General Practitioners

• Arthritis
  Peripheral nerve microsurgery is utilized to treat nerve related pain due to trauma, failed surgery, diabetes, chemotherapy induced pain, rheumatoid arthritis, foot drop, and other conditions.
• Plantar Fasciitis
• Medical Weight Loss
  Generally a healthy lifestyle with a weight reduction and a moderate exercise program guided by the primary physician are beneficial in further reducing risk of diabetes related foot and ankle complications.
• Primary Care

Internists

• Internal Medicine
  Internal Medicine specializes in the management and treatment of chronic and acute illness relating to the internal functions of the body. Internists are doctors for adults who diagnose and treat illnesses such as hypertension, diabetes, heart disease, and high cholesterol to name a few. Anastasia Medical Group is dedicated to providing high quality care for the treatment and prevention of illnesses. The office is equipped to perform many diagnostic services which allow for optimal diagnostics and treatment.

Neurologists

• Neurolysis
  A neuroma is a pathological condition of the common digital nerve between the third and fourth metatarsals (third inter-metatarsal space). The nerve sheath becomes abnormally thickened with fibrous (“scar”) tissue and the nerve fibers eventually deteriorate. The sensory nerve causing the neuroma is isolated by stimulation with an electrode. The radiofrequency generator then transmits a signal through the electrode, creating a lesion on the nerve in a process called thermo-neurolysis resulting in denervation of the neuroma rendering the same result as a surgical excision but without surgery. The procedure is performed in the office setting and Patients are allowed to walk immediately.

Endocrinologist

• Diabetes Care
• Endocrinology

Radiologist

• Ultrasound
  In order to control the backward flow of blood in these large veins, the vein that is the source of the visible varicosities must be sealed shut or removed. The vein may be sealed shut using energy sources such as a laser, or radiofrequency energy, or by ultrasound guided sclerotherapy injections.
• Chemotherapy

Surgeons

• Arthroscopy
  Technological instrumentation has led to the development of surgical techniques for the diagnosis and treatment of joint disorders. Arthroscopy is a procedure that utilizes 2-3 mini incisions around a particular joint and needle-like probes enter the joint. Dr. Pereira then introduces a tiny camera to inspect the joint. Additional instrumentation in then inserted through the other mini incision to perform the appropriate treatment within the joint. Unlike traditional joint surgery that requires large incisions to expose the joint, arthroscopy uses small openings to examine the joint. By eliminating the need for large incisions, arthroscopy reduces the risk of infection and swelling. Arthroscopy is performed as an outpatient procedure.
• Wound Care
  An opening in the skin may necessitate treatment. Dr. Pereira will discuss options prior to beginning treatment. Options for wound care are inclusive to the wound vac, surgical debridement, application of biological grafts in the office, or complex plastic surgical procedures that necessitate skin grafts and flaps performed in the operating room to cover the wound and ensure adequate healing
• Minimally Invasive Surgery
  Ryan J. Pereira provides the latest and the most advanced elective and reconstructive surgical techniques for all foot, ankle and leg problems. Dr. Ryan Pereira performs reconstructive techniques that are superior to conventional procedures that allows for early mobility through minimally invasive surgery. Every procedure is custom tailored to the individual patient which allows for dramatic results and focuses on patient comfort.
• Ankle Surgery
  Dr. Ryan Pereira’s practice is very niche oriented and focuses on the treatment of varicose veins, complex limb reconstruction, diabetic limb salvage, reconstructive foot & ankle surgery, and microsurgery.
• Bunion Surgery
  The arthrodiastasis procedure is indicated for an alternative to fusion or joint replacement in the younger population. The distraction creates a larger space or distance between the big toe joint. A monolateral fixator is applied across the joint for 6-8 weeks, followed by a period of physical therapy. During the distraction period, the patient is allowed to fully walk as tolerated. Furthermore Arthrodiastasis can be performed with good results for patients who have a stiff big toe joint with or without previous joint replacement, and failed bunion surgery that prematurely leads to osteoarthritis of the big toe joint.
• Joint Replacement
  The arthrodiastasis procedure is indicated as an alternative to fusion or joint replacement in the younger population. The distraction creates a larger space or distance between the distal tibia and the talus. A circular ring fixator is applied to the distal portion of the leg and foot for 6-10 weeks, followed by a period of physical therapy. During the distraction period, the patient is allowed to fully walk as tolerated. Arthrodiastasis can be performed with good results for patients who have a stiff ankle with or without previous joint replacement.
• Orthopedic Surgery
  The field of Orthoplastic surgery is a ‘marriage’ of conventional orthopedic surgery and plastic surgery in the operating room. In general, conventional orthopedic surgery focuses on the treatment of musculoskeletal problems. Plastic surgery focuses on the treatment of soft tissue problems. Orthoplastic surgery is best defined as “the principles and practices of both specialties applied to a clinical situation, either by a single provider, or teams of providers working simultaneously for the benefit of the patient”.
• Neurosurgery
  One of the main reasons for nerve surgery is failure of pain to resolve within the expected time period, worsening pain or continued loss or diminished muscle control.
• Toe Surgery
• Vascular Surgery
• Arthroscopy

