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FALL IN LOVE with your legs! Complimentary Seminar
Meet Dr. Magnant & his team of providers for an intimate Q&A session. Limited seating. Call 239-694-8346 & mention code VS11
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ACCREDITED VEIN CENTER
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WeKnowVeins.com 239.694.VEIN (8346) Fort Myers
1500 Royal Palm Square Blvd., Suite 105
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3359 Woods Edge Cir., 102 2018 mylivinglocal. com Suite | OCTOBER
From the
Publisher E
very month I learn something new from reading the feature stories in livinglocal®. I’m continually amazed by the number of health conditions that stem from venous insufficiency and how Dr. Magnant is able to connect the dots for people who have been suffering for years. Sometimes even decades. This month’s feature is no exception. Read inside of a young woman’s struggle with chronic pelvic pain and how she found relief within one week of her treatment at Vein Specialists. Are you going “pink” this month? October is National Breast Cancer Awareness Month and the perfect time for us to shine our For a Greater Cause spotlight on Partners for Breast Cancer Care (PFBCC). This local non-profit organization provides mammograms, an important tool in the early detection of breast cancers, to women who are uninsured or those who do not have the financial means. In addition, PFBCC funds all follow-up diagnostic tests as well as treatment if a diagnosis is made. They are making a lasting impact on lives and we are honored to feature PFBCC and donate to their cause this month. Thank you, Vein Specialists for doubling our donation! October is also National Dental Hygiene Month, a reminder to make sure your dental health is in check. If you are wanting information on the ART DIRECTOR
Teddy Tedford Teddy brings a wealth of branding, marketing and creative experience to livinglocal®. Throughout his design career he has worked with local SW Florida businesses and luxury brands across the state.
mylivinglocal.com | OCTOBER 2018
— Audrey & her son Timothy
newest dental procedures, cosmetic options, or just general tips to keep up your healthy smile, we have it from the experts in SW Florida! The Florida Everblades season is just around the corner and we couldn’t be more excited to continue our partnership with them. If you haven’t already, like and follow us on social media – we will be giving away tons of tickets. And while you’re at the game, check out the visitor’s penalty box. A special thank you goes out to our readers and followers that participated and voted on our new sign! Before you get reading, don’t forget to visit us online at mylivinglocal.com. It’s all that makes livinglocal great and so much more. There you may view our current magazine, search past articles and find great incentives…and share it with your friends and family too! Thank you SW Florida friends for “living local” with us!
Audrey
LOCAL CONTRIBUTOR
Gina Birch Gina is a freelance writer for USA Today 10Best and a well-known TV & radio personality in SW Florida. Google her blog, “The Birch Beat” and follow her on Facebook & Twitter @GinaBirch.
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Steve Burgio
Dr. Joseph Magnant
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Vein Specialists
Sal & Alex Basile
Dr. Michael Collins
Dr. Samanta Andisco
Richard Romeis
Janet Noack, CPA
Robin Powers
Dr. Carmella Fernandez
Theresa Clements
The Saucy Meatball
Collins Vision
s.m.i.l.e. dental
Noack & Company
Gardner Orthopedics
MedSpa Del Mar
Fernandez Upper Extremity Institute
Fast & Frugal Interiors
Recipe of the Month
The Saucy Meatball Our mission at livinglocal includes spotlighting local non-profits that are making a difference in our community. In addition to sharing their story, we also provide a monetary donation on behalf of our advertisers. In honor of Breast Cancer Awareness Month, we are featuring Partners for Breast Cancer Care. This organization’s mission is to save lives and reduce suffering from breast cancer through improved early detection, education, and access to healthcare. They are dedicated to serving our community’s women and men who desperately need help by funding breast screening, diagnostic testing and treatment at no cost to them.
Serving Fort Myers, Estero, Bonita & Naples C O NNE CT W ITH U S
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mylivinglocal.com | OCTOBER 2018
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Pelvic Pain C
hronic pelvic pain is a common problem in women, but because of its private nature, many patients suffering from it don’t talk about it openly. Women with this kind of pain typically seek help from their OB/GYN specialists, as well as a range of other specialists, only to be told nothing is wrong or there is nothing that can be done to help them. B u t t hat ’s simp l y not t he c ase according to Dr. Joseph Magnant, fo u n d e r of Ve i n S p e c ia l i s t s . H e says women, as well as men, with unexplainable pelvic pain could be suf fering from a venous condition called Pelvic Congestion Syndrome (PCS).
PCS is a condition characterized by the following signs or symptoms: large varicose veins from the groin, vulva, or gluteal fold; leg swelling, ulcers or stasis dermatitis; pain in the pelvis and abdomen with squatting or crouching; painful intercourse; painful menstruation; pain in but tocks, posterior thigh, or knee with prolonged sitting or standing. mylivinglocal.com | OCTOBER 2018
PCS may be secondary to iliac vein compression where the iliac veins narrow or become blocked by the overlying artery, essentially being pinched between the artery and the lumbar spine. This causes blood to back up in the legs and other collateral pathways must develop to drain the lower extremities and the pelvis. These pelvic varicose veins may wrap around the ovaries, uterus, vagina, bladder, and even the bowel. Other signs or symptoms may include buttock pain, varicose veins in the vulva or buttock fold area, and achiness in the posterior thigh down to the knee, typically worse around menstruation. That was the case with Lindsay. Her problems began during her second pregnancy; she was only 28-years old. The young mom says, “I started noticing a lot of leg pain and swelling; my feet were huge.” In addition, “The back of my thigh was throbbing, aching with pain. I developed a varicose vein in the back of my leg and could pinpoint that spot as the source for a lot of my pain.”
