Dry E T ARTICLES Weath ering Hawthorne Village of Dry

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Health Care Patron PRSRT.STD. U.S. POSTAGE PAID Tampa, FL Permit No.2397 Florida Health Care News Carrier-Route Pre Sort Brandon/Sun City Center Edition Summer 2020 FEATURED ARTICLES Florida Eye Specialists & Cataract Institute 4 Together Forever Picture Perfect Feel Like a New Person Reserved for Relief 3 Hawthorne Village of Brandon 7 Physician Partners of America TMS of Central Florida 8 South Florida Eye Clinic HemWell America Eye Floater Laser Quick, Easy and Effective (see Weathering Dry Eyes , page 2) LAWRENCE C. TAYLOR, MD HAROON ILYAS, MD GEORGE FISHER, MD NEAL HONICKMAN, MD TEOFIL KULYK, MD JENNIFER LANDY, MD AMY MARTINO, MD CAROL MARQUIS, OD Weaering Dry Eyes Retired hurricane hunter can see clearly after combination therapy Once a hurricane warning is issued, most Floridians secure their homes and brace for the high winds and torrential downpours that accompany the tempest. Not James Roles. He made his living defying the alarms and flying directly into the eye of the storm. Before retiring in January, James worked for 30 years as an electronics engineer for the National Oceanic and Atmospheric Administration, which operates a fleet of “hurricane hunter” aircraft for research and surveillance. “My primary job was to manage the scientific instrumentation on the aircraft,” James describes. “There was radar; temperature, pressure and humidity sensors; as well as many proto- type instruments. “In addition, I served as a crew- member aboard the plane to operate the equipment during the flights. For the last 10 years of my career, I worked as a manager and didn’t fly as much. But for the first 20 years, I flew through most of the major hurricanes, including Gilbert, Hugo and Katrina. “We didn’t count the number of hurricanes we flew through, but we did count the times we flew through the eye of a hurricane. I did that more than 250 times.” Despite the dangerous nature of his work, James says his job rarely scared him. In fact, he can remember only one instance when he became truly frightened, in 1989. “e scariest moment came during Hurricane Hugo,” he remembers. “Another plane that was flying at the same time as mine started having problems, and we almost lost it. I knew everybody on that plane so it was a pretty scary day.” “James came to us suffering from significant discomfort and fatigue in both eyes due to dry eye disease,” Dr. Ilyas recalls. “He tried over-the-counter drops to help with the discomfort and the blurriness in his vision, but they were unsuccessful. He came to us for alternative treatments, and I recommended a combination of therapies.” Maintain Moisture Dry eye disease is a common condition affecting 30 million to 40 million Americans, Dr. Ilyas reports. It is an inflammatory disorder where there is not enough moisture on the surface of the eyes to maintain comfort and provide for visual needs. Symptoms of dry eye include burning, stinging and dryness. Some people with dry eye feel eye fatigue, espe- cially toward the afternoon and evening hours. Blurred vision and fluctuating vision are common symptoms as well. It is not uncommon for people with dry eye to have a condition called blepharitis, which can contribute to dry eye development. Blepharitis is a chronic infection and inflammation of the eyelids and lashes. James had significant blepharitis on his eyelids. “In our office, we have several treatments for dry eye,” Dr. Ilyas notes. “One of them is the BlephEx ® . James took his perilous job in stride but grew uneasy last year when his eyes became so dry and irritated that he stopped wearing his contact lenses. James reports that his eyes have always been a little dry, a problem that got substantially worse five years ago. When it got so that he couldn’t wear his contacts, he broke down and consulted his doctor. “e dryness seemed even worse at night,” James recalls. “Every hour or so, I had to put drops in my eyes, otherwise the dryness would wake me up. When it was really bad, I was getting up four or five times a night. And when I woke up, my eyes were irritated. “My dry eye was worse at certain times of the year as well due to allergies. I worried that my eyes could be damaged if they stayed this dry for a long period of time. “I talked to my doctor about my dry eye, and he recommended I visit an ophthalmol- ogist. I did some research on eye doctors in the area and chose Brandon Eye Associates.” at’s where he met Haroon Ilyas, MD, a board-certified, fellowship-trained eye surgeon. James Roles For additional health care information, visit us on the web at The online presence of Florida Health Care News DRY EYE TREATMENT

Transcript of Dry E T ARTICLES Weath ering Hawthorne Village of Dry

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Brandon/Sun City Center Edition Summer 2020

FEATURED ARTICLES

Florida Eye Specialists & Cataract

Institute

4Together Forever

Picture Perfect

Feel Like a New Person

Reserved for Relief

3Hawthorne Village of Brandon

7Physician

Partners of America

TMS of Central Florida

8

South Florida Eye Clinic HemWell America

Eye Floater Laser Quick, Easy and Effective

(see Weathering Dry Eyes , page 2)

LAWRENCE C. TAYLOR, MDHAROON ILYAS, MD

GEORGE FISHER, MDNEAL HONICKMAN, MD

TEOFIL KULYK, MDJENNIFER LANDY, MD

AMY MARTINO, MDCAROL MARQUIS, OD

Weath ering Dry Eyes

Retired hurricane hunter can see clearly after combination therapy

Once a hurricane warning is issued, most Floridians secure their homes and brace for the high winds and torrential downpours that accompany the tempest. Not James Roles. He made his living defying the alarms and � ying directly into the eye of the storm.

Before retiring in January, James worked for 30 years as an electronics engineer for the National Oceanic and Atmospheric Administration, which operates a � eet of “hurricane hunter” aircraft for research and surveillance.

“My primary job was to manage the scientific instrumentation on the aircraft,” James describes. “There was radar; temperature, pressure and humidity sensors; as well as many proto-type instruments.

“In addition, I served as a crew-member aboard the plane to operate the equipment during the flights. For the last 10 years of my career, I worked as a manager and didn’t � y as much. But for the � rst 20 years, I � ew through most of the major hurricanes, including Gilbert, Hugo and Katrina.

“We didn’t count the number of hurricanes we flew through, but we did count the times we � ew through the eye of a hurricane. I did that more than 250 times.”

Despite the dangerous nature of his work, James says his job rarely scared him. In fact, he can remember only one instance when he became truly frightened, in 1989.

“� e scariest moment came during Hurricane Hugo,” he remembers. “Another plane that was � ying at the same

time as mine started having problems, and we almost lost it. I knew everybody on that plane so it was a pretty scary day.”

“James came to us suffering from significant discomfort and fatigue in both eyes due to dry eye disease,” Dr. Ilyas

recalls. “He tried over-the-counter drops to help with the discomfort and the blurriness in his vision, but they were unsuccessful. He came to us for alternative treatments, and I recommended a combination of therapies.”

