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Without the cramping and pain in their legs,Cli� and Rhonda are enjoying boating more

JOSEPH G. MAGNANT, MD, FACS, RPVI

Thirty-four years as a career � re� ghter wasn’t enough for Cliff Linzalone.

Although he “retired” two years ago, he continues to volunteer with

a company in nearby Alva. He’s also a member of a regional search and rescue team.

As for Cli� ’s wife, Rhonda, she works in the cafeteria of a local school, where she spends a lot of time on her feet. At one point, she began experiencing uncomfortable issues with her legs. She also had several unsightly varicose veins that annoyed her.

“A few years back, I had swelling, achiness and heaviness in my legs,” she describes. “I was also having leg cramps, and I would get restless legs at night that kept me awake. I had some trouble walking because my legs would cramp up and hurt, and then they would swell. I also had big, green veins on my legs.”

For yea r s , Rhonda s imp ly “tolerated” the issues with her legs, but she recently decided to get rid of the ugly veins. A coworker recommended Joseph G. Magnant, MD, a board-cer t i f ied vascular surgeon who specializes in treating vein disorders.

Dr. Magnant’s practice, Vein Specialists, is dedicated to the modern eval-uation and minimally invasive treatment of leg vein disorders. Vein Specialists has o� ces in Fort Myers and Bonita Springs.

W h e n R h o n d a m e t w i t h Dr. Magnant, she learned he could treat her varicose veins as well as her other leg issues. He told her all of her symptoms were caused by a disorder a� ecting her veins called venous insu� ciency.

Veins are the blood vessels that return deoxygenated blood to the heart

and lungs. Inside the veins are one-way valves that assist blood flow against gravity. Venous insufficiency occurs when these valves fail, creating pressure that builds up in the veins. � is leads to signs and symptoms such as varicose veins, swelling, heaviness, achiness or cramping, discoloration, restless legs and frequent nighttime urination.

After an ultrasound evaluation, Dr. Magnant confirmed that Rhonda had venous insu� ciency in both legs. He recommended a treatment called endo-venous ablation, a minimally invasive procedure that uses radiofrequency energy to close leaking veins and reroute the blood through healthy veins.

Following the procedure, Rhonda’s symptoms improved tremendously, but she continued to follow up with Dr. Magnant to have several small spi-der veins treated. At one follow-up appointment, she brought Cli� with her.

Secondary InjuryDuring one of Rhonda’s procedure appointments, Dr. Magnant came out to the waiting room to speak with Rhonda’s husband Cliff and noticed his swollen, disfigured and discolored right leg and ankle. He asked Cli� about it, and Cli� explained that he had been in a motorcy-cle accident ten years earlier, and nearly

had his right foot severed o� as a result of a badly injured ankle. Despite receiving appropriate limb-saving treatment from an orthopedic surgeon, the ankle had been swollen and painful ever since.

“My foot was ninety percent severed in the accident, and I eventually had eight di� erent operations to save it,” Cli� clar-i� es. “After that, my ankle blew up to twice its normal size. It was always swell-ing and hurting. My leg from the knee down looked like a diabetic’s leg; it was really discolored.

“I lived with it every day and did what I had to do because I was a � re� ghter, but I did it with a lot of pain. Every time I went to the orthopedist, he told me it was all because of the trauma. He said the ankle wasn’t getting the right blood � ow because of the injury.”

When Cliff accompanied Rhonda to her appointment at Vein Specialists, he wore shorts, which made his swollen, discolored leg visible. When Dr. Magnant looked over from Rhonda and saw it, he knew he had to speak with him.

“Cli� was willing to proceed with an evaluation, and our venous ultrasound revealed he had significant, treatable venous insu� ciency,” shares Dr. Magnant. “His problem was pretty straightforward. I performed an endovenous ablation with a ClosureFast™ catheter (radiofrequency), just like I did for Rhonda.”

Orthovenous Disease“� e symptoms of venous insu� ciency and orthopedic disease are different,” explains Dr. Magnant. “Orthopedic dis-ease, whether it’s in the ankle, knee or hip, is usually worse after prolonged periods of immobility, such as riding in a car, sitting in a chair or sleeping. When you stand up, there’s a sti� ness that generally works its way out a little bit as you walk. However, by walking, you put stress on the joint, so eventually, it’s going to hurt more.

“Venous disease is generally better after sleeping or elevating the legs for a period of time, and gradually gets worse with sitting or standing and as the day

Psychiatric Associates of Southwest Florida

Defeating Depression

Advanced Dentistry of Fort Myers

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Weight & Wellness

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Advanced Orthopedic CenterOn the Road Again

Vascular surgery

Buon Appetito!Customized weight-loss program improves health, vitality

A trip to the Cape Coral area isn’t complete without a visit to Miceli’s waterfront Italian restaurant, where the Pasta

Ala Miceli is one of the best options on a menu the Miceli family has been honing since it opened its � rst eatery some 20 years ago.

“It’s a bounty of fresh, local sea-food – clams, shrimp and calamari,” says Vincenzo Miceli, who opened this par-ticular restaurant ten years ago. “You can even get it with Fra diavolo, which is a spicy red sauce. � at’s how I like it. It’s our signature pasta dish.”

A restaurant owner since he left college, 38-year-old Vincenzo says he makes a point of tasting every dish made in his kitchen each day. Some would consider that one of the perks of the job, but Vincenzo learned a few years ago that it has some drawbacks.

“I had some pictures taken pro-fessionally of me and my family at my restaurant, and I was very dissatisfied with the way I looked in them,” Vincenzo reveals. “I could see I was overweight, and that got me very concerned.”

Vincenzo had good reason to be concerned. At the time the pictures were taken, he weighed more than 320 pounds and was experiencing pain and tingling in his legs, symptoms he suspected were a result of his excess weight.

� e son of a man who had a heart attack at the age of 39 and the father of two young daughters, Vincenzo also worried his excess weight was putting him at greater risk for a heart attack or stroke that would forever alter his life and/or that of his family.

It was those concerns that prompted Vincenzo to visit a doctor. His choice of physician was Keith Susko, MD, who spe-cializes in pain management at Pain Relief & Physical Rehab in Fort Myers.

Vincenzo’s choice was fortuitous because Dr. Susko also specializes in obe-sity medicine. Following a nerve study of Vincenzo’s legs, Dr. Susko con� rmed Vincenzo’s belief that his weight was causing his leg pain and recommended he begin a diet plan.

An Ideal Fit The plan Dr. Susko endorses is Ideal Protein®. It is a four-phase, ketogenic, medical ly developed weight-loss and lifestyle protocol that helps

participants lose excess body fat and effectively improve their health and wellness while increasing vitality.

“Ideal Protein is such a complete and effective nutrition program that it has actually helped some patients reduce blood pressure, cholesterol or diabetes medications they need to take,” Dr. Susko explains.

“Some of those patients have been able to get o� their medications entirely by sticking to this program, which helps them maintain their fat loss because it changes their eating habits and the way they look at food.”

In addition to improving blood sugar and cholesterol levels and reducing blood pressure, Ideal Protein also helps participants foster better appetite control and develop and maintain eating habits that become second nature to them.

Those goals are achieved through customized meal plans that help to burn stored fat and preserve lean muscle by emphasizing high-quality proteins that are easily absorbed and by limiting the amount of sugars and dietary fats that are taken in.

“Another thing I like about the pro-gram is that it acts as a natural appetite suppressant by increasing the fat-burning mechanism of the body, which suppresses the craving for additional carbohydrates,” Dr. Susko adds.

“� at’s why it’s so easy for partici-pants to stay on the program, because they’re not craving food and feeling hun-gry the way you do when you’re on a regular, high-carbohydrate diet.”

Adapted from a � tness and nutri-tion program designed for Olympic athletes, Ideal Protein also helps partic-ipants preserve and sometimes increase muscle mass, which further fuels weight loss and helps to build added strength.

“Ideal Protein burns fat while pre-serving muscle mass, which is what you need to stay healthy and maintain a high metabolic rate, which is the rate of energy the body needs to function prop-erly,” Dr. Susko informs.

Because the program removes most of the dairy, grains and a lot of fruits from their diet, Ideal Protein participants need

to take a multivitamin as well as potas-sium, � sh oil and calcium supplements to ensure they receive an adequate amount of minerals each day.

“I highly recom-mend the supplements, but the advantage you get from eliminating a lot of the dairy and grains from your diet is that you’re also elimi-nating some of the most inflammatory foods

people tend to eat,” Dr. Susko educates.“I run a medical practice where I treat

a lot of pain, and I’ve noticed that when I get patients to use the Ideal Protein pro-gram, their pain levels drop because they’ve reduced the systemic in� ammation caused by some of the foods they’ve eliminated.

“Another advantage is that Ideal Protein helps patients decrease their gastroesophageal re� ux and any med-ications they may be taking for that. It can also help with snoring or sleep apnea problems.

“That’s partly because fat loss in general helps with those things, but we notice that happens very quickly with people on the Ideal Protein pro-gram. In fact, within a week or two of starting the program, we start seeing all of these benefits.”

Participants in the Ideal Protein Protocol are also encouraged to exercise regularly. To aid them in that endeavor, participants are given access to � tness videos showing them a variety of exer-cises that can be done to help them burn more calories.

“It’s always helpful to exercise when you’re in any type of diet program and that includes Ideal Protein,” Dr. Susko explains. “But I started o� ering the Ideal Protein program because I had so many patients who simply could not exercise because they were in too much pain.

“I was looking for a way to help them lose weight because people tend to get heavier due to a lack of exercise. � e beauty of Ideal Protein is that, if you can exercise you’ll get better results; but if you can’t, it is still a medically sound way to control your weight.

Life-Changing Results Vincenzo is proof of that. Because of his work schedule, he is one who sim-ply doesn’t have much time to exercise. Still, he has lost more than 100 pounds since he began the program a few years ago. And he’s done that without having to change his work habits.

“Ideal Protein worked for me because it teaches you how to eat right and what to eat to keep your body burning fat,” Vincenzo says. “It gives you the tools to succeed that all the other diet plans I’d tried over the years never did.

“And believe me, I tried a lot of other diet plans. But this was by far the most bene� cial because it taught me portion control, which was my biggest problem. It also taught me about the right types of food to eat and when to eat.

“And one of the best things is that I was able to stay on this diet and still be productive at my restaurant, where I need to do a lot of taste testing and am always creating new things. All I had to do was stick to the guidelines of the program, and it worked.

