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Skipping breakfast may increase heart attack risk AUGUST ISSUE - 2013 n
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Another reason to eat breakfast: Skipping it may increase your chances of a heart attack.
Other studies have suggested a link between breakfast and obesity, high blood pressure, diabetes and other health problems seen as precursors to heart problems.
Robbin Lee, RN, MBA was promoted to Chief Executive Officer of Wellington Regional Medical Center
By MIKE STOBBE, AP Medical Writer
study of older men found those who regularly skipped breakfast had a 27 percent higher risk of a heart attack than those who ate a morning meal. There's no reason why the results wouldn't apply to other people, too, the Harvard researchers said.
South Florida Radiation Oncology is proud to annouce a new addition to their staff: Andrew Oâ€™Leary, M.D. "But no studies looked at long-term risk of heart attack," said Eric Rimm, one of the study authors at the Harvard School of Public Health. Why would skipping breakfast be a heart attack risk?
Experts aren't certain, but here's what they think: People who don't eat breakfast are more likely to be hungrier later in the day and eat larger meals. Those meals mean the body must process a larger amount of calories in a shorter amount of time. That can spike sugar levels in the blood and perhaps lead to clogged arteries. Breakfast continued on page 2
Hospitalized Seniors Should Watch Out if They're Under Observation By S.Z. Berg
NEW YORK (MainStreet)--An increasing number of hospitalized patients age 65 and over are being classified as outpatients under observation rather than as admitted. "When hospitals classify people as 'outpatients,' on observation status, rather than as admitted inpatients, those patients cannot obtain Medicare nursing home coverage and may also have hospital bills they would not have if properly considered inpatients," says Judith Stein, executive director of Center for Medicare Advocacy.
Medicare will only cover the cost of nursing home care when a patient has been hospitalized as an inpatient for three consecutive days. In these cases, Medicare will foot the entire bill for the first 20 days in an approved facility. Patients who have been classified as outpatients will have to pay the entire tab. In addition, Medicare patients who have been relegated to observation status may be responsible for paying cost sharing and the unreimbursed cost of prescription drugs under Medicare Part B that under
Hospitalized continued on page 7
Andrew Oâ€™Leary, M.D.
Bill Tavernise joins Wellington Chamber President's Circle
Bill Tavernise. GLOBAL HEALTH TRIBUNE P.O. Box 213424 Royal Palm Beach, FL 33421
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Breakfast continued from cover page
Metformin Cuts Dementia Risk in Type 2 Diabetes
But is a stack of syrupy pancakes, greasy eggs and lots of bacon really better than eating nothing?
The researchers did not ask what the study participants ate for breakfast, and were not prepared to pass judgment on whether a fatty, sugary breakfast is better than no breakfast at all. Other experts agreed that it's hard to say.
"We don't know whether it's the timing or content of breakfast that's important. It's probably both," said Andrew Odegaard, a University of Minnesota researcher who has studied a link between skipping breakfast and health problems like obesity and high blood pressure.
"Generally, people who eat breakfast tend to eat a healthier diet," he added.
The new research was released Monday by the journal Circulation. It was an observational study, so it's not
designed to prove a cause and effect. But when done well, such studies can reveal important health risks.
The researchers surveyed nearly 27,000 men about their eating habits in 1992. About 13 percent of them said they regularly skipped breakfast. They all were educated health professionals — like dentists and veterinarians — and were at least 45.
Over the next 16 years, 1,527 suffered fatal or non-fatal heart attacks, including 171 who had said they regularly skipped breakfast. In other words, over 7 percent of the men who skipped
breakfast had heart attacks, compared to nearly 6 percent of those who ate breakfast.
The researchers calculated the increased risk at 27 percent, taking into account other factors like smoking, drinking, diet and health problems like high blood pressure and obesity. As many as 18 percent of U.S. adults regularly skip breakfast, according to federal estimates. So the study could be important news for many, Rimm said.
"It's a really simple message," he said. "Breakfast is an important meal."
Healthy Heart Health Fair and Screenings at Wellington Regional Medical Center
Wellington, FL – Wellington Regional Medical Center (WRMC) will host a “Healthy Heart Health Fair and Forum” on Wednesday August 28th from 10 am to 2 pm on the hospital campus in Wellington. The objective of this community event is to increase awareness about heart disease and encourage people to learn the facts about prevention and treatment. So what is Heart Disease? Heart and blood vessel disease — also
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called cardiovascular disease — is a medical condition that refers to numerous problems, many of which relate to atherosclerosis. Atherosclerosis is a condition that develops when plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to easily flow through. If a blood clot forms, it can stop the blood flow and result in a heart attack, stroke or aneurysm.
In addition to free blood pressure and cholesterol screenings and educational resources, “Lunch and Learn” physician lectures are scheduled for 11:30 am and 12:30 pm: Deborah Lynn Staff Writer / Associate Editor (312) 351-2383 Deborah@globalhealthtribune.com
11:30 am – 12:30 pm “Risk Factors and Preventing Cardiovascular Disease.” Dr. Michael B. Lakow, boardcertified cardiologist, will discuss risk factors, prevention, prevalence, diet and exercise.
12:30 – 1:30 pm “Cardiovascular Disease Intervention.” Participate in an informal, interactive discussion about interventional treatment options and heart-healthy lifestyle choices. A healthy lunch will be served, so reservations are encouraged. Call 561-798-9880 to reserve your place.
Jessica Gallon Staff Writer / Sales Executive (561) 255-2249 Jessica@globalhealthtribune.com
Megan Brooks, Medscape. Jul 16, 2013.
ype 2 diabetes doubles the risk for dementia, and a large new observational study suggests that treatment with metformin may significantly lower that risk. In contrast, other diabetes treatments, including insulin, were associated with increased dementia risk.
about a 20% reduced risk for dementia (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.65 - 0.95), Dr. Whitmer reported.
