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Brandon/Sun City Center Edition Summer 2019

FEATURED ARTICLES

(see Back to Life, page 4)

Nonsurgical spinal decompression

alleviates debilitating pain

W hen Ernesto Galindo, 33, was a child, his father moved his fam-ily from Mexico to the

United States in search of work. � e fam-ily initially relocated to the West Coast, but as a migrant farmworker, Ernesto’s father took them across the country as he shadowed the crop harvests.

“We used to live in California when I was younger, but my Dad would fol-low the seasonal work,” Ernesto recalls. “We traveled to di� erent states, and the last state we came to was Florida. We ended up staying here, and I’ve lived In Florida since 2001.”

For several years, Ernesto followed in his father’s footsteps and worked on farms in the Sunshine State. His work required a lot of bending to pick the various crops, including tomatoes and strawberries. All those years of bending and picking had a negative impact on Ernesto’s back, and he began to experience back pain.

“About six years ago, while I was farming, I started feeling symptoms of back pain,” Ernesto con� rms. “At � rst, I essentially ignored it. I’d rest a little bit, then go right back to work.”

After three years of fighting those nagging back aches, Ernesto changed jobs and became an air conditioning techni-cian. � at job requires a lot of bending as well and plenty of twisting and turning, often in tight spaces. Like picking crops,

the air conditioning work has also had a negative e� ect on Ernesto’s back.

“� ree years ago, after I started as an AC technician, I began having terrible episodes of back pain two or three times a year,” Ernesto reports. “� e most recent episode was in October. It was so pain-ful that I couldn’t even walk. I couldn’t bend. I couldn’t do anything because I was in so much pain.

“It was a stabbing pain. It felt like my back was going to break. I could feel the pain when I bent a little bit, and it would throw me to the ground and I couldn’t move. I couldn’t walk straight; I walked sideways. � e pain was so severe, I couldn’t work for three months.”

� e pain in Ernesto’s back interfered with his family life as well.

“I like to play basketball with my kids when I get home from work,” he relates. “� ere’s a park in our community, and every day we would go there and play. But I couldn’t do that while I was in pain. I couldn’t go anywhere really. My family always went places without me, then I

would get mad really easily. I was always grumpy because of the pain.”

Ernesto’s doctor performed an exam-ination and ordered an MRI to determine the cause of his intense pain. It was dis-covered that Ernesto had two herniated discs and resulting pinched nerves.

Due to the severity of Ernesto’s pain, the doctor recommended spine surgery and even went so far as to schedule a pro-cedure. But Ernesto wasn’t convinced that was the direction he wanted to go.

“I did a lot of research on spine surgery and talked to a lot of people who have back problems,” he states. “They were telling me not to have sur-gery, so I backed out of that surgery at the very last minute.

“Then I did some additional research and saw that Preferred Injury Physicians had very good reviews. So, I went to the office. As soon as I walked in, everybody there saw that I was in pain and quickly attended to me.”

Preferred Injury Physicians is a full-service chiropractic practice with nine locations in Florida including in Brandon, Tampa and Wesley Chapel. � e practice is devoted to the nonsurgical treatment of neck and back disorders that can result in severe pain and disability. Travis Utter, DC, owner/operator of Preferred Injury Physicians, remembers Ernesto’s � rst visit.

TRAVIS UTTER, DC

Ernesto Galindo

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11

ChiropraCtiC

ROBERT C. LUPO, DC

Robert C. Lupo, DC, is the clinic director and a chiro-practic physician at Physical Medicine Center, which off ers holistic health care, chiroprac-tic and primary medical care as well as physical therapy. Treatments include spinal decompression, stem cell/PRP, addiction management,

bio-identical hormone replacement, weight loss and IV nutrition. Dr. Lupo received his Doctor of Chiropractic degree from Life University in Marietta, GA, and has done postgraduate work in nutrition, chiropractic orthopedics, neurology, spinal disc injury care and auto accident injury care. He is a member of the American Academy of Anti-Aging Physicians.

Sound Advice Acoustic wave technology delivers hope for ED

For Radiant Health

Physical Medicine Center is a multidisciplinary treatment and care center. To schedule

a consultation, please contact or visit the o� ce in

New Tampa at:

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For more information on Physical Medicine Center, go online to mybackinplace.com

Y ears ago, when Calvin* was in the United States Marine Corps, he was stationed at a radar

installation. Somehow, signs desig-nating the area around the control room were removed, and Calvin was exposed to a type of radiation.

Calvin can’t say for sure that it was the radiation exposure that caused it, but soon thereafter, he started having problems with erec-tile dysfunction (ED), which is the inability to achieve or maintain an erection suitable for sexual activity.

“After that incident, I was told I’d probably never have children either,” Calvin shares. “Fortunately, God intervened, and I had three great kids. But I’ve had severe erectile dysfunction for almost twenty-� ve years, since I was about forty-seven or so.”

Some men may be embarrassed to talk about ED, but it’s a common issue, one that a� ects about 52 percent of all men. And of those a� ected, more than half are aged 40 to 60.

ED is frequently related to impair-ment of the tiny blood capillaries in the penis and urogenital area, which hinders the natural erectile response. Vasculogenic issues, causing decreased blood � ow, are estimated to a� ect about 80 percent of men with the condition.

“I went to a urologist back home in Maryland who said my ED was pretty classic,” Calvin continues. “He said it often starts with position. At first, I couldn’t lie in bed and have sex with my wife; I had to stand up. Eventually, even standing up, I couldn’t keep an erection. We’d start having sex, and I’d lose it. It frustrated my wife to the nth degree.”

While living in Boston, Calvin went to a men’s clinic for advice and treatment. Doctors there diagnosed him with very low testosterone, and initially treated him through hormone replacement therapy.

� e increased testosterone in his sys-tem caused him more side effects than bene� ts, and did little to correct his ED. As a result, Calvin later tried medications

such as Viagra®, Cialis® and Levitra®. He also used an ED pump and took ED injec-tions. None produced the desired e� ect.

� en, after relocating to Florida sev-eral years ago, Calvin began searching for a new doctor to treat his ED. Calvin discovered that Robert C. Lupo, DC, of Physical Medicine Center in Tampa offered a non-drug treatment for ED called GAINSWave®.

“I spoke with Dr. Lupo, and he asked me what I wanted to achieve with the treatment,” Calvin says. “I told him I just wanted to be able to get an erec-tion and that I’d been exposed to radiation while in the Marine Corps and again in 2008 as part of my treat-ment for prostate cancer. That also contributes to ED, and he said, We can start therapy today, but I make no promises. I agreed to the treatment and started therapy with GAINSWave.”

Unique Treatment“GAINSWave is a unique treatment that uses sound-wave technology to clear the tiny microvessels in the urogenital region,” explains Dr. Lupo. “� is increases circulation to the penis, which improves sensitivity and the quality of the erection, intensifying the entire sexual experience.”

Dr. Lupo says GAINSWave uses the same technology that has been e� ective for years in the US and Europe to treat plantar fasciitis; heel, knee and elbow pain; scar tissue, tendonitis and connec-tive tissue injuries.

“GAINSWave emits concentrated blasts of sound waves akin to ultrasound or sonar technology,” he educates. “� ese sound waves travel faster than the speed of sound, and when applied through the correct number of pulses,

frequency and energy, they can have a positive e� ect on tissue to restore blood � ow and nerve sensitivity.”

Some men have experienced a renewed ability for healthier erections after only a few GAINSWave treatments, reports Dr. Lupo. Just two painless treatments per week over a three-week period is all most men need to restore or improve erectile function.

“GAINSWave’s ability to improve blood � ow, increase new vascularization

and increase nerve sensitivity in the urogenital region has been pretty phe-nomenal,” declares the doctor. “The erection ability is stronger, longer, better and more impressive. It’s tak-ing men back to more youthful times in their lives with-out the necessity for medications.”

The noninva-sive GAINSWave therapy is also used to successfully treat a painful syndrome called Peyronie’s

disease. This condition is the result of a build-up of scar tissue and causes cur-vature of the penis.

In addition to receiving GAINSWave treatments, Calvin was also given another treatment by Dr. Lupo called the P-Shot®. � e P stands for platelet-rich plasma, or PRP, which Dr. Lupo says he uses in really tough cases when there is a lot of scar tissue, damage or Peyronie’s disease.”

With PRP, Dr. Lupo extracts the patient’s own platelets from his blood to obtain a high-quality platelet solution. He then injects the solution into strate-gic points in the penis. � e PRP contains many growth factors and healing sub-stances, so it begins to rejuvenate and heal the tissues of the penis.

“The P-Shot is like fertilizer that makes the cells in the tissue grow,” notes

Dr. Lupo. “It helps patients with scar tissue achieve more improve-ment with GAINSWave. In Calvin’s case, the combination therapy made him responsive to TriMix, which he had not responded to previously. TriMix is a di� erent type of injection made up of three med-ications that help men achieve and maintain erections.”

Full of AppreciationCalvin had many factors working against him. In addition to the radia-tion exposure in the Marines, he had additional exposure during his treat-ment for prostate cancer. He also had the resulting scar tissue as well as the low testosterone level. It was a lot to overcome, but he felt he made tre-mendous strides with GAINSWave.

“I started GAINSWave, and very slowly, things started to hap-

pen,” Calvin recalls. “I woke up one morning with an erection, and I can’t remember the last time I had a morning erection. I was thrilled to death. � en a week or two after that, I woke up several times during the night with nocturnal erec-tions, which are normal in healthy men.

”My condition since GAINSWave is better,” enthuses Calvin. “To have intercourse with my wife and have it to completion, I still need an injection of TriMix, but to me, GAINSWave therapy has been successful because I’ve come so far. I’m thrilled with the results I’ve achieved.”

For Calvin, GAINSWave is not a one-and-done treatment. He regularly returns for follow-up sessions to further the improvement he’s made with the therapy.

“I went through the initial course of therapy and renewed the treatment several times,” he states. “Now, I call Physical Medicine Center, go in and get treated a few times. � en, I stop for a month or two, then go in for a few more treatments. I truly appreciate everything Dr. Lupo has done for me.”

Adds Dr. Lupo: “We’re very encour-aged by what GAINSWave has done for hundreds of ED patients without harm-ful side e� ects. Any man who wants to restore youthful performance should call us to explore this option.”FHCN staff article. GAINSWave graphic courtesy of

GAINSWave. mkb

*Patient’s name withheld at his request.

Page 2 | Florida Health Care News | Summer 2019 | Brandon/Sun City Center Edition ErECtilE DysfunCtion

KELLY ENNIX KING, MD

Visit Releaf MD on the web at www.ReleafMDonline.com

Kelly Ennix King, MD, is board certifi ed by the American Board of Internal Medicine and is trained in primary care and hospital medi-cine. She earned her medical degree from the University of Tennessee School of Medicine and completed her residency at Alameda County Medical Center in Oakland, CA. In addition to primary care, Dr. King has experience as a hospitalist as well as a hospice, palliative and geriatric care provider. She is a member of Minorities for Medical Marijuana, the Florida Cannabis Coalition and South Florida NORML.

