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Summer 2019

FEATURED ARTICLES

(see Precise Approach, page 4)

Elaine Johnson

Precise APPROACH

Epidural injections allay back pain from herniated discs

D uring her working career, Elaine Johnson, 76, man-aged the production of a major corporation’s

proposals for projects up for bidding. Merging data from multiple sources, edit-ing text and inserting graphics on tight deadlines was stressful work.

A West Virginia native, Elaine is convinced that the stress of her job greatly contributed to a long-term issue with back pain, one that she long kept at bay through the use of a combination of therapies.

Over time, the pain intensified and eventually threatened to interrupt her laid-back retirement lifestyle, where she was content to relax with her husband, volunteer in the community and work in her garden.

“For at least twenty-� ve years, I expe-rienced muscle spasms in my back,” Elaine divulges. “Twice a month, I went to a chi-ropractor and a massage therapist, and they pretty much kept the spasms down. But after I moved to Florida, my back got worse.

“� e pain became excruciating. My back ached and throbbed, and it was unbearable. It was like a toothache, and to me, that’s one of the worst pains you can have. � e pain throbbed, stopped for a cou-ple of seconds, then throbbed again. And I never knew when it was going to start up.

“It hurt to do everything because of the throbbing. � e pain kept me out of the garden and interfered with my sleep. � en, I didn’t want to get up in the morn-ing because my back hurt so bad. � e pain was really severe for about eight months,

and during that time, I didn’t do much of anything except go to doctors.”

Among the doctors Elaine visited were a neurologist, a pain management specialist and an orthopedic surgeon. � ese physicians used several techniques in their attempt to relieve her pain,

including physical therapy and injections to block the irritated nerves in her back. Unfortunately, their treatments didn’t provide the relief Elaine desired.

“I’d been to every physical therapist in the region,” Elaine remarks. “I even tried acupuncture, but nothing helped. The only medication I take on a regular basis is an antidepressant, and the neurologist switched it to one that’s good for pain, but that had no e� ect. At that point, my family doctor recommended Dr. McGreevy.”

Kai McGreevy, MD, is a board-certi� ed neurologist and pain manage-ment specialist at McGreevy NeuroHealth, which has o� ces in Palm Coast and St. Augustine. Dr. McGreevy uses a wide range of advanced therapies to treat pain and many other conditions associated with nerve disorders. He uncovered the reason for Elaine’s excruciating back pain.

“When Elaine came in, she reported pain in the region of her thoracic spine, which is the mid back,” Dr. McGreevy discloses. “� is area was tender to the touch, and her pain was made worse with coughing, sneezing and bearing

down. She described the pain as an elec-tric shooting sensation in the middle of her back that radiated around to her side.

“Elaine’s MRI showed disc herniation as the result of degenerative disc disease. Because she had already tried conserva-tive measures, including physical therapy

and over-the-counter anti-in� ammatories, we recommended special-ized injections called transforaminal epidural

steroid injections to relieve the in� amma-tion surrounding the spinal nerve roots exiting her damaged discs.”

Slightly Off Center� e cushioning discs between the verte-brae of the human spine have a hard, outer layer and a soft, jelly-like, inner core. Over time or because of an injury, the outer layer can break open, or herniate. When this happens, some of the jelly-like mate-rial leaks out and puts pressure on nearby tissues, including nerves. � at’s what hap-pened to Elaine, Dr. McGreevy informs.

“Not only did Elaine’s MRI show her disc herniation, it also pointed me to the in� amed nerve roots exiting those discs that were the likely cause of her pain,” he notes. “I performed a nerve conduction study to con-� rm those were the nerves involved, then we moved on and began the series of injections.”

Transforaminal epidural steroid injec-tions are speci� cally placed in the back by a trained specialist using � uoroscopic (continuous x-ray) guidance.

KAI MCGREEVY, MD

Coastal Integrative Healthcare

6Bird’s Eye View

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EXCELLENCE in Specialty Eye Care

Founded in 1979, Florida Retina Institute has an experienced team of doctors dedicated to providing comprehensive vitreous and retinal ophthalmology. To schedule a consultation, please call or visit one of their two convenient locations close to you:

Palm Coast Leanni Way, Suite E

(386) 447-1847St. Augustine

Plantation Island Drive South, Suite

(904) 826-0663

THOMAS A. BARNARD, MDMATTHEW A. CUNNINGHAM, MDWILLIAM J. DUNN, MD, FACS, CHE

S.K. STEVEN HOUSTON III, MDABDALLAH M. JEROUDI, MD

JAYA B. KUMAR, MDELIAS C. MAVROFRIDES, MD

RAUL J. MORENO, MDJAMES A. STAMAN, MD

JONATHAN A. STAMAN, MDBENJAMIN J. THOMAS, MD

Eerie ImagesSudden eye � oaters can indicate

serious retinal disorders

The human eye is an amazing organ. Light enters through the pupils, is focused by the lens and is converted by the retina into nerve signals understood by the brain, which turns

the signals into images. But sometimes, the brain sees irreg-ular smudges hovering in the vision. � ese are eye � oaters.

Abdallah M. Jeroudi, MD, is board certified by the American Board of Ophthalmology. He earned his bache-lor’s degree in Biochemistry from The University of Texas at Austin and his Doctorate of Medicine degree from Baylor College of Medicine in Houston, TX. Dr. Jeroudi completed an internship at Emory University School of Medicine in Atlanta, GA and an ophthalmology residency at Emory Eye Center in Atlanta. He then completed a vitreoretinal sur-gery fellowship at The Retina Institute in

St. Louis, MO. Dr. Jeroudi is a member of the American Academy of Ophthalmology and American Society of Retina Specialists. He is committed to advancing vision research and is a recipient of the Vitreoretinal Surgery Foundation Research Award.

To learn more, visit them online at � oridaretinainstitute.com

“Eye � oaters are due to an opacity that occurs in the center part of the eye, speci� cally in the area behind the lens and in front of the retina,” describes Abdallah M. Jeroudi, MD, a board-certi� ed, fellowship-trained retina specialist at Florida Retina Institute. “� is area is � lled with a jelly-like substance called vitreous humor.

“� ere are many reasons eye � oaters develop, the most common being that the vitreous humor naturally degrades over time, and the jelly begins to liquify. � e liqui� ed form of the vitreous can be perceived as string-like or hair-like � oaters.”

String-like � oaters are rather common and usually benign. Many people start to see them when they reach their 20s and 30s, but most get accustomed to them. Over time, the brain realizes that the person has � oaters and that they typically hang out in certain areas of the eye and ignores them.

“We do not generally recommend treatment to remove these � oaters because they tend to dissipate nat-urally,” Dr. Jeroudi notes. “� e body will absorb them or the brain will learn to disregard them. But there are di� erent types of � oaters that can be dangerous.

“Dangerous types include a sudden onset of � oaters or those that appear as a shower of numerous � oaters or large, thick, ribbon-like � oaters. Floaters that are di� erent than the ones they are accustomed to seeing can be concerning.”

People who experience sudden onset or new, numerous or large � oaters should call their eye doctors immediately and consult with the retina specialists at Florida Retina Institute. Floaters like these can be symptoms of retinal tears or detachments, which are serious eye disorders.

“Along with numer-ous floaters, people should be aware of mul-tiple � ashing lights that look like comet streaks or lights from a camera � ash,” Dr. Jeroudi states. “These can be signs of tension on the retina, which can lead to a reti-nal tear. � e appearance of a curtain drawn across the vision may indicate a retinal detachment.”

Retinal RepairsIf people suffer a sud-den onset or numerous � oaters, the retina spe-cialists at Florida Retina Institute prefer to exam-ine them within one to two days after symptoms begin to test for a retinal tear or detachment. If the diagnosis is a retinal tear, it can be treated with one of two in-o� ce procedures.

“� e goal of treatment for a retinal tear is to seal the tear and prevent its progression to a retinal detach-ment,” Dr. Jeroudi relates. “It is much like having a tear in wallpaper. If a person picks at that tear, they can pull all of the wallpaper o� of the wall. With a retinal tear, the retina can be pulled o� of the back wall of the eye. � at’s a retinal detachment, and it can cause blindness.

“� ere are two basic methods for treating a retinal tear. One is a laser treatment. Using this approach, we apply several rows of small laser spots around the tear, which act as a glue or tiny pushpins to seal the edge of the tear. Imagine putting pushpins around the tear in the wallpaper. � e wallpaper cannot be pulled back past the pushpins.”

� e second way of treating a retinal tear is with a procedure called cryoretinopexy.

“During cryoretinopexy, we use a probe to make an indentation on the eye wall, then we provide a spot of freezing treatment, which creates an ice ball that forms an adhesive seal around the tear,” Dr. Jeroudi explains.

“Cryoretinopexy is much like the laser treatment except it is performed using a probe externally, whereas the laser is performed using laser light applied through the pupil. � e premise of the two procedures is the same, however: to create a seal around the tear so it does not progress to a retinal detachment.”

Retinal detachments occur when the retina falls o� of the back wall of the eye. � is is a problem because part of the retina’s nourishment comes from being against the back wall. If the retina remains detached for a period of time, it could lead to vision loss. If it remains detached for a long time, such as several months, the condition could be irreparable.

“We repair retinal detachments by re-adhering the retina to the back wall of the eye,” Dr. Jeroudi observes. “A certain subset of patients can be treated in the o� ce. In very speci� c circumstances, we can inject a gas bubble into the eye, which helps hold the retina against the back wall, then we perform the laser or freezing treatment.”

Most retinal detachments, however, require sur-gery in an operating room. � e procedure is generally performed as an outpatient surgery. Patients enter the hospital and go home the same day.

“� e procedure we perform is called vitrectomy,” the doctor educates. “During this procedure, we make tiny incisions through the wall of the eye and remove the vitreous jelly and any � oaters in the way so we can access the retina. � en we smooth the retina against the back wall of the eye. It is like smoothing wallpaper on the wall in a room.

“Next, we perform the laser treatment to seal the tear that initiated the detachment. � en, we inject a gas bubble to hold the retina in place. � e gas bubble enables the retina to heal in its proper position, and it naturally dissipates over several weeks.”

Precious SenseMost simple, string-like eye � oaters occur due to the degradation of the aqueous humor. Others form from a tear or detachment of the retina. Floaters can also occur due to an underlying disease process.

“Sometimes, people with diabetes, especially those who have had diabetes for a very long time or have a history of poorly controlled diabetes, can develop eye � oaters,” Dr. Jeroudi reports.

“But they are a di� erent type of � oater. In this case, dangerous blood vessels form in reaction to chronically high blood sugar, and they can rip and � ll the eye with blood. We tell all our patients with diabetes who get sudden � oaters to have their eyes examined to look for this complication.”

Dr. Jeroudi stresses that people who experience sud-den or numerous eye � oaters, � ashing lights or a sense that a shade has been drawn across their vision should not hesitate to call their doctor immediately.

