IPALC Patient Newsletter
February/March - In This Issue:

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Thank You
Thank you to the community at large, who support the vision of IPALC and the leaders who devote their time, talent and treasure to keep goals in focus.  Without the patients of Lee County, the Physicians of Lee County wouldn't matter!

Transcranial Magnetic Stimulation: Drug-free Treatment for Depression

"TMS is transcranial magnetic stimulation, so it's a pulse magnetic field that we are able to localize in a particular area of the brain in order to stimulate the nerves within the brain and we can actually inhibit some of the nerves in the brain," he said.

Dr. Friday says the difference between pills and TMS is that TMS causes the nerves in the brain to fire as opposed to manipulating them with chemicals.

"What we found in patients with depression is the activity in their brain is low there are areas in the brain that activity are very low so the nerves are not firing activity."

Each year, around 45 million Americans complain about headaches.  It is one of the ailments people complain about the most. Approximately 8 million people per year make a trip to the doctor to seek diagnosis and management for headaches.  Making a correct diagnosis is the most efficient way to get control of this common problem. Causes include: tension headaches, migraines, cluster headaches, sinus headaches and neuralgia headaches. Headaches vary in severity and length.

Many people reach for over-the-counter pain killers to bring them relief. However, there are some other ways to potentially dull or eliminate the pounding in your head. Below, I will detail features of the various kinds of headaches.

According to the Centers for Disease Control and Prevention (CDC), 1 in 10 Americans have some form of liver disease.  About 25 percent of Americans have some degree of non-alcoholic fatty liver disease (NAFLD). NAFLD is the buildup of extra fat in the liver cells that is not caused by alcohol. The liver is supposed to contain some fat, but if more than 5 to 10 percent of the liver's weight is fat, then it is called a fatty liver.
A common cause of liver inflammation is an entity called NASH. This stands for NonAlcoholic SteatoHepatitis.   NASH comes from prolonged NALFD- NonAlcoholic Fatty Liver Disease.
Risk factors associated with NAFLD include: eating excess calories resulting in being overweight, obese, acquiring diabetes and high cholesterol/high triglycerides.  As we see with many disease conditions, poor eating habits can lead to this disease.  Rapid weight loss can be associated with fatty liver as well.
Most people with NAFLD do not have symptoms.  If symptoms do occur they come in the forms of fatigue, weight loss, nausea, abdominal pain, jaundice, weakness, itching, edema, and mental confusion which are signs and symptoms of cirrhosis/liver failure.  Blood tests and ultrasounds can determine if a person has NAFLD.
If a person has fatty liver disease and goes untreated, he or she runs the risk of active liver inflammation which is then called - non-alcoholic steatohepatitis or NASH. Persistent abnormal liver inflammation can progress to scarring and atrophy of the liver.  NASH is becoming the primary reason for liver transplant and end stage liver disease in the United States.
When a person has fatty liver disease, they do have an accumulation of excess fat in the liver, but that does not mean there is any damage to the liver yet. Through dietary changes, a person can help manage NAFLD and NASH with reversal or inhibiting any further damage.  Data has shown that taking statin medication can reverse the inflammation as well as reduce the changes that lead to cirrhosis.

Abdominal pain is one of the most common complaints people tell their doctors. There are numerous causes for such pain, many of which will resolve on their own over time. Some abdominal pains can be more complicated, troubling, and even life-threatening. One such cause of abdominal pain is gallstone obstruction. Gallstones are common and often don't cause symptoms unless they interfere with the normal flow of bile through the liver, gallbladder or bile ducts.

