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Lung More than half of young HIV-infected Americans are not aware of their status cancer NOVEMBER ISSUE - 2012
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Young people between the ages of 13 and 24 represent more than a quarter of new HIV infections each year (26 percent) and most of these youth living with HIV (60 percent) are unaware they are infected, according to a Vital Signs report from the Centers for Disease Control and Prevention. P2
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More than half of young HIV-infected Americans are not aware of their status Too many young people continue to become infected and few are tested for HIV
Y
oung people between the ages of 13 and 24 represent more than a quarter of new HIV infections each year (26 percent) and most of these youth living with HIV (60 percent) are unaware they are infected, according to a Vital Signs report from the Centers for Disease Control and Prevention. The most-affected young people are young gay and bisexual men and African-Americans, the report says. The analysis looks at the latest data on HIV infections, testing, and risk behaviors among young people and was published in World AIDS Day.
Overall, an estimated 12,200 new HIV infections occurred in 2010 among young people aged 13-24, with young gay and bisexual men and AfricanAmericans hit harder by HIV than their peers. In 2010, 72 percent of estimated new HIV infections in young people occurred in young men who have sex with men (MSM). By race/ethnicity, 57 percent of esti-
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mated new infections in this age group were in AfricanAmericans.
“That so many young people become infected with HIV each year is a preventable tragedy,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “All young people can protect their health, avoid contracting and transmitting the virus, and learn their HIV status.”
According to CDC experts, a number of factors contribute to the high levels of HIV in young people and vary by population. HIV prevalence is higher in some communities than in others, which can increase the likelihood that a person will be exposed to infection with each sexual encounter. Previous research has also found that other factors can increase risk of infection, such as higher levels of unrecognized and untreated infection, as well as social and economic factors, such as poverty, lack of access to health care, stigma, and discrimination.
Despite recommendations from CDC and the American Academy of Pediatrics that call for routine HIV testing of youth in medical settings, the analysis shows that 35 percent of 18-24 year olds have been tested for HIV, while only 13 percent of
high school students (and 22 percent of sexually experienced students) have ever been tested.
Partially as a result of lower testing levels, HIV-infected people under the age of 25 are significantly less likely than those who are older to get and stay in HIV care, and to have their virus controlled at a level that helps them stay healthy and reduce their risk of transmitting HIV to partners. CDC also examined risk behaviors among high school students in 12 states and nine large urban school districts, and found that young MSM reported engaging in substantially higher levels of risk behavior than their heterosexual male peers:
Young MSM were more likely to report having had sex with four or more partners or ever injecting illegal drugs. Among students who were currently sexually active, young
MSM were more likely to have used alcohol or drugs before their last sexual experience, and were less likely to have used a condom. Young MSM were also less likely to report having been taught about HIV or AIDS in school. “We can and must achieve a generation that is free from HIV and AIDS,” said Kevin Fenton, M.D., director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. “It will take a concerted effort at all levels across our nation to empower all young people, especially young gay and bisexual youth, with the tools and resources they need to protect themselves from HIV infection.” These efforts are underway as part of the National HIV/AIDS Strategy. CDC works with partners across the country to help prevent HIV and other STDs among young people. These efforts include encouraging HIV education and testing, funding the delivery of targeted testing and prevention services for youth at greatest risk, and working to address the social and environmental factors that can place some youth at increased risk. CDC also provides data and support to help communities develop effective school- and community-based HIV and STD prevention efforts.
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Another Successful Central Palm Beach County Chamber Networking Event ll for One hosted a networking event on behalf of the Central Palm Beach County Chamber of Commerce on November 1. Since the Palms West Chamber and Lake Worth Chamber had joined forces, they have held one successful event after another with many more to come.
For upcoming events, please visit the chamber website at www.cpbchamber.com
Dr. Arthur Hansen and Samir Qureshi.
Kimberly Leland, David Leland and Diane Kelly.
Four of our finest physicians.
Marybeth Bochel and Staci Martin.
Herman Steinberg, Becca Houser and Will Damhuis.
Enjoying the food and networking.
Dr. Zeltzer is always entertaining.
Derrick Martin, Barb, and Doug Kingera.
NOVEMBER ISSUE • 2012 3
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Arch Pain
ability to walk. The human foot contains 26 bones, more than 30 joints, more than 100 tendons, and muscles and ligaments that all work intricately together to produce a foot capable of walking. With each step, thousands of interactions between these bones, muscles, nerves, tendons and ligaments occur. During each step that we By Arthur Hansen DPM, M.S. take, our feet must first become flexible to act like shock ake a minute and think absorbers to account for our about how far you walk weight, then mobile adapters in during a day, a week, a order to adapt to the surface we month, a year, and even a are walking on and finally our lifetime. I think you will agree feet must become like rigid that it is a lot of walking. And levers in order to propel us to the your feet will take you all of the next step. way. Walking is not only enjoyable, but it is also very As our heel strikes the ground, good for you. It is a wonderfully the joints in the foot become relaxing and a good loose and flexible and our foot cardiovascular workout. pronates or "flattens." This flexibility enables the foot to However, all of this walking distribute body weight forces takes a toll on your feet and it is throughout the skeleton and to easy to see that your feet are adapt to the terrain. As our heel entitled to a little pain and comes off the ground and our suffering. If during all of this weight moves to the ball of the walking, your feet do not foot, the joints begin to lock, the function as efficiently as they arch rises or supinates, and our should, you may notice all sorts foot becomes like a rigid lever of foot, ankle, knee/hip, and even that propels our body forward. lower back pain. These events must occur sequentially with precise timing I would bet that you have never in order for the foot to function taken the time to think about ideally and thus most efficiently. how your foot functions. After However, very few feet, if any, all, one of the most complex function ideally. Also, due to the motions taken for granted is our complexity of these motions and
T
Conservative & Surgical Treatments Available Whirlpool with every visit!
the variety of physiological differences among individuals (weight, height, etc.) no two people’s feet function are exactly the same.
On one extreme, some of us have very high arched rigid feet that fail to pronate or "flatten" enough and therefore are unable to act as sufficient shock absorbers. In this instance, the ability of the foot to absorb and disperse shock at heel contact is denied, and the forces have be
Unaffected foot Claw foot
absorbed elsewhere which can cause our ankles, knees and hips to accept more of the weight that is transmitted when walking. Some common foot problems associated with this foot type, known as pes cavus, include hammertoe deformities, claw toes, painful corns, and pain in the ball of the foot.
The other extreme is that some of us have very flat flexible feet that fail to supinate. This prohibits the arch from "rising" enough and the foot from
becoming stable yielding it unable to function as a rigid lever. This extreme flexibility forces the muscles in the foot and leg to work harder and longer. This foot type, known as pes planus, often has the common problems of bunions, arch pain, painful callouses, and muscle fatigue. Most of us, however, fall somewhere in between these two extremes and may experience symptoms of both foot types.
