentistry Digitally� e CEREC system is digital dentistry at work. � e system consists of three main parts – the computer system, the software and the milling unit. � ese parts work in concert to create the � nished restoration.

“� e � rst part of the system is called an acquisition unit,” Dr. Manzur explains. “It’s essentially a computer with a special camera, called an Omnicam, that digi-tally takes three-dimensional photos of the patient’s teeth. These photos take the place of the impression. � en, the software on the computer enables the dentist to digitally design the restorations.

“� e milling unit is the third part of the CEREC system. It’s a little, breadbox-sized machine that has diamond drills in it. It fabricates the restoration out of a big, square block of ceramic material that matches the patient’s other teeth.”

Dr. Manzur notes that the ceramic material that’s used for the individual restorations varies. He chooses the material that’s best suited for the patient and the location of the restoration. He prefers having control over choosing the material rather than relying on the judgment of a dental lab.

“If the patient is a grinder or if they clench their teeth, I choose a very strong material, such as zirconia,” informs Dr. Manzur. “For teeth in the front of the mouth, directly in the smile line, I choose a material that has more glass in it, which

is more aesthetically pleasing.”

With CEREC, Dr. Manzur uses high-tech, space-a g e c e r a m i c materials that are much stronger than any materials avail-able in dentistry in the past. These advanced materials

give the CEREC restorations unmatched durability.

Dr. Manzur also likes that CEREC puts many of the functions of a dental lab right at his � ngertips. He can use this chairside system to fabricate the restorations and make major changes while patients wait. � e technology is so advanced that it can o� er extensive color-matching capa-bilities, as well as long-term stability and beautiful, re� ned milling.

“With the old way of doing resto-rations, the technicians at the lab did

their best to get the color to match the patient’s other teeth,” he acknowledges. “They worked off of standard shade guides and the input of the patient’s den-tist. With single-visit restorations, I have the patient in my o� ce, so I can match the restoration perfectly before he or she leaves the o� ce.

“� e restorations are made right here in the o� ce before we cement them in the patient’s mouth. If something isn’t quite right with a restoration, which is uncommon because CEREC is extremely accurate, I don’t have to send it back to the lab. I can correct the issue right here and re-make a new restoration before the patient leaves. It only takes a few minutes, so there’s never the need for another visit.”

Single-Visit SensationsTraditionally, when patients went to the dentist to get crowns placed over their teeth, they had impressions made in one visit, then had to wait two weeks to get their permanent crowns from the den-tal lab. � ey then returned for a second appointment to have the � nished crowns permanently cemented into place.

“During those two weeks, the patients wore temporary crowns,” Dr. Manzur describes. “Because those restorations are placed with temporary cement, they could come o� . When they did, it tended to be at the most inconvenient times. Lost temporaries could cause embarrassing and uncomfortable problems for the patients.”

With CEREC, patients come in for an appointment, and Dr. Manzur pre-pares the tooth that is getting crowned. Once the tooth is prepared, he scans it digitally with CEREC’s Omnicam to obtain an exact measurement of size and bite. � at information is sent to the com-puter’s software.

“We design the crown on the com-puter and make sure we get the color matched and everything else correct,” notes the dentist. “We then send that design information to the milling unit, which makes the crown.

“CEREC makes bridges the same way. If patients need bridges that span

more than four or � ve teeth, those still have to be sent to the lab. However, basic bridges, the three-unit bridges that cover one missing tooth, can be fabricated by CEREC in one day.”

One benefit of using CEREC to make restorations is that Dr. Manzur does not have to use gooey material to

make impressions of his patients’ teeth. Traditionally, patients had to sit with this material in their mouths for at least 20 minutes while it molded to their teeth. It was uncomfortable for most patients and untenable for some.

“Many of my patients have a severe gag re� ex, so they have a di� cult time going through the impression process with the gooey material,” he observes. “With CEREC, patients don’t have to do that. Impressions are made with a simple scan of their teeth. � ere’s no gooey mate-rial involved.

“Another benefit is patients get their restorations in a single day. They don’t have to wear temporaries. They get their permanent restorations in one appointment, and they’re able to eat and chew within a few hours of the appointment. It’s also nice that patients only have to be numbed one time because there’s no second visit.”FHCN article by Patti DiPanfilo. Photos by Jordan Pysz.

Stock photo from Pixabay. mkb

West Citrus County Edition | Spring 2019 | Florida Health Care News | Page 3CoSmetiC and FunCtional dentiStry

(continued from page 1)

RegenaSpine are both minimally invasive procedures that are performed right in the doctor’s o� ce using a local anesthetic. Patients typically resume normal activities right away.

To precisely deliver stem cells into the painful area, Dr. Grana uses image guidance through ultrasound and � uoros-copy (continuous x-rays). He uses imaging to ensure precise place-ment of the stem cells, which restore function, improve qual-ity of life and reduce or eliminate the need for surgery and/or nar-cotic medications. Many other clinics don’t use this process.

“� is imaging guides us to put the stem cells where they need to go,” the physician asserts. “Not everybody does it this way, which is a shame because the results are much better when the stem cells are delivered to the area where they’ll do the most good.”

Threefold TargetThe main culprit in many of the joint issues patients bring to Regenerative Orthopedic Institute is osteoarthritis.

“Osteoarthritis is the degen-eration of the joint that happens over time,” Dr. Grana notes. “It’s a mechanical as well as a chemical disease, where harm-ful chemicals inside the joints prevent them from repairing themselves. Thus, the normal wear and tear occurs without regeneration.

“Within three minutes, RegenaJoint reduces chronic inflammation. It restores the normal chemistry of the knee joint so there is balance again,

Joint Investment

Erick A. Grana, MD, is a diplomate of the American Board of Physical Medicine and Rehabilitation and the American Board of Electrodiagnostic Medicine, with subspecialty certification in pain medicine. After he received his medical degree from the University of Puerto Rico School of Medicine, he completed his internship and residency at the

university’s hospital and was subsequently awarded a fellowship from the department of rehabilitation medicine at the University of Washington in Seattle. Dr. Grana is a former assistant professor at Baylor College of Medicine in Houston and a member of the American Medical Association, the International Spinal Injection Society and the Florida Academy of Pain Medicine.

Don’t Operate, RegenerateFor more information about stem cell therapy, please call

or visit Regenerative Orthopedic Institute in Tampa at:

8011 North Himes Avenue, Suite 3

(813) 868-1659Visit Regenerative Orthopedic Institute on the web at www.dontoperate.com

“� en they took my blood, spun it and removed the plate-lets. � ey mixed the stem cells and platelets together, then Dr. Grana injected the mixture into my knee. I’ve had shots in my knee before, and if they’re not done properly, they can be very painful. But Dr. Grana did this one properly. He knows what he’s doing with the knee because I really didn’t feel anything at all.”

Ongoing Progress� ough patients typically begin to feel the e� ects of stem cell treat-ment about six weeks after receiving it, Raymond felt improvement after only four weeks. His pain continued to decrease as time went on. Today, he continues to recover and is still experiencing results from his procedure.

“After about a month, I noticed the pain was starting to feel a little better,” he enthuses. “� en it kept getting better and better. Some days now, I have no pain. Other days, I have a little bit of pain, but it’s going down at a rapid rate. � at’s a very good sign for my recovery.

“At this point, my knee is great. � e procedure was done in October. It’s now January, and I’ve gotten back about eighty-� ve percent of my knee. � e pain in my knee went from a nine to a one, maybe one and a half, and that’s manageable. My stem cell treatment was a de� nite success.”

� e reduction in Raymond’s knee pain is a game changer for him, especially because he achieved it without surgery. While he’s not gol� ng yet, he is walking comfortably again. He credits Dr. Grana and his stem cell therapy for the turnaround. Raymond believes the doctor and his treatment are worth bragging about.

“I’ve already recommended Dr. Grana and Regenerative Orthopedic Institute to several people,” he says. “As far as stem cell therapy, I was a skeptic at � rst, but now I’m a � rm believer based on the outcome with my knee. I recommend the treat-ment totally!”FHCN staff article. Graphics from kisspng. mkb

*Patient’s name withheld at his request.

allowing regeneration that can heal the wear and tear occurring inside the joint. At the same time, it can repair some of the damage that has occurred previously.”

Dr. Grana stresses that when combined with concentrated platelets and growth factors, stem cells become a powerful, natural repairing mech-anism for painful joints and aching backs.

“Pat ients usu-ally have three goals for RegenaJoint and RegenaSpine: � rst, to get their pain relieved; second, to resume former activ-ities that they weren’t able to do because of their arthritis; and third, to avoid surgery,” Dr. Grana observes. “� ese are the main goals that most patients want to achieve.”

“Grow New Cartilage”Raymond says he was initially a bit apprehensive about receiving stem cell treatment because there were no guarantees. He went to the Institute anyway and spoke to the nurse, whose � ndings encour-aged him to go ahead with it.

“The nurse looked at my knee through an x-ray and said, � ere’s still some cartilage in there, so we can grow new cartilage,” Raymond recalls. “She went on to explain exactly how it is they do that, so I agreed to have the procedure, which was performed in October.

“The staff at Regenerative Orthopedic Institute took two

big syringes of my fatty tissue and two big syringes of my blood and spun the plasma out of my fatty tissue and took out the actual stem cells.

Stem cells are extracted from the patient’s own bone marrow or fatty tissue and can be used to regenerate

joints such as the shoulders, knees and ankles.

Page 4 | Florida Health Care News | Spring 2019 | West Citrus County Edition

Barry LevineExecutive Publisher

Gina L. d’AngeloCFO/HR

Roy CummingsEditorial Supervisor

Michelle BrooksCreative Director

Brian LevineProject Coordinator

Patti DiPanfiloAnnette MardisEditorial Staff

Laura EngelProduction Assistant

Nerissa JohnsonGraphic Designer

Nerissa JohnsonJordan PyszFred BelletPhotography

Steve TurkMario Hill

Kent BoothRobert MizeRick Bowser Distribution

Regenerative Orthopedic InstituteStem Cell Therapy/ Pain Management

L. Amarchand, MD, FACPCardiology

Nature Coast DentistryCosmetic and Functional Dentistry

Regional RehabPhysical Therapy

Premier Vein CentersVein Treatment

Sonlife Prosthetics and Orthotics, Inc.