Compared with patients starting TZD, those starting metformin had a 23% lower risk for dementia during follow-up (HR, 0.77; 95% CI, 0.66 - 0.90). In contrast, starting SU (compared with metformin) was associated with a 24% increased risk for dementia (HR, 1.24, 95% CI, 1.1 - 1.4); TZD, an 18% increased risk (HR, 1.18; 95% CI, 1.1 - 1.4); and insulin, a 28% increased risk (HR, 1.28; 95% CI, 1.1 - 1.6). The results were the same after the researchers took into account diabetes duration, age, and glycemic control and when they considered dementia subtypes. The findings provide "preliminary evidence that metformin may have benefits on brain health," Dr. Whitmer said.
"These results provide preliminary evidence that the benefits of insulin sensitizers may extend beyond glycemic control to neurocognitive health," said Rachel Whitmer, PhD, senior scientist at the Kaiser Permanente Northern California Division of Research, Oakland. The results build on a "nice line of evidence" from animal models and cell culture studies showing that metformin might be neuroprotective by promoting neurogenesis and ameliorating neuronal insulin resistance. Dr. Whitmer presented her group's findings here at the Alzheimer's Association Diabetes and Dementia International Conference (AAIC) David S. Knopman, MD, from 2013. the Mayo Clinic, Rochester, Minnesota, who moderated a New Users press briefing on this topic, noted For this report, researchers that the relationship between studied a cohort of 14,891 diabetes and the development of patients with type 2 diabetes age dementia has generated "great 55 years and older who began interest" in the scientific diabetes therapy between community. October 1999 and November 2001. In this "new user" cohort, This type of epidemiologic study, only patients who started a single he noted, is intended to "generate drug (metformin, sulfonylureas hypotheses that can be tested in [SU], thiazolidinediones [TZDs], proper therapeutic trials." The or insulin) were included. findings from Dr. Whitmer's group During 5 years of follow-up, suggest a rationale for doing such dementia was diagnosed in 1487 a trial. Indeed, trials are underway (9.9%) patients. to evaluate metformin as a potential therapeutic agent for Compared with patients starting mild cognitive impairment and SU, those starting metformin had dementia.
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THE FORGOTTEN FOOT
Your foot… the body’s most used Part? many life-enhancing activities, while making others impossible.
Arthur Hansen DPM, M.S.
My feet are killing me'' may very well be one of the most common health complaints heard each day. But, let’s face it, who really does anything about it? Very few people heed the advice of their feet and continue to stand, walk and work through the pain.
Feet are the most used and abused parts of the human body. According to a study conducted by the Pennsylvania College of Podiatric Medicine, the average American walks 115,000 miles in a lifetime. That is the equivalent of more than four times around the world. Each step exacerbates minor abnormalities in foot structures or shoes that don't fit right, or both, resulting in pain. It has been estimated that 87 percent of Americans suffer from some form of foot problem. Even though these problems are not life threatening, they do inhibit the ability to fully partake in daily activities and most definitely take the joy out of
The recent surge of body weight in Americans and the subsequent craze that has millions of American feet jogging, running, dancing and jumping have greatly increased the ranks of podiatric and orthopedic patients. In addition, medical problems like diabetes, obesity and circulation issues predispose patients to foot problems that require professional attention.
Before seeking professional attention for those foot pains, many people try to manage their foot problems on their own and unfortunately they usually waste money on over-the-counter fixes. Many times self-treatment can make the problems much worse. Fortunately, many foot ailments are avoidable. Shoe gear should fit well and feet should be washed daily with soap and water. Shoes and socks should also be changed daily.
Some of the most common foot complaints are corns and calluses. These are located over high pressure areas on the foot and are layers of dead skin cells. They are the result of repeated friction or pressure against parts of the foot and actually represent the body's attempt to protect sensitive tissue.
Hard corns are usually found on
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the top of toes, where skin rubs against the shoe. Sometimes a corn will form on the ball of the foot beneath a callus, resulting in a sharp localized pain with each step. Corns are cone-shaped, with the tip pointing into the foot. When a shoe exerts pressure against the corn, the tip of the cone can hit sensitive underlying tissue, causing pain.
Self-treatment can be risky, since the chemicals used to soften corns also damage healthy tissue. Be sure to follow the directions carefully and limit self-treatment to five applications. People with poor circulation, such as diabetics, should seek professional help. Removal of corns with a razor blade should never be attempted. Hard corns are best prevented by protecting any rubbed area with a pressure relieving non-medicated corn pad or horseshoe-shaped piece of moleskin or foam rubber and by not wearing the shoes that are the culprits.
Soft corns, which are rubbery, form between toes where the bones of one toe exert pressure against the bones of its neighbor. To help prevent their formation, use lamb's wool or cotton between toes that rub together. Once established, these corns are best treated professionally.
Callouses form over a flat surface and have no tip. They
usually appear on the weightbearing parts of the foot like the ball or heel. Each step presses the callus against underlying tissue and may cause aching, burning or tenderness. Callouses may result from the friction of loose-fitting shoes or the pressure of shoes that are too tight. Women who wear highheeled shoes are especially vulnerable to calluses.
People with high arches are also vulnerable since the heel and ball of the foot bear all the weight. Arch supports may help to relieve the pressure and cause the callous to disappear slowly. Cushioned innersoles may also help. Callouses can be gradually eliminated by rubbing the callused area with a pumice stone after soaking or bathing has softened the dead skin. Then apply a moisturizing lotion. Do not try to remove too much of the callus at once. Diabetics should see a professional rather than attempt self-treatment.
Bunions appear as swollen and inflamed protrusions on the side of the foot at the joint of the big toe. A similar swelling can occur at the outside of the foot, where it's called a bunionette. Dynamic forces during the gait cycle cause imbalances at the joints and over time deformities such as bunions do occur. Bunions are most often irritated by the persistent
Get back on your Feet!
wearing of shoes that are too tight and short. Not surprisingly, bunions are four times more common among women, many of whom wear high-heeled and pointed shoes that cause undo pressure on the big toe.