Research into the fascinating field of human biomechanics has shown that there is an ideal foot position (neutral position) that if obtained during standing, walking, and running will produce a maximally efficient functioning foot. Once a foot attains and maintains this biomechanical neutral position, many people find relief from foot/leg fatigue, low back pain, painful bunions and hammertoes, arch pain, heel pain, painful corns/calluses and, at the same time, prevent uneven shoewear.
One way of achieving this neutral or ideal position is with the use of orthoses, or orthotic devices. These orthotic devices are inserted into your shoe and help your foot to maintain its neutral position. Many people incorrectly refer to orthoses as arch supports. However, orthoses are actually like braces
Get back on your Feet!
that fit into your shoes. Like eyeglasses for your eyes, orthotic devices are prescribed just for you and your foot. A cast is made of your foot and with the results of a gait analysis a specific prescription, ideal for your foot, is determined. As per the prescription, the orthoses are fabricated based on the malfunctions of your foot. There are three basic types of orthoses; those that attempt to alter foot function, those that accommodate feet, and those that do a little of both.
A podiatrist will be able to determine which type best suits your feet and your lifestyle. So, if you suffer from painful feet, legs, knees, hips or have lower back pain, go and see a welltrained, qualified podiatric physician and find relief. Remember, don't forget your feet, they have a lot of walking to do.
Call to make your appointment
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Personal & Gentle Care For:
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What is Select Specialty Hospital? By Mike Corvaia
hen people ask me, what is Select Specialty Hospital, my response is always the same. Select Specialty Hospital is the most unique hospital in all of Palm Beach County. How so, you might ask?
First off, Select Specialty Hospital provides acute care like any other major hospital in the area, but the key difference is that Select Specialty does not have an emergency room. We often see patients who have been admitted though an ER and have been stabilized, yet who are not ready to be discharged from acute care. The vast majority of our patients are referred to us directly from the intensive care unit or ICU. Select Specialty Hospital is not a short term acute care hospital, or STACH, even though our licensure is the same. Instead, we are considered a long term acute care hospital or LTACH. In essence, we see the same patients that require acute care but we are designed to treat those medically complex patients for a few weeks rather than a few days.
So, you’re like a rehab hospital?
name just a few procedures, as well as an intensive care unit.
No, we are not a rehab hospital, but we do provide extensive rehab with a full staff of physical, occupational, and speech therapy specialists which are available to every patient. Well, then you’re like a skilled nursing facility, right?
We are actually much more than that. Physicians and case managers alike are continually impressed with the varying levels of acuity we handle here at our facilities. Select Specialty Hospital is an acute care hospital, and any patient requiring critical care nursing, intensive respiratory services, and rehabilitation therapy would benefit greatly from our hospital.
A typical patient at Select Specialty is one who requires acute medical care for their disease or illness, and who is not medically stable enough to allow transfer to a lower level of care, such as a skilled nursing facility, rehab hospital, nursing home, or in-home care. Make no mistake, our goal at
Select Specialty is to get you or your loved one to your desired destination: a stable, healthier level of care. We help to fulfill that goal in a clean, safe environment that is fully staffed with professional healthcare providers at every level. At Select Specialty, we only employ highly trained critical care Registered Nurses. Our nurse to patient ratio is better than what is offered at most hospitals and at every level of lower care such as a skilled nursing facility or rehab, where the ratio is 1:15 or more. Our ICU is staffed with a 2:1 ratio for the sickest patient(s) we admit to our hospital. We have physicians in our facility around the clock. Respiratory therapy is available 24 hours of
every day, and pharmacists are present seven days a week. Our staff features specialist physicians available for consult, whose areas of medicine include pulmonary, nephrology, cardiology and infectious disease, ear-nose and throat, neurology, internal medicine, and pain management. Our staff also includes general and trauma surgeons, as well as a designated wound care team. In addition to the more than 150 physicians on staff at Select Specialty, we also offer CT scan, a full rehab gym, an operating room for tracheostomy placement, percutaneous endoscopic gastrostomy or (PEG) placement, complex wound care debridement and skin grafts to
We encourage you to tour our facilities in person, so feel free to come by for a visit. We are centrally located in Lake Worth, just minutes from Palms West, St. Mary’s, Palm Beach Gardens, West Palm, and Delray, to name just a few hospitals within miles of us. Or, if you’d prefer to see us right now, log on to selectmedical.com, click the location icon and type in “Lake Worth, FL” to take a virtual tour of our hospital. We hope that you and your loved ones won’t require a stay within any hospital, but should you need specialized acute care, we at Select Specialty would like to reassure you that we are a hospital with a proven record of exceptional patient outcomes, with a family of physicians and healthcare professionals that genuinely care about your wellbeing. Select Specialty Hospital of Palm Beach 3060 Melaleuca Lane, Lake Worth, FL 561-357-7200 (Main line) www.selectmedical.com
6 NOVEMBER ISSUE
• 2012
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The Shot That Prevents Heart Attacks
f you’re tempted to skip your flu shot, consider this: Getting vaccinated cuts risk for a heart attack or stroke by up to 50 percent, according to two studies presented at the Canadian Cardiovascular Congress. Scientists from TIMU Study Group and Network for Innovation in Clinical Research analyzed published clinical trials involving a total of 3,227 patients, half of whom had been diagnosed with heart disease. Participants, whose average age was 60, were randomly assigned to either receive flu vaccine or a placebo shot, then their health was tracked for 12 months. Those who got the flu shot were 50 percent less likely to suffer major cardiac events (such as heart attacks or strokes) and 40 percent less likely to die of cardiac causes. Similar trends were found in patients with and without previous heart disease. The findings suggest “that flu vaccine is a heart vaccine,” lead study author Jacob Udell.
Flu and Heart Attacks Strike in Tandem
A number of studies have shown a link between heart attacks and a prior respiratory infection. A 2010 study of about 78,000 patients age 40 or older found that those who had gotten a flu shot in the previous year were 20 percent less likely to suffer a first heart attack, even when such cardiovascular risks as smoking, high cholesterol, hypertension and diabetes were taken in account. Scarier still, researchers report that up to 91,000 Americans a year die from heart attacks and strokes triggered by flu. This grim statistic prompted the American Heart Association and American College of Cardiology to issue guidelines recommending vaccination for patients with cardiovascular disease (CVD). The CDC advises flu shots for everyone over six months of age, but cautions that certain people should check with a medical
Survivorship Clinic Cooks FRO Survivorship Clinic welcomed Chef Bridgette as part of it's continuing effort to promote healthy eating. The menu consisted of a beautifully spiced up salmon salad as spices are on the agenda.
provider before being immunized. Sadly, fewer than half of Americans with high-risk conditions like heart disease get the shot, leaving themselves dangerously unprotected against both flu complications and cardiovascular events. In fact, the CDC actually uses heart attack rates to track seasonal flu outbreaks, says Dr. Bale. “They look for areas with a sudden surge in heart attacks and send a team to investigate, because the cause is almost always a spike in flu cases.”
