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South Tampa Edition Spring 2020

FEATURED ARTICLES

(see Eyecare For All, page 4)

Institute opens full-service eye clinic in

South Tampa

GREGORY L. HENDERSON, MD, FACSL. RAY ALONZO, OD

ROBERT J. APPLEBAUM, MD, MBARONNI M. CHEN, MD

IGNATIUS C. CYRIAC, MDEDWARD J. HUGGETT, OD

DEEN G. KING, MDMARGUERITE KOHLHEPP, MD

JAMES X. LAWRENCE, ODSELINA J. LIN, MD

CHARLES A. LUXENBERG, MDPRIYA M. MATHEWS, MD, MPH

DAN P. MONTZKA, MDCRAIG E. MUNGER, MD, PHD

ANA-MARIA OLIVA, MDNANDESH PATEL, MD

DILIP RATHINASAMY, MDWILLIAM A. REEVES, MD

PAULINE THAI, OD

I n September, Florida Eye Specialists & Cataract Institute opened a new eye clinic in South Tampa, where it offers a complete range of eye treatments and surgeries. The South Tampa practice is Florida Eye Specialists & Cataract Institute’s � fth location, further reinforcing the Institute’s commitment to serve the greater Tampa Bay community.

� e new clinic is located at 3115 West Swann Avenue in Tampa, and it is an integral member of Florida Eye Specialists & Cataract Institute’s family of eye care centers that includes clinics in Brandon, Riverview, Ruskin and Sun City Center. � ese full-service centers make quality eye care available to more patients in the region.

� e physicians on sta� at the South Tampa center provide general ophthal-mology as well as specialty services. � ose providing care at the practice include ophthalmologists Deen G. King, MD, a glaucoma and cataract specialist; Robert J. Applebaum, MD, an oculofacial plastic and reconstructive surgeon; Dilip Rathinasamy, MD, a cataract specialist; Priya M. Mathews, MD, a cornea specialist; Selina J. Lin, MD, a vitreoretinal surgeon; and optometrist Pauline � ai, OD.

At the South Tampa clinic, Dr. King sees patients with cataracts and other eye conditions.

“Cataracts are a clouding of the clear lens in the eye that leads to a progressive

loss of vision,” Dr. King describes. “All light entering the eye passes through the lens, which is made mostly of water and protein.

“As a person ages, the proteins can begin to clump together, and the lens becomes cloudy. � is clump can grow larger over time, eventually interfering with the light reaching the retina and, ultimately, the sharpness of vision.

“� e only treatment that provides a cure for cataracts is surgery. Cataract surgery is one of the safest, most predict-able surgeries, but any surgery has minimal risks. Cataract surgery is a totally elective procedure.”

Dr. King also treats patients with glaucoma, which is the second leading cause of blindness in the United States and a serious threat to vision. Glaucoma is the degeneration of the optic nerve � bers that send signals to the brain, enabling vision to occur. It has been associated with abnormal eye pressure due to elevated intraocular � uid pressure. � is increased pressure damages the optic nerve � bers, a� ecting vision.

Glaucoma has no obvious symptoms in its early stages, Dr. King warns, but as the disease progresses and more damage occurs to the optic nerve, blind spots may develop in the peripheral (side) vision. � is often goes unnoticed until the disease is advanced and the damage to the optic nerve has become severe. Without treatment, this loss of vision can progress to blindness.

“It’s estimated that about four million people have glaucoma, half of whom don’t even know they have it,” Dr. King reports. “Unfortunately, there isn’t a cure yet, so early detection is critical. Once we catch glaucoma, we can control it. � e earlier we catch it, the easier it is to control.

“When we catch glaucoma early, it is often the case that the patient will never have a problem with their vision. We try to prevent them from ever developing a problem, so our treatments are geared toward reducing pressure within the eye. � is reduction in pressure has been proven to slow down or halt the progression of glaucoma.”

Dr. King points out that for patients with mild glaucoma, the use of medicated eye drops or a laser treatment to lower intraocular pressure may be all that’s needed to keep the disease under control.

“In more advanced stages, some patients may require a procedure called surgical trabeculectomy to rechannel the drainage passages and improve the � ow of excess eye � uids,” he says. � is also lowers eye pressure.

Beautiful EyesDr. Applebaum uses his skills in ophthal-mology and oculoplastic surgery to perform a wide variety of cosmetic and functional procedures on the face and eyes. Blepharoplasty is among those procedures.

Deen G. King, MD

Eyecare

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Dr. Profet Health & Wellness CenterImage of Health

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12

OphthalmOlOgy

A lready weary from a long day of work, the last thing Mario Profet, MD, wanted to do on the night in 2006 that he traveled to San Juan, Puerto Rico was stop and visit friends on his way to Guayama, where he was scheduled to take a licensing exam the next day.

Of Sound BodyThe staff at Dr. Profet Health & Wellness Center has extensive experience in the fi eld of

internal medicine and is certifi ed in vascular, cardiac and obstetric-gynecological ultrasound. To learn more about the practice or to schedule an appointment,

call or visit their offi ce in Tampa at:

11017 N. Dale Mabry Highway, Suite B(813) 337-7402

Also referred to as sonography, an ultrasound scan is a medical test in which high-frequency waves capture live images from inside the body. � ose images allow phy-sicians to see problems with organs, vessels and tissues without making an incision.

Unlike many other imaging procedures, ultrasound does not use radiation. Because of that, it is the pre-ferred method for viewing a developing fetus during pregnancy. Dr. Profet performs obstetric ultrasound exams during the � rst trimester.

“I immediately sent this gentleman to the emergency room, and he had surgery that night. � at’s just another example of us helping someone with a serious complaint. Were it not for the ultrasound, who knows what would have happened to this man.”

A Deeper Dive A similar situation developed with another older gentle-man who came to Dr. Profet complaining of knee pain. During a musculoskeletal ultrasound of the man’s knee, Dr. Profet found the cause of his pain to be a Baker’s cyst, a common swelling behind the knee joint.

But his ultrasound exam also found that the man had a blood clot in one of his leg veins. Fearful that the clot might break free and move to the lungs, which could have been fatal, Dr. Profet immediately began treating the clot with anticoagulants to dissolve it.

“With a patient like that, a lot of doctors would have simply ordered an x-ray to see what the cause of his knee pain was,” Dr. Profet remarks. “By doing an ultrasound exam, we were able to � nd not only the cause of his knee pain, but another, more serious situation.

“� at clot could have embolized to the lungs at any time, but because we were able to start dissolving the clot right away, he was able to recover perfectly. And not only is that man still walking today, but he’s still my patient.”

With early detection being such a critical factor in the successful treatment of so many medical issues, point-of-care ultrasound is fast becoming one of the most valuable tools primary care physicians can have in their tool belt, Dr. Profet says.

“� is is something that can help us detect serious issues in patients long before they’re experiencing symp-toms,” Dr. Profet says. “For that reason alone, this is an invaluable medical tool that patients can greatly bene� t from. � at’s why it’s such a big part of my practice.” FHCN article by Roy Cummings. Photo by Fred Bellet. ke

Visit them on the web at www.doctorprofet.com

MARIO PROFET, MD, RPVI

Mario Profet, MD, RPVI, is a family medicine specialist who has been in practice since . He received his medical degree from the University of Havana in Havana, Cuba in . He is also a Registered Physician in Vascular Interpretation®, the highest attainable stan-dard in vascular sonography interpretation. Dr. Profet performed his internship at the San Gerardo Hospital in San Juan, Puerto Rico and was an internist at Woodlands Hospital in Georgetown, Guyana. He has also worked in the medical clin-ics of United States federal prisons.

“I was very tired, and it’s a two-hour drive from San Juan to Guayama, but because my plane arrived a half-hour earlier than planned, the friend who picked me up at the airport insisted on stopping and visiting these friends,” Dr. Profet remembers.

“During our visit, the wife of one of them suddenly asks me, Do you have your little portable ultrasound machine with you? I told her I did, and she asked me, Would you scan my gallbladder for me. I think I might have a problem there.

“I scanned her, and she was � ne. But then every-one else started asking me to check this and that for them. One of my friends eventually asked me to check his abdomen, and when I passed over his left kidney, I thought I saw something.

