At Leesburg Regional Medical Center, we live by our Mission to improve your health and well being. The experienced heart surgeon and heart valve team work together seamlessly to pioneer groundbreaking technologies and deliver state-ofthe-art heart valve care.
No matter where you live in the region, you have access to the unparalleled heart valve care that is Leesburg Regional Medical Center Valve Institute.
If you are concerned about your heart valve disease or heart murmur and would like to be evaluated, please call the Heart Care Coordinator today at 352-504-6043.
The area’s finest practicing healthcare professionals combine state of-the-art technologies with state-of-the-heart compassion.
INSTITUTE OF MEDICAL EXCELLENCE
Summerfield 10435 SE 170th Place // 352.233.4393
The Villages 1950 Laurel Manor Dr., Bldg 240 // 352.509.9295
Williston 412 W. Noble Ave. // 352.528.0790 ocalaice.com
LIMBSTITUTE
Summerfield 10435 SE 170th Place // 352.233.4393
Tavares 2754 Dora Ave. // 352.259.5960
The Villages 1050 Old Camp Road // 352.259.5960 limbstitute.com
26
They help treat diseases, deliver babies, cure toothaches, and relieve debilitating back pain. Yet, doctors have another full-time job: keeping themselves healthy and in tip-top shape. We are putting the spotlight on several local physicians and discovering what they practice outside of their medical office. Despite their busy and demanding schedules, they find the necessary time to exercise, which ultimately makes them better physicians.
WRITER: JAMES COMBS
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What was dubbed the answer to the United States’ ailing health insurance system calls for nationwide enrollment by the March 1. Yet since enrollment began in October, the process hasn’t quite worked as originally pitched. With the deadline looming, “Healthy Living” places the Affordable Care Act under the microscope to take a closer look at some of its most praised yet controversial aspects, its trials, and the recent updates that will help you know what to expect.
WRITER: JOHN SOTOMAYOR
35
Medicine is thriving in Lake County, which is beneficial for our overall health, well-being, and peace of mind. Local residents are fortunate to have top-notch doctors, advanced medical procedures, and leading-edge hospitals right in their backyard. Be sure to read about them in this month’s special Health Pros section.
10
CORNER
HEALTHY INSPIRATION
MEDICAL MYSTERIES
HEALTHYBODY
SHAPE
80 BUILDING A BETTER CHEST
Making sure your pecs get a workout is more important than you think.
WRITER: TRACY DRAPER
EAT FIT/NOT FAT
84 WHAT TO EAT, OR WHAT NOT TO EAT
The right food choices can make or break a healthy diet.
CHANGES
86 WHAT A DIFFERENCE A YEAR CAN MAKE Resolve to have a better bill of health in 2014.
WRITER: RICHARD T. BOSSHARDT, M.D., FACS
Cognitive bias modification may be the key to positive thinking.
DAWN
92 WAKE UP WITH A SMILE Morning rituals are a great way to get ready for the day.
HEALTHYSPIRIT
96 HEART HERO
Appreciating life means not sweating the small stuff.
WRITER: MORGAN ELLIS
IMPROVE
98 BUILD A BETTER YOU There are ways to overcome life’s endless obstacles.
MENCOURAGEMENT
100 A TIGHT PAIR OF SHOES Learn to listen more than you speak.
114
FREEDOM
102 BECOME FINANCIALLY INDEPENDENT IN 2014
Become financially independent in 2014. Have a plan of attack, then act!
WRITERS: THOMAS FROSS AND ROBERT FROSS
DAVE SAYS
102 86 CONT 90
104 THE BABY TIMELINE Questions about emergency funds, college savings, and babies are answered.
Board-Certified Orthopaedic Surgeon
Fellow: American Academy of Orthopaedic Surgeons
Fellowship: Sports Medicine
“FMI has performed thousands of surgeries, but I felt like their #1 priority. ”
With knee replacements, one size does not fit all. That’s why among my many specialties, I perform the “gender knee” procedure, which accommodates different knee shapes and sizes. After all, each patient is different, so not every approach should be the same. I get to know each patient thoroughly to customize my care, beginning with effective conservative treatments and, when necessary, advanced surgical techniques.
Total Joint Replacement (including gender-specific knee)
Sports Medicine
Shoulder Surgery
Arthroscopic Surgery
Trauma & Fracture Care
Osteoporosis Evaluation
Occupational Medicine
753-4366
KENDRA AKERS publisher/editor-in-chief kendra@akersmediagroup.com
DOUG AKERS vice president doug@akersmediagroup.com
JAMIE EZRA MARK chief creative officer jamie@akersmediagroup.com
I always get excited this time of year. One reason is the weather is cooler and that always seems to give me an extra boost of energy and a bit more pep in my step. The other reason is January represents a fresh new year and a fresh new start. It is exciting to think about the idea of a clean slate and a second chance to do things all over again, but to do them better than the first time.
For me, that second chance means reflecting on the past five years of publishing Healthy Living. We typically have months like January where we publish the same topic each year and by doing so, each year we must find creative ways to top the previous year’s issue. I am proud to say we have done just that with this year’s Doctors Issue. In 2013, we made a dedicated effort to improve our editorial content and the stories we choose to feature in the magazine. For a story to make it into the magazine, it must fall in line with Healthy Living’s overall focus on a balanced lifestyle. We have four pillars that guide us through our decision-making process. We feel that if you are healthy physically, mentally, spiritually, and financially, you are living a well-balanced life.
Therefore, our idea for a renewed Doctors Issue was to highlight our area physicians who represent our four pillars. Our main feature story this month is about fit physicians. These physicians don’t just preach health; they make it a daily practice in their own lives. It is interesting to see all of the different ways these busy doctors find time to include physical fitness into their busy work days.
Also, this month we introduce a new contributing writer to the Healthy Living team, John Sotomayor. We wanted to cover the new changes coming about this month with the Affordable Healthcare Act; however, our editorial team was already overloaded with assignments and early deadlines due to the holidays. Therefore, we reached out to John, offered him the opportunity to take it on, and he eagerly said, “Absolutely.” Thank you, John, for bringing this important information to our readers.
My excitement for the New Year inspires me to look forward to 2014 and to think about the great stories we have planned. We are working hard to continually engage our readers and keep them entertained and well informed. I invite you to join us each month by reading the magazine and visiting our website (lakehealthyliving.com) and Facebook page. We appreciate any feedback you would like to offer. That is how we stay on track. Thank you for a great 2013, and here’s to an even better 2014.
EDITORIAL // DESIGN
TINA MORRISON editorial/community relations director tina@akersmediagroup.com
MARY ANN D ESANTIS editor-at-large maryann@akersmediagroup.com
SHEMIR WILES copy editor/writer shemir@akersmediagroup.com
JAMES COMBS staff writer james@akersmediagroup.com
HEATHER TOOTLE office manager heather@akersmediagroup.com
contributing writers
RICHARD T. BOSSHARDT, MD, FACS RICHARD BURGUET
MORGAN ELLIS
ROBERT FROSS
THOMAS FROSS
FRED HILTON JOHN SOTOMAYOR
STEVEN J. CODRARO associate creative director steve@akersmediagroup.com
JOSH CLARK senior designer/advertising josh@akersmediagroup.com
ANTHONY CASTO senior designer/editorial anthony@akersmediagroup.com
MICHAEL GAULIN production director michael@akersmediagroup.com
FRED LOPEZ chief photographer fred@akersmediagroup.com
AUBREY AKERS receptionist contributing photographer MORGAN ELLIS RON VANDEVANDER MICHAEL CORRADINO
SALES // MARKETING
TIM MCRAE vice president of sales and marketing tim@akersmediagroup.com
MIKE STEGALL senior marketing representative mike@akersmediagroup.com
LORI STRONG marketing representative lori@akersmediagroup.comHEIDI RESSLER marketing representative heidi@akersmediagroup.com
SHAENA CHASTAIN sales assistant shaena@akersmediagroup.comDISTRIBUTION
SCOTT HEGG distribution manager scott.hegg@akersmediagroup.com
Have a heaHave a happy, healthy New Year!
Kendra Akers Publisherkendra@akersmediagroup.com.
Start the New Year right by feeling good about yourself and potentially saving a life. January is National Blood Donor Month, a reminder about the importance of blood donations. According to the American Red Cross (ARC), 38 percent of the U.S. population is eligible to donate blood, but less than 10 percent do so each year— a disheartening statistic when you consider a car accident victim may require as many as 100 pints of blood.
One Blood has four locations in Lake County. For more information, call the Clermont office at 352.241.7543, the Lady Lake office at 352.750.4088, the Leesburg office at 352.728.1223, and the Tavares office at 352.742.2020. Also, visit oneblood.org.
• Every two seconds someone in this county needs blood.
• More than 41,000 blood donations are needed nationally every day.
• The blood type most requested by hospitals is Type O.
• All donors are given a mini-physical to check the donor’s temperature, blood pressure, pulse, and hemoglobin to ensure it is safe for the donor to give blood.
• A healthy donor may donate red blood cells every 56 days.
• The actual blood donation takes 10 to 12 minutes.
• All donated blood is tested for HIV, hepatitis B and C, syphilis, and other infectious diseases.
When it comes to orthopaedic procedures as complex as total ankle replacements, reverse shoulder replacement and joint replacements of the hip and knee, why trust anyone besides a specialist?
Our board certified orthopaedic surgeons are specialists who are fellowship trained in their areas of expertise. They are known for their advanced skill, training and experience. It’s their names you will find scrawled on referral notes from physicians from across the state or featured on the front covers of a surgeon’s training manual. From conservative care for sports injuries to advanced ankle, shoulder, hip and knee replacements, trust the specialists trusted by other surgeons.
Source: www.womansday.com/home/organizing/100-Ways-to-Get-Organized
Since 1977, Lake Eye Associates has developed a reputation for providing the most advanced and comprehensive eye care in Central Florida.
Of course, expert ophthalmologists and advanced technology are not the only things cooking at Lake Eye.
The practice’s employees recently published a new cookbook titled Delicious Morsels. The book features a list of recipes assembled by Lake Eye staff, their family members, and friends. The public can purchase the book for
There is no doubt that families today lead chaotic lives. Moms, dads, and kids are all heading in different directions, pursuing many hobbies and interests, and coming home to houses that are in disarray. One way to keep your sanity and make your home more functional is to be more organized. January is National Organization Month, but it also marks the beginning of a new year. What better time to start organizing your life than now? Here are some helpful tips for around the home.
• Consider putting wastebaskets in every room so trash does not accumulate in unwanted places.
• Put CDs and DVDs in a storage wallet to rid the clutter of jewel boxes and CD stands.
clutter of boxes and CD stands.
$10 at Lake Eye’s offices in Tavares, Leesburg, and The Villages.
vares,
Proceeds will benefit New Vision for Independence, a nonprofit organization that provides rehabilitation, education, and support services for people with low vision or blindness in Lake and Sumter counties. The cookbook can also be purchased at New Vision for Independence’s office in Leesburg.
For more information, call Lake Eye Associates at 352.750.2020 or New Vision for Independence at 352.435.5040.
• Have a whiskbroom and dustpan handy in each bathroom for a quick, daily dust-up.
• Write down your cleaning routine on sticky notes and post them in places where you will see them daily.
• Gather your children’s balls into a large drawstring bag.
• Always have a two-compartment hamper in your kids’ rooms to sort lights from darks.
• Leave a shoe basket by the front door to avoid having dirt, mud, or grass tracked into the house.
• Buy a weatherproof storage box for the children’s outdoor toys.
• Maintain a list of weekly dinner menus to make shopping much easier and potentially less expensive.
• Photocopy your favorite recipes and place them in plastic sheet protectors inside a binder instead of creating cookbook clutter. Chances are you use only one or two recipes regularly from a cookbook. You can also find most recipes online.
• Avoid buying items such as juicers and waffle irons if you are rarely going to use them.
• Use two-tiered turntables to help double your cabinet space.
• Assign a specific space for everything you own.
• you own.
• Prepare a to-do list of chores for your children, which will leave you with less work and teach them responsibility.
• a to-do list of chores for your children, which will leave you with less work and teach them responsibility
• Organize takeout coupons by placing them inside an envelope. Place the envelope inside a cabinet door that is closest to your phone.
door that is closest to your phone
In October, South Lake Hospital held a groundbreaking ceremony for the South Lake Heart and Vascular Institute. Scheduled to open this summer, the facility will provide cardiac rehabilitation, vascular services, and endocrinology to the community through a partnership with Mid-Florida Cardiology, Vascular Specialists of Central Florida, and South Lake Hospital. With this collaborative approach at the institute, patients can be seen at one location for a variety of cardiac and vascular services, streamlining the process to create a better patient experience. Moreover, patients will be able to receive advanced medical care close to home.
Mark Swain, chief executive officer of The Arc Sunrise of Central Florida in Leesburg, received the Ivan Canuteson Political Leadership award. The award recognizes leaders who provide outstanding leadership and support for the organization’s goal of improving the quality of life for Floridians with developmental disabilities.
The award ceremony was held in Tallahassee and attended by Sen. Thad Altman and state Rep. Janet Adkins.
“I am absolutely thrilled and honored,” Swain said. “I want to thank the people we serve throughout this great state.”
The Arc Sunrise of Central Florida helps more than 120 adults with intellectual and developmental disabilities to achieve the highest level of independence.
Dr. Shawn Wilker, a nationally renowned boardcertified and fellowship-trained ophthalmologist, has joined the staff at Mid Florida Eye Center.
Dr. Wilker, along with Dr. Ray Maizel, will head the practice’s Retina Institute, which focuses on the diagnosis and treatment of vitreo-retinal and macular diseases. Both doctors are leaders in the science and technology of retinal care and have participated in numerous high-profile clinical research trials, leading to advances in the field.
“With the partnership of Dr. Wilker and Dr. Maizel, two renowned researchers, our Retina Institute is poised to do amazing things,” says Dr. Jeffrey Baumann, Mid Florida Eye Center’s co-founder and one of the practice’s cataract specialists. “Best of all, it translates to new treatment options and new possibilities for our patients.”
Dr. Wilker completed his undergraduate training at Stetson University and received his medical degree from Case Western Reserve University. He later completed an internship in internal medicine at the University of Florida, and since 2009, he has served as an assistant professor of ophthalmology at Case Western Reserve University.
My passions are being a dad, a husband, and a cardiologist.
I enjoy the interaction with my patients and their families.
I always strive to treat my patients exactly how I would want a physician to treat my mom or dad.
Ethan Green can say the exact amount without hesitating: $44,086.55.
That’s how much debt he and his wife, Lindsay, had accumulated since marrying in July 2007. Most of it was student loans — the couple met at Clearwater Christian College and together owed $34,000. They were also paying off credit card debt and an automobile loan.
During the fi rst few years of their marriage, they never gave much consideration to their fi nancial situation. After all, they rented a small mobile home and had no mortgage payment. They assumed their debt was normal for a couple in their mid-20s. “We have friends in their 50s who are still paying their student loans, so we assumed we’d be paying off our loans forever,” says Lindsay, a teacher at Liberty Christian Prep School in Tavares. “We never realized the severity of our situation.”
That quickly changed in January 2010 when the Mount Dora couple attended a Dave Ramsey Financial Peace class at
Liberty Baptist Church in Tavares. Realizing they could utilize a more efficient system to manage their fi nances and pay off debt, they immediately applied the principles they learned in class: careful budgeting, cutting up their credit card, paying for everything in cash, and putting money into different envelopes dedicated to various types of expenses.
Their fi rst step was establishing a $1,000 emergency fund. They then paid off their smallest debt —Lindsay’s $3,000 student loan — and began using the leftover money to pay off their next smallest debt, their automobile loan. By December 2012, Ethan’s student loan was paid off, and the Greens found themselves debt free.
This was a remarkable feat, especially considering they spent 35 months consistently living within their means and budgeting every penny. The couple went without cable television, rarely ate at restaurants, and had basic cellphone packages.
Moreover, they never once dipped into their emergency fund, which has since increased to $16,000.
“Doing this is not easy and it takes lots of discipline,” says Ethan, a part-time police officer with the Mount Dora Police Department. “At one time I was working four different jobs. However, when you realize sacrifice is for a reason, you do not feel like it’s a sacrifice. We are trading the niceties of now for a fi nancially stable future.”
Today, Ethan, 29, and Lindsay, 28, remain on
the fi nancial straight and narrow. They now have an 18-month-old son, Cooper, and are saving to purchase a home next year. Any leftover money in a given month automatically goes into a savings account.
“Budgeting is the most important step, so I let Ethan do the budget, and then I approve it,” Lindsay says and laughs. “We want to set a good example for Cooper because we don’t want him going through the same thing we did after graduating college.”
GIVE THEM SOME CREDIT — THIS MOUNT DORA COUPLE SUCCESSFULLY PAID OFF MORE THAN $40,000 IN DEBT.
“Why People Get Goose Bumps,” Today Found Out. J an. 14, 2011. www.todayifoundout.com/index.php/2011/01/why-people-get-goose-bumps/ (Accessed Nov. 25, 2013)
WRITER: FRED HILTON
We have all had goose bumps. You remember when you left the pleasant warmth of the Florida sunshine and walked into that store where the air-conditioning was blasting away, making the temperature slightly above zero. Tiny bumps formed on your forearms. The same condition can happen when you are watching a scary movie and something creepy happens.
Goose bumps are caused by an involuntary action that has been with humans since our ancient ancestors ate mastodon steaks. According to the Mother Nature Network, “goose bumps are one of those fight-or-flight responses of the sympathetic nervous system. When you experience cold or fear, for example, a nerve reaction is sent to the muscles that control the hair follicles on your skins, which causes them to contract. This muscle contraction causes the hair follicles to elevate about the skin and your hair to stand erect.”
Back in the days when our ancestors were a lot hairier than we are today,
DID
this reaction made the human look larger and might have helped scare away a hungry bear or tiger. Goose bumps are a vestigial reflex — something left over from days past but is no longer useful.
As you would expect, folks in the scientific field have fancier terms for this phenomenon than “goose bumps.” Goose bumps are known as piloerection or horripilation and occur in many mammals. Horripilation comes from the Latin words for “stand on end” and “hair.” Medical people have their own term for goose bumps: cutis anserina, which comes from the Latin words for “skin” and “goose.”
e have ungry umps m eful. , eld his se on m d ical is m or e
That brings us back to the question of the day: why are these things called “goose bumps?” It is not very complimentary to the goose, but not many sayings about that poor critter are positive. For example, you have “wild goose chase,” “goose-neck lamp,” and “blank through a goose.”
The term “goose bumps” goes back more than 200 years. Goose feathers grow from openings in the skin
similar to human hair follicles. When a goose’s feathers are plucked, its skin has protrusions where the feathers were. These bumps resemble the human condition.
When a goose’s feathers where the feathers when their “goose bumps” could just as
Other birds also show protrusions when their feathers are plucked. Our “goose bumps” could just as easily be called “chicken bumps” or “duck bumps.”
Goose bumps can also be caused by drug withdrawal, which gives us the term “cold turkey.” An addict suddenly stopping drug use can experience cold sweats, clammy hands, and goose bumps — much like a cold (dead) turkey.
FRE D HILT ON 36 for James Madison in as s
FRED HILTON spent 36 years as the chief public relations officer/spokesman for James Madison University in Virginia and 10 years prior as a reporter and editor for The Roanoke Times in Roanoke, Virginia. He is now happily retired in The Villages with his interior designer wife, Leta, their Cadillac Escalade golf cart, and their dog, Paris. (Yes, that makes her Paris Hilton).
TheNewYearalwayspromptsustolookaheadand makeplansandresolutionsforupcomingdays.Butit isalsovaluabletotakeaquickglanceatthepasttosee whatgotusthroughanotheryearandsetusonthe pathswe’vetaken.
InthisissueofIMPULSEwewilllookback—insome casesdecades—togainaperspectiveondevelopments incardiovasculartreatments,limbsalvage,andthe stridesmadeinoverallfamilyhealth.
Milestonesincardiologyhavebeenremarkablefor theirimmediateimpactonhearthealthandrecapturing qualityoflife.Stentdevelopments,catheterization techniques,newmaterials,anddrugshaveallledusto abetterunderstandingofheartandarteryhealth,and bodeverywellforallourfutures.
TheLimbstituteisthemostsignificantdevelopment— certainlyinourarea,andforFloridaasawhole—in improvingtheoutlookforpatientswhoarechallenged byischemiclimbsthreatenedwithamputation.
Yet,developmentsinprimarycareandaresurgence intheimportanceoffamilypractice—includingtrends thatemphasizewellnessandpatientsassumingmore responsibilityfortheiroverallhealth—impactthe well-beingofmoreinourareathananyothermedical specialty.
Withallthatinmind,ourgoalsforthenewyearwillbe tocontinueourfocusonindividualpatientneedsaswe developnewopportunitiestoexpandourphilosophy— Innovation.Compassion.Excellence.—intonewareas andspecialties.
Wewishyouallanewyearfullofhappinessand abundanthealthandthankyouforyourcontinued support.