The gallbladder is found in the right upper part of your abdomen right under/beneath the liver. The gallbladder holds bile, a digestive fluid, that gets released into the small intestine. A major reason why gallstones form is due to not-so-great chemistry of cholesterol. If this cholesterol is unable to stay in a dissolved state, it crystallizes resulting in  stone formation. Gallstones can be as small as a grain of sand and up to as big as a golf ball.

s stated earlier many people will never feel their gallstones.  If a gallstone lodges in a duct causing a blockage to bile flow, a person can experience intense pain in the upper abdomen, back pain between the shoulder blades, pain in the right shoulder and pain in the center of the abdomen right below the breastbone.
Bile duct obstruction can cause more than a transient attack of abdominal colic.  A person can become jaundiced (skin and whites of eyes turn yellow) due to bile accumulation in the tissues.  Jaundice is usually quite itchy.  The gallbladder can become infected as can the bile ducts- this is a very serious situation and potentially life-threatening.  Gallstones and "sludge" in the bile ducts can also promote acute pancreatitis which also can be life-threatening. This is a very painful condition with generalized abdominal pain, potentially fever and serious infection as well.

Read more

More health blogs are available by going to ipalc.org/blog/


Raymond Kordonowy, MD

Here we are at the beginning of April already.  Before we know it everyone will be packing up or joining the family for summer vacations.  

Our association will be having its membership meeting in the next couple of months.  We are surveying our members in preparation for his.
Unfortunately, any changes at the national level regarding health care law seems to remain "frozen".

This only reinforces the perspective of our independent physicians -we provide services and access with the patient as our center focus.  More of us are offering direct patient care memberships and as President I will continue to encourage our doctors to inform the public of their prices for services. 

Having transparent price disclosure helps patients and citizens take more control and responsibility for their health care choices.

We are into the second month of offering our operator hotline on our website.  Please avail yourselves of their assistance if you need doctor and health diagnostic services.  We encourage you to choose independent physicians as they have the least conflicts of interest when it comes to taking care of folks in need.

I hope you enjoy our "in the news" topics.  Feel free to provide us feedback as it relates to our doctors association, operator service or website.  

Thanks for your patronage!

Raymond W. Kordonowy MD IPALC President

Physician Spotlight

IPALC would like to offer you a different feature physician each month to help you learn who our Independent Physicians are in our community. 


As you begin reading our newsletter, if there is a specific group or physician in Lee County you wish to know more about,  send an email to  info@ipalc.org so that we may feature that physician or group.

Dr. Harold Tsai, M.D.
Board Certified with the 
American Board of Urology


 About Dr. Harold Tsai, M.D. 

Are you looking for a urologist who can help you with a medical condition that makes you feel uncomfortable, embarrassed or perhaps even scared? 

Imagine finding a doctor that could help you with your problem while giving you genuine care and advice you would expect from the very best.

I'm Dr Tsai...  You can call me Harry.  I realize that most people don't like what has happened to medicine in America today; It used to be that your doctor used to take the time to get to know you and "listen" and now, it seems like many doctors' offices have become high speed corporate managed machines.  Offices seem overbook patients and doctors are stressed out because they have to keep their time with patients very short.  If you are tired of long lines, doctors that don't seem to care and only minutes with your health care provider, then I would like to invite you to come see us.

At Fort Myers Urology , we treat you the same way doctors did in what is referred to as the "good old days."  We are polite and helpful on the phone, we don't overbook patients and wait times are kept to the absolute minimum.  On the flip side, I will personally be your doctor and I will make sure to take care of you the same way I would a member of my own family.  

Oh, and don't worry about quality of care, I come highly qualified; (20 years of experience, education and training. Attended University of Chicago (College), Rush Medical College (Medical School), Albert Einstein College of Medicine and Montefiore Medical Center (Residency Training) and Memorial Sloan Kettering Cancer Center (Fellowship Training.)) I am constantly studying and learning the latest techniques and technology.  When you come to our office, you get the best possible treatments and you walk away feeling good.  

To me, I agree with the "Patch Adams" approach to medicine where getting rid of the stress and feeling happy is half the cure.

One more thing; When was the last time you had an emergency and wished you could reach your doctor at night or on the weekend?  If you become a patient, you can feel free to call me anytime if something comes up and you need to reach me.

Thank You,
Dr Harry Tsai


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