Bunions cannot be self-treated and only surgery can correct the problem. However, considerable relief may be obtained through conservative measures. These include devices in the shoes that change the foot's dynamic forces and by wearing shields to protect the bunion from friction against the shoe. Hammer toes are deformities of the toes where the joints bend causing pressure points. Hammertoe deformities can affect all the toes but the most common toe affected is the second toe, which on most people is longer than the big toe.
Blisters commonly appear where a shoe rubs against skin that is unprotected by a corn or callus. Ease the friction with moleskin padding, wear socks and change shoes. Don't pop blisters, since they may then become infected. If a blister breaks on its own, apply an antiseptic and keep the area covered with a sterile bandage. Remove the bandage at night to promote healing. Your feet have a long way to go, so take care of them.
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• Diabetic Foot Care • Hammer Toe • Fracture Care • Ingrown Nails, Bunions • Ankle/Heel/Foot Pain • Poor Circulation • Neuropathy • WOUND Care • Custom Molded Orthotics • Diabetic Shoes Medicare Medicaid HCD - PPO & Most Insurances Accepted
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Rock Purple for the Cause he rain did not put a damper on the Lupus Foundation Southeast Florida Chapter’s “Rock Purple for the Cause” awareness dinner held in West Palm Beach. Lupus is a chronic, autoimmune disease that currently affects over 1.5 million Americans. This disease can damage any part of the body with signs and symptoms often lasting longer than six weeks. The event was organized and hosted by Michelle and Marshall Meikle, owners of Meikle’s Creative Catering and Rhonda
Davis, owner of RAD Event Production. Thanks to Michelle, Marshall, and Rhonda, the entire evening was a complete success from the choice of venue, food, guest speakers to the beautiful songs performed live. The evening was truly one of hope for those affected with this disease. Also in attendance were Florida House of Representatives, Bobby Powell, Jr. and singing sensation Michaela Paige. For information on this disease, contact the Lupus Foundation of America at www.lupus.org.
Tattoo Removal News
R. Sabates MD, CLS, CME
attoo remorse is leading many of the painted masses to rethink their ink and opt for increasingly available laser removal procedures. A recent survey found a 34 % increase in tattoo removal in the past two years alone. The main reason it concluded, was job related issues. In this tight job market, employers of restaurants, hospitals, banks, the armed forces, police and Disney World are shunning visible tats on their employees.
It seems that the pendulum is finally swinging back after years of dramatic increases in the number of tattoos. This increase has been mainly driven by celebrities and in the media. For example, 70% of NBA players are sporting tats. Shows like Miami Ink however, are now being replaced with the more realistic Bad Ink. Unfortunately, in this TV program, unhappy customers are encouraged to get cover-up tattoos. That is the worst possible solution. Not only does it require an expert artist, but the older tattoo will always come back in view after a few short years as the body clears the new ink. Today, laser tattoo removal is faster, cheaper, better and with
no more discomfort than putting on the tattoo.
Laser tattoo removal is the gold standard for safely and effectively getting rid of the ink. There are three main laser wavelengths used: Nd:YAG, Alexandrite and ruby lasers. Manufacturers have fine-tuned the equipment with more power and better results. In South Florida, the Nd:YAG has the advantage on darker tanned skin.
A series of laser treatments are required to progressively fragment the encapsulated ink pigment. Approximately 6 to 10 passes are required to significantly clear the ink. Because the laser light goes into the deep skin layer, it doesn’t affect the superficial skin. Therefore, since there is generally no bleeding or scarring, the healing time is only a few days. The laser light does
not really remove the ink. It’s our own bodies’ specialized immune cells that attack and carry away the ink particles that have been broken up into smaller particles by the laser.
The latest big news in tattoo removal was the recent (2012) discovery that dramatically speeds up the whole removal process. Instead of having one pass every 4-6 weeks that can take up to a year to remove, we can now safely and effectively do up to 4 passes only 20 minutes apart on the same day. This is called the R20 method. The peer reviewed results showed that 60% of amateur black ink tattoos were removed in a single day with 4 passes without any increase in complications. This advance has overcome one of the biggest patient hurdles – wanting it done yesterday! In the past, patients rarely finished all their
recommended treatments because of time constraints. This led to less than optimal results with laser treatment. The R20 technique has also decreased the cost as physicians usually charge less for same-day treatments.
It is important to note that in Florida, the tattoo industry as well as the ink industry, is poorly regulated. Tattoo artists are no longer required to have physician supervision. While the tattoo “artist” is only required to attend an infectious disease course and have $150.00 to set-up shop, laser tattoo removal is limited to a physician, a nurse practitioner or a physician’s assistant. For every beautifully done tattoo, there are five awful ones - so think before you ink. Other news worth mentioning is that researchers have discovered
there are health related hazards of tattoo ink. The injected ink acts as a foreign substance which activates our immune system to mount an attack on the ink. Researchers have found an increase health risks in patients that have autoimmune diseases, such as lupus, psoriasis, asthma, eczematous dermatitis, rheumatoid arthritis, and so on. The more ink – the worse the reaction. Kidney toxicity has also been found. Another interesting fact, if you have recently applied or removed ink, you cannot be a kidney donor. The future of laser tattoo removal is bright. Newer equipment (Picosecond) has just come on the market, although right now it’s very expensive. This laser has the ability to remove the harder to remove colors like green, blue, orange and yellow. Unfortunately, it’s not very good on black. Since 95% of tattoos use mostly black color the Nd:YAG does a great job on black and red. If you must have that special tattoo, try to stick to these two colors for now. To schedule your free consultation, please call Tropicalaser at 561-753-3336. Or, stop by our office at 2515 S. State Road 7 in Wellington (behind Office Depot).
HEALTH & WELLNESS
Knee Pain – Osteoarthritis Symptoms and Treatment
By Deborah Lynn
steoarthritis is the most common form of arthritis, which equally affects men and women. In the United States alone, approximately 27 million people live with this often disabling disease. Although common in adults over the age of 65, it can occur earlier in life. I had an opportunity to ask Dr. Jose Ortega of The Center for Bone & Joint Surgery to help shed some light on this disease, which can have an impact on the livelihood of anyone affected. As always, Dr. Ortega graciously agreed to give some insight on osteoarthritis and even went a step further by focusing on how it can impact your knees.