“When this occurs, eye doctors want to be called so they can begin treatment and hopefully stop potential vision loss,” he encourages. “Patients experiencing those symptoms should never feel like they’re bothering their physicians by contacting them immediately. � eir vision is too precious to wait.” FHCN article by Patti DiPanfilo. Photo by Nerissa Johnson. mkb

Page 2 | Palm Coast Health Care News | Summer 2019 oPhthalmology/retiNa SPeCialiSt

Save theSkin

You’re InBlue Ocean Dermatology

welcomes new patients. For more information on what they

can do for you or to make an appointment, call or visit them at

their offi ce in Port Orange at:

3951 S. Nova Road, Suite 3

(386) 256-1444

STANLEY N. KATZ, MDNITRA H. WELCH, MSN, NP-CJASON L. WELCH, MSN, NP-C

ALINA COLLINS, ARNP

Stanley N. Katz, MD, obtained his medical degree from New Jersey Medical School (UMDNJ) in . He has since played vital roles in a broad range of medical disciplines, his specialization being achieved in dermatology. With a diverse background and more than years of experience, Dr. Katz is eminently qualifi ed to care for even the most complicated dermatological cases. Dr. Katz is currently committed to working closely with the other providers on the Blue Ocean Dermatology team. Patients appreciate his thorough care and professionalism. Outside of the offi ce, Dr. Katz is an avid fi sherman and enjoys nothing more than the strike of a bass.

Nitra H. Welch, MSN, NP-C, received her Bachelor of Science degree in Nursing from Troy State University in Troy, AL. She was an ICU nurse for eight years. She earned her Master of Science degree in Nursing and her family nurse practitioner certifi cate from the University of Central Florida in Orlando. Nitra also attended an advanced training fellowship at UCF. She is licensed in Florida as an advanced registered nurse practitioner and she is certifi ed by the American Academy of Nurse Practitioners. Nitra also has national certifi cation as a family nurse practitioner and a dermatology nurse practitioner. She has been working in dermatology since .

Jason L. Welch, MSN, NP-C, received his Bachelor of Science degree in Nursing from Florida State University in Tallahassee. He was an ICU nurse for seven years. He earned his Master of Science degree in Nursing and family nurse practitioner certifi cate from the University of Central Florida in Orlando. He is certifi ed by the American Academy of Nurse Practitioners and holds certifi cation in family practice and dermatology. Jason is a United States Naval veteran, and he served as a combat medic during Operation Desert Storm. Jason has been working in dermatology since .

Alina Collins, ARNP, received her bachelor’s degree from Walsh University in North Canton, Ohio and her master’s degree in Nursing from the University of Central Florida in Orlando. Prior to earning her master’s degree, she worked as a registered nurse in the critical care unit of a Level I Trauma Center in Orlando. During her dermatology rotation while studying to become a nurse practitioner, she realized her passion for the specialty. Her area of special interest is primary prevention through education about the risks and early detection of skin cancer. Alina is sensitive to individual patient concerns and encourages patients to ask questions and understand their treatment plans.

Since Paul Day was a teen, he su� ered with an irritating dis-order that caused � aky patches to form on his body that were

both uncomfortable and unsightly. His doctor diagnosed his condition as the skin disease psoriasis.

Psoriasis occurs when an overac-tive immune system produces too many new skin cells to replace skin cells that are damaged or die. As a result, the extra skin cells pile up on top of one another, forming tough, � aky patches.

“My psoriasis started as areas about the size of a lemon, with big, white � akes on my knees, elbows and the top of my head,” describes the former carpenter. “� ey didn’t hurt. It was more embar-rassing than anything, so I always wore jeans and long-sleeve shirts to cover up my elbows and knees.”

As Paul grew older, his psoriasis became progressively worse. Eventually, the Maryland native sought treatment for his condition from several skin specialists.

“I went to one dermatologist for nine months, and they gave me creams to treat my psoriasis,” Paul recalls. “Another dermatologist tried lotions and ultraviolet light, but none of that worked. For six months they did that and nothing helped.”

When those practitioners failed to � nd answers for Paul’s uncomfortable symptoms, his wife decided to research other providers in the area. Her search

led her to Blue Ocean Dermatology in Port Orange, where her husband met with Jason L. Welch, MSN, NP-C, a certi� ed nurse practitioner specializing in dermatology.

“I really like Jason,” Paul states. “He’s very knowledgeable and answered all my questions. � e � rst thing he told me was, Get rid of that cream. You’ve got to treat psoriasis from the inside out instead of the outside in.”

Cancer and PrecancerAccording to the latest estimates, 6.7 million people in the United States are afflicted with some form of psoriasis, Jason reports. It’s caused by a disconnect in the body’s protein chain that tells the skin to stop making new cells.

“The process is similar to that of fixing a pothole in a highway,” Jason describes. “In that case, workers hurry to � ll in the hole before a car gets damaged. When there’s a break in the skin, the body hurries to repair it before bacteria get in. To do the repair work, the body produces a protein that tells it to make layers of skin cells to � ll in the wound.

“Once the wound is healed, that cell-making mechanism stops. But with psoriasis, it doesn’t stop. � e skin con-tinues to produce skin cells on top of skin cells, then plaques form. Further, the skin around the plaques itches intensely. When that occurs, most peo-ple scratch, which breaks the skin again. It’s a continuous cycle.”

Traditionally, the mainstays of psoriasis treatment have been topical ste-roids, tar treatments and light therapy. Unfortunately, light therapy also poses a risk of skin cancer, so using it is a double-edged sword. A little more than a decade ago, however, a new type of treatment became available that revolutionized pso-riasis management.

“About thirteen years ago, biologic medications such as ENBREL® and HUMIRA® were introduced to treat pso-riasis,” Jason observes. “Protein-based biologics work by targeting specific types of immune system cells that are involved in the development and pro-gression of psoriasis.

“These treatments are especially important because psoriasis is not just a skin disorder. It also causes psoriatic arthritis, which can attack the joints and

the tissue lining the organs and damage them. Psoriatic arthri-tis causes in� ammation, and chronic inflamma-tion can also lead to heart attacks and cancer.”

A t B l u e O c e a n Dermatology, Jason and the rest of the sta� have access to a full complement of therapy options for treating patients with psoriasis.

“We’ve got all the tools avail-able,” he verifies. “In addition to a phototherapy cabinet and excimer laser, which is another therapy for psoriasis, we also have an extensive knowledge and expertise in the use of biologics.

“� ere are a number of biolog-ics available to prescribers, and based on my experience, I chose the one for Paul that reacted for him as I expected, which is COSENTYX®, and gave him an injection on November � rst.”

Beautiful ElbowsJason explains that with COSENTYX, he gives the � rst injection to the patient in the office. The patient then returns to the o� ce four weeks later for a second dose. After that, dosing is once a month. Eventually, patients are able to give themselves the injections. That’s how Paul receives his medication now, and he’s thrilled with the results.

“I noticed a real di� erence in the appearance of my skin about two months after I started to receive the injections, and now, I love the way my skin looks,” Paul raves. “My wife says my elbows are beautiful, and my knees are looking excellent. I’m not embarrassed to show my skin anymore. I wear short-sleeve shirts and shorts now.

“I recommend Jason and Blue Ocean Dermatology to anybody.”FHCN article by Patti DiPanfilo. Photo by

Nerissa Johnson. nj

Biologics EFFECTIVE as weapon against psoriasis

Paul Day

“I love the way my skin looks. My wife says my elbows are

beautiful, and my knees are looking

excellent.” – Paul

Visit their website at www.BlueOceanDermatology.com or � nd them on Facebook at Blue Ocean Dermatology.

Summer 2019 | Palm Coast Health Care News | Page 3dermatology

Wave of the FutureLet a board-certified neurologist and pain

management specialist help get you on the road to recovery. McGreevy NeuroHealth has two locations

to serve you:

Palm Coast57 Town Court, Suite 123

St. Augustine559 W. Twincourt Trail, Suites 607-608

To schedule an appointment at either location, call:

Kai McGreevy, MD, is board certifi ed in neurology and pain medicine by the American Board of Psychiatry and Neurology. The American Board of Independent Medical Examiners also certifi es him. His medical train-ing includes completion of a neurology residency at the University of California, San Diego, and an interven-tional pain medicine fellowship at The Johns Hopkins University School of Medicine in Baltimore, MD. While at Johns Hopkins, he was mentored by leading fi gures

in the fi eld of pain management and published over ten peer-reviewed articles in prestigious journals such as Pain Physician. Dr. McGreevy has presented his clinical research at the national level, earning prestigious awards from the American Society of Regional Anesthesia and Pain Medicine. He is a member of the American Academy of Neurology and the American Society of Interventional Pain Physicians. (904) 230-3006

(continued from page 1)

A Fortuitous Discovery

A s a neurologist, Dr. McGreevy performs a com-prehensive neurological evaluation on all of his patients as part of their initial assessments. Sometimes, those evaluations lead to the discovery

of previously undiagnosed conditions.Just such a � nding was made when Dr. McGreevy per-

formed his initial neurological evaluation on Elaine, who was found to have an abnormal issue that put her at risk for serious complications.

“As part of my neurological evaluation, I assess for carotid artery disease, which is more common in people ages sixty and older,” Dr. McGreevy states. “During Elaine’s ultrasound evaluation, I discovered a vascularized mass behind her right carotid artery.

“After a CT scan, the mass was diagnosed as a carotid para-ganglioma, a benign tumor that generally is not malignant but can, in some cases, cause compression of important structures in the neck and create serious problems. I sent Elaine for a neurosurgical consult, and it was determined that the tumor needed to be removed.”

Initially, the neurosurgeon attempted to embolize the tumor, or destroy it by cutting o� its blood supply. � at was unsuccessful. Elaine’s carotid artery was too twisted, and the sur-geon couldn’t reach the tumor with the embolizing instruments.

“When they couldn’t embolize the tumor, they performed surgery to remove it, which was very successful,” Elaine enthuses. “I now have a scar down my neck, but it’s hidden by some wrinkles, and you can barely see it.

“Dr. McGreevy will do another scan next year to make sure the tumor doesn’t come back because he really takes an interest in his patients. He was concerned about my entire body, not just my back, and he is very thorough. � at’s how he found this tumor.”

Look for them online at mcgreevyneurohealth.com

“In the injections, we use the combination of a nerve pain blocker and a steroid, which is a potent anti-inflammatory,” Dr. McGreevy explains. “� at combination o� ers pain relief as well as reduced swelling of the spinal nerves. � is takes the pressure o� the irritated nerve roots and provides relief, which can last for months.

“Transforaminal is a technical approach to the target nerve. With the classic epidural, the labor or interlaminar epidural, the needle is positioned right at the midline of the spine. � e problem with that is the medicine doesn’t necessarily get to the site where the disc is encroaching upon the nerve root.”

� e transforaminal approach enables the physician to safely posi-tion the needle slightly o� midline so the area injected is closer to the site of the injury. It is a technique that produces improved outcomes for patients with nerve root in� ammation that Dr. McGreevy is specially trained in.

“Transforaminal epidural steroid injections are performed under local anesthesia,” the doctor reports. “� e injections are very com-fortable, they take less than � ve minutes to perform and their results speak for themselves.”

Sudden SatisfactionWhen Dr. McGreevy performed Elaine’s transforaminal epidural steroid injections, he explained that she might not gain relief from her pain right away, and he was right. Once they did take e� ect, though, the relief proved to be long-lasting.

“I received the nerve blocks two years ago in January,” Elaine recalls. “About three weeks later, I was driving along when all of a sudden I realized I wasn’t in pain anymore. I remember it well. It was February 12, 2017 when my back stopped hurting, and it hasn’t hurt since.

“It’s been more than two years, and I haven’t had any back pain. On a scale of one to ten, the pain was a ten before the injections. Now, it’s zero.”

With zero pain, Elaine can sleep soundly at night and be active during the day. She credits her turnaround to Dr. McGreevy and his injections.