“� at’s why I owe a debt of gratitude to Dr. Susko. He was instrumental in changing my life because when I started this program, all I saw in my daughters’ eyes was love and when I looked in the mirror, all I saw in my own eyes was pain.

“I wanted them to see love in my eyes, too. I committed to losing the weight not only for myself but also for my daughters. � ey’re just eight and ten now, and I need to be around for them, and this is going to help me do that.”FHCN article by Roy Cummings. Before and after images

courtesy of Vincenzo Miceli. mkb

Vincenzo Miceli

BEFORE AFTER

IDEAL WEIGHT & WELLNESSKEITH SUSKO, MD

Live a Better

LifeThe experienced staff at Ideal Weight & Wellness specializes in medically supervised weight loss as well as rehabilitation and restoration of function. For more information on how they can help you, call or visit their offi ce in Fort Myers at:

4977 Royal Gulf Circle

(239) 226-0077

Keith Susko, MD, is a board- certified physical medicine and rehabilitation specialist who is also trained in obesity medicine. He received his medical degree from Eastern Virginia Medical School in and later completed his internship and residency at

the same school. He has been in practice for more than years and is one of seven doctors at Cape Coral Hospital and one of ten at Gulf Coast Medical Center who specialize in phys-ical medicine and rehabilitation.

ON THE ROAD AGAINUnique shoulder surgery serves dual purpose

with the very tip of my left shoul-der and the left side of my head. My head was actually okay, but my shoulder was not.”

The problem with Ray’s shoulder prompted a trip to the emergency room, where x-rays revealed Ray had broken his clavicle into four separate parts that were posi-tioned in a way that would not make for an easy repair.

“One of the x-ray techs told me it was one of the ten worst clavicle breaks he’d ever seen, which I really didn’t want to hear,” Ray says. “� ey then recommended I go to Advanced Orthopedic Center to see about getting it � xed.

“Now this was two days before Christmas, so I wasn’t really sure what was going to happen, but they were able to get me in right after Christmas, and when they looked at my shoulder, they said, Yep, you’re going to need surgery.”

One for TwoThe doctor who examined Ray is Jason Mlnarik, DO, a board-certi� ed orthopedic surgeon who specializes in treating traumatic injuries. He discov-ered that Ray had suffered two such injuries during his fall.

“He had a bad clavicle, or collarbone, fracture at the very end of the clavicle, where it meets the shoulder blade,” Dr. Mlnarik reports. “He also had an AC separation, which means the collarbone was separated from the shoulder blade.

“� at’s the same kind of injury that a football player getting slammed to the ground or a hockey player getting slammed into the boards often gets, and it

causes the collarbone to spring up and the ligaments around the collarbone to tear.

“Most of the patients I see have suf-fered one or the other of those injuries. It’s rare that someone has su� ered both, but that’s what had happened with Ray, so his case was a little unique, and the repair work had to be a bit unique as well.”

To r e p a i r R a y ’s s h o u l d e r, Dr. Mlnarik inserted a plate that spanned the collarbone and pushed it back down into its proper position. In addition to holding the collarbone in place, the plate also allowed Ray’s torn shoulder ligaments to heal.

The plate Dr. Mlnarik used is designed primarily for use in repairing AC joint sprains, but in Ray’s case, it served the dual purpose of holding his collarbone in place so that it would heal while also allowing the ligaments to heal and reat-tach to the bone.

“� e kind of clavicle fracture that Ray had is typically not operative,” Dr. Mlnarik educates. “But by using this very atypical procedure, we were able to treat Ray’s entire shoulder area and get it to heal, all with one surgery.

“And that’s important, especially for someone who is active like Ray. For active patients with these ligament injuries, this surgery is a good option because it allows us to restore the actual architecture so that the patient is not limited after everything heals up.”

KENNETH D. LEVY, MDRONALD M. CONSTINE, MD

DALE A. GREENBERG, MDNICHOLAS J. CONNORS, MD

ROBERT P. STCHUR, MDGREGORY P. GEBAUER, MD

JASON E. REISS, DOSTEVEN R. ANTHONY, DO

LEE M. JAMES, DOJASON M. MLNARIK, DO

Advanced Orthopedic CenterREPAIR RESTORE RECOVERY

“No Limitations”� e plate Dr. Mlnarik used in the surgery had to be removed four months later, so Ray did eventually undergo a second sur-gery. But by repairing both injuries with one procedure, Dr. Mlnarik allowed Ray to regain normal use of his shoulder.

“� ey told me right up front that the plate would have to come out, so I knew that was going to happen, which was � ne,” Ray says. “In between those two surgeries, they did check-ups and x-rays to make sure everything was heal-ing right, and it was.

“ I have full range of motion again and no limitations with my shoulder, so we’re back on the road again, heading back up the East Coast to visit my daugh-ter in Maine, with a few stops in between for sightseeing and museums.

“I might not be doing that were it not for Dr. Mlnarik, so I’m really apprecia-tive of all the great work he did. I’m even back riding my bike again and being a bit more careful, but I know exactly where to go if something happens – Advanced Orthopedic Center.” FHCN article by Roy Cummings. Photos by Jordan Pysz. nj.

Ray is back on the road again following shoulder surgery.

The � rst thing Ray Hanson and his wife did after Ray retired last year was hop into their 33-foot motorhome and head west from

their home state of Maine on a four-month, cross-country sojourn to Alaska.

� at four-month road trip literally changed their lives.

“� e whole time we were on the road, we were always wondering what was going on with the house,” Ray explains. “When we got back, the house was � ne. But it was right about then that we decided to sell the house and just live in the motorhome.

“And we love it. We set our own sched-ule, we travel about visiting lots of national parks, and because I love history and my wife likes mansions, we visit a lot of places that allow us to satisfy those interests.”

With daughters in Maine, New York and Florida and other relatives in Arizona, Ray and his wife have several places where they can park and get o� the road for a while. It was during one such respite last winter that Ray literally ran into trouble while on the road.

“We came down to Florida to visit our daughter for the Christmas holiday, and a couple days before Christmas, I went out for a bike ride, which is some-thing I often do just to stay physically � t,” Ray states.

“While I was riding, I got to a spot where a car was parked across the side-walk. In the process of going around the car and coming back up on the sidewalk, my front wheel hit a ridge or something, and I ended up doing a face and shoulder plant into the sidewalk.

“When I got up, some people there asked me if I was okay. I said, No, I don’t think I am, because I’d hit the sidewalk

Jason M. Mlnarik, DO, is a board-certified orthope-dic surgeon specializing in traumatic injuries and other orthopedic-related problems. Dr. Mlnarik earned his med-ical degree at the University of Health Sciences College of Osteopathic Medicine in

Kansas City. He served his fellowship in ortho-pedic traumatology at Grant Medical Center in Columbus, Ohio. Dr. Mlnarik is a member of the American Academy of Osteopathic Surgeons and the American Osteopathic Association. He is a former member of the Trauma Commission and the Trauma Morbidity and Mortality Committee in Kansas City, where he practiced as a trauma surgeon for ten years.

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

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

or call one of their offi ces.

Port Charlotte 1641 Tamiami Trail, Suite 1

(941) 629-6262

Punta Gorda350 Mary St., Suite F

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

Give Them a Call!

• Pain with motion• Pain that fl ares up with

vigorous activity• Tenderness when pressure is

applied to the joint• Diffi culty walking

• Joint swelling, warmth and redness

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

Serving patients in the southwest Florida area since 1980, our top-notch surgeons o� er comprehensive orthopedic care to all ages. Our courteous and caring sta� is ready to assist and ensure your satisfaction.

Our Specialties Include:• Spine surgery• Sports medicine• Total and partial joint replacement• Foot and ankle care• Hand care• Upper extremity fracture care• General orthopedics• Interventional pain management• Trauma surgery

Welcome to Advanced Orthopedic Center

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

Ray Hanson

Page 2 | Florida Health Care News | Fall 2019 | Lee County Edition Lee County Edition | Fall 2019 | Florida Health Care News | Page 3Weight loss and Wellness orthopedic surgery and sports Medicine

The dawn of antidepressants began rather by accident in 1958 when a team of researchers treating patients for tuberculosis discovered their patients became almost euphoric when

given a drug called isoniazid.Since then, more than two dozen drugs have been

designed speci� cally for the treatment of major depres-sion, which now ranks as the most common mental illness throughout the world, according to the World Health Organization (WHO).

More than 350 million people su� ered some sort of depressive episode last year, according to the WHO, which notes that in the United States alone, approxi-mately 16 million people experience at least one episode of major depression each year.

� e e� ects, of course, can range from mild mel-ancholy to debilitating, and for many of those who struggle with major depression, the standard treat-ments such as antidepressant medications and talk therapy simply don’t work.

For those who have sought relief from depression but not found it through those standard practices, there is new hope, and it can be found in the o� ces of Robert Pollack, MD, at Psychiatric Associates of Southwest Florida.

Something NewAt his Fort Myers-based practice, Dr. Pollack embraces the use of many emerging therapies based on pioneering discoveries about the brain in his treatment of depres-sion, which he emphasizes is an actual illness.

“Depression is a brain disease,’’ Dr. Pollack reiterates. “It’s not an adjustment disorder. It’s not somebody who’s feeling sad. In the same way that cancer and diabetes are illnesses, depression is an illness, and it’s treatable with a multitude of therapies.”

� ose therapies include genomic testing, which can determine which antidepressant will work best for a patient, and intravenous infusions of an anesthetic agent called ketamine that can alleviate suicidal thoughts and acts more quickly than many antidepressants.

Dr. Pollack is one of an ever-growing number of mental health professionals who have begun offer-ing treatment for major depression through the use of transcranial magnetic stimulation (TMS) and theta-burst stimulation (TBS).

Discovered by a team of researchers at the Medical University of South Carolina in the 1980s, TMS uses short 10Hz magnetic pulses while TBS uses 50Hz pulses to rouse the part of the brain that is underactive in people who su� er with depression.

� ese magnetic pulses are similar to those used in MRI stimulation, and are delivered through a paddle-shaped device with a magnetic coil that is placed on the prefrontal cortex while the patient rests in a comfortable chair similar to a dentist’s chair.