Plastic Surgeons

• Plastic Surgery

Dermatologists

• Ulcer
  A skin ulcer is caused by a venous reflux disorder that is called a venous stasis ulcer. Early signs that a venous stasis ulcer may develop include a darkening of the skin in the area of the ankle. Gradually, the skin may become leathery or waxy in appearance. Without treatment of the venous disease, the skin may breakdown and bleeding may occur.
• Calluses
  The causes of diabetic foot ulcers are multi factorial. Poor circulation (PAD), loss and lack of sensation (neuropathy) and an impaired immune response system are some of the major contributing factors to the development of diabetic foot ulcers. Local problems such as calluses, deformed nails, inadequate foot and ankle hygiene and poorly fitting shoes also play an important role.
• Skin Care
  The estimated risk for major amputation in the individual with diabetes is 15-40X higher than the general population. This risk can be reduced by awareness, tight blood sugar control, lifestyle modification, good skin care and pressure reduction footwear.
• Burns

Physical Therapists

• Physical Therapy
  Cindy Chaconas practices orthopaedic physical therapy at Anastasia Medical Group. As a Doctor of Physical Therapy her expertise focuses on the physical rehabilitation of musculoskeletal pain and injury. Cindy graduated from the University of Florida with a Bachelors degree in Health and Human Performance in 2002 and the University of St. Augustine with a Doctor of Physical Therapy in 2007.
• Flatfoot Correction
• Heel Pain
• Orthotics and Prosthetic Therapy
  Dr. Pereira is a strong proponent of Limb salvage through a comprehensive multidisciplinary team approach. His team usually is inclusive of the patients primary care physician, endocrinology, infectious disease, vascular surgery, endovascular specialist, radiologist, plastic surgeon, and physical therapist. Once the patient is identified as patient at risk for limb loss via a thorough medical exam, Dr. Pereira will head the entire salvage team effort. Once limb salvage is attained these patients are then fitted for custom orthotics and prosthetics. Finally a physical therapy program is then started to attain complete functional rehabilitation.

Podiatrists

• General Podiatry
  Dr. Pereira graduated from the Ohio College of Podiatric Medicine with his Doctorate in Podiatric Medicine. He completed his residency in Podiatric Surgery at St. Francis Hospital and Medical Center in Hartford, Connecticut. Dr Pereira underwent additional training in Microvascular Surgery at Columbia University Medical Center in New York.
• Calluses
• Diabetic Foot Care
• Hammertoes
  Hammertoe, mallet toe are cross-over toe are terms used to describe an assortment of deformities of the toes. A frequently overlooked condition is called second toe instability, which produces fullness under the ball of the foot, associated with pain and a contracture of the second digit. Various options are utilized to allow for customized treatment. Treatment for hammertoes range from fusions, to joint reconstruction with or without implants along with tendon balancing procedures.
• Heel Spurs
  Prior to performing heel spur surgery for plantar fasciitis all other causes of heel pain must be excluded. Most patients do not require heel spur removal. If injections and orthotics fail, patients undergo an endoscopic plantar fasciotomy. A mini incision is created on the inside of the foot. A blade mounted on a camera is then inserted below the ligament. The ligament is then visualized while it is being cut. Patients are allowed to walk immediately after surgery.
• Heel Pain
• Plantar Fasciitis
• Podiatric Deformities
  The Limb Care Centre serves as a referral center for patients with diabetic Charcot foot deformities. This condition, properly called Charcot neuroarthropathy, develops in approximately 10% of individuals with diabetes. Of those people 10% develop the disease process to both feet. The condition results in a foot that undergoes spontaneous fractures, severe deformities and ultimately, ulcerations that may progress to an infection. If managed appropriately and in a timely fashion most patients are candidates for a Charcot reconstruction to allow them to ambulate on a stable foot.
• Podiatric Surgery
  Drop foot is a result of muscle imbalance due to a nerve injury. Options for drop foot surgery are inclusive to nerve releases, nerve repair, tendon lengthening, tendon transfers and fusion of joints of the foot and ankle. The appropriate treatment is based on advanced diagnostic testing.