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KEEP THE PAST BEHIND YOU // WORK OUT — THE RIGHT WAY // PAYING FOR LONG-TERM CARE

Unlimited life spans… disease-free living… the end of genetic illnesses. The limit of medicine’s capabilities just may be the limit of our imaginations. What does the future hold for us today?


w o ! N n e p O Theressa Foster

Sr. Executive Director


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HAVE YOU THOUGHT ABOUT Emergency

Medical

Services

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BROOKSVILLE 11373 Cortez Blvd., 352.596.5505 19438 Cortez Blvd., 352.799.7047 13078 Cortez Blvd., 352.596.8261 31807 Cortez Blvd., 352.754.1100

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9481 S. Suncoast Blvd., 352.621.7829

14308 Spring Hill Dr., 352.799.8878

6748 W. Gulf to Lake Hwy. 352.564.8300

INVERNESS 97 S. Pine Ave, 352.344.8996

11218 Springhill Dr., 352.686.0910

1801 NW Hwy. 19 #509 352.795.9792

2639 E. Gulf to Lake Hwy. 352.637.0800

DUNNELLON 11150 N. Williams St. #102 352.489.1120

SPRING HILL 4144 Mariner Blvd., Unit No. A 104 352.684.9565

HOMOSASSA 3756 S. Suncoast Blvd., 352.628.6822

5394 Spring Hill Dr., 352.686.0992

ZEPHYRHILLS 6512 Gall Blvd., 813.788.9677


GOOD NEWS Oak Hill Hospital has achieved National Certification in Hip Replacement, Knee Replacement and Spinal Fusion

First hospital in the area to earn The Joint Commission’s Gold Seal of Approval. • 16 orthopaedic and spine specialists • Most certified orthopaedic nurses (ONC) in the area • Dedicated rehab therapists • State-of-the-art infection control measures • Thorough pain and symptom management • Extensive education for patients and family (Pictured Above - L to R) Mohamed Shahout, MD; Lu Aubi, RN, ONC; James Ronzo, DO; Fernando Garcia, PTA; Imad Tarabrishy, MD; Daniel Moynihan, MD; Liz Scavuzzo, RN, ONC; Michael Higgins, DO

Certified Hip Replacement (The Joint Commission) Certified Knee Replacement (The Joint Commission) Certified Spinal Fusion (The Joint Commission)

Learn more by calling the Orthopaedic & Spine Institute at 352-596-6632 Hernando 352-628-6441 Citrus or log onto OakHillHospital.com.


Inverness

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AETNA Medicare

United Healthcare Coventry


CONTENTS

OCTOBER 2012

FEATURES

The future of medicine

28

Major technological advances in fields such as physics, chemistry, genetics, and radiology… even engineering and thermodynamics are helping shape the future of medicine. Procedures and devices that were mere figments of imagination for forward-thinking science fiction writers of the past are being used today to save lives and treat chronic illnesses. Why wait for tomorrow when the future is here today? Written by Betsy Stoutmorrill and Jim Gibson Illustrations by Steven Codraro

KEEP THE PAST BEHIND YOU // WORK OUT — THE RIGHT WAY // PAYING FOR LONG-TERM CARE

Unlimited life spans… disease-free living… the end of genetic illnesses. The limit of medicine’s capabilities just may be the limit of our imaginations. What does the future hold for us today?

ON THE COVER

direction: Jamie Ezra Mark photoshop: Josh Clark design: Steven J. Codraro

www.naturecoasthealthyliving.com

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CONTENTS OCTOBER 2012

IN EVERY ISSUE

Publisher’s Corner

12

Health Matters

16

Healthy Business

20

Medical Mysteries

22

Heart of the Community

68

57 Healthy Mind 53

Closing the door on the past

54

Going green will save you green

56

The benefits of flowers

Healthy Body 57

Overload and Adapt: How to build muscle correctly

60

Relax, it’s just a job

60

54 Healthy Spirit 61

61

Mencouragement: Mister, tear down that wall

62

Mood me colorful

63

Hair confident: healthier hair

Healthy Finance 65

Dave says

66

Paying for care

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CONTRIBUTORS Fred Hilton

Jenn Lee

Fred Hilton spent 36 years as the chief public relations officer/spokesman for James Madison University in Virginia and 10 years prior as a reporter and editor for The Roanoke Times in Roanoke, Virginia. He is now happily retired with his interior designer wife Leta, their Cadillac Escalade golf cart, and their dog Paris. (Yes, that makes her Paris Hilton).

National speaker, small business advisor, media correspondent and life coach Jenn Lee isn’t letting anyone or anything stop her from helping Americans shift their thinking, boldly move forward, and bring sanity back into their everyday lives! www. coachjennlee.com

Greg Frescoln

Robert Linkul, MS CSCS-CPT *D

Greg Frescoln is native of Iowa having graduated from Iowa State University in 1985 with degrees in history and international studies. He graduated from the University of Florida in 1990 with a master’s degree in education and in 2000 graduated with a specialist degree in K–12 education.

Robert Linkul is the strength and fitness director for Arden Hills Resort Club and Spa. He mentors a team of certified personal trainers, nutritionists, and strength coaches as well as trains more than 125 clients per week. Robert has his master’s degree in personal training, is a certified strength and conditioning specialist with distinction, and is an NSCA certified personal trainer. He is the NSCA’s Southwest Regional Coordinator and was named the 2012 Personal Trainer of the Year.

Jeff Griesemer

Ellen Wilcox

Jeff Griesemer is co-founder, president and chief executive officer of Child Rescue Network, Inc. Prior to becoming involved with missing and victimized children, Jeff enjoyed a 20-year career in broadcasting and presently consults businesses and nonprofit organizations on the benefits of causerelated marketing.

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Ellen B. Wilcox is a graduate estate planning consultant. Educated at Gettysburg College, the University of Maryland, Paris, France, and Arizona State University, Ms. Wilcox brings more than 33 years of experience to her clients. She is president and CEO of Wilcox Wealth Management, a full-service financial advisory company. Ms. Wilcox may be reached at 352.259.1547.

Dave Ramsey

Jeff Wittman

Dave Ramsey is a personal money management expert, a national radio personality, and best-selling author of The Total Money Makeover. Ramsey earned his Bachelor of Science in Finance and Real Estate from the University of Tennessee. A frequent speaker around the country at large-scale live events, he has a nationally syndicated talk show, The Dave Ramsey Show.

Jeff Wittman is a licensed nutritionist, nutrition counselor, and instructor. Jeff is a member of the Florida Board of Medicine Dietetic and Nutrition Practice Council and host of the popular radio show, The Nutrition Show. He owns and operates two nutrition stores.

www.naturecoasthealthyliving.com


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PUBLISHER’S CORNER

Wendell Husebo publisher wendell@naturecoasthealthyliving.com Lanny Husebo president lanny@naturecoasthealthyliving.com

A season of change

Lynn Van Meter marketing representative lynn@naturecoasthealthyliving.com

Michele Salvadeo marketing representative michele@naturecoasthealthyliving.com

Tanya Hinebaugh accounting tanya@naturecoasthealthyliving.com

AKERS MANAGEMENT GROUP

Autumn ushers in another exciting month, and the time is ripe for Healthy Living. Yes, we have some of the best doctors in the world right here on the Nature Coast. Local patients are treated using the newest, latest, and greatest procedures medicine has to offer. Medical breakthroughs are bursting in the fields, and we don’t want you lost in the corn maze! Let’s talk about these wonderful breakthroughs for a moment. Many times we think of them as something happening elsewhere, and other times, we may not even hear about them at all. Well, this month we are showcasing Nature Coast’s own bounty of medical breakthroughs. These are amazing successes that will not only benefit us but could potentially benefit the entire world. I am reminded there are those in this world who don’t even have a toothbrush, much less access to Stereotactic Radiosurgery. “New procedures” in these areas are virtually unknown. Yet, in America, we sometimes take our scientific breakthroughs for granted. America’s healthcare system has fostered the most advanced and affordable traditional healthcare in the world. As a free people, we have been able to pursue our ambitions and in doing so, have discovered some of Creation’s secrets. This is humbling — and exciting at the same time! When I lived in Australia, I would frequently hear of Australians flying to America for less expensive and more advanced medical procedures. I also met aspiring surgeons who were trying to get accepted into American medical schools because they said they wanted to attain the best possible credentials.

I find it interesting that Australia is not a Third World country but a fully developed country that practices western medicine, and yet have you ever thought about flying to Australia to have a heart transplant? I sure haven’t. So I thought, Why do they go to America? The answer is that America still stands on top of the medical pyramid. As you read this month’s issue, you will surely come to appreciate our Nature Coast medical community as part of that answer. Now that’s something even the scarecrows can celebrate. Hold on to your hat, because our hayride showcases cancer-zapping radiation laser beams and genetically modified mosquitoes! You won’t want to be left behind. Stay healthy my friends,

Wendell Husebo + publisher

Doug Akers president doug@akersmediagroup.com Kendra Akers vice president kendra@akersmediagroup.com Jim Gibson executive editor jim@akersmediagroup.com

Jamie Ezra Mark creative + content director jamie@akersmediagroup.com

Tiffany Roach managing editor tiffany@akersmediagroup.com

Steven J Codraro art director steve@akersmediagroup.com

James Combs staff writer james@akersmediagroup.com

Josh Clark senior graphic designer josh@akersmediagroup.com

Betsy Stoutmorrill copy editor betsy@akersmediagroup.com

Anthony Casto graphic designer anthony@akersmediagroup.com

contributing writers

Fred HIlton Greg Frescoln Jeff Griesemer Dave Ramsey Robert Linkul Tanya Senseney Ellen Wilcox Jeff Wittman

Tina Morrison administrative assistant tina@akersmediagroup.com

Cierra Chappell production manager cierra@akersmediagroup.com Fred Lopez chief photographer fred@akersmediagroup.com contributing photographers Chris Fiffie

Heather Tootle office manager heather@akersmediagroup.com

Phone: 352.430.4004 | Fax: 352.787.5510 P.O. Box 491320 | Leesburg, FL 34749 www.naturecoasthealthyliving.com

Comments or questions for our publisher? Please email wendell@naturecoasthealthyliving.com Our goal is to provide you with the best quality publication, so your feedback is vital.

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All contents are copyright © 2012 by Amazing Media Group, LLC. Any reproduction or use of content without written persmission is strictly prohibited under penalty of law. The contents of the Nature Coast Healthy Living Magazine are for informational purposes only. The information is not intended to be an alternative to professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider before starting a new diet or exercise program.


NATURE COAST

ADVISORY BOARD GEORGE G. ANGELIADIS, ESQ., is a graduate of South Texas College of Law and has been an attorney in Hernando County since 1996. He is a partner with The Hogan Law Firm and practices in the areas of local government law, civil litigation, criminal defense, construction litigation, and personal injury. Angeliadis was previously appointed by the governor to serve on the Fifth Circuit Judicial Nominating Committee and donates his time to many local boards and organizations. Visit www.hoganlawfirm.com for more information

MICHAEL D. HEARD is a partner of the Silverthorn

ANNE BLACK is the community relations coordinator for HPH Hospice in Citrus County. She has 30 years experience as a health educator and community relations expert. Anne and her husband, Jerry, moved to Citrus County from St. Petersburg in 1989. She is a member of the Rotary Club of Inverness and Florida Public Relations Association. She is also on the board of the Senior Foundation of Citrus County and is chairman of the School Health Advisory Committee.

LANNY HUSEBO is president and CEO of Husebo Advertising and Public Relations. Founded in 1962, the company is celebrating its 50th year in business. Lanny specializes in marketing and building medical practices through the use of traditional and social media. He is married with six children and four grandchildren. His son, Wendell, has joined the family business with a focus on Internet marketing.

BONNIE CLARK is currently Associate Provost on the

NATALIE LEIBENSPERGER, D.O., FACOOG is board-certified by the American Osteopathic Board of Obstetrics and Gynecology and is a Fellow of the American College of Osteopathic Obstetricians and Gynecologists. Her practice, “My Gynecologist,” is located on County Line Road in Spring Hill. In addition to the treatment of women’s health issues and obstetrics, Dr. Leibensperger is an advocate for the diagnosis and treatment of urinary incontinence through medication or minimally invasive surgeries. mygyn.net.

SONDRA LLOYD CRANFORD is the health education director for Central Florida Institute (CFI). She has more than 12 years of experience in medical and dental career training and 20 years of experience in the fitness and weight-loss industry. Sondra has a Master of Education from National Louis University, a Bachelor of Occupation Education and an associate degree in veterinarian technology.

KATIE LUCAS, public information officer for Nature

PATRICIA CROWLEY, IOM has been a resident of Hernando County for 23 years. With more than 30 years experience in sales and business management, she joined the Greater Hernando County Chamber of Commerce in the spring of 2000 and was promoted to president/ CEO in 2004. Patricia serves on the Oak Hill HospitalBoard of Directors, the Suncoast Trail Advisory Group, the Career Central Workforce Transition Committee, and is president elect of the Kiwanis Club of Brooksville.

KATIE MEHL is the public relations coordinator for

Spring Hill campus of Pasco-Hernando Community College (PHCC). Prior to her appointment to the Spring Hill campus in November 2009, Bonnie held positions at PHCC as Dean of Arts and Sciences, Associate Dean, and Assistant Dean of Student Development. She has a master’s degree in counseling psychology from Gannon University and a bachelor’s degree in psychology from Mercyhurst College. She is currently completing her doctoral studies at University of South Florida.

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Country Club, LLC; president of the Florida Blueberry Festival, Inc.; director/ president of the Brooksville Vision Foundation; and the assistant ambassador of commerce and employment for the city of Brooksville. Prior to moving to Brooksville in 2001, Michael owned and operated the Island Print Company in Sanibel Island and Jerry Heard Enterprises, Inc., an industrial product importing company. She also represented Gilligan O’Malley Sleepwear, Inc., in New York as a national account manager.

Coast EMS, has lived in Citrus County more than 21 years. She is an active member in the community, working with several business and charitable organizations. Her background includes marketing, sales, public relations and graphic design, and she has worked in radio, television, and newspaper. Her duties at Nature Coast include working with other county emergency responders, dispersing public information, community outreach, and speaking engagements.

