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St. Augustine/Ponte Vedra Beach Edition

FEATURED ARTICLES

Winter 2019

(see Back Surgery Avoided!, page 4)

TYLER ALBRECHT, DCERIN BAILEY, DC

Denise Moxon

Back Surgery

Avoided!Nonsurgical treatment

promotes natural healing, eliminates disabling back pain

D enise Moxon, 65, is a retired registered nurse who stays � t by engaging in a variety of activities that include

yoga, weight training and the challeng-ing horse-riding discipline called dressage.

Looking after her barn and horses requires physically demanding chores, but that never fazed her. � at is until the day her back went out when she was shoveling dirt.

� e intense pain started in her lower back and radiated into her right thigh. At � rst, Denise thought rest would make the pain go away, so she stopped exercising and riding her horses.

When the pain remained, Denise looked for remedies with two priorities in mind: She wanted to avoid surgery and narcotic pain medications. Over four months, she tried physical therapy, mas-sage, steroid injections and acupuncture.

“I did all of these things just trying to get out of pain and thinking time would take care of it,” she recalls. “But it kept getting worse and worse until I couldn’t even walk my dog for a short distance. Physical therapy did not help, and massage did not help.

“� e acupuncture was the only thing that alleviated the pain, but it wasn’t a cure. I’d be pain free, but then I’d need acupuncture again. By the sixth month, I couldn’t tolerate it any longer. I was begin-ning to believe that surgery was the only thing that could help me.”

Denise consulted a neurosurgeon, who ordered an MRI. � e imaging study revealed two herniated discs in her lower spine. She agreed with her physician they needed sur-gical repair and scheduled a date for surgery.

Due to the busy surgeon’s schedule, the operation couldn’t be performed for three months. Denise was resolved to su� ering until then, but shortly after scheduling the surgery she learned about Tyler Albrecht, DC, at St. Augustine Spine Center.

While researching the practice she became intrigued by a therapy that Dr. Albrecht uses to treat herniated and bulging discs called nonsurgical spinal decompression. Wanting to learn more, Denise made an appointment to consult with Dr. Albrecht.

Natural Healing Technique“When Denise came to us, she was in really bad shape,” states Dr. Albrecht. “She could only walk or stand for two minutes before the pain would become severe. She couldn’t do any bending or lifting, and the pain was interrupting her sleep.”

Denise’s herniated discs were causing spinal stenosis, a condition that causes nar-rowing of the space for the spinal cord. � is narrowing puts pressure on the spinal cord or spinal nerves, causing pain.

� rough his examination of Denise, Dr. Albrecht determined she was a candidate for nonsurgical spinal decom-pression. � e therapy works to restore herniated or bulging discs to a healthier state, thus relieving the pain.

“What I’ve found is that spinal decompression is usually the best treat-ment for a herniated disc because it helps to reverse the pressure on the disc and allows the disc to heal rather than just try-ing to cover up the pain with injections or medication,” notes Dr. Albrecht.

“Our decompression table does this by gently pulling the two vertebrae on either side of the a� ected disc, producing a vac-uum e� ect. � is allows bulging material and nutrients to be drawn back into the disc over time, allowing it to heal naturally. Advanced technology and computerized load sensors combine to create a gentle, pain-free treatment that avoids the muscle guarding re� ex that is commonly triggered with rudimentary traction devices.”

Denise liked how Dr. Albrecht explained the process clearly and comprehensively.

“Dr. Albrecht is very articulate and knowledgeable,’’ she describes. “He’s informative and factual. � e result was that I could make the decision on my own about whether to pursue treatment. He didn’t try to make the decision for me, which I appreciate in a doctor.”

Denise began a seven-week treatment regimen with three sessions of spinal decompression each week. In addition, she was treated with a combination of other modalities that are part of the disc rehabilitation program at St. Augustine Spine Center. They included manual therapy, chiropractic care, ice, electrical stimulation and laser therapy to help speed the healing process.

Coastal Integrative HealthcareStanding Her Ground

FHCN Special ReportFoot or Ankle Pain?

FHCN Special ReportEar Effects

Acute Wound CareIn-Home

Compression Pumps

Palm Coast Family DentistryOne-and-Done Dentistry

Atlantic Eye CenterWatching the Wheels

McGreevy NeuroHealth

6Holiday Stress Management

Good-Bye Leg Pain

Double Play

Catch the Wave

3Symphony

at St. Augustine

9McGreevy

NeuroHealth

Alpha Medical Group

12

Spinal DecompreSSion

Alexandra Kostick, MD, FACS, FRCSC,  is board certi� ed by the American Board of Ophthalmology. After earning her medical degree at the University of Manitoba in Winnipeg, Dr. Kostick served a mixed surgery internship at St. Boniface Hospital at the University of Manitoba, and an ophthalmology residency at the University of Saskatchewan in Saskatoon. She was fellowship trained in ocular pathology and intraocular lens research at Storm Eye Institute at the Medical University of South Carolina. She was also fellowship trained in cornea/external disease/refractive surgery through the University of Missouri in Columbia. Dr. Kostick is a fellow of the American Board of Ophthalmology, American Academy of Ophthalmology and the American College of Surgeons. She is a member of the American Society of Cataract and Refractive Surgeons, the American Academy of Cosmetic Surgery, the Flagler County Medical Association and the Florida Medical Association.

The Eyes Have It!Dr. Kostick welcomes the opportunity to help you protect and improve your eye health and achieve your best vision. Atlantic Eye Center is in Palm Coast at:

Pine Cone Dr., Suite

(386) 446-9590

Dr. Kostick wants the readers of Florida Health Care News to know that she is currently accepting new patients into her

eye care practice. All new patients receive a complete eye examination and screenings

for various ocular conditions, including cataracts, glaucoma and macular degeneration.

Dr. Kostick invites you to visit her website at www.atlanticeyecenter.com

ü Complete eye exams

ü No-stitch, no-needle, no-patch cataract surgery

ü Diabetic eye care

ü Glaucoma treatment and surgery

ü Second opinions

ü Cosmetic/ plastic eye surgery

ü BOTOX®/ JUVÉDERM®/ VOLUMA® anti-wrinkle treatments(these are not eye

care services)

ALEXANDRA KOSTICK, MD, FACS, FRCSC

You’re Invited

Additional Services:

Brent is riding safely with 20/20 vision following cataract surgery.

Watching the WheelsCataract surgery allows motorcycle enthusiast to ride safely again

T he older Brent Cole gets, the more daring he becomes. For example, it wasn’t until about 17 years ago that the

now 69-year-old adventurer took up the hobby of vintage racecar driving.

o� ers a wide range of services, including cataract and glaucoma screenings, and even performed upper-lid blepharoplasty on Brent’s eyelids a couple years ago.

A Natural Development “Brent came in this past April saying that his vision was starting to get blurry,” Dr. Kostick reports. “He said he was hav-ing trouble working on the computer and reading and mentioned that he was expe-riencing some glare issues when driving.

“We have been following Brent as a general patient for years, and we noticed a year ago that he was developing cata-racts. When he came back this time, it was apparent that the time had come for us to take those cataracts out.”

Cataracts develop naturally in about 90 percent of all people 65 or older, usually from a breakdown of the eye’s lens � bers, a clumping of the eye’s proteins, or both. They typically cause blurred vision, an increase in sensitivity to light and a reduc-tion in color vibrancy.

� ough cataracts usually develop slowly, they can be corrected quickly and easily through an outpatient procedure where the natural lens is removed and replaced with an arti� cial intraocular lens, or IOL.

After examining Brent, Dr. Kostick immediately scheduled him for cataract sur-gery. Prior to surgery, however, the doctor and the patient must agree on the speci� c type of IOL the patient will have implanted.

Standard IOLs correct a patient’s vision primarily for distance, meaning the patient may still need to wear glasses for reading. Patients can also have one eye corrected for distance vision while the other is corrected for reading, a process called monovision.

Brent chose to receive multifo-cal lenses, which are the best option for patients seeking to reduce their depen-dence on glasses, be it for distance vision or reading. Brent also had an astigmatism corrected in his left eye during his surgery.

“We corrected the astigmatism by performing a limbal relaxing incision,” Dr. Kostick informs. “� at’s a procedure done right at the time of the cataract surgery in which we create a � attening by making incisions at opposite edges of the cornea.”

In addition, Dr. Kostick used a special machine called the ORA™, which stands for Optiwave Refractive Analysis, to obtain the most accurate measurements possible of the shape of Brent’s eyes during the surgery.

“� e ORA � ne-tunes the power, and therefore narrows down the selection, of the intraocular lens implant,” Dr. Kostick notes. “� ere’s no way our pre-op measure-ments can compete with it, so it makes the patient’s end result much, much better.”

A good end result from cataract surgery is a patient who can literally see better than they have in decades, and that

was the end result for Brent, whose vision was returned to 20/20 following cataract surgery.

“The outcome has been outstand-ing,” Brent enthuses. “It’s like a miracle happened to me. I’m seeing like I did

when I was a kid again, even for reading. I don’t need glasses anymore for anything, and that’s a great feeling.”

Family-Like AtmosphereAs a longtime patient of Dr. Kostick’s, Brent says he knew all along that he was getting the best care a cataract patient could possibly get. Dr. Kostick managed to impress Brent nevertheless.

“She’s just awesome,” Brent exudes. “She’s a great professional, and she

explained everything about the procedure very well. I knew exactly what to expect every step of the way, and that kind of thing is very important. I mean, there were no surprises at all.

“And it’s the same with her entire sta� . � ey’re all great people and so professional. I’ve got nothing but good things to say about them all. One of the things I love most is that everybody there treats you like you’re a member of the family. � ey really do.”

A family-like atmosphere is a big part of what Dr. Kostick strives for at Atlantic Eye Center. She is proud to be treating the sons, daughters and grandchildren of patients she has been treating for years.

“Our patients become part of our extended family,” Dr. Kostick asserts. “We strive to make them comfortable by creating a very caring environment. � ey know they are going to be treated with a personal touch whenever they come here.”

A strong reputation in the commu-nity is also something the sta� at Atlantic Eye Center strives to maintain.

“I think word of mouth is very important for doctors, and we pride our-selves on the referrals we get,” Dr. Kostick adds. “I can honestly say that my sta� go out of their way to ensure that people are cared for to our utmost capability.”FHCN article by Roy Cummings. Photo by Nerissa Johnson.

Tire background from Pixabay. mkb

� e Palm Coast resident still rides motorcycles, too. Brent will be the � rst to tell you, though, that it’s not just his passion that keeps him riding the open road. Were he not a safe, defensive driver, Brent says he might not be riding at all.

“I’ve been riding motorcycles for � fty-three years, and you have to be a defensive rider, or you won’t be riding for long,” Brent says. “You especially need to be defensive when you’re approaching an intersection because that’s where a lot of accidents happen.

“Another smart thing to do is to watch the spokes of the wheels of vehi-cles coming out of the side streets. You can see that spoke moving before you can perceive the car moving, so that’s a good way to avoid a problem.”

A driver doesn’t need to have perfect 20/20 vision to see the spokes of a wheel moving, but Brent recently learned that poor or deteriorating vision can indeed reduce a person’s ability to pick out that important detail.

“I noticed that my vision was starting to go a little bit, and then it got to a point where if I was about � fty yards out from a side street or intersection, I still couldn’t see those spokes moving, and that worried me,” Brent reveals.

Brent’s concerns prompted a trip to the eye doctor. Just as he’s done since his wife � rst recommended her about 15 years ago, Brent went to see Alexandra Kostick, MD, at Atlantic Eye Center in Palm Coast for a detailed evaluation.