“Today, I feel really wonderful, and I’m out there gardening whenever I can,” she relates. “My massage therapist says I’m the healthiest seventy-six-year-old she knows.

“I absolutely recommend these injections to anybody with back pain, and I’ve endorsed Dr. McGreevy a number of times already. When people on Facebook ask about a neurologist or somebody for back pain, I recommend Dr. McGreevy and McGreevy NeuroHealth all the time. � ey’re wonderful!”FHCN staff article. Photos by Nerissa Johnson. mkb

Precise APPROACH

Elaine, shown here with Lucky, feels fortunate to have found Dr. McGreevy.

Page 4 | Palm Coast Health Care News | Summer 2019

Barry LevineExecutive Publisher

Thom GiordanoAssociate 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 MizeGary SmithDistribution

McGreevy NeuroHealthNeurology and Pain Care

Florida Retina InstituteOphthalmology/Retina Specialist

Blue Ocean DermatologyDermatology

Atlantic Eye CenterOphthalmology

Coastal Integrative HealthcareRegenerative Medicine

Suncoast Vein & Vascular ClinicVein and Vascular Disease

All About Feet & LegsPodiatry/Wound Care

Sabal Palms Assisted Living & Memory Care

Assisted Living and Memory Care

Dental Specialists of North Florida

Periodontics and Implant Dentistry

Palm Coast Family DentistryRestorative, Implant and

Cosmetic Dentistry

Alpha Medical GroupErectile Dysfunction

215 Bullard ParkwayTemple Terrace, FL 33617

(813) 989-1330

Palm Coast Health Care News

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

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

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articles in this publication: THE PATIENT AND ANY OTHER PERSON

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

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

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kisspng.com or pixabay.

Neurology aNd PaiN Care

Alexandra Kostick, MD, FACS, FRCSC, is board certifi ed by the American Board of Ophthalmology. After earning her medical degree at the University of Manitoba in Winnipeg, Dr. Kostick served a mixed surgery internship at St. Boniface Hospital at the University of Manitoba, and an ophthalmology residency at the University of Saskatchewan in Saskatoon. She was fellowship trained in ocular pathology and intraocular lens research at Storm Eye Institute at the Medical University of South Carolina. She was also fellowship trained in cornea/external disease/refractive surgery through the University of Missouri in Columbia. Dr. Kostick is a fellow of the American Board of Ophthalmology, American Academy of Ophthalmology and the American College of Surgeons. She is a member of the American Society of Cataract and Refractive Surgeons, the American Academy of Cosmetic Surgery, the Flagler County Medical Association and the Florida Medical Association.

The Eyes Have It!Dr. Kostick welcomes the

opportunity to help you protect and improve your eye health and achieve your best vision. Atlantic

Eye Center is in Palm Coast at:

3 Pine Cone Dr., Suite 104

(386) 446-9590

Dr. Kostick wants the readers of Palm Coast Health Care News to know that

she is currently accepting new patients into her eye care practice. All new patients receive a complete eye examination and screenings for various ocular conditions,

including cataracts, glaucoma and macular degeneration.

Dr. Kostick invites you to visit her website at www.atlanticeyecenter.com

ü Complete eye exams

ü No-stitch, no-needle, no-patch cataract surgery

ü Diabetic eye care

ü Glaucoma treatment and surgery

ü Second opinions

ü Cosmetic/ plastic eye surgery

ü BOTOX®/ JUVÉDERM®/ VOLUMA® anti-wrinkle treatments(these are not eye

care services)

ALEXANDRA KOSTICK, MD, FACS, FRCSC

You’re Invited

Additional Services:

Bird’s Eye ViewExperience, equipment and technique key to success in complex cases

Most transplanted north-erners end up in Florida as part of some grand plan to escape the frigid

winter cold back home. Deborah Lavery’s plan was to escape the frigid winter cold all right. But how she wound up in Palm Coast was more or less an accident.

“It was a � uke,” Deborah con� rms. “I just wanted to be in a warmer place, and my husband and I were traveling south, looking around at di� erent places along I-95, and at one point, I said, I’m tired of looking; let’s just get o� here. � at was in Palm Coast.”

Deborah made that decision in 2014, not long after she was forced to retire from her job as a certi� ed nursing assistant – a position she held for more than 20 years – because of a rare autoimmune disease called birdshot chorioretinopathy.

Caused by an inflammation of the uvea, which is the part of the eye that supplies most of the blood to the retina, birdshot chorioretinopathy is largely hereditary and most often occurs in Caucasian people between the ages of 45 and 50.

In its early stages, it results in blurred vision and eye � oaters, but over time, pain in the eyes, sensitivity to light, a loss of depth perception and a loss of peripheral vision can occur. In Deborah’s case, it led to all that and also contributed to the development of cataracts.

“It wasn’t from old age that I got the cataracts,” Deborah, 65, says. “It was from the steroid injections I had to get to cor-rect the e� ects of the birdshot. But it was either that or go blind. � at’s what the doctors told me.

“I got my � rst cataract in 2006. It was in my left eye, and because of the birdshot, I was more or less a guinea pig because the doctors really weren’t sure if the surgery was going to work.”

� e surgery did work, but 11 years later, another cataract developed, this time in Deborah’s right eye. And this time, the e� ects were far worse, this second cataract causing such an impairment in Deborah’s vision that she wound up injuring herself.

“I had to give up driving, and there was one time where I walked into a wall,” Deborah says. “I thought I was walking through the doorway, but I wasn’t paying close enough attention and walked into the wall instead. It left a big bruise on my face.”

� at incident prompted a search for a new eye surgeon in the Palm Coast area. With the help of her insurance company, Deborah soon found board-certi� ed oph-thalmologist Alexandra Kostick, MD, of Atlantic Eye Center.

A Challenging Case “Deborah proved to be quite a challeng-ing case because performing cataract surgery on someone with birdshot dis-ease can actually make the disease worse,” Dr. Kostick informs. “� e concern stems from the fact that there’s chronic in� am-mation in the eyes already.

“Now factor in that cataract surgery in and of itself causes in� ammation, and you get the added concern that by doing a procedure that naturally causes inflammation in somebody who is already in� amed, you’re only going to exacerbate the problem.

“If that happens, if we make the birdshot worse and exacerbate the inflammation in the back of the eye, postoperative complications can develop that could leave the patient with retinal swelling and possibly even permanent vision loss.”

� e increased risks associated with Deborah’s case meant she needed a special-ist who is experienced, adept in advanced surgical techniques and has access to the most technologically advanced equipment available today.

She found just that in Dr. Kostick.Recognized throughout the oph-

thalmologic field as one of its most accomplished surgeons, Dr. Kostick has been successfully treating complex cases such as Deborah’s for 23 years. She put that experience and much more to work in treating Deborah.

To begin with, she worked in tandem with Deborah’s retinal specialist to ensure that for more than a month prior to sur-gery, Deborah’s birdshot condition was stable and under control. � en, during the surgery itself, she made use of a special device called the ORA™.

ORA stands for Optiwave Refractive Analysis. It is a diagnostic device that pro-vides accurate measurements of the shape of the eye during procedures such as cataract surgery after the cataract has been removed.

“The ORA fine-tunes the power and therefore narrows down the selec-tion of the intraocular lens implant that

is implanted in the patient’s eye after the natural lens has been removed,” Dr. Kostick educates. “And it’s done while I’m performing the surgery.

“� ere’s no way that our pre-op mea-surements can compete with that, because it helps to make the patient’s end result much, much better. A good end result, of course, includes the patient seeing extremely well, and that’s what we got with Deborah.

“She turned out perfectly, and that’s quite a success because with all of her in� am-mation, the implant power could have been completely wrong. But we were able to avoid all complications, in part because of the state-of-the-art equipment we have.”

Family-Like Atmosphere Deborah was � t with a standard intra-ocular lens, or IOL, that corrected her distance vision to 20/20. She still wears glasses for reading but says her overall vision is better than it has been in years.

“I really can’t believe how well I’m seeing,” Deborah enthuses. “I can see birds and trees again. I can literally see all the way to the top of the trees. And I’m not walking into walls anymore. I really couldn’t be happier, and I’m extremely pleased with Dr. Kostick.

“She’s a great doctor, and I thank God every day that I met her. I recom-mend her to everyone I meet who has an eye problem. I literally hand her cards out like they’re candy. She’s a true specialist, and she treats you like family.”

A family-like atmosphere is a big part of what Dr. Kostick strives for at Atlantic Eye Center. She is proud to be treating the sons, daughters and grandchildren of patients she has been treating for years.

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

A strong reputation in the commu-nity is also something the sta� at Atlantic Eye Center strives to maintain.

“I think word of mouth is very import-ant for doctors, and we pride ourselves on the referrals we get,” Dr. Kostick adds. “I can honestly say that my sta� members go out of their way to ensure that people are cared for to our utmost capability.”FHCN article by Roy Cummings. Photo by Nerissa

Johnson. mkb

Summer 2019 | Palm Coast Health Care News | Page 5oPhthalmology

Timothy Ste� ik, DC, is a licensed doctor of chiropractic who graduated from Palmer College of Chiropractic in Port Orange, Florida in and now serves as the clinic director and president of Coastal Integrative Healthcare. He is an adjunct professor at Palmer College of Chiropractic who earned his bachelor’s degree in Biology with pre-med from Brigham Young University in . He is well-versed in the latest technology and techniques in his fi eld and has been trained in the use of the AMA Guides to the Evaluation of Permanent Physical Impairment. Dr. Stefl ik is an active fi tness enthusiast who was featured on American Ninja Warrior as “The Accordion Ninja.” His run can be seen on YouTube.

Jessica Cole, MSN, ARNP, FNP-C, is a board-certifi ed family nurse practicioner licensed in the state of Florida. She earned her bachelor’s degree in Nursing from West Virginia University, where she graduated Magna Cum Laude. She later received her master’s degree in Nursing from the same school, this time graduating Cum Laude. She began working at Coastal Integrative Healthcare shorter after earning her master’s degree in . Medical treatments pro-vided by Jessica in offi ce include: stem cell therapy, platelet rich plasma therapies, trigger point injections, therapeutic joint injections, hyaluronic acid injections, vitamin supplementation, growth hormone replacement therapy, functional examinations and new patient examinations.

Bryan Call, DC, is a chiropractic specialist who graduated with honors from Palmer College Chiropractic in Davenport, Florida in . He has more than two years of diverse experiences and now provides his services for Coastal Integrative Healthcare in Palm Coast.

What Conditions Respond to Stem Cell Therapy?

• Partial Tear of Rotator Cu� • Knee Arthritis and Degeneration• Plantar Fasciitis• Shoulder Pain• Tendonitis and Tendinosis

(biceps and triceps)• Medial Epicondylitis/Lateral Epicondylitis

(golfer’s elbow/tennis elbow)• Post-Operative Pain• Neurological Conditions

In-O� ce Procedure• Takes about 15 minutes• No hospital, No ambulances,

No anesthesia• Zero recovery time

(There are some small limitations)• Expect signi� cant regeneration

within 28 days• No adverse e� ects (% eff ective)• 28-day healing time

At Coastal Integrative Healthcare, we use umbilical cord stem cells that are donated by healthy mothers

at live-birth C-sections and � uid processed in a “clean room” environment that exceeds American Association

of Tissue Banks (AATB) standards and are subject to United States Pharmacopeia (USP) testing. Visit them online at www.coastalintegrativehealthcare.com

The Way We Were

efore it becomes the gas that fuels your car, crude oil is � rst excavated from the ground and then transported to a re� nery either through pipelines or by a train or a river barge the likes

of which Michael � ompson pushes for a living. “I captain a towboat that pushes barges that are a

thousand feet long,” says Michael, who has been on the water since he earned his Master of Boating Vessels

license in 1992. “We push other stu� , too, but it’s mostly oil that’s on those barges now.

