MyNorth Medical Insider 2014

2014-2015

Medical Insider Professionals • Hospitals • Practices • Technology

Moving Forward:

Dr. Jill Vollbrecht, Diabetes Specialist with Munson Healthcare

Northern Michigan Health Care Inside

A Rock Star Talks Straight About Diabetes New Technology Helps Avoid Bypass Surgery Need to Know Info About HPV and Mouth Cancer Amazing Miniature Pacemakers Why You Should Not Numb Your Baby’s Gums

From the publishers of

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MI 1

From left: Dr. Robert Sprunk and Dr. Michael Forness

Pediatric Care

BETH PRICE

Pediatric Specialties Physicians in the Grand Traverse region have long wanted to reduce the number of trips that children with complex medical issues must take to downstate hospitals for specialty pediatric care, especially for things like regular checkups or more routine aspects of treatment.

Providing care closer to home would not only decrease the inconvenience of travel, but also would help families’ finances by saving gas money and avoiding time off work. “In conversations with physicians at DeVos Children’s Hospital, we’d say things like, How can we collaborate to

better care for our region’s children?” says Dr. Robert Sprunk, a pediatrician with Grand Traverse Children’s Clinic.

Earlier this year, several of those conversations became reality with the opening

“In conversations with physicians at DeVos Children’s Hospital, we’d say things like, How can we collaborate to better care for our region’s children?”

in Traverse City

of the Helen DeVos Children’s Hospital Pediatric Clinic in Traverse City, a collaboration between Spectrum Health Medical Group and Munson Medical Center. The clinic is offering regular visits—in some cases a few times a month, in others a few times a week—by physicians with specialties in pediatric orthopedics, pediatric gastroenterology and pediatric neurosurgery.

The clinic builds upon other children’s specialty clinics that DeVos physicians have started up in recent years, with specialties in pediatric endocrinology, hematology, oncology and cardiology. 4

Heart Technology

Wireless Pacemakers Being Tested at Munson

FROM TOP: COURTESY OF NANASTIN. ANGELA DOSTER BROWN.

Pacemakers have given untold numbers of people extended years of active living since 1958, when Earl Baaken, founder of Medtronic, developed the first wearable external pacemaker and installed it on a patient. Each year 700,000 more people are added to the ranks of pacemaker users. But even good technology can be made better, and there are aspects of traditional pacemakers that researchers have been working to improve. Physicians would especially like to eliminate the wire leads that traditional pacemakers use to monitor heartbeats and convey electrical impulses to the heart-leads that run a foot to two feet long. What’s more, the pacemaker control unit is implanted just below the skin near the shoulder; patients don’t like that it is visible and that the site poses an infection risk.

Today, however, pacemakers that resolve those key issues—wires, visibility and infection—are being implanted at Munson Medical Center as part of a nationwide medical trial that will install the device into 670 patients in 50 hospitals in the United States. For its part, Munson will install 12 of the devices, made by Nanostim, during the yearlong trial, explains Dr. Robert Kennedy, a cardiac electrophysiologist who is performing some of the implants.

Called leadless pacemakers, the devices are about the size of a Bic pen cap—less than 10 percent the size of typical pacemakers—and they are installed directly into the heart. Currently, the leadless pacemakers are approved only for placement into the lower right chamber of the heart, so if a patient were to need multiple points of stimulation, say for two or three chambers of the heart, he or she would require a traditional pacemaker with multiple leads, Kennedy says.

Physicians use catheter technology to install the device, with point of entry being the vein of the right leg. “The device is on the tip of the catheter, and using X-ray guidance, we guide it into the heart,”

Sprunk credits Dr. Michael Forness, a DeVos pediatric orthopedic surgeon, for playing a large role in the clinic formation. Forness practiced in Traverse City until 2004 and then went to DeVos, so it was natural for him to see the health care connections between Grand Rapids and Traverse City. “He began a clinic in Traverse City that ran three days a week, three weeks a month, so that was a tipping point, to have a clinic with that much activity,” Sprunk says.

The new clinic is one more step in Munson’s desire to increase what Sprunk calls the pediatric services line. “If you look at the number of in-patients at Munson at any given time the pediatric share is a small number, but if you look at the total

Kennedy says. The target site is the lowermost point inside the right ventricle, called the apex. Once in place, “we rotate the device and it screws into the muscle of the heart,” he says. The doctor then partially undocks from the device, tests to ensure proper function, and then removes the heart catheter from the patient. Typically the implant portion of the procedure takes about a half-hour. “It makes sense that this will be the way pacemakers are done in the future,” Kennedy says.

231.935.5000, munsonhealthcare.org

services rendered for children over the course of a year it is substantial,” Sprunk says. Bringing pediatric specialists into Munson’s world will also help regional pediatricians provide more comprehensive care close to home.

For Sprunk, it’s gratifying to see pediatric care continue to expand at Munson, a trend that is part of a pediatric care tradition that he sees reaching all the way back to the 1930s, when, in the depths of the Great Depression, Dr. Mark Osterlin helped launch the Central Michigan Children’s Clinic.

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MI 1

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Cancer Care

The Team-Based Approach With Munson’s Dr. David Gordon As the date approaches for the opening of Munson’s Cowell Family Cancer Center in 2016, we spoke with Dr. David Gordon about the evolution of cancer care at Munson and how new thinking is shaping the building’s design.

PHOTO AND RENDERING COURTESY OF MUNSON MEDICAL CENTER

Give us a sense for how the Munson medical team is approaching cancer diagnosis and treatment today.

In a traditional scenario, you have a diagnosis that requires input from a surgeon, an oncologist, a radiation therapist and others, and you would typically have to schedule time to see each of those specialists in their offices, which can take a period of time. Meanwhile, you are nervous because you have a diagnosis of cancer, and you want to know the plan and start treatment.

What we are moving to is a process where the patient will see all of the specialists on the same day. On that day there will be a meeting of all the specialists where all relevant clinical information is discussed in detail. Then at the end of that same day the patient will get a recommendation about treatment.

We’ve heard you have begun this process in a limited way.

Yes. First we focused on lung cancer, and we’ve been doing that for not quite a year now. The lung cancer patient is admitted to the clinic, and all the studies are arranged before the clinic day by the staff. On the day of the clinic, all the physicians are there. In addition, attendants include cancer research specialists, financial navigators, dietitians, and palliative care staff. We assign a physician extender, who becomes the clinical navigator for that patient. That person will be their “best friend” during therapy. We also assign a financial navigator, to facilitate the patient’s financial issues. This innovation has been very successful in saving the patient money and helping make sure the hospital is reimbursed. This entire approach will be used as a prototype for other tumors.

How does Munson’s affiliation with the University of Michigan dovetail with this approach?

We are evolving to a more intimate relationship with U of M. There are some things we can’t do here. If a patient has a problem that exceeds our capability and needs some help from U of M, they typically would have to go to Ann Arbor to see the specialists. Perhaps they would need to go back multiple times. It’s very inconvenient for the patient.

We are now doing real-time telemedicine tumor boards every week. For example we might have a patient with a pancreatic tumor and we need help from the U of M team. It’s a live video connection between the Munson team and the U of M team, and the patient’s doctor presents the case, shows all of the images and discusses the case with the U of M experts to develop the best recommendation.

Our pilot programs are in pancreatic cancer, liver cancer and stem cell/bone marrow transplants.

How does the design of the new cancer center reflect this teamcentered approach?

The purpose of the new building is to bring the disciplines related to cancer to one location. We’ll have radiation oncology there, the chemotherapy infusion clinic, and support staff including the clinical and financial navigators. The third floor is designed to facilitate multidisciplinary clinics. In addition, pediatric oncology clinics and adult medical oncology clinics will be housed there. We plan other support services to be in the center, including a chapel, a cancer apparel shop and meeting rooms and library for the staff and the public.

231.935.5000, munsonhealthcare.org MyNorth Medical Insider

MI 3

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Artificial Hips

Anterior Hip Replacement Leads to

Superior Results

BETH PRICE

Since 1947 surgeons have been working to perfect a procedure that would enable them to perform hip replacements through the front of the hip (direct anterior lateral replacement) rather than from the rear of the hip (posterior lateral replacement). Driving their interest was a desire to eliminate the cutting of large, important muscles, which lengthened healing time, caused pain and weakened the musculature surrounding the hip, increasing the odds that the artificial joint could pop out of place.

Today, however, the elusive goal of anterior hip replacement is a safe and reliable option for many patients, thanks to evolutions in equipment and surgical techniques. “A key benefit is that by going through the front, you don’t have to cut any muscles at all,” says Dr. Todd Galdes, an orthopedic surgeon with Great Lakes Orthopedic Center.

Galdes completed a fellowship at Emory Hospital in Atlanta, where he focused on the anterior replacement procedure.

A second benefit is stability. “Because you don’t need to cut muscle, the risk of the ball popping out of the socket is Dr. Todd Galdes almost zero,” he says. By comparison, the risk of dislocation following the posterior procedure averages about 2 percent.