“I asked him, Are you having any problems with your kidneys or experiencing any symptoms of any kind? He said no, so I scanned him again, and the second scan con-� rmed there was in fact something there.

“A few days later, he had some other tests – an MRI, a CT scan and a bone scan – and it turned out that he had a cancerous tumor on his kidney. Two weeks after that, he had the tumor removed, and he’s been cancer free ever since.

“I tell that story because I’ve always found it fasci-nating how that decision to stop and visit those friends, and the fact that I had that portable ultrasound machine with me, actually saved a friend’s life.”

The chain of events that led to that lifesaving moment actually began just over a decade earlier when Dr. Profet, a primary care physician and the proprietor of Dr. Profet Health & Wellness Center in Tampa, � rst decided to learn ultrasound scanning techniques.

“� at was in 1995. After taking several courses and becoming skilled in ultrasound technology, I went to a conference in Spain, where I learned that most of the general practitioners there use ultrasound on a routine basis in their practices,” Dr. Profet explains.

“� ey were treating it like a stethoscope, as just another tool in their practice, and I’ve been performing what we call point-of-care ultrasound in my practice ever since. If someone is having a problem or a complaint, we scan them right there in our o� ce.”

Extensive Experience As Dr. Profet’s story shows, point-of-care ultrasound is a medical specialty where medical professionals trained in that speci� c technological � eld can use portable ultrasound devices to diagnose problems in patients anytime, anywhere.

Among the bene� ts for patients is the ability to be treated faster, more accurately and in a noninvasive manner by a highly trained medical professional without having to make visits to a radiology center.

At Dr. Profet Health & Wellness Center, Dr. Profet and his sta� have extensive experience in the � eld of internal medicine and are certi� ed in several areas of point-of-care ultrasound, including vascular, cardiac and obstetric-gynecological ultrasound imaging.

“We also do echocardiogram and musculoskeletal exams as well as guided ultrasound intervention. Instead of placing a needle without knowing where it should go, we use ultrasound to help us guide the needle to the right place,” Dr. Profet says.

Abdominal ultrasounds that allow physicians to look at organs such as the liver, gallbladder, spleen and kidneys are among the most common ultrasound exams performed, says Dr. Profet, who recently performed a rather critical abdominal ultrasound.

“� is much older gentleman came into our o� ce one day complaining of heartburn and abdominal pain in the epigastric region,” Dr. Profet remembers. “While examining him, I said, Let’s do a scan of your abdomen.

“� at scan revealed a gallbladder full of stones as well as signs of in� ammation. Now, if you have gallstones with no in� ammation, you can have the stones removed later. But if you have gallstones with in� ammation, as this man did, that’s an emergency situation.

Dr. Profet performs a point-of-care ultrasound exam.

I n 1999, Maggie* was only 18 when her agonizing journey of pain began with a constant aching in her left knee. She was initially diagnosed with osteochondritis, an in� ammation of the bone-cartilage juncture. From that point, the discomfort intensi� ed, and complications with her knee condition caused the pain to spread to her lower back and hip.

Sunil J. Panchal, MD, is board certifi ed by the American Board of Anesthesiology in interventional pain medicine. He earned his bachelor’s degree in Biology from Rensselaer Polytechnic Institute in Troy, NY, and earned his medical degree from Albany Medical College of Union University in Albany, NY. In addition, Dr. Panchal completed The Business of Medicine Graduate Program at Johns Hopkins University in Baltimore, MD. Dr. Panchal completed an internship in general surgery at the University of South Florida in Tampa, a residency in anesthesiology at Northwestern University in Chicago, IL and a fellowship in interventional pain medicine at the University of Illinois in Chicago. He previously served as co-director of the chronic pain service and director of the multidisciplinary pain fellowship training program at Johns Hopkins University and subsequently as director of the division of pain medicine at Cornell University in New York. He is a member of the North American Spine Society, the North American Neuromodulation Society, the International Neuromodulation Society and the

American Academy of Pain Medicine. Dr. Panchal has authored numerous peer-reviewed journal articles and has served as a reviewer and editor for several journals. He is the co-editor and co-author of the textbook Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches (). Dr. Panchal is a principal investigator in numerous clinical trials, including a current study evaluating sacroiliac joint fusion.

Our Highest PriorityNational Institute of Pain makes patient

care their highest priority. They use a multidisciplinary team approach to provide

comprehensive care and advance the treatment of pain. If you’re hurting, the institute has two locations to serve you:

Lutz4911 Van Dyke Road

Tampa 10740 Palm River Rd., Suite 490

For an appointment at either location, call:

(813) 264-PAIN (7246)

NATIONAL INSTITUTE OF PAINSUNIL J. PANCHAL, MD

Look for them online at www.nationalinstituteofpain.org

He began that process by � rst per-forming a sympathetic nerve block test to determine if her sympathetic nerves were involved. A sympathetic nerve block is an injection during which a needle is placed into the back alongside the spine where the sympathetic nerves are located.

Maggie achieved significant pain relief from the nerve block that lasted approximately three days. The test thus confirmed that her sympathetic nerves were indeed involved in her pain condition.

“After we determined the source of the problem, we discussed treatment options,” notes Dr. Panchal. “Maggie wanted something that would be e� ec-tive and long-lasting, so I recommended the spinal cord stimulator.”

New GenerationSpinal cord stimulation uses implanted electrodes to send electrical impulses that keep pain messages from traveling from the a� ected nerves to the brain. By interrupting these messages, the stimu-lus for pain is not detected, so there is less pain felt by the patient.

When it was � rst introduced some 40 years ago, spinal cord stimulation involved implanting the electrodes near the problem nerves coming o� the spine and a pacemaker-sized control device under the skin of the lower abdomen. Battery changes, however, required a surgical procedure.

“The newest generation sys-tem I use, called Stimwave, requires only a small wire implant,” explains Dr. Panchal. “It’s essentially a tube that

has metal contacts where the electri-cal current exits. � e tube contains a computer chip that receives power from the battery, and it has an antenna at its end. � e antenna communicates with the battery.

“� e Stimwave’s battery is external and wireless. It’s housed in a small con-trol box. It has a cable attached to a � at antenna, which is placed over the site of the wire implant. � e battery device is generally worn under the patient’s clothing. Some clip it to their pants; some women clip it to their bras to keep it as unobtrusive as possible.”

The latest generation of stimulators also uses a different type of program-ming that provides more comfort for the patient.

“When stimulators � rst came out, they used tonic stimulation,” Dr. Panchal educates. “With that type of stimulation, the patient’s pain was replaced with a tin-gling sensation, called a paresthesia. Some patients didn’t like the tingling, however, and in many patients with neuropathic pain, the tingling actually aggravated their symptoms.

“Now, they’ve developed a high-frequency stimulation that sends the electrical signals at a much faster rate, so patients don’t feel any tingling at all. It simply reduces pain. As it turns out, the success rate with the paresthesia-free approach to stimulation is actually higher than with the old approach.”

� e newer technology stimulators are also less bothersome to patients because they don’t feel changes in their condition when they move their body

positions, which occurred with older models. � ere’s also nothing to aggra-vate neuropathic symptoms, explains Dr. Panchal, who has particular exper-tise with Stimwave stimulators.

When the system’s first generation of devices was launched in 2015, he performed the first surgery with that system in the United States. When the second generation was released, Dr. Panchal did the first implant of that system worldwide.

Relief at LastDr. Panchal has now performed more than 100 permanent implant proce-dures with the advanced Stimwave system, the most procedures of anyone in the world. As the first step in that implant process with Maggie, he per-formed a stimulator trial that involved placing a temporary wire on her spine and evaluating the results.

� e trial gave the doctor a good idea of the extent to which a permanent stim-ulator would bene� t his patient.

“Maggie got sixty-� ve to seventy per-cent relief from the trial and quali� ed to receive a permanent stimulator system,” Dr. Panchal states. “I then implanted the permanent Stimwave system under Maggie’s skin, and she reported as much as eighty-percent relief from that. She also reported that her episodes of numbness went away.

“Maggie had been treated with pain medications, including opioids,” notes Dr. Panchal. “Neuropathic pain tends not to respond well to narcotics, and too many people in our country have a prob-lem with opioids. Spinal cord stimulation is an excellent, drug-free option that works e� ectively to relieve people’s pain.”