“I currently go from St. Paul, Minnesota all the way down to the Gulf of Mexico and from Corpus Christi, Texas all the way to Pensacola. I drive those towboats down the Mississippi, the Ohio and the Illinois Rivers and across the Intracoastal Canal.”

Prior to beginning his career as a boat captain, Michael, 65, served as a policeman in his home of New Smyrna Beach and later worked with an emergency services unit at Cape Canaveral, where training was a grueling daily exercise.

“We did a lot of running and ran across a lot of obstacle courses during our training for that job, and I have beaten my body up pretty badly over

“She also made an appointment for me to come back and get a chiropractic adjustment. When I went back for that, they showed me the x-rays and explained that the reason I was in so much pain was because there was almost no cartilage left in my knees.

“� ey also told me they could � x that with stem cell therapy. At that point, I was willing to do anything to alleviate the pain because I knew my quality of life was only going to get worse if I didn’t do something.”

Our Body’s Building BlocksStem cells are the basic foundation cells that grow all of the tissue and organs in our body. When injected into a damaged organ or tissue, such as the cartilage in Michael’s knees, they support the natural healing pro-cess by regenerating that tissue.

Also known as regenerative medicine, stem cell therapy uses stem cells to stimulate the body’s natural repair mechanisms. Many in the medical community, including those at the National Institutes of Health and the Institute of Medicine, consider it the future of medicine.

“It’s de� nitely on the leading edge of medical technology,” states Timothy Ste� ik, DC, of Coastal Integrative Healthcare. “It’s a great alter-native to surgery. It regenerates the body instead of trying to � x it or cover up a problem with surgery.

“� e real beauty of it is that it is a one-and-done, in-o� ce procedure that takes about � fteen minutes and needs no anesthesia. It’s a simple injection of the cells that are cryo-preserved right in our o� ce.

“For some patients, we do a color ultrasound to guide the injection because we need to be very speci� c where the cells are placed. Once the cells are injected, the patient just needs time to heal. � ey can return to normal activities right away.”

Stem cell therapy can be used anywhere in the body where there is arthritis, or a muscle or tendon tear, Dr. Ste� ik educates. In addition to knees and shoulders, medical providers at Coastal Integrative Healthcare have performed the procedure on hamstrings, ankles and wrists.

Not all patients are good candidates for the procedure. Patients who have su� ered a tear of more than 50 percent of the rotator cu� in their shoulder, for example, or have absolutely no cartilage left in their knee would be encouraged to try other options � rst.

Back to the Beach Chuck Farrell knows one of those other options all too well. He has a couple of friends whose ceaseless knee pain resulted in them opting for replacement surgery. One of those friends, he says, had a good experience. � e other, not so good.

Convinced that the odds were stacked against him, Chuck, 78, had long been reluctant to have the surgery that more than one doctor told him he needed to rid him of the right knee pain that had all but disabled him.

“I’m seventy-eight years old, a retired REALTOR®, but I like to stay active,” Chuck explains. “I especially like walking on the beach. � at’s why my wife and I bought a house here in New Smyrna Beach, because we like the beach.

“I wasn’t really noticing any improvement. But then, after I started to do some physical therapy and some exercises to help build up my leg muscles, I started to notice a real di� erence, and my knee started to feel a lot better.”

Chuck has continued to experience improvement ever since, to the point where he is once again taking his walks along the beach. He’s still not walking the distances he once was, but he’s con� dent he’ll be walking those distances again soon.

“� e pain is gone, and I even cut the grass here a while back,” Chuck reports. “I wore a brace to do that, but I’m able to push the mower again without the pain. I can’t tell you how great a feeling it is to be able to do that and walk the beach again.”

Pain Free AgainMichael knows the feeling. He received his stem cell injections last September during one of the breaks in his work schedule, which calls for him to work 28 straight days, with a two-week break in between work periods.

He also started doing physical therapy at that time and wearing knee braces for support. When he returned to Coastal Integrative Healthcare a little more than a month after receiving his injections, the sta� was amazed at his improvement.

“I was already walking much better and was in a lot less pain,” Michael says. “I was told I could stop wearing the knee braces at that time, but one of the nurses there, Greg Salter, saw I had some bone spurs.

“He said the bone spurs are the body’s way of forming a cast to keep any more damage from happening, and he recommended I use a rolling pin of all things to get them out. So, I got a rolling pin and rolled that across my knees a couple times a day.”

� e rolling pin treatment was a bit painful at � rst, but Michael stuck with it in part because Greg told him it would not only break down the bone spurs but generate blood � ow, which would further promote healing and new growth.

� at’s exactly what it has done. When Michael returned to Coastal Integrative Healthcare again a couple of months ago for another check-up, he reported that his knee pain was virtually nonexistent and that he was resuming normal activities.

“� e pain in my right knee is completely gone,” Michael con� rms. “I still had some pain in my left knee then, but that’s because x-rays showed I was nearly bone on bone in that knee, so I got a booster shot to help that. Now, my � exibility is almost back to normal.

“I work with another captain who told me recently that when I � rst came on this boat, he didn’t know how much longer I was going to be able to do this. But now, he sees me getting on the boat, and he says I’m almost nimble.”

Michael chose to have the stem cell therapy in part because he knows two people who have undergone knee surgery, and both had bad expe-riences with it. He says the therapy worked for him and is glad he went to Coastal Integrative Healthcare to get it.

“� ey’re all great people, unlike a lot of doctors, who forget about you once you’re out the door,” Michael says. “Dr. Ste� ik has called me several times to check up on how I’m doing, and I really appreciate that. It shows how much he cares.”

Chuck agrees. He says he could tell just how much Dr. Ste� ik cares about his patients when he spoke during the seminar. He adds that he was not disap-pointed in any way when he actually became a patient of Dr. Ste� ik’s himself.

“Everyone there is very professional, but what really stuck with me is how friendly everybody is,” he says. “You go in for a treatment or for phys-ical therapy and everyone greets you with a Hello and a How are you doing?

“It’s a great place, and you can take it from me, they do great work.”FHCN article by Roy Cummings. Chuck’s photo by Nerissa Johnson. Michael’s photo courtesy of Michael

Thompson. mkb

A He al thier YouTo see if stem cell therapy is right for you, Coastal Integrative Healthcare is happy to offer a free consultation with one of the doctors. To schedule an appointment, call or visit one of Coastal Integrative Healthcare’s locations:

Palm Coast Florida Park Drive North

(386) 445-4455Edgewater

N. Ridgewood Ave.

(386) 427-8403

the years, because I developed some serious knee issues,” Michael relates.� ose knee issues became acute a few years ago after Michael spent a

long weekend visiting his family in Marietta, Ohio, where he spent an eve-ning taking in a � reworks show during the area’s annual Sternwheel Festival.

“I spent most of that night carrying my sister’s granddaughter on my shoulders so that she wouldn’t have to � ght the crowd to see the � reworks,” Michael remembers. “� e next day, my knees hurt so bad, I could barely walk.”

Michael had fought through his moderate knee pain for years at that point, but it was so intense following his trip to the festival that he sought advice from his primary care physician, who immediately sent him to a bone doctor.

� e bone doctor sent Michael to a knee specialist who gave Michael an injection of cortisone, a hormone that is often e� ective in reducing in� ammation and pain in joints and tendons. It wasn’t e� ective in reduc-ing Michael’s pain.

“It helped very little,” Michael says of the cortisone shot. “� at doc-tor got me approved for another type of shot, but I can’t even tell you what it was. It was a lubricant of some kind, but that didn’t help either.”

The Last StrawMichael spent more than a year waiting for � rst the cortisone shot and later for the lubricant to take e� ect. It was a miserably long wait that was made worse by the fact that the pain prohibited him from exercising in any way.

“I was hurting so bad, I couldn’t even walk, and I used to walk every day for exercise,” Michael says. “� row in the fact that I sit for twelve hours a day driving the boat and before long, I started putting on weight. Lots of weight.

“I eventually got up to three hundred and � fty-six pounds. � en, last summer, I brought my twin sons down here from Ohio for a vacation. Well, the � rst thing they wanted to do when they got here was take a walk on the beach.

“I couldn’t go with them because I couldn’t walk. It was just too painful, especially on the beach like that. � at was the last straw for me. � at’s when I said, Enough and decided I had to get something done about this once and for all.”

Michael’s decision sparked a conversation with his family mem-bers over what route to follow next. It was during that conversation that his cousin’s daughter suggested he visit Coastal Integrative Healthcare, where she had worked as a massage therapist.

Michael acted immedi-ately on the recommendation. During his � rst visit, he was given a thorough examination that included x-rays and was advised by one of the treating physicians to start taking magnesium for his pain.

“She said the magnesium would help because she suspected that the pain and extra weight I’d put on was making me walk di� erently than usual, and that was likely causing the muscles to � ght each other and cramp,” Michael says.

“Well, about � fteen years ago, I started having knee problems – a lot of pain – and I was told on more than one occasion that it was pretty much bone on bone in my right knee and that my only choice was to have surgery.

“I always thought I was too young to have replacement surgery, and really, I didn’t want it anyway, so I put it o� . When the pain got real bad, I’d just take Aleve® or something like that. After I retired, though, the pain started to get a lot worse.

“� ere was a point where it was so bad, I couldn’t even mow the lawn. I had to buy a riding mower because it hurt too much to walk behind a push mower. And as for those walks on the beach, well, I went for years without being able to take one of those.”

Despite the impact it was having on his lifestyle, Chuck refused to seriously consider knee replacement surgery, which another doctor recom-mended just last year. � en came a day a few months ago when he discovered an alternative while reading a local newspaper.

“I attended a seminar about stem cell therapy at the public library here in New Smyrna Beach to see what it was all about,” Chuck reports.

� e seminar Chuck attended was facilitated by Coastal Integrative Healthcare. � e featured speaker was Dr. Ste� ik, who impressed Chuck so much that he immediately made an appointment with the doctor to see if he was a candidate for the treatment.

During that appointment, which took place in January, an x-ray of Chuck’s right knee was taken that revealed he still had some cartilage left, enough to make him a candidate for stem cell therapy. Chuck agreed then and there to give the treatment a try.

“I � gured, What do I have to lose?” Chuck reveals. “I thought, If it doesn’t work, I can always go back and have the surgery. And for the � rst twenty-eight days or so after I received the injection, I was thinking I might have to do that.

JOSE ORTIZ, DCBRYAN CALL, DC

GREG SALTER, MSN, ARNPJESSICA COLE, MSN, ARNP, FNP-C

JASON SCHULTZ, MDTIMOTHY STEFLIK, DCMELONY THOMAS, DCAMANDA VOZAR, DC

Page 6 | Palm Coast Health Care News | Summer 2019 regeNerative mediCiNe

Timothy Ste� ik, DC, is a licensed doctor of chiropractic who graduated from Palmer College of Chiropractic in Port Orange, Florida in and now serves as the clinic director and president of Coastal Integrative Healthcare. He is an adjunct professor at Palmer College of Chiropractic who earned his bachelor’s degree in Biology with pre-med from Brigham Young University in . He is well-versed in the latest technology and techniques in his fi eld and has been trained in the use of the AMA Guides to the Evaluation of Permanent Physical Impairment. Dr. Stefl ik is an active fi tness enthusiast who was featured on American Ninja Warrior as “The Accordion Ninja.” His run can be seen on YouTube.

