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Correct the Cause of

PainFollow stretching protocol for pain-free, � exible back

and neck

Robert Wolf

JEFFREY P. JOHNSON, DC

(see Correct the Cause of Pain, page 4)

C areer business executive Robert Wolf had long-term issues with his back. When he relocated to Florida upon

his retirement two and a half years ago, the Iowa native looked forward to a life of lei-sure and gol� ng. His body had other ideas.

“I’ve had lower back pain through-out my life from playing sports, and I just lived with it,” Robert shares. “I’ve been to many doctors and chiropractors, but nothing really helped. For years, I just put the pain in the back of my mind and went on with my life.”

When Robert � rst moved to Florida, he played golf four or � ve times a week, which he’s sure aggravated his condition. Over time, the pain became severe and got to the point where he could no lon-ger tolerate it. He was eventually forced to give up golf and had di� culty with other activities as well.

“When I would swing a golf club, I would almost scream from the pain, and I’d fall to my knees,” he describes. “It was very troublesome not only to me, but to the golfers playing with me. I had to stop gol� ng altogether.

“I also had to give up walking. I have a Golden Retriever, and we like to go for walks, but I couldn’t walk him. My wife had to do it. � en a friend told me about Dr. Johnson and Sedative Stretching, so I made an appointment.”

Robert was referred to Jeffrey P. Johnson, DC, of Johnson Medical Center in Venice. At his practice, Dr. Johnson o� ers a unique treatment protocol called Sedative Stretching. Sedative Stretching is an expanded and comprehensive form of Manipulation Under Anesthesia, or MUA.

“When I � rst saw Robert, he told me he’s had recurring lower back pain for the past forty years,” reports Dr. Johnson. “His most recent episode started six months prior to coming into my o� ce. He was not improving and at times, the pain was debilitating.

“An MRI of the lumbar spine showed advanced degenerative changes occurring in his lower back. Robert rated his pain as an eight, and described it as aching, sharp, stabbing, sti� and tight.”

“Dr. Johnson said he believed Sedative Stretching would be very good for me,” says Robert. “I said, Let’s do it.”

Increased Stiff ness and PainLike Robert, Colleen Sterling had long-term issues with her back. When she was in her 20s, she learned she had scoliosis. As she got older, the curvature in her spine became more pronounced. Because her spine was not straight, she su� ered con-stant pain in her lower back and neck.

“I’m kind of a vain person,” Colleen admits. “I never wanted the scoliosis to look bad, so I would try my best to � ght my body and stand as straight as I could. But that e� ort made my lower back and neck very painful.

“� ankfully, I have a high threshold for pain, so I was able to manage it pretty well and work through it.”

A year and a half ago, after she moved to Florida from Ohio, Colleen needed to � nd a chiropractor experienced in treating scoliosis patients. A friend in her condo association, who also has scoliosis, recom-mended Dr. Johnson.

“Dr. Johnson was great,” she relates. “He explained that with scoliosis, I have muscles on one side of my body pulling my spine. On the other side, the muscles are stretching my spine. He said he thought Sedative Stretching would help me.

“Dr. Johnson never tried to push me to have Sedative Stretching or said, You need to get this done. He’s a great doctor and very professional, so I trusted him and decided to go through with it. It’s the best thing I’ve ever done.”

Restricted MovementSedative Stretching can bene� t many peo-ple with various painful muscle and joint conditions. Ideal candidates are those with conditions such as unresolved neck and back pain, herniated discs, spinal stenosis, sciatica, frozen shoulder, acute and chronic muscle spasm, headaches and failed back surgery syndrome. � e pro-cedure can also bene� t people who want to regain lost � exibility or those who are “sick and tired” of being “sti� and sore.”

The sooner a person addresses the cause of that condition, the better. � e chronic sti� ness, tightness and pain causes excessive “wear and tear” on the joints of the spine and extremities, resulting in per-manent degeneration and arthritis.

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Advanced RejuvenationReverse Hearing Loss

Sedative Stretching

Erick A. Grana, MD, is a diplomate of the American Board of Physical Medicine and Rehabilitation and the American Board of Electrodiagnostic Medicine, with subspecialty certi� cation in pain medicine. After he received his medical degree from the University of Puerto Rico School of Medicine, he completed his internship and residency at the university’s hospital and was subsequently awarded a fellowship from the Department of Rehabilitation Medicine at the University of Washington in Seattle. Dr. Grana is a former assistant professor at Baylor College of Medicine in Houston and a member of the American Medical Association, the International Spinal Injection Society and the Florida Academy of Pain Medicine.

Don’t Operate, RegenerateRegenerative Orthopedic Institute

is located in Tampa at 8011 North Himes Avenue, Ste. 3

ERICK A. GRANA, MD

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

–

Nonsurgical protocol regenerates injured, arthritic joints

Dave Drakulich has always excelled at sports. Even no w, he plays at an elite level. In September, his team won

the world championship of senior soft-ball for the third time in four years. Every member of his team is 80 years old or older.

Dave’s proud he’s able to perform at such a high level after su� ering a devastating knee injury years ago. He recalls the injury to his knee and how it kept him out of the game.

“I severely damaged my right knee playing fast-pitch softball when I was thirty-eight,” confirms the Northern Ohio native. “It was so bad at the time, I had to quit playing. I couldn’t run. My knee became habitually swollen after that, and it would occasionally bother me. If I didn’t exercise, it really hurt.

“After I moved to Florida, I got asked to play softball in a church league, and I started playing again. I ended up in an over-� fty league, and I’ve been in that league ever since.”

Still, the swelling continued in Dave’s right knee. It often became painful after a day of activity, especially gol� ng, one of his favorite pastimes. � is spring, he decided it was time to seek help for his knee. He wasn’t interested in anything surgical and wanted to investigate a leading-edge treatment he’d heard about called stem cell therapy.

Dave also heard Erick A. Grana, MD, at Regenerative Orthopedic Institute in Tampa was a pioneer in this safe, nonsur-gical treatment for eliminating joint pain. Using stem cell therapy, Dr. Grana has helped hundreds of people � nd relief from painful knees, necks, shoulders, elbows, hips, lower backs and other joints. In June of this year, Dave asked Dr. Grana for help with his knee.

“I met with Dr. Grana, and he laid out a plan of action for me,” reports Dave. “He explained that the therapy would include � ve injections and have a six-week healing period, but my knee would continue to regenerate after the six weeks. He scheduled the treatment for the Monday after Father’s Day, which was the nineteenth of June.”

On the Friday before, Dave played golf with his son. He soon regretted it, however, as his knee became very painful afterward.

“� at night, I couldn’t sleep because my knee hurt so badly,” he relates. “It was a dull ache, but it hurt enough that I couldn’t sleep. On a scale of one to ten,

the pain was an eight and half to nine. Dr. Grana said it was caused by the twist-ing and turning of my golf swing.

“On Monday, I had the shots, and I’ve had no pain since.”

Regeneration Stimulation“When Dave came to me, he was experi-encing knee pain and decreased range of motion at the joint, resulting in decreased

function,” describes Dr. Grana. “He was having di� culty with work and sports, and wanted to get back to his normal activities. He had osteoarthritis in his right knee due to a past injury. He was a good candidate for stem cell therapy.”

With stem cell therapy, people can regain function of a damaged joint with-out surgery. It is regenerative medicine that harnesses the body’s natural healing mechanisms. Not only does it o� er pain relief, but it also has the capacity to repair damage that moderate-to-severe arthritis or injuries can cause.

Stem cell therapy is autologous, mean-ing it utilizes stem cells, platelet-rich plasma (PRP) and growth factors from the patient’s own body. Using the patient’s own cells eliminates the chances of reac-tive side e� ects or rejection.

These harvested cells are then injected into the painful area to stimulate

regeneration of damaged tissue and the heal-ing of tendons, ligaments, joints or spinal discs. � e goals are to relieve pain, restore function and, importantly, help people avoid surgery and the risks that come with it.

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

“Patients with osteoarthritis, like Dave, have very few choices other than surgery when the condition advances and damages the joint,” he adds. “Since sur-gery has potential complications, when we treat arthritic joints without surgery, patients do much better.”

Pioneered ProtocolsTo e� ectively deliver stem cells, PRP and growth factors into the pain generators in and around joints, such as shoulders and knees, Dr. Grana pioneered a specialized protocol called RegenaJoint. He also developed a sys-tem to treat the spine in a similar manner through a process called RegenaSpine.

“As part of the protocol, we extract stem cells from bone marrow or fat and platelet-rich plasma from the patient’s own blood to use in the problem areas,” explains Dr. Grana. “We perform RegenaJoint by placing injections into

the knee joint and ligaments surround-ing the knee, the ligaments around the shoulder and inside the shoulder joint, or into the hip joint area. If the problem is in the back, the RegenaSpine procedure can be performed on the discs and facet joints of the spine.”

“� e therapy was relatively painless,” o� ers Dave. “Dr. Grana explained what he was doing all the way through the pro-cedure. When he inserted the needle, the solution just felt a little cold. I got imme-diate relief. I could do everything normal except golf for the next four weeks.”

To precisely deliver stem cells into the painful area, Dr. Grana uses image guid-ance through ultrasound and � uoroscopy (continuous x-rays). Many other clinics do not use this process.

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

“Many patients over seventy believe stem cell therapy will not help them because their stem cells are old and will not work as well. Dave’s case shows that senior patients do very well with this procedure. He was able to continue his active lifestyle.”

� e minimally invasive RegenaJoint and RegenaSpine procedures are per-formed in the o� ce with no bleeding, scarring or downtime. Patients typically resume normal activities right away.

Stem Cell FertilizerAfter the � rst four weeks, Dave went back to Regenerative Orthopedic Institute, and Dr. Grana took a blood sample from him. � e doctor’s assistant processed the sample and removed the platelets, and Dr. Grana reinserted them into Dave’s knee as a booster.

“I say it was the fertilizer,” quips Dave. “Dr. Grana doesn’t call it that, but the blood platelets are what help the stem cells work harder.”

Dave notes his pain level before stem cell therapy had gotten as high as a nine. Now, he reports, it’s a zero. He’s returned to all of his activities without swelling or discomfort.

“After seven weeks, I started gol� ng again,” he veri� es. “Now, I can turn and swing properly, and there’s no pain. I still ache a little bit if I overdo it in the garden, but overall, the therapy was very successful.

“� e sta� at Regenerative Orthopedic Institute is very helpful and considerate. Dr. Grana’s explanation of how the pro-cedure worked was exact. He certainly knows his business. Dr. Grana did a great job with my therapy, and if I had to do it over again, I would.”FHCN article by Patti DiPanfilo. Graphic from istockphoto.

com. Photo by Jordan Pysz.mkb

At , Dave plays softball at an elite level.

at 81!