A third benefit derives from a key piece of technology called the Hana Table. The table is radiolucent, allowing Galdes to The improved stability also means there are no “hip precautions,” use X-ray throughout the procedure to see precisely where all the or restrictions on movement for the patient, and most patients are able artificial hip pieces are fitting and is extremely helpful in making sure to return to work in about six weeks. For hip replacement patients, the patient’s leg length is accurate. common lifelong restrictions are generally aimed at avoiding activities that involve high impact. So, running on pavement, high impact aerobics and singles tennis are discouraged.

The major cause of hip replacements is long-term arthritis, which A second benefit is stability. “Because results in a nagging, annoying pain in the groin. “A lot of people don’t you don’t need to cut muscle, the risk realize the pain is coming from their hip,” Galdes says. “Everybody’s of the ball popping out of the socket is story is different, and there are different reasons for hip pain, but if somebody has that pain, it is worth getting it checked out,” Galdes says. almost zero,” he says. By comparison, the

risk of dislocation following the posterior procedure averages about 2 percent.

231.935.5000, munsonhealthcare.org MyNorth Medical Insider

MI 5

GIVING YOU A CHOICE

Cancer touches an increasing number of people every year and treatments can require traveling long distances, sometimes to an unfamiliar area.

Being away from home frequently adds stress to an already stressful situation.

Now you have a choice.

We’ve responded to the need for cancer care close to home by adding the Sarah M. Foster, MD Chemotherapy-Infusion Center, offering treatment in a calming, comfortable environment, overlooking the healing waters of Lake Michigan. Ask your health care provider for a referral.

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Diabetes

Star Shares His Experience

Diabetes specialist Dr. Jill Vollbrecht

A

The national rate of diabetes is 8.5 percent; the Northern Michigan diabetes rate is nearly double that, 15.2 percent. These numbers loom large in the mind of diabetes specialist Dr. Jill Vollbrecht of Munson Healthcare.

TOP: BETH PRICE. BELOW: GETTY

She has spent many hours training primary care physicians to work with patients to improve their blood sugar levels and has received national attention for her work.

But practicing in a region with some of the highest diabetes rates in the nation, she knows the message has to be more widespread, and reach far more people, far faster.

This summer, Vollbrecht took a first shot at going mass media with her message when she arranged an interview with rock star and Type 1 diabetic Bret Michaels when he was in Traverse City for a concert.

Vollbrecht visited Michaels and asked him to share advice about what it’s like to manage his diabetes despite a very busy lifestyle.

“Bret Michaels has had diabetes for a long time, since he was six, yet he has overcome his medical issues and been very successful. A lot of people say, ‘I’m too busy to manage my blood sugar carefully.’ So I wanted to show them somebody who has

a crazy busy hectic lifestyle and still controls his diabetes,” Vollbrecht says.

Vollbrecht, with the help of Munson’s Community Health Manager Christi Nowak, recorded the interview, transcribed it and posted the conversation on the web.

She’d like to do similar interviews with famous diabetics a few times a year.

Below is an excerpt of the interview. To read the entire interview, visit nmdiabetes.org.

Vollbrecht: What would you say to my patients who tell me ‘I’m just too busy to check my blood sugar, I’m too busy to count my carbs and things like that?

Bret Michaels: My first reaction is that I check my blood sugar a minimum 10 times a day since as long as I can remember, right. And I’d say, that one day if you don’t check your blood sugar, you get too busy, you may not need to be busy over anything because you won’t be checking anything, because you will be in ketoacido-

sis, you’ll be getting your kidneys worked on, losing a leg. I don’t want to use a scare tactic thing. But what I’m saying is that you’ve got to take care of yourself first, and checking that blood sugar, you don’t want to be in the middle of an important business meeting, or taking care of your kids, or doing whatever you are doing and your blood sugar drop out or you’re running at 500. Diabetes is a blessing and a curse—it’s a lot of work. And you have to be willing to accept it. I accepted the card I was dealt. That’s my best advice, I accept it. I’m a diabetic, I’m not going to beat this disease. So let me learn how to work with it and make the most out of my life, and I’m out here today playing soccer and football. I say be active, as active as you can physically be.

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Interview

McLaren Northern Michigan CEO

David Zechman

MCLAREN NORTHERN MICHIGAN

A year ago, amid a rapidly evolving health care environment and shortly after Petoskey’s hospital joined with the 12-hospital system of McLaren Health Care, David Zechman accepted the positions of president and chief executive officer of McLaren Northern Michigan. We asked him to weigh in on recent and expected changes.

The Affordable Care Act requires hospitals to take a more active role in raising the overall health of their communities. What does this mean for McLaren Northern Michigan in terms of the way it interacts with local people?

One of the biggest things we are doing in terms of raising overall health is we have a community wellness program, based in the Denmer Wellness Pavilion—which was totally donated by the Denmer family—and we have a range of services that includes massage therapy, aquatic therapy, health screenings, and many more, some at no charge. And we are taking some of these out to the communities. So for example, we are providing student heart screenings in schools in Rogers City and Beaver Island. And we have a terrific weight loss program for children. Our biggest chal-

lenges are obesity, lung cancer and diabetes. We don’t get paid for community outreach services, so of course the cost of providing these services is a challenge.

What changes and service expansions are you most enthused about at McLaren Northern Michigan?

First, we are exploring ways that McLaren Northern Michigan can improve community health in the region by working in partnership with other providers.

We are just in the preliminary stages, but we hope to find ways to improve access to health care, which improves quality of health care, patient safety and at the same time reduces cost to the region. We can’t talk about specifics on that yet, but the discussions have begun. Clearly we need to find innovative ways to improve access to healthcare.

Second, we are excited about our patient portal, which is an opportunity for patients to track their health information after a hospital stay. We built a strong foundation with our digital medical records and now patients can review information such as lab results, imaging results and discharge information at home online from a secure connection. The more patients are informed about their personal health care, the more compliant they are in managing their health issues.

What are some of the most noteworthy changes in Petoskey-area health care resulting from the McLaren acquisition?

We are now part of the Karmanos Cancer Institute, and the significance that has for our community is that it brings new cancer drug trials to people in Northern Michigan, trials that they did not have access to prior to joining Karmanos. This means that patients do not have to drive downstate to receive the highest level of cancer treatment. That said, some patients will still have to go to Karmanos for more complicated cancer care, but many will be able to receive those services here.

More broadly, from a business model perspective, our focus is on reducing the cost of health care while improving services. Our purchasing power through McLaren reduces costs of supplies and equipment, which helps keep our financial results stable. Also, we can interact with the 11 other hospitals in the McLaren system and benchmark on best practices, things like patient safety and clinical quality— everybody’s results will improve because we can benchmark against best practice.

800.248.6777 northernhealth.org MyNorth Medical Insider

MI 9

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Cancer Treatment

McLaren Collaborates with

Cancer Leader Earlier this year, McLaren Northern Michigan announced that the McLaren network of hospitals formed a collaboration with the Barbara Ann Karmanos Cancer Institute, one of just 41 hospitals in the United States designated by the National Cancer Institute as a Comprehensive Cancer Center. For patients at McLaren Northern Michigan, the partnership will mean easier access to state of the art cancer care and, notably, easier access to leading edge treatment therapies that are still in clinical trial.

For community hospitals, fighting cancer presents some especially daunting challenges, explains Kirk Parent, manager of Radiation Oncology and Hematology/Oncology Services with Karmanos Cancer Institute at McLaren Northern Michigan in Petoskey.

First, of course, is the fundamental complexity of the disease and the specialized expertise needed to identify and treat its many types, but also there are basic management issues, like highly specialized treatments that might require the patient to visit the hospital several days a month.

Often in the past, cancer patients, especially those with advanced cancers or rare cancers, have had to travel several hours to specialized cancer centers downstate—Karmanos’s main campus, for example, is in Detroit.

The new Karmanos Cancer Institute collaboration addresses these issues directly.

As for tapping into the expertise of specialists and cancer researchers, Karmanos physicians based in Petoskey and Detroit work in two main ways, Parent explains.

Complementary Treatment for Cancer

TOP: MCALARAN NORTHERN MICHIGAN. BELOW: DR. KATHERINE ROTH.

The Good Fight

In 2004, Traverse City psychologist Greg Holmes, Ph.D., was diagnosed with an extremely rare and extremely aggressive form of cancer of the nasal passages. His oncologists said they’d do the best they could with traditional treatments of radiation and chemotherapy, but they also proffered little hope because the survival rate for that type of cancer was so low. That was ten years ago, and Holmes is still alive, and this year he and his wife, Dr. Katherine Roth, M.D., released a book, The Good Fight, that chronicles in both a deeply personal and professional way the battle that led to Holmes’s triumph over the disease.

While not discounting the effectiveness of traditional cancer treatments, Holmes and Roth also knew that the results of that protocol had not saved the vast majority of people who had faced this cancer before, so they turned to Roth’s knowledge of alternative medicine to find complementary therapies. Roth, trained in both traditional and alternative medicine, spent hundreds of hours researching cancers and alternative treatments and developing and producing a rigorous schedule of supplemental vitamins and herbs to keep Holmes’s immune system strong and to help heal the broad damage that chemo and radiation therapy were inflicting on his normal cells. Roth includes links to medical research as well as recipes in the book.