Freedom From Pain Without

NarcoticsDr. King and her staff at Releaf MD look forward to helping new patients on their journey toward eliminating narcotic pain medications from their lives. To schedule a confidential consultation, visit or call their offi ce in Brandon at:

505 Eichenfeld DriveSuite 107

(844) 735-3231

Flash ForwardMedical marijuana calms distressing symptoms of PTSD

O n the outside, Trent* is a successful businessman at a thriving company. But few are aware of the

struggles he faces internally. Most of his emotional distress can be connected to his two tours of duty in Iraq with the US Army Corp of Engineers.

“During my second tour of duty, I was on the bomb squad, and our primary mission was to counter IED [impro-vised explosive device] operations,” Trent describes. “Our job was to go out every day and cruise the streets of Baghdad look-ing for roadside bombs to disassemble.

“We successfully disarmed just under two hundred roadside bombs, but we also had several explode on us. It was really scary when they exploded.”

Once Trent’s second tour in Iraq ended, he returned to the United States. At � rst, he felt � ne and thought everything was going well. But over the course of the year, he began experienc-ing di� culties in his day-to-day life, and that concerned him.

“I wasn’t sleeping well, and I was facing some physical and emotional challenges,” Trent shares. “I had trouble concentrating, my anxiety level was high and I was su� ering from headaches.

“I also experienced � ashbacks to my time on the bomb squad and saw things that weren’t there. If I drove past a gar-bage pit where someone was burning garbage, that was a very strong � ashback trigger for me. I � nally realized I needed professional help.”

Trent initially sought assistance from the Veterans Administration, where medical center sta� diagnosed his condition as post-traumatic stress disorder (PTSD). To treat it, the doctors at the VA prescribed medications for sleep, anxiety and depression.

“I tried the medications, but they didn’t work,” Trent relates. “And I was concerned about the serious side e� ects that can occur with them. I respect the doctors at the VA, but the tools they had available just weren’t helping me, so I started looking for alternative ther-apies. I did an internet search and found Dr. King at Releaf MD in Brandon.”

Kelly Ennix King, MD, is a board-certi� ed internist who is licensed to treat patients in Florida with medical mar-ijuana. At Releaf MD, Dr. King tailors safe treatment plans for patients with var-ious conditions, including PTSD, using medical cannabis. She is among the three percent of Florida physicians licensed to prescribe medical marijuana.

“One of the main compounds found in marijuana is cannabidiol,” Dr. King says of the extract better known as CBD. “It is a very potent anx-iolytic, meaning it is extremely e� ective at diminishing anxiety in patients and helping to relieve the other distressing symptoms of PTSD. � at’s why I rec-ommended medical cannabis as a good option for treating Trent’s condition.”

At � rst, Trent was a little uncer-tain about using medical marijuana for his PTSD, but after speaking with Dr. King, he was motivated to try the alternative treatment.

“I’m a skeptical person by nature,” he states. “But with Dr. King, I felt con� dent that I was working with a doctor who was committed to me and believed in what she could do for me. When I walked out of her o� ce at Releaf MD, I was excited about exploring an alternative to medica-tion for treating my PTSD.”

Dispensing Relief With PTSD, the thoughts about a trau-matic event and the feelings about those thoughts originate in an area of the brain called the amygdala and the hippocampus, Dr. King explains.

“Another main compound in medical marijuana, THC, works at the amygdala and hippocampus to help uncouple those thoughts and feelings,” the doctor notes. “As a result, patients’ thoughts and feel-ings about their traumatic event are not as intense or debilitating.”

Another common problem a� ecting people with PTSD is di� culty sleeping.

“During the day, there are many inhi-bitions present as people focus on their daily activities,” Dr. King informs. “But at night, these inhibitions are no longer present. � e thoughts about the traumatic event become much more prominent, and many times result in nightmares and night terrors. THC helps people relax and promotes sleep.”

Dr. King tailors a treatment plan to each patient’s symptoms and diagnosis. Often, she uses more than one strain of medical marijuana and more than one method of delivery, which might include sublingual drops or edible or topical formulations to fully address the patient’s needs.

“I use several combinations depend-ing on what the patient’s symptoms are,”

she veri� es. “Indica is a type of cannabis plant that we prescribe for patients to use during the evening and at night. It helps with things such as relaxation and sleep, whereas Sativa is a strain that we utilize during the day. It is more ener-gizing and stimulating.

“The dispensaries offer the different strains as well as extracts in which they adjust the levels of CBD and THC. � at is the beauty of medical marijuana. I can use dif-ferent formulations and rotate the routes of delivery to address a patient’s symptomology.

“Patients’ symptoms are going to be di� erent throughout the day, so di� erent strains and delivery routes are especially useful for addressing that. And one per-son’s PTSD is not exactly like another

person’s PTSD. That’s why we target each person’s particular symptoms and circumstances.”

Initially, Dr. King made several sug-gestions for Trent’s treatment plan. After discussing the risks and benefits with Trent, Dr. King chose a treatment regi-men consisting of a CBD-THC mixture using the two marijuana strains and sev-eral routes of delivery.

“At Dr. King’s recommendation, I use some medical marijuana products that are e� ective during the day and some that are more e� ective in the evening,” Trent states. “I might use drops in the evening and maybe something edible or a vape cartridge during the day. � e best thing is, it’s working for me.”

Leaving Worries BehindDr. King’s treatment plan for Trent, with its combination of medical cannabis strains and multiple delivery methods, is working well for him. Trent’s PTSD symptoms are dramatically improved, and he is back to experiencing a more “normal” day-to-day life. He’s extremely pleased with his degree of improvement using the alternative therapy.

“� e medical marijuana treatment at Releaf MD is absolutely successful,” Trent raves. “I sleep much better now, which is the best part of the results for me. My anxiety and headaches have also decreased dramatically.

“� e � ashback triggers still exist, but I’ve noticed that my threshold for the triggers is higher now. � ey’re much easier to handle.”

Not only were the medications from the VA doctors ine� ective for Trent, he also worried about the drugs’ side e� ects. But after beginning his medical marijuana therapy at Releaf MD, he left most of those worries behind.

“I’m not currently using the majority of the medications the doctors at the VA

originally prescribed because I no longer need them,” Trent says. “� at’s probably the most important thing to me. I believe there’s a time and place for medication in treating disorders like PTSD, but they weren’t doing the job for me.

“Dr. King and her medical mari-juana treatment are doing the job for me. Dr. King is a godsend!”FHCN article by Patti DiPanfilo. mkb

*Patient’s name withheld at his request.

Brandon/Sun City Center Edition | Summer 2019 | Florida Health Care News | Page 3MEDiCal Marijuana

(continued from page 1)

“Ernesto came to us in December 2018,” the doctor notes. “He told me he had not been able to work for three months because of his back pain. � ere was not any accident, injury or single factor that initiated his pain. Rather, it was something that simply progressed over time, likely exacerbated by his occupation.

“Ernesto had gone for a surgical consultation, and it was looking like he might end up needing surgery. However, he did not have health insurance at the time, so that would have been an exorbitant cost for him. He was very interested in our nonsurgical treatment protocol for back pain.”

Sophisticated SolutionPreferred Injury Physicians’ treatment protocol for back and neck pain is a package of therapies that includes nonsurgical spinal decompression, spinal manipulations and physical therapy. Spinal decompression, however, is the cornerstone of the protocol.

“Spinal decompression is an excellent nonsurgical conservative option for dealing with various spinal conditions, the biggest being disc bulges, disc herniations, facet syndrome and even spinal stenosis,” Dr. Utter informs.

Before treatment with spinal decompression, doctors � rst deter-mine the major factors contributing to the patient’s pain and other symptoms. � ey do this by correlating the � ndings from a physical examination to the results of imaging tests such as x-ray or MRI.

“When we examine all of this information, we are able to hone in on the speci� c level of the spine where the problem is occurring,” Dr. Utter explains. “At Preferred Injury Physicians, we use a very sophisticated spinal decompression table that allows us to isolate a speci� c level of the spine for treatment.

“Sometimes, there is more than one spinal level contributing to the pain. Our table also allows us to start working on one level, achieve some ben-e� t, then move on to treat the next level.”

� e spinal decompression treatment itself is rather simplistic, Dr. Utter asserts, especially in cases of disc hernia-tion, which was Ernesto’s diagnosis. With a herniation, pain comes from compression of the spinal nerves by collapsed vertebrae or by the material from the center of the disc seeping out through the break, or herniation, in the disc.

“� e bones of the spine, or vertebrae, along with the bulged or herniated disc can compress the nerves that exit the spine. Spinal decompression pulls those bones apart, but extremely gently,” Dr. Utter describes. “As it starts to separate the bones, it creates negative pressure inside the center of the disc. � is negative pressure sucks in the disc material that has herniated onto the nerves.

“By pulling back that disc material, the amount of water and nutrients needed to start e� ectively controlling, containing and repairing the herniation is increased. Spinal decompression is typ-ically administered in a series of treatments that e� ectively build upon each other. Over time, there is continued improvement until the patient is stable and can be discharged from care.”

“I Have Zero Pain”“� e spinal decompression treatment took the pressure o� of my spine,” Ernesto shares. “I could feel the machine pull me, but it wasn’t painful at all. When I � rst went to Preferred Injury Physicians, they put electrical stimulation on my back, then a heating pad to loosen my muscles before I went for the decompression. It felt really nice.”

Ernesto completed Preferred Injury Physicians’ entire treat-ment protocol for his back pain, but he was most impressed by the

e� ectiveness of the spinal decompression. He was especially pleased because decompression is nonsurgical, and he wanted to avoid a surgical procedure.

“As soon as I � nished my � rst spinal decompression treatment, I could walk better,” Ernesto raves. “I was a little sore, but after three or four treatments, I started feeling even better. I could stretch more and my back felt good.

“I was amazed by how quickly I was able to go back to work, because after just two weeks of treatment every day, I went to Dr. Utter and asked him if I could go back to work because I felt that much better.

“I’m also back to playing basketball with my kids. Every day, we go out and play. And I’m a lot less grumpy with my family. I’m back to normal again.”

Ernesto says that before he underwent spinal decompression therapy, his back pain averaged a seven on a scale of one to ten. After two weeks of

treatment, his pain level was down to two.“Right now, I have zero pain,” he enthuses. “But if I overdo it,

like if I work really late or work a lot, I might feel a little bit of pain coming on. But then I rest, and the pain goes back to zero again.”

To better accommodate his ongoing back condition, Ernesto has adjusted his work duties to ease the stress on his spine. He’s grateful to his employers for their cooperation, but he cred-its most of his pain relief to Dr. Utter and his treatment at Preferred Injury Physicians.

“I do a lot of service work now, more troubleshooting,” Ernesto describes. “That’s less heavy work and lifting than the installations I used to do. My company was good to move me to service. It’s a lot easier on my back.

“Going to Preferred Injury Physicians was the best thing I’ve done. � ey treated me very, very well, and I feel great now. I recom-mend Preferred Injury Physicians to anybody who has back pain.”FHCN article by Patti DiPanfilo. Photos by

Jordan Pysz. mkb

Travis Utter, DC, earned a Bachelor of Arts degree in communica-tions from the University of Central Florida in Orlando and a Doctor of Chiropractic degree from Palmer College of Chiropractic. He received additional training in NCV/EMG from the Neurodiagnostics Institute

and in whiplash and accident reconstruction from the Spine Research Institute of San Diego. Dr. Utter is certified in whiplash and

accident reconstruction.