“I achieved great results with the new spinal cord stimulator,” says Maggie. “I recommend it and Dr. Panchal toanyone in pain.” FHCN article by Patti DiPanfilo. ke

*Patient’s name withheld at her request.

“My doctors tried to relieve my pain with various treatments such as surgery and pain medications, including opi-oids,” relates Maggie. “But they didn’t work for me. I didn’t get lasting relief from them.”

Although Maggie was treated for her pain, her overall condition deteriorated further until the fall of 2017. � at’s when she consulted Sunil Panchal, MD, a board-certified interventional pain specialist. Dr. Panchal is president and medical direc-tor of National Institute of Pain, which has centers in Lutz and Riverview.

“After her osteochondritis diagnosis, Maggie was treated with bone graft sur-gery and cartilage replacement,” reports Dr. Panchal. “Over time, she had six more surgeries on her left knee and four on her right knee.

“With the repeated surgeries, Maggie developed neuropathic nerve pain, so she had symptoms of numbness in her legs and pain and burning with light touch. Her left leg also turned purple, which meant the nerve control to her blood vessels was abnormal.

“� e pain she experienced altered the way she walked, and that triggered her back pain,” continues Dr. Panchal. “� en, after her last surgery, she devel-oped hip pain as well. � e back and hip pain had been going on since 2014, so in October 2017, she came to me for an evaluation.”

Dr. Panchal knew pain medications were not a treatment option for Maggie. He also knew that other treatments such as physical therapy and injections had provided limited relief for her, so he knew he would have to dig deep into his arsenal of treatment tools to � nd an e� ective alternative for her.

“Spinal cord stimulation is an excellent,

drug-free option that works e� ectively to relieve

people’s pain.”

Page 2 | Florida Health Care News | Spring 2020 | South Tampa Edition South Tampa Edition | Spring 2020 | Florida Health Care News | Page 3primary Care pain management

Sight For LifeAt Florida Eye Specialists & Cataract Institute, the goal is to off er an all-encompassing practice that provides patients the highest quality of eye care for life. For more information or to schedule an appointment, call or visit the location nearest you:

South Tampa3115 West Swann Ave.

(813) 492-2020 Brandon

403 Vonderburg Dr., Suite 101

(813) 681-1122

Riverview13106 Vail Ridge Dr.

(813) 392-3311Sun City Center

1701 Rickenbacker Drive, Suite 102

(813) 634-8877Ruskin

612 North Tamiami Trail

(813) 645-3831Find Florida Eye Specialists & Cataract Institute online at www.� oridaeye.org

(continued from page 1)

“Blepharoplasty is a surgical procedure that involves removing excess eyelid tissue, which can make people look tired, sad or even mean upon first impression,” Dr. Applebaum describes. “Blepharoplasty can be done on both the upper and lower eyelids, and can make a dramatic di� erence in the appearance of the face.

“ Wi th upper blepharoplasty, excess skin is removed from the upper eyelids,

which can droop due to muscle weakness. � e repairs I perform help functionally because the excess tissue can get in the way of vision and endanger the patient. It can also cause headaches and other problems.

“I also perform blepharoplasties for cosmetic purposes, when people are unhappy with the appearance of their lids. � ese surgeries can signi� cantly improve the look of their eyes.”

� e lower lids can project a poor � rst impression as well.“Most people are born with � ve bags of fat around the eye to

protect it and hold it in the socket,” Dr. Applebaum educates. “However, with aging, that fat can come forward and appear as pu� -iness under the eye. Lower blepharoplasty can diminish the look of tiredness and aging by decreasing excess fat and skin beneath the eyes.”

Surgery Advancement Surgery is an art form, and surgeons spend years perfecting their tech-nique. Surgeons, like artists, are always striving to improve upon their craft. For the surgeons at Florida Eye Specialists & Cataract Institute, advancing with new technology is one way they re� ne their creative skills.

An example of this advancement is the LENSAR® Laser System for use during cataract surgeries. LENSAR is on the leading edge in femtosecond laser technology. Its added functions and precise laser incisions enable surgeons to remove the cataracts with increased safety and position the replacement lens, known as an intraocular implant, with greater accuracy. � ese innovations lead to better vision following surgery.

“� e LENSAR automates certain aspects of the surgical process that were traditionally done by hand, and makes them more e� cient, more e� ective and safer,” notes Dr. Rathinasamy, whom patients refer to as Dr. “Samy.”

“For example, the laser makes the initial incision into the eye. It can also create the capsulotomy, which is an opening into the thin, fragile membrane that holds the cataract, and it does so with exceptional precision.

“A capsulotomy done by hand can be less than perfect. It is important to have a perfect capsulotomy so the replacement lens can sit in a more optimal position, which ultimately gives the patient better vision.”

� ough it also bene� ts the surgeon, the LENSAR Laser System allows patients to walk away from the surgery with the clearest vision possible. One way it does that is by a� ording the surgeon the technology to correct astigmatism during surgery.

“To correct astigmatism, we make what are called limbal relaxing incisions, which are tiny cuts in the cornea to reshape it,” Dr. Samy explains. “� e corneal reshaping done by the LENSAR can reduce astigmatism and help people see more clearly after surgery.”

Selective Transplant Dr. Mathews performs the full range of corrective eye procedures, including cornea surgery, refractive surgery (including LASIK®) and cataract surgery. Her primary interest is the treatment of conditions a� ecting the cornea.

“� ere are certain surgeries I learned over the past few years that, prior to my arrival, weren’t widely available in the Tampa Bay area,”

From left to right: Robert Applebaum, MD, MBA - oculoplastics; Priya Mathews, MD, MPH - cornea & LASIK; Selina Lin, MD - retina; Pauline

Thai, OD - primary eye care; Dilip Rathinasamy, MD “Dr. Samy” - cataracts; Greg Henderson, MD, FACS - cataracts

Dr. Mathews notes. “One of those techniques is DMEK, which is an acronym for Descemet membrane endothelial keratoplasty. DMEK is a newer, more advanced type of cornea transplant.”

� e cornea is made up of � ve layers, and during a traditional cornea transplant, the entire cornea is removed and replaced with donor tissue. With the newer surgical techniques, including DMEK, surgeons can select the diseased layer of the cornea and replace only that layer.

During DMEK, the surgeon removes and replaces a very thin layer of the cornea. In this case, it’s two layers, the Descemet membrane, the basement membrane that lies deep in the cornea, and the endothelium.

“Techniques such as DMEK, which transplant only a portion of the cornea, provide patients with much better vision than can be achieved by replacing the entire cornea,” Dr. Mathews asserts. “And because the patient is keeping most of their own cornea and only receiving a small piece of donor tissue, there’s less chance for rejection.”

Dr. Mathews also performs keratoprosthesis surgery, which is the replacement of the entire cornea with an arti� cial cornea. � is may be an option for patients who are not suitable candidates for fresh tissue transplant.

“Cornea transplants are the most frequently performed trans-plants in the world, so advances such as DMEK and arti� cial corneas are really exciting,” she relates.

Follow the Leaders Dr. Lin’s decision to become a retina surgeon bore her father’s in� uence. When she � rst showed interest in eye care, her father, an anesthesiolo-gist, encouraged her to learn everything she could about the specialty.

“My father’s good friend was one of the � rst doctors in Florida to perform LASIK eye surgery,” she remembers. “When I was young, I went to his o� ce and watched him perform LASIK, cataract and other eye surgeries. � e experience got me really interested in ophthalmology.

“During my residency, my father was working at University of Florida Shands Hospital, and became good friends with the depart-ment of ophthalmology chairman, who was a vitreoretinal surgeon. After talking with him, I became interested in retina care.

“Whenever I came home during my residency, I went into the operating room and watched this vitreoretinal surgeon perform surgery. � at’s how I was exposed to retina surgery, and I remember thinking, � is is for me.”