Page 2 | Florida Health Care News | Spring 2018 | South Sarasota County Edition Stem cell therapy/pain management

DAVID A. NAPOLIELLO, MD, FACS

For more information, please visit www.DavidNapolielloMD.com

David A. Napoliello, MD, FACS, is board certi� ed by the American Board of Surgery and is a fellow of the American College of Surgeons. He earned his undergraduate degree at Bucknell University, Lewisburg, PA, and his medical degree at Georgetown University School of Medicine. Dr. Napoliello completed his residency in general surgery at Penn State–Geisinger Medical Center, Danville, and a Fellowship in Minimally Invasive and Advanced Laparoscopic Surgery at Mayo Clinic Jacksonville. He is past chief of surgery for Venice Hospital and Lakewood Ranch Medical Center. In addition, Dr. Napoliello was voted one of the top general surgeons in Sarasota and Manatee Counties by his peers and patients for the Castle Connolly list of America’s Top Doctors eight years in a row.

Dr. Napoliello and his staff look forward to answering your questions. For more information or to schedule an appointment, call the number below or visit them at one of their two

offi ce locations:Bradenton

Medical Offi ce Building 8340 Lakewood Ranch Blvd., Suite 101

Venice1211 Jacaranda Blvd.

(941) 388-9525

Pennsylvania native Steve Stevens made a dramatic location change to recreate his career. He left his hometown to become a

professional yacht broker in Sarasota.“I moved to Florida in 2000 from

outside of Philadelphia,” he explains. “I relocated down here for the nice weather and to get into the boat business.”

Business was brisk, often turning into six or seven-day workweeks. It left him little time for leisure activities. In October, however, even work became difficult when a health issue started slowing him down and interfering with some of his usual undertakings.

“I had a hernia on my right side,” shares Steve. “It was just a normal hernia with bulging in the groin, discomfort and pain.

“It was bothersome, but I went to work every day and did my thing. It wasn’t like I was at home sick, but it de� -nitely impeded my daily functions, like lifting and bending.”

Steve went to his primary care physi-cian for treatment. His doctor con� rmed Steve’s hernia, but knew he needed sur-gical treatment and wanted to send him to a surgeon with hernia expertise. His doctor referred Steve to David A. Napoliello, MD, who is board certi� ed by the American Board of Surgery and is a Fellow of the American College of Surgeons. When Steve met the surgeon, he was immediately impressed.

“Dr. Napoliello was great,” he says. “I really enjoyed meeting him. He was very personable. He got right to the point, and he explained all my choices. What I liked most about him was that he was open to what I wanted. He gave me all the options, and we agreed on the one that would make me feel the best.”

Options available include open sur-gery under general anesthesia or a less invasive procedure using light sedation, called twilight sedation or twilight sleep, which relaxes the patient and reduces anxiety but does not leave the patient unconscious. Another option is lapa-roscopic surgery, a minimally invasive technique that uses thin instruments

and a camera inserted into the abdomen through tiny incisions.

“We chose surgery using twilight sleep instead of general anesthesia because I don’t do well with general anesthesia,” relates Steve. “� e recovery is a little lon-ger than with the laparoscopic surgery, but I felt better about doing the twilight sleep, so that’s the route we took.”

an incision, pushes the protruding tissue back into place and stitches the tissue lay-ers together. � e potential disadvantages of this type of surgery include relatively long recovery periods, high recurrence rates and discomfort following surgery.

“Today, we can o� er a variety of both minimally invasive open procedures and laparoscopic procedures. Unlike the ten-sion repair, laparoscopic and minimally invasive open procedures are tension free because the stitches or sutures used do not put tension on the sides of the defect to keep it closed. Instead, we use special mesh patches that limit the size of the required incision. � ese procedures o� er lower recurrence rates, quick recovery and only minor discomfort afterward. � e minimally invasive open approach can also allow the patient to avoid gen-eral anesthesia.”

� ere are two main options for lap-aroscopic surgery, continues the skilled surgeon. “In the transabdominal approach, the physician makes a small incision and slides a laparoscope, which is a thin tele-scope, through the abdominal wall into the abdomen. For the preperitoneal approach, the laparoscope slides in between the tis-sues of the abdominal wall. With both approaches, surgeons view the hernia and surrounding tissue on a video screen.

Bulging TireHernias can develop in adults and chil-dren alike as a result of heavy lifting, straining, coughing or any unusual stress that causes a sudden increase of intra-abdominal pressure. Some her-nias are congenital, or present at birth, whereas others develop as a result of a predisposition for hernia. Also, anyone who has had surgery may experience a weakening of tissue at the incision site that could result in a hernia.

“Steve had an inguinal hernia, which is the most common type of hernia,” notes Dr. Napoliello. “Inguinal hernias occur due to a defect or weakness in the abdom-inal muscle wall through which intestine and fat layers protrude, forming a visible bulge in the groin area.

“To visualize the dynamics of it, think of an automobile tire. The abdominal wall is like the thick outer wall of the tire. Should the tire get damaged, the inner tube can push through the weakened area or crack, forming a small bubble. If the abdominal wall becomes weakened, the tissue that lines the inside of the abdo-men and holds the intestines in place, called the peritoneum, can bulge into the outer wall. In the tire, the inner tube can become strangled by the pressure of the edges of the crack through which it pro-trudes. It’s the same with a hernia.”

� e � rst sign of a hernia is a bulging under the skin. Additional symptoms may include discomfort while lifting heavy objects, sneezing or coughing, straining while using the toilet, or while standing or sitting for long periods of time. Because delayed treatment can sometimes result in the intestine being trapped inside the hernia sac, resulting in gangrene, any bulge should be brought to a physician’s attention immediately so that diagnosis and treatment can begin. Left untreated, certain complications from hernias can be fatal.

Repair TechniquesTo repair hernias, surgeons have the option of one of several surgical tech-niques. They choose the best option depending upon the patient and the size of the hernia.

“Formerly, the only hernia repair option available was an open surgical pro-cedure called a tension repair,” describes Dr. Napoliello. “The physician makes

Fine Choice� e surgery Dr. Napoliello performed on Steve required an incision, but it was less invasive than a general open proce-dure. Using the twilight sedation, Steve su� ered no risks or side e� ects associated with general anesthesia. His recovery was shortened as well.

“� e procedure itself and the recovery were � ne,” Steve relays. “Dr. Napoliello told me what to do and not to do, and I followed his directions. When I went to the follow-up appointment in his o� ce, he checked everything and said it was good, and now I’m feeling � ne.”

Steve is back to everyday activities without restrictions. He is thrilled with the outcome of his surgery and how quickly he is back to his routine. He thanks Dr. Napoliello for getting him there.

“� e healing is perfect,” reports Steve. “I’m back to the gym four days a week doing what I want. I’m doing everything I couldn’t do before.

“Dr. Napoliello did a great job, and he’s a very personable doctor. I really liked that he went through all the opera-tive possibilities, and we made a decision together. I would highly recommend Dr. Napoliello.”FHCN staff article. Photo by Jordan Pysz. Stock photo

from istockphoto.com. mkb

South Sarasota County Edition | Spring 2018 | Florida Health Care News | Page 3minimally invaSive general Surgery

(continued from page 1)

“People start losing � exibility when their typical, daily activities cause a minor injury that leads to chronic, low-grade in� ammation. Many times, this occurs in early childhood and is a long-forgotten event,” informs Dr. Johnson. “In� ammation is part of the body’s natural healing process, which lays down a mesh of connective tissue, commonly known as scar tissue. Over time, layer upon layer of scar tissue can form in the muscles, tendons and ligaments around the joints, restricting the joints’ ability to move properly. � ese layers of scar tissue are called adhesions.”

� e slow and insidious loss of � exibility is among the warning signs and symptoms generally associated with adhesions, as are increasing achiness and soreness. Most people attribute this to normal aging. While it’s very common to become sti� and sore with age, it’s not normal.

“When this occurs, people will compensate how they move their bodies, although they don’t always realize it,” acknowledges Dr. Johnson. “� is is evident everywhere while watching the way people walk, bend, twist and turn.”

Sadly, many people wait until signi� cant damage has occurred from excessive wear and tear before seeking appropriate care. Often, patients will utilize over-the-counter and prescriptive medications, which help alleviate their symptoms. Unfortunately, this gives the patient a false sense of being “cured” while the underlying scar tissue continues to cause excessive damage.

Flexibility ProtocolDuring Sedative Stretching, the patient is put under light sedation, sometimes called “twilight” sedation. With the patient relaxed, doc-tors can then take the a� ected joints through their normal full range of motion, freeing the adhesions that have developed between the joints that are causing the pain.

“While the patient is sedated, we use light, comprehensive stretch-ing techniques,” explains Dr. Johnson. “Since we don’t have to contend with tense, guarded muscles, we are able to free up the scar tissue and mobilize the joints without causing the patient any discomfort. � is would be impossible to do without the use of sedation.”

A highly trained team of medical professionals coordinates the Sedative Stretching procedure. Generally, there are multiple health care providers present, including an anesthetist and several nurses. Patients usually require only one procedure. It is very rare that patients require a second procedure to fully address their condition.

Je� rey P. Johnson, DC, is a member of the National Academy of Manipulation Under Anesthesia Physicians and has per-formed more than 1,000 procedures to date. He is also a graduate of Life Chiropractic University in Marietta, GA, with additional training through the National College of Chiropractic in Chicago. His training included: Manipulation Under Anesthesia, proprietary substances and chiropractic adjunctive physiotherapy. He earned his undergraduate

degree from the University of South Florida in Tampa. Dr. Johnson holds certi-� cation from the National Board of Chiropractic Examiners and is a member of the American Chiropractic Association, the Florida Chiropractic Association, the American Board of Disability Analysts and other professional and civic organi-zations. He has been in private practice since 1986.

Stop the Pain

For more information, please visit www.DRJPJ.com

For a consultation appointment, please contact Johnson Medical Center, located in Venice at:

401 Johnson LaneSuite 101

(941) 484-5333

Without back pain, Colleen can work in her yard.

Correct the Cause of Pain

Following the procedure itself, there are typically a couple of weeks of rehabilitation to reinforce the increased movement obtained from the procedure. During this time, patients are instructed how to perform stretching exercises to prevent the condition from recurring, notes Dr. Johnson.

“By following this protocol, patients regain the � exibility they had decades before, and typically, they return to activities they haven’t done in years,” he asserts. “� is is truly correcting the original cause of their conditions.”

The Rest of the StoryColleen reports feeling no pain after her Sedative Stretching session. � at encouraged her as she continued with the rest of the treatment protocol. After the procedure, her daughter told her the “scoliosis hump” on her back was substantially smaller and that she was stand-ing much straighter and taller.

“� ere’s more to do after the procedure is done,” she states. “I have to do my part with exercises at home. I do yoga every other day, and stretching on the days I don’t do yoga. � is keeps the results going.”

Robert agrees that the follow-up program complements the e� ects of the Sedative Stretching.

“I was careful right after the procedure,” he says, “because I knew there was still work to be done if I wanted the relief to be long-lasting. I needed to do the rest of the program, which is therapy, stretching and exercise.”

Both Colleen and Robert experienced pain relief and improved � exibility after their Sedative Stretching sessions. � ey were able to return to their activities without di� culties.

“When I � rst came out of sedation, I felt cured!” marvels Robert. “I hadn’t felt that kind of pain relief in a long time. Before, I didn’t get any relief unless I took some serious pain pills. But after Sedative Stretching, I was ready to golf that afternoon. I felt great.