Board certified by the American Board of Ophthalmology, Dr. Kostick

Page 2 | Florida Health Care News | Winter 2019 | St. Augustine/Ponte Vedra Beach Edition ophthalmology

Nancy Nichols

Setting a New Standard

in Memory CareSymphony at St. Augustine is a 64-unit memory care community designed exclusively for residents with Alzheimer’s disease, memory loss and other forms of dementia. Through its physical design and holistic memory care approach, the community addresses the unique needs of residents in ways that help them feel safe, secure and valued. Sta� members are happy to answer questions or supply more information about the new memory care community located o� State Road 16.

Village Crossing Court

(904) 432-1640

Holiday Stress Management

Tara Tosh

Visit Symphony at St. Augustine online at www.symphonyatstaugustine.com and on Facebook at www.facebook.com/staugustinememorycare

Memory care community o� ers relief for caregivers

D onna* describes her mother, Meredith, as an 81-year-old � recracker who’s very phys-ically � t. Donna says her mother has been that way all her life and can even outrun

and outjump her.Two years ago, however, Meredith was diagnosed

with frontal temporal lobe dementia.

“Mom’s symptoms started a year after my father’s death, which was in mid June 2015, and were vague at � rst,” Donna shares. “My sisters and I live � fteen hun-dred miles away, so we checked on Mom by phone daily and every six weeks, one of us went to Florida for a week or two to be with her.

“� en, we started getting phone calls from Mom’s neighbors who were saying Mom was doing funny things and wondering if she should still be living alone.

“� e neighbors told us Mom was getting lost driving in the neighborhood, and she backed up and hit a mailbox. She also broke the back windshield of her SUV and wasn’t home when the technician came to the house to � x it. She started going days without sleeping and got a little delusional. She started saying things that didn’t make sense.”

Initially, Meredith ended up in emergency care, where she was diag-nosed with dementia. She then went to an assisted living facility, where she developed a close bond with staff member Nancy Nichols.

Not long thereafter, Nancy left that community to become the marketing direc-tor at Symphony at St. Augustine, a memory care facility for people with dementia. � e move had a great e� ect on Meredith.

“I almost felt like my mother was grieving for Nancy,” Donna relates. “It was another loss for her. I kept Nancy’s number in my phone and eventually called her and arranged to have my mother moved to Symphony at St. Augustine. � at was in December of last year.

“Symphony at St. Augustine was like Walt Disney World®. We were very impressed and loved the sta� . My sister and I talked to Nancy and then met the executive

director Tara Tosh. My sister and I said, Mom will like it here. It’s all memory care, and she can be outside in the park if she wants to be.”

Because Meredith was fond of doing house-work, Donna was not surprised that Symphony at St Augustine’s housekeeping staff became some of Meredith’s best friends. But it was in the community’s kitchen that she found her second calling.

“Mom helps the kitchen sta� with breakfast, lunch and dinner,” states Donna. “She folds napkins, puts the silverware together and makes sure everybody’s got their meals in front of them. She loves working and being in that work atmosphere. I think working in the kitchen promotes a lot of self-esteem for her.

“Mom likes it at Symphony at St. Augustine, but if you ask her, she’ll say she’s going home any day now. � e structure they o� er there, as well as the activities, are very good for my Mom.”

Holiday Option� e holidays can be stressful for anyone, but they can be extra stressful for someone with dementia or some-one caring for a loved one with dementia. Adding shopping, holiday parties, travel, family gatherings and other activities to the hustle and bustle of daily

life can lead to confusion and acting out in people with

dementia, and fatigue and guilt in caregivers.

“ Pr i m a r y c a r e -givers try to squeeze in activities at church

or with grandchildren, and get stressed because

they can’t leave their loved ones with dementia home for

long because they’re not safe,” describes Tara. “� en when the care-

givers get home, they feel guilty because their loved ones feel that stress and might

act out with a negative behavior.“The holidays are also a common time for

depression in any senior, much more so in people who have dementia. It’s a time of year when they look for loved ones they’ve lost and think about family gather-ings they used to have. At home, there’s generally not much conversation or interaction with others.”

Meredith’s move to Symphony at St. Augustine came right around the holidays, a time when care-givers for people with dementia sometimes become stressed and anxious that they’re not giving their loved ones enough time and attention.

Caregivers also worry that their added activities at this time of year interfere with their loved ones’ routine schedules. To help alleviate those concerns, Symphony at St. Augustine o� ers short-term stays for those loved ones with dementia.

“When caregivers need a respite and want a more stimulating environment for their loved ones with dementia, they can be comfortable leaving their loved ones here because it’s a safe environment,” o� ers Tara.

“� eir loved ones will be happy here. � ere are activ-ities to keep them active, and they’ll be around other people the same age, so they’ll make friends. � ere’s a daily routine and schedule, which helps people with dementia stay focused. Many of them love it so much here that they decide to stay permanently.”

� e atmosphere at Symphony at St. Augustine is always warm and inviting, but it is especially so during the holidays. � e campus is festively decorated, and it opens its doors to family members and friends to cele-brate with residents. � ere are many scheduled activities with a holiday � avor.

“Family members don’t have to feel guilty, because their loved ones are celebrating the holidays,” assures

Tara. “� e building is decorated to a tee to bring joy to the residents. Often, when people get older, they don’t decorate as much because they get tired. � e residents will get to see our sta� ’s holiday spirit.”

“Caregivers and family members can have holiday dinner with the residents,” adds Nancy. “Dinner will always be at the same time. Here, everything stays on schedule, even on the holidays. Structure is vital for people with memory problems because it decreases neg-ative behavior and keeps their expectations even. It’s very important to stick to a routine.”

Being There Meredith’s was a permanent stay from the beginning, not a converted short stay. Donna opted to cut back on her visits for a while so Meredith could get accustomed to living at the community.

“Mom went to Symphony at St. Augustine the � rst week of December, and I chose to stay away for a couple of weeks so she could get acclimated,” Donna con� rms. “Of course, I was there to celebrate the holidays.”

Donna retired last year and now lives in Florida from the beginning of November until late June. Now that she’s in Florida during the holiday season, she gets to spend that time with Meredith. Donna’s sister visits with her mother as well. Between the two of them, Meredith is never alone during the holidays.

“We love Symphony at St. Augustine,” Donna exudes, “and we love that Mom is thriving there.”FHCN staff article. Tara’s photo by Jordan Pysz. Nancy’s photo by Nerissa Johnson.

Background graphic from Pixabay. mkb

*Patients’ names were changed to protect their privacy.

St. Augustine/Ponte Vedra Beach Edition | Winter 2019 | Florida Health Care News | Page 3memory care

Page 4 | Florida Health Care News | Winter 2019 | St. Augustine/Ponte Vedra Beach Edition

Barry LevineExecutive Publisher

Thom GiordanoAssociate 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

Kent BoothRobert MizeRick Bowser Distribution

St. Augustine Spine CenterSpinal Decompression

Atlantic Eye CenterOphthalmology

Symphony at St. AugustineMemory Care

Palm Coast Family DentistryRestorative, Implant and Cosmetic

Dentistry

McGreevy NeuroHealthVenous Disease

Acute Wound CareCompression Therapy

McGreevy NeuroHealthNeurology and Pain Care

Coastal Integrative HealthcareRegenerative Medicine

Alpha Medical GroupErectile Dysfunction

215 Bullard ParkwayTemple Terrace, FL 33617

(813) 989-1330

Florida Health Care News

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

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

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

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

Articles reflect the opinion of the sponsoring profes-sional or organization and do not necessarily reflect the opinions of other contributing editors. Contributing editors have approved all text contained within their respective articles.

© 2019 Florida Health Care News, Inc. All rights reserved. The contents of this publication, including articles, may not be reproduced in any form without written permission from the publisher.

FOR ALL health care professionals having

articles in this publication: THE PATIENT AND ANY OTHER PERSON

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

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

PERFORMED AS A RESULT OF, AND WITHIN 72 HOURS OF RESPONDING TO, THE ADVERTISEMENT FOR A FREE,

DISCOUNTED OR REDUCED FEE SERVICE, EXAMINATION OR TREATMENT.

Winter 2019

Pain-Free Solution� e therapy sessions were pleasant experiences, Denise relates.

“� e atmosphere in Dr. Albrecht’s o� ce is lovely and peaceful,” she says. “And the decompression treatments were very comfortable and easy to do. � ey’re pain free. You can watch videos while you’re lying on the decompression table, which I did a lot, and it’s restful.”

Halfway through her treatment program, Denise discovered how much spinal decompression was helping. She went to a boat show with her husband and was stunned to realize that walking didn’t hurt anymore.

“We were walking around and after about forty-� ve minutes, I stopped and said, Art, I have no pain,” remembers Denise. “Before, I would go places, even though it hurt to walk, because I’m an active person. I would walk, hurt, sit; walk, hurt, sit.

“At the boat show, it suddenly dawned on me that I had been walking for forty-� ve minutes and hadn’t needed to sit down because I wasn’t hurting.”

Before her � rst visit with Dr. Albrecht, Denise says her average pain level was six on a scale of one to ten. By the end of treatment, she says, it had dropped to zero.

Dr. Albrecht uses another feedback measure, the Low Back Pain and Disability Index, to gauge results. � e questionnaire focuses on how much back pain interferes with daily activities.

“When we started out, Denise was at sixty-six percent in terms of how much the pain was disabling her,” states Dr. Albrecht. “When we � nished, she was down to zero percent, meaning she had experi-enced a full recovery.”

Denise is slowly working her way back into horse-riding shape. And before she resumes yoga and weight training, she is following a regimen of stretching and strengthening her core.

“I’m not trotting or cantering on my horse at this time, but slowly we’ll get there,” she says. “I was in pretty darn good shape for my age before that [injury] occurred, and I’m going to make sure I am again before I resume all my activities.”

Back Surgery Avoided!

Tyler Albrecht, DC, attended Palmer College of Chiropractic in Port Orange, FL, where he graduated summa cum laude and was honored as a presidential scholar. He attended Western Michigan University for undergraduate studies. In 2011, he com-pleted post-graduate study for the Certi� ed Chiropractic Sports Practitioner program through the American Chiropractic Board of Sports Physicians. He is a member of the Florida Chiropractic Association, and Spinal Decompression Doctors.

Erin Bailey, DC, earned her undergraduate degree in exercise physiology from Harding University. She earned her Doctor of Chiropractic degree from Palmer College of Chiropractic Florida. She is an active member of the Florida Chiropractic Association.

For more information about St. Augustine Spine Center, please visit the website at www.StAugustineSpineCenter.com

Back Pain Relief and MoreSt. Augustine Spine Center’s mission is to provide the highest quality of care available to patients su� ering with severe and chronic back pain, neck pain and peripheral neuropathy and return them to a pain-free, active lifestyle. The sta� at St. Augustine Spine Center utilizes the most advanced nonsurgical, drug-free procedures available, including spinal decompression and class IV laser therapy. Spinal decompression is an FDA-cleared technology that o� ers a pain-free solution to patients with bulging or herniated discs, degenerative disc disease, pinched nerves, posterior facet syndrome, sciatica or spinal stenosis. For more information or to schedule an appointment, call or visit their o� ce in St. Augustine at:

1750 Tree Blvd., Suite 8

(904) 429-7750

Nonsurgical Spinal Decompression

Relieves Pain Caused By:• Bulging or

Herniated Discs

• Degenerative Discs

• Pinched Nerves

• Facet Syndrome

• Sciatica

• Neck and Arm Pain

• Spinal Stenosis

Services Available at St. Augustine Spine

Center Include:• Spinal decompression

• Chiropractic care

• Auto injury care

• Sports injury care

• Peripheral

neuropathy care

• Class IV laser therapy

• Physiotherapy

• Wellness care

Types of Spinal StenosisCervical stenosis. In this condition, the narrowing occurs in the part of the spine in your neck.

Lumbar stenosis. In this condition, the narrowing occurs in the part of the spine in your lower back. It’s the most common form of spinal stenosis.

SymptomsMany people have evidence of spinal stenosis on an MRI or CT scan but may not have symptoms. When they do occur, they often start gradually and worsen over time. Symptoms vary depending on the location of the stenosis and which nerves are a� ected.