Dr. Lin o� ers medical treatment for retina diseases as well as retina surgery at the new South Tampa location.FHCN article by Patti DiPanfilo. Group doctor photo courtesy of Florida Eye Specialists & Cataract

Institute. Cover photo and building photos by Jordan Pysz. mkb

The new South Tampa office of Florida Eye Specialists & Cataract Institute

ERICK A. GRANA, MD

Erick A. Grana, MD, is a diplomate of the American Board of Physical Medicine and Rehabilitation and the American Board of Electrodiagnostic Medicine, with sub-specialty certification in pain medicine. After he received his medical degree from the University of Puerto Rico School of Medicine, he completed his internship and residency at the university’s hospital and was subsequently awarded a fellow-ship from the department of rehabilitation

medicine at the University of Washington in Seattle. Dr. Grana is a former assistant professor at Baylor College of Medicine in Houston and

a member of the American Medical Association, the

International Spinal Injection Society and the Florida Academy of Pain Medicine. Visit Regenerative Orthopedic Institute on the web at www.dontoperate.com

Don’t Operate,

REGENERATEFor more information about stem cell therapy, please call

or visit Regenerative Orthopedic Institute in Tampa at:

8011 North Himes Avenue, Suite 3

(813) 868-1659

S ome people know early in life what they want to do for a career, and they follow clear paths to reach their goals. � at wasn’t the case for Geraldine Duez. For years, Geraldine worked in various capac-ities before � nally � nding her calling as a certi� ed nursing assistant (CNA).

“I started out working as a beauti-cian and did that for a while,” Geraldine relates. “� en, I went to work in a fac-tory and from there to working in an o� ce, which I did for a few years. After that, I started my career as a CNA and worked in nursing for twenty years. I even did private care for a while. I retired as a CNA in 2015.

“I initially became a CNA because I knew there were jobs in that � eld. � ere’s always a need for nursing care. But I really enjoyed working in nursing because I got to know a lot of people, and I liked mak-ing patients happy.”

Retirement suited Geraldine, but she soon became hampered in her favor-ite activities, including working in her yard, by intense pain in her lower back and leg. � e pain, her doctor told her, was the result of sciatica, a pinching of the spinal nerves supplying the legs by degenerated discs.

“� e pain started on the left side of my lower spine and ran down my left leg,” Geraldine describes. “It really hurt. Sometimes, the pain started up when I was driving and made it hard to drive because it hurt so bad.

“I eventually had an MRI done in Port Charlotte, and it showed a lot of narrowing on the left side of my spine. � e pain it caused was o� and on, but it bothered me enough that I knew I had to get rid of it.”

Matters got worse for Geraldine before they got better. Over time, her troubling back pain was compounded by excruciating pain in her left knee.

“� ere was a burning pain on the left side of my knee,” she states. “At times, the pain was a nine on a scale of one to

ten. Occasionally, it hurt at the bottom of that knee as well, but that pain occurred at di� erent times. It wasn’t constant.

“Sometimes, my knee was unstable. I was afraid I might go down because it felt like my knee wasn’t going to hold me up. It usually held, but the feeling it might not was scary.”

Living with terrible back and knee pain took all of Geraldine’s energy. She finally accepted that she required a doctor’s care in order to find relief, but she d i d n’t k n o w where to turn. That changed when she picked up a copy of Florida Health Care News one day and read about Erick A. Grana, MD, of Regenerative Orthopedic Institute in Tampa.

“I read the article in the newspa-per about Dr. Grana and his treatment and thought, Maybe he could help me,” Geraldine remembers. “When Dr. Grana reviewed my MRI, he said my back was pretty bad, but he could treat me with his procedure. I thought I might as well have my back and knee treated at the same time. Dr. Grana told me he would give me a discount to have both done, and I always like a deal.”

Natural Process “Geraldine’s sciatica and knee pain were the result of degenerative arthritis,” Dr. Grana reports. “She was looking for a way to relieve her pain without resorting to surgery or heavy pain medications. She wanted a more natural way to ease the pain and manage the underlying arthritis.”

To addres s condi t ions l ike Geraldine’s, Dr. Grana uses regenerative medicine, which treats patients with a nonsurgical technique called stem cell

therapy. This therapy uses the patient’s own specialized stem cells to promote the growth of new tissue in joints rav-aged by arthritis or injury.

“Regenerative medicine treats dis-ease and injuries by harnessing the body’s own healing powers,’’ Dr. Grana informs. “� e natural healing process is accelerated by a combination of growth factors and bioactive cells in the form

o f s t em ce l l s and platelet-rich plasma (PRP).

“� e process of using stem cells and PRP results in a safe, effec-tive treatment,” Dr. Grana assures. “And unlike tradi-

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

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

Dr. Grana extracts stem cells from the patient’s bone marrow or fat, while the PRP is taken from the patient’s own blood. After the stem cells are harvested, they are separated through a centrifuge and injected into the painful area to stim-ulate the regeneration of damaged tissue and the healing of tendons, ligaments, joints or spinal discs.

Dr. Grana has developed a system for the delivery of stem cells and PRP into the pain generators in and around joints such as the knees, shoulders and hips. It’s called RegenaJoint™. He used this technique on Geraldine’s left knee. He has also developed a similar system to treat the spine called RegenaSpine™, which he used on Geraldine’s low back and sciatic pain.

“RegenaJoint and RegenaSpine are both minimally invasive proce-dures that are performed right in my office using a local anesthetic,” the doctor describes. “Patients typically resume normal activities immediately following the procedures.”

“Dr. Grana took fatty tissue from my stomach and took the stem cells from that,” Geraldine recalls. “Then he got platelets from the blood he took from my arm. He mixed the stem cells and plate-lets together and injected the combination into my back and knee.”

“I Feel Great” “About two weeks after the injections, I started to feel better,” Geraldine reports. “I had a lot of energy, and I was able to do all sorts of projects. I trimmed a palm bush in the yard, then put rubber rings around its trunk. I also spread mulch, which made the yard look really nice. I carried all of the mulch and dirt I used, and I wasn’t in pain.”

Geraldine continues to reap the ben-e� ts of her stem cell therapy and today, she’s amazed by how much improvement she’s achieved. She recognizes Dr. Grana and his treatments for her success.

“I feel great,” Geraldine raves. “I no longer have any pain in my back or down my left leg. Every once in a while, my knee hurts a little in one place, but when I mentioned that to Dr. Grana, he said it takes time for the joint to heal. Unless it gets worse, there’s nothing to worry about.

“� e stem cell treatment was success-ful. � e knee pain I have left is only a one on a scale of one to ten. And I no longer get that feeling it’s going to give out on me. Unfortunately, now my right knee sometimes feels that way. I told Dr. Grana maybe next year, I’ll have that knee done, too.

“I recommend RegenaJoint and RegenaSpine and already have to a few people. And I have recommended Dr. Grana and Regenerative Orthopedic Institute as well.”FHCN staff article. Photo by Jordan Pysz. mkb

Geraldine Duez

Page 4 | Florida Health Care News | Spring 2020 | South Tampa Edition South Tampa Edition | Spring 2020 | Florida Health Care News | Page 5

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OphthalmOlOgy Stem Cell therapy

The experienced staff at Infinity Medical Institute looks forward to working with you. They are located in Tampa at:

1715 N. Westshore Blvd.Suite 100

(813) 871-2929For more information, please visit www.in� nitymedicalinstitute.com

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Reveal a more youthful you.

I nfinity Medical Institute recently welcomed Teresa “Tami” McGarry, PA-C, to its Tampa location. Tami was brought on board to perform bio-nat-ural hormone replacement therapy, or BHRT, and to expand the institute’s cosmetic services. She is excited about all the services added at this premier medical clinic that was voted number one in the greater Tampa Bay area.

“I earned my physician assistant degree through a program at Kettering College in Kettering, Ohio, and I have twenty-eight years of experience as a PA,” Tami relates. “I started working in facial reconstructive neurosurgery and did that at a Level One trauma center in Ohio for nineteen years.

“I’ve always loved the art of aesthetics. I love the creative aspect of it, so I wanted to take the skills I learned in the surgical arena and apply them to the cosmetic � eld. In 2012, I made the decision to train in aesthetics, and I’ve been practicing aesthetic health and well-ness medicine in Florida and Ohio ever since.”

Tami describes In� nity Medical Institute as “one of the premier BHRT centers with a very large, satis� ed client base that comes in every three months to get their hormone pellets.” She adds that during that visit, patients can also receive cosmetic services such as BOTOX® Cosmetic, � llers, platelet-rich plasma (PRP or PRF), PDO � readLift, and peptide therapy.