Jessica Cole, MSN, ARNP, FNP-C, is a board-certifi ed family nurse practicioner licensed in the state of Florida. She earned her bachelor’s degree in Nursing from West Virginia University, where she graduated Magna Cum Laude. She later received her master’s degree in Nursing from the same school, this time graduating Cum Laude. She began working at Coastal Integrative Healthcare shorter after earning her master’s degree in . Medical treatments pro-vided by Jessica in offi ce include: stem cell therapy, platelet rich plasma therapies, trigger point injections, therapeutic joint injections, hyaluronic acid injections, vitamin supplementation, growth hormone replacement therapy, functional examinations and new patient examinations.

Bryan Call, DC, is a chiropractic specialist who graduated with honors from Palmer College Chiropractic in Davenport, Florida in . He has more than two years of diverse experiences and now provides his services for Coastal Integrative Healthcare in Palm Coast.

What Conditions Respond to Stem Cell Therapy?

• Partial Tear of Rotator Cu� • Knee Arthritis and Degeneration• Plantar Fasciitis• Shoulder Pain• Tendonitis and Tendinosis

(biceps and triceps)• Medial Epicondylitis/Lateral Epicondylitis

(golfer’s elbow/tennis elbow)• Post-Operative Pain• Neurological Conditions

In-O� ce Procedure• Takes about 15 minutes• No hospital, No ambulances,

No anesthesia• Zero recovery time

(There are some small limitations)• Expect signi� cant regeneration

within 28 days• No adverse e� ects (% eff ective)• 28-day healing time

At Coastal Integrative Healthcare, we use umbilical cord stem cells that are donated by healthy mothers

at live-birth C-sections and � uid processed in a “clean room” environment that exceeds American Association

of Tissue Banks (AATB) standards and are subject to United States Pharmacopeia (USP) testing. Visit them online at www.coastalintegrativehealthcare.com

The Way We Were

efore it becomes the gas that fuels your car, crude oil is � rst excavated from the ground and then transported to a re� nery either through pipelines or by a train or a river barge the likes

of which Michael � ompson pushes for a living. “I captain a towboat that pushes barges that are a

thousand feet long,” says Michael, who has been on the water since he earned his Master of Boating Vessels

license in 1992. “We push other stu� , too, but it’s mostly oil that’s on those barges now.

“I currently go from St. Paul, Minnesota all the way down to the Gulf of Mexico and from Corpus Christi, Texas all the way to Pensacola. I drive those towboats down the Mississippi, the Ohio and the Illinois Rivers and across the Intracoastal Canal.”

Prior to beginning his career as a boat captain, Michael, 65, served as a policeman in his home of New Smyrna Beach and later worked with an emergency services unit at Cape Canaveral, where training was a grueling daily exercise.

“We did a lot of running and ran across a lot of obstacle courses during our training for that job, and I have beaten my body up pretty badly over

“She also made an appointment for me to come back and get a chiropractic adjustment. When I went back for that, they showed me the x-rays and explained that the reason I was in so much pain was because there was almost no cartilage left in my knees.

“� ey also told me they could � x that with stem cell therapy. At that point, I was willing to do anything to alleviate the pain because I knew my quality of life was only going to get worse if I didn’t do something.”

Our Body’s Building BlocksStem cells are the basic foundation cells that grow all of the tissue and organs in our body. When injected into a damaged organ or tissue, such as the cartilage in Michael’s knees, they support the natural healing pro-cess by regenerating that tissue.

Also known as regenerative medicine, stem cell therapy uses stem cells to stimulate the body’s natural repair mechanisms. Many in the medical community, including those at the National Institutes of Health and the Institute of Medicine, consider it the future of medicine.

“It’s de� nitely on the leading edge of medical technology,” states Timothy Ste� ik, DC, of Coastal Integrative Healthcare. “It’s a great alter-native to surgery. It regenerates the body instead of trying to � x it or cover up a problem with surgery.

“� e real beauty of it is that it is a one-and-done, in-o� ce procedure that takes about � fteen minutes and needs no anesthesia. It’s a simple injection of the cells that are cryo-preserved right in our o� ce.

“For some patients, we do a color ultrasound to guide the injection because we need to be very speci� c where the cells are placed. Once the cells are injected, the patient just needs time to heal. � ey can return to normal activities right away.”

Stem cell therapy can be used anywhere in the body where there is arthritis, or a muscle or tendon tear, Dr. Ste� ik educates. In addition to knees and shoulders, medical providers at Coastal Integrative Healthcare have performed the procedure on hamstrings, ankles and wrists.

Not all patients are good candidates for the procedure. Patients who have su� ered a tear of more than 50 percent of the rotator cu� in their shoulder, for example, or have absolutely no cartilage left in their knee would be encouraged to try other options � rst.

Back to the Beach Chuck Farrell knows one of those other options all too well. He has a couple of friends whose ceaseless knee pain resulted in them opting for replacement surgery. One of those friends, he says, had a good experience. � e other, not so good.

Convinced that the odds were stacked against him, Chuck, 78, had long been reluctant to have the surgery that more than one doctor told him he needed to rid him of the right knee pain that had all but disabled him.

“I’m seventy-eight years old, a retired REALTOR®, but I like to stay active,” Chuck explains. “I especially like walking on the beach. � at’s why my wife and I bought a house here in New Smyrna Beach, because we like the beach.

“I wasn’t really noticing any improvement. But then, after I started to do some physical therapy and some exercises to help build up my leg muscles, I started to notice a real di� erence, and my knee started to feel a lot better.”

Chuck has continued to experience improvement ever since, to the point where he is once again taking his walks along the beach. He’s still not walking the distances he once was, but he’s con� dent he’ll be walking those distances again soon.

“� e pain is gone, and I even cut the grass here a while back,” Chuck reports. “I wore a brace to do that, but I’m able to push the mower again without the pain. I can’t tell you how great a feeling it is to be able to do that and walk the beach again.”

Pain Free AgainMichael knows the feeling. He received his stem cell injections last September during one of the breaks in his work schedule, which calls for him to work 28 straight days, with a two-week break in between work periods.

He also started doing physical therapy at that time and wearing knee braces for support. When he returned to Coastal Integrative Healthcare a little more than a month after receiving his injections, the sta� was amazed at his improvement.

“I was already walking much better and was in a lot less pain,” Michael says. “I was told I could stop wearing the knee braces at that time, but one of the nurses there, Greg Salter, saw I had some bone spurs.

“He said the bone spurs are the body’s way of forming a cast to keep any more damage from happening, and he recommended I use a rolling pin of all things to get them out. So, I got a rolling pin and rolled that across my knees a couple times a day.”

� e rolling pin treatment was a bit painful at � rst, but Michael stuck with it in part because Greg told him it would not only break down the bone spurs but generate blood � ow, which would further promote healing and new growth.

� at’s exactly what it has done. When Michael returned to Coastal Integrative Healthcare again a couple of months ago for another check-up, he reported that his knee pain was virtually nonexistent and that he was resuming normal activities.

“� e pain in my right knee is completely gone,” Michael con� rms. “I still had some pain in my left knee then, but that’s because x-rays showed I was nearly bone on bone in that knee, so I got a booster shot to help that. Now, my � exibility is almost back to normal.

“I work with another captain who told me recently that when I � rst came on this boat, he didn’t know how much longer I was going to be able to do this. But now, he sees me getting on the boat, and he says I’m almost nimble.”

Michael chose to have the stem cell therapy in part because he knows two people who have undergone knee surgery, and both had bad expe-riences with it. He says the therapy worked for him and is glad he went to Coastal Integrative Healthcare to get it.

“� ey’re all great people, unlike a lot of doctors, who forget about you once you’re out the door,” Michael says. “Dr. Ste� ik has called me several times to check up on how I’m doing, and I really appreciate that. It shows how much he cares.”

Chuck agrees. He says he could tell just how much Dr. Ste� ik cares about his patients when he spoke during the seminar. He adds that he was not disap-pointed in any way when he actually became a patient of Dr. Ste� ik’s himself.

“Everyone there is very professional, but what really stuck with me is how friendly everybody is,” he says. “You go in for a treatment or for phys-ical therapy and everyone greets you with a Hello and a How are you doing?

“It’s a great place, and you can take it from me, they do great work.”FHCN article by Roy Cummings. Chuck’s photo by Nerissa Johnson. Michael’s photo courtesy of Michael

Thompson. mkb

A He al thier YouTo see if stem cell therapy is right for you, Coastal Integrative Healthcare is happy to offer a free consultation with one of the doctors. To schedule an appointment, call or visit one of Coastal Integrative Healthcare’s locations:

Palm Coast Florida Park Drive North

(386) 445-4455Edgewater

N. Ridgewood Ave.

(386) 427-8403

the years, because I developed some serious knee issues,” Michael relates.� ose knee issues became acute a few years ago after Michael spent a

long weekend visiting his family in Marietta, Ohio, where he spent an eve-ning taking in a � reworks show during the area’s annual Sternwheel Festival.

“I spent most of that night carrying my sister’s granddaughter on my shoulders so that she wouldn’t have to � ght the crowd to see the � reworks,” Michael remembers. “� e next day, my knees hurt so bad, I could barely walk.”

Michael had fought through his moderate knee pain for years at that point, but it was so intense following his trip to the festival that he sought advice from his primary care physician, who immediately sent him to a bone doctor.

� e bone doctor sent Michael to a knee specialist who gave Michael an injection of cortisone, a hormone that is often e� ective in reducing in� ammation and pain in joints and tendons. It wasn’t e� ective in reduc-ing Michael’s pain.

“It helped very little,” Michael says of the cortisone shot. “� at doc-tor got me approved for another type of shot, but I can’t even tell you what it was. It was a lubricant of some kind, but that didn’t help either.”

The Last StrawMichael spent more than a year waiting for � rst the cortisone shot and later for the lubricant to take e� ect. It was a miserably long wait that was made worse by the fact that the pain prohibited him from exercising in any way.

“I was hurting so bad, I couldn’t even walk, and I used to walk every day for exercise,” Michael says. “� row in the fact that I sit for twelve hours a day driving the boat and before long, I started putting on weight. Lots of weight.

“I eventually got up to three hundred and � fty-six pounds. � en, last summer, I brought my twin sons down here from Ohio for a vacation. Well, the � rst thing they wanted to do when they got here was take a walk on the beach.

“I couldn’t go with them because I couldn’t walk. It was just too painful, especially on the beach like that. � at was the last straw for me. � at’s when I said, Enough and decided I had to get something done about this once and for all.”

Michael’s decision sparked a conversation with his family mem-bers over what route to follow next. It was during that conversation that his cousin’s daughter suggested he visit Coastal Integrative Healthcare, where she had worked as a massage therapist.

Michael acted immedi-ately on the recommendation. During his � rst visit, he was given a thorough examination that included x-rays and was advised by one of the treating physicians to start taking magnesium for his pain.

“She said the magnesium would help because she suspected that the pain and extra weight I’d put on was making me walk di� erently than usual, and that was likely causing the muscles to � ght each other and cramp,” Michael says.

“Well, about � fteen years ago, I started having knee problems – a lot of pain – and I was told on more than one occasion that it was pretty much bone on bone in my right knee and that my only choice was to have surgery.