Prosthetics and Orthotics

South Florida Eye ClinicOphthalmology

The Dentofacial & Cosmetic Surgery InstituteOral & Maxillofacial Surgery

Alpha Medical GroupErectile Dysfunction

Acute Wound CareCompression Therapy

Pain Institute of Central FloridaPain Management

215 Bullard ParkwayTemple Terrace, FL 33617

(813) 989-1330

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Spring 2019

Stem Cell therapy/pain management

Even at age 95, George is still fl ying high.

Proven ResultsCharles C. Donley, PT, is director of Regional Rehab. He earned his Bachelor of Science degree in Physical Therapy, graduating cum laude, from the University o f P i t t s b u rg h , PA . H e served on the board of the Hernando County United

Way, is a director with Touching Nations Today, Inc. and was the Staff PT for Dance Revolution Ministries for ten years. Charles has been a John Maxwell Team Member since 2015, and is certified in public speaking, leadership and coaching.

Visit Regional Rehab on the web at regionalrehabptlaser.com

The experienced therapists at Regional Rehab look forward to working with you. Se habla Español. For more information or to make an appointment, call the number below or visit their offi ces in Spring Hill at:

465 Mariner Blvd.

CHARLES C. DONLEY, PTPAUL ERNANDES, PT, PhD

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“AUTO ACCIDENT INJURY CASES WELCOME”

State-of-the-art laser treatment gives WWII fighter pilot a lift

A t 95 years young, George Pasternack refuses to accept the title of “hero.” But how else would you describe some-

one who � ew dozens of combat missions during World War II and still takes to the skies on occasion even today?

“I joined the service right after I got out of high school and got into the war right after the Battle of Midway,” the Spring Hill resident explains. “I used to � y o� carriers in the South Paci� c and all that stu� , and I’m still � ying.

“I have three planes that I used to own that I have access to, and when I go back home to North Dakota in the sum-mertime, I usually take them up. People ask me all the time, When are you going to quit � ying? I tell them, When I get older.”

Records show that George is the old-est World War II pilot still licensed and � ying in the United States, but he was recently grounded after he began experi-encing a great deal of unsteadiness and imbalance issues while walking.

“I was feeling like I was going to fall over and found that I was walking all hunched over and bent at the waist, the way older people do,” George says with a snicker. “Whenever I stood up or tried to walk, I felt that way.”

� e issues even-tually forced George to begin walking with a cane. When the deacon at his church noticed that, h e i m m e d i a t e l y urged George to visit Regional Rehab, where the deacon himself had received some care for a sim-ilar problem a few months earlier.

Laser Light Show “When George first came to us, I thought he was suffering from dizzi-ness, because he was very unsteady,” recalls Paul Ernandes, PT, PhD, at Regional Rehab. “But after I exam-ined him, I realized it was neuropathy in his lower legs that was causing the imbalance.”

To c o r r e c t the problem, Paul recommended a combinat ion of manual therapy and treatment with the Class IV deep tissue therapeutic laser, which uses speci� c wavelengths of red and near-infrared light to stimulate the body’s natural ability to heal cells.

Paul says the laser acts like a “snowplow on a winter’s street” by releasing nitric oxide, which removes congestion and swell-ing and promotes faster healing while reducing discomfort and increasing blood circulation.

“� e Class IV laser is an impressive and versatile tool,” adds Charles Donley, PT, director of Regional Rehab. “We’ve used it for burn and wound patients as well as for all the di� erent musculoskele-tal issues we typically treat, such as acute, chronic and postoperative pain.”

� e combination of the manual ther-apy, which included a series of stretching and balance exercises, and the Class IV

laser treatments helped George regain his stability and got him back on his feet again.

“Once we were able to stretch him out, George did great with the balance exercises,” Paul con� rms. “But it was the laser treatment that made the biggest dif-ference and really helped him with the sensation in his legs.”

George concurs, and adds that he was at a point where he was almost afraid to leave his house because he feared he might lose his balance and fall. Now, that summer trip to North Dakota to � y his old private planes is back on his schedule.

The Magic Touch “� e people there are all just so tremen-dous, and Paul and I hit it o� right away,” George exudes. “His knowledge and level of professionalism are just remarkable, and as soon as he started working on me, I knew I was in the right place.

“I had so much con� dence that what he was doing for me was going to help me, and when we were done, I came out of there feeling like my old self again. And that’s saying a lot because I really had lost a lot of stability.

“I’d lost so much stability, it was almost scary. I was almost falling over whenever I tried to walk, but he took care of that and helped me one hundred percent. I’m not kidding you when I say Paul has that magic touch, because I feel so much better now.”

One Tool, Many Uses

O ver the course of the last ten years, the certified staff at Regional Rehab has administered thou-

sands of treatments using the Class IV deep tissue therapeutic laser. During that time, the sta� has discovered the laser’s e� ectiveness in treating an array of disorders, including shingles.

That recently worked out to the benefit of Mary Suggs, a former high school teacher and publishing house editor of mostly military history and Christian non-fiction books, who began suffering from a bad case of the herpes zoster virus last fall.

It is treatable with the Class IV laser because the laser decreases the conges-tion of the cells that are swollen and blistered and helps bring oxygen and water to the in� amed area, which fur-ther advances healing.

Mary admits to having been a bit skeptical of the suggested laser treat-ments, which she began receiving the week before � anksgiving. She began to feel relief from her shingles just days after beginning the laser treatments.

“I had four treatments altogether about two days apart, and by the third treatment, I didn’t have much pain at all,” Mary reveals. “We went ahead and did the fourth treatment just to be sure, but I really didn’t need it, and I haven’t had any pain since.

“I was told that if the pain did come back that I could go back to Regional Rehab and they’d give me another

treatment, but I haven’t had to do that. I can’t tell you how thankful I am for that and for all the care I received there.

“I’ve already told several people about Regional Rehab and what they did for me, including one person who has had shingles for quite a while. Everyone is so caring and helpful there. I honestly could not be more pleased with the care I received.”FHCN articles by Roy Cummings. Patient photos by Jordan Pysz. mkb

Mary Suggs

Paul Ernandes, PT, PhD, joined the Regional Rehab team in April 2018. His arrival comes after he spent nearly a year serving as the director of physical therapy at Vitality Physicians and Rehab. Paul previously worked for ten years as the director of reha-

bilitation at Oak Hill Hospital in Brooksville. He has also worked as a home health physical therapist for BayCare Health Systems, as the director of rehabilitation services at Mariner of Inverness and as the regional rehab director for Comprehensive Rehabilitation Services.

“I didn’t know what it was until I went to a doctor,” Mary says of the painful rash the virus causes. “But the minute he looked at me, he said, You’ve got shingles and prescribed an antiviral, which I started taking right away. I also had the shingles shot.

“A few days after I was diagnosed, I was telling someone about it, and they mentioned to me that a friend who had shingles went to Regional Rehab and was treated with a laser that worked really well, so I decided to check it out.”

� e herpes zoster, or chickenpox, virus lies dormant in the spinal column and can emerge unexpectedly, sometimes due to stress, across the torso, chest or back in the form of a painful, red rash when nerve roots in those areas become in� amed.

SoaringWest Citrus County Edition | Spring 2019 | Florida Health Care News | Page 5phySiCal therapy

Henry’s vein

treatment makes

working on the farm a lot easier

Ravi Sharma, MD, is board certi� ed by the American Board of Thoracic Surgery. He completed his under-graduate studies at the University of Maryland at College Park and attended the University of Maryland

Graduate School, Baltimore, before receiving his medical degree from Eastern Virginia School of Medicine, Norfolk. Dr. Sharma completed his intern-ship and residency in general surgery at Eastern Virginia Graduate School of Medicine Department of Surgery, Norfolk, and completed his residency in thoracic surgery at George Washington University, Washington, DC.

For Premier Vein Treatment

Premier Vein Centers o� ers free initial consultations. To � nd out more, visit www.premierveincenters.com, or call (352) 621-0777.

Expertise, leading-edge technology allow for

customized care

F or 42 years, Henry Landrum worked as a registered nurse, 30 of them in the emergency room. He spent hours on his feet caring for

patients. He also sat for long periods noting patients’ symptoms and treatments in their medical charts. Add all that to a genetic pre-disposition for them, and Henry eventually developed severe varicose veins.

“I had really bad veins in my upper and lower legs,” con� rms the Brooksville native. “I inherited them from my mother, who had terrible ulcers on her legs. I’ve had varicose veins for years, and they’ve bothered me o� and on for about ten years. I’ve been retired now for � ve years, and my veins have gotten worse within the last three or four.

Risk Factors for Varicose Veins� ese factors increase your risk of developing varicose veins:

• Age. � e risk of varicose veins increases with age. Aging causes wear and tear on the valves in your veins that help regulate blood � ow. Eventually, that wear causes the valves to allow some blood to � ow back into your veins, where it collects instead of � owing up to your heart.

• Sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstrua-tion or menopause may be a factor. Female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.

• Family history. If other family members had varicose veins, there’s a greater chance you will, too.

• Obesity. Being overweight puts added pressure on your veins.

• Standing or sitting for long periods of time. Your blood doesn’t � ow as well if you’re in the same position for long periods.

“I felt a lot of pain in my legs toward eve-ning. I had achiness, swelling and cramping at night, and it became hard for me to walk, which is problematic when you live on a farm as I do. What really alarmed me, though, was when my feet and legs started to become dis-colored. I knew then I really had a problem and needed to do something about it.”

Henry’s daughter, an ultrasound tech-nician, encouraged him to have his legs evaluated by a vein specialist. He knew of one in the area, Ravi Sharma, MD, of Premier Vein Centers in Homosassa and � e Villages®. Dr. Sharma is a board-certi� ed cardiovascular surgeon with expertise in blood vessel disorders a� ecting the legs.