Relieved of his back pain, Ernesto says he is “back to normal again.”

Find Preferred Injury Physicians online at www.pipdoc.com

Page 4 | Florida Health Care News | Summer 2019 | Brandon/Sun City Center Edition

Barry LevineExecutive Publisher

Dan OchmanSenior Associate Publisher

Gina L. d’AngeloCFO/HR

Roy CummingsEditorial Supervisor

Michelle BrooksCreative Director

Brian LevineProject Coordinator

Patti DiPanfiloAnnette MardisEditorial Staff

Laura EngelProduction Assistant

Nerissa JohnsonGraphic Designer

Nerissa JohnsonJordan PyszFred BelletPhotography

Steve TurkMario Hill

Robert MizeGary Smith

Aldy LaracuenteDistribution

Preferred Injury Physicians Chiropractic

Physical Medicine Center, Inc.Erectile Dysfunction

Releaf MDMedical Marijuana

Hawthorne Village of BrandonRetirement Community/AL 9949

Florida Eye Specialists & Cataract Institute

Ophthalmology

Riverview Chiropractic CenterChiropractic

South Florida Eye ClinicOphthalmology

Regenerative Orthopedic InstituteStem Cell Therapy/ Pain Management

Holistic Medical Care Clinic, LLCHolistic Medicine

HemWell AmericaHemorrhoid Treatment

Brandon TMS & PsychiatryDepression

Physician Partners of AmericaPain Management/Spine Surgery

215 Bullard ParkwayTemple Terrace, FL 33617

(813) 989-1330

Florida Health Care News

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ChiropraCtiC

To learn more, please visit www.Hawthornevillageofbrandon.com

Mail to:Hawthorne Village of BrandonAttn: Administration W. Lumsden Rd.Brandon, FL () -

YES! Please send me additional FREE information about:

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Hawthorne Village of Brandon

Family TiesParent’s positive

experiences in� uence career decisions

I t wasn’t long after she moved her mother into the long-term care community at Hawthorne Village of Brandon that Patti Bramble

found her passion for senior care while serving as the marketing director for an assisted-living community.

Three years later, at a time when she was preparing to leave that industry, Hawthorne Village’s plans for expansion and her own positive personal experience with that community lured her back in.

“Hawthorne Village was opening its independent living community, � e Estates, and somebody from there saw me one day and said, I’ve been trying to � nd you,” says Patti, � e Estates manager. “When I asked why, they said, we want you to come to work at Hawthorne.

“I told them I was actually mov-ing away from senior housing, but they encouraged me to come and talk to them anyway. After that chat, I thought, you know, I think I’d be interested in helping to open this up. � at was in 2000, and I’ve been here ever since.”

It wasn’t just the opportunity to man-age its independent living community that drew Patti to Hawthorne Village.

It was the warm, friendly feeling she got whenever she visited the community to see her mother, who passed in late 1997.

“� ere’s a special feeling you get when you walk through the doors, and it’s really that feeling that lured me here,” Patti says. “There’s a very friendly, home-like atmosphere, and it made so much of an imprint on me that I wanted to be a part of it.

“� e other thing that I had a strong feeling towards is the value we offer. Having been in the industry, I knew there were similar products. But we o� er the same services and with just 69 apartments, we have more of a boutique-like setting.”

More Than Meets the EyeLocated just east of Tampa, Hawthorne Village of Brandon is a not-for-pro� t,

full-service retirement community com-posed of three separate facilities. Each specializes in its own speci� c aspect of carefree retirement living and wellness.

For seniors who are looking for max-imum independence and privacy, The Estates o� ers the opportunity to live an active and independent lifestyle in an exquisite apartment home nestled inside a carefree, amenity-� lled environment.

For seniors who want to live inde-pendently but need assistance during the day or night, Hawthorne Inn provides highly trained professionals who can o� er medication assistance as well as aid with basic daily activities such as bathing, dressing and grooming.

And for seniors who require special-ized memory care, Hawthorne Village o� ers its Garden Court, where sta� mem-bers are trained in activity-based programs designed to minimize the negative e� ects of Alzheimer’s disease and dementia.

Hawthorne Village of Brandon also o� ers skilled nursing and rehabilitation therapies on an inpatient and outpatient basis through its Bounce Back Rehab® program, which is designed to help seniors recovering from major illness or trauma regain function and mobility.

Love at First SightIt’s in Hawthorne Village’s skilled nursing and rehabilitation building that you’ll � nd Maureen Tornillo, a semi-retired personal trainer who, much like Patti, developed a unique passion for the retirement commu-nity after moving her parents there in 2004.

“My parents fell in love with The Estates the very first time I brought them here for a visit,” says Maureen, a semi-retired personal trainer. “And after they moved in they were so happy. � ey loved the independence and the security of knowing that if they did need help, it was close by.

“I think the years they spent here were probably some of the happiest years of their lives together. I remember my father telling me once, I’m so glad you found this place, because it’s just great, we love it here, and I agreed with him.

“I actually told my dad, one day I’m probably going to come to work here, and

I did because when you walk through the door here, you feel like you’re home. That’s the feeling I got whenever I came to see my parents here, and it’s the feeling I get now.

“� ere’s just a warmth about it, and it doesn’t come from the walls. It comes from the people. You get the feeling that you’re welcome, that you are among family and friends and that you’re cared for and cared about.”

Maureen’s parents lived together in a two-bedroom suite in � e Estates for � ve years. After her father passed away, her mother transitioned into a one-bedroom suite in the assisted-living community.

Patti says the experience she and Maureen gained while moving their parents into the retirement community is one that allows them to better aid others who are bringing their parents to Hawthorne Village.

“I know that when people come and sit down with me here, they’re feeling a lot of emotions,” Patti explains. “And I know the person or the couple that’s moving into an apartment here aren’t the only ones who have those feelings.

“It’s everyone in the family; it’s their friends. We are really attuned to what they’re going through and how they’re coping, so we’ve learned to become really good listeners. That’s how you come to understand their real needs and wants.

“Sometimes you need to peel away the onion because they’re hinting at something they need but not really expressing it, and it’s important to understand that need so that they will have the best experience possible.

“We know how stressful and emo-tional this time can be and having people around who have experienced that time and know what to expect of it the way Maureen and I have, I think that helps us make the transition just a little easier for our residents.”FHCN article by Roy Cummings. Photos by Jordan Pysz. mkb

Patti (left) and Maureen are part of the fabric at Hawthorne Village.

Brandon/Sun City Center Edition | Summer 2019 | Florida Health Care News | Page 5rEtirEMEnt CoMMunity/al 9949

Ronni M. Chen, MD, is a board-certifi ed ophthalmologist. She completed her undergraduate studies, graduating with highest distinction, at the University of Michigan, Ann Arbor, and received her medical degree from the University of Michigan Medical School, Ann Arbor. Dr. Chen completed a transitional internship at Saint Barnabas Medical Center, Livingston, NJ, and her residency in the Department of Ophthalmology at Baylor College of Medicine, Houston, TX, where she also received fellowship training in pediatric ophthalmology and strabismus. Dr. Chen is a member of the American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology and American Medical Association.

Marguerite Kohlhepp, MD, is a board-certifi ed ophthalmologist. She completed her undergraduate studies, graduating summa cum laude, at State University of New York at Albany and earned her medical degree from the Stony Brook School of Medicine, State University of New York at Stony Brook. She completed an internship in the Department of Pediatrics at Stony Brook University Hospital, Stony Brook School of Medicine, and another in the Department of Internal Medicine, Winthrop University Hospital, an affi liate of Stony Brook School of Medicine, Mineola. She completed her residency in ophthalmology at Catholic Medical Center, Albert Einstein College of Medicine of Yeshiva University, Flushing, NY, and is fellowship trained in vitreo-retinal surgery through the University of Nebraska, Omaha. Dr. Kohlhepp is a member of the Pasco County Medical Society, American Medical Association and the American Academy of Ophthalmology.

Charles A. Luxenberg, MD, is a board-certifi ed ophthalmologist who completed his undergraduate studies at Union College in Schenectady, NY and his medical degree at Downstate Medical College in Brooklyn, NY. He then completed a medical internship at Beth Israel Hospital in New York and an ophthalmology residency at University of South Florida Medical Center in Tampa. He is a member of the Pinellas County Medical Society, Florida Medical Association, Tampa Bay Ophthalmological Society, American Academy of Ophthalmology and American College of Surgeons.

Robert J. Applebaum, MD, MBA, began his undergraduate education at Georgetown University in Washington, DC, then transferred to the University of North Carolina at Chapel Hill, where he earned a Bachelor’s degree in Public Policy with a specialization in Health Policy. He then completed a combined MD and MBA program at the University of Florida in Gainesville. Dr. Applebaum completed a one-year transitional internship at the Virginia Tech University Carilion School of Medicine and an ophthalmology residency at the University of South Florida in Tampa. Following his residency, Dr. Applebaum completed a fellowship in oculofacial plastic and reconstructive surgery at the J. Justin Older Eyelid Institute in Tampa.

Sight For LifeAt Florida Eye Specialists & Cataract Institute, the goal is to o� 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:

GREGORY L. HENDERSON, MD, FACSRONNI M. CHEN, MD

CRAIG E. MUNGER, MD, PHDDAN P. MONTZKA, MD

DEEN G. KING, MDWILLIAM A. REEVES, MD

MARGUERITE KOHLHEPP, MDIGNATIUS C. CYRIAC, MDANA-MARIA OLIVA, MDNANDESH PATEL, MDL. RAY ALONZO, OD

EDWARD J. HUGGETT, ODJAMES X. LAWRENCE, ODDILIP RATHINASAMY, MD

ROBERT J. APPLEBAUM, MD, MBACHARLES A. LUXENBERG, MD

T he eye may be a small organ in the body, but it plays a big role in sensory perception. People receive more than 75 percent of

their information about the world around them through the sense of sight.

� e highly trained ophthalmologists at Florida Eye Specialists & Cataract Institute are committed to pro-tecting eyesight and the health of their patients’ eyes. In April 2018, the Institute shared that vision and opened a sat-ellite clinic in Riverview.

“Our vision is to be a full-service center in Riverview, taking care of a com-plete range of eye disorders,” emphasizes Robert J. Applebaum, MD, a board-certi� ed ophthalmologist at the Riverview and Brandon locations. “We perform routine eye exams and prescribe eyeglasses, but we also treat more serious con-ditions such as diabetes-related eye diseases, macular degeneration and glaucoma, as well as perform cosmetic surgery.”

“It’s exciting for Florida Eye Specialists and Cataract Institute to have a location in Riverview,” o� ers Ronni M. Chen, MD, a board-certi� ed ophthalmologist who is fel-lowship trained in pediatric ophthalmology. “I’m excited to provide specialty pediatric eye care in Riverview. I think it’s a great ser-vice to children and families in the area.”

Physicians in multiple specialties, including oculoplastic surgeons and retina specialists, rotate through the Riverview clinic, so area residents don’t need to travel for specialty eye care. And the physicians have access to advanced technology for testing and treatment.

“� e Riverview clinic is state-of-the-art,” Dr. Applebaum asserts. “� e o� ce has the most updated equipment available, including a device that produces three-dimensional pictures of the retina as well as a high-tech peripheral visual � eld machine. We’ve also got two lasers that we use to treat various eye conditions.