“I always thought I was too young to have replacement surgery, and really, I didn’t want it anyway, so I put it o� . When the pain got real bad, I’d just take Aleve® or something like that. After I retired, though, the pain started to get a lot worse.

“� ere was a point where it was so bad, I couldn’t even mow the lawn. I had to buy a riding mower because it hurt too much to walk behind a push mower. And as for those walks on the beach, well, I went for years without being able to take one of those.”

Despite the impact it was having on his lifestyle, Chuck refused to seriously consider knee replacement surgery, which another doctor recom-mended just last year. � en came a day a few months ago when he discovered an alternative while reading a local newspaper.

“I attended a seminar about stem cell therapy at the public library here in New Smyrna Beach to see what it was all about,” Chuck reports.

� e seminar Chuck attended was facilitated by Coastal Integrative Healthcare. � e featured speaker was Dr. Ste� ik, who impressed Chuck so much that he immediately made an appointment with the doctor to see if he was a candidate for the treatment.

During that appointment, which took place in January, an x-ray of Chuck’s right knee was taken that revealed he still had some cartilage left, enough to make him a candidate for stem cell therapy. Chuck agreed then and there to give the treatment a try.

“I � gured, What do I have to lose?” Chuck reveals. “I thought, If it doesn’t work, I can always go back and have the surgery. And for the � rst twenty-eight days or so after I received the injection, I was thinking I might have to do that.

JOSE ORTIZ, DCBRYAN CALL, DC

GREG SALTER, MSN, ARNPJESSICA COLE, MSN, ARNP, FNP-C

JASON SCHULTZ, MDTIMOTHY STEFLIK, DCMELONY THOMAS, DCAMANDA VOZAR, DC

Summer 2019 | Palm Coast Health Care News | Page 7regeNerative mediCiNe

Rachael Becker

“� ey got so swollen and painful that it was hard to walk,’’ she says. “Going to theme parks, even taking the kids to the park was di� cult.”

Rachael didn’t seek medical atten-tion for the problem until after she woke up one day and could barely stand. A hospital visit resulted in the detec-tion of a blood clot.

Advised to see a spe-cialist to care for the blood clot, Rachael visited Sukhender Singireddy, MD, at Suncoast Vein & Vascular Clinic. After treat-ing the clot, Dr. Singireddy took on the task of treating Rachael’s vein issues.

In-Offi ce Solutions“During my examination of Rachael’s legs, I found she had multiple bulging veins as well as leaking valves in the long vein running the length of her right leg, a condition known as venous insu� ciency,’’ Dr. Singireddy says.

To correct the problem, an endovenous laser ablation (EVLA) was performed. EVLA uses heat energy to cauterize the vein. it is a minimally invasive in-o� ce procedure that is performed under local anesthesia while the patient is slightly sedated.

“Once we clean and prep the legs, we insert a catheter into the defective vein,’’ Dr. Singireddy explains. “We then use ultrasound guidance to make sure the cath-eter is in the right location and advance the catheter all the way up to the groin.

“Through the catheter, we insert a very thin laser � ber up to the groin and apply local anes-thesia around the defective vein. After that, we slowly withdraw the catheter, cauterizing the vein and basically shutting it down.”

Dr. Singireddy also removed the bulging veins that ran from Rachel’s thighs

to her ankles using a microphlebectomy pro-cedure. During a microphlebectomy, local anesthesia is applied along the course of the vein. Small punctures are then made in the skin and through those punctures, a tool that looks like a crochet hook is used to remove the vein bit by bit.

Most patients begin to experience relief from their pain and swelling within a few days of undergoing these procedures. � at was the case with Rachael, who describes the results of her treatments as “amazing.”

“When I saw the before and after pic-tures, I was shocked,’’ she says. “I’d kind of forgotten how bad my legs looked. Now, my legs look and feel great, and I’m moving around normally and doing all the things I want and need to do.”

Suncoast Vein & Vascular also offers radiofrequency ablation and a glue treat-ment called VenaSeal® as alternatives to the laser treatment as well as cosmetic sclerother-apy for the treatment of spider veins.

� e VenaSeal treatment shuts down the defective veins without using heat so there is less risk of damaging the adjacent nerves causing numbness. � is treatment alone requires no stocking use.FHCN article by Roy Cummings. Patient photo courtesy of

Rachael Becker. Before and after images courtesy of Suncoast

Vein & Vascular Clinic. mkb

Now O� eringThe clinic also offers treatment for Peripheral Arterial Disease, including balloon angioplasty, stenting and laser arthrectomy with excellent patient outcomes. These are all done in outpatient settings.

Why Choose UsSuncoast Vein & Vascular Clinic provides comprehensive care for a variety of venous issues. For more information or to schedule an appointment, call or visit them in:

Port Orange1728 Dunlawton Ave., Suite 5

Ormond Beach325 Clyde Morris Blvd., Suite 300

Palm Coast385 Palm Coast Pkwy. SW, Suite 2

(386) 304-3404or

(386) 304-1811

Sukhender Singireddy, MD, is a board-certified phlebologist and interven-tional radiology specialist with more than years of experi-ence. He completed four years of radiology residency at the

University of Medicine and Dentistry of New Jersey in and was fellowship trained in vascular and interventional radiology at Henry Ford Hospital in Michigan from -.

BEFORE AFTER

Closing TimeMinimally invasive procedures repair damaged veins

SUNCOAST VEIN & VASCULAR CLINIC

SUKHENDER SINGIREDDY, MD

Visit them on the web at www.suncoastvein.com

R achael Becker is proof you don’t have to be of an adult age to get varicose veins. Rachael’s first varicose vein

appeared when she was still in high school.

“It was in my right calf, and I wouldn’t go so far as to say it sidelined me, but I played soccer in high school and when I played, I de� nitely noticed it,’’ Rachael says. “As time went on, the pain and swelling just got worse and worse.”

Now 36 and a single mother of three, Rachael eventually developed several bulging veins that grew decid-edly worse every time she gave birth. Eventually, the pain and swelling in her legs became debilitating.

OPS™ replacement surgery more precise

T he number of Americans hav-ing hip replacement surgery has grown steadily over the past 18 years. It’s estimated

that this year, more than 300,000 peo-ple will undergo the procedure, up from 138,000 in 2000. � e procedure, fortu-nately, has improved as well.

A recent advancement to hip replace-ment surgery was the release and FDA approval of a technology that helps surgeons determine the most accurate alignment of the replacement implants. � is technology is the optimized position-ing system, or OPS™.

� e inspiration behind OPS is the fact that no two people move the same way, and this can make a significant impact on the proper positioning of the hip implants. OPS is designed to account for the di� erences. It tailors the implant placement to each patient.

The hip joint has two essential parts, the ball and the socket. � e ball of the joint is the head of the femur, or thigh bone. � e socket, or acetabulum, is a concave depression in the pelvis, in which the ball sits. � e ball and socket are the parts that are replaced during surgery and must be positioned appro-priately for the best outcome.

To get the proper position, hip replacement surgery using OPS begins long before the procedure is performed. An extensive preoperative evaluation is � rst performed to determine how the patient’s femur, pelvis and spine work together during routine daily activities. This

evaluation provides a speci� c functional simulation of the patient’s movement.

� e information is essential to achiev-ing optimum results during surgery. If the implants aren’t positioned precisely during surgery, there’s a greater risk for compli-cations such as premature wear, implant loosening and dislocation, as well as nerve impingement.

The preoperative evaluation also includes imaging such as x-rays and CT scans to generate pictures of how the patient’s hip moves in three dimensions. The imaging captures the anatomical geometry around the person’s hip joint.

Using all of the information gath-ered from the preoperative evaluation, surgeons create exact 3-D models of the patients’ anatomy. � ey then use these models as guides to optimize implant position during the hip replacement procedure.

The preoperative evaluation is the � rst step in the hip replacement using OPS process. � e second step is using the system during the procedure itself. During surgery, the 3-D model, which is unique to each patient, is combined with a laser guidance system. Surgeons match up the laser points to ensure the optimized plan is accurately recreated during surgery.

Need for OPS� e most common reason for needing hip replacement surgery with OPS is deterio-ration of the hip joint from arthritis. � e most common type of arthritis is osteo-arthritis, also known as “wear and tear”

arthritis. Osteoarthritis generally devel-ops with age. It’s estimated that more than 28 million Americans su� er from the disorder.

Osteoarthritis can develop in any joint in the body, but it most often a� ects weight-bearing joints such as knees and hips. � e hip is one of the largest joints in the body, and like other joints, its surfaces are covered with a smooth cushioning material called articular cartilage. � is cartilage enables the bones to slide over one another more easily.

Joints also contain another cushion-ing substance called synovial � uid. � is � uid lubricates the joint cartilage and aids in movement. With osteoarthritis, the articular cartilage begins to wear away, and the synovial � uid begins to thin out. � is results in the bones of the joint rubbing together without cushioning. Damaged bone may also start to grow. � ese result-ing growths are called bone spurs.

All of the damage to the hip joint is degenerative; it gets worse over time. It also causes pain, swelling and other symp-toms that get progressively more intense. Additional symptoms of osteoarthritis include tenderness around the hip, lim-ited range of motion, a grating sensation with movement and di� culty walking.

� e doctor can generally diagnose osteoarthritis through a complete his-tory and physical exam. � e doctor will con� rm the � ndings with an x-ray of the patient’s hip.

Treatment for osteoarthritis generally begins with lifestyle modi� cations, such

as switching from high-impact activi-ties to lower-impact activities and losing weight. Other conservative treatments include doing physical therapy, using support such as a cane when walking and taking anti-inflammatory and/or pain medications.

If conservative treatments fail to relieve symptoms, the doctor may sug-gest surgery. Surgical options include hip resurfacing and total hip replacement. FHCN staff article. mkb

Need New Hip Joint?

Page 8 | Palm Coast Health Care News | Summer 2019 veiN aNd vaSCular diSeaSe

SPeCial to FhCN

BEFORE AFTER

Clean Cut Minimally invasive procedure heals diabetic foot ulcers

R amon Giordano, 88, grew up in an Italian neighborhood in his native North New Jersey before joining the US Air

Force, � nishing college and relocating to Florida. During his working career, Ramon held several jobs, but he retired as an insur-ance company executive. In that role, he was responsible for developing new business.

As Ramon neared retirement, he developed Type 2 diabetes, a condition that led to complications with his feet. One such complication developed on the bot-tom of his right foot at the joint where his little toe meets the ball of his foot. It was a complication that worsened considerably because Ramon’s Type 2 diabetes limits the feeling he has in his feet.

“� e problem I had was my foot was always getting in� amed and sore around my small toe, and there was a wound caus-ing the in� ammation,” Ramon shares. “It hurt the most when I tried to walk, but not so much that I stopped walking. I just had to put my foot down so that the right side didn’t touch the � oor.”

Despite the adjustments he made to his walking pattern, Ramon’s foot problem didn’t go away. As a result, he eventually turned to the professionals at All About Feet & Legs in St. Augustine for help. That’s where he met Rosana Rodriguez, DPM, CWS and Hany M. Je� ry, DPM, MBBS.