In the Neck (Cervical Spine)• Numbness or tingling in a hand, arm, foot or leg• Weakness in a hand, arm, foot or leg• Problems with walking and balance• Neck pain• In severe cases, bowel or bladder dysfunction

(urinary urgency and incontinence)

In the Lower Back (Lumbar Spine)• Numbness or tingling in a foot or leg• Weakness in a foot or leg• Pain or cramping in one or both legs when you stand for long periods

of time or when you walk, which usually eases when you bend forward or sit

• Back pain

Once she felt certain that spinal decompression had given her long-lasting relief, Denise canceled her surgery date. Ultimately, she succeeded in � nding a treatment that took away her severe back pain without surgery or drugs.

“It was a long road because I tried so many things,” she relates. “I’m really pleased with my treatment by Dr. Albrecht. It’s pretty impressive.” FHCN article by Roy Cummings. Photos by Jordan Pysz. mkb

Denise is back in the saddle now that her back pain is gone.

(continued from page 1)

Spinal DecompreSSion

Jayraj J. Patel, DMD, has been practicing gen-eral dentistry in the Central Florida region since graduating from the University of Florida College of Dentistry. His goal is to deliver comprehensive, compassionate care to his patients in a caring, comfortable and professional environment. He and his team at Palm Coast Family Dentistry strive to provide advanced, personalized and complete care to each patient using the latest dental tech-

nologies and treatment modalities, with an aim to build a long-term relationship based on trust, respect and friendship. Dr. Patel has extensive training in dental implant therapy through comprehensive courses such as the AAID MaxiCourse® from Augusta University and the Comprehensive Implant Continuum from Implant Educators™. He is a Fellow of the International Congress of Oral Implantologists and an Associate Fellow of the American Academy of Implant Dentistry and is currently pursuing his Fellowship in the Academy of General Dentistry.

Modern Dentistry, Personalized Care

Palm Coast Family Dentistry specializes in family, implant and cosmetic dentistry for all ages. The practice is focused on creating healthy smiles in a stress-free, caring environment. For more information or to schedule an appointment, call or visit the o� ce in Palm Coast at:

50 Cypress Point Parkway

(386) 445-0977

JAYRAJ J. PATEL, DMD

Visit them on the web at palmcoastfamilydentist.com

Serving All Your Dental Needs

At Palm Coast Family Dentistry, their goal is to provide the best care possible in an environment in which patients have the opportunity to communicate with the entire dental team regarding their oral health. Their services include:

¡ General Dentistry ¡ CEREC (same-day porcelain

crowns and fi llings) ¡ Cosmetic Dentistry ¡ Invisalign® (clear braces) ¡ Implant Dentistry ¡ Pinhole® Gum Rejuvenation ¡ Sedation Dentistry ¡ Platelet-Rich-Fibrin Therapy

Crowns, implant restorations completed in a single visit

One-and-Done Dentistry

N ew England native Ronald Brown is 76 years old, but this spry sort says with pride that he neither feels nor acts his age.

“I still think I’m twenty-� ve, and let me tell you, that gets me into a lot of trouble sometimes,” Ronald says with a chuckle.

Once the owner of his own insurance adjust-ment company, Ronald’s healthy zest for life includes playing golf several days a week. It was during one of his recent rounds of golf that Ronald noticed his age catching up with him a bit.

“I’m a guy who has a real high tolerance for pain, but one day a little more than a year ago, I noticed that when my blood got to � owing a little bit, there was a tooth that really started to bother me,” Ronald relates.

When the issue with his tooth worsened, Ronald made an appointment to see his dentist. For almost as long as Ronald has lived in Florida, that dentist has been Jayraj J. Patel, DMD, of Palm Coast Family Dentistry.

“Dr. Patel became my dentist when he bought out the practice from the husband and wife dental team that was working in the build-ing he’s in now,” Ronald relates. “One of the � rst things he did for me was � nish o� a job the previous dentists had started.”

� at job was the restoration of a failed tooth that had to be extracted and replaced with a dental implant by an outside specialist. Dr. Patel com-pleted the restoration by placing the abutment on top of the implant and topping the abutment o� with a crown.

� at job took about eight months to complete, so when Ronald learned that this latest problem required an implant procedure as well, he immediately envisioned another long run of dental visits.

Dr. Patel told him that he could do the job in half the time it took to do the � rst one.

“Let’s Get It On” “I didn’t even know at the time that Dr. Patel did that kind of specialty work, but when he told me he did and gave me the time frame, I said, Fine, let’s get it on,” Ronald exudes. “I’m telling you right now, it was one of the smartest things I’ve ever done.”

Ronald Brown

� e tooth Dr. Patel was charged with replacing was the incisor just to the left of Ronald’s two front teeth. � at tooth had become fractured to the point where it was non-restorable, which is why Dr. Patel recommended implant therapy.

Dr. Patel’s treatment plan for Ronald began with the extraction of the damaged tooth. To ensure he met his goal of completing the entire implant procedure in four months, Dr. Patel had to take extra care in the removal of that tooth and perform immediate implant placement therapy.

“� e tooth needed to be extracted with the least amount of trauma possible, making sure that most of the important bone structure and gum tissue were preserved so that we could place the implant the same day, which is critical to expediting the process,” Dr. Patel says.

“The next thing was to prepare the area for the implant. Instead of cutting the bone to create space for the implant, I performed a process called osseodensi� ca-tion in which the bone is condensed to create that space.

“When the tooth comes out, the hole that’s left is bigger than the hole needed for the implant. With the osseodensi� -cation process, the bone is condensed to prepare the implant placement site, which results in the patient needing less bone grafting material to secure the implant.”

In addition to performing the osseodensi� cation process, Dr. Patel used some of Ronald’s own blood to create a special mixture called platelet-rich � brin, which was applied to the implant area to further expedite the healing process.

“Not only does the platelet-rich � brin expedite the healing process, which is again critical to the outcome, but it creates an environment for better acceptance of the implant and reduces the chance of pain or infection in the area,” Dr. Patel educates.

Time Well Spent Ronald says he spent about four hours at Dr. Patel’s o� ce during the day that the tooth was extracted and the implant with the temporary crown was placed. He said the time was well worth it because it set the stage for the fast recovery Dr. Patel was aiming for.

“First of all, I was amazed that Dr. Patel could do all the work that he did in those four hours,” Ronald says. “And second, I couldn’t believe that the tooth extraction went as easy as it did. � e tooth was out before I even knew he’d taken it.

“Believe me, I remember back in the 1950s when dentists almost had to stand on your chest to pull a tooth out, and it was painful as all get out. But Dr. Patel got that thing out of there, and I literally didn’t feel a thing.

“After that first day of dental work in mid December of last year, all I had to do was heal for a few months. By the end of April, I was back in Dr. Patel’s chair getting my permanent tooth placed and everything was done. So just like Dr. Patel said, the whole thing took about four months.”

Ronald wasn’t the only one who benefitted from Dr. Patel’s expedited work process. Dr. Patel used Ronald’s case during his certi� cation process to gain his Associate Fellowship with the American Academy of Implant Dentistry.

“The importance of the case is that we can greatly reduce the time needed to replace a fully functional tooth, and that time can be signi� cant when working on the upper front teeth, where the bone is softer, and the work is slightly more chal-lenging,” Dr. Patel says.

Ronald’s work with Dr. Patel didn’t end there. Not long after completing the implant procedure, he had to have an emergency root canal and crown placement performed on another tooth.

By using a sophisticated ceramic restoration machine called CEREC®, which allows dentists to create dental restoration pieces such as crowns and bridges right in their own o� ce, Dr. Patel managed to do that work in a single visit.

“� e way he was able to create that crown while I waited in the chair was just fascinating to me,” Ronald says. “And I loved that I didn’t have to spend two weeks or whatever wearing a temporary crown and waiting for the permanent one to be made.“� at was great, but that’s the kind of care you get

from Dr. Patel. Believe me, I’ve gone through a lot of dentists in my day, but never have I had one who works as fast and well as Dr. Patel does. He’s fast, he’s good and best of all, he’s a really great guy, a family man, and I’m glad that I’ve got him as my dentist.”FHCN article by Roy Cummings. Photo by Nerissa Johnson. mkb

St. Augustine/Ponte Vedra Beach Edition | Winter 2019 | Florida Health Care News | Page 5reStorative, implant anD coSmetic DentiStry

KAI MCGREEVY, MD

wave of the

futureLet a board-certified neurologist and pain management specialist help get you on the road to recovery. McGreevy NeuroHealth has two locations to serve you:

St. Augustine559 W. Twincourt Trail

Suites 607-608

Palm Coast57 Town Court

Suite 123

To schedule an appointment at either location, call:

(904) 230-3006

Kai McGreevy, MD, is board certi� ed in neurology and pain medicine by the American Board of Psychiatry and Neurology. The American Board of Independent Medical Examiners also certi� es him. His medical training includes completion of a neurology resi-

dency at the University of California, San Diego, and an interventional pain medicine fellowship at The Johns Hopkins University School of Medicine in Baltimore, MD. While at Johns Hopkins, he was mentored by leading � gures in the � eld of pain management and published over ten peer-reviewed articles in presti-gious journals such as Pain Physician. Dr. McGreevy has presented his clinical research at the national level, earning prestigious awards from the American Society of Regional Anesthesia and Pain Medicine. He is a member of the American Academy of Neurology and the American Society of Interventional Pain Physicians.

good-bye leg painLaser energy repairs damaged veins

Degeneration caused John Darnell’s spinal discs to begin collapsing, placing pressure on his spinal cord and nerves. To

ease the pain that resulted, John tried a num-ber of treatments, including physical therapy and surgery. � e pain, however, outlasted all attempts to relieve it.

“I had several treatments on my back, including two surgeries by a spine surgeon, and still had pain,” John con� rms. “I was going to my family doctor, and he referred me to a specialist who began treating me for the pain in my back.”

“When Dr. McGreevy � rst noticed my legs, he said, “� ey don’t look good,” John con-� rms. “He mentioned the discoloration and told me, � at’s not a tan. It’s a circulation prob-lem. Your legs are holding blood. He told me I had varicose veins, which surprised me because I didn’t have any bulging veins on my legs at all.

“My ankles swelled, particularly in the morning when I woke up and started walk-ing, but as the day went on, I really didn’t notice it as much. I guess with activity, my blood started circulating in my legs. But when I would lie down in bed at night, the swelling would build up. I also had cramps in my legs, but it wasn’t a continuous problem.”

As part of the body’s circulatory system, leg veins have the job of pumping blood upward, against gravity, toward the heart. � ey get help from the power of leg muscle contractions. To further assist with this task, there are a series of one-way valves in leg veins that keep the blood from � owing in reverse, or re� uxing.

“With age, heredity or long hours of sitting or standing, these valves can weaken, and blood can � ow backward and collect in the legs and ankles, causing symptoms,” describes Dr. McGreevy. “� is condition is called venous insu� ciency.”

To diagnose venous insufficiency, Dr. McGreevy performs a Doppler venous ultrasound examination that allows him to see the � ow of blood from the legs toward the heart. In John’s case, the simple, non-invasive exam revealed signi� cant venous insu� ciency in both legs.

Dr. McGreevy responded by recommend-ing John wear compression stockings for about four weeks to help eliminate the swelling and heaviness in his legs. � e stockings had little e� ect, however. At that point, Dr. McGreevy knew a new course of action was necessary.

“I sat down with John and discussed his entire scenario with him,” describes the doctor. “We developed a game plan for his leg veins.”

Symptom Reliever� e treatment plan for John’s legs included a procedure called endovenous laser ablation, or EVLA, in which the doctor introduces a sterile laser � ber into the problematic vein via a tiny puncture in the leg.

During EVLA, laser energy is delivered through this � ber, gently collapsing and seal-ing the vein. Blood � ow from the sealed vein then reroutes through other, healthy veins in the leg, which reduces the impact of venous insu� ciency on the patient.