“We have a very friendly sta� , including a great office manager and front desk per-son. All of the techs who rotate through the clinic are highly motivated, really care about the patients and do an excellent job. I believe Florida Eye Specialists and Cataract Institute at Riverview is an excellent place to come for eye care.”

Laser RelationsAs part of a routine eye exam, Charles A. Luxenberg, MD, a board-certified ophthalmologist, measures his patients’ vision and prescribes eyeglasses. � e ophthalmolo-gist also evaluates the overall health of his patients’ eyes and checks for any eye disorders.

Riverview13106 Vail Ridge Dr.

(813) 392-3311Brandon

403 Vonderburg Dr., Suite 101

(813) 681-1122Sun 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

“We treat many conditions in Riverview, including eye infections, in� ammatory disor-ders, cataracts and glaucoma,” Dr. Luxenberg acknowledges. “If we discover cataracts, we refer the patients to our Brandon location for surgery, but we follow-up with them in Riverview for their postoperative care.

“Sometimes, a patient’s lens capsule will become cloudy following cataract sur-gery. If that occurs, we can perform a simple laser procedure to clear it up and return the patient’s vision to its post-surgery clarity.”

Dr. Luxenberg also uses a laser to treat the two main types of glaucoma, open-angleglaucoma and narrow-angle glaucoma. For open-angle glaucoma, the laser works

directly on the out� ow � lter, or trabecular meshwork, of the eye. Opening up this mesh-work with the laser enables the � uid in the eye to � ow better, which lowers eye pressure.

“With open-angle glaucoma, something is wrong with the trabecular meshwork and its function is impaired,” Dr. Luxenberg explains. “As a result, there’s a back-up of � uid, which causes increased pressure in the eye. High eye pressure can damage optic nerve � bers, and that can lead to visual � eld defects and eventually blindness.

“With narrow-angle glaucoma, the angle of the out� ow tract is narrow due to the anat-omy of the person’s eye. � is narrow angle causes the problem with � uid � ow rather than the out� ow � lter itself being impaired. We use the laser to widen the angle.”

Treating patients with lasers is an important part of Dr. Luxenberg’s work at Florida Eye Specialists & Cataract Institute at Riverview. Another key function he performs is treatment for the terrible twosome of eye disorders: blepharitis and dry eye syndrome.

Blepharitis is an infection of the eyelids and eyelashes. It is most often caused by an overgrowth of bacteria living along the mar-gins of the eyelids and at the base of the lashes.

Dry eye syndrome, which is generally the result of clogged glands, is a con-dition where there a ren’t enough tears on the surface of the eye to keep it adequately l u b r i c a t e d , thus the eyes become dry.

Blepharitis and dry eye commonly occur simultaneously. If left untreated, these con-ditions can lead to permanent eyelid and tear gland dysfunction as well as corneal damage.

“We treat dry eye with various eye drops, including the prescription drops RESTASIS® and Xiidra®,” Dr. Luxenberg observes. “We also use a laser procedure to close the tiny openings in the eyelid that drain � uid, called punctum. � is procedure, laser punctal ablation, keeps the tears on the surface of the eye longer.

“For blepharitis, we recommend eyelid scrubs twice a day and also suggest a very effective therapy using a machine called BlephEx®. During a BlephEx treatment, we use the instrument to clear all of the debris from the eyelid margin and the lashes. It also thoroughly cleans those areas to kill any bacteria growing there.”

Functional and CosmeticDr. Applebaum is the son of a cardiologist, so he had no shortage of inspiration to become a physician himself. But he wanted to be highly specialized, so he opted to pursue ophthalmology and focus his skills further by completing a fellowship in oculoplastic surgery. Oculoplastic surgery is a subspecialty that concentrates on cosmetic and recon-structive surgery of the face and eye area.

Dr. Applebaum uses his skills in oph-thalmology and oculoplastic surgery to perform a wide range of cosmetic and functional procedures on the face and eyes, including blepharoplasty, at Florida Eye Specialists & Cataract Institute at Riverview.

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

“With upper blepharoplasty, excess skin is removed from the upper eyelids, which can droop due to muscle weakness. The 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 cos-metic 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 for-ward and appear as pu� ness under the eye. Lower blepharoplasty can diminish the look of tiredness and aging by decreasing excess fat and skin beneath the eyes.”

Dr. Applebaum performs many other surgical procedures at the Riverview clinic as well. � ese include reconstructions following skin cancer removal, endoscopic eyebrow and forehead lifts, tear duct surgery, earlobe recon-structions and correction of eyelid malposition.

In addition to these surgical proce-dures, Dr. Applebaum also o� ers a variety of nonsurgical facial cosmetic services. � ese include BOTOX® Cosmetic injections and a variety of facial � llers. � ese options can help reverse the changes associated with aging.

“BOTOX Cosmetic is a synthetic toxin that is altered so that it is non-toxic to the body of a healthy person,” Dr. Applebaum notes. “It blocks the release of neurotrans-mitters that trigger muscle contractions.”

A m o n g t h e f i l l e r s u s e d b y Dr. Applebaum are JUVÈDERM® , VOLUMA® and RESTYLANE®. Many � llers contain hyaluronic acid, a substance found naturally in the body that helps restore vol-ume and hydration to the skin.

“Over time, materials in the skin, includ-ing the collagen and base membranes, break down, so the face begins to sag,” the doctor explains. “We use these � llers in the cheeks to add volume and give the face a nonsurgical lift.

“We also use fillers in areas slightly lower on the face to decrease the appearance of � ne lines and wrinkles around the nose and lips. Oftentimes, we use them in the lips to give the lips more fullness.

“KYBELLA® is another � ller that is used speci� cally to decrease the appear-ance of a double chin. It is injected into

the fatty tissue of the chin, where it breaks down the fat cells, reducing the appear-ance of fat under the chin.”

Retinal Restraints� e retina is a thin layer of specialized tissue that lines the back of the eye. It senses light as it enters the eye and sends it to the brain to process as images. Unfortunately, there are many disorders that a� ect the retina.

� e two most common disorders of the retina are diabetic retinopathy and macular degeneration, which are the two leading causes of blindness in adults. Board-certi� ed ophthalmologist and fellowship-trained retina surgeon Marguerite Kohlhepp, MD, has expertise in treating retinal diseases. She o� ers that expertise at Florida Eye Specialists & Cataract Institute at Riverview.

“Diabetic retinopathy is the most com-mon eye disease associated with diabetes and is caused by changes in the blood vessels of the retina,” Dr. Kohlhepp states. “In some

cases, abnormal blood vessels develop on the surface of the retina. In others, blood vessels begin to bleed or leak � uid.

“Anyone who has diabetes is at risk for developing diabetic retinopathy, and the risk increases with the duration of having the disease. � e main reason: High glucose levels a� ect the blood vessels and make them unhealthy.

“Diabetic retinopathy generally has no symptoms in its early stages, so screen-ing and early diagnosis are of incredible importance. We have treatments that will

overturn poor visual outcomes, but they require early detection.”

Another serious threat to sight that can occur as people age is macular degenera-tion. It is a disease of the central vision with which the main images in the vision become less discernible.

“� ink of the retina as being ten layers thick with many blood vessels nourishing it,” Dr. Kohlhepp elaborates. “Macular degen-eration is a disease in which some of those layers essentially become diseased and waste away. As a consequence, some of the blood vessels pop and leak.

“The first situation, where the layers waste away, is what we consider dry macu-lar degeneration. When blood vessels start popping and leaking, that’s what’s called wet macular degeneration. � is type does consider-able damage that translates into poor vision.”

� e most common treatment for wet macular degeneration is anti-VEGF therapy. � at involves injections of a medicine called anti-vascular endothelial growth factor, which inhibits new blood vessel growth.

Dr. Kohlhepp treats both medical and surgical retinal disorders. Diabetic retinop-athy and macular degeneration are two examples of medical retinal disorders.

“Of the surgical disorders, some of the more common are retinal tears and retinal detachments,” Dr. Kohlhepp reports. “� en there are other disorders called macular pucker and macular hole.

“Macular pucker and macular hole are not as catastrophic as retinal detachment or vitreous hemorrhage, where there’s complete loss of vision that evolves very quickly, some-times within hours or days. Macular pucker and macular hole are conditions that come on somewhat slowly and involve a disruption in the normal architecture of the macula.”

Dr. Kohlhepp suspects a retinal tear when patients report flashing lights or floaters, which are common complaints. Flashing lights and � oaters can be due to normal changes of the eye, but one of � ve who present with those symptoms will likely have a retinal tear to explain them.

“A retinal tear is an unwanted conse-quence of a normal, age-related process where the vitreous gel between the lens and retina is lique� ed, but that process is com-plicated by the vitreous inadvertently pulling at the retina,” she describes. “� at’s how a retinal tear is formed.”

If a retinal tear occurs, it’s critical that it’s treated right away. If not treated immedi-ately with laser or freezing, a tear lends itself to developing into a retinal detachment.

“� e big, gaping hole in the retina allows fluid to pass through it,” Dr. Kohlhepp

informs. “� is � uid is found on the undersur-face of the proverbial wallpaper, and the next thing you know, the wallpaper is falling o� of the wall, and that’s a retinal detachment.”

Child Friendly As a pediatric ophthalmologist, Dr. Chen treats all of the eye conditions that are commonplace during childhood and ado-lescence. Often, her patients are children who have failed screening exams by their physicians or schools.

� ree eye disorders that Dr. Chen treats that can be corrected easily with eyeglasses are myopia, hyperopia and astigmatism. � ese are all refractive errors – vision prob-lems caused by the eye’s inability to properly focus light on the retina to form clear images.

“Myopia is also known as nearsight-edness, and hyperopia as farsightedness,” Dr. Chen educates. “Astigmatism is an irregularity that forms in the corneal tissue, causing part of the cornea to be steeper along one axis than another.

“I also treat other routine eye condi-tions, including blocked tear ducts, which can lead to infections, chronic tearing and foreign bodies children may get in their eyes while playing outside. Two of the most common eye disorders I see at the Riverview clinic are amblyopia and strabismus.”

Amblyopia, also called lazy eye, results when the eyes’ acuity develops unevenly. � e brain accepts the visual images from the stronger eye and ignores the images from the weaker eye. A� ecting four in every 100 children, amblyopia can be treated with eye drops or by placing a patch over the stronger eye, forcing the weaker eye to work harder.

Strabismus, or crossed eye, occurs as frequently as amblyopia and results from a misalignment of the eye muscles, which interferes with the ability of the eyes to work together. One eye may appear to drift, seem-ingly looking up, down, in toward the nose or out toward the cheekbone.

“Children coping with strabismus may squint one eye in bright sunlight or com-plain of eyestrain or headaches when trying to read,” Dr. Chen notes. “If the a� ected eye goes untreated, the child may develop amblyopia as a result of strabismus.

“Strabismus can occasionally be treated with eyeglasses that force the a� ected eye to work in concert with its partner. But the condition most often requires eye muscle

surgery to align the eyes properly. Although this surgery is safe and effective, some children require more than one surgical pro-cedure to fully correct the condition.”

On the days Dr. Chen provides her ser-vices at Florida Eye Specialists & Cataract Institute at Riverview, the o� ce transforms into a child-friendly sanctuary. � e environ-ment and the personnel are all dedicated to the special needs of children. � e sta� use pictures, toys, even puppets to connect with the children.

