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disorders tamed by

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DR. CRAIG S. ADERHOLDT

S eventy-six-year-old Pennsylvania native Shirley Piazza has su� ered from back problems o� and on for years. Physicians diagnosed

a combination of disorders including spi-nal stenosis, sciatica and arthritis. Shirley’s condition deteriorated over time, and last year, it became so severe that nothing she tried alleviated her intense pain.

“� e pain just grabbed me,” Shirley describes. “It felt like pressure pushing on a nerve. It went from my right hip down my leg, and I never knew when it would hit. Sometimes, it hit me when I was sitting down. Other times, it hit if I was on my feet too long. I couldn’t predict it, but when it did hit, it really stopped me in my tracks.”

Two of Shirley’s favorite hobbies are cooking and baking, which require being on her feet for extended periods. She also likes to work in her yard, exercise and walk, pursuits that also put pressure on her hip and leg. Shirley’s pain made it dif-� cult for her to perform these activities.

“At times, it was hard to function with the pain,” Shirley confirms. “I’m usually pretty active, but the pain de� -nitely slowed me down. It almost made me have to stop doing the things I like to do, but I kept on doing them, just with a lot of discomfort. I can handle pain. I can manage a ten on a scale of one to ten. But when the pain went up to � fteen, I knew it wasn’t going to get any better.

“I tried many treatments seeking pain relief, but nothing helped. I tried manipulations, pain pills, steroids, anti-in� ammatories, exercise and physi-cal therapy. I was worried I was going to need surgery.”

Before it went that far, Shirley recalled an incident that occurred months earlier that introduced her to Dr. Craig S. Aderholdt and the specialized treat-ment he offers at Back Pain Institute of West Florida. Shirley wondered if Dr. Aderholdt’s treatment could help her.

“My sister-in-law was here on vacation when she reached up into a cab-inet and pulled something in her back,” Shirley relates. “My husband had heard of Dr. Aderholdt and said, He’s close by; why don’t you try him. My sister-in-law went to Dr. Aderholdt for treatment and recommended him to me. I � gured I tried everything else. What do I have to lose?”

At Back Pain Institute of West Florida, Dr. Aderholdt provides the most advanced treatments for patients in severe

pain. Among them is a unique, nonsur-gical treatment called VAX-D® � erapy, which is a patented, FDA-approved medical decompression technique for alle-viating pressure on the discs of the spine.

“Shirley had a very painful lower back condition with pain radiating into her right leg, and as I do with many patients with similar painful conditions, I recommended VAX-D � erapy,” notes Dr. Aderholdt, who is one of the few doctors in the coun-try who o� ers this unique treatment.

As soon as Shirley arrived at Back Pain Institute of West Florida, she knew she made the right decision by visiting the practice. She was immediately impressed by Dr. Aderholdt’s knowledge, as well as his empathy and compassion.

“I could tell right away that Dr. Aderholdt is an expert in his � eld,” Shirley states. “And he is so easy to talk to. He really understands pain and cares about his patients so much. I got the feel-ing from him that he wanted to help me.

“Dr. Aderholdt suggested VAX-D Therapy because my spine was out of line, and that was a� ecting the lower half of my body. I’ve had alignment problems for years, so I knew what he was talking about. I thought, I don’t want surgery and VAX-D sounds pretty good, so I agreed to the treatment.”

Shirley Piazza

Advanced Orthopedic CenterPain Free at Last

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Advanced RejuvenationHearing Loss Is

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ChiropraCtiC

John Lieurance, DC, DACNB (Board Eligible), received his Doctor of Chiropractic degree from Parker College of Chiropractic and his Doctor of NMD degree through St. Luke’s Medical School. He is also a board-eligible chiroprac-tic neurologist through the Carrick Institute of Neurology. Dr. Lieurance is the developer of Functional Cranial Release, and teaches and certifi es these methods to physicians around the world. He has practiced in Sarasota for the past years.

JOHN LIEURANCE, DC, DACNB (BOARD ELIGIBLE)

For Health and Comfort

The staff of Advanced 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:

2033 Wood St.Suite 210

(941) 330-8553To learn more about Lumomed laser therapy, visit Advanced Rejuvenation on the internet at advancedrejuvenation.us

Hearing Loss Is ReversibleLumomed™ laser restores damaged ear cells

A fter working for 42 years as a � orist in their small, family-owned shop in Albany, New York, Sandy* and her hus-

band retired at the ages of 67 and 68 respectively, moved to Florida and began living what Sandy calls “the good life.’’

As the years rolled on, however, the good life became increasingly di� cult, par-ticularly for Sandy, who realized not long before her 80th birthday that she was expe-riencing the kind of hearing di� culties all too common among people her age.

“I’d be talking to someone and I’d only catch half of what they were saying,” Sandy recalls. “I’d have to ask them over and over again, what did you say? Or if I answered them wrong, they’d give me a funny look and I’d have to explain, I didn’t totally hear you.”

Sandy’s inability to carry on a conver-sation without constantly asking people to repeat themselves was especially frus-trating for her husband, who encouraged her to have her hearing tested. � ose tests revealed a hearing loss signi� cant enough to warrant Sandy being � t for hearing aids. But Sandy soon found her hearing aids to be a nuisance.

“I was constantly turning them up higher and down lower,” Sandy com-plains. “It was a pain in the neck, but I had no choice, because some people talk loud and some people talk soft, so I was always having to adjust them.”

By the time she began her eighth decade of life, Sandy was resigned to the

idea she’d need to wear the annoying hearing devices for the rest of her life. � en one day, Sandy’s husband picked up a copy of Florida Health Care News while waiting for an appointment in a doctor’s o� ce.

� e publication included an article about an innovative inner ear treatment designed to reverse hearing loss that is performed by John Lieurance, DC, at Advanced Rejuvenation, a regenerative medical practice in Sarasota.

Sandy says that upon � rst meeting with Dr. Lieurance, she found him to be “very, very thorough” during her initial examination and consultation, which included a comprehensive hearing test.

“He explained everything – how the laser therapy worked and what I could expect as far as getting my hearing back,” adds Sandy, who accepted Dr. Lieurance’s recommendation to undergo the therapy, a full course of which consists of 15 thirty-minute laser treatments on each ear.

“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 mitochondria. 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 per-formed with specialized laser equipment set at very speci� c settings. � e Lumomed laser showers energy into the ear in the form of photons. � is energy is then used by the hair cells to repair themselves.”

Better With Each Treatment� 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 � rst two treatments, I was told not to wear my hearing aids anymore,” Sandy remembers. “I should just trust that my hearing was slowly getting better, and it did get better with each treatment.”

Today, Sandy can hear as well as she did years ago. She’s living proof that it is possible to turn back time, and that hear-ing loss is reversible.

“If I hadn’t met up with Dr. Lieurance I would still be wearing hearing aids,” Sandy shares. “People are telling me, Your hearing is back! Your hearing is back! I am very, very happy.”FHCN article by Annette Mardis. Arrow graphic from Pixabay. mkb

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• Hip joint arthritis

Advanced Rejuvenation also o� ers:• Advanced stem cell treatments using LumoStem Activation • Prolotherapy with dextrose-based injections• Whole body cryotherapy using nitrogen gas to lower the

skin’s surface temperature for several minutes• Medical ozone injections• Hyperbaric oxygen therapy, which involves breathing pure

oxygen in a pressurized room• Intravenous laser therapy to irradiate white blood cells

“My husband showed me the article and when I read it, I thought, this sounds pretty good,” Sandy shares. “I said to my husband, this is something that can really help people, so we made an appointment and went and checked it out.”

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

One of a KindAdvanced 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 neurology practice when he heard about Lumomed from one of his patients. While in Germany, the patient 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 won-derful work in Germany for inner ear regeneration. It would be such a great adjunct to what you’re doing in Florida,” Dr. Lieurance relates.

Dr. Lieurance contacted Dr. Kaiser and traveled to Germany to study the sci-ence they had discovered and the methods for the treatment 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.

Page 2 | Florida Health Care News | Summer 2019 | Manatee County Edition Laser therapy

DAVID A. NAPOLIELLO, MD, FACS

For more information, please visit www.DavidNapolielloMD.com

David A. Napoliello, MD, FACS, is board certifi 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 sur-gery 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.

Learn MoreDr. 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:

Lakewood RanchMedical Offi ce Building

8340 Lakewood Ranch Blvd.Suite 101

Venice411 Commercial Court

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Trailblazing TreatmentNew, minimally invasive technique resolves acid re� ux disease

T he misery often starts with a burning sensation behind the breastbone that radiates to the neck and throat. In addition to

this pain, known as heartburn, there may be nausea, regurgitation, bad breath and, even-tually, tooth decay. � ese are some of the telltale signs of a common condition known as gastroesophageal re� ux disease, or GERD.

� e term gastroesophageal refers to the stomach (gastro) and the esophagus, or food pipe. � e esophagus empties into the stom-ach through a circular band of muscle called the lower esophageal sphincter (LES). If the LES doesn’t open and close properly, diges-tive acids from the stomach can � ow back into the esophagus and cause symptoms.

“When this backflow of stomach acids happens persistently, the condition is diagnosed as GERD,” explains 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. “Over time, GERD can damage the esopha-gus and lead to serious complications.”

Among these complications are esoph-agitis, or in� ammation of the esophagus; and stricture, a narrowing of the esophagus due to scar tissue from acid erosion. Other complications include the formation of ulcers in the esophagus and the develop-ment of precancerous changes in the tissue, a condition called Barrett’s esophagus.

Being obese or pregnant, smoking, overeating, eating late at night; eating certain foods, such as fried or fatty foods; drinking alcohol or co� ee, and taking certain medi-cations, including aspirin, can contribute to the weakening of the LES and the develop-ment of GERD. Another factor associated with GERD is hiatal hernia.

“There is a natural space in the diaphragm, the thin muscle wall that sep-arates the chest cavity from the abdomen,

that allows the esophagus to pass through to the stomach. It’s called the hiatus,” Dr. Napoliello educates. “� e hiatus can become abnormally large from actions such as years of coughing or straining. � e stomach can inappropriately slip upward into the chest cavity though that enlarged hiatus. � at is a hiatal hernia.

“� e normal position of the stomach is a major force in re� ux management. When the stomach and its connection to the esophagus are in the wrong anatom-ical position, the proper food depositing mechanism is broken. � is contributes signi� cantly to the heartburn and regur-gitation associated with GERD.”

With GERD and hiatal hernia, people can experience all of the usual symptoms of GERD and also su� er additional symp-toms attributed to hiatal hernia. � ese can include di� culty swallowing and respira-tory issues such as chronic coughing and asthma-like symptoms.

Anti-Refl ux RoutesPeople can have GERD without hav-ing a hiatal hernia and a hiatal hernia without having GERD, but in most instances, people with hiatal hernia also have GERD. They generally co-exist. In some cases of simple hiatal hernia, there may be no symptoms, but symptomatic patients are treated with medication or surgery, Dr. Napoliello notes.

“� ere is a type of hiatal hernia called a paraesophageal hiatal hernia that is dan-gerous because with it the stomach can get constricted and its blood supply can get cut o� ,” he informs. “With that type of hiatal hernia, surgery is indicated upon diagnosis.”

When surgery for GERD with hiatal hernia is warranted, Dr. Napoliello can typically treat both conditions during one surgical session. He performs most of these combined procedures as laparoscopic surgeries with the patients under general anesthesia. Laparoscopic surgery is a min-imally invasive technique that uses thin instruments and a camera inserted into the abdomen through tiny incisions. � e surgeons view the esophagus, hiatal hernia and surrounding tissue on a video screen.