What is Osteoarthritis?
Osteoarthritis, also known as degenerative joint disease, is a condition that affects the joints by causing degeneration of the cartilage, meniscus and bone. I prefer to call it wear and tear arthritis.
What causes Osteoarthritis?
Osteoarthritis could be seen in
joints that are overloaded due to weight, after trauma, or it could be hereditary. It also occurs as part of the normal aging process and overuse.
patients that are stiff.
What is Viscosupplementation?
Viscosupplementation is a procedure in which a thick “gel” is injected into the joint. It works as a lubricant and shock absorber. The goal of this therapy is to relieve pain and restore function.
Osteoarthritis breaks down the tissue that covers the ends of your bones at the joint. This tough, but cushioning tissue is known as Cartilage. As you lose cartilage, your bones will eventually start to rub together causing pain and discomfort.
Is there anything new or on the horizon?
What are the most common symptoms of Osteoarthritis in the knee?
The most common symptoms are pain, swelling, tightness or stiffness, and in some cases – loss of motion or locking.
How do I know if I have Osteoarthritis?
Patients that have knee pain without a specific injury or condition, especially worsening of symptoms over time may have osteoarthritis. In most cases, a simple x-ray is all the orthopaedic surgeon needs to diagnose the problem.
What will the x-ray show and what are the typical
Typically, there is a narrowing of the joint space, bone spurs and malalignment.
What can I do to get relief from the pain? In most cases, we start treatment that includes antiinflammatories, ice, activity modification and physical therapy. Other possibilities include the judicious use of
corticosteroids or viscosupplementation injections.
How does physical therapy help or work?
Physical therapy will strengthen the muscles around the knee. These muscles act as shock absorbers and joint stabilizers. Therefore, you get better support and better shock absorbers. Therapy will also help to improve range of motion on
Studies have shown that plateletrich plasma (PRP) may reduce the rate at which a joint degenerates. This procedure involves harvesting platelets from your blood and injecting them in the joint. The platelets are the cells that carry the growth factors that promote wound healing.
Can arthroscopy help?
In selected patients, in which the main symptom is mechanical locking or bucking, arthroscopy may help. In some cases, loose pieces of bone or cartilage tears can be removed or shaved minimizing those symptoms. If the arthritis is advanced and the patient has failed conservative treatment, a total knee replacement may be indicated.
Jose Ortega, M.D., FAAOS Diplomate American Board of Orthopedic Surgery
• Arthroscopic Surgery • Sports Medicine • Fracture Care • General Orthopedics
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Robbin Lee, RN, MBA promoted to Chief Executive Officer for Wellington Regional Medical Center
ellington, FL – July 25, 2013 Wellington Regional Medical Center is pleased to announce the promotion of Robbin Lee to Chief Executive Officer of Wellington Regional Medical Center, effective August 1, 2013. Lee is a seasoned healthcare executive with 30 years of experience. She has served in various senior level positions throughout her career and brings extensive health care management and leadership
skills to the Wellington team. Prior to Wellington, Lee served as the Chief Operating Officer of HCA owned JFK Medical Center and Lawnwood Regional Medical Center in Florida. She has also served as the Chief Executive Officer of Northlake Medical Center in Atlanta, Senior Vice President of Operations of Stamford Health System in Connecticut, and Associate Administrator at Emory Healthcare in Atlanta. Lee is an RN and has an MBA,
having earned her Master’s Degree in Business Administration from Emory University. A Georgia native, she started her healthcare career as a unit nurse at Georgia Baptist Medical Center in Atlanta. Lee has earned numerous honors and awards, and has served on various community boards. She currently resides in Palm Beach County with her husband. About Wellington Regional, Wellington Regional Medical Center is a progressive 233 bed
over the study period. For their part, patients can't tell the difference between whether or not they've been admitted into the hospital or are classified as under observation as an outpatient. They lie in the same beds, wear the same gowns, eat the same hospital food, receive
the same nursing care and wear the same ID bracelets. The Brown University researchers, led by Zhanlian Feng, assistant professor of health services, policy and practice, noted that there was a lead up to a shift in Medicare costs to patients and hospitals,
Hospitalized continued from cover page
inpatient status would have been paid for by Medicare Part A. In June 2012, a study was published in the journal Health Affairs showing that there has been a sharp rise in the number of Medicare patients held in the hospital under observation. This finding was accompanied by a downward shift in patient admissions into the hospital. The Brown University researchers reported that the ratio of patients placed in observation to patients admitted into the hospital increased 34% between 2007 and 2009 and that outpatient observation hospitalizations grew 7% longer, on average,
acute-care facility and medical center that has been serving Palm Beach County and the surrounding region since 1986. We are a thriving community hospital, proud to offer the "high-tech" advantages of a bigcity hospital and the personalized care of a hometown provider. For more information on Wellington Regional Medical Center and its services, please contact the hospital at 561.798.8500.
most recently through the Affordable Care Act, which includes a provision that penalizes hospitals for high readmission rates. Hospitals are able to avoid readmitting patients and dodge the associated penalty by classifying patients as outpatients, either on their initial or second visit. In addition to shifting the burden of costs to Medicare patients, this practice has consequences for public health data. "When people are classified on observation status, they are not considered hospital inpatients and, therefore, if they need to return to the hospital, those admissions are not considered readmissions," Stein says. "Thus we cannot accurately determine which hospitals tend to have a lot
of admissions and readmissions." Last year, the Center for Medicare Advocacy filed a class action lawsuit against the federal government to get hospital labeling policy changed. The filing for the Bagnall suit notes that in some cases patients are admitted into the hospital and their status is later changed to observation, an outpatient status. It goes on to note that under the secretary's Medicare manual, observation status is generally supposed to last no more than 24 hours, but that "both the incidence of placing beneficiaries on observation status and the average time period in which beneficiaries are on observation status have been increasing dramatically in recent years."
