- Osteoporosis
- ArthritisAutoimmune diseases arise from an inappropriate immune response of the body against substances and tissues normally present in the body. In other words, the immune system mistakes some part of the body as foreign and attacks its own cells. Some examples of common autoimmune diseases are rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, and psoriatic arthritis. Some of the less common ones are Wegener’s granulomatosis, Vasculitis, and Raynaud’s phenomenon.
- Fibromyalgia
- Medical Weight LossIn the long term the gout patient has to make changes to their diet. Restricting foods which are rich in purines, compounds which break down into uric acid, is a must. Such foods are meat, certain types of seafood, and alcohol (especially beer). Weight loss is suggested and compliance with your treatment plan is critical. Gout is strongly linked to high blood pressure, hyperlipidemia, diabetes, and heart and kidney disease. Gout tends to run in families and rarely affects children. Lifestyle changes can have a very positive outcome in the management of gout.
- RheumatologyThe American College of Rheumatology (ACR) has compiled this list to give you a starting point for your own additional research. The ACR does not endorse or maintain these websites, and is not responsible for any information or claims provided on them. It is always best to talk with your rheumatologist for more information and before making any decisions about your care.
- Primary CareOur rheumatologists do not refill any prescriptions that he/she did not prescribe. It is necessary to have a primary care physician who will provide overall medical care for each patient.
- Ophthalmology
- Pregnancy
- Internal MedicineThe physician who is best suited to treat problems of the joints and musculoskeletal system is the Rheumatologist. Rheumatologists are physicians who specialize in treating people who have persistent aches and pains. Initially, a Rheumatologist is trained in Internal Medicine so he is very familiar with the various medical problems that may present with joint complaints. After specializing in Internal Medicine, the Rheumatologist spends two more years sub-specializing in pure rheumatic disease so that by the time he goes out into practice, he is able to recognize the causes o
- Gastroenterology
- Nephrology
- Ovarian CancerAt the moment, probably close to 28 million Americans are affected by osteoporosis. This is almost one out of every two women over the age of 50. By the age of 75, 1/3 of all men will be affected by osteoporosis. Osteoporosis causes nearly 1.6 million fractures annually resulting in costs directly and indirectly of nearly $10 billion dollars. The truth is that individuals suffering hip fractures have a 5 to 20% greater risk of dying within their first year following an injury than other individuals in their age group. A woman’s risk of hip fractures is equal to her combined risk of breast, uterine and ovarian cancer. The point is that, this can be totally prevented and ultimately osteoporosis is a disease that can be eradicated if we make an early diagnosis and aggressively treat people who have bone loss. We now have a number of different prescription drug treatments. All these drugs help to stop bone loss, reverse bone loss and/or aid in the making of new bone. These treatments are tailored individually to the patients’ needs and have reduced the incidence of bone fractures dramatically. Additionally, there is an exciting new non-pharmaceutical treatment option, the BioDensity machine, now available in our office.
- Neurology
- Carpal Tunnel SyndromeSymptoms related to problems from the carpal tunnel are a very frequent cause of patients coming into my office. Very often the diagnosis has been missed, ignored or misdiagnosed because of nonspecific complaints the patient demonstrates. The carpal tunnel is a space in the lower forearm formed by the bones in the wrist and the distal ends of the radius and ulnar. It is through the so-called “carpal tunnel” that the median nerve runs into the hand, in particular, to the thumb and middle three fingers. It does not go to the 5th finger, which is why symptoms of carpal tunnel syndrome will rarely, if ever, affect the 5th finger and will primarily affect the side of the hand and the fingers closest to the thumb. The symptoms of carpal tunnel may go from the wrist down to the fingers, or may radiate in a retrograde fashion backwards and up the forearm. Typically, patients may complain of numbness in the thumb and middle fingers, with pain and unusual sensations in the same distribution.