Fortunately, Dr. Napoliello has expertise in surgically treating GERD with hiatal hernia. He is a specially trained re� ux surgeon who completed a fellowship in minimally invasive and advanced laparoscopic surgery at the world-famous Mayo Clinic.

“During the combined GERD/hia-tal hernia surgery, we begin by repairing the hiatal hernia,” Dr. Napoliello states. “� at involves first putting the stomach back into its appro-priate position. � en we sew the defect in the diaphragm closed with or without the use of a biologic mesh patch. After that, we pursue the anti-re� ux procedure.

“� ere has been classically one type of anti-reflux surgery, called Nissen fundoplication, during which the surgeon wraps the upper portion of the stomach around the esophagus. � is adds pressure to the LES and lower end of the esophagus. � is procedure, although tried and tested, has some rare pitfalls that would favor a simpler intervention.”

Now, however, there is a new option for GERD treatment that is less inva-sive and proving to be equal, if not more e� ective than fundoplication in reducing GERD symptoms. � is technique uses a re� ux-preventing device called the LINX® Re� ux Management System.

outpatient procedure or with an over-night stay in the hospital. A standalone LINX procedure takes about one hour to perform. When done as a GERD/hiatal hernia repair, surgery time is slightly longer, about an hour and a half. The LINX device can be removed or replaced if necessary.

“The LINX device was developed by pioneers in re� ux surgery and studied for more than ten years,” Dr. Napoliello reports. “� e LINX Re� ux Management System is a safer choice for people whose GERD has not responded to medications, and surgery is the next step in treatment.”

� e LINX technique is also a good option for those who are concerned about the risks and side effects of long-term medication use to manage their GERD symptoms, adds the doctor.

“There have been reports recently questioning the standard medical man-agement of GERD, especially the use of

proton pump inhibitors,” Dr. Napoliello observes. Proton pump inhibitors are a group of medications that stop production of a pro-tein in the stomach that is necessary for acid secretion.

“ T h e s e m e d i c a -tions have been linked to decreased calcium and mag-nesium, stomach tumors,

blood clots and even the development of dementia. Patients who have concerns about these risks now have a new answer for treatment of their GERD. It is the less invasive surgery using the LINX device.

“The LINX Reflux Management System is a simpler, more readily revers-ible option that can provide signi� cant GERD relief. The LINX procedure is excellent for GERD, especially for GERD in combination with hiatal hernia.”FHCN article by Patti DiPanfilo. Header photo from

Pixabay. LINX graphic courtesy of Torax. mkb

“The LINX Re� ux Management System is a safer choice for people whose GERD has not responded to medications, and

surgery is the next step in treatment.” – Dr. Napoliello

Magnetic Mastery� e LINX system is a drug-free treat-ment for patients who continue to experience signi� cant GERD symptoms despite conservative treatments such as lifestyle changes and acid-suppressing medications. The LINX procedure is considerably less invasive than fundo-plication because it doesn’t require any surgical changes to the anatomy.

“� e LINX device is a small, � exible, circular band of interlinked magnetic beads made of titanium,” Dr. Napoliello describes. “� e device is placed around the base of the esophagus, and it essentially acts as a new, arti� cial lower esophageal sphincter.

“The beads in the device form a strong magnetic bond, which holds this arti� cial LES tightly closed. When patients swallow, the movement of food passing through the lower part of the esophagus breaks that bond and allows food to pass from the esophagus into the stomach. After that, the magnetic bond quickly reforms, which resists gas-tric pressures and prevents acids from � owing backward.”

Surgery to install a LINX Reflux Management System can be done as an

The LINX device is only slightly larger than a quarter.

Manatee County Edition | Summer 2019 | Florida Health Care News | Page 3MiniMaLLy invasive GeneraL surGery

Triple(continued from page 1)

Negative PressureDr. Aderholdt stresses that while VAX-D � erapy is a medical decompression technique, it is not a traction device. It works dif-ferently and achieves signi� cantly better results, the doctor assures.

“Chiropractic adjustments alone can actually relieve the pain for many patients,” Dr. Aderholdt maintains. “For select people with sciatica or herniated, bulging or degenerated discs, however, VAX-D � erapy has proven extremely e� ective.

“Like Shirley, many back and neck pain su� erers are good candi-dates for VAX-D because the treatment can alleviate neck pain, low back pain, numbness, tingling and pain radiating down the arms and legs.”

During VAX-D � erapy, the patient relaxes on a comfortable, computer-controlled table, secured with a pelvic belt or patented

cervical collar, depending on the area to be treated. Carefully speci� ed tension and pressure changes guide the use of VAX-D, allow-ing the therapist to focus decompression at the exact level of spinal dysfunction.

Because the VAX-D system is computerized, it enables the table to make subtle but tar-geted movements, which create a powerful vacuum within the disc space. � is vacuum gently draws the disc back to its proper ori-entation, which pulls nutrient-rich spinal � uid into the disc and stimulates repair cells that e� ectively mend the disc.

“Nothing else can create such a powerful vacuum,” Dr. Aderholdt declares. “� at is what makes VAX-D such a valu-able tool for pain relief. � ere are imitators, but the vacuum e� ect is the most powerful one known.

“It doesn’t allow the muscles to contract like other machines might. In fact, VAX-D is the only nonsurgical treatment that has been clinically proven to reduce disc pressure to negative levels.”

“VAX-D � erapy straightens and heals the spine, and there’s noth-ing to it,” Shirley shares. “During treatment, the quali� ed technicians at Back Pain Institute of West Florida place a strap around me for support, then connect me to a machine that slowly stretches my spine.

“� ere’s nothing to be afraid of. � e treatment is gentle. It’s not painful. I just lie there and relax, and the treatment slows the progression of my spinal stenosis, sciatica and arthritis.”

Long-Term Eff ectivenessDr. Aderholdt points out that VAX-D � erapy has a long track record of leaving customers satis� ed. Long-term studies show that VAX-D is e� ective in more than 88 percent of patients who go through the treatment.

“I consider VAX-D one of the most e� ective nonsurgical med-ical treatments for low back pain, neck pain and sciatica today,” Dr. Aderholdt asserts. “� is revolutionary technology is one more tool I can o� er my patients as we work toward relieving pain and maintaining the health of the lumbar and cervical spine.”

Dr. Aderholdt says many patients report a signi� cant reduction in back pain within only a few treatments, although the total heal-ing process takes longer. � e reason it takes a longer period of time, Dr. Aderholdt explains, is that bulging or herniated discs require a series of VAX-D sessions to fully reposition themselves.

“Some patients think they will get relief after a handful of sessions and they can just quit, but that’s not the case,” he cautions. “You must follow through with all of the required treatments to get the full benefit.”

� e doctor notes that VAX-D � erapy has the added bene� t of eliminating the need for surgery in many cases.

Triple Play

Shirley is encouraged by the substantial improvement she has achieved

through VAX-D Therapy.

Craig S. Aderholdt, DC, received his undergraduate degree from the Pennsylvania State University, State College, and his Doctor of Chiropractic degree from Life University School of Chiropractic, Marietta, GA, where he grad-

uated cum laude. Dr. Aderholdt also holds certification in Chiropractic Adjunctive Physiotherapy from New York Chiropractic College and completed extensive post-graduate training in therapeutic modalities at National-Lincoln School. He is a member of the Florida Chiropractic Association and American Chiropractic Association and is a certifi ed VAX-D Therapy consultant. He was also voted the Bradenton Herald People’s Choice Awards Winner for , the Manatee Herald-Tribune Awards winner for , and and the Sarasota Herald-Tribune fi nalist for , , and winner in .

Bradenton5221 26th St. West

Sarasota7345 International Place, Suite 101

Lakewood Ranch

(941) 756-5528

Get “Back” to Wellness … Naturally!

î VAX-D Therapy î Cervical (neck) VAX-D

Therapy î Back and neck pain î Headaches î Spinal stenosis î Sciatica î Kinesiology î Manipulation Under

Anesthesia (MUA) î Automobile accident

injuries

Call Back Pain Institute of West Florida today for more

information about:

Please visit www.backpaininstitutew� .com

If your MRI shows disc herniation, a bulging disc or degenerative disc disease, you may be a candidate for VAX-D Therapy. It may be the

treatment that helps you avoid an unnecessary surgery. For additional information or to schedule a free consultation, call or visit one of

these Back Pain Institute of West Florida locations:

“Shirley wanted to avoid surgery, and that is something that VAX-D allows,” Dr. Aderholdt says. “Preventing surgery is important because whenever an invasive procedure can be avoided and noninvasive measures used instead, the risk of complications is significantly reduced.”

Forward ProgressAs Shirley � nishes her course of VAX-D � erapy, she’s encouraged by the substantial improvement she’s achieved from the treatment thus far. She’s already experienced signi� cant pain relief from the spinal stenosis, sciatica and arthritis in her back. And she’s relieved that she won’t have to face surgery at this point.

“Right now, I don’t have any pain,” Shirley enthuses. “If I’m on my feet too long or lift something heavy, it can come back, but I’m careful about that. When my back does bother me, the pain level is about a � ve. But ninety percent of the time, it’s zero. I’m not in any pain.”

Now that the intense, grabbing pain in Shirley’s hip and leg is relieved, she can resume her favorite activities. She can cook, work in the yard, clean house and be on her feet without the pressure and discomfort she previously experienced. And Shirley wants the pain relief to last into the future.

“I can also walk and exercise in comfort now, but Dr. Aderholdt told me to go easy for a while because I can aggravate the problem again,” she reports. “And once I’m done with therapy, I plan to con-tinue with maintenance sessions to keep my progress going.

“I can do most anything I want to do now, with caution. VAX-D � erapy has worked well for me, and I look forward to when my treatment is over and I can say it’s completely successful. But with Dr. Aderholdt’s VAX-D � erapy, I’m well on my way to healing.”FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

DR. CRAIG S. ADERHOLDT

TriplePage 4 | Florida Health Care News | Summer 2019 | Manatee County Edition

Barry LevineExecutive Publisher

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Back Pain Institute of West Florida, P.A.

Chiropractic

Advanced RejuvenationLaser Therapy

David A. Napoliello, MD, FACSMinimally Invasive General Surgery

20 Minutes to FitnessPhysical Fitness

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Sarasota Foot and Ankle Center Podiatry

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Erectile Dysfunction

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(813) 989-1330

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ChiropraCtiC

My Go-To ProgramMy Go-To Program

The staff at Minutes to Fitness

look forward to serving all your fi tness needs.

They off er personalized, one-on-one training with

no annual contracts or membership fees.

For a complimentary orientation, please call or visit

one of their locations:

Lakewood Ranch6257 Lake Osprey Drive

(941) 309-8989Sarasota

209 N. Lime Avenue

(941) 361-1000Tampa

11610 N. Dale Mabry Hwy.

(813) 664-8888Learn more at www.20minutesto� tness.com

Anna Fotopoulos is a Nationally Certified P e r s o n a l Tr a i n e r w o r k i n g w i t h Minutes to Fitness. She enjoys compet-ing in various fitness competit ions and spending time with her family.

Once-a-week workouts keep busy folks � t

W hen she walked away from her 38-year career as an educator sev-eral years ago, Marian

Orlosky didn’t think she’d � nd another line of work more rewarding than the one she had teaching special education students and special education teachers.

Then she became a provider of Interactive Metronome®.

A therapeutic assessment and training program, Interactive Metronome (IM) has proven e� ective in helping children and adults alike, including many with autism, improve their cognitive and motor skills and their ability to perform daily tasks.