Citrus Memorial Health System. She holds both a Bachelor of Arts and Master of Arts in mass communications from the University of Central Florida. She is a member of the Florida Public Relations Association (FPRA) and is acting president-elect for the Nature Coast Chapter of FPRA.

N


MARY JO PAIGE is part of the marketing team at Oak Hill Hospital and has more than 20 years experience in the advertising agency business working for Young and Rubicam, Bozell Worldwide and ultimately becoming a principal in Ellis and Paige Advertising in Tampa. She has a Master of Science in advertising from the University of Illinois and a Bachelor of Science in business administration. She is a graduate of Leadership Hernando and Leadership Tampa Bay.

DENNIS WILFONG founded Innovative Technology, Inc. He received the 1988 Business of the Year Award, the 1989 Free Enterprise Award, the 1992 Businessperson of the Year Award, the 1996 Environmental Safety Award, the 1996 Business of the Year Award from the Hernando County Chamber of Commerce, and the 1996 Governor’s Award. Dr. Wilfong has assisted the development of business locally and has chaired the Business Development section of the Hernando County Summit. He serves on various advisory boards for the county.

JOANIE POCHIS is a registered nurse at Seven Rivers

LYNN VAN METER is the owner and CEO of Fiddlehead Marketing Advertising Public Relations, located in Spring Hill. She holds a Master of Business Administration and a bachelor’s degree in public relations. In addition to meeting the needs of her clients, Lynn is actively involved in several non-profit groups, which include the Greater Hernando County Chamber of Commerce, and serves on the board of directors for the Florida Blueberry Festival and the Life Center.

SAM SHRIEVES is the marketing president of

VINCE VANNI has devoted more than 35 years to creatively marketing a variety of products, programs, and organizations. He has a reputation for creativity, efficiency, and above all, effectiveness. He enjoys a lucrative practice and is consultant to some of this area’s leading businesses, medical practices, and public officials. In 2005, Vince was the recipient of the Greater Hernando County Chamber of Commerce Small Business of the Year Award and Chamber Service Award.

JENNIFER SIEM is the adult member services and wellness director for the Hernando branch of the YMCA of the Suncoast. Jennifer is a wife and mother of three teenagers, as well as a certified personal trainer, cycling instructor, and group fitness instructor. Motivating others to lead healthier lives is the fuel that drives her passion for health and wellness.

JOSH WOOTEN, a Florida native, has called Citrus

Regional Medical Center and a longtime resident of Citrus County. Joanie has more than 11 years experience in healthcare and currently serves as a member of the Quality/ Risk Services team and manages the Employee Health, Worker’s Compensation and Infection Prevention programs at Seven Rivers Regional Medical Center. As a resident of the Nature Coast community, her enthusiasm and commitment is to promote excellence in healthcare for Citrus County.

Capital City Bank for Hernando/Pasco. He started his banking career in Hernando County in 1978. Sam attended Pasco-Hernando Community College, graduated from the University of Florida School of Banking in 1986 and from the Graduate School of Banking of the South at Louisiana State University in 1991. He serves on the Greater Hernando Chamber of Commerce, United Way of Hernando County, Oak Hill Hospital Community Advisory Council, and the Hernando County Education Foundation.

County home for more than 25 years. He became president/ CEO of the Citrus County Chamber of Commerce in March 2009. He served as county commissioner from 2000–04 and was a founder of Keep Citrus Beautiful. He served on the Citrus Memorial Health System Advisory Board and the Citrus County Stakeholder’s Advisory Group. As Chamber president, he is actively involved with the Citrus County Economic Development Council on a daily basis.

NATURE COAST Our board is made up of a unique cross-section of business professionals who offer an exclusive blend of diverse viewpoints. Their distinct perspectives allow us to attain a clear picture of how to best serve the residents of Citrus and Hernando counties. Their input helps us create the best magazine possible — a custom fit — just for you and your health needs.

www.naturecoasthealthyliving.com

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COMMUNITY MATTERS

THE “TRICKS” TO HALLOWEEN SAFETY Ghosts, vampires, and witches may be spooky, but the scariest aspects of Halloween are the reckless drivers, unsafe neighborhoods, and toxic candy. Children are more likely to be hit by a car on Halloween than any other day of the year, according to Safe Kids USA, an organization committed to preventing accidental childhood injuries. To make Halloween a hauntingly happy experience, make sure your young trick-or-treater follows these tips provided by the American Red Cross. • Remember to bring a flashlight. • Wear light-colored clothing so motorists can see you in the dark. • Use face paint instead of masks. A mask covers your eyes. • Walk on the sidewalks rather than streets. Always be on the lookout for motorists. • Cross the street only at corners. Remember to look both ways. • Use a glow stick instead of a candle. Wigs, capes, and costumes are flammable. • When you’re finished trick-or-treating, allow an adult to thoroughly inspect your candy.

BRUSH UP ON THE BASICS OF HEALTHY TEETH Smile because October is National Dental Hygiene Month. It’s said that first impressions are extremely important, and certainly a beautiful smile and pearly white teeth go a long way in making an excellent first impression. Implementing healthy dental habits can help you maintain a healthy smile. Here are a few tips provided by the American Dental Hygienists’ Association. • Brush twice a day for at least two minutes. This is instrumental in reducing plaque build-up and plaqueassociated disease such as gingivitis and cavities. • Floss daily to ensure you successfully remove plaque and food particles from between the teeth and at the gum line. • Rinse with mouthwash because brushing may leave plaque and gingivitis germs behind. Also, make sure your antiseptic mouthwash has the American Dental Association’s (ADA) Seal of Acceptance. • Chew sugar-free gum after eating. This helps stimulate saliva, which is the most important natural defense against tooth decay. Saliva helps fight cavities, neutralizes plaque acids, washes away food particles, and re-mineralizes enamel to strengthen teeth.

Stay abreast of

breast cancer

October is National Breast Cancer Awareness Month. We cannot stress enough the importance of selfexaminations and annual mammograms because early detection is crucial in defeating this disease. Do not take our word for it. Consider these breast cancer statistics provided by breastcancer.org. • One in eight women in the United States will develop invasive breast cancer during her lifetime. • For women in the United States, breast cancer death rates are higher than those for any other cancer besides lung cancer. • With the exception of skin cancer, breast cancer is the most commonly diagnosed cancer among women in the United States. • About 85 percent of breast cancers occur in women who have no family history of breast cancer. • The most significant risk factors for breast cancer are gender and age.

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Syed Wajahat Ali

Seema Nishat

Welcome Aboard! Access Healthcare Physicians, LLC announces that Syed Wajahat Ali and Seema Nishat have joined Access Healthcare and have relocated their practice to 11451 Cortez Boulevard in Brooksville. Access Healthcare is a multi-service medical practice consisting of more than 95 healthcare providers and almost 500 employees in over 50 locations throughout Florida. Both Dr. Ali and Dr. Nishat are board-certified in internal medicine. Each received their MBBS (Bachelor of Medicine, Bachelor of Surgery) at the prestigious Osmania Medical College in India. They also both completed their residencies at Cook County Hospital in Chicago.


After suffering from spinal aging for years, I knew something had to be done. Following a long road of surgeries and epidurals, I simply wasn’t able to enjoy my life anymore. I finally found relief from the pain with the help of the doctors. The pain clinic provided me with compassionate care and the correct medication that enables me to feel my best. I owe them my deepest gratitude for enabling me to live with less pain.

— Thomas Bisceglia

Why suffer needlessly? AGING OF THE SPINE: As we age, our chances for back pain increase. With normal aging, the soft discs between the vertebrae (which bear up to 80 percent of the weight of the vertebral column above them) begin to harden and compress. This disc degeneration by itself can cause considerable discomfort but even more pain may occur when the delicate vertebral joints (which normally bear the other 20 percent of the weight load of the vertebral column) are forced to carry more weight and osteoarthritis sets in. When both disc degeneration and osteoarthritis occur, it can lead to a painful condition called spinal stenosis (narrowing of the spinal cord). The providers at the pain clinic can find the right combination of therapies to help alleviate the pain of spinal aging. Proper medications, blocks or injections, infusion pumps, thermal therapy, peripheral devices, and complementary therapies such as, hypnosis, acupuncture, aroma therapy, deep muscle massage, chelation, and biofeedback are our healing modalities of choice. Let us help find the perfect combination that can make you pain-free today!

COMPREHENSIVE PAIN MANAGEMENT®

305 S Line Ave. Inverness, FL 34452

352.344.4791

Robert Ulseth, M.D.

Roger Spencer, M.D.

Scan the QR code to see Drs. Spencer and Ulseth’s video profiles.

Agda O. Hart, PA-C


COMMUNITY MATTERS

Say “owie” no more

Pregnant women know how uncomfortable wearing a seat belt is. Never fear, the Owie Pillow is here! The Owie Pillow is a product that helps redistribute the pressure of a seatbelt on the stomach, effectively relieving stress and pain on the area. It was invented by Kristine Currier, who had difficulty coping with an uncomfortable seat belt during her pregnancy. The pillow is equally effective for people recovering from surgeries, suffering from abdominal problems, or travelers who desire a little extra comfort on the road. It won Start Up Nation’s 2011 Leading Moms in Business Award and has been featured on Fox 5 news, in Healthy Mom and Baby Magazine, and numerous blogs. For more information, visit www.owiepillow.com.

ON A MISSION In May, Good Shepherd Medical Clinic physicians Dr. Brian Roebuck and Dr. Robert Ebert, as well as ultrasonographer Theresa Erwin, went on a week-long medical aid mission trip to Guatemala. In conjunction with the nonprofit organization, Advocates for World Health, the mission team included six college students from the University of South Florida who were recently accepted to medical school. Some of the Guatemalan villagers walked two to three hours to reach the mission’s clinic area. “We dealt with abdominal pain, pelvic pain, arthritic pain, chest pain, gall bladder problems, uncontrolled high blood pressure, uncontrolled diabetes — basically what you have here in the United States,” says Dr. Roebuck. “We were doing ultrasounds, EKGs, X-rays, and running labs. It was quite challenging as a physician, because we were working with very few resources.”

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HEAD OF THE CLASS

In May, Oak Hill Hospital announced it graduated another Introduction to Healthcare Supervision class. This is a course designed and taught by Oak Hill Hospital CEO Mickey Smith. It is a two-hour weekly class based on the book The Indispensable Healthcare Manager by Leebov and Scott. Topics covered in the class include: customer obsession, the organization perspective, getting results, relationships, leadership, and management tools.

Making the GrAde In June, the Leapfrog Group made its Safe Hospital Scores public. The scores are derived from Leapfrog’s key questions and publicly reported data. Regional Medical Center Bayonet Point received an A rating for safety. The hospital received a perfect score in all the areas of “safe practice measures.” Those include culture measurement feedback and intervention; teamwork, training, and skill building; identification and mitigation of risks and hazards; nursing workforce; medication reconciliation; hand hygiene; and care of ventilated patients. The Leapfrog Group was founded more than a decade ago and strives to make giant leaps forward in the safety, quality, and affordability of healthcare in the United States by promoting transparency and valuebased hospital incentives.


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HEALTHY BUSINESS

Our community’s health Evaluating the economic health of a community requires an examination of the wealth of its citizens. Measuring wealth is far more complicated than the simple balance of our checking accounts or the digits on our paystubs. Indeed, agreeing on a definition of wealth is difficult because the term tends to be subjective — varying from one person to the next. Yet, understanding wealth creation is a fundamental step in understanding how to enhance our community’s economic health. Wealth is the accumulation of economic value, which contributes to improving a person’s ability to create options for improving their standard of living while minimally meeting lifesustaining necessities. I put in italicized text the three terms that make wealth so subjective: value, options and necessities. You can see how any two of us might disagree on what is of value, which option is the right one to choose, and just exactly what should be considered a necessity. I would argue my Barry Goldwater T-shirt has value. Beyond the emotional value of him losing the election on my birthday, my belief that the shirt has economic value is tied to my expectation that I can get a few dollars for it on eBay. The shirt technically only has economic value when I can convince someone else to exchange money or another object they possess (perhaps a rookie baseball card of Glenn Beckert, which I desire more than my shirt). So, economic value requires exchange potential or demand. When I choose to exchange the T-shirt for money or a baseball card, I am better off after the exchange than before. Both parties in the exchange have something they wanted more — both are wealthier. The more economic potential I have in terms of things of value, the more options I have to exchange for things I need (and want). We’ve

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just identified two roles played by money, by the way. It stores value and enables exchange. I might have to give you $200 for the Glenn Beckert rookie card, particularly if you value money more than you value my Barry Goldwater T-shirt. So, according to our definition of wealth, the more money you have, the more value you have to exchange for other things. So, money creates options. You are free to choose to exchange your money for groceries or an iPhone 5 this month. If you have enough money, you can choose both without sacrifice. Whether an iPhone 5 is a necessity or a want is up to you to determine (subjectivity). We’ve just demonstrated wealth is the accumulation of value that creates options and provides for necessities and wants, both highly desirable for individuals and communities. But how do we create wealth? We must put ourselves in a position to offer others something of value and be free to exchange that value with each other. The most straight-forward way this is done in an economy is through our labor. When we go to work, we are exchanging our abilities to perform what a business needs in exchange for wages. This assumes the business has the ability to pay us, which, in turn, requires the business creates something of value others are willing to exchange for money. Don’t miss the central role here played by creating value. The more value a business creates for its customers, the greater the potential for increasing its store of value in terms of profits. However, not all exchanges result in profit sufficient to pay employees. Let’s take a lemonade stand for example. If Gideon’s total costs for his lemonade stand are $20, and he only has enough lemons to make 20 glasses of lemonade, then he must sell each glass for more than $1 per glass to make a profit.

If his neighbor, Elena, is able to reduce her costs to $10 while still being able to make 20 glasses of lemonade, any price above 50 cents allows Elena to pay her costs and use the profits to pay herself and maybe her little sister, Shira, who helped. In the meantime, she may just put Gideon out of business. As employees, our wealth is tied to the ability of our company to create value for others while keeping costs in check sufficiently to pay us, not to mention having enough to cover future expenses such as more lemons and even a new blender to offer frozen lemonade some day. What can go wrong? This free enterprise model assumes we are all free to choose whatever we determine to be the best of the available options, including what price we are willing to exchange our labor. When this basic free market principle is manipulated, unintended consequences arise, such as unemployment. We will explore unemployment during next month’s community health checkup. For the future of Florida,

Dale A. Brill, Ph.D.