- Multiple Sclerosis
- Diabetes Care
- ThyroidMales may also benefit from a bone density because osteoporosis is not a disease limited to women alone. If a male has similar problems to the ones I just mentioned, including hormonal issues such as thyroid disease, chronic illness and use of chronic medications for other conditions, for example, corticosteroids, they may also be at a high osteoporosis fracture risk. I strongly recommend that everybody that has a bone densitometry should have both the hip and spine measured. The use of bone density models that simply analyze a finger or a heel is a very primitive screening process.
- UltrasoundViscous supplements are a new class of medications used to treat osteoarthritis of the knee. Sodium hyaluronate (hyaluronan or HA) is a natural chemical found in your body and in joint tissues and synovial fluid that fills your joints. Your body’s own hyaluronan acts like a lubricant and shock absorber in synovial fluid of a healthy joint. There are a number of products like this which are used to treat osteoarthritis of the knee. These products are administered as injections given into the knee, sometimes under ultrasound guidance. Osteoarthritis negatively affects the quality of synovial fluid and therefore its ability to protect and lubricate your joint. The goal of a viscous supplement like sodium hyaluronate is to supplement the poor quality HA in your painful knee with additional highly purified HA.
- MRIUse of MRI to Evaluate Patients on Infliximab Therapy Use of MRI to Evaluate Patients on Infliximab Therapy Dr. Norman B. Gaylis USE OF IN-OFFICE MRI IN THE EVALUATION OF PATIENTS WITH RHEUMATOID Objectives: To assess the performance of an in-office magnetic resonance imaging (MRI) system in the diagnosis of rheumatoid arthritis (RA) [...]
- X-Rays
- Wound CareDr. Epstein was also the team physician for St. Thomas University and medical advisor for the World Olympians Association and USA Judo. He was the medical coordinator for the Volvo Ocean Race Around the World during its stop in Miami, and a member of the Miami Dade Sports Commission. He is a graduate of Tulane University and obtained his medical degree from the Autonomous University of Guadalajara, and is fluent in Spanish. He has been involved in numerous publications and research studies, and has developed wound care and exercise equipment.
- Botox
- Dermatology
- LesionsMany people are surprised to hear that psoriasis, a condition that has historically always been associated with affecting the skin only, may in fact also be part of one of the more common causes of arthritis, known as psoriatic arthritis. Psoriatic arthritis is a condition that can be seen either with the typical skin changes of psoriasis and with associated pain and swelling of the joints or, alternatively, may present with pain and swelling of the joints without the skin lesions being present. It is only after evaluating the patient’s fairly typical joint presentations, performing further blood tests and X-rays that the diagnosis of psoriatic arthritis is made. If the correct diagnosis is missed, the patient is given more than one diagnosis and the treatment, which in recent times has become more beneficial and is capable of reversing the joint damage, is not utilized.
- PsoriasisIn many cases, there may well be a family history of psoriasis, especially in males, but females may also be subject to developing psoriasis and psoriatic arthritis. The condition may occur at any age, but it is often present at a very young age and usually presents by the time the patient reaches middle age. There is an association of a specific gene called HLA-B27, which when present causes the type of psoriasis arthritis that affects the spine in a similar way to ankylosing spondylitis. These patients present more commonly with neck and back pain rather than involvement of the peripheral joints. Another form of psoriatic arthritis mimics the arthritis seen in rheumatoid arthritis and will primarily affect the joints in the toes and hands. Classically, these patients may develop what we call “sausage toes” as their toes swell up like small cocktail sausages and very often there will be nail changes in the hands and the feet which help the physician to make the diagnosis. The condition is often aggravated by stress and worsens in the presence of other co-existing diseases.
- Sports MedicineSports injuries and the injuries of the Aging Jock Sports injuries and the injuries of the Aging Jock Dr. Norman B. Gaylis One of the most common complaints that I am asked to treat in my practice is the early retired male or female patient who has waited his/her whole life to [...]
- Physical TherapyThe common treatment plan for AS includes physical therapy, the use of anti-inflammatories, an exercise routine, as well as the use of heat/cold to relax the muscles and relieve joint pain. The second line of treatment choices include disease modifying anti-rheumatic drugs (DMARDS) and biologic agents such as TNF blockers.
- Back Pain
- General Podiatry