Maintain MoistureDry eye disease is a common

condition a� ecting 30 million to 40 million Americans, Dr. Ilyas reports. It is an in� ammatory disorder where there is not enough moisture on the surface of the eyes to maintain comfort and provide for visual needs.

Symptoms of dry eye include burning, stinging and dryness. Some people with dry eye feel eye fatigue, espe-cially toward the afternoon and evening hours. Blurred vision and fluctuating vision are common symptoms as well.

It is not uncommon for people with dry eye to have a condition called blepharitis, which can contribute to dry eye development. Blepharitis is a chronic infection and inflammation of the eyelids and lashes. James had

signi� cant blepharitis on his eyelids.

“In our office, we have several treatments for dry eye,” Dr. Ilyas notes. “One of them is the BlephEx®.

James took his perilous job in stride but grew uneasy last year when his eyes became so dry and irritated that he stopped wearing his contact lenses. James reports that his eyes have always been a little dry, a problem that got substantially worse � ve years ago. When it got so that he couldn’t wear his contacts, he broke down and consulted his doctor.

“� e dryness seemed even worse at night,” James recalls. “Every hour or so, I had to put drops in my eyes, otherwise the dryness would wake me up. When it was really bad, I was getting up four or � ve times a night. And when I woke up, my eyes were irritated.

“My dry eye was worse at certain times of the year as well due to allergies. I worried that my eyes could be damaged if they stayed this dry for a long period of time.

“I talked to my doctor about my dry eye, and he recommended I visit an ophthalmol-ogist. I did some research on eye doctors in the area and chose Brandon Eye Associates.”

� at’s where he met Haroon Ilyas, MD, a board-certi� ed, fellowship-trained eye surgeon.

James Roles

For additional health care information,

visit us on the web at

The online

presence of

Florida Health

Care News

Dry EyE TrEaTmEnT

Haroon Ilyas, MD, is board-certified by the American Board of Ophthalmology. Dr. Ilyas completed his undergraduate studies at Duquesne University in Pittsburgh, earning a bachelor’s degree in molec-

ular biology. He attended medical school at Medical College of Pennsylvania Hahnemann University in Philadelphia. Dr. Ilyas completed an internship in internal medicine at Mercy Hospital in Pittsburgh and an ophthalmology res-idency at University of South Florida College of Medicine in Tampa. He went on to complete a fellowship in cor-

nea and refractive surgery at the USF medical school. Dr. Ilyas is a member of the American Academy of

Ophthalmology, Florida Society of Ophthalmology, American Society of Cataract and Refractive Surgery, and International Society of Refractive Surgery.

(continued from page 1)

At Brandon Eye Associates, the board-certified ophthalmologists’ main priority is the safety and well-being of their patients. To meet qualified physicians who use their hearts to care for your eyes, call or visit one of these locations:

Want to learn more? Visit them on the web at brandoneyeassociates.com

Caring For Eyes With Heart

Brandon540 Medical Oaks

Ave., Suite 103

Plant City105 Southern

Oaks Ave.

Sun City Center779 Cortaro Dr.

(813) 684-2211

� is is a small machine that thoroughly cleanses the eyelids and lashes to reduce the bacterial load that leads to the chronic infection of blepharitis.”

� e second treatment is called MiBo. � is uses a probe that delivers thermal pulsations to the eyelids to help the glands there secrete the oils they produce. � is oil helps maintain a lasting tear � lm on the surface of the eye, keeping it moist.

“� e third treatment we have is called intense pulsed light, or IPL,” Dr. Ilyas explains. “� is has been used by dermatologists for years, but ophthalmologists have found it useful to treat Meibomian gland disease along the lids and lashes. Meibomian gland disease contributes to dry eye by blocking the production of essential oils.

“IPL delivers light pulsations to the Meibomian glands so they create more of their natural oils and release them onto the surface of the eye.”

Since dry eye is an in� ammatory disease, it can also be treated medically. Dr. Ilyas often uses anti-in� ammatory eyedrops to calm the eyes’ immune cells. Examples of these medications include RESTASIS®, XIIDRA® and CEQUA™. LOTEMAX® is a another anti-in� ammatory medication that is also a steroid.

“Punctal plugs are another treatment for dry eye that we often use,” Dr. Ilyas points out. “� ese are little plugs placed in the tear ducts to retain more moisture on the surface of the eye.”

“De� nitely Less Dry”As part of his combined treatment, James underwent three IPL treatments last summer.

“Dr. Ilyas also prescribed RESTASIS and LOTEMAX eye drops,” James explains. “He did a cleaning process on my eyelids and gave me a cleansing regimen to follow at home.

“I still use LOTEMAX, but only when I wear my contacts, which I don’t do much anymore. I plan to undergo three more IPL treatments this summer, and Dr. Ilyas will perform another assessment of my eyes after that.”

The therapies offered through Brandon Eye Associates significantly improve dry eye symptoms, but there is no cure for the inflammatory disease. Ongoing follow-up and treatment are typically necessary to maintain eye comfort and clear vision.

“My eyes are definitely less dry than they were when I started treatment at Brandon Eye Associates,” James relates. “For one thing, I wake up less at night to put drops in my eyes – maybe once a night compared to four or five times. And I definitely think my eyes are in better health.

“The treatment certainly helped, but it’s not a magic cure. Dry eye is something I’ll have to deal with for the rest of my life. But I think that if I hadn’t gotten treatment, it would eventually cause damage to my eyes.

“Dr. Ilyas is a very nice and knowledgeable doctor. Everyone at Brandon Eye Associates is nice, and it’s a big place with lots of people. When I went back for a follow-up visit after the reopening after COVID-19, the staff handled the situation very well and I felt safe.

“I recommend Dr. Ilyas and Brandon Eye Associates. The practice is very good. They have professionals that cover almost every aspect of the eyes. Dr. Ilyas is the only doctor I’ve seen, but he is very good. I’m very happy with his work.”FHCN article by Patti DiPanfilo. Photo courtesy of James Roles. mkb

CAUSES

SYMPTOMS

TREATMENTS

DRY

EYE

DIS

EASE Gary and

Patricia Manack

To learn more, please visit www.Hawthornevillageofbrandon.com

Mail to:Hawthorne Village of BrandonAttn: Administration851 W. Lumsden Rd.Brandon, FL 33511(813) 661-8998

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Together Forever

Eileen and John

Brooke

Couples separated by medical needs can enjoy life together

H awthorne Vil lage of Brandon residents John Brooke and Gary Manack have more than a few

things in common. � ey both love base-ball; they both remain married; and they both live independently at � e Estates at Hawthorne Village of Brandon.

Because of their spouses’ specific medical needs, however, John and Gary both live separately from their wives.