President, Florida Chamber Foundation


ExpEriEncEd physicia

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The Good Shephard Medical Clinic provides quality specialized care right here, close to home. These experienced physicians have long been a part of the The Good Shepherd Medical Clinic is providing quality spe community, treating you as here, close to home. These experienced physicians have lon neighbors and friends first, community, treating you as neighbors and friends first, and and as patients second. The Good Shepherd Medical Clinic is providing quality specialized care right

A long history of A ExpEriEncEd physicians.

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here, close to home. These experienced physicians have long been a part of the For more information about Lyndon Garcia, M.D., Anil Bhatia, M.D., Roger Lee, M.D., Nathanfirst, Devabose, Carmen Nan, M.D.,information community, treating you as neighbors and friends andM.D., asFor patients second. more about our outstanding our outstanding physicians, Hubert Garcia, M.D., Brian Roebuck, M.D., Carmen Mohai, M.D., Robert Ebert, M.D. For more information about our outstanding physicians, call 352-797-4600.

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MEDICAL MYSTERIES

The brain: is bigger better? WE’VE ALWAYS BEEN TOLD that “bigger is better.” That’s certainly the case with pieces of coconut cream pie, bowling scores, and tax refunds. But is a bigger brain better? Does it make us smarter? Unfortunately, I can’t give you a definitive answer. There’s really no consensus among those who should know that sort of thing. Some remain steadfast in saying that a bigger brain makes you smarter. Dr. Michael A. McDaniel, an industrial and organizational psychologist, says that “for all age and sex groups, it is now very clear that brain volume and intelligence are related.” Dr. McDaniel, a professor of management at Virginia Commonwealth University (VCU), says he finds that intelligence rose with increased brain volume, according to a VCU news release. A Canadian psychologist, J. Philippe Ruston, had the temerity to suggest that studies indicate men are smarter than women because they have bigger brains, according to Live Science. Robert Deaner, an assistant professor at Grand Valley State University, says otherwise: “There are no consistent sex differences in IQ yet men generally have larger brains.” My brain is big enough to know better than to pursue that particular discussion in either direction. Of course, humans don’t have the biggest brains on earth. The whale has the biggest brain of them all, and nobody has accused whales of being particularly bright. An exception might be Moby Dick, who did a real number on Captain Ahab. Obviously, the relation of brain size to body mass fits into the bigger-is-better discussion, but there are problems there, too. Neanderthals had bigger brains than the modern Homo sapiens, but they didn’t have enough sense to avoid becoming extinct 40,000 years ago. The latest — and probably strongest — theory is that the deciding factor in intelligence is not simply the size of the brain but its underlying organization and molecular activity. Albert Einstein’s brain was examined after he died, and it was found to be of normal size but differed in its ratio of certain cells to neurons. So, in all likelihood, there’s only one really good answer to the brain-size question. You’ve probably already said it to yourself by now: “It isn’t important how big your brain is, it’s important how you use it.” Sources: Discovery Health, “Brain Size and Intelligence” http://health.howstuffworks.com/human-body/systems/nervous-system/ brain-size2.htm: Live Science, “Men Smarter than Women, Scientist Claims”, http://www.livescience.com/7154-men-smarterwomen-scientist-claims.html: Scientific American, “Fact or Fiction: When It Comes to Intelligence, Does Brain Size Matter?” http://www.scientificamerican.com/article.cfm?id=does-brain-size-matter&print=true (Accessed April 25, 2012)

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PHOTO © SHUTTERSTOCK

WRITTEN BY FRED HILTON


A SERVICE OF THE INSTITUTE OF CARDIOVASCULAR EXCELLENCE

cardio-tech A new technology gets to the heart of blocked blood vessels. Atherectomy actually removes arterial plaque.

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A SERVICE OF THE INSTITUTE OF CARDIOVASCULAR EXCELLENCE

Atherectomy

Eliminates arterial blockages by eliminating arterial plaque. Atherectomy is a nonsurgical medical procedure that helps open up blocked arteries by removing plaque deposits — especially for patients diagnosed with P.A.D. (Peripheral Arterial Disease). It was fi rst introduced as a technique for removing plaque from coronary arteries some 20 years ago. Today, improvements in the technique and refinements in the medical devices used have led to long-term results that, according to many studies, are superior

to angioplasty. The reason? Unlike angioplasty, which uses a balloon inserted into the artery by catheter that is then expanded to press plaque up against artery walls, atherectomy actually strips plaque from artery walls and removes it altogether. The beginning of the two procedures is similar. The patient is awake but sedated. Medications that control blood pressure and prevent blood clots from forming are administered. As with angioplasty, a

catheter is inserted into the artery and carefully guided to the site of the blockage. But instead of a balloon, the catheter is fitted with an atherectomy device designed to remove the plaque. The head of the device is placed against the blockage and then engaged. Depending on the device’s specific design, plaque is either sliced, ground away, or vaporized from the artery walls to return blood flow to the artery. But each case is different. The types of blockages,

their locations, and plaque composition and severity are all factors that will ultimately determine which procedure may be recommended for the best outcome. In fact, both atherectomy and angioplasty may sometimes be used in tandem to restore blood flow to a clogged vessel. The procedure finally used is a decision physician and patient will make together.

Smartery decisions

Cardiologists today have their choice of plaque removal techniques. There are several types of atherectomy devices available to cardiologists. All perform in slightly different ways. But every one of them ultimately removes plaque from the artery walls. DIRECTIONAL atherectomy scrapes the dislodged plaque into one side of the head of the atherectomy device where it is stored for eventual removal. ORBITAL atherectomy utilizes a device with a rotating head. Small burrs on the head “pulverize” plaque into superfi ne particles that are flushed downstream of the blockage. LASER atherectomy vaporizes plaque in the artery by using high-energy light emissions so there is no plaque remaining to collect.

The technique preferred by Dr. Qamar at ICE is directional atherectomy with the SilverHawkTM Plaque Excision System, developed by ev3, Inc. The SilverHawk is the premier device for directional atherectomy, incorporating a breakthrough called Micro Efficient Compression (MEC) Technology. Essentially the speed of the cutting tip is harnessed along with micro-fi ne slits in the cutting head to provide an increase in the amount of plaque that can be stored in the device’s head for eventual removal. ICE has been treating its P.A.D. patients with the SilverHawk for more than five years and has been enjoying consistent and excellent outcomes throughout that time.

“Use of atherectomy as a debulking device

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Anyway you slice it — it’s got to be ICE When it comes to atherectomy, the combination of leading edge technology, compassionate care, convenience, and outstanding results can only mean one place — The Institute of Cardiovascular Excellence. The outpatient capabilities of ICE make it possible for all its patients, even those with the severest incidence of P.A.D., to receive the treatment they need from expertly-trained professionals in a stress-free, caring environment. Whatever cardio treatment or test a patient could conceivably need today was planned for in Dr. Qamar’s earliest visions of what his Institute would be able to provide: • Cardiac Catheterization • Coronary Angiogram • Echocardiogram • PET Stress Test • TEE Test (Transesophageal Test) • Radio Frequency Ablation • T-Wave Alternans • Pulmonary Function Test • ANSAR Test (Autonomic Nervous System Test) Of course, the state-of-the-art equipment and advanced technologies at ICE are important, as is the highlyqualified staff found at every level of patient interaction from procedure to post-op care. But it is the complete experience — guided by Dr. Qamar and his commitment to excellence — that is rapidly establishing the Institute of Cardiovascular Excellence as a leader in cardiovascular care. And this stellar reputation extends not just locally and regionally, but across the nation for all those who have the need for superior cardiovascular care.

F A S T

F A C T S

MoreAmericans thanhave12P.A.D.* million Almost 2 million have had it diagnosed.* According to the CDC, total Angioplasty and Atherectomy procedures combined in the U.S. for 2009 were

605,000 *Figures from the National Institute of Health

Advantages of Atherectomy

1. Less invasive than surgery (endarterectomy) 2. Less vessel barotrauma compared to angioplasty (less stretching/ damaging vessel walls). 3. No foreign object left in the body (as with use of stents). 4. All future treatment options at the site are left open.

has revolutionized the percutaneous treatment of arterial disease” — AsadQAMAR ADVERTISEMENT


A SERVICE OF THE INSTITUTE OF CARDIOVASCULAR EXCELLENCE

JanetWHITAKER Ocklawaha, FL

“My legs have hurt most of my life and I thought I might have to live with it. But after a while, the pain became so bad. No matter what I did or where I would go, my legs hurt all the time. “I went to see three different doctors and they all told me the same thing… that they couldn’t help me. No one could help me. My son told me about Dr. Qamar. He wanted me to go and see what he might have to say. “So I scheduled an appointment. I told Dr. Qamar what the other physicians told me and he just said, ‘Well, let’s see.’ Then he examined me and performed some tests. He said I did indeed have blockages in my legs, but he thought he might be able to do something about them. “So far he has worked on one leg — three operations on my left one. Dr. Qamar said I must have had these blockages a long time because they were very hard — like hitting a brick wall. He plans to work on my right leg next. “I can tell he’s already helped me. I’m still hopping around the house but I know it’s going to get a lot better and the hurting is going to start going away. For the first time, I’m very positive about it, about how good it will be when my legs stop hurting. “I just worry about Dr. Qamar. He’s such a nice man and everyone likes him. I worry that he works too much. Still, I’d like to thank him for all he’s doing for me. Three doctors said there was nothing they could do but Dr. Qamar said he thought he could — and he is doing just that.”

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W NO IS

e r u INE C U I F D E E H T FM O t. h g i of l ay. d tod pee s e — t th logy a rd no a h c w for s te ’ g w n ovi orro m m e is ce to c n cie perien s l a Ex dic e M

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+

stereo actic Radiosurgery A laser beam of radiation obliterating a brain tumor may seem like a scene from an Isaac Asimov short story, but this concept is much more than science fiction. Stereotactic Radiosurgery (SRS) is the cutting edge when it comes to operating deep within the mysterious recesses of the human brain. Villages’ resident Judy Holbrook has experienced the future of brain tumor surgery firsthand, and it has given her a second chance at life. Judy, who ironically lost her first husband to esophageal cancer that had metastasized to his brain in 2001, was diagnosed with kidney cancer in October 2008. In an effort to halt the spread of the disease, doctors at Shands Teaching Hospital in Gainesville removed her right kidney in January 2009. She remained cancerfree until a routine three-month CT scan exactly one year later revealed new tumors in her left kidney and in the chest cavity outside her lungs. Following treatment in a controlled experimental drug study and conventional chemotherapy, Judy thought she and her doctors finally had the cancer in her body under control. “We were on vacation, and I suddenly noticed I could no longer understand what I was reading,” Judy says. “I am a big reader and suddenly I just couldn’t put together the words on a page and understand what they meant. Very quickly after that I also noticed I could no longer say what I wanted to say.” Her husband, Tom, called her physician at Moffit, Dr. Mayer Fishman, and the doctor immediately ordered a CT scan of her head. The scan revealed a small tumor near the center of her brain. Dr. Fishman determined it was a metastatic kidney tumor. Knowing conventional surgery could leave lasting adverse physiological effects, Dr. Fishman decided on SRS. “This type of radiosurgery is a highly precise form of radiation therapy initially developed to treat small brain tumors and functional abnormalities in the brain,” says Dr. Prakash Chinnaiyan, assistant member of the Department of Experimental Therapeutics SRS in Radiation Oncology at Moffitt. “Highly precise radiation, where delivery is accurate within one to two millimeters, allows advanced radiation treatment, which permits maximum dose delivery within the target while minimizing dose to the surrounding healthy tissue. The goal is to deliver doses that will destroy the tumor and achieve permanent local control. In effect, it is surgery without a scalpel.” Judy was fitted with a “thermoplastic mask” that held her firmly in place while five radiation lasers were fired simultaneously at the tumor deep inside her brain. According to Dr. Chinnaiyan, if you fired only one laser at 100 percent power at the tumor, it would damage all the tissue it passed through on its way

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to the tumor site. Using five lasers at 20 percent power from various angles, it enables the beams to meet at the exact site of the tumor and only then deliver 100 percent of its strength. None of the healthy tissue in the brain is damaged, only the tumor itself. This is why it was imperative that Judy be strapped into a position where her body could not move more than one millimeter in any direction. The lasers had to meet at precisely the right spot. “However, what makes radiosurgery unique,” Dr. Chinnaiyan says, “is that each of the five beams are actually arcs, meaning they are emitting small doses of radiation while rotating around the patient. So, actually, it results in nearly 1,000 low-energy radiation beams that focus on the tumor, which results in a very high dose of radiation where you want it (the tumor) and low doses where you don’t (surrounding normal tissue).” The procedure was over in 20 minutes, and Judy’s only restriction was that she couldn’t drive home. The effects were immediate. Judy’s problems with word comprehension and speech disappeared, but she was left speechless one more time when she heard the doctor’s follow-up report. “Following the surgery I went back for an MRI,” she says. “The radiologist described the changes as ‘dramatic.’ The tumor had disappeared, the fluid around it had disappeared, and the blood vessels feeding it had disappeared.” The change was so dramatic that they double checked Judy’s name along with her previous MRI to make sure they were dealing with the same patient. According to Dr. Chinnaiyan, SRS is now being used for small malignant and benign tumors (less that 3 centimeters in diameter), including meningiomas and acoustic neuromas, and arteriovenous malformations. He says this type of technology is also being used to treat lung, pancreatic, and liver cancer and tumors that have spread to the spine. In the future it will be used for large tumors, including ones that are not otherwise surgically accessible using conventional means. Naturecoast physician Shilen Patel of Florida Cancer Affiliates in Brooksville points out the advantages of this type of “surgery.” “A major benefit SRS provides over conventional surgery is extremely quick recovery times,” says Dr. Patel. “A person can return to daily activities, including work, the day of or the day after treatment. Also, there are no incisions, so there is no risk of infection or bleeding, and the entire procedure is virtually painfree. This technology has expanded the ability of cancer physicians to treat complex cancers, and in some cases, it is the only available option that may lead to a cure or better quality of life for the patient.”