As a longtime cardiovascular surgeon, Dr. Sharma spent many years working with the intricate blood vessels surrounding the heart. He now focuses his practice full-time on treating patients with venous disease of the legs. Henry was surprised to � nd that he had crossed paths with Dr. Sharma in the past.

“I had heard of Dr. Sharma; he was a chest surgeon in the Tampa area,” Henry relates. “He had a very good reputation as a surgeon, so I decided to have him check me out. I’ll be darned if he isn’t the same doctor who worked on my father at one time. I could hardly believe it.

“Dr. Sharma is very knowledgeable. He is also a very nice gentleman and very professional. He is very confident in

what he does. He performed the ultrasounds on my legs and said I needed to have several procedures to take away the swelling and get my legs better so I could walk again. I decided to go ahead and have them done.”

Among the procedures Dr. Sharma used to help Henry was the latest technology, non-thermal VenaSeal™.

seen. � ey include throbbing, aching, sting-ing, burning, itching, nighttime leg cramps and restless legs. � ese are all indications that the veins are not functioning properly.

“For patients who experience any of these signs or symptoms, it is important that they have their veins assessed,” Dr. Sharma stresses. “Leaving the condition untreated can lead to more serious di� culties, including leg ulcers, infection and a breakdown of the skin.”

� e cardiovascular surgeon reports that venous insu� ciency is more common than many people think. It is estimated that more than 30 million Americans su� er with symp-tomatic venous insu� ciency. Venous vascular disease is � ve times as prevalent as peripheral arterial disease, or PAD, and more than two times as prevalent as coronary artery disease.

“A huge problem in getting venous insuf-� ciency properly treated is that many of its symptoms are invisible and often misunder-stood by patients,” Dr. Sharma notes. “One of those symptoms is leg pain. Pain is common with many disorders, so venous insu� ciency is often overlooked or misdiagnosed.

“Patients and physicians alike need to understand that vein problems are often present before they are visible on the surface. Symptoms such as pain, heaviness and restless

legs can signal vein disease without the correspond-ing visible varicose veins. With the right diagnosis, a patient’s leg pain can be relieved with simple, min-imally invasive techniques.

“When seeking a phy-sician for care, it is crucially important for people to choose surgeons who spe-cialize in venous diseases. The physicians should also be experienced in the advanced procedures avail-able to treat these diseases. Physicians with these qual-

i� cations achieve the best outcomes.”

Advanced OptionsAt Premier Vein Centers, a full range of advanced, minimally invasive treatment options for addressing varicose and spider veins is available. � ese treatment options

include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections and the new, non-thermal procedure, VenaSeal.

Microphlebectomy has replaced strip-ping, an outdated, more involved procedure during which doctors treated the large veins by making big gashes across the leg that often left the patient with large scars.

“With microphlebectomy, the incision is tiny – about the size of the tip of a scalpel – and we can do much more through that small incision,” Dr. Sharma assures. “And with this procedure, patients end up with tiny marks on the skin or no scars at all.”

During EVLA, a sterile laser � ber is intro-duced into the incompetent vein via a small puncture in the leg. Laser energy is then deliv-ered through the � ber, painlessly closing the vein in less than an hour, using local anesthesia.

Sclerosing injections are used to treat spider veins, which are tiny, dilated blood vessels in the skin that become swollen with stagnant blood. Dr. Sharma uses ultrasound-guided sclerotherapy (UGS) to guide the injec-tions that gently close the problem vessels.

VenaSeal is a non-thermal closure sys-tem that relieves symptoms by delivering a small amount of a specially formulated med-ical adhesive, or “super glue,” to the diseased vein. � is permanently seals the vein. � is procedure does not require multiple needle sticks and, in some cases, support stockings aren’t necessary.

Dr. Sharma uses his expertise to deter-mine which procedures to use based on each patient’s symptoms and health status. � ese advanced treatments are all performed in a comfortable o� ce setting and result in little or no downtime and discomfort.

“Our patients are often very relieved to discover that there is no general anesthesia involved in our minimally invasive treat-ments,” Dr. Sharma acknowledges. “And they’re happy to learn that they can resume activities right away.”

Premier Vein Centers provides a free ini-tial consultation and accepts most insurance, including Medicare.

The Preacher’s WifePreachers never retire, and neither do preachers’ wives. Mary Jim Campbell has assisted her husband in building churches in many states, including Florida. A few years ago, they returned to Florida and settled in Summer� eld. Soon after, they began a new church, where Mary Jim’s husband continues to minister.

“As a preacher’s wife, I work with him,” Mary Jim explains. “When we build churches, I’m right alongside him doing whatever needs to be done. I work to pro-mote him and make his life comfortable because preachers in this day and age deal with a lot of issues.”

Mary Jim recently had a few issues of her own to deal with. For one, she had a bulging varicose vein on her left calf. She’d actually had it for many years, but it never really con-cerned her. It bulged, but was barely visible because of its location on her leg.

“� at vein appeared after a tumbling accident in high school,” Mary Jim reports. “I had a bulge, but it was on the inside of

my leg right about where the muscle is. � at one didn’t bother me. I’ve just lived with it since the Fifties.”

While Mary Jim ignored the vein on her left leg, she did become concerned when unsightly veins suddenly began appearing on her right leg. She was self-conscious about the highly visible veins and considered hav-ing that leg treated.

“After we moved to Florida, a vein popped out on my right thigh and started crossing over my kneecap,” Mary Jim con-� rms. “It was very unsightly. Of course, in Florida I was wearing shorts more, and it felt like everybody was noticing it. I had a little swelling in my legs as well, and some painful leg cramps.

“I’m not really vain, and I’ve lived with the vein on my left leg for many years, but I really felt I needed to take care of the ones on my right leg.”

Mary Jim’s desire to seek treatment for her leg veins led her to Dr. Sharma.

“I thought I was going in for cosmetic treatment until I had my consultation with Dr. Sharma,” Mary Jim remembers. “He explained that my problem had to do with circulation and that if I didn’t do something about both legs now, I would have major problems down the line. Treatment would eliminate the unsightly veins as well.”

� rough the use of ultrasound images, which he obtained after learning of her health history, Dr. Sharma diagnosed Mary Jim with venous insu� ciency. Dr. Sharma recommended several procedures to address her condition.

Treatment TrioMary Jim was impressed with Dr. Sharma’s expertise. She was also intrigued with the treatments she received at Premier Vein Centers, where Dr. Sharma addressed her venous insu� ciency by employing a trio of procedures.

“I had laser ablation, microphlebectomy and sclerotherapy, and I was amazed by how little pain was involved,” Mary Jim marvels. “During one procedure, Dr. Sharma actually took out a piece of my vein and showed it to me. It was fascinating.

“To do the vein over my kneecap, he made a small incision in the knee with a scalpel and punctured the skin. � ere were no stitches with any of the procedures, and you can’t tell at all now that I had anything done to my legs.”

Dr. Sharma used the same three proce-dures, as well as VenaSeal, to treat Henry’s

venous insufficiency, and they achieved positive results with him as well. Henry is very pleased with how his legs look and feel since his treatment at Premier Vein Centers.

“My legs look a lot better,” he enthuses. “� ey don’t swell nearly as much as they did. � e color is also much better than it was. Overall, the cir-culation has improved one hundred percent. I’m amazed.

“ I w e n t f r o m e x c r u c i a t i n g pain to no pain.

“I’m also walking a lot better than before. I can walk for extended periods of time, and walking great distances doesn’t bother me. Before, it was getting so my legs hurt so badly that I couldn’t walk very far without having to stop.”

Mary Jim credits Dr. Sharma and his sta� with making her experi-ence a positive one. � ey even let her husband sit in on one of the pro-cedures. She was truly pleased with the ease of the procedures and very happy with the results.

“I can’t say enough about the thorough-ness and friendliness of Dr. Sharma and his sta� ,” Mary Jim says. “� ey told me what they were doing when they did the procedures. � ere was no fear involved, and I was very comfortable. I felt very con� dent in what Dr. Sharma was doing.

“My legs look and feel fine now. All my bulges and bumps are gone, and there’s no swelling or cramps. I can’t say I ever had beautiful legs, but they sure look a lot better now than they did before I went to Dr. Sharma. My legs look as good as they possibly can for a seventy-eight-year-old woman. I no longer have any concerns what-soever about wearing shorts.”

Completion of Henry’s vein treatment was delayed because he had to stop midway and have his hip replaced. While it seemed like an extra-long process for him, Henry says the results are well worth the wait.

“� e knotty varicose veins on my legs are gone,” he describes. “I just have a few little spider veins, and those are going away

as well now that Dr. Sharma gave me the injections, so my procedures were all very successful.

“I know there are a lot of places out there advertising vein treatment, but Dr. Sharma is the number one doctor in Central Florida without question. I have con� dence in him. I recommend him to

anyone who wants to have these procedures done.”

According to Mary Jim, the caring, comfort-ing treatment she received in Dr. Sharma’s operating suite is given everywhere at Premier Vein Centers. Because of the inviting atmosphere, Mary Jim says she actually enjoys her visits there, which is not typically the case with

her doctor appointments.“I don’t go to the doctor unless it’s nec-

essary,” she shares. “But with Premier Vein Centers, I look forward to going there. Dr. Sharma and his sta� are friendly and happy. � ey create a family-type of environment.

“If anyone has varicose veins, I rec-ommend the treatments I had done, and I recommend they go to Dr. Sharma at Premier Vein Centers to get them done. On a scale of one to ten, I give them a ten!” FHCN article by Patti DiPanfilo. Patient photos by Jordan Pysz.mkb

Dr. Sharma, a board-certifi ed cardiovascular surgeon, invites you to have a complimentary

leg evaluation at one of the two Premier Vein Centers locations:

Homosassa S. Suncoast Blvd.