“I’m back to gol� ng. I can also walk my dog, and he just loves me. He’s pretty happy, and so is my wife. It put quite a burden on her when I couldn’t do it. My pain is better now. I rate it as a zero, whereas it used to be an eight.”

“Since the treatment, my � exibility is amazing,” o� ers Colleen. “Now, I can do all the yoga positions I couldn’t do before without pain. I can do yoga like I did when I was in my twenties. My pain level now is about a two, and some days, I don’t feel any pain.

“I feel so blessed to have found Dr. Johnson because there aren’t that many doctors who do Sedative Stretching. He’s � fteen minutes from where I live, but I would drive an hour to see him if I had to. � at’s how good I think he is. Dr. Johnson is an amazing healer!”FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

“Now, I can do all the yoga positions I couldn’t do before without pain.”

– Colleen

“When I first came out of sedation, I felt cured! I hadn’t felt that kind of

pain relief in a long time.” – Robert

Robert’s dog, Buddy, is also bene� tting from his owner’s recovery.

Page 4 | Florida Health Care News | Spring 2018 | South Sarasota County Edition

Barry LevineExecutive Publisher

Gina L. d’AngeloCFO/HR

Roy CummingsEditorial Supervisor

Michelle BrooksCreative Director

Brian LevineProject Coordinator

Patti DiPanfiloAnnette MardisEditorial Staff

Laura EngelProduction Assistant

Nerissa JohnsonGraphic Designer

Nerissa JohnsonJordan PyszPhotography

Steve TurkMario Hill

Kent BoothRick BowserRobert Mize Distribution

Johnson Medical CenterSedative Stretching

Regenerative Orthopedic InstituteStem Cell Therapy/ Pain Management

David A. Napoliello, MD, FACSMinimally Invasive General Surgery

Medic InfusionWeight Loss

Siesta Dental General, Cosmetic and

Emergency Dentistry

South Florida Eye ClinicOphthalmology

Family DermatologyDermatology

Joyce Vein & Aesthetic InstituteVein Treatment and Aesthetics

Sarasota Foot and Ankle Center

Podiatry

Advanced RejuvenationLaser Therapy

Advanced Orthopedic CenterOrthopedic Surgery and

Sports Medicine

215 Bullard ParkwayTemple Terrace, FL 33617

(813) 989-1330

Florida Health Care News

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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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Sedative Stretching

Tetyana Metyk, MD , graduated from the Crimea Medical Institute in Simferopol, Ukraine. Dr. Metyk is board certified in internal medicine. She is affiliated with Bayfront Health Port Charlotte and Fawcett Memorial Hospital.

Look and Feel Your BestDr. Metyk and her sta� welcome

new patients to their practice. The o� ce is in Port Charlotte at: 3191 Harbor Blvd., Suite D

(941) 613-1919

MEDIC INFUSIONTETYANA METYK, MD

R eitha Butson is a retired nurse, so she knows all too well the potential conse-quences of being overweight.

Nevertheless, the Illinois native has struggled for years to keep her own weight in check, never quite obtaining the desired results she sought through the use of traditional diet programs and weight-loss products.

“� rough the years, I tried pills and popular diet plans and would lose some weight, but it seemed to come back on very quickly,” she confirms. “What’s more, I’d be on those diets for months and only lose a little weight, maybe ten or � fteen pounds.

“My weight became a health prob-lem. I have degenerative joint disease and had a knee replacement. � e extra weight bothered my knees and my back, and recent lab work showed my thyroid was a little sluggish.”

Are You Struggling with Your Weight?

The medically supervised weight-loss program at Medic Infusion may be just the thing for you! For more information or to schedule a consultation, call (941) 613-1919. The initial consultation is free.

LOSE WEIGHT EffortlesslyMedically supervised program produces dramatic results

weight-loss program can continue to lose weight after their 23 or 46 days are up if they maintain a sensible diet and engage in some exercise, reports Dr. Metyk.

“As part of our comprehensive weight-loss program, we recommend patients continue to exercise after their cycle is com-pleted. Before they began the program, many patients felt fatigued and did not have the energy or desire to exercise because of their weight. Afterward, however, they regain that desire because they feel so much better.”

Maintaining SuccessAfter completing her 46 days on the Medic Infusion weight-loss program, Reitha entered the maintenance phase. She contin-ues eating a sensible diet and getting daily physical activity, either exercising in her pool or riding her bike. She was inspired to continue because of the excellent results she achieved through the program.

“I lost more than thirty pounds, and I’m still working on it,” she enthuses. “I’d like to lose another twenty, but even now I’m � tting into clothes I haven’t worn in years, which makes me feel good. And

I’m more energetic. I feel like there’s been a change in my body. It seems like I burn calories di� erently than I did before.

“I feel a lot better. When I walk now, I don’t get out of breath like I used to, and my joints feel much better without so much weight on them. Next month, I’m due to get all my lab work, and I’m con� dent my choles-terol and sugar levels will have improved because thirty pounds is a good amount of weight loss.”

Reitha relates that she has already recommended Medic Infusion and

Dr. Metyk to many of her friends and family and that some of them have started seeing the experienced and caring internist.

“Dr. Metyk spends time with her patients,” says Reitha. “It’s not like she’s rushed. She makes you feel like her time is your time while she’s there with you. And she actually sits down and looks at you and listens to what you have to say.

“I recommend Medic Infusion’s med-ically supervised weight-loss program, especially for people who have tried every-thing else, because this program works!” FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. Before

image courtesy of Reitha Butson. Graphic from Pixbay.com. nj

thirty to � fty pounds. I carefully manage the patient’s health throughout the course of the program.”

“It was a low-calorie diet, but as long as I did the injections, I didn’t really get hungry,” reports Reitha. “Sometimes, I had to remind myself to eat. � e diet is pretty simple. I ate regular food, but my choices were limited. I could eat � sh, chicken, green vegetables, shrimp and lobster, and salad of course. It was easy to prepare meals ahead of time.

“Dr. Metyk recommended limited exercise. She said to do about � fteen minutes a day of moderate activity. I mostly got in the pool and did a few exercises in the water. � e � rst three days on the diet, I lost four pounds. I lost three-quarters of a pound to one pound every day after that.”

Energizing AdvantagesAs people age, their metabolism slows down. � ey simply don’t burn as many calories from food as e� ciently as they did when they were younger, observes Dr. Metyk.

“Teenagers can eat multiple slices of apple pie and not gain weight, but peo-ple in their � fties gain weight just looking at the pie,” she remarks. “� at’s because their metabolisms are slower. Metabolism involves all the processes that occur inside the body to keep it functioning.

“HCG has a few fundamental e� ects on the body. For one thing, it naturally increases metabolism when used with a low-calorie diet. When a person is con-suming fewer calories to generate energy, HCG prompts the body to use its stored fat to get the energy for its daily repairs and activity, thus energizing metabolism.”

A second e� ect of HCG is it greatly reduces cravings for food. Instead of feel-ing hungry, people on the Medic Infusion program are able to eat a sensible diet and feel full. As a result, they consume fewer calories and lose weight.

“As part of our program, we implement nutritional counseling with our patients,” stresses Dr. Metyk. “We review guidelines for appropriate, healthy diets and help them create eating plans using fresh foods.”

There are other advantages to using HCG in Medic Infusion’s medically super-vised weight-loss program. HCG also creates a leaner, � tter appearance by building additional muscle. � is helps patients keep the weight o� after the HCG is stopped because muscle is a potent calorie burner.

“Further, many patients report that their various health ailments improve after being on the program,” informs Dr. Metyk. “� ey tell me their arthritis feels better, they’re no longer fatigued and

have more energy. Once people with knee, hip or back pain lose the extra pounds, their joints feel and move much better.

“I’ve even had some patients who were feeling a little depressed say their moods improved after being on the pro-gram. � at is oftentimes the result of weight loss, as well as increased muscle tone and energy.”

People on the Medic Infusion

Reitha maintains her

weight by riding her bike

Before

Lab work also showed that in recent years Reitha’s blood-sugar levels had begun to creep up as well. Fortunately, they have not yet reached the pre-diabetes level, but “as a nurse, I knew I needed to get a handle on these things,” Reitha states.

“I was quickly approaching two hundred pounds, and I was really getting anxious about my weight. I just turned sixty-eight, and I realized that at my age, I had to get some of the weight o� . I knew if I took it o� , I would feel better.”

Reitha shared her concerns with her primary care physician, internist Tetyana Metyk, MD, at Medic Infusion in Port Charlotte. The physician agreed that Reitha needed to lose weight to increase her joint mobility and safeguard her over-all health. Dr. Metyk told Reitha about a medically supervised weight-loss program o� ered through her practice.

“Our weight-loss program involves following a low-calo-rie, low-carbohydrate diet supplemented with daily, painless injections of human chorionic gonadotro-pin, or HCG, a hormone manufactured by the human body,” describes Dr. Metyk. “� e program cycle lasts for twenty-three or for-ty-six days, depending on how the patient progresses.

“This program generally produces dramatic weight loss. Many patients lose an average of up to a pound a day. By the end of the twenty-three- or forty-six-day cycle, it is not unusual to see patients lose

“I lost more than thirty pounds… I’m � tting into clothes I haven’t worn in years,

which makes me feel good. And I’m more energetic.” – Reitha

South Sarasota County Edition | Spring 2018 | Florida Health Care News | Page 5Weight loSS

ALEXANDER GAUKHMAN, DMD

A l e x a n d e r Gaukhman, DMD, e a r n e d h i s d e n -tal degree at Nova S o u t h e a s t e r n University College o f D e n t i s t r y, F t . L a u d e r d a l e . H e

completed his undergraduate stud-ies at Florida Atlantic University, Boca Raton. Dr. Gaukhman is a diplomate of the International Congress of Oral Implantologists and a member of the American Academy of Implant Dent is t r y, Academy of Genera l Dentistry, Florida Dental Association, Sarasota Dental Association and American Dental Association.

Better bite,

better smile

Dr. Gaukhman is accepting new patients

and welcomes the opportunity to help you improve your smile and bite function. He invites

the readers of Florida Health Care News to visit

or call Siesta Dental.

Sarasota Avenida Navarra

(941) 266-7000Venice

US Hwy. Bypass S. (941) 375-4488

Osprey S. Tamiami Trail,

Suite F(941) 497-5650

ç Dental implants

ç Extraction of teeth

ç Crowns

ç Deep cleaning

ç Bleaching

ç ZOOM!® whitening

ç Root canals

ç Laser surgery

ç Invisalign®

ç Dentures

ç Partials

ç Bridges

Siesta Dental ServicesSiesta Dental specializes in all aspects of dentistry,

including but not limited to:

H ailing from a little town outside Niagara Falls, New York , Gera ld Conahan � rst became a snowbird in 1998 when he

bought a condo in Venice. Shortly thereafter, Gerald’s annual, two-month stay in Florida turned into a nine-month stay, and now he’s o� cially a resident of the Sunshine State.

In Florida, Gerald found more than warm weather and a great place to spend most of the months of his retirement years. He also discovered the answer to a longtime problem he had with his teeth.