“One of the major goals of the lead-ership at In� nity Medical Institute,” Tami points out, “is to provide a variety of services

The O-Shot is a unique treatment for urinary incontinence o� ered at In� nity Medical Institute. It can help reverse the condition’s uncomfortable symptoms.“Incontinence often affects every aspect of a woman’s

life, from her sleep patterns to her personal interactions,” Dr. Moffitt reports. “The O-Shot helps to tighten, or strengthen, the bladder muscles and stop the leakage.

“� ere are far too many women experiencing incontinence issues when they cough, laugh or sneeze, and we want them to know there is help available.”

Most women have a series of shots, usually a total of three, averaging one injection every three months, the doctor explains. Many experience a 90-percent improvement after the third shot, and typically, a vast improvement soon after the � rst shot.

Dr. Mo� tt assures patients that the procedure is pain free and there are no side e� ects.

“We make sure patients are comfortable, well informed and at ease with the procedure before and during the treatment,” she stresses. “There is never any pain, and the results are felt very quickly.”

The O-Shot® Advantage

Tami specializes in cosmetic and BHRT treatments.

that help patients look and feel younger as they live longer.”

“We’ve expanded our cosmetic services to provide a one-stop shop for whole-body wellness and youthfulness,” elaborates Michael Montemurro, president of In� nity Medical Institute. “� is way, we can help our patients look more youthful to match how they’re feeling on the bio-natural hormones.”

BOTOX Cosmetic and XEOMIN® are examples of popular neuromodulators available at Infinity Medical Institute. Neuromodulators relax muscle contractions to smooth � ne lines and wrinkles on the face.

The practitioners at Infinity Medical Institute also offer a variety of fillers for cheek, chin and lip augmentation. Some of the � llers available include RADIESSE® and the entire JUVÈDERM® collection: JUVÈDERM Ultra, JUVÈDERM Ultra Plus, VOLBELLA® XC, VOLLURE™ XC and VOLUMA® XC. All cosmetic fillers have unique properties that perform best in different areas of the face and last for di� erent periods of time.

“As people age, they start to lose volume in the face,” Tami explains. “The cheeks begin to sag; the lips begin to lose fullness, wrinkle and turn in; and people get that natural aged appearance. Fillers restore volume to the face.”

Fillers placed in the cheeks elevate the cheekbones and eliminate the drawn-out look of the face. Fillers applied to the lips give them a full, soft, pouty appearance. Fillers can be used in men along the jawline to give them a more masculine jaw or around the brow and temple area to square out the male face.

“RADIESSE is di� erent than the other � llers,” Tami asserts. “It’s a volumizing � ller for deep wrinkles, and we use it primarily in the cheeks and marionette lines. It’s one of my favorite � llers because it lasts from eighteen to twenty-four months. It also initiates collagen production, so it lays down a more permanent base. And it’s the only � ller that’s calcium-based, which provides the long-lasting e� ect.

“In the skilled hands of a trained prac-titioner, all of these products are safe. We’ve been using them for years and achieving

very rewarding cosmetic e� ects. � e key is for the artist to know which product to use on which patient in which area to give the patient the best look. � e products are di� erent and have di� erent uses, and no two faces are the same.”

New HorizonsIn� nity Medical Institute also o� ers PRP, which can regenerate and tighten skin as well as change skin tone, and recently expanded

its cosmetic services to provide a nonsurgical facelift called the PDO � readLift.

“ T h e P D O ThreadL i f t i s an FDA-approved proce-dure using absorbable

polydioxanone sutures to lift, tighten and smooth skin, improving texture,” Michael informs. “� ere are various types of threads used to achieve the desired results. � ey are safe and used in cardiothoracic surgery.

“Smooth threads are used for � ne lines and improving overall skin texture, twisted threads are used for deep folds or wrinkles and barbed threads are used to visibly lift the skin around the face, eyes and neck, commonly referred to as a mini facelift.”

“� e PDO � readLift is performed in the o� ce and the results are immediate,” Tami adds. “During the procedure, we pass the threads through the areas of the face to be treated. As we withdraw the threads, they tighten the skin. It’s similar to the e� ect that occurs with a facelift, but without the surgery.”

Results of the PDO ThreadLift are immediate using barbed threads, but all three threads force the skin to produce collagen, which lifts the skin and � lls in lines over the following three to six months. � reads are absorbed throughout that time as they are replaced with new collagen.

“Microneedling is another procedure we o� er that results in collagen production to smooth the skin and improve its appear-ance,” Michael observes. “Microneedling is a minimally invasive procedure that causes microscopic punctures to the skin’s surface, which initiates the production of collagen.”

Although not a cosmetic service, In� nity Medical Institute is also o� ering peptide therapy to help patients feel younger, stronger and sexier.

“Peptides are amino acids that are essential for the body to function properly,” Tami educates. “� ey keep the body healthy and operating e� ciently. Peptides are helpful for weight loss, vitality, energy and overall looking and feeling younger.

“It is sometimes difficult for people to obtain enough peptides through food products, so In� nity Medical Institute now o� ers peptide programs tailored to address a multitude of concerns such as weight, hair loss, low immunity and muscle loss.

“Michael and his team of professionals also plan to o� er stem cell therapy in the near future,” Tami adds.

also achy and overweight. I felt like I was aging at a rate faster than I wanted.

“Sleeping wasn’t that much of an issue, except for when the hot � ashes woke me up at � ve o’clock in the morning. My biggest problem was that feeling of fatigue that sat me down in a corner and knocked me out. My energy was really low.

“I continued to exercise, but I wasn’t experiencing any of its bene� ts. I wasn’t losing weight or gaining muscle. It was like I hit a plateau. I was stagnant in my workouts.”

When Donna’s friend told her about a seminar on hormone therapy held by In� nity Medical Institute, she decided to attend. � e presentation left a positive impression.

“The people from Infinity Medical Institute were very knowledgeable, upbeat and positive,” Donna describes. “I was impressed because In� nity Medical Institute’s program has a medical basis to it. Many other places are more like spas, so you don’t know how medically sound their programs are.”

Following the seminar, Donna decided to visit Infinity Medical Institute and undergo an examination. � e sta� ’s testing of Donna’s blood revealed that her hormone levels were quite low and were therefore the cause of her unpleasant symptoms.

Donna’s low hormone levels also made her an ideal candidate for In� nity Medical Institute’s BHRT, notes Moriah Mo� tt, MD, a physician on sta� at the institute.

“When I first went in and met with Dr. Mo� tt, she went over my blood tests,” Donna remembers. “She was very knowl-edgeable, and I felt very secure with her. And again, that medical component is one of the reasons I chose In� nity Medical Institute over other places.

“Another reason I chose In� nity Medical Institute is that before they inject the pellets every three months, they do a blood test to measure your hormone levels. Other places only do blood tests once a year.

“� e sta� at In� nity Medical Institute treat me as an individual, and they adjust my pellets to what my blood tests show. � ey don’t just follow a standard game plan.”

Bio-Identical Match� e bio-natural L3 hormone pellets used by In� nity Medical Institute are derived from plants, a natural material that is molecularly changed in structure and function for a 100-percent bio-identical match to the body’s own hormones. Synthetic hormones, by contrast, can be as little as six- to eight-percent bio-identical, therefore leading to known high risk factors.

“Hormones a� ect everything, including our growth through childhood, our sexual

development, our moods, how we break down our food, our sleep patterns, stress, how much weight we gain – just about every function in the body, big and small,” Dr. Mo� tt observes. “� ey also play a role in many health conditions such as diabetes, an over- or underactive thyroid, osteoporosis, obesity, anxiety and depression.

“Our bio-natural L3 pellet hormone therapy helps to give effective results as we provide patients with a product that is all natural, and we stand behind it. It’s the most effective hormone treatment on the market because it’s replacing natural, normal hormones with biologically identical hormones that the body is used to seeing, rather than synthetic versions of the hormones.

“Through our bio-natural hormone replacement therapy, patients such as Donna achieve consistent absorption of the proper, predictable levels of the hormones their bodies require for optimum health,” Dr. Mo� tt continues. “� is is done through the simple insertion of a pellet approximately every three to � ve months.”