“What we found when Ramon came to the o� ce was an ulcer under the head of the � fth metatarsal bone of his right foot,” Dr. Rodriguez veri� es. “Essentially, the head of his metatarsal bone pointed downward, and the pressure from that caused a pre-ulcerative callus. Eventually,

Hany M. Jeffry, DPM, MBBS, is board certified by the American Board of Multiple Specialists in Podiatry for primary care in podiatric medicine. Dr. Jeff ry earned a Doctor of Medicine and Surgery degree (MBBS) from King Abdul Aziz University School of Medicine in Jeddah, Saudi Arabia, then a Doctorate of Podiatric Medicine from Barry University in Miami Shores, FL. He completed a podiatry residency at Jackson North Medical Center in Miami, FL and a fellowship at the Paley Advanced Limb Lengthening Institute at St. Mary’s Medical Center in West Palm Beach, FL. He is a member of the American Public Health Association and the Florida Public Health Association.

Rosana Rodriguez, DPM, CWSP, is board certifi ed by the American Academy of Wound Management and by the American Podiatric Medical Specialties Board in prevention and treatment of diabetic foot wounds. She earned her undergraduate degree from the University of Puerto Rico, San Juan, and her Doctor of Podiatric Medicine degree from Ohio College of Podiatric Medicine. Dr. Rodriguez completed a rotating podiatric residency at Columbia University General Hospital in Seminole. FL, and a residency in podiatric surgery at Northside Hospital and Heart Institute in St. Petersburg, FL. She has been providing podiatric services since .

Quality Care With Individualized Attention

At All About Feet & Legs, the priority is to deliver quality care to all patients in a comfortable, convenient setting. To learn more or to schedule a consultation, call or visit their offi ce in St Augustine at:

6 St. Johns Medical Park Drive

(904) 823-3301Visit All About Feet & Legs on the web at StAugustineFootDoctor.com

the callus broke open into an ulcer, and an infection developed in the area.”

Luckily, Ramon’s wound infection didn’t spread to the bone, and the doctors were able to control the infection before it developed into a limb-threatening dia-betic infection.

While treating the infection, the doc-tors were able to achieve wound closure using an o� oading pad that shifts the pressure away from the wound by tem-porarily lifting the metatarsal bone.

“Following up with Ramon, Dr. Rodriguez and I tried several treat-ments to prevent the pre-ulcerative callus from recurring under the bone, including various shoe inserts, but those e� orts were not successful,” Dr. Je� ry reports. “We � nally decided that Ramon’s callus was not going to heal unless we cut the bone, which would eliminate that pressure, so we performed a very minimally invasive procedure for him.”

Moving Upward� e procedure Dr. Je� ry performed on Ramon is called a dorsi� exory osteotomy of the metatarsal head. It is typically performed through a major incision in the skin through which the sur-geon cuts the bone with a bone saw. Because of its invasive nature, the patient has to go under gen-eral anesthesia, and the incision from this standard version of the procedure requires at least three weeks of healing time.

For Ramon, Dr. Jeffry performed a variation of that procedure in which he created a much smaller inci-sion, one just large enough to accommodate a much smaller bone-cutting tool. � e inci-sion is so small – about the

size of a pinpoint, Dr. Jeffry relates – that it sometimes doesn’t even require sutures to close it.

“We use this small tool to slice through the bone from the top, away from the wound,”

the doctor explains. “Once the bone is cut, we shift it upward and toward the center of the foot. � at is why the procedure is called dorsi� exory. � at means going up. Doing this avoids pressure on the area where the callus forms. � en

we maintain the bone in its new position with wrapping and a surgical shoe.

“Once we’re done, we simply put a dressing on the wound, and it usually heals in less than two weeks,” Dr. Je� ry adds. “As we did with Ramon, we typi-cally perform this procedure minimally invasive because it is much more tolerable for the patient. It results in less pain and h a s a quicker recovery time,

which allows the patient to return t o a c t i v i t i e s sooner.”

Following the surgery, Ramon was able to walk immediately wearing the

surgical shoe. � e surgical shoe helps push the bone upward and keep the correction in place.

“Bones generally take about six weeks to heal, so we typically take patients out of the surgical shoes between four to six weeks after the procedure,” Dr. Je� ry reports. “In Ramon’s case, we also performed basic wound care

until his ulcer completely healed. Now, he does not even have a callus in the pressure spot, and that is very good news.”

Younger FeetDr. Je� ry performed the minimally inva-sive version of the dorsi� exory osteotomy of the metatarsal on Ramon on January 30. It was an in-office procedure that took less than an hour to complete. As expected, Ramon recovered quickly with little discomfort. And he’s delighted by the � nal outcome of the procedure.

“� e surgery was very minor,” he says. “It was one, two, three and done, and I didn’t have to be put under for it. I was awake the whole time. � ey just used a local anesthetic on my foot, and I didn’t experi-ence any pain during the surgery. Best of all,

I haven’t had any pain since then either.“To this day, I have not had a prob-

lem with or any pain in my right foot. I have no more in� ammation and no more di� culty. It’s amazing what a little thing can do to you and how a minor correction can prevent the problem.”

R a m o n s a y s h e ’s a l s o extremely pleased with Dr. Je� ry, Dr. Rodriguez and the sta� at All About Feet & Legs. He credits them with his now healthy feet.

“Dr. Je� ry is very nice,” he comments. “I think very highly of him, even more so now that

my surgery was so successful. � e sta� is also excellent. Everyone is very

highly quali� ed. I’m happy to be their patient for more than � fteen years.

“� e sta� schedules me for routine appointments. � ey trim my toenails and check the bottoms of my feet. � ey’re always checking on me.

“Let’s face it, at eighty-eight, my feet are not as good as they were when I was nineteen, but with the help of All About Feet and Legs, they’re better

now than they used to be!”FHCN article by Patti DiPanfilo. Photso by Nerissa

Johnson. Before and after images courtesy of All About

Feet & Legs mkb

ALL ABOUT FEET & LEGSROSANA RODRIGUEZ, DPM, CWS

HANY M. JEFFRY, DPM, MBBS

Summer 2019 | Palm Coast Health Care News | Page 9Podiatry/WouNd Care

SABAL PALMS ASSISTED LIVING & MEMORY CARE

Visit them online at sabalpalmsseniorliving.com

Beautiful and Tranquil

At Sabal Palms Assisted Living & Memory Care, success is measured not only by the wellness factor but by the happiness factor. The goal is to create a personal and carefree environment for all residents with service based on integrity, honesty and dignity. For more information, call or visit them in Palm Coast at:

2125 Palm Harbor Parkway

(386) 225-4070

The Best of Both WorldsPerfect home for an independent active lifestyle or those needing a little assistance

A former college lacrosse player at Rensselaer Polytechnic Institute, Ron has spent each of the last 25 years, including the past two at Matanzas, passing on his expertise in the sport of lacrosse as a vol-unteer assistant coach.

It’s one of the many activities that keep this 88-year-old former computer systems manager from feeling his age.

“Age has never bothered me,” Ron says. “A lot of that is because I take good care of myself. But I think the fact that I’m so active and I’m always busy doing something is one of the big reasons I feel as good as I do.”

In addition to his work as an assis-tant lacrosse coach, Ron is also an active member of a Palm Coast area camera club, an amateur magician and the pres-ident of the Resident Council at Sabal

Palms Assisted Living & Memory Care, where he now lives.

Ron took on that last duty not long after he moved to Sabal Palms last October. That move came at the behest of his children, who worried his active lifestyle was making it hard for him to keep his two-story home in order.

“The house was getting to be too much for me,” Ron explains. “So, my daughter started looking for a place and found Sabal Palms. We both checked it out and agreed it was the right place for me.”

Five Levels of Care Sabal Palms Assisted Living & Memory Care is a senior living community. It offers studio, one- and two-bedroom suites and � ve levels of customized care as well as specialized care for those residing in its secured memory care community referred to as “Journeys”.

� e care levels begin with minimal assistance, such as medication manage-ment, transportation and housekeeping and move up to include incontinence care and shower assistance. � e commu-nity also has a complete � tness room with exercise equipment, a piano lounge, wine bar, game room and more.

Yoga, cooking, painting and music classes are among the vast array of daily activities open to all residents, who are also treated to a movie each night in the

community’s theater, where popcorn is always served.

� e use of the � tness room was instrumental in helping Ron get back on his feet. When he � rst arrived, he was coming off a month-long hospital stay due to a bout with pneumonia and needed to get himself back in shape for lacrosse season.

“I was actually in a wheelchair when I first got here, but I got rid of that pretty quickly after I started doing physical therapy there,” he says. “Now, I’m back driving again and doing all the things I like to do.”

Ron, who has been performing magic since he was in college, says he plans to put on a magic show for the residents at Sabal Palms later on this year. It’s one of the ways he intends to show his appre-ciation for all that’s done for him there.

“It’s really a great lifestyle,” he says. “I don’t have to worry about laun-dry or cleaning or cooking. All that is taken care of for me, and the food is great. I really like it here, and I can come and go as I please and do all the things I like to do.

“I go out and take pictures; I coach; I do my magic. It’s a great situation for me, and the care here is exceptional. Everyone is very friendly and helpful. Like I said, I really like it here. It’s home now.”FHCN article by Roy Cummings. Photo by Nerissa Johnson. mkb

The Matanzas High School lacrosse team compiled a respectable 9-7 record before bow-

ing out of the state playo� s after one game this past spring. The Pirates’ season might not have been as successful as it was were it not for Ron Coyle.

Ron Coyle

John W. Thousand IV, DDS, MSD, earned his bachelor’s degree in Molecular, Cellular and Developmental Biology from the University of Colorado, Boulder and his graduate dental degree from the Anschutz Medical Campus, School of Dental Medicine. Dr. Thousand completed his specialty training in periodontics at the University of Colorado School of Dental Medicine, where he received a Master’s degree in Periodontology. As a resident, he conducted research studying the eff ects of bone grafting materials on the sinus fl oor topography as well as the eff ect of various cementing techniques on residual cement around implant restorations.

Robert R. Thousand, Jr., DDS, graduated from Central Missouri State University with a bachelor’s degree in Biochemistry and additional minors in both physics and math. Directly after college, Dr. Thousand and his brother Dr. Dennis Thousand served in the United States Army as drill sergeants during the Vietnam War. While serving in the Army, Dr. Robert Thousand attended dental school at the University of Missouri in Kansas City with a full scholarship. He graduated with honors from the oral surgical department and cultivated an interest in the surgical aspects of dentistry.

JOHN W. THOUSAND IV, DDS, MSDROBERT R. THOUSAND, JR., DDS

Visit them on the web at www.dsnfperio.com

Excellent, Compassionate

Dental CareAt Dental Specialists of North Florida, the staff combines their dental expertise with compassion and integrity to create beautiful smiles and help patients maintain excellent oral health. To learn more about their mission or to schedule an appointment, call or visit one of their two office locations.

Palm Coast Cypress Branch Way

Suite (386) 313-8644St. Augustine

St. Johns Medical Park DriveSuite C(904) 794-1000

Dr. Carolyn Landolfo

F or as long as she can remem-ber, Carolyn Landolfo has had problems with her teeth. As a child, she fought a constant

battle with decay. During her teenage years, overcrowding became an issue. In time, so did gum recession.

� e latter two issues followed Carolyn into adulthood, where the 56-year-old cardiologist eventually began a new bat-tle with decay, largely as a result of her gums receding to a point where they left the roots of her teeth exposed.

“I had what I would describe as dis-� guring gum recession because the color of the teeth above the normal gumline was darker than the rest of the teeth and so, in terms of my smile, I was always very self-conscious about the way I looked,” Carolyn reveals.