Yours,
Improvements in the care and treatment of cardiology patients have been dramatic over the past 20 years with the promise of much more to come in the future. Both doctor and patient continue to realize significant benefit from the developing technologies and techniques….
For the cardiologist Improvements range from better tools to treat everything from blockages and heart rhythm irregularities to maintaining blood chemistry, reigning in plaque formation, and controlling blood pressure. Many of them can be summed up in a single word: stents.
Stents have come a long way from the first coronary implant in 1986.* There are coronary stents, self-expanding stents, drug-eluding stents, carotid stents, stents for aneurysms and peripheral arterial stents. Their designs have improved while their materials have evolved. Even the ways they are delivered have improved with lower profile catheters and better closure devices after arterial procedures. Even the drugs a cardiologist has to choose from have improved for a variety of conditions. There are anti-platelet drugs, combination therapy for cholesterol lowering, medications for high BP management, and
Asad U. Qamar, MD
FACC, FCCP, FSGC, FACP, FSCAI Cardiologist
“Developments in primary care and a resurgence in the importance of family practice may very well impact the well-being of more in our area than any other medical specialty. ”
— Dr. Asad Qamar
Cigarette smoking causes coronary heart disease, the leading cause of death in the United States. Cigarette smokers are 2–4 times more likely to develop coronary heart disease than nonsmokers.Source: Smoking and Tobacco Use, CDC
newer blood thinners that provide alternatives to the use of coumadin.
What is better for the doctor almost always translates to a faster and better recovery for the patient. Improved catheterization methods mean a greater number of procedures are now performed as outpatient and or sameday procedures. Better sedation is leading to less patient discomfort. Smaller-caliber catheters mean less discomfort and a shorter stay. Improved closure devices have shortened stays and lessened the risk of bleeding. Fewer emergency bypass surgeries are performed now because of improved stent platforms. Carotid surgery can often be avoided by using stents. Even abdominal aortic aneurysms can be treated with stents instead of subjecting a patient to risky open abdominal
surgery. Better medicines today have lessened the chances of blockages recurring tomorrow, as well as initial and followup heart attacks and strokes.
Patients can still do some improving on their own by limiting unhealthy behaviors. Smoking is the number one contributor to heart and arterial disease.** Obesity ranks a close second, especially when coupled with its primary complication— Type 2 diabetes.
As successful as the past 20 years of cardio care have been, the future holds even more promise. Smaller devices and improved closure systems will lead to better results in PAD treatment with fewer complications—including returning blockages. Better drugs are on the horizon for the treatment of atherosclerosis. Lastly, preventative care will continue to grow more important and make all of us better doctors and healthier patients.
Significant milestones in the development of effective limb salvage techniques began with the introduction of insulin to combat diabetes in the 1920s. Insulin use drastically reduced deaths from diabetic coma just as mortality from diabetic gangrene surged dramatically. As a result, serious attention focused on the treatment of another byproduct of diabetes — the diabetic foot.
Fast-forward 20 years and there are even more advances in comprehensive vein care and limb salvage treatments — the most important being adopting a team management approach for treatment.
It has been known for a long time that involving different specialties would ultimately be necessary for a successful outcome. Diabetologists and endocrinologists control nutrition and a patient’s glycemic levels; podiatrists and specialists repair wounds; and vascular surgeons improve blood flow. Instead of days, it now takes hours to coordinate the examinations, treatment, and results from these medical disciplines.
Surgical techniques to improve circulation are another improvement in the treatment of at-risk limbs. Of those, the adoption of extreme distal artery reconstruction is one that has reduced the need for toe and transmetatarsal amputations in hundreds of cases. These techniques include stenting and breaking up blockages in the arteries, and the use of radiofrequency techniques to correct vein pathology is being offered exclusively at the Limbstitute.
** Cigarette smoking causes coronary heart disease, the leading cause of death in the United States. Cigarette smokers are 2–4 times more likely to develop coronary heart disease than nonsmokers., Smoking and Tobacco Use, CDC
Finally, the establishment of the Limbstitute itself is one of the most undeniable improvements in limb salvage — especially for patients in surrounding areas. Combining comprehensive vein care limb salvage specialists under one roof helps bring a standard of care and treatment second to none.
Insulin use drastically reduced deaths from diabetic coma (from 60% to 5%) just as mortality from diabetic gangrene surged dramatically.Source: History of the team approach to amputation prevention: pioneers and milestones., J Am Podiatr Med Assoc. 2010 SepOct;100(5):317-34.
Source: National Trends in Healthcare and Family Medicine, Dr. Jerry Kruse, SIU School of Medicine
The past 20 years have shown us just how critical primary care medicine is to the health of both patients and the medical establishment as a whole.
Since 2000, the proportion of women appropriately screened for cervical and breast cancer has declined. In 2002, the U.S. infant mortality rate rose for the first time in 40 years, the only industrialized nation to experience such a rise. The U.S. still trails most of the industrialized nations in life expectancy, death rates from cardiovascular disease and cancer, and infant mortality, and since 2000, the gaps have widened.*
The precipitous rise in the costs of health care and the drain on resources has, in recent years, increased interest in preventive medicine. Patients, doctors, and even insurance companies realize the best way to avoid the pain and high cost of disease is to not get the disease in the first place. So, the focus has shifted from treating the problems when they arise to emphasizing healthier lifestyles that eliminate them.
Enter family practice and the primary care physician. Family practices like IME are uniquely positioned to be the vanguard for counseling patients on nutrition, the benefits of exercise, and the elimination of bad habits like smoking and overeating. Wellness programs that catch problems early underscore the importance of regular visits with a primary care physician. Patients, in particular, and the health care establishment as a whole will be all the healthier for it.
ocalaice.comocalaice.comlimbstitute.com
Ocala 4730 SW 49th Rd. // 352.854.0681
Summerfield 10435 SE 170th Place // 352.233.4393
Tavares 2754 Dora Ave. // 352.259.5960
The Villages 1950 Laurel Manor Dr., Bldg 240 // 352.509.9295
The Villages 1050 Old Camp Road // 352.259.5960
Williston 412 W. Noble Ave. // 352.528.0790
The U.S. still trails most of the industrialized nations in life expectancy, death rates from cardiovascular disease and cancer, and infant mortality, and since 2000, the gaps have widened.
“I had a filling in a front tooth come out which caused it to break and abcess. My mouth became very swollen and painful, and Dr. Barr was able to work me into his schedule the same day. After two weeks on antibiotics, he removed the broken pieces and was able to create a bridge to replace the missing tooth. It gave me a beautiful smile I hadn’t seen in years. I now smile ear to ear because of this wonderful gift Dr. Barr gave me.”
— Adam Evans
These area physicians are dedicated to working on bodies almost every day of the week. However, in this case, it’s their own.
WRITER: JAMES COMBS PHOTOS: FRED LOPEZ + PROVIDEDDoctors spend an incredible amount of hours tending to the health care needs of their patients. Yet, many still fi nd ways to squeeze in exercise and physical activities into their busy schedules. By practicing what they preach, the doctors in the following pages have discovered their patients are more inclined to listen.
Certainly, every professional field needs its share of role models, and medicine is no exception. Meet the local physicians who set excellent examples for their patients by striving to lead healthy lifestyles.
In a world fi lled with laughable exercise excuses, there is one that seems quite legitimate: being pregnant while holding down a full-time job. Surely, an expectant mother in this situation would be exhausted by the end of the day, right?
Not if you’re Dr. Danielle Menneto. She is actually coasting through life and ‘wheeling’ herself to remain in tip-top shape despite being 29 weeks pregnant.
Although she sees an average of 60 patients a day as a chiropractor with Wagner Chiropractic in Eustis, she still has the energy to rollerblade two miles around her neighborhood after arriving home. Dr. Menneto, 30, hopes her healthy lifestyle proves beneficial when she gives birth to Camden Joseph Menneto, whose expected due date is March 9.
“It is important to remain in good shape so I’ll be stronger when I’m going through labor and delivering my baby,” she says. “Another reason I rollerblade is because it helps tone my muscles and keeps me from gaining additional weight. Therefore, I will have an easier time getting my body back to where it was before I became pregnant.”
For Dr. Menneto, rollerblading has become a nightly routine. She arrives home, straps on her inline skates, grabs a flashlight, and heads out into the darkness. Of course, she is never alone. Accompanying her on each journey are her two Puggles, Brodi and Luke. She has each dog on a leash, and they usually pull her for the fi rst lap.
“After they tire out a little bit I propel myself,” she says. “However, they love going rollerblading with me. When I grab their leash, they come running to me with their tails wagging and immediately go right to the door. Being able to exercise with my dogs is a lot of fun and helps me relax and decompress after a hard day at work.”
Long before most people take their first sip of coffee or a morning shower, Dr. Kurt Wagner has already worked up quite a sweat on his beloved Fuji road bike. Two days a week, this 60-year-old physician rises at 5a.m., dons his cycling attire, and heads out for a morning spin.
Cycling is his medicine.
“For many years I was a runner, but I started cycling two years ago because I began having knee problems,” says
Dr. Wagner, a family practice physician who works at Lake Primary Care Associates in Tavares. “I wanted to preserve my knees, so cycling seemed like a good alternative.”
Locally, Dr. Wagner enjoys cycling on public bike trails, as well as secluded roads around Lake Dalhousie in Eustis. Sometimes he takes his road bike on trips, as was the case last October when he visited North Carolina.
“It was very pretty, but the
elevation changes combined with the temperature and wind presented a challenge,” he says. “I was doing some heavy duty breathing.”
On mornings when he does not cycle, Dr. Wagner works out at the gym.
“I can see a big difference in my patients who exercise religiously like me versus the ones who are inactive. My active patients can still do many activities, even as they grow older.”
For Dr. Eddie Orobitg, one of the most defining moments of his triathlon career did not involve crossing the finish line. It occurred while he was training in Georgia for an upcoming competition.
“While I was running, a guy patted me as he was passing and encouraged me to keep going. I looked at him and noticed he was missing three limbs. I thought to myself, ‘I am getting passed by a triple amputee.’ This put things in perspective for me. I realized how blessed I am and told myself that I was never going to complain whenever I’m cramping or feeling pain.”
This has served the 43-year-old dentist well since he began competing in triathlons four years ago. Among his achievements is completing an Ironman triathlon, a 140.6-mile race that is known as the Super Bowl of triathlons. Of course, the sport is about more than just swimming, biking, and running.
“Being a triathlete keeps me very focused and helps me be a better husband, father, and dentist,” says Dr. Orobitg, who owns a dental practice in Leesburg. “When I’m training at 4a.m., it is a time to look at the stars, listen to my footsteps, and become centered with God. It is very peaceful.”
This year, Dr. Orobitg will compete in two Ironman triathlons— the Coeur d’Alene (Idaho) Ironman in June and the Florida Ironman in November.
After falling off a horse and breaking her left leg and ribs in 1995, Dr. Shelley Glover discovered that working out was painfully difficult.
“I had a rod put in my left leg as a result of the accident,” says Dr. Glover, who owns Clermont-based Gynecological Specialty Care and Your Body in Balance, an anti-aging practice. “Fifteen years ago I tried running on a treadmill and was in excruciating pain. I could not walk for two weeks.”
However, her left leg pain has lessened considerably since she began a CrossFit class last summer at Clermont CrossFit. The 48-year-old gynecologist faithfully attends
the class four times a week and focuses on stretching, mobility, and strength training.
“I was taking a boot camp class for four years prior to CrossFit, but I discovered CrossFit takes things to another level,” she says. “My left side and particularly my left leg have been strengthened. Now, I can do activities that I haven’t done in years, such as running and jumping rope.”
Seeing these positive results keeps Dr. Glover motivated. “It is a brutal workout, but I keep coming back for more because I feel so good afterward. Plus, it is fun being around like-minded individuals who enjoy getting beat up.”
Dr. Richard Bosshardt recently completed one of the most grueling races known to mankind — a full Ironman triathlon.
During the race, which was held November 2 in Panama City, the 61-year-old plastic surgeon fi nished a 2.4-mile ocean swim, a 112-mile bicycle ride, and a 26.2-mile run in 13 hours, 36 minutes, and 33 seconds. Adrenaline pumped through his body as he arrived at the fi nish line, where he was greeted by a cheering crowd and the booming voice of the race announcer who proudly proclaimed, “Richard Bosshardt, you are an Ironman!”
At that moment, Dr. Bosshardt realized the impossible just became possible. This magnificent triumph was the culmination of a year’s worth of intense training and digging deep whenever difficulties arose.
“During the swim portion, I was accidentally kicked in the hand and hit in the eye by someone’s heel,” says Dr. Bosshardt, who owns Bosshardt and Marzek Plastic Surgery Associates in Tavares. “At that point, I just told myself to embrace the chaos and have a good time. And at the beginning of the run
my muscles did not want to work because I had just completed a 112-mile bike ride. I kept running and after a few miles, my muscles limbered up. I paced myself and conserved energy.”
For Dr. Bosshardt, this was the latest feat in an impressive list of athletic accomplishments. He has completed two other Olympic-distance triathlons and a half Ironman. Each April, he participates in a two-day, 100-mile bicycle ride to raise money for multiple sclerosis research. He has also conquered both the Boston Marathon and Disney Marathon.
Although his career as a plastic surgeon keeps him busy, he always fi nds time to exercise. He says others should be able to fi nd time, as well.
“We all have 24 hours in a day, and everyone has time if they make time,” says Dr. Bosshardt, who became a vegetarian in July 2012. “I also believe that everyone is capable of doing more than they do. In one year you can be in a completely different place.”
When it comes to health and fitness, Dr. Ishbel Nieves has no problem getting down and dirty.
A local dentist, Dr. Nieves, 32, puts her athletic ability and endurance to the test by competing in 5- and 13-mile mud runs sponsored by companies like Savage Race and Tough Mudder. During these races, she conquers numerous obstacles, such as submerging herself in an ice water bath, hurdling over fire, crawling under barbed wire, and climbing over cargo nets.
She typically fi nishes a 13-mile mud run in three hours. However, she says the competitions are more about camaraderie and teamwork than trying to set personal records. “I compete with my husband, Eric Diaz, and a group of friends,” says Dr. Nieves, who owns Highland Lakes Dental in Leesburg. “There are some obstacles I would not be able to complete without their encouragement and help. My husband and I do not have any family in Florida, so competing in these events has been a wonderful way to meet new friends.”
In addition to mud runs, Dr. Nieves also competes in 5Ks, 10Ks, and half marathons. She and Eric are also owners of South Lake Crossfit and Barbell Club.
“Exercising and staying healthy gives me an outlet to do something other than dentistry. It frees my mind.”
While many people have adopted CrossFit as a lifestyle, for some it’s been a life-changing experience. That is certainly the case for Dr. Felix Esarey, a podiatrist and owner of Tri-County Podiatry in The Villages. He credits CrossFit for helping him get off medication for high cholesterol, high blood pressure, and gout.
Four days a week, he attends a class at LBC Crossfit in Lady Lake. On Monday, Wednesday, and Friday, his class is from 5 to 6a.m. That commitment pays dividends when running a busy podiatry practice.
“It is never easy getting up that early, but I find that I have more energy throughout the day,” says Dr. Esarey, who turned 45 in November. “I still want to walk and be mobile when I retire, and I feel my CrossFit workouts will help me achieve that.”
Dr. Esarey has gravitated toward CrossFit because the workouts change with each session. One day, his class completed 100 squats with 95 pounds. The following day, they ran one mile, did 100 pullups, 200 pushups, 300 squats, and then ran another mile.
“By changing things up, my body does not get accommodated to one particular exercise,” says Dr. Esarey, “and that is why I’m achieving the results I desire.”
By providing quality, comprehensive care that is tailored to the unique needs and desires of each patient, our accomplished board-certified physicians, physician assistants, and doctors of audiology can effectively diagnose and treat individuals who come to our offices looking for answers and solutions.
Q:Will I gain weight after thyroid surgery?
A:Questions about weight gain and thyroid surgery are a very popular topic. The truth is that following surgery, there is a medication that is taken to replace the function of the thyroid. The trade name is Synthroid and it is a combination of the storage form and the active form of the thyroid hormone. So following surgery, your body does not know that the thryoid hormones are not being made by the thryoid gland. Having the right amount is all that is required to keep the metabolism functioning normally. The dose level is regulated through blood tests which have to be repeated until the correct dose is found.
Dr. Judith C. Milstead
What
An outer ear infection is an infection of the skin of the ear canal. This can be caused by water or other liquid getting into the ear or any trauma, such as a scratch, of the skin of the canal, resulting in pain and swelling of the canal skin. A middle ear infection occurs behind the eardrum and is usually caused from sinus or allergy problems, causing fluid to accumulate in the middle ear space.
Learn more about sinus conditions and the Balloon Sinuplasty procedure at our dedicated website www.LakeSinusRelief.com
To learn more about FREE upcoming seminars, screenings and special offers from our wellness division, please visit Face2FaceFL.com or subscribe to our exclusive e-newsletter by sending an email to Face2FaceFL@Gmail.com
With the introduction of laser and radiofrequency ablation around the turn of the new millennium, the whole landscape of venous therapy changed. Previously, patients underwent an operation that required general anesthesia and lengthy recovery. However, due to other conditions and their age, many of these patients couldn’t have surgery with general anesthesia.
Now, there is a treatment that requires only local anesthesia and doesn’t cause any debility. As the medical director of Central Florida’s first wound care center, where a large percentage of patients suffer with venous ulcers around their ankle, this new technology has been a godsend. Those of us who embraced laser and radiofrequency ablation early noticed a significant reduction in the time to heal these ulcers. Additionally, we have seen a very low reoccurrence rate. Before, compression was often the only treatment, but resulted in prolonged outcomes and frequent recurrence.
The new technology has also been a game changer, especially for those with symptoms of vein disease
(aching, throbbing, pressure, cramps, and heaviness) and early signs of vein disease, such as swelling, shin dryness, and thickening. In the past, patients would have shied away from an operation because of what was entailed or rumors from a friend or family member who had the
operation but experienced a less-than-optimal experience. Now, patients can rest easy knowing they will receive nothing but the utmost care.
With the greatest experience of any vein center in Florida,
Vascular Vein Centers was one of the earliest practices to utilize this new, revolutionary laser technology. Let our experience in treating the most challenging cases throughout Central Florida benefit you!
P. Martin, MD, FACS Vascular Surgery/Phlebologist Founder and Medical Director
General Surgery/Phlebologist
General Surgery/Phlebologist
Board-Certified in Gastroenterology, Digestive Tract, Liver, and Pancreatic diseases
Dr. Lal Nagabhairu (Dr. Lal) received his medical training at Guntur Medical College in India. He performed his residency training in internal medicine at Our Lady of Mercy Medical Center in New York Medical College and completed his gastroenterology fellowship at the prestigious Henry Ford Medical Hospital in Detroit, Mich.
Dr. Lal is highly skilled in endoscopic retrograde cholangiopancreatography (ERCP,) which assists in the diagnosis of problems of the bile duct and pancreas. He is also an expert at diagnosing motility problems of the esophagus, non-cardiac chest pain, anorectal problems such as incontinence, and other gastrointestinal motility disorders. He has excellent accuracy and safety records in all types of endoscopic procedures.
Board-Certified in Gastroenterology, Digestive Tract, Liver, and Pancreatic diseases
Dr. David Elijah joined Gastro-Intestinal Consultants in May 2013. He earned a Bachelor of Science degree in electrical engineering from Rice University. He attended medical school at the University of South Florida, which is where he also completed his residency and fellowship. He is board-certified in internal medicine and gastroenterology. He specializes in procedures such as radiofrequency ablation of pre-cancerous lesions in the esophagus. In addition, he performs endoscopic removal of large lesions and superficial cancers in the stomach and colon so patients can avoid surgery.
Founded in 2002, GastroIntestinal Consultants, LLC provides an array of diagnostic and therapeutic endoscopic services to treat digestive disorders and liver diseases. We have three convenient locations, including our main office in Tavares and two locations in The Villages.
Our physicians — Dr. Lal S. Nagabhairu and Dr. David F. Elijah — are board-certified in gastroenterology. Their education combined with their vast experience makes GIC one of the most respected gastrointestinal practices in Central Florida. Our physicians have privileges at Florida Hospital Waterman, The Villages Regional Hospital, Leesburg Regional Medical Center, and Premier Surgical Center. The majority of procedures we offer are performed at the Premier Surgical Center, including colon cancer surveillance.
GastroIntestinal Consultants provides costeffective treatment tailored to meet each patient’s individual needs. We communicate with the patient’s personal physician to keep the physician up-to-date on the treatment plan and the patient’s progress.
The physicians of GastroIntestinal Consultants remain dedicated to providing quality and compassionate care for a wide array of gastrointestinal, liver, and biliary tract diseases. Physicians have access to the most cutting-edge technology, including esophageal manometry, endoscopic retrograde cholangiopancreatography (ERCP), and capsule endoscopy.
MEASURES THE PRESSURE INSIDE THE LOWER PART OF THE ESOPHAGUS.
The purpose of esophageal manometry is to see if the esophagus is contracting and relaxing properly. The test helps diagnose any swallowing problems. Your health care provider may request that this test be performed if you have symptoms of acid reflux (heartburn or nausea after eating) or problems swallowing (feeling like food is stuck behind the breast bone) which can be due to motility problems in the esophagus.
PROCEDURE USED TO SEE INSIDE THE COLON AND RECTUM.
During colonoscopy, patients lie on their left side on an examination table. In most cases, a light sedative, and possibly pain medication, helps keep patients relaxed.
The doctor inserts a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with air or carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine, allowing the doctor to carefully examine the intestinal lining. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing.
Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. Bleeding and puncture of the large intestine are possible but uncommon complications of colonoscopy.
(EGD) IS A TEST TO EXAMINE THE LINING OF THE ESOPHAGUS, STOMACH, AND FIRST PART OF THE SMALL INTESTINE.
A local anesthetic may be sprayed into your mouth to prevent you from coughing or gagging when the endoscope is inserted. A mouth guard will be inserted to protect your teeth and the endoscope.
An IV may be inserted into a vein in your arm to give you medications during the procedure. You will be instructed to lie on your left side.
After the sedatives have taken effect the endoscope is inserted through the esophagus to the stomach and duodenum. Air is put into the endoscope to make it easier for the doctor to see. The lining of the esophagus, stomach, and upper duodenum is examined.
“I can’t say enough good things about Dr. Nagabhairu. When he purchased the practice several years ago, he reviewed my medical records and treatment history. He concluded that I did not have Crohn’s disease as had previously been diagnosed. He was going to prescribe a different medication, which should greatly improve my quality of life if his diagnosis was correct. It was! In just one day I was given my life back. Dr. Nagabhairu, not a day goes by that I do not thank you for the life that I now enjoy.”
— Richard LindgrenEXAMINES THE LINING OF THE MIDDLE PART OF YOUR GASTROINTESTINAL TRACT.
Capsule endoscopy helps your doctor evaluate the small intestine. This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease, ulcers, and tumors of the small intestine.
ERCP IS A PROCEDURE THAT COMBINES UPPER GASTROINTESTINAL (GI) ENDOSCOPY AND X RAYS TO TREAT PROBLEMS OF THE BILE AND PANCREATIC DUCTS.
An endoscope is inserted down the esophagus, through the stomach, and into the duodenum. Video is transmitted from a small camera attached to the endoscope to a computer screen. Air is pumped through the endoscope to inflate the stomach and duodenum, making them easier to examine.
A catheter is slid through the endoscope and guided through the papillary opening so the doctor can inject a dye into the ducts. This allows the ducts to be seen on x rays to identify and treat narrowed areas or blockages. Treatment can include opening blocked ducts, breaking up or removing gallstones, removing tumors in the ducts, or inserting stents.
A state-of-the-art ambulatory surgical center conveniently located on U.S. Highway 441 in Tavares, which features first class treatment under one roof. Our doctors erforming a variety of approved ASC procedures, including:
• Pulmonology cases
Bronchoscopes
• Ophthalmology cases
Cataract and Corneal Transplants
• Urology cases
Inner Stem Transplant, Cystoscopy, Lithotripsy, Circumcisions
• Neurology cases
Spinal Procedures and Injections (Laparoscopic Laminectomy Spinal Injections)
• Gastroenterology Cases
Colonoscopy, EGD/Enteroscopy, IRC, Video Capsule Studies, PEG, ERCP, Anorectal and Esophageal Anometry, Bravo Ph, and Halo
In the near future we will be adding:
• Cardiology cases: Pacemakers
• Orthopedic cases: Knee Transplants
• And more ASC approved procedures.
Samuel Hess MD (Orthopedic Surgery)
Venkatesswara Goli MD (Urology)
Fouad Shami MD (Urology)
Yonas Zegeye MD (Neurosurgery)
Dan Tran MD (Surgery)
Shams Tabrez MD (Gastroenterology)
David F Elijah MD (Gastroenterology)
Lal Nagabhairu MD (Gastroenterology)
Hazem El-Arousy MD (Vascular Surgery)
Harsh Duphare MD (Gastroenterology)
Paul Goldberg MD (Gastroenterology)
2130 VINDALE RD., TAVARES, FL 32778
352.385.7171
Board-Certified in Ophthalmology
Dr. Vinay Gutti is a board-certified ophthalmologist who practices comprehensive eye care at Eyemax Vision Center in Tavares. He specializes in cataract, corneal, and refractive (LASIK) surgery.
Dr. Gutti believes in personalized, patientcentered care, and his motto is to treat all of his patients as if they were family members.
Dr. Gutti grew up in the central Pennsylvania town of State College where Penn State University is located. He had the opportunity to spend time on the East Coast, Midwest, and West Coast during his extensive training. Dr. Gutti’s clinical interests focus on cataract surgery and premium lens implantation including Crystalens HD, Alcon Toric IOL, ReStor IOL, and Tecnis Multifocal IOL.
He also has surgical expertise in advanced corneal transplantation techniques, specifically femtosecond laser-enabled keratoplasty (laserassisted corneal transplant) and Descemet’s stripping endothelial keratoplasty (DSEK), where he is able to preserve most of a patient’s own cornea while only transplanting the inner layer called the endothelium.
Dr. Gutti performs a majority of his operations in Tavares at the world-class Premier Surgical Center, which offers him the latest surgical equipment and technology so he can achieve optimal visual results for his patients.
Dr. Gutti has published his research in numerous peer-reviewed journals and has authored chapters in highly respected ophthalmic textbooks. He has traveled nationally to present his research at prestigious academic meetings.
In his free time, Dr. Gutti enjoys spending time with his wife and daughter and playing golf at many of Central Florida’s beautiful golf courses.
Board-Certified in Neurological Surgery
Dr. Yonas Zegeye earned his medical degree from Drexel University in 1979. As a student, he received the American Hepatic Foundation Medical Student Research award in 1975, as well as the Special Honors Award from the American Hepatic Foundation in 1976.
In 1980, he completed a yearlong internship at Howard University Hospital in Washington, D.C. For the next five years, he served as a neurosurgery resident at Montreal Neurological Institute and Hospital in Canada. He completed two fellowships in 1985—the fi rst in micro-vascular neurosurgery in Ontario, Canada, and the second in clinical neurology in London, England.
Since 2004, Dr. Zegeye has operated a private practice in Florida. In recent years, he has served as president of the Brain and Spine Institute and also as a professor of neurology and neurosurgery at Addis Abama University in Ethiopia.
In addition to his professional accomplishments, Dr. Zegeye has a strong passion for community development and self-awareness. He is continuously involved in projects promoting the development of his home country of Ethiopia. His recent endeavors include development projects for much-needed hospitals in the region, as well as educational facilities.
Professionally, Dr. Zegeye’s interests include brain and spine surgery, minimally invasive spine surgical procedures, and educating and mentoring new doctors. In his spare time, he constantly strives to aid others and expand his own knowledge.
Lake County residents are blessed with outstanding medical services thanks to talented local physicians and the facilities that accommodate them. In this month’s special issue of Health Pros, you will have an opportunity to meet these physicians, which range from dentists and heart surgeons to chiropractors and internists, as well as learn about cutting-edge treatments and well-respected practices throughout the area.
We feel honored to recognize the hardworking professionals of the health care field, especially since they provide compassion during difficult times and meet the health needs of the communities where we work and live.
With any luck, you may discover a medical service or specialty physician who is best for you, your family members, or your friends.
Easily navigate our Health Pros healthcare directory by choosing the section that best fits your individual needs. Looking for a physician? Our Profiles section allows you to get to know each doctor individually on a one-on-one basis. Maybe you are looking for a special practice. Just thumb through the Practice section until your needs are met. And lastly, if you are considering a specific medical procedure, just search through our Procedures section and you will be sure to find exactly what you need.
says you only receive quality health care in large metropolitan areas?
Dr. Asad Qamar is the visionary behind ICE, the premier provider of whole body wellness. Innovation, compassion, and excellence are the foundation of the multispecialty practice, which are realized through the Institute of Cardiovascular Excellence, the Institute of Medical Excellence, and the Limbstitute.
The Institute of Cardiovascular Excellence is the area’s premier heart and vascular care center.
The physicians and staff provide patients with physical and emotional care, as well as the most advanced medical technologies. They procure and evaluate their equipment so they can be confident in delivering the most innovative and accurate tests and treatments. Cardiovascular care is offered in four locations, including Ocala where a state-of-theart catheterization lab and recovery floor is housed.
The Institute of Medical Excellence offers primary and internal medicine with a seamless continuum of care. By pooling their resources, they deliver a range of services from annual checkups and treatment of common aches and pains to specialized therapy. The combination of family and primary care services with cardiovascular proficiency, peripheral, and vascular proficiency provides patients with a complete medical package that tends to the patient as a whole.
The third specialized service is the Limbstitute, a center for comprehensive treatment of venous and arterial diseases with the goal of keeping patients active. The Limbstitute aims to prevent limb loss by testing and treating peripheral arterial and venous diseases. Under one roof, these medical professionals can treat venous insufficiencies, detect peripheral artery disease (PAD), and treat non-healing wounds, all of which contribute to critical limb ischemia.
Dr. Qamar and his team pride themselves on providing the kind of cutting-edge technology, unrivaled expertise, and personalized attention patients demand and deserve from their health care providers. Dr. Qamar has completed both his residency and fellowship at Yale University School of Medicine. He is board certified in interventional cardiology and is rated a five-star doctor by HealthGrades®, one of the country’s leading health care ratings organizations.
Physician assistants (PAs) and advanced registered nurse practitioners (ARNPs) are licensed health care professionals who practice medicine and provide healthcare services. Much like physicians they perform exams, order and interpret diagnostic tests, diagnose illnesses, initiate and manage treatment plans, counsel patients on all aspects of preventive health care, and prescribe medications. They are trained to work closely with physicians and complement physician care in all respects.
“Our PAs and ARNPs enable us to provide the best integrated health care available today. I consider their care and expertise to be on level with that of a physician. Many times, as a physician, I fi nd that my time is stretched, but I have such confidence in and work so closely with our PAs and ARNPs that I know each one of our patients is getting just as much care from them as I am able to provide,” says Dr. Asad Qamar, founder of ICE.
Kevin Noon, MSN, ARNP, has been with Dr. Qamar since 2008. “I’ve always had a passion for cardiology and I feel like I’ve returned to my
roots,” he says. “I’m very glad that Dr. Qamar has allowed me to continue my journey in this exciting field of medicine.”
Sheila DePaolo, MPAS, PA-C, who joined ICE in 2011, states, “I love the responsibility that comes with being a PA. We are educated and trained to know and practice all the different health care specialties, allowing a broad foundation of medical knowledge. We have the freedom to work with the entire patient, and I love that.”
Devin Di Scala, ARNP, FNP-C, is the newest addition to the Institute of Medical Excellence division of ICE. As a registered fl ight nurse with experience in emergency room (ER) trauma, ICU, and cardio-pulmonary care, she says, “I look forward to bringing my critical care skillset to the ICE family of services and providing individualized care by partnering with patients throughout their lifetime of health and wellness.”
It takes many people to provide Innovative, Compassionate, and Excellent medical care. Mid-level medical practitioners play a critical role.
The Institute of Medical Excellence (IME) is a place where quality is more important than quantity. The modern medical
practice incorporates state-of-the-art technologies with old-fashioned values. At IME, patients feel a personal connection with their doctor while receiving the most comprehensive care possible.
Dr. Asad Qamar of ICE created IME to add an integrated internal medicine practice to his already-thriving cardiovascular practice. If numerous health ailments arise, patients can enjoy a continuum of care from the same medical company that incorporates a patient-fi rst, wholebody health philosophy.
The concept of “whole body health” is extremely beneficial to patients — in terms of both efficiency and quality of health care. Offering a wide range of medical services under one roof means patients do not have to travel to different doctors’ offices to get the care they need. This saves time and reduces the frustration often encountered when going to multiple medical clinics and dealing with different doctors and office staff. Having a primary care physician and a variety of specialists in the same facility allows physicians from different specialties to interact and share information with one another. The end result of the “whole body” approach is more efficient and offers a better quality of medical care.
Dr. Juio Ugarte, Dr. Clarissa Abrantes, and Dr. Anis Shahmiri treat patients with a variety of illnesses, including hypertension, diabetes, chronic obstructive pulmonary disease, and asthma. They also provide medical management of coronary artery disease and offer preventive care for men and women.
At IME, the practitioners and staff members explain things in a clear and concise way so patients can understand their medical treatments, plans of action, and health conditions. They understand there is a treatment for every disease, but the doctors at the Institute of Medical Excellence treat not just the disease but also the patient as a whole.
Tom Tran, PA-C, Mike Richards, PA-C, and Dr. Asad Qamar of the Institute of Cardiovascular Excellence pride themselves in delivering high-tech care with a very personalized touch. In the summer of 2013, they combined their talents and formed the Limbstitute, based in Summerfield.
The facility is retrofitted to include all the technology and diagnostic resources necessary for testing, locating, and facilitating the treatment of venous insufficiencies, peripheral arterial disease (PAD), and non-healing wounds.
Expanding ICE’s services into a division dedicated solely to limb salvage and comprehensive vein care answers a critical need in the community. Many amputations performed across the nation could have been prevented, and this center makes it easier for patients to receive world-renowned care under one roof. In addition to the management of PAD, services include the use of the most innovative and minimally invasive procedures for the advanced treatment of veins and wounds.
“The biggest advantage of combining specialties is we can provide rapid diagnosis and rapid treatment,” says PA Richards. “All too often, patients end up losing limbs because they are referred to other physicians, then await test results, and then have to make an appointment with the physician. The process becomes delayed.
At the Limbstitute, the process is streamlined to achieve maximum results for patients.”
The Limbstitute’s practitioners focus solely on what they are trained to handle. PA Richards explains, “We don’t try to do more than we’re capable of. If a patient has a vein problem, he will see either me or Tom. If a patient has an arterial problem, we have access to the cardiology specialists of ICE.”
Cardiology is not the only specialty available to Limbstitute patients. They also have access to the ICE family of services including phlebology (vein care) and primary and internal medicine. ICE and the Limbstitute will continue to offer their services backed by the founding principles of Innovation, Compassion, and Excellence.
The Institute of Cardiovascular Excellence (ICE) is the ultimate cardiovascular wellness center offering access to the most comprehensive diagnostic, interventional, and therapeutic patient care services possible. With locations throughout Lake, Sumter, Marion, and Levy counties, patients have the most caring and compassionate team of medical professionals within reach.
Dr. Asad Qamar, the founder of ICE, has brought together a team of cardiovascular professionals who believe treating patients for their physical health is just as important as supporting them in their emotional and wholebody health.
With heart disease being the leading cause of death in the United States, the practitioners at ICE know overall wellness begins with cardiovascular health. Dr. Justin Ferns joined the ICE team in 2013. He is a board-certified cardiologist with the American College of Cardiology and is the founder of CardioWaltz, an innovative approach to cardiovascular disease prevention. The program is a healthy blend of risk modification through regular exercise sessions, professional dance tutorials, educational programs, and vascular screening clinics.
Another addition to the ICE team, Dr. Kalpesh Solanki, is a Fellow of the American College of Cardiology. He practices cardiology with a specialty in device therapy: pacemakers, defibrillators, and cardiac resynchronization. “My expertise in device therapy complements the ICE team in that we are able to provide more services in one state-of-the-art building where communication between doctors is seamless,” states Dr. Solanki about joining the ICE team.
Should a patient need further diagnostic testing, Ocala ICE houses two catheterization labs and a recovery floor and is staffed with seasoned professionals, some of which have been working as a team for 15 years. ICE promotes the management of heart disease with a well-rounded approach that is individualized to each patient and is always communicated throughout all levels of patient care.
Physician assistants (PAs) and advanced registered nurse practitioners (ARNPs) are licensed health care professionals who practice medicine and provide healthcare services. Much like physicians they perform exams, order and interpret diagnostic tests, diagnose illnesses, initiate and manage treatment plans, counsel patients on all aspects of preventive health care, and prescribe medications. They are trained to work closely with physicians and complement physician care in all respects.
“Our PAs and ARNPs enable us to provide the best integrated health care available today. I consider their care and expertise to be on level with that of a physician. Many times, as a physician, I fi nd that my time is stretched, but I have such confidence in and work so closely with our PAs and ARNPs that I know each one of our patients is getting just as much care from them as I am able to provide,” says Dr. Asad Qamar, founder of ICE.
Kevin Noon, MSN, ARNP, has been with Dr. Qamar since 2008. “I’ve always had a passion for cardiology and I feel like I’ve returned to my
roots,” he says. “I’m very glad that Dr. Qamar has allowed me to continue my journey in this exciting field of medicine.”
Sheila DePaolo, MPAS, PA-C, who joined ICE in 2011, states, “I love the responsibility that comes with being a PA. We are educated and trained to know and practice all the different health care specialties, allowing a broad foundation of medical knowledge. We have the freedom to work with the entire patient, and I love that.”
Devin Di Scala, ARNP, FNP-C, is the newest addition to the Institute of Medical Excellence division of ICE. As a registered fl ight nurse with experience in emergency room (ER) trauma, ICU, and cardio-pulmonary care, she says, “I look forward to bringing my critical care skillset to the ICE family of services and providing individualized care by partnering with patients throughout their lifetime of health and wellness.”
It takes many people to provide Innovative, Compassionate, and Excellent medical care. Mid-level medical practitioners play a critical role.
At Vascular Vein Centers, we are dedicated to your total leg health. The treatment of venous disease is a medical problem, not a cosmetic one. If you need surgery, you want an experienced surgeon with proper training from a reputable institution. You want a surgeon with the judgment to recommend the best care for your condition. Vein therapy is no different.
The vascular specialists at Vascular Vein Centers have dedicated over 50 years to diagnosing and treating the most difficult vein problems. There is no replacement for experience.
Our staff members who perform the diagnostic studies have board certification — registered vascular technician (RVT) or registered vascular specialist (RVS). Our clinics have been certified by the Intersocietal Accreditation Commission to carry out venous and arterial ultrasound. This means we have shown continued excellence in performing vein and arterial studies that meet the highest standards.
Trust your legs to someone with the proper credentials and experience to diagnose your leg problems accurately and deliver effective treatment. Trust Vascular Vein Centers with your total leg health.
When it comes to treating vein problems, look no further than the experts at Vascular Vein Centers.
Cardiovascular Associates of Lake County has made strides to become one of the premier providers of cardiac care in the Central Florida area. Founded by Dr. J. Henry Lesmes in 1992, the practice has stood as a pillar in the medical community for more than 20 years, a legacy of longevity and consistency that their patients value.
“As one of the oldest private cardiology practices in the region, we are an institution in this community,” says Dr. Samuel Goss, an invasive cardiologist with Cardiovascular Associates. “We pride ourselves on maintaining such a stellar reputation all these years and in return, we continuously give our patients respect, compassion, and the best in cardiovascular medicine.”
At Cardiovascular Associates, their team of board-certified physicians uses state-of-the-art testing methods designed to diagnose a wide range of cardiac and vascular diseases. The practice is also highly innovative, bringing the fi rst EP physician, Dr. Miguel Bryce, and the fi rst cardiac PET to the area. “We offer a number of services such as coronary and peripheral angiography and interventions, cardiac electrophysiology (EP), echocardiography, SPECT nuclear stress testing, and cardiac PET,” explains Dr. Moises Fraifeld, an interventional cardiologist with Cardiovascular Associates.
As a full service cardiology practice with preventative, diagnostic, and treatment options, Cardiovascular Associates provides complete care for any heart and vascular condition, including a vein clinic at their Tavares location. The group maintains privileges at area hospitals, though their chief hospital is Florida Hospital Waterman.
Individually, the highly trained cardiologists of Cardiovascular Associates possess unique capabilities and experience that keep them on the cutting edge of advanced heart medicine. However, they collectively maintain a strong sense of camaraderie that assists in giving patients a full continuum of care and a sense of ease every time they visit the office.
“We have a team approach,” Dr. Goss says. “We make sure our patients get to know all the doctors and nurses, as well as the nurse practitioners and front office staff. We want our office to be relaxing, friendly, and inviting so patients always feel comfortable.”
“We have very little turnover at our office,” adds Dr. Fraifeld. “Many of our employees have worked here for more than 10 years, and we have had the same core group of physicians for about 15 years.”
Strong partnerships, gracious professionalism, and service with compassion are just a few of Cardiovascular Associates’ core standards. Over the years, these standards have remained solid, making Cardiovascular Associates the place where employees want to work, patients want to receive care, and physicians want to practice.
When Dr. Norman Novis and his wife, Alona, opened Patients First Primary Care in December 2012, they had a vision in mind: develop strong relationships with patients and utilize a family-centered approach by treating patients like they would treat members of their own family. Both Dr. Novis and Alona, who serves as manager of the practice, enjoy going the extra mile to satisfy all your health care needs.
In their case, actions speak louder than words. Dr. Novis not only treats patients at his facility; he
personally visits his patients at hospitals, nursing homes, rehabilitation centers, and specialty care facilities. Moreover, the practice has a nurse who provides home health care.
“This is a better way of treating patients,” he says. “I already know their medical background, and visiting them at health care facilities allows me to check on their condition and ensure they are receiving adequate treatment. It also allows me to know them on a more personal level.”
It is obvious that local residents truly appreciate such superior care, as evidenced by the practice’s patient base tripling in less than one year. “The goal of our practice is to take care of patients to the best of our ability and keep them from going to the hospital,” Dr. Novis says. “We are about total wellness.”
While many doctors focus on a particular part of the body or a specific disease, Dr. Novis provides comprehensive care to patients with all sorts of conditions. He treats patients with diseases ranging from diabetes and heart conditions to chronic obstructive pulmonary disease (COPD) and osteoporosis. He also is a strong believer in preventive medicine and therefore offers routine exams such as a Pap smear.
“We are about total wellness and offer patients both conventional and preventive approaches to medicine,” he says. “I have been working in the area for six years and understand the population and how to best treat patients here.”
Without question, Dr. Adam J. Barr’s dental practice in Eustis offers the best of both worlds. Patients receive excellent results that they’d expect from dentists in large metropolitan areas while still enjoying a warm, sincere small-town atmosphere.
Since he started practicing in Lake County four years ago, Dr. Barr has gained a reputation for offering quality general and cosmetic dentistry. Whether patients desire a beautiful smile makeover or simply want to maintain healthy, strong teeth, his strict attention to detail and meticulous dental work continue leaving patients with stunning results.
Better yet, patients see the same smiling faces every time they walk into the office. The staff treats patients like members of their own family.
“We’re not just treating teeth; we are treating people,” Dr. Barr says. “We are improving the overall quality of their lives. We spend the necessary time with patients and go above and beyond to help them achieve the dental results they desire.”
A native of California, Dr. Barr earned a bachelor’s degree in business management from Brigham Young University and later graduated with honors from the University of the Pacific School of Dentistry in San Francisco. He was elected to the Omicron Kappa Upsilon Honor Society, a prestigious honor reserved for the top 12 percent of a graduating dental school class.
He began practicing in 2006 and is currently
a member of the American Dental Association (ADA), Florida Dental Association (FDA), and the Academy of General Dentistry (AGD).
“I enjoy being a dentist because I love working with people,” he says. “When someone fi rst enters my office in pain and then leaves my office pain-free, it makes me feel fantastic. Another thing I enjoy doing is winning over patients who, at fi rst, are afraid of the dentist. Once they are comfortable, I can help them get back on track as far as their dental health is concerned.”
Dr. Barr delivers state-of-the-art dental care by utilizing the most up-to-date products and techniques. For instance, he uses a dental laser to manage and treat gum problems. The laser promotes faster healing and less infl ammation than traditional scalpels.
“Using the latest advancements in dentistry allows me to provide dental care that is safer, easier, and more pleasant for the patient,” he says. “Also, patients receive better, longerlasting results.”
Outside his dental practice, Dr. Barr spends quality time with his wife, Lianne, and three children: Clara, 9; Ian, 5; and Sophie, 2. He is active in his church, as well as the Boy Scouts of America. He also enjoys basketball, golf, and reading.
While aging is a natural part of life, there is nothing wrong with wanting to look as young as you feel. Lake Ear, Nose, Throat, and
Facial Plastic Surgery’s Face 2 Face Aesthetics and Wellness Center offers a number of services designed to rejuvenate and give you the youthful, vibrant appearance you desire.
Dr. Madonna, who is well known and respected for accomplishing outstanding results in cosmetic and reconstructive facial plastic surgery, says Face 2 Face helps clients not only look good but also feel good.
“In addition to offering traditional spa services, we can perform body composition
analysis, screen for varicose veins, and assist with weight management for those desiring to shed a few pounds,” says Dr. Madonna. “We offer spa-like services such as facials, fillers, and Botox, as well as surgical and laser procedures. Through health and wellness, our team of estheticians, massage therapists, pedicurists, and manicurists can help you receive continued maintenance and care for improved long-term results. We strive to provide comprehensive services so you can look and feel good.”
Throat problems are common. From strep throat to tonsillitis, most problems are minor and go away on their own. However, some conditions such as voice and swallowing disorders can arise that may require the care of a trained professional.
Lake ENT employs the most state-of-the-art technology to evaluate, diagnose, and treat a variety of voice and swallowing conditions such as laryngeal cancer, vocal fold lesions, acid reflux, and vocal fold weakness or paralysis. “We offer in-office diagnostic testing,” says Dr. Vaught. “For example, we use video laryngeal stroboscopy to evaluate the movement of your vocal cords and the condition of your larynx. With the flexible endoscopic evaluation of swallowing (FEES) test, we can assess the source of pain, hoarseness, or other problems a patient is experiencing with the swallowing process.”
Once a diagnosis is complete, Lake ENT provides a stellar continuum of care by offering various treatment options. “Services may include speech/voice therapy, as well as surgical therapy and medication management,” explains Dr. Vaught.
In the world of thyroid and parathyroid conditions, thyroid nodules are fairly common. “Most nodules are benign,” explains Dr. Milstead. “However, if they are larger than one centimeter (about half an inch), we always perform further diagnostic studies followed by serial ultrasounds to make sure the condition remains under control. If the nodule grows, it can cause difficulty swallowing and breathing. And if it becomes
cancerous, we can perform surgery to remove the entire thyroid. We always say nodules are nothing to worry about, but you shouldn’t ignore them either.”
In addition, the parathyroid glands, which keeps the right balance of calcium and phosphorous in your body, can be affected by a number of disorders such as hyperparathyroidism.
At Lake ENT, Dr. Milstead and her team can order tests to
determine whether you have a thyroid or parathyroid condition and what the most appropriate treatment option may be. Such treatments offered include medications or surgery.
For those suffering with persistent sinus pressure, headaches, and drainage, balloon sinuplasty is a minimally invasive, in-office procedure that can improve one’s quality of life. The procedure involves the insertion of a guide wire catheter with a tiny balloon through a patient’s nostril. The balloon is then inflated, widening the sinus passageway.
Aside from saving patients the cost of hospital bills, patients can drive themselves to and from the office and return to normal activities the following day.
As for allergies, the medical professionals of Lake ENT can perform allergy, skin, and blood tests to start your journey toward relief. Treatment includes medication and allergy desensitization, which can change a person’s allergies, making them less dependent on medication.
“People don’t have to suffer with these problems,” says Dr. Freedman. “They can come to us for a complete evaluation so that the proper therapy can be recommended so they can go back to smelling the roses.”
hether you suffer from allergies or congestion that results in sinus headaches or overall breathing difficulties, Lake ENT can help.practice profile procedures
The da Vinci® surgical system takes laparoscopic surgery to the next level by providing surgeons with better vision and precision.
For an estimated 21 million Americans, living with chronic acid reflux disease (GERD) can mean being in a constant state of pain and discomfort. Luckily, for many sufferers, their condition can be controlled with simple antacids or over-the-counter medications. Some may require prescribed medications for relief.
Nevertheless, for those whose symptoms can’t be relieved with a simple tablet, more aggressive treatment may be required. “The reasons why that might happen is a stomach abnormality called a hiatal hernia,” explains Dr. Christopher Johnson. “This condition disrupts the normal anatomy of where the stomach and the esophagus meet. Reduction of the pressure in the lower esophageal sphincter (LES) means stomach acid will move up into the esophagus, causing symptoms of acid reflux. GERD can also cause other complications that cannot be resolved with medications alone; therefore, surgery may become the only option.”
For many decades, doctors have performed a surgical procedure called Nissen fundoplication to help prevent further acid reflux. During the procedure, surgeons are tasked with recreating the natural orientation of the stomach and esophagus in the body. It can be performed either as a traditional open surgery through a large open incision in the abdomen or a laparoscopic procedure, which is performed through a tiny incision. Nevertheless, Dr. Johnson explains that even performing the surgery laparoscopically still has its drawbacks. “Laparoscopic surgery still leaves the surgeon limited in reach, and it is also limited in scope of use,” he says.
The use of the da Vinci® surgical system at South Lake Hospital changes all that by combining the advantages of both open and laparoscopic surgical techniques, according to Dr. Johnson, who was one of the first physicians to undergo additional training to perform this procedure robotically. “The da Vinci® device is a minimally invasive tool that allows surgeons to do an open operation through a small opening,” he explains. “Using the device, I can simulate all the fingerlike movements and wristed maneuvers without having to place my hand inside the body. And unlike with laparoscopic surgery, I can work in the fairly tight space without the instrument becoming disruptive.”
While the da Vinci® device offers a multitude of advantages for surgeons, the patients also experience several benefits, including significantly less pain, fewer complications, less scarring, a shorter hospital stay, and quicker recovery from surgery.
“The results so far have been good. We have had no failures or complications and 93 percent of the people who have received this operation go on to eliminate all their medications,” Dr. Johnson says.
Having the da Vinci® surgical system gives those who suffer from acid reflux disease an option for lasting relief that is less invasive than ever before. “Before, many people would choose to continue taking medication for the rest of their life instead of having surgery,” Dr. Johnson says. “But now I can offer a great alternative that has had very successful results. This tool gives me a mechanical fix for a mechanical problem.”
“This tool gives me a mechanical fix for a mechanical problem.”
Every day, Dr. Jeffery Glover enjoys providing the kind of chiropractic care that helps people get back to living.
“I enjoy giving back to my community on a daily basis,” says Dr. Glover, a Lake County native who opened his practice in November 2012.
“When someone who comes into my office bent over in pain, It makes me feel good knowing they will leave feeling and walking better. I’m glad I have the skills to restore someone’s health.”
Instead of relying on surgery, medication, or injections — all of which come with risks — Glover Chiropractic Clinic in Leesburg utilizes drug-free, non-surgical approaches to treat a number of chronic and/or debilitating conditions. Decompression therapy provides relief to patients with lower back pain, sciatica, neck pain, or a variety of symptoms related to damaged or degenerative discs. “When a patient has a degenerative disc, they can only walk 10 to 15 feet before they start experiencing pain. Decompression therapy rehydrates and feeds nutrients into the disc. This helps the patient walk farther and experience a better quality of life,” Dr. Glover explains.
For those suffering from soft tissue injuries, Dr. Glover uses LiteCure deep tissue laser therapy, which reduces inflammation in the body, thereby reducing or even eliminating pain. “Instead of having 10 to 12 ultrasound treatments, this laser can knock out those symptoms in one to two treatments,” he says. The laser also helps treat sports injuries, sprains, strains, arthritis, shoulder pain, knee pain, and other inflammatory conditions.
In addition to the various services at Glover Chiropractic, licensed massage therapist Tracy Zito works in the office two days a week to help patients who may require further care following a treatment. “Through massage, Tracy is able to increase vascular flow and speed up the healing process for those patients still experiencing some discomfort,” Dr. Glover says.
At Glover Chiropractic, Dr. Glover and his team strives to offer state-of-the-art, holistic chiropractic solutions to target every patient’s specific needs. They also believe in providing excellent customer service to make their patients feel at home. “I’m here to treat and care for the community because I care about the community,” Dr. Glover says. “We don’t make you feel like a number; we make an effort to know everyone’s name and give our patients a homey atmosphere. At the end of the day, I want people to know I care about them.”
“I enjoy giving back to my community on a daily basis.”
In the late 1990s, there was a great need in the community for open-heart surgery. Up to that point, patients requiring cardio-thoracic surgery had to travel to larger cities.
This need became a reality in November 1998 when the fi rst open-heart surgery was successfully performed at Leesburg Regional Medical Center (LRMC). Since that time, advances in technology and techniques have allowed for new, cutting-edge heart procedures to be utilized at the hospital, and as a result, patients are receiving both excellent care and outstanding surgical outcomes. LRMC is home to the second-largest open heart program in Florida.
None of this would be possible without the dedicated doctors, nurses, surgical staff, and intensive care unit (ICU) at LRMC. Another reason for the program’s success stems from the talented team of cardio-thoracic surgeons at Ocala Leesburg Heart Institute, which includes Dr. Robert Richardson, Dr. Duane Cook, and Dr. Tim Moore.
“At our practice, we feel fortunate to have a great partnership with LRMC because it offers an outstanding group of nurses and a great operating room staff,” Dr. Moore says. “This is why we can perform around 700 surgeries each year.”
According to Dr. Moore, the open-heart program has evolved throughout the years. He and his colleagues are now offering valvular surgeries,
mitral valve repair, minimally invasive valve surgery, the Maze procedure for atrial fibrillation, and transcatheter aortic valve implantation (TAVI).
“We also perform high-risk surgeries on patients who are turned away elsewhere,” Dr. Moore says. “One of the reasons for our success is our team sits down on a daily basis and discusses our patients. Therefore, everyone knows what is going on with my patients and vice versa. The continuity of care is always there.”
Sharon Franklin has spent the past 11 years as a charge nurse who oversees the care of cardiac patients inside the operating room. She says LRMC’s outstanding outcomes reflect the performance of the entire surgical staff.
“The team of surgeons, nurses, scrub techs, physician’s assistants, and paramedics display incredible teamwork during each procedure,” she says. “Each of them has honed their skills over the years and play off each other’s strengths. Some of them have been in open-heart surgery programs for more than 25 years. “
After surgery, a team of cardiothoracic surgeons and highly trained nurses carefully monitor patients’ progress and continue providing excellent care throughout the duration of their stay.
To fi nd a board-certified cardiologist at Leesburg Regional Medical Center, call 352.323.1000.
ince its opening in 1977, Lake Eye Associates has become renowned throughout Central Florida as one of the most advanced ophthalmology practices in the state. Lake Eye Associates’ Dr. Shelby L. Terpstra, DO, is a Board-certified Comprehensive Ophthalmologist experienced in a wide range of ophthalmic services, from general eye care to conditions such as cataracts, glaucoma, ocular surface disorders, macular degeneration, diabetic retinopathy, and a service that is rapidly growing in popularity, cosmetic blepharoplasty.
Dr. Terpstra is a member of the American Academy of Ophthalmology and the Academy of Cataract and Refractive Surgeons. She received her training from the Michigan State University College of Osteopathic Medicine, where she served as Assistant Clinical Professor and Chief Resident Ophthalmologist. Since medical school, Dr. Terpstra knew that she wanted to be an ophthalmologist, but blepharoplasty (eyelid surgery) was a specialization she acquired due to the increasing demand for procedures to help reverse the toll that sagging, drooping or outturning eyelids takes on people’s vision and appearance. For Dr. Terpstra, freeing people from the vision impairment caused by eyelid problems, and making them look younger and more vital, has become a personal mission.
“There are many causes for droopy eyelids,” she says. “Some are congenital, but in most cases, they simply come from getting older.” A common eyelid disorder is dermatochalasis (baggy lids), a condition in which there is excess skin in the upper and/ or lower eyelids. Not only does the excess skin make a person look more aged and tired than he or she may feel, it can obstruct vision and, in extreme cases, cut a person’s visual field by as much as half.
“I had a patient who suffered serious vision trouble from dermatochalasis, which affected both his upper and lower lids,” says Dr. Terpstra. “Because
his baggy upper lids impaired his vision, his Medicare coverage took care of that part, but he also wanted to look and feel younger. We discussed his options and he opted to have both his upper and lower lids treated. He was delighted with the results. As was I,” she adds, smiling. “I’m always pleased to improve a patient’s life in such a dramatic and obvious way.”
Another condition, called ptosis, is where the lid margin rests lower on the eyeball. Ptosis is more than a nuisance. Left untreated, a drooping eyelid can cause other disorders, including amblyopia and astigmatism. One sufferer, Mrs. Simone Hasker, had ptosis to such a severe degree that it was impairing her vision. Mrs. Hasker met with Dr. Terpstra, who performed visual field testing in her office. “Dr. T actually taped up my eyelids to show me how much better I would see after the surgery,” says Mrs. Hasker. “It was like night and day! And I was so happy to find out that my insurance was going to cover it.”
Mrs. Hasker found the process to be positive throughout. “Dr. T was extremely thorough in explaining the procedure. I had the surgery at the Santa Fe Surgery Center and was out in less than two hours. There was no pain, no bruising, the healing process was extremely quick.
“Everything about Dr. T and this procedure exceeded my expectations,” she says, “and I would do it again in a second.”
According to Dr. Terpstra, Mrs. Hasker’s outcome is typical of other patients on whom she has performed eyelid surgery. “I’ve done countless blepharoplasties and seeing the boost to patients’ function and self-esteem is rewarding every time,” she says.
Prospective patients will be heartened to learn that the surgery itself is relatively simple and can
correct an array of pathologies, functional problems and cosmetic disfigurations. Tiny incisions are made inside the creases of the upper and/or lower eyelid, where any miniscule scarring will be naturally concealed. Then excess skin and adipocyte fat is removed, and the remaining skin is repositioned to reduce sagging, slackness or puffiness.
Post op, Dr. Terpstra’s patients report enjoying an increased field of vision and improved peripheral vision, enabling them to do everyday things many were no longer able to do, such as watch TV, read and drive. Patients who get the surgery to restore their vision are invariably pleased with the “sideeffect” of looking more youthful and refreshed.
Patient Mary Allen describes her experience. “I have been a patient of Dr. Terpstra’s for some time now. When it came time to address my problems seeing due to my eyelids drooping, we discussed the procedure in depth, what to expect before and after. I had no worries being in her care.
“My experience with this procedure was excellent. The results have been amazing and so much so, I sent my husband to her to have the same procedure - now both of us are seeing better!”
Dr. Terpstra fi nds performing blepharoplasties to be one of the most gratifying elements of her job. “Every service and treatment I provide is designed to help people see and feel better, so all of it is rewarding; but this type of surgery is unique in that it can actually enhance a person’s appearance to match their improved vision and outlook.”
Her commitment to patients is one that is shared among her colleagues at Lake Eye. “Treating our patients’ eye conditions is what we’re trained to do,” says Dr. Terpstra, “but treating their concerns is our passion.”
Hearing those dreadful words from a doctor can be devastating. A cancer diagnosis is a time fi lled with fear and anxiety. It is also an extremely stressful time, as patients do not know what to expect or what challenges lie ahead.
Realizing that patients are much more than a
diagnosis, Florida Hospital Waterman’s Cancer Institute offers a patient navigator program that is focused on patient and family-centered care. Eileen Bascomb, an oncology nurse for more than 20 years, serves as the hospital’s patient navigator. In her role, she helps support, guide, and educate cancer patients throughout every step of their journey. She serves as a liaison between patients and their care team, which ensures continuity of care during the treatment process.
Eileen maintains an unwavering passion to provide patients with answers and equip them with the necessary tools so they can make informed and educated decisions regarding their cancer care.
“I help patients navigate the labyrinth of cancer care,” she says. “I make sure their appointments are set and make sure patients are where they need to be. I also provide them with support because they need a safe place where they can come and share their thoughts and feelings. We are not charging patients; we do it because it is the right thing to do.”
Having a patient navigator like Eileen is undoubtedly one of the greatest gifts a cancer patient could possibly receive. Without question, she is a very hard-working and caring nurse who goes the extra mile for her patients. She even accompanies them to doctor appointments.
“If you are frightened about going to a doctor, sometimes you only hear every fourth or fi fth word a doctor is saying. I am like a second pair of ears for them. Once the appointment is over, we come back to my office and I help them understand what the doctor told them.”
“You have cancer.”
People suffering from varicose veins often experience the following symptoms in their legs: pain, aching, heaviness, skin discoloration, and ulcers. This is because varicose veins do not function properly and return blood back to the heart.
Fortunately, Dr. Seble Gabre-Madhin with the Center for Advanced Surgery in Tavares offers endovenous laser ablation, a state-of-the-art treatment that provides relief from unsightly and painful veins. During the procedure, laser energy is administered to the problematic vein or veins, causing them to collapse. Blood is rerouted to healthier veins, resulting in improved circulation and decreased symptoms. There is also minimal bleeding and bruising.
“I have used this procedure on young people and also on people in their 80s,” Dr. GabreMadhin says. “They are able to resume their normal activities the following day. Of course, before the surgery, we fully assess all patients to determine if the problem stems from veins, arteries, or a neurological problem.”
CENTER FOR ADVANCED SURGERY
3350 Waterman Way | Tavares, Florida 32778
352.742.2223 | www.centerforadvsurgery.com
Dr. Michael Fountain, a urologist in Tavares, has been performing urological surgery at Florida Hospital Waterman for 19 months. During that time, he has worked closely with hospital administrators to bring in cutting-edge technology.
One example is the Plasma Button, which treats benign prostatic hyperplasia (BPH), more commonly known as enlarged prostate. Men with this condition often experience a weak urinary stream, dribbling after urination, and frequent urination. With this minimally invasive procedure, Dr. Fountain uses low-temperature plasma energy to remove enlarged prostate tissue, resulting in better flow of urine.
Dr. Fountain is also excited about a diagnostic procedure known as narrow band imaging (NBI). This optical image enhancement technology enhances the visibility of vascular areas and helps him detect abnormal tissue.
“Florida Hospital Waterman is a cutting-edge facility,” Dr. Fountain says. “Bringing in these technologies is further proof that the hospital is fully invested in making sure patients receive the best care possible.”
UROLOGY SPECIALISTS OF LAKE COUNTY
1210 Waterman Way | Tavares. Florida 32778
352.343.2364 | www.lakecountyurology.com
Dr. Harsh Duphare recently opened Center for Digestive Care in Tavares. A gastroenterologist since 2000, he is utilizing several innovative procedures at Florida Hospital Waterman.
The fi rst is a PillCam, a miniature device with a video camera that allows him to takes pictures of the small intestine. This helps him effectively diagnose and ultimately treat problems such as tumors, abnormal bleeding, and diseases of the lining of the small intestine. He is also utilizing an advanced diagnostic tool known as endoscopic ultrasound, which allows him to obtain high-quality images of the digestive tract and surrounding tissue and organs.
“The really fascinating thing about these technologies is we’re scanning the body from the inside,” he says. “It translates into better care and being able to save lives. With the PillCam, we can also determine whether food and fluid are transiting at normal speeds.“
CENTER FOR DIGESTIVE CARE
3345 Waterman Way | Tavares. Florida 32778
352.742.5020 | www.thecenterfordigestivecare.com
Dr. Dan Tran of Lake Surgical Associates is fellowship-trained in minimally invasive surgery. A surgeon in Lake County for nine years, he utilizes minimally invasive techniques for the following procedures: inguinal hernia, incisional hernia repair, appendix, gallbladder, anti-reflux, and colon resection for benign disease or malignant disease.
These minimally invasive techniques are performed through tiny incisions and offer Florida Hospital Waterman patients many benefits over traditional surgery. Not only are they more cosmetically pleasing, they also allow for quicker recovery times, less scar tissue, less pain, less bleeding, and reduced chance of developing infection. Some are even performed on an outpatient basis.
“With minimally invasive surgery, I use fiber-optic cameras because they give me better visualization and magnification inside the body,” says Dr. Tran, who completed medical school at the University of Florida and surgical training at the University of Louisville. “My patients receive excellent results.”
1290 Waterman Way | Tavares. Florida 32778
352.742.0054 | www.fhmedicalgroup.com
Surgeons who perform knee surgery at Florida Hospital Waterman are given an extra hand — in the form of a robot. MAKOplasty robotic partial knee resurfacing was introduced at the hospital in 2012. So far, the results have been excellent, with patients experiencing smaller incisions, shorter hospital stays, faster recovery times, and less rehabilitation.
Before the surgery, a CT scan is used to make a three-
dimensional image of a patient’s knee. Then, the surgeon calculates a customized surgical plan that precisely pinpoints where arthritic knee surfaces need to be removed and where an implant should be placed. An added benefit is that healthy bone, ligaments, and tendons are spared. This technology allows the
surgeons to precisely execute the pre-operative plan.
Florida Hospital Waterman is the only hospital in Lake, Marion, Sumter, Citrus, and Putnam counties to offer MAKOplasty robotic partial knee resurfacing. The procedure typically lasts between forty-five minutes to one hour.
Never fear. The future of knee surgery has already arrived at Florida Hospital Waterman.
When the hospital’s patients undergo partial or total knee replacement, some receive the BioPro® Total Knee Original (TKO) implant. In traditional knee replacements, a patient’s anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are removed and their function is only partially restored. In addition, there is excessive bone loss.
Conversely, the BioPro® implant spares a patient’s ACL and PCL, as well as healthy bone. Moreover, the product’s revolutionary thin design
ebilitating knee pain can adversely affect your overall quality of life and keep you from performing everyday activities such as bathing, cooking meals, and completing household chores.proportionately matches the natural anatomy of the knee, allowing the knee to be restored to a more natural acting and responsive state. As a result, patients enjoy longer-lasting relief from debilitating knee pain.
practice profile procedures
Modern medical advances allow minimally invasive surgeries to be performed at the Surgery Center of Mount Dora, providing patients with high quality, safe surgical care.
Those facing outpatient, same-day surgery will experience all this at the Surgery Center of Mount Dora without the cost and expense of hospitalization. Since opening its doors in 2009, the center has provided patients with outstanding surgical results in a warm, friendly atmosphere.
Designed exclusively for outpatient surgery, the 11,500-square-foot facility features state-of-the-art equipment and a staff of board-certified surgeons, anesthesiologists, registered nurses, and medical personnel who are professionally trained in surgical and recovery care.
In addition, the center provides patient registration, waiting rooms, surgical suites, and recovery rooms all in one convenient location. Therefore, patients find the Surgery Center of Mount Dora is easier to navigate than a typical hospital environment. Your family members can be by your side until it is time for surgery. After the procedure, patients are carefully monitored and recover comfortably at their own pace until discharge.
Dr. Donald Perry, an orthopedic surgeon at Radnothy and Perry Orthopaedic Center in Tavares, has been performing surgeries at the center since it opened. He says it offers advantages for both patients and physicians.
“For patients, the surgery center offers an easier, more convenient experience,” he says. “In certain cases, patients may walk in the door and leave in two or three hours. Also,
unlike a hospital, a patient’s procedure is never delayed by an emergency surgery. For physicians, this center is excellent for time management. If I have three or four surgeries in one day, I can do them much more efficiently here.”
Most importantly, physicians and staff are dedicated to providing the highest quality of individualized care.
“We operate very efficiently and provide one-on-one care here,” says Shirley Thomas, who serves as administrator of the Surgery Center of Mount Dora. “For us, it is a privilege when patients come through our door, and we treat them to the best of our ability because we are privileged to have them.”
That detailed attention to personalized care is one reason why the center consistently receives scores in the high 90s on patient satisfaction surveys. It also explains why some patients have chosen to undergo various surgical procedures at the Surgery Center of Mount Dora.
“We have made every effort to create the ideal patient experience here,” says Juan Uson, director of nursing. “We’re a one-stop shop with state-of-theart medical equipment and a top-notch medical team.”
The Surgery Center of Mount Dora is owned by nine local physicians representing various medical fields such as orthopedics, gastroenterology, general and vascular surgery, podiatry, urology, and ear, nose, and throat (ENT). In addition, gynecological and pain management services are also offered. The center maintains a partnership
with Leesburg Regional Medical Center and is under the management of Regent Surgical Health, one of the country’s leading management and development companies.
“A procedure at a surgery center is 25 percent less expensive than the same procedure performed at a hospital,” says Dr. Jack Cassell, an urologist in Mount Dora who performs several outpatient procedures at the surgery center. “Another great benefit is our infection rate is exemplary due to the clean environment and the fact there are not nearly as many sick patients here.”
The Surgery Center of Mount Dora also offers surgical procedures that formerly required overnight hospital stays. One of those is partial knee replacements (also called unicompartmental knee replacements), a minimally invasive procedure used for patients who have arthritis in only one compartment of the knee.
“A partial knee replacement is beneficial to patients because it involves smaller incisions, less bleeding, quicker recovery, and less bone loss than a total knee replacement,” says Dr. Samir Guru, an orthopedic surgeon with Manoogian and Guru Orthopedic Center in Mount Dora. “It also feels more natural than a total knee replacement because we do not cut tendons and ligaments.”
Before the procedure, an anesthesiologist will perform a femoral or saphenous nerve block, and once the surgery is complete, the surgeon will inject the knee for pain relief. Following the surgery, patients remain in a recovery room for nearly two hours and are encouraged
to walk with a walker.
“In most cases, my patients are walking without a cane, crutch, or walker in two weeks,” Dr. Guru says. “In four to six weeks I return them to their normal everyday activities.”
The Surgery Center of Mount Dora is located at 3710 Lake Center Drive in Mount Dora. For more information, please call 352.383.1268 or visit surgerycentermountdora.com.
THE NINE LOCAL PHYSICIANS AND TWO COMPANIES THAT OWN THE SURGERY CENTER OF MOUNT DORA INCLUDE THE FOLLOWING:
• Dr. David Bjerken general and vascular surgeon
• Dr. Jack Cassell urologist
• Dr. Samir Guru orthopedic surgeon
• Dr. Vrej Manoogian orthopedic surgeon
• Dr. Borys Mascarenhas general surgeon
• Dr. Jon Radnothy orthopedic surgeon
• Dr. Ronald Roth gastroenterologist
• Dr. Donald Perry orthopedic surgeon
• Dr. Victor Torres podiatrist
• Leesburg Regional Medical Center
• Regent Surgical Health
OF FLORIDA’S MOST EXPERIENCED CATARACT SURGEONS ARE RIGHT HERE, NEAR YOUR DOORSTEP.
Each year, three million Americans have cataract surgery, and locally, those in the know choose the surgeons of Lake Eye. Over the past decade, Drs. Scot Holman and Scott Wehrly have performed thousands of successful, complicationfree cataract surgeries, preventing cataract-related blindness and restoring clear, healthy vision to multitudes of satisfied patients.
You could travel outside Lake County for cataract surgery, but you won’t find superior quality,
safety or precision than you will at Lake Eye. Drs. Holman and Wehrly are not only cataract surgery specialists, they are caring doctors who live and work locally, so your follow-up exam, treatment and questions can be addressed quickly, conveniently, and with a personal touch no outside surgery center can match.
After all, when you need care, you want it now, not when it suits the schedule of a doctor many miles from home.
Talk to our patients and they’ll tell you: Lake Eye is the only choice for a lifetime of healthy vision. See real patient reviews on our website: www.LakeEye.com
If you or a loved one needs cataract surgery, Lake Eye provides world-class surgical experience, training and technology – right here in your neighborhood. Having your doctor close to home adds more than just convenience – it provides peace of mind.
available 5 days a week.
the Santa Fe Surgery Center, which is owned and run by our eye surgeons here in The Villages.
eliminate cataracts and restore crisp vision, including Toric ® , ReSTOR® and TECNIS ® multifocal lens implantation.
® refractive
“bladeless,” stitch-free laser cataract surgery.
Board-certified ophthalmologists:
SCOT C. HOLMAN, MD and SCOTT R. WEHRLY, MD
Your eyes deserve unsurpassed safety, performance and personal attention.
Dr. Bono is a graduate of the University of Central Florida and Nova Southeastern University in Fort Lauderdale where he earned his degree in Osteopathic Medicine. He performed both his internship and residency at Botsford General Hospital in Farmington Hills, Michigan and completed a neurosurgical and orthopedic surgery fellowship in the Department of Spinal Surgery at St. Joseph Mercy Hospital in Ann Arbor, Michigan.
• Board certified and fellowship-trained orthopedic surgeon specializing in disorders of the spine
• Winner of multiple research awards from the American College of Osteopathic Surgeons and the Michigan Osteopathic Association
• Published author and speaker on spinal reconstruction
SCAN TO LEARN MORE ABOUT DR. BONOPRACTICE IS 100% DEVOTED
Dr. Ronzo attended the University of Central Florida and Nova Southeastern University College of Osteopathic Medicine in Miami where he received his medical degree. He spent five years in Grand Blanc, Michigan, where he fulfilled his orthopaedic surgery residency and internship.
• Board-certified in orthopedics
• Teaches minimally invasive techniques to visiting spine surgeons from around the country
• Mentor to spine and neuro surgeons in the art of minimal access spine techniques in spinal fusions
• National and international lecturer on bone morphogenetic protein and minimally invasive spine fusions
SCAN TO LEARN MORE ABOUT DR. RONZO BOARD CERTIFIED // FELLOWSHIP TRAINEDTHE HIGHEST LEVEL OF SPINE CARE!”
OFFERING ADVANCED TREATMENT OPTIONS AND MAINTAINING A COMMITMENT TO EXEMPLARY SERVICE. OUR DOCTORS FOCUS ON THE SPECIFIC NEEDS OF EACH PATIENT WITH THE GOAL OF RETURNING THEM TO A HEALTHY, ACTIVE LIFESTYLE AS SOON AS POSSIBLE.
We all know how debilitating back pain can be. It can adversely affect our quality of life and sideline us from participating in our favorite activities.
Gulfcoast Spine boasts two physicians who are nationally renowned for their success in performing minimally invasive spine surgery. Those physicians are Dr. Frank Bono and Dr. James Ronzo. They offer the most advanced diagnostics and treatments for relief of back and spine problems.
The central focus of Gulfcoast Spine is an unrelenting commitment to explore every
possibility of improving patients’ lives and helping them return to their prior level of functioning. Providing total patient-centered care in a compassionate, competent manner has and always will be of utmost importance to the entire GSI team.
When you visit Gulfcoast Spine, their medical providers make sure to listen to your questions and concerns, making a thorough list of symptoms before proceeding with a detailed physical exam. These nationally recognized leaders in spine surgery work with you to develop a plan of individualized treatment
to meet your needs. With their state-ofthe-art technology and personable staff, Drs. Bono and Ronzo are dedicated to building a sincere relationship with each patient they treat and doing whatever it takes to ensure your overall health and wellbeing.
Life doesn’t have to stop when pain strikes. We understand how important it is to return to normal, fun-filled activities like hitting the golf course with friends or swimming with the grandchildren on the weekend. Everyone deserves to live a happy, healthy, and pain-free life!
Less than 10% of existing spine surgeons actually perform surgery using minimally invasive techniques.
Dr. Ronzo and Dr. Bono’s surgical process begins with a ¾”incision, to be followed with the use of dilators to gently separate the muscle. This important step eliminates the cutting of muscle fibers. This process leaves little scarring, fast recovery times, and excellent outcomes.
92% OF OUR BUSINESS IS REFERRED BY A PHYSICIAN OR WORD-OF-MOUTH
LESS THAN 60 MINUTES
THE AVERAGE SURGERY TIME BY DRS. RONZO & BONO
12,432 SURGERIES AND PROCEDURES PERFORMED
100% OF OUR PRACTICE HAS BEEN AND WILL CONTINUE TO BE EXCLUSIVELY DEDICATED TO SPINE CARE
NOT ALL PHYSICIANS ARE CREATED EQUAL
INTENSE BACK PAIN, COLORADO RESIDENT JEANNE HENSCHEN FLEW FROM DENVER TO FLORIDA TO UNDERGO SURGERY WITH DR. RONZO. SIMPLY PUT, SHE WANTED ONLY THE BEST.
Patients come from all over the country to Gulfcoast Spine, which is nationally renowned for providing comprehensive care in spine procedures and treatments.
This was the case with Jeanne Henschen of Denver. More than 20 years ago, Jeanne was told that she would eventually require a spinal fusion. She heard stories about this procedure being unsuccessful, requiring long, painful recoveries. She did everything
possible to postpone it — including seeing a chiropractor, exercising, acupuncture and physical therapy. Her pain intensified over the years and she realized she could not delay the inevitable.
Luckily, her daughter Katherine, was working as a hospital consultant for HealthGrades was very familiar with the success stories of Gulfcoast Spine and Dr’s. Ronzo and Bono. After an in-depth review of Jeanne’s case by Dr. Ronzo….a flight was
FROM A FINANCIAL STANDPOINT, THE MERE MENTION OF THE WORD SURGERY MAKES US WANT TO PULL OUT OUR HAIR. MOST OF US ASSUME WE’LL END UP BROKE AFTER HAVING ANY TYPE OF SURGICAL PROCEDURE.
Fortunately, Gulfcoast Spine is Medicare-approved and operates out of Medicareapproved facilities. The doctors operate out of Medicare-approved facilities so there are little or no out of pocket “facility fees” for those with Medicare and a secondary insurance.
Patients can regain their quality of life without having to spend excessive out-ofpocket costs.
It is good to know you can get quality healthcare at a practice that accepts most major health insurance plans. Our staff not only makes sure your insurance company is on our list of accepted providers, we also assist in filing your insurance claim. All you do is recover and return to your active lifestyle; we take care of the details of filing. It simply can’t get any easier than that.
In Recognition of Valuble Contributions to Excellence in Clinical Care were recipients of the HealthGrades Spine Surgery Excellence Award™ 4 years in a row (2008 - 2011)
RANKED #1 IN FLORIDA FOR SPINE SURGERY
HealthGrades is the leading resource for comprehensive information about physicians and hospitals.
TAMPA // 5301 AVION PARK DRIVE
We are expanding into the Tampa Bay area! Gulfcoast Spine Institute is proud to announce our new state-of-art surgery center, the BioSpine Institute. This facility has been created to provide the very latest advances in spine care for today and into the future.
TAMPA // 6101 WEBB RD. THE VILLAGES // 785 HWY. 466
HERNANDO // 2300 E. NORVELL BRYANT HWY. IN INVERNESS BROOKSVILLE // 7101 MARINER BLVD. IN SPRING HILL CALL TOLL FREE // 1-855-GULFCOAST (1-855-485-3262)
GULFCOASTSPINE.COM
/USER/GULFCOASTSPINE
“Being part of the physical therapy program at TriCounty Podiatry rejuvenated my life. I found that the staff involved in this aspect of the practice is every bit as dedicated to their jobs as those I deal with when I receive foot care. They knew precisely what exercises to have me do to help strengthen my joints.”
—Clarence Barrett
No other policy under President Barack Obama’s administration rallied with greater determination under the campaign slogans of “Hope” and “Yes We Can” like his Affordable Care Act (ACA), also known as Obamacare. Yet since enrollment began on Oct. 1, the process hasn’t quite worked as originally pitched, leaving many to doubt and ponder, “Can we?” With the March 31 deadline only three months away, HealthyLiving places ACA on the examination chair, taking a close look at some of its most praised yet contentious aspects, its challenges, and recent updates to help you better understand what to expect.
WRITER: JOHN SOTOMAYOR PHOTOS: FRED LOPEZIrony has a way of deepening one’s perspective on a situation. Tasked with the examination of the overwhelmingly massive health care law and pressed for time, I found the number of a local navigator — an expert on the health insurance marketplace — and called for help. The answering machine message said, “Please allow up to 72 hours for my returned call.” That navigator serves two counties. The next closest navigator serves four. My instinct said this could take forever. The clock was ticking; I did not have three days to wait. I had to work fast but could not access the system. What was I to do? At that very moment, I understood what the dilemma of the new health care legislation was all about.
On paper, the initial diagnosis looked good. If the ACA was compared to a vaccine, then its antibodies were fortified with immunity. Following years of Capitol Hill drama, a Supreme Court case, a polarizing presidential election, and even the threat of a Mayan apocalypse, the law staved off partisan infection, clearing the way for enrollment. But as thousands attempted to enroll, the marketplace website was plagued with problems that created backlogs, delays, and mass confusion. The ACA was in need of some immediate medical attention.
The ACA is actually comprised of two separate legislative acts: the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. Together, they were expected to essentially expand insurance coverage, lower costs, and guarantee more health treatment choices for all Americans. It was also anticipated to expand Medicaid coverage to millions of low income Americans, while holding insurance companies accountable for specified essential services.
One of the greatest commitments of the ACA is to mitigate the denial of coverage for people with pre-existing conditions. The Pre-Existing Condition Insurance Plan (PCIP) establishes health coverage availability to United States citizens who have been refused health insurance and who have been uninsured
for at least six months.
Insurers have warned, however, a large group of young people is needed to join because the premiums paid by younger, healthier adults between 18 and 35 are needed to offset the cost of older and less healthy customers, who generally produce far more in medical bills than they provide in premiums.
Dr. Richard Bosshardt, a plastic surgeon with Bosshardt & Marzek Plastic Surgery Associates in Tavares, feels this is a fatal flaw. “In order to cover people with serious medical problems and pre-existing conditions, insurance companies will have to either recoup with an increase in premiums or transfer the cost to healthier people. Obamacare must sign up enough young people that are not consumers of medical care to buy health insurance in order to pay for the care of the unhealthy… If they don’t, Obamacare will flat out fail because it won’t be able to sustain itself.”
Dr. Steven Pillow, a private practice OB-GYN in Mount Dora, says shouldering younger Americans with the burden for the elderly, unhealthy ones was attempted before and should indicate what we can expect.
“This was tried with the HMOs,” Pillow said, “and that was not a resounding success.”
The ACA is not free care. With many more people who cannot afford to pay — or to pay more to get more coverage — where will the money to fund that come from? The short answer is taxes. Many of the taxes are aimed at the health industry itself, including affi liated services like massage parlors and tanning services. Some individuals, mostly the wealthiest Americans, will also be shouldered with the burden of paying more into Medicare. To counter, hospitals and insurance companies participating in Medicare will get paid somewhat less.
It was expected once the health care law went into effect that the fundamental ways we would all acquire health care would be through your employer, the government, the
“Shouldering younger Americans with the burden for the elderly, unhealthy ones was attempted before and should indicate what we can expect. This was tried with the HMOs and that was not a resounding success.”
— DR. STEVEN PILLOW
marketplace, or continue with no coverage. Approximately half of us would get insurance through our jobs, as we have been. Nearly a third would get coverage from the government through Medicare and Medicaid. Almost one in 10 would buy insurance themselves. However, another 30 million of us would remain without coverage. Yet within the fi rst three months of implementation, the ACA has seen some disparity here, as well.
The expectation of the new health care law was that many Americans would receive coverage by their employers and for them, not much would change. The promise included new advantages, like free preventative care and caps on how much you would have to pay out of pocket. The unforeseen direction, however, is that some small employers are likely to stop offering health benefits, particularly if a large percentage of their workers are eligible for subsidies to buy health insurance on the marketplaces set up through the ACA.
The major changes are for those employed in larger companies but not currently covered. Insurance reform will require companies with 50 employees or more to cover fulltime workers or pay a penalty; however, this mandate has been delayed until 2015. Smaller businesses will not be penalized for declining to buy insurance, but they will be encouraged to do so.
In addition to offering health care to the currently uninsured, the belief was that Medicaid would expand to cover poor adults, many of whom are not currently eligible.
If your income is up to 138 percent of the poverty level, or $15,856 income for a single person, Medicaid would cover you, most likely under a private insurance plan.
“The concept that all patients will have insurance is very attractive,” Bosshardt said, “but the moment I heard the Obamacare ‘safety net’ for the uninsured was going to be to expand Medicaid, my fi rst thought was, ‘This is never going to work… Medicaid doesn’t work very well now, it will be even worse when you make it into a bigger program.’”
The expectation was that those of us covered with government assistance would continue with little change for seniors on Medicare. Yet providers are looking at major reimbursement cuts and many Medicare Advantage plans have seen significant changes. Medical Advantage plans are a type of Medicare health plan offered by private companies that contract with Medicare to provide Part A and Part B benefits. Medicare Advantage plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. According to The Heritage Foundation, a conservative research think tank based in Washington, D.C., Medicare payment cuts would total $716 billion over the next 10 years.
“In order to cover people with serious medical problems and pre-existing conditions, insurance companies will have to either recoup with an increase in premiums or transfer the cost to healthier people.”
— DR. RICHARD BOSSHARDT
Hospitals would take the biggest hit ($260 billion), followed by the Medicare Advantage program ($156 billion).
Dr. Kim Ireland, an ophthalmologist with St. Luke’s at the Villages, warns that patients need to be aware of the type of plans they are participating in and make sure nothing has changed. For instance, Dr. Ireland sees more and more patients are signing up for Medicare Advantage plans, or other substitutes for Medicare, and not all of the Medicare Advantage plans allow free access to the doctor of choice. Some of the advantage plans limit the participating doctors.
“It has been a challenge for us to maintain participation in many of these plans,” she says.
Another hitch is the Supreme Court ruled state governors and legislatures should decide whether to participate in Medicaid expansion. The federal government will cover the bulk of the cost for participating states. For those who do not, the marketplace will be federally facilitated. The poor, however, may be left with the same options they currently have. According to the Kaiser Family Foundation, a nonprofit private operating foundation, Florida did not decide to implement Medicaid expansion at this time (as of December 2013), so Florida is a federally facilitated marketplace.
For those not covered, or fi nd their work coverage too expensive, there is a new way to buy insurance on your own
under the marketplaces. The expectation on the marketplace has been the equivalence to a health insurance mega-mall, designed to make buying health care coverage easier, useful, and more affordable. It was projected to enable individuals, families, and small businesses to fi nd answers to questions, compare health plans, determine eligibility for tax credits, and ultimately help people enroll in a health plan that met their needs and budgets. The promise included private insurers would compete for your business.
However, due to website woes and registration roadblocks, the marketplace at this point has not lived up to expectations. Since commencement on Oct. 1, the marketplace has had incomplete back-end payment access and is plagued with extensive technical issues that, to this day, prevents registration.
A Dec. 3 Reuters article stated the Centers for Medicare and Medicaid Services (CMS) had not yet completed the backend part of the website that would transfer billions of dollars in subsidies for plan premiums and cost-sharing payments to insurance companies. CMS media representative Julie Batalie stated that “the government will make the payments to insurers for premium tax credits and cost sharing on time,” leaving some to wonder if that meant the federal government would be the ones left paying the premiums.
Within the same article, Bataille stated the government has a work-around, whereby the insurance companies would calculate the amount for those subsidies, bill the government, and the actual amount would be reconciled later.
There are other safe measures in play. Recently, federal officials announced a pilot program allowing consumers to enroll directly through insurance companies and to bypass the troubled Healthcare.gov. Federal health officials said that the pilot program has worked well in the test states of Florida, Ohio, and Texas — and that some insurers are planning to expand direct enrollment beyond their initial efforts.
“Patients need to be aware of the type of plans they are participating in and make sure nothing has changed.”
— DR. KIM IRELAND
For instance, Florida Blue, the state’s largest health insurer, recently announced the company will expand direct enrollment capabilities to all of its channels, including retail centers, online, and through agents and brokers.
Concerns have also been raised whether coverage will be active without a method to pay for the insurance once they register on the marketplace. Heather James, navigator for Marion and Sumter counties, recommends the safest course for consumers to take is not to wait and see, rather take the initiative and contact their insurer directly after enrolling in a plan and confi rm that they have paid their premium in the correct manner and that the consumers initial enrollment materials will be mailed to them.
America collectively needs a healthy workforce that produces more than it consumes so that we are a healthy nation in a competitive world. As Americans ring in 2014, chief among their New Year’s resolutions should include starting a healthier lifestyle and in the event of an unforeseen accident or illness, be properly covered.
With so many options, you will need to do your own research to find the plan that fits best with your medical needs and budget. The ACA provides experts called health insurance marketplace navigators to assist you. The phone numbers for the nearest health insurance marketplace navigators in our local area are:
1.877.564.5031 (Orange, Osceola, Seminole, and Lake) and 352.359.2519 (Marion and Sumter). To learn more about navigators and health insurance exchanges, visit www.wellflorida.org.
Open enrollment concludes on March 31, so now is the time to figure it out and set yourself up for the best insurance for you.
EDITOR’S NOTE: Join us next month as we follow contributing writer John Sotomayor’s documented step-by-step procedure as he embarks on his ACA enrollment and selection of an insurance provider for his needs.
Essential health benefits must include items and services within at least the following 10 categories, starting in 2014:
• Ambulatory patient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use disorder services, including behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care
“Obamacare is just a series of medical exchanges where people can find traditional insurance plans at more competitive rates. How could anyone have a problem with that?”
— DR. JAMES YOUNG
Would you like something to smile about in the New Year? Many resolutions get made, though only those paired with action will come true. In the spirit of making the most of our 2014, let’s usher in the New Year with a resolution to invest in and rejuvenate ourselves! Is this the year that you will commit to looking and feeling your best?
You can start your year off right with ImageLift®! With so many surgical and nonsurgical treatment options, it’s easier than ever to look your best. The signs of aging continue to become more apparent with each year that passes, and our appearance can betray how young we feel on the inside. Wish you could turn
back the clock this New Year? Well, now you can. People are living longer, the likelihood that people will live to 100 is higher than it has ever been! Taking care of yourself is like a home improvement model, and we say that prevention is better than renovation to obtain the youthful look you want!
Using the latest proven technologies, such as our 1440 Laser Lyte Treatment, we specialize in any cosmetic treatment of the face, neck, and skin. The 1440 Laser Lyte Treatment of the neck and jawline is a highly effective treatment
neck and jawline with no stitches or scalpels! This simple, but effective
procedure can rejuvenate your appearance with little or no downtime. We offer a variety of services and procedures that are not offered in many
At ImageLift, we are a National Center training other doctors in the ImageLift techniques. The combined experience
Plastic Surgeons, Dr. Rich Castellano and Dr. Randall Weyrich, is sought after across the country and internationally. They will absolutely provide you with a customized treatment plan that works for you and your individual needs, right here in The Villages, no travel required! Want to learn more about this from the comfort of your home? Be sure to request a download our new at giving@ImageLift.com and we will donate $1 to breast cancer research for every book request. Please provide name, contact information, and physical address to mail the book if you prefer the hard copy.
• Conservative, bone sparing technique
• Does not sacrifice any ligaments
• 20+ years of successful patient outcomes
• Restores your knee to a more natural state
ACL and PCL critical for knee stability
Unlike most knee implants, the ACL and PCL are not sacrificed with the TKO
Total knee replacement is intended for individuals with degenerative, rheumatoid and post-traumatic arthritis of the knee. Knee replacement surgery is contraindicated for patients with certain types of infections, some mental or neuromuscular disorders, compromised bone stock, skeletal immaturity, severe instability of the knee, or excessive body weight.
As with any surgery, knee replacement surgery has certain risks. Speak to your surgeon to decide if knee replacement surgery is appropriate for you. Individual results vary and not all patients will return to the same activity level.
Dr. Vrej Kristapor Manoogian is offering the most advanced treatments available for hip, knee, and shoulder problems.
Dr. Manoogian is the inventor of the “Living Hip” total hip replacement. This is the most bone-conserving total hip available and has the ability to maintain bone integrity throughout the entirety of a patient’s life.
With regards to shoulders, Dr. Manoogian performs arthroscopic rotator cuff repairs through incisions only millimeters in length. He also performs a multitude of other completely arthroscopic shoulder treatments, open procedures, and, when necessary, total shoulder replacement arthroplasty.
When it comes to knees, Dr. Manoogian offers the TKO implant, a complete ligament-sparing total or partial knee replacement. He offers other surgical knee replacement procedures, as well. Rather than using a one-size-fits-all approach, he carefully examines the ligament and functional status of the patient’s knees to see which option would best suit the individual patient.
Dr. Manoogian’s treatment philosophy has been and always will be to proceed with the most conservative treatments available to restore function to normal or as normal as possible.
SHAPE // EAT FIT/NOT FAT // CHANGES
BUILDING A BETTER CHEST 80 WHAT TO EAT, OR WHAT NOT TO EAT 84
WHAT A DIFFERENCE A YEAR CAN MAKE 86
PUMPING UP YOUR PECS CAN BOOST YOUR STRENGTH AND CONFIDENCE.
Happy New Year! You may have decided to start 2014 with an exercise routine or have chosen to get serious about that gym membership you’ve been ignoring. Either way, you are to be congratulated because with consistency and a plan you will see your body change for the better over time. Remember to make several
1. Select dumbbells that are light-to-medium weight; keep them close by on the floor.
2. Sit on top of the stability ball; roll down the front of it by walking your feet out. Stop when the ball fully supports your head, neck, and your legs are at a 90-degree table position. Pick up the weights and hold them straight over your chest, palms facing in.
3. With elbows soft, inhale and open up the arms to the side, stopping with hands slightly in front of shoulders.
4. Exhale and bring hands back to center, elbows soft.
5. Repeat 10–15 times and keep your form correct for three sets.
dates with yourself each week to work out and let nothing stand in your way. No one will do it for you! Getting those chest muscles stronger isn’t just for the guys. Anyone who picks things up, moves objects forward, raises their arms in front of them, or reaches across their body can benefit from these exercises.
6. Start position
• Squeeze your pectoral muscles while bringing arms back to center.
• Imagine squeezing a giant beach ball to deflate it.
• Be careful not to let the hands drop wide below the shoulder because an injury could occur.
MUSCLE GROUPS TARGETED: pectoralis major, minor, and deltoid
Being on the road and away from home has some benefits and some challenges. For example, you will need to make healthy food choices as not to add extra softness to your midline. A bonus for your exercise routine is that you are forced to shake it up and do something different. This is fantastic for your muscles — as well as your self-discipline.
For this modification, all you will need is a place to lie flat on your belly. Follow these simple instructions and feel your deltoids light up.
1. Put a towel or pillow underneath your forehead or turn your face to one side.
2. With arms outstretched, keep your elbows soft, palms facing the floor.
3. Inhale and contract your abs, tighten your glutes and legs.
4. Exhale and lift your arms off the floor, squeezing your shoulder blades toward each other
ve e rd
If your chest muscles are too tight, it causes you to have a slightly forward hunch and a rounded upper back. Be sure to stretch them after workouts by bringing your arms wide and elbows bent, making a “W” with your hands and elbows.
5. Relax and repeat 12–15 times.
Challenge: Hold full water bottles in each hand or hold a book in one hand and lift one arm at a time.
Second position
1. Using a shoulder press machine, sit straight with back pressed into the pad. Place hands on handles at shoulder height.
2. Exhale and press overhead; do not fully extend elbows at the top.
3. Repeat 12–15 reps for three sets.
• Challenge: pause halfway up and halfway down during each lift.
• Each repetition should be to a slow count of four for best results.
• Squeeze chest muscles and triceps as you do these for extra credit!
MUSCLE GROUPS TARGETED: pectoralis major, minor, and deltoid
It is crucial to maintain proper form and alignment during this exercise, otherwise the lower back can be injured. Remember to lightly hold the handles with the thumb around the hand grip. The wrists should be in alignment with the forearms to avoid strain.
1.
Begin with lower back pressed into pad of the pec deck machine. Keep elbows at chest height.
2
Exhale and slowly bring hands together, keeping elbows slightly flexed.
3.
Inhale and slowly return to start position. Repeat 12–15 times and do three sets for best results.
• There is no reward for lifting heavy weights with improper form.
• Pull in your abs as you bring the elbows together.
• Keep your shoulders down and neck long.
A chest full of toned muscles will not only make you feel more confident but it will also make you stand taller, as long as you equally work your upper and middle back muscles. Your shirts will hang properly, and you will even be able to breathe easier with your rib cage held in place by balanced muscles.
MUSCLE GROUPS
TARGETED: pectoralis major, minor, and deltoid
MAKING
CAN YIELD MULTIPLE HEALTH BENEFITS
Whether you are looking to lose weight, manage a health condition, or simply trying to increase energy levels, there are some basic eating guidelines to follow for living a healthy lifestyle. The following suggestions can assist you in this important personal task:
Eating foods in their natural state offers the best nutrient intake. Focus on eating plenty of fresh fruits and vegetables, which are packed with vitamins and minerals and are known to protect against disease. Shop the perimeter of the store to find the most whole foods. Keep menus simple but be sure to write a list before going to the grocery store to help you make healthy choices.
Choose complex carbohydrates such as those found in whole grains and vegetables over white flour products. Whole grains are an important part of anyone’s diet as they contain necessary vitamins, minerals, protein, low-glycemic carbohydrates, and dietary fiber. The fiber in whole grains also helps to support healthy digestion, regulate blood sugar levels, and improve cholesterol levels and overall heart health. Some nutritious whole grains to choose from include brown rice, cracked wheat, oats, buckwheat, quinoa, amaranth, and millet. When buying whole grains, it is a good idea to opt for organic varieties to support optimal health.
Reduce animal proteins (meat and dairy). Research shows that high levels of animal protein have been associated with greater risk of diabetes, heart disease, and cancer. When eating animal protein, be sure to choose only hormone/ antibiotic-free meats, eggs, and dairy products. Additionally, opt for leaner meats and get protein from other sources, including beans, lentils, legumes, fresh vegetables, seeds, and nuts. Choose healthy fats like nuts and seeds and cook with unrefined oils, such as extra virgin olive oil and coconut oil.
Focus on “cleaner eating” by reading food labels. Be aware of what is in the food that you are buying. Select natural foods, working to eliminate artificial colors, flavoring, and preservatives. Foods that are full of additives block the absorption of nutrients in the body, so take a back-to-basics approach when it comes to making food choices.
SOURCE:
Along with these important tips, choose healthy cooking methods such as baking, broiling, poaching, and steaming. Try to maintain a healthy variety in the diet. Variety not only helps to increase the intake of important nutrients, but also helps to reduce the development of food
sensitivities. Be sure to drink plenty of pure, clean water every day. Water is the most important nutrient of all, making up 70 percent of the body. Finally, practice moderation when eating low nutrition treats, keeping the emphasis on eating healthy foods for a healthy body.
Alot can happen in a year. There is an apocryphal story about a counselor to a king who was caught red-handed stealing from the treasury and sentenced to die. He was hauled before the king who asked, “Give me a reason why I should not have your head this very minute?” The counselor answered, “Oh king, live forever. I am the best teacher in the kingdom. Grant me a year’s reprieve and I will teach your favorite horse to sing.” Intrigued, the king granted his request. The counselor’s friends said to him, “This is a fool’s bargain. You will not succeed and in a year, the king will have your head.” “Perhaps,” replied the counselor, “but I have gained a year and a lot can happen in a year. The king may die. I may die. The horse may die. Or, who knows… the horse just might sing!”
When I took physics in college, I was introduced to Albert Einstein’s theory of relativity. One of its tenets is time is not fixed. If a person somehow manages to travel at speeds approaching that of light, time literally slows down and that person will age more slowly than a person who is moving slower or not at all.
In a somewhat different way, we see time’s relativity every day. We all start each day with the same 24-hour period, but it seems some people make that time go so much further and accomplish a lot more
than others do. It is almost as though they stretch out those minutes and hours in some way. For me, time always seems to speed up at year’s end.
We live in a culture obsessed with time, especially compressing time in order to get as much done in as little time as possible. As evidence of our ever-decreasing attention spans, we multitask, receive our news in sound bites, and communicate in 140 character “tweets” on Twitter. Whether in our personal or professional lives, we want results and we want them now; therefore, long-term planning is not our forte.
A little over one year ago, I decided to make some major changes in my life. At age 60, I had gained more than 20 pounds, my cholesterol was creeping up, and I was worried because heart disease runs in my family. Thus, in 2012, I did two things: adopted a largely vegetarian diet and committed to make my dream of completing an Ironman triathlon a reality.
A year later, I have lost the extra weight and my cholesterol is down to where it was when I was a medical student. It was a 12-month investment of commitment, planning, and effort. Changes did not come easily or quickly but looking back, I am amazed at how different my life is. A month after successfully finishing the Florida Ironman, it is still hard to grasp all that has happened.
The question I have for you, dear readers, is where will you be 12 months from now? The facts are unassailable. Nearly two-thirds of the adult U.S. population is overweight or obese. Eighty percent of U.S. citizens 18 years or older do not perform the recommended 150 minutes of moderate exercise and two days of muscle strength training per week. Seventy percent of all Americans are on one or more prescription drugs for their blood pressure, elevated cholesterol, depression, diabetes, arthritis, etc.
We are victims of our own success and it is killing us and destroying our economic future. Technology has advanced to where we can almost live our lives from a chair. We have made food so inexpensive, plentiful, and accessible that we can eat large portions whenever we wish. As if that weren’t enough, we have made food almost addicting because of its sugar, salt, and fat content. Our medical care has become so effective that we can continue to lead our sedentary, gluttonous lives and rely on medicine to keep us alive despite our growing litany of chronic illnesses. Healthcare costs make up a sixth of our economy; they are soaring and not sustainable.
So, what about you? Everyone has the same 12-month period available at the start of each year. If you lose one to one-
and-a-half pounds per week, you stand to lose between 50 and 75 pounds in a year. What difference might that make in your diabetes, high blood pressure, arthritis, cholesterol, and overall sense of wellbeing? How much better might you feel? How much might you save in personal health care costs? Imagine the possibilities.
Ask yourself, “Where do I want to be in one year, five years, or 10 years?” What are you doing today to get there? In all
honesty, we can all do better in taking care of ourselves. If it seems overwhelming to think a year ahead, focus on today. After all, a year is made up of 365 todays. Do something today that will move you toward where you want to be a year from now. Find your dream and turn it into a goal by setting a deadline and implementing a plan to get there. Enlist your physician, a family member, or a trusted friend to accompany
you, encourage you, and hold you accountable. You have nothing to lose and much to gain. Who knows, in a year, the horse might just sing.
PERSPECTIVE // DAWN
TRAINING FOR A NEW ATTITUDE 90 WAKE UP WITH A SMILE 92
Back in the caveman days, our ancestors were stressed and anxious much of the time. It is hardly surprising since they faced deadly threats almost every day, especially from other humans. To survive, they had to be constantly vigilant. Whenever they would encounter a group of people, especially strangers, they would quickly scan their faces for any signs of hostility or aggression. This defense mechanism was triggered repeatedly over thousands of years and eventually became an automatic response hardwired in our ancestors’ brains. It didn’t make them any less stressed, but it gave those who quickly sensed danger a better chance of survival. Today, most of us don’t face those kinds of immediate physical threats, yet being in that constant state of alert is still with us. That is why many of us pay more attention to negative information than positive information and often feel mildly anxious and stressed for no apparent reason. Psychiatrists call this “negative attention cognitive bias.”
Another common cognitive bias is “interpretation bias,” which is when a person interprets neutral information as being negative. An often-cited example of this bias is how different people react when an acquaintance they pass on the street fails to acknowledge them. People with a positive frame of mind usually assume the acquaintance is preoccupied or distracted. People with a negative frame of mind — a
negative interpretation bias — believe the other person is snubbing them.
As we know, some people’s anxiety, stress, and depression are severe enough to warrant medication, talk therapy, or both. However, such interventions are problematic because medication doesn’t always work and often has unpleasant side effects, and counseling is time-consuming, expensive, and isn’t always effective either.
In the last decade or so, a number of leading neuroscientists from around the world have been collaborating to develop faster, more accessible, and more affordable remedies. Much of their research focuses on the knowledge that the brain’s “negative” wiring, or neural connections, can be altered with practice in much the same way we alter neural connections when we learn to play the piano or type.
Experiments with computer-based systems are particularly encouraging because people can undergo the therapy at home. Using a mouse and keyboard, the user is instructed to repeatedly perform various routines with the aim of altering negative thought patterns. One such routine presents the user with a matrix of faces that quickly alternate between those with happy expressions and those with gruff or neutral expressions. The user’s task is to click on as many happy faces as possible within a defined time. Another task involves a crossword-like rectangle filled with words. The aim is to highlight
as many positive words as possible, such as “loving,” “prized,” and, “accepted,” within a defined time.
Research carried out at many leading academic institutions around the world, including Harvard and Oxford, shows that such specially designed software used for around 15 minutes a day over a period of a few weeks produces results at least as beneficial as months of talk therapy and/or medication, and has no adverse side effects.
Nevertheless, computer-based cognitive bias modification programs are relatively new. Much work needs to be done to establish the best tasks to include in them, the optimum duration of each task, and crucially, whether a layperson using the software should have professional medical supervision, and if so, what kind and how much. All such systems will have to undergo exhaustive testing before they are endorsed as legitimate therapies by the appropriate medical authorities.
In the meantime, there is nothing to stop anyone trying out the concept. Variations of the software are available to the public via the Internet. Unlike drugs, they can be used without risk or prescription. They don’t claim to be medical therapies because the research and testing is still in progress. Instead, they are promoted as computer games designed to “improve your mood.” If they are games that help users reduce stress and anxiety, they are games well worth playing.
Work on establishing a more positive frame of mind with these cognitive bias modification applications.
Anxiety Mint: For iPhone users, this app helps those who suffer from anxiety to focus on positive information using faces. When presented with a threatening facial expression and a neutral or positive facial expression, an anxious person will usually be drawn to the negative expression. This app urges users to pick the happy face from the sea of negative or neutral facial expression. With practice, the user will learn to ignore the negative facial cues and will begin to develop a positive attentional bias. Anxiety Mint is unique in that it helps monitor the user’s progress with a scoring system. Points are awarded for speed.
Psych Me Up!: For Android users, Psych Me Up! follows the same format as Anxiety Mint. It is designed for stress reduction and for improving self-confidence, performance, and productivity. The app also includes a quiz about your current frame of mind and background scientific information about attention training.
ornings can be hard... really hard. After too few hours of sleep or a restless night, even the sprightliest early birds can feel annoyed at the first sounds of the alarm clock. Nothing beats getting adequate sleep, but morning rituals can help you start the day less stressed and more energized.
One of the most important aspects of a calm morning is giving yourself enough time to properly wake up and get ready. If you must help your family get ready for school or work, it may seem impossible to accomplish everything without dashing around the house but it can be done. Organize as much as possible the night before by preparing lunches, packing bags, signing forms, and laying out clothes.
Though it’s tempting to hit the snooze button and sleep for just five more minutes, try to resist. Help your circadian rhythm by allowing some natural light into your bedroom. This allows your brain to slowly wake up as the sun rises. If you can’t sleep with any external stimuli and have too much light coming in from the street, you can buy an alarm clock that can be programmed to simulate the brightening sun. If it’s warm outside, you can also leave your windows open. The fresh air will help you wake up feeling more rejuvenated.
After turning off your alarm clock, take a few moments to allow your body to rouse. While still lying down, stretch your arms and legs, wiggle your toes and fingers, and rotate your ankles and wrists. Once out of bed, do a few arm and leg stretches, bend forward and backward to stretch your back, and touch your toes. These stretches are easy to do while still a little drowsy and will promote blood circulation in order to feel more awake.
After stretching, drink a glass of water. Your body has spent the night detoxifying and repairing cells; drinking water helps flush out the toxins. Since dehydration is often a cause of grogginess and fatigue, try to drink water throughout the entire day.
Now it’s time for a nice morning shower. The water will help you feel refreshed, more awake, and ready to tackle the day. If you prefer to shower at night, you can still get similar benefits in the
morning by washing your face. Citrus scents have been shown to improve alertness, so look for body washes and cleansers that contain citrus aromas. If you already have a skin care regimen and the products do not contain citrus odors, you can purchase aromatherapy oils in orange, lemon, lime, or grapefruit scents and take a nice whiff of them instead.
After enjoying your shower or wash, get dressed and head into the kitchen. If you have a morning coffee or tea, don’t gulp it down while trying to do 20 other things. Sit down and savor it. If you’re not a tea or coffee drinker, a great way to still enjoy a satisfying, hot beverage is to drink a mug of warm water flavored with lemon juice.
If the weather is too warm for hot drinks, a smoothie is the perfect alternative. It also makes a great, healthy breakfast. Simply combine frozen fruit, such as berries or a banana, with your liquid of choice (milk, almond milk, soymilk, etc.), a handful of raw spinach, and a tablespoon of cocoa or peanut butter. Blend until smooth. This drink is jam-packed with nutrients and is easy for your body to digest, so you won’t feel sluggish after drinking it.
While enjoying your morning drink, listen to some of your favorite music. If you have certain songs that make you feel upbeat and positive, put them in a playlist and let them elevate your mood. If there is a particular morning show on the television or radio that you like, use that instead. Try to avoid depressing news and seek out programs that are uplifting and entertaining.
By changing negative thoughts and practices and deciding to embrace the day’s beginning, you can transform your morning from being a hurried, harried, stressful time into being a relaxed, pleasant, and uplifting experience. This creates a positive environment for you and any other household members and will benefit the emotional and physical health of everyone involved. When you feel great, you emanate positivity and others around you will sense this. By taking control of your mornings and, in turn, your overall attitude, you’ll have the power to change all aspects of your life. Don’t settle for a life of snooze buttons. Wake up and get living!
We here at Lake OMS practice a full scope of oral and maxillofacial surgery that includes expertise in the areas of corrective jaw surgery, wisdom teeth removal, diagnosis and treatment of facial injuries, as well as bone-grafting procedures Drs. Azizi and Figueroa employ the most recent advances in dental implant technology by utilizing CT-guided system for minimally-invasive implant surgery. With this technology, we can evaluate the bone ahead of time and place implants precisely in an ideal functional and esthetic position. We are committed to provide the highest quality treatment so our patients can smile and function with confidence.
There is no such thing as “perfect timing” after you become a parent. We are always faced with life’s unexpected events. Being a mother has helped me appreciate those unexpected things that turn my world upside down — the Kool-Aid on the carpet, the melted crayons in the dryer, the strawberry stain on a brand new shirt. These things become so trivial when you experience something you never thought was possible. Suddenly, you are given a new perspective on what is truly important.
I knew when my oldest daughter Madison was a toddler that I loved being a mother and wanted a bigger family. My husband and I tried for almost eight months before I became pregnant. At my first appointment, we discovered we were not just adding one additional member to our family but two. Yes, twins!
My pregnancy with the twins was mostly uneventful except for the first trimester morning sickness. My prenatal care was excellent, my doctors were amazing, and all of my sonograms showed the twins growing on track with perfect weights and strong fetal heartbeats. I made it to 35 weeks before going into
labor on Christmas Day. The next day, Gracie and Gavin entered the world happy and healthy, weighing in at 4 pounds 10 ounces and 5 pounds 1 ounce. All three of us were released with a clean bill of health after only 48 hours in the hospital, and we made our first adventure home as a family of five.
The twins appeared very healthy their first month, but during their first pediatric checkup, the doctor noticed Gavin had a slight heart murmur and suggested we see a pediatric cardiologist to make sure it wasn’t serious. I scheduled an appointment immediately only to be faced with what felt like my world shattering into pieces. An echocardiogram revealed my six-week-old son had a congenital heart defect, a bicuspid aortic valve with stenosis. In other words, his aortic valve did not form right during gestation. Instead of having three openings for oxygenated blood to pump to the rest of his body and prevent blood from flowing backwards into the heart, his valve has only two. This condition affects less than two percent of the population. The aortic valve stenosis, which is the narrowing of the valve, creates pressure when
the blood is pumped through to the aorta and can cause thickening of the ventricle due to the extra pumping required to force the blood through the faulty valve. The treatment for this condition involves multiple valve replacements.
A part of me died that day in the doctor’s office as the next few weeks became a frustrating cycle of researching the procedures, and calling doctors around the country to find the best place for the surgery. I began to panic.
Questions began rushing through my head: “How much pain would he feel?” “What if he didn’t survive the surgery?” “How would I explain his scars?” “Would he remember?” However, the most terrifying question was, “When?” I felt like Gavin was a ticking time bomb because no one could tell us when he would need surgery.
His doctors explained that having routine echocardiograms until the pressure inside his valve became severe enough for surgery was the only answer. In the meantime, I didn’t sleep and I worried all the time that something was going to happen. Plus, I was caring for my two other children.
Every doctor appointment, I
thought, “Today is going to be the day they tell me it’s time.” There is no way of knowing what could cause his condition to worsen or how fast it could happen. I spent so much of my time being overprotective and trying to control the inevitable. At this point in my life, I grew in my faith and had to give it all to God. It wasn’t in my control and accepting that was painstakingly hard.
Then at age 3, Gavin developed severe asthma in addition to the heart condition, which created a new set of issues. After almost two years of constant doctor and hospital visits, we eventually found a medicine that helped his asthma without affecting his heart.
It’s been almost fi and the pressure inside his valve continues to remain stable with only very slight increases. The doctors hope he can make it to adolescence when the heart is fully-grown. Then he will only need one valve replacement. Therefore, we just hope for time. I am not really sure how to prepare for that time when it comes. I am not sure how to explain to Gavin his condition nor do I want him to feel any less capable than his sisters. We have tried to let him do as much
as possible without hindering his ability to be a normal and active little boy. He has a few restrictions that I hope he will learn to accept once he is older and can understand.
If you looked at Gavin with his friends on the playground, you would never guess he was a child with a congenital heart defect and severe asthma. He is just amazing. He has the biggest heart of any kid I know, and he always wants to help others. He is my super hero.
As parents, my husband and I consider every day a blessing. This experience with Gavin has given our whole family a new perspective on how precious every moment is. My husband’s favorite saying is “Don’t cry over spilled milk.” I think as a family that saying has really made us appreciate the small annoyances in life because we have overcome something so much bigger. For us, enjoying the time we have together, no matter how small, is what helps us live life to the fullest.
“Every moment of light and dark is a miracle.” – Walt Whitman
MORGAN ELLIS is from western Michigan and graduated from Davenport University with a bachelor’s degree in business management and marketing. She now resides in Central Florida with her husband and three children and works as a professional photographer. She is an active member in the community and a proud parent and stay-at-home mom.
Very few people live their lives free of challenges, where the cup is perpetually half-full of opportunity and good fortune. Hardships are a part of life, no matter who says otherwise. Below are five ways to transcend life’s inevitable disappointments while improving your wellbeing in the process.
1. Practice gratitude. It is easy to become discouraged when life throws punches like being overlooked for a job promotion or arguing with a loved one. Instead of letting these disappointments morph into something toxic, focus on the positives. Be grateful to have a job and look for ways to improve your performance so future opportunities are not missed. Learn from the argument and communicate more
effectively with other family members and friends while appreciating their presence in your life.
2. Help others. Whether it’s volunteering at a local soup kitchen or helping to care for an elderly neighbor, there’s no greater satisfaction than knowing you’ve made a difference in another person’s life. By giving just a small portion of your own life, skills, and time, a sense of purpose and fulfillment is gained. This also ties into practicing gratitude; by seeing firsthand how others suffer or struggle, you begin to appreciate your own life.
3. Experience nature. Even if you live inside an urban concrete jungle or within a secluded countryside, there is something to be said for fresh air and adequate
sunshine. Take a walk along the beach one evening or read a favorite novel beneath the canopy of trees at your favorite local park. No matter the time or place, be sure to take a moment to connect with nature, which will ultimately lead to less fatigue and reduced stress.
4. Eat well and care for your health. This may seem like a given, but a healthy body leads to a healthy mind. Try to fill your diet with fresh fruits and vegetables by eating home-cooked meals instead of fast food whenever possible. Even if the changes are small, your increased energy levels and more glowing appearance will translate into a better attitude and mindset.
5. Make time for yourself. Although much can be gained from helping
others, giving too much of yourself can be selfdestructive. Allow yourself time for a hobby. Read for 30 minutes after dinner, play in a neighborhood soccer league, or get a pedicure. Make time in your busy schedule to allow for leisure and pampering. Even a few minutes a day to unwind can rejuvenate and invigorate your body and mind for the days ahead.
At some time or another, everybody struggles with stress and anxiety with work, school, or family life. Instead of giving into these feelings and letting your health suffer, take these steps toward selfimprovement. No matter how challenging life becomes, there is always an opportunity to turn inward and improve your life and point of view.
DON’T LET RAINY DAYS PERMANENTLY STEAL YOUR SUNSHINE; OVERCOME ADVERSITY THROUGH SELF-IMPROVEMENT.
WRITER: RICHARD BURGUET
Ihave figured something out about myself: I can always spot a fool, unless he is hiding in me. Maybe I have learned this because I have given my wife, my parents, my children, my coworkers, and many others good opportunities to point out my lack of wisdom, especially when it comes to relationships. Having recently had my foolishness pointed out to me, I was thinking I needed to learn something about “wisdom.” Now, I could have gone to the local bookstore and picked up any number of books or magazines offering relationship wisdom, but I decided to look at what the “Wisdom Literature” reference book of the Bible said instead. I found some uncomfortable “shoes” to put on as I shopped around in the book of Proverbs.
Just for brevity sake, here are five of those “shoes” that made me uncomfortable. Proverbs 12:16 says that “a fool is easily upset.” A little later on, I’m reminded that “a fool is fiercely independent” (Proverbs 28:26) and “a fool believes everything he reads” (Proverbs 14:15). The 18th chapter says that “a fool starts fights” (Proverbs 18:6) and “he loves to talk, but hates to listen” (Proverbs 18:2). The only one that didn’t personally nail me to the floor was from Proverbs 15:20, which says that “a fool hates his mother.”
Speaking of uncomfortable shoes, one of my daughters was on a ballet scholarship during high school and college. Since she danced for several hours five days a week, we were buying new pointe shoes for her monthly. Relational wisdom is sort of like a pointe shoe. Relationships will wear out, and even die, if not cared for properly. We need to look constantly for ways to renew them, and the way to do that is by listening from the heart and honestly receiving what others may point out to us.
Therefore, distilling the wisdom of Proverbs for myself — especially how I can be wiser in my relationships — boils down to a new resolve to communicate and work through issues with others. I am not going to blame our issues with relational wisdom on what I used to call “testosterone poisoning” because I have been watching television and apparently lots of us have low-T. I think it is a systemic problem that is rooted in our hearts, and Proverbs hits the issue directly when it reminds readers “a fool makes light of sin” (Proverbs 10:23).
This issue of the heart where men are told to hold things in until we explode is deeply rooted in who we are. We do this not just with relationships; we do this with work issues, personal issues, friendships, and the list goes on. We need to be brutally honest about it. Our failures in relationships stem from a heart that is self-centered, and although we may not acknowledge our sin, it is apparent to others.
I think it is interesting God made most of us with two ears and one mouth. That means we need to learn to listen twice as much as we talk. Think about how it might change your relationships at home or in the workplace. No, I am not suggesting you just “clam up,” but simply listen more! Maybe when someone points out your relational foolishness, you could actually consider the issue they have brought to light. I am thinking it may take me a while to break in those new shoes, but eventually they will be as comfortable as my favorite pair of hunting boots. I am going to work on being honest and opening up with those who love and trust me. I may grow my relational wisdom this year.
By the way, I was glad I didn’t totally strikeout with the six descriptions of a fool from Proverbs. I really do love my mama. This is a new year and I honestly believe that as long as we have breath, we can grow and become wiser — even in that most mysterious and convoluted area of relationships.
WRITERS: THOMAS FROSS AND ROBERT FROSS
Should auld finances be forgot and never brought to mind? Certainly not! Start 2014 on the right foot with a resolution to be financially independent. The beginning of a new year is the perfect time to sit down as a family, evaluate your finances, and set goals for the year. Here’s a plan to help you make 2014 the healthiest one yet.
The first step to success in the New Year means reviewing last year’s finances, identifying any areas of improvement, and getting everyone on board with your goals for the year. It’s important not to neglect the emotional and psychological aspects of family finances. Accountability and commitment to success are significantly improved when everyone in the household feels included in the planning process and understands the family goals.
Gather financial documents such as bills, account statements, credit card statements, and any other documents needed to build a comprehensive picture of your finances. Total last year’s spending and determine whether you’re staying within your means (and meeting savings goals) or if you’re off track. If you’re not doing a great job of abiding by your budget, identify the areas where you’re spending too much money. It’s pretty common for sneaky budget overages to accumulate where you least expect it, e.g.
credit card finance charges, hefty cellphone bills, and those “miscellaneous” expenses for which you can’t account.
Use this time to plan the year’s major anticipated expenses, like family vacations, big purchases, insurance payments, holiday spending, and anything else. Planning for these expenses will help ensure you have enough money on hand to cover them instead of having to reach for a credit card. Also, use the opportunity to shop around for better insurance quotes and ask for a lower credit card interest rate.
Using information from the past year, create a monthly household budget. It should be fairly easy to determine your fixed expenses, which include things like rent or mortgage payments, car loans, utilities, and phone bills. Estimating variable expenses like gas, entertainment, and grocery budgets can be a bit harder, and reviewing your check register and credit card bill may help. If you’re not sure where you spend your money, collect your receipts for a month or track expenses in a notebook. Create a miscellaneous category for those odd expenses that don’t fit anywhere else; however, if you notice that your miscellaneous spending is a large part of your budget, you may want to create more categories for better control.
Add in monthly contributions toward
your major anticipated expenses so that money is being set aside every month. Don’t forget saving for the future! When you make saving a regular part of your monthly expenses, you’ll be much more likely to get into the saving habit. You may find it helpful to automatically transfer a certain dollar amount into a savings or investment account every month. A financial adviser can help you understand the many benefits of saving early and often and work with you to develop a long-term strategy to help meet your financial goals.
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An emergency fund protects your family from unforeseen circumstances like the loss of income or an unexpected major expense. We suggest the average family build a cash fund to cover three-to-six months’ worth of expenses, though every family has different needs. It’s important to have this cash reserve so you’re not forced to rely on credit cards or liquidate your long-term investments for cash. It’s also very important to pay off any high-interest credit card balances or personal loans so you can wipe out finance charges.
Reaching your financial goals takes commitment. Sit down regularly as a family to review your budget and progress toward goals. If you have a tough time sticking to your budget, you’re not alone. Research into
behavioral economics shows many people struggle with forgoing short-term benefits (such as shopping and eating out) for longterm goals (like saving for retirement or a big family vacation).
We will leave you with some tips on changing spending habits to help reach your financial goals.
• Curb impulse buys by staying away from shopping malls or leaving your credit cards at home.
• Motivate yourselves with small rewards when you complete financial tasks or meet intermediate goals.
• Involve your family members in discussions about which financial choices will benefit you the most in the long run. Will eating out daily give you the most pleasure, or would you rather put that money toward a long-term goal like a family vacation?
We hope these tips will help you and your family achieve your resolution to be financially independent in 2014.
ROBERT AND THOMAS FROSS founded Fross & Fross Wealth Management with the shared vision of creating a truly world-class experience for their clients. Specializing in offering comprehensive financial planning to high net-worth retirees, Fross & Fross manages over $300 million in assets and maintains a stellar reputation of professionalism and experience throughout The Villages.
Dear Dave, I’m in the military, and my wife and I have $13,000 in the bank along with $35,000 in a Roth IRA. We also have no debt, and we put $3,500 into our savings account each month. Our new baby is due to arrive this month, so do you think this would be a good time to buy our first home?
—Tom
Dear Tom,
Based on the market alone, it’s a great time to buy a house. Interest rates are fantastic, and prices are recovering but still buyerfriendly. However, considering your wife’s delivery date and the fact that it takes a while to find and complete the process of buying a home, I think I’d wait on this. Moving is stressful enough under normal circumstances, but combining that with a pregnancy could shoot your wife’s stress levels into the stratosphere. I really don’t think you want to do that to her. And speaking as an old married guy, it’s something you don’t want to experience, either.
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Another thing to consider is if there’s a good chance you’ll be reassigned in the next four or five years. We work with the military a lot, and that means we see people who buy, and get stuck with, homes all over the country. These places usually become rental homes because they don’t sell quickly. And this is a situation you want to avoid because being a long-distance landlord is a real pain. If everything falls into place, you could easily have enough set aside for a big down payment a few months after the baby arrives. At that point, things will feel a little more settled. I know the temptation is great right now to move into a place you can call your own, but you want buying a home to be a blessing, not a curse. Take a little more time, and see how things feel career- and family-wise in a few months. That’s my advice.
Dear Dave,
An insurance salesman told me it’s better to use a life insurance policy for college savings rather than a 529 plan because the child can use it for anything instead of just college. Is that true?
—Rusty
Dear Dave,
Is it better to keep your emergency fund in a certificate of deposit or a money market account?
—Tom
Dear Tom,
Dear Rusty,
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Of course that’s what he told you. He’s an insurance salesman! He was right on one point. If the kid doesn’t go to college, the savings inside an insurance policy can be used for anything. But here’s the catch: There won’t be much waiting for you because you saved it inside a life insurance policy. The returns stink! Savings inside a life insurance policy won’t get you anywhere near the cash you’d have by investing in a 529 plan.
Right now, a short-term certificate of deposit (CD) pays about the same as a money market account. The problem is you’re only going to make about 1 percent with either one. The good thing about a money market, though, is that there are no early withdrawal fees attached.
In my mind, an emergency fund isn’t there for the purpose of making money. It needs to just sit safe and sound until it’s needed. It should also be in a program where it’s easily accessible and there are no stupid fees or penalties for simply using your own money.
to be lots o It’s not rea impor uncertain coll
If you are going to save for your kids’ college fund, there needs to be lots of talk around the house about actually going to college. It’s not really brainwashing them so much as it’s letting them know the importance of a good education. And they need to know, on no uncertain terms, that the money you’re saving for them is for one thing: college.
So, yeah, savings interest rates right now are aggravating. But you don’t have 3- or 4-percent-home-mortgage world without a 1-percent CD world. They kind of go together. Just remember that interest rates aren’t the end game when it comes to your emergency fund. You want three to six months of expenses just sitting there, waiting for life to happen. Trust me, it will!
—Dave
What you experienced, Rusty, was an insurance salesman trying to sell insurance. Stay away from it when it comes to saving up for college!
—Dave
What to s coll —Da
Imagine if simple tasks such as walking to the bathroom or climbing stairs caused severe pain. Since the pain may subside when you rest, you might automatically chalk it up to old age. However, it is crucially important to rule out peripheral artery disease (PAD).
As many as 12 million Americans suffer from PAD, according to the American Heart Association. People with PAD experience narrowing or clogging in the arteries that deliver blood to the body and are outside the heart and brain. It often occurs in the lower extremities and if left untreated, can result in limited mobility, increased risk of heart attack or stroke, and limb amputation. The disease is more common in individuals who are ages 50 and older, and risk factors typically include high cholesterol, diabetes, smoking, hypertension, obesity, and a sedentary lifestyle.
Those who suffer from PAD may experience symptoms such as sores that do not heal; pale, bluish, or shiny skin; a noticeably lower temperature in one leg or foot; poor nail or hair growth; or erectile dysfunction. If you are at risk or have experienced any or all of these symptoms, it is vitally important to see a doctor. Remember, the earlier the diagnosis, the better the likelihood for a successful outcome. Many of these symptoms can be remediated or even resolved using medication or other minimally invasive techniques.
Fortunately, Citrus Cardiology and Vascular Center specializes in the diagnosis and treatment of PAD. The practice’s renowned team of expert interventional cardiologists provides the best screening, diagnostic tests, and treatment options available — all under one roof.
Patients who undergo screening for PAD have blood tests to check for diabetes or high cholesterol levels. An ankle brachial index (ABI) is often used as a screening test for PAD. This is a simple and painless test that compares the blood pressure readings in a patient’s ankle to blood pressure readings in a patient’s arms. A Doppler ultrasound, which measures sound waves to measure blood flow, is an effective tool to determine the degree to which someone is experiencing PAD.
Even when patients are diagnosed with the disease, they can rest assured knowing most cases are treatable. Treatment options may include making lifestyle changes or taking medication to mitigate the disease’s effects. In serious cases, patients may need to undergo minimally invasive surgery, angioplasty, or a bypass procedure.
PAD patients continually receive excellent results at Citrus Cardiology and Vascular Center, where a highly skilled team of cardiologists stays on the cutting-edge of cardiovascular diseases. More importantly, the team is committed to providing patients with high-quality, compassionate care. This is achieved by always putting the patient fi rst.
Citrus Cardiology and Vascular Center is located at 801 E. Dixie Ave. in Leesburg and at 910 Old Camp Road, Suite 210, in The Villages. For more information, please call 352.315.0627 (Leesburg) or 352.751.3356 (The Villages).
While many may claim to stand apart from their peers, the Retina Specialty Institute (RSI) brings superb expertise, experience, and compassionate care.
“We started in The Villages in the spring of 2013 and since that time, we have grown quite nicely,” says Dr. Shalesh Kaushal, a vitreoretinal specialist with RSI. “We have been working diligently to create awareness in the area about retinal diseases, as well as maintain the highest level of care that our patients have come to expect and appreciate. That’s my passion.”
A visit to RSI means being in the hands of knowledgeable professionals who care about your eye health and overall wellbeing. The level of medical information shared empowers patients to take charge of their health care decisions. In addition to educating patients, the team at RSI works to maintain a comfortable, welcoming, and thoughtful experience from beginning to end during every office visit.
“For example, in most retina practices, people have grown accustom to waiting two to three hours before they can see the doctor,” says Dr. Kaushal. “At our office, we have substantially shortened that wait time, and that is something our patients value.”
Meeting patient’s needs and top-notch customer service are the highest priority at RSI; however, this thriving practice places even greater emphasis on having only the finest and most highly experienced medical professionals in their field. For example, Dr. Kaushal obtained his undergraduate education at Yale University and subsequently earned his medical degree from Johns Hopkins University School of Medicine and Ph.D. from Massachusetts Institute of Technology (MIT) in biochemistry with the Nobel Laureate Dr. Har Gobind Khorana. He completed his ophthalmology training at USC/ Doheny Eye Institute. He then completed two retina fellowships, one at Barnes Retina Institute in St. Louis and the other at Moorefields Eye Hospital in London.
Motivated by a desire to help patients and their families through every step and stage of their vision journey, RSI continues to play a key role in furthering medical advances to give patients access to the most advanced retinal care. As an avid researcher, Dr. Kaushal has participated in numerous clinical trials involving revolutionary breakthroughs in retina care such as gene therapy, stem cell treatment, and new drugs. He was one of three surgeons in the world to perform retinal gene therapy and was the first person in the world to use two other drugs for retinal diseases. He’s already working on bringing novel, cutting-edge clinical trials to The Villages and Florida.
RSI is making strides to treat many conditions that can lead to blindness by collaborating with Intelligent Retinal Imaging Systems
(IRIS) and the Lions Clubs International to help screen for retinal diseases like age-related macular degeneration and diabetic retinopathy. In less than 10 minutes, IRIS’ low-cost, non-invasive technology can detect early signs of retinal diseases. For the first time in the country, two screenings were recently performed — one in The Villages and one in Citrus County — and yielded great results.
“It’s quite remarkable. Using this automated camera system, we were able to pick up on very early diabetes-related retinal changes, as well as other pathologies such as scar tissue on the retina and glaucoma,” says Dr. Kaushal. “In bringing this kind of innovative technology to The Villages, we can help educate patients and also manage their conditions. We’re dedicated to doing what we believe is in our patients’ best interest.”
The best is what RSI strives for every day by offering state-ofthe-art clinical and surgical procedures for patients suffering from eye diseases such as macular degeneration, as well as conditions brought about by illnesses in the body. “Nearly every disease manifests itself in the eye,” explains Dr. Kaushal. “For example, cardiovascular diseases can cause changes in the vascular system. This can be directly visualized in the blood vessels of the retina. Nutrition and genetics can also play a key role in the health of our eyes. In a real sense, the retina reflects the overall condition of the body.”
As a result, Dr. Kaushal makes it a point to hold talks throughout The Villages and surrounding areas as a way to help educate and raise awareness in the public about the importance of overall health and eye health.
Personally and professionally, Dr. Kaushal finds the retina to be a fascinating part of the body, and he understands how important sight is to living a healthy lifestyle. “It’s always been a passion of mine, along with helping people,” he says. “As much as I intensely enjoy taking care of people, I’ve come to appreciate how important it is to provide meaningful, up-to-date medical information to patients. This motivates me immensely and is central to the service my team and I give to our patients.”
makes patient care and leading edge research its top priorities.
Tired of just making a living?
Chronic wounds can drastically impact your ability to live an active life. At Florida Hospital Waterman Wound and Hyperbaric Center, our goal is to help you during the healing process and help prevent the recurrence of chronic wounds. Our expert team of physicians, nurses, and staff work together with you and your physician to develop an individualized treatment plan. We continually monitor the progress and effectiveness of your plan and follow through to achieve the most concise and complete healing outcome. The Florida Hospital Waterman Wound and Hyperbaric Center is the only center in Lake County located on a hospital campus, giving patients access to advanced hospital services.
Patients may require care from the Wound and Hyperbaric Center for:
• Foot wounds resulting from diabetes
• Leg ulcers due to poor circulation
• Venous leg ulcers
• Pressure ulcers (bed sores)
• Non-healing surgical or traumatic wounds
• Burns
For more information or to schedule an appointment, please call 352-253-3100 or visit FHWat.org
The brand new and state of the art Villages Rehab and Nursing Center is now open and accepting seniors in need of a helping hand recovering from a recent hospital stay to quickly and thoroughly return to their previous active lifestyle. We are proud to bring to the area pioneering concepts to make rehab a personalized and positive experience for the patient and their family.
Join guest speaker Amy Tejeda and Soul Sisters, a local women’s outreach group and mission, at Family Bible Church in Eustis from 6:30 to 8:30p.m. This event for the community will feature shopping vendors and a raffle for a $25 gift. Information: Sabrina at 352.267.3871
Age well in your own home by learning how to modify your home for safety and convenience. Topics also will include practical tools and gadgets to simplify your life and what to consider when hiring individuals to help with personal needs and health care. From 10a.m. to noon at the Lake County Extension Office, 1951 Woodlea Road, Tavares. Cost is $5. Information: Julie England at 352.343.4101, ext.2721
The Lake Soil & Water Conservation District, in partnership with the Florida Forest Service, will give away 12-to-14 inch bare-root tree seedlings. Each person will be allowed one tree of each variety: dogwood, crape myrtle, American elm, nuttal oak, redbud, and pine. Starting at 11a.m. at the Lake County Extension Office in Tavares, this event is free to the public, although donations are accepted. Information: Patty Fletcher at 352.253.1646
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Wallace Fitness is hosting a fun, free family event to promote health and fitness awareness from 10a.m. to 2p.m. at Donnelly Park in downtown Mount Dora. Activities include fitness demonstrations, weight loss education, live entertainment, prizes, contests, food trucks, and demonstrations by community health care providers. Information: www.wallacefitness.com/expo
Kick your new year into gear. The race takes place at a new venue: Lake Apopka Restoration Area in Astatula. Also, longtime adventure racer Manny Otero is designing the course for the third straight year. There will be a Sport 3 Hour race and an Elite 8 Hour race. Information: pangeaadventureracing.com
Guest artist Katelyn Leigh will open this event, which also will feature the comedy of Philly Plowden (“America’s Got Talent”) and other guest comedians. There also will be music and dancing with retro band Go Get Gone. Vic’s Embers will provide table seating with drinks and hors d’oeuvres. Doors open at 7p.m. at the Leesburg Opera House, 108 S. Fifth St. Cost is $20. Information: Kinne Pearce at 352.516.8719
A ticket to this third annual event gives attendees the opportunity to win many fun door prizes and visit with health and wellness providers. Enjoy lots of great food, drinks, and entertainment. All proceeds benefit World Wellness Education, a 501(c)3 nonprofit organization. From 4 to 7p.m. at the Leesburg Community Center, 109 E. Dixie Ave. Information: Jean Sumner at 352.459.1655
The three-day educational symposium will include the latest information on critical care, as well as cardiovascular. Relax and socialize at the Heart-to-Heart After Dark party on Thursday, Feb. 6. Tickets are just $10, which includes great food, drink tickets, entertainment, and more. The cost for Central Florida Health Alliance (CFHA) employees is $75 for one day, $100 for two days, or $150 for three days. The cost for non-CFHA employees is $100 for one day, $150 for two days, or $200 for three days. All prices include breakfast, lunch, and conference materials. Information: Becky Craine at bcraine@chfalliance.org or 352.323.5400
This huge white elephant sale will feature new and used items, including original artwork and crafts, plants, jewelry, books, puzzles, and home-baked goods. Any unsold items will be donated to charity. The event will be from 8a.m. to 2p.m. at 440 Fox Run Blvd., Tavares. Information: Eileen Brey at 352.343.4152 or Barb Graff at 352.552.3328
Get ready to shop at this event that benefits New Beginnings, a nonprofit that helps Lake County homeless children and their families. The festivities start at 10a.m. at Trilogy Orlando, 107 Falling Acorn Ave. Groveland. Tickets are $25. Information: 352.617.8788
Warm up with a bowl of chili in downtown Bushnell Plaza Park from 11a.m. to 1p.m. Prizes for the best chili will be announced at 1:30p.m. Wristbands are $5 and all proceeds benefit Sumter County Hospice and Lane Purcell Hospice Care. Information: Susan Bennett at 352.742.6807
After researching several companies to remodel our outdated kitchen, we selected Wildwood Kitchen & Baths for several reasons. They have an excellent professional reputation. When you enter their showroom, the quality and craftsmanship is very evident. We sat down with a very warm and personal Denise Berlin, co-owner and interior designer, to discuss our dream kitchen. It was a overwhelming task, but was made very easy by her knowledge and expertise. Measurements were taken at our home by co-owner Greg Berlin, where discussions of physical obstacles were overcome, such as removing two walls, insuring the intergrity of the roof, plumbing, and electrical considerations.
The craftmen were all very professional, courteous, and on time when working in our home. Our suggestions and concerns were always addressed promptly. Our kitchen is now the showpiece of our house. We would recommend Wildwood Kitchen & Bath to anyone considering remodeling. Whether it is a minor update or complete overhaul, Wildwood Kitchen & Bath is the company for you! DAN & MICHELLE GENTRY, SUMMERFIELD, FL
The fourth annual Memory and Movement Case Manager/Social Worker Symposium was held at Mission Inn Resort and Club. This event allowed care coordinators, certified disability management specialists, discharge planners, social workers, nurses, and educators an opportunity to earn up to 12 continuing education units (CEUs). Attendees also enjoyed food and beverages, as well as a reggae concert by local orthopedic surgeon Dr. John Williams.
1. Karen Deweese, Pamela Thomas, Ann Ford, Vanessa Garcia, Kristin Greenwell, and Maria Meneses
2. Anastassia Abramenko and Besnik Mecaj
3. Dr. Wade and Lynne Winker with Ted Williams
4. Ty, Heidi, and Mike Price
5. Suzann Turner and Darian Gomillion
6. Joseph Pressoir
SPONSORS: GIFT-IN-KIND SPONSORS:
Golf Vest Sponsor
Medical Imaging Professionals, P.A.
Silver Sponsor
Florida Emergency Physicians
Media Sponsors
Healthy-Living Magazine
Hometown Health TV, LLC
Printing Sponsor
Ford Press, Inc.
Cooler Sponsor
Johnson-Laux Construction
Golf Towel Sponsor
Mission Cardiovascular & Thoracic Surgeons
Golf Ball Sponsor
Urology Specialists of Lake County
Hole-in-One Sponsors
Data Graphics, Inc.
The Pepsi Bottling Group
Vann Gannaway Chevrolet, Inc.
Hole Plus Four Sponsors
Avante’ at Mount Dora
Bosshardt & Marzek Plastic Surgery Associates
Central Florida Pathology Group, P.A.
Coastal Mechanical Services, LLC
Electric Services, Inc.
Dr. Randy Glisson
Lake ENT & FPS
Lake Internal Medicine Associates, P.A.
Morrison Management Specialists, Inc.
North American Credit Services
PCL Construction Services
Shuffield, Lowman & Wilson, P.A.
TECO, People’s Gas System
United Southern Bank
Closest-to-the-Pin Sponsor
DG Promotions, Inc.
Tee Sign Sponsors
EZ Access Docs, P.A.
Gaylord & Rogers, L.L.C.
Keith Lemon
The Pepsi Bottling Group
Sumter Electric Cooperative, Inc.
Supporter Sponsors
Tara Dufrene
Proforma Albrecht & Co.
Vann Gannaway Chevrolet, Inc.
Waterman Communities, Inc. Workscapes
A 1 Orange Cleaning Service Co., Inc.
Advantage Waypoint
Bosshardt & Marzek Plastic Surgery Associates
Claudia’s Florist
Clerbrook Resort
Compass-USA
Deer Island Golf and Lake Club
Delaware North Companies
Parks & Resorts
Goblin Market
Harbor Hills Country Club
Lake Sentinel Lakeside Inn
Miami Dolphins, Ltd.
Mission Inn Resort & Club
Mount Dora Golf Association
Mount Dora Historical Inn B & B
O’Keefe’s Irish Pub & Restaurant
Proforma Albrecht & Co
RedTail Golf Club Golf Shop
Smallwood Sign Company, Inc.
Sun Publications
The Pepsi Bottling Group
U. S. Foodservice
Ultra Pure Bottled Water, Inc.
University of Florida Athletic Association
Vic’s Embers Supper Club
Waterman Communities, Inc.
Weyand Food Distributors
THANKS TO OUR SPONSORS!
$65,000 Raised for the Heart Center at Florida Hospital Waterman
Student veterans at Lake-Sumter State College now have a place to study, relax between classes, and connect with other veterans. The college recently held a special ceremony to unveil its Veterans Center Lounge. During the event, guests had an opportunity to tour the lounge, and the presentation of colors was presented by V.F.W Post 8087.
Heart disease is the leading cause of death claiming the lives of one in three women.
Go Red For Women® is the American Heart Association’s national movement to end heart disease in women.
Because our health is non-negotiable, because we have the power to save our lives, and because the best force for women, is women.
The Lake Sumter Medical Society’s 2013 Annual Meeting and Medical Expo was held at Mission Inn Club and Resort. This private tradeshow allowed vendors, physicians, and practice managers from throughout Florida to network with one another and share ideas. In addition, door prizes were given away. The Lake Sumter Medical Society serves as an advocate for physicians and patients by promoting high standards of care.
The symposium, which was held last October at Mission Inn Resort and Club, proved successful once again. The event featured networking, education, and celebrating the Case Manager of the Year from Central Florida hospitals. In addition, talented orthopedic surgeon Dr. John Williams conducted a fundraising concert to raise awarness of the challenges caregivers face. The event raised over $100,000 for the Dwight M. Cearley
Endowment Fund. The fund helps obtain respite care for caregivers providing for a loved one with a memory or movement disorder. For more information contact Dolly McCranie at 325•516•5425, Amy Cearley at 352•205•9316 or John Lazo at 352•603•3330
4TH
& MOVEMENT CASE MANAGER/SOCIAL WORKER SYMPOSIUM
WOULD LIKE TO THANK ITS SPONSORS AND ATTENDEESKaren e Harvey Promise Hospital Nanancy Arnold Leesburg rg g Reg R Re ion onnal al a M Medica a cal C Center er Ki Kim m im Hefelfinger So Sououth th L Lakake Hospital Geri i Pena The e Villa laages es gees g Re R gional Hospital al
Held Thursday, October 10, 2013 at Lake Receptions Proceeds supporting Florida Hospital Waterman Cancer Institute & Heart Center
Presented by:
Media Sponsors:
Exhibitor Booth Sponsors:
Acupuncture & Physical Therapy Specialists, Inc.
Cornerstone Hospice and Palliative Care, Inc.
Creations By JoAnn
Donald & Audrey Conry CREATION Health Center
Florida Hospital Waterman Cancer Institute
Florida Hospital Waterman Food & Nutrition
Florida Hospital Waterman Heart Center
Florida Hospital Waterman Home Care Services
Florida Hospital Waterman Pastoral Care
Florida Hospital Waterman Rehabilitation Center
Insight Credit Union
JoinThePinkArmy.com
KATYDID Enterprises
Landseair Travel Service of Eustis, Inc.
Morinda Bioactives - Velma S. Dawson PalmCourtGallery.com
Supporter Sponsors:
June Johnson
Auction & Prize Donors:
Acupuncture & Physical Therapy Specialists, Inc.
Blue Flame Promotional Agency, Inc.
Cornerstone Hospice and Palliative Care, Inc.
Creations By JoAnn
Delia’s Boutique
Florida Hospital Waterman Heart Center
Florida Hospital Waterman Home Care Services
Jimmie Jo Hixon
KATYDID Enterprises
Brenda Mulholland
Orlando Science Center
SAK Comedy Lab
At Florida Hospital Waterman, our patients’ health and wellbeing is our top priority. We know patients turn to us trusting we will do our best to get them back to their best. We’re committed to providing advanced, safe, compassionate care to each and every patient. And we’re proud to be recognized as Lake County’s safest hospital with the county’s only “A” Hospital Safety Score based on how well we protect patients from accidents, errors, injuries and infections. Visit FHWat.org to learn more about our commitment to safety and improving patient care.
www.hospitalsafetyscore.org