“It’s a remarkable program, and I know it works because I’ve seen it work in my own practice,” Marian shares. “I’ve worked with several people who have Asperger’s syndrome, which is on the same spectrum as autism, and the results I’ve seen are amazing.

“I also worked with a six-year-old who has autism. Once, I worked with her three days a week for the entire school year, and by the end of the school year, she wasn’t displaying any autistic symptoms at all. � at’s how amazing this program is.”

Marian’s passion for the IM program is so great that, even at age 69, she has no plans to retire anytime soon. She’s simply too busy making other people’s lives bet-ter. She’s also too busy to maintain what most consider a normal workout routine.

“I tried the old three-days-a-week thing, but I just couldn’t � t it into my schedule,” Marian relates. “I then found a twenty-four-hour place, but the trainers there never really calibrated the machines properly for my body.

“� e other thing I have to be con-scientious of is the fact that I have a congenital spine problem. My lower lum-bar vertebrae are fused to my hip bone. � at presents a weakness, and it gets out of place pretty easily. When it does, the muscles and nerves get in� amed.

“I’m the kind of person who would rather cure the problem than mask it with pain medication, so I was looking for a place to go, and a little more than a year ago, I read about 20 Minutes to Fitness in Florida Health Care News and decided to try it.”

Tailored TrainingAt 20 Minutes to Fitness, clients work out one-on-one with a nationally certi� ed per-sonal � tness coach who creates and supervises an individualized workout program. The program is designed to do exactly what the business’ name implies: achieve results through one 20-minute session once a week.

� e workouts are structured around an exercise method known as slow-cadence training. � e coach guides the client’s pace and form as weights are lifted in ultra-slow

movements on highly specialized equip-ment. Repetitions during each workout last approximately 20 seconds, thereby maximizing muscle performance.

The slow-paced movements that comprise each workout create continu-ous tension on the muscle � bers, which allows clients to get more physical ben-efits from a 20-minute, once-a-week workout than they would get from going through a traditional workout program three or four times a week.

Each 20-minute, full-body workout consists of six to seven exercises that last for approximately two minutes each. � e goal is to reach what is known as peak performance, the point where blood � ows to the muscle and supercharges the body. � is helps burn fat while the muscles are rebuilt and strengthened naturally.

“Participants get the maximum benefit through one twenty-minute workout per week,” explains Angela Begin, general manager and part owner of 20 Minutes to Fitness.“By going slowly, we get down deeper into the muscle � bers and force them to work at their peak per-formance. And we work the entire body to keep it strong.”

� e program has years of research and plenty of science behind its success. � e highly specialized weight-trainingequipment is part of that success. The equipment features a patented double-stacking system, where weight can be increased in increments of 2 pounds instead of the traditional 5, 10 or 20.

The equipment is also calibrated to work specific muscle groups with-out putting undue stress on joints or ligaments. Research has shown that in addition to improving strength, weekly 20-minute slow-cadence training

sessions can also help improve balance, increase energy, control arthritis, increase bone density, � ght symptoms of diabetes and reduce back pain.

“We have clients who are planning to have hip or knee replacement surgeries, and their doctors refer them to us because they know we can help them build the muscle around those joints prior to sur-gery,” Angela adds. “This allows for a quicker recovery after surgery.

“We’ve even had some people who have been able to hold off on those surgeries because they’ve built up the muscle around the joint. Most of our clients, though, are people who want to stay � t and don’t have the time or don’t want to spend hours in a gym and possibly risk injury.

“They want a safe, quiet, private studio environment, and that’s what we o� er, in addition to building back that muscle that people lose as they age. � e other thing is, you’re never too young or too old to do this. We have teenagers who come in, as well as clients who are in their nineties. We have clients who have never worked out as well as athletes. We build your strength from where you are today.”

Back in ActionBuilding strength is precisely why Marian began working out at 20 Minutes to Fitness.She initially went there seeking something to augment the chiropractic adjustments she needed for her back. Now, thanks to her weekly workouts, she seldom if ever needs those adjustments.

“I had been going to the chiropractor regularly, sometimes twice a week, for � f-teen years,” Marian says. “And when you go, of course, it’s never just, get an adjust-ment and you’re done. No, you have to go

home and ice it afterward and everything else, and that’s time-consuming, too.

“But ever since I started doing the 20 Minutes to Fitness workouts, I haven’t needed those adjustments as much. My chiropractor has even called me a couple of times, asking, Are you okay? Did you � nd another chiropractor? What’s happening?”

What’s happened is that the 20 Minutes to Fitness workouts have proved to be just the right remedy Marian needed to strengthen her back muscles, keep her back in alignment and stay in shape. And the workouts � t perfectly into her busy schedule.

“It’s twenty minutes once a week; I mean, I can do anything for twenty min-utes once a week,” she says. “And if I can build the muscles in my back that allow me to stay in alignment at my age in just twenty minutes, well, that’s going to be my go-to program.

“And while that ability to stay in alignment structurally is the most import-ant thing for me, I also like the idea that I’m far more � t now than I used to be. And by that, I don’t mean � t in terms of a size-four dress kind of thing.

“I’m not in the same life space as I was when I was in my twenties, thirties and forties. � e next stage of my life will be an aging stage, and I need a body that will allow me to get through that and keep doing what I enjoy while I get through it.

“� at’s what 20 Minutes to Fitness is allowing me to do. � at’s how 20 Minutes to Fitness is impacting my life and making it better, and I would recommend it to anyone looking to stay in shape and build strength, because it really works.” FHCN article by Roy Cummings. Photo by Fred Bellet. mkb

With the help of her trainer, Anna Fotopoulos (left), Marian is getting great results from her 20 Minutes to Fitness workouts.

Manatee County Edition | Summer 2019 | Florida Health Care News | Page 5physiCaL Fitness

Daniel E. Friedman, MD, FACC, FHRS, is board certifi ed in clinical cardiac electrophysiology and cardiovascular diseases by the American Board of Internal Medicine. Dr. Friedman completed his undergraduate studies at Tulane University in New Orleans, then earned his medical degree at Tulane University School of Medicine. He completed an internal medicine residency at Mayo Clinic College of Medicine in Rochester, MN, then went back to New Orleans for a cardiovascular diseases fellowship at Tulane University Health Sciences Center. Dr. Friedman entered a second cardiovascular diseases fellowship at the Texas Heart Institute at Baylor University College of Medicine after Hurricane Katrina. He also completed a clinical cardiac electrophysiology fellowship at Saint Louis University Health Sciences Center. Dr. Friedman is a fellow of the American College of Cardiology and of the Heart Rhythm Society. He is a member of the American Medical Association, Florida Medical Association and Manatee County Medical Society.

DANIEL E. FRIEDMAN, MD, FACC, FHRS

PHYSICIANS ARE ON THE MEDICAL STAFF OF MANATEE MEMORIAL HOSPITAL, BUT, WITH LIMITED EXCEPTIONS, ARE INDEPENDENT PRACTITIONERS WHO ARE NOT EMPLOYEES OR AGENTS OF MANATEE MEMORIAL HOSPITAL. THE HOSPITAL SHALL NOT BE LIABLE FOR ACTIONS OR TREATMENTS PROVIDED BY PHYSICIANS. FOR LANGUAGE ASSISTANCE, DISABILITY ACCOMMODATIONS, AND THE NON-DISCRIMINATION NOTICE, VISIT OUR WEBSITE.

Please visit Manatee Memorial Hospital online at ManateeMemorial.com

Advanced CareTrust your care to Manatee

Memorial Hospital. The hospital also off ers several programs to help educate the public about

maintaining or regaining health. Manatee Memorial Hospital

is in Bradenton at:

206 2nd St. East(941) 745-7545

Wireless pacemaker takes the lead in heart health care

M emphis, Tennessee native Jim Blackburn spent only two of his 45 years as a sheet metal worker installing

ductwork in the Holiday Inn® motels that were popping up all over America back in the 70s. � ose two years wound up having a long-lasting impact on him.

“� at’s when I � rst got the travel bug,” Jim states. “� e contractor I was working for back then knew Kemmons Wilson, the founder of the Holiday Inn chain, and they were so tight that Mr. Wilson wound up giv-ing my boss the contract for the duct work in his hotels. After that, I spent the next two years traveling all over.”

Jim found himself on the road yet again soon after that contract ran out. A Memphis area bricklayers’ strike put a halt to con-struction in the Mid-South city, forcing Jim to look for work elsewhere. He eventually found it in Kansas City, where he stayed until health matters forced him to retire in 1998.

“I had to have both my knees replaced, and after that, I had to hang up my tools,” Jim explains. “By then, our kids were mar-ried and out of the house, so my wife and I decided to sell the house, downsize and start traveling. We bought a motorhome and spent the next several years traveling all over the United States.”

Jim and his wife’s travels took them to all but four states – Alaska, Hawaii, New Hampshire and Vermont – and while they developed a special a� nity for Washington and Oregon, the Sunshine State is where they eventually settled. Shortly after mak-ing the move, Jim began to feel decidedly unsettled physically.

Comfortable and Convenient

Manatee Memorial Hospital has a long tradition of providing medical care in a comfortable and convenient environment for thousands of patients. Serving the community for years, the -bed, acute-care facility off ers access to more than physicians and allied health professionals, with a broad range of specialties. Manatee Memorial Hospital can off er patients the added benefi t and convenience of outpatient and inpatient testing including radiology services such as x-rays, D Mammography, CT scans, MRIs plus laboratory testing, all conducted in one place.

Jim Blackburn

“It was right about the time we bought our house here in Florida that I started to have trouble with A-Fib,” Jim says, referring to atrial � brillation, which is a quivering or irregular heartbeat. “I know that with some people, they can live with A-Fib and it doesn’t really bother them. Well, that’s not me. � is thing tore me apart.

“Sometimes, my heart would beat really fast and then it would stop and go back to normal, but then it would pick back up again. It was very sporadic, and if I got up o� the couch too quickly, I’d get really dizzy and would feel faint. I was always feeling very tired and out of breath. It was like I had no energy.

“It was a real problem, because here we are, my wife and I, and we’re trying to enjoy retirement, but we couldn’t get out and do much. I just didn’t feel up to it. We stopped going out to dinner, except for maybe once a month, and I all but had to give up my favorite hobby, which is � shing. I live on a lake, Lake June, but I had to put my boat in dry dock.”

The symptoms Jim experienced are typical of those su� ering from A-Fib, which can also cause fatigue, shortness of breath, lightheadedness and confusion. For many people whose heartbeat � uctuates in and out of normal rhythm, A-Fib can often be controlled through medication. For others, more advanced treatments are required.

One such treatment is an electrical cardioversion. Performed while the patient is asleep under anesthesia, this procedure administers an electric current to the patient that resets their heart and normalizes its rhythm. Another procedure often performed to correct A-Fib is called a cardiac ablation.

After he was initially diagnosed with A-Fib in 2009, Jim was put on medication. When it was discovered the medication wasn’t correcting the problem, he was given the � rst of what proved to be six electrical cardioversions, each one losing its impact after a few months. He then underwent a cardiac ablation.

Cardiac ablations are most often per-formed using a diagnostic catheter that is threaded through a vein or blood vessel in the groin and up into the heart. Once the heart has been reached, the tissue that is found to be disrupting the rhythm of the heartbeat is modi� ed in an e� ort to re-es-tablish the normal � ow of electrical signals to the heart.