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S n

io at sion ulepres rD

We’ve all suffered depression at one time or another, but for some unfortunate individuals, depression is a way of life. Major depressive disorder (MDD), bipolar disorder (BD), and treatment resistant depression (TRD) affect millions of persons worldwide. For many suffering from these disabling diseases, each day is an endless spiral of hopelessness and despair. Many find some relief from medications such as Prozac, Zoloft, Paxil, and other antidepressants that have become household names… but for those persons afflicted with TRD, no matter what treatment doctors have tried, from cognitive therapy to medication to electroconvulsive therapy,

nothing has been able to lift this veil of darkness — until now. Deep brain stimulation has been used for years to treat diseases such as Parkinson’s, dystonia, uncontrollable tremor and to alleviate chronic pain. Doctors have now discovered that for some persons it is a miracle cure for chronic depression. Single-blind, placebocontrolled studies have shown that electrical stimulation of the subcallosal cingulate and the nucleus accumbens alleviates almost all symptoms of chronic MDD and hard-to-treat BD for certain patients. In most cases, four insulated electrodes are implanted deep into the brain. They come out

the top of the head, run under the scalp, and behind the ear and then connect to a small impulse generator implanted near the collarbone. Electrical impulses, either continuous or pulsed, then stimulate the area or areas of the brain where the electrodes end. Scientists still aren’t sure as to why this mechanism works to alleviate symptoms of physical and mental illness, but in some instances the results are being hailed as astounding. Different studies are producing differing results and while deep brain stimulation isn’t a cure for depression, it looks to be a promising weapon in the ever-growing arsenal used to fight mental illness.

+es Therapy: SGLT2 Inhibitors

Novel diabe

There is no cure for diabetes, so the Centers for Disease Control have reason for concern because 26 million children and adults have diabetes and about 70 million have pre-diabetes. Medications can help most people regulate their bodies’ sugar levels, but it seems that a “paradigm shift” is taking place with a new class of drugs called sodium-glucose co-transporter 2 protein inhibitors or SGLT2 inhibitors. This new class of drugs, like Dapagliflozine, treats diabetes in an entirely different way by causing excess sugar to be excreted in the urine. According to an article published online in Pharma Times by Kevin Grogan, recent research trials have shown that because SGLT2 inhibitors work independently from insulin, this class of new drugs would be easier to combine with others. Grogan says research also shows “the drug provided substantial and sustained glycemic improvements in adults with Type 2 diabetes and was generally well-tolerated.” A great side effect of this new treatment is calories are lost during urination, meaning SGLT2 contributes to weight loss. There are clinical trials for this class of drugs both here in the U.S. and abroad, but they still face approval by the Food and Drug Administration (FDA). A decision on whether or not to approve Dapagliflozine is expected in October. SOURCE: Cleveland Clinic http://www.clevelandclinic.org/innovations/summit/top-ten-innovations/2012/one.html PharmTimes http://www.pharmatimes.com/article/12-06-12/SGLT2_inhibitors_under_spotlight_at_US_diabetes_meeting.aspx: Gebel http://forecast.diabetes.org/magazine/only-online/new-drug-faces-a-roadblock (Accessed August 23, 2012)

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Sources: Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Unipolar and Bipolar Depression; http://archpsyc.jamanetwork.com/article.aspx?articleid=1107402: Brain electrodes fix depression long term; http://www.nature.com/news/brain-electrodes-fix-depression-long-term-1.9727 (Accessed August 30, 2012)

+imfo

in a r b p e de


injections

O YGEN

What happens when a patient codes on our favorite TV medical drama? They call in the crash cart carrying the defibrillator and all sorts of medications. You sit on the edge of your seat wondering if they will get the person’s heart beating in the precious seconds it takes before their brain is damaged irreparably, or they die. Boston Children’s Hospital research scientists report they have found what may be the newest addition to crash carts in hospitals, ambulances, and medical transport helicopters. This discovery will assist

medical personnel treating patients in instances of catastrophic respiratory failure. They have designed oxygencarrying micro-particles that can be injected into a patient’s bloodstream. These particles keep all the cells in the body oxygenated for up to one-halfhour without the patient taking a single breath. By injecting this new miracle elixir, doctors buy themselves time to diagnose and treat patients who have quit breathing and are at risk of brain damage or death. John Kheir, M.D., at the Department of Cardiology at

Boston Children’s Hospital, and his colleagues discovered a way to suspend oxygen in fatty particles made up of layers of lipids that can hold 3–4 times the oxygen of a red blood cell. Tests completed on animals showed rabbits injected with these oxygen-carrying particles were able to survive for 15 minutes with their windpipes completely blocked. This breakthrough has the potential to save millions of human lives each year. Source: http://www.newser.com/story/149114/injections-keep-peoplebreathing-in-emergencies.html; http://gizmodo.com/5921868/scientistsinvent-particles-that-will-let-you-live-without-breathing (Accessed September 10, 2012)

+Glasses

smar

Let there be light. Technology is shining its light into the land of perpetual darkness as researchers seek pathways to bring sight to the blind. The most innovative idea comes from Japanese designer Xu Guang-suo. Their “sonar glasses” are fitted with sensors that detect solid objects in front of, beside, and behind the person wearing them. This information is transformed into auditory cues (different ranges of sound) that enable the wearer to “see” what is in front of him or her. This version of smart glasses also has a microphone that enables the wearer to communicate with the glasses and ask them questions such as, “Is the stop light green?” Another concept undergoing clinical trial is a pair of glasses created by Joseph Rizzo III, the director of neuro-ophthalmology at Mass Eye and Ear. Dr. Rizzo’s smart glasses consist of a camera that not only maps out objects in front of and beside the wearer but can also read signs using text character recognition software. Data is fed into a GPS-enabled processor, and the wearer “sees” their surroundings through auditory signals sent to speakers on the earpiece and also through small vibrating devices placed behind the ear and near the temple. SOURCE: Navigation Glasses For The Blind Help Visually Impaired See Through Sound; http://www.huffingtonpost.com/2012/06/15/navigation-glasses-for-the-blind_n_1599573.html; http://www.bostonmagazine.com/articles/2011/11/top-docs-14-medical-breakthroughs/10/ (Accessed August 30, 2012)

+

a brief his ory of medical breakthroughs

1. Human Anatomy (1538)

Andreas Vesalius dissects human corpses, revealing detailed information about human anatomy and correcting earlier views. Vesalius believes understanding anatomy is crucial to performing surgery, so he dissects human corpses himself (unusual for the time). His anatomical charts detailing the blood and nervous systems, produced as a reference aid for his students, are copied so often that he is forced to publish them to protect their accuracy. In 1543, he publishes De Humani Corporis Fabrica, transforming the subject of anatomy. www.naturecoasthealthyliving.com

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n

+io

iza ar ul ll ce de

n o i s u f r e p

If the tin man in the Wizard of Oz had only known about perfusion decellularization he wouldn’t have had to settle for a “ticker”; he could have had a real heart made from the DNA in his own cells (tin men do have DNA, right?). Perfusion decellularization has the potential to make organ transplant practically as simple as taking out your appendix. No more waiting lists, no more waiting for one person to die so another may live, no more organ rejection, and no more of the major side-effects that come with antirejection medications makes this novel idea a major medical breakthrough. In perfusion decellularization, an organ, such as a heart taken from the cadaver of a person deceased from natural causes, can be perfused with a mild detergent. This is called micromatrix perfusion, and it involves funneling the

detergent through the artery that formerly supplied blood to the organ. The detergent flows throughout all the capillaries of the vascular system and “cleanses” each cell, removing all the components from inside the cell membrane. This material is then flushed out through the veins leaving behind the original cellular architecture of the organ. This “scaffold” is then recellularized with a mixture of vascular and organ specific regenerative cells from a donor (you). This mixture enters each cell, and the “new” organ is put into a bioreactor where it grows and matures. The mature organ, created with your DNA inside, is then transplanted into your body with no organ rejection whatsoever. There is still a lot of work to be done in the area of perfusion decellularization, but it just could be possible that one day even the scarecrow could wind up with a real scarecrow brain.

SOURCES: Perfusion-decellularized matrix: using nature’s platform to engineer a bioartificial heart; http://www.nature.com/nm/journal/v14/ n2/abs/nm1684.html: Perfusion Decellularizaton; http://midwestresearchswine.com/productsservices/midwest-porcine-recovery/perfusiondecellularization/ (Accessed August 25, 2012)

2. Blood Circulation (1628)

William Harvey discovers blood circulates through the body and names the heart as the organ responsible for pumping the blood. His groundbreaking work, Anatomical Essay on the Motion of the Heart and Blood in Animals published in 1628, lays the groundwork for modern physiology.

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3. Vaccination (1796)

Edward Jenner, an English country doctor, performs the first vaccination against smallpox after discovering inoculation with cowpox provides immunity. Jenner formulated his theory after noticing patients who work with cattle and had come into contact with cowpox never came down with smallpox when an epidemic ravaged the countryside in 1788.


Renal

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denerva ion The American Heart Association reports high blood pressure threatens the lives of 78 million people in the U.S. and an additional 27 million will be added to that number by 2030. Half of all Americans over age 50 are hypertensive (pressure at 140/90 or above) and by age 75, three-fourths will suffer from elevated blood pressure. High blood pressure is called the silent killer and is a main cause of heart attack, stroke, and kidney failure. Most people respond to medication and/or diet and lifestyle changes, but some are drug-resistant. Many of these may take up to six medications at any given time in an effort to keep the disease under control. For those persons suffering from drug-resistant hypertension, there is a new therapy called renal denervation. How does it work? The kidneys play an integral part in maintaining a constant acceptable blood pressure. Whenever we are stressed or in

danger, nerves in the kidneys signal the adrenal glands to release adrenaline into our bloodstream. Adrenaline causes our blood vessels to constrict, thereby raising our blood pressure. In today’s stress-filled world, this “fight or flight” response doesn’t turn off, even when we are not in imminent danger. This may lead to constant and uncontrollable high blood pressure. Researchers have found that by damaging the renal nerves, they can slow down the signals from the kidneys to the adrenal glands, thereby lowering blood pressure. Doctors insert a catheter into blood vessels in the groin, thread it up into the kidneys, and ablate a portion of the renal nerves. Renal denervation has been shown to cause significant drops in blood pressure and shows promise in treating chronic kidney disease, insulin resistance, and heart failure. SOURCE: Huffington Post http://www.huffingtonpost.com/2012/05/29/hypertension-destroy-nerves-high-blood-pressure_n_1552375.html Cleveland Clinic: http://www.clevelandclinic.org/innovations/summit/top-ten-innovations/2012/one.html (Accessed August 21, 2012)

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NEX generation gene sequencing Every cell’s double helix of DNA is made up of 20,000–25,000 genes, which make up the human genome. The Human Genome Project worked for 13 years using the sequencing method invented in 1975 by Frederick Sanger (and $2.7 billion) to map the human genome sequence — so science could uncover the “genetic errors that trigger disease.” To what end? Genome sequencing will eventually become a part of everyone’s medical care, allowing doctors to determine exactly why an individual is ill and in some cases, head off disease before the first symptoms appear. This could eventually lead to “customized” medical care for every individual on Earth. Even though it is cost-prohibitive at the present time to gene sequence each individual person, new techniques in sequencing now being created will make it much more affordable in the near future. SOURCE: Cleveland Clinic http://www.clevelandclinic.org/innovations/summit/top-ten-innovations/2012/one.html

4. Germ Theory (1800s)

French chemist Louis Pasteur finds certain microbes are disease-causing agents. At the time, the origin of diseases such as cholera, anthrax, and rabies is a mystery. Pasteur formulates a germ theory, postulating that these diseases and many others are caused by bacteria. Pasteur is called the “father of bacteriology” because his work leads to a new branch of scientific study.

5. Anesthesia (1842–1846)

Several scientists discover certain chemicals can be used as anesthetics, making it possible to perform surgery without pain. The earliest experiments with anesthetic agents — nitrous oxide (laughing gas) and sulfuric ether — are performed mainly by 19th-century dentists.

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y er liv de Molecular

One of the great pitfalls physicians encounter when prescribing injectable medications to patients is that of compliance. People simply don’t want to stick themselves with a needle each and every day. MIT professors Robert Langer and Michael Cima have discovered a novel way to overcome the problem — an implantable chip. The chip, manufactured by the company MicroCHIPS, is implanted under the skin and when prompted remotely, either by the patient or the doctor, releases whatever drug it is programmed to release into the body of the patient. The chip was success-

fully tested on seven women using the osteoporosis drug teriparatide. Results showed the drug maintained its efficacy and was more reliable in dosage amounts than if the women had injected themselves manually. The medication is contained in small reservoirs “about the size of a pinprick” that are capped with a layer of platinum and titanium. The patient or physician sends a radio signal to the chip through a small handheld transceiver that initiates a small electric current which melts the metal cap, releasing the medication into the body. At the present time, the transceivers only work at a distance of several inches, but Langer and Cima foresee

the day when they will work over great distances, allowing physicians to control patient dosages from their office or anywhere in the world. There are practically no limits to what the chips can achieve, either in the number of dosages or number of drug types contained on each chip. MicroCHIPS recently developed a chip that can detect blood glucose levels. This device coupled with a chip programmed to dispense insulin could mean diabetics would no longer have to monitor their blood sugar levels and inject themselves when blood sugar levels rise. The chip could automatically dispense insulin when needed and in exactly the right amounts.