Visit Psychiatric Associates of Southwest Florida online at www.pasw� .com

Leading-Edge Treatments in Caring

PracticePsychiatric Associates of Southwest Florida is committed to care in a compassionate environment that respects patients’ humanity. The staff utilizes the most up-to-date science, providing hope and healing for conditions such as treatment-resistant depression and post-traumatic stress disorder. Therapies include ketamine, TMS and TBS. If you’re suff ering from depression or another disorder that is making it diffi cult to enjoy life or to function, contact the center to discuss how you may be helped. The offi ce is in Fort Myers at:

6804 Porto Fino Circle Suite 1

(239) 332-4700

PSYCHIATRIC ASSOCIATES

OF SOUTHWEST FLORIDA

ROBERT POLLACK, MD

Approved by the US Food and Drug Administration in 2008 for people with treatment-resistant depression and those who can’t tolerate the side e� ects of antidepressants, TMS can also be used to treat a host of issues such as chronic pain, � bromyalgia and bipolar disorder.

� e biggest di� erence between the noninvasive TMS and TBS treatments, the latter of which gained FDA approval in 2018, is the amount of time required for each treatment session and the number of sessions prescribed during a typical treatment period.

TMS treatment sessions last approximately 19 min-utes each, and a typical TMS treatment protocol calls for patients to receive a total of 36 treatments over a period of six to eight weeks.

TBS treatment sessions last only three minutes and are typically administered once a day at 120-percent of motor threshold, which is the stimulation strength at which a minimal motor response is evoked.

“Put simply, motor threshold is the amount of energy required to apply a current to the left temporal area that results in your right thumb wiggling involuntarily,” Dr. Pollack educates. “When we see that wiggle, we know we’ve hit the right spot.”

TBS treatments were originally administered twice a day for ten days at 80-percent motor threshold, but Dr. Pollack says it was recently discovered that fewer treatments at the higher threshold worked better.

“With the advent of more and more people receiving these treatments, it was determined that one hundred twenty percent of motor threshold is more e� ective, and I have found that to be accurate,” he states.

“We recently had a patient who received ten treatments at one-hundred-twenty percent of motor threshold, and his mental health score went from four-teen to six, with six meaning there is basically nothing wrong with you. It was amazing to watch.”

Safe and EasyEqually amazing is the overall e� ect of TMS and TBS treat-ments. Studies show that about 40 percent of patients receiving these treatments become completely asymptomatic, while about 60 percent feel better but are still not at a level where they consider themselves to be completely asymptomatic.

In addition to their e� ectiveness, TMS and TBS treatments are also safe and easy on the body. � e most common side e� ect is some mild to moderate scalp dis-comfort stemming from the treatment applications.

Dr. Pollack has found that the only trepidation some patients express about TMS therapy lies in their fear that it may be similar to electroconvulsive therapy, or ECT. Dr. Pollack assures the two therapies are quite di� erent.

For starters, TMS is done in the doctor’s o� ce while the patient is awake. ECT must be done in a hospital or surgery center because the patient must be anesthetized. � e biggest di� erence, however, is in what the two treatments deliver.

ECT causes the patient to go into a seizure. TMS, through its electromagnetic induction, avoids seizures and instead stim-ulates and exercises the part of the brain involved in mood regulation in a way that brings about positive changes.

“And when you’re done with a TMS or TBS treat-ment, you simply get up out of the chair, walk out of the o� ce and go home or back to work,’’ Dr. Pollack explains, “� at’s one of the beauties of it and why it, and some of these other treatments, are becoming so popular.

“You know, for years, � nding the right medication or treatment for someone su� ering from depression or anxiety or any mental health disorder was a lot like trying to trap a ball of mercury under your thumb.

“It was very di� cult, because it involved a lot of trial and error. But it’s a whole lot better now because of genom-ics and because of treatments such as ketamine, TMS and TBS. � ese are the tools that are allowing us to hit the nail on the head and give people the relief they need.” FHCN article by Roy Cummings. ke

“Depression is a brain disease. It’s not an adjustment disorder. It’s not somebody who’s feeling sad. In the same way that cancer and diabetes are illnesses, depression is an illness, and it’s treatable with a multitude of therapies.”

– Dr. Pollack

Robert Pollack, MD, has practiced psy-chiatry since and is the founder and CEO of Psychiatric Associates of Southwest Florida. He earned a bachelor’s degree in Biology at Yale University and a medi-cal degree at Downstate Medical Center College of Medicine in Brooklyn, NY. He then completed a residency in psychiatry at the University of Florida, where he served as chief resident and medical faculty member. Dr. Pollack is a Life Fellow of the American Psychiatric Association and board certifi ed in psychiatry by the American Board of Psychiatry and Neurology.

DEFEATINGDEPRESSION

Leading-edge magnetic pulse therapy offers relief

Smooth Out Your Problem Veins

Dr. Joseph Magnant welcomes all questions regarding this article as well as other topics

related to veins. Call or visit one of the two Vein Specialists locations:

Fort Myers Royal Palm Square Blvd.

Suite

Bonita Springs Woods Edge Circle

Suite

(239) 694-VEIN (8346)

(continued from page 1)

Take your FREE virtual vein consultation from the privacy and comfort of your own home at eveinscreening.com.

Visit Vein Specialists’ website at www.weknowveins.com as well as their screening website, eVeinscreening.com

Get started today at:

Follow them on:

Joseph G. Magnant, MD, FACS, RPVI, is a fellow of the American College of Surgeons and is board certifi ed by the American Board of Surgery in vascular surgery. He earned his medical degree from Medical College of Virginia. He completed a general surgery residency at Medical College of Virginia Hospitals and a fellowship in vascular surgery at Dartmouth-Hitchcock Medical Center, Lebanon, NH. Dr. Magnant of Vein Specialists

focuses exclusively on vein evaluation and modern treatments in a dedi-cated, outpatient, vein-centered facility. Dr. Magnant is an active member of the American College of Phlebology, Society for Vascular Surgery and Society of Vascular Ultrasound.

wears on. It’s improved by walking, elevation and compression hose.”

Dr. Magnant notes that arthritis is a common orthopedic condition that frequently a� ects the hip, knee and ankle, as well as other parts of the leg. The population most often a� ected by arthritis are those in their 40s through 80s.

attractive, it also gave him more mobility. Since his surgery, Cli� can be on his feet for hours with-out the pain and cramping that hampered him before.

“After I had the vein proce-dure, all my symptoms cleared up,” he con� rms. “Now, I can

walk most of the day without any problem. A couple of weeks after surgery, I went to Walt Disney World® and walked all over the place all day.”

Dr. Magnant stresses the importance of a venous evalua-tion for patients with orthopedic ailments because people with bone and joint disorders often have a co-existing venous disease. Rhonda agrees.

“Everybody should look into their veins as a cause of their symptoms because venous disease can cause a lot of trouble,” she suggests. “Dr. Magnant is a great doctor, and I really like him.”

SYMPTOMS (What you feel)

✓ Leg pain ✓ Achiness ✓ Nighttime cramps or

charley horses ✓ Nighttime urination ✓ Heaviness ✓ Restless legs

SIGNS (What you see)

✓ Varicose veins ✓ Spider veins ✓ Swollen legs ✓ Cankles ✓ Discolored skin ✓ Bleeding ✓ Open wound

of the discomfort is vein-related and treat it? � en, you can elim-inate the venous symptoms and improve treatment of the ortho-pedic condition.”

If venous insufficiency is detected and treated before surgery, it leads to more than

symptom relief. It results in improved wound healing, which reduces swelling postoperatively.

“Patients have better mobil-ity in the postoperative period if there’s less swelling,” notes Dr. Magnant. “� erefore, phys-ical therapy, walking, range of motion, recovery – everything that goes along with an orthope-dic intervention – are improved.

“In addition, the risk of DVT blood clots and the com-plications related to them, such as pulmonary embolism and death, is reduced.”

Enjoying Life AgainThe endovenous ablation procedures performed by Dr. Magnant improve circula-tion in the legs and eliminate symptoms. Rhonda and Cliff are delighted by the outcomes of their procedures.

“My results are great,” comments Rhonda. “Now, I can sleep through the night without any pain or discom-fort. My legs look a lot better, too. I’m happy with the way the procedure turned out.”

“My results are excellent,” agrees Cli� . “My ankle is nor-mal size now; it’s not all swollen. Everyone who sees it tells me, Your leg is skinny! � ey used to call it a cankle because it was always twice the size from the leaking and swelling.

“The blood flow is really good now, and my leg isn’t dis-colored and doesn’t look like a diabetic’s leg anymore.”

Not only did Cliff ’s pro-cedure make his leg more

“Venous disease is very com-mon in this age group, as well,” observes the doctor. “We have developed an excellent working relationship with orthopedic surgeons in Southwest Florida and are often asked to evalu-ate their total joint candidates prior to surgery. In some cases, we are asked to consult on their patients postoperatively as well to rule out deep vein thrombosis, or DVT, with ultrasound.

“Patients may be negative for DVT yet have undiagnosed venous insu� ciency as a con-tributing factor to their residual leg swelling postoperatively. Some of these patients may benefit from formal venous evaluation and minimally invasive vein treatment such as what we used with Cli� .

“Why not consider a thor-ough venous evaluation to determine whether or not some

“Absolutely, we recommendDr. Magnant and Ve in Spec i a l i s t s ,” s ay s C l i f f . “We already have.” FHCN article by Patti DiPanfilo. Photos by

Fred Bellet. nj

Cliff Linzalone

RhondaLinzalone

If you have more than one of these on each side or more than two on one side,

you should consider a vein evaluation.

SIGNS AND SYMPTOMS OF VENOUS

INSUFFICIENCY

Page 4 | Florida Health Care News | Fall 2019 | Lee County Edition Lee County Edition | Fall 2019 | Florida Health Care News | Page 5

Barry LevineExecutive Publisher

Gina L. d’AngeloCFO/HR

Roy CummingsEditorial Supervisor

Michelle BrooksCreative Director

Brian LevineProject Coordinator

Patti DiPanfiloEditorial Staff

Laura EngelProduction Assistant

Nerissa JohnsonKristy EllenbeckerGraphic Designer

Nerissa JohnsonJordan PyszPhotography

Steve TurkGary Smith

Aldy LaracuenteBob Mize

Distribution

Shyan Blaze ClarkIntern

Vein Specialists Vascular Surgery

Ideal Weight & WellnessWeight Loss and Wellness

Advanced Orthopedic CenterOrthopedic Surgery and

Sports Medicine

Psychiatric Associates of Southwest Florida

Depression

Advanced Dentistry of Fort Myers

Comprehensive Dentistry

Riverside Recovery of TampaAddiction Treatment

Acute Wound CareCompression Therapy

South Florida Eye ClinicOphthalmology

Gulf Coast AudiologyHearing Care

Hal L. Bozof, DPMPodiatry

Bell Tower Dental CareImplant, Restorative and

Family Dentistry

215 Bullard ParkwayTemple Terrace, FL 33617

(813) 989-1330

Florida Health Care News

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

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

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

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

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FOR ALL health care professionals having

articles in this publication: THE PATIENT AND ANY OTHER PERSON

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

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

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DISCOUNTED OR REDUCED FEE SERVICE, EXAMINATION OR TREATMENT.