“We have children’s movies playing, and we have a playroom for them,” Dr. Chen describes. “I’m a fellowship-trained pediatric ophthalmologist who’s been in practice for twenty-one years, and my sta� is specially trained to treat children and make their eye exams as easy as possible for them.FHCN article by Patti DiPanfilo. FHCN file photos. mkb

High pressure damages

optic nerve

Drainage canal

blocked: Excess fl uid

increases pressure

Marguerite Kohlhepp,

MD

Eye institute expands specialty services in RiverviewShared Vision

Page 6 | Florida Health Care News | Summer 2019 | Brandon/Sun City Center Edition ophthalMology

Ronni M. Chen, MD, is a board-certifi ed ophthalmologist. She completed her undergraduate studies, graduating with highest distinction, at the University of Michigan, Ann Arbor, and received her medical degree from the University of Michigan Medical School, Ann Arbor. Dr. Chen completed a transitional internship at Saint Barnabas Medical Center, Livingston, NJ, and her residency in the Department of Ophthalmology at Baylor College of Medicine, Houston, TX, where she also received fellowship training in pediatric ophthalmology and strabismus. Dr. Chen is a member of the American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology and American Medical Association.

Marguerite Kohlhepp, MD, is a board-certifi ed ophthalmologist. She completed her undergraduate studies, graduating summa cum laude, at State University of New York at Albany and earned her medical degree from the Stony Brook School of Medicine, State University of New York at Stony Brook. She completed an internship in the Department of Pediatrics at Stony Brook University Hospital, Stony Brook School of Medicine, and another in the Department of Internal Medicine, Winthrop University Hospital, an affi liate of Stony Brook School of Medicine, Mineola. She completed her residency in ophthalmology at Catholic Medical Center, Albert Einstein College of Medicine of Yeshiva University, Flushing, NY, and is fellowship trained in vitreo-retinal surgery through the University of Nebraska, Omaha. Dr. Kohlhepp is a member of the Pasco County Medical Society, American Medical Association and the American Academy of Ophthalmology.

Charles A. Luxenberg, MD, is a board-certifi ed ophthalmologist who completed his undergraduate studies at Union College in Schenectady, NY and his medical degree at Downstate Medical College in Brooklyn, NY. He then completed a medical internship at Beth Israel Hospital in New York and an ophthalmology residency at University of South Florida Medical Center in Tampa. He is a member of the Pinellas County Medical Society, Florida Medical Association, Tampa Bay Ophthalmological Society, American Academy of Ophthalmology and American College of Surgeons.

Robert J. Applebaum, MD, MBA, began his undergraduate education at Georgetown University in Washington, DC, then transferred to the University of North Carolina at Chapel Hill, where he earned a Bachelor’s degree in Public Policy with a specialization in Health Policy. He then completed a combined MD and MBA program at the University of Florida in Gainesville. Dr. Applebaum completed a one-year transitional internship at the Virginia Tech University Carilion School of Medicine and an ophthalmology residency at the University of South Florida in Tampa. Following his residency, Dr. Applebaum completed a fellowship in oculofacial plastic and reconstructive surgery at the J. Justin Older Eyelid Institute in Tampa.

Sight For LifeAt Florida Eye Specialists & Cataract Institute, the goal is to o� 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:

GREGORY L. HENDERSON, MD, FACSRONNI M. CHEN, MD

CRAIG E. MUNGER, MD, PHDDAN P. MONTZKA, MD

DEEN G. KING, MDWILLIAM A. REEVES, MD

MARGUERITE KOHLHEPP, MDIGNATIUS C. CYRIAC, MDANA-MARIA OLIVA, MDNANDESH PATEL, MDL. RAY ALONZO, OD

EDWARD J. HUGGETT, ODJAMES X. LAWRENCE, ODDILIP RATHINASAMY, MD

ROBERT J. APPLEBAUM, MD, MBACHARLES A. LUXENBERG, MD

T he eye may be a small organ in the body, but it plays a big role in sensory perception. People receive more than 75 percent of

their information about the world around them through the sense of sight.

� e highly trained ophthalmologists at Florida Eye Specialists & Cataract Institute are committed to pro-tecting eyesight and the health of their patients’ eyes. In April 2018, the Institute shared that vision and opened a sat-ellite clinic in Riverview.

“Our vision is to be a full-service center in Riverview, taking care of a com-plete range of eye disorders,” emphasizes Robert J. Applebaum, MD, a board-certi� ed ophthalmologist at the Riverview and Brandon locations. “We perform routine eye exams and prescribe eyeglasses, but we also treat more serious con-ditions such as diabetes-related eye diseases, macular degeneration and glaucoma, as well as perform cosmetic surgery.”

“It’s exciting for Florida Eye Specialists and Cataract Institute to have a location in Riverview,” o� ers Ronni M. Chen, MD, a board-certi� ed ophthalmologist who is fel-lowship trained in pediatric ophthalmology. “I’m excited to provide specialty pediatric eye care in Riverview. I think it’s a great ser-vice to children and families in the area.”

Physicians in multiple specialties, including oculoplastic surgeons and retina specialists, rotate through the Riverview clinic, so area residents don’t need to travel for specialty eye care. And the physicians have access to advanced technology for testing and treatment.

“� e Riverview clinic is state-of-the-art,” Dr. Applebaum asserts. “� e o� ce has the most updated equipment available, including a device that produces three-dimensional pictures of the retina as well as a high-tech peripheral visual � eld machine. We’ve also got two lasers that we use to treat various eye conditions.

“We have a very friendly sta� , including a great office manager and front desk per-son. All of the techs who rotate through the clinic are highly motivated, really care about the patients and do an excellent job. I believe Florida Eye Specialists and Cataract Institute at Riverview is an excellent place to come for eye care.”

Laser RelationsAs part of a routine eye exam, Charles A. Luxenberg, MD, a board-certified ophthalmologist, measures his patients’ vision and prescribes eyeglasses. � e ophthalmolo-gist also evaluates the overall health of his patients’ eyes and checks for any eye disorders.

Riverview13106 Vail Ridge Dr.

(813) 392-3311Brandon

403 Vonderburg Dr., Suite 101

(813) 681-1122Sun 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

“We treat many conditions in Riverview, including eye infections, in� ammatory disor-ders, cataracts and glaucoma,” Dr. Luxenberg acknowledges. “If we discover cataracts, we refer the patients to our Brandon location for surgery, but we follow-up with them in Riverview for their postoperative care.

“Sometimes, a patient’s lens capsule will become cloudy following cataract sur-gery. If that occurs, we can perform a simple laser procedure to clear it up and return the patient’s vision to its post-surgery clarity.”

Dr. Luxenberg also uses a laser to treat the two main types of glaucoma, open-angleglaucoma and narrow-angle glaucoma. For open-angle glaucoma, the laser works

directly on the out� ow � lter, or trabecular meshwork, of the eye. Opening up this mesh-work with the laser enables the � uid in the eye to � ow better, which lowers eye pressure.

“With open-angle glaucoma, something is wrong with the trabecular meshwork and its function is impaired,” Dr. Luxenberg explains. “As a result, there’s a back-up of � uid, which causes increased pressure in the eye. High eye pressure can damage optic nerve � bers, and that can lead to visual � eld defects and eventually blindness.

“With narrow-angle glaucoma, the angle of the out� ow tract is narrow due to the anat-omy of the person’s eye. � is narrow angle causes the problem with � uid � ow rather than the out� ow � lter itself being impaired. We use the laser to widen the angle.”

Treating patients with lasers is an important part of Dr. Luxenberg’s work at Florida Eye Specialists & Cataract Institute at Riverview. Another key function he performs is treatment for the terrible twosome of eye disorders: blepharitis and dry eye syndrome.

Blepharitis is an infection of the eyelids and eyelashes. It is most often caused by an overgrowth of bacteria living along the mar-gins of the eyelids and at the base of the lashes.

Dry eye syndrome, which is generally the result of clogged glands, is a con-dition where there a ren’t enough tears on the surface of the eye to keep it adequately l u b r i c a t e d , thus the eyes become dry.

Blepharitis and dry eye commonly occur simultaneously. If left untreated, these con-ditions can lead to permanent eyelid and tear gland dysfunction as well as corneal damage.

“We treat dry eye with various eye drops, including the prescription drops RESTASIS® and Xiidra®,” Dr. Luxenberg observes. “We also use a laser procedure to close the tiny openings in the eyelid that drain � uid, called punctum. � is procedure, laser punctal ablation, keeps the tears on the surface of the eye longer.

“For blepharitis, we recommend eyelid scrubs twice a day and also suggest a very effective therapy using a machine called BlephEx®. During a BlephEx treatment, we use the instrument to clear all of the debris from the eyelid margin and the lashes. It also thoroughly cleans those areas to kill any bacteria growing there.”

Functional and CosmeticDr. Applebaum is the son of a cardiologist, so he had no shortage of inspiration to become a physician himself. But he wanted to be highly specialized, so he opted to pursue ophthalmology and focus his skills further by completing a fellowship in oculoplastic surgery. Oculoplastic surgery is a subspecialty that concentrates on cosmetic and recon-structive surgery of the face and eye area.

Dr. Applebaum uses his skills in oph-thalmology and oculoplastic surgery to perform a wide range of cosmetic and functional procedures on the face and eyes, including blepharoplasty, at Florida Eye Specialists & Cataract Institute at Riverview.

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

“With upper blepharoplasty, excess skin is removed from the upper eyelids, which can droop due to muscle weakness. The 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 cos-metic 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 for-ward and appear as pu� ness under the eye. Lower blepharoplasty can diminish the look of tiredness and aging by decreasing excess fat and skin beneath the eyes.”

Dr. Applebaum performs many other surgical procedures at the Riverview clinic as well. � ese include reconstructions following skin cancer removal, endoscopic eyebrow and forehead lifts, tear duct surgery, earlobe recon-structions and correction of eyelid malposition.

In addition to these surgical proce-dures, Dr. Applebaum also o� ers a variety of nonsurgical facial cosmetic services. � ese include BOTOX® Cosmetic injections and a variety of facial � llers. � ese options can help reverse the changes associated with aging.

“BOTOX Cosmetic is a synthetic toxin that is altered so that it is non-toxic to the body of a healthy person,” Dr. Applebaum notes. “It blocks the release of neurotrans-mitters that trigger muscle contractions.”

A m o n g t h e f i l l e r s u s e d b y Dr. Applebaum are JUVÈDERM® , VOLUMA® and RESTYLANE®. Many � llers contain hyaluronic acid, a substance found naturally in the body that helps restore vol-ume and hydration to the skin.

“Over time, materials in the skin, includ-ing the collagen and base membranes, break down, so the face begins to sag,” the doctor explains. “We use these � llers in the cheeks to add volume and give the face a nonsurgical lift.

“We also use fillers in areas slightly lower on the face to decrease the appearance of � ne lines and wrinkles around the nose and lips. Oftentimes, we use them in the lips to give the lips more fullness.

“KYBELLA® is another � ller that is used speci� cally to decrease the appear-ance of a double chin. It is injected into

the fatty tissue of the chin, where it breaks down the fat cells, reducing the appear-ance of fat under the chin.”