� e cardiac ablation gave Jim about � ve years of relief, but he required a second abla-tion procedure a little more than a year ago. � is time, the ablation provided only a few months of relief. � at’s when Jim’s cardiol-ogist suggested he get a pacemaker and sent him to Daniel E. Friedman, MD.

Dr. Friedman is a board-certified clinical cardiac electrophysiologist. He works at the Bradenton Cardiology Center and is a member of the Structural Heart Team at Manatee Memorial Hospital, which recently invested in the most advanced pacemaker available – a leadless pacemaker known clin-ically as the Medtronic Micra™ Transcatheter Pacing System.

Wireless Technology A pacemaker is a small device that deliv-ers subtle electrical impulses that keep the heart beating in proper rhythm. Standard pacemakers consist of a pulse generator and a series of wires, or leads, that deliver the impulses to the speci� c chamber or cham-bers of the heart where they are placed.

A leadless pacemaker is smaller (about the size of a AAA battery) than a standard pacemaker. It is a completely self-contained pacing device that includes a battery that lasts about 12 years, and in place of wires, it has at one end a small electrode that literally touches the heart to stimulate the heartbeat.

Designed in the 1970s, the leadless pace-maker was � rst approved for use by the US Food and Drug Administration in 2016. Since then, its popularity has grown exponentially among physicians, many of whom believe it will soon become the standard for patients requiring pacemakers. Its many advantages over the current standard are the reason.

Among those advantages is the simplicity of the implantation procedure. � e implantation of the leadless pacemaker is not as invasive as the procedure for the tra-ditional pacemaker, where the surgeon must implant the pacing device in the chest, then run the wires through the veins to the chambers of the heart.

That surgery usually leaves about a two-inch scar as well as a vis-ible pocket in the skin where the device is placed. It’s a procedure that is also prone to infection, notes Dr. Friedman, who says one

to two percent of all patients receiving tradi-tional pacemakers wind up with infections.

� e leadless pacemaker carries with it a much lesser risk of infection. In fact, accord-ing to Dr. Friedman, there are currently no known reports of infection associated with the leadless pacemaker, which is delivered directly to the right ventricle of the heart through a catheter that is threaded through a vein that runs from the groin to the heart.

“Because it’s a cath-eter-delivered device, there’s no cut t ing involved in the implant procedure for the lead-less pacemaker,” Dr. Friedman informs. “Once the device is delivered, the catheter is removed, and you’re done. Overall, the implant procedure for the leadless pacemaker is much easier and much quicker than it is for the traditional pacemaker.”

Another advantage of the leadless pace-maker is that the time needed to recover from the implant procedure is much less than it is with a traditional pacemaker. Patients receiv-ing a leadless pacemaker can typically return home within 24 hours of its implantation and are usually allowed to resume normal activi-ties immediately thereafter.

� at’s not the case with patients receiving traditional pacemakers. � e far more invasive surgical procedure associated with traditional pacemakers typically requires a hospital stay of a few days and a three- to four-week period

in which the patient is limited in terms of activities. It can also leave an

emotional scar that the leadless pacemaker does not.

“We have found that patient acceptance of the leadless pacemaker is much higher because patients don’t feel like they have a device because they can’t see

it or feel it under their skin,” Dr. Friedman con-

firms. “It’s not visible to anybody, so it’s seamless in

that regard, and that’s a big advantage, too.”

Immediate Impact When he � rst met with Dr. Friedman, Jim was given the choice of receiving either a tra-ditional pacemaker or a leadless model. After hearing of all the advantages associated with the leadless pacemaker, he chose the latter. He knew he made the right choice within minutes of waking up from the implantation procedure.

“As soon as the anesthetic wore o� and I was awake again, I knew I was better,” Jim enthuses. “I noticed immediately that I was breathing easier and that I could take deep breaths again. I could tell right away that my heartbeat was in rhythm, because I wasn’t feeling dizzy or lightheaded or faint in any way. I felt great.”

Jim felt even greater a couple days later when, for the � rst time in months, he went � shing again. � at’s something he would not have been able to do for another few weeks had he opted for the traditional pacemaker. � e leadless pacemaker allows people to live

life normally again immediately after implan-tation, and Jim is de� nitely doing that.

Since receiving his pacemaker, he has taken his boat out of dry dock and is out on the water almost daily. He’s also venturing out for dinner more often. His quality of life has improved so much, in fact, that Jim says he wishes he had received a pacemaker years ago instead of going through the electrical cardioversions and cardiac ablations.

“I’m doing all the things I want to do now, and never experienced any pain as a result of having this procedure,” Jim shares. “I had a lit-tle bit of soreness down around my groin area from where they ran the catheter, but that went

away after a couple of weeks. Since then, I’ve just felt better and better.”

Taking the Lead Better is exactly how Becky Grohoske, 74, feels these days. Like Jim, she too was recently � t with a leadless pacemaker, the implantation of which was part of a 14-year-long health struggle that began with the onset of Parkinson’s disease and included a battle with breast cancer.

“I learned I had breast cancer about two years after I learned I had Parkinson’s dis-ease,” Becky relates. “� en, about four years ago, I was diagnosed with A-Fib. It was dis-covered during a check-up, and at the time, they decided to give me a loop monitor to keep track of my heartbeat.”

A loop monitor is a recording device about the size of a computer thumb drive. It is typically implanted under the skin of the chest, where it can continuously record the electric signals of the heart for up to three years. � at information is then downloaded into a computer by a doctor to determine whether the heart is beating in proper rhythm.

� e monitor Becky was � tted with showed that she was su� ering from a very rapid heart-beat. To correct that problem, she was put on medication. At times, however, the medication caused Becky’s heart to beat so slowly that she would nearly faint. It was then that she was told she needed to get a pacemaker.

“I knew I needed to do something because I was always feeling like I was going to pass out,” Becky says. “One day, I went to the grocery store, and no sooner did I get inside the door when everything went white. I had to put my hand out over a chair to keep from falling. It was just a horrible feeling.”

Her fear of passing out forced Becky to cut back on a number of normal, daily activities, including driving. For a while, she was virtually homebound, in part because

her cardiologist had recently retired, and she was in the process of having her care transferred to another doctor. � at doctor was Dr. Friedman.

Just as he did with Jim, Dr. Friedman gave Becky the option of receiving a tradi-tional pacemaker or the new leadless model. Becky was a little hesitant at � rst to commit to the new pacemaker, but she eventually accepted the offer and received the new device earlier this year. She hasn’t had any heart issues since.

“To begin with, the surgery – if you can even call it that – went great,” Becky enthuses. “It’s so easy. � ey don’t have to cut you open or anything. And they put this tiny, little thing in your heart that you don’t even know is there, but I know

it’s working because I don’t have any feel-ings like I’m going to pass out anymore. I feel great.”

Becky continues to take medication for a rapid heartbeat and high blood pressure, but the pacemaker is allowing her to toler-ate the medication by eliminating the pauses that were causing her to feel faint. She says she’s thankful for Dr. Friedman’s advice and expertise in suggesting and implanting the leadless pacemaker.

“I really like Dr. Friedman,” she says. “He’s very quiet, methodical and meticu-lous, and I really trust him. I was a little nervous about getting this new kind of pacemaker, but he told me it was going to be the best thing for me, and he was right. It’s working great.”

Willing and Able Dr. Friedman says he can only take part of the credit for how much better Becky and Jim are feeling. He says the bulk of the credit has to go to Manatee Memorial Hospital for its decision to support the implantation of the leadless pacemaker and for having the foresight to invest in that and other new technologies.

“They’re very accommodating,” Dr. Friedman says of the hospital. “When there’s new technology like this, a lot of times the knee-jerk reaction to it from a hos-pital is that it’s way too expensive to invest in, because the hospital is worried about the return on their investment. � at’s not how it is at Manatee Memorial Hospital.

“Manatee Memorial Hospital has always been on the leading edge of new technolo-gies. � ey often allow physicians to use new technologies to bene� t their patients, and there is de� nitely a need for these leadless pacemakers. � ey are, without question, the future of pacemakers.”

It’s not just the doctors who are accom-modated at Manatee Memorial Hospital. Patients are treated with special care as well. “And Dr. Friedman is an excellent doctor. Instead of speaking in a bunch of medical terms that you can’t understand, he speaks English. And he’s so well informed on all the new technologies and trends. He told me all about this new pacemaker and told me it was a perfect � t for me, and he was absolutely right. I recommend them both.”FHCN article by Roy Cummings. Photos by Jordan Pysz.

Pacemaker graphic courtesy of Medtronic. mkb

Becky Grohoske

Page 6 | Florida Health Care News | Summer 2019 | Manatee County Edition speCiaLty Care hospitaL

Daniel E. Friedman, MD, FACC, FHRS, is board certifi ed in clinical cardiac electrophysiology and cardiovascular diseases by the American Board of Internal Medicine. Dr. Friedman completed his undergraduate studies at Tulane University in New Orleans, then earned his medical degree at Tulane University School of Medicine. He completed an internal medicine residency at Mayo Clinic College of Medicine in Rochester, MN, then went back to New Orleans for a cardiovascular diseases fellowship at Tulane University Health Sciences Center. Dr. Friedman entered a second cardiovascular diseases fellowship at the Texas Heart Institute at Baylor University College of Medicine after Hurricane Katrina. He also completed a clinical cardiac electrophysiology fellowship at Saint Louis University Health Sciences Center. Dr. Friedman is a fellow of the American College of Cardiology and of the Heart Rhythm Society. He is a member of the American Medical Association, Florida Medical Association and Manatee County Medical Society.

DANIEL E. FRIEDMAN, MD, FACC, FHRS

PHYSICIANS ARE ON THE MEDICAL STAFF OF MANATEE MEMORIAL HOSPITAL, BUT, WITH LIMITED EXCEPTIONS, ARE INDEPENDENT PRACTITIONERS WHO ARE NOT EMPLOYEES OR AGENTS OF MANATEE MEMORIAL HOSPITAL. THE HOSPITAL SHALL NOT BE LIABLE FOR ACTIONS OR TREATMENTS PROVIDED BY PHYSICIANS. FOR LANGUAGE ASSISTANCE, DISABILITY ACCOMMODATIONS, AND THE NON-DISCRIMINATION NOTICE, VISIT OUR WEBSITE.

Please visit Manatee Memorial Hospital online at ManateeMemorial.com

Advanced CareTrust your care to Manatee

Memorial Hospital. The hospital also off ers several programs to help educate the public about

maintaining or regaining health. Manatee Memorial Hospital

is in Bradenton at:

206 2nd St. East(941) 745-7545

Wireless pacemaker takes the lead in heart health care

M emphis, Tennessee native Jim Blackburn spent only two of his 45 years as a sheet metal worker installing

ductwork in the Holiday Inn® motels that were popping up all over America back in the 70s. � ose two years wound up having a long-lasting impact on him.

“� at’s when I � rst got the travel bug,” Jim states. “� e contractor I was working for back then knew Kemmons Wilson, the founder of the Holiday Inn chain, and they were so tight that Mr. Wilson wound up giv-ing my boss the contract for the duct work in his hotels. After that, I spent the next two years traveling all over.”

Jim found himself on the road yet again soon after that contract ran out. A Memphis area bricklayers’ strike put a halt to con-struction in the Mid-South city, forcing Jim to look for work elsewhere. He eventually found it in Kansas City, where he stayed until health matters forced him to retire in 1998.

“I had to have both my knees replaced, and after that, I had to hang up my tools,” Jim explains. “By then, our kids were mar-ried and out of the house, so my wife and I decided to sell the house, downsize and start traveling. We bought a motorhome and spent the next several years traveling all over the United States.”