While The Good Fight operates on many levels, at its core “it is a story about love,” says Roth.

“It’s about how Greg loves life and wouldn’t give up, and it’s about the love of the people around him, and about my love for him and the work I did because of that.”

Find The Good Fight in bookstores and on Amazon.com.

231.935.5000, munsonhealthcare.org

“On Thursdays, Karmanos Cancer Institute physicians do a video teleconference, reviewing cases that we feel would benefit from the discussion, which tends to be advanced cancers or more rare cancers,” he says. All information related to the case would be part of the presentation, including pathology reports and any imaging studies.

The second communication avenue would be more traditional one-to-one conversations by phone and email as part of daily work flow. Soon, all Petoskey- and Detroit-based Karmanos teams will have full online access to cancer patient records, making collaboration that much tighter.

As for making cancer care available in the community and reducing the need to travel, the collaboration allows leading edge infusion strategies to be deployed onsite, meaning a patient’s journey to treatment might be a few miles instead of a few hours.

Not every patient’s case is right for treatment in clinical trials, but for those that are, gaining access to Karmanos research protocols could be highly valuable, Parent explains.

How it works is the Petoskey-based Karmanos physicians will have a greater awareness of any clinical trials underway.

The team in Petoskey compares its patients’ conditions with the requirements of the clinical trials, and when the two match up, the teams confer and consult with the patient about the pros and cons of entering the clinical trial regimen.

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MI 11

Justin Allen, hyperbaric program coordinator

Wound Healing

MCLAREN NORTHERN MICHIGAN

Hyperbaric Oxygen Treatment When poor blood circulation prevents adequate oxygen from reaching a wound, that wound is unable to heal, and very serious consequences result. The most common examples are seen among diabetics who might have poor circulation at their extremities. A foot gets a sore, the lack of feeling in the foot leads to an untreated wound, which then becomes larger, and things like gangrene and amputation can ensue. McLaren Northern Michigan has recently added technology called hyperbaric oxygen therapy that addresses the issue of oxygen supply to a wound head on.

The treatment involves the patient lying in a clear acrylic chamber that is filled with 100 percent oxygen. Patients would typically lie in the chamber for about two hours at a time and would attend sessions five days a week for a month or more.

That’s a big commitment, but the results are worth the effort, explains Justin Allen, the hyperbaric program coordinator. The increased oxygen supply super-saturates the patient’s plasma and hemoglobin, which increases collagen and the creation of tiny new blood vessels (a process called angiogenesis), which improves longerterm blood supply to the area. The increased oxygen supply also increases white blood cell supply to the wound, which naturally helps the wound heal.

Side effects of the treatment include the rare chance of barotrauma to the ear. The chamber is normally pressurized—equal to the pressure of being under 33 feet of water—so patients must equalize the pressure in their ears like SCUBA divers do.

What about claustrophobic patients? “The chamber is clear acrylic, so patients are able to see outside the chamber all around them. Also patients are able to relax and watch TV,” Allen says.

“Generally even people who are a little uncomfortable at first do well. But otherwise we can offer relaxation medicine.”

Among the greatest success stories, Allen recalls a patient who had not had feeling in the feet for nearly two years, and following treatment, feeling returned. The patient’s wound healed, and with increased feeling, the patient is more likely to detect wounds early on, so wound care treatment can be initiated if needed before they worsen.

Other problems the technology treats includes repairing tissue damage from cancer radiation therapy, repairing skin grafts that start to separate, and helping wounds resulting from crush injuries. The technology was originally developed to help SCUBA divers suffering from the bends, and it can also be deployed for that as well.

800.248.6777, northernhealth.org MyNorth Medical Insider

MI 13

We Are Munson Healthcare.

We are the people who care for the people of northern Michigan. We believe the best health care is delivered as close to home as possible by people who live and work in your community.

Our eight community hospitals are committed to the well-being of each patient.

We collaborate in a regional system of care, knowing that working together and sharing our strengths allows us to serve our communities better.

Our eight supporting partners contribute to regional health care through coordinated services that result in quality, convenient, easy to use care for patients and their families.

Together, we are Munson Healthcare.

Munson Healthcare Hospitals

Charlevoix Area Hospital Kalkaska Memorial Health Center Mercy Hospital Cadillac Mercy Hospital Grayling

Munson Medical Center Otsego Memorial Hospital Paul Oliver Memorial Hospital West Shore Medical Center

Partners Kalkaska and Munson Dialysis Centers Munson Home Health Munson Hospice North Flight EMS

Munson Mobile Imaging Northern Michigan Supply Alliance Great Lakes Mobile PET Northwest Michigan Surgery Center

To find a physician in your area, call Munson HealthLink at 1-800-533-5520 or visit munsonhealthcare.org.

MI 14

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Interview

Munson Medical Center

COO Derk Pronger Traverse City–raised Derk Pronger made the transition from vice president of operations at Munson Medical Center to chief operating officer on July 1, 2014, assuming responsibility for Northern Michigan’s largest hospital. We check in with Pronger to see what tops his agenda.

We’ve heard of the “care close to home” initiative, can you elaborate on the goal?

We’ve been working with our seven Munson affiliate hospitals to have them provide care that people would normally have to drive to Traverse City to receive.

For example, chemotherapy, patients in Grayling would typically have to drive to Traverse City to receive infusion treatments, possibly several times a week. That can now take place in Grayling. That gets us excited. It’s convenient for the patient and is what the region wants. We’ve also been expanding outpatient services to other

regions, partnering with physician offices where we don’t have a hospital. Kingsley, for example, opened in late January. Over the summer we opened in Elk Rapids, primarily providing diagnostic testing, like laboratory and X-ray services.

Technology advances are so central to medical care these days, can you share some new technologies at Munson that the community should know about?

The first that comes to mind is we have recently replaced all of our computerized tomography (CT) machines and now have

Heart Technology

BETH PRICE

Coronary Atherectomy

Deploying a balloon on the tip of a catheter to open a clogged coronary artery and then keeping the artery open with a tiny wire-mesh stent has helped millions of people avoid heart bypass surgery in the past decade. But some patients are unable to take advantage of the balloon catheter procedure, called balloon angioplasty, because the plaque in the artery has become hard. “The artery becomes so calcified it is like a pipe lined with cement,” says Dr. Roberto Corpus, an interventional cardiologist at Munson Medical Center.

Arteries hardened to that degree can become severely damaged with balloon angioplasty because the plaque will not allow the artery to stretch and expand to accept the stent. Instead, the hard plaque can fracture, possibly perforating the artery wall or partially breaking away from the wall to block the artery. Both of these situations are very dangerous, so instead patients have coronary bypass surgery or are treated with medications alone.

Earlier this year, however, a new option became available in Northern Michigan for people with hardened plaque in coronary arteries. Called coronary atherectomy, the procedure involves using a catheter to insert what is essentially a tiny orbital sanding tip into the target artery and sanding away at the plaque, eventually removing enough to allow the artery to regain its pliability and undergo the standard balloon angioplasty followed by stenting.

“The device has a proven track record because we have long used it in the legs,” says Corpus. “It was a natural extension that if you can use the technology in the legs, you should be able to do the same thing in the heart.”

231.935.5000, munsonhealthcare.org

some of the most advanced equipment in the world for diagnostic work in Traverse City. The nice part is it allows for better imaging and reduces by up to 70 percent the radiation exposure for the patient.

By year-end we will have a piece of technology called a Maldi TOF, which will allow us to identify bacteria in a sample in just eight minutes, whereas normally that takes 24 hours to do a laboratory work-up.

We can then target the bacteria with specific antibiotics rather than use broad-spectrum antibiotics. A third piece of technology is an ultraviolet (UV) light disinfecting system.

It’s like a robot that you wheel into a room, close the door, turn it on, and it kills a very high percentage of the organisms, in every nook and cranny, floor to ceiling. It is more effective than traditional cleaning and kills with energy rather than chemicals.

Have you seen much impact from the roll out of the Affordable Care Act? Beginning in May we noticed an increase in how busy we are. The hospital is on a record-setting pace. And we are hearing similar things from hospitals in Michigan and nationally. The previous couple of years we saw flat volumes. The industry is saying the increase is not only because more people are covered with private insurance under the Affordable Care Act, but also because of expansion in Medicaid with Healthy Michigan. That’s good for the people because they are getting services they need but might have been putting off, and it’s good for Munson because it means we are getting reimbursed for services that we otherwise would have not been paid for because the patient would have been uninsured.

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GRAND TRAVERSE CHILDREN’S CLINIC, PC

Robert W. Sprunk, MD

David S. Olson, MD Andrew D. Tursman, MD

Fall Into A Great Deal!

Lisa B. Chimner, MD Kimberly A. Hegewald, MD

Best of 2014

WINNER • Specialty Care for Northern Michigan Infants, Children and Adolescents • Same-day appointments are offered

BUY ONE GET ONE FREE! Purchase a complete pair of prescription eyeglasses or sunglasses and receive a second pair of equal or lesser value free.* This offer includes designer frames and prescription sunglasses! * Some restrictions apply, see store for details.