+argetedtherapy

Targeted therapy is the new kid on the block when it comes to destroying cancerous tumors throughout the human body. Though in the early stages of development, they show great promise and have proven to be less toxic to healthy tissue than the standard therapies, chemotherapy, and radiation. Molecular targeted therapy involves a group of medications that block or interfere with the growth of cancerous tumors. They do this in several different ways. Some medications signal cancer cells to stop the uncontrolled growth that characterizes a tumor and then initiate aptosis, or cell death. Some carry toxic substances directly into the cancer cells, and this stimulates the body’s own natural

immune system to destroy the then-toxic cancer cells. Yet others turn on the cancer cells’ own aptosis mechanism, therby signaling each cell to self-destruct. So far, the Food and Drug Administration has approved several drugs for targeted therapy. Some of the cancers that can be treated with this type of therapy include: certain types of breast cancer (significantly advanced metastatic breast cancer), some types of leukemia (significantly acute lymphoblastic leukemia), non-small cell lung cancer, squamous cell carcinoma of the head and neck, certain cases of colorectal cancer, some pancreatic cancer, advanced renal cell carcinoma, kidney cancer, advanced cutaneous T-cell lymphoma, and others. SOURCE: Targeted Cancer Therapies; http://www.cancer.gov/cancertopics/factsheet/Therapy/targeted (Accessed August 30, 2012)

6. X-rays (1895)

Wilhelm Roentgen accidentally discovers X-rays as he conducts experiments with the radiation from cathode rays (electrons). He notices the rays are able to penetrate opaque black paper wrapped around a cathode ray tube, causing a nearby table to glow with florescence. His discovery revolutionizes physics and medicine, earning him the first-ever Nobel Prize for physics in 1901.

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7. Vitamins (early 1900s)

Frederick Hopkins and others discover some diseases are caused by deficiencies of certain nutrients, later called vitamins. Through feeding experiments with laboratory animals, Hopkins concludes these “accessory food factors” are essential to health.

SOURCE: Successful human tests for first wirelessly controlled drug-delivery chip; http://web.mit.edu/newsoffice/2012/wireless-drug-delivery-0216.html (Accessed September 11, 2012)

ug dr

p i h c o r ic m


Concussion

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managemen for young athletes

Many people, especially parents of young athletes, may be unaware sportsrelated concussions are second only to car accidents as the leading cause of traumatic brain injury (TBI). Common school-age sports activities such as football, soccer, and wrestling carry a high risk of head injury — even when protective headgear is used. Another important, but little known fact, is a person does not have to lose consciousness to have a concussion. Returning to the game too soon, athletes can suffer what’s called second impact syndrome, which can possibly lead to death. This has become a major medical concern, especially with the recent media focus on older athletes having early-onset dementia due to repeated undetected TBI. One innovation is the Concussion Management System, which provides a baseline assessment of cognitive and motor skills at the beginning of a season. The young athlete wears a special mouthpiece during the season that monitors the severity of each impact he or she experiences. Bluetooth technology then records and reports the data to coaches and physicians. If a child suffers a head injury, retesting of cognitive and motor skills lets sports physicians know when it is safe for them to return to sports activities.

8. Blood Groups (1902)

Concussion management in neighboring counties In an effort to protect schoolchildren from the debilitating effects of head injuries, some county school systems have implemented the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) software program. Carol Kneller, manager of sports medicine and human performance for the National Training Center, explains athletic trainers complete a process to be certified to perform the ImPACT baseline assessment with students, re-test after suspected injury, and evaluate the data received to decide when an athlete needs further medical attention or can return to the field. The online cognitive assessment is not an IQ test but an interactive 25-minute evaluation. The responses and response times result in a baseline number that can be used throughout an athlete’s life, not simply in high school sports programs. SOURCE: NTC; http://www.usantc.com/: ImPACT; http://www.impacttest.com/: http:// www.clevelandclinic.org/innovations/summit/top-ten-innovations/2012/one.html (Accessed August 13, 2012)

Austrian biologist Karl Landsteiner and his group discover four blood groups and develop a system of classification. Knowledge of the different blood types is crucial to performing safe blood transfusions, now a common practice.

9. Insulin (1920s)

Frederick Banting and his colleagues discover the hormone insulin, which helps balance blood sugar levels in diabetes patients and allows them to live normal lives. Before insulin, diabetes meant a slow and certain death.

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scan + for early detection of lung cancer

Spiral C

“This low-dose radiation screening has the potential to save 1 of every 5 patients who are at high risk for lung cancer,” says Maen Hussein, M.D., of Florida Cancer Specialists. “This protocol could do for lung cancer what mammograms have done for breast cancer.” He explains that in the first week of offering spiral CT scanning, 40 of his patients qualified for the procedure. The protocol is for patients to receive the screening CT every year for three years if they are 55–74 years old, have been one packa-day smokers for 30 years, or smoked two packs for 15 years, or who have quit no more than 15 years ago. “This screening tool is one way we work on prevention of cancer to prolong life,” says Dr. Hussein. The Cleveland Clinic (CC) reports more Americans ages 45–75 will die of lung cancer than “from breast, prostate, colon, and pancreatic cancers combined” because there is no effective screening method for early detection. And only 15 percent of lung cancer patients are alive after five years of diagnosis because by the time of detection, the cancer has already spread throughout the body.

“All that has changed now with the introduction of lowradiation-dose spiral computed tomography (spiral CT). This high-tech scan generates a series of detailed cross-section images of the lungs that are used to create a three-dimensional image. These scans cannot only identify tumors earlier but also spot them when the tumors are smaller and more treatable by surgery,” says the CC. The National Cancer Institute sponsored the National Lung Screening Trial (NLST), which provided either a spiral CT or a standard chest X-ray once a year for three years for 53,000 men and women between the age of 55 and 74. Participants also were followed for five years after the screening years. “The NLST results were very surprising, significant, and potentially game changing for the 7 million Americans who are heavy smokers and the 94 million current and former smokers. The study reports 20 percent fewer lunch cancer deaths among older, current, or former heavy smokers screened with CT compared with chest X-ray,” says the CC.

10. Penicillin (1920s–1930s)

11. Sulfa Drugs (1930s)

Alexander Fleming discovers penicillin, then Howard Florey and Boris Chain isolate and purify the compound, producing the first antibiotic. Fleming’s discovery comes completely by accident when he notices mold has killed a bacteria sample in a petri dish that is languishing under a pile in his lab’s sink. Fleming isolates a sample of the mold and identifies it as Penicillium notatum. With controlled experimentation, Florey and Chain later find the compound cures mice with bacterial infections. 40 |

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SOURCE: Cleveland Clinic http://www.clevelandclinic.org/innovations/summit/top-ten-innovations/2012/one.html (Accessed August 23, 2012)

Gerhard Domagk discovers Prontosil, an orange-red dye, cures infections caused by the common bacteria streptococci. The finding opens the door to the synthesis of chemotherapeutic drugs (or “wonder drugs”) and sulfa drugs in particular.


SOURCE: Study Shows Oxitec GM Mosquitoes Work: What It Means for a Florida Experiment; http://blogs.browardpalmbeach.com/pulp/2012/09/study_shows_oxitec_gm_mosquito.php: Genetically engineered mosquitoes in the U.S.; http://libcloud.s3.amazonaws.com/93/df/1/959/5/Issue_brief_GE_mosquitoes_in_U.S.pdf (Accessed August 30,2012)

s itoe squ mo ed difi mo

e n e g

y l l a ic

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Dengue fever affects 50–100 million people each year. This sometimes fatal tropical virus has no vaccine, and there is no cure for the disease once a person is infected. It is spread almost exclusively by the bite of the female Aedes Aegypti mosquito. This mosquito breeds in open water containers and prefers the blood of human hosts over other animals. Once a mosquito becomes infected with the dengue virus (which is harmless to the mosquito), it will be infected for its lifetime and can infect a human with only one bite. In 2009 and 2010, there were approximately 100 cases of dengue fever reported in the Florida Keys. In order to avert an epidemic, local mosquito control efforts shifted into high gear, and the danger seems to have passed — for now. With cases on the rise in nearby tropical islands, officials believe another, and possibly more virulent, outbreak is inevitable. Oxitec, a British biotech company, thinks they have found a way to stop the spread of dengue fever and other mosquito-borne dis-

12. Oncogenes (1975)

eases: genetically modified mosquitos. Using advanced genetics, Oxitec has created genetically engineered (GE) male Aedes Aegypti mosquitos that can be released into the wild. The males have an autocidal gene, which means once they mate with a female in the wild the offspring produced do not survive. Nature Biotechnology recently published a study showing an 80 percent decline in the Aedes Aegypti population in the Grand Cayman Islands after 3 million sterile genetically modified male Oxitec mosquitos were released there in 2009. Oxitec does not claim their GE mosquitos will wipe out Dengue fever; they simply assert that they can successfully lower the population of female Aedes Aegypti mosquitos and thereby reduce the chances of a person being bitten by an infected insect. The idea of genetically modified insects has created a firestorm of controversy, and it will be left up the scientific community to verify the safety and efficacy of the concept.

Harold Varmus and Michael Bishop discover oncogenes — normal genes that control growth in every living cell but can contribute to converting normal cells into cancer cells if mutated or present in abnormally high amounts. Varmus and Bishop worked from the theory that the growth of cancerous cells does not occur as the result of an invasion from outside the cell but as a result of mutations possibly aggravated by environmental toxins such as radiation or smoke.

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Double-S randed

RNA Activated Caspase Oligomerizer (DRACO) Now that’s a mouthful… in more ways than one. DRACO is one of the first successful attempts to produce broad-spectrum antiviral medications that kill a multitude of viruses. How does this class of antiviral medications work? In layman’s terms, these drugs can differentiate between healthy human cells and infected viral cells that are replicating within the body. Once it recognizes the viral cells, it enters the cell and programs it to commit suicide without further replication. Game over. Massachusetts Institute of Technology senior staff scientist Todd Rider created this novel approach and DRACOs have proven effective against all the viruses they have been tested against thus far. The list includes polio, dengue fever, several hemorrhagic fever viruses, adenoviruses (respiratory system), H1N1 influenza (human, avian, and swine influenza), and rhinoviruses (yes, the common cold). Scientists know more tests have to be performed to prove both its efficacy and its safety but theorize that this new drug has the potential to eventually treat all the world’s viruses… even AIDS, Ebola, SARS, hepatitis, and other emerging viruses that undergo constant mutation. Although its actual full-scale production could be years away, the scientific world is abuzz about DRACO. A pill to cure many of the world’s most endemic viral diseases… and flu and the common cold? Now that truly is a mouthful.

SOURCE: MIT Lincoln Laboratory researchers develop a technique to cure a broad range of viruses; http://www.ll.mit.edu/news/DRACO.html (Accessed August 29, 2012)

13. The Human Retrovirus HIV (1980s)

Competing scientists Robert Gallo and Luc Montagnier separately discover a new retrovirus later dubbed HIV (human immunodeficiency virus), and identify it as the causative agent of AIDS (acquired immunodeficiency syndrome).

SOURCE: The Science Channel 100 Greatest Discoveries: Medical; http://science.discovery.com/ convergence/100discoveries/big100/medicine.html: Reprint by permission (Accessed March 27, 2012)

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In the business of

SAVING

LIVES

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AS YOU ARE DRIVING ALONG, you suddenly hear the sound of sirens. You look in your rearview mirror and see a Nature Coast EMS ambulance rapidly approaching. Instinctively, you pull off the side of the road, knowing that a critically ill or injured patient is being rushed to a nearby hospital to receive immediate medical care. Some may not realize it, but Nature Coast EMS does much more than simply provide a speedy ride to the hospital. As a matter of fact, the team of emergency medical technicians and paramedics begin pre-hospital medical treatment as soon as they arrive at the scene. Assessing ill and injured persons and initiating appropriate treatment allows for the best possible patient care and outcomes. “Some believe we pick patients up, and drop them off at the nearest hospital,” says Nature Coast EMS Public Information Officer Katie Lucas. “Life-saving medical skills begin in the field. This continuity of care provides hospitals or trauma centers with an accurate patient assessment and proper protocols of treatment which greatly increase the patient’s chances of survival.” Last year Nature Coast EMS responded to more than 21,000 calls. Although it is Citrus County’s ambulance service, it is privileged to have strong relationships with facilities outside the county, including Marion County hospitals, Oak Hill Hospital, Regional Medical Center Bayonet Point, Shands Hospital, and Tampa General Hospital.

medical technology. In 2008, the organization became the first ambulance service in Florida to use Induced Cooling (ICE) to treat post-cardiac arrest patients. Team members also cross train with the U.S. Coast Guard in a rescue swimmer program. “As an organization, we always strive to think outside the box in order to maintain the highest standard of care possible,” Lucas says. “If we discover new processes and procedures that are of value to the community, our medical director, Dr. Mary Ann Kolar, evaluates and prepares the protocols necessary and then implements the training.” The organization’s commitment to excellence was certainly evident at the Florida Sterling Conference held last May in Orlando. It was there where Nature Coast EMS was presented the prestigious Governor’s Sterling Showcase Award. During the event, which recognizes organizations and businesses in Florida that achieve performance excellence within their management and operations, members of the Nature Coast EMS “Team Staying Alive” demonstrated how they have lowered response times and increased cardiacarrest survival rates. Nature Coast EMS defeated several large Florida companies such as Lockheed Martin, Miami Children’s Hospital, Imperial Point Medical Center, and RTI Biologics. Next spring, the organization will compete on the national level in Indianapolis.

A Commitment to Excellence

At Nature Coast EMS, improving the lives of patients means much more than administering life-saving treatment. It also means giving back to the communities it serves. Members give their time and skills by volunteering at community events and supporting worthwhile causes such as Habitat for Humanity and breast cancer awareness. Last March, the organization hosted a fundraiser for Blessings in a Backpack, which provides needy elementary school children with backpacks of food for 38 weekends during the school year and CASA, the Citrus Abuse Shelter Association. Nature Coast EMS also offers unique and exciting opportunities for those who desire to learn about or pursue a career in emergency medicine. The Citizen’s Academy is a free eight-week program for

This month, Nature Coast EMS celebrates its 12th anniversary of saving lives. The accredited nonprofit 501(c)(3) organization began with 50 employees, seven ambulances and two paramedic response vehicles. It has grown side by side with the community and now employs 100 team members, has 16 ambulances, five paramedic response vehicles, a “gator” UTV ambulance, and nine stations covering 500 square miles. More importantly, Nature Coast EMS has developed a reputation for delivering the highest standard of care in any environment or situation. Its team of emergency medical technicians and paramedics undergo continuous training to keep abreast of the latest changes in emergency

Commitment to Community

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“We always strive to think outside the box in order to maintain the highest standard of care possible.” — Katie Lucas people 18 years and older and provides a hands-on opportunity to see and learn what Nature Coast EMS Paramedics and EMTs do every day. Our graduates learn skills they can use in actual emergencies through training, showing and teaching the skills that an EMS crew may use. In the final session participants care for a simulated patient in a mock patient-care scenario and have the opportunity to ride along with paramedics and EMTs on actual emergency calls. Another exciting program is Explorer Post 605, which provides young adults with valuable insight into the profession and teaches them about the skills and responsibilities necessary to be successful in the emergency medical field. Graduates of the program leave as skilled first responders. Nature Coast EMS provides flu shot clinics and is also an American Heart Association Training Center. This includes not only CPR but first aid, as well as advanced classes for medical professionals. Finally, Nature Coast EMS operates an EMT and paramedic school that has even attracted students from other Florida counties. Once students have graduated they are prepared for state certification testing. Nature Coast EMS maintains a high degree of proficiency and professionalism and the mission is to set the standard for EMS training in the Citrus County area and prepare clinically competent, technically proficient graduates for positions as entry-level EMTs in the municipal, volunteer, and private sectors. The Paramedic program is designed to prepare students to provide advanced lifesupport measures. Nature Coast EMS is located at 3876 W. Country Hill Drive in Lecanto. For more information, call 352.249.4700 or visit www.naturecoastems.org.