Retinal Restraints� e retina is a thin layer of specialized tissue that lines the back of the eye. It senses light as it enters the eye and sends it to the brain to process as images. Unfortunately, there are many disorders that a� ect the retina.

� e two most common disorders of the retina are diabetic retinopathy and macular degeneration, which are the two leading causes of blindness in adults. Board-certi� ed ophthalmologist and fellowship-trained retina surgeon Marguerite Kohlhepp, MD, has expertise in treating retinal diseases. She o� ers that expertise at Florida Eye Specialists & Cataract Institute at Riverview.

“Diabetic retinopathy is the most com-mon eye disease associated with diabetes and is caused by changes in the blood vessels of the retina,” Dr. Kohlhepp states. “In some

cases, abnormal blood vessels develop on the surface of the retina. In others, blood vessels begin to bleed or leak � uid.

“Anyone who has diabetes is at risk for developing diabetic retinopathy, and the risk increases with the duration of having the disease. � e main reason: High glucose levels a� ect the blood vessels and make them unhealthy.

“Diabetic retinopathy generally has no symptoms in its early stages, so screen-ing and early diagnosis are of incredible importance. We have treatments that will

overturn poor visual outcomes, but they require early detection.”

Another serious threat to sight that can occur as people age is macular degenera-tion. It is a disease of the central vision with which the main images in the vision become less discernible.

“� ink of the retina as being ten layers thick with many blood vessels nourishing it,” Dr. Kohlhepp elaborates. “Macular degen-eration is a disease in which some of those layers essentially become diseased and waste away. As a consequence, some of the blood vessels pop and leak.

“The first situation, where the layers waste away, is what we consider dry macu-lar degeneration. When blood vessels start popping and leaking, that’s what’s called wet macular degeneration. � is type does consider-able damage that translates into poor vision.”

� e most common treatment for wet macular degeneration is anti-VEGF therapy. � at involves injections of a medicine called anti-vascular endothelial growth factor, which inhibits new blood vessel growth.

Dr. Kohlhepp treats both medical and surgical retinal disorders. Diabetic retinop-athy and macular degeneration are two examples of medical retinal disorders.

“Of the surgical disorders, some of the more common are retinal tears and retinal detachments,” Dr. Kohlhepp reports. “� en there are other disorders called macular pucker and macular hole.

“Macular pucker and macular hole are not as catastrophic as retinal detachment or vitreous hemorrhage, where there’s complete loss of vision that evolves very quickly, some-times within hours or days. Macular pucker and macular hole are conditions that come on somewhat slowly and involve a disruption in the normal architecture of the macula.”

Dr. Kohlhepp suspects a retinal tear when patients report flashing lights or floaters, which are common complaints. Flashing lights and � oaters can be due to normal changes of the eye, but one of � ve who present with those symptoms will likely have a retinal tear to explain them.

“A retinal tear is an unwanted conse-quence of a normal, age-related process where the vitreous gel between the lens and retina is lique� ed, but that process is com-plicated by the vitreous inadvertently pulling at the retina,” she describes. “� at’s how a retinal tear is formed.”

If a retinal tear occurs, it’s critical that it’s treated right away. If not treated immedi-ately with laser or freezing, a tear lends itself to developing into a retinal detachment.

“� e big, gaping hole in the retina allows fluid to pass through it,” Dr. Kohlhepp

informs. “� is � uid is found on the undersur-face of the proverbial wallpaper, and the next thing you know, the wallpaper is falling o� of the wall, and that’s a retinal detachment.”

Child Friendly As a pediatric ophthalmologist, Dr. Chen treats all of the eye conditions that are commonplace during childhood and ado-lescence. Often, her patients are children who have failed screening exams by their physicians or schools.

� ree eye disorders that Dr. Chen treats that can be corrected easily with eyeglasses are myopia, hyperopia and astigmatism. � ese are all refractive errors – vision prob-lems caused by the eye’s inability to properly focus light on the retina to form clear images.

“Myopia is also known as nearsight-edness, and hyperopia as farsightedness,” Dr. Chen educates. “Astigmatism is an irregularity that forms in the corneal tissue, causing part of the cornea to be steeper along one axis than another.

“I also treat other routine eye condi-tions, including blocked tear ducts, which can lead to infections, chronic tearing and foreign bodies children may get in their eyes while playing outside. Two of the most common eye disorders I see at the Riverview clinic are amblyopia and strabismus.”

Amblyopia, also called lazy eye, results when the eyes’ acuity develops unevenly. � e brain accepts the visual images from the stronger eye and ignores the images from the weaker eye. A� ecting four in every 100 children, amblyopia can be treated with eye drops or by placing a patch over the stronger eye, forcing the weaker eye to work harder.

Strabismus, or crossed eye, occurs as frequently as amblyopia and results from a misalignment of the eye muscles, which interferes with the ability of the eyes to work together. One eye may appear to drift, seem-ingly looking up, down, in toward the nose or out toward the cheekbone.

“Children coping with strabismus may squint one eye in bright sunlight or com-plain of eyestrain or headaches when trying to read,” Dr. Chen notes. “If the a� ected eye goes untreated, the child may develop amblyopia as a result of strabismus.

“Strabismus can occasionally be treated with eyeglasses that force the a� ected eye to work in concert with its partner. But the condition most often requires eye muscle

surgery to align the eyes properly. Although this surgery is safe and effective, some children require more than one surgical pro-cedure to fully correct the condition.”

On the days Dr. Chen provides her ser-vices at Florida Eye Specialists & Cataract Institute at Riverview, the o� ce transforms into a child-friendly sanctuary. � e environ-ment and the personnel are all dedicated to the special needs of children. � e sta� use pictures, toys, even puppets to connect with the children.

“We have children’s movies playing, and we have a playroom for them,” Dr. Chen describes. “I’m a fellowship-trained pediatric ophthalmologist who’s been in practice for twenty-one years, and my sta� is specially trained to treat children and make their eye exams as easy as possible for them.FHCN article by Patti DiPanfilo. FHCN file photos. mkb

High pressure damages

optic nerve

Drainage canal

blocked: Excess fl uid

increases pressure

Marguerite Kohlhepp,

MD

Eye institute expands specialty services in RiverviewShared Vision

Brandon/Sun City Center Edition | Summer 2019 | Florida Health Care News | Page 7ophthalMology

Steven J. Minafri, DC, is a licensed chiropractor who graduated with honors from Life Chiropractic College in . Prior to beginning his chiropractic studies, he attended Thomas Edison State College and graduated with a Bachelor’s degree in Applied Science and Mathematics. He has been in practice for more than years, including more than a decade at Riverview Chiropractic Center. Dr. Minafri is also a respiratory therapist, and an emergency medical technician with over years of experience caring for injured patients.

Visit them online at riverviewchiropracticcenter.com

Personalized Patient CareAt Riverview Chiropractic Center, they proudly provide the highest quality chiropractic care available and precisely tailor their treatments for each individual patient. For more information or to schedule an appointment, please call or visit their offi ce in Riverview at:

10732 Ketchum Valley Drive

(813) 677-2700

RIVERVIEW CHIROPRACTIC CENTER

STEVEN J. MINAFRI, DC

Doctor RecommendedChiropractic maintenance program reduces � are-ups, setbacks

A n opportunity to play college football was there for him when he left high school, but at � ve feet, ten inches tall and

190 pounds, John Masiello knew it was best to quit the game while he was ahead.

“At my size, you can be a pretty good high school player, which I was,” the Long Island, New York native says. “But you’re only going to go so far, and guys like me just tend to get ground down in college, so I passed.”

Now 53 and the owner of a building maintenance company, John doesn’t regret his decision. � e fact that he’s battled nagging lower back pain stemming from a wrestling injury he su� ered only con-� rmed his suspicions regarding his body.

“I got hurt just before the county tour-nament,” John recalls. “It was a lower back injury, and it was so painful, you wouldn’t believe it. So I took two weeks o� and went to see a chiropractor who got me into a position to compete in the tournament.

Chiropractic maintenance care keeps John on his feet.

“� at was thirty-six years ago, and I’ve been seeing a chiropractor ever since, though more or less for general mainte-nance than anything else. I’ve become what I consider the poster child for gen-eral maintenance. Unless I’m on vacation, I never miss a week.”

John kept his string of regular chi-ropractic visits intact even through his recent move to Florida, where he has handed those duties o� to a strong advo-cate of general chiropractic maintenance, Steven J. Minafri, DC, of Riverview Chiropractic Center.

Keeping Pain Away“A lot of people use chiropractors as kind of a BAND-AID®, where they come to see us, and once the pain goes away, they disappear for a while,” Dr. Minafri says. “Inevitably, those same people show up again six months later complaining of the same problem.

“That’s the way most people approach their health in general. � e only time they think to do something is when they become symptomatic. But when it comes to what we do, once we’ve

got you feeling better, there’s usually more to do to keep you feeling good.

“That’s why general maintenance is so important. It varies from person to person, depending on their issues, but even if you come in just once a month, we can keep those problems that were bothering you in the first place from coming back.

“And there’s value in that. By making those regular visits and receiving what we call maintenance care, you’re not going to be missing days of work or needing to give up your favorite activities or things you might want to do with your family.”

John is a very active person. In addi-tion to running his business, he also works out regularly and plays racquetball. He says he wouldn’t be able to do those things were it not for the maintenance care he receives from Dr. Minafri.

“In all these years, the only time I’ve missed my regular visits with the chiro-practor is when I’ve been on vacation for more than two weeks,” John says. “And that’s only happened a few times. � e reg-ular visits are what keep me going.

“And what Dr. Minafri does for me is so amazing that I just can’t say enough about him. He is truly exceptional at what he does. I see him every week because that’s what I require, and he knows what to do to keep everything in order.”FHCN article by Roy Cummings. Photo by Fred Bellet. mkb

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

Page 8 | Florida Health Care News | Summer 2019 | Brandon/Sun City Center Edition ChiropraCtiC

ophthalMology

ERICK A. GRANA, MD

Erick A. Grana, MD, is a diplomate of the American Board of Physical Medicine and Rehabil i tat ion and the American Board of Electrodiagnostic Medicine, with subspecialty certifica-tion 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 fel-lowship 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.

For more information about stem cell therapy, please call or visit Regenerative Orthopedic Institute in Tampa at:

8011 North Himes Avenue, Suite 3

Visit Regenerative Orthopedic Institute on the web at www.dontoperate.com

(813) 868-1659

New GenerationRegenerative stem cell therapy relieves

disabling knee pain without surgery

T he arrival on the internet of websites such as Ancestry.com,FamilySearch.com and MyHeritage.com has helped

turn genealogy into the second most popular hobby in America. Eighty-two-year-old Lydia Pain is among those caught up in the craze.

“It’s fascinating,’’ Lydia declares. “I recently found out that my family actually has its roots in Greece, Italy and Spain and that someone way back was a privateer, which is like a pirate who’s licensed to hold up merchant ships on the high seas during a war.”

The wife of a retired US Army Lieutenant Colonel, Lydia’s passion for researching the family trees of friends and other family members has replaced the passion she once had for gardening, which remains the number one hobby in the country.

“Gardening used to be my favorite hobby, but I had to give that up a couple of years ago,’’ Lydia says. “I say I gave it up because of my age, but I had some knee problems that made it hard for me to get up and down and made gardening di� cult.”