Offer also valid at Midland and Mt. Pleasant locations.

• New patients are welcome • Expectant parents are encouraged to arrange a visit to meet the doctors

OPEN 7 DAYS MON-FRI 8AM-6PM

SAT 8AM-Noon

SUN 9AM-Noon

3537 West Front Street, Suite G • Traverse City, MI 49684 www.GTChildrens.com • 231-935-8822

MI 16

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www.facebook.com/TraverseVision

336 W. Front St.

| Traverse City, MI | (231) 941-5440 traversevision.com

A Leader in Non-Emergency Medical Transport When it comes to non-emergency medical transportation, one Michigan company that has made this service a priority focus comes to mind . . . Coastline Transportation.

Through their nine years of specializing in non-emergency medical transportation services over local & long distances, Coastline Transportation has partnered with many medical facilities to offer much needed transportation for Michigan’s elderly and disabled persons to appointments, treatments, outpatient services and more.

Coastline’s NEMT services are a cost effective transportation option when a patient, (i.e. worker’s comp or auto accident survivor), needs to get to and from these types of medical services, where ambulance services usually would be cost prohibitive.

You can rely on Coastline Transportation to help you or your patients arrive in a safe and timely manner in one of their modern, clean & handicapped accessible vans. If a non-emergency transport becomes an emergency, Coastline Transportation’s personnel are prepared to handle it.

Several of Coastline’s drivers have a medical license either EMT-B or MFR. All drivers are certified in CPR and AED. Coastline Transportation offers reasonably priced rates for both their local and long distance services and are available 24 hours a day 7 days a week with advance notice.

Call Coastline Transportation at 231-398-0360 to discuss how their services can help you or your patients!

(231) 398-0360 • CoastlineTransportation.com STATE LICENSED • FULLY INSURED

Professional Shoe Fitting Orthotic Shoes Specializing in Sizes & Widths Athletic Shoes • Foot Care Products Over the Counter Arches & Insoles Internal & External Shoe Modifications Board Certified Pedorthist Orthopedic Prescriptions Filled Prefabricated & Customized Orthotics

231-946-7810

13920 S. West Bay Shore Drive • Traverse City MyNorth Medical Insider

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Congratulations to Physician Practices Awarded Patient-Centered Medical Home Designation 2014, Traverse City MI Patient-Centered Medical Home (PCMH) is a model of care -

healthcare centered on the patient.

Blue Cross® Blue Shield® of Michigan has announced the physician practices in Northern Michigan that have been designated as Patient-Centered Medical Homes (PCMH) for 2014.

Northern Physicians Organization (NPO) wishes to acknowledge and congratulate its members for this achievement. The following practices are among a select group of primary care physicians in Michigan who are improving health care quality by adopting the respected PCMH model of care.

Bay Area Family Care Bayside Family and Sports Medicine Brookside Family Medicine Bruce Lirones, D.O., PLLC Cherry Bend Family Care, PLC Debra Graetz, MD Gary S. Ruoff, D.O., PC Grand Traverse Children’s Clinic Grand Traverse Internists, P.C. Internal Medicine of Northern Michigan Kalkaska Family Practice, P.C.

Katherine Roth, M.D. Kids Creek Children’s Clinic Joel Anhalt, D.O. Lakeshore Family Care, P.C. Mark C. Antonishen, M.D. Milliken Medical, PLLC Munson Family Practice Center Northern Michigan Medicine and Pediatrics Northern Pines Health Center Partners in Family Practice Partners in Health

Petoskey Child Health Associates Petoskey Pediatrics Dr. Russell VanHouzen, M.D., FACP Superior Family Medical Associates Suttons Bay Medical Clinic, PLC. Thirlby Clinic, P.L.C. Traverse Area Pediatric and Adolescent Clinic Village Family Practice West Front Primary Care, P.L.L.C. West Shore Medical Center-Physician Services Your Health Family Medicine

“Blue Cross® Blue Shield® of Michigan is a nonprofit corporation and independent licensee of the Blue Cross® and Blue Shield® Association.”

7985 Mackinaw Trail, Suite 100 Cadillac | 231-779-9550 324 Meadows | Grayling 989-348-4383

Home Care

More people are discovering the benefits of the home environment as a place that helps in healing and faster recovery.

Since 1985, Mercy Home care has provided the best in personalized healthcare services in the most important environment of all, the home.

Hospice When the end of life is near Mercy Home care / Hospice provides comfort, safety, and compassionate care for patients and their families.

To get more information on home care or hospice services, please call or see us online at www.trinityhomehealth.org.

MI 18

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WE FIX Shoulders and

Knees, Ankles, Wrists, Hips…

Together we’re BETTER at FIGHTING CANCER.

Don’t let an injury or pain compromise your lifestyle, happiness, and overall wellness.

The six board-certified surgeons of Bay Street Orthopaedics have built their reputation on advanced care since 1975.

B e t t e r Tr e a t m e n t s | B e t t e r O u t c o m e s More Moments

PETOSKEY · CHARLEVOIX · CHEBOYGAN · ST. IGNACE · GAYLORD · ROGERS CITY

baystreetortho.com 231.347.5155 800.968.5155

( 8 0 0 ) 24 8 - 67 7 7 n o r t h e r n h e a l t h . o r g /c a n c e r RNs | LPNs | CNAs

When life changes, we help.

Serving all of Northern Michigan 24 hours a day, 365 days a year.

Companions & Homemakers | Nursing Services Diabetic Care | Foot Care Services | Medication Management & Reminders | Transportation/Errands Bathing & Personal Care | Respite & Dementia Care Light Housekeeping | New Mother & Baby Care

C O M PA S S I O N AT E Q U A L I T Y C A R E (231) 932.0708 | www.monarchhomehealth.com

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Health Partners Specializes in Rehabilitation and Private Home Care Solutions • 6 Michigan offices • Specializing in serving brain and/or spinal cord injured people with experienced nursing and aide care • Over 20 years of experience assisting Michigan families • HP understands your rights under the Auto-No Fault law and advocates to protect your benefits

Christine Tocco, Customer Service Executive

616.292.2011

954 Business Park Dr. Ste 1 Traverse City, MI 49686 932-7300 or 888-834-2851

Please call us to discuss your needs or visit our website at www.healthpartnersinc.com

Through patient-centered care, our team of 12 providers offer adult primary care, treat patients as individuals, foster a proactive approach, and work together to promote overall health and wellness.

doctors4adults.com 231.487.9702 BURNS PROFESSIONAL BUILDING, SUITE

MI 20

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300 · PETOSKEY

Munson Services are Closer than You Think Where can you find Munson Outpatient Services?

We are located over the next vineyard-laden hill, near the pine-scented forest, or just beyond a spectacular drive around your favorite glittering lake.

No matter where you live in our beautiful region, you are never far from Munson Outpatient Services.

You came here to relax and enjoy life. So we put the health services you need just around the next scenic bend in the road.

4 5 10 7

8

6 3

1 2 9

We’re here for you. Please stop by any of our convenient locations. For more information or services in your area, visit munsonhealthcare.org/outpatient.

1 Munson Community Health Center - Traverse City* 550 Munson Ave., Traverse City | (231) 935-8470

6 Munson Outpatient Services - Frankfort** 826 Forest Ave., Frankfort | (231) 352-5271

2 Munson Laboratories at Grand Traverse Commerce Centre* (across from Grand Traverse Mall) 3287 South Airport Road, Traverse City | (231) 392-0380

7 Paul Oliver Memorial Hospital - Frankfort** 224 Park Ave., Frankfort | (231) 352-2204

3 Munson Outpatient Services - Benzonia** 6277 Frankfort Hwy., Benzonia | (231) 882-1062 4 Munson Outpatient Services - Elk Rapids* 119 Bridge St., Elk Rapids | (231) 264-0024 5 Munson Outpatient Services - Empire** 9973 Ottawa Ave., Empire | (231) 326-2053

8 Munson Outpatient Services - Interlochen** 1975 Stirling Dr., Interlochen | (231) 275-6980 9 Munson Outpatient Services - Kingsley* 2291 M-113 East, Kingsley | (231) 392-7890 10 Munson Outpatient Services - West Front 3643 W. Front St., Ste. B, Traverse City | (231) 935-0590

* A Service of Munson Medical Center ** A Service of Paul Oliver Memorial Hospital

munsonhealthcare.org/outpatient MyNorth Medical Insider

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Northwest Michigan Long Term Care Specialists

Crawford, Grand Traverse, Leelanau, Missaukee, Roscommon and Wexford Counties

Serving: • Persons with Intellectual/Developmental Disabilities • Adults with Mental Illness • Children with Serious Emotional Disturbance • Persons with Substance Use Disorders • Community provider in Mental Health First Aid

Our Mission is to provide outstanding geriatric care to residents in Long Term Care environments.

Team of providers: Mark Jackson MD, Peter Viall MD, Kathy Reid GNP, Kate McCaffrey GNP, Lynn Shattuck NP, Sean Cameron PA

Proudly serving the facilities of :

TTY 711

• Grand Traverse Pavilions & Cottages • Bortz Healthcare • Orchard Creek Skilled Nursing • Concord Place • Bay Ridge Continuum Care Community • Cherry Hill Haven

• Country Pleasures Assisted Living • Culver Meadows Senior Living Center and Assisted Living • Orchard Creek Assisted Living • Traverse Manor Assisted Living • Traverse Victorian Senior Living

Business Office 231.922.0449

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Fit for You Health Club 1226 S. Garfield Ave • Traverse City, MI 49686 231-922-7285 • www.traversecityhealthclub.com Don’t forget your heart attack will happen tomorrow morning at 5:00 a.m.

If you were able to get advance notice… what would you do?

You would probably do anything you could to avoid it… to just have more time, precious time! Think about that!

Why wait until you have no more time. Live life to its fullest every single day. At Fit For You we want you to feel the way we do… fantastic, I mean on top of the world fantastic.

How does it work?

It all starts with a conversation!

A conversation about you, your goals and ambitions, your dreams, worries and fears. What has kept you from succeeding MI 22

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at health in the past?

We’ll show you our Fit For You 80/20 system with 5 very easy steps to success, but also how to maintain your success.

You see, at Fit For You, it’s not about providing you with a place to work out, it’s about giving you a happy, healthy caring club that wants you to feel as good as we do.

Please join us and see how we’ve been changing lives for 28 years!

Call today for a no obligation conversation - and start feeling better tomorrow!

MYNORTH MEDICAL INSIDER

Macular Degeneration Losing Central Vision

BY Robert K. Butryn, M.D. Robert K. Butryn, M.D. Board Certified Opthamologist

Northern Vision Eye Care delivers state-o-the-art medical, surgical and optical eye care with a passion for excellence, individuality and community service.

4033 Eastern Sky Drive Traverse City, Michigan 49684 (231) 932-9000

www.northernvisioneyecare.com

It sometimes takes losing something for us to appreciate what we had. The ability to read this sentence, for example, is a luxury many people with Age Related Macular Degeneration (AMD) have lost.

While our entire retina gathers light, which allows for a broad, 200-degree view of our environment, it’s the fovea in the macular region that gives us sharp reading vision and subtends only 15 degrees. To illustrate this point, look at the edge of this page and try to continue reading. This is similar to the visual frustration many with AMD experience because they cannot see with their central vision and are forced to look near but not at their target. AMD is a leading cause of irreversible vision loss in those over 40 years old. AMD is caused by a degeneration of retinal cells within the eye causing pigment changes and an accumulation of waste products known as drusen, which can be seen on examination. There are two main types of AMD. Dry AMD, which is most common and is characterized by drusen and pigment changes in the retina, and wet AMD, which is characterized by the formation of new blood vessels, which often leak or bleed. Wet AMD causes 90% of the severe visual loss in AMD patients. Significant risk factors include increasing age and cigarette smoking. Other factors that play a role include hypertension, atherosclerosis, antioxidant deficiency, dietary fat, hormonal status, sunlight exposure, alcohol use, and heredity. The retina is the most

metabolically active tissue in the body, and while there is no cure for AMD, we do have clinically proven methods for treating both the wet and dry form. The Age Related Eye Disease Studies (AREDS) found that antioxidants plus zinc reduced the risk of wet AMD and vision loss in those with intermediate and advanced AMD. While laser and photodynamic therapy were originally used to treat wet AMD, intraocular injections have now become the most common form of treatment for the wet form. These injections use medications designed to inhibit the new blood vessels found in wet AMD. With the proven treatment options at various stages now available for AMD, accurate screening and diagnosis are of the utmost importance.

In addition to a complete and comprehensive dilated eye examination, Northern Vision Eye Care utilizes diagnostic studies including fluorescence angiography, ocular coherence tomography (OCT), and Optomap laser scanning with auto fluorescence analysis to help determine the stage of AMD and the best course of treatment on an individualized basis. Early diagnosis and treatment can help prevent the progression of vision loss associated with AMD. Call us today to schedule your appointment at 231-932-9000. We look forward to helping you with your eye care needs.

MyNorth Medical Insider

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MYNORTH MEDICAL INSIDER

Back Row: H. Dziedzic, C. Schmucker, C. Bingham, S. Mika, P. Wyers, J. Schmuckal. Middle Row: P. Bevelhymer, K. Smith, M. Wangseng, C. Stevens, A. Bell, C. Zaki. Front Row: M. Polanski, D. Phillips, T. Piotrowski, K. Roop, J. Carpenter, D. Jordan, D. Hubbell, M. Herweyer. Not Pictured: M. Petersen, C. Kroupa, S. Noteware, G.Bultsma, C. Lawson, M. Welch, G. Brzezinski, A. Meeder.

Celebrating 10 Years of Providing Quality Care at the Lowest Cost.

Breaking New Ground In 2004, Northwest Michigan Surgery Center (NMSC) was developed by local physicians, in a unique partnership with Munson Medical Center, to create a state-of-the-art surgical care center.

“It was an exciting time,” recalls Tina Piotrowski, RN BSN and Clinical Director at NMSC. “We were breaking new ground by bringing the very first multi-specialty ambulatory service to this area. Outpatient procedures could now be handled more efficiently and cost effectively, with great care.”

An Amazing Group of People The Northwest Michigan Surgery Center team is comprised of 80 board-certified or board-eligible physicians, 43 anesthesiologists and a dedicated staff of over 120 health care professionals.

Pictured are many of the original staff members who have been a part of the NMSC team for all 10 years.

“It’s an amazing group of people,” says Mary Herweyer, Business Manager at NMSC. “Our staff, leadership, and physicians are completely engaged in our mission. We work as a team with a common goal: To provide excellent care at the lowest cost. Period.”

Designed to Run Efficiently Our highly-specialized approach to outpatient surgeries and procedures allows NMSC to lower the cost of health care and pass along direct savings to patients through lower copays and out-of-pocket expenses.

“We are able to offer lower rates because we are designed to run efficiently, without waste,” states Mary Herweyer. “We work very hard to keep our operating costs low. It’s particularly important today with high deductible health care plans.”

A Great Place for Surgery NMSC is equipped with the finest and latest technology.

Our facility is meticulously maintained and is state and federally MI 24

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regulated to ensure that we provide the highest quality of care under safe conditions.

“I tell patients, family and friends that the Center is a great place to have their surgery performed,” says Dr. Ward Gillett of Bay Area Urology Associates. “And they won’t regret having it performed there. The Center serves the residents of Northern Michigan in a cost efficient, high quality way.”

What We Do Best In 2014, our tenth year of providing care to the community, we expect to surpass 100,000 total patients served at NMSC. While no one can accurately predict the future of health care over the next decade, you have our promise that we’ll continue to provide you with the highest quality surgical care at the lowest cost.

“I’m very proud to be a part of the Northwest Michigan Surgery Center,” Dr. Kurt Sanford of Digestive Health Associates stated.

“As a board member and one of the founding physicians, I’m pleased that we’ve been able to offer such high quality, patientcentric, multi-specialty surgical care right here in Traverse City.

And we’ll continue to do what we do best, outpatient procedures, and work with existing health care plans to offer new outpatient procedures in the coming years.”

To learn more about Northwest Michigan Surgery Center, please go to: surgerytc.com

4100 Park Forest Drive Traverse City, Michigan 49684 231-392-8900 • 877-392-9800

MYNORTH MEDICAL INSIDER

Helping people hear better ultimately improves their quality of life and is very rewarding.

3241 Racquet Club Dr., Suite B Traverse City, Michigan 49684 (231) 922-1500 www.hearingsolutionstc.com

We Hear with our Brain; Not our Ears Hearing and listening are not the same. However, you must have good hearing to be a good listener. If a person does not have normal hearing sensitivity, hearing aids can help ensure the ear receives the signal so that the brain can process it. Listening is an active process and takes some effort. Listening takes even more effort when hearing loss is untreated.

As reported by Robert Sweetow, PhD, Professor of Otolaryngology, University of California, San Francisco, there is evidence that loss of hearing in the ear literally produces physical changes in the brain. These changes are called neural plasticity and data shows that when parts of the brain aren’t being used, they actually change their function (not in a positive manner).

Thus, the old adage “use it or lose it” actually applies to listening because the hearing impaired person’s brain may not be receiving the kind of stimulation it needs to maintain proper function.

Unfortunately some people with hearing loss refuse to wear hearing aids and develop coping strategies that cost them in the long run. They may withdraw from social situations and stop doing the things they once enjoyed because it becomes too difficult and they are afraid they might make a mistake. They may lose self confidence and become isolated and depressed. And others may monopolize conversations so that they don’t have to do the listening. Hearing loss affects quality of life.

Today’s hearing aids can make speech audible for the hearing impaired person, but good listening skills are important too.