She was also concerned because the root of a tooth is more susceptible to decay than the crown, which is not

covered with enamel. Without enamel the protective dentin can literally be brushed away with normal brushing.

Carolyn was plagued by all of those issues for years. It wasn’t until a friend told her of a new area periodontist – John � ousand IV, DDS, of Dental Specialists of North Florida – that she found a solu-tion to her problem.

Immediate Eff ect“� e technique I use is called tunneling,” Dr. � ousand says. “It’s a painless grafting procedure in which we tunnel underneath

the gums and slide graft material in there that thickens the gums.

“When you pull the gums back down, the roots are no longer exposed, and the e� ect is immediate. When the patient goes home, they can look in the mirror and see immediately that their gums are back to where they should be.”

That is precisely the effect the procedure had on Carolyn. After being fitted with braces to correct the overcrowding, she now has a smile she’s proud of, one she says she prob-ably would not have had she not met Dr. Thousand.

“My gums look so much better now, and I haven’t had a cavity since I had the gum procedure,” she says. “To me, that was the most important part of my restoration, even bigger than the bite correction and the braces.

“It’s made a huge di� erence, and it wasn’t until I found Dr. � ousand that I even learned of this procedure. No other dentist I’d been to ever suggested any-thing like it, so I was very fortunate to have found him.

“He’s an exceptional dentist. He’s very careful and meticulous, and his level of expertise and enthusiasm for want-ing the best outcome is really unique. I’ve already referred several friends and associates to him because I think so highly of him.”FHCN article by Roy Cummings. Photo by Nerissa Johnson. mkb

Recession Correction“Tunneling” technique improves smile, oral health

Page 10 | Palm Coast Health Care News | Summer 2019 aSSiSted liviNg aNd memory Care

PeriodoNtiCS aNd imPlaNt deNtiStry

Jayraj J. Patel, DMD, has been practicing general dentistry in the Central Florida region since graduating from the University of Florida College of Dentistry. His goal is to deliver comprehensive, compassionate care to his patients in a caring, comfortable and professional environment. He and

his team at Palm Coast Family Dentistry strive to provide advanced, personalized and complete care to each patient using the latest dental technologies and treatment modal-ities, with an aim to build a long-term relationship based on trust, respect and friendship. Dr. Patel has extensive training in dental implant ther-apy through comprehensive courses such as the AAID MaxiCourse® from Augusta University and the Comprehensive Implant Continuum from Implant Educators™. He is a Fellow of the International Congress of Oral Implantologists and an Associate Fellow of the American Academy of Implant Dentistry and is currently pursuing his Fellowship in the Academy of General Dentistry.

Modern Dentistry, Personalized Care

Palm Coast Family Dentistry specializes in family, implant and cosmetic dentistry for all ages. The practice is focused on creating healthy smiles in a stress-free, caring environment. For more information or to schedule an appointment, call or visit the offi ce in Palm Coast at:

50 Cypress Point Parkway

(386) 445-0977

JAYRAJ J. PATEL, DMD

Serving All Your Dental Needs

At Palm Coast Family Dentistry, the goal is to provide the best care possible in an environment in which patients have the opportunity to communicate with the entire dental team regarding their oral health. Their services include:

¡ General Dentistry ¡ CEREC® (same-day porcelain

crowns and fi llings) ¡ Cosmetic Dentistry ¡ Invisalign® (clear braces) ¡ Implant Dentistry ¡ Pinhole Gum Rejuvenation® ¡ Sedation Dentistry ¡ Platelet-Rich-Fibrin Therapy

T ucked away deep inside its state’s southern pocket, Beckley, West Virginia sits just a tad north of the Virginia border in the heart of coal-mining country. For as long as Henry*

can remember, his father worked that town’s coal mines.

“He was a mine superintendent there, and after I got out of high school, I worked there for � ve or six years, too,” Henry says. “I wasn’t actually in the mines, though. I would have to go in from time to time, but I mostly worked various jobs outside the mines.”

Henry worked those various jobs until he got out of college and became a teacher. After � ve or six years of teaching, his career as an educator took a turn that, much like his career in the coal-mining industry, left him on the outside looking in.

“I really liked teaching, but I found out there wasn’t a whole lot of money in it, so I eventually started working for a company selling textbooks to schools,” he says. “I did that for probably twenty years. It was an interesting job. I liked it a lot.”

One of the things Henry liked about that job was that it brought him to Florida. His initial stay in the Sunshine State was brief, but when Henry and his wife, Irene*, retired seven years ago, they returned to Florida and made Palm Coast their new home.

In the course of settling into retirement, Henry and Irene began looking for a new dentist. � ey eventually settled on Jayraj J. Patel, DMD, the owner of Palm Coast Family Dentistry. � e couple has been seeing Dr. Patel regularly ever since.

“I started out seeing Dr. Patel for cleanings and � llings, routine stu� like that, but during his � rst exam-ination of me, he told me there were some problems with some teeth that were going to have to come out or they’d start giving me trouble,” Henry says.

Triple Trouble � e news didn’t come as a shock to Henry. His previous dentist had told him the same thing regarding two teeth – the lateral incisor and the eye tooth – in the upper left side of his jaw. Henry was also missing the � rst premolar on the upper left side.

“All the teeth were in a row, and they all fell in his smile zone, meaning you can see them when he smiles,” Dr. Patel informs. “The problem was the two that remained were going bad because of poor periodontal health and had to come out.

“They didn’t have to come out immediately. In fact, we � rst did the cleanings to get Henry’s periodon-tal health back in order. But I told him that this was a

Dr. Patel seeks to build long-term relationships with all his patients based on trust, respect and friendship.

Visit them on the web at palmcoastfamilydentist.com

situation where it would be best to take them out and replace them before they became a problem.”

In addition to the two failing teeth on the upper left, Henry also had a problem in his lower left arch, where he had previously lost a back molar and was using a wisdom tooth to chew his food. Mostly, though, he was chewing on the right side of his mouth.

“� at’s a situation that’s not good for long-term suc-cess either because if you chew on just one side, those teeth are eventually going to fail and then you’ll need treatment for those teeth, too,” Dr. Patel informs.

“� e other issue there is that the bite is no longer balanced, and that imbalance can negatively a� ect the jaw joint. So, this was another problem where it was in Henry’s best interest to have the issue taken care of sooner rather than later.”

Cognizant of the potential for future problems, Henry agreed that the time had come to correct the � aws in his smile and function. He also agreed with Dr. Patel’s suggestion that dental implants would provide the best solution for both issues.

Dental implants are titanium, root-shaped bodies that are surgically placed into the jawbone. � e implant supports an abutment and a crown, which is cemented to or screwed into the abutment, creating a new tooth.

Once they have been placed in the jaw, the bone grows around the implant creating a solid foundation for replacement teeth, which can be a crown for a single tooth or a bridge, partial or full denture when replacing multiple teeth.

In Henry’s case, Dr. Patel extracted the two fail-ing teeth on Henry’s upper arch, then � t him with two implants. � ose implants became the foundation for a three-tooth bridge. He later � t Henry with a single implant that served as the base for a new lower left molar.

In both cases, Dr. Patel pretreated the area where the implants were eventually placed by performing

a bone-grafting procedure. The bone graft builds up the jawbone and creates a more stable foundation for the implant.

An “Amazing” Process � e work on Henry’s upper arch began in October 2017. After a brief period, during which he wore a temporary bridge, Henry was � t with his permanent bridge in March 2018. By May, Henry also had a new, implant-supported molar on his lower arch.

“� e process is really quite amazing, and I couldn’t be happier with the outcome,” Henry says. “I literally cannot tell the di� erence between the teeth Dr. Patel put in for me and my real teeth. It’s something I will de� nitely do again if the need ever arises.

“And I would definitely want Dr. Patel to do the work. My wife and I have grown pretty fond of him. He’s very down-to-earth and very personable. With a lot of dentists, you’re kind of in and out. That’s not the case with Dr. Patel. He really gets to know you, and we like that.”

Dr. Patel got to know Irene as well as he got to know Henry after she, too, became a patient of his. He has worked to maintain her good periodontal health, restored a few broken or failing teeth and performed general maintenance on some others.

“Henry and Irene have both been with me since December 2016, and they are emblematic of what we do for our patients here,” Dr. Patel says. “First of all, we are a very family-oriented practice. We want to treat the entire family, and we treat patients like family.”

“� e other thing is that we are a comprehensive dental practice. Not only do we perform general mainte-nance to help you maintain good periodontal health, but we also do � llings and crowns, and we have the equip-ment here to do same-day crowns.”

“We also have the ability to do more involved work such as what we did with Henry. We’re a one-stop shop, and that’s important because it means fewer visits to the dentist. And we always strive to make sure your visits here are a pleasant ride.”FHCN article by Roy Cummings. Photo by Nerissa Johnson. mkb

*Patient’s names withheld at their request.

One for All Complete dental care available in this patient-centered o� ce

Summer 2019 | Palm Coast Health Care News | Page 11reStorative, imPlaNt aNd CoSmetiC deNtiStry

John Ligeon, MD, is board certifi ed in internal medicine and is a 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 . A diplomate in internal medicine, he has practiced in inpatient hospital medicine, as well as in outpa-tient primary care, for the past 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 certifi ed in pathology, laboratory medicine, and informatics. He earned his medical degree from the University of Miami Medical School in and became board certifi ed in medicine soon there-after. 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.

JOHN LIGEON, MDSCOTT HOLLINGTON, MD

The New WaveThe physicians at Alpha Medical Group’s goal is to find 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.

Palm Coast515 Palm Coast Pkwy. SW

Suite 5

(386) 276-3075Leesburg

4120 Corley Island Rd.Suite 500

(352) 816-1901Jacksonville

6817 Southpoint Pkwy.Suite 503

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

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.

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 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.”

penis but stimulate the nerve endings to enhance sensitivity and enhance the feel-ing of an orgasm.

“� e treatment is based on the same technology that’s used to break up gall-stones,” says Scott Hollington, MD, at Alpha Medical Group. “� e device trans-mits acoustical waves that break up the plaque and calcium that have built up inside the penis’ blood vessels.

“It works like a little jackhammer. Once that plaque and calcium are 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 flow through existing blood vessels, 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

Remarkable ResultsESWT calls for patients to receive two treatments per week for three 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 ESWT experience a reversal of their con-dition, 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 virtually painless. A few min-utes 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 ESWT for anyone who has a problem with ED.”FHCN article by Roy Cummings. mkb

*Patient’s name withheld at his request.

Acoustic Pressure Wave Technology � e practice Tom found is Alpha Medical Group. With offices in Palm Coast, Leesburg and Jacksonville, it specializes in the administration of ESWT, or APWT which treats erectile dysfunction through the use of acoustical wave therapy.

Using a small, handheld device, the acoustical waves are delivered through a series of short, virtually painless pulsations that not only open the blood vessels in the

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 vessels and break down the scar tissue that may be causing that irregular shape,” Dr. Hollington informs.

ESWT treatments only take about 10 to 15 minutes to complete, but prior to providing any such treatment, Dr. Hollington begins his care for patients 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 reevaluate the blood vessels after completion of the treatment .”

“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 erec-tile dysfunction, which is typically the result of circulatory impairment in the blood capillaries 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

“I just turned seventy a couple months ago, and in the bedroom,

I feel like I’m half that age.It’s really remarkable

what this ESWT does for you.”

- Tom

Page 12 | Palm Coast Health Care News | Summer 2019 ereCtile dySFuNCtioN