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Reasons for Rehab at Seven Rivers Regional Proper rehabilitation is key to prompt and full recovery from serious illness or injury. Seven Rivers Regional Medical Center’s acute inpatient rehabilitation facility offers patients a unique opportunity to receive the finest therapy available not only in Citrus County but in the surrounding five-county area. Why choose Seven Rivers Regional for your rehab care?

1. Individualized care

When you are recovering from serious illness or injury, you want personalized care. That is exactly what the acute inpatient rehab facility at Seven Rivers Regional offers. This state-of-the-art 16-bed facility seems just like home with spacious private rooms designed to make you as comfortable as possible while receiving intensive rehabilitation. Around the clock nursing care enhanced by an experienced interdisciplinary rehabilitation team provides the care you need for a quick and full recovery. The entire rehabilitation process is guided by a board-certified:

2. Physiatrist

Anuj Sharma, D.O., leads a team of nurses and therapists whose sole purpose is to ensure your complete and comfortable recovery. Medicare and most insurance company guidelines require physicians at skilled nursing facilities to visit patients in rehabilitative care just once each month. At Seven Rivers Regional’s acute inpatient facility, the patient’s primary care physician and specialists, along with Dr. Sharma are there for you every day, providing the skilled care when you need it. Dr. Sharma utilizes all hospital facilities, including X-ray, lab, respiratory therapy, etc. to ensure that you get the very best in medical care. And he is backed up by a professional:

3. Rehabilitation team

This team includes physical and occupational therapists and speech pathologists. “It is a fact that the sooner you receive physical and speech therapy after an illness such as stroke, the outcome is better,” says Dr. Sharma. “Our goal is to start therapy within 24 to 48 hours after the patient has been stabilized and make sure that therapy is consistent and regular. We provide therapy 3 hours per day, 6 days a week. It is this consistency that allows our patients to heal sooner and more effectively.” This highly qualified team of therapists is assisted by:

4. Skilled nurses

Nursing care is available 24-hours a day, seven days a week. RNs trained in the treatment of rehab patients provide professional compassionate care. One-on-one patient interaction and personalized care helps speed the healing process. Part of this healing process includes diet. An important member of the Seven Rivers Regional team is a licensed:

5. Dietitian

In order for the body to heal quickly and efficiently, proper diet is essential. A licensed nutritionist guides each patient in choosing the foods necessary to provide ultimate healing and educates patients in how to make the correct nutritional lifestyle

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changes to ensure long-term healing. Coordinating patient care while in rehab and making sure each patient is taken care of following discharge is the job of:

6. Licensed social workers

A skilled social worker helps guide each patient through the maze of paperwork that can sometimes accompany rehab. They are also there to assist patients in the transition from inpatient care to either assisted living care, home health care or home care provided by family members. The care and concern of all inpatient rehab staff members leads to the ultimate goal:

7. Improved chances of recovery

The aggressive yet compassionate care that can be found at Seven Rivers Regional’s acute inpatient rehab facility has been shown to reduce the length of stay, which results in significantly better and longerlasting outcomes. Average stay to meet goals is 14 to 20 days compared to skilled nursing rehab which is up to 100 days to meet the same goals. Using this type of approach, over 8 out of 10 patients return home sooner than using conventional rehab methods found at other facilities.

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It’s anythIng but medIcIne-as-usual at brooksvIlle and sprIng hIll regIonal hospItals. When medical advancements are announced, you might think, “What does that have to do with me?” The three newest breakthroughs now featured at Brooksville and Spring Hill Regional Hospitals offer benefits that apply directly to patients. These innovative technologies reflect big changes in robotic surgery and imaging techniques.

news In knees. With MAKOplasty® surgical knee resurfacing, patients have the option of restoring a knee without replacing it. Individuals with osteoarthritis may be candidates for this procedure that repairs the affected part of the knee while preserving healthy bone, soft tissue and ligaments.

into the swing of things in a matter of weeks. Brooksville Regional is the only hospital in Hernando, West Pasco and Citrus counties to offer this advanced surgical option.

MAKOplasty is a less invasive surgery that may result in a shorter hospital stay, more rapid recovery and more natural knee function. Patients who opt for traditional knee replacement could take as long as several months to return to normal daily activities, yet MAKOplasty can get patients back

brooksville regional is the only hospital in hernando, west pasco and citrus counties to offer this advanced surgical option.

see if makoplasty is right for you. For more information or to request a free makoplasty information pack, please visit brooksvilleregionalrobotics.com 


easIer testIng For small bowel Issues. Another new technology available at Brooksville and Spring Hill is beneficial to patients with disorders of the small bowel. CT enterography is a highly sensitive technology that’s especially useful for diagnosing and treating Crohn’s disease. This non-invasive method can also detect ulcerative colitis, celiac disease and small bowel diverticulitis. Quite simply, it uses CT scanning technology as an alternative to the traditional fluoroscopy. It allows physicians to assess solid organs and provides a global overview of the abdomen. “If you think of the small bowel as a loaf of bread, the CT takes a slice out of the middle and we look at that,” said Radiology Director Amy Moore. “With this new with this new technology, patients enterography, we remain fully clothed on the exam can see within table, and we can see everything the structure in we need to see in an hour. real time. “The traditional small bowel series can take up to six hours to complete, depending on the metabolism of the patient,” she said. “This process can be hard on the patient and time consuming. With this new technology, patients remain fully clothed on the exam table and we can see everything we need to see in an hour.” This technology gives physicians more options to determine a diagnosis and potential treatments. And because of the strong, accurate images yielded, the need for additional testing is often eliminated.

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aIr does the trIck. When most patients need an angiogram, they first receive an injection of an IV contrast that highlights the internal organs. This fluid is ultimately filtered through the kidneys, which isn’t a problem for most patients. Some patients, brooksville and spring hill regional however, are hospitals are now the only two hospitals allergic to the in the area to use co2 angiography. contrast. Other individuals whose kidneys are not functioning well—dialysis patients, for example—can experience difficulties with this method. Brooksville and Spring Hill Regional Hospitals are now the only two hospitals in the area to use CO2 angiography instead of the contrast, making this procedure possible for patients who are allergic or have compromised kidney function. “The interventional radiologists are able to see and follow the air rather than the contrast to make their diagnoses or evaluations,” said Amy Moore. “Now, kidney patients are able to get other tests they need without putting stress on their kidneys. This is a great alternative for renal deficient patients.”

to find out more about these medical breakthroughs and other advancements, visit HernandoHealthcare.com

These hospitals are partially owned by physicians.


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The latest arrhythmia technology is available here

The Arrhythmia Center of Florida offers a full-service program to diagnose and treat patients who experience all types of cardiac arrhythmias, including:

The expert physicians and healthcare professionals at the Arrhythmia Center of Florida are well known for their advanced skill in diagnosing and treating arrhythmias. They have served West Central Florida patients since 1995—and perform over 1,000 electrophysiology procedures each year. The Arrhythmia Center of Florida’s dedicated team of eXperienced electrophYSioloGiStS (cardiologists who specialize in arrhythmia treatment and diagnosis) is the area’s largest. Each electrophysiologist works closely with their patients’ primary care physicians to achieve the best outcomes.

• Atrial fibrillation (A-FIB) • Atrial flutter • Inappropriate sinus tachycardia • Supraventricular tachycardia (SVT) • Wolff-Parkinson-White syndrome • Ventricular tachycardia (VT) • Ventricular fibrillation

The Arrhythmia Center of Florida is also home to the area’s most comprehensive electrophysiology lab. Procedures offered in the lab range from the latest in diagnostic imaging to comprehensive treatment. Having cutting-edge technology in place gives patients every advantage as they battle arrhythmias and other cardiac issues.

For West Central Floridians who suffer from a cardiac arrhythmia, the new Arrhythmia Center of Florida is a much-needed development in local cardiac care. Patients who suffer from arrhythmias require specialized diagnosis and treatment, something that wasn’t always available in the immediate area. Now, these patients have a premier facility that’s close to home—and completely focused on treating arrhythmias.


Luis R. Annoni, MD Medical Director

Darshan V. Patel, MD

Huang-Ta Lin, MD

The electrophysiology lab at the Arrhythmia Center of Florida delivers the latest technologies and minimally invasive treatments, including: • Advanced 3-D mapping • Advanced imaging • Radiofrequency ablation • Cryoablation • Pacemaker implantation • Internal cardiac defibrillator implantation • Cardiac resynchronization therapy • Tilt table test The Arrhythmia Center of Florida is located at Regional Medical Center Bayonet Point, but is also accessible to patients at Medical Center of Trinity and Oak Hill Hospital. As part of the nationally recognized Heart Institute, arrhythmia patients receive care at one of Florida’s most advanced cardiac facilities.

What is ElEctrophysiology? Electrophysiology (EP) is the study of electrical pulses in the heart. It is sometimes called cardiac electrophysiology. An arrhythmia happens when the heart’s electrical systems malfunction.

Raul Jimenez, MD

Rajiva Goyal, MD

Kenneth H. Yamamura, MD

about cardiac arrhythmias A cardiac arrhythmia is when the heart changes pace, making the heartbeat too slow, too fast, or irregular. Cardiac arrhythmias can occur at any age, but are most common in middle-aged adults. For some, an arrhythmia could pose no cause for concern. For others, it could turn serious. An arrhythmia can lead to congestive heart failure, more serious heart problems, and stroke. According to the American Heart Association, 15 to 20 percent of all strokes occur in people with atrial fibrillation, which is the most common type of cardiac arrhythmia. A person with atrial fibrillation is five times more likely to have a stroke than a person with a normal heartbeat.

to speak with a health care professional: 727-869-5565 • toll-free 855-534-4325 YourHeartBeat.com

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Shiela Villacastin, ARNP

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with promotional products since 1985

www.joniindustries.com INDUSTRIES

16230 Aviation Loop Dr., Brooksville, Florida 34604

352.799.5456 800.722.2881


HEALTHY MIND

Closing the door on the past WRITTEN BY ALLEN SPEEGLE

“CLOSE THE DOOR when you come inside! This is not a barn!” Did you ever hear anything like that when you were growing up? Maybe it was to keep the cold out or maybe to keep bugs out. Whatever the reason, most of our parents preached at us when we were children to shut the door when we came inside. But somehow, we leave doors to our past standing wide open. By leaving doors to the past open we end up encountering the same problems over and over. We blame others for our problems. We learn to cover up our “stuff” and live a fake life. Do you have patterns — recurring incidents — that keep happening in your life? Or maybe there are painful emotions you keep experiencing, just when you thought you were over them. If this sounds like you at all then it is time to close the door on your past. How? It’s easier than you think.

PHOTO © SHUTTERSTOCK.COM

Admit that you cannot change the past. Chances are the person who hurt you is sleeping just fine at night while you lose sleep. There is something comforting about accepting what cannot be changed. Phrases such as, “I should have…” or “If I had only…” just serve to set you back. The past is over. The present is here.

Stop hiding behind the hurt and making excuses.

Because of past failures and fears, we tend to let our pain become our “crutch” so-to-speak. Instead of taking a chance and possibly failing, we don’t try at all. That’s not living! We will never move past our pain or our fears if we don’t confront them. Today is a new day. Just because something happened in our past does not mean it is a mental jail sentence for the rest of our lives.

Invite the Change Agent into your life. With God’s help, all things are possible! Hebrews 4:16 says, “Let’s walk right up to Him (God) and get what He is so ready to give. Take the mercy, accept the help.” (Message Bible) No matter how many times you have messed up, God is ready and willing to help you out of the hole you have dug. Trying with our own effort and with our own strength only frustrates us and sets us back. Receiving help from God through His word, positive reading materials, a local church, and people who encourage us, are all ways we can get ahead in this healing process. I challenge you to close the door on your past. Every day is a new beginning for you. Your past has passed. Let’s move on. The future is ours!

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HEALTHY MIND

Going green will save you green HERE ARE FIVE SIMPLE, COST-EFFECTIVE IDEAS IN WHICH GOING GREEN CAN

SAVE YOU MONEY. THESE SMALL INVESTMENTS IN ENERGY CONSERVATION CAN PAY

BIG DIVIDENDS!

1. Replace showerheads with low-flow heads and replace faucets or adjust aerators Low-flow showerheads can save you

10–16 percent of water heating costs

and reduce water usage by 20,000 gallons per year.

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HEALTHY MIND

2.

Install ceiling fans

This will cut air conditioning costs by 40 percent

in summer. Alternatively, in winter, ceiling fans circulate warm air from the ceiling back down to the floor

to save heating costs.

3.

Night Lights

Replace your light bulbs

Energy-efficient compact fluorescent bulbs last 8–12 times longer than incandescent.

Just one bulb alone can save at least $30 in electric cost

over its lifespan and reduce greenhouse emissions from power plants. Just five bulbs could

cut 50 percent off your annual lighting bill.

4.

Install a hot water heater timer

With a timer, your electric water heater can turn off at night and on again in the morning. Without a timer, your hot water heater is constantly cycling and heating the water in your tank even if you are not using it. If you only turn it off for the 8 hours you are sleeping

you can save close to $60 per month on your electric bill!