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

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depressionVascular surgery

Risk Factors for Periodontal Disease• Lack of oral hygiene• Poorly contoured restorations• Crowded or crooked teeth• Loose teeth• Hormonal changes

(Pregnancy, Menopause)

• Smoking and nicotine• Systemic diseases

(Diabetes, Osteoporosis)• Hereditary factors• Some medications

and/or steroids

• Red, swollen or tender gums or other pain in your mouth• Bleeding while brushing, fl ossing or eating hard food• Gums that are receding or pulling away from the teeth• Loose or separating teeth• Pus between your gums and teeth• Sores in your mouth• Persistent bad breath• A change in the way your teeth fi t together when you bite• A change in the fi t of partial dentures

Warning Signs of Gum Disease:

SueChaplin

Katrine A. Farag, DMD, earned her Doctor of Dental Medicine degree from Nova Southeastern University after completing her undergraduate studies in neuroscience at Vanderbilt University. She is a member of the Florida Academy of Cosmetic Dentistry. Dr. Farag stays up-to-date on the latest technologies and is a certifi ed Invisalign® pro-vider. Dr. Farag has worked in public health, as well as private practice. She has provided both pediatric and adult dental care in southwest Florida for more than eight years.

Joseph H. Farag, DMD, earned his Doctor of Dental Medicine degree from the University of Florida College of Dentistry, Gainesville, FL after completing his undergraduate degree at Florida Atlantic University, Boca Raton, FL. Dr. Farag served an implant residency at the Misch Institute and is trained in advanced laser dentistry. He is a member of the American Dental Association, American Association of Dental Practitioners, American Academy of Operative Dentistry, International Association of Dental Researchers, and is a Diplomate of the International Congress of Oral Implantologists.

KATRINE A. FARAG, DMDJOSEPH H. FARAG, DMD

Find them on the web at www.advanceddentistryo� tmyers.com

Drs. Farag and Farag look fo r w a r d t o h e a r i n g f r o m readers of Florida Health Care News. For more information or to make an appointment, call them or visit their office, which is conveniently located in Fort Myers at:

16601 San Carlos Blvd.

(239) 466-3131

Welcoming New

Patients

John EastmanW ith more than ten

billion tons of raw materials, finished goods and food-stuffs being moved

across the US by truck each year, the trucking industry is considered the life-blood of the US economy.

Without those trucks, economists fear the economy would come to a virtual stand-still. � at’s why the service company Sue Chaplin took over after her husband passed away a few years ago is so important.

“� e company is like AAA for trucks,” Sue explains. “When a truck breaks down anywhere in the United States, the driver calls into a call center, and we have vendors that will go out and � nd the driver and their truck and get them moving again.”

With the help of her son, Sue runs her family’s company from the home in Punta Gorda she moved to after spending the previous 38 years in Green Bay, Wisconsin, where she raised her family and helped her husband create and run the company.

“Green Bay is a great place to raise a family,” Sue says. “� e people are all very nice and friendly, but it’s very cold there. So, we built a home in Florida and moved here in 2013. My husband died a few years after we moved, in 2016.”

Before passing, Sue’s husband became a patient of Joseph H. Farag, DMD, of Advanced Dentistry of Fort Myers. Sue, 71, says her husband used to rave about Dr. Farag’s work. She remembered that recently when a dental problem of her own arose.

Word of Mouth Patient recommendations

pave way for dental restorations

Sue After

Sue Before

“It wasn’t long after we � rst moved to Florida that I was eating an olive that I didn’t know had a seed in it,” Sue explains. “When I bit down on that seed, it cracked a tooth, and I went back to Green Bay to get it � xed.

“� ey wound up doing a root canal, but it must not have been done correctly because it was always very tender and had kind of a zing to it. About the time my husband died, it was really bothering me, so I decided to see if Dr. Farag could do something about it.”

� ough it was the problem stemming from the root canal that prompted Sue to visit Dr. Farag, that was not the only issue she voiced a concern about during her � rst visit to Advanced Dentistry of Fort Myers.

“� e other problem was one I’d had for a number of years,” Sue confesses. “At � rst, I didn’t think it was a dental problem because it started out as me getting earaches and hav-ing some slight neck and jaw pain. But over time, it just got progressively worse.

“I went to a few medical doctors for it, but none of them ever put together what the problem was. One of them actually told me, No, you don’t have an earache. I knew that

I did, of course, and knew that I had this constant neck and jaw pain, too.

“I think it was probably due to the stress of my husband passing, but about three years ago, it got really bad. So while I was visiting with Dr. Farag, I mentioned this pain I was having to him and asked him if he had any idea what may be causing it.”

More Than Meets the EyeIt didn’t take long for Dr. Farag to solve the mystery behind Sue’s discomfort. During his initial examination, he found she had previously undergone an extensive dental restoration, the � nishing touches of which were proving problematic for her.

“She had received a number of crowns,” Dr. Farag reports. “In fact, most of her teeth had been given crowns. � e problem was that the crowns as they were weren’t allowing her teeth to meet properly when she closed her mouth.

“Bottom line, she had a bite problem. Because the crowns weren’t meeting properly when her mouth was in the closed position, her jaw was not resting properly. � at’s what was causing the earaches and the neck and jaw pain.”

Dr. Farag’s discovery came with a bit of bad news. � ough he had clearly found the cause of Sue’s pain, it became immediately clear to him that the only way to resolve the issue and rid Sue of her discomfort was to re-crown all of her teeth.

Knowing it was the best thing for her, Sue agreed to what amounted to another full dental reconstruction. � is one, how-ever, proved to be a bit more extensive, in part because of the cracked tooth she created when she bit into the olive pit.

� e repair of that tooth, a lower molar, required more than just a crown. Because the crack ran so deep, it required the tooth to be pulled and the root to be replaced with a dental implant.

Dental implants are screw-like posts that are made of a titanium alloy that are surgically implanted within the bone of the patient’s jaw. Once the implants are in the jaw, they fuse over time with the bone and become a solid unit.

It typically takes three to six months to complete the fusion process, but once that solid unit is formed, it provides stability for an abutment, which is then capped o� with a crown for a single tooth or a partial or full denture for patients replacing multiple teeth.

Dr. Farag also provided Sue with an implant for a tooth that was missing. In that case, he � rst had to perform a bone graft, where bone particulate is injected into the empty socket to ensure the jawbone will sup-port the implant.

“The bone graft does a number of things,” Dr. Farag explains. “One of those things is, it helps to maintain the volume of bone that is already present in the jaw so that we don’t have any atrophy in the height, width and depth of the bone.”

Bone grafts are not always necessary. When they are, it takes about three months for the bone to heal to a point where it can

receive and support an implant, which is put in place with the aid of a computer-assisted, 3-D guidance system.

A Comfortable Fit� e crown itself looks like a real tooth and is fashioned out of ceramic using a machine that allows the dentist to make it on the spot on the day it is screwed onto the implant. In Sue’s case, this crown was one of more than 20 that Dr. Farag created for her.

“We did all of her lower teeth � rst and got her into temporary crowns, which I kept her in for about three months,” Dr. Farag says. “We did that so that she was sure she was going to be comfortable with the � t.

“We eventually had to make some adjustments, but we � nalized both the lower teeth and the upper teeth, including another implant where the crown wasn’t � tting right. She now has the comfortable bite she was missing and is out pain.”

� e entire reconstruction of Sue’s mouth took about two years to complete, but Sue says the outcome was well worth the invest-ment in time. She says her teeth now look and feel better than they ever have.

“� e best thing is that the earaches are gone,” she exudes. “So is the neck sti� ness and jaw pain. Everything � ts the way it’s supposed to now. I’m so glad I went to see Dr. Farag, because he solved this longstanding pain problem I had when no one else could.

“I really thought I might have to live with this problem forever. But Dr. Farag took care of it, and I’d recommend him to anyone because he’s very thorough, very patient and he obviously does great work.”

Arrested DevelopmentSyracuse, New York native John Eastman decided at a relatively early age that the cold, snowy Northeastern winters weren’t for him,

so about eight years ago, he and his wife packed up their lives and moved to Florida.

Now an inventory specialist for Charlotte County Fire and EMS, John cur-rently spends not only his winters but every other season making sure the � re trucks, ambulances and animal control trucks used across Charlotte County stay in tip-top shape.

“Whenever one of those emergency vehicles needs a part, I order it, and I keep a stock count of everything we have and what we use the most so that we have everything we need to keep those vehicles on the road and running,” John relates.

“What I do now is a bit of a combina-tion of what I used to do in New York, where I worked in the parts department for J.B. Hunt Transportation and spent about � fteen years serving as a volunteer � re� ghter.”

John’s New York-based � re� ghter train-ing did not transfer to Florida, so his days as a volunteer � re� ghter have been put on hold. He recently wound up � ghting a three-alarm � re all his own nevertheless.

“I was not one of those guys who went to the dentist all the time, and it eventually caught up with me, because I got to a point recently where I could not brush my teeth without my gums bleeding and bleeding badly,” John explains.

“Every day, my gums would bleed when I brushed my teeth, and I also had what I later found out was tartar build-up on the back of my bottom front teeth that was breaking o� . At the time, though, I thought it was parts of my teeth that were chipping o� .”

Those two issues sparked an ear-nest search for a dentist that began with John asking some of his co-workers for recommendations. One co-worker recommended he visit Dr. Farag at Advanced Dentistry of Fort Myers.

“� is guy could not say enough good things about Dr. Farag, so I decided to see if he could take me on as a new patient,” John relates “When I called the o� ce, they said to come on in, so I went ahead and gave Dr. Farag a try.”

John first saw Dr. Farag the first week of January 2018. During that visit, Dr. Farag learned that John was a heavy smoker who had neglected his teeth for years. A full examination revealed the result of those habits was a severe case of periodontal disease.

“We noticed he had a lot of deep pock-ets in the gums around his teeth,” Dr. Farag explains. “Most of those pockets were � ve millimeters deep, but in some cases, they were up to ten millimeters deep, whereas healthy pockets are between one and three millimeters.

“In addition, the x-rays we took showed he had a lot of bone loss around the teeth and that there was a great deal of tartar build-up on his teeth. Both of those were signs of a chronic condition that was ongoing.”