“When I was very young, I had soft teeth,” Gerald shares. “Even though I went to the dentist regularly, I couldn’t keep my teeth from decaying. When I was in my twenties, one tooth got so bad that my den-tist said he couldn’t save it. One thing led to another, and eventually, all my teeth had to be removed. I’ve been wearing upper and lower dentures ever since, for at least thirty, maybe forty years.”

In most cases, upper dentures � t securely because the palate enables the creation of enough suction to hold the appliance in place. � is was true in Gerald’s case. � e story is often di� erent with lower dentures, however.

Lower dentures can be more di� cult to keep stable. � is is because there is no palate in the bottom jaw, due to the location of the tongue, and less suction is produced. As a result, lower dentures tend to slip and slide.

Like many people with lower dentures, Gerald had di� culties keeping his lower denture secure.

Gerald spreads his smile all around town now

Gerald Conahan

– Rita

“I’m very happy with the entire experience and my decision to go to

Siesta Dental, and I’m ecstatic about

my results.”

– Gerald

“I would absolutely recommend the

implant process and Siesta Dental.

Everybody there is very professional, and they’re very patient oriented”

“After a while, my lower denture would become loose and get very sloppy,” Gerald describes. “It wasn’t comfortable, and I had trouble chewing. I really had to watch what I ate.

“I couldn’t eat anything that took a lot of heavy chewing, especially steak, unless it was a � let mignon, and even that had to be very, very tender. I couldn’t eat any other cut of steak or anything else that was tough to chew.”

Not long ago, Gerald learned how some dentists use dental implants to secure dentures and keep them from moving. He inquired about them at one dental practice but was told he was not a candidate because he lacked su� cient bone in his jaw to bond with the implants.

Gerald was not deterred. He mentioned his interest in dental implants to another dentist, who referred him to Alexander Gaukhman, DMD, of Siesta Dental. Dr. Gaukhman is an experienced, skillful dentist who o� ers exceptional general, cos-metic and restorative dentistry at his o� ces in Sarasota, Venice and Osprey.

“I had already been to one dentist and had new dentures made,” relates Gerald. “Still, I had it in the back of my mind to look into the implants. When Dr. Gaukhman looked me over, he said, Yes. He could put the implants in with the bone I had left in my lower jaw.”

Atypical Scenario“Gerald was referred to my practice by another dentist speci� cally because he could not keep his lower denture stable,” reports Dr. Gaukhman. “He could not eat because the denture would slide right out.

“� e denture he had was made prop-erly, but Gerald didn’t have enough bone in his lower jaw to support it, which is very common. However, he did have just enough

bone to place dental implants. Securing a lower denture with dental implants is the most e� ective way to stabilize it. I recom-mended two implants to secure Gerald’s lower denture.”

Dental implants are screw-like metal posts that are surgically placed into the jawbone and serve as the foundation for replacement teeth. � e replacements may be crowns in the case of single teeth, or bridges or dentures for multiple teeth. Implants are made of a titanium alloy that fuses with the patient’s bone to become a solid unit.

When dentures are secured by implants, they don’t rock or move; they stay in place when wearers speak and eat. Secured den-tures also provided added strength for biting and chewing. At Siesta Dental, implants are often placed on the day of tooth extraction. In most cases, temporary dentures are also created at that time.

“Typically, once the patient’s problem is diagnosed and the treatment is determined, I take impressions of the teeth,” expounds Dr. Gaukhman. “When the dentures are ready, which is usually the same day or the next day, I extract the teeth and put the dentures in right away. � e dentures act like a bandage. � ey stop bleeding and limit swelling.

“For the next three to six months, the patient wears temporary dentures until the implants fuse and the gums heal. � en the temporary dentures are replaced with the permanent appliances.”

Gerald’s situation was a little di� erent. He had recently gotten new dentures and didn’t need another lower denture made for him, temporary or permanent. � at was no problem for Dr. Gaukhman. He was able to adjust Gerald’s existing denture to � t with the implants.

“In Gerald’s case, I placed the two implants, and after they healed, I was able to retro� t his existing denture,” con� rms Dr. Gaukhman. “We do not have to start from scratch for people who have relatively new, two- to three-year-old appliances. Retro� tting a denture essentially involves making two holes in the denture to accept the implant attachments.

“Since we have our own dental lab on site at Siesta Dental, it is especially easy for us to do this work. It takes just a couple of hours and can be done in one visit.”

“Dr. Gaukhman put in the implants for me, and that went very well,” says Gerald. “He gave me some type of Novocain®, and the procedure wasn’t too bad. I went back to the o� ce regularly so he could check the implants and make sure everything was okay.

“Several months went by while we waited for the implants to fuse with the bone in my jaw. Just a couple of weeks ago, he pre-pared my lower denture with the clips that snap onto those implants, and everything went � ne with that as well.”

Upper Denture Downside Rita* is a retired administrative assistant and a Staten Island native who relocated to Florida four years ago to � ee the cold and snow of New York. But she couldn’t � ee from a deteriorating dental issue that had been dogging her for years.

“I knew for a while I had a problem with my upper gums, but I kept putting o� doing anything about it,” recalls Rita. “Every time I went to the dentist, I’d hear the same thing about how my gums were receding.

“I had pain occasionally, and there was sensitivity because as my gums receded, more nerve was exposed. I was told to expect that.”

Dentists typically monitor progression of recession by measuring the gum pockets. � ese are the spaces between the edge of the gums and the teeth. � e deeper these pockets become, the more likely it is that a tooth will loosen and the higher the risk of losing the tooth.

“I wanted to do something about my gums before my teeth fell out,” recounts Rita. “When I � rst moved to Florida, I lived in Bradenton, and I went to a dentist there. He wanted to � t me for a denture, but I wasn’t sure about that then.

“When I decided it was the right time to get the work done, I started looking around for a dentist. I wanted dental implants, and since I was told I probably needed a denture, I went online and did research.”

Rita wanted a dentist with expertise in dentures and implants to do the job, and her search led her to Dr. Gaukhman at Siesta Dental. She saw that Dr. Gaukhman scored rave reviews online. � e dentist was also close to her new home in Venice, which was a bonus.

Rita’s mind was made up to visit Dr. Gaukhman when she read about his process for restoring smiles with implant-retained dentures in Florida Health Care News. She read that he makes the molds, extracts the teeth and creates a temporary denture in his in-o� ce lab in one day.

“I wanted dental implants, and I saw that Dr. Gaukhman did implant surgery at Siesta Dental, so I went there,” o� ers Rita. “I had all my top teeth removed and got a temporary denture the same day. I expected that, but I didn’t expect the denture to look so nice or the process to cause so little pain.”

“When Rita � rst arrived, she had badly receding gums,” verifies Dr. Gaukhman. “When the gums recede due to periodontal disease, patients like Rita lose bone due to bacteria. � e only treatment is to remove the teeth because those bacteria cannot be killed with just antibiotics.

“Rita had tried antibiotics and deep cleanings to treat her condition, but those attempts were unsuccessful. Her condition got worse until her upper teeth were no longer salvageable, so I extracted them and created a denture for her.”

While Rita was pleased with the appear-ance of her temporary denture, she was less than thrilled with the way it felt.

“It covered the roof of my mouth, and that was annoying, as well as a little uncomfortable,” she explains. “It didn’t hurt; it’s just that I couldn’t eat the way I wanted to because I couldn’t really bite into certain foods, like steak. I didn’t eat steak for six months.”

Secure SolutionUpper dentures generally � t securely because there’s enough suction from the palate to hold them in place. However, traditional upper dentures have some drawbacks that can be corrected by securing them with dental implants.

“� e tongue is mainly responsible for discerning taste, but the palate, or roof of the mouth, plays a role as well,” informs the dentist. “When a denture is made for the upper jaw, it covers the palate, which can deprive patients of sensing the full range of tastes.

“In addition, some patients have a gag re� ex due to the denture being placed over the palate. With an implant-retained upper denture, the shape of the denture is more like a horseshoe instead of a full, palate-covering appliance. It frees up the taste buds and eliminates the gag reflex. Implant-retained upper dentures are simply more comfortable.”

When Dr. Gaukhman creates implant-retained lower dentures, he gener-ally secures them with two implants, as he did for Gerald. For upper dentures, however, he typically uses four implants.

“I use four implants on the top due to gravity,” he discloses. “Dentures work with or against gravity. Lower dentures move down with gravity, so two implants are su� -cient. Implant-retained upper dentures have to work against gravity without the help of suction from the palate, so four implants keep them more securely in place.”

Lasting ImpressionsAfter being told he was not a candidate for dental implants, Gerald didn’t give up. His persistence paid off when he found Dr. Gaukhman and Siesta Dental. Gerald is pleased with the dentist’s process, but his journey is not over yet. � e clips currently on Gerald’s lower denture that attach it to the implants are temporary.

“I have to wait about six weeks until these clips loosen, and then Dr. Gaukhman will put in the permanent clips,” he states. “I also had to go back to the o� ce early on to have the denture � led down a little because it bothered my gums, but they said that was normal. � e dental technician � xed them, and now they’re perfect.”

From the begin-ning, Rita wanted implant s fo r he r upper denture to ensure its stabil ity. Keeping the appliance o� her palate and more comfortable became another important con-sideration after wearing the temporary. With her permanent

upper denture secured by implants, Rita has that comfort and stability, as well as strength for biting and chewing.

“I love my permanent denture,” she enthuses. “It’s much more comfortable because I don’t have a plate covering the roof of my mouth. And it’s so much easier to eat; I can eat anything I want now. I’ve already eaten steak, hamburgers, all sorts of things.

“Steak was one of the � rst things I ate after I got my denture. Just to be able to bite into a hamburger now is great.”

Gerald � nds it easier to eat as well. While he’s eating a lot more foods than he did before the implants, he isn’t rushing into all of his favorite hard-to-chew foods just yet.

“I’m eating and chewing a lot better, but I haven’t taken on steak yet,” he muses. “I’m going to wait until I get the permanent clips, then I’ll de� nitely be at one of those steak places trying out my denture. I’m looking forward to it.”

Comfort isn’t the only bene� t of Rita’s new denture. She also likes its appearance and the ease of its wear and care.

“� e new denture is wonderful,” she marvels. “Everybody tells me it looks abso-lutely natural. I really like that it doesn’t slip and slide all around. It snaps in and out. I take my denture out at night to clean it, snap it back in my mouth in the morning and I’m good to go.”

For Gerald, the most amazing thing is the permanence of his lower denture. Unlike before, the implant-retained denture doesn’t become loose and move around when he speaks and eats.

“Sometimes before, when I bit on something on one side of my mouth, the denture would lift up on the other side, so I had to chew o n both

sides of my mouth at the same time,” he observes. “Now, I don’t have to worry about that. I’m thrilled with the results.”

Rita and Gerald say their overall expe-riences at Siesta Dental were very positive. Rita gives Dr. Gaukhman and his sta� credit for making her visits to the practice as easy and pain free as possible.

“When I walk into the o� ce, every-body is so nice, and they take good care of me,” she comments. “Personally, I’m one of those people who hate dentists, but I can’t hate these people. Dr. Gaukhman is great. He made me feel very comfortable about getting this work done.