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The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask the lawyer to send you free written information about their qualifications and experience.
South Florida Radiation Oncology is proud to annouce a new addition to their staff
Kishore K. Dass, MD
Andrew O’Leary, M.D.
Board-Certified Radiation Oncologist
Board-Certified Radiation Oncologist
ndrew O'Leary was a professional firefighter before electing to pursue a career in medicine. He received his A.S. from Florida Institute of Technology in Melbourne, Fla., graduating with honors. He then obtained his B.S. from the University of Miami, graduating with distinction. Dr. O'Leary received his medical degree from Ohio University College of Osteopathic Medicine in Athens, Ohio. After a one-year traditional internship, he started his radiation oncology residency at
the University Hospitals of Cleveland/Case Western Reserve University in Ohio, which he completed in 2000.
During his four years of residency, Dr. O’Leary presented several abstracts at national meetings, including the American Radium Society conference in Hawaii, and three times at the International Prostate Cancer Update in Vail, Colo. He has been published in the International Journal of Radiation Oncology, Biology and
Physics and the International Brachytherapy Journal.
Before joining South Florida Radiation Oncology, Dr. O'Leary was the primary radiation oncologist and medical director of Mercy Cancer Center in Elyria, Ohio, from 2007 to 2013.
Dr. O'Leary is board certified in radiation oncology and has a special interest in prostate cancer and lung cancer. He sees patients at SFRO’s Boynton Beach – West and Wellington offices.
West Boca Medical Center Emergency Department Director Recognized by the Palm Healthcare Foundation Boca Raton, FL (May 2013) – West Boca Medical Center joins the Palm Healthcare Foundation in celebrating Margaret Neddo MSN, RN, as the recipient of the 2013 Leadership Award. The annual Nursing Distinction Awards ceremony, hosted by the Palm Healthcare Foundation, was held on May 3rd at the Breakers Palm Beach and honored several nurses from our community for their dedication
to excellence and commitment to the profession of nursing. Neddo serves as the Emergency Department Director at West Boca Medical Center and was nominated for the Leadership Award by her peers.
“Margaret joined West Boca Medical Center as Director of Emergency Services, after 27 years with our parent company, Tenet Healthcare, the last eight as the Clinical Manager of Emergency Services at Delray Medical Center,” commented Mitch Feldman, chief executive
officer at West Boca Medical Center. “Her level of commitment to patient care is unwavering. She has over 20 years of emergency nursing experience and serves as a tremendous role model for everyone in our hospital and in the nursing community.
earned a bachelor of science degree in Nursing from Nova and a master’s of science degree in Nursing from Florida Atlantic University.
Neddo holds multiple certifications including, Basic Life Support, Advanced Cardiac Life Support, Pediatric Advanced Life Support, Trauma Nursing Core Course and Emergency Nursing Pediatric Course. She
Margaret Neddo MSN, RN.
AUGUST 2013 SUNDAY
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1-2pm, 2:303:30pm Tai Chi
3:30-4:30pm Let's Talk
1-2pm, 2:303:30pm Tai Chi
21 2-3pm Yoga
3:30-4:30pm Let's Talk
28 10-11am Yoga 3:30-4:30pm Managing Anxiety 5:30-7:30pm Cooking Demonstration
1-2pm, 2:303:30pm Tai Chi
31 10-11:30am Healthy Brain Workshop
Massage by appointment contact Tara Pocius, LMT at 508-654-5556
Neddo is also a member of several organizations, including the Healthcare Emergency Response Coalition for Palm Beach County, EMS Fire Council for Palm Beach County, EMS Provider Council of Palm Beach County, Emergency Department Nurses Forum for Palm Beach County and the Emergency Nurses Association.
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Upcoming Charity, Medical or Fundraising Events August 1 – 31, 2013
Junior League of the Palm Beaches. Happy Hour for a Cause. Blue Martini, City Place in West Palm Beach. $10.00 for members and $15.00 for nonmembers. For additional information, go to www.westpalm100.org.
Mac and Cheese Charity Block Party: Benefitting Team Molly. 5:30 – 7:00pm at Whole Foods Market in Wellington. $10.00 donation per person at the produce section entrance. All the proceeds to Team Molly at the Leukemia and Lymphoma Society. Visit the website at www.wholefoodsmarket.com.
Healthy Heart Health Fair and Forum. Wellington Regional Medical Center. In addition to free blood pressure and cholesterol screenings and educational resources, physician lectures are scheduled for 11:30am and 12:30pm. A healthy lunch will be served, so reservations are encouraged. Call 561-798-9880 to reserve your place.
Disaster Relief Fund. To donate money to the victims of the recent tornado in Oklahoma, visit the American Red Cross website at www.redcross.org Send us your information at email@example.com
Americans Living Longer, Healthier Lives: Study
MONDAY, July 29 (HealthDay News)
ot only has Americans' life expectancy increased in recent decades, they also are healthier later in life, a new study shows.
"With the exception of the year or two just before death, people are healthier than they used to be," study author David Cutler, a professor of applied economics at Harvard University, said in a university news release.
"Effectively, the period of time in which we're in poor health is being compressed until just before the end of life," Cutler said. "Where we used to see people who are very, very sick for the final six or seven years of their life, that's now far less common. People are living to older ages and we are adding healthy years, not debilitated ones." Increased access to and improvements in health care are among the reasons people are healthier later in life, but further research is needed to identify all the factors.
Light of the World Charities Brightens the Lives of Others
By Deborah Lynn In 1999, Light of the World Charities was formed by co-founders the late Reverend Bernard Powell and Mrs. Theresa Banks. As a registered nurse and parishioner at Holy Redeemer Catholic Church in Palm City, Theresa participated in other medical missionary trips prior to being invited by Father Powell to help promote a new stewardship program he was establishing, Light of the World Charities (LOTWC).
Their initial mission was to Chiclayo, Peru, where they sent a surgical group with the help of a Peruvian Priest. They have also visited Tanzania, Africa, the Republic of Haiti and Nicaragua. However, it was with the help of the Congregation of the Franciscan Friars of the Renewal that they were afforded an opportunity to send a surgical team to Honduras.