Regenerative ProcedureBased on his findings, Dr. Farag recom-mended John undergo a speci� c minimally invasive laser treatment that he’s been performing for more than a decade called LANAP®, which stands for laser-assisted new attachment procedure.

LANAP is not the only treatment option for patients su� ering from periodon-tal disease, but Dr. Farag considers it best because it improves the attachment between the gums and teeth, does not result in a gross loss of tissue or gum recession and is pain free.

“If you use another laser with a di� er-ent methodology, you’ll end up with tissue harm, necrosis or a recession of the gums around the tooth bridge,” Dr. Farag edu-cates. “We do not want the gums to recede because that can make the teeth appear lon-ger. � e goal is healthy gums that reattach naturally to the teeth, and LANAP does this without harming the healthy tissue.”

Another reason Dr. Farag recommended the LANAP procedure for John is because of the signi� cant loss of bone he had su� ered around his teeth. In addition to healing gum tissue, Dr. Farag explains, LANAP can also improve bone quality and density.

“� e LANAP procedure does improve the quality of the existing bone, and in some cases, we can re-grow bone,” Dr. Farag con-� rms. “But in cases involving a smoker such as John, we’re often happy if we can stop the bone loss.

“Smoking ampli� es the periodontal dis-ease. It makes it worse because nicotine in the cigarette constricts the capillaries, which are the blood vessels in the tissue, stalls healing and creates an environment where bacteria thrive.

“� ose bacteria thrive because they’re not getting attacked by the immune system. Blood supply to the tissue is reduced. � ere’s some, but the tissue is not healthy, and that’s why heavy smokers usually have worse cases, including more bone loss.”

In John’s case, the bone loss was, in some areas, signi� cant. � ough the loss was 20 percent in most areas, there were areas where the loss was nearly 40 percent and some oth-ers where it was greater than 70 percent.

Because of the bone loss and the advanced nature of his periodontal dis-ease, John was on a track that would have resulted in him eventually losing several teeth. That bottom line made him an ideal candidate for the LANAP procedure, which John agreed to.

“No Discomfort at All”“My only hesitation was that I have a problem holding my mouth open for long periods of time because I always begin to gag,” John says. “� at’s one of the reasons why I’ve never really gone to the dentist a lot.

“But Dr. Farag assured me everything would be fine and gave me a very light

relaxant of some kind, something I took about an hour before the surgery and that helped to settle me down, which made the procedure even easier on me.

“And just like Dr. Farag said, it really was pain free. I was surprised by that, because the thought of a laser cleaning between my gums and teeth scared me. I was thinking, How can this not hurt? But it didn’t. � ere was no discomfort at all.”

D e s p i t e t h e advanced nature of his periodontal dis-ease, John’s LANAP procedure took only about two hours to complete, which is typical. During those two hours, the entire mouth was treated through three steps.

D r . F a r a g explains that during the first laser pass, the energy from the laser kills any bac-teria in the gums, vaporizes the dis-eased gum tissue and dehydrates the tartar on the teeth, making it brittle and easy to remove.

During the sec-ond step, the tartar is removed with a � ne-tipped, vibrating, ultrasonic instru-ment. The teeth are then rinsed with an antimicrobial sub-stance that halts the growth of new bacte-ria. During this step, the diseased lining of the tissue is removed and the bone surround-ing the teeth is debride of infected tissue.

Finally, during a third pass of the laser at a di� erent setting than the � rst two, an antimicrobial seal is created that prevents re-infection and releases growth factors from blood cells that help regenerate the attach-ment between the gums and the teeth.

“� e patient doesn’t have any sensation of what we’re doing during the procedure because we use a local dental anesthetic, just as we do if we’re doing a � lling,” Dr. Farag says. “� at’s how patients stay comfortable during the process.

“And there is no post-op discomfort because we’re not traumatizing anything. The gums are not inflamed, so they’re not painful. Afterward, however, we do ask patients to briefly stay on a soft-food diet to prevent any tearing of the new tissue that’s forming.”

� at soft-food directive wasn’t the only post-procedure instruction John received. He was also ordered not to smoke during

John recently resumed his smoking habit, but he says he is smoking only about ten cigarettes a day now and is on a “quit plan” that he is con� dent will rid him of the habit for good. Meanwhile, his gums have healed nicely, and his overall oral health has improved markedly.

“My teeth feel much, much better, and there’s no more bleeding when I brush any-more,” John exudes. “I’m forty-� ve years old, and for the � rst time in my life, really, I’m taking care of my teeth the right way because Dr. Farag and his sta� showed me how to brush and � oss properly. Now, I know why my buddy couldn’t stop talking so highly of Dr. Farag.

“� e treatment worked great, so if you need it, don’t hesitate to get it. And if you need to get it, get it done by Dr. Farag. My experience with Dr. Farag was by far the best dental experience I’ve ever had.”FHCN article by Roy Cummings. Sue’s photo courtesy of Sue

Chaplin. John’s photo by Fred Bellet. Before and after images

courtesy of Advanced Dentistry of Fort Myers. mkb

the healing process. For a man with a nearly two-pack-a-day habit, that figured to be a di� cult order to follow. John managed, however.

“Dr. Farag told me that if I smoked at all during the healing process, it would do more damage than what I had in the � rst place,” John notes. “So, I didn’t. From that day on, I literally did not smoke one cigarette for four months.”

Page 6 | Florida Health Care News | Fall 2019 | Lee County Edition Lee County Edition | Fall 2019 | Florida Health Care News | Page 7coMprehensiVe dentistry

T en years ago, Binghamton, New York native Sally Youngstrom survived a bat-tle with non-Hodgkin’s

lymphoma. Along the way, however, she developed lymphedema, a condition that causes excess � uid in the lymph vessels.

Caused by her cancer, the lymph-edema a� ected Sally’s arms and legs, but especially her legs, causing them to be constantly swollen and uncomfortable.

“The swelling in my right leg was really bad, and my left leg wasn’t that good either,” Sally relates. “My right leg was larger than my left leg. You could see it in my pant legs. � e one on the right side was really tight.

“I started to wear compression stockings, which helped, and I also had procedures on my leg veins. But last August, I underwent knee surgery. After the surgery, the swelling was even worse and eventually became out of control.

“I knew I had to do something about it, so I asked my vein specialist what could be done. He recommended a compression pump from Acute Wound Care.”

Massaging MomentsLymphedema, venous disease can cause limb swelling; compression pumps can help

Sally Youngstrom

Visit Acute Wound Care on the web at

www.acutewoundcare.comor call them directly:

Toll Free

(855) 949-HEAL (4325)Locally

(239) 949-4412

Are You Suffering From

Chronic Limb Swelling?

Lymphedema affects the body’s lymphatic system, which con-sists of an extensive network of

vessels and nodes. Protein-rich � uid called lymph circulates throughout the body in the lymph vessels. � is � uid collects bacteria, viruses and waste products, and carries them through the lymph vessels to the lymph nodes.

� e harmful substances in the lymph are � ltered out by infection-� ghting cells called lymphocytes that reside in the lymph nodes. In this way, the lymphatic system coordinates with the immune system’s function to protect the body from foreign substances.

Lymphedema is a long-term condition whereby excess lymph collects in the tissue of the arms or legs causing edema, or swelling. Lymphedema can be caused by any condition or procedure that damages the body’s lymph nodes or vessels.

Common causes of lymphedema include surgery to remove lymph nodes or vessels, injury to the nodes and vessels,

radiation treatment for cancer that can cause scarring and in� ammation of the nodes and vessels, and infection of the lymph nodes, which can restrict the � ow of � uid and cause swelling.

In addition to swelling, other symp-toms of lymphedema may include a heavy or tight feeling in the arms or legs; discomfort or aching in the affected limb; a tingling sensation, like pins and needles, in the a� ected limb; recurrent skin infections; and a thickening or hardening of the skin.

Lymphedema is generally diagnosed after a careful evaluation of the patient’s medical history, including any past sur-geries or treatments. � e evaluation also includes a review of the patient’s current medications and symptoms, and a thor-ough physical examination. In some cases, tests such as CT, MRI or ultrasound may be used to rule out other conditions as the cause of the swelling.

Treatments for lymphedema vary, depending on the severity and cause of

the condition. If an infection is the cause, antibiotics are generally prescribed. In other cases, treatment may include spe-ci� c exercises or limitations on certain activities that may increase swelling.

Other treatments for lymphedema may include manual lymphatic drain-age therapy, which is a gentle form of skin massage, specialized wrapping techniques, compression stockings, and mechanical pumping devices such as the hospital-grade compression pumps from Acute Wound Care.

Lymphedema cannot be cured. But with proper care and treatment with an Acute Wound Care compression pump, the a� ected limb can usually be restored to a manageable size and shape. It can also be controlled so it doesn’t get worse.

If left untreated, however, lymph-edema can lead to increased swelling and a hardening of the tissue. � is can result in decreased function and mobility in the a� ected limb, as well as chronic infections and other illnesses.

Lingering Lymphedema

Acute Wound Care is a fully accred-ited home medical equipment provider specializing in hospital-grade compressiondevices and specialty wound-care dressings. The compression pumps, which reduce swelling caused by condi-tions such as lymphedema and venous disease, are prescription devices. � ey are approved by most insurers.

Rhythmic Patterns Acute Wound Care’s easy-to-use compression pumps remove � uid that has accumulated in the patient’s legs or arms, observes Alyssa Parker, certi� ed compres-sion therapist with Acute Wound Care.

“The pump’s limb-sized sleeves gently massage the limb, draining any excess fluid back into the body’s cir-culatory system so it can be naturally eliminated,” Alyssa explains. “� is allevi-ates swelling and many painful symptoms.

“� e pumps are highly e� ective and noninvasive, and for the legs, they are much easier to use than compression stockings. Patients generally use the pump twice a day for forty-� ve minutes, usually in the morning and in the evening. While using the pump, patients simply sit back with their limbs raised to further assist with decreasing swelling.”

� e sleeves of the compression pump contain multiple chambers. During treat-ment, each chamber fills up with air. � en, each chamber releases, and the pat-tern repeats in a rhythmic fashion, forcing any excess � uid out of the limbs.

“� e pump also boosts circulation by contracting the leg muscles, assisting blood � ow back toward the heart,” Alyssa notes. “Results are often apparent imme-diately. Many patients see a noticeable di� erence in the swelling and in the size of their limbs after their � rst forty-� ve-minute pumping session.”