“EVLA relieves the symptoms, including pain, swelling, fatigue, itching and weakness,” notes Dr. McGreevy. “It also improves the aesthetics of the legs, reducing any discolor-ation and breakdown of the skin, as well as the appearance of varicose and spider veins.”

“Getting those test results prompted me to make an appointment to have the laser treatment on my right leg, and after I made the appointment, I picked up a brochure about it on the way out of Dr. McGreevy’s o� ce,” John notes.

“The brochure explained everything about venous insu� ciency, and it veri� ed everything Dr. McGreevy told me. When I returned to his o� ce in St. Augustine and had the procedure done, it was painless.

“After rubbing my skin with a solution to deaden the pain, a technologist put nee-dles in my leg. He had a scope that traced the vein Dr. McGreevy wanted to block o� , then he injected it with numbing medicine.

“After that, Dr. McGreevy came in and performed the laser treatment. � ere was a little bit of a burning sensation, but it was bearable. Afterward, they wrapped my leg in ACE™ bandages. I had the treatment on a � ursday and had to keep the ACE bandages on with compression until Sunday, then I could take the bandages o� .”

“We performed EVLA on both greater saphenous veins in John’s legs, and he expe-rienced signi� cant physical improvement,” Dr. McGreevy says. “John was pretty amazed by how much better his legs felt as well. He had reduced discomfort in his legs with less fatigue, swelling and cramping.

“Sometimes, when we perform EVLA, it takes a little while for the results to be fully realized by patients. In John’s case, however, he had a very quick response. Within a week of performing EVLA on his right greater saphenous vein, he indicated he already started to feel a di� erence in his right leg.”

Prevalent ProblemVenous insufficiency is a very common condition. It is estimated that more than 30 million Americans su� er with symptomatic venous insu� ciency. Venous vascular disease is � ve times as prevalent as peripheral arterial disease, or PAD, and more than two times as prevalent as coronary artery disease.

Symptoms of venous insu� ciency include pain, aching, swelling, heaviness, nighttime cramps, restless legs, discoloration and, in later stages, skin ulceration, but it’s “hugely underdi-agnosed,” asserts Dr. McGreevy. Symptoms are often attributed to other disorders.

“Symptoms of venous insu� ciency, the things that can be felt by the patient, can result in sensory changes such as numbness, tingling, weakness and fatigue,” he states.

“� ese are all things patients describe to me every day when I examine them and perform nerve conduction studies.

“� ese symptoms may appear neuro-logic at � rst glance, but there’s no perfect box they � t into, so I don’t make assump-tions that they’re caused by nerve injury. If I test and discover these symptoms are not nerve related, they can be generated from multiple sources.

“If these symptoms are accompanied by visible signs such as swelling in the legs, I look at other possible sources. I have to rule out a

cardiac condition such as heart failure, as well as a liver condition, protein imbalance and other disorders that can lead to leg swelling.”

In the absence of those sources, Dr. McGreevy continues, there’s a high index of suspicion for venous insu� ciency, the treatments for which are generally covered by insurance. � ey’re covered not just for pain relief, but also for prevention because there are complications that can occur later in life that are very expensive to treat.

Wholehearted TrustIn 2015, Patti Adornetti was involved in a seri-ous auto accident that left her badly injured and ended her career as a high-production print specialist for Xerox® Corporation. � e Cleveland, Ohio native su� ered severe pain in her legs and back, which required surgery, and eventually, she turned to Dr. McGreevy for help with pain management.

“I’ve been Dr. McGreevy’s patient for going on two years,” shares Patti. “The doctor who performed my back surgery recommended him.”

During that two-year per iod, Dr. McGreevy used several pain man-agement techniques to help keep Patti’s back pain at bay. At the same time, how-ever, Patti was being bothered by another uncomfortable issue.

“Over the years, I developed pain in my legs, and about a year and a half ago, the varicose veins on my legs started to become more and more intense,” she relates. “� e discomfort was becoming intense as well.

“� e pain was mostly a tired and achy feeling, but it became more of a stabbing pain at night, especially when I was trying to sleep. During the day, my legs ached and felt heavy, like their weight had doubled.

“As the pain got worse, I had to give up doing some of the activities I used to do routinely. It became di� cult for me to do things I liked, including kayaking, walking and riding my bike.”

One day, while driving to McGreevy NeuroHealth for a pain management appointment, Patti saw a message about varicose veins, and it got her thinking. � at day, as she talked with Dr. McGreevy, she casually said, “I want to do something about my varicose veins.” In response, the doctor explained that he treated vein concerns as well as nerve disorders.

“It was just a coincidence,” comments Patti. “I only said something because I saw that message. After he told me he did vein treatment as well, I told him, Good. I’ll have you take care of my veins, because I trust him wholeheartedly.”

Just as he did with John, Dr. McGreevy began his treatment of Patti’s veins with a Doppler ultrasound examination. � e exam-ination revealed that Patti, too, was su� ering from signi� cant re� ux in her super� cial veins and was therefore a good candidate for EVLA.

“At the time of the procedure, the technol-ogist did the preparation, such as numbing the area, and then Dr. McGreevy stepped in and took care of the veins,” Patti reports. “He used a laser to treat the veins and relieve the pain.

“� e procedure wasn’t bad at all. � e worst part of it was when they numbed me because they had to give me several shots to numb the area around the veins. I couldn’t even feel it when Dr. McGreevy came in and did his part. I didn’t feel any real pain after the treatment, either.”

Miraculously SuccessfulJohn’s right leg didn’t look much better that Sunday after his � rst EVLA, but it did by the following week, when he returned to McGreevy NeuroHealth to have the treat-ment on his left leg.

“My right leg cleared up miraculously,” John raves. “It was very clear and had light-ened up considerably compared to the leg Dr. McGreevy hadn’t treated yet. When I � rst went into the o� ce, the receptionist said, Look what happened here. I walked into the little sta� area, and everybody looked at my right leg and said, Wow!

“I looked at my leg and said, Gee, I really did have a problem. I didn’t know the prob-lem with heaviness in my legs was that bad, but since I had the procedures on my vari-cose veins, my legs are a lot lighter and I can walk much better. I must have gotten used to the heaviness. I don’t have the swelling anymore, either.

“And all this time, Dr. McGreevy is still treating my back pain.”

� e EVLA was a success for Patti as well. She reports that her legs feel good since the treatment. She’s also very pleased with the

aesthetic results she’s achieved so far, and Dr. McGreevy told her it will only get better. He said it will take about a year for her legs to be completely healed and functioning optimally.

“My legs look great,” she marvels. “My right leg had very big, bulging veins, and they’re completely gone. � ere are no vari-cose veins in my right leg at all. My left leg had bad veins as well. � ere are still a few little pieces of vein visible on my left leg, but they will eventually work their way out once everything has properly healed.

“� e pain is phenomenally better than it was before. I would say it’s about a two out of ten now, when it used to be seven or eight.”

With Dr. McGreevy managing her back pain and since achieving relief from the achiness of her varicose veins, Patti’s been able to return to her active lifestyle. She’s thrilled because she likes to stay active for fun and � tness.

“I’m back to doing the activities I had to stop doing before,” she con� rms. “Now, I’m � nding it easier to walk and bike again.”

John and Patti are impressed by Dr. McGreevy and his sta� at McGreevy

NeuroHealth. � ey � nd the neurologist to be knowledgeable, kind, understanding and worthy of their trust.

“Over the years, I had a knee replace-ment and a broken ankle that was due to my back and loss of balance,” offers John. “I went to physical therapy for both of those conditions. Nobody noticed I had a problem with my leg veins except Dr. McGreevy.

“My EVLA procedures were absolutely, in capital letters, successful. I recommend EVLA for varicose veins, and I recommend McGreevy NeuroHealth and Dr. McGreevy. I have complete con� dence in him.”

“Everybody at McGreevy NeuroHealth is great,” adds Patti. “I think Dr. McGreevy is a fantastic doctor. He listens to me. Of all the doctors I’ve been to over the years, he’s de� nitely one of the best. I wouldn’t have gone to another doctor. Dr. McGreevy is de� nitely the only doctor I would let touch my legs. He’s a great physician, and I rec-ommend him one hundred percent!”FHCN article by Patti DiPanfilo. Photos by Nerissa Johnson.

mkb

John’s doctor referred him to Kai McGreevy, MD, a board-certi� ed neurol-ogist and pain management specialist at McGreevy NeuroHealth in St. Augustine. Dr. McGreevy uses a variety of techniques to relieve his patients’ pain.

“Initially, I was treating John’s back pain using medial branch nerve blocks, which pro-vided some relief,” reports Dr. McGreevy. “We have now completed those nerve blocks, and we’re close to performing radiofrequency ablation (RFA) on his spinal nerves, which is the next step in his treatment.

“Before doing those treatments, how-ever, while completing a full history and physical on John, he relayed that he was experiencing a little heaviness in his legs. Many times, that’s attributed to the spine, but upon inspection, I saw he had discolor-ation and swelling in both legs. He then told me that he had been experiencing cramping and fatigue as well.”

Patti has resumed her � tness-oriented lifestyle

EVLA treatment relieved John of the

heaviness and swelling in his legs

Risk Factors for Varicose Veins

These factors increase your risk of developing varicose veins:

Age. The risk of varicose veins increases with age. Aging causes wear and tear on the valves in the veins that help regulate blood fl ow. Eventually, that wear causes the valves to allow some blood to fl ow back into the veins, where it collects instead of fl owing up to the heart.

Sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor. Female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase the risk of varicose veins.

Family history. If other family members had varicose veins, there’s a greater chance the person will, too.

Obesity. Being overweight puts added pressure on the veins.

Standing or sitting for long periods of time. The blood doesn’t fl ow as well if a person is in the same position for long periods.

John shows o� some of his stained glass handiwork

Patti Adornetti

Page 6 | Florida Health Care News | Winter 2019 | St. Augustine/Ponte Vedra Beach Edition venouS DiSeaSe

KAI MCGREEVY, MD

wave of the

futureLet a board-certified neurologist and pain management specialist help get you on the road to recovery. McGreevy NeuroHealth has two locations to serve you:

St. Augustine559 W. Twincourt Trail

Suites 607-608

Palm Coast57 Town Court

Suite 123

To schedule an appointment at either location, call:

(904) 230-3006

Kai McGreevy, MD, is board certi� ed in neurology and pain medicine by the American Board of Psychiatry and Neurology. The American Board of Independent Medical Examiners also certi� es him. His medical training includes completion of a neurology resi-

dency at the University of California, San Diego, and an interventional pain medicine fellowship at The Johns Hopkins University School of Medicine in Baltimore, MD. While at Johns Hopkins, he was mentored by leading � gures in the � eld of pain management and published over ten peer-reviewed articles in presti-gious journals such as Pain Physician. Dr. McGreevy has presented his clinical research at the national level, earning prestigious awards from the American Society of Regional Anesthesia and Pain Medicine. He is a member of the American Academy of Neurology and the American Society of Interventional Pain Physicians.

good-bye leg painLaser energy repairs damaged veins

Degeneration caused John Darnell’s spinal discs to begin collapsing, placing pressure on his spinal cord and nerves. To

ease the pain that resulted, John tried a num-ber of treatments, including physical therapy and surgery. � e pain, however, outlasted all attempts to relieve it.

“I had several treatments on my back, including two surgeries by a spine surgeon, and still had pain,” John con� rms. “I was going to my family doctor, and he referred me to a specialist who began treating me for the pain in my back.”

“When Dr. McGreevy � rst noticed my legs, he said, “� ey don’t look good,” John con-� rms. “He mentioned the discoloration and told me, � at’s not a tan. It’s a circulation prob-lem. Your legs are holding blood. He told me I had varicose veins, which surprised me because I didn’t have any bulging veins on my legs at all.