To picture how flu could ignite a heart attack or stroke in someone with CVD, think of cholesterol plaque as kindling, says Dr. Bale. “Inflammation, which has recently been shown to actually cause heart attacks, is what lights the match, causing plaque to explosively rupture through the arterial wall.” When a plaque rupture tears the blood vessel lining, the body tries to heal the injury by forming a blood clot. If the clot obstructs a coronary artery, it can trigger a heart attack, while a clot that travels to the brain could ignite an ischemic stroke. It’s a myth that plaque buildup alone sparks heart attacks, since numerous studies have shown that what chokes off flow to the heart is a clot. “Inflammation is a key player in destabilizing plaque, explaining why some people with relatively little build up in their arteries have heart attacks or stroke, while others with substantial plaque deposits never suffer these events,” says Dr. Bale, who advises all of his patients to get flu shots to guard against inflammation, the body’s response to viral and bacterial infections.
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If you would like additional information or to view their upcoming schedule, please visit www.sfrollc.com.
The Inflammation Connection
RESENTS P W E R C DREW’S
Eat & Drink
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Good Samaritan Medical Center Receives American Heart Association’s Get With The Guidelines-Stroke Silver Quality Achievement Award
W
est Palm Beach, FL. (Nov. 2012) — Good Samaritan Medical Center has received the Get With The Guidelines®–Stroke Silver Quality Achievement Award from the American Heart Association. This award reflects Good Samaritan Medical Center’s commitment and success to an 85 percent or higher compliance rate for seven care measures over 12 months.
Get With The Guidelines–Stroke helps Good Samaritan Medical Center’s staff develop and implement acute, as well as secondary prevention guideline processes to improve patient care and outcomes. The program provides hospitals with a web-based patient management tool, best practice discharge protocols and standing orders. In addition, the program includes a robust registry and real-time benchmarking capabilities to track performance. The quick and efficient use of guideline procedures can improve the quality of care for stroke patients and may reduce disability and save lives.
According to the American Heart Association/American Stroke Association, stroke is one of the leading causes of death and serious, long-term disability in the United States. On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year. However, “recent studies show that
patients treated in hospitals participating in the American Heart Association’s Get With The Guidelines-Stroke program, receive a higher quality of care and may experience better outcomes,” said Lee H. Schwamm, M.D., chair of the Get With The Guidelines National Steering Committee and director of the TeleStroke and Acute Stroke Services at Massachusetts General Hospital. “Good Samaritan Medical Center’s team is to be commended for their commitment to improving the care of their patients.”
Following Get With The Guidelines-Stroke treatment guidelines, patients are started on aggressive risk-reduction therapies including the use of medications such as TPA, antithrombotics and anticoagulation therapy. Patients are also given cholesterol reducing drugs and smoking cessation counseling. These treatment options are all aimed at reducing death and disability and improving the lives of stroke patients. Hospitals must adhere to these measures at a set level for a designated period of time to be eligible for the achievement awards. “Good Samaritan Medical Center is dedicated to making our quality of care for stroke patients among the best in the country. The American Heart Association’s Get With The Guidelines– Stroke program helps us accomplish this goal,” said Chief Executive Officer, Mark Nosacka. “This recognition ensures that our hospital continues to demonstrate fast and complete diagnosis and treatment for stroke patients in the community.”
NOVEMBER ISSUE • 2012 7
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I
Halloween Party at the home of Dr. Arthur Hansen and Dr. Lori Lane t was a wickedly good time for those lucky enough to attend the annual Halloween party at the home of Dr. Arthur Hansen and Dr. Lori Lane. As the Master and Mistress of Ceremonies, they greeted every guest upon their arrival, that is after you made it through the beautifully decorated walkway and past the scary creatures jumping out at you.
Welcome to Dr. Arthur Hansen's and Dr. Lori Lane's....
Daniella Viotti mixed up a witches brew.
Sarah Hansen and Manda Galin.
Master and Mistress of Ceremonies - Dr. Arthur Hansen and Dr. Lori Lane.
Josh and Christina Smith with Samir Dharia.
David Kledonis, two lovely ladies and Dr. and Mrs. Zucker.
Alan Hartstein and Dan Kapp.
Trish and David Schnitzer.
8 NOVEMBER ISSUE
• 2012
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Lung cancer L
Kishore K. Dass, MD
Board-Certified Radiation Oncologist
ung cancer is the leading cause of cancer death for both men and women. It accounts for about 30% of all cancer deaths each year. Lung cancer is divided into two types: small cell and non-small cell. Under nonsmall cell lung cancer, there are several different subtypes such as squamous cell, adenocarcinoma, and large cell; however, these all are treated the same way due to their similar behavior. Moreover, stage plays an important role in the type of treatments available to patients.
Albert Attia, MD
Radiation Oncologist – South Florida Radiation Oncology, LLC
Small cell lung cancer is less common but unfortunately, is also more aggressive than nonsmall cell lung cancer. It has a strong predilection to metastasize to brain, liver, or bone. Almost all patients who develop this type of cancer will have had a significant smoking history. If it is caught before metastasis, then standard therapy would include chemotherapy and radiation given concurrently. Occasionally, due to the oftenlarge size of these tumors, 1-2 cycles of chemotherapy are given upfront to shrink the disease.
This in turn, allows the radiation oncologist to treat a smaller area in the lung, which would cause fewer side effects. Radiation therapy for small cell can be done in one of two ways. One method is daily treatment, Monday thru Friday for approximately 6-7 weeks. The other method, which is called hyperfractionated radiotherapy, consists of treatments twice daily for 3 weeks. An additional aspect of the radiation treatment is prophylactic cranial irradiation (PCI). Due to this type of cancer’s tendency to spread to the brain, it has been found that if these patients are given a low dose of brain radiation, then the chance of developing brain metastasis decreases by half. Moreover, these patients tend to live longer. The reason for this treatment is that many of the patients with small cell lung cancer have microscopic cells floating in the blood and possibly in the brain. This low dose radiation kills these cells before they develop into masses or tumors in the brain. Non-small cell lung cancer is potentially curable, but this depends on the stage of the
cancer. Early stage tumors are usually treated with surgery upfront. Sometimes adjuvant chemotherapy and possibly radiation are necessary depending on the findings at the time of surgery such as positive lymph nodes or positive margins. Early stage tumors that have not spread to lymph nodes can also
be treated with radiation using a technique called stereotactic body radiotherapy (SBRT). This technique delivers a high dose of radiation in usually 3-5 treatments. Many times, lung cancer patients have frail lungs and health in general due to their past smoking history and are unable to undergo surgery. Fortunately, with SBRT, these early stage patients can be
Doctor-Patient Communication
Cindy Collins, Ph.D., R.D.