Acute Wound Care is proud of its hands-on approach to patient care. Not only does a compression therapist go to patients’ homes to set up the equipment

and instruct them on how to use it, they also adjust the pump’s pres-sure level to the patients’ comfort.

“ W h e n we are in the patient’s home, we set the pressure based on the severity of the condition and the physic ian’s prescription,” states Alyssa. “We then adjust the pump so the patients are comfortable and will actually meet the requirements of the treatment, so they get great results.”

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

“Many doctors have told me they’ve encouraged their patients to use the pump to reduce limb swelling and improve circulation,” Alyssa con� rms. “� ey say the compression pumps are safe, noninvasive devices that greatly supplement the medical treatment they provide to those patients.

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

“That same doctor said he’s so sat-isfied with Acute Wound Care that he strongly endorses them and their com-pression devices to other physicians. He said he’s personally thrilled with Acute Wound Care because they help doctors improve their quality of care and the quality of their patients’ lives.”

“I Have Ankles Again”Sally has been using her compression pump from Acute Wound Care for four months and is thrilled with the results. Because she works full-time, she generally uses her device once a day instead of twice, but she uses it for longer than 45 minutes.

“� e compression pump is wonderful,” Sally raves. “I use it for an hour or an hour and a half, and when the session is over, I can really see a change. Since I’ve been using the pump, I can’t believe the di� erence in the size of my legs. I have ankles again.”

Because Sally’s leg swelling is e� ectively managed with her compression pump, she can enjoy her favorite activi-ties without discomfort. She has plans to return to even more activities soon.

“I’m dancing, playing a little golf and walking, things I like to do when I’m not working,” she reports. “My husband and I have a motorhome and do some traveling with it. � at got curtailed due to my leg and knee problems, but we’ll probably get back into that now as well.

“I couldn’t be more pleased with the care I received from everyone at Acute Wound Care. And I couldn’t be happier with my results. � e compression pump works, and it was very successful for me. I just wish I got it sooner.

“I absolutely recommend Acute Wound Care and their compression pumps to anybody in a situation like mine.”FHCN article by Patti DiPanfilo. Photo by Jordan Pysz.

Compression pump photo courtesy of Acute Wound Care. ke

At Riverside Recovery of Tampa, substance abuse is well understood. Riverside Recovery of Tampa is a com-prehensive center o� ering a full continuum of care to treat all aspects of the disease. Sta� members engage cli-ents in a Residential Treatment Program and an Intensive Outpatient Program, as well as through ongoing therapy and support services.

� e sta� at Riverside Recovery of Tampa realize substance abuse a� ects more than the indi-vidual a� icted with it. It a� ects that person’s entire family as well. Its consequences impact the family’s communication and dynamics. � at’s why the sta� at Riverside Recovery of Tampa have developed a wide-ranging Family Services Program to educate and support families facing this disease.

“Many families believe substance abuse is their loved ones’ problem, and if they just get better, every-thing will be fine,” says Louise Wallowitz, LMHC, CAP, director of family services at Riverside Recovery of Tampa. “We get the families involved in treatment so they can begin to understand it really is a family disease.”

Often, Louise notes, parents of individuals with substance abuse get caught up in what they did to cause their loved ones to have the disease. � e sta� at Riverside Recovery of Tampa Family Services focuses instead on educating families about risk factors for the development of substance abuse.

“For one thing, research shows that genetics play a big role in substance abuse,” Louise observes. “We also teach families about the di� erent parts of the brain and what happens when the prefrontal cortex, which is responsible for executive functioning, is damaged or its growth is stunted. If that occurs, their loved ones are not going to make good decisions.

“� rough education, we help family members really understand what’s going on neurologically and realize that substance abuse is a disease, not a weakness. � en they can recognize that what they’re seeing is not really their loved ones. � ey’re seeing how the disease a� ects their loved ones’ brains and, therefore, their behavior.

“� ere are also environmental risk factors, including peer pressure. And if people are already genetically at risk for substance abuse, it’s likely their use will be a lot di� erent than that of someone who uses drugs or alcohol while in college and then stops.”

As part of the education process, the Riverside Recovery of Tampa Family Services sta� use a variety of videos and printed materials. � ese resources assist families in compre-hending how their loved ones’ brains are not functioning at full capacity, which contributes to their substance abuse.

Team Eff ort� e sta� at Riverside Recovery of Tampa work as a team to help their clients beat substance abuse and believe their clients’ families are a key part of that team. Riverside Recovery of Tampa Family Services provides several opportunities for families to become part of the e� ort.

“� ere are two family groups per week, and it’s man-datory for family members to attend at least one group to visit their loved ones,” Louise describes. “Every � ve weeks, we o� er a family weekend. � at’s a three-day weekend when families receive a lot of education about substance abuse and how to live with someone battling it.

Break Free From Addiction

Drug and alcohol addiction is a disease that can steal your happiness and your life. If you suff er from the disease of addiction, Riverside Recovery of Tampa is here to help with its comprehensive treatment. For more information, call or visit their offi ce at:

4004 N. Riverside Drive

(800) 871-5440

Education and support for families facing substance abuse“At that point, we provide additional support and

encouragement to clients to live sober lives and to regularly attend twelve-step meetings, some of which we hold in-house,” Louise relates. “� is part of the program is individualized and aimed at a slow transi-tion back into life for clients. It could last two to four weeks, depending on the client.

“Next, clients transition into the Intensive Outpatient Program, which requires nine hours of ther-apy per week, or three nights a week. Following that is Aftercare, when many alumni take part, which adds support for the clients. � at’s good for the alumni as well because the longer they remain engaged with us, the longer they’re away from substances.”

� e program at Riverside Recovery of Tampa focuses on abuse of drugs and alcohol, but substance abuse often coexists with other disorders such as depression and anxiety.

“In most cases, it’s a dual diagnosis,” Louise con� rms. “Clients will come in with substance abuse, but also depression, anxiety, bipolar or another dis-order. While we’re treating the substance abuse, we’re also stabilizing these disorders or whatever the sec-ondary diagnosis might be.”

Creative ModalitiesAs part of the treatment at Riverside Recovery of Tampa, clients are shown they can live happy, normal, healthy lives without the use of drugs and alcohol. � e center o� ers amenities and activities to guide them in this discovery.

The center has a half-court basketball court, a yoga studio, an exercise room with weight and ellipti-cal machines, and a swimming pool. Construction has started on a deck overlooking the Hillsborough River, which will allow clients to enjoy scenic views while taking part in outdoor activities.

“We show our clients they can have a lot of fun while sober and clean, doing things like working out, playing basketball, swimming or � shing, and they can enjoy them clear-minded,” Louise comments. “� ey will actually have more fun than if they were drunk or high.

“We do the deep work here. We get to the root cause of what’s going on with people and show them their lives are not over. With the help of Riverside Recovery of Tampa, people with substance abuse can be happy and laugh and enjoy life again.”

� e Riverside Recovery of Tampa sta� are able to address clients’ needs in creative ways as well, including art therapy and physical therapy. Unfettered by limiting program restrictions, Riverside Recovery of Tampa can use any treatment modality it sees � t to help improve a client’s physical and mental health. FHCN article by Patti DiPanfilo. Photo by Fred Bellet.nj

ubstance abuse is an insidious disease. It will creep into someone’s life and rob them of their physical and mental health. In the process, it damages their fami-lies and relationships. It destroys their self-con� dence

and well-being. It carries the prospect of death.

of Tampa“During family weekend, families learn how to com-

municate with their loved ones in a healthy way. � ey learn about boundary setting, building contracts and most important, how to support their loved ones in a positive way without enabling.”

During the family weekend, the Riverside Recovery of Tampa Family Services sta� educates families about the neuroscience of substance abuse and the changes that occur in the brain. Sta� explain how substance abuse recovery does not happen overnight. It takes two years for the brain to heal and create new pathways responsible for behavior.

“Part of our instruction is to educate families about the holistic approach implemented with our clients,” Louise states. “� at approach includes therapies such as yoga, meditation, exercise, eating right and getting better sleep. � ere’s evidence these activities help in the recovery process. An educated family can support their loved ones in this process.

“We encourage family members to continue coming to the group even after their loved ones leave Riverside Recovery of Tampa to get ongoing support. We also encour-age them to seek outside support such as that from Alcoholics Anonymous® or Narcotics Anonymous®.”

� roughout the recovery process, the Riverside Recovery of Tampa Family Services sta� works to develop relation-ships with family members that close

the gaps between their loved ones and their therapists.“Sometimes, family members pick up on things in

conversation that the therapists miss or misunderstand,” Louise relates. “Closing the gaps in communication decreases the chance for relapse.

“Family involvement is crucial to their loved ones getting well. We see an increase in success when every-one is working together. Families must be a part of treatment because substance abuse is a family disease, and everybody plays a part in o� ering support.”

Road to RecoveryThe comprehensive recovery process at Riverside Recovery of Tampa begins with the Medical Detox Program, then the Residential Program, which varies in length, Louise notes. From there, clients transition into Day/Night Treatment (PHP), which is a day program during which clients return to Riverside Recovery of Tampa from 8:00 a.m. to 4:30 p.m.

Visit them at www.rrtampa.com

Page 8 | Florida Health Care News | Fall 2019 | Lee County Edition Lee County Edition | Fall 2019 | Florida Health Care News | Page 9coMpression therapyaddiction treatMent

SOUTH FLORIDA EYE CLINICSCOTT L. GELLER, MD

For Eye Floater Solutions

South Florida Eye Clinic is located in Fort Myers at:

4755 Summerlin Rd. Call Dr. Geller at:

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

(877) 371-3937

Scott L. Geller, MD, is board certified by the A m e r i c a n B o a r d o f O p h t h a l m o l o g y. H e is a graduate of Ohio Wesleyan University and Rush Medical College. While in medical school, he was awarded a student

fellowship to study tropical medicine at a missionary hospital in India, and pursued additional studies at the famous Brompton Hospital in London, England. He interned at Presbyterian Hospital, Pacific Medical Center, San Francisco, CA, and completed his residency in ophthalmology at Sinai Hospital of Detroit, which was affi liated with Wayne State Medical School and Kresge Eye Institute. Dr. Geller was fellowship-trained in anterior segment and refractive surgery with Dr. William Myers of the Michigan Eye Institute. Dr. Geller is a fellow of the American Academy of Ophthalmology and has presented papers on eye fl oater laser treatment at the International Congress of Ophthalmology, European Congress of Cataract & Refractive Surgery, European Congress of Ophthalmology and the Florida Society of Ophthalmology.