“My ankles swelled, particularly in the morning when I woke up and started walk-ing, but as the day went on, I really didn’t notice it as much. I guess with activity, my blood started circulating in my legs. But when I would lie down in bed at night, the swelling would build up. I also had cramps in my legs, but it wasn’t a continuous problem.”

As part of the body’s circulatory system, leg veins have the job of pumping blood upward, against gravity, toward the heart. � ey get help from the power of leg muscle contractions. To further assist with this task, there are a series of one-way valves in leg veins that keep the blood from � owing in reverse, or re� uxing.

“With age, heredity or long hours of sitting or standing, these valves can weaken, and blood can � ow backward and collect in the legs and ankles, causing symptoms,” describes Dr. McGreevy. “� is condition is called venous insu� ciency.”

To diagnose venous insufficiency, Dr. McGreevy performs a Doppler venous ultrasound examination that allows him to see the � ow of blood from the legs toward the heart. In John’s case, the simple, non-invasive exam revealed signi� cant venous insu� ciency in both legs.

Dr. McGreevy responded by recommend-ing John wear compression stockings for about four weeks to help eliminate the swelling and heaviness in his legs. � e stockings had little e� ect, however. At that point, Dr. McGreevy knew a new course of action was necessary.

“I sat down with John and discussed his entire scenario with him,” describes the doctor. “We developed a game plan for his leg veins.”

Symptom Reliever� e treatment plan for John’s legs included a procedure called endovenous laser ablation, or EVLA, in which the doctor introduces a sterile laser � ber into the problematic vein via a tiny puncture in the leg.

During EVLA, laser energy is delivered through this � ber, gently collapsing and seal-ing the vein. Blood � ow from the sealed vein then reroutes through other, healthy veins in the leg, which reduces the impact of venous insu� ciency on the patient.

“EVLA relieves the symptoms, including pain, swelling, fatigue, itching and weakness,” notes Dr. McGreevy. “It also improves the aesthetics of the legs, reducing any discolor-ation and breakdown of the skin, as well as the appearance of varicose and spider veins.”

“Getting those test results prompted me to make an appointment to have the laser treatment on my right leg, and after I made the appointment, I picked up a brochure about it on the way out of Dr. McGreevy’s o� ce,” John notes.

“The brochure explained everything about venous insu� ciency, and it veri� ed everything Dr. McGreevy told me. When I returned to his o� ce in St. Augustine and had the procedure done, it was painless.

“After rubbing my skin with a solution to deaden the pain, a technologist put nee-dles in my leg. He had a scope that traced the vein Dr. McGreevy wanted to block o� , then he injected it with numbing medicine.

“After that, Dr. McGreevy came in and performed the laser treatment. � ere was a little bit of a burning sensation, but it was bearable. Afterward, they wrapped my leg in ACE™ bandages. I had the treatment on a � ursday and had to keep the ACE bandages on with compression until Sunday, then I could take the bandages o� .”

“We performed EVLA on both greater saphenous veins in John’s legs, and he expe-rienced signi� cant physical improvement,” Dr. McGreevy says. “John was pretty amazed by how much better his legs felt as well. He had reduced discomfort in his legs with less fatigue, swelling and cramping.

“Sometimes, when we perform EVLA, it takes a little while for the results to be fully realized by patients. In John’s case, however, he had a very quick response. Within a week of performing EVLA on his right greater saphenous vein, he indicated he already started to feel a di� erence in his right leg.”

Prevalent ProblemVenous insufficiency is a very common condition. It is estimated that more than 30 million Americans su� er with symptomatic venous insu� ciency. Venous vascular disease is � ve times as prevalent as peripheral arterial disease, or PAD, and more than two times as prevalent as coronary artery disease.

Symptoms of venous insu� ciency include pain, aching, swelling, heaviness, nighttime cramps, restless legs, discoloration and, in later stages, skin ulceration, but it’s “hugely underdi-agnosed,” asserts Dr. McGreevy. Symptoms are often attributed to other disorders.

“Symptoms of venous insu� ciency, the things that can be felt by the patient, can result in sensory changes such as numbness, tingling, weakness and fatigue,” he states.

“� ese are all things patients describe to me every day when I examine them and perform nerve conduction studies.

“� ese symptoms may appear neuro-logic at � rst glance, but there’s no perfect box they � t into, so I don’t make assump-tions that they’re caused by nerve injury. If I test and discover these symptoms are not nerve related, they can be generated from multiple sources.

“If these symptoms are accompanied by visible signs such as swelling in the legs, I look at other possible sources. I have to rule out a

cardiac condition such as heart failure, as well as a liver condition, protein imbalance and other disorders that can lead to leg swelling.”

In the absence of those sources, Dr. McGreevy continues, there’s a high index of suspicion for venous insu� ciency, the treatments for which are generally covered by insurance. � ey’re covered not just for pain relief, but also for prevention because there are complications that can occur later in life that are very expensive to treat.

Wholehearted TrustIn 2015, Patti Adornetti was involved in a seri-ous auto accident that left her badly injured and ended her career as a high-production print specialist for Xerox® Corporation. � e Cleveland, Ohio native su� ered severe pain in her legs and back, which required surgery, and eventually, she turned to Dr. McGreevy for help with pain management.

“I’ve been Dr. McGreevy’s patient for going on two years,” shares Patti. “The doctor who performed my back surgery recommended him.”

During that two-year per iod, Dr. McGreevy used several pain man-agement techniques to help keep Patti’s back pain at bay. At the same time, how-ever, Patti was being bothered by another uncomfortable issue.

“Over the years, I developed pain in my legs, and about a year and a half ago, the varicose veins on my legs started to become more and more intense,” she relates. “� e discomfort was becoming intense as well.

“� e pain was mostly a tired and achy feeling, but it became more of a stabbing pain at night, especially when I was trying to sleep. During the day, my legs ached and felt heavy, like their weight had doubled.

“As the pain got worse, I had to give up doing some of the activities I used to do routinely. It became di� cult for me to do things I liked, including kayaking, walking and riding my bike.”

One day, while driving to McGreevy NeuroHealth for a pain management appointment, Patti saw a message about varicose veins, and it got her thinking. � at day, as she talked with Dr. McGreevy, she casually said, “I want to do something about my varicose veins.” In response, the doctor explained that he treated vein concerns as well as nerve disorders.

“It was just a coincidence,” comments Patti. “I only said something because I saw that message. After he told me he did vein treatment as well, I told him, Good. I’ll have you take care of my veins, because I trust him wholeheartedly.”

Just as he did with John, Dr. McGreevy began his treatment of Patti’s veins with a Doppler ultrasound examination. � e exam-ination revealed that Patti, too, was su� ering from signi� cant re� ux in her super� cial veins and was therefore a good candidate for EVLA.

“At the time of the procedure, the technol-ogist did the preparation, such as numbing the area, and then Dr. McGreevy stepped in and took care of the veins,” Patti reports. “He used a laser to treat the veins and relieve the pain.

“� e procedure wasn’t bad at all. � e worst part of it was when they numbed me because they had to give me several shots to numb the area around the veins. I couldn’t even feel it when Dr. McGreevy came in and did his part. I didn’t feel any real pain after the treatment, either.”

Miraculously SuccessfulJohn’s right leg didn’t look much better that Sunday after his � rst EVLA, but it did by the following week, when he returned to McGreevy NeuroHealth to have the treat-ment on his left leg.

“My right leg cleared up miraculously,” John raves. “It was very clear and had light-ened up considerably compared to the leg Dr. McGreevy hadn’t treated yet. When I � rst went into the o� ce, the receptionist said, Look what happened here. I walked into the little sta� area, and everybody looked at my right leg and said, Wow!

“I looked at my leg and said, Gee, I really did have a problem. I didn’t know the prob-lem with heaviness in my legs was that bad, but since I had the procedures on my vari-cose veins, my legs are a lot lighter and I can walk much better. I must have gotten used to the heaviness. I don’t have the swelling anymore, either.

“And all this time, Dr. McGreevy is still treating my back pain.”

� e EVLA was a success for Patti as well. She reports that her legs feel good since the treatment. She’s also very pleased with the

aesthetic results she’s achieved so far, and Dr. McGreevy told her it will only get better. He said it will take about a year for her legs to be completely healed and functioning optimally.

“My legs look great,” she marvels. “My right leg had very big, bulging veins, and they’re completely gone. � ere are no vari-cose veins in my right leg at all. My left leg had bad veins as well. � ere are still a few little pieces of vein visible on my left leg, but they will eventually work their way out once everything has properly healed.

“� e pain is phenomenally better than it was before. I would say it’s about a two out of ten now, when it used to be seven or eight.”

With Dr. McGreevy managing her back pain and since achieving relief from the achiness of her varicose veins, Patti’s been able to return to her active lifestyle. She’s thrilled because she likes to stay active for fun and � tness.

“I’m back to doing the activities I had to stop doing before,” she con� rms. “Now, I’m � nding it easier to walk and bike again.”

John and Patti are impressed by Dr. McGreevy and his sta� at McGreevy

NeuroHealth. � ey � nd the neurologist to be knowledgeable, kind, understanding and worthy of their trust.

“Over the years, I had a knee replace-ment and a broken ankle that was due to my back and loss of balance,” offers John. “I went to physical therapy for both of those conditions. Nobody noticed I had a problem with my leg veins except Dr. McGreevy.

“My EVLA procedures were absolutely, in capital letters, successful. I recommend EVLA for varicose veins, and I recommend McGreevy NeuroHealth and Dr. McGreevy. I have complete con� dence in him.”

“Everybody at McGreevy NeuroHealth is great,” adds Patti. “I think Dr. McGreevy is a fantastic doctor. He listens to me. Of all the doctors I’ve been to over the years, he’s de� nitely one of the best. I wouldn’t have gone to another doctor. Dr. McGreevy is de� nitely the only doctor I would let touch my legs. He’s a great physician, and I rec-ommend him one hundred percent!”FHCN article by Patti DiPanfilo. Photos by Nerissa Johnson.

mkb

John’s doctor referred him to Kai McGreevy, MD, a board-certi� ed neurol-ogist and pain management specialist at McGreevy NeuroHealth in St. Augustine. Dr. McGreevy uses a variety of techniques to relieve his patients’ pain.

“Initially, I was treating John’s back pain using medial branch nerve blocks, which pro-vided some relief,” reports Dr. McGreevy. “We have now completed those nerve blocks, and we’re close to performing radiofrequency ablation (RFA) on his spinal nerves, which is the next step in his treatment.

“Before doing those treatments, how-ever, while completing a full history and physical on John, he relayed that he was experiencing a little heaviness in his legs. Many times, that’s attributed to the spine, but upon inspection, I saw he had discolor-ation and swelling in both legs. He then told me that he had been experiencing cramping and fatigue as well.”

Patti has resumed her � tness-oriented lifestyle

EVLA treatment relieved John of the

heaviness and swelling in his legs

Risk Factors for Varicose Veins

These factors increase your risk of developing varicose veins:

Age. The risk of varicose veins increases with age. Aging causes wear and tear on the valves in the veins that help regulate blood fl ow. Eventually, that wear causes the valves to allow some blood to fl ow back into the veins, where it collects instead of fl owing up to the heart.

Sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor. Female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase the risk of varicose veins.

Family history. If other family members had varicose veins, there’s a greater chance the person will, too.

Obesity. Being overweight puts added pressure on the veins.

Standing or sitting for long periods of time. The blood doesn’t fl ow as well if a person is in the same position for long periods.

John shows o� some of his stained glass handiwork

Patti Adornetti

St. Augustine/Ponte Vedra Beach Edition | Winter 2019 | Florida Health Care News | Page 7venouS DiSeaSe

Visit Acute Wound Care on the web at

www.acutewoundcare.com

or call them directly:

Toll Free (855) 949-HEAL (4325)

Locally (239) 949-4412

Are You Su� ering From

Chronic Limb Swelling?