Jim and his wife’s travels took them to all but four states – Alaska, Hawaii, New Hampshire and Vermont – and while they developed a special a� nity for Washington and Oregon, the Sunshine State is where they eventually settled. Shortly after mak-ing the move, Jim began to feel decidedly unsettled physically.

Comfortable and Convenient

Manatee Memorial Hospital has a long tradition of providing medical care in a comfortable and convenient environment for thousands of patients. Serving the community for years, the -bed, acute-care facility off ers access to more than physicians and allied health professionals, with a broad range of specialties. Manatee Memorial Hospital can off er patients the added benefi t and convenience of outpatient and inpatient testing including radiology services such as x-rays, D Mammography, CT scans, MRIs plus laboratory testing, all conducted in one place.

Jim Blackburn

“It was right about the time we bought our house here in Florida that I started to have trouble with A-Fib,” Jim says, referring to atrial � brillation, which is a quivering or irregular heartbeat. “I know that with some people, they can live with A-Fib and it doesn’t really bother them. Well, that’s not me. � is thing tore me apart.

“Sometimes, my heart would beat really fast and then it would stop and go back to normal, but then it would pick back up again. It was very sporadic, and if I got up o� the couch too quickly, I’d get really dizzy and would feel faint. I was always feeling very tired and out of breath. It was like I had no energy.

“It was a real problem, because here we are, my wife and I, and we’re trying to enjoy retirement, but we couldn’t get out and do much. I just didn’t feel up to it. We stopped going out to dinner, except for maybe once a month, and I all but had to give up my favorite hobby, which is � shing. I live on a lake, Lake June, but I had to put my boat in dry dock.”

The symptoms Jim experienced are typical of those su� ering from A-Fib, which can also cause fatigue, shortness of breath, lightheadedness and confusion. For many people whose heartbeat � uctuates in and out of normal rhythm, A-Fib can often be controlled through medication. For others, more advanced treatments are required.

One such treatment is an electrical cardioversion. Performed while the patient is asleep under anesthesia, this procedure administers an electric current to the patient that resets their heart and normalizes its rhythm. Another procedure often performed to correct A-Fib is called a cardiac ablation.

After he was initially diagnosed with A-Fib in 2009, Jim was put on medication. When it was discovered the medication wasn’t correcting the problem, he was given the � rst of what proved to be six electrical cardioversions, each one losing its impact after a few months. He then underwent a cardiac ablation.

Cardiac ablations are most often per-formed using a diagnostic catheter that is threaded through a vein or blood vessel in the groin and up into the heart. Once the heart has been reached, the tissue that is found to be disrupting the rhythm of the heartbeat is modi� ed in an e� ort to re-es-tablish the normal � ow of electrical signals to the heart.

� e cardiac ablation gave Jim about � ve years of relief, but he required a second abla-tion procedure a little more than a year ago. � is time, the ablation provided only a few months of relief. � at’s when Jim’s cardiol-ogist suggested he get a pacemaker and sent him to Daniel E. Friedman, MD.

Dr. Friedman is a board-certified clinical cardiac electrophysiologist. He works at the Bradenton Cardiology Center and is a member of the Structural Heart Team at Manatee Memorial Hospital, which recently invested in the most advanced pacemaker available – a leadless pacemaker known clin-ically as the Medtronic Micra™ Transcatheter Pacing System.

Wireless Technology A pacemaker is a small device that deliv-ers subtle electrical impulses that keep the heart beating in proper rhythm. Standard pacemakers consist of a pulse generator and a series of wires, or leads, that deliver the impulses to the speci� c chamber or cham-bers of the heart where they are placed.

A leadless pacemaker is smaller (about the size of a AAA battery) than a standard pacemaker. It is a completely self-contained pacing device that includes a battery that lasts about 12 years, and in place of wires, it has at one end a small electrode that literally touches the heart to stimulate the heartbeat.

Designed in the 1970s, the leadless pace-maker was � rst approved for use by the US Food and Drug Administration in 2016. Since then, its popularity has grown exponentially among physicians, many of whom believe it will soon become the standard for patients requiring pacemakers. Its many advantages over the current standard are the reason.

Among those advantages is the simplicity of the implantation procedure. � e implantation of the leadless pacemaker is not as invasive as the procedure for the tra-ditional pacemaker, where the surgeon must implant the pacing device in the chest, then run the wires through the veins to the chambers of the heart.

That surgery usually leaves about a two-inch scar as well as a vis-ible pocket in the skin where the device is placed. It’s a procedure that is also prone to infection, notes Dr. Friedman, who says one

to two percent of all patients receiving tradi-tional pacemakers wind up with infections.

� e leadless pacemaker carries with it a much lesser risk of infection. In fact, accord-ing to Dr. Friedman, there are currently no known reports of infection associated with the leadless pacemaker, which is delivered directly to the right ventricle of the heart through a catheter that is threaded through a vein that runs from the groin to the heart.

“Because it’s a cath-eter-delivered device, there’s no cut t ing involved in the implant procedure for the lead-less pacemaker,” Dr. Friedman informs. “Once the device is delivered, the catheter is removed, and you’re done. Overall, the implant procedure for the leadless pacemaker is much easier and much quicker than it is for the traditional pacemaker.”

Another advantage of the leadless pace-maker is that the time needed to recover from the implant procedure is much less than it is with a traditional pacemaker. Patients receiv-ing a leadless pacemaker can typically return home within 24 hours of its implantation and are usually allowed to resume normal activi-ties immediately thereafter.

� at’s not the case with patients receiving traditional pacemakers. � e far more invasive surgical procedure associated with traditional pacemakers typically requires a hospital stay of a few days and a three- to four-week period

in which the patient is limited in terms of activities. It can also leave an

emotional scar that the leadless pacemaker does not.

“We have found that patient acceptance of the leadless pacemaker is much higher because patients don’t feel like they have a device because they can’t see

it or feel it under their skin,” Dr. Friedman con-

firms. “It’s not visible to anybody, so it’s seamless in

that regard, and that’s a big advantage, too.”

Immediate Impact When he � rst met with Dr. Friedman, Jim was given the choice of receiving either a tra-ditional pacemaker or a leadless model. After hearing of all the advantages associated with the leadless pacemaker, he chose the latter. He knew he made the right choice within minutes of waking up from the implantation procedure.

“As soon as the anesthetic wore o� and I was awake again, I knew I was better,” Jim enthuses. “I noticed immediately that I was breathing easier and that I could take deep breaths again. I could tell right away that my heartbeat was in rhythm, because I wasn’t feeling dizzy or lightheaded or faint in any way. I felt great.”

Jim felt even greater a couple days later when, for the � rst time in months, he went � shing again. � at’s something he would not have been able to do for another few weeks had he opted for the traditional pacemaker. � e leadless pacemaker allows people to live

life normally again immediately after implan-tation, and Jim is de� nitely doing that.

Since receiving his pacemaker, he has taken his boat out of dry dock and is out on the water almost daily. He’s also venturing out for dinner more often. His quality of life has improved so much, in fact, that Jim says he wishes he had received a pacemaker years ago instead of going through the electrical cardioversions and cardiac ablations.

“I’m doing all the things I want to do now, and never experienced any pain as a result of having this procedure,” Jim shares. “I had a lit-tle bit of soreness down around my groin area from where they ran the catheter, but that went

away after a couple of weeks. Since then, I’ve just felt better and better.”

Taking the Lead Better is exactly how Becky Grohoske, 74, feels these days. Like Jim, she too was recently � t with a leadless pacemaker, the implantation of which was part of a 14-year-long health struggle that began with the onset of Parkinson’s disease and included a battle with breast cancer.

“I learned I had breast cancer about two years after I learned I had Parkinson’s dis-ease,” Becky relates. “� en, about four years ago, I was diagnosed with A-Fib. It was dis-covered during a check-up, and at the time, they decided to give me a loop monitor to keep track of my heartbeat.”

A loop monitor is a recording device about the size of a computer thumb drive. It is typically implanted under the skin of the chest, where it can continuously record the electric signals of the heart for up to three years. � at information is then downloaded into a computer by a doctor to determine whether the heart is beating in proper rhythm.

� e monitor Becky was � tted with showed that she was su� ering from a very rapid heart-beat. To correct that problem, she was put on medication. At times, however, the medication caused Becky’s heart to beat so slowly that she would nearly faint. It was then that she was told she needed to get a pacemaker.

“I knew I needed to do something because I was always feeling like I was going to pass out,” Becky says. “One day, I went to the grocery store, and no sooner did I get inside the door when everything went white. I had to put my hand out over a chair to keep from falling. It was just a horrible feeling.”

Her fear of passing out forced Becky to cut back on a number of normal, daily activities, including driving. For a while, she was virtually homebound, in part because

her cardiologist had recently retired, and she was in the process of having her care transferred to another doctor. � at doctor was Dr. Friedman.

Just as he did with Jim, Dr. Friedman gave Becky the option of receiving a tradi-tional pacemaker or the new leadless model. Becky was a little hesitant at � rst to commit to the new pacemaker, but she eventually accepted the offer and received the new device earlier this year. She hasn’t had any heart issues since.

“To begin with, the surgery – if you can even call it that – went great,” Becky enthuses. “It’s so easy. � ey don’t have to cut you open or anything. And they put this tiny, little thing in your heart that you don’t even know is there, but I know

it’s working because I don’t have any feel-ings like I’m going to pass out anymore. I feel great.”

Becky continues to take medication for a rapid heartbeat and high blood pressure, but the pacemaker is allowing her to toler-ate the medication by eliminating the pauses that were causing her to feel faint. She says she’s thankful for Dr. Friedman’s advice and expertise in suggesting and implanting the leadless pacemaker.

“I really like Dr. Friedman,” she says. “He’s very quiet, methodical and meticu-lous, and I really trust him. I was a little nervous about getting this new kind of pacemaker, but he told me it was going to be the best thing for me, and he was right. It’s working great.”

Willing and Able Dr. Friedman says he can only take part of the credit for how much better Becky and Jim are feeling. He says the bulk of the credit has to go to Manatee Memorial Hospital for its decision to support the implantation of the leadless pacemaker and for having the foresight to invest in that and other new technologies.

“They’re very accommodating,” Dr. Friedman says of the hospital. “When there’s new technology like this, a lot of times the knee-jerk reaction to it from a hos-pital is that it’s way too expensive to invest in, because the hospital is worried about the return on their investment. � at’s not how it is at Manatee Memorial Hospital.

“Manatee Memorial Hospital has always been on the leading edge of new technolo-gies. � ey often allow physicians to use new technologies to bene� t their patients, and there is de� nitely a need for these leadless pacemakers. � ey are, without question, the future of pacemakers.”

It’s not just the doctors who are accom-modated at Manatee Memorial Hospital. Patients are treated with special care as well. “And Dr. Friedman is an excellent doctor. Instead of speaking in a bunch of medical terms that you can’t understand, he speaks English. And he’s so well informed on all the new technologies and trends. He told me all about this new pacemaker and told me it was a perfect � t for me, and he was absolutely right. I recommend them both.”FHCN article by Roy Cummings. Photos by Jordan Pysz.