“I felt relief within a week of treatment.” — Lindsay She had trouble staying on her feet during the day and suffered from restless leg syndrome at night. Her doctors attributed the pain to her pregnancy and advised wearing compression stockings. That’s not an easy task for a pregnant woman in Southwest Florida who needs compression up high, around the groin. After she delivered her baby, the pain didn’t go away. “It became unbearable after my fourth pregnancy,” says Lindsay, “I was 32 and too young to be feeling like I was. I couldn’t be on my feet all day, yet I had toddlers to run after. The pain was drastically impacting my life.” That’s when she turned to Vein Specialists and Dr. Magnant for help with her varicose vein. “The vein had gotten so big. It was bulging from my inner thigh and groin, around the bottom of my butt, and then down my leg to the knee.” After ultrasounds of both legs and pelvis, she was diagnosed with severe venous insufficiency, as well as left iliac vein compression or May Thurner syndrome, an often-overlooked cause of Pelvic Congestion Syndrome.
Joseph G. Magnant
MD, FACS, RPVI Vascular Surgeon & Vein Expert
Although her pain was on the right side of the body, the problem was on the left; an 80% narrowing of the left common iliac vein. Through a high-tech intravascular ultrasound (IVUS), the vein was opened back up with a balloon and stent. Technology has made this disease much easier to diagnose than in the past according to Dr. Magnant. In addition, he says, “There has to be some imagination by doctors. If people complain about pain and a specialist can’t find anything, one needs to consider there may be a vascular problem.” Pelvic Congestion Syndrome is not something that just affects young or pregnant women. Men and women of all ages may be affected by it as well. Painful intercourse (dyspareunia)is another symptom of PCS. “Some women with pelvic congestion syndrome haven’t had sex in years because the pain is so bad. Their husbands say they are making excuses and the OB/GYN may prescribe antidepressants labeling the pain as psychogenic,” says Dr. Magnant. mylivinglocal. com | OCTOBER 2018 Continued on next page
ILIAC VEIN COMPRESSION SYNDROME Signs & Symptoms “I had a 69 year old woman who had been suffering for 15 years from pelvic pain. She had a high grade narrowing of left iliac vein which we were able to diagnose with IVUS and treat with a stent. Within a week after her procedure, she had complete resolution of pain,” says Dr. Magnant. She and her husband we able to experience intimacy without pelvic pain once again, within a week of her procedure.
“I was 32 and too young to be feeling like I was. I couldn’t be on my feet all day, yet I had toddlers to run after. The pain was drastically impacting my life.” — Lindsay
Lindsay felt relief from her venous pain within a week after her treatment. She says, “I recently went to Walt Disney World with my family and walked all day for four days straight. I didn’t even think about sitting, putting my legs up, or how to get comfortable in a hotel room with pillows under my feet.” She adds, “I always knew when my period was coming because I would be in so much pain in my legs, but now I can’t tell at all.” She doesn’t have to wear clothing to hide compression stockings either. “I feel young again, not like a 30 year old in an 80 year old body.”
Joseph G. Magnant mylivinglocal.com | OCTOBER 2018
MD, FACS, RPVI Vascular Surgeon & Vein Expert
Large varicose veins from the groin, vulva, or gluteal fold Leg swelling (one or both legs), one leg may be larger than the other Discolored leg skin and non-healing leg ulcers Pain in the pelvis or abdomen with squatting or crouching Pain in the buttocks, posterior thigh or knee with prolonged sitting or standing Painful intercourse (during or after) & increased pain with menstruation “Women rarely talk openly about their pelvic congestion symptoms,” says Dr. Magnant. “It’s very personal. Most will go to their gynecologist for assistance and perhaps undergo laparoscopy for their PCS, 20-40% of which are negative for pathology. So what do they have?”
“I feel young again, not like a 30 year old in an 80 year old body.” — Lindsay He continues, “There are more patient s with a treatable cause of the their pelvic pain than we realize and many of t hem may have iliac vein compressi o n s y n d ro m e o r M a y T hu r n e r syndrome as the underlying pathology.” I f you have any of t he ab ove symptoms and have been unable to find answers for their cause, call Dr. Magnant at Vein Specialists today.
www.WeKnowVeins.com
About Dr. Magnant Dr. Magnant grew up in Northern Virginia, the son of a pediatrician. Of the eight Magnant children, six attended and graduated from the Medical College of Virginia. Dr. Magnant went on to complete his general surgery residency at the Medical College of Virginia and performed a vascular surgery fellowship at Dartmouth-Hitchcock Medical center in Hanover New Hampshire. After 14 years of arterial vascular surgery in private practice, the accomplished surgeon, his wife Patty and their two children left Rome, Georgia to open Vein Specialists in Southwest Florida. Since then Vein Specialists has become the premier vein center in Southwest Florida. Dr. Magnant not only has a strong commitment to family but also community by supporting local charitable organizations, including Make a Wish Foundation, Ronald McDonald House Charities, Special Equestrians and others!