Hannah enjoys doing puzzles after therapy.

Reduce limb swelling and improve circulation

H annah Heit spent more than 40 years as a registered nurse, first in pediatrics and later in quality assur-

ance, reviewing several departments. � e Kentucky native lived most of her adult life in Michigan, and it was from there she relocated to Florida and retirement. All those years on her feet as a nurse, however, had a profound e� ect on her legs.

“A few years ago, my legs started swelling, and they were uncomfortable,” she shares. “I didn’t really have any pain, but I couldn’t wear shoes because my feet were as big as my legs. My legs were also discolored from the ankle to about mid calf. � ey were a kind of bluish-red color.”

Initially, Hannah was told she had venous insu� ciency, a condition in which the veins in the legs are unable to do their job of pumping blood back to the heart. Blood leaks and pools in the legs, causing symp-toms such as swelling and discoloration. Subsequently, Hannah underwent vein sur-gery to treat her insu� ciency she reports.

“I was told to put my legs up at night, but I couldn’t always do that,” Hannah adds. “I was also supposed to wear these special compression hose, but I couldn’t wear them because it was too much trouble getting them on and o� .”

The swelling and discomfort in Hannah’s legs continued after surgery, so she eventually sought the advice of her primary care provider.

“� e nurse practitioner I saw in my internist’s o� ce looked at my legs and said, You have lymphedema, excess � uid in your lymph vessels,” notes Hannah. “I’m not sure, but it may have been caused by the venous insu� ciency. � e nurse thought I would bene� t from a compres-sion pump. She called the company that provides them and got me all set up.”

� e company the nurse practitioner contacted was Acute Wound Care, a fully accredited home medical equipment provider specializing in hospital-grade compression devices and specialty wound-care dressings. � e compression pumps are prescription devices and are approved by Medicare and covered by many com-mercial insurers.

“Our easy-to-use compression pumps remove � uid that has accumulated in the legs or arms,” describes Alyssa Parker, cer-ti� ed compression therapist with Acute Wound Care. “The pump’s limb-sized sleeves gently massage the limb, drain-ing any excess � uid back into the body’s circulatory system so it can be naturally eliminated. Compression pumps increase circulation in the a� ected limbs while alleviating many painful symptoms.

“� e pumps are both highly e� ec-tive and noninvasive, and for the legs, they are much easier to use than com-pression stockings. Patients generally use the pumps twice a day for forty-� ve

minutes, with an interval of at least two hours between treatments, so it is usually done in the morning and in the evening. While using the pumps, patients simply sit back with their limbs raised to further assist with circulation.”

Once Acute Wound Care received Hannah’s prescription, a compression therapist contacted her to review the next step and answer any questions. After that, the therapist delivered the device, set it up and explained to Hannah how to use and care for it.

Healthy DiscoveryThe nurse practitioner who diagnosed Hannah’s lymphedema treats a full range of medical conditions at the practice, including lymphedema, persistent leg edema and venous disease among the most common.

For patients with these disorders it’s generally recommended to try con-servative therapy first. Examples are compression stockings, optimizing water and electrolyte balance, and diuretics. � e compression device is a great treatment option for those who have tried conser-vative therapy and still have persistent swelling or poor circulation.

Many patients have significant improvements in terms of diminished � uid retention in their legs or arms after using the compression pump. With con-sistent compression therapy the swelling improves as well as the venous blood � ow, wound healing, and overall mobility.”

Circulation SupportAlyssa agrees that patients with lymph-edema, venous disease and other conditions leading to poor circulation once had few options beyond the standard therapies for limb swelling. � at’s a treatment hole Acute Wound Care’s compression pumps � ll. � e safe and painless pumps not only

reduce � uid retention in the limbs, they also improve overall blood � ow.

“� e pumps assist circulation by con-tracting the leg muscles, assisting blood flow back toward the heart,” explains Alyssa. “� ere, the blood is collected, sent to the lungs to be oxygenated and then returned to the body’s organs and tissues.

“To aid blood � ow, the pumps have multiple chambers. Each chamber � lls up with air, from the foot to the groin. � en, each chamber releases, and the pattern repeats in a rhythmic fashion.

“In addition to the circulation boost, many patients will see a noticeable dif-ference in the swelling and in the size of their limbs after their � rst forty-� ve-min-ute pumping session.”

Acute Wound Care is proud of its hands-on approach to patient care. Not only does a compression therapist go to patients’ homes to set up the equipment and instruct them on how to use it, they also adjust the pump’s pressure level to the patients’ comfort.

“When we are in the patient’s home, we set the pressure based on the severity of the condition and the physician’s pre-scription,” states Alyssa. “We then adjust it so the patients are comfortable and will actually meet the requirements of the treatment, so they get great results.”

Doubly EndorsedHannah has been using her compression device from Acute Wound Care for more than a year now. She says she is pleased with the results she’s getting from it. She’d like to use it more often than she does, but she’s established a treatment schedule with her doctor that works well for her.

“The usual treatment with the compression pump is twice a day for forty-five minutes,” relates Hannah. “But I do it once a day for an hour. � e limb sleeves feel � ne when I have them on, and then my legs are nice and small when I take them o� . � e swelling goes down signi� cantly.”

In addition to reducing the swelling, the compression pump treatments have also relieved much of Hannah’s leg dis-comfort and have enabled her to wear shoes again. The discoloration, which is related to her venous insufficiency, remains and may take years to fade, if it does at all. However, the circulation in her leg veins has improved with treatment, aiding her venous insu� ciency.

“I’ll continue using the compres-sion pump,” she comments, “and I

“The pumps assist circulation by contracting

the leg muscles, assisting blood flow back

toward the heart.”

The pumps are non-invasive

and highly e� ective

recommend it to others with conditions like mine. I recommend Acute Wound Care, too. I had no problems with any part of their process.”

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

“Many doctors have told me that they’ve encouraged their patients to use the pumps to reduce limb swelling and improve circulation,” Alyssa con� rms. “They say the compression pumps are great, safe, noninvasive devices that sup-plement the medical treatment they’ve provided to those patients.

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

“� at same doctor said he’s so sat-is� ed with Acute Wound Care that he strongly endorses them and their com-pression devices to other physicians. He said he’s personally thrilled with Acute Wound Care because they help doctors improve their quality of care and the quality of their patients’ lives.”FHCN article by Patti DiPanfilo. Photo by Jordan Pysz.

Photo of pump courtesy of Acute Wound Care. mkb

Page 8 | Florida Health Care News | Winter 2019 | St. Augustine/Ponte Vedra Beach Edition compreSSion therapy

Double PlayDoctor’s expertise relieves di� erent conditions

David and Noreen

Acheson

KAI MCGREEVY, MD

Let a board-certified neurologist and pain

management specialist help get you on the road

to recovery. McGreevy NeuroHealth has two

locations to serve you:

St. Augustine559 W. Twincourt Trail,

Suites 607-608

Palm Coast57 Town Court, Suite 123

To schedule an appointment

at either location, call:

Kai McGreevy, MD, is board certi� ed in neurology and pain medicine by the American Board of Psychiatry and Neurology. The American Board of Independent Medical Examiners also certi� es him. His medical training includes completion of a neurology residency at the University of California, San Diego, and an interventional pain medicine fellowship at The Johns Hopkins University School of Medicine in Baltimore, MD. While at Johns Hopkins, he was men-tored by leading � gures in the � eld of pain management and published over ten peer-reviewed articles in prestigious journals such as Pain Physician. Dr. McGreevy has presented his clinical research at the national level, earning prestigious awards from the American Society of Regional Anesthesia and Pain Medicine. He is a member of the American Academy of Neurology and the American Society of Interventional Pain Physicians.

Look for them online at mcgreevyneurohealth.com

(904) 230-3006

Wave of the Future

Retired professionals in their 70s, David and Noreen Acheson both prefer Florida’s weather over the snowy win-

ters of Pennsylvania where they were living. � eir laid-back lifestyle in Florida was eventually compromised after each became incapacitated by a health condition.

David, 78, a former sales manager for an oil company, struggled to cope with the effects of a debilitating neurological illness called essential tremor, a nervous system disorder characterized by uncontrollable shaking, or tremors.

� is trembling can a� ect almost any area of the body but is most often present in the hands. David, who says he and his sister both inherited the condition from their father, felt its e� ects most often in his hands and arms.

“� e degree of the shaking rated a � ve or six out of ten on most days, but some days were worse and some days were better,” David shares. “� at’s how the dis-ease works. Because of my tremors, my handwriting was terrible. I couldn’t write my own name.

“I could scribble, but as far as writ-ing numbers, that was impossible. I also couldn’t thread a needle or eat with a fork. By the time I got the food from the plate to my mouth, it was all over the place. I had to eat with a spoon, and sometimes, even that was di� cult.”

As David’s condition deteriorated over time, he sought the help of several specialists. He became discouraged, how-ever, because the treatments the various physicians prescribed didn’t really help him very much.

Eventually, David became thoroughly frustrated with the medications’ limited e� ectiveness, and he wanted a doctor with di� erent treatment ideas. He expressed those thoughts to his primary care physi-cian, who referred him to Kai McGreevy, MD, a board-certi� ed neurologist and pain management specialist at McGreevy NeuroHealth, which has offices in St. Augustine and Palm Coast.

“I ruled out other possible causes of David’s tremors, such as Parkinson’s disease, and con� rmed his essential tremor diag-nosis,” reports Dr. McGreevy. “He had already tried the medications approved to treat that condition, but didn’t have a good response to them, so he was frus-trated and willing to do anything to have a better quality of life. � at’s when I sug-gested deep brain stimulation, or DBS.”

DBS is an FDA-approved treatment for certain movement disorders, including Parkinson’s disease and essential tremor. It involves the surgical implantation of elec-trodes within the areas of the brain known to regulate movement. Stimulation of these areas helps to control abnormal movements such as tremors.

“Dr. McGreevy was very personable, professional and smart, and he spent the necessary time with me to appropriately

evaluate my cond i t i on ,” r e c o u n t s D a v i d . “Afterward, he

asked me, Have you ever considered surgery for your condition? I wondered, Surgery? � en he told me about deep brain stimu-lation and explained everything about it. I said, Let’s go for it!”

Wounded NervesNoreen spent years as a registered nurse, and although she’s 77 and primarily retired, she continues to keep her nursing license active in Pennsylvania. She worked in long-term care most of her career, which means she often moved patients who were largely incapacitated. It really wasn’t a surprise to her doctor when she began having pain in her cervical spine.

“About ten or eleven years ago, I started having di� culty in my neck and shoulders,” she remembers. “I went to multiple doctors and was diagnosed with degenerative disc disease of the neck.

“I had a lot of pain in my neck, and it really hurt every time I moved. I couldn’t turn my head. I couldn’t walk with my head up. I couldn’t lift up my arms with-out pain. I dance with a senior dance group, and it was getting more and more di� cult to do the dances because of the neck pain. Sometimes, I couldn’t even sit without resting my head on something.

“My neck just hurt. � e pain was eas-ily a six or seven out of ten.”

Over the years, Noreen tried many treatments for her neck pain, but none brought her signi� cant relief. Like her hus-band, David, she became frustrated with the unsuccessful attempts to ease her pain.

“I did physical therapy, took pain pills, got the shots, everything,” she relates. “Finally, last September, I said to my pri-mary care physician, I can’t tolerate this anymore. Who do you recommend? He recom-mended Dr. McGreevy, and David agreed.

“Noreen had severe arthritis in the facet joints in her neck, which caused discomfort to the point her quality of life was impacted,” informs the doctor. “Her range of motion was limited so that it was

di� cult for her to engage in simple activ-ities, such as driving. She couldn’t turn her head to look around when she drove.

“After examining Noreen, reviewing her imaging and performing diagnostic testing, I determined that a procedure called radiofrequency ablation, or RFA, would be the best � t to improve her pain, range of motion and quality of life.”

During RFA, radio waves are used to produce heat that is delivered through a probe to a group of speci� ed spinal nerves. The heat creates a lesion, or wound, on the nerve tissue that interferes with the transmission of pain signals to the brain, thereby reducing discomfort in the troubled area.

“When Dr. McGreevy and I talked about the radiofrequency ablation proce-dure, he explained to me that the relief can last twelve to eighteen months. I agreed to it because I hadn’t been pain free for more than a decade. In April, he started with one side of my neck. A week later, he did the other side.”

Utensils UtilizedFor David and Noreen, who had com-pletely di� erent health challenges to overcome, Dr. McGreevy’s expertise in neurology and pain management provided the solutions to both of their conditions. David’s uncontrollable tremors were brought under control through deep brain stimulation, and Noreen’s pain was relieved through radiofrequency ablation.

“� e results of the DBS are amaz-ing,” David marvels. “My handwriting is much better. It’s not perfect, but it’s bet-ter, and my hands don’t shake as badly. Before I got the DBS stimulator, I rated my shaking a � ve or six out of ten. Now, I give it about a two. I can eat with a fork and a spoon now, so my quality of life is much better.”

� e RFA procedures Dr. McGreevy performed on Noreen’s cervical nerves were equally effective for the arthritis pain in her neck. � ey provided her with

signi� cant relief, which enabled her to move her head to drive, dance and do other activities without di� culty.

“I’ve been pain free since I had the radiofrequency ablation procedures,” she enthuses. “I can lift up my arms. I can walk with my head up. I can do things I didn’t think I’d ever do again as far as exercises and activities, and I’m so pleased.

“ I ’ve a l ready recommended Dr. McGreevy. I’ve taken flyers from McGreevy NeuroHealth and given them out to people because Dr. McGreevy does such a good job with his patients. He does his best to � x whatever happens to be wrong. He helped us and gave us both a better quality of life.”FHCN article by Patti DiPanfilo. Photo by Nerissa Johnson.

mkb

St. Augustine/Ponte Vedra Beach Edition | Winter 2019 | Florida Health Care News | Page 9neurology anD pain care

Ear E� ectsResearch shows link between alcohol and hearing loss.

Although it can be fun, drink-ing alcohol has its drawbacks. Studies have connected it to numerous health disorders,

including several liver diseases and some cancers. Now, research has con� rmed the link between alcohol consumption and hearing loss.

Past research suggested that alcohol a� ects hearing in two signi� cant ways. First, consuming alcohol over a long period of time can actually shrink the auditory cortex, the area of the brain that processes sound.

� e auditory nerves in the ears trans-mit what is heard via nerve impulses to the auditory cortex. Changes to the cortex limit the brain’s ability to translate those impulses into sound, and hearing de� cits result. � is can a� ect one’s ability to hear music or discern words.

Further, damage to the auditory nerves and auditory cortex is cumulative, so even social drinkers are at risk for hearing loss.

� e second way alcohol consumption can a� ect hearing is by damaging the tiny hair cells in the inner ear. � ese cells convert what is heard into the nerve impulses that are sent to the brain to be processed. Hair cells do not regenerate, so any hearing loss related to damaged hair cells is permanent.

In both instances, damage occurs because alcohol produces a toxic envi-ronment in the ear. � is condition is known as ototoxicity.

More recently, researchers from the University of Ulm in Germany completed

a new study of the e� ects of alcohol on hearing. During their study, the research-ers tested the brainstem auditory evoked potentials (BAEPs), or responses to sounds, of both heavy and social drinkers.

By testing the BAEPs, the research-ers measured the level of damage to the auditory system. � e results con� rmed the correlation between alcohol consumption and hearing loss. � e researchers, however, were unable to determine the quantity and length of time of consumption required to accomplish the damage measured.

This study concluded that even though the ear may be functioning perfectly, the brain is no longer able to process sound, and thus provide clear hearing, due to alcohol.

Cocktail DeafnessDamage to the hair cells and auditory cortex results in permanent hearing loss, but alcohol can also a� ect hearing temporarily. One way is a condition that occurs when drinking alcohol is combined with exposure to loud noise. � is condition is often referred to as cocktail deafness.

Hearing health care profes-sionals coined the term “cocktail deafness” because the condition often arises when people go to parties or clubs. In these sit-uations, people are generally drinking, and there’s also loud music playing and people talking loudly to be heard over the music.

Cocktail deafness is an acute hear-ing loss, which means it’s sudden, unlike many other types of hearing loss, which develop over time. With cocktail deafness, hearing tends to be more a� ected in the lower frequency ranges, which are crucial for decoding and understanding speech, than in the higher ranges.

If the party or club a person is attending allows smoking, matters are complicated even more. � e nicotine in cigarette smoke adds to the ototoxicity in the ear and can further a� ect hearing. � e combination of alcohol, loud noise and exposure to cigarette smoke is especially dangerous to hearing health.

Fortunately, cocktail deafness is tem-porary and generally resolves the day after the event. However, prolonged exposure to the combination of heaving drinking and loud noise, especially if cigarette smoke is also present, can lead to perma-nent hearing damage.

Drinking Defi nedResearch proves the con-nection between alcohol

use and hearing loss, although it’s not clear how much alcohol it takes before perma-nent damage is done. Heavy drinkers, however, are at greatest risk.

The National Institutes of Health de� ne a “light drinker” as someone who consumes between one and 13 drinks per month. A “moderate drinker” consumes between four and 14 drinks per week, and a “heavy drinker” consumes more than two drinks per day.

Currently, the recommendation of the general medical community for accept-able drinking is moderation. � ey explain it as no more than one drink per day for women and no more than two drinks per day for men. A standard “drink” is de� ned as 12 ounces of regular beer, 5 ounces of wine or 1.5 ounces of distilled spirits.

Health specialists may permit drink-ing in moderation, but before taking that drink, remember: Damage to the hearing center of the brain adds up over time. Alcohol consumption, even social drinking, can a� ect hearing health in the

long run.FHCN staff article. mkb

A ches and pains in the feet or ankles may be a common complaint among seniors, but it’s important to under-

stand that just because something is commonplace does not mean it’s normal.

Although certain medical conditions such as arthritis and diabetes can cause foot pain, the primary cause of most foot pain is actually a problem with the foot’s function or biomechanics.

Pain in the foot or ankle that recurs on a regular basis or lasts for an extended period should be evaluated by a board-certi� ed podiatrist – a physician specially trained in the treatment of the foot, ankle, and lower leg.

Experiencing Foot or Ankle Pain?Podiatrists treat a wide variety of

podiatric complaints, including heel, foot, and ankle pain and di� cult-to-heal wounds on the lower extremities.

Heel pain may result from stress on the muscles and ligaments of the foot, stretching and tearing of the � brous con-nective tissue that runs along the bottom of the foot, or tearing of the membrane that covers the heel bone.

Plantar fasciitis, or chronic in� am-mation of the plantar fascia, is the most common cause of heel pain. � e plan-tar fascia is the rigid ligament along the bottom of the foot, and it often becomes a problem for runners and other athletes, people who are required to stand for long periods at work, or even as a result of pregnancy.

A neuroma is an in� ammation and swelling of the digital nerve on the bot-tom of the foot, running between the metatarsal heads at the base of the toes.

Bunions result when a patient’s foot is or becomes unstable, causing the foot to roll and weakening the tendons and ligaments that stabilize the great toe. Repetitive motion from rolling, or over-pronating, allows the bone to drift and causes pain and bone enlargement.

Hammertoe is a bending or curl-ing of the toe, often resulting in the formation of painful corns as the toe deformity presses unnaturally against the patient’s footwear.

Conservat ive treatments for these conditions may include hot or cold compresses, physical therapy,

anti-in� ammatory medications, and cor-tisone injections to relieve pain.

In the event that conservative treat-ments do not provide long-term relief, many of these troublesome conditions can be addressed with a minimally inva-sive outpatient procedure.

For bunions, an osteotomy may be used to surgically realign the bones of the toe, and the corrected position is secured with a small titanium screw implant. In most instances, patients are able to begin wearing soft, comfortable shoes within just two weeks after the procedure.

Patients suffering from unresolved plantar fasciitis often bene� t from endo-scopic plantar fasciotomy, or EPF, a minimally invasive outpatient surgery performed under local anesthesia with mild sedation. � e procedure takes only a few minutes, and patients are typically allowed to return to normal activities within a week.

Morton’s neuroma can typically be treated without surgery in most cases. Dehydrated alcohol injections provide long-term relief for many patients, even in cases where the patient has had a neu-roma excision in the past.

Any course of treatment should be over-seen by a board-certi� ed podiatrist. Above all else, it is important to remember that foot pain is not normal, and that it should be evaluated and treated as soon as possible.

Although we may sometimes take our feet for granted, we shouldn’t. � e better we treat them, the better our active life-styles can be.FHCN staff article. mkb

Common foot and ankle conditions

• Achilles Tendinitis• Ankle Pain• Arthritis• Bunions• Diabetic Foot

Complications (ulcers)

• Flat feet (adult and pediatric)

• Foot Pain• Fractures• Hammer Toes• Heel Pain (Plantar

Fasciitis)• Ingrown Toenails• Morton’s neuroma• Nail Fungus• Plantar Fasciitis• Sprains• Warts

Podiatrists treat problem areas of

the feet, ankle or lower leg by

prescribing one or several of the

following:• Physical therapy• Prescription drugs• Surgery on lower

extremity fractures• Orthotic inserts

or soles

Page 10 | Florida Health Care News | Winter 2019 | St. Augustine/Ponte Vedra Beach Edition Special to Fhcn

Special to Fhcn

CorrineMahon

TIMOTHY STEFLIK, DCJOSE ORTIZ, DC

TARA SWANTON, ARNP

Stem cell therapy puts hairdresser back on her feet

L yndon Johnson was in the White House; the Beatles were at the top of pop music charts and Muhammad Ali was on his

way to becoming the greatest prize � ghter of all time when Corrine Mahon opened up her hair salon in Sanford in 1964.

Fifty-four years later, Corrine’s Beauty Salon is still standing. So is Corrine. � ough she has su� ered nine warning strokes, sometimes referred to as transient ischemic attacks, or TIAs, she still works half days � ve days a week.

“I’ve cut back from working the long hours,” Corrine, 78, explains. “But then I come home and I start working around the house anyway. � ere’s always some-thing to do, you know, so I don’t ever really stop. I’ve always been that way.”

Indeed she has. A few years back, for example, Corrine took up running, largely in an e� ort to get herself into the best shape possible for a family reunion at which she intended to arrive as the � ttest member of her large family.

“I was going to be the oldest one at that reunion, but I also wanted to be the prettiest one, so I started running with one of my other hair dressers,” Corrine explains. “One day, while we were run-ning, I hit a raised part of the sidewalk, stumbled and fell.

“� at fall just shattered my right knee and then, while I was still recovering from

that fall, I lost my balance one day while I was getting the mail and fell and tore the meniscus in my left knee. I’ve been in bad shape ever since.”

When Corrine � rst decided earlier this year to � nally do something about her aching knees, her initial plan was to have knee replacement surgery. � ose plans were shot down by her doctor, who cited those nine TIAs in suggesting surgery was too risky.

Disappointed with the doctor’s deci-sion but determined to � nd a solution for her ever-increasing knee pain, Corrine called up one of her cousins – a doctor who keeps close tabs on her health - and asked for advice on where to turn to next.

“He said, Corrine, your only option is to have stem cell therapy,” Corrine relates. “After that, I went to see my doctor and he said, I absolutely believe in stem cell therapy and think you should do it. Just be sure to sit in on a seminar about it � rst.”

� e seminar Corrine sat in on was conducted by Timothy Ste� ik, DC, of Coastal Integrative Healthcare. Corrine was so impressed with the presentation that she immediately set up a consultation with Dr. Ste� ik for later that week.

The Body’s Building BlocksStem cells are the basic foundation cells that grow all of the tissue and organs in our body. When injected into a damaged tissue or organ, they support the natural healing process by regenerating that tissue.

Stem cell therapy, also known as regenerative medi-cine, uses stem cells to stimulate the body’s natural repair mecha-nisms. Many in the medical community, including those at the National Institutes of Health and the Institute of Medicine, consider it the future of medicine.

“It’s de� nitely on the leading edge of medical technology, because it’s a great alternative to surgery,” Dr. Ste� ik states. “It regenerates the body instead of trying to � x it or cover up a problem with surgery.

“� e real beauty of it is that it’s a one-and-done, in-o� ce procedure that takes about � fteen minutes and needs no anes-thesia. It’s a simple injection of the cells that are cryo-preserved in our o� ce. And after we’re done, the patient can return to normal activities right away.”

Stem cell therapy can be used anywhere in the body where there is arthritis, or a muscle or tendon tear, Dr. Ste� ik relates. In addition to knees and shoulders, medical providers at Coastal Integrative Healthcare have per-formed the procedure on hamstrings, ankles and wrists.

“Now, I’m doing everything again just like I used to before

I hurt my knees.”

Not all patients are good candidates for the procedure, however. Patients who have su� ered a tear of more than 50 per-cent of the rotator cu� in their shoulder, for example, would be encouraged to try other options � rst.

Despite all the damage she had suf-fered, Corrine still had cartilage left in her knees and therefore proved to be a good

candidate for the procedure. She was an eager candidate as well, requesting the procedure be done immediately upon learning she was fit for it.

“She asked, Well, can we do it right now?” Dr. Ste� ik remembers. “And with people like Corrine, who drove thirty to forty-� ve minutes to come see us, we de� -nitely try to do the procedure that very same day for them if they’re a good candidate.”

Corrine is amazed at how e� cient and e� ective stem cell treatment is. In less than half an hour, both her knees were treated through a relatively painless injection of the stem cells, which have provided her with an ever-increasing relief from her knee pain.

“I started to feel better almost imme-diately and then, after about three weeks, I really began to notice a difference,” Corrine reports. “Now, I’m doing every-thing again just like I used to before I hurt my knees and had to spend so much time o� my feet.

“I’m walking straighter and I’m standing all the time just like before. � e

only time I really sit down or lie down now is when I go to bed, but I’m actually staying up later because I feel so much better. I really feel great.”

Corrine’s improved health has become a regular topic of conversation around her beauty salon, where Corrine has become an ambassador for Coastal Integrative Healthcare and the advantages of stem cell therapy.

“I tell everybody all day long about my experience with Dr. Ste� ik and Coastal Integrative Healthcare,” Corrine enthuses. “I think they’re all just great there, and one customer of mine has already been to see them on my recommendation.

“I have another friend who checks in on me all the time and when I told him how I was feeling, he said, I’m going over there to get my knees done, too. Hairdressers can spread the word like that and I’m doing it, because I think everyone should hear my stem cell story.”FHCN article by Roy Cummings. Photo by Nerissa

Johnson. mkb

What Conditions Respond to

Stem Cell Therapy?• Partial Tear of Rotator Cuff • Knee Arthritis and

Degeneration• Plantar Fasciitis• Shoulder Pain• Tendonitis and Tendinosis

(biceps and triceps)• Medial Epicondylitis/Lateral

Epicondylitis (golfer’s elbow/tennis elbow)

• Post-Operative Pain• Neurological Conditions

Visit them online at www.coastalintegrativehealthcare.com

Timothy Ste� ik, DC, is a licensed doctor of chiropractic who graduated from Palmer College of Chiropractic in Port Orange, Florida in 2011 and now serves as the clinic director and president of Coastal Integrative Healthcare. He is an adjunct professor at Palmer College of Chiropractic who earned his Bachelor’s degree in Biology with pre-med from Brigham Young University in 2008. He is well-versed in the latest technology and techniques in his � eld and has been trained in the use of the AMA Guides to the Evaluation of

Permanent Physical Impairment. Dr. Ste� ik is an active � tness enthusiast who was featured on American Ninja Warrior as “The Accordion Ninja.” His run can be seen on YouTube.

A Healthier YouTo see if stem cell therapy is r ight for you, Coastal I n t e g r a t i v e H e a l t h c a r e is happy to offer a free consultation with one of the doctors. To schedule an appointment, call or visit one of Coastal Integrative Healthcare’s locations:

Palm Coast3 Florida Park Drive North

(386) 445-4455Edgewater

315 N. Ridgewood Ave.

(386) 427-8403

How We Do ItWe use amniotic stem cells in our offi ce that are:

• Donated by healthy moms at live-birth C-sections

• Placenta tissues and fl uid processed in a “clean room” environment that exceeds American Association of Tissue Banks (AATB) standards

• Subject to United States Pharmacopeia (USP) testing

St. Augustine/Ponte Vedra Beach Edition | Winter 2019 | Florida Health Care News | Page 11regenerative meDicine

John Ligeon, MD, is board certi� ed in internal medicine and is a 2001 graduate of the University of Miami School of Medicine. Following graduation, Dr. Ligeon trained and specialized in internal medicine at Orlando Regional Medical Center in Orlando, where he completed his training in 2004. A diplomate in internal medicine, he has practiced in inpatient hospital medicine, as well as in outpatient primary care, for the past 14 years. His special interests include the areas of men’s health, preventive medicine such as weight loss and management, and care for US veterans.

Scott Hollington, MD, is board certi� ed in pathology, laboratory medicine, and infor-matics. He earned his medical degree from the University of Miami Medical School in 1992 and became board certi� ed in medicine soon thereafter. He spent four years serving his residency at the University of Florida, Jacksonville and then spent a year training at Wilford Hall USAF Medical Center, Texas. Dr. Hollington also practices emerg-ing medicine, bringing to his patients treatments that are not widely available through conventional clinics.

Catch the Wave

JOHN LIGEON, MDSCOTT HOLLINGTON, MD

Noninvasive ED treatment improves sexual performance

T he � rst thing Tom* did upon returning to the United States following his 14-month tour of duty in Southeast

Asia during the Vietnam War was kiss his high school sweetheart. Later that same day, he went out and married her.

“I actually proposed in a letter I sent from overseas about six months before I came home,” the former US Marine Corps sergeant reveals. “She said yes in her next letter back to me, and we later decided we’d get married as soon as I got back, � rst thing.”

Natives of Central Florida, Tom and his wife have “been going strong,” as Tom puts it, ever since. � ey now have three grown children, a granddaughter, and a grandson on the way. � ere’s just one problem.

For the better part of the year that followed his 69th birthday last August, Tom had trouble developing and main-taining an erection strong enough to have sexual intercourse. � e issue is known as erectile dysfunction, or ED, and it’s more common than many think.

Studies show that more than half of all men will experience some form of erectile dysfunction during their lifetime and that the chances of dysfunction are even greater among men su� ering from hypertension, diabetes and cardiovascular disease.

Studies show that smoking, heavy consumption of alcohol, and drugs (either illicit or prescription) can also cause erectile dysfunction, which is typically the result of circulatory impairment in the blood capil-laries or urogenital areas of the penis.

For years, medications such as VIAGRA® and CIALIS® have been the � rst line of defense against ED. If those prove unsuccessful, the next treatment option is generally injections into the penis. If that fails, the last resort has long been a penile implant.

Tom wanted nothing to do with the injections or implants, so after visiting a urologist, he � rst tried correcting the problem by taking CIALIS. “� e CIALIS worked okay for a while,” Tom says, but

he didn’t like the headaches that often came as a result of using it.

On the advice of his urologist, Tom considered trying another medication, but he soon took it upon himself to begin researching the problem and other forms of treatment. � at’s when he stumbled on the Extracorporeal Shock Wave � erapy or ESWT.

“I was searching the internet and � nally found this website for a place that didn’t treat erectile dysfunction with pills or injections,” Tom says. “I � gured it wouldn’t hurt to give them a try, so I called and made an appointment.”

Acoustic Wave Technology The practice Tom found is Alpha Medical Group. With offices in Palm Coast, Leesburg and Jacksonville, it specializes in the administration of the ESWT, which treats erec-tile dysfunction through the use of acoustical wave therapy.

Using a small, handheld device, the acoustical waves are delivered through a series of short, painless pulsations that not only open the blood vessels in the penis but s t i m u l a t e t h e nerve endings to enhance sensitiv-ity and enhance the feeling of an orgasm.

“The treat-ment is based on the same technol-ogy that’s used to break up gall-stones,” says Scott Hollington, MD, at Alpha Medical Gr o u p . “ T h e device transmits acoustical waves that break up the plaque and cal-cium that have built up inside the penis’ blood vessels.

“It works like a little jackhammer, except you don’t feel it because it doesn’t touch your skin. Once that plaque and calcium is broken up, you get better blood � ow, and it’s that improved blood � ow that leads to better, longer-lasting erections.”

In addition to providing better blood � ow through existing blood vessels, the ESWT also stimulates the growth of new nerve tissue, which is vital for achieving and maintaining healthy erections.

Dr. Hollington points out that it can also be used to treat Peyronie’s disease, which is what occurs when scar tissue builds up in the penis and causes an abnormal bend, or curvature, to the penis that can impede urination and/or ejaculation.

“By making certain adjustments to the machine’s settings, we can treat

the � brous tissue the same way we treat blood ves-sels and break down the scar tissue that may be causing that irregular shape,” Dr. Hollington informs.

ESWT treat-ments only take about 15 to 20 minutes to com-plete, but prior to providing any such treatment, Dr. Hollington begins his care f o r p a t i e n t s such as Tom by

doing a Doppler ultrasound exam to determine the amount of vascular compromise in the penis.

“We look for something similar to what a cardiologist looks for in the heart, which is an occlusion of seventy percent or more,” Dr. Hollington informs. “If we see that, we go ahead with the treatment, and we reevaluate the blood vessels after completion of the treatment.”

Remarkable ResultsESWT calls for patients to receive two treatments per week for six weeks. Patients are then evaluated 12 weeks later and if necessary, they can be given a second, third or even fourth round of treatments.

Dr. Hollington says many patients opt for subsequent rounds of treatment, though most experience an improvement in sexual function after just one round. Overall, 83-percent of all men treated with the ESWT experience a reversal of their condition, the doctor notes.

Tom is one of those who reported positive results after just one round of

treatments. He says he may opt to have another round of ESWT treatments but that right now, his performance is more than satisfactory.

“I just turned seventy a couple months ago, and in the bedroom, I feel like I’m half that age,” Tom exudes. “It’s really remarkable what this ESWT does for you. And the treatments are all very quick and painless. A few minutes and you’re out of there.

“And one of the best things is how professional the technicians at Alpha Medical Group are. Let’s face it, this is a touchy subject for men. It’s not some-thing anybody is going to brag about. But they put you at ease, and make you feel comfortable.

“I can’t thank Dr. Hollington and his sta� enough for treating me so well and for giving me back this part of my life. � ey did a great job, and I recommend them and the ESWT for anyone who has a problem with ED.”FHCN article by Roy Cummings. ESWT FHCN file

graphic. Wave stock photo from Pixabay. mkb

*Patient’s name withheld at his request

The New WaveThe physicians at Alpha Medical Group practice both traditional and naturopathic medicine. Their goal is to fi nd the root cause of their patient’s problems and to treat them with the safest, most eff ective drug-free, surgery-free treatments available. For more information or to schedule an appointment, call or visit one of their three locations.

Palm Coast515 Palm Coast Pkwy. SW

Suite 5

(386) 276-3075Leesburg

4120 Corley Island Rd.Suite 500

(352) 816-1901Jacksonville

6817 Southpoint Pkwy.Suite 503

(904) 763-1400Visit them on the web at www.alphamedicalgroup.com

Page 12 | Florida Health Care News | Winter 2019 | St. Augustine/Ponte Vedra Beach Edition erectile DySFunction