Pacemaker graphic courtesy of Medtronic. mkb

Becky Grohoske

Manatee County Edition | Summer 2019 | Florida Health Care News | Page 7speCiaLty Care hospitaL

J. Terry Alford, DMD, practices general, cosmetic and restor-ative dentistry in Bradenton. He received his undergraduate degree from Rollins College, Winter Park, and his dental degree from the University of

Alabama, Birmingham, with additional training in anesthesia. Dr. Alford has also received addi-tional training in implant dentistry. He is a member of the American Academy of Cosmetic Dentistry, American Academy of Implant Dentistry, American Dental Association, Florida Dental Association and Manatee County Dental Society. He spent six years in the US Air Force as a jet pilot instructor and was decorated for his service in Vietnam.

Everyone at Advanced Dental Cosmetic Center looks forward to meeting the readers of Florida Health Care News. Their office is located in Bradenton in the:

Park Place Professional Park Manatee Ave. WestBuilding , Suite

(941) 792-3033

ADVANCED DENTAL COSMETIC CENTER, P.A.

J. TERRY ALFORD, DMD

Learn More

I n today’s society, having a beauti-ful smile can mean the di� erence between getting a second look or not. With so many ways to be seen

in everyday events and through social media, many people still choose not to smile. So, what’s holding them back?

“People don’t smile because of two major issues,” says J. Terry Alford, DMD, who practices general, cosmetic and restorative dentistry at Advanced Dental Cosmetic Center in Bradenton. “Either they are in pain or they are in denial, at least outward denial, of what their smile may or may not be.”

Pain might be related to temporoman-dibular joint disorder (TMD), which is the second most common joint discomfort in the body, preceded only by back pain. Facial pain can also be caused by other issues associated with the teeth and gums or by a combination of factors.

“� ese pains can be related to trauma, tooth loss or chronic actions where the patient is clenching, gnashing or grinding

their teeth or has an inappropriate bite,” explains Dr. Alford. “All of these issues can be addressed in the modern dental o� ce.”

Sometimes, people don’t smile because they feel insecure. They might have crooked, eroded or discolored teeth, all of which can contribute to how they look when they smile. Dentists today can easily address all of these concerns as well.

“For many people, their self-con-sciousness is why they don’t smile,” notes Dr. Alford. “Because of this, they are not able to project a nice, healthy look. � ey feel they cannot show a sexy, beau-tiful or youthful smile, so they do not smile at all.”

Some people just have a fear of the unknown. Dr. Alford puts it simply: “Fear is a problem because most patients have a very poor understanding of what can be accomplished to improve their smile and evaluate their pain. We have treatments that can give them that bal-ance they are looking for.”

New TechnologyAdvanced Dental Cosmetic Center can

address TMD and other issues a� ecting patients’ smiles with

the help of new technology, including the Tekscan

T-Scan III Occlusal Analysis System.

“� e Tekscan T-Scan III has an oral sensor that is placed in the mouth,” describes Dr. Alford. “� e patient bites down on the sensor, and it gives us incredible informa-tion regarding not only where the patient bites, but also the force and the length of time of the bite. � e system also produces a three-dimensional bar graph showing the strength of the contact of the teeth.”

This technology gives the dentist more information about what is occur-ring within the mouth compared to the articulating paper method of bite analy-sis, including the timing of � rst and last contact and the biting relationship of the teeth. � e dentist can then examine how all of these forces are transmitted to the temporomandibular joint.

“I can use the T-Scan III to identify disharmonies and interferences in the bite that cause severe pain when chewing, such as a TMD issue.”

With this new technology, Dr. Alford has the tools to create a smile the patient will be proud to show. Avoiding oral care does not � x the problem. Seeing a quali-� ed dentist does.

Dr. Alford concludes, “We like to see patients walk out of our o� ce with a smile, because smiles are our business.”FHCN staff article. mkb

Show Your SmileDentist eases fears, restores con� dence

Dawn Chiu, DPM, AACFAS, is a board-qualifi ed podiatric surgeon and Associate of the American College of Foot and Ankle Surgeons. She graduated from the University of California, Davis with a degree in zoology and received her Doctor of Podiatric Medicine degree from the California College of Podiatric Medicine in San Francisco. Dr. Chiu completed her podiatric surgical residency at Frankford Hospital in Philadelphia.

Arthur D. Clode, DPM, AACFAS, is a board-qualifi ed podiatric surgeon and Associate of the American College of Foot and Ankle Surgeons. He earned a degree in biological sciences from Florida International University and a Doctor of Podiatric Medicine degree from the California College of Podiatric Medicine in San Francisco. He completed his podiatric surgical residency at Golden Glades Regional Medical Center in Miami.

SARASOTA FOOT AND ANKLE CENTER

DAWN CHIU, DPM, AACFASARTHUR D. CLODE, DPM, AACFAS

Make the Call

To learn more about the PinPointe FootLaser, visit www.sarasotafoot.com

There’s no need to drive to Fort Myers or Tampa for laser toenail fungus

treatment. FDA-approved PinPointe FootLaser is available at

Sarasota Foot and Ankle Center, which has three locations:

Painless, in-o� ce laser treatment corrects toenail fungus

A fter working alongside one another for the better part of 30 years, Ashleigh* and her husband, a noted New Jersey

periodontist, decided to reward themselves in retirement with a new home in Florida.

Sarasota th Street

Englewood Old Englewood Rd.(941) 366-4888

Sun City Center Rickenbacker Dr.(813) 634-8980

which I really appreciate. I de� nitely rec-ommend Dr. Chiu and Sarasota Foot and Ankle Center. � ey do a great job there.”FHCN article by Roy Cummings. Before and after images

courtesy of Sarasota Foot and Ankle Center. mkb

*Patient’s name withheld at her request.

Pointe of Order � e in-o� ce treatments take only a few minutes, during which time the laser is passed over the nail in a crisscross pat-tern to ensure full coverage. � e patient usually feels a warm sensation on their toe while the laser is passed but no pain.

Afterward, the patient can walk out of the o� ce and resume normal activi-ties. Dr. Chiu recommends the patient return for follow-up visits every three months for a year, which is the length of time the nail needs to fully grow out as a clear, new nail grows in.

When combined with topical oint-ments, the laser treatment has an 80 percent success rate, states Dr. Chiu, who recommended the treatment for Ashleigh, who was very pleased with the results of her treatment.

“I’d done some reading on the laser treatment before I had it done, so I knew it was the right way to go,” Ashleigh says. “And just as I thought, it cleared up the problem very nicely, and more quickly than if I had only used ointments.

“It was all very painless, and now that toenail has grown back normally and looks great. Dr. Chiu did a great job, she wasn’t pushy at all about the treatment, and her sta� is very professional as well.

“� ey did a great job of calling and reminding me of my check-up appoint-ments that I had every three months,

It was a little more than a year ago, while the couple was in the process of preparing for their move south, that a relatively minor, everyday type of mishap sparked a slightly larger issue for Ashleigh.

“I don’t r e m e m -ber exactly when it hap-pened, but I dropped a bottle of shampoo on my foot in the shower one day, and it broke my left big toenail,” Ashleigh reveals. “When the nail started growing back, it didn’t grow back properly.”

Ashleigh knew she had a prob-lem that had to be addressed, but she waited until she’d completed her

family’s move to Florida to address it. She’s glad she did because it was here in Florida that she found the right doctor and the right treatment.

“I just happened to pick up a copy of Florida Health Care News one day, and in there was a story about a doctor who was doing a laser treatment for toenail fungus,” Ashleigh relates. “I called her up and made an appointment.”

On Pointe � e doctor Ashleigh read about is Dawn Chiu, DPM, a board-quali� ed podiat-ric surgeon at Sarasota Foot and Ankle Center, where she � rst saw Ashleigh a

little more than a year ago and dis-covered she was suffer-i n g f r o m

trauma-induced toenail fungus.Dr. Chiu’s preferred weapon of choice

in � ghting toenail fungus is a laser treatment called PinPointe™ FootLaser® therapy. She prefers it because it requires no blood tests, kills the underlying fungus, causes no side e� ects and can be done in the doctor’s o� ce.

Page 8 | Florida Health Care News | Summer 2019 | Manatee County Edition GeneraL, CosMetiC and restorative dentistry

podiatry

to Erectile Dysfunction

David S. Zamikoff, DC, is a board-certified chiro-practor with more than years of experience. He graduated from the Cleveland Chiropractic College in Los Angeles,

California in and is currently licensed both nationally and at the state level. Dr. Zamikoff holds certifi cation in operat-ing room protocols and Manipulation Under Anesthesia by the American Academy of Manual and Physical Medicine. Dr. Zamikoff also holds a diplomate degree from the American Academy of Trauma Professionals and is the director of the Florida Chiropractic Association for Southwest Florida.

DAVID S. ZAMIKOFF, DC

The Art of HealingNatural Healing Arts Medical Center is a multidisciplinary offi ce that takes a multi-doctor approach to healing and off ers chiropractic care, massage, physical therapy, acupuncture and medical services provided by an emergency medicine doctor and nurse practitioner. For more information call or visit their offi ce in Bradenton at:

2215 59th Street West

(941) 761-4994Find them on the web at myo� ceinfo.com and on Facebook at facebook.com/Natural Healing Arts Medical Center

L ike a lot of young college stu-dents, Davis* spent his early 20s burning the candle at both ends. He didn’t have much of a

choice. Forced to pay for school himself, Davis chose to work his way through col-lege instead of leaning on student loans.

“I had a part-time job working about thirty hours a week at a shoe store, and I was taking a full load of classes,” Davis explains. “As you might guess, I didn’t get much sleep back then. But when you’re young, you don’t necessarily need a lot of sleep. Or so I thought.”

Davis maintained his hectic pace without issue for about two years. � en, about midway through his junior year, he began to feel sluggish. When the prob-lem persisted, he visited a doctor who told him the cause of his fatigue wasn’t his schedule, it was low testosterone.

“� e doctor told me to exercise more and eat better and that would probably take care of it,” Davis says. “And it did – for a while. A couple years later, I had the same problem again. � is time, the doctor put me on a testosterone booster.

“I’ve been taking that ever since, and for twenty-� ve years, all through my marriage, I never had another problem. � en about a year or two after my divorce, another problem developed. It wasn’t fatigue. It was erectile dysfunction.”

Erectile dysfunction is the inability to develop and maintain an erection, which is a condition far more common than many realize. In fact, studies show that some form of erectile dysfunction a� ects more than half of all men during their lifetime.

The likelihood of a dysfunctional episode is even greater among men suf-fering from hypertension, diabetes and cardiovascular disease. Smoking and the heavy consumption of alcohol and/or drugs (either illicit or prescription) can also cause erectile dysfunction.

Another cause of erectile dysfunc-tion is low testosterone. When Davis � rst experienced it, he naturally thought that was the cause of his struggle. He soon learned the problem was not a lack of tes-tosterone but a lack of su� cient blood � ow to the penis.

“For the past several years, I’ve been seeing a different doctor, and when I went to see him for this, he told me the blood vessels in my penis were clogged,” Davis recalls. “� at was the bad news. � e good news was, he had something that could � x it.”

The cause of Davis’ erectile dys-function is one that doctors have treated most often with oral medications such as VIAGRA®, CIALIS® and LEVITRA®, all of which can deliver the desired results. So, too, can some surgical procedures.

But there is now a far more prom-ising, nonsurgical, drug-free treatment for erectile dys-function that many doctors, including Davis’ doctor, David S. Zamikoff, DC, of Natural Healing Arts Medical Center in Bradenton, prefer.

Root CauseThe treatment is called GAINSWave® therapy, and it has become the choice of many doc-tors instead of medications because unlike medications, it addresses the root cause of erectile dysfunction, or ED, which is often a lack of proper blood flow to the penis.