SCAN THIS TO YOUR SMARTPHONE

TO SEE ACTUAL PATIENTS

Dr. Geller has performed more than 20,000 documented eye � oater laser sessions.

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

Eye Floater LaserScott Geller, MD, teaches the technique worldwide

W ith more than 20,000 documented eye � oater laser sessions com-pleted, Dr. Scott Geller,

a board-certi� ed ophthalmologist, has the largest and longest clinical series of eye � oater laser sessions in the United States, and probably worldwide.

“I became interested in this niche ophthalmic specialty after I was trained by the professors in Switzerland who were using lasers to cut membranes in diabetic patients,” Dr. Geller explains. “� ey never thought of applying it to eye � oaters.”

Some doctors and patients creditDr. Geller with inventing the technique.

“I just applied the training and tech-niques I learned to eye � oaters, and have had amazing success,” Dr. Geller says. “I have presented my results and technique at major scienti� c meetings worldwide starting with the International Congress of

Ophthalmology in Singapore over twenty-� ve years and thousands of cases ago.”

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

“Almost all ophthalmologists use lasers in their practice, but they can’t treat eye � oaters with the precision and predictability required to do the best job possible, because most YAG lasers are not configured to work in the vit-reous gel, where floaters are created,” Dr. Geller states.

Worldwide Patient BaseRecently, a major ophthalmic laser manufacturer has devised a laser for � oaters.

“� e problem is, there have been no training courses for ophthalmologists who might be interested in this area,” Dr. Geller notes. “And that can lead to complications.”

Dr. Geller was the prin-cipal author of the only presentation on this subject at the American Academy of Ophthalmology in 2012.

“I have tried the other lasers, and if they were superior, I would purchase one immedi-ately,” Dr. Geller says. “I use the

Swiss made LASAG laser. It is de� nitely, in my hands, superior to the others out there. And I have two of them.”

Dr. Geller has a worldwide patient base. He has treated patients from Europe, Russia, China, Japan and most recently, an anesthesiologist from Brazil.

Dr. Gel ler a lways welcomes colleagues to observe or just call if they need to re� ne their own technique.

“Laser treatment of eye � oaters is fas-cinating,” Dr. Geller says. “I look forward to doing this every day.”Article submitted by Scott L. Geller, MD. Photo by Jordan

Pysz. mkb

BEFORE

AFTER

Tips To Keep Toenail Fungus From Spreading:

In-o� ce procedure eliminates unsightly, painful condition

Symptoms of fungal nail infections vary. Symptoms will depend on the type of

infection and may eventually cause discomfort.

Symptoms can include:

Hal L. Bozof, DPM, is board certifi ed by the American Board of Podiatric Surgery and the American Academy of Wound Management. He is a fellow of the American College of Foot & Ankle

Surgeons. He completed his undergraduate degree at Memphis State University, Memphis, and received his Doctor of Podiatric Medicine degree from the Dr. William Scholl College of Podiatric Medicine, Chicago. He completed a podiatric surgical residency at Baptist Memorial Hospital of Memphis. Dr. Bozof is a member of the American Podiatric Medical Association, Florida Podiatric Medical Association and American Academy of Pain Management.

For more information, visit Dr. Bozof’s website at www.docbozof.com

Do You Have Hammertoes, Foot Pain or Toenail Fungus?Dr. Hal Bozof is Lee County’s leading provider of podiatry services. He and his staff can help you get back on your feet. For more information regarding the array of services he can provide, call or

visit his offi ce in Fort Myers at:

2540 Winkler Avenue

(239) 278-4100Se Habla Español

Wash your feet daily and dry completely

Cut nails regularly and do not share clippers

Alternate shoes

Discard old shoes that may carry fungus

When using public showers, wear � ip-� ops

Make sure nail salons sterilize their equipment

• Yellow or white streaks in the nail bed and throughout the nail plate.

• Build-up of bits and pieces of skin and nail fragments (debris) under the nail.

• A discolored and thickened nail that may separate from the skin underneath the nail.

• A brittle, broken, crumbly and/or thickened nail.

• Discomfort, especially when wearing closed-toe shoes.

Ellie Cherwick has always hated her feet.

“I’ve never really liked the way they look,’’ Ellie laments.

“And I’ve always had problems with them.’’One of those problems is hammer-

toes, which is a bending or curling of the toes that often results in the formation of corns or calluses as the toe deformity presses unnaturally against the patient’s footwear and/or the ground.

The condition is one that Ellie’s mother and daughter have had to deal with as well, and for years, Ellie dealt with it rather simply by wearing closed-toe shoes to mask the hammertoes’ unsightly nature.

“Mostly, I just hated the way they looked,” Ellie explains. “They weren’t

uncomfortable, so I never had much pain, until recently. I guess they just got a lot worse over time, so I decided to do something for myself and get them repaired.”

Ellie’s decision resulted in a visit to her long-time podiatrist, Hal Bozof, DPM, who says hammertoes are typically caused by an irregular and potentially permanent short-ening of tendons and muscles that results in the deformity of the toe joints.

“� is contracture is often the cause of a muscle imbalance in the foot that causes the toe to dorsally contract, meaning the toe pushes up and the end of the toe ham-mers to the ground,” Dr. Bozof explains. “Frequently, it is inherited or caused by wearing shoes that are the wrong � t.”

Dr. Bozof adds that hammertoes can develop at any age. � ey can occur in people as young as 30 or even 20 years of age, he says.

“It can develop at a young age, especially in women who wear high heels a lot,” Dr. Bozof explains. “� e older we get, the more likely the hammertoes are to get worse. � ey are more prevalent in women, but I do see men with them as well.

“Hammertoes can become very pain-ful,” the doctor continues. “Sometimes, they can rub against the inside of the shoe, causing a corn to occur. Unless the a� ected toe is straightened out, there will inevitably be an issue with corns or calluses.

“Sometimes, an ulcer can form as well. � is results in extreme discomfort caused from the toe hammering against the ground and can lead to an infection. Also, painful calluses may develop on the bottom of the foot due to the underlying contracture of the hammertoes.”

Progressive ProcedureDr. Bozof says hammertoes are very com-mon and notes that in the past, treatment was performed in a surgery center or a hosptial and typically required four to six weeks of recovery time. Today, however, there is a pain-free in-o� ce procedure that eliminates hammertoes quickly.

“This new procedure starts with the application of a local anesthetic that numbs the toe,” Dr. Bozof explains. “After that, a very small opening requiring no stitches is made to release the tendon, which allows the toe to straighten out.”

Dr. Bozof says that following the procedure, the patient’s toe is put in a bandage that is worn only for a day. He adds that most patients can walk on the foot with the treated toe the very same day, “usually without any pain.”

Ellie con� rms that the procedure was indeed painless and adds that she is back to enjoying working in her yard and wear-ing most any shoe she wants again.

“I couldn’t wait to get a pedicure once the procedure was � nished,” Ellie says. “Dr. Bozof does great work. I am ecstatic with the results! I love my feet again!”

W hile serving in the United States Armed Forces, Chet Young did three tours of duty in

Vietnam. At some point, during at least one of those tours, Chet was exposed to Agent Orange, a hazardous material that can cause diabetes, kidney disease and many other chronic conditions.

Years later, when he � rst learned he had indeed contracted Type 2 diabetes, the diagnosis came as no surprise to Chet, who more recently thought a problem with toenail fungus was being caused by his dia-betes. He soon found out di� erently.

“I have my feet examined on a regular basis because diabetes can cause circulatory issues and problems with the feet,” he explains. “When the fungus appeared, I assumed the two were connected, but they’re not.”

After moving to Fort Myers a few years ago, Chet was referred to Hal L. Bozof, DPM, a board-certi� ed podiatric physician, for treatment. Dr. Bozof explained to Chet that toenail fungus can be di� cult to eliminate.

TOENAIL FUNGUSLaser Advantages“It typically grows in a dark, warm, moist environment,” Dr. Bozof explains. “Once it gets under the skin or nail, that’s a perfect place for the fungus to thrive. It can then spread from one toenail to the next. Oftentimes, the fungus will develop underneath the nail plate.”

Historically, treatment for fungal nails has included topical medica-tions, oral agents (pills) or surgical removal of the nail plate, which have been relatively ineffective.

“� e most e� cient way to kill the fungus is with the Fox Laser, which we use in my o� ce,” Dr. Bozof explains. “It is essentially pain free, and there are no side e� ects. It takes only a short time per treatment and may require two or three sessions, depending on how many nails are treated and the extent of the fungus.

“� e laser produces heat that pene-trates the nail plate and thereby kills the fungus, which lives in and underneath the toenail,” continues Dr. Bozof.

“One of the most impressive features is that there is no recovery time,” adds Dr. Bozof. “Shoes can be

worn immediately after the treatment, unlike having the nails removed.”

Toenails grow very slowly. It can take up to a year or more to grow a new toenail, which is why it can be so hard to get rid of toenail fungus. The fungus often doesn’t go away until a new toenail can grow back.

Chet is thrilled with the care he received and says that the fungus condi-tion has been resolved and his nails are now normal once again.

“I don’t have to be embarrassed about my feet anymore!” he exclaims. “I can wear sandals and � ip-� ops and not be worried about how my feet look. It’s a relief!”FHCN articles by Roy Cummings. Ellie’s photo by Jordan

Pysz. Chet’s photo by Nerissa Johnson. Before and after image

courtesy of Ellie Cherwick. nj

Ellie happily

shows off her feet

Chet can wear fl ip-fl ops once again and no longer has to hide his feet

Find out if your hearing problems can be eased with

one of the many models of state-of-the-art hearing

instruments available at Gulf Coast Audiology.

Dr. Duran invites readers of Florida Health Care News to call for a consultation or to visit her

at her offi ce in Fort Myers at:

8900 Gladiolus Dr., Suite 201

() 267-7888

Hear Better Now

Drianis Duran, AuD, is a board-certifi ed audiologist with clinical expertise in the areas of hearing loss and dizziness and balance disorders. She holds credentials from the American Board of Audiology, the American Academy of Audiology, the Academy of Doctors of Audiology and the Florida Academy of Audiology. She has also received certifi cation from the American Institute of Balance.

DRIANIS DURAN, AUD

Longtime Chicago, Illinois res-ident Cheryl Haught thought her career in customer service ended when she retired and

moved to Florida a few years ago. � en her son came calling for a friend who needed a customer service rep at his bank.

“I had been o� for about two years when my son called and asked if I wanted to go back to work part-time,” Cheryl explains. “That soon became full-time, but that’s okay because it’s a wonderful community bank, I � t in really well and customer service is so important.”