It was there that Dr. Yvette Laclaustra traveled on her latest mission. Having first traveled to Honduras and Haiti as early as 2002, these patients have truly become part of her. She had asked that I not focus on her in this article, but instead bring to light the need for additional funding in order to continue and grow the missions that are put together by this amazing not-for-profit organization.
According to Dr. Laclaustra, there are normally four surgical teams that are made up of a number of specialized physicians. Those include general surgeons, orthopedic surgeons, gynecologists, urologists and dentists and more.
In the past, they would put an ad in local papers stating the American doctors were coming and the lines would start to form. These days, there is a natural structure to it all as the patients are seen privately, prior to the arrival of the team of physicians. Once they arrive, they will review the patient assessment and if they agree, they will proceed.
The most recent trip to Honduras was a special one for Dr. Laclaustra as her son Adrian Vinas, a pre-med student was also in attendance. He captured photos from the mission and we are pleased to share some with you at this time. The surgical team from this trip came from Atlanta, New York, Texas and Florida. In addition to Dr. Laclaustra and Adrian, there was also a father and daughter team and as she explained, it truly is something that is handed down from generation to generation.
During the Honduras trip, they were able to see 81 patients and did 95 procedures over the four and a half days. “We tried to do as much as we can. We built operating rooms and recovery rooms. There is also a clinic and examining rooms, all of the money was raised through the annual fundraiser” stated Dr. Laclaustra.
There are currently over 400 medical and non-medical volunteers of which give their time, money and expertise in the United States and abroad. It is because of these amazing individuals that LOTWC continues to provide surgical treatment to the poor and needy.
Most of the money they receive to organize and carry out these missions is through their annual charity event. However, they are always in need of additional funds in order to continue their humanitarian missions.
If you would like to help LOTWC or to simply find out more information, please visit their website at www.lightoftheworldcharities.com. To view additional photos from the most recent trip to Honduras, go to www.lotwhonduras2013gallery.weebly.com.
What Every Man Should Know About Prostate Cancer Screening
Ross A. Cohen, M.D.,
Ross A Cohen, M.D., is a Board Certified Urologist who has been in practice here in Palm Beach County for 23 years. His new office is located at 5065 State Road 7, Suite 203, Lake Worth, Florida. Call (561) 432-0067 to make an appointment or more information.
By Ross A. Cohen, M.D.
rostate cancer is the most common cancer among men (behind skin cancer), and the second leading cause of cancer death in men. One in six men will be diagnosed in his lifetime. In 2012, more than 240,000 men were diagnosed with prostate cancer and about 28,000 died of the disease. Prostate specific antigen (PSA) is a protein secreted by the prostate gland and is detected in the blood. Since the late 1980’s,
PSA has emerged as the most important tumor marker for screening, detection, staging and monitoring of prostate cancer. This test when used with a digital rectal examination (DRE) of the prostate has been the mainstay of detecting prostate cancer in its earliest, therefore most curable stage. In May of 2013, the American Urologic Association released a new Clinical Practice Guideline on the Early Detection of Prostate Cancer.
The previous AUA recommendation was PSA testing and DRE annually for men 50 years or older. For African American men or men of any race with a family history of prostate cancer, testing was recommended to begin at age 40. The new guideline does not recommend routine screening in men of all ages, but, rather recommends that health care professionals utilize a more targeted approach to screening. The decision to test should be made in the context of a conversation between a man and his health care provider. The key points of the guideline include: • Routine screening is not recommended in men under age 40.
• For men 40-54 there was
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insufficient evidence to recommend routine screening, and the decision to screen should be discussed with their provider.
• The greatest evidence of benefit of routine prostate cancer screening was found in men ages 55 to 69.
• Men with risk factors including race, family history or urinary symptoms should talk with their health care provider regarding testing. • Routine screening is not recommended in men over the age of 70, or in men with a less than 10 – 15 year life expectancy. They also concluded, however, some men over age 70 could benefit from testing.
If prostate cancer screening is chosen, a PSA and DRE are performed by your health care provider. An abnormal PSA, DRE or both usually leads to a consultation with a Urologist. It is at this visit that it would be determined if further testing would be beneficial in diagnosing prostate cancer early, before it has spread. Transrectal ultrasound and biopsy to evaluate the prostate further and obtain tissue for diagnosis is
usually the first diagnostic test. This is an office based procedure, performed under local anesthesia and is the only test that can truly differentiate prostate cancer from benign conditions of the prostate such as benign prostatic hypertrophy (BPH) or prostatitis.
If one is diagnosed with prostate cancer, the decision whether, when and how to treat it needs to be addressed. The treatment recommended depends on whether the cancer is thought to be localized (confined to the prostate) or if it is metastatic (spread beyond the prostate). This is usually determined with a CT scan or MRI of the pelvis and a Bone Scan. These are usually done at an imaging center. Treatment options must also take into consideration other factors including age of the patient, the presenting PSA, aggressiveness of the cancer on biopsy, the overall health of the patient, and the life expectancy of the patient. The most appropriate treatment for localized prostate cancer continues to be debated. Treatment options for localized prostate cancer include:
• Watchful Waiting • Robotic, laparoscopic or open radical prostatectomy
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• External Beam radiation therapy • Brachytherapy (high dose radiation or low dose seed implantation) • Proton Beam Therapy • Cyberknife • Cryotherapy • HIFU (High Intensity Focused Ultrasound)
Treatment options for metastatic prostate cancer include: • Hormone therapy • Chemotherapy • Immunotherapy
Prostate Cancer screening carries with it potential benefits and risks. Benefits include stress relief if the screening is normal, minimizing the chance of cancer spreading if detected early and potentially helping some men live longer. Possible risks of screening include a “false negative” result in which some prostate cancers may be missed, a “false positive” result which can lead to needless stress and an unneeded prostate biopsy.