“Of the millions of men who struggle to achieve a natural erectile response, approximately eighty per-cent do so because of poor circulatory issues in which the tiny capillaries in the penis and urogenital area are impaired,” Dr. Zamiko� educates.

“The likelihood of that kind of impairment increases dramatically as men age and plaque builds up in the blood ves-sels, but oral medications cannot remove

the plaque or open those compromised blood vessels to allow for a more regular � ow of blood to the penis.

“� e one treatment that can do all that and much more is GAINSWave therapy, which is based on the same tech-nology that’s used to break up kidney stones, meaning it uses sound wave tech-nology to do the job.”

Referred to clinically as extracor-poreal shock wave therapy, or ESWT, GAINSWave uses rapid pulses of high-frequency acoustic sound waves to break up the plaque and calcium that have built up inside old or damaged blood vessels.

� e result is an increase in blood � ow through the existing, rejuvenated blood

vessels, the cre-ation of new blood vessels and the cre-ation of new nerve tissue that improves sensitivity in the penis, which then improves the qual-ity of the erection.

“It’s the new-e s t a n d m o s t promising treat-ment yet for ED,” Dr. Zamiko� says of the FDA-approved GAINSWave proce-dure, which has been used as a treatment option in Europe for more than 15 years and was approved

for use in the United States in 2015.GAINSWave can also be used to treat

Peyronie’s disease, which is what occurs when scar tissue builds up in the penis and causes an abnormal bend or curvature to the penis that can impede urination and/or ejaculation.

“By making certain adjustments to the machine’s settings, we can treat � brous tissue the same way we treat blood vessels and break down the scar tissue that may be causing the irregular shape,” Dr. Zamikoff states. “The result is a straighter, pain-free erection.”

Using a handheld device, GAINSWave treatments are performed in the doc-tor’s o� ce, where a single treatment lasts about 30 minutes. A full course of therapy

generally consists of six sessions performed twice a week over the course of three weeks.

“� e response in many cases is almost immediate,” Dr. Zamiko� enthuses. “In fact, most patients begin to experience a noticeable di� erence in the quality of their erections as well as an improvement in sex-ual performance after just one treatment.

“Another advantage we’ve found is that there are no side e� ects associated with this treatment. Nor is there any downtime for the patient. Once the pro-cedure is over, the patient can walk out of the o� ce and return to normal activities.”

Remarkable ResultsThe success rate associated with the GAINSWave technology is exceptional as well. One study performed in Europe discovered that the bene� ts of a single, 12-treatment course of GAINSWave ther-apy can last for as long as two years.

Dr. Zamiko� says that more than a year of continuous bene� ts is the norm for most patients. He also notes that while it’s not necessary, some patients choose to return for once-a-month “maintenance treatments” to ensure sustained bene� ts.

“� is really is the wave of the future for ED treatment because for someone who is young without any medical problems, the success rate is nearly one hundred per-cent,” Dr. Zamiko� adds. “And overall, the success rate is about seventy-� ve percent.”

Davis is among those who reported positive results. He says that after just four treatments, he and his girlfriend of about a year both noticed a signi� cant di� erence in the strength and length of his erections as well as his ability to maintain them.

“Now, I have no trouble getting an erection at all,” Davis reports. “I’m even waking up with an erection every morning. It had been a while since that happened, so I’m doing really well for a sixty-nine-year-old guy.

“And that’s all thanks to Dr. Zamiko� . I’ve been with him now for almost ten years, and I pretty much go to him for all my medical problems because he stays current on all the latest technology.

“� at is why I so highly recommend him. He’s on top of everything, he has a great sta� that helps him and everyone there is very nice and professional. You won’t go wrong with Dr. Zamiko� and the sta� at Natural Healing Arts. I can promise you that.”FHCN article by Roy Cummings. Graphic courtesy of

GAINSWave. mkb

*Patient’s name withheld at his request.

New-age treatment corrects disorder’s

root cause

Manatee County Edition | Summer 2019 | Florida Health Care News | Page 9ereCtiLe dysFunCtion

For Eye Floater SolutionsSouth Florida Eye Clinic is located

in Fort Myers at:

4755 Summerlin Rd. Call Dr. Geller at:

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

(877) 371-3937

Scott L. Geller, MD, is board certifi ed by the American Board of Ophthalmology. He is a graduate of Ohio Wesleyan University and Rush Medical College. While in medical school, he was awarded a student fellowship to study tropical medicine at a missionary hospital in India, and pursued additional studies at the famous Brompton Hospital in London, England. He interned at Presbyterian Hospital, Pacifi c Medical Center, San Francisco, CA, and completed his residency in ophthalmology at Sinai Hospital of Detroit, which was affi liated with Wayne State Medical School and Kresge Eye Institute. Dr. Geller was fellowship-trained in anterior segment and

refractive surgery with Dr. William Myers of the Michigan Eye Institute. Dr. Geller is a fellow of the American Academy of Ophthalmology, and has presented papers on eye fl oater laser treatment at the International Congress of Ophthalmology, European Congress of Cataract & Refractive Surgery, European Congress of Ophthalmology and the Florida Society of Ophthalmology.

SOUTH FLORIDA EYE CLINICSCOTT L. GELLER, MD Dr. Geller has performed more

than 15,000 documented eye fl oater laser sessions.

Scott Geller, MD, teaches the technique worldwide

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

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

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

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

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

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

Dr. Geller uses the Swiss made Lasag laser.

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

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

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

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

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

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

SCAN THIS TO YOUR

SMARTPHONE TO SEE ACTUAL

PATIENTS

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

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

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

is not

acceptable.”

“Live with it

Allergic to Eats?Food allergies and how to deal with them

I f it seems as if everyone you know su� ers from an allergy of one kind or another, it’s probably because it’s true. More than 50 million

Americans su� er from allergies. Most, of course, su� er from the kind of allergies that lead to a runny nose and watery eyes at certain times of the year, but imagine having symptoms even worse than that every time you put food in your mouth.

According to the US Centers for Disease Control and Prevention, that’s the case for four to six percent of the chil-dren and four percent of the adults in this country. � e latest research also shows the number of children under 5 diagnosed with peanut allergy has increased by 100 percent.

Substances that trigger an allergic reaction are called allergens. Pretty much any food can be an allergen, but there are a few that are the biggest offenders. These eight types of food account for about 90 percent of all allergic reactions: Eggs, milk, peanuts, tree nuts, � sh, shell� sh, wheat and soy.

Good News, Bad News� ere’s good news and not-so-good news when it comes to these allergens. Allergies to milk, eggs, wheat and soy may disappear over time, but allergies to peanuts, tree nuts, � sh and shell� sh tend to hang on for life. Also, you can develop an allergy to a food you’ve never been allergic to before.

So, what causes food allergies? � ese allergies are an overreaction by the body’s immune system to proteins in certain foods that it detects as foreign and attacks. � e immune system reacts by triggering its white blood cells to produce food-speci� c immunoglobulin E (IgE) anti-bodies to neutralize the allergens.

When the allergic person eats the o� ending food, the IgE antibodies detect it and signal the immune system’s mast cells to release a chemical called hista-mine. Histamine is responsible for the symptoms of food allergies, just like it leads to the runny nose and itchy, watery

eyes of respiratory allergies.

Some of the symptoms associated with food allergies are uncomfortable but not serious. � ese include a rash on the skin, tingling or itching in the mouth, lightheadedness, nausea, diarrhea, stom-ach cramps and coughing.

Other symptoms can be very seri-ous, even life threatening. � ese include panting and wheezing; a swelling of the throat that makes it di� cult to breath; blue lips from lack of oxygen; a drop in blood pressure and heart rate; diz-ziness; fainting and unconsciousness. � ese are some of the symptoms of a whole-body allergic reaction called ana-phylaxis, which is potentially deadly if not treated right away.

It’s a no-brainer that the best way to dodge food allergy symptoms is to avoid the trigger foods altogether. But even if you’re careful, you may be exposed unknowingly. � e best way to prepare for any potential reaction is to have an allergy action plan, created with help from your doctor.

Educate YourselfEducation is an important

part of your plan. Due to the prevalence of food allergies in this country, manufactures are

required to label their products indicating if they contain any

amount of the most common aller-gens. So learn to read labels, and don’t

forget the � avorings and additives. � ey might contain trace amounts of the o� ending allergens.

Also, don’t be afraid to ask your server or the chef about the ingredients in your meals when you go out to eat. Remember, you can have a reaction even if the cooking surface or pans used to make the food have come into contact with an allergen. So, be aware and ask about how your food is being prepared.

When a person is diagnosed with a food allergy, the doctor generally pre-scribes an auto-injector of epinephrine to be used if symptoms of anaphylaxis occur. If they do, the person, or some-one close to him or her, should inject the epinephrine into the outer thigh as soon as the symptoms appear. � en, the person needs to go immediately to an emergency room for follow-up care.

If your child has a food allergy, be sure his or her teachers and other close adults are aware and know what to do in case of a reaction. � ey should understand how to use the epinephrine auto-injector and to get the child to the ER right away.

Everyone eats. Unfortunately, it can be a risky experience for some people. You can help by being patient with people who have food allergies and learning what to do if someone close to you has a seri-ous reaction such as anaphylaxis. Sharing what you learn is the best way to help!FHCN article by Patti DiPanfilo. mkb

Page 10 | Florida Health Care News | Summer 2019 | Manatee County Edition ophthaLMoLoGy

speCiaL to FhCn

Lee M. James, DO, received his undergraduate degree from the University of South Florida. He earned his medical degree at Nova Southeastern University. Dr. James is board certified in physical medi-cine and rehabilitation, and pain medicine. He completed

his physical medicine and rehabilitation res-idency at the University of North Carolina Hospitals in Chapel Hill. He completed his pain medicine fellowship in the department of anes-thesiology at the University of North Carolina Hospitals in Chapel Hill. He is a member of the Spine Intervention Society, International Neuromodulation Society, American Academy of Pain Medicine and American Academy of Physical Medicine and Rehabilitation.

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

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

joint replacement, joint revision, sports medicine and surgery of the spine. To

schedule an appointment, please visit or call one of their offi ces.

Port Charlotte 1641 Tamiami Trail, Suite 1

(941) 629-6262

Punta Gorda350 Mary St., Suite F

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

Give Them a Call!

• Pain with motion• Pain that fl ares up with

vigorous activity• Tenderness when pressure is

applied to the joint• Diffi culty walking

• Joint swelling, warmth and redness

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

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

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

Welcome to Advanced Orthopedic Center

I ncluded in the 18 years Michael Herman spent serving his coun-try in the US Army were several harrowing days during which the

former buck sergeant had a front row seat for some of the largest tank battles of the First Gulf War in Iraq.

Pain Free at LastMinimally invasive procedure provides long-sought relief

“We were connected to a tank unit because we hauled ammunition,” Michael says of the 15-man squad he led. “We were no more than twenty yards from some of those tanks at times, and let me tell you, it was like the Fourth of July out there.

“We were right there where every-thing was going on all the time because we had to move the ammunition, which made us a big target. If we had ever been hit, you can’t imagine the hole it would have created in that desert.”

Michael didn’t make it out of the war unscathed. He is permanently dis-abled now with post-traumatic stress disorder (PTSD), and he continues to � ght a number of other health issues. For years, one of those was chronic neck pain and weakness in his left arm.

“I carried that one around for a long time,” Michael con� rms. “I used to just � ght through it, but I’m � fty-nine now, and I recently reached a point where the pain and weakness was too much to ignore, so I decided, I’ve got to get this � xed.”