(352) 621-0777Summer� eld

Spruce Creek Medical Center

SE th Ave., Suite

(352) 693-2052

Mary Jim Campbell

Henry Landrum

Mary Jim says, “My legs look as good

as they possibly can for a seventy-eight-

year-old woman”

Symptoms Unseen� e human circulatory system is composed of an intricate series of blood vessels. Veins are the vessels that return oxygen-depleted blood back to the heart. There are three types of veins: super� cial veins, deep veins and perforating veins. Super� cial veins lie close to the skin, deep veins lie in groups of muscles, and perforating veins connect the super� cial veins to the deep veins.

“When the leg veins cannot pump blood back to the heart, it is a condition called venous insufficiency,” Dr. Sharma states. “Chronic venous insu� ciency has multiple causes. Over long periods of sitting or standing, the blood in leg veins can pool. � is increases the venous blood pressure and weakens the vein walls and valves, thereby damaging the valves. Damaged valves prevent proper blood � ow back to the heart.”

Venous insu� ciency has many signs and symptoms, Dr. Sharma adds. Signs are the issues that can be seen, such as bulging varicose veins, swelling, and thickening and discol-oration of the skin of the ankles or legs. Symptoms are those things that are felt, not

RAVI SHARMA, MD

Premier Vein Centers

Page 6 | Florida Health Care News | Spring 2019 | West Citrus County Edition Vein treatment

Henry’s vein

treatment makes

working on the farm a lot easier

Ravi Sharma, MD, is board certi� ed by the American Board of Thoracic Surgery. He completed his under-graduate studies at the University of Maryland at College Park and attended the University of Maryland

Graduate School, Baltimore, before receiving his medical degree from Eastern Virginia School of Medicine, Norfolk. Dr. Sharma completed his intern-ship and residency in general surgery at Eastern Virginia Graduate School of Medicine Department of Surgery, Norfolk, and completed his residency in thoracic surgery at George Washington University, Washington, DC.

For Premier Vein Treatment

Premier Vein Centers o� ers free initial consultations. To � nd out more, visit www.premierveincenters.com, or call (352) 621-0777.

Expertise, leading-edge technology allow for

customized care

F or 42 years, Henry Landrum worked as a registered nurse, 30 of them in the emergency room. He spent hours on his feet caring for

patients. He also sat for long periods noting patients’ symptoms and treatments in their medical charts. Add all that to a genetic pre-disposition for them, and Henry eventually developed severe varicose veins.

“I had really bad veins in my upper and lower legs,” con� rms the Brooksville native. “I inherited them from my mother, who had terrible ulcers on her legs. I’ve had varicose veins for years, and they’ve bothered me o� and on for about ten years. I’ve been retired now for � ve years, and my veins have gotten worse within the last three or four.

Risk Factors for Varicose Veins� ese factors increase your risk of developing varicose veins:

• Age. � e risk of varicose veins increases with age. Aging causes wear and tear on the valves in your veins that help regulate blood � ow. Eventually, that wear causes the valves to allow some blood to � ow back into your veins, where it collects instead of � owing up to your heart.

• Sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstrua-tion or menopause may be a factor. Female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.

• Family history. If other family members had varicose veins, there’s a greater chance you will, too.

• Obesity. Being overweight puts added pressure on your veins.

• Standing or sitting for long periods of time. Your blood doesn’t � ow as well if you’re in the same position for long periods.

“I felt a lot of pain in my legs toward eve-ning. I had achiness, swelling and cramping at night, and it became hard for me to walk, which is problematic when you live on a farm as I do. What really alarmed me, though, was when my feet and legs started to become dis-colored. I knew then I really had a problem and needed to do something about it.”

Henry’s daughter, an ultrasound tech-nician, encouraged him to have his legs evaluated by a vein specialist. He knew of one in the area, Ravi Sharma, MD, of Premier Vein Centers in Homosassa and � e Villages®. Dr. Sharma is a board-certi� ed cardiovascular surgeon with expertise in blood vessel disorders a� ecting the legs.

As a longtime cardiovascular surgeon, Dr. Sharma spent many years working with the intricate blood vessels surrounding the heart. He now focuses his practice full-time on treating patients with venous disease of the legs. Henry was surprised to � nd that he had crossed paths with Dr. Sharma in the past.

“I had heard of Dr. Sharma; he was a chest surgeon in the Tampa area,” Henry relates. “He had a very good reputation as a surgeon, so I decided to have him check me out. I’ll be darned if he isn’t the same doctor who worked on my father at one time. I could hardly believe it.

“Dr. Sharma is very knowledgeable. He is also a very nice gentleman and very professional. He is very confident in

what he does. He performed the ultrasounds on my legs and said I needed to have several procedures to take away the swelling and get my legs better so I could walk again. I decided to go ahead and have them done.”

Among the procedures Dr. Sharma used to help Henry was the latest technology, non-thermal VenaSeal™.

seen. � ey include throbbing, aching, sting-ing, burning, itching, nighttime leg cramps and restless legs. � ese are all indications that the veins are not functioning properly.

“For patients who experience any of these signs or symptoms, it is important that they have their veins assessed,” Dr. Sharma stresses. “Leaving the condition untreated can lead to more serious di� culties, including leg ulcers, infection and a breakdown of the skin.”

� e cardiovascular surgeon reports that venous insu� ciency is more common than many people think. It is estimated that more than 30 million Americans su� er with symp-tomatic venous insu� ciency. Venous vascular disease is � ve times as prevalent as peripheral arterial disease, or PAD, and more than two times as prevalent as coronary artery disease.

“A huge problem in getting venous insuf-� ciency properly treated is that many of its symptoms are invisible and often misunder-stood by patients,” Dr. Sharma notes. “One of those symptoms is leg pain. Pain is common with many disorders, so venous insu� ciency is often overlooked or misdiagnosed.

“Patients and physicians alike need to understand that vein problems are often present before they are visible on the surface. Symptoms such as pain, heaviness and restless

legs can signal vein disease without the correspond-ing visible varicose veins. With the right diagnosis, a patient’s leg pain can be relieved with simple, min-imally invasive techniques.

“When seeking a phy-sician for care, it is crucially important for people to choose surgeons who spe-cialize in venous diseases. The physicians should also be experienced in the advanced procedures avail-able to treat these diseases. Physicians with these qual-

i� cations achieve the best outcomes.”

Advanced OptionsAt Premier Vein Centers, a full range of advanced, minimally invasive treatment options for addressing varicose and spider veins is available. � ese treatment options

include microphlebectomy, endovenous laser ablation (EVLA), sclerosing injections and the new, non-thermal procedure, VenaSeal.

Microphlebectomy has replaced strip-ping, an outdated, more involved procedure during which doctors treated the large veins by making big gashes across the leg that often left the patient with large scars.

“With microphlebectomy, the incision is tiny – about the size of the tip of a scalpel – and we can do much more through that small incision,” Dr. Sharma assures. “And with this procedure, patients end up with tiny marks on the skin or no scars at all.”

During EVLA, a sterile laser � ber is intro-duced into the incompetent vein via a small puncture in the leg. Laser energy is then deliv-ered through the � ber, painlessly closing the vein in less than an hour, using local anesthesia.

Sclerosing injections are used to treat spider veins, which are tiny, dilated blood vessels in the skin that become swollen with stagnant blood. Dr. Sharma uses ultrasound-guided sclerotherapy (UGS) to guide the injec-tions that gently close the problem vessels.

VenaSeal is a non-thermal closure sys-tem that relieves symptoms by delivering a small amount of a specially formulated med-ical adhesive, or “super glue,” to the diseased vein. � is permanently seals the vein. � is procedure does not require multiple needle sticks and, in some cases, support stockings aren’t necessary.

Dr. Sharma uses his expertise to deter-mine which procedures to use based on each patient’s symptoms and health status. � ese advanced treatments are all performed in a comfortable o� ce setting and result in little or no downtime and discomfort.

“Our patients are often very relieved to discover that there is no general anesthesia involved in our minimally invasive treat-ments,” Dr. Sharma acknowledges. “And they’re happy to learn that they can resume activities right away.”

Premier Vein Centers provides a free ini-tial consultation and accepts most insurance, including Medicare.

The Preacher’s WifePreachers never retire, and neither do preachers’ wives. Mary Jim Campbell has assisted her husband in building churches in many states, including Florida. A few years ago, they returned to Florida and settled in Summer� eld. Soon after, they began a new church, where Mary Jim’s husband continues to minister.

“As a preacher’s wife, I work with him,” Mary Jim explains. “When we build churches, I’m right alongside him doing whatever needs to be done. I work to pro-mote him and make his life comfortable because preachers in this day and age deal with a lot of issues.”

Mary Jim recently had a few issues of her own to deal with. For one, she had a bulging varicose vein on her left calf. She’d actually had it for many years, but it never really con-cerned her. It bulged, but was barely visible because of its location on her leg.

“� at vein appeared after a tumbling accident in high school,” Mary Jim reports. “I had a bulge, but it was on the inside of

my leg right about where the muscle is. � at one didn’t bother me. I’ve just lived with it since the Fifties.”

While Mary Jim ignored the vein on her left leg, she did become concerned when unsightly veins suddenly began appearing on her right leg. She was self-conscious about the highly visible veins and considered hav-ing that leg treated.

“After we moved to Florida, a vein popped out on my right thigh and started crossing over my kneecap,” Mary Jim con-� rms. “It was very unsightly. Of course, in Florida I was wearing shorts more, and it felt like everybody was noticing it. I had a little swelling in my legs as well, and some painful leg cramps.

“I’m not really vain, and I’ve lived with the vein on my left leg for many years, but I really felt I needed to take care of the ones on my right leg.”

Mary Jim’s desire to seek treatment for her leg veins led her to Dr. Sharma.

“I thought I was going in for cosmetic treatment until I had my consultation with Dr. Sharma,” Mary Jim remembers. “He explained that my problem had to do with circulation and that if I didn’t do something about both legs now, I would have major problems down the line. Treatment would eliminate the unsightly veins as well.”

� rough the use of ultrasound images, which he obtained after learning of her health history, Dr. Sharma diagnosed Mary Jim with venous insu� ciency. Dr. Sharma recommended several procedures to address her condition.

Treatment TrioMary Jim was impressed with Dr. Sharma’s expertise. She was also intrigued with the treatments she received at Premier Vein Centers, where Dr. Sharma addressed her venous insu� ciency by employing a trio of procedures.

“I had laser ablation, microphlebectomy and sclerotherapy, and I was amazed by how little pain was involved,” Mary Jim marvels. “During one procedure, Dr. Sharma actually took out a piece of my vein and showed it to me. It was fascinating.

“To do the vein over my kneecap, he made a small incision in the knee with a scalpel and punctured the skin. � ere were no stitches with any of the procedures, and you can’t tell at all now that I had anything done to my legs.”

Dr. Sharma used the same three proce-dures, as well as VenaSeal, to treat Henry’s

venous insufficiency, and they achieved positive results with him as well. Henry is very pleased with how his legs look and feel since his treatment at Premier Vein Centers.

“My legs look a lot better,” he enthuses. “� ey don’t swell nearly as much as they did. � e color is also much better than it was. Overall, the cir-culation has improved one hundred percent. I’m amazed.

“ I w e n t f r o m e x c r u c i a t i n g pain to no pain.

“I’m also walking a lot better than before. I can walk for extended periods of time, and walking great distances doesn’t bother me. Before, it was getting so my legs hurt so badly that I couldn’t walk very far without having to stop.”

Mary Jim credits Dr. Sharma and his sta� with making her experi-ence a positive one. � ey even let her husband sit in on one of the pro-cedures. She was truly pleased with the ease of the procedures and very happy with the results.

“I can’t say enough about the thorough-ness and friendliness of Dr. Sharma and his sta� ,” Mary Jim says. “� ey told me what they were doing when they did the procedures. � ere was no fear involved, and I was very comfortable. I felt very con� dent in what Dr. Sharma was doing.

“My legs look and feel fine now. All my bulges and bumps are gone, and there’s no swelling or cramps. I can’t say I ever had beautiful legs, but they sure look a lot better now than they did before I went to Dr. Sharma. My legs look as good as they possibly can for a seventy-eight-year-old woman. I no longer have any concerns what-soever about wearing shorts.”

Completion of Henry’s vein treatment was delayed because he had to stop midway and have his hip replaced. While it seemed like an extra-long process for him, Henry says the results are well worth the wait.

“� e knotty varicose veins on my legs are gone,” he describes. “I just have a few little spider veins, and those are going away

as well now that Dr. Sharma gave me the injections, so my procedures were all very successful.

“I know there are a lot of places out there advertising vein treatment, but Dr. Sharma is the number one doctor in Central Florida without question. I have con� dence in him. I recommend him to

anyone who wants to have these procedures done.”

According to Mary Jim, the caring, comfort-ing treatment she received in Dr. Sharma’s operating suite is given everywhere at Premier Vein Centers. Because of the inviting atmosphere, Mary Jim says she actually enjoys her visits there, which is not typically the case with

her doctor appointments.“I don’t go to the doctor unless it’s nec-

essary,” she shares. “But with Premier Vein Centers, I look forward to going there. Dr. Sharma and his sta� are friendly and happy. � ey create a family-type of environment.

“If anyone has varicose veins, I rec-ommend the treatments I had done, and I recommend they go to Dr. Sharma at Premier Vein Centers to get them done. On a scale of one to ten, I give them a ten!” FHCN article by Patti DiPanfilo. Patient photos by Jordan Pysz.mkb

Dr. Sharma, a board-certifi ed cardiovascular surgeon, invites you to have a complimentary

leg evaluation at one of the two Premier Vein Centers locations:

Homosassa S. Suncoast Blvd.

(352) 621-0777Summer� eld

Spruce Creek Medical Center

SE th Ave., Suite

(352) 693-2052

Mary Jim Campbell

Henry Landrum

Mary Jim says, “My legs look as good

as they possibly can for a seventy-eight-

year-old woman”

Symptoms Unseen� e human circulatory system is composed of an intricate series of blood vessels. Veins are the vessels that return oxygen-depleted blood back to the heart. There are three types of veins: super� cial veins, deep veins and perforating veins. Super� cial veins lie close to the skin, deep veins lie in groups of muscles, and perforating veins connect the super� cial veins to the deep veins.

“When the leg veins cannot pump blood back to the heart, it is a condition called venous insufficiency,” Dr. Sharma states. “Chronic venous insu� ciency has multiple causes. Over long periods of sitting or standing, the blood in leg veins can pool. � is increases the venous blood pressure and weakens the vein walls and valves, thereby damaging the valves. Damaged valves prevent proper blood � ow back to the heart.”

Venous insu� ciency has many signs and symptoms, Dr. Sharma adds. Signs are the issues that can be seen, such as bulging varicose veins, swelling, and thickening and discol-oration of the skin of the ankles or legs. Symptoms are those things that are felt, not

RAVI SHARMA, MD

Premier Vein Centers

West Citrus County Edition | Spring 2019 | Florida Health Care News | Page 7Vein treatment

DAVID S. GORIS, CPO, LPOBILL WOSLUM, CO, LO

To learn more, please visit www.sonlifeprosthetics.com

Man at WorkProsthetic leg restores mobility

John’s prosthetic

leg provides the � exibility he needs to stay active on the job

O ne of the most difficult decisions John Labrie has ever made came as a result of the 62-year-old plumb-

ing contractor failing to act his age while making a routine run to a local supply shop one day last October.

“I was picking up stu� for the guys in the � eld, and when I jumped out of the side of the bed of the pick-up truck, I landed awkwardly on the slope of the loading dock and popped the arch in my right foot,” John explains. “I guess I forgot I’m not twenty anymore.”

� at incident was the beginning of a long but failed healing process that � rst began to go awry when John’s midfoot fusion surgery left him with a painful bone spur and a foot ulcer the size of a quarter.

John was advised to stay o� his feet until the ulcer shrunk to the size of a dime. But instead of shrinking, the ulcer grew larger and became so infected that doctors could not guarantee that even an eight-week, in-hospital regimen of antibiotics would heal it.

It was then that John, eager to get back to work and thinking he was likely going to lose the foot anyway, made the di� cult decision to have doctors surgi-cally remove his right leg below the knee.

“� e thing is, there was no guarantee that the antibiotic treatments were going to work,” John relates. “And by then,

another ulcer had formed on the side of my foot. Not only that, but there’s a his-tory of diabetes in my family.

“I saw my grandmother suffer from poor circulation because of that, and it wasn’t pretty. I � gured this is what I might be look-ing at eventually anyway, so I had the surgery, and I was out of the hospital a few days later.”

John left the hospital with a list of companies that could eventually � t him with a prosthetic leg. Based on location, he chose Sonlife Prosthetics and Orthotics, but he soon discovered that Sonlife stood out for reasons other than location.

“� ey were very informative and took me through the whole process of how I would be measured and � t for a new pros-thetic leg,” John says. “And then we got into the discussion of exactly what it was that I needed out of my new leg.”

John had those discussions with David Goris, CPO, LPO, who specializes in designing, building and � tting pros-theses based on each patient’s individual needs. In John’s case, those needs largely centered around his line of work.

“John works at construction sites all day and is on his feet a lot, so we wanted to make him something that was light-weight and maneuverable, something that allowed him to move smoothly across uneven ground and get up and down ladders and stairs,” David reports.

Back in the SwingJohn received his prosthetic leg about two weeks after that meeting with David. Since then, he has adjusted to it very well. He estimates that he puts in about three miles a day of walking and running on the leg and has no issues with it.

“I’m still a little slow going down ladders, but I can go up them without a problem, and I can pretty much run up and down stairs the way I used to as well,” John enthuses. “And boy, you should see me golf now.

“I had the new leg for about two weeks the � rst time I went gol� ng again, and because I’m not raising my leg and my knee is locked in, I hit the ball straighter than I ever have before. I had just one slice that whole day.

“I just can’t thank the guys at Sonlife enough for all they’ve done for me. � ey’re really great, and they answer all your questions, whatever it is that you need to know. I de� nitely picked the right place when I picked Sonlife for my prosthetic.”FHCN article by Roy Cummings. Photo by Jordan Pysz.

Graphic from Pixabay. mkb

Inspired SolutionsAt Sonlife Prosthetics and Orthotics, caring professionals put their years of experience to work for you. To learn more about their full range of prosthetic and orthotic services, please call or visit one of their o� ces:

Spring Hill6111 Deltona Blvd.

(352) 596-2257Inverness

2024 Hwy. 44 West(352) 344-8200

Toll Free

(800) 562-4133

For Eye Floater SolutionsSouth Florida Eye Clinic is located

in Fort Myers at:

4755 Summerlin Rd. Call Dr. Geller at:

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

(877) 371-3937

Scott L. Geller, MD, is board certi� ed 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, Paci� c Medical Center, San Francisco, CA, and completed his residency in ophthalmology at Sinai Hospital of Detroit, which was a� liated 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 � oater laser treatment at the International Congress of Ophthalmology, European Congress of Cataract & Refractive Surgery, European Congress of Ophthalmology and the Florida Society of Ophthalmology.

SOUTH FLORIDA EYE CLINICSCOTT L. GELLER, MD

Dr. Geller has performed more than 15,000 documented � oater laser sessions.

Scott Geller, MD, teaches the technique worldwide

“L aser treatment of eye � oat-ers is fascinating,” says Scott Geller, MD, a board certified ophthalmologist

with a specialty clinic in Fort Myers. “I look forward to doing this every day. And our

reputation has become worldwide with the advent of the internet. We’ve had a steady � ow of patients from Europe, Canada, and even Russia, China, Arabia, and Israel.”

Dr. Geller can rightly claim to have started this niche area of ophthalmic surgery, with the largest, continuous clinical series, having performed more than 15,000 documented eye � oater laser sessions.

“I’m always asked why this useful treatment modality is not more widely available, or why some doctors try it but give it up,’’ Dr. Geller explains. “The answer is simple: there are no courses for training, and there is a lack of proper equipment.”

Dr. Geller was trained directly by the professor who researched laser inside the human eye at the famous University Eye Clinic in Bern, Switzerland.Dr. Geller adds: “� ey never thought this would be applica-ble to eye � oaters, but I proved them wrong.”

Dr. Geller uses the Swiss made Lasag laser.

“I have tried others, but there is absolutely no doubt in my mind this is the most versatile and precise instrument,’’ he notes. “In fact, I have two of them, and

I � y in the engineers from Switzerland to update and service them yearly.”

A Doctor and an EducatorDr. Geller has personally trained the most experienced ophthalmologists in the US, as well as the top surgeons from Italy and Holland, who have visited his Florida facility.

“I am concerned about colleagues rushing into some-thing new without having a formal preceptorship,’’Dr. Geller says. “It is easy to push the button, but not so easy to get the optimal result and avoid complications.”

To improve physician education, Dr. Geller gave an hour-long course this year at one of the country’s major ophthalmology associations.

“This was the first course of this quality anywhere in the US,’’ notes Dr. Geller. “And I am going back to Italy, where I was invited to lecture at a major

SCAN THIS TO YOUR

SMARTPHONE TO SEE ACTUAL

PATIENTS

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

ophthalmology meeting. � is is the fourth invitation, and I will also consult and treat patients there, as I have in the past.”

Dr. Geller welcomes other ophthalmol-ogists to come and observe, and to call if they need advice on di� cult cases.Article submitted by Scott Geller, MD. Photo by Jordan Pysz. mkb

is not

acceptable.”

“Live with it

Page 8 | Florida Health Care News | Spring 2019 | West Citrus County Edition proSthetiCS and orthotiCS

ophthalmology

Michael Hashemian, MD, DMD, is a diplomate of the American Board of Oral and Maxillofacial Surgery and a Fellow of the American Association of Oral and Maxillofacial Surgeons and of the American College of Oral and Maxillofacial Surgeons. He earned his dental degree from the University of Florida Dental School and his medical degree from the University of Florida College of Medicine. Following his graduation, he continued his surgical training at Shands Hospital in Gainesville. Dr. Hashemian’s residency included training in general surgery, surgical intensive care, general anesthesia, and oral and maxillofacial surgery. His professional memberships include the American Academy of Cosmetic Surgery, the American Dental Association, the American Medical Association, the International Congress of Oral Implantologists and the Academy of Osseointegration, among others.

MICHAEL HASHEMIAN, MD, DMD

about this and other procedures/surgeries,

please call or visit one of Dr. Hashemian’s

three offi ce locations:Lecanto

591 N. Lecanto Hwy.

(352) 527-8000Spring Hill

32 Seven Hills Drive

(352) 688-4556Land O’ Lakes

2651 Narnia Way, Suite 101

(813) 922-1818For more information, please visit www.dentofacialinstitute.com

To Learn More…

When Ron Tyrie, 63, was a child living in his hometown of Lafayette, Indiana, he had several

bad experiences with his family’s dentist. � ose experiences left him reluctant to seek dental care as he got older, and the health of his teeth su� ered as a result.

So did his smile.“I never had great teeth, and I really

didn’t take good care of them like I should have, so they were in pretty bad shape,” Ron admits. “It got so bad I was uncom-fortable with my smile. I didn’t show my teeth when I smiled or talked.

“My parents moved our family to Florida when I was fourteen, and as an adult, I � nally found a wonderful dentist in Homosassa. About twelve years ago, my dentist referred me to Dr. Hashemian to replace a single tooth with a dental implant.”

Ron’s dentist sent him to skilled oral and maxillofacial surgeon Michael Hashemian, MD, DMD, of The Dentofacial & Cosmetic Surgery Institute, which has o� ces in Lecanto, Land O’ Lakes and Spring Hill. Ron was imme-diately impressed by Dr. Hashemian’s expertise and chairside manner.

“Dr. Hashemian cared, and he took good care of me,” Ron says. “I felt he truly had my best interest at heart. After my � rst visit to Dr. Hashemian, my den-tist told me I was going to need some additional work, so I went back to Dr. Hashemian a few more times to have other teeth replaced with implants.

“When my den-tist retired, I asked Dr. Hashemian to recommend a new one, which he did. My new dentist looked in my mouth and asked, Where do you want to be ten years from now? You’ve been replacing what was there. It might be better to do something else.”

After discussing the matter further with Ron, Ron’s dentist consulted with Dr. Hashemian. Based on Ron’s wishes, Ron’s dentist and Dr. Hashemian came up with several options that they later presented to Ron.

“Ron didn’t want to go with any-thing removable in his mouth because he couldn’t tolerate it,” Dr. Hashemian

explains. “He always wanted something � xed to replace his missing teeth.

“That’s why every time he lost a tooth, he opted for a dental implant with a crown. After several years of getting this type of treatment, it was suggested that he treat his entire upper arch.”

� e option Dr. Hashemian recom-mended and Ron agreed to called for Dr. Hashemian to remove Ron’s remain-

ing natural upper teeth, which were failing, and replace them with an upper denture secured by dental implants. The oral surgeon o� ered to perform the conver s ion using his All in a Day Teeth process.

“With All in a Day Teeth, we work in conjunction with the patient’s general dentist to complete the process in one

day,” Dr. Hashemian describes. “I per-form the surgical procedure, removing the teeth and placing the dental implants.

“The general dentist converts the denture, which was fabricated ahead of time, to a � xed bridge that � ts securely over the implants. Sometimes, a dental lab technician comes to the o� ce to assist the general dentist in the bridge conversion process. At the end of the day, the patient goes home with brand-new teeth.”

“Dr. Hashemian set aside his entire morning for me, and even opened an hour early,” Ron relates. “With my dentist, a per-son from the dental lab and their assistants all present, Dr. Hashemian began working on me at seven o’clock in the morning. He was done at noon. � en my dentist and the lab technician took over.

“I walked out of Dr. Hashemian’s o� ce that afternoon with an absolutely perfect set of beautiful, straight, full teeth on the top of my mouth.”

Old and NewRon’s full arch restoration procedure included Dr. Hashemian’s implant surgery followed by the conversion of his pre-fabricated denture into a � xed bridge by his dentist. Dr. Hashemian says there are several advantages of performing this pro-cedure using the All in a Day Teeth process.

“Many people are attracted to this solution because the downtime is mini-mal,” the oral surgeon informs. “� ey get the surgical portion of the procedure done and receive the prosthetic all in the same day and basically, they’re done.

“Now, the prosthetic the patient gets on that day is made of acrylic. After six months, that prosthetic is converted to a hybrid bridge, which is a combi-nation of titanium alloy and acrylic. � ese restorations are very strong and natural looking.”

� e � xed bridge is secured by dental implants. For dental implants to become solid in the jaw, the patient must have suf-� cient bone mass to fuse with the implants.

In some cases, general dentists recommend bone grafting before implants can be placed. � is wasn’t necessary in Ron’s case.

“The All in a Day Teeth process essentially eliminates the need for bone grafting,” Dr. Hashemian reports. “Generally, there is enough bone that we can use tilted implants and place them where the bone is most dense. These tilted implants have the same strength as straight implants. It’s a new technique in implant dentistry, and it makes the pro-cess quicker and easier on the patient.

“Here’s another thing that’s notable about patients like Ron who’ve had mul-tiple implants placed in the past. We are able to use those single implants that are embedded into solid bone to help secure the full arch, or � xed bridge.

“� e crowns may need to come o� , but the implants themselves don’t have to be wasted. And we may need to place one or two additional implants, but we can still use the old ones to � x the new denture.”

Stage Presence� e results of Dr. Hashemian’s All in a Day Teeth process gave Ron a tremendous con-� dence boost. With his new denture, he no longer hides his teeth when he smiles.

“I love my smile now,” Ron raves. “As one of my passions, I’m a bluegrass musi-cian. I play banjo and a little bit of guitar, and the folks I play with say I’m smiling a lot more when I’m playing.

“I like to think my playing has gotten better,” he jokes. “It hasn’t, but my self-esteem has increased. Anytime you increase your self-esteem, it’s a positive change. My wife is even happy we decided to go in this direction.”

Ron hasn’t kept Dr. Hashemian’s expertise a secret. He shares his personal knowledge of the oral surgeon’s excep-tional abilities and sterling reputation with anyone who might need the services Dr. Hashemian provides.

“I’ve recommended Dr. Hashemian to several people I used to work with who’ve had abscesses and needed to get their teeth pulled,” Ron confirms. “There’ve also been neighbors who’ve been to other oral surgeons and wanted to get second opinions. Dr. Hashemian has taken care of them and met their needs, and I’ve never gotten bad feedback.

“Dr. Hashemian is a very compassion-ate doctor and a very skilled surgeon. I feel very fortunate to have been referred to him, and I’m proud to refer others to him.”FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb

Single-Day Smiles Entire arches restored in one visit

Ron is one of many patients to take advantage of the All in a Day Teeth process.

West Citrus County Edition | Spring 2019 | Florida Health Care News | Page 9oral & maxilloFaCial Surgery

John Ligeon, MD, is board certi� ed in internal medicine and is a 2001 graduate of the University of Miami School of Medicine. Following graduation, Dr. Ligeon trained and specialized in internal medicine at Orlando Regional Medical Center in Orlando, where he completed his training in 2004. A diplomate in internal medicine, he has practiced in inpatient hospital medicine, as well as in outpa-tient primary care, for the past 14 years. His special interests include the areas of men’s health, preventive medicine such as weight loss and management, and care for US veterans.

Scott Hollington, MD, is board certi� ed in pathology, laboratory medicine, and informatics. He earned his medical degree from the University of Miami Medical School in 1992 and became board certi� ed in medicine soon thereafter. He spent four years serving his residency at the University of Florida, Jacksonville and then spent a year training at Wilford Hall USAF Medical Center, Texas. Dr. Hollington also practices emerging medicine, bringing to his patients treatments that are not widely available through conventional clinics.

Catch the Wave

JOHN LIGEON, MDSCOTT HOLLINGTON, MD

Noninvasive ED treatment improves sexual performance

T he � rst thing Tom* did upon returning to the United States following his 14-month tour of duty in Southeast

Asia during the Vietnam War was kiss his high school sweetheart. Later that same day, he went out and married her.