“I only have good things to say about Dr. Gaukhman and his sta� because they’re just excellent. � ey’re so friendly and caring. I’m very happy with the entire experience and my decision to go to Siesta Dental, and I’m ecstatic about my results. I recommend Dr. Gaukhman to anyone.”

Gerald agrees.“I would absolutely recommend

the implant process and Siesta Dental. Everybody there is very professional, and they’re very patient oriented and con-cerned. After I had my implants put in, they called me to make sure I was heal-ing properly, in addition to the regular appointments I had with them.

“I give Dr. Gaukhman and Siesta Dental a double A-plus rating!”

FHCN article by Patti DiPanfilo. Gerald’s

photo by Jordan Pysz. mkb

*Patient name witheld at their request.

Dual-Use Dental ImplantsSecured foundations stabilize lower and upper dentures

Please visit Siesta Dental’s website at www.SiestaDental.com

Page 6 | Florida Health Care News | Spring 2018 | South Sarasota County Edition general, coSmetic and emergency dentiStry

ALEXANDER GAUKHMAN, DMD

A l e x a n d e r Gaukhman, DMD, e a r n e d h i s d e n -tal degree at Nova S o u t h e a s t e r n University College o f D e n t i s t r y, F t . L a u d e r d a l e . H e

completed his undergraduate stud-ies at Florida Atlantic University, Boca Raton. Dr. Gaukhman is a diplomate of the International Congress of Oral Implantologists and a member of the American Academy of Implant Dent is t r y, Academy of Genera l Dentistry, Florida Dental Association, Sarasota Dental Association and American Dental Association.

Better bite,

better smile

Dr. Gaukhman is accepting new patients

and welcomes the opportunity to help you improve your smile and bite function. He invites

the readers of Florida Health Care News to visit

or call Siesta Dental.

Sarasota Avenida Navarra

(941) 266-7000Venice

US Hwy. Bypass S. (941) 375-4488

Osprey S. Tamiami Trail,

Suite F(941) 497-5650

ç Dental implants

ç Extraction of teeth

ç Crowns

ç Deep cleaning

ç Bleaching

ç ZOOM!® whitening

ç Root canals

ç Laser surgery

ç Invisalign®

ç Dentures

ç Partials

ç Bridges

Siesta Dental ServicesSiesta Dental specializes in all aspects of dentistry,

including but not limited to:

H ailing from a little town outside Niagara Falls, New York , Gera ld Conahan � rst became a snowbird in 1998 when he

bought a condo in Venice. Shortly thereafter, Gerald’s annual, two-month stay in Florida turned into a nine-month stay, and now he’s o� cially a resident of the Sunshine State.

In Florida, Gerald found more than warm weather and a great place to spend most of the months of his retirement years. He also discovered the answer to a longtime problem he had with his teeth.

“When I was very young, I had soft teeth,” Gerald shares. “Even though I went to the dentist regularly, I couldn’t keep my teeth from decaying. When I was in my twenties, one tooth got so bad that my den-tist said he couldn’t save it. One thing led to another, and eventually, all my teeth had to be removed. I’ve been wearing upper and lower dentures ever since, for at least thirty, maybe forty years.”

In most cases, upper dentures � t securely because the palate enables the creation of enough suction to hold the appliance in place. � is was true in Gerald’s case. � e story is often di� erent with lower dentures, however.

Lower dentures can be more di� cult to keep stable. � is is because there is no palate in the bottom jaw, due to the location of the tongue, and less suction is produced. As a result, lower dentures tend to slip and slide.

Like many people with lower dentures, Gerald had di� culties keeping his lower denture secure.

Gerald spreads his smile all around town now

Gerald Conahan

– Rita

“I’m very happy with the entire experience and my decision to go to

Siesta Dental, and I’m ecstatic about

my results.”

– Gerald

“I would absolutely recommend the

implant process and Siesta Dental.

Everybody there is very professional, and they’re very patient oriented”

“After a while, my lower denture would become loose and get very sloppy,” Gerald describes. “It wasn’t comfortable, and I had trouble chewing. I really had to watch what I ate.

“I couldn’t eat anything that took a lot of heavy chewing, especially steak, unless it was a � let mignon, and even that had to be very, very tender. I couldn’t eat any other cut of steak or anything else that was tough to chew.”

Not long ago, Gerald learned how some dentists use dental implants to secure dentures and keep them from moving. He inquired about them at one dental practice but was told he was not a candidate because he lacked su� cient bone in his jaw to bond with the implants.

Gerald was not deterred. He mentioned his interest in dental implants to another dentist, who referred him to Alexander Gaukhman, DMD, of Siesta Dental. Dr. Gaukhman is an experienced, skillful dentist who o� ers exceptional general, cos-metic and restorative dentistry at his o� ces in Sarasota, Venice and Osprey.

“I had already been to one dentist and had new dentures made,” relates Gerald. “Still, I had it in the back of my mind to look into the implants. When Dr. Gaukhman looked me over, he said, Yes. He could put the implants in with the bone I had left in my lower jaw.”

Atypical Scenario“Gerald was referred to my practice by another dentist speci� cally because he could not keep his lower denture stable,” reports Dr. Gaukhman. “He could not eat because the denture would slide right out.

“� e denture he had was made prop-erly, but Gerald didn’t have enough bone in his lower jaw to support it, which is very common. However, he did have just enough

bone to place dental implants. Securing a lower denture with dental implants is the most e� ective way to stabilize it. I recom-mended two implants to secure Gerald’s lower denture.”

Dental implants are screw-like metal posts that are surgically placed into the jawbone and serve as the foundation for replacement teeth. � e replacements may be crowns in the case of single teeth, or bridges or dentures for multiple teeth. Implants are made of a titanium alloy that fuses with the patient’s bone to become a solid unit.

When dentures are secured by implants, they don’t rock or move; they stay in place when wearers speak and eat. Secured den-tures also provided added strength for biting and chewing. At Siesta Dental, implants are often placed on the day of tooth extraction. In most cases, temporary dentures are also created at that time.

“Typically, once the patient’s problem is diagnosed and the treatment is determined, I take impressions of the teeth,” expounds Dr. Gaukhman. “When the dentures are ready, which is usually the same day or the next day, I extract the teeth and put the dentures in right away. � e dentures act like a bandage. � ey stop bleeding and limit swelling.

“For the next three to six months, the patient wears temporary dentures until the implants fuse and the gums heal. � en the temporary dentures are replaced with the permanent appliances.”

Gerald’s situation was a little di� erent. He had recently gotten new dentures and didn’t need another lower denture made for him, temporary or permanent. � at was no problem for Dr. Gaukhman. He was able to adjust Gerald’s existing denture to � t with the implants.

“In Gerald’s case, I placed the two implants, and after they healed, I was able to retro� t his existing denture,” con� rms Dr. Gaukhman. “We do not have to start from scratch for people who have relatively new, two- to three-year-old appliances. Retro� tting a denture essentially involves making two holes in the denture to accept the implant attachments.

“Since we have our own dental lab on site at Siesta Dental, it is especially easy for us to do this work. It takes just a couple of hours and can be done in one visit.”

“Dr. Gaukhman put in the implants for me, and that went very well,” says Gerald. “He gave me some type of Novocain®, and the procedure wasn’t too bad. I went back to the o� ce regularly so he could check the implants and make sure everything was okay.

“Several months went by while we waited for the implants to fuse with the bone in my jaw. Just a couple of weeks ago, he pre-pared my lower denture with the clips that snap onto those implants, and everything went � ne with that as well.”

Upper Denture Downside Rita* is a retired administrative assistant and a Staten Island native who relocated to Florida four years ago to � ee the cold and snow of New York. But she couldn’t � ee from a deteriorating dental issue that had been dogging her for years.

“I knew for a while I had a problem with my upper gums, but I kept putting o� doing anything about it,” recalls Rita. “Every time I went to the dentist, I’d hear the same thing about how my gums were receding.

“I had pain occasionally, and there was sensitivity because as my gums receded, more nerve was exposed. I was told to expect that.”

Dentists typically monitor progression of recession by measuring the gum pockets. � ese are the spaces between the edge of the gums and the teeth. � e deeper these pockets become, the more likely it is that a tooth will loosen and the higher the risk of losing the tooth.

“I wanted to do something about my gums before my teeth fell out,” recounts Rita. “When I � rst moved to Florida, I lived in Bradenton, and I went to a dentist there. He wanted to � t me for a denture, but I wasn’t sure about that then.

“When I decided it was the right time to get the work done, I started looking around for a dentist. I wanted dental implants, and since I was told I probably needed a denture, I went online and did research.”

Rita wanted a dentist with expertise in dentures and implants to do the job, and her search led her to Dr. Gaukhman at Siesta Dental. She saw that Dr. Gaukhman scored rave reviews online. � e dentist was also close to her new home in Venice, which was a bonus.

Rita’s mind was made up to visit Dr. Gaukhman when she read about his process for restoring smiles with implant-retained dentures in Florida Health Care News. She read that he makes the molds, extracts the teeth and creates a temporary denture in his in-o� ce lab in one day.

“I wanted dental implants, and I saw that Dr. Gaukhman did implant surgery at Siesta Dental, so I went there,” o� ers Rita. “I had all my top teeth removed and got a temporary denture the same day. I expected that, but I didn’t expect the denture to look so nice or the process to cause so little pain.”

“When Rita � rst arrived, she had badly receding gums,” verifies Dr. Gaukhman. “When the gums recede due to periodontal disease, patients like Rita lose bone due to bacteria. � e only treatment is to remove the teeth because those bacteria cannot be killed with just antibiotics.

“Rita had tried antibiotics and deep cleanings to treat her condition, but those attempts were unsuccessful. Her condition got worse until her upper teeth were no longer salvageable, so I extracted them and created a denture for her.”

While Rita was pleased with the appear-ance of her temporary denture, she was less than thrilled with the way it felt.

“It covered the roof of my mouth, and that was annoying, as well as a little uncomfortable,” she explains. “It didn’t hurt; it’s just that I couldn’t eat the way I wanted to because I couldn’t really bite into certain foods, like steak. I didn’t eat steak for six months.”

Secure SolutionUpper dentures generally � t securely because there’s enough suction from the palate to hold them in place. However, traditional upper dentures have some drawbacks that can be corrected by securing them with dental implants.

“� e tongue is mainly responsible for discerning taste, but the palate, or roof of the mouth, plays a role as well,” informs the dentist. “When a denture is made for the upper jaw, it covers the palate, which can deprive patients of sensing the full range of tastes.

“In addition, some patients have a gag re� ex due to the denture being placed over the palate. With an implant-retained upper denture, the shape of the denture is more like a horseshoe instead of a full, palate-covering appliance. It frees up the taste buds and eliminates the gag reflex. Implant-retained upper dentures are simply more comfortable.”

When Dr. Gaukhman creates implant-retained lower dentures, he gener-ally secures them with two implants, as he did for Gerald. For upper dentures, however, he typically uses four implants.

“I use four implants on the top due to gravity,” he discloses. “Dentures work with or against gravity. Lower dentures move down with gravity, so two implants are su� -cient. Implant-retained upper dentures have to work against gravity without the help of suction from the palate, so four implants keep them more securely in place.”

Lasting ImpressionsAfter being told he was not a candidate for dental implants, Gerald didn’t give up. His persistence paid off when he found Dr. Gaukhman and Siesta Dental. Gerald is pleased with the dentist’s process, but his journey is not over yet. � e clips currently on Gerald’s lower denture that attach it to the implants are temporary.

“I have to wait about six weeks until these clips loosen, and then Dr. Gaukhman will put in the permanent clips,” he states. “I also had to go back to the o� ce early on to have the denture � led down a little because it bothered my gums, but they said that was normal. � e dental technician � xed them, and now they’re perfect.”

From the begin-ning, Rita wanted implant s fo r he r upper denture to ensure its stabil ity. Keeping the appliance o� her palate and more comfortable became another important con-sideration after wearing the temporary. With her permanent

upper denture secured by implants, Rita has that comfort and stability, as well as strength for biting and chewing.

“I love my permanent denture,” she enthuses. “It’s much more comfortable because I don’t have a plate covering the roof of my mouth. And it’s so much easier to eat; I can eat anything I want now. I’ve already eaten steak, hamburgers, all sorts of things.

“Steak was one of the � rst things I ate after I got my denture. Just to be able to bite into a hamburger now is great.”

Gerald � nds it easier to eat as well. While he’s eating a lot more foods than he did before the implants, he isn’t rushing into all of his favorite hard-to-chew foods just yet.

“I’m eating and chewing a lot better, but I haven’t taken on steak yet,” he muses. “I’m going to wait until I get the permanent clips, then I’ll de� nitely be at one of those steak places trying out my denture. I’m looking forward to it.”

Comfort isn’t the only bene� t of Rita’s new denture. She also likes its appearance and the ease of its wear and care.

“� e new denture is wonderful,” she marvels. “Everybody tells me it looks abso-lutely natural. I really like that it doesn’t slip and slide all around. It snaps in and out. I take my denture out at night to clean it, snap it back in my mouth in the morning and I’m good to go.”

For Gerald, the most amazing thing is the permanence of his lower denture. Unlike before, the implant-retained denture doesn’t become loose and move around when he speaks and eats.

“Sometimes before, when I bit on something on one side of my mouth, the denture would lift up on the other side, so I had to chew o n both

sides of my mouth at the same time,” he observes. “Now, I don’t have to worry about that. I’m thrilled with the results.”

Rita and Gerald say their overall expe-riences at Siesta Dental were very positive. Rita gives Dr. Gaukhman and his sta� credit for making her visits to the practice as easy and pain free as possible.

“When I walk into the o� ce, every-body is so nice, and they take good care of me,” she comments. “Personally, I’m one of those people who hate dentists, but I can’t hate these people. Dr. Gaukhman is great. He made me feel very comfortable about getting this work done.

“I only have good things to say about Dr. Gaukhman and his sta� because they’re just excellent. � ey’re so friendly and caring. I’m very happy with the entire experience and my decision to go to Siesta Dental, and I’m ecstatic about my results. I recommend Dr. Gaukhman to anyone.”

Gerald agrees.“I would absolutely recommend

the implant process and Siesta Dental. Everybody there is very professional, and they’re very patient oriented and con-cerned. After I had my implants put in, they called me to make sure I was heal-ing properly, in addition to the regular appointments I had with them.

“I give Dr. Gaukhman and Siesta Dental a double A-plus rating!”

FHCN article by Patti DiPanfilo. Gerald’s

photo by Jordan Pysz. mkb

*Patient name witheld at their request.

Dual-Use Dental ImplantsSecured foundations stabilize lower and upper dentures

Please visit Siesta Dental’s website at www.SiestaDental.com

South Sarasota County Edition | Spring 2018 | Florida Health Care News | Page 7general, coSmetic and emergency dentiStry

Alla Gruman, MD

is board certified in pediatrics and dermatology. Dr. Gruman completed her undergraduate studies in mathematics and biol-ogy at New York University. She earned her medical degree at The Johns Hopkins University School of Medicine in Baltimore, MD and completed two dermatology residencies, one at Harvard Children’s Hospital in Boston, MA and the other at Boston University, also in Boston.

Committed to patient-centered,

individualized careDr. Gruman looks forward to meeting

and helping new patients at her practice by diagnosing and treating any skin condition. To schedule an

appointment or learn more about how Family Dermatology can help you, call

or visit their o� ce in Osprey at:929 S. Tamiami Trail

Suite 201

(941) 918-1900Visit Family Dermatology on the web at www.sarasotafamilydermatology.com

ALLA GRUMAN, MD

Family Dermatolog Careful surveillance catches a vicious killer

In 2000, a mole on John Bass’ fore-head began to grow and change colors. His family doctor referred him to a dermatologist who imme-

diately performed a biopsy. � e diagnosis was malignant melanoma.

“I went to a local cancer center, where they were very thorough,” recounts John. “That September, they did surgery to remove the mole, and they also removed six lymph nodes around my neck. � ey said the cancer generally goes there � rst if it spreads.”

After the surgery, John needed a dermatologist to regularly examine him for recurrence of the melanoma on his skin. John’s doctor recommended Alla Gruman, MD, a board-certified dermatologist at Family Dermatology in Osprey.

“I started seeing Dr. Gruman every year for surveillance,” elaborates John. “� en in March 2015, I felt a knot as big as a golf ball under my arm. I called the cancer center, but had trouble getting an appointment right away.

“I called Dr. Gruman and told her I couldn’t get in at the cancer center. She talked with them and got me an appoint-ment immediately. After they checked out the knot, they told me it was metastatic mel-anoma. I had three to six months to live.”

Risks and WarningsMelanoma is a form of cancer charac-terized by uncontrolled growth of the pigment-producing cells in the skin. It is the most dangerous type of skin cancer. If it’s allowed to grow, it can quickly spread to other parts of the body.

“When melanoma is found early, how-ever, it is very treatable,” assures Dr. Gruman. “For that reason, people need to be aware of its risk factors and warning signs.

“People who used tanning beds or had blistering sunburns between the ages of twenty and fifty are at higher risk. Others at risk are those who live in sunny climates, have had many years of sun exposure, a family history of melanoma

John takes time from his cancer fi ght to relax and fi sh.

Regular skin inspections by a dermatolo-gist help catch melanoma in its earliest, most treatable stages.

“Melanoma is a vicious cancer. If not caught and treated early, it can cause seri-ous morbidity and even mortality down the road years later.”

Precious GiftsDoctors at the cancer center told John his cancer was now on his chest, under his arm and in his liver and left lung. � e only thing they could do for him was enroll him in clinical trials for new can-cer drugs. � e � rst one he tried caused his cancer to grow. “� e second drug was a miracle,” reports John.

“In March, I’ll have made it three years instead of three months, and Dr. Gruman guided me through all of it.”

Since the return of his melanoma, John has his skin examined by Dr. Gruman every six months. With her support, he cel-ebrates every day as a precious gift.

“Dr. Gruman is so concerned and knowledgeable, especially about cancer,” he says. “I don’t think there’s a better doctor when it comes to knowledge and caring!”FHCN article by Patti DiPanfilo. Photo by Fred Bellet. nj

or other cancer, fair skin and blue eyes, or many moles or large moles.”

A change in the size, color or border of a mole is a warning sign of possible skin cancer, as is the sudden presence of a new mole. Contrary to popular belief, mela-noma lesions are not always dark. � ey may appear pink, beige or light brown.

“Some signs of melanoma are sub-tle,” warns Dr. Gruman. “For example, people who’ve had moles for a long time often think they are normal. � ese peo-ple don’t get in the habit of checking their moles, so they don’t notice any changes or the appearance of a new mole.

“In March, I’ll have made it three years instead of three

months, and Dr. Gruman guided me through all of it.”

– John

SOUTH FLORIDA EYE CLINICSCOTT L. GELLER, MD

“Live with it” – is NOT acceptablewww.vimeo.com/eye� oaters

For eye � oater solutionsSouth Florida Eye Clinic is in Fort Myers at:

4755 Summerlin Rd. (239) 275-8222(877) 371-3937

www.vitreous� oaters.com

Scott L. Geller, MD, is board certified by the American Board of Ophthalmology. He is a gradu-ate of Ohio Wesleyan University and Rush Medical College. While in medical school, he was awarded a student fellowship to study tropical medicine at a missionary hospital in India, and pursued additional studies at the famous Brompton Hospital in London, England. He interned at Presbyterian Hospital, Paci� c

Medical Center, San Francisco, CA and completed his residency in ophthalmology at Sinai Hospital of Detroit, which was a� liated with Wayne State Medical School and Kresge Eye Institute. Dr. Geller was fellowship-trained in anterior segment and refractive surgery with Dr. William Myers of the Michigan Eye Institute. Dr. Geller is a fellow of the American Academy of Ophthalmology, and has presented papers on eye � oater laser treatment at the International Congress of Ophthalmology, European Congress of Cataract & Refractive Surgery, European Congress of Ophthalmology and the Florida Society of Ophthalmology.

“Today’s medicine has progressed beyond the state of advising patients with serious visual disabilities caused by eye � oaters that nothing can be done,” advises Scott

Geller, MD. “� ere is much that can be done to help.”How does one choose the proper facility for their

ophthalmologic needs? Here is the answer from the oph-thalmologist who started it all in Florida, when it comes to laser surgery for eye � oaters.

“I have two of these lasers, and I am convinced they are the safest and most e� ective out there for treating eye � oaters,” he explains. “We � y in expert technicians every year from Switzerland to service and update our units, and our results re� ect that.”

World-Renowned TreatmentDr. Geller has performed more than 15,000 documented � oater laser sessions – no other eye surgeon, or facil-ity, holds his same experience or expertise in the � eld, including well-known facilities in Miami, Philadelphia and Boston. He has performed this laser procedure on patients from all over the world.

“We have a worldwide patient following and have helped people from Japan, the People’s Republic of China, Russia and almost every European country, as well as from throughout the United States,” notes the doctor.

Another sure way to judge a surgeon is by his pre-sentations to medical colleagues.

Dr. Geller has presented and lectured at confer-ences worldwide, including the prestigious Shanghai Eye and Ear Institute in China. Other sites of oph-thalmic congresses attended throughout the world include Singapore, Berlin, Rome and Istanbul. In the United States, Dr. Geller has presented at conferences in Boston, at the American Academy of Ophthalmology in Chicago and before members of the Florida Society of Ophthalmology.

“We are so con� de nt in our outcomes, that we shared our � ndings on eye � oater laser complications at the pres-tigious American Academy of Ophthalmology meeting in 2012,” Dr. Geller emphasizes. “We had the fewest seri-ous problems of the three facilities participating in this research. � is is important for patients to know.”

Dr. Geller has personally trained prominent eye � oater laser specialists in the US and Europe.

“I’d hate to see a worthwhile medical procedure get a bad rap because of problems caused by ophthalmologists who have never had formal training. � e eye � oater laser procedure is not as easy to perform as many ophthal-mologists may think, and complications can be serious.”

Dr. Geller shares that while self-satisfaction comes from helping people, he also welcomes the opportunity to share his technique with others in his � eld: “Other ophthalmologists need only call me and I would be will-ing to share my experience and knowledge with them to bene� t their own patients.”Article submitted by South Florida Eye Clinic. FHCN file photo. mkb

“Patients need to understand that laser surgery on eye � oaters is not simply a matter of pushing a button,” Dr. Geller explains. “We perform a lot of ‘re-dos’ on patients from all over the United States and as far away as Europe who went to inexperienced surgeons with inadequate equipment and little training. � is can be an expensive lesson for people to learn.”

Laser SelectionDr. Geller is one of the few surgeons in the country who have the Swiss-made LASAG Microruptor YAG laser.

“� is laser was speci� cally designed by renowned Professor Franz Fankhauser of the University Eye Clinic in Bern, Switzerland to safely cut membranes deep in the eye’s interior,” explains Dr. Geller, who himself was trained by Professor Fankhauser.

Dr. Geller has performed more than

, documented fl oater laser sessions

Page 8 | Florida Health Care News | Spring 2018 | South Sarasota County Edition

dermatology

ophthalmology

DOUGLAS H. JOYCE, DO, FACOS, FACPh

Douglas H. Joyce, DO, FACOS, FACPh, is board certi� ed in phlebology (venous disease), cardio-thoracic and vascular surgery, and gen-eral surgery. After receiving his Doctorate from Michigan State University College of Osteopathic Medicine, Dr. Joyce completed his internship

and surgical residency at Lansing General Hospital. He went on to receive several fellowships, including a surgical fellowship in cardiovascular thoracic surgery and a special fellowship in cardio-pulmonary perfusion from Cleveland Clinic Foundation, as well as a fellowship in congenital and adult cardiovascular-thoracic surgery from Deborah Heart and Lung Center, Browns Mills, NJ. Dr. Joyce is a diplomate of the American College of Phlebology, American College of Osteopathic Surgeons and International College of Surgeons, and a former assistant clinical professor of surgery for the department of osteopathic medicine at Michigan State University College of Osteopathic Medicine and UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ.

Reclaim Your Youthful Appearance To schedule an appointment or learn more about how JVAI can help you, call or visit their offi ce in Punta Gorda at:25092 Olympia Avenue, Suite 500

(941) 575-0123

Visit Joyce Vein & Aesthetic Institute on the web at www.jvai.com

“Because of Dr. Joyce, I’m able to do

what I want to do.” – David

BEFORE AFTER

Shades of DistressDiscoloration signals advanced venous disease

W hen David Snook settled in Florida, he found his niche teaching gardening to mentally disabled students. He also keeps busy as a wrestling referee.

“I settled in Florida about � fteen years ago,” shares the Grand Rapids, Michigan native. “I decided to get into education, and that’s what I’ve been doing for the last eleven years. I’m also an o� cial for high school wrestling.”

When he’s not teaching, David spends time in his garden.

Four years ago, David began experiencing distressing symptoms in his left leg, primarily his foot and ankle. � e symptoms were both annoying and agonizing, and they began a� ecting him in his daily life and on the job.

“My leg started itching, and sometimes I would scratch it until I broke the surface of the skin, and it would bleed,” he describes. “It was really irritated and painful. It also swelled and changed colors; it was maybe four or � ve colors. My leg was pretty scary looking.

“I figured I’d have to stop officiating because I couldn’t be on my feet and have this much pain. I move around a lot while I’m refereeing, and that caused my symptoms to become even worse.”

While working a wrestling tournament, David � nally accepted he had a serious problem. While David was changing his shoes, another o� cial caught a glimpse of his foot. � e colleague remarked that the foot looked severe and needed to be evaluated by a physician.

� at comment prompted David to visit his doctor, who referred him to vein specialist Douglas H. Joyce, DO, of Joyce Vein & Aesthetic Institute. Dr. Joyce impressed David from the � rst appointment.

“Dr. Joyce looked at my leg and knew exactly what was going on,” remembers David. “I was a little worried about it, but he had so much con� dence and said, I can take care of this issue so you don’t have to be in pain.”

As a vein specialist, Dr. Joyce immediately rec-ognized venous disease by David’s symptoms. Initial symptoms of venous disease include swelling, tired legs, spider veins, varicose veins and a feeling that the legs are getting progressively heavier. Over time, venous disease slowly worsens. Left untreated, it can lead to skin discol-oration, thickening and ulceration.

“� ere are two systems of veins in the legs,” explains Dr. Joyce. “� ere are the high-pressure deep veins in the middle of the leg, and the low-pressure super� cial veins near the surface of the skin. With venous disease, we � nd numerous connections between the super� cial system and the deep system that are not functioning correctly.”

� ese connections, called perforator veins, can be identi� ed using ultrasound, a safe and painless imag-ing test. Once Dr. Joyce con� rmed the problem areas in David’s leg, he initiated his treatment plan.

notes Dr. Joyce. “We teach physicians from all over the world how to do this technique. We have developed it to the point where it’s quite successful and have performed more than � fty-� ve hundred procedures, with a very high success rate and almost no complications.”

Absolute SuccessDavid was thrilled with the results of his laser ablation. He began to feel a di� erence in his leg quickly after his procedure. To David, Dr. Joyce cured his venous disease and gave him back his life.

“I had the procedure with Dr. Joyce, and I immedi-ately started feeling some relief,” he con� rms. “� e next day, my pain was better. I couldn’t believe it. Now, the itching has been eliminated. � ere is no swelling, no pain and no discoloration. My leg is normal.

“� e surgery was an absolute success. I’m able to do things I thought I couldn’t do or had to stop doing. Before, I thought I was not going to be able to o� ciate, but I’ve been o� ciating every year since. It would’ve been a loss of a lot of income if I couldn’t o� ciate.

“Because of Dr. Joyce, I’m able to do what I want to do.”David adds that he would recommend Joyce Vein

& Aesthetic Institute and Dr. Joyce without a doubt.

“Dr. Joyce is very con-� dent, and that made me as a patient feel comfortable. He’s also knowledgeable and professional, and his sta� is wonderful.

“Going to Joyce Vein and Aesthetic Institute was a great experience, and the procedure took care of my problem. If anyone asks me, I say, Dr. Joyce is the best!”FHCN article by Patti DiPanfilo. Photo

by Fred Bellet. Graphic from istockphoto.com. Staff photo, before and after

images courtesy of Joyce Vein & Aesthetic Institute.

“We scheduled the surgery,” relates David. “I was terri� ed at � rst, but Dr. Joyce has good people working at Joyce Vein and Aesthetic Institute. � ey made me feel relaxed. While I was a little apprehensive, the procedure was worth it because afterward I wasn’t in pain anymore.”

Laser Energy There are six stages of venous disease, informs Dr. Joyce, and symptoms such as leg swelling, pain and varicose veins are common in stages one through three. Discoloration like David experienced occurs in stage four. A healed ulcer is stage � ve venous disease, and an open ulcer is stage six. Stages four through six are consid-ered advanced disease. Joyce Vein & Aesthetic Institute specializes in treating advanced venous disease.

“Anytime patients have leg discoloration, they’re heading toward serious problems with their legs,” notes Dr. Joyce. “People who start to get discoloration need to have their veins evaluated right away, before ulcers form. Without correcting the underlying vein disorder, an ulcer is very di� cult to heal permanently.”

For David, the leg itching was a particularly bother-some early-stage symptom. Dr. Joyce explains that itching is not unusual with venous disease. It is one possible reac-tion to the increased pressure caused by venous disease.

“� at pressure stimulates the nerves in an unfamiliar manner, and the brain identi� es that stimulus in di� erent ways,” educates Dr. Joyce. “Some people feel pressure, some feel pain and some feel electrical shocks. Others might get the feeling of water on their legs or of insects crawling on their legs. Some people, like David, feel itching.”

Dr. Joyce approaches vein disease in all stages with the same purpose. He begins with an ultrasound examination to identify which veins are not working properly, and then determines the appropriate course of action to treat them.

“� e problem is usually with the perforator veins and the long veins of the legs,” he observes. “We close those leaking veins with laser energy and reroute the blood through healthy veins. Fortunately, we have meth-ods of doing this that are noninvasive and well tolerated.”

Dr. Joyce is a pioneer in treating all of the causes of venous disease of the leg. He has developed new tech-niques to treat venous disease, including single-needle laser ablation, a noninvasive method of treating the dis-eased veins responsible for advanced venous conditions.

“Joyce Vein and Aesthetic Institute is one of the few centers in the United States performing a signi� -cant number of the single-needle ablation procedures,”

South Sarasota County Edition | Spring 2018 | Florida Health Care News | Page 9vein treatment and aeStheticS

Page 10 | Florida Health Care News | Spring 2018 | South Sarasota County Edition

Special to Fhcn

podiatry

John Lieurance, DC, DACNB (Board Eligible), received his Doctor of C h i r o p r a c t i c d e g r e e from Parker College of Chiropractic and his Doctor of NMD degree through St. Luke’s Medical School. He is

also a board-eligible chiropractic neurologist through the Carrick Institute of Neurology. Dr. Lieurance is the developer of Functional Cranial Release, and teaches and certi� es these meth-ods to physicians around the world. He has practiced in Sarasota for the past 20 years.

JOHN LIEURANCE, DC, DACNB

(BOARD ELIGIBLE)

For health and comfort

Th e s t a f f o f Ad va n ce d Rejuvenation looks forward to meeting the readers of Florida Health Care News. To learn more about laser therapy or other rejuvenation options, contact the holistic health and chiropractic center. Mention this article and receive a free audiometric evaluation. Their offi ce is located in Sarasota at:

In addition to hearing loss, tinnitus and balance disorders, Advanced Rejuvenation treats various musculoskeletal, neurological and chronic diseases, including:

• Osteoarthritis, a degenerative joint condition• Chronic sinusitis• Snoring• Sleep apnea• Degenerative neurological disorders, i.e. Parkinson’s• Arthritis of joints and spine

Advanced Rejuvenation also o� ers:• Stem cell treatments using LumoStem Acivation• Prolotherapy with dextrose based injections• Prolozone• Whole body cryotherapy• Hyperbaric oxygen therapy• Intravenous laser therapy to irradiate white blood cells

W ith her 80th birthday approaching, Mary* began experiencing hearing difficulties all

too common for people her age.

Reverse Hearing LossLumomed™ laser rejuvenates damaged ear cells

To learn more about Lumomed laser therapy, visit Advanced Rejuvenation on the internet at advancedrejuvenation.us

“When I would be talking to some-one, I would only catch half of what they were saying,” she recalls. “I’d have to ask over and over again, I’m sorry, what did you say? Or if I answered them wrong, they’d give me a funny look and then I’d explain, I didn’t totally hear you.”

Her inability to carry on a conversa-tion without constantly asking people to repeat themselves was especially frustrat-ing for her husband, Mary says.

She had her hearing tested and bought hearing aids. But she soon found them to be a nuisance.

“I was constantly turning them up higher, down lower,” Mary complains. “It was a pain in the neck, but I had no choice. Some people talk louder, some people talk softer, and that was a pain in the neck, too.”

By the time she began her eighth decade of life, she was resigned to the idea she’d need to wear such devices for the rest of her life.

� en one day, Mary’s husband picked up a copy of Florida Health Care News in a doctor’s o� ce.

� e publication included an article about an innovative inner ear treatment performed by John Lieurance, DC, to reverse hearing loss.

“I read it and I said, Hmm, sounds pretty good that he can help people,” Mary shares.

Dr. Lieurance is a chiropractic neu-rologist and naturopath, as well as a certified provider of Lumomed sound laser therapy, which is designed to reju-venate damaged ear cells. Treatments have been clinically shown to improve hearing loss, as well as to reduce the e� ects of many balance disorders and tinnitus, or ringing in the ears.

Mary made an appointment with Dr. Lieurance at Advanced Rejuvenation, a regenerative medical practice in Sarasota. She reports the doctor was “very, very thor-ough” during her initial examination and consultation, which included a hearing test.

“He explained everything – how the laser therapy worked and what I could expect as far as getting my hearing back,” Mary adds.

Dr. Lieurance scheduled her for a course of Lumomed therapy, which consisted of 15 thirty-minute laser treatments on each ear.

Healing EnergyAdvanced Rejuvenation is the only cen-ter in the United States approved to use Lumomed’s protocols. Dr. Lieurance had been treating hearing loss, balance disorders and tinnitus for many years through his functional chiropractic neu-rology practice when he heard about Lumomed from one of his patients. While in Germany, she received the treatment from Dr. Amon Kaiser, who has worked with lasers for more than 30 years.

“My patient got in touch and told me, Hey, this doctor is doing wonderful

work in Germany for inner ear regener-ation. It would be such a great adjunct to what you’re doing in Florida,” Dr. Lieurance relates.

He contacted Dr. Kaiser and traveled to Germany to study the science they had discovered and the methods for the treat-ment protocols.

“I was so impressed that I brought this back to Sarasota,” Dr. Lieurance states. “It’s phenomenal. I’m constantly looking for the best and most e� ective technologies to help people with con-

ditions that are considered untreatable. When someone tells me, You can’t do it, it makes me want to do it even more.”

Dr. Lieurance explains the science behind Lumomed this way: Special nerve cells in the inner ear, called hair cells, allow for the perception of sound and are essen-tial for balance. If those cells are damaged, an individual may su� er hearing loss, tin-nitus or a debilitating balance disorder such as vertigo.

“We have a great deal of technology today, such as cell phones, iPods® and com-puters,” he expounds. “� at technology, along with sirens and various machines in our environment, make di� erent, high-pitched sounds that are very loud. As a result, the hair cells are highly stressed.

“When these cells are constantly over-whelmed by noise and stress, they cannot process energy correctly,” Dr. Lieurance continues. “With low or depleted energy, the auditory and vestibular cells in the ear lose their ability to do their jobs, and disease results, whether it’s a hearing loss, dizziness or tinnitus.”

� e hair cells have their own energy source, which is adenosine triphosphate, or ATP. It is produced by structures inside the cells that act as power plants, called mito-chondria. Maintaining the ears when they’re stressed requires vast amounts of energy. Without it, the cells begin to break down.

“Studies have shown that hair cell regeneration is possible,” Dr. Lieurance

asserts. “Inner ear laser therapy is performed with specialized laser equip-ment set at very specific settings. The Lumomed laser showers energy into the ear in the form of photons. This energy is then used by the hair cells to repair themselves.”

No More Hearing Aids� e therapy is most e� ective for younger patients, who are “developing their language based on what they hear,” Dr. Lieurance points out. “If we can � x their hearing at a young age, they don’t develop a lot of speech impediments.”

The laser, which is applied while patients wear goggles and lie on a treat-ment table, emits very little heat. Some people feel the sensation of sunshine, while others feel nothing.

Some patients notice an improve-ment in their hearing within the � rst few sessions, Dr. Lieurance informs. For oth-ers, it takes longer.

“After the first two treatments, I was told not to wear my hearing aids anymore,” Mary remembers. “I should just trust that my hearing was slowly getting better, and it did get better” with each treatment.

Today, Mary says she can hear as well as she did years ago. She’s living proof that

it is possible to turn back time, and that hearing loss is reversible.

“ I f I hadn’t met up w i th Dr. Lieurance, I would still be wearing hearing aids,” Mary shares. “People are telling me, Your hearing is back! Your hear-ing is back! I am very, very happy.”FHCN article by Annette Mardis. mkb

*Patient name withheld at their request.

2033 Wood St.Suite 210

(941) 330-8553

South Sarasota County Edition | Spring 2018 | Florida Health Care News | Page 11laSer therapy

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

Shifting into

ReverseReverse shoulder replacement corrects severe shoulder damage

Sally Van Dyke

Give them a call!The sta� 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 o� ces.

Port Chartlotte 1641 Tamiami Trail

Suite 1

(941) 629-6262

Punta Gorda350 Mary St.

Suite F

(941) 639-6699

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:

O Spine surgery O Sports medicine O Total and partial joint replacement O Foot and ankle care O Hand care O Upper extremity fracture care O General orthopedics O Interventional pain management O Trauma surgery

Welcome to Advanced

Orthopedic Center

Visit Advanced Orthopedic Center on the web at www.advancedorthopediccenter.com

Robert P. Stchur, MD, is a board-certi� ed orthopedic surgeon specializing in the treatment of severe shoulder disorders. He completed a sports medicine fellowship at the Lake Tahoe Sports Medicine Program. He is originally from Michigan and received his medical degree, with honors, from Wayne State University School of Medicine. Dr. Stchur completed his residency at the University of Michigan. He specializes in arthroscopic shoulder surgery. He serves as a Team Orthopedic Consultant for the Tampa Bay Rays and Team Orthopedic Surgeon for the Charlotte Stone Crabs. Dr. Stchur is a member of the Arthroscopy Association of North America. In his free time, he is an avid � sherman, particularly enjoying spear � shing.

The DELTA XTEND™ System is a total semi-constrained shoulder arthroplasty. It reverses the normal relationship between the scapular and humeral components, moving the scapulo-humeral joint center of rotation medially and inferiorly. By doing this, it increases the deltoid lever arm as well as the deltoid tension therefore allowing the muscles of the deltoid group to compensate for rotator cu� de� ciency. Each design feature of the Delta XTEND Reverse Shoulder System was chosen to accelerate recovery, optimize function and maximize survivorship.

Sally Van Dyke, 66, and her hus-band, Steve, consider themselves “hard-core” sailing enthusiasts. A quick glance through their ship’s

log explains precisely what they mean by hard-core. In addition to sailing locally on the Gulf of Mexico, Sally and Steve have sailed their 45-foot Gulfstar from New York to Bermuda and from New York to their Florida home in Punta Gorda.

It was while they were preparing for another long excursion – a 2017 summer trip from Florida back to New York – that Sally injured her left shoulder while rais-ing the mainsail.

“We were going out sailing one day, and I just got a little overzealous with it,” Sally explains. “At � rst, I didn’t want to say anything to my husband about it because we were planning on sailing back to New York the following week, and I didn’t want anything to mess up our trip.

“And really, it wasn’t like the pain was all that unbearable. I thought it was just a muscle, but then it got to the point where I couldn’t move my arm at all. Sleeping became impossible because I couldn’t turn over and lie on my side. I couldn’t even lift a co� ee cup o� the table with my left hand.”

Sally’s symptoms were not foreign to her. She went through a similar experience in 2009 when she tore the rotator cu� in her right shoulder. A doctor in New

York repaired that injury, but she tore the rotator cu� again in 2015. � at’s when she met Robert P. Stchur, MD, at Advanced Orthopedic Center.

“I had been referred to Advanced Orthopedic Center by a friend when I was having some trouble with my knees,” Sally informs. “So when I hurt my right shoul-der again, I went back and spoke to the doctor who had done my knees. He said to me, Well, Dr. Stchur [pronounced Sure] is our shoulder man, so you should see him.”

After an MRI revealed that too much damage had been done to repair Sally’s right rotator cuff, Dr. Stchur recom-mended doing a reverse total shoulder replacement. � e results were so favorable that Sally opted for the same procedure after Dr. Stchur’s examination of her left shoulder injury revealed the same problem.

Transfer of PowerOriginally designed in Europe in the 1980s, the reverse total shoulder replacement pro-cedure was approved by the Food and Drug Administration for use in the United States in 2003. It is considered a better option for patients who have su� ered a complete tear of a rotator cu� or someone experiencing severe shoulder pain, because it results in the shoulder using di� erent muscles than it normally does to lift the arm.

In a healthy shoulder, the muscles and tendons in the rotator cuff work together to keep the ball of the upper arm bone, which is the humerus, in the shoul-der socket. � ey also work to power the process of raising and rotating the arm.

� e reverse total replacement procedure transfers the task of powering the arm to the deltoid muscle through the use of a device that places a metallic ball where the socket was and the socket where the ball was.

“You’re basically just flipping the joint around,” says Dr. Stchur. “Especially with older patients, it’s the best way to go, because the failure rates are much higher in big tears and poor quality tissue.

“And I’ve seen it happen where some-one has gone through a big repair and months of rehabilitation and then they tear it again, and they have to go in and do the reverse anyway. � at’s why we’re favoring the reverse more and more.”

� e reverse total shoulder replace-ment is not just for people su� ering from severe rotator cu� damage. Anyone who has su� ered a complex fracture or dis-location of the shoulder joint is a good candidate for the procedure as well.

“With the rotator cu� , a lot of people don’t really have any symptoms until it gets to that point where it’s worn down enough so that they start to have pain,” Dr. Stchur relates. “� at’s when we rec-ommend the reveres procedure.’’

For those procedures, Dr. Stchur uses the DELTA XTEND™ system, which he describes as a better physical design of the shoulder joint.

“In the normal shoulder, there’s a big ball in a very small socket,’’ Dr. Stchur educates. “It’s a lot like a golf ball on a tee. It’s just very unstable and it’s a weak rotator on its own because there’s no good fulcrum there. But by � ipping the

construction around, you’re constraining it to a certain extent so that you have a ful-crum that, when the deltoid � res, allows the arm to just pivot right up.”

Speedy RecoveryAnother advantage of the reverse total shoulder replacement procedure is the recovery time. � ough it is more invasive than some other treatment options, the time needed to recover is “shockingly fast because we’re not really repairing any-thing,” Dr. Stchur explains.

Sally was among those who returned to normal almost immediately. A shooting enthusiast as well, she says she was able to return to the gun range and was back working as the � rst mate to her husband, the captain on their sailboat, shortly after the reverse total replacement procedure was completed.

“� ey get you moving right away in the hospital and so I had good movement with my arm within a couple of days after the surgery,” she reports. “And the pain I felt in my shoulder while recovering from the surgery was less than the pain I had in my shoulder before the surgery was done. � ey were just excellent.

“And I have to admit that, coming from New York, I was a little concerned about the medical situation here in Florida. But the entire experience I had with Advanced Orthopedic could rival anything that I had done up in New York City. � ey were very caring, and thanks to them, I’m back to being myself again.”FHCN article by Roy Cummings. Photos by Jordan Pysz. mkb

Sally is back to working as � rst mate to her husband,

Steve.

Page 12 | Florida Health Care News | Spring 2018 | South Sarasota County Edition orthopedic Surgery and SportS medicine