|
(239) 694-VEIN (8346)
3359 Woods Edge Cir., Suite 102 Bonita Springs, FL 34134 1500 Royal Palm Square Blvd., Suite 105 Fort Myers, FL 33919
mylivinglocal.com | OCTOBER 2018
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TA K E C A R E
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OF YOUR
You’re skin is one of the first things people notice when they look at you, and it can give your age away in an instant. Skin and beauty are two things Robin Powers has dedicated her career to at MedSpa del Mar on Fifth Avenue South in Naples. As an aesthetician, she performs luxurious and rejuvenating facials as well as more powerful laser treatments to repair aging, sun-damaged skin, and improve the appearance of fine lines and wrinkles. She went to school for graphic design and worked in the Boston area for 15 years, saying, “I always liked the art field and that led me to makeup, which then led me to medical spas and working with skin.” As an aesthetician, Robin is certified to perform many different types of medical aesthetic treatments. Her extensive training and knowledge of skin gives her the ability to create customized treatments resulting in younger, healthy and more vibrant skin. Not only does Powers administer facials and chemical peels at MedSpa del Mar, she is also an expert in many areas, from eye lash extensions to the most advanced and powerful laser treatments available. With her certification, Robin is the “go to girl” in SWFL for Icon laser treatments that repair aging, sun-damaged skin. One of her favorite treatments to perform is micro-needling that she says, “creates micro channels in your skin; the healing process producing new collagen and elastin.”
Denise Morris, owner of MedSpa del Mar, says, “Robin is one of our very talented and experienced aestheticians. She is caring, conservative and great at what she does. She is that person who will always do the right thing by her clients.”
Sun damage is one of the most common skin issues she deals with, explaining, “People say ‘I don’t spend time in the sun’ but when they walk their dog or drive a car, they are in the sun. Sunscreen is so important, which is why we only offer ZO Skin Health by Dr. Obagi, Neocutis and SkinCeuticals sunscreen and skin care at MedSpa del Mar.”
“I love seeing positive changes in someone’s skin,” says Powers. “It’s like being a detective, uncovering what’s going on and then fixing it. It’s very rewarding.”
“Protection is the best defense against aging and skin cancer,” the aesthetician advises.
898 5th Avenue S. #204, Naples 239-315-4492
Dr. Manuel Peña, M.D. Medical Director
medspadelmar.com mylivinglocal.com | OCTOBER 2018
Dr. Collins performing LASIK surgery on Lily
SEEING MORE CLE RLY WITH LASIK
V
L
ASIK surgery is the most popular refractive surgery in the United States and it has a remarkable success rate when it comes to helping patients see better. It’s one of the many surgeries you’ll find performed by Dr. Michael J. Collins, Founder and Medical Director of Collins Vision. In this delicate surgery, a thin flap is made in the cornea. The flap is gently folded back, so the surgeon can reshape the cornea to correct nearsightedness, farsightedness, and even astigmatism. More than 96% of patients who have LASIK surgery are happy with the results. Lily Nunez is one of those happy patients. “I started having problems with my vision in the 4th grade,” she says, “I couldn’t see the black
board and it was affecting my grades.” After a routine eye exam she was given her first pair of glasses. At the age of eleven, she ditched the glasses for contacts and successfully wore them into her late 20’s. Soon after that, she could no longer find comfortable contacts. “I changed brands, I tried different types, and nothing was working,” she recalls. Lily was familiar with LASIK, had done her homework, and called Collins Vision for a consultation to see if she was a candidate. She was indeed. When it comes to choosing an eye surgeon, Dr. Collins says, “The most important precaution you can take is to find a surgeon trained and qualified to confirm that the procedure is truly right for you.”
FORT MYERS OFFICE
6900 International Center Blvd. mylivinglocal. com | OCTOBER 2018
by Gina Birch
NAPLES OFFICE 860 111th Avenue North
He says, “I see a fair amount of patients that should never have had a particular procedure, and I can tell you from experience that it is much easier to do the procedure the right way, than to try and fix it.” Furthermore, the idea that a discounted LASIK procedure is just as good as an expensive one is a myth according to Dr. Collins. “Differences in practice prices are due to the competence and size of the staff, the access to the surgeon, whether or not a blade is used, the quality of the lasers, and the level of pre-operative diagnostic imaging and testing involved in determining candidacy.” Collins Vision does not cut costs when it comes to taking care of their patient’s vision. They offer the best and most comprehensive treatment available. These are some of the many reasons why Lily went to Collins Vision. The day of surgery she was a little anxious. “It was really just fear of the unknown. The staff was amazing. They made me feel comfortable and walked me through everything.” Once in the surgery room, she says, “Dr. Collins did an amazing job of explaining everything in great detail to me. He literally told me everything he was doing and it helped so much.” As her anticipation began to build and the procedure was about to start, she remembers, “I grabbed the table. Then I felt someone touch my hand. They held it the entire time. It was a moment I wont forget; how caring Dr. Collins and everyone was.” As it turns out she experienced little discomfort, the procedure was fast, and when she sat up, Lily could see across the room. She says, “It was a little foggy, not blurry, but I could actually see the clock on the wall. That was major.” The day after her LASIK surgery Lily says, “I woke up and could see the green trees, I could see the leaves and thought this is how life is suppose to be. Today I feel like nothing had ever happened, as if all those years of glasses and contacts were erased from my memory. I could not be more happy.”