An ability to communicate clearly is among the core skills every customer service rep must possess, and Cheryl always had it while working in Chicago. Shortly after beginning work here in Florida, she realized she was suddenly lacking in that area.

“I was having to ask customers to repeat themselves, and that was embarrassing,” she says. “And of course, when you’re working at a bank, you really need to be able to hear what the customers are saying. So, I � gured it was time to get my ears checked.”

After seeing the practice on a drive into work one day, Cheryl researched Gulf Coast

“But that’s also why properly and successfully treating hearing loss has such a positive impact on someone’s life. It results in increased productivity, better interpersonal relationships and better emotional and physical health, including brain health.”

Cheryl can con� rm that. Since being � t with Phonak Marvel hearing aids – a small, inconspicuous device featuring state-of-the-art technology – she says she

is hearing clearly again in all environments and, in some cases, better than ever.

“One of the � rst things I noticed was the clicking of the keys on my keyboard at work,” she says. “I’d literally forgotten that the keyboard made that sound because I had not heard it for so many years.

“� ere are a lot of little things like that that I’m hearing again, but the best part is talking to my grandson and my son-in-law or daughter-in-law, who all talk quietly and fast, but I now catch everything they’re saying.

“At work, I can hear people talking from across the room. I can’t believe what a di� erence these hearing aids have made in my life, and I can’t thank Dr. Duran enough for what she’s done. I recom-mend her to everybody I meet who has a hearing problem.”FHCN article by Roy Cummings. Photo by Jordan Pysz. nj

Audiology and chose to have her hearing checked there. She knew she had chosen wisely as soon as Drianis Duran, AuD, began testing her for possible hearing loss.

Proper Treatment Is Critical“For one of the first tests, she simply walked out of the room and started talking to me,” Cheryl relates. “� en she asked if I could hear her and, of course, I couldn’t. � en she put a hearing aid in my ear and walked out of the room again.

“When she started talking to me again, I could hear her clearly. � at told me I de� nitely needed hearing aids. After that, she started asking me questions about my lifestyle, my job, how socially active I was, what my hobbies were.”

“By asking those questions, I learned that in addition to working with the public every day, Cheryl is still very active socially as well as with her son and grandson. We used that information to determine the right technology for her,” Dr. Duran explains.

“� at part is absolutely critical because hearing is the sense that never rests, the sense that more than any other allows us to enjoy family and friends and be productive at work. � at’s why untreated hearing loss so negatively a� ects many areas of our lives.

Cheryl Haught

Visit Gulf Coast Audiology on the web at www.gulfcoastaudiology.com

Page 10 | Florida Health Care News | Fall 2019 | Lee County Edition Lee County Edition | Fall 2019 | Florida Health Care News | Page 11ophthalMology podiatry

hearing care

Here For YouDr. Andersen and his staff at Bell Tower Dental Care welcome your questions about implant, restorative and family dentistry. To learn more or to schedule an appointment, call or visit their offi ce in Ft. Myers:

5245 Big Pine WaySuite 103

(239) 332-5660

Michael J. Andersen, DDS, earned his undergraduate degree from Ohio University and his Doctor of Dental Surgery degree from Case Western Reserve University, Cleveland. Dr. Andersen also completed a post-d o c t o r a l p r o g r a m i n

advanced general dentistry at CWRU. He is a member of several professional associations, including the American Dental Association, and is past president and a board member of The Society for the Preservation of Oral Health.

For more information, visit www.belltowerdentalcare.com

MICHAEL J. ANDERSEN, DDS, P.A. Jimmy (After)

Jimmy (Before)

W hen meeting some-one for the first time, many peo-ple say their smile is the first thing

they notice. Serving food and drinks at a country club, Jimmy* comes face to face with numerous people for the � rst time on a regular basis. However, greet-ing them with a smile is not something he’s always felt con� dent about.

iTero® Scanner simulates results for orthodontic and dental patients

Visualize Your Outcome

• Comfort Dentistry • Gentle, Professional

Cleaning • Oral Sedation • Crowns • Traditional Crowns • Dental Imaging • Digital X-rays • iTero Scanner• Intraoral Camera • Dentures • Implant-Retained

Dentures • Traditional vs. Premium

Dentures

• Emergency Dental Care • Endodontics • Cracked Teeth • Oral Trauma • Pulpotomy • Root Canal Therapy • Implants • Individual Upper Implants • Oral Health • Cold Sore Treatment • Comprehensive Exams • Gentle, Professional

Cleaning • Mouth Guards • Night Guards

• Oral Cancer Screening • Periodontal/Gum Disease

Treatment • Smoking Cessation • Oral Surgery • Bone Grafting • General Anesthesia • Local Anesthesia • Wisdom Teeth Removal • Teeth Whitening • Take Home Trays • Zoom! • Invisalign

Bell Tower Dental Care o� ers an array of dental services, including:

“I was a bit self-conscious because my front teeth were crooked and I had a bit of a gap in my teeth,” Jimmy shares. “I had braces when I was younger, and I didn’t wear my retainer like I was supposed to, and that caused my teeth to shift.”

All through college, Jimmy was bothered by his lackluster smile, so when he returned home to Fort Myers, he decided to have his smile corrected. He made an appointment with his dentist of 15 years, Michael J. Andersen, DDS, of Bell Tower Dental Care.

“Jimmy and I had previously dis-cussed correcting his teeth,” Dr. Andersen reports. “� ey had rotated and become crooked, and he wanted to feel more con-fident smiling and talking to people. We discussed all the options and agreed that the best plan was to use Invisalign® clear aligners.”

Inv i sa l ign i s a great option for patients who don’t want to wear tradi-tional metal braces. � ey are clear, mak-ing them almost undetectable, and patients can take them out when eating or brushing their teeth.

Seeing Your Future SmileAs part of its Invisalign program, Bell Tower Dental Care utilizes the iTero Scanner, a state-of-the-art digital imaging device that allows patients to see 3-D images of what their teeth can look like at the end of their treatment plan.

And while it was designed with that aspect of the orthodontic process in mind, the iTero Scanner can also be used

in other ways, including making digital impressions that eliminate the need for the foul-tasting paste impressions that cause a gag re� ex in many patients.

“We use the iTero Scanner on all our patients to give us a digital record of what their teeth look like,” Dr. Andersen notes. “It allows us to eas-ily see if there are any crooked teeth or spaces or if they have any bite issues.

“We still use x-rays and clinical obser-vation, but the scanner helps us better show the patient where their problem areas are. It gives them a visual picture that we can rotate to show them what may be causing an incorrect bite.

“We also use it for restorative work, partials, dentures and crowns. If a patient wants a new denture, we use the scanner to send digital impressions to the lab. � e lab then sends the models to us with the teeth, and we try them on the patient.

“I’ve been doing partials for quite a while, and I can honestly say that, with the iTero Scanner, the bite and � t we get with our partials is perfect. Previously, I would often need to make some kind of adjustment, but with the iTero Scanner, the partials come in perfect every time.”

As he does with most of his patients, Dr. Andersen began his work on Jimmy by using the iTero Scanner to create a 3-D image of his teeth as they were then. He then used the scanner to create an image of how his teeth would look following the Invisalign treatment.

“Once we’ve c o m p l e t e d t h e scan, we send it to Invisalign, and from those images, they are able to create a proper treatment plan for each per-son,” Dr. Andersen continues. “They deliver that plan to us through the computer, then we look to see if there are any changes we want to make. If not, they make the liners. If we have corrections, they

apply them and send another treatment plan back for approval.

“Another thing the scanner allows us to do is scan the patient at di� erent inter-vals throughout their treatment. � at way, if certain teeth are not moving properly or we feel they should be further along than they are, we can stop them at that point,

rescan and initiate new liners to be made to get back on track or to proceed on get-ting more movement from certain teeth.”

� at advantage proved bene� cial for Jimmy, who required a bite adjustment after wearing his aligners for approx-imately three months. At that point, though, Dr. Andersen simply arranged for another scan, from which another Invisalign program was created.

Results Lead to Big SmilesEach clear Invisalign aligner is designed to be worn day and night for approx-imately one to two weeks, after which the aligner is changed out for a new one. � e entire length of time a patient wears Invisalign clear aligners depends on how misaligned their teeth are.

Jimmy wore his aligners for only a few months, and he is very happy with the results. He is also pleased with how easy the iTero Scanner made it for Dr. Andersen to develop and then correct his treatment.

“I’ve got a terrible gag re� ex, so by using the scanner to create the impres-sions, I didn’t have to go through the hassle of having all that goop in my mouth that would have caused me to gag,” Jimmy shares. “So for me, the scan-ner really helped.

“As for the aligners, I could see dra-matic results in the first three or four weeks of treatment. After Dr. Andersen made a new treatment plan to help correct my bite, I wore them for another nine to twelve weeks, and it was very successful.”

Jimmy celebrated his new smile with a trip to Costa Rica. When he returned, he was � t with custom-made Vivera® clear retainers. Like Invisalign clear aligners, Vivera retainers are a little di� erent than basic orthodontic wire retainers.

� ey are similar to the liners that are used throughout treatment, but they’re made of thicker material and are snapped over the upper and lower teeth to keep the teeth in the correct position. � is is done so there is no movement in the pos-terior or anterior areas.

Patients are instructed to wear the retainers for a speci� ed amount of time to stabilize the teeth. Following that ini-tial period, the retainers only need to be worn at night when sleeping.

“If you stop wearing the retainers, what’s going to happen is what happened to Jimmy,” Dr. Andersen states. “If he had had these Vivera retainers and wore them the � rst time, he would never have had to go through braces a second time.”

� at second time proved to be the charm, though.

“Invisalign is a great treatment plan,” Jimmy shares. “I didn’t feel self-conscious about having braces and was able to � x my teeth the way I liked. And with the iTero Scanner, I was able to see my prog-ress every step of the way.

“I would definitely recommend Invisalign and the iTero Scanner for sure. I also recommend Dr. Andersen and the staff at Bell Tower Dental Care. They made the whole process go smoothly. He’s been my dentist pretty much my whole life, and I plan to keep it that way.”FHCN article by Laura Engel. Photos courtesy of Bell Tower

Dental Care. mkb

*Patient’s name withheld at his request.

The iTero Scanner is a digital imaging device that gives

patients the ability to see 3-D images of what their teeth could

look like following treatment.

Page 12 | Florida Health Care News | Fall 2019 | Lee County Edition iMplant, restoratiVe and FaMily dentistry