There’s a difference between liv-ing separately and being apart, though, because if you were to watch each of them go through their daily routines, you’d see that John and his wife, Eileen, and Gary and his wife, Patricia, spend most of their days and evenings together.

“They keep her very busy during the day with a lot of activities, so I don’t bother her during that time. � ey also schedule a lot of trips to museums and things like that for the residents there, and whenever she goes on one, I’m always right there with her.”

Gary, 80, has a daily schedule similar to John’s. His wife is a stroke victim who has lost the use of most of the right side of her body and now lives in the long- term skilled nursing center of Hawthorne Village of Brandon. Gary is a regular visitor there.

“I walk over to Patricia’s place three times every day – in the morning, again at noon and then again at night,” Gary says. “And even though she’s in a wheelchair, she’s still mentally sharp, so I make sure to get her out as often as possible.

“Every day that it’s not raining, I’ll wheel her all around the campus, and sometimes, we’ll go to lunch at one of the nearby restaurants. I also cook din-

ner for her at my place here at � e Estates twice a week, on Wednesdays and Sundays.”

Gary’s daily routine has been in place since December 2015. That’s when he � nally succeeded in getting Patricia moved to Hawthorne Village of Brandon after she had spent the previous 14 months recovering from her stroke in area hospitals and rehab centers.

“After Patricia had her stroke, I didn’t want to live alone, so I sold our house and moved to Hawthorne Village,” Gary says. “One of the reasons I moved here was because it would help me get Patricia here. � is is where I wanted her to be.

“I knew she was going to need a lot of assistance, and I know there are a lot of other assisted-living communities around, but none are like this. This is the best there is, and one of the best things they do is help people like Patricia.”

More Than Meets the EyeLocated just east of Tampa, Hawthorne Village of Brandon is a not-for-pro� t, full-service retirement community composed of three separate facilities. Each specializes in its own speci� c aspect of carefree retirement living.

For seniors such as John and Gary who are looking for maximum inde-pendence and privacy, � e Estates o� ers the opportunity to live an active and independent lifestyle in an exquisite apartment home nestled inside a carefree, amenity-� lled setting.

For seniors who want to live inde-pendently but need assistance during the day or night, Hawthorne Inn provides highly trained professionals who can o� er

medication assistance as well as aid with basic daily activities such as bathing, dressing and grooming.

And � nally, for seniors, such as Eileen, who require specialized memory care, Hawthorne Village o� ers the Garden Court, where sta� members are trained in activity-based programs designed to minimize the negative e� ects of Alzheimer’s disease and dementia.

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

The Best There IsEileen moved into the Garden Court about a year ago after she and John, a retired engi-neer, made the decision to sell their home in the nearby Bloomingdale community and move to Hawthorne Village.

“Eileen had a stroke about � ve years ago, and after that, I became her full-time caregiver,” John explains. “I was with her 24/7, and after about four years, it just got to the point where I couldn’t handle taking care of her and the house.

“� e biggest problem was the demen-tia and the fact that Eileen had started to roam away from the house. At � rst, I put bells on the doors so I would know when she left the house, but one day, she got out and was gone for � ve hours before we found her.

“After that, I got her a SafetyNet® bracelet, and that’s when my family started pushing me to sell the house and move to Hawthorne Village. They had already checked it out, and they thought it would be the best place for both of us.”

John and Eileen initially moved into an apartment in The Estates. During their � rst night there, however, Eileen wandered out of the room three times. During their second night there, Eileen wandered out two more times.

“� at’s when we decided to move her to the Garden Court,” John says. “And it

was the best thing we could have done. It’s allowed her to be in a place where she gets the speci� c care she needs, and it’s freed me up from having to watch her 24/7.

“� e day after she moved there is the day I started the routine I’ve kept with her for almost � ve years, and it’s worked out very well for us. � at’s why I would rec-ommend Hawthorne Village of Brandon for anyone with a situation like ours.

“It’s the best place you’ll � nd, and the sta� and everybody here is so friendly and helpful. � ey’ll do anything for you. Even if you just have a light bulb out in your apartment, you let them know and they’re right there to take care of it for you.”

Gary highly r e c o m m e n d s Hawthorne Village of Brandon as well. His is a recommen-dation that comes after months of experience with at least one other

assisted-living community in the area.“Everything here is excellent,” Gary

enthuses. “No matter which part of the community you live in, the care and attention is exceptional. � is is one of the most highly rated retirement communi-ties you’ll � nd, and they’ve earned that rating because it’s the best.”FHCN article by Roy Cummings. Patient photos by Fred

Bellet. Facility photo by Jordan Pysz. mkb

“I go to see my wife at least twice a day, seven days a week,” John, 87, says of Eileen, who lives in Hawthorne Village of Brandon’s Garden Court, a community designed specifically for the care of residents with Alzheimer’s disease and dementia.

“I’m always over there � rst thing in the morning, and we have our breakfast and read the paper together for a couple of hours. � en I’m back before 6, and we watch the news and a couple of our favorite TV shows together before I leave, usually about 8 o’clock.

Page 2 | Florida Health Care News | Summer 2020 | Brandon/Sun City Center Edition Brandon/Sun City Center Edition | Summer 2020 | Florida Health Care News | Page 3

Barry LevineExecutive Publisher

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Roy CummingsEditorial Supervisor

Michelle BrooksCreative Director

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Nerissa JohnsonGraphic Designer

Nerissa JohnsonJordan PyszFred Bellet

Photography

Dominic Donnell Aldy Laracuente

Bob Mize Gary Smith Steve TurkDistribution

Brandon Eye AssociatesDry Eye Treatment

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Retirement Community/ AL 9949

Florida Eye Specialists & Cataract InstituteOphthalmology

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Dry EyE TrEaTmEnT rETirEmEnT CommuniTy/aL 9949

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

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

IGNATIUS C. CYRIAC, MDEDWARD J. HUGGETT JR., OD

DEEN G. KING, MDMARGUERITE KOHLHEPP, MD

JAMES X. LAWRENCE, ODCHARLES A. LUXENBERG, MDPRIYA M. MATHEWS, MD, MPH

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

ANA-MARIA OLIVA, MDNANDESH PATEL, MD

DILIP RATHINASAMY, MDWILLIAM A. REEVES, MD

PAULINE THAI, OD

Sight For

LIFE

Brandon403 Vonderburg Dr., Suite 101

(813) 681-1122Riverview

13106 Vail Ridge Dr.

(813) 392-3311Sun City Center

1701 Rickenbacker Dr., Suite 102

(813) 634-8877Ruskin

612 N. Tamiami Trail

(813) 645-3831South Tampa

3115 W. Swann Ave.

(813) 492-2020Find Florida Eye Specialists & Cataract Institute online at www.� oridaeye.org

Much like a camera, the eye uses a lens to focus on images. When a camera’s lens becomes cloudy, it cannot

take clear pictures. � e same is true of the eye, which can naturally become cloudy as people age. � is natural clouding of the eye’s lens, known as a cataract, a� ects more than half of Americans by age 80.

� e only way to treat cataracts is by surgically r e m ov i n g t h e a� ected natural lens and replacing it with a clear, synthetic intraocular lens, or IOL. To achieve the best possible outcomes for their patients, the cataract surgeons at Florida Eye Specialists & Cataract Institute employ the most advanced surgical technologies.

An example is the LENSAR® Laser System. LENSAR is on the leading edge of femtosecond laser technology. Its added functions and precise laser incisions enable surgeons to remove cataracts with increased safety and position IOLs with greater accuracy. � ese innovations lead to better vision following surgery.

“I have performed thousands of cataract surgeries during my career, and I must say, the LENSAR technology is one of the most exciting innovations I’ve seen,” asserts Gregory L. Henderson, MD, who founded Florida Eye Specialists & Cataracts Institute in 1981.

“� e LENSAR Laser System replaces the blades and instrumentation of the past with an advanced femtosecond laser. Even the most experienced surgeon’s hand cannot match the precision and gentle touch of the LENSAR system.”

� e LENSAR automates certain aspects of cataract surgery that were traditionally done by hand. � e surgery is more e� cient, more e� ective and safer.

“The laser makes the initial incision into the eye,” Dilip “Dr. Samy” Rathinasamy, MD, says. “It can also create the capsulo-tomy, which is an opening into the thin, fragile membrane that holds the cataract. And it does so with exceptional precision.

“A capsulotomy done by hand can be less than perfect. � e impor-tance of having a perfect capsulotomy is that

the replacement lens can then sit in a more optimal position, which ultimately gives the patient better vision.”

Three in One Another example of advanced technology used by the cataract surgeons at Florida

Eye Specialists & Cataract Institute is the PanOptix® trifocal lens by Alcon.

“ T h e P a n O p t i x trifocal intraocular lens became available in the United States in late 2019, and it is the only trifocal lens approved for use in the US,” Priya M. Mathews, MD, describes. “It has quickly become a popu l a r l en s choice because it virtually eliminates t h e n e e d f o r glasses following cataract surgery.

“ P e o p l e today have more active lifestyles and use the i r

computers and smartphones with greater frequency. � ey want to be able to see at all distances following cataract surgery, and they do not want the hassle of glasses.”

“� e PanOptix trifocal lens gives people that luxury because it gives them near, inter-mediate and distance vision, eliminating the need for spectacles,” Dr. Samy adds. “� e PanOptix uses di� erent locations on the lens, called the optic, to enable clear vision at these three di� erent focal points.”

Nontraditional Transplant � e eye’s cornea is made up of � ve layers, and during a traditional cornea transplant, the entire cornea is removed and replaced with donor tissue. With the newer

surgical techniques performed at Florida Eye Specialists & Cataract Institute, surgeons can select the diseased layer of the cornea and replace only that layer.

“One technique i s ca l l ed DMEK , which is an acronym for Descemet membrane endothelial kerato-plasty,” Dr. Mathews expla ins . “Dur ing DMEK, the surgeon

removes and replaces a very thin layer of the cornea. In this case, it is two layers, the Descemet membrane, the

basement membrane that lies deep in the cornea, and the endothelium.

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

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

Dr. Applebaum describes. “The repairs we perform help functionally because the excess tissue can get in the way of vision and endanger the patient. It can also cause headaches and other problems.

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

� e lower lids can project a poor � rst impression as well.

“Most of us are born with � ve bags of fat around the eye to protect it and hold it in the socket,” Dr. Munger notes. “With aging, however, that fat can come forward and manifest itself as pu� ness under the eye. Lower blepharoplasty can diminish the look of tiredness and aging by decreasing excess fat and skin beneath the eyes.”

Dr. Applebaum and Dr. Munger also o� er a variety of nonsurgical facial cosmetic services. � ese include BOTOX® Cosmetic injections, a variety of facial � llers and intense pulsed light, or IPL. � ese options can help reverse the changes associated with aging.

Lashing OutA common condition treated at Florida Eye Specialists & Cataract Institute is blepharitis, an infection of the eyelids and eyelashes. Blepharitis commonly occurs simultaneously with dry eye. If left untreated, these condi-tions can lead to permanent eyelid and tear gland dysfunction as well as corneal damage.

“Blepharitis is most commonly caused by an overgrowth of bacteria that live along the margins of the eyelids and at the base of the lashes,” L. Ray Alonzo, OD, reports. “Not only do these bacteria cause the symp-toms of blepharitis, they also produce the substances that in� ame the oil glands in the eyes, causing dry eyes.

“Blepharitis should be taken seriously because of its link to dry eyes and because it can lead to complications. � ese include lashes falling out, lashes growing in the wrong direction because the base of the lash gets scarred, and lashes growing inward toward the eye and damaging the cornea.”

The complications associated with blepharitis and dry eye can be treated and possibly prevented if eyelid hygiene is properly undertaken. For years, hygiene options included cleaning the lids with diluted baby shampoo or eye scrub pads. Now, there’s also the BlephEx®. � e BlephEx is a handheld machine with a medical-grade micro sponge that gently spins to scrub and massage the eyelid margins, cleaning and exfoliating the eyelids and lashes, and relieving symptoms.

“The BlephEx removes all the debris around the base of the eyelashes and helps keep the lids cleaner,” Pauline Thai, OD, confirms. “That takes away

the food for the bacteria causing the redness and inflammation around the eyelids that occur with blepharitis and dry eye.

“We do a one-minute cleaning of the lid margins in one direction, then press a button and the machine spins in the opposite direction. We go back over the lids, and the sponge removes everything that was loosened on the first pass. I’ve seen really great improvement in bleph-aritis and dry eye using the BlephEx.”

are trying to do is prevent them from ever developing one, so our treatments are really geared toward reducing pressure within the eye. � is reduction in pressure has proven to slow down or halt the progression of glaucoma.”

and is caused by changes in the blood vessels of the retina,” Dr. Kohlhepp states. “In some cases, abnormal blood vessels develop on the surface of the retina. In others, blood vessels begin to bleed or leak � uid.

“Diabetic retinopathy generally has no symptoms in its early stages, so screening and early diagnosis are of incredible importance. We have treatments that will overturn poor visual outcomes, but they require early detection.”

Macular degeneration is another serious threat to sight that can occur as people age. It is a disease in which the main images in vision become less discernible.

“� ink of the retina as being 10 layers thick with many blood vessels nourishing it,” Dan P. Montzka, MD, elaborates. “Macular degeneration is a disease in which some of those layers essentially become diseased and waste away. As a consequence, some of the blood vessels pop and leak.

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

Diabetic retinopathy and macular degener-ation are examples of medical retinal disorders.

“Of the surgical disorders, some of the more common are retinal tears and retinal detachments,” Nandesh Patel, MD, reports. “Then there are other disorders called macular pucker and macular hole.

“Macular pucker and macular hole are not as catastrophic as retinal detachment or vitreous hemorrhage, where there’s complete loss of vision that evolves very quickly,

sometimes within hours or days. Macular pucker and macular hole

are conditions that come on somewhat

slowly and involve a disruption in the

normal architecture of the macula.”

Dr. Patel suspects a retinal tear when

patients report flashing lights or floaters, which

are common complaints. Flashing lights and � oaters

can be due to normal changes of the eye, but one

of five who present with those symptoms will likely

have a retinal tear.“A retinal tear is an unwanted conse-

quence of a normal, age-related process where the vitreous gel between the lens and retina is lique� ed, but that process is complicated by the vitreous inadvertently

pulling at the retina,” he describes. “� at’s how a retinal tear is formed.”

Kid Stu� Ronni Chen, MD, a pediatric ophthalmolo-gist, sees patients at the Brandon clinic on a part-time basis. She treats all the eye condi-tions that are commonplace during childhood and adolescence. Often, her patients are children who have failed screening exams by their physicians or schools.

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

“Myopia is also known as nearsight-edness, and hyperopia as farsightedness. Astigmatism is an irregularity that forms in the corneal tissue, causing part of the cornea to be steeper along one axis than another.”FHCN article by Patti DiPanfilo. Photos by Jordan Pysz, Nerissa

Johnson & Fred Bellet. mkb

Advanced technology leads to successful treatment of vision, eye disorders

Webinars Available

OnlineFlorida Eye Specialists & Cataract Institute hosted a series of patient seminars on its website in May. Two of the programs can now be viewed online: a LASIK seminar by Priya M. Mathews, MD, MPH, and a cataract surgery seminar by Dilip Rathinasamy, MD.In early May, Florida Eye Specialists & Cataract Institute

reopened its doors to patients seeking non-emergency appointments and elective procedures. But the health and safety of patients and staff remain the Institute’s

top priority.During the COVID-19 pandemic, Florida Eye Specialists &

Cataract Institute is taking extra precautions to provide a clean, safe environment. � ese include reducing the number of daily appointments, limiting visitors and monitoring common areas to maintain social distancing.

All staff personnel will wear masks and have their temperatures checked daily. Patients are asked to wear masks at all times at the clinic. Patients with fever, cough or any other � u-like symptoms are requested to remain at home and reschedule their appointment.

A sta� member will call patients the day before their appoint-ments to review screening questions. Patients will be screened and have their temperatures checked upon arrival. With the new registration process, most of the paperwork can be completed online prior to the appointment.

To further ensure everyone’s safety, Florida Eye Specialists & Cataract Institute has also developed a comprehensive disinfec-tion protocol to be carried out before and after each patient enters the o� ce. � e protocol includes cleaning all surfaces and testing instruments in each room. In addition, the clinic is disinfected on a routine basis throughout the day and evening.

While these steps help limit the spread of the coronavirus, the highly trained specialists at Florida Eye Specialists & Cataract Institute continue to o� er an array of services – from cataract surgery to facial � llers.

Brandon Eye Clinic O� ers Comprehensive Care In New Era

Seeing Is Believing� e eyes are one of the � rst things people notice when meeting someone and can say a lot about that person.

“When we first meet someone and initially make eye contact with them, we immediately begin to form our first impression of that person,” asserts Craig E. Munger, MD, PhD, an oculoplastic surgeon. “We judge that person to be tired, sad, angry or pleasant based on the appearance of the area around their eyes.”

Puffy or drooping eyelids can make people look old, tired or even mean. When their patients have sagging eyelids, Dr. Munger and colleague Robert J. Applebaum, MD, often recommend blepharoplasty, a safe, e� ective and cosmet-ically appealing procedure also known as eyelid surgery.

Blepharoplasty is a surgical procedure that involves removing excess eyelid tissue. It can be done on the upper and lower eyelids, and can make a dramatic di� er-ence in the appearance of the face.

“With upper blepharoplasty, excess skin is removed from the upper eyelids, which can drop due to muscle weakness,”

Pressure CookerGlaucoma, the second leading cause of blindness in the country, is the degenera-tion of optic nerve � bers that are sending signals to the brain, enabling vision to occur. Glaucoma has been associated with abnormal eye pressure due to elevated intra-ocular � uid pressure (IOP). � is increased pressure damages the optic nerve � bers.

“Glaucoma can occur at any age,” William A. Reeves, MD, observes, “but the risk increases with age. Unlike cataracts, the

vision loss from glaucoma cannot usually be restored. Consequently, early detec-tion and management of this disease is important to try to prevent progression of vision loss.”

Many people are affected by glaucoma, and some are unaware the condition is there.

“It is estimated that about 4 million people have glaucoma, half of whom don’t even know they have it,” Ignatius C. Cyriac, MD, asserts. “� at is why early detec-tion is so important.

“� ere is not a cure for glaucoma yet, which is another reason early detection is so critical. Once we diagnose glaucoma, we can control it, and the earlier we catch it, the easier it is to control.”

“When we diagnose glaucoma early, patients may never have a problem with their vision,” Dr. Reeves says. “What we

“� e latest in the treatment of glaucoma is microinvasive glaucoma surgery, or MIGS,” Ana-Maria Oliva, MD, points out. “� at is a procedure we are actually able to perform during cataract surgery. Twenty percent of the population that has cataract surgery also has mild to moderate glaucoma.”

MIGS is done while the patient is already in the operating suite and prepped for surgery. It is performed immediately following the cataract surgery, after the replacement lens is implanted, and takes less than � ve minutes to complete.

“A new device used during MIGS is called the iStent inject®,” Dr. Oliva describes. “� e iStent inject is used in adults with mild to moderate open-angle glaucoma as well as cataract patients currently using glaucoma medication. � e iStent inject creates new pathways in the drainage system for better fluid � ow out of the eye.”

Retinal Restraints T h e t w o m o s t common disorders of the retina are d iabe t i c re t inopa thy and macular degeneration, two leading causes of blindness in adults. Marguerite Kohlhepp, MD, has exper t i se in treating retinal diseases.

“Diabetic retinopathy is the most common eye disease associated with diabetes

At Florida Eye Specialists & Cataract Institute, the goal is to

o� er an all-encompassing practice that provides patients the highest

quality of eye care for life. For more information or to schedule an appointment, call or visit the

location nearest you:

Page 4 | Florida Health Care News | Summer 2020 | Brandon/Sun City Center Edition Brandon/Sun City Center Edition | Summer 2020 | Florida Health Care News | Page 5ophThaLmoLogy

SOUTH FLORIDA EYE CLINICSCOTT L. GELLER, MD

SOUTH FLORIDA EYE CLINICSCOTT L. GELLER, MD

For Eye Floater Solutions

South Florida Eye Clinic is located in Fort Myers at:

4755 Summerlin Rd. Call Dr. Geller at:

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

(877) 371-3937

For Eye Floater Solutions

South Florida Eye Clinic is located in Fort Myers at:

4755 Summerlin Rd. Call Dr. Geller at:

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

(877) 371-3937

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

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

SCAN THIS TO YOUR SMARTPHONE

TO SEE ACTUAL PATIENTS

SCAN THIS TO YOUR SMARTPHONE

TO SEE ACTUAL PATIENTS

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

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

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

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

Eye Floater Laser

Eye Floater Laser

Scott L. Geller, MD, teaches the technique worldwide

W ith more than 20,000 documented eye � oater laser sessions completed, Dr. Scott L. Geller, a

board-certi� ed ophthalmologist, has the largest and longest clinical series of eye � oater laser sessions in the United States, and probably worldwide.

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

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

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

W ith more than 20,000 documented eye � oater laser sessions completed, Dr. Scott L. Geller, a

board-certi� ed ophthalmologist, has the largest and longest clinical series of eye � oater laser sessions in the United States, and probably worldwide.

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

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

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

Congress of Ophthalmology in Singapore over 25 years and thousands of cases ago.”

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

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

Congress of Ophthalmology in Singapore over 25 years and thousands of cases ago.”

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

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

Recently, a major oph-thalmic laser manufacturer has devised a laser for � oaters.

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

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

“I have tried the other lasers, and if they were supe-rior, I would purchase one immediately,” Dr. Geller says. “I use the Swiss made LASAG laser. It is definitely,

in my hands, superior to the others out there. And I have two of them.”

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

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

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

Jordan Pysz. mkb

Recently, a major oph-thalmic laser manufacturer has devised a laser for � oaters.

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

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

“I have tried the other lasers, and if they were supe-rior, I would purchase one immediately,” Dr. Geller says. “I use the Swiss made LASAG laser. It is definitely,

in my hands, superior to the others out there. And I have two of them.”

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

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

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

Jordan Pysz. mkb

Scott L. Geller, MD, teaches the technique worldwide

F or the better part of the 10 years he suffered from hemorrhoids, Jason* told no one of the condition, not

even his wife or doctor. “I guess like a lot of people I was

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

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

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

“Hemorrhoids are swollen veins in the rectum or anal canal, and they’re extremely common,” notes Linh B.

F or the better part of the 10 years he suffered from hemorrhoids, Jason* told no one of the condition, not

even his wife or doctor. “I guess like a lot of people I was

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

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

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

“Hemorrhoids are swollen veins in the rectum or anal canal, and they’re extremely common,” notes Linh B.

Microcurrent Electrolysis Hemorrhoid Treatment

• FDA-approved• Well-tolerated –

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Microcurrent Electrolysis Hemorrhoid Treatment

• FDA-approved• Well-tolerated –

no anesthesia required• No downtime• No special preparation• No painful surgery• Covered by most

insurance and Medicare• Highly e� ective and safe

Linh B. Nguyen, MD, is board-certi� ed and is a diplomate of the American Board of Family Practice. He is a graduate of the University of Florida and received his

medical degree from Hahnemann University, Philadelphia. He is certi� ed in microcurrent electrolysis for the treatment of hemorrhoids.

Linh B. Nguyen, MD, is board-certi� ed and is a diplomate of the American Board of Family Practice. He is a graduate of the University of Florida and received his

medical degree from Hahnemann University, Philadelphia. He is certi� ed in microcurrent electrolysis for the treatment of hemorrhoids.

If pain, itching and bleeding from hemorrhoids are a� ecting you, there’s

help. Call HemWell America today or visit one of their o� ces:

If pain, itching and bleeding from hemorrhoids are a� ecting you, there’s

help. Call HemWell America today or visit one of their o� ces:

Tampa8553 W. Linebaugh Ave.

Pinellas Park5265 Park Blvd., Suite 101

(855) 697-WELL

Tampa8553 W. Linebaugh Ave.

Pinellas Park5265 Park Blvd., Suite 101

(855) 697-WELL

Visit www.hemwellamerica.com

Visit www.hemwellamerica.com

Nguyen, MD, of HemWell America. “In fact, more than 50 percent of people age 50 or older have them to some degree.”

Most sufferers are understandably reluctant to try the avail-able treatment options, some of which have traditionally been both painful and inconve-nient. Fortunately, Dr. Nguyen offers m i c r o c u r r e n t electrolysis (MCE), an FDA-approved,

nonsurgical method for treatment of hemorrhoids. � e noninvasive, relatively painless outpatient proce-dure has been helping patients for more than 20 years and is completed in the doctor’s o� ce.

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

“In addition to being well-tolerated

Nguyen, MD, of HemWell America. “In fact, more than 50 percent of people age 50 or older have them to some degree.”

Most sufferers are understandably reluctant to try the avail-able treatment options, some of which have traditionally been both painful and inconve-nient. Fortunately, Dr. Nguyen offers m i c r o c u r r e n t electrolysis (MCE), an FDA-approved,

nonsurgical method for treatment of hemorrhoids. � e noninvasive, relatively painless outpatient proce-dure has been helping patients for more than 20 years and is completed in the doctor’s o� ce.

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

“In addition to being well-tolerated

by patients, this method does not require anesthesia, and it’s highly e� ective, safe and convenient. Up to 90 percent of people who have it done get relief from their hemorrhoids, and it can be safely repeated as needed.

“One of the best things about it is that there is no need to take any special

preparation to clear the bowels.

by patients, this method does not require anesthesia, and it’s highly e� ective, safe and convenient. Up to 90 percent of people who have it done get relief from their hemorrhoids, and it can be safely repeated as needed.

“One of the best things about it is that there is no need to take any special

preparation to clear the bowels.

Patients can have the procedure done and go back to work immediately, so there is no downtime. � e entire procedure takes approximately 20 minutes.”

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

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

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

“I tell people that this is the most comfortable treatment, and it’s not an embarrassing situation,” he notes. “If you’re putting treatment off because of embarrassment, don’t wait another second. Pick up the phone and get it done because it’s not embarrassing at all.”FHCN staff article. mkb *Patient’s name withheld at his request.

Patients can have the procedure done and go back to work immediately, so there is no downtime. � e entire procedure takes approximately 20 minutes.”

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

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

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

“I tell people that this is the most comfortable treatment, and it’s not an embarrassing situation,” he notes. “If you’re putting treatment off because of embarrassment, don’t wait another second. Pick up the phone and get it done because it’s not embarrassing at all.”FHCN staff article. mkb *Patient’s name withheld at his request.

Safe, nonsurgical treatment relieves hemorrhoids

Safe, nonsurgical treatment relieves hemorrhoids

Quick, Easy and E� ective

Quick, Easy and E� ective

(9355)

(9355)

LINH B. NGUYEN, MD

LINH B. NGUYEN, MD

Why Su� er?

Why Su� er?

DR. JAMES ST. LOUISDR. ABRAHAM RIVERA

James St. Louis, DO, earned his Bachelor of Science and Master of Science degrees from the University of Wisconsin-La Crosse. He received his osteopathic medicine degree from the Kansas City University of Medicine and Biosciences in Missouri, and completed his surgical

training in the US Army and at Kennedy Medical Center in Cherry Hill, NJ. Dr. St. Louis is a member of many medical organizations including the American Osteopathic Association, American Osteopathic Academy of Orthopedics, American Medical Association and American Association of Physician Specialists.

Abraham Rivera, MD, earned his Doctor of Medicine degree from the University of Puerto Rico School of Medicine and completed a residency in anesthesiology and pain management at Albany Medical Center in New York. Dr. Rivera’s decades of experience equip him to treat even the most complex pain conditions. He o� ers consultations in cooperation with Physician Partners of America’s Minimally Invasive Spine Group in Florida and Texas, and performs spinal cord stim-ulation, spinal cord paddles, intrathecal pain pumps and spinal decompression procedures.

Leaders in Interventional Pain Management and Minimally Invasive Laser Spine Surgery

(877) 331-6603

Physician Partners of America is committed to providing the highest levels of compassionate, patient-centered care. They have 20 locations across Florida to serve you. To schedule a consultation with one of their pain management or minimally invasive laser spine specialists, call or visit one of their o� ces in Florida:

To learn more, visit them online at PPOASpine.com

Iraq War vet nally winning his battle against back pain

I n March, Steve Selman marked his 30th year in the Army Reserve. Seventeen of those years were spent on active duty tours,

including one with the 1st Armored Division during the Iraq War. In the years that followed, Steve lived with a painful reminder of his time in Iraq.

“In 2003, right after the war started, I was a captain running a forward command post in southern Iraq,” Steve, 47, remembers. “One day, as it neared dusk and visibility was fading, a Category 4 sandstorm came up on us without warning, and the wind became � erce.

“I yelled at the sergeants to grab the tent before it blew away. As I grabbed it, a huge gust of wind blew that swept up both me and the tent. � e wind carried me about 50 feet and threw me against a nearby truck. I hit the very top of the truck with my back � at, then fell about nine feet to the ground.

“At that point, I was partially para-lyzed. I couldn’t move my legs. Once we rode out the storm, I was medevaced to Kuwait City for treatment. After about a day and a half, I was able to move my legs, but I still couldn’t walk. � ey then medevaced me to a military hospital in Germany, where I spent six weeks recu-perating. After that, I was redeployed to � nish my tour.”

Heading back into the fray so quickly may not have been the best decision for Steve. He did so based on a sense of duty to his country and his fellow soldiers, who were away from their families and � ghting to survive in a war zone, not because he was healthy enough to return.

“I told the doctor I was better than I really was just so he would clear me to redeploy,” Steve admits. “� at was a mistake, because I’ve been dealing with chronic back pain ever since.

“Over the years, my back pain � ared up every three or four months. When it � ared, I could hardly walk and often had to use a cane. Doing anything physical, even putting on my shoes, was extremely challenging. But the pain always got better after a few days.

“� en in December 2018, something changed. I started having massive nerve

pain down my legs that I never felt before. I had to use my cane to walk all the time. But unlike previous � are-ups, this pain didn’t get better. It got worse. On a scale of one to 10, the pain was a nine or 10. I’ve never experienced pain like that before.”

Fortunately, a friend told Steve about Physician Partners of America. There, he met with the practice’s chief medical o� cer, Dr. Abraham Rivera. � e doctor began his evaluation by reviewing Steve’s MRI and performing a series of diagnostic nerve blocks to assess Steve’s condition.

Dr. St. Louis performs minimally invasive laser spine surgery. He determined that Steve was a good candidate for the surgery.

“Upon evaluating Steve, I discovered that a damaged disc in his lower spine was pinching the nerves exiting through the openings in the spinal column, called foramen,” Dr. St. Louis explains. “Pressure on the nerves caused the pain in his back and down his legs.

“To address Steve’s condition, I chose to perform two minimally invasive laser spine procedures, a laminotomy and a

incision in the back,” Dr. St. Louis reports. “The incision is carefully placed with the help of a special x-ray called C-arm � uoroscopy. Laminotomy is carried out using a scope with a camera, and the surgeon operates while visualizing images from the camera on a computer screen.

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

To relieve pressure on spinal nerves, Dr. St. Louis uses a Kerrison t o r e m ove s o m e o f t h e b o n e surrounding the area where the nerves exit the spinal cord. This is a foraminotomy. Because laminotomy and foraminotomy are performed minimally invasively, recovery is short and complications are rare.

“I typically instruct patients to walk for an hour the day after surgery in three 20-minute intervals,” Dr. St. Louis describes. “Total recovery time depends on the patient’s degree of activity. If they’re returning to a desk job, they can go back within a week. If they do manual labor, they must wait anywhere from two weeks to a month.”

“Amazing Transformation”Steve reports that he didn’t feel pain relief right away following his minimally invasive laser spine surgery. But Dr. Rivera and Dr. St. Louis reassured him that he would feel better with time.

“� ey told me my nerves were irri-tated from the surgery and I had to give myself a chance to heal,” Steve relates. “I was a tad skeptical because I went through several procedures. But before long, I started feeling a di� erence.

“Two months after my procedures, I felt great, a lot better than I had in years. � e pain wasn’t completely gone, but there was an incalculable di� erence in how I was feeling versus how I felt in the past.

“My back pain went from a nine or 10 on the pain scale to a two or three, which is manageable, in a matter of months. It was an amazing transformation. My injury may require additional procedures in the future, but for now, I’m winning the battle against my back pain.”FHCN article by Patti DiPanfilo. Photo courtesy of

Physician Partners of America. mkb

“By administering the nerve blocks, I learned that there were several suspi-cious areas in Steve’s spine, and I was able to pinpoint the source of his pain,” Dr. Rivera reports. “Once my evaluation was concluded, I diagnosed Steve with radiculopathy, a ruptured disc and a pinched nerve, along with low back pain.”

Operation DecompressionTo help Steve achieve pain relief, Dr. Rivera joined forces with Dr. James St. Louis, director of Physician Partners of America’s Minimally Invasive Spine Group.

foraminotomy. The goal of performing those procedures was to decompress Steve’s nerves and relieve his painful symptoms.”