“I actually proposed in a letter I sent from overseas about six months before I came home,” the former US Marine Corps sergeant reveals. “She said yes in her next letter back to me, and we later decided we’d get married as soon as I got back, � rst thing.”

Natives of Central Florida, Tom and his wife have “been going strong,” as Tom puts it, ever since. � ey now have three grown children, a granddaughter, and a grandson on the way. � ere’s just one problem.

For the better part of the year that followed his 69th birthday last August, Tom had trouble developing and main-taining an erection strong enough to have sexual intercourse. � e issue is known as erectile dysfunction, or ED, and it’s more common than many think.

Studies show that more than half of all men will experience some form of erectile dysfunction during their lifetime and that the chances of dysfunction are even greater among men su� ering from hypertension, diabetes and cardiovascular disease.

Studies show that smoking, heavy consumption of alcohol and drugs (either illicit or prescription) can also cause erectile dysfunction, which is typically the result of circulatory impairment in the blood capil-laries or urogenital areas of the penis.

For years, medications such as VIAGRA® and CIALIS® have been the � rst line of defense against ED. If those prove unsuccessful, the next treatment option is generally injections into the penis. If that fails, the last resort has long been a penile implant.

Tom wanted nothing to do with the injections or implants, so after visiting a urologist, he � rst tried correcting the problem by taking CIALIS. “� e CIALIS worked okay for a while,” Tom says, but

he didn’t like the headaches that often came as a result of using it.

On the advice of his urologist, Tom considered trying another medication, but he soon took it upon himself to begin researching the problem and other forms of treatment. � at’s when he stumbled on the Extracorporeal Shock Wave � erapy or ESWT.

“I was searching the internet and � nally found this website for a place that didn’t treat erectile dysfunction with pills or injections,” Tom says. “I � gured it wouldn’t hurt to give them a try, so I called and made an appointment.”

Acoustic Wave Technology The practice Tom found is Alpha Medical Group. With offices in Palm Coast, Leesburg and Jacksonville, it specializes in the administration of the ESWT, which treats erec-tile dysfunction through the use of acoustical wave therapy.

Using a small, handheld device, the acoustical waves are delivered through a series of short, painless pulsations that not only open the blood vessels in the penis but s t i m u l a t e t h e nerve endings to enhance sensitiv-ity and enhance the feeling of an orgasm.

“The treat-ment is based on the same technol-ogy that’s used to break up gall-stones,” says Scott Hollington, MD, at Alpha Medical Gr o u p . “ T h e device transmits acoustical waves that break up the plaque and cal-cium that have built up inside the penis’ blood vessels.

“It works like a little jackhammer, except you don’t feel it because it doesn’t touch your skin. Once that plaque and calcium is broken up, you get better blood � ow, and it’s that improved blood � ow that leads to better, longer-lasting erections.”

In addition to providing better blood � ow through existing blood vessels, the ESWT also stimulates the growth of new nerve tissue, which is vital for achieving and maintaining healthy erections.

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

“By making certain adjustments to the machine’s settings, we can treat

the � brous tissue the same way we treat blood ves-sels and break down the scar tissue that may be causing that irregular shape,” Dr. Hollington informs.

ESWT treat-ments only take about 15 to 20 minutes to com-plete, but prior to providing any such treatment, Dr. Hollington begins his care f o r p a t i e n t s such as Tom by

doing a Doppler ultrasound exam to determine the amount of vascular compromise in the penis.

“We look for something similar to what a cardiologist looks for in the heart, which is an occlusion of seventy percent or more,” Dr. Hollington informs. “If we see that, we go ahead with the treatment, and we re-evaluate the blood vessels after completion of the treatment.”

Remarkable ResultsESWT calls for patients to receive two treatments per week for six weeks. Patients are then evaluated 12 weeks later and if necessary, they can be given a second, third or even fourth round of treatments.

Dr. Hollington says many patients opt for subsequent rounds of treatment, though most experience an improvement in sexual function after just one round. Overall, 83-percent of all men treated with the ESWT experience a reversal of their condition, the doctor notes.

Tom is one of those who reported positive results after just one round of

treatments. He says he may opt to have another round of ESWT treatments but that right now, his performance is more than satisfactory.

“I just turned seventy a couple months ago, and in the bedroom, I feel like I’m half that age,” Tom exudes. “It’s really remarkable what this ESWT does for you. And the treatments are all very quick and painless. A few minutes and you’re out of there.

“And one of the best things is how professional the technicians at Alpha Medical Group are. Let’s face it, this is a touchy subject for men. It’s not some-thing anybody is going to brag about. But they put you at ease, and make you feel comfortable.

“I can’t thank Dr. Hollington and his sta� enough for treating me so well and for giving me back this part of my life. � ey did a great job, and I recommend them and the ESWT for anyone who has a problem with ED.”FHCN article by Roy Cummings. ESWT FHCN file

graphic. Wave stock photo from Pixabay. mkb

*Patient’s name withheld at his request

The New WaveThe physicians at Alpha Medical Group practice both traditional and naturopathic medicine. Their goal is to fi nd the root cause of their patient’s problems and to treat them with the safest, most eff ective drug-free, surgery-free treatments available. For more information or to schedule an appointment, call or visit one of their three locations.

Leesburg4120 Corley Island Rd.

Suite 500

(352) 816-1901 Palm Coast

515 Palm Coast Pkwy. SWSuite 5

(386) 276-3075Jacksonville

6817 Southpoint Pkwy.Suite 503

(904) 763-1400Visit them on the web at www.alphamedicalgroup.com

Page 10 | Florida Health Care News | Spring 2019 | West Citrus County Edition ereCtile dySFunCtion

Visit Acute Wound Care on the web at

www.acutewoundcare.com

or call them directly:

Toll Free (855) 949-HEAL (4325)

Locally (239) 949-4412

Are You Su� ering From

Chronic Limb Swelling?

Hannah enjoys doing puzzles after therapy.

Reduce limb swelling and improve circulation

H annah Heit spent more than 40 years as a registered nurse, first in pediatrics and later in quality assur-

ance, reviewing several departments. � e Kentucky native lived most of her adult life in Michigan, and it was from there she relocated to Florida and retirement. All those years on her feet as a nurse, however, had a profound e� ect on her legs.

“A few years ago, my legs started swelling, and they were uncomfortable,” she shares. “I didn’t really have any pain, but I couldn’t wear shoes because my feet were as big as my legs. My legs were also discolored from the ankle to about mid calf. � ey were a kind of bluish-red color.”

Initially, Hannah was told she had venous insu� ciency, a condition in which the veins in the legs are unable to do their job of pumping blood back to the heart. Blood leaks and pools in the legs, causing symp-toms such as swelling and discoloration. Subsequently, Hannah underwent vein sur-gery to treat her insu� ciency she reports.

“I was told to put my legs up at night, but I couldn’t always do that,” Hannah adds. “I was also supposed to wear these special compression hose, but I couldn’t wear them because it was too much trouble getting them on and o� .”

The swelling and discomfort in Hannah’s legs continued after surgery, so she eventually sought the advice of her primary care provider.

“� e nurse practitioner I saw in my internist’s o� ce looked at my legs and said, You have lymphedema, excess � uid in your lymph vessels,” notes Hannah. “I’m not sure, but it may have been caused by the venous insu� ciency. � e nurse thought I would bene� t from a compres-sion pump. She called the company that provides them and got me all set up.”

� e company the nurse practitioner contacted was Acute Wound Care, a fully accredited home medical equipment provider specializing in hospital-grade compression devices and specialty wound-care dressings. � e compression pumps are prescription devices and are approved by Medicare and covered by many com-mercial insurers.

“Our easy-to-use compression pumps remove � uid that has accumulated in the legs or arms,” describes Alyssa Parker, cer-ti� ed compression therapist with Acute Wound Care. “The pump’s limb-sized sleeves gently massage the limb, drain-ing any excess � uid back into the body’s circulatory system so it can be naturally eliminated. Compression pumps increase circulation in the a� ected limbs while alleviating many painful symptoms.

“� e pumps are both highly e� ec-tive and noninvasive, and for the legs, they are much easier to use than com-pression stockings. Patients generally use the pumps twice a day for forty-� ve

minutes, with an interval of at least two hours between treatments, so it is usually done in the morning and in the evening. While using the pumps, patients simply sit back with their limbs raised to further assist with circulation.”

Once Acute Wound Care received Hannah’s prescription, a compression therapist contacted her to review the next step and answer any questions. After that, the therapist delivered the device, set it up and explained to Hannah how to use and care for it.

Healthy DiscoveryThe nurse practitioner who diagnosed Hannah’s lymphedema treats a full range of medical conditions at the practice, including lymphedema, persistent leg edema and venous disease among the most common.

For patients with these disorders it’s generally recommended to try con-servative therapy first. Examples are compression stockings, optimizing water and electrolyte balance, and diuretics. � e compression device is a great treatment option for those who have tried conser-vative therapy and still have persistent swelling or poor circulation.

Many patients have significant improvements in terms of diminished � uid retention in their legs or arms after using the compression pump. With con-sistent compression therapy the swelling improves as well as the venous blood � ow, wound healing and overall mobility.”

Circulation SupportAlyssa agrees that patients with lymph-edema, venous disease and other conditions leading to poor circulation once had few options beyond the standard therapies for limb swelling. � at’s a treatment hole Acute Wound Care’s compression pumps � ll. � e safe and painless pumps not only

reduce � uid retention in the limbs, they also improve overall blood � ow.

“� e pumps assist circulation by con-tracting the leg muscles, assisting blood flow back toward the heart,” explains Alyssa. “� ere, the blood is collected, sent to the lungs to be oxygenated and then returned to the body’s organs and tissues.

“To aid blood � ow, the pumps have multiple chambers. Each chamber � lls up with air, from the foot to the groin. � en, each chamber releases, and the pattern repeats in a rhythmic fashion.

“In addition to the circulation boost, many patients will see a noticeable dif-ference in the swelling and in the size of their limbs after their � rst forty-� ve-min-ute pumping session.”