M
Experimental Health Psychology / Nutrition
By Cindy Collins
any patients report that they feel especially vulnerable during a medical consultation. They may have difficulty expressing disagreement or even asking questions and sharing their opinion. The result may be less involvement in making their own medical decision and being a more active participant in the course of their medical treatment.
As described in the Monitor On Psychology (November, 2012) professionals across disciplines are developing ways to improve the patient –physician dialogue. Focus groups held by Dominick Frosch, Ph.D., UCLA’s Palo Alto Medical Foundation Research Institute reveal that even welleducated patients feel intimidated during a physician consulta-
tion. Psychologists have targeted training in behavior change and communication. In response to the need for integrated medicine, psychologists are working from both ends of the relationship. They can help patients to be better prepared for the medical appointments, formulating questions and anticipating the situation as well as dealing with the appointment in the aftermath. Likewise, physicians can be assisted in understanding cognitive deficits or other difficulties that may lead to anxiety or other hindrances in communication on the part of the patient.
Kelly Haskard-Zolnierek, Ph.D. of Texas State University reports a link between better communication and patient compliance, patient satisfaction and reported control of pain. Training in communication skills is more common in medical schools now. But barriers persist: language barriers, anxiety, lack of consistent health care provider and time constraints. Communication must be improved even in short interactions. Amazingly some small behavioral changes on the part of the physician often ease the patient’s concern and make them more satisfied. They include pulling up a chair to talk rather than sitting and a short exchange outside the exam room as the patient departs. Rather than see good communication as taking time, it would benefit health care providers to realize the time saved from future potential
issues when communication is improved.
Some physicians have experienced training on the job with psychologists following, monitoring and providing suggestions for improved communication. They have been receptive to the feedback, wanting to provide the best care that they can. Studies show that interventions assisting both patient and physician in communication give the best results. Just a few minutes of patient coaching could be provided pre-visit by mail or email. The need for preparation may be even more important for patients who need to discuss their use of Complementary and Alternative
Medical (CAM) treatments. Most patients are reluctant to discuss their use of CAM and this may have a significant impact on their care.
Finally the health care team is the likely next focus for training in communication skills. The team approach is much more common in integrated medicine. The team approach can solve time constraints and help with patient compliance and satisfaction. For more read: Improving patient-physician communication/Monitor on Psychology/November 2012/Vol43/No 10
treated non-invasively and have very favorable outcomes. The medical community is in the process of comparing surgery to SBRT to see if there are any differences between the two treatments for these early-stage lung cancer patients. Early data indicates that there may not be a difference, but the research is still maturing. Once a patient develops a very large tumor that invades surrounding structures or has lymph node metastasis to the chest, then surgery is usually not an option and the patients are treated with concurrent chemotherapy and radiation. Radiation is delivered daily for approximately 6-7 weeks. No benefit to PCI has been seen in patients with non-small cell lung cancer. As with almost all other types of cancer, lung cancer treatment requires a team approach with a thoracic surgeon, pathologist, radiologist, medical oncologist, and radiation oncologist. Together, they can accurately diagnose and stage the patient as well as determine the best treatment required for the patient and help them to hopefully a path to a cure.
Reading, Games May Help Aging Brains Stay Sharp
Reading, writing and playing cards and board games may be more than just fun pastimes, they may also help aging brains stay healthy, researchers say. These types of mental activities appear to help preserve structural integrity in the brains of older people, according to Konstantinos Arfanakis and colleagues from Rush University Medical Center and Illinois Institute of Technology, in Chicago. The researchers used MRI to scan the brains of 152 people, average age 81, in order to assess the effects of mental activity on the brain's white matter, which is composed of nerve fibers that transmit information throughout the brain. There was a significant association between frequent mental activities and structural integrity in several areas of white matter in the brain, the investigators found. The study was scheduled for presentation at the annual meeting of the Radiological Society of North America, in Chicago. "Reading the newspaper, writing letters, visiting a library, attending a play or playing games, such as chess or checkers, are all simple activities that can contribute to a healthier brain," Arfanakis said in a society news release.
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10 NOVEMBER ISSUE
• 2012
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Sleep Better and Extend Your Life those lives, perhaps making it so that they can sleep in the same bedroom as their spouse again, and allowing them to feel like they have energy rather than being run down.”
Alvaro Betancur, DDS, has practiced dentistry in Florida since 1990. After receiving his dental degree, Dr. Betancur completed a residency in craniofacial pain and pathofunction at the University of Florida and a fellowship at the University of Florida Pain Center rand the American Academy of Craniofacial Pain. Dr. Betancur is a member of the American Academy of Dental Sleep Medicine.
By Deborah Lynn
Obstructive sleep apnea (OSA) is a breathing disorder in which there is a brief interruption of breathing during sleep. The throat collapses during sleep causing the individual to snort and gasp for breath. These episodes are called apneas (a temporary suspension of breathing) and can last from ten seconds to over a minute. Hundreds of these episodes can occur every night. According to Dr. Alvaro Betancur, "The body needs oxygen, if it is deprived of oxygen, something bad is going to happen."
Dr. Betancur's practice encompasses general and cosmetic dentistry, oral surgery, dental implants, and sleep medicine. He considers sleep apnea to be significantly under diagnosed, which is part of what drew him to obtain advanced training in that area. With the help of an oral appliance, patients suffering from OSA can discover restful nights and better health.
"It's one of the most rewarding parts of my practice. You actually extend patient’s lives, as well as increase the quality of
"Sleep apnea has so many comorbidity factors, such as heart disease, high blood pressure, and adult-onset diabetes," adds Dr. Betancur. Other risk factors include; snoring, old age, men are twice as likely to have OSA, menopause, excess weight, narrow airway, chronic nasal obstruction, a family history of sleep apnea, smoking and use of alcohol, sedatives or tranquilizers. “It’s also one of the main causes of acid reflux. Treatment just makes life a whole lot easier for patients."
Dr. Betancur points to the incidence of cardiac arrest by way of example. "When do most people have a heart attack? Between 11:00 p.m. and 4:00 a.m. and although it may say heart attack on the death certificate, what actually happened is that an episode of sleep apnea has triggered cardiac
arrest. The breathing stops, the pulse skyrockets which causes the heart to pump much harder as it tries to get oxygen."