Gardening wasn’t the only activity that became di� cult for Lydia. Her knee pain also made it hard for her to climb stairs and eventually made walking more of a chore than it should be. At one point, she was literally bedridden by her pain.

“My husband purchased a walker for me, but even with the walker, the pain was so intense, I couldn’t do anything,’’ Lydia relates. “I was probably in bed for two weeks before I � nally built up the courage to do something about it.”

What held Lydia back from seeking medical attention was her suspicion she would be told the problem could only be corrected through knee replacement sur-gery. She wasn’t surprised then when the � rst doctor she visited suggested just that.

Largely because of her age and the time required for recovery, Lydia was unwilling to go through surgery. As a result, she began looking for an alterna-tive. She found it while reading a copy of Florida Health Care News.

Since receiving the RegenaJoint treatment, Lydia has been pain free for two years. 

“I was looking through the paper and saw an article about him and his practice,” Lydia says of Erick A. Grana, MD, of Regenerative Orthopedic Institute. “After reading the article, I was intrigued by his work and the success he’s had.

“After that, I started researching him a little more, and the more I researched him, the more I learned things that made me comfortable with him. I learned, for example, that Dr. Grana was a professor at Baylor University in Texas.

“My brother taught there for a while, too, and that was a selling point for me. Since I had someone in my own family who had taught at the same university he had, I felt good about him and decided to see if he could help me.”

New Age Specialty Dr. Grana specializes in regenerative medicine and treats patients with a nonsurgical technique called stem cell therapy. � is therapy uses the patient’s own specialized stem cells to promote the growth of new tissue in joints ravaged by arthritis or injury.

“Regenerative medicine treats disease and injuries by harnessing the body’s own healing powers,’’ Dr. Grana explains. “� e natural healing process is accelerated by a combination of growth factors and bio-active cells in the form of stem cells and platelet-rich plasma (PRP).

“� is process results in a safe, e� ective treatment, and unlike traditional 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 recov-ery than surgery. 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.

Stem cells are extracted from the patient’s bone marrow or fat, while the PRP is taken from the patient’s own blood. The harvested stem cells are separated through a centrifuge and injected into the painful area to stimu-late the regeneration of damaged tissue and the healing of tendons, ligaments, joints or spinal discs.

“When I was first introduced to stem cell therapy, I recognized its tre-mendous potential for patients who would otherwise have limited treatment options for pain relief,” Dr. Grana dis-closes. “Patients with osteoarthritis, in particular, have very few choices other than surgery when the condition advances and damages the joint.

“Since surgery has potential com-plications, when we treat arthritic joints without surgery, patients do much bet-ter. Not only can we relieve the patient’s pain, but we can also reverse some of the damage done by the osteoarthritis. � is is accomplished by regenerating the cartilage and connective tissues in and around the joint area.”

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 also developed a similar system to treat the spine called RegenaSpine™. RegenaJoint and RegenaSpine are both minimally invasive procedures that are performed right in the doctor’s office using a local anesthetic. Patients typically resume normal activities immediately fol-lowing the procedure.

Marvelous Outcome Lydia � rst went to see Dr. Grana two years ago. � ough the doctor she � rst visited told her she had no cartilage left in her knees, she was con� dent there was enough left to make her a candidate for stem cell therapy. Dr. Grana con� rmed her belief.

“I had done my homework and thought I understood that there is almost always a little bit of cartilage left that can grow,’’ she says. “� at’s what I was aiming for, and when Dr. Grana said there was, I said, Great, let’s go ahead with the injections.”

After going through the extraction process, which she describes as simple and painless, Lydia eventually received stem cell injections in both knees. She returned about a month later for a sec-ond injection in each knee. Her pain began to disappear soon thereafter.

“After I received the injections, it was like a miracle had happened,’’ Lydia exudes. “I was in pain for so long, but I have now been pain free going on two years. I do walk with a cane when walk-ing long distances, but that’s because I’m afraid of falling, not because of pain.

“� e pain is truly gone, and that’s the most important thing because pain is very aging. It makes you not want to do things, but Dr. Grana took care of that. I have to tell you, he is so nice, and he answered all the questions I had.

“He explained everything about the procedure so well, and he really knows what he’s doing. As for me, I just mar-veled at the whole thing because it’s such a simple procedure compared to the replacement surgery, and it gets even better results.

“I was so impressed that I even encouraged my son, who is � fty-� ve and has some knees that are in very bad shape, to have it. He did, and he’s thrilled with the outcome, just like I am.”FHCN article by Roy Cummings. Photos by Jordan Pysz. mkb

Lydia Pain

Don’t Operate, Regenerate

Brandon/Sun City Center Edition | Summer 2019 | Florida Health Care News | Page 9stEM CEll thErapy/pain ManagEMEnt

Nataliya Sia, ARNP, is an adult nurse practitioner specialist who earned her bache-lor’s and master’s degrees from the University of South Florida, where she graduated with honors in . She also has a Master of Arts degree in Chinese Language and Literature from Dnepropetrovsk State University in Ukraine. She has more than six years of medical experience and believes that the only way to treat any disease is through the holistic approach of combining lifestyle changes, exercise and con-ventional medicine. She is a native of Ukraine who speaks four languages (Russian, Ukrainian, Chinese-Mandarin and English).

Sunny A. Sia, MBA, MSN, PMHNP-BC, is a psychiatric mental-health nurse practitioner who holds an MBA from the University of Virginia. He earned his master’s degree in Psychiatric Mental Health Nurse Practitioner from the University of South Alabama, with a specialization in child psychiatry. Sunny’s psychiatric care experience includes addiction psychiatry, medication management and child and adult psychiatry.

Visit them on the web at holisticmedicalcare.net

The Right TrackHolistic Medical Care Clinic is the leading expert in holistic and integrative medicine in Brandon. The clinic strives to provide the best health care available utilizing a blend of conventional/Western medicine and complementary therapies. For more information or to schedule an appointment, call or visit their offi ce in:

Brandon W. Morgan Street

(813) 398-0470

NATALIYA SIA, ARNPSUNNY A. SIA, MBA, MSN, PMHNP-BC

Free Hyperbaric Oxygen Therapy

For a limited time, the Holistic Medical Care Clinic is o� ering a free

HBOT session for every PRP/stem cell therapy procedure done.

Health ManagementIntegrative medicine treatments increase energy

A n unbeaten middleweight champion, an undefeated welterweight champion and a 2012 Olympian from Brazil

are part of the stable of professional � ght-ers Jody Caliguire manages through his Tampa-based promotions company, Fire Fist Boxing.

“I have boxers from all over the world, including one from right here in Tampa,” Jody says. “We recently had a couple of events out in Las Vegas where my boxers were main-event boxers. We’re all working hard to get these guys moved up the ladder.”

Jody is no stranger to hard work. He considers his management gig a “nighttime job” because he spends his days running the site development company he owns. An ex-boxer, he also works out regularly.

� at latter activity was once a chal-lenge for him, in part because of a bout with fatigue that he fought for a period of time. Seeking more of a holistic solution for the issue, Jody recently began visiting the Holistic Medical Care Clinic for help.

Positive Impact � e objective of the Holistic Medical Care Clinic’s founders, Nataliya Sia, ARNP, and Sunny Sia, PMHNP-BC, is to treat patients with a blend of conventional/Western medicine and complementary natural therapies. � is treatment philosophy is also called inte-grative medicine.

“We avoid prescribing medications as much as possible and look to heal patients a more natural way,” Nataliya says. “We specialize in treatments such as intrave-nous (IV) vitamin therapy, ultraviolet blood irradiation (UBI) intravenous therapy and hyperbaric oxygen therapy (HBOT).”

Intravenous vitamin therapy uses a mixture of vitamins and minerals that are delivered directly into the bloodstream to � ght fatigue as well as a variety of poten-tial vitamin de� ciencies.

Ultraviolet blood irradiation is a procedure where blood is exposed to ultraviolet light. � e light exposure helps regulate the body’s immune system, which helps it fight off infection and manage autoimmune conditions such as lupus and rheumatoid arthritis.

Hyperbaric oxygen therapy oxy-genates the body, calms the central nervous system and increases energy. It is often used as a complement to other therapies, as the oxygenation helps expedite healing and recovery through cell regeneration.

Nataliya’s care of Jody began with a test that determined he was de� cient in a number of vitamins. To correct the issue, Jody was given the � rst of a series of intra-venous vitamin therapy treatments.

“We started doing Vitamin C and ended up with general nutritional IVs for Jody,” Nataliya says. “We now see him every several months to monitor his vitamins and adjust the IVs for him

when necessary. He now walks three miles a day, does weight training and cardio exercises, and he’s very happy.”

“� e Holistic Medical Care Clinic is the right � t for me, and I really enjoy going there,” Jody says. “I get a lot of interaction regarding general health and a lot of routine testing that allows me to be at my best. I highly recommend it.”FHCN article by Roy Cummings. Photo by Jordan Pysz. mkb

Jody Caliguire

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 reve-latory 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 treatment options, some of which have traditionally been both painful and inconvenient. Fortunately, Dr. Nguyen o� ers microcurrent electrolysis (MCE), an FDA-approved, nonsurgical 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.

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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

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Visit www.hemwellamerica.com

Page 10 | Florida Health Care News | Summer 2019 | Brandon/Sun City Center Edition holistiC MEDiCinE

hEMorrhoiD trEatMEnt

Rebecca has her life back after treatment.

Boris Kawliche, MD, i s a board-certifi ed psychiatrist who has spent more than years treating adult, pediatric and ado-lescent patients while off ering a full range of psychiatric services. He received his undergraduate

degree from the University of South Florida and later attended medical school at USF. He received his residency training in psychiatry at USF and completed a fellowship program in child and adolescent psychiatry at the school. He now specializes in treatment using transcra-nial magnetic stimulation (TMS).

Are You Su� ering With Depression?

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BORIS KAWLICHE, MDJEAN ARROYO, ARNP

DEANNA MANN, ARNP

Revolutionary TMS therapy doing the job antidepressants haven’t

Hope for DEPRESSION

“Dr. Kawliche prescribed antidepres-sants, and they did work for a while. I felt better some days – good enough to at least be able to function with some normalcy day-to-day.”

But when her back pain magni� ed, Rebecca says she was forced to undergo surgery. � at was when things took a turn for the worse.

“It was my fourth back surgery,” Rebecca informs. “Afterward, I felt about as low as a person could get mentally. I would get up at eleven in the morning, stay up until about two in the afternoon and then go back to bed.

“� en, I would get back up later and make dinner, crochet a little bit or read a book, and stay awake watching television until eleven at night and just repeat the same thing the next day. I used to be so active. Suddenly, all of that was gone, and I felt useless.”

During her recovery period follow-ing back surgery, Rebecca didn’t take any medication for her depression because of the potential interference with her pain medications. One day, when she was at her pain management doctor for a follow-up visit, Rebecca was advised to go back to see Dr. Kawliche.

“My pain management doctor could see I was struggling mentally,” Rebecca shares. “� at’s when I went back to see Dr. Kawliche, and he told me I was a strong candidate for transcranial magnetic stimulation, or TMS,” Rebecca con� rms. “I discussed it with my husband, and he was on board with it.”

The TMS EraA new chapter in depression treat-ment, TMS began in the 1980s when a researcher at the University of South Carolina discovered how magnetic pulses could stimulate part of the brain that is underactive in people with depression.