� e � x Michael eventually settled on was surgery to relieve a pinched nerve. � at surgery was performed in March 2015 and was considered successful because it alleviated the weakness and pain Michael was experiencing in his left arm, It did not permanently relieve Michael of the pain he was experiencing in his neck, which soon grew worse.

When it did, Michael’s case was handed over to Lee M. James, DO. A board-certified rehabilitation and pain medicine specialist at Advanced Orthopedic Center, Dr. James � rst tried relieving Michael’s pain through epidural steroid injections.

The injections provided only temporary relief, and as a result, Dr. James next performed a radiofrequency ablation

in which rad io waves produce an electrical current that heats the nerves and decreases the pain signals sent to the joints in the neck.

Like the steroid injections, the radio-frequency ablation pro-vided relief for only a month or two. When Michael’s persistent neck pain returned yet again, Dr. James decided to see if a spinal cord stimulator would alleviate his symptoms.

New Wave Treatment Spinal cord stim-ulation produces electrical impulses tha t keep pa in m e s s a g e s f r o m t r a v e l i n g f r o m affected nerves to the brain. By inter-rupting these messages, the stimulus for pain is not detected, so less pain is felt by the patient.

At Advanced Orthopedic Center, the � rst phase of spinal cord stimulation treatment is a three- to seven-day trial period during which Dr. James deter-mines whether the patient would indeed bene� t from the therapy.

Michael’s trial period began with Dr. James threading two small catheters the width of a strand of spaghetti into the epidural space in his neck. � ose catheters contain electrodes that are connected at the bottom end to an external battery.

“� e electrodes sit in the epidural space, and the battery creates the electrical

impulse that blocks the body’s painful pathway and replaces the pain with a very smooth and gentle tingling sensation that we call a paresthe-sia,” Dr. James informs.

“The technology is such now that we can create pro-

grams, where the patient doe sn’t f e e l

m u c h o f any-

thing. Our goal, of course, is to reduce our patients’ pain and increase their activity.

“For example, if you can walk a block, we want you to be able to walk two blocks. But a lot of our patients are older and just want to be able to go to the grocery store, travel, go � shing or play golf again.

“Our objective is to help them meet those goals, so during the trial period, we encourage them to go out and do something they normally don’t do because of their pain. � at will give us an idea of what they can achieve with a permanent implant.”

Michael’s trial began on a Monday. He returned to see Dr. James four days later, on Friday, and like most patients, he reported experiencing a signi� cant reduc-tion in pain. It was then that Michael and Dr. James decided to insert a permanent spinal cord stimulator.

High Rate of Success “About ninety-two percent of my patients who do the trial go on to the permanent implantation, and of that ninety-two percent, most report a long term reduc-tion in pain of anywhere from � fty to seventy-� ve percent on average, which we consider a success,” Dr. James explains.

“We usually wait three to four weeks after the trial before doing the permanent implant, which is done through two small incisions about an inch long. � rough one incision, the electrodes are implanted and anchored into some tissue under the skin.

“� ey are then tunneled into an area in the body that has a little bit of fat, which is where the battery is placed. � e battery is about the size of a pacemaker. All of that gets implanted underneath the skin, and the incisions are closed with dissolvable sutures.”

Patients control the impulses with a remote control and are asked to avoid excessive bending, lifting and twisting for about six weeks while scar tissue builds up around the electrodes and battery.

After six weeks, patients are free to resume normal activities, which for Michael are still limited because of his other health issues. He’s happy to say, though, that neck pain is no longer one of the things holding him back.

“My neck feels great,” he says. “I don’t have any of that pain anymore, and what a relief it is after thirty years. Dr. James did a wonderful job, a beautiful job. And what a sta� he has. � ey’re all just great.

“A lot of people probably say this about Dr. James, but I’m the kind of guy that will tell you what is and what isn’t, and Dr. James and his sta� are some of the best medical people I’ve ever dealt with. And I’ve dealt with a lot of them. But these guys are fabulous.”FHCN article by Roy Cummings. Photo courtesy of Michael

Herman. mkb

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

Manatee County Edition | Summer 2019 | Florida Health Care News | Page 11orthopediC surGery and sports MediCine

Physicians are on the medical sta� of Lakewood Ranch Medical Center, but with limited exceptions, are independent practitioners who are not employees or agents of Lakewood Ranch Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. For language assistance, disability accommodations and the non-discrimination notice,

please visit our website at lakewoodranchmedicalcenter.com.

To make an appointment with a physician on sta� at the hospital, call Direct Doctors Plus® at (941) 708-8100

Clinical Expertise, Exceptional Care

To learn more, please visit www.LakewoodRanchMedicalCenter.com

Center eases surgical process for joint replacement patients

W hile preparing for Hurricane Irma in 2017, Dawn Lacey could barely climb the ladder

to install her storm shutters due to nag-ging pain in her left knee. At the time, the retired UPS® driver shrugged o� her knee problem, but it grew increasingly worse until last fall, when the pain became so intense, she could no longer bear it.

“My knee began swelling every day, and it became a nuisance,” recounts the New Jersey native. “I didn’t injure it. I think it got bad from a lifetime of athletics and working the way I did. It buckled and gave out on me once in a while. I couldn’t sleep at night because of the pain, which was both aching, and sharp and stabbing. From one to ten, the pain rated an eight or nine on some days.

“I rested my knee and put ice on it every night, hoping the pain would sub-side, but that didn’t help. I like to golf and walk � ve miles every day, and I contin-ued to walk through the pain, but I had to stop gol� ng because it was extremely painful to swing the clubs.”

Once Dawn’s knee pain began inter-fering with her golf game, her quality of life quickly diminished. It was then that she � nally decided to seek help for her knee pain and made an appointment with her primary care physician, who ordered x-rays and an MRI of her knee.

“My doctor did the initial tests and said I had a torn meniscus and really bad arthritis in my knee,” Dawn shares. “He suggested I visit an orthopaedic surgeon and recommended Dr. Askins. I researched Dr. Askins and discovered he was highly regarded in his � eld, so I went to see him.”

Vance Askins, MD, of Askins Orthopaedics is a board-certified orthopaedic surgeon. A primary focus of his practice is joint replacement surgery, including hip and knee replacements. Dr. Askins performs his surgeries at Lakewood Ranch Medical Center in Bradenton.

When Dawn met with Dr. Askins, she was impressed by his knowledge and manner. She was taken aback, however, by

Surgery alleviated

Dawn’s nagging left

knee pain

Vance Askins, MD, is board certified by the American Board of Orthopaedic Surgery. He earned his Bachelor of Science degree in Microbiology from the University of Florida and his medical degree from the University of Florida College of Medicine. He completed a general surgery internship and an orthopaedic surgery residency at the University of Miami Jackson Memorial Medical Center. Dr. Askins is a member of the American Association of Hip and Knee Surgeons, and is a Fellow of the American Academy of Orthopaedic Surgeons.

Since it opened its doors in , Lakewood Ranch Medical Center has earned the Gold Seal of Approval for its commitment to performance standards and an “A” safety rating from the Leapfrog Group. Its patients have access to more than physicians and allied health professionals who practice in a comprehensive range of specialties and use the hospital’s advanced medical technology. To learn more, call or visit the hospital at:

8330 Lakewood Ranch Blvd.Lakewood Ranch

(941) 782-2100

the surgeon’s conclusion after his evalua-tion of her knee and review of her MRI.

“My primary care doctor forwarded my test results, so Dr. Askins had all of my information,” Dawn states. “I thought I was going to need some type of arthroscopic surgery, if that, but instead, I got the shock of my life. Dr. Askins told me I needed a totally new knee.”

“Dawn su� ered with ongoing arthri-tis in her left knee,” Dr. Askins notes. “She failed all conservative measures to treat her pain, including anti-in� ammatory medications and physical therapy. She also wasn’t a candidate for an outpatient arthroscopic procedure, which wouldn’t adequately address her condition.

“Arthroscopic procedures help with pain, but they don’t stop the arthritis. They simply treat its symptoms for a period of time. An arthroscopic surgery wouldn’t change the fact that Dawn would eventually need a new knee joint.”

Because Dawn is still young, she’s 61, and her quality of life was being negatively a� ected, she and Dr. Askins agreed that a total joint replacement was appropriate in her case. Her surgery was performed on October 16, 2018.

“Well-Oiled Machine”At Lakewood Ranch Medical Center, Dr. Askins’ joint replacement patients participate in the education and treatment program o� ered through the hospital’s

Orthopaedic Spine and Joint Center. � e Center’s program includes a preoperative class, support throughout the surgical process and recovery in the Center itself.

“The Orthopaedic Spine and Joint Center sta� does an excellent job of educa-tion,” Dr. Askins reports. “� e pre-op class makes the surgical process more endurable for patients because it gives them insights

into what to expect of their post-op care, as well as what’s expected of them. It takes a great deal of anxiety out of the experience.”

After surgery, patients are taken directly to � e Orthopaedic Spine and Joint Center, a 21-bed unit at Lakewood Ranch Medical Center dedicated to orthopaedic patients. At the Center, they begin rehabilitation of their new joints right away.

“As soon as I woke up after surgery, the nurses wanted me to eat something to get my strength back,” Dawn remembers. “� ey got me up that afternoon. � e next day, I had therapy in the morning and again in the afternoon.

“� is was a very big surgery for me, but the sta� at � e Orthopaedic Spine and Joint Center helped me through it. � ey operated like a well-oiled machine.”

Everyone associated with The Orthopaedic Spine and Joint Center fol-lows established protocols for caring for joint replacement patients.

“From the pre-op testing to the OR to post-op recovery in the Center, everybody on sta� , including the nurses and ther-apists, works in coordination to prepare the patients for going home or to rehab,” Dr. Askins points out. “� e case managers in the Center do a great job of coordinat-ing patients’ home care, so there’s never a gap when they get home.

“Surgery is only one piece of the pro-cess. � e Orthopaedic Spine and Joint Center sta� performs the key pre-op and post-op measures to ensure my patients have the best outcomes.”

Prevailing Over PainDawn began rehabbing her new knee in � e Orthopaedic Spine and Joint Center soon after her surgery. With the help of her orthopaedic surgeon and the atten-tiveness of Center sta� , Dawn says she wasn’t in much pain, nor is she now as she continues her rehab at home.

“Dr. Askins placed these little pain-killer beads in my knee before he closed my surgical incision,” Dawn describes. “When I put pressure on my knee, the beads released and gave me pain relief. � at enabled me to start my rehab with-out intolerable pain.

“My pain level as I rehab now is nothing like it was before my surgery. It used to be an eight or nine. Now, it’s a two on a bad day.”

Dr. Askins reports that Dawn is making good progress and meeting the recovery goals she set for herself, which include returning to the golf course and resuming her daily, � ve-mile walks.

Dawn knows she must exercise con-sistently and ice and massage her knee to meet those goals, and happily reports she is starting to turn the corner toward achieving those objectives.

“I’m able to walk, although I’m not walking � ve miles just yet. I’m working up to that,” she relates. “I’m not gol� ng yet either, but I think that’s more of a mind over matter thing with me. I’m still afraid to swing the club. Once I conquer walk-ing, I’ll get back out on the golf course.

“I de� nitely recommend Dr. Askins and Lakewood Ranch Medical Center. For a big surgery, the whole process, from my preadmission through surgery and my stay in � e Orthopaedic Spine and Joint Center, was a good experience for me.”FHCN article by Patti DiPanfilo. Patient photo by Jordan

Pysz. Boxing glove photo from kisspng. mkb

Page 12 | Florida Health Care News | Summer 2019 | Manatee County Edition MediCaL Center