In addition, treatment of prostate cancer can cause problems with erectile, urinary and bowel function. This is why men should discuss prostate cancer screening with their health care provider and see if it is right for you.
Krishna Tripuraneni M.D., M.B.A.
Call Us Today If You Suffer From Any Of The Following: Digestive Diseases Stats Dysphagia Gallstones Gastroesophageal Jaundice Lactose Intolerance Liver Disease Nervous Stomach
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Pancreatis Stomach and Duodenal Ulcer Ulcerative Colitis Reflux Disease Hemochromatosis Hemorrhoids Hepatitis
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Venra Clinical Studies, LLC 561-795-3330 ex. 249 firstname.lastname@example.org
1157 South State Road 7 Wellington, Florida 33414
1200 South Main Street #102 Belle Glade, Florida 33430
At Palm Beach Surgery Center we provide a safe and friendly environment, with a highly qualified and dedicated staff. A variety of procedures such as colonoscopy, endoscopy, gastroplications, ERCP, Liver Biopsy, 24 PH Monitoring/BRAVO can be done at our facility thus avoiding the need for hospitalization.
Diabetes Mellitus a silent malady One of the most common symptoms of Diabetes Mellitus is polyuria which means frequent urination on a daily basis. Other symptoms are excessive hunger called polyphagia and excessive thirst polydypsia when one drinks a lot of water.
Failure to diagnose Diabetes Mellitus can be due to various reasons such as: individuals not seeking medical attention, or the physician not doing a simple blood sugar level. Persons with diabetes usually present themselves to a physician feeling good, with no symptoms. Sometimes the individual may say that they have blurry vision, numbness of the extremity, and feeling weak and fatigued. Studies have shown that complications of Diabetes Mellitus, especially microvascular disease (which means blood vessel disease) has a direct correlation with control of one’s blood sugar. Cardiovascular disease also remains a leading cause of death in Diabetes Mellitus Type II individuals. Other risk factors like hypertension, (which means blood pressure) high cholesterol, and obesity in Diabetes Mellitus should be taken into consideration in coordination with good control of one’s blood sugar.
Shekhar V. Sharma, M.D. Board Certified in Internal Medicine
iabetes Mellitus can be defined as a disease where an individual’s overnight fasting blood sugar is more than 125 mg. Impaired blood sugar is defined as blood sugar levels between 110 mg. and 125 mg. A diabetic can only be diagnosed by the checking of blood sugars. Diabetes Mellitus is definitely a silent disease that can hurt an individual without their knowledge. In fact, most of the time, one could be totally unaware that one has it. It is a condition that could become worse if left undiagnosed, untreated, and mishandled. How does one get Diabetes Mellitus? One of the reasons is impairment of insulin secretion from a group of cells in the pancreas called the ‘Islets of Langerhans’.
Individuals with impaired fasting blood sugar are at high risk for the development of diabetes and
arterial disease. Approximately one-third of patients with impaired blood sugar develop full blown Diabetes Mellitus.
Diabetes Mellitus also runs in families and family history is an important indicator of this disease.
Complications of Diabetes Mellitus are strokes, heart attacks, kidney disease, peripheral arterial disease, especially of the lower extremities and retinopathy of the eyes which can lead to blindness if left untreated. Treatment for Diabetes Mellitus is first of all DIET CONTROL -
controlling what you eat. This way, you will not only lose weight, but you can also control your diabetes. Eating the right foods and avoiding foods such as high carbohydrate/starch, diet and sweets with high sugar content is important. Reduction of saturated fat intake and the addition of high fiber in one’s diet have become critically important. Exercise has been shown to be beneficial in the prevention of the onset of Diabetes Mellitus Type II. The added benefits of exercise is lowering of one’s blood pressure, improving cardiac performance and raising the good cholesterol called HDL in the blood. If blood
sugars are still high despite diet and exercise, I would recommend a continuation of a diet and exercise program along with pharmaco therapy.
There are various ways of treating Diabetes Mellitus with either tablets or with insulin and blood sugars can definitely be contained.
We all need to be aware that there is so much more to this disease that is not understood by the lay person. This is where the physician who is well-versed and experienced in the disease steps in and this can be beneficial to any individual with this disease.
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Select Specialty Hospital Do you have a success story?
Mike Corvaia has been in healthcare administration for over ten years and is currently the Director of Business Development for Select Specialty Hospital in Palm Beach. He holds a Bachelor’s degree from the University of Florida and is completing his Master’s Degree this year in Business Administration, with an emphasis on Healthcare Administration.
Please feel free to send any healthcare related questions to email@example.com
Judy Barth was working in her yard when she experienced what she thought was heartburn. The pain increased to the point that she called for help. The last thing she remembers is scrambling for her insurance cards and passing out. Her next memory is one month later when she woke up at Select Specialty Hospital- North Knoxville. Judy had gone into cardiac arrest and was admitted to the local medical center where she was treated and
stabilized. Doctors were concerned that a lack of oxygen might have affected her brain. Judy had spent almost a month unconscious and on a ventilator in the ICU when she was referred to Select Specialty Hospital to get her off the ventilator and functioning again. During her two week stay at Select Specialty Hospital, Judy woke up, got off the ventilator and beat the odds by discharging home. She has since returned to work and walks one to two miles every day.
Eugene Harris and his wife Jerlean were working on his antique truck, trying to get it to start. He was working with the carburetor when it blew up. Eugene was sent to the burn unit in Memphis in critical condition with twenty-four percent of his body burned. His family was told he might not survive. A month and a half later, still unconscious and having survived several life-threatening infections, Eugene was transferred to Select Specialty Hospital in Memphis. He was on a ventilator with pneumonia and required dialysis. Eugene was with Select for nearly two months, his wife by his side every day. While he was at Select, he weaned from the ventilator and saw his kidney injuries resolved. He no longer needed dialysis. His burns continued to heal and he was discharged to a rehab facility
with the goal of returning home as soon as possible. Almost four months after the accident, Eugene returned home. He says now he plans to enjoy the comforts of home with his wife of 46 years.
Bill Tavernise joins Wellington Chamber President's Circle
Thirty eight year old Myrtle Mason had been struggling for breath for about a month. Her body was swollen from fluid retention due to congestive heart failure and she had been sleeping upright in a chair so she could breathe at night. When she could no longer take it, Myrtle sought the help of a physician. She was admitted to the local medical center with acute respiratory failure and was placed on a ventilator. Doctors told her family that getting off the ventilator would be a long shot and she might not survive. Then, Myrtle was transferred to Select Specialty Hospital- Fort Smith. At Select, the team got her up and moving again. Her congestive heart disease, diabetes and blood pressure were brought under control and she was weaned from the ventilator. Myrtle was originally scheduled to go to rehab, but she surprised everyone by walking out of the hospital on her own and discharging home. It was her son’s 18th birthday. Myrtle feels like she has learned the importance of taking care of herself and is grateful for a second chance. “They gave me my life back. They were there for me.”
The Wellington Chamber is honored to announce the appointment of Bill Tavernise to the Trustee level President’s Circle. Bill is the Managing Broker of Keyes Real Estate, Mortgage, Title and Insurance. He has spent over 26 years in the Real Estate Industry in both NY and Florida. His Professional Accreditations include RAPB Government Affairs Committee ( 2011-2012), Broker-Owner “Lifestyle Under The Sun Real Estate, Inc.”, and “Florida Style Real Estate, Inc.”(2001-2008), Wellington Chamber of Commerce Past- President and current Board Member as well as past Chairman of the Business and Economic Development Team. In addition, Mr. Tavernise serves on the Board Of
Directors for Palms West Hospital, the Advisory Committee for Kids Cancer Foundation of The Palm Beaches and was PastPresident of the " Little Smiles" organization.
Bill and his wife Andrea currently reside in Jupiter and have been South Florida residents since 1994.
Please join us in welcoming Bill Tavernise to our illustrious list of trustees! Bill Tavernise Keyes Real Estate, Mortgage, Title and Insurance Managing-Broker, DSM, CDPE, CAIS
Announcement It is our pleasure to announce a beautiful addition to our extended family. Michael Joseph Corvaia was welcomed into this world on June 23, 2013 weighing in at 7lbs, 4oz. and 20 inches long. He is the first child for Michael and Marianne Corvaia. Congratulations and may you have many - many wonderful years ahead.
Dear Deborah DEAR DEBORAH:
A relative recently introduced me to a single guy that works with him. One day, when I was e-mailing him, I put his e-mail address in the search line by mistake. Well, I was shocked with what came up. He has a few profiles on escort dating web sites that show what he wants from a woman! I tried to pull up his complete profile, but it did not allow me to look further. So, I took a few keywords that were listed in the visible portion of his profile and searched a little deeper. He listed himself as a “hobbyist” and what I found when searching would make anyone blush. He actually posted reviews about the women that he slept with! What’s worse, he is a partner in a law firm and this was all visible online for anyone to see since he uses his personal e-mail address. Is he that clueless or just not care that anyone can see what he has been doing? Needless to say, he is out of the potential dating pool. - Risky Business
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Dear Risky Business:
That is quite an interesting story. One can only hope that he is indeed naïve because who in their right mind, and in such a position, would be so careless with their behavior? The Hobbyist designation refers to a man that makes a lifestyle out of sharing time with escorts, in essence, it’s a hobby. Some people enjoy painting, he enjoys sex. Hobbyists put reviews on web sites, blogs and message boards basically rating the women they have been with. Since he is single, this is obviously his lifestyle choice. You did not mention if you told him what you found. If you haven’t and feel the need – tell him. First, explain to him that you are not passing judgment, however he should be more aware of what information is out there that would reflect poorly on his character. You can further state that his law partners, associates, and clients can easily see
what type of behavior he maintains and that would not be favorable to his career. By no means am I condoning this type of lifestyle. People need to realize that nothing is hidden these days, true or untrue, and if he plans to continue, he needs to create a separate e-mail address that is not linked to everything else that he does on a daily basis. I commend you for eliminating him from your dating pool as you will never feel comfortable with his loyalty to you. DEAR DEBORAH:
I recently started dating someone whom I met on a dating site. He seems to be a great guy and has his head on straight. He has children as do I. After a few dates, he mentioned that he is not interested in dating anyone else, but still has his profile up. Being the snoop that I am, I have been checking to see if he has been online and sure enough, he has been on daily. Do I tell him that I know? Or, do I just ignore that he obviously DOES have an interest in other women and has clearly lied to me. I am so tired of wasting time on men that are not being honest. Should I walk away? - Hanging on for Love?
Dear Hanging on for Love:
I am one to give people the benefit of the doubt; however you are already questioning his behavior. My advice to you is to be upfront and ask him if he would like to be exclusive. If he does not and you do, you have a choice to make. If he does, simply ask him to put his profile on hold or delete it for now. You may already feel close to him, but you truly have nothing invested if you just started dating him. At this point, you can always walk away. I am always upfront with what I am looking for in a partner and will only date those of the same mindset.
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: firstname.lastname@example.org as we would love to help.
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A few months befor before e the summer Olympics, I fell of offf my horse and completely shatter ed my knee. shattered When the doctors told me I needed surgery, I was devastated. How could surgery, recover in time to qualify for the I recover U.S. team? To To give me my best shot, I needed a stellar orthopedic team and found it at Wellington. Wellington. surgery was on January 14 and My surgery by April, I was back in the saddle. Thanks to specialized car e, I qualified care, for the Olympic team and went on to compete in London. I am living pr oof of first-class proof orthopedics at Wellington Wellington Regional.
McLain W Ward ard Olympic Gold Medalist
To T o read read more more of McLainâ€™ McLainâ€™ss story, story, visit
WellingtonLivingProof.com WellingtonLivingProof.com Orthopedic Pr Program ogram Physicians are are independent practitioners who ar are e not employees or agents of Wellington Wellington Regional Medical Center. Center. treatments provided provided by physicians. The hospital shall not be liable for actions or treatments