Hormone pellets are about the size of a grain of rice and are typically injected under the skin in the hip or buttocks. To ensure the patient is receiving the proper amount of hormones, comprehensive evaluations of overall health are performed prior to the pellets being administered. Hormone levels are measured before each new pellet is inserted as well.

“We want to be sure that the treat-ment we administer is going to be the overall best course of action for that patient,” Dr. Mo� tt notes. “We’re very thorough with the labs at every visit in order to see what has changed, and what needs to be altered.

“We want t o b e s u r e every patient is feeling the best they possibly can. We not only

look at their labs, but we look at their overall health because other issues such as diabetes and high blood pressure can a� ect how the treatment is administered.”

A-Plus RatingIn� nity Medical Institute provides custom-ized treatment because people respond di� erently after beginning BHRT. Donna experienced a quick reaction to her hormone therapy, and the bene� ts remained evident months after her initial pellets were inserted.

“After the � rst treatment, my hot � ashes were gone, and I started getting more energy,” she raves. “A couple of months later, I began to feel like I wanted to work out instead of like I had to work out.

“And once I did start working out again, I started building muscle and losing weight. Now, I feel like I’m in my forties, not my � fties. It’s amazing. Now that my hormones are consistent, my moods are level, I’m sleeping well and I’ve got my energy back.”

Donna is excited by her BHRT results, but its success highlighted another concern for her. While she felt much better about her

body, she felt less comfortable about her face. She believed it needed

a little lift to give her a more youthful appearance to go with her renewed energy.

“Even though I felt great, I thought my face made me look tired all the time, like I just woke up,” Donna confirms. “I thought it could use a little tweak. First, I was treated with XEOMIN, which is

a neuromodulator l ike BOTOX Cosmetic. I got the treatment in my forehead and around my eyes to soften the l ines and wrinkles.

“My face was also a little saggy because

the tissue starts to break down as

people age. I recently had a � ller injected into

my cheeks and chin to build up that tissue again. I

underwent a PDO � readLift to tighten up my cheeks as well.”

Donna took advantage of several cosmetic treatments available at Infinity Medical Institute. She says the results appear very soft and natural. � ey make her look as good as she feels on the bio-natural hormone therapy.

“It’s not like a facelift, where people look like the Joker, with their skin stretched tight like a balloon,” she elaborates. “Instead, most people don’t even realize I had anything done. � ey just say I look well-rested and happier.

“The woman who injected the filler started me o� with a little bit, just enough to � ll in some creases but not enough to change the shape of my face. It tightened up around my cheeks and neck because those are the areas that bothered me most.”

Donna says she began to see a di� er-ence in her face and neck within a week of receiving the � ller and PDO � readLift. � at and the results of her other treatments earned In� nity Medical Institute’s sta� a perfect score from the entrepreneur.

“� e treatments are slowly tightening and taking away the waddle under my neck and the creases in my cheeks,” she enthuses. “Now, I look like I’m smiling instead of grumpy. And I know there’s going to be even more tightening.

“I can’t say enough good things about the people at Infinity Medical Institute. � ere’s a doctor who treats me, a nurse who works with me and owner/managers who check on my progress. It’s so good to know they actually care about me and care that I’m getting good results.

“My experience at Infinity Medical Institute rates an A-plus. On a scale of one to ten, I give them a ten.”FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

Donna is looking and feeling better and gives In� nity Medical Institute

an A+ grade for making that happen.

Tailored Game PlanIllinois native Donna Turner spends her days juggling two demanding careers. She’s a landlord for the eight rental properties she owns but also manufactures swimming pool and spa accessories.

With her busy schedule, Donna can’t afford to be slowed by the nagging, tiring symptoms of perimenopause. Those symptoms recently began to take a toll on her nonetheless.

“Being a woman of a certain age, I began having hot � ashes, which were miserable, and I was fatigued,” Donna shares. “I was Look Good,

Feel Great

Page 6 | Florida Health Care News | Spring 2020 | South Tampa Edition South Tampa Edition | Spring 2020 | Florida Health Care News | Page 7BiO-natural hOrmOne replaCement therapy/ aeSthetiCS

F or the better part of the ten years he suffered from hem-orrhoids, Jason* told no one of the condition, not even his wife or his doctor.

“I guess like a lot of people I was too embarrassed to talk about it,” Jason con� des. “It was de� -nitely a problem, though. I’d wake up in the middle of the night, itching like crazy. I tried hemorrhoid cream, but it didn’t do anything. It was horrible.”

Now retired, Jason spent his working years in the broadcasting industry, where he managed radio and television stations. One day, he heard about HemWell America and had a revelatory moment.

“I said to myself, � at’s me. I’m not telling my wife about this; I’m not telling anybody,” Jason recalls. “So I went home that night and told my wife, I’m having a little problem down there and I’m going to make an appointment with HemWell.”

Outpatient Procedure“Hemorrhoids are swollen veins in the rectum or anal canal and they’re extremely common,” notes Linh B. Nguyen, MD, of HemWell America. “In fact, more than � fty percent of people age � fty or older

have them to some degree.”Most sufferers are

understandably reluctant to try the available treat-ment options, some of which have traditionally been both painful and inconvenient. Fortunately, Dr. Nguyen o� ers microcur-rent electrolysis (MCE), an FDA-approved, nonsurgi-

cal method for treatment of hemorrhoids. � e noninvasive, relatively painless outpa-tient procedure has been helping patients for more than 20 years and is completed right in the doctor’s o� ce.

“A low current is applied to the base of the hemorrhoid, causing a chemical reaction that induces the hemorrhoid to shrink,” the doctor explains. “This method doesn’t cause the agonizing pain often associated with traditional hem-orrhoid surgery and is covered by most insurances and Medicare.

“In addition to being well tolerated by patients, this method does not require anesthesia, and it’s highly e� ective, safe

and convenient. Up to ninety percent of people who have it done get relief from their hemorrhoids, and it can be safely repeated as needed.

“One of the best things about it is that there is no need to take any special preparation to clear the bowels. Patients can have the procedure done and go back to work immediately, so there is no downtime. � e entire procedure takes approximately twenty minutes.”

“Feel Like New”“Dr. Nguyen makes you feel very comfort-able during the procedure,” says Jason, who reports that the MCE treatment was not only painless but immediately e� ective.

“I felt like a new person when I walked out of the doctor’s o� ce after the proce-dure,” he says. “� e itching was gone.”

Also gone is Jason’s unwillingness to talk about hemorrhoids. In fact, he talks about them freely now, in case it helps others.

“I tell people that this is the most comfortable treatment and it’s not an embarrassing situation,” he notes. “If you’re putting treatment o� because of embarrassment, don’t wait another sec-ond. Pick up the phone and get it done because it’s not embarrassing at all.”FHCN staff article. mkb

*Patient’s name withheld at his request.

Quick, Easy and E� ective Safe, nonsurgical treatment

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Microcurrent Electrolysis Hemorrhoid Treatment

• FDA-approved• Well-tolerated – no anesthesia

required• No downtime• No special preparation• No painful surgery• Covered by most insurance and

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Linh B. Nguyen, MD, is board certifi ed and is a diplomate of the American Board of Family Practice. He is a graduate of the University of Florida and received his medical degree from Hahnemann University, Philadelphia, PA. He is certifi ed in microcurrent electrolysis for the treatment of hemorrhoids.

Why Su� er?If pain, itching and bleeding from

hemorrhoids are aff ecting you, there’s help. Call HemWell America

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LINH B. NGUYEN, MD

Visit www.hemwellamerica.com

SOUTH FLORIDA EYE CLINICSCOTT L. GELLER, MD

For Eye Floater Solutions

South Florida Eye Clinic is located in Fort Myers at:

4755 Summerlin Rd. Call Dr. Geller at:

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

(877) 371-3937

Scott L. Geller, MD, is board certifi ed by the American Board of Ophthalmology. He is a graduate of Ohio Wesleyan University and Rush Medical College. While in med-ical school, he was awarded a student fellowship to study tropical medicine at a missionary hospital in India, and pursued additional studies at the famous Brompton Hospital in London, England. He interned at Presbyterian Hospital, Pacific Medical Center, San Francisco, CA, and completed his residency in ophthalmology at Sinai Hospital of Detroit, which was affi liated with Wayne State Medical School and Kresge Eye Institute. Dr. Geller was fellowship-trained in anterior segment and refractive surgery with Dr. William Myers of the Michigan Eye Institute. Dr. Geller is a fellow of the American Academy of Ophthalmology and has presented papers on eye fl oater laser treatment at the International Congress of Ophthalmology, European Congress o f C a t a r a c t & Refractive Surgery, European Congress of Ophthalmology and the Florida S o c i e t y o f Ophthalmology.

SCAN THIS TO YOUR SMARTPHONE

TO SEE ACTUAL PATIENTS

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

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

Eye Floater LaserScott Geller, MD, teaches the technique worldwide

W ith more than 20,000 documented eye � oater laser sessions com-pleted, Dr. Scott Geller, a board-certi� ed ophthalmologist, has the largest and longest clinical series of eye � oater laser sessions in the United States, and probably worldwide.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Pysz. mkb

The staff at Minutes to Fitness look forward to

serving all your fi tness needs. They off er personalized,

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Denise McQuillen grew up just outside of Indianapolis, Indiana, where basketball is more of a religion than a sport. Oddly, basketball is one of the few sports this self-proclaimed tomboy never played during her youth.

“I’m only � ve-feet, two-inches tall now as an adult, so basketball was not a good sport for me,” says Denise, now 68. “But I was always active and involved in sports growing up. I jogged a lot and was an avid tennis player for years. Now, I’m an avid golfer.”

� e switch from tennis to golf came about nine years ago, long after Denise moved to Florida. It was a switch brought on in great part by the fallout from the surgery she had in 1987 to correct a lower back injury she su� ered in a car accident.

“I was thirty-five years old when I had the surgery, which was done to correct spinal damage and soft tissue damage in my lower back,” Denise reports. “But ever since that surgery, I’ve been struggling with pain in my upper back and shoulder area.

“It was at that same time that I went to court reporting school for two years and became a court reporter. I think that being in that awkward position all day where you’re sitting with your arms out in front of you aggravated the problem.”

Another contributor to her upper back and shoulder discomfort, Denise believes, was her penchant for tennis, where players preparing to receive a serve or volley typically stand with both hands holding the racket out in front ofthe middle of their body.

“I was in pain all the time when I was playing tennis, and I was in pain after I got o� the court,” Denise recalls. “� e pain was constant. It was there when I went grocery shopping, when I was cook-ing dinner or shopping for clothes.

“When I asked my physical therapist about it, she said the body positioning in tennis was really just compounding the problem. � at’s why I switched to golf because in golf, she said, you’re actually stretching those muscles more.”

The switch to golf did alleviate some of Denise’s pain, but neither that nor the physical therapy sessions and home exercises she was devoted to ever rid her of enough pain to leave her feel-ing comfortable.

“I was thinking that I’d been doing all these exercises and things for so long and not getting the results that I needed,” Denise relates. “� en I thought, you know, I’ve got a friend who goes to 20 Minutes to Fitness and thought, maybe I should try that.

“� is was about a year ago, and I know that at my age, you automati-cally start losing muscle mass, so I was thinking that I needed to get stronger all across my body anyway, so I made the decision to give it a try.”

Tailored TrainingAt 20 Minutes to Fitness, clients work out one-on-one with a nationally certi-� ed personal � tness coach who creates and supervises an individualized workout program. � e 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 equipment. Repetitions during each workout last approximately 20 seconds, thereby maximizing muscle performance.

The slow-paced movements that comprise each workout create contin-uous tension on the muscle fibers, which allows cli-ents to get more physical benefits from a 20-minute,o n c e - a - w e e k workout than they would from going through a tradi-t ional 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 performance. 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-training equip-ment is part of that success. � e 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.

Alena is a Nationally Certifi ed Personal Fitness Coach who has been with Minutes to Fitness since . She earned her bachelor’s degree in Exercise Science from the University of South Florida and has been teaching children one year old and older how to swim for

more than years. She has a strong commitment to improving all clients’ quality of life.

The equipment is also calibrated to work speci� c 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 ses-sions 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 surger-ies, and their doctors refer them to us

because they know we can help them build the mus-cle around those joints prior to sur-gery,” Angela adds. “� is allows for a quicker recovery after surgery.

“We’ve even had some people

who have been able to hold o� 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.

“� ey 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 teenag-ers 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 was the primary reason Denise began working out at 20 Minutes to Fitness, but she has since realized a few other benefits of the workouts con-ducted by Alena, her certi� ed personal � tness coach.

“First of all, the physical therapist that I’ve been seeing for the past thir-teen years says my spine is functioning better than she’s ever seen it,” Denise reports. “And the massage therapist that’s part of that group says he’s seen a bigdi� erence, too.

“He always said my back muscles were like steel rebar and coiled metal ropes, but now he says my back muscles actually feel like normal muscle tissue. And believe me, I can feel the di� erence, because I don’t have all that pain and dis-comfort anymore.

“Now that my back feels better, I’m getting more rotation in my golf swing and actually hitting the golf ball farther when I play. Some of my gol� ng friends have even commented on how much more I can turn my shoulders now.”

Denise says the impact 20 Minutes to Fitness workouts have made on her life have made her a � rm believer in the program, so much so that she has already recommended it to several of her friends.

“One of my friends is already going,” Denise says, “and my physical therapist, who has followed my progress and asked me a lot of questions about 20 Minutes to Fitness, is now recommending it to other patients.

“It’s really a great program because the coaches are all properly trained, and they do a great job of watching you to make sure your form is right and you’re using the equipment properly. For me, 20 Minutes to Fitness has been a fantastic experience.”FHCN article by Roy Cummings. Photo by Jordan Pysz. ke

“My physical therapist, who has followed my

progress and asked me a lot of questions about 20 Minutes to Fitness, is

now recommending it to other patients.”

Alena (left) keeps a watchful eye on Denise as she completes her workout.

Page 8 | Florida Health Care News | Spring 2020 | South Tampa Edition South Tampa Edition | Spring 2020 | Florida Health Care News | Page 9

hemOrrhOid treatment

eye FlOater treatment phySiCal FitneSS

is carried out using a scope with a camera, and the sur-geon operates while visualizing images from the camera on a computer screen.

“Once the incision is made, we insert a series of tubes to dilate the muscles that sit on top of the bone and create an opening in the lamina using a laser, small drill and a kerasin. We use rongeurs to remove the pieces of bone that were in the lamina.”

To relieve pressure on spinal nerves, Dr. St. Louis uses the kerasin to remove some of the bone surrounding the foramen where the nerves exit the spinal cord. � is is a foraminotomy. Because laminotomy and foramino-tomy are performed minimally invasively, recovery is short and complications are rare.

“I typically instruct patients to walk for an hour the day after surgery in three twenty-minute intervals,” Dr. St. Louis informs. “Total recovery time depends on the patient’s degree of activity. If they’re return-ing to a desk job, they can go back within a week. If they do manual labor, they must wait anywhere from two weeks to a month.”

Dr. St. Louis makes a point of noting that Physician Partners of America accepts Medicare, so patients with Medicare don’t have to pay large out-of-pocket sums for their laser surgery. � is is important because many of the conditions that require procedures such as laminotomy and foraminotomy are common in older adults.

“As people age, they often develop bone spurs that can pinch the spinal cord or spinal nerves and cause pain,” the doctor observes. “In addition, every nerve travels through a tunnel, and over time, that tunnel shrinks and puts pressure on the nerve. Laminotomy and foraminotomy remove the bone spurs and open up the tunnels, freeing the nerves and relieving pain.”

“Immediate Relief”Dr. St. Louis thoroughly explained what was causing Larry’s back and leg pain, and detailed how laser lami-notomy and foraminotomy would repair the problem. Larry agreed to undergo the procedures and was amazed by how quickly he noticed a di� erence in his condition.

“I felt immediate relief,” Larry enthuses. “And my recovery was very quick. I walked out of surgery with no pain in my back or down my legs. At � rst, I attributed most of the relief to the anesthesia, but the pain hasn’t returned. � ere’s zero pain now, when before it was a ten.”