Acute Wound Care is proud of its hands-on approach to patient care. Not only does a compression therapist go to patients’ homes to set up the equipment and instruct them on how to use it, they also adjust the pump’s pressure level to the patients’ comfort.

“When we are in the patient’s home, we set the pressure based on the severity of the condition and the physician’s pre-scription,” states Alyssa. “We then adjust it so the patients are comfortable and will actually meet the requirements of the treatment, so they get great results.”

Doubly EndorsedHannah has been using her compression device from Acute Wound Care for more than a year now. She says she is pleased with the results she’s getting from it. She’d like to use it more often than she does, but she’s established a treatment schedule with her doctor that works well for her.

“The usual treatment with the compression pump is twice a day for forty-five minutes,” relates Hannah. “But I do it once a day for an hour. � e limb sleeves feel � ne when I have them on, and then my legs are nice and small when I take them o� . � e swelling goes down signi� cantly.”

In addition to reducing the swelling, the compression pump treatments have also relieved much of Hannah’s leg dis-comfort and have enabled her to wear shoes again. The discoloration, which is related to her venous insufficiency, remains and may take years to fade, if it does at all. However, the circulation in her leg veins has improved with treatment, aiding her venous insu� ciency.

“I’ll continue using the compres-sion pump,” she comments, “and I

“The pumps assist circulation by contracting

the leg muscles, assisting blood flow back

toward the heart.”

The pumps are non-invasive

and highly e� ective

recommend it to others with conditions like mine. I recommend Acute Wound Care, too. I had no problems with any part of their process.”

Physicians throughout Florida have been recommending Acute Wound Care’s compression pumps to their patients for years and have been getting great results.

“Many doctors have told me that they’ve encouraged their patients to use the pumps to reduce limb swelling and improve circulation,” Alyssa con� rms. “They say the compression pumps are great, safe, noninvasive devices that sup-plement the medical treatment they’ve provided to those patients.

“One even told me that he received feedback from his patients, and that they agree the devices and the out-comes are positive. He said the patients also appreciate how good a job Acute Wound Care does of following up and mentioned that all are very pleased with Acute Wound Care and its product.

“� at same doctor said he’s so sat-is� ed with Acute Wound Care that he strongly endorses them and their com-pression devices to other physicians. He said he’s personally thrilled with Acute Wound Care because they help doctors improve their quality of care and the quality of their patients’ lives.”FHCN article by Patti DiPanfilo. Photo by Jordan Pysz.

Photo of pump courtesy of Acute Wound Care. mkb

West Citrus County Edition | Spring 2019 | Florida Health Care News | Page 11CompreSSion therapy

Mark Fallows, DO, is board certified by, and a diplomate of, the American Board of Interventional Pa i n Phys i c i a n s. He is also board certified by, and

a fellow of, the American Osteopathic Board of Anesthesiology. He com-pleted his undergraduate work at Alma College, Michigan, and earned his osteo-pathic medicine degree from Kirksville College of Osteopathic Medicine, MO. Dr. Fallows interned at Wellington Regional Medical Center, West Palm Beach, FL, and completed his anesthesiology residency at Detroit Osteopathic Hospital/Bi-County Community Hospitals, Warren, MI, with a fellowship in cardio-thoracic anesthesia completed at Ingham Medical Center, Lansing. He is a diplomate of the National Board of Osteopathic Medical Examiners and is a fellow of the American Osteopathic College of Anesthesiologists. Dr. Fallows is a member of The American Society of Interventional Pain Physicians, Florida Society of Interventional Pain Physicians, International Spine Intervention Society, the North American Neuromodulation Society and the Society of Cannabis Clinicians. He is a past president of the Florida Wellcare Alliance and the Citrus County Medical Society. He is also a Trustee of the Citrus County Hospital Board.

If You Have PainDr. Fallows is the medical director of Pain Institute of Central Florida,

which off ers patients a comfortable and private experience in a state-

of-the-art medical offi ce. He invites your inquiries regarding

the management of chronic pain. For information or a consultation,

please contact:

Pain Instituteof Central Florida

70 N. Lecanto Hwy.                                    Lecanto                                                     

(352) 527-4444

MARK FALLOWS, DO Board Certi� ed in Interventional Pain Management

Dual-Action RemedyAnxiety and pain relieved with medical marijuana

I n 2001, Amanda* was working nights unloading trucks at a dis-count department store. She was handling a case of antifreeze, but

the bottom of the box was not sealed tightly. � e bottles began falling out, and as Amanda tried to catch them, she wrenched her back and injured it badly. � at started the severe pain that’s plagued her to this day.

“The pain was horrible after my back injury,” recounts the Massachusetts native. “And it just got worse over the years as di� erent things happened.”

Following her back injury, Amanda decided to seek the assistance of a phy-sician to help her manage her pain. She did some research and chose pain man-agement specialist Mark Fallows, DO, of Pain Institute of Central Florida.

Dr. Fallows is uniquely qualified to manage his patients’ complex pain issues. He is certi� ed by the American Osteopathic Board of Anesthesiology and the American Board of Interventional Pain Physicians (ABIPP), which has certi-� ed fewer than 400 physicians nationally. Further, Dr. Fallows is the only physician in Citrus County who is board certi� ed in interventional pain management. He has served area residents since 1990.

“After I hurt my back, things just went downhill for me,” relates Amanda. “My pain started getting really bad after I was diagnosed with � bromyalgia in 2010. But the worst was when I got hit by a truck in my car in 2013.

“At that time, my life got ripped out from underneath me. My left shoulder was injured, so now I can’t raise my arm over my head. � e accident left me with nerve damage in my left arm and left leg. I had to quit the job I had for twenty years at a hospice. After that, I su� ered from depression, post-traumatic stress disorder and body-wide pain.

“Right now, I have terrible pain mostly in my back, left shoulder and neck. It used to be my left leg was worse, but now I feel awful pain in my right leg. I had been active. I loved to swim and ride my motorcycle, but I had to stop doing those things.”

Dr. Fallows tried several treatments for Amanda’s pain, including physical therapy, pain patches and spinal injec-tions, but they didn’t do the job for her. He then resorted to opioid pain medica-tions, but after a time, Amanda no longer wanted to take them.

“I’m still on one painkiller, but after so many years, I don’t want to be on it anymore,” veri� es Amanda. “Right now, we’re trying to wean me o� of it.”

After all the conservative methods of treatment that he tried with Amanda failed, Dr. Fallows tried another, less con-ventional route to treat her pain.

Factors in Eff ectAt Pain Institute of Central Florida, Dr. Fallows offers comprehensive treat-ments to ease his patients’ suffering. He specializes in a variety of pain manage-ment techniques, including spinal cord stimulation, spinal infusion pumps and radiofrequency ablation. Recently, Dr. Fallows added medical cannabis, or medical marijuana, to his toolbox of pain management treatments. This was an option he chose for Amanda.

“At fifty, Amanda is a relatively young per-son, and she su� ers from chronic, widespread pain,” describes the doctor. “She’s had injections in the past and was on opiate pain medications, but they stopped working for her. When I saw she was not improving with other treat-ments and was devastated by the pain, I decided to try medical cannabis.”

In Florida, medical marijuana is available as an extract to be vaporized, drops that go under the tongue, capsules and a top-ical preparation, reports Dr. Fallows. Unlike many other states that have legalized medical cannabis, Florida has not legalized the smoking of marijuana. Dr. Fallows chose the drops as the method of administration for Amanda.

“I � nd that sublingual drops are the best way to start because I can easily adjust the dose,” he explains. “I can control the dose milligram by milligram and change how many times a day the patient uses the drops. Ultimately, the patient may need a larger dose fewer times a day.”

Dr. Fallows notes that it’s unknown exactly how medical marijuana works, but

it has three major components that are known factors in its e� ectiveness. � ese are THC, CBD and terpenes.

“Many of my patients do well with CBD oil alone, and I generally have them try that before moving on to medical marijuana,” the doctor discloses. “CBD oil is legal in every state. If that doesn’t help them, then they may need the combination of CBD, THC and terpenes.

“Medical marijuana is federally ille-gal, so there is only beginning to be good research done on it. However, it has been shown to help relieve pain and reduce the symptoms of a number of con-ditions, including anxiety and post-traumatic stress disorder.

“Anxiety is often part of the pain patients’ experience,” continues Dr. Fallows. “� ey worry about when the pain will come back and how bad it will be when it does. With medical marijuana, not only do we reduce the pain, we also reduce the anxiety compo-nent. So the treatment helps the patient on two fronts.”

Enthusiastic Evaluation“I get anxious about why I can’t get rid of the pain,” con� des Amanda. “Sometimes when I have pain, I get a pins-and-needles feeling in my left arm. � en I get an achy feeling with chest pain, and I worry, Am I having an anxiety attack or a heart attack? � at stresses me out.”

Dr. Fallows says it’s important to keep in mind that medical marijuana can be used to treat pain as well as many disorders, but it does not cure them. So far, it has proved to be a good option for Amanda.

She is currently being treated for her pain with medical cannabis that she receives in the form of sublingual drops

that she takes three times a day. � e early results of the unconventional therapy have her encouraged.

“My mood is a lot better,” she enthuses. “My family has noticed that I’m more social with them now, which is very positive. I’m still having some issues with anxiety, but it’s much better than it was before.

“� e medical marijuana is helping with my pain, but it’s hard to tell just how much at this point. I’m weaning o� the painkiller right now, and when you’re detoxing, everything is uncomfortable. My goal is to get o� of the medication completely and manage my pain with the medical marijuana alone.”

Amanda says her experiences with Pain Institute of Central Florida are always excellent. She is especially happy with the care she receives from Dr. Fallows.

“Dr. Fallows is wonderful,” she raves. “He truly cares about his patients. If anyone is looking for an awesome doctor who really listens to you, Dr. Fallows is the one to see.”FHCN article by Patti DiPanfilo. Header graphic from

Pixabay. mkb

*Patient’s name withheld at her request.

Page 12 | Florida Health Care News | Spring 2019 | West Citrus County Edition pain management