We have also found that the number one reason for grinding of the teeth is sleep apnea, notes Dr. Betancur. "We used to think it was a result of stress, but now we know that it occurs because of the body's protective mechanism of moving the jaw forward to open the airway so the patient can breathe. When you treat the sleep apnea using oral appliances, the grinding comes to a halt. Patients don't wake up in the morning with headaches or sore jaws, plus it
SNORING AND DAYTIME SLEEPINESS may signal a potentially life threatening disorder:
OBSTRUCTIVE SLEEP APNEA OR OSA OSA can lead to heart attack and reduced libido
Member Alvaro Betancur, D.D.S.
From a financial standpoint, sleep apnea treatment is considered economical by patients and insurance companies alike. "Most patients who have acid reflux, for example, after being treated with a sleep apnea appliance, don't need their medication anymore. However, they should follow up closely with their physician.” "That's one possible reason that medical insurance, as well as Medicare, pays for the treatment. It's far cheaper for them to treat the sleep apnea than to handle the co-morbidities down the road."
Dr. Betancur hopes to help as many sleep apnea sufferers as he can. "We work with a number of physicians and pulmonologists. For sleep apnea patients who cannot be treated with a CPAP (continuous positive airway pressure) machine, or who drop out of treatment, there are alternatives using oral appliances that enable us to extend their lives. In addition, the convenience of an oral appliance leads to a greater chance of compliance in their treatment." In terms of those oral alternatives, Dr. Betancur adds, patients have many options. "There are ninetytwo FDA-approved appliances for the treatment of sleep apnea," he explains.
To find out more about sleep apnea and treatment, visit www.sleepsnoredentist.com
Understanding and treating sleep apnea leads to better rest, higher energy levels, and improved heart health. If you are concerned about the possibility of sleep disordered breathing for yourself or a loved one, Dr. Betancur and his staff would like to help. The practice accepts Medicare and most major insurance plans. The offices are located at 3401 N. Federal Hwy., Suite 101, in Boca Raton, telephone (561) 750-6790 and 18203 Pines Blvd, Suite 305 in Pembroke Pines, telephone (954) 392-1851.
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protects their teeth, which ends up saving them a great deal of money.”
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Obstructive Sleep Apnea (OSA) affects more than 18 million Americans and can lead to hypertension, heart attack, stroke, diabetes, reduced libido, TMJ Dysfunction, morning headaches and excessive daytime Sleepiness which can lead to work and car accidents.
St. Mary’s Medical Center Makes History Photographing a Living Logo in Celebration of its 75th Anniversary
West Palm Beach, Fla. (Nov. 2012) – St. Mary’s Medical Center proudly announces the creation of its first ever Living Logo in honor of the hospital’s upcoming 75th Anniversary celebration.
St. Mary’s logo is a fresh look, incorporating iconography as it points to the hospital’s rich heritage of compassion and legacy of excellent clinical care. The logo is a reminder of the medical cross and medical excellence that the hospital provides to our community, while it subtly hints at a religious cross, as St. Mary’s founding was by the Franciscan Sisters of Allegany, New York. The dove carrying the olive branch is a symbol to remind people of the Holy Spirit bringing peace and healing to all patients who enter the hospital’s care. The blue and green are refreshing and calming hues that are meant to signify healing. In addition, the blue is the color associated with Mary, the mother of Jesus. The logo design is meant to connect St. Mary’s heritage to its bright future that lies ahead, as the hospital continues to provide the highest standard of medical care to our community. In order to make the living logo
Permits Movement
Eliminate the CPAP mask and continue using CPAP equipment with the new oral appliance to obtain the benefits of both. OAT is covered by most Medical Insurance and Medicare
St. Mary’s Living Logo is to honor the staff and community for the hospital’s success as a leader in excellent healthcare to the community it serves as it grows and changes. The living logo will be featured as a part of the celebration of St. Mary’s 75th Anniversary in April 2013.
Our Services Include:
Dental Implants
Snoring ruins your sex life
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Since its establishment in 1938, St. Mary’s continues its mission to provide high quality health care to the communities it serves. Today, it has developed into a 464-bed, acute care hospital that provides medical, surgical, obstetrical, oncology, pediatric, trauma and emergency services to the greater West Palm Beach area for more than 70 years.
Family Dental Care Comprehensive
Treatment with Oral Appliance Therapy (OAT): for mild and moderate sleep apnea and snoring. Plus severe OSA when the patient is intolerant to CPAP or needs to be used in conjuntion with CPAP.
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come to life, over three hundred St. Mary’s employees, physicians, nurses, community members, volunteers and patients joined together to create the emblem entirely out of people. Each participant wore either a blue, green or white shirt, which are the colors of the hospital’s logo. Together, as one unit, participants stood on the St. Mary’s helipad and turned it into the hospital’s logo in human form.
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NOVEMBER ISSUE • 2012 11
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The Importance of Mammograms, Ultrasounds and Self Breast Exams the past year alone, two of them were stage IV when they came to see her and one was in her late 20’s.
By Deborah Lynn
aving met Dr. Yvette LaClaustra, a breast oncologist, at a work function in the past, you would never imagine the powerful message this beautiful petite woman packs – but she does.
As we sat in her Wellington office, Dr. LaClaustra is clearly a HUGE proponent of teaching women how to do self-exams and making sure that they have a regular mammogram or ultrasound done. “People need to realize that there is no perfect test and unfortunately, about 10% of cancers are missed during those medical screenings. Therefore, you need to be followed up by your clinician at least once a year.” “I do not feel we are doing a good job if 40,000 women die each year.” Her passion is more than evident in her voice as she has a message – get screened. “Certainly we don’t want people to panic as the 90% will be fine with the mammogram or ultrasound, but it’s the 10% that I am concerned about.”
Sadly, Hispanic and African American women are not getting screened enough. As Dr.
Dr. Yvette LaClaustra.
LaClaustra continues, “There is also the false perception out there that if you are young – you will not get breast cancer and nothing could be farther from the truth.” Dr. LaClaustra sees patients young and old and over
Dr. LaClaustra has graciously offered to teach women how to give themselves breast exams. If you would like to meet with Dr. LaClaustra, you can visit her office at 3319 State Road 7, Suite 105 in Wellington. To make an appointment, please call 561-965-1100.