� e Food and Drug Administration approved the noninvasive therapy in 2008 for people with treatment-resistant depression and those who can’t tolerate the side e� ects of antidepressants.

Once the patient is settled into a com-fortable chair, a paddle-shaped device with a magnetic coil is placed on the prefrontal cortex. It emits a magnetic � eld, similar to that of an MRI, in short pulses to stim-ulate the brain. � ese magnetic pulses are delivered intermittently in a precise sequence that is computer-generated.

The magnetic pulses are precisely targeted to the prefrontal cortex, which is the part of the brain associated with mood regulation and cognitive functions. Research studies have shown this area can be underactive in depressed people.

TMS treatments last approximately 30 minutes, and patients typically receive a total of 36 treatments over a period of six to eight weeks. Patients are treated � ve times per week for the � rst six weeks and are gradually weaned o� the treatment in the � nal weeks.

“Most people start to notice changes within two or three weeks after beginning treatment,” notes Dr. Kawliche. “� ey say, I have more energy. I’m thinking a little clearer. My motivation is better. I feel like doing things.

“As the treatments continue, the brain gets used to maintaining a higher level of functioning through the repe-tition of treatments. This helps create muscle memory and oxygen � ow to parts of the brain that may have been weakened by the depression.

“� is treatment is truly unique. Not only does it help alleviate symptoms of depression, it also regulates sleep and helps stimulate blood � ow to the brain. And it’s a painless treatment that, for many patients, works far better than antidepressants.”

Antidepressant medications have become a common treatment, but a large percentage of people with depression fail to respond to the medications. Either that or they stop working after a while.

Statistics show that in patients who have tried three antidepressants that have either not worked or have stopped work-ing, the chances of a fourth such medication working e� ectively are just seven percent.

“The chances of TMS working in those patients are much better,” Dr. Kawliche says. “For those patients, there is a much better chance that they will regain the function and enjoyment

in life they had prior to their depres-sive episode, which is why TMS can be life-changing for these patients.”

Getting Her Life Back“I had TMS treatments � ve days a week for six weeks, and started feeling better after about two weeks,” Rebecca reports. “It was a huge commitment, but I fol-lowed through with the entire treatment plan to the end, and I’m glad I did.

“By the end, I felt like I could get up and get moving every day. I wasn’t just lying around doing nothing all day the way I used to. I was slowly getting my life back because I felt rejuvenated.”

Rebecca says TMS was a life-changing treatment for her.

“I am back to my old self again now,” she says. “I am doing yard work again, volunteering again and enjoying all of the daily activities I had shelved for so long. I still see Dr. Kawliche every six weeks or so for follow-up care, but I feel great.

“I owe a lot to Dr. Kawliche,” Rebecca emphasizes. “TMS was a lifesaver for me because I had exhausted the use of antidepressant medications. � is was kind of a last-resort e� ort, and it worked! I � nally have my life back, and I could not be happier. I feel great!”FHCN staff article. Patient photo courtesy of Rebecca Coupe.

Doctor photo by Jordan Pysz. mkb

To learn more about TMS, visit them on the web at www.brandontmsandpsychiatry.com

R ebecca Coupe moved to Florida from Ohio in 1996 to escape the harsh Midwest winters. She planned to spend

her days basking in the warm sunshine, but chronic back issues kept Rebecca from enjoying the subtropical lifestyle.

Her incessant back pain forced Rebecca to quit her job long before she had planned to and dramatically altered her lifestyle. Annoyed by the discomfort, she lost the desire to see or even talk to anyone and soon found herself con� ned to her home.

“When I say I am retired, I was kind of forced into it,” she admits. “Physically, I couldn’t do anything because of the pain, so I had to retire. My back hurt almost every day, and I was irritable all the time. I just had no ambition or desire to do anything.”

Unable to afford surgery, Rebecca struggled through the pain and eventually fell into a deep depression. It wasn’t until she found something that motivated her to get out and interact with people again that she realized some relief.

“I started volunteering for the American Veterans [AMVETS] service organization. My son is in the US Army, and I enjoyed spending my time giving back to those who served so sel� essly. It helped to take my mind o� the pain and ease the depression.”

In 2013, Rebecca says, her daily life began to unravel again, this time as a result of a bout with double pneumonia. � at, cou-pled with her ongoing back issues, left her weak and fragile and feeling unlike herself.

“I started to get depressed because I was on oxygen all the time and had a portable tank I had to drag behind me everywhere,” Rebecca recalls. “I never left the house. It was easier that way. I was cooped up. I was forced to stop volun-teering because I was so sick.”

On the advice of her primary care physician, Rebecca sought help for her depression from Boris Kawliche, MD, at Brandon TMS & Psychiatry.

Dr. Kawliche says the TMS machine is a safe and e� ective way for treating chronic depression.

Brandon/Sun City Center Edition | Summer 2019 | Florida Health Care News | Page 11DEprEssion

DreamsSweetEnd back pain

with minimally invasive laser procedures

Laura Wall

JAMES ST. LOUIS, DOBRETT MENMUIR, 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 osteo-pathic 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.

Brett Menmuir, MD, earned his Bachelor of Science degree from Georgetown University and his medical degree from Georgetown University School of Medicine. He completed his residency in orthopedic spine surgery as well as a fellowship at Twin Cities Spine Center in Minneapolis, MN. He is a member of the American Academy of Orthopaedic Surgeons, Society of Lateral Access Surgery and AO Spine.

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T he nightmare began five years ago for Michigan native Laura Wall. That’s when the former Ford Motor

Company employee first experienced stabbing pain in her lower back. Her doctor diagnosed the problem as spinal stenosis, a narrowing of the spinal canal and neuroforamen, in the areas where nerves exit the spinal cord though the vertebrae.

“It was an excruciating, throbbing, sharp pain in my lower back, and it was getting very achy,” Laura, 64, shares. “And it was constant. It didn’t last just for � ve minutes. � e pain was present every hour, every day, whether I was sitting or lying down.”

Over the years, Laura’s spinal ste-nosis deteriorated further, and her back pain intensi� ed. Two years ago, the pain became so unpleasant, it began interfering with her daily endeavors. By that time, Laura had retired and was looking ahead to a long, active retirement in the warmer Florida climate. But her back condition threatened to derail those plans.

“� e pain increased until I couldn’t walk very far without holding my back in extreme agony,” Laura relates. “I could hardly walk to the mailbox from my house, which is only six houses down, without pain. I couldn’t swim. I could hardly stand up, but I couldn’t sit for very long, either. � e pain was a ten on a scale of one to ten.”

In search of a solution to her agoniz-ing back problem, Laura turned to several spine specialists for their expert guidance. She visited one specialist while still living in Michigan and two others after she moved to Florida. None had good news for her.

“� e doctors said they couldn’t help me,” she recalls. “� ey said I would have to have major surgery on my discs, and it probably still wouldn’t help with the pain. I cried when I heard that. I thought, Here I am retired, and I can’t do anything because of my back. My life was just terrible at that point.”

Laura’s fortunes began to change in early 2018 after she heard about a seminar on minimally invasive spine sur-gery that was o� ered by the spine specialists at Physician Partners of America. She decided to attend the seminar, and there she met James St. Louis, DO, director of Physician Partners of America’s Minimally Invasive Spine Group. Dr. St. Louis gave Laura what the other doctors did not: hope.

After reviewing her MRI, Dr. St. Louis told Laura she didn’t need major surgery on her discs. Instead, he could perform a minimally invasive spine procedure that would relieve her pain. Laura was ecstatic and agreed.

Sparing MusclesWhen it comes to surgery, the term

“minimally invasive” is typically equated with a procedure performed through smaller inci-sions than those used during open surgery. But with minimally

invasive spine procedures, there’s more to it than that. These procedures are muscle-sparing as well.

“During traditional open surgery on the back or neck, the muscles are cut away from the bone so that the surgeon can visualize the area and see what he or she is doing to the spine,” describes Dr. St. Louis,who is a pioneer in the � eld. “And once a muscle is cut, it is damaged forever and can no longer function appropriately.

“ D u r i n g minimally invasive spine surgery, the muscles are not cut at all. Instead, we insert special dilators between the muscle

� bers and simply push the muscles aside. � is way, we preserve the muscles and their function.”

Because surgeons spare the muscles, and use smaller incisions during mini-mally invasive spine surgery, there is less bleeding, less pain and a quicker recovery. It can be performed as an outpatient pro-cedure rather than requiring a several-day hospital stay.

Surgeons at Physician Partners of America can also use minimally invasive techniques to perform procedures such as laminotomy and foraminotomy using a laser. � ese procedures make room for nerves that are pinched at the openings between the discs or at the neuroforamen.

“We use various instruments to move past the muscles and get to the bone,” explains Brett Menmuir, MD, another Physician Partners of America minimally invasive spine surgeon. “Guided by the patient’s MRI, we assess what is pinching the nerve. It could be a bone spur, a thickened ligament, a cyst or a piece of herniated disc material. We use a laser to free up the nerve by remov-ing whatever is pinching it.

“Using this technique, patients generally have significant

improvement in their pain. And the procedures are performed through an incision that is typically an inch or smaller.”

“A New Life”Laura had a laminotomy

and foraminotomy to relieve her agonizing back pain. Dr. St. Louis used a laser that enabled him to target the speci� c area of her low back that was the source of her problem: lumbar discs three and four.

“Apparently, swollen nerves were wrapped around my spinal cord,” Laura describes. “During surgery, Dr. St. Louis shaved a little bit o� of my spine to make room for the nerves. I walked out of the hospital the same day. I received excellent care, and after two days, I felt fantastic.”

Laura underwent her minimally inva-sive spine procedure in March 2018. Now, more than a year later, she’s still amazed by the surgery’s overwhelming success.

“It’s been a new life for me since I had this surgery,” Laura raves. “Now, I can sleep, I can bend over, I can sit for hours. Everything I couldn’t do before I

can do now. And my pain level is zero. It was zero two days after surgery.

“Now, I can walk to the mailbox and walk long distances. I couldn’t walk very far for � ve years. Now, I walk � ve miles a day. Since my surgery, I can do every-thing without any back pain whatsoever. And it’s been wonderful. I’m going to be sixty-� ve in September, and I’m having the time of my life.”

� e other doctors Laura visited gave her little hope of � nding relief from her ago-nizing back pain, but she de� ed their dire prognoses. She’s especially pleased that her retirement plans are back on schedule. Her nightmare is back to being a sweet dream.

“Getting this minimally invasive laser spine surgery was the best thing that ever happened to me,” Laura enthuses. “It changed my whole retirement life. Now, I can swim. I can play with my grandkids. I can sit and do my pottery. I like to shop, and now I can. I can walk in the park and on the beach. I can do anything I want.

“What’s better than walking out the front door after surgery and going home, relaxing for a day or two, then carrying on with your life the way you want? � ere is no better way to deal with severe back pain than that. So yes, I think min-imally invasive spine surgery at Physician Partners of America is fantastic. I really appreciate what they did for me.”FHCN article by Patti DiPanfilo. Photo by Nerissa Johnson. mkb

Page 12 | Florida Health Care News | Summer 2019 | Brandon/Sun City Center Edition pain ManagEMEnt/spinE surgEry