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

“Minimally invasive laser lamino-tomy is performed through a half-inch

Orlando1736 33rd St.

Tampa4730 N. Habana Ave., Suite 202

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LasEr spinE surgEry

CHARLES DEVINE, MDTROY NOONAN, MD

Charles DeVine, MD, specializes in psychiatry and neurology, and has been in practice for more than 20 years. He earned his medical degree from the University of South Florida College of Medicine in

1995 and later performed his residency at the University of South Florida. He is a member of the Florida Psychiatric Society and is a fellow of the American Psychiatric Association.

Troy Noonan, MD, specializes in general psychiatry, and child and adolescent psychiatry. He earned his medical degree from the Chicago Medical School at Rosalind Franklin University in Illinois in 1996 and has been in practice for more than 20 years. He is a member of the American Board of Psychiatry and Neurology.

Visit them online at www.tmscentral� orida.com

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

Be Your Best Self

(813) 423-7037Brandon

1119 Nikki View Dr.

Nonsurgical TMS therapy clears dark

cloud of depression

Decorative handmade journals are at the top of the list of creations that Anne Marie Murphy, a self-proclaimed “ultimate crafter,” loves to work on when she takes a

break from her job as a stay-at-home mom and home-school teacher.

“I do everything from paper to art to sewing, but creating handmade journals is my favorite of them all,” Anne Marie con� rms. “A lot of them end up as

Christmas presents. In fact, I’m still working on a few that I didn’t quite � nish in time for the holidays.”

T h i s p a s t holiday season was one of the more joyful ones Anne

Marie has had in recent years. Her emergence from a near decade-long bout with treatment-resistant depression, general anxiety disorder and post-traumatic stress disorder (PTSD) is the reason.

“� ose problems all started seven years ago when I � rst started speaking out about a sexual abuse that happened to me in my childhood,” says Anne Marie, 50. “It was the � rst time I’d spoken about it, and it blew a valve wide open.

“Once I started talking about it, I couldn’t stop. And because of that, I went to a very dark place that I couldn’t get out of. I started having a lot of physical issues around that time as well, things like widespread muscle and joint pain and headaches.

“I also became very intolerant of heat and very sensitive to loud noises and light, but it was the pain that triggered me to start seeking help. Finally, after a lot of tests, I was diagnosed with � bromyalgia, so I was dealing with that as well as all the other things.”

For help dealing with her depression, anxiety and PTSD, Anne Marie began seeing a psychologist. � at psychologist soon referred Anne Marie to a psychiatrist, Kathleen Carroll, MD, who began treating Anne Marie with antidepressants.

When Dr. Carroll moved her practice to TMS of Central Florida in Brandon a couple years ago, Anne Marie followed her, largely because the antidepres-sants that she was taking were working well for her.

“But then, last spring, I started having trouble staying above what I would consider a normal quality of life,” Anne Marie says. “My moods were extremely low, I was having suicidal ideations and was pretty much con� ned to my bed. I wasn’t functioning.

“I had also maxed out on my meds, and nothing else I tried, like medical marijuana, ketamine and acupuncture, was working. � en one day, I was sitting in Dr. Carroll’s o� ce and suddenly noticed the sign in her o� ce that says TMS and asked her about it.”

The TMS EraApproved by the Food and Drug Administration in 2008 for people with treatment-resistant depression, TMS, or transcranial magnetic stimulation, uses magnetic pulses to stimulate the parts of the brain that are insu� ciently active in people su� ering from depression.

which is what we’re trying to target with medications.“At its core, TMS is a noninvasive, nonmedicinal

therapy that produces a genuine anatomical change, which in terms of regulating blood sugar is di� erent than insulin. While insulin helps somebody regulate their blood sugar, you have to keep taking your insulin to keep it regulated. � at’s not the case with TMS.

“When TMS is successful, there is a true anatomical and physiological change within the brain. � e anatomical change is the increased blood flow. The physio-logical change is the better regulation of blood sugar and brain chemistry that produces a result where people can either come o� their medication altogether or function better with it.”

Life-Changing Results � e amount of time it takes for patients to begin realizing results from TMS therapy treatments varies. Many notice a change after just a few treatments. Others don’t notice a di� erence in their mood for a few weeks. Anne Marie was among those who needed a few weeks to see a di� erence.“It took her about 10 treatments to start noticing a di� erence, and even then, it was mostly her husband and daughter who were noticing the change,” Dr. Carroll reports. “But then about two weeks later, she started to notice a difference herself, and she suddenly became a lot more engaging in activities and things.”

Encouraged by the results from the initial TMS treatment session, Dr. Carroll recommended, and Anne Marie agreed to, a second session of 36 treatments. Anne Marie says the second round of treatments “changed her life” in a way that she had not thought possible in years.

“I feel like a new person,” she raves. “I have control over my moods again, and there’s a hope-fulness that I have now, whereas before, that word didn’t even exist in my vocabulary. I’m still taking medications, but compared to where I was when I started, the difference is amazing.

“I have that quality of life back that I wanted. I feel like I’m successful now and I can live a normal life. I didn’t think that was possible for me before I started TMS treatment, so I would absolutely recommend it to anyone who is struggling with depression and feels like they’re out of options.

“I de� nitely recommend TMS of Central Florida. � ey are really the best.” FHCN article by Roy Cummings. Photo by Jordan Pysz. mkb

� e magnetic pulses are similar to those emitted during an MRI, the di� erence being they are delivered through a cup-shaped device that is placed on the prefrontal cortex of the patient while he or she rests comfortably in a chair similar to a dentist’s chair.

TMS treatments last for 18 minutes, 45 seconds, and patients typically receive a total of 36 treatments over a six- to eight-week period. Patients are usually treated � ve times per week for the � rst � ve weeks of the program, with the length of treatments and their number being reduced beginning in the sixth week.

“TMS allows us to help someone feel a noticeable di� erence in their depression in a very short period of time,” Dr. Carroll states. “Medications can take weeks to bring about those changes, and there can be a lot of trial and error with them. With TMS, we know we’re targeting the area of the brain that’s involved in emotional control.”

Far di� erent than electroconvulsive therapy, which uses an electric stimulus, TMS treatments are adminis-tered in the doctor’s o� ce and are considered safe and easy on the body. � e most common side e� ect is some mild to moderate scalp discomfort stemming from the treatment application.

“What TMS does is stimulate blood � ow to the frontal lobes of the brain, which is where the emotional regulatory centers are located,” says Charles Devine, MD, of TMS of Central Florida. “By increasing that blood flow, the brain is stimu-lated to more ef fect ively r e g u l a t e i t s own b l o o d s u g a r,

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