In an effort to educate women on the importance of breast exams, family history and other areas of breast cancer, Dr. LaClaustra will be running a series of articles in the upcoming issues
Delray Medical Center Among America’s 100 Best Hospitals for Orthopedic Surgery, Stroke Care and General Surgery, 2013 Delray Medical Center recognized by independent healthcare ratings organization as #1 in Florida for neurosciences and treatment of stroke in 2013
Delray Beach, FL (October 23, 2012) – Delray Medical Center has been recognized as one of America’s 100 Best Hospital’s for orthopedic surgery, stroke care and general surgery by Healthgrades, the leading provider of information to help consumers make an informed decision about a physician or hospital. The findings are part of American Hospital Quality Outcomes 2013: Healthgrades Report to the Nation, which evaluates the performance of
approximately 4,500 hospitals nationwide across nearly 30 of the most common conditions and procedures. For its 2013 hospital quality outcomes analysis, Healthgrades evaluated approximately 40 million Medicare hospitalization records for services performed from 2009 through 2011. Healthgrades independently measures hospitals based on data that hospitals submit to the federal government. No hospital can opt in or out of being measured, and no hospital pays to be measured. Mortality and complication rates are risk adjusted, which takes into account each hospital’s unique population (demographics and severity of illness).
12 NOVEMBER ISSUE
• 2012
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The Importance of Annual Physical Examinations then summarize and come to a conclusion called an assessment. After which we will develop a plan of action. That plan may include laboratory tests, scans (if needed) and I feel an EKG is essential and in some cases a chest x-ray. There are many physicians who believe that an annual physical examination is not necessary for generally healthy people. But, how do we know who is healthy and who is not until we do a physical examination?
M
Shekhar V. Sharma, M.D. Board Certified in Internal Medicine
By Shekhar Sharma, M.D.
ost of you might know by now that Medicare recently has advocated annual physical examinations on seniors, but they also made it a must for every Medicare recipient for better health through preventive healthcare.
I have found many a patient who has walked into my office for their annual physical examination who is seemingly healthy and yet, they actually have an underlying problem they never knew about and thought they were healthy. I have saved quite a few lives because of a simple annual physical examination. For example, there are a lot of hypertensive and diabetics who do not know they have these conditions. It takes a good physical examination and testing to come to a diagnosis.
The basics of an annual physical examination is to get a good solid medical history from the patient, intently listening in detail as to what a patient is complaining about, list any previous and present allergies, compile a list of medications, their family history, and lastly, their alcohol, drug and smoking history. All of the above is very important prior to moving on with the physical examination of the patient where a doctor checks everything from head-to-toe, in some cases even finding abnormalities, which we will
I would like to share with you a good example of why a thorough
physical examination is necessary. On a recent return trip from India to the United States, I was sitting in an aisle seat of the plane as a friend of mine sat next to me. There was a young gentleman, that could not have been more than 30
alive. All of this happened midair at approximately 20,000 feet! I sat next to him the remainder of the flight and used whatever there was in the aircraft emergency kit while keeping a close watch on him. My fingers were on his wrist constantly
which he denied. He stated that he has always been healthy.
Now, while keeping this in mind, I have become more resolute about the need for an annual physical exam for everyone over the age of 18. This gentleman could have had an underlying cardiac problem without even knowing it and you may as well.
As this is a real life example of one of the many that I have seen, it certainly was the scariest. Since there were limited supplies available to me on the aircraft, I had no way to monitor him after his episode of cardiac arrest.
years old, who suddenly slumped over in his seat and the passenger next to him called me urgently. I came over and sat next to the young man as he was slumped over to find that he had stopped breathing and had no pulse. I thumped his chest three times and basically revived him from a cardiorespiratory arrest. Although he still quite lethargic and feeling very dizzy – he was
monitoring his pulse rate while taking his blood pressure often. Of course we laid him flat on the floor of the plane and he was alive when we landed at an International airport midway between India and the United States. Prior to him being whisked away by ambulance to a nearby hospital, I asked this unfortunate gentleman whether he had any medical problems, of
Therefore, I want to reiterate that everyone needs to follow a healthy diet, exercise daily (if you are healthy enough to do so), maintain regular visits to your doctor, do not smoke, drink in moderation and do not use drugs (other than those prescribed by your physician). If you are in need of an annual physical examination, please contact either my Wellington office at 561-968-9900 or Belle Glade at 561-968-7742 to schedule an appointment today.
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NOVEMBER ISSUE • 2012 13
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Delray Medical Center Announces Third Quarter DAISY Award Winner and Nominees Delray Beach, FL. (Nov. 2012) – To recognize nurses that provide extraordinary nursing care, Delray Medical Center announces its third quarter DAISY Award finalists and winner. Three nurses were selected as nominees of whom one winner was selected. All nominees were chosen based on their education, training, skill, judgment and compassionate care, which truly makes a difference in the lives of the hospital’s patients and the community. The third quarter DAISY Award winner is Karla Castillo from the Trauma Intensive Care Unit. Nominees were Regitha Sebastian and Swann McCrary from the NICU. “Delray Medical Center is pleased to celebrate all of our DAISY Award nominees and
Jeff Welch COO, Swann McCrary NICU, Karla Castillo TICU, Regitha Sebastian NICU and Jennifer Chiusano CNO.
winner, Karla Castillo,” said Chief Executive Officer, Mark Bryan. “We value our nurses’ contribution and recognize them for their extraordinary acts of compassion and excellence in their works with patients, families, the community and their
co-workers.” For the DAISY Award, numerous hospitals and medical facilities around the country select award recipients each quarter. Recipients are chosen by their nurse administrators, peers, physicians and patients.
Emergency nurse of the year 2012 Palm Beach Gardens Medical Center recognized Lauren Abdul’s significant contribution and excellent service as an Emergency Department nurse with the 2012 Emergency Department Nurse of the Year Award! Lauren has been a nurse in the Emergency Department at Palm Beach Gardens Medical Center for seven years. She enjoys hitting the beach and spending time with her husband and children.
Palm Beach Gardens Medical Center Among America’s 100 Best Hospitals for Stroke Care, 2013 Palm Beach Gardens Medical Center once again is recognized by independent healthcare ratings organization as being ranked among the top 5% of the nation for Stroke Care in 2013
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alm Beach Gardens, FL (October 23, 2012) – Palm Beach Gardens Medical Center has been recognized as a recipient of the Stroke Care Excellence Award four years in a row (2010-2013) and as one of America’s 100 best hospitals for stroke care by Healthgrades, the leading provider of information to help consumers make an informed decision about a physician or hospital. The findings are part of American Hospital Quality Outcomes 2013: Healthgrades
Report to the Nation, which evaluates the performance of approximately 4,500 hospitals nationwide across nearly 30 of the most common conditions and procedures. For its 2013 hospital quality outcomes analysis, Healthgrades evaluated approximately 40 million Medicare hospitalization records for services performed from 2009 through 2011. Healthgrades independently measures hospitals based on data that hospitals submit to the federal government. No hospital can opt in or out of being measured, and no hospital pays to be measured. Mortality and complication rates are risk adjusted, which takes into account each hospital’s unique population (demographics and severity of illness).