PHOTO Š SHUTTERSTOCK.COM

5.

Install outdoor solar lighting

It is easy to install and virtually maintenance-free. Best of all, it provides free electricity. While you are working on your outside lighting, add lighting controls and timers. Motion detectors outside can increase security and decrease energy expenditure. Timers can be set to turn off and on at predetermined times.

This is an energy saver.

It has probably happened to you in the past. While walking outside your home at night you accidentally stepped on a toy, tool, or an uneven piece of sidewalk or driveway. Before you can react, you have fallen. One way to add safety to your home is by installing outdoor lighting fixtures along your sidewalk or driveway.

THE BENEFITS OF OUTDOOR LIGHTING FIXTURES ARE: SAFETY: Well-lit sidewalks and driveways can help you avoid accidents. SECURITY: Landscape lighting can discourage criminal activity, giving you peace of mind. INVESTMENT: Dramatically lit grounds at night beautify your home, increasing its resale value.

Source: www.lightinginconline.com

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HEALTHY MIND

The

benefits

FLOWERS PROVIDE MORE than just beauty, whether in their natural setting or situated in arrangements in the home. Dr. Nancy Etcoff in Harvard University’s MindBrain-Behavior Initiative found that presence of flowers in the home can elevate mood and boost energy levels. In her study, Dr. Etcoff found that when flowers were placed in a person’s home for even less than one week, people felt more compassion for others and had less anxiety and worry. After study participants placed them in kitchens, living rooms, and dining rooms, they found themselves feeling less negative and anticipating seeing the flowers when they first woke in the morning. Dr. Etcoff found that flowers boost energy and enthusiasm and that energy enhancement even carried over into the workplace, making participants happier and more productive.

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Flowers are also used in various medicines, as in poultices used for skin diseases or injuries or brewed in teas to alleviate of symptoms associated with certain illnesses. Their pleasing fragrance is used for aromatherapy, which is said to aid in mood, cognitive function, and overall health. Brighten up your life and your mood with flowers.

“The presence of flowers in the home can elevate mood and boost energy levels”

Source: Home Ecology of Flowers Study: http://www.flowerpossibilities. com/2010/08/home-ecology-of-flowers-study/ (Accessed September 10, 2012)

of flowers


HEALTHY BODY

Overload and Adapt: How to build muscle correctly WRITTEN BY ROBERT LINKUL, MS, CSCS-CPT *D

THE KEY TO SUCCESS in life and in the weight room is education. Educating yourself on the proper way to train your body will greatly increase your ability to make the changes you have deemed fit. Many non-traditional techniques have been experimented with to build strong and beautiful muscles; however, the most efficient technique has been around from the beginning. Guidelines, known as overload and adaptation, are the two basic principles of all exercise. Overload is a progression of volume. Volume is made up of two components: repetitions and weight. Any change in volume will change the load. In the case of wanting to define muscle and burn fat, the load must be more than what the body is used to handling easily. This would classify the volume as an “overload.” Once an overload has been established, it must then be placed into a workout (program design) to challenge the individual performing it. If the program design is created correctly, the body will begin to “adapt” to the

overload. The body adapts by increasing binding sites in the muscle. As these binding sites increase in strength and in size, the overload becomes simply a “load” which is no longer a challenge to manipulate. The cycle of overload and adaptation must then repeat itself for more muscle change to occur. Using the overload and adaptation principles, I will show you how to build the legs you have always dreamed of having. The secret to achieving this goal is not really a secret at all. The answer lies within the hard work you are going to put in and the progressive program design I have created for you. I have outlined three lower body exercises for you to implement on a weekly basis. For best results, you must follow the program design exactly as it is written. Focus on your technique and follow the cues as listed. A program design is much like instructions for a new device. If they are not followed correctly, the device will not work as it was designed.

Robert Linkul, NSCA 2012 Certified Personal Trainer of the Year

TIPS TO SUCCESS: ALLOW FOR PROPER RECOVERY. You must allow 24 to 48 hours of recovery time for any muscle group prior to your next training session. Overtraining and injury can occur if this rule is not followed. YOU MUST SAFELY EXCEED your comfort zone and push your physical limits to produce a true overload so your muscles will adapt. To produce a true overload, you must have perfect technique, working a full range of motion while utilizing a challenging weight. www.naturecoasthealthyliving.com

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Overload Adapt HEALTHY BODY

and

How to build muscle correctly

Dumbbell goblet Bulgarian lunge in place:

STEP 1: The key to performing a lunge correctly is in proper foot placement. To start, place your rear knee on the floor and align your front heel directly under your knee. This should make a 90-degree angle in both knees. Once your knees are properly aligned, place your rear foot on a step three to four inches high, allowing for a larger range of motion (ROM) and a greater stretch on your rear hip flexor.

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STEP 2: Lunges move up and down not forward and back. Place yourself along side a mirror to watch your posture. Your torso should move vertically allowing the rear leg to do the work. You will feel a stretch on your rear hip flexor. If this stretch is too much place your rear foot on the floor and continue.

STEP 3: Both hands should hold the dumbbell in the goblet position. The goblet position not only applies the overload, but also activates your core. Keep shoulders back, chest up, with elbows down and in tight to the dumbbell. Remember, posture is the key! If your posture starts to fail, use a lighter weight or remove the weight all together until you build a solid strength foundation.


HEALTHY BODY

Kettlebell Sumo Squats: STEP 1: Foot placement is most important when attempting to emulate the sumo. Start with your feet directly under your hips and toes pointed straight. Take one foot-width step out to each side (about three or four inches) and turn your toes out to the side about 45 degrees. Push your knees out to match the angle of your toes. This is your sumo position. STEP 2: The key to a good sumo squat is in the hips. You must stick your butt out as far as possible. Allow the knees to bend, but not drift forward. The knee should not move beyond the thread of your shoelaces. STEP 3: Stick your butt out as far as possible and allow the hips to lower while keeping your torso at 45 degrees. Shoulders back, chest up and keep a slight flex in your elbows to keep them from locking. Drive dominantly from your heels and be light on your toes. This will keep the workload in your butt and not in your quadriceps.

Physioball Hamstring Curls: STEP 1: Lay face up (supine) on the floor with your arms out at 90 degrees and your heels placed in the middle of the physioball. Keeping your toes pulled back (dorsi flexion) and a slight (five degrees) bend in your knees, push down on your heels and raise your butt and lower back off the floor. STEP 2: Keep your focus on squeezing your gluteus muscles together and digging your heels into the ball, while pulling your heels back toward your butt. Your hips must stay elevated for this exercise to work the entire back side (posterior) aspect of your body. STEP 3: Keeping dorsiflexion in the toes, extend your feet back out to the starting position without lowering the hips. Repeat this “curl� until your set is completed. Do not be surprised if you feel more than just your butt working. Your hamstrings, calves, lower back, upper back, and a couple other muscle groups are working as well. www.naturecoasthealthyliving.com

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HEALTHY BODY

Relax, it’s just a job Those deadlines are right around the corner. That annoying co-worker keeps barging in your office. Your boss isn’t exactly thrilled about your latest project. Do these dreaded workplace experiences sound familiar? If so, you know all about dealing with stress while on the job. Right? Well, rather than coming unraveled, there are some simple ways to de-stress yourself so you can adequately focus on the task at hand. With two of these techniques, you don’t even have to leave the comfort of your office! Squeeze Play-Doh: No, we’re serious. The squishy stuff you played with as a child can actually whisk you back to your childhood years when you were carefree and stress-free. It comes in numerous colors, adding brightness to your dark day. Play-Doh is proven to be every bit as therapeutic for adults as it is for children, so don’t hesitate to squeeze, squish and smash your stress away! Toe Lifts: Realizing those toes were made for lifting can help you become a happy “sole!” Start by sitting in your office chair with knees bent and feet flat on the floor. Then, lift your toes and the forefoot of both feet off the ground—keeping heels on the floor. Try to lift as high as you can and point the toes toward the ceiling. Not only are you relieving stress, you are also strengthening and shaping calf muscles. Take a Walk: Your feet were made for walking. Use those 15-minute breaks or even your lunch break to take a brief walk and temporarily leave your stressful environment. This is an excellent way to help clear your head, reduce stress, blow off some steam, and receive a much-needed breath of fresh air. Remember, exercise releases those feel-good endorphins, which will undoubtedly help improve your mood.

Rather than coming unraveled, there are some simple ways to de-stress yourself.

Sources: Play Dough Therapy; http://parentingpink.com/2009/09/play-dough-therapy/:Toe Raises; http://www.teachpe.com/strengthening/toe_raises.php (Accessed August 9, 2011)

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PHOTOS © SHUTTERSTOCK.COM

Mencouragement:

HEALTHY SPIRIT

Mister, tear down that wall

WRITTEN BY NATHAN HAWKINS

FOR MOST OF YOUR ADULTHOOD, life has been one smooth ride. You are gainfully employed and live in a nice home. Sharing that home with you is a beautiful, loving wife and two children who are excelling in school and sports. You are blessed with a great circle of friends and socialize with them regularly. In recent months, though, things have spiraled out of control. Your 75-year-old mother suffered a crippling stroke. The company where you have been employed for 17 years is considering laying off a dozen workers, and you fear your job is in jeopardy. You wonder if Mom should be in a nursing home or if she should move in with your family. And you worry whether you will be able to pay the bills in a few months. Pressure, stress, and anxiety mount. How will you address this? As a man, you will likely fail to communicate your worries and concerns to family members, friends, and counselors. Men have a wall — it is called pride. That wall contains five feet of concrete and 10 layers of steel. We protect this wall to protect pride; that is how we are built and wired. Where men commonly fail is in not being able to communicate their problems effectively. We carry burdens on our shoulders, and at some point, the burden becomes too much, and we break down. Men need to have an effective outlet to deal with adversity in life. The key is finding the proper coping mechanism for you. I regularly visit a life coach who clinically and professionally gives me advice on how to handle certain issues. For me, it feels wonderful to openly discuss my problems. Every man needs an outlet to deal with stress. Here are some ideas you can explore:

• Call local churches and find out whether they have an available life coach or other licensed professional with whom you can share your problems. Perhaps you can talk to several life coaches or professionals before sticking with one who makes you the most comfortable. • Ask around and see if there are local men’s groups. Maybe you will make a friend or two who are experiencing similar problems in life. You can

openly share your problems and formulate solutions. • Find a golf group that meets on Saturdays. You can always talk with someone while riding on the golf cart. • Simply take a walk in the woods and reflect on everything that is troubling you. Getting away from your usual surroundings and enjoying new scenery can be healing. www.naturecoasthealthyliving.com

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HEALTHY SPIRIT

Did you know that the colors you wear can affect your mood and body chemistry? Dark colors tend to take us into deep/ dark moods that can make us withdrawn and disconnected. So… spruce up your spirit this spring by wearing bright colors! Passionate and intense RED: Enhances blood circulation to the heart. Pure and sweet PINK: Brings relaxation and minimizes depression. Lively and warm ORANGE: Increases self-esteem and improves the digestive as well as the immune system.

Wealthy and natural GREEN: Strongly associated with the heart — it promotes blood circulation and also enhances feelings such as empathy and nurturing. Peaceful and wise BLUE: Heals, relieves pain, inflammation, and stress. Blue can also lower blood pressure and strengthen mental sharpness. Darker blues are connected with femininity and intuition. Royal and rich PURPLE: Is associated with emotions such as intuition, compassion, sensitivity, spirituality, etc.

Innocent and vital WHITE: Is purifying to your emotions and promotes physical and mental health. Mourning and distant BLACK: Excess creates a decline in mental and physical health. However, wearing some and certain, shades of black can protect and boost the immune system. Secure and connected BROWN: Promotes feelings of security and connection to nature and those around you.

Source: Colourful Women’s Clothing – Healthy Benefits of Colour; http://hubpages.com/hub/healthy-colourful-clothing (September 10, 2012)

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HEALTHY SPIRIT

Hair confident: healthier hair

PHOTOS © SHUTTERSTOCK.COM

Bad hair days can mean just plain bad days, according to a study conducted at Yale University. The study, which questioned 60 men and women between the ages of 17 and 30, found that people’s self confidence in performance dramatically decreased when they perceived their hair as looking bad. They felt less smart and tended to “intensify self-criticism, increase social insecurity, felt less capable, more embarrassed, and less sociable.” It seems the best thing to do would be to prevent bad hair days by taking care of your hair! Some suggestions are: use shampoos and conditioners that do not contain damaging chemicals; buy products that cater to your hair type; use oils such as olive oil, castor oil, or almond oil; or use yogurt, eggs, milk, honey, etc. Do not shampoo your hair every day because it takes away the vital, natural oils your body produces. But, first and foremost, hair care starts with healthcare. If the body is not healthy it will not produce healthy hair. So make sure to eat healthy foods and exercise.

Source: New Study Conducted at Yale University Concludes that ‘Bad Hair Days’ Affect More Than Your Appearance; http://www.super-hair.net/yale-hair.html (Accessed September 10, 2012) www.naturecoasthealthyliving.com

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Dr. Ivan Diaz


HEALTHY FINANCE DAVE SAYS

Choose wisely

Debt collectors and the law

Dear Dave,

Dear Dave,

I’m a landlord in New York, and I’ve always felt it is not a good idea to rely entirely on previous landlords for referrals on prospective tenants. Do you have any tips for selecting good renters?

A debt collector has been calling members of my family to get information on me. She has identified herself as collector, and I want to pay what I owe, but is it legal for them to do this? If not, what can I do to make them stop?

PHOTO PROVIDED

— Jean

DEAR JEAN, I think you are on the right track. Most landlords are not thorough enough with the screening process. You can’t get to know someone without spending some time with them and digging into their personalities and backgrounds a little. I have several rental properties, and here are a few tricks that work well for me. I always pull a credit bureau report on prospective renters. I also get a big deposit up front. I spend quite a bit of time talking to them one on one, as well, so with all this they would have to be a pretty good con artist to get past me. Another thing I do is drive by the place where they are currently living. I like to see what condition the house is in, and if they keep the yard maintained. To me, this is a great indication of how responsible they are and how they would treat my property. It is not a bad idea to get some proof of them having made previous rental payments on time, either. In some ways it is a leap of faith any time you sign an agreement with a new tenant. But there are things you can do in order to make a more informed decision as with whom you are doing business. And who knows? Lots of renters appreciate knowing they have a landlord who handles things in a professional manner. Maybe these suggestions will help you both feel a little more at ease. Good luck, Jean!