Larry no longer su� ers with discomfort in his back or legs, so he’s able to perform his favorite activities. � ose include working in the garden, shades of his days on the ranch.

“My wife doesn’t call me a gardener,” Larry relates. “She calls me a landscaper because what I do requires a lot of physical activity. We walk daily as well. And I recently picked up an airbrush. I’ve been an artist all my life, so I’m moving into a di� erent level of art.

“I’m looking forward to getting back to boating and traveling. I had to cancel a couple of trips due to my back pain, but that’s all behind me now. I highly recom-mend Dr. St. Louis and his team at Physician Partners of America. � ey provided me with pain relief and in turn gave me my life back.”FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. ke

JAMES ST. LOUIS, DOKEITH GIRTON, MD

James St. Louis, DO, earned his Bachelor of Science and Masters of Science degrees from the University of Wisconsin, La Crosse. He received his osteopathic medicine

degree from the Kansas City University of Medicine and Biosciences, and completed his surgical training in the US Army and at Kennedy Medical Center in Cherry Hill, NJ. Dr. St. Louis is a member of many medical organizations including the American Osteopathic Association, American Osteopathic Academy of Orthopedics, American Medical Association and American Association of Physician Specialists.

L arry Solie grew up on a ranch, so he’s no stranger to responsibility and hard work out-doors. Every day, he toiled in the garden and cared for the horses. It was a natural transition when he became executive director of a wilderness pro-gram for troubled teens.

“The program operated over a fifty-thousand- acre spread in Central Oregon,” Larry describes. “We worked with three hundred teens a year. � ey learned tracking and navigation skills, how to build � res with-out matches and many Native American-style ways of living in the wilderness.

“Before I took over that program, I was head-master at a school for troubled boys. During that time, I met the founder of the wilderness program – an ex-ranger who wanted help with his business. We formed an alliance to cross-train our kids, and I eventually bought his program.”

Larry expanded the program, which was featured on a television series in 2003. The show garnered national recognition for Larry’s program as well as the attention of larger organizations doing residential and wilderness-based programming. Larry left his program in the capable hands of one of those organizations and retired in 2006.

Unfortunately, all those years of working on the ranch and hiking and sleeping on the hard ground in the wilderness took a toll on Larry’s back. � at distress was compounded by damage done to his back during his military career.

“I served during the Six-Day War, and we got banged around on my ship quite a bit,” Larry recalls. “When my

ship was torpedoed, I su� ered an injury to my spine that didn’t show up until later. Couple that with the

walking and lifting I did, and the strain on my back really got bad.

“The first symptom I noticed was weakness in my right leg,

followed by numbness and cramping in both legs. I also experienced pretty

intense pain in my back and down my left leg. � ere were

stabbing, sharp pains, then there were dull pains. It ran the gamut, but the pain was a ten on a scale of one to ten. If I lifted something, I could guarantee I’d be in pain for

days. I’m a very active person. It was di� cult for me to just sit still.

“My wife and I like to go boat-ing and travel, and I draw and paint outside, but with a bad back, I didn’t

do much but sit on ice and take pain pills. It got to the point that my wife

said, Look, I want to travel, but if you want to sit here in pain, I’ll

get you a subscription to the newspaper. � at prompted

me to seek treatment.”Larry already had

an idea where he’d go for help with his bad

back. His daughter worked for Physician Partners of America, and Larry

knew their surgeons performed minimally invasive laser spine surgery. Larry made an appointment and met with Dr. James St. Louis, director of the practice’s Minimally Invasive Spine Group.

Attachment Point “Upon evaluating Larry, I discovered that a dam-aged disc in his lower spine was pinching the nerves exiting through the openings in the spinal column, which are called foramen,” Dr. St. Louis explains. “Pressure on the nerves caused the pain in his back and numbness down his legs.

� e a� ected nerve is identi� ed after evaluating the patient’s symptoms and using MRI to pinpoint the speci� c nerve.

“To address Larry’s condition, I chose to perform two minimally invasive laser spine procedures, a lamino-tomy and a foraminotomy. � e goal of performing those procedures was to ease the pressure on Larry’s nerves and relieve his painful symptoms.”

A lamina is a part of the vertebral arch. A pair of laminae join with the bony projections that jut from the middle of the vertebrae, called spinous processes, to provide a point of attachment for the spine’s muscles and ligaments. A laminotomy is the removal of some of the lamina to relieve pressure from the bone pressing on the spinal cord.

“Minimally invasive laser laminotomy is performed through a half-inch incision in the back,” Dr. St. Louis explains. “� e incision is carefully placed with the help of a special x-ray called C-arm � uoroscopy. Laminotomy

Leaders in Interventional Pain Management and Minimally Invasive Laser Spine Surgery

(877) 331-6603

Physician Partners of America is committed to providing the highest levels of compassionate, patient-centered care possible. They have locations across Florida to serve you. To schedule a consultation with one of their pain management or minimally invasive laser spine specialists, call or visit one of their offi ces:

Keith Girton, MD, is board certifi ed by the American Board of Orthopaedic Surgery. He is a native of Columbus, Ohio and earned his medical degree from The Ohio State University College of Medicine. Dr. Girton completed a residency in family medicine at Miami Valley Hospital in Ohio and a residency in orthopedics at Fort Worth Affi liated Hospitals in Texas. During his second residency, he joined the US Air Force and was stationed at Scott Air Force Base near Belleville, Illinois. He was honorably discharged.

To learn more, visit them online at PPOASpine.com

Tampa N Habana

Avenue, Suite

St. Petersburg th Avenue N.

Suite B

CHARLES DEVINE, MDKATHLEEN CARROLL, MD

TROY NOONAN, MD

Charles Devine, MD, (center) specializes in psychiatry and neurology and has been in practice for more than years. He earned his medical degree from the University of South Florida College of Medicine in and later performed his residency at the University of South Florida. He is a member of the Florida Psychiatric Society and is a Fellow of the American Psychiatric Association.

Kathleen Carroll, MD, (left) specializes in psychiatry and neurology and has been in practice for more than years. She earned her medical degree from the University of South Florida College of Medicine in and later completed a general psychiatry residency at the University of South Florida. She received advanced training in electroconvulsive therapy at Bay Pines Veterans Administration Hospital and is a member of the Florida Psychiatric Society as well as a Fellow of the American Psychiatric Association.

Troy Noonan, MD, (right) specializes in general psychiatry, and child and adolescent psychiatry. He earned his medical degree from the Chicago Medical School at Rosalind Franklin University in Chicago, Illinois in and has been in practice for more than years. He is a member of the American Board of Psychiatry and Neurology.

The highly trained doctors and sta� members at TMS of Central Florida are committed to providing their patients with compassionate care in a comfortable environment. The staff utilizes the most advanced technology available in providing hope and healing for conditions such as treatment-resistant depression. If you’re su� ering from depression or another disorder that is making it di� cult to enjoy life or to function, call or visit the o� ce for a free consultation.

Be Your Best Self

(813)423-7037

Visit them online at www.tmscentral� orida.com

Nonsurgical, drug-free therapy restores passion for life

TMS is helping Mishelle enjoy life

again

Brandon1119 Nikki View Dr.

T o say that Mishelle Delfrate was once a fitness fanatic would be a bit of an understatement. For this 54-year-old native of El Paso, Texas, � tness was never just a pastime or even a passion. It was a way of life.

“It pretty much encompassed my life,” Mishelle con� rms. “I was a Zumba® instructor and a yoga instructor, and for years, that was where I drew most of my friends from and where a lot of the excitement in my life came from. It was my identity.”

Mishelle’s passion for � tness instruc-tion didn’t come without consequences. From simple wear and tear, she twice tore her left rotator cu� so badly that she needed surgery to repair it. However, it was a non-work-related shoulder injury that robbed her of her identity.

“I was on my way to a doctor’s appointment one day in 2011 when I got rear-ended,” Mishelle explains. “� e person who hit me never stopped and hit me so hard that as my car spun around, the seat belt cut into my shoulder and severed all the nerves.”

Mishelle’s third shoulder injury in two years required yet another surgery, but this time, the damage was so great that full range of motion could not be

restored to the shoulder, which she can no longer lift over her head.

That limited mobility ended Mishelle’s career as a � t