Here are some strategies for better communication with hearing impaired people…

Coping strategies for a hearing impaired listener…

• be patient • watch faces and gestures • repeat back what you heard to verify you got it right • think of new ways to ask for repetition other than “huh” • tell people about your hearing loss • use captions on TV and consider using a caption phone Coping strategies for friends and family of a hearing impaired person…

• get the person’s attention before speaking • repeat once, if the person still doesn’t get it rephrase the message, use different words • don’t shout or talk too fast • use visual cues (look at the listener, move closer, sit at eye level, and don’t talk with your hand by your mouth) • use gestures and facial expressions • mustaches and beards make it more difficult to lip read If you think you have hearing loss, talk to your physician about it and rule out any possible medical causes. Then ask your physician for a referral to an audiologist who can evaluate and treat your hearing loss and come up with a comprehensive communication plan.

MyNorth Medical Insider

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MYNORTH MEDICAL INSIDER

Great Lakes Vein Specialist P E T O S K E Y

SURGEONS, PC 521 Monroe St. Petoskey, Michigan 49770 (231) 487-9090 Fax (231) 487-9191 www.greatlakesveins.com www.petoskeysurgeons.com

L-R, Kevin M. Markham, M.D., James Gracy, PA-C and David J. Rynbrandt, M.D

Kevin M. Markham, M.D. is board-certified and practices in general and vascular surgery. He graduated from Wayne State University Medical School in 1995 and completed his six-year residency in general surgery at William Beaumont Hospital in Royal Oak. He began practice with Petoskey Surgeons, PC as an attending surgeon at Mclaren-Northern Michigan Hospital in 2001. In addition to his surgical practice, Dr. Markham has been performing in-office endovenous ablation since 2011.

David J Rynbrandt, M.D. is board-certified and practices primarily in general surgery. He graduated from the University of Michigan medical school in 1981 and stayed in Ann Arbor for an additional five years completing a general surgery residency at St. Joseph Mercy Hospital.

He began practice in Petoskey as an attendlng surgeon at Mclaren-Northern Michigan hospital in 1989. He is the former Chief of Staff of Northern Michigan Hospital and more recently served on the hospital Board of Trustees. In addition to his busy surgical practice, he has been performing in-office endovenous ablation since 2011. ]ames Gracy, PA-C received an undergraduate degree from Northern Michigan University in 1980. He attended Mercy College of Detroit (University of DetroitMercy) where he obtained his degree as a Physician Assistant in 1989. He has been on staff at Mclaren-Northern Michigan Hospital since 1991 working in the cardiothoracic and vascular surgery section until his recent appointment to general and vascular surgery. He has participated in over 5000 open-heart surgeries and has personally performed over 3500 vein procedures including 1700 endovenous ablations since 2007.

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Great Lakes Vein Specialists Petoskey Surgeons, PC Chronic venous insufficiency (CVI) or “varicose vein disease” is a common medical condition that affects up to 50% of the adult population; women are affected two times more frequently than men. If either of your parents had vein problems, you are more likely to have them yourself. Symptoms include leg aches, fatigue, heaviness, discomfort, swelling, itching, burning and cramps. Many people have a combination of these symptoms without having the obvious visible signs of varicose veins.

CVI is a disorder marked by veins inability to pump sufficient blood to the heart from the legs because of valves that are damaged or not working effectively. In order to return to the heart, blood in the legs must travel “uphill” against gravity.

To assist with this directional flow, veins have one way valves that assist in moving the blood along. When the valves become damaged, blood can leak backward which results in the veins becoming dilated and ineffective. Over time, it becomes increasingly more difficult for the blood to return back to the heart and the blood ends up “pooling” in the legs for long periods of time; this is when CVI develops.

An ultrasound and clinical evaluation is the key to making an accurate diagnosis. After that, symptoms may respond well to conservative treatments like leg elevation, avoiding prolonged sitting or standing, daily exercise, weight reduction and compression hose. Some people require more advanced treatment techniques such as endovenous thermal ablation, laser ablation, microphlebectomy and cosmetic skin laser ablation and sclerotherapy.

At Great Lakes Vein Specialists, we maintain that our vast experience in vascular surgery enables us to provide the most comprehensive assessment of venous problems resulting in accurate treatment options. Our “vein clinic” was formed to offer patient’s state-of-the-art diagnostic and treatment options which result in expected outcomes with minimal patient discomfort. No other practice in our region offers patients every known treatment option that currently exists.

No referral is required and you can contact us for a “free screening” by simply calling our office at 231-487-9090.

MYNORTH MEDICAL INSIDER

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5 Summit Park Drive Timothy • Charlevoix · Professional Building C JarviArea MDHospital and Debra Denton

OD, along theirDenton staff at Summit 231-348-3600 • 877-270-1373 Timothy Jarvi MD andwith Debra OD, Park Eye and Cosmetic Specialists (SPECS)

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It is theireye degeneration, glaucoma, or diabetic ook your best! disease; or desire such pleasure and privilege toprocedures help you seeas and cosmetic eyelid surgery, Botox, permanent look your best! makeup or one of various skin tightening procedures; our compassionate Whether you need a comprehensive eyeand experienced professionals will provide you Whether you need a comprehensive eye exam, new prescription eyeglasses, the with the best care availableor anywhere– exam,here newlocally! prescription eyeglasses, or the right very latest invery cataract surgery techniques; latest in cataract surgery techniques; Call to make an appointment today, equire management of macular degenerarequire management of macular degeneraor just stop by and browse our large tion, glaucoma, diabetic eyein disease; ion, glaucoma, or diabetic eye disease; or or collection of theorlatest styles quality eyeglasses and sunglasses.

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CallCharlevoix to make an appointment today, or just Area Hospital stop by and browse ourBuilding large collection Professional C Call to makeofan today,eyeglasses or just theappointment latest styles in quality

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CO2 Laser and Pelleve Radio •Cataract Cataract Surgery Advanced Surgerywith with Advanced • Botox/Fillers Frequency Skin Tightening Technology Intraocular Implants Technology Intraocular Implants (Tattoo) Makeup Botox/Fillers Cataract Surgery with Advanced• Permanent (See what you’ve been missing!)

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MYNORTH MEDICAL INSIDER

The OMH Medical Group-Indian River 3696 S. Straights Hwy • Indian River, MI 49749 231.238.0581 • myomh.org/indian-river The OMH Medical Group-Indian River, which first opened in 2012, is rapidly expanding to better serve patients closer to home. Just this year, OMH Obstetrics and Gynecology physicians began seeing patients in Indian River, significantly reducing travel time for expecting moms. The OB/GYNs join Gilbert Noirot, MD, an OMH Orthopedic Surgeon also regularly seeing patients in the Indian River practice location. According to Barb Miller, OMH Vice President of Physician Services, “This is just the beginning of many good things to come in Indian River. We look forward to continually expanding our specialty services offered to Indian River and the surrounding communities.” The practice also offers primary and walk-in services. Michael Florek, DO, is

joined in practice by Peggie Rorick, NP, and Julie Hodson, NP. All three local providers have extensive experience and are accepting new patients. Whether in town visiting when a flu bug hits, or seeking a skilled primary care provider, the OMH Medical GroupIndian River can help. For more information, or to schedule an appointment, please call the office at 231-238-0581.

MYNORTH MEDICAL INSIDER

3291 Racquet Club Dr., Suite C • Traverse City, MI 49684 231-421-8000 • chroniccertcenter.com.

Chronic Certification Center offers a holistic approach to improve patients’ quality of life. Empowering patients to take charge of their own health is one of the most satisfying experiences of our profession. We want our patients to have a meaningful experience when they walk through the door. Our mission and goal is to provide patient-centered education and assistance in the Medical Marihuana certification process. We are the only center that takes the time to really evaluate each patient, looking at all aspects of care; mind, body, spirit, and emotional

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needs. We listen. Your concerns, goals, and needs are important to us. Your privacy is guaranteed. Our doctors and staff of Medical Marihuana specialists in Northern Michigan maintain their position at the forefront of ever-expanding scientific research of the medical use of marihuana by actively studying the latest developments in this highly specialized field. Chronic Certification Center is now accepting new patients and would like to invite you for a personal experience with our staff. Please call us for an appointment or find us on our Facebook page.

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1221 Sixth Street, Suite 306 • Traverse City, MI 49684 231-935-2400 • www.surgicalassociatestc.com Growing our practice into the future…

Surgical Associates has been caring for Northern Michigan for more than 35 years. Comprised of board certified specialists in general, colorectal, and vascular surgery, we provide the highest quality of care and the latest innovations in surgery.

During the past year, the growth of our practice has continued.

To keep up with increasing demand, our 15-year veteran nurse practitioners – Toni Gaultier, ANP, and Sue Barner, FNP – are now seeing new patients under the supervision of our six general surgeons. Together, our physicians have over 100 years’ experience in their specialty areas.

As always, we continue to incorporate new technologies and techniques into our practice to better serve the medical needs of you and your family. Drs. Richard Tooley and Michael VanderKolk utilize the laparoscopic da Vinci Surgery System, which can decrease length of hospital stay and post-operative pain for patients with diagnoses such as colorectal cancer and diverticulitis.

Services Include: • Hernia Repair • Breast Surgery • Endocrine Surgery • Colorectal Surgery • Cancer-Related Surgery

• Gallbladder Surgery • Vasectomy • Nodule/Mass Excisions • Varicose Vein Treatment •Vascular Ultrasound Testing

• Laparoscopic Surgery • Upper Endoscopy • Colonoscopy • Flexible Sigmoidoscopy

Our surgeons and administration keep abreast of the latest advances to serve you best. Our goal is to provide you with superior medical care, while helping you navigate the surgery process with ease. We provide unequaled surgical expertise, and we strive to address your needs in a professional and compassionate manner that exceeds your expectations.

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Family Hearing Care 315 N. Division, STE 120 • Traverse City, MI 49684 (231)946-2200 • office@familyhearingtc.com www.familyhearingtc.com How does FAMILY define our business? Communication is the key to any relationship, and FAMILY relationships suffer when hearing loss interferes. There’s a difference between hearing, listening, and understanding. Knowing those differences is important. This is why we include your significant others during your appointments (spouse, child, sibling, or friend). Any hearing aid can increase volume, but at FAMILY HEARING CARE it’s the counseling, experience, and expertise that will guarantee your satisfaction. Listening to your needs, forming a lasting partnership, and earning your trust through true caring and concern means we’ll do whatever we can to help. The process of purchasing hearing aids can be confusing and frustrating. Our Flex:

Dr. Paul Hanrahan AuD, CCC-A, Ed Smith M.A., CCC-A

Try Before You Buy program lets you experience the benefit of hearing aids in your own home with no cost or obligation.

Call, stop in, or find us on the web. We are FAMILY HEARING CARE with “Decades of experience bringing you sound advice for a better future”….. Homemade cookies? Cup of coffee? Relax, you’re FAMILY coming by for a visit, located next to Sleder’s Family Restaurant.

MyNorth Medical Insider

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Advances in

Northern Michigan Dental Care MI 30

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Oral Cancer

HPV Virus Is Leading Cause

Infant Safety

OPPOSITE: JOKIC/ISTOCKPHOTO. ABOVE: EMIR MEMEDOVSKI.

FDA Warns Against Teeth-Numbing Gels Parents have long used topical anesthetics with Lidocaine Viscous to numb a baby’s gums during teething, but on June 26, 2014, the Food and Drug Administration issued a strong warning against the practice. The FDA’s warning singled out prescription products containing 2 percent Lidocaine Viscous, but also discouraged using over-thecounter brands as well.

“It’s been shown that when too much Lidocaine Viscous gets swallowed it can cause seizures, brain injuries and problems with the heart,” says Traverse City dentist Dr. Peter Piché. The FDA’s review also found cases in which infants died following use of the prescription strength product. “The problem comes when too much is given,” Piché says.

“The husband gives it, and the mom doesn’t know that, so she gives more. The product is flavored, so the baby is intentionally licking his gums and swallowing the medicine.”

The FDA’s announcement says, “We are requiring a new Boxed Warning, FDA’s strongest warning, to be added to the drug label to highlight this information.”

Back in 2011 the FDA issued infant and child warnings about using common overthe-counter gum-numbing gels that contain benzocaine, products such as Anbesol, Hurricaine, Orajel, Baby Orajel, Orabase, and various store brands.

“Parents should know that teething pain is a short-term thing. It will pass,” Piché says. As alternatives to pain-killing medicine, he suggests water-filled teething rings that are chilled but not frozen and massaging the gums.

Dr. Peter W. Piche, DDS, 231.947.2716

The role of human papillomavirus (HPV) in causing cervical cancer has been widely publicized in recent years, less well publicized, however, is the role of HPV in causing oral cancers.

“Twenty years ago, the main risk factors for oral cancers were smoking, smokeless tobacco and heavy drinking, but today the leading cause of oropharyngeal cancers, those in the back of the mouth, is HPV,” says Dr. Dave Swan, a Traverse City dentist.

More than 40 different strains of HPV infect the genital region, but two of them—No. 16 and No. 18—account for the vast majority of the 8,400 HPV-caused oral cancers diagnosed each year. Numbers 16 and 18 are the same HPV types that account for 70 percent of cervical cancers. Other types of HPV commonly cause warts.

“HPV viruses are ubiquitous,” Swan says.

“The vast majority of people are exposed to these types of HPV in their lives, but in most cases, your immune system takes care of it.” The vaccine Gardasil, recommended for females and males, is effective against HPV 16 and 18 and other strains that cause 90 percent of warts.

Researchers say that changes in sexual behavior, particularly an increase in oral sex, is to blame for the increase in oral cancers caused by HPV. Men are three times more likely to have oral cancers than women.

The take-away is that oral cancer screenings need to be a part of quality dental care. “If you can catch the cancers early on, your survival rate is much, much higher,” Swan says.

As a medical professional, Swan knows that some people vacillate on whether to have their boys and girls immunized. “You can say, ‘all I have to do is not engage in a risk factor and I won’t get it,’ and sometimes that is realistic and sometimes it is not,” Swan says. “When you have sexual contact with somebody, you potentially expose yourself to viruses carried by everybody they’ve ever had sex with and everybody who those people have ever had sex with.”

Dr. Dave Swan 231.947.0210 MyNorth Medical Insider

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Early Detection for Tooth Decay

How regular dental visits and simple procedures promote your health and well-being.

BY DR. MELISSA MAKOWSKI OF LAKEVIEW DENTISTRY

Dr. Melissa Makowski and her team at Lakeview Dentistry of Charlevoix are committed to providing exceptional care by utilizing the most advanced dental technology. She has undergone extensive laser training with and holds a mastership in the World Clinical Laser Institute. She is a member of the Academy of Laser Dentistry and has also received training in Botox use specific for dentistry by the American Academy of Facial Esthetics. Dr. Makowski is also a member of the dental honor society Omicron Kappa Upsilon, the Academy of General Dentistry, American Academy of Cosmetic Dentistry, American DenAMILY AND ENTISTRY tal Association, MichiganASER Dental Association and the Vacationland District Dental Society.

Dr. Makowski dedicates herself to continuing education to bring the most advanced dental care to her patients.

F

L

D

Lakeview

D E N T I S T RY O F C H A R L E V O I X

Conservation. Education. Prevention.

109 West Hurlbut Charlevoix, Michigan 49720 (231) 547-4347 www.charlevoixdentist.com

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At Lakeview Dentistry of Charlevoix, Dr. Makowski continues to lead the way with innovative dentistry in northern Michigan.

Utilizing the most state of the art, non-invasive way to detect early dental decay, she has elected to incorporate the Spectra system by Air Techniques into her practice. Spectra is an FDA approved tool that uses a color visual system and software analysis to provide a picture of the tooth showing where the structure is deteriorating. As early as 1998, research in dental decay detection was recognizing that in the presence of certain light, a chemical that bacteria produce called porphyrin readily fluoresces red whereas sound enamel fluoresces green. The bacteria that are responsible for dental decay, S.mutans, produce porphyrin when they are active.

Capturing this fluorescence, the Spectra allows for early detection that goes beyond the dentists visual examination and x-ray capability, to identify what was not easily seen by the naked eye. Historically, an x-ray and a sharp dental tool were the only diagnostic tools a dentist had to detect decay.

The tooth may have appeared healthy on the surface, but in reality was diseased. By the time the decay was apparent with either of these modalities, the area of decay was quite large, necessitating a larger restorations.

The advanced Spectra system can be used as a baseline which allows patients to be a partner in their dental treatment and better understand the options of treatment or observation. As an image is captured, values are set for specific areas on the teeth and recorded. This allows for comparison as time progresses. At the earliest sign of deterioration, the cavity can be identified and restored.

If a cavity is identified and the patient decides not to treat it right away, these previous records can be accessed for comparison. The

Spectra shows the patient the presence of harmful bacteria in the mouth, and corresponding oral hygiene status. This can help motivate the patient to carry out a regimen of better dental care—both at home and through regular check-ups and cleanings at the office. Dr. Makowski continues to bring innovative technology to her practice because her mission is to educate patients about their oral health, prevent decay by disease, and to conserve as much natural tooth structure as possible. Dr. Makowski elected for the Spectra system because it can be used on all areas of a tooth, even areas next to old fillings. Early disease detection is the key and can make a significant difference between patients needing extensive restoration of a tooth versus a surface filling only requiring minimal treatment.

Dentures

Munson Medical Center

Secure Fit With Implant Posts

STEVE COLE IMAGES

Standard lower dentures have long vexed dentists and customers alike because in many cases they do not fit securely.

The problem often gets worse over time because the ridge of bone and gum the dentures sit upon tends to shrink with age, and the lower denture becomes more and more loose. But denture patients need not live with an improper fitting lower set of teeth. Dentists can install implants—most commonly two tiny posts in the lower jaw—that a denture snaps on to, fixing the denture snugly in place. The denture easily detaches from the implant for cleaning.

“Patients just can’t believe how tightly the dentures hold,” says Traverse City dentist

Phil Yancho. “And they can’t believe their improved comfort level and their ability to chew things that they could not before.”

Implant-secured dentures are not new; they’ve been around for decades. But in the past dozen years they’ve grown in popularity, in part because of improved function.

“The success rate is higher and higher and they are seen to be lasting longer and longer,” Yancho says. Dentists now counsel that people who receive denture implants during their 40s will most likely have them the rest of their lives. “The success rates for the procedure are among the highest in the profession, in the mid to high 90 percent rate,” he says.

Higher initial cost for implants is a main reason people choose to go with standard dentures: the implant approach can double the expense. But over the long term, the secure, well-fitting dentures ca avoid other issues and save lifetime dental expenses.

Higher initial cost for implants is a main reason people choose to go with standard dentures: the implant approach can double the expense. But over the long term, the secure, well-fitting dentures can avoid other issues and save lifetime dental expenses.

Patients should also know that existing dentures can often be retrofitted with the implant connectors, so upgrading existing dental work is sometimes an option.

Like the good dentist that he is, Yancho reminds: The best dentistry is no dentistry.

“Don’t let what you got rot,” he says. “It so often comes back to the way people are raised. I had a patient recently who is 95 and she has all her own teeth. Her parents took her to the dentist regularly.

Take your kids to the dentist, take them every six months. An ounce of prevention is still worth a pound of cure!”

231.941.2201, yanchodentistry.com MyNorth Medical Insider

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CAPTION: (L-R) Dr. David Whalen, Dr. Michael Hutchison

Associates in Family Dentistry

10850 E. Traverse Hwy Ste 2250 • Traverse City, MI 49684 231-946-9644 • www.smiletc.com Nestled in the beautiful surroundings of Northern Michigan, in the heart of Traverse City, MI, you will find a dental office unlike any other. Amidst the relaxing view of West Grand Traverse Bay, a dental team committed to the endless pursuit of excellence is waiting to welcome you. We are Associates in Family Dentistry.

“Our practice utilizes CEREC Omni-Cam 3D technology to deliver exceptional, highly aesthetic restorations. This amazing piece of equipment eliminates the need for conventional impressions, temporaries and the requirement of two appointments! Because CEREC restorations are precision-milled at the time of your visit, they are placed immediately, requiring only ONE appointment for crown restorations! CEREC’s full-porcelain restorations possess long-term durability and look as natural as your existing teeth.”

From same-day crowns to exceptional laser dentistry, dental implants to routine cleanings, our team is committed to providing the highest quality in dental healthcare. Our practice always welcomes new MI 34

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Services Include: • Complimentary X-Rays for New Patient • Same-Day Crowns • Dental Implants • Cosmetic Dentistry (Accredited in Academy of Cosmetic Dentistry)

• Laser Dentistry

• Porcelain Veneers • Metal-Free Fillings • Root Canals • Sleep Apnea • TMJ Treatment & Management • Periodontal Therapy • Digital X-Rays

patients and provides complimentary digital x-rays to all new patients at their initial exam and cleaning appointment.

Dr. Michael Hutchison and Dr. David Whalen, along with their entire team, invite you to experience the difference today. Welcome!

MYNORTH MEDICAL INSIDER

Expanding the World of Orthodontics for the love of doing it better

Dr. William Northway

TRAVERSE CITY 12776 S. West Bay Shore Dr. Traverse City, Michigan 49684 GRAYLING 6957 West M-72 Grayling, MI BEULAH 67 South Benzie Boulevard Beulah, MI 49617

800-771-6951 www.northodontics.com

While in dental school at the University of Michigan Dr. William Northway took a job at the Center for Human Growth and Development. It was there that he was exposed to research and acquired his conspicuous love for improving the science of dentistry. With his contacts and experience from CHGD he was able to develop the growth data from the University of Montreal into a seminal paper on the effect of losing baby teeth early. While practicing in Canada Dr. Northway was fortunate enough to develop relationships with Drs. Rolf Frankel and Egil Harvold who helped him to adopt a more European approach to orthodontic growth modification. These experiences have been essential to the development of his protocol for early treatment – a subject on which he has lectured around the world.

Dr. Northway feels fortunate to have been able to team up with colleagues Dr. Royce Beers and David Howard; it was this opportunity to play off of his experience with them that led him to publish and develop courses on methods of providing upper jaw expansion to patients of all ages. He also discovered and popularized a method to remedy the problem of congenitally missing lower premolars.

This “hemisection technique” has resulted in the savings of hundreds of thousands of dollars in healthcare costs. His team has also been working to provide further financial savings by alleviating the need for dental implants to replace anterior teeth.

During the last few years, Dr. Northway has been taking aim at improving the periodontal impact of orthodontics by actually reducing and even eliminating gingival recession through orthodontics. While surgical grafting had been recommended for the patient shown on the right, her exposed roots were treated by orthodontics alone – this gum tissue correction was accomplished at the same time that the teeth were being made straight.

Before

Prescription Appliance

After

Dr. Northway will tell you he’s the luckiest guy on the face of the Earth to be able to “work” by finding new ways of making people and their smiles more beautiful.

“I don’t know what I’d rather be doing than orthodontics. Every case presents a new and different challenge”. His love for orthodontics and improving the artistry therein is evident in his final results.

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Dr. John Holcombe Dr. Steve Hall 1299 South West Bayshore Drive • Suttons Bay, MI 49682 231-271-6700 • suttonsbaydental.com Dr. John Holcombe and Dr. Steve Hall are proud to provide high quality dental care to their patients. Established in 1977, the Suttons Bay Dental Center has been providing Leelanau County with conservative esthetic and family dentistry for over 30 years. A dedication to personalized, comprehensive dental care with a special focus on each patient’s comfort helps to define their team’s mission.

Now on their second decade of offering computerized CAD CAM dentistry, the office is often described by patients as high tech and cutting edge. Dr Holcombe remarks, “Many of our new patients are retired to the area and often are surprised that our

Leelanau County office is more advanced than their ‘big city’ office back home.” Digital x-rays, one visit CAD CAM designed crowns, and paperless records all contribute to the office’s advances in technologies.

Although technology is important, the biggest point of pride for the doctors is the experienced, caring staff. Seeing a familiar face at appointments helps to establish relationships with the patients thus making visits enjoyable and relaxing.

The most rewarding part of their day is helping patients change their smiles. Drs. Holcombe and Hall have emphasized this in their practice and are thrilled to see a new smile change a patient’s life.

MYNORTH MEDICAL INSIDER

Traverse Dental Associates 555 S Garfield Ave • Traverse City, MI 49686 231-947-0210 • traversedental.com A Team Approach to Dentistry Drs. David Swan, Macare Lumbrezer, Chris Mazzola, Josh Van Horn, and Christina Mazzola are all graduates of the University of Michigan School of Dentistry. The greatest advantage of working in a practice with five doctors is the ability to collaborate on patient care. This team approach gives patients the benefit of all of their advanced training and collective skills. They meet regularly to discuss cases and share techniques they’ve learned at continuing education courses.

Patients appreciate that we can perform most services right in our office including dental implants, sedation dentistry, and wisdom teeth extraction. Whether you are a new patient or one MI 36

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(Back row:) Dr. Swan, Dr. Van Horn, Dr. Mazzola (Front row:) Dr. Lumbrezer, Dr. Mazzola

of the many patients that have been in our office for decades, our goal is to exceed your expectations at every visit.

Our team approach is successful due to the efforts of our hygienists, dental assistants, and business staff. Every day we hear patients comment on the care they receive; complementing our team as happy, eager to help, and, of course, smiling.

Learn more about our office at: www.traversedental.com or call us at 231.947.0210.

MYNORTH MEDICAL INSIDER

Mason Periodontics & Dental Implants 541 South Garfield • Traverse City, MI 49686 231-932-4223 • www.masonperiodontics.com Mason Periodontics provides personalized dental care to patients all over Northern Michigan. When you visit our office you can be confident that you are receiving the finest and most advanced dental care available. Our office uses state-of-the-art technology and materials to allow us to detect dental concerns at the earliest stages, treat your dental issues with precision, and provide stunning results. Our practice also employs a premium dental software system to maximize our efficiency and reduce the time of your office visit. We pride ourselves on the warm, individualized care we offer to our patients, as well as, utilizing the most modern equipment and methods available.

Dr. Suzanne Mason grew up spending summers in Omena,

WellnessRadio.com Featuring Dead Doctors Don’t Lie with Dr. Joel Wallach

Weekdays • 5am

• 8pm

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Hear Dr. Joel Wallach with Youngevity Health Team

Mi chiga nTa l k . co m

Michigan with her family and working at a local restaurant in Northport. She received her B.S. in physiology, DDS from the University of Detroit Mercy School of Dentistry, and a M.S. in Periodontics from the University of Michigan, Ann Arbor. She was elected as American Academy of Periodontology Student Ambassador and is a member of the Michigan Dental Association, the American Dental Association, American Academy of Periodontology, the American Academy of Dental Research and the Midwest Society of Periodontology. Dr. Mason is a Michigan Board certified periodontist and a diplomat of the American Board of Periodontology.

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