— Katherine

DEAR KATHERINE, No, it is not legal. If she identified herself in any way as a debt collector and spoke with anyone but you about your debt, she has broken federal law. This is a violation of the Fair Debt Collection Practices Act. You need to file a complaint with the Federal Trade Commission (FTC) against this collector and her company. I would also advise recording the conversation the next time she calls. Just tell her at the beginning that you will be taping any interaction you have with her from that point forward, and tell your relatives to do the same thing. That way, you’ll have proof of misbehavior to hand over to the FTC or the attorney general. You might even be able to get this crooked collector shut down. Don’t get me wrong. It is perfectly okay to collect a debt. If you are a creditor or collector, it is simply money that is owed to you, and you deserve it. But you must do it within the confines of the law, and you should do it within the confines of good taste. If you owe money, you should be honorable enough to pay what you owe. But this kind of behavior is just harassment and intimidation. Don’t let them get away with it, Katherine! – DAVE

– DAVE www.naturecoasthealthyliving.com

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HEALTHY FINANCE

Paying for care WRITTEN BY ELLEN B WILCOX

WHETHER YOU ARE A CHILD, PARENT, SIBLING OR SPOUSE, whether you are young or old, male or female, the chances are that at some point you will be tapped to pay for the care of some other family member. As more and more of us live longer and longer, the inevitability of caring for a relative is practically assured. A good time to begin the search for competent and affordable care is when a problem first becomes apparent and not when the problem has elevated to crisis status. Barring sudden trauma such as a stroke or an accident, the physical, emotional or mental decline of any individual usually comes with ample warning signs. For those with limited funds, state and county government offices and the Social Security Administration offices are usually good starting places. It is possible to gather a substantial amount of information, brochures and forms needed to begin the process by visiting these offices. Armed with information, such as cost and availability, the selection process can begin to move forward. A local hospital or hospice can also often provide key facts and viable alternatives. Cost is often the main factor differentiating many of these facilities, although convenience of location and quality of care can also be significant when making a decision. Long-term Care Insurance (LTCI) can help provide quality care. Those holding LTCI contracts have taken the Boy Scout motto to heart, and those ultimately responsible for their care should rejoice in that foresight. Those without LTCI often rely on family members or government programs to support the cost of care. Even with LTCI, home healthcare may or may not be covered. It’s important to read the policy carefully and to consult with the issuing insurance company or agent for specific details and questions. There are basically three levels of

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care available with each having several sub-categories. The three main levels are assisted living, skilled nursing, and long-term care. Each has its own set of qualifications and corresponding costs. Currently in Florida, long-term care costs are averaging $7,000 per month! If your loved one is in Connecticut, New York or California, the average cost is a whopping $10,000 per month with $12,000 not being unusual in major metropolitan areas. For those over 65, Medicare covers the expense of home healthcare, assisted living, and skilled nursing care, but only for a short period of time — and only upon the orders of a physician immediately following release after a hospitalization. Many specific criteria must be met with the hospital playing a key advisory role. For those nearing end of life, hospice is also covered by Medicare, but again, specific criteria must be met, and there is a finite time period of coverage. Qualifying for care through the Medicaid program is complicated and involves extensive planning. Qualification is not only based on income but also includes assets. Medicaid does not pay directly to the individual but only to the institution involved. Generally there is little or no choice of location, which can make family visits difficult or even impossible. Medicaid information and qualification guidelines are available at the Medicaid website, www.Benefits. gov. For those able to pay for help with this cumbersome process, a qualified attorney can take you through the many steps. Just be sure not to sign for something irrevocable without complete understanding of all the issues. The need to care for a family member at some future point in time requires planning ahead and would seem to be the sensible thing to do. Unfortunately that is seldom the case. One way, to plan ahead is through

the purchase of Long-term Care Insurance (LTCI). This financial planning tool has become such an important piece of the financial planning puzzle that financial advisors may now face litigation for not discussing it with our clients. (California has ruled on several such cases!) I make LTCI a part of every initial consultation and every annual client review. However, my recommendations in this area often fall on deaf ears! Because we live in a state densely populated with retirees, the cost of LTCI

“Currently in Florida, long term care costs are averaging $7,000 per month!”


PHOTOS © SHUTTERSTOCK.COM

HEALTHY FINANCE

is often prohibitive due to age and/or health conditions of the applicant. I like to have my clients consider applying for LTCI while they are young and healthy — attributes which help keep the cost of premiums lower. Without LTCI, it is highly likely that other family members will ultimately be burdened with the dollar amount of care needed. Such a burden, especially over an extended period, may wreak financial havoc from which there is virtually no recovery. For those with both the means and the emotional capability, a “Life Care” facility may prove the best answer for the patient as well as for those asked to provide the care. Facilities of this type generally require a “buy-in” at a significant

cost. At three local facilities I researched, entry costs ranged from $65,000 for a studio apartment to $750,000 for a three-bedroom apartment in an elegant, new complex. Monthly fees at these same locations were between $1,560 and $4,200. Rates in urban areas were noticeably higher. Monthly fees typically include use of pool, hot tub, fitness center, library, and a minimum of one hot meal per day. Most have monthly cost options for additional meals if desired. Special activities, trips or classes may have additional costs as well. Most such facilities offer multiple buy-in plans with some plans guaranteeing a portion of the buy-in cost returned to the occupant’s estate at

death. Expensive, but worth it to know that all future healthcare needs will be provided, including long-term and memory care. Emotionally speaking, most who opt for this lifestyle have spent a lifetime engaging in prudent financial planning and essentially pre-paying for their own future needs. Often they do so to retain a sense of independence and to avoid becoming a burden to other family members. In today’s world of financial uncertainty, it’s hard to beat a good financial plan with goals and objectives clearly defined and, when possible, fully funded. Are you on a path that will provide for your future?

Ellen B Wilcox is a Registered Principal with, and offers securities through, LPL Financial, Member FINRA/SIPC. Ms Wilcox is President and CEO of Wilcox Wealth Management, which is not affiliated with LPL. She may be reached at Ellen@ellenwilcox.com or www.ellenwilcox.com. The opinions expressed in this material are for general information only and are not intended to provide specific advice or recommendations for any individual. To determine which investment(s) may be appropriate for you, consult your Financial Advisor prior to investing. All performance data reference is historical and is no guarantee of future results. All indices are unmanaged and cannot be invested into directly. There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not ensure against market risk. Stock investing involves risk including loss of principal. International investing involves special risks such as currency fluctuation and political instability and may not be suitable for all investors. www.naturecoasthealthyliving.com

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HEART OF THE COMMUNITY

Simply Superior PHOTOS BY CHRIS FIFFIE

08/17/12

A ribbon-cutting ceremony and open house was held for Superior Residences of Lecanto, a state-of-the-art housing community that will specialize in memory care and dementia. The facility will feature 60 studio apartments and accommodations for up to 80 residents. In addition, nursing care will be provided 24 hours a day. 02 03 04 05 06

Josh Wooten, Citrus County Sheriff Jeff Dawsy, Theressa Foster, and Geoffrey Greene Cindy and Stephen Rice, with Allison Bishop Frank and Mary Mudd, with Theressa Foster Michele Salvadeo, Sylvia Martinez, and Sandra Innis Pat and Dennis Damato, with Theressa Foster

01

02 03 04

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MATTERS OF THE HEART Citrus Cardiology offers a very comprehensive set of diagnostic and monitoring testing to handle all your cardiac needs. The practice also offers numerous in-office procedures so patients can enjoy a seamless continuum of care under one roof. Most importantly, these services are offered in a warm, comfortable environment and administered by a team of healthcare professionals who genuinely care about each patient. That explains why the majority of the practice’s business comes from repeat patients or referrals. Citrus Cardiology recently welcomed two physicians whose skills and experience complement the practice’s proud reputation of delivering outstanding cardiovascular care. Without question, they take the health and well-being of patients to heart! Dr. Nishant Nerella joined Citrus Cardiology’s Crystal River location and will undoubtedly take Citrus Cardiology’s

CRYSTAL RIVER

760 SE 5th Terrace, Crystal River, FL 34429 352.795.4165

comprehensive care to another level. A non-invasive cardiologist, he enjoys having the opportunity to treat the whole patient by offering preventive measures, as well as treatment for patients with heart problems. His specialties are echocardiography, nuclear cardiology, and vascular ultrasound. “I tailor treatment to each individual patient to the best of my ability,” he says. “My best days are when I go home at midnight dead-tired knowing I saved several lives. That is what makes me happy.” Dr. Nerella completed his fellowship in cardiovascular diseases and residency in internal medicine at Maimonides Medical Center in Brooklyn. He also served as a clinical instructor and hospitalist at Brown University Rhode Island Hospital. Dr. Hari Kannam is an interventional cardiologist who joined the practice’s Inverness office. He possesses numerous skills in the field of cardiology, including nuclear cardiography,

INVERNESS

308 W. Highland Blvd, Inverness, FL 34452 352.726.8353

2-D Doppler echocardiography, transthoracic and transesophageal echocardiography, clinical cardiography, stress testing, and Holter monitoring. He also uses a radial approach to diagnose and treat patients with coronary artery disease by threading a catheter in the patient’s arm through the radial artery. He says this is beneficial because patients experience lower rates of complications, shorter recovery times, and increased comfort. “I love my job because I can instantly help patients feel better,” he says. “For instance, if a patient has trouble walking because he or she has blockage, I can put a stent in, and they immediately are walking much better.” Dr. Kannam is board-certified in nuclear cardiology, cardiovascular diseases, and interventional cardiology. He completed his fellowship in interventional cardiology at Detroit Medical Center and also served as chief instructor of medicine at New York Medical College.

LEESBURG

801 E. Dixie Avenue, Suite 107, Leesburg, FL 34748 352.315.0627

www.citruscardiology.org

THE VILLAGES 910 Old Camp Road Building 210

Lake Sumter Professional Plaza,

The Villages, FL 32162 PHONE 352.751.3356


HEART OF THE COMMUNITY

Cancer Center Groundbreaking PHOTOS BY CHRIS FIFFIE

07/10/12

In July, Florida Cancer Specialists and Research Institute held a groundbreaking ceremony on the site of its new million-dollar center. The center, which is slated to open in December, will be built on County Line Road near Spring Hill Regional Hospital. Florida Cancer Specialists’ board member Dr. Vikas Malhotra says that the new facility will provide “renewed hope to an even greater number of cancer patients.”

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Sherrie Lalande, Ann Bute, Tammy Mackiewicz, and Kacie Legendre Thomas Tang, Vikas Malhotra, Rob Foreman, and Mary Li Shauna McKinnon, Jorge Ayub, Vikas Malhotra, Mary Li, April Saxer, and Thomas Tang Samantha Watkins, Sue Parker, and Jim Graham Thomas Tang, Samantha Watkins, Jeff Esham, and Jeff Rubin Jeff Rubin, Wendy Malluck, and Mary Li

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HEART OF THE COMMUNITY

Getting down to business PHOTOS BY WENDELL HUSEBO

07/25/12

Members of the Greater Hernando County Chamber of Commerce assembled at Silverthorn Country Club for the organization’s monthly membership meeting. The event, which typically attracts 130–200 people, allows members to network and market their businesses. Dr. Dale Brill, president of the Florida Chamber Foundation, served as the keynote speaker. 01 02 03 04 05 06

Dr. Dale Brill, President of the Florida Chamber Foundation Leslie Talyor and Carla Hayes, of HPH Hospice Achilles Thomas, Nancy Holley, and Scott Griffin, of Monster Transmissions Pat Crowley and John Mitten Barbara and Steve Manual, of 99.9 WXJB Lynn Van Meter and Carry Bruzzi

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Tune in for Glenn Beck, Rush Limbaugh, Todd Schnitt and many more!

www.wxjbfm.com | 352.796.7469

NATURE COAST

MAGAZINE

SALES REPRESENTATIVE

Nature Coast Healthy Living is looking for an Advertising Sales Representative. This position requires a self-motivated person with outstanding work ethic. Previous advertising sales experience preferred. Please email resumĂŠs to wendell@naturecoasthealthyliving.com

www.naturecoasthealthyliving.com

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ents Actual resid

4865 Gulf to Lake Highway, Lecanto

352.746.5483 www.superioralf.com Assisted Living #pending

Theressa Foster says, “Live the moment. Love the moment at our premier communities. Meeting all your needs from basic to advanced in Citrus County.�

Call today for your free tour!


LIGHT Citr for Alzh UP T us! eime HE r’s a NI wa GH ren es

Thursday, October 25, 2012 5:30–7:30p.m.

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Superior Residences • Lecanto, FL

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PLEASE come out to support YOUR community!

• Alzheimer’s info and available services • $10 Chicken Dinners • “Virtual Dementia Tour” • Raffles/prizes Sponsored and Hosted by:

All proceeds raised will go to Citrus County BOCC to distribute to Senior Programs to provide respite and daycare to those with Alzheimer’s. Please make plans to attend! For more info, contact Amy Holaday 352-621-8017, ext. 402


www.citruscardiology.org

INVERNESS

308 W. Highland Blvd, Inverness, FL 34452 PHONE 352.726.8353

CRYSTAL RIVER

760 SE 5th Terrace, Crystal River, FL 34429 PHONE 352.795.4165

Left to right: Suman Pasupuleti, M.D., Luis Delfin, M.D., FACC, Nishant Nerella, M.D., Javier Gonzalez, M.D., FACC, Stephen Stark, M.D., FACC, Dennis Walker, M.D., Hari Kannam, M.D., Gisela Trigo, M.D., FACC, Kenneth Savage, M.D.

LEESBURG

801 E. Dixie Avenue, Suite 107, Leesburg, FL 34748 PHONE 352.315.0627

THE VILLAGES 910 Old Camp Road Building 210

Lake Sumter Professional Plaza,

The Villages, FL 32162 PHONE 352.751.3356


Nature Coast Healthy Living