14 NOVEMBER ISSUE
• 2012
Upcoming Charity and Medical Fundraising Events November 20 – December 31, 2012
NOVEMBER 22 United Way. 4th ANNUAL TOWN OF PALM BEACH UNITED WAY 5K TURKEY TROT. Please contact Laurie at 561655-1919 or visit their website at www.palmbeachunitedway.org.
NOVEMBER 29 New Hope Charities. Holiday Bazaar. The Beach Club in Palm Beach. For additional information, contact Jane Maestro at 561366-5093 or jmaestro@newhopecharities.org.
NOVEMBER 30 Schepens Eye Research Institute. A Night for Sight Gala. The Breakers, Circle Ballroom, Palm Beach. Cost is $750.00. For additional information, please contact Ganshree Benjamin at 617573-3773, or ganshree_benjamin@meei.harvard.edu.
DECEMBER 1 Palm Beach County Medical Society (PBCMS). Annual Installation Gala: Joy – A Holiday Cabaret. The Kravis Center Cohen Pavilion, West Palm Beach. Individual tickets are $150.00. For additional information, please contact Tara at 561-433-3940 or tarar@pbcms.org.
The Lois Pope Life Foundation. 19th Annual “Lady in Red” Gala. Join Jay Leno and other celebrities at Mar-a-Lago Club in Palm Beach. Individual tickets are $700.00. To request an invitation or for more information, please contact LIFE at 561-865-0955.
DECEMBER 5 Kids Cancer Foundation (support one of their “Little Warriors”). Benefit and fundraiser for Andrew (Drew) Dawson. Roxy’s in West Palm Beach from 6:00 pm – 11:00 pm. Cost is $25.00 and includes two drinks and an appetizer buffet. At three, Drew was diagnosed with Acute Lymphoblastic Leukemia in July. For additional information, please contact mandagalin@comcast.net.
DECEMBER 7 Speak Up! For Kids’ of Palm Beach County. Tina’s Café on Olive Street in West Palm Beach. $10.00 at the door and bring a new unwrapped toy for a child. For additional information, call 561-389-7740 or visit their website at ww.speakupforkidspbc.org.
ONGOING EVENTS Salvation Army Tree. Gardens Mall, Palm Beach Gardens. This event is going on now until December 18. Stop by the tree near Sears Court and pick an Angel off the tree and purchase a gift for someone in need. For information, please call 561-622-2115. DEAR DEBORAH: At 50, I find myself single, yet again. At the urging of my sister, I have gone online looking for that special woman to share my life. It’s been eight months now and I have really enjoyed communicating and meeting these women from all over. I do talk with them for some time before we meet to be sure that we get along and have things in common. Even though I have met some great women, I am still looking for the one that fits all of my wants and needs. My concern is that I may be losing sight of the big picture because I am enjoying myself too much in the process. I do tend to have sexual relations with almost all of them and very rarely will I see them again for one reason or another. I don’t want to hurt any of them and that is my concern and question to you – should I continue to have relations with these women even though I know that I am not interested in them almost immediately? - Enjoy Them All? Dear Enjoy Them All: There is nothing wrong with
waiting for the right woman to come along. We all have a list of qualities and traits that we want our partner to possess. Some of them are deal breakers and some are workable. I don’t see anything wrong with dating women – whether that be one or a few. My concern is that you are being sexually active with most of them, especially when you know it will not go beyond that one date or a weekend. You have to remember, most women become mentally connected when communicating. However, once they have sexual relations, they will become physically and emotionally connected as well. Therefore, I would hold off on having random sexual escapades if you have no intention of seeing that woman again. If you like a woman enough and want a second date – wait until you see her again. There is certainly a lot to be said for waiting and building that desire to be together. DEAR DEBORAH: I work in the travel industry and at times, I work with the same woman a few times a month. Since we are co-workers, how can I ask her out without putting
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Grapefruit and Medications May Be A Deadly Mix
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he number of common prescription drugs that can interact with grapefruit— with potentially serious or even fatal results—is climbing sharply, according to a new comprehensive review published in Canadian Medical Association Journal.
Researchers from Western University report that grapefruit juice can interact with more than 85 oral medications, including certain cholesterol-lowering statins, cancer medications, antibiotics, anti-depressants, pain medications, heart drugs and other widely used pills. "What I've noticed over the last four years is really quite a disturbing trend, and that is the increase in the number of drugs that can produce not only adverse reactions but extraordinarily serious adverse drug reactions," lead researcher David Bailey, a clinical pharmacologist at the Lawson Health Research Institute.
Potentially Fatal Interactions
Between 2008 and 2012, the number of drugs with the potential to cause the most dangerous interactions, including acute kidney or respiratory failure and GI bleeding, has jumped from 17 to 44, says Bailey, “Half of these drugs actually can cause sudden death,” if taken within hours of drinking grapefruit juice (or eating the fruit.)
her in an uncomfortable position? Also, in general, what is the best way to see if a woman is interested in me and how do I approach the subject of dating? - Is She Interested?
Dear Is She Interested? As for the co-worker, you have to be a bit more delicate. I would suggest starting out a bit slower by arranging meet-ups with her and other co-workers. When you spend more time with her – even in a group setting, you will be able to determine if you are still interested, what type of personality she has and if she is in fact interested in you as well. At that point, if you want to ask her out – be direct. As for the best approach when being interested in a woman in general – simply ask her for a date. You can drop hints that you are interested and play it that way, but why? I am speaking from personal experience as I am oblivious to the subtle approach. If you like someone and enjoy being around them I would simply say, “Would you like to go out to dinner Saturday night?” ALWAYS give a day or date when asking someone out. If
Although the tart citrus can interact with more than 85 drugs, some interactions are unlikely to cause serious harm. Here’s a closer look at the research and what you need to know to protect your health. A number of other foods, including deli meat, milk and even candy, can also react adversely with certain drugs.
Why Are GrapefruitDrug Interactions So Dangerous?
Twenty years ago, the same team of researchers discovered that grapefruit disrupts the body’s metabolism of certain drugs. The tart citrus contains compounds called furanocoumarins that interfere with enzymes that break down the drugs in the gut. That means more of the drug stays in your body, which could cause it to build up to toxic or even lethal levels. The same compounds are also found in other citrus fruits, including Seville oranges (the kind used in marmalade), limes and pomelos, the study reports, but not in regular oranges. These adverse reactions can occur many hours after someone consumes grapefruit or its juice—and as little as one glass
of grapefruit juice can be enough to trigger dangerous interactions, the researchers report.