CollinsVision.com
What to Expect at Your LASIK Consultation Appointment
CHECK-IN
We’re so excited you are here! Be sure to grab a cookie (or 2) and some coffee while you finish filling out your new patient paperwork!
TESTING
We don’t cut corners. Prepare for your technician to perform the most comprehensive eye exam you’ve ever had! At our practice, every detail matters to ensure your best surgical results!
EXAM
Dr. Collins will review the test results, personally examine your eyes and discuss your expectations and personal goals in regards to your vision.
COUNSELING
A surgical counselor will recap your visit, including Dr. Collins’ recommended treatment plan to make sure you feel educated, prepared, and excited about your upcoming surgery!
239.936.4706 mylivinglocal. | com
OCTOBER 2018
Southwest Florida Businesses & Physicians! We’ve Got You Covered Dr. Michael J. Collins EYE CARE COMMITTED TO QUALITY
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BEST HOME SERVICES
o i g r u B Steve IS PROUD TO RECOGNIZE
AIR CONDITIONING • ELECTRICAL • PLUMBING • DRAINS mylivinglocal.com | OCTOBER 2018
BEST
Home Services, Southwest Florida’s leading home service company providing exceptional air conditioning, electrical, and plumbing services to residents from Naples to Bradenton for the last 38 years, is pleased to recognize plumbing technician Steve Burgio and his 1 year of service with the company. Steve became a part of the Best Home Services family in September of 2017. Steve has seen and been a part of the rapid growth and development of Best Home Services in the Southwest Florida area. He feels that the word “awesome” is the best way to describe the company. “Keegan and Chadd know how to run a company,” Burgio said. “The management is accommodating to employees, they make sure that everyone has what they need.” We asked Steve, as a plumbing technician, what advice does he have for his customers in Southwest Florida. He says that if you have a leaky toilet, faucet, or hot water heater turn off the main valve, and wait for the Best Home Services to get to your home. Steve believes that the best thing to do when helping customers is to give them good and honest advice. “Don’t push customers to buy things that they don’t need,” Burgio said. “Only try and recommend what they need.” Steve has learned in his position as a plumbing technician that sometimes customers like to focus on their wants, and not their needs. “Make sure that the customer is getting what they need,” Burgio said. “I always talk about the most important issues that the customer is having with their plumbing, before talking about what they want.”
Steve, who is originally from Rochester, NY, moved to Southwest Florida because he was tired of the cold weather in New York. “When I first moved to Florida, I lived in Clearwater,” Burgio said. After living in the Tampa Bay Area for four years, Steve realized that he didn’t like the traffic in Tampa. “I didn’t like the busyness in Tampa, and I wanted to live somewhere slower.” Last year, Steve decided that he was going to move to Southwest Florida. “Living in Southwest, FL is the slower life that I wanted, and I’m happy at Best Home Services.” Steve is in a committed relationship with his lifelong-partner Dawn Smith. Steve has two kids that live in New York. When Steve isn’t working, he’s out finding the best fishing spots in Southwest, FL. “I fish all over the place.” I fished in some of the ponds in Tampa, Captiva, Sanibel, and the Skyway Bridge.”
PLUMBING of the monthTIP If you have a leak, turn off the main valve!
Best Home Services is a local, family owned and operated company that is focused on caring for their customers and the community. Their team relentlessly works to continuously improve their service in order to make Southwest Florida homes safer, more comfortable, and more efficient-one job at a time! To learn more about Best Home Services’ story and their Best Home Services Guarantee, please visit their website at w w w.get b est .com or c all 239-217-1698.
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3 Locations In Naples & Bonita Springs
Naples - 1575 Pine Ridge Rd & Naples - 1514 Immokalee Rd Bonita - 3300 Bonita Beach Rd •
General & Cosmetic Restorative Dentistry for the entire Family OCTOBER SPECIAL
99
$
includes
REGULAR CLEANING X-RAYS EXAM Doctors Samanta Andisco & Robert Bracho
Valid through October 31st. D0274, D0330, D0150, D1110
9500 Bonita Beach Rd. SE • Suite 301, Bonita Springs • 239-319-2440 SmileDentalBonita.com smiledentalbonita mylivinglocal.com | OCTOBER 2018
D E N T A L for
H E L P
Sleep Apnea Relief
Sleep Apnea is a condition in which people stop breathing during their sleep. It could happen a few times, a few hundred times, and for periods that can exceed a minute. It’s a condition that Dr. Samanta Andisco, co-owner of Smile Dental Bonita Springs, has dedicated herself to treating; so has her partner, Dr. Robert Bracho. Sleep Apnea is a medical condition that, for some patients, can have a dental solution. Dr. Andisco explains, “It has to do with not getting enough air into your body through your nose or mouth. Because dentists deal with the mouth, we can often help.”
To be diagnosed and get treatment for Sleep Apnea, a patient must undergo a sleep study. Depending on results, doctors often recommend a breathing machine known as CPAP. But not everyone can or wants to wear one at night. This is where Dr. Andisco comes in. She can fit a patient with a mandibular repositioning device; a custom fit mouthpiece that advances the jaw forward. Dr. Andisco explains, “This allows the tongue to move forward as well and therefore more air can enter your airways through the mouth rather than the nose.” She became interested in Sleep Apnea five years ago when her mother was diagnosed with it. Dr. Andisco says, “I felt like I needed to learn and get trained so I could help her.” She has crafted three different devices for her mom, saying, “She loves them all and they all work.” Impressions and scans are done to create individualize mouthpieces that allow a patient to breath better and sleep in comfort—not just the patient, but their partners too.
9500 Bonita Beach Rd. SE • Suite 301, Bonita Springs • 239-319-2440 SmileDentalBonita.com smiledentalbonita mylivinglocal.com | OCTOBER 2018
OSTEOARTHRITIS& PHYSICAL THERAPY New Treatment Options By Gina Birch
“I want to help people walk out of here with less difficulty and less pain. I want to see them smile.” Richard Romeis
D IRE C TO R OF P H YSI CA L T H E RA PY
I
f you’ve ever suffered a serious injury to a bone or joint, or have undergone surgery to fix them, you probably already know the important role that physical therapy (PT) plays in healing. PT is also extremely beneficial for people suffering from osteoarthritis. On the cutting edge to help these patients is Gardner Orthopedics, with new technology and equipment that is producing great results. “Blood flow restriction is one of the latest and greatest treatment techniques,” says Richard Romeis, director of physical therapy at Gardner. However, not all blood flow restriction devices are created equal. Gardner Orthopedics is the only clinic in Southwest Florida with Delfi, one of the
mylivinglocal.com | OCTOBER 2018
most advanced and effective systems for blood flow restriction therapy. In this type of therapy, cuffs are placed on a patient’s arms and/or legs during PT exercises. The cuffs create a partial occlusion of blood flow, which allows a muscle to hit the point of fatigue at lower intensity exercises rather than higher. For example, Romeis says, “If I want to make my bicep bigger I need to curl 50 pounds. With blood flow restriction, I only need to use 10 pounds to get same results.” When a muscle is fatigued, lactic acid builds up. When lactic acid builds up, it sets off a chain of events that result in strength building and improvements in
muscle size. Many people who are recovering from surgery or injuries, who are in pain, or who have osteoarthritis, are physically unable to hit the point of fatigue necessary for gaining strength. Because the cuffs partially restrict blood flow, fatigue can be achieved at a level of intensity that almost anyone can manage, regardless of how weak they might be or how much pain they are experiencing. In addition, this type of training has an analgesic effect, according to the therapist, which helps to decrease pain. “It is recommended to do this two to three times a week for 6 weeks to achieve the full potential.” However, Romeis says, “Results can be seen in as little as two weeks.” Blood flow restriction is most often used to improve function for patients with issues in the joints of the arms or legs, but has a wide range of application possibilities. The Delfi cuff system used at Gardner Orthopedics is unlike any other. Its pressure adapts during movement to fit the needs of each individual rather than a standard setting. The cuffs are wider, safer, and easier to apply higher up on limbs. In addition, “The system is able to maintain that individualize pressure during a patient’s dynamic movement for consistent, partial occlusion of blood flow,” says Romeis. It’s a treatment that Romeis is excited about. “Overall improvement of a patient’s function and movement is home base for a physical therapist in an outpatient setting, and this method is a great help.” Romeis first started working for Dr. Ronald Gardner at the age of 18, at the front desk. Today he has a Doctorate in Physical Therapy from Florida Gulf Coast University and is a board certified specialist in Orthopedic Physical Therapy. Romeis has received extensive training and while passionate about helping people with osteoarthritis and those recovering from injury, he chuckles, “I’m a therapist not a magician. While I cannot promise to reverse arthritis, I can help with range of motion, strength, pain control, flexibility, and balance.”
Blood flow restriction can be tricky, so Romeis advises due diligence for anyone looking to begin this therapy, especially in places such as gyms. “It’s important for a therapist using this method of treatment to have the training that I have and to know how to apply this treatment in a clinical setting.” Romeis says, “If I can use blood flow restriction as part of the therapy process to improve lives, it’s like a dream come true. I want to help people walk out of here with less difficulty and less pain. I want to see them smile.” To explore blood flow restriction physical therapy, call Gardner Orthopedics.
3033 Winkler Avenue • Ft Myers
Dr. Ronald Gardner
(239)277-7070
www.GardnerOrthopedics.com @moreoptionslessrisk
@gardnerortho239
mylivinglocal.com | OCTOBER 2018
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mylivinglocal.com | OCTOBER 2018
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mylivinglocal.com | OCTOBER 2018
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mylivinglocal.com | OCTOBER 2018
Carpal Tunnel Syndrome
D
Facts & Treatment
o you ever find yourself waking up in the middle of the night, shaking your hands to wake them up? Have you ever dropped your favorite coffee cup because you didn’t have feeling in your hands? If you said “yes” to either of the aforementioned questions, you may be affected by carpal tunnel syndrome. What is carpal tunnel syndrome? Carpal tunnel syndrome is the most common compressive neuropathy of the upper extremity. It is essentially a pinched nerve in the wrist which can produce numbness and tingling in the hand as well as weakness. Initially symptoms are often intermittent, occurring in the evening and periodically throughout the day, however can become constant with long standing compression. Where is the carpal tunnel and what are the components of the tunnel? The carpal tunnel is a space in the wrist, near the palm of the hand, that
resembles a tunnel. The walls of the tunnel are formed by the small bones in the wrist, called carpals, and the roof of the tunnel is formed by a firm, thick ligament. The ligament is called the Transverse Carpal Ligament. The contents of the tunnel include a total of 9 tendons whose purpose is to move the fingers as well as one nerve, called the median nerve. Who gets carpal tunnel? Carpal tunnel is approximately five times more common in women than men, and affects patients of all age groups, however is most common between the ages of 30-60. Individuals with medical comorbidities such as diabetes or thyroid disease have a predisposition to developing carpal tunnel syndrome, however advancing age, genetics, and obesity also predispose individuals to developing carpal tunnel. During pregnancy, women experience fluctuations in hormones associated with fluid shifts which can result in swelling within the carpal tunnel producing symptoms. In addition, traumatic injuries to the wrist can cause swelling, producing carpal tunnel. How is carpal tunnel diagnosed? Carpal tunnel is primarily a clinical diagnosis, however there are also electrodiagnostic tests, such as nerve conduction and electromyography, which can be useful when evaluated in conjunction with a thorough clinical exam.
1012 Goodlette Frank Rd Ste 101 | Naples, Florida | 239-777-9321
mylivinglocal.com | OCTOBER 2018
What are treatment options for carpal tunnel syndrome? There are a number of nonsurgical and surgical treatment options for carpal tunnel syndrome. Nonsurgical options range from night splints to corticosteroid injections within the carpal tunnel. Surgical options involve release of the transverse carpal ligament and this can be performed via an open incision within the palm of the hand or through a small incision in the wrist utilizing a camera. The decision to proceed with nonsurgical versus surgical treatment is primarily based on the severity of the symptoms at presentation while taking into account the patient’s overall health. What is the best approach to carpal tunnel syndrome? Dr. Fernandez’ treatment plan is primarily based upon her findings during the clinical exam. Unfortunately, compression of any nerve can potentially lead to permanent nerve injury if it is not treated, so she urges patients with symptoms to come in for an evaluation. If surgery is chosen, Dr. Fernandez is pleased to offer her patients’ an endoscopic release for their carpal tunnel. Studies have cited numerous advantages to the endoscopic approach over the open approach to carpal tunnel decompression such as the following: less postoperative pain, faster return to functional activities, and an improved early grip and pinch strength. Fernandez’ clinical results parallel these outcomes, allowing her patients to return to hobbies they love such as golf, tennis, and pickleball. If you or someone you know is suffering from carpal tunnel syndrome, please contact Fernandez Upper Extremity Institute at 239-777-9321.
Dr. Carmella Fernandez
BOARD CERTIFIED ORTHOPEDIC SURGEON
Dr. Carmella Fernandez is a dual fellowship trained Orthopedic surgeon, specializing in non-operative and operative treatments for the hand, wrist and elbow. She has an established private practice, The Fernandez Upper Extremity Institute, in Naples, FL.
mylivinglocal.com | OCTOBER 2018
Fast&Frugal INTERIORS DESIGN With An EDGE
H
TIP OF THE MONTH Cabinets are one of largest features in your kitchen
ome improvement shows are some so when it comes to replacing them it can be very of the most addicting programs on expensive. If they are in good condition structurally, repainting them. Even if you hire a television. They can inspire you to take consider professional painter and add new hardware you on a new decorating project or redo your will have exactly what you were looking for…a fresh entire home décor. But looking at all of the new look to your kitchen at a fraction of the cost! various patterns, textures and styles can If you need more direct assistance, be a tad bit overwhelming if you have no Clements says, “Get on your running shoes, idea where to start. we’re gonna work.” She will become your – to furniture, That’s when you call Theresa Clements, personal shopper, taking –you owner of Fast and Frugal Interiors. For over consignment and home improvement stores 25 years, she’s been bringing her client’s to find the perfect accent pieces, paint colors visions to life through interior design. She’s and more, all within your budget. even been featured on HGTV thanks to her About her job, Clements says, “It’s exciting unconventional technique. for me to open new doors to clients and give
In the beginning of her career as part owner of Galloways, Clements and Associates in Royal Palm Square, she had what she calls ‘a dream team’ of architects, designers, builders and contractors, at her disposal. Fast and Frugal is a spinoff of sorts, targeting the everyday homeowner who wants to transform their living space but needs expertise. She says, “I’m trying to reach people who wouldn’t think of calling a designer.” Although the name speaks to her efficiency, Clements makes sure to spend adequate time with each client in order to capture their vision in the most accurate way.
them a way to solve what they thought was a huge problem.” She continues, “Once you see their vision, the fun thing is giving them the best version of that vision.”
If a home consultation is all you have the budget for, she will come in and decide on a game plan, giving you a road map of where to go and how to achieve exactly what you want.
1637 HENDRY STREET • FORT MYERS • 239-936-1231 mylivinglocal.com | OCTOBER 2018
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2775 N Airport Rd • #102 • Ft Myers mylivinglocal.com | OCTOBER 2018
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2018 Tax Planning
Don’t Wait until the End of the Year! By Janet Noack,
The passage of the new tax reform act is the most sweeping tax reform in more than 30 years. It requires a well laid-out plan to maximize your benefits. If you have asked yourself these questions, you need to schedule a meeting with your tax advisor. How are the new tax laws going to affect me? Am I going to save on taxes? Will I owe more tax? Are there opportunities to grab or pitfalls to avoid? Income taxes play a major role in the business and personal decisions we make everyday. If you are using 2017 as the savings guide for your 2018 taxes, in all likelihood you will miss out on a substantial amount of savings. That being said, there is a good chance you are saving too much that could be reinvested for business or personal use. With the new tax reform, business owners have an opportunity to avoid tax on 20% of their 2018 business profit. Therefore, a tax strategy plan must be in place and accomplished prior to year-end. There are many qualifications that MUST be met prior to the new year and it is specific to each taxpayer’s situation.
Do you know
CPA
Your year-to-date profit for 2018? Your projected profit from today until the end of the year? Your 2018 projected tax liability? If you are paying the correct amount of wages for maximum benefit? Your specific tax situation and the options to lower your 2018 tax liability? If you were unable to answer “yes” to all of these questions, please reach out to your tax advisor. Our firm has already had many tax strategy meetings with our clients and we continue to schedule more. Clients have been surprised to learn that there is specific action required to receive the BEST advantage of the new legislation and that this varies based on the individual’s situation. The new tax code remains lengthy and complex, but with careful analysis and expertise, this new legislation presents opportunities that may benefit you. We encourage you to plan now and receive all of your potential benefits for 2018.
www.cpaofflorida.com Ft Myers (239) 936-6144 Naples (239) 591-3461 Sanibel (239) 395-1132
mylivinglocal.com | OCTOBER 2018
Classic Italian With A
I
MODERN TW ST
f you’ve been in Southwest Florida for any length of time and you love Italian food, chances are you know, or know of, Sal Basile. The longtime restaurateur is part of the brains behind The Saucy Meatball in Gateway Estates, Fort Myers; his son Alex is the other half. At the age of 10 Sal was putting slices on the counter of his family’s pizza parlor in New Jersey and later mastered the art of pizza making at a shop in Brooklyn. His first restaurant partnership came at the age of 18; Giuseppi’s, located at Miner’s Corner in Fort Myers. However, he might best be known for Taste of New York. Sal has opened numerous successful establishments over the last four decades, and is now poised to hand over his restaurant reigns to Alex, who started making pizzas in one of Sal’s restaurants at the age of 12. The apple doesn’t fall far from the tree.
mylivinglocal.com | OCTOBER 2018
By Gina Birch
The Saucy Meatball is Alex’s first big project. It’s modern with a younger vibe but still has that friendly neighborhood feel. It may not be classic Italian in appearance, but you’ll find classic Italian food from family recipes, along with dishes that have decadent and fun twists. Take for instance the Drunken Sicilian Pizza; you’ll need a knife and fork to eat it. A perfectly cooked pie is layered with mozzarella, ricotta, bacon, chicken and tomato, and then topped with rigatoni in vodka sauce. Pasta on top of pizza? Carb lovers will think they’ve died and gone to heaven. Keeping up with times, The Saucy Meatball also has a gluten free menu and several more healthful options such as the Oriental Salmon Salad. It is a generous bed of mixed greens tossed in a mandarin ginger dressing, sprinkled with almonds, pineapple, and mandarin
SaucyMeatball.com
www.
oranges. Then it’s topped with a perfectly grilled piece of salmon. One of many things about this restaurant that stands out to Sal is, “When you have a smaller place like this you have the ability to really watch the food. It’s great for quality control.” Alex adds, “It all goes out hot and fresh. It doesn’t sit in a window allowing the cream to change or the sauces to thicken up.” Happy Hour is now seven days a week from 2-6:30, with drink specials and Saucy Snacks. Many of the 14 beers on tap are local or from Florida, the wine list has much more than Italian brands, and the creative cocktails are made from wine based spirits. Alex drew on his experience bartending at their sister restaurant, Two Meatballs in the Kitchen, to come up with items like a fresh Lemongrass Mojito. The lemon grass comes from the restaurant’s herb garden. A favorite is the refreshing Limoncello Martini topped with prosecco. New to the lineup is red sangria made with Angry Orchard Rosé Cider; it’s an all-day sipper. The portions are generous and even
if you don’t have room, you must make room for dessert. The bread pudding changes often, however, ours was made with chocolate chip cookie dough and a sinful Nutella ganache, with a scoop of vanilla bean ice cream; WOW. Cannoli Chips is another WOW dessert. A huge bowl of cannoli cream filling is surrounded by pieces of crispy cannoli shells dusted in powdered sugar for dipping. It’s perfect for sharing. The Saucy Meatball is like two restaurants in one, with a takeout counter in the front serving slices and sandwiches for lunch, and the full-service restaurant with outdoor seating in the back. The kitchen can accommodate catering, even on a busy night. The restaurant will soon hit its one-year mark and there are plans to add a homemade pasta station among other things. About stepping into the shoes of his popular father, Alex says, “It’s bitter sweet. He has helped us and worked hard for us our whole lives. It’s good to know he will always be here, but it’s time for him to finally relax a little. It’s in my blood to keep things going.”
Lunch 11:00Am -4:00 pm Dinner 4:00pm-9:30 pm
239.800.7172 • 12401 Commerce Lake Drive, Ft Myers (Gateway)
mylivinglocal.com | OCTOBER 2018
Free M A M MOG R A MS for Southwest Florida’s Uninsured and Underserved
O
ctober is Breast Cancer Awareness Month and a perfect time to shine a spotlight on a local organization that helps low income and uninsured women and men pay for mammograms, diagnostic testing, and breast cancer treatments. “Partners for Breast Cancer Care (PfBCC) is the best kept secret in Lee County,” says executive director Janet Darnell. But she wants the secret out of the bag, especially since the non-profit is expanding its footprint to Hendry, Glades, Collier, and Charlotte Counties where volunteers and healthcare professionals are needed to join the life-saving organization. The initiative began in 1991 with a grant to study who in Lee was not getting mammogram screenings and why not. Volunteers literally went door-to-door in low-income, at risk neighborhoods, and found lack of finances was a top culprit. The grant also provided money for some of these women to get mammograms, but if a problem was found, there was no funding for more testing or treatment; they were left hanging.
mylivinglocal.com | OCTOBER 2018
By Gina Birch
That planted a seed for what is today, Partners for Breast Cancer Care. Founders got hospitals, surgeons, doctors, and others to provide their services for underserved men and women at negotiated rates and at no cost to the patient. Janet says, “Those fees have remained the same for 28 years. We have more than 100 partners in health.”
“I don’t know what I would’ve done without PfBCC.” —Canady Benjamin
Money to pay those negotiated fees comes from grants, donations, and fund raising. More is needed. Janet is not only the executive director of PfBCC, she is also a former client. A single mom with no insurance, working long hours to keep her cleaning business going, Janet was led to get a mammogram after seeing a television program on breast cancer. She scraped together just enough money to get the screening only to find out she needed more testing and she couldn’t afford it. PfBCC paid for her needle biopsy. She had cancer. PfBCC stepped in again to fund her lumpectomy and radiation, essentially saving her life. Janet said, “I knew I had to give back, so I started volunteering.” That was nearly 20 years ago. She has been executive director for the last 12. “It breaks my heart that there are people who don’t know about us and don’t get treatment because they don’t’ know where to turn,” she says.
“For A Greater Cause” is a monthly initiative of livinglocal, spotlighting a local nonprofit that is making a difference in our community. livinglocal also makes a monetary donation to the nonprofit on behalf of its advertising partners.
According to Breastcancer.org, every three minutes a woman is diagnosed wit h breas t cancer and close to 200,000 new cases are diagnosed each year. Canady Benjamin was one of those women. She found a lump in her breast, but had just started a new job and didn’t have insurance. She says, “I kept praying that God would take it away. I didn’t want to deal with it.” After seeing a flier in her break room about Partners for Breast Cancer Care, Canady picked one up and called for help. She was sent to a doctor, got a mammogram, and then a biopsy at no cost to her. Then she got the call. “The doctor said, ‘I really don’t want to do this over the phone, but you have cancer. It’s progressive and I don’t want to waste time.’” Her cancer was stage two but she also had the nefarious BRCA gene. By the time she made it to surgery, the cancer had spread to her lymph nodes. Now cancer free, Canady says, “I don’t know what I would’ve done without PfBCC. I would’ve kept praying, but by the time I got insurance, who knows how big it would’ve been.”
Breast cancer doesn’t just affect women. Men get it too and PfBCC has seen a few come through their doors. It also does not discriminate between young and old. Having been there herself, helping those without the means to pay for breast cancer screenings and treatments is Janet’s passion. “I’ve made a promise to keep these doors open. We are helping people. We are saving lives.” PfBCC has a number of fund raising events this month. For more information on them, becoming a volunteer, and the criteria for receiving help from PfBCC, check out the website www.pfbcc.org.
Janet Darnell Executive Director
Partners for Breast Cancer Care, Inc.
9470 Healthpark Circle www.pfbcc.org
Fort Myers, FL 33908 239-454-8583
mylivinglocal.com | OCTOBER 2018
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