Which Drugs Interact with Grapefruit?
All of the drugs cited in the review are taken orally and share certain characteristics. They have limited “bioavailability,” meaning that, normally, only small amounts of the drug circulate in the bloodstream. And they all interact in the gut with an enzyme called CYP3A4.
Although this information is included in medication packet inserts, many people, including doctors, aren’t aware of this hazard, the review reported. Drugs with the potential to interact with grapefruit include the following: • statins (Zocor, Lipitor) • calcium channel blockers (Procardia, Nimotop, Sular)
And certain medications for the following conditions: • anxiety (BuSpar) • heart arrhythmias (Cordarone) • depression (Zoloft) • seizures (Tegretol, Carbatrol) • malaria (quinine) • insomnia (Halcion)
Dear Deborah she is interested and cannot make it on that specific date, she will give an alternate date. If you ask, “Would you like to go out with me some time?” That is an open question and you will likely not get the response that you desired.
DEAR DEBORAH: I developed an interest in an intelligent and attractive woman who joined my circle of friends. Though she has no shortage of guys interested in her, she and I share quite a few atypical interests, outlooks, and beliefs and enjoy each other's company. I decided to make her aware of my romantic interest in her, but, unfortunately, she didn't have the same feelings for me. I've decided to preserve my dignity by not being another one of the men orbiting her world; I will limit my contact with her. Does this sound reasonable to you, or am I being petty? - Head Held High
Dear Head Held High: No, you are not being petty – you are being smart. As it appears that she is a recent addition to your circle of friends, you need time to get to know one another within the friendly confines of your group. That being said, since you are both part of the same circle of friends, it may not be the best idea to couple up as it may become uncomfortable at some point. If something went wrong, it may be awkward for both of you to remain friends and that has the potential of alienating either or both of you from the group. My advice is to simply stay friends and see what happens in the future. You can always revisit the dating aspect, but please consider everyone else prior to doing so.
Dear Deborah is a monthly advice column written by Deborah Lynn with a common sense approach to dating. If you have any questions or comments, please forward them to: questions@globalhealthtribune.com as we would love to help.
NOVEMBER ISSUE • 2012 15
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Home Depot welcomes the Kids Cancer Foundation he children from the Kids Cancer Foundation were treated to a fun-filled afternoon on November 4 – thanks to the staff at Home Depot in Wellington. Whether it was potting a plant, picking out and receiving their favorite paint color, making a turkey napkin holder or just enjoying snacks together, it was truly a wonderful experience for young and old alike.
Now is the time to buy!
A special thank you goes to those employees that shared in this lovely afternoon; Thom, Grace, George and John. In addition, Michelle O’Boyle, the founder of the Kids Cancer Foundation is always right there with the children that she so lovingly supports. You put a smile on those beautiful young faces – of which are so deserving.
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By Bob Wolff
eal Estate in Palm Beach County is alive and very well.
Yes, there are enormous quantities of homes that are short sales and many more going into foreclosure, but this is a rare buying opportunity. I might be so bold as to say - it is a seller’s market for the time being. A recent experience beautifully illustrates my point. I had a listing in Wellington for
Colorful Fruits, Vegetables May Be Key to Cancer
Many cancer-fighting fruits and vegetables are at their nutritional peak in the fall, and it's a good time to incorporate them into your diet, a nutritional expert advises. For example, research suggests that eating an apple a day really may keep the doctor away, by helping to prevent throat, mouth, lung and possibly breast cancer, noted Stacy Kennedy, a senior nutritionist at the Dana-Farber Cancer Institute in Boston. "The key is to eat them raw and with the skin on. That's where many of the nutrients are found," Kennedy said in an institute news release. Cranberries, another healthy fall favorite, are in season and at their nutritional peak now. Kennedy suggested stocking up on bags of cranberries and freezing them for use throughout the year, because there is evidence that the benzoic acid found in these berries may inhibit lung and colon cancer, and some forms of leukemia.
$450,000 which was a little high after comparatives were examined and three offers came in within 24 hours. The actual selling price was the asking price and those who were convinced that they could get a deal, lost out. They were outbid….and one of the buyers offered to close in 30 days, putting down 40%.
Why is this today’s selling environment? The answer is simple. Inventory of homes for sale is down significantly. Mortgage rates will likely not be as low as they are today for a very long time. People are flocking to Florida again because environmental changes are making us the place to be. Our weather is fantastic! Add another significant factor…rents are way up and investors are back.
Now is the time to bite the bullet and buy a home or invest in a rental.
Inventory is low! Mortgage rates are low! Rents are high! It's time to act!
Bill Tavernise 561-209-8304
BillTavernise@keyes.com
The Leading Brokerage Company in Florida since 1926
www.keyes.com
Bob Wolff 561-352-0620
BobWolff@keyes.com
WELLINGTON REGIONAL MEDICAL CENTER
REACHING
NEW HEIGHTS IN HEALTHCARE When we opened our doors in 1986, Alan B. Miller, Chairman of the Board and CEO at Universal Health Services, Inc., shared his vision for Wellington Regional Medical Center. That the patient would always be at the center of our care and our hospital would one day be at the center of a thriving community. Since then, we have continued to expand to meet the needs of the growing communities we serve. Throughout our journey, the patient experience has remained a top priority. We are elevating this experience to new heights with the opening of our patient pavilion.
Introducing The Alan B. Miller Pavilion … A towering achievement in innovative healthcare design, distinguishing Wellington Regional Medical Center from every other hospital in the region. The new pavilion transforms Wellington Regional Medical Center into a flourishing, 233-bed medical complex. By incorporating the latest breakthroughs in technology, we are increasing staff efficiency, fostering patient engagement, augmenting the healing process and improving the overall patient experience.
PAVILION FEATURES: 3QUARE &EET s !LL PRIVATE 0ATIENT 2OOMS s )#5 3TEP DOWN 5NITS s (ARDWOOD &LOORS s 0ENDANT ,IGHTING 3PA LIKE $ÏCOR &INISHES s #OMPLIMENTARY 7I &I 3ERVICE s &LAT 3CREEN 4ELEVISIONS s 5PGRADED $INING !MENITIES .EW %XPANDED 0HARMACY s .EW ,OBBY AND 2EGISTRATION !REAS 4HOUGHTFUL SPACES FOR FAMILY AND FRIENDS s 3OPHISTICATED 4ECHNOLOGY
Learn much more about the Alan B. Miller Pavilion and how we are elevating the patient experience at www.WellingtonRegional.com/patientexperience.
Alan B. Miller PAVILION
We l l i n g t o n R e g i o n a l . c o m Physicians are independent practitioners who are not employees or agents of Wellington Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians.