BRIGHTON SOMEONE’S DAY FOR BREAST CANCER AWARENESS MONTH P14 The Beauty Delray Medical Dr. Becker opens Beast Center celehis home to the Radio brates 30 year Boys & Girls Show P 2 anniversary P 7 Club P 14
Global Health OCTOBER ISSUE - 2012
S er vin g: J upiter
P alm Beach G ar dens
Treatment of Breast Cancer n
Royal P alm Beach
Belle G lade
w w w. g l o b a l h e a l t h t r i b u n e . c o m
Lake Wor th
Boca Rato n
The role of the Medical Oncologist P4
St. Mary’s Medical Center
President Barack Obama delivers remarks on the health insurance reform bill at the Department of Interior, March 23, 2010. PAGE 2
Alan B. Miller Pavilion Grand Opening Event
Welcomes Neurosurgeon Dr. Brett A. Osborn P 7 The ribbon cutting ceremony for the new Alan B. Miller Pavilion proved to be a wonderful mix of local dignitaries and some of the top physicians in the area. Dr. Ishan Gunawardene and Jerel Humphrey were also on hand and participated in the ceremony with the invocation being offered by Pastor Harvey Montijo, M.D. PAGE 13
More Drugs Linked to Meningitis Outbreak: FDA
Dr. Brett A. Osborn, D.O.
Cherries are Delicious and Nutritious
Cindy Collins, Ph.D., R.D. Experimental Health Psychology / Nutrition
Wellington Regional Medical Center announces the opening of the Alan B. Miller Pavilion. The spectacular, 103,000 square foot, three-story Pavilion attaches to the north face of the hospital, transforming it into a flourishing, 233-bed medical complex.
Delray Medical Center, Good Samaritan Medical Center, St. Mary’s Medical Center and West Boca Medical Center Honor Breast Cancer Awareness Month P6
Is Genetic Testing for You?
GLOBAL HEALTH TRIBUNE P.O. Box 213424 Royal Palm Beach, FL 33421
Dr. Humberto Caldera MD. Medical Oncologist Hematologist
WEST PALM BCH, FL PERMIT NO. 1340
PRSRT STD U S POSTAGE
2 OCTOBER ISSUE
Understanding the Reforms about the Affordable Care Act. O n March 23, 2010, President Obama signed the Affordable Care Act into law, putting in place comprehensive reforms that improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices. The law allows all Americans to make health insurance choices that work for them while guaranteeing access to care for our most vulnerable, and provides new ways to bring down costs and improve quality of care.
Stronger Consumer Rights and Protections In the past, insurance companies could take advantage of you. They could deny coverage to children who had asthma or were born with a heart defect, put a lifetime cap on the amount of care they would pay for, or cancel your coverage when you got sick just by finding an accidental mistake in your paperwork. The Affordable Care Act creates a new Patient’s Bill of Rights that protects you from these and other abusive practices. 105 million Americans no longer have lifetime dollar limits on their coverage. More than 17.6 million children with pre-existing conditions can no longer be denied coverage.
with pre-existing conditions have gained coverage through the new Pre-Existing Condition Insurance Plan.
President Barack Obama greets doctors and nurses following his remarks about health care reform in the East Room of the White House, March 3, 2010.
More Affordable Coverage The law helps you by bringing down health care costs and making sure your health care dollars are spent wisely. Insurance companies will now be accountable to their customers for how they are spending premium dollars, and how much they are raising rates. Plus, the new law will help lower costs through new tax credits and new marketplaces where insurers will have to compete for your business.
Private insurers that provide coverage for nearly 174 million Americans must now justify double-digit premium increases, and nearly 76 million Americans are covered by insurers that are now required to spend at least 80% of premium dollars on health care.
360,000 small businesses received a tax credit in 2011 to help them pay for health insurance for an estimated 2 million workers.
Better Access to Care The health care law builds on what works in our health care system. And it fixes what’s broken by providing you with more health insurance choices and better access to care.
54 million Americans now can receive a free preventive service, such as cancer screenings, through their private insurance plan. 3.1 million young adults have coverage on a parent’s plan through age 26. More than 50,000 Americans
Stronger Medicare Nearly 50 million older Americans and Americans with disabilities rely on Medicare each year, and the new health care law makes Medicare stronger by adding new benefits, fighting fraud, and improving care for patients. The life of the Medicare Trust Fund will be extended to at least 2024 as a result of reducing waste, fraud, and abuse, and slowing cost growth in Medicare. And, over the next ten years, the law will save the average person in Medicare $4,200. People with Medicare who have the prescription drug costs that hit the so-called donut hole will save an average of over $16,000. 3.6 million people received a 50% discount—worth an average of $604 each—on brand name prescription drugs after hitting the Medicare donut hole in 2011. More than 32.5 million seniors received one or more free preventive services.
The average person with Medicare will save about $4,200 from 2011 to 2021. Those with high prescription costs will save up to $16,000.
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SFRO’s Survivorship Clinic meets The Beauty Beast Radio Show
During the taping of The Beauty Beast Radio Show.
Richard Ashton, Dawn Dallin, Judy Armstrong, Wendy Bright and Karen Alleyne-Means.
By Deborah Lynn
hen Judy Armstrong called and asked me to attend the live broadcast of The Beauty Beast Radio Show at the new SFRO Survivorship Clinic in Palm Beach Gardens – I jumped at the chance.
The hour-long show which was broadcast on Monday, October 8, not only featured the wonderful husband and wife team of
Richard Ashton and Dawn Dallin, but also included breast cancer survivor and Publisher of HERLIFE Magazine, Karen Alleyne-Means. In addition, Wendy Bright from Stylist 1 was there as was Judy Armstrong from SFRO Survivorship Clinic. The one thing that became abundantly clear during the taping was that each and every one of them not only had a story, but were so incredibly passionate about cancer.
Karen herself is a breast cancer survivor as she was diagnosed at 39. She strongly believes that everyone has to be their own advocate for their health. Unfortunately, when she was diagnosed and throughout her treatment, there were no clinics of this type in the area.
As a matter of fact, SFRO Survivorship Clinic is the only clinic of its type in Palm Beach County. Having just recently opened its doors, the clinic offers just about everything you need to help educate and guide you through your journey. There are a variety of alternative therapies
such as; acupuncture, physical therapy, massage therapy, psychotherapy, as well as studied therapies. In addition, they will have classes in meditation, yoga, and a full kitchen with cooking lessons from a chef along with nutritional advice. On October 24, a French Chef will be on hand to teach the attendees how to cook salmon and use spices. There is also a library with computers, books and other sources of information to help educate yourself on your diagnosis. This will allow you to make the right choices for you and your family. They also offer a number of support groups to help you get through
those difficult times when you feel as though no one else knows what you are going through.
The clinic is located at 3355 Burns Rd, Suite 105 in Palm Beach Gardens. Their door is also open to every family member or friend of anyone that had been touched by their diagnosis as well.
For additional information on SFRO Survivorship Clinic, please visit their website at www.sfrollc.com. You can also go to www.thebeautybeastradioshow.com to view this segment and many others.
OCTOBER ISSUE • 2012 3
Fungal Nails One of the most common causes of thickened, discolored, and painful toenails is a fungal infection.
Arthur Hansen DPM, M.S.
oenails....why do we have them? Sometimes it seems that all they are good for is snagging our socks and running our stockings. However, our toenails are actually somewhat complicated parts of human anatomy that are often forgotten. Forgotten, that is, until they become diseased, traumatized, or painful.
Just like hair and skin, nails are a part of the epidermis and primarily serve as protection. Specifically, to protect the ends of our fingers and toes. Nails can also make fashion statements when trimmed, buffed, and painted. But for those of us who suffer from thickened and discolored toenails they make anything but a fashion statement. They become so hard they are difficult to trim, so long and thick they are painful, and sometimes they can even smell!
Fungus is all around us and all over us. It is normal to find some amount of fungus on our nails. However, under certain circumstances, the fungus either gains the ability to invade the nail or is provided with an environment conducive to it's growth and it actually infects the nail. Any individual who might be slightly immunocompromised, who experiences trauma to the nails, or whose feet always seem to be warm and moist is prone to a fungal infection of the toenails.
Fungus prefers a warm, dark, moist environment to live. Shoes provided the darkness and when mixed with our infamous Florida warmth and humidity you have got a cocktail for one happy fungus. The fungus begins to breed faster than your nail can grow and invades the
nail. Once the fungus invades and the conditions are good infection may develop. The fungus also has the potential to spread to other toenails and even to the skin around the nails.
A fungal infection of the toenail is very difficult to get rid of and can even be with you all of your life! However, once a physician has diagnosed your fungal infection, there are several forms of treatment available. Proper debridement or cutting of the nail with the utilization of a Dremel. There are several over-thecounter and prescription topical anti-fungal drugs that can be used on the nails. These work best when applied to the affected nails when the nail is soft, such as after a shower or bath. They work even better if the top of the nail is filed and buffed before applying. The medication is usually applied two times a day and it may take as long as nine months to a year to see results.
Whirlpool with every visit!
If regular nail debridement and meticulous application of the topical anti-fungal medications fails to show results your physician may opt to remove the infected fungal nail with the hope of it regrowing without the fungus. Another option is when removing the nail to also remove or kill the matrix (what makes the nail grow). Doing this will usually cure the fungal infection since the toenail will no longer grow. These are surgical procedures and do require local anesthesia. A fungal infection of your toenails can be very painful and interfere with your daily activities. If you think you may be suffering form a fungal infection of you toenails get it under control. And remember, don't forget your feet, they have a lot of walking to do. Call to make your appointment
Fungal infection of the toenails
These changes in our toenails can be caused by disease, trauma, infection, biomechanical abnormalities, hereditary or genetic factors, and the effects of aging.
Conservative & Surgical Treatments Available
There are also prescription oral antifungal medications that your doctor can prescribe. However, these have adverse side effects and are usually not prescribed for nail fungal infections since the side effects may be worse than the infection itself.
Get back on your Feet!
(561) 433-5577 WEST OFFICE:
3347 SR 7, Suite 204 Wellington, FL 33449 EAST OFFICE:
2326 South Congress Ave. Suite 1-A West Palm Beach, FL 33406
Podiatric Physicians & Surgeons
Personal & Gentle Care For:
• 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
Dr. Juan Sardina
Dr. Lori Lane
Dr. Arthur Hansen
Dr. Shelley Plumb
Dr. Daniel Heck
(561) 433-5577 w w w. l a p o d i a t r y g r o u p . c o m
3347 State Rd 7 Suite 204 Wellington, FL 33449
2326 S. Congress Ave. Suite 1-A West Palm Beach, FL 33406
4 OCTOBER ISSUE
Treatment of Breast Cancer The role of the Medical Oncologist
Dr. Humberto Caldera
MD. Medical Oncologist Hematologist
irst, in order to establish an accurate diagnosis, screening procedures and physical exam by a qualified health care provider are a must. Then, a Radiologist gets involved to interpret the various imaging studies. The next step involves performing a biopsy, which is usually done by the Surgeon. After a sample is obtained, it goes to the pathology laboratory, where the microscopic diagnosis is made by the Clinical Pathologist. Once the pathology report and imaging studies are available, a treatment strategy is developed, ideally with the participation of the Breast Surgeon, the Radiation Oncologist, the Medical Oncologist, and the Plastic/Reconstructive Surgeon. The Medical Oncologist is generally in charge of determining the need for hormonal therapy, chemotherapy, and/or targeted therapy. These are very complex decisions, as treatments are tailored to the individual patient, based on her or his particular situation and tumor characteristics. We cannot generalize treatments and give every patient the same drugs. Depending on the staging, some patients may only need surgery, or surgery and radiation; however, most patients will need additional treatment measures. Patients with non-metastatic disease (stages I-III), have a better
A multidisciplinary approach is the best strategy when treating patients with breast cancer. Breast cancer treatment in both women and men is very complex, and to obtain the best results, many specialists and testing procedures must be coordinated.
prognosis, and the goal of therapy is to cure the disease; whereas patients with advanced disease (stage IV) are generally treated more conservatively, and the goal is to prolong life, to maintain quality of life, and to improve the symptoms of the disease.
If the tumor overexpresses Estrogen and/or Progesterone receptor, the standard of care is to use antiestrogen therapy with drugs like tamoxifen (particularly in pre-menopausal women), or the newer generation aromatase inhibitors. Also it is very important to determine if the tumor overexpresses the Her-2-neu receptor, in which case targeted therapy against that particular receptor must be used. Available medications include Herceptin (intravenous), tykerb (oral), and newer medications that are in the process of being approved. Chemotherapy is mandatory if a patient has an aggressive tumor, or if the axillary lymph nodes were found to be involved at the time of diagnosis (palpable lymph nodes), or during the surgical resection of the tumor. Many chemotherapy combinations are available for those situations.
In most patients with positive axillary lymph nodes (stages IIIII), the treatment consists of surgery with axillary lymph node dissection, followed three to six weeks later by 4 to 6 cycles of chemotherapy, and then radiation therapy to the affected breast and axilla (if several lymph nodes involved), and finally, at the completion of radiation, five years of oral antiestrogen thera-
py if the tumor overexpressed hormonal receptors. Treatment with targeted anti-Her-2-neu agents for one year is also given to appropriate patients. The availability of molecular testing has dramatically changed the treatment approach for patients with early stage disease (Stage I). These are generally patients with small breast tumors and negative axillary lymph nodes. In the recent past, we used to offer chemotherapy to all patients with a tumor larger than 1 cm, but fortunately that has changed, and nowadays we can
determine more accurately what patients harbor an aggressive disease, with poorer prognosis, despite only having small tumors. Available molecular testing includes Oncotype DX, and Mammaprint. Basically, the tumor sample is analyzed in the laboratory, and based on the presence of particular gene combinations; we can estimate the risk for the development of metastasis and/or increased chance for mortality in the next 10 years from the time of the surgery. Patients with early stage disease,
but high-risk disease by molecular profile are offered chemotherapy after surgery. Regardless of the staging, the absence of hormonal receptors in the tumor (ER/PR negative disease) also indicates high-risk disease, and those patients are also offered chemotherapy treatments. In general, for patients that are treated with curative intent, the role of the chemotherapy, antiestrogen therapy, and targeted therapy, is to prevent relapses in the future, or the development of metastatic disease. Many trials have demonstrated that an effective adjuvant strategy will significantly improve cure rates and overall survival. Patients with recurrent or metastatic disease have poorer outcomes. In those patients that present with metastasis, surgery
and radiation therapy may not be necessary, and the main treatment strategy includes hormonal manipulation, targeted therapy when appropriate, and chemotherapy for selected and better fit patients. Using a rational approach on these cases usually leads to a prolonged survival with good quality of life. It is not unusual to see patients in our clinic being able to perform their regular activities and surviving many years despite having metastatic disease. Patients with metastatic breast cancer, particularly those with only bone metastasis, have in general a bet-
ter prognosis and prolonged survival, compared to patients with metastatic disease for other types of cancer.
One of the major issues in patients with breast cancer is the presence of bone metastasis, which could lead to devastating and disabling fractures that will negatively impact the quality of life. Fortunately, we can now treat and prevent those complications with drugs that strengthen the bones and decrease the frequency of those complications. Such drugs include the bisphosphonates (Zometa and Aredia), and most recently, the Rank ligand inhibitor Xgeva. The timely use of periodical physical examination (and appropriate blood work in selected cases),Follow-up mammograms and breast ultrasounds, and other imaging studies when needed, allow us to be ahead of the game, and to anticipate complications before they occur and have a negative impact in the life of survivors of breast cancer. The Medical Oncologist has a very important role in treating women and men with breast cancer at all stages of the disease, and for following up periodically the many patients that are now survivors. Our main role is to use of the weapons available to cure more patients and to prolong and improve the quality of the life of those that are not curable. We must be very aware of the multiple advances and many drugs being developed in order to offer our patients the best chances to win the battle. Our hope (and is happening) is to every day improve the cure rates of breast cancer, and to provide adequate therapy without significantly affecting quality of life of our brave patients. It is a long battle. You can ask our patients and their families, who inspire us every day to do our best as Physicians and human beings. The message is clear: DO NOT EVER GIVE UP.
Is Your Brain Working as You Nap? P eople who say they think better after having a nap may now have evidence to support their claim. A study of 15 people found that when they rested, the right hemisphere of their brains talked more to itself and to the left hemisphere than the left hemisphere communicated with itself and with the right hemisphere. This was true in both right- and left-handed people, even though right-handed people use their left hemisphere to a greater degree and left-handed people rely more on their right hemisphere. The findings suggest that the right hemisphere "is doing important things in the resting
state that we don't yet understand," Andrei Medvedev, an assistant professor in the Center for Functional and Molecular Imaging at Georgetown University Medical Center, said in a center news release. Activities undertaken by the right hemisphere during rest could be daydreaming or processing and storing previously acquired information. "The brain could be doing some helpful housecleaning, classifying data, consolidating memories," Medvedev said. "That could explain the power of napping. But we just don't know yet the relative roles of both hemispheres in those processes and whether the power nap might benefit righties more than lefties."
The findings, scheduled for presentation at the annual meeting of the Society for Neuroscience, suggest that brain researchers should start paying more attention to the right hemisphere, Medvedev said. "Most brain theories emphasize the dominance of the left hemisphere especially in right-handed individuals, and that describes the population of participants in these studies," Medvedev noted. "Our study suggests that looking at only the left hemisphere prevents us from a truer understanding of brain function." The data and conclusions of research presented at meetings are typically considered preliminary until published in a peerreviewed medical journal.
OCTOBER ISSUE • 2012 5
Kathleen Minnick M.D.
By Dr. Kathleen Minnick
ell, I’ve got good news and I’ve got bad news. I’m an optimist so I like to end on a good note so we’ll start with the bad news. You can only prevent a disease if you know its cause. We do not know what causes Breast Cancer. Therefore, we cannot prevent Breast Cancer. But all is not lost. Here’s the good news. We do know how to reduce your risk of Breast Cancer. And, here’s the best part, it is 5 easy steps! Oh and there are bonus prizes with some of the steps! I love a freebie. Let’s get started.
Step 1: Maintain a healthy weight. It has been reported that a 50 lb weight gain after the age of 18 will increase your risk of Breast Cancer by 50%! But, a 22lb weight reduction after menopause will reduce your risk of Breast Cancer by 57%! If your New Year’s Resolution is to reduce your risk of Breast Cancer, set a goal of losing that 22 pounds. Over the course of a year that is a little less than half a pound a week!
A pound is about 3600 calories. That means ‘in theory’ that you need to eat 900 calories less and burn 900 calories more each week to total 1800 calories a week for half a pound. I say in theory because I know from personal experience that it ain’t that easy! But, trying to lose 22 pounds over the course of year is a reasonable and worthy goal. Slow steady weight loss tends to be maintained better. And BONUS—rates of heart disease, colon cancer, diabetes, osteoarthritis, and stroke decrease as your weight decreases!
Step 2: Exercise. It has been reported that exercising 45-60 minutes more than 5 days a week can decrease your risk of Breast Cancer. And some recent studies suggest that the intensity of the exercise is less important than previously thought. In other words, you don’t have to be a Triathlete to get a benefit from excercise. In fact many studies include aerobic exercise (running, swimming), balance (yoga, tia chi), resistance training (weights or bands), and core strength (pilates). There are many ways to exercise. Find a way that works for you. And BONUS-- Studies have also been done on exercise and the Breast Cancer patient. These have shown that Breast Cancer Survivors who exercise regularly tend to have a better quality of life, less side effects, and some small studies suggest regular exercisers may get more benefit from cancer treatments. Think of your body as an engine. An engine that is run often and well maintained will be able to do whatever you ask of it better whether that means winning a race or pulling a heavy load.
The same goes for your body. If you use it regularly and maintain it well, when you ask it to help you beat a cancer it’s ready to go. BONUS BONUS—in addition, regular exercise lowers your blood pressure, stabilizes blood glucose, strengthens your heart, lungs, muscles, and bones, burns fat, and improves mood, cognitive skills, and memory!
Step 3: Limit Alcohol Intake. Studies have shown that as few as 2 glasses of beer, wine, or spirits a week can increase your risk of Breast Cancer by more than 40%. That’s a lot of risk for a glass of wine on Friday and Saturday night!
And, the amount of alcohol that is considered a ‘serving’ is smaller for women than for men. Pour 1.5 ounces of coffee into a clear glass and take a good hard look. That’s a serving of spirits for a man. Take away half an ounce and you have the serving size for a woman. Looks like what is left in the glass after you’re done doesn’t it. BONUS—Alcohol is just empty sugars as far as your metabolism is
considered Your body handles the calories from alcohol consumption just like calories from candy. They usually store it as fat. So skipping that beer or glass of wine may save you some fat. And if you really need a treat, you could always choose to have a little dark chocolate instead!
Step 4: Avoid Hormone Replacement Therapy (HRT). Studies have demonstrated an increased rate of breast cancer in women who are taking Hormone Replacement. The risk seems to rise around year five of consumption of the medication. One of the problems with HRT is that the hormones stimulate the breast and create density. When you are young, your breasts are dense. This means there are a lot of ducts and lobular tissue which is white on mammogram. As we age, the lobules naturally involute and fat fills in the spaces. This is known as fatty replacement. The fat is black on mammogram. When you reach about 40 years old, there is a balance between the amount of black and white in your breast and mammograms become a valuable screening tool. HRT increases the whiteness on your mammograms making them less effective. This makes it harder to find the cancer which is also white on mammogram. Whoever said the good guys always wear white didn’t know didley about Breast Cancer. The good news is the risk seems to return to normal for your age after you have been off HRT for 7 years. Some women experience disabling side effects during menopause that are refractory to all medications except HRT. The
decision to take HRT needs to be made by you and your gynecologist or primary care doctor after you’ve had a discussion about the risks, benefits, and alternatives for you.
Step 5: Eat a Diet Rich in Colorful Fruits and Vegetables. Everyone has heard the saying “An apple a day will keep the doctor away”. But do you know why? Perhaps it is because of the lutein, Zeaxanthin, Vitamin A, Folate, and Vitamin C that an apple contains. Have you ever wondered why Popeye gets so strong by eating spinach? It’s the Vitamin A, Beta Carotene, Lutein, Zeaxanthein, Vitamin K, folate, and Vitamin C. The reason why colorful fruits and vegetables are so good for you is because they contain Antioxidants. Antioxidants are natural compounds found in fresh fruits and vegetables that have the ability to neutralize damaging free radicals, repair cellular DNA and protect other antioxidants. Free radicals are one of the substances that damage cellular DNA leading to disease. Antioxidants protect us from this damage and repair the damage. For example, Lycopene which is found in tomatoes has been shown to be good for prostate, lung and stomach cancers. Lutein is found in green leafy vegetables like spinach and kale and helps protect the eye from macular degeneration. Vitamin E helps protect cells from radiation damage. BONUS—Eating a diet rich in the colorful (non beige) fruits and vegetables helps your body in many ways. It can lower cholesterol, help you lose weight, and improve your heart attack, stroke, and diabetes risk. And, it’s delicious!
6 OCTOBER ISSUE
Delray Medical Center, Good Samaritan Medical Center, St. Mary’s Medical Center and West Boca Medical Center Honor Breast Cancer Awareness Month Hospital’s Campaign Encourages Women to “Picture Yourself Healthy”
alm Beach County – OCTOBER, 2012 –Delray Medical Center, Good Samaritan Medical Center, St. Mary’s Medical Center and West Boca Medical Center want women to “Picture Yourself Healthy” during Breast Cancer Awareness Month by taking the one picture that could save their life – a mammogram.
“Picture Yourself Healthy is more than just a reminder to get a mammogram,” explains Tenet Florida’s Vice President of Operations, Marsha Powers. “It’s about women keeping themselves in the picture by making their health a top priority.” According to the American Cancer Society, breast cancer accounts for more than one in four cancers diagnosed in the United States, making it the most common cancer among women, other than skin cancer.
However, early detection through mammogram screenings, increased public awareness of breast cancer and improved treatments have helped reduce the rate of death from breast cancer in the United States. Mammogram screenings can detect breast cancer when it is smaller and more confined to the breast, allowing the cancer to be treated more easily.
To help encourage women to get a mammogram Tenet Florida is offering screening opportunities throughout Palm Beach County for the month of October. DMC West Boynton Imaging and DMC Palm Court Imaging, affiliates of Delray Medical Center, will be offering mammograms for $65 with free hand sanitizers for patients who get their screenings done in October. Screenings will be held at Canyon Town Center 8756 W. Boynton Beach Boulevard, Suite 100 and Palm Court Plaza 5130 Linton Boulevard, Suite 1-5. To reserve a spot, call 561-6375400. For any Medicare beneficiary, if your cost is not covered by Medicare, your cost will be
limited to $99.00. Medicare recipients can choose to pay at the time of service, or request that the claim be submitted to Medicare to see if the service will be covered.
Good Samaritan Medical Center (GSMC) is offering the following specials at the GSMC Comprehensive Breast Center and the five Outpatient Midtown Imaging Centers: self-pay screening mammograms for $65 cash price, accompanied by a BMI and Blood Pressure Screening, and extended hours for participants. The GSMC Comprehensive Breast Center is
located on GSMC’s Campus at 1309 N Flagler Drive West Palm Beach, FL 33401. To schedule an appointment or inquire for the specials, please call 561-6506023. For any Medicare beneficiary, if your cost is not covered by Medicare, your cost will be limited to $99.00. Medicare recipients can choose to pay at the time of service, or request that the claim be submitted to Medicare to see if the service will be covered. St. Mary’s Medical Center (SMMC) is offering free bone density screenings. Screenings will be held every Friday in October from 10am-4pm, at the Imaging Center located on the St. Mary’s Campus at 901 45th Street West Palm Beach, FL 33407. Participants will receive a free gift at the screenings and can enter for a chance to win prizes. To schedule your free bone density screening or to make your mammography appointment, call 561-882-9100. For any Medicare beneficiary, if your cost is not covered by Medicare, your cost will be limited to $99.00. Medicare recipi-
ents can choose to pay at the time of service, or request that the claim be submitted to Medicare to see if the service will be covered.
West Boca Medical Center (WBMC) is encouraging women to schedule their mammograms for $99 by offering free bone density screenings and a free gift at the screenings to all participants in October. All screenings will be held in the Diagnostic Imaging Center at 7070 West Palmetto Park Road Boca Raton, FL 33433. Please schedule separate appointments for mammograms and free bone density screenings, to do so, call 1-866904-9262. For any Medicare beneficiary, if your cost is not covered by Medicare, your cost will be limited to $99.00. Medicare recipients can choose to pay at the time of service, or request that the claim be submitted to Medicare to see if the service will be covered. There is no guaranteed way to prevent breast cancer, but early detection through regular mammograms is very important.
What IS a Respiratory Therapist?
Sheryl Gilman has been practicing respiratory care for 14 years in Palm Beach County. For the last 5 years she has been the Clinical Supervisor of the Cardiopulmonary Department at Lakeside Medical Center, the hospital in Belle Glade serving the residents of the Western Communities. She has specialty certifications in Neonatal and Pediatric care, Pulmonary Function Testing, and is a Certified Tobacco Cessation Specialist as well as having a Bachelor degree in Health Care Services Management.
By Sheryl Gilman
ctober is National Healthy Lung Month as sponsored by the American Lung Association. At the end of the month, October 21-27, is a special week to all respiratory therapists. Respiratory Care Week is a yearly celebration of the Respiratory Care profession and the men and women dedicated to ensuring easy breathing for all. Everyone who has difficulty breathing or issues has at one time or another received care from a respiratory therapist. Many who have heart issues and
some who have kidney problems have also received some kind of care from one of these dedicated personnel. But, who are these people called respiratory therapists? Are they specialized nurses? Are they some kind of doctor? What is it exactly that they do? What kind of training and education have they received?
What Education is Required? Respiratory therapists are specialists in patient assessment, diagnosing and treating (under a physician’s authority) lung disorders and breathing difficulties. They are sub-specialists in heart and kidney disorders as all three areas are intimately related. To accomplish this level of proficiency, many years of education and specialization are invested by each therapist. First, time is spent procuring educational prerequisites such as Anatomy and Physiology, Chemistry, Biology, and Physics along with mathematics such as Algebra. Then each therapist must pass a qualifying process that includes personal interviews and observation of practicing respiratory therapists. Once accepted to one of a limited number of seats, the student spends the next two years studying gas laws, extensive
physiology of lungs, heart, kidneys, and blood, diseases of these systems, and the various methods and processes of treating the damaged systems. At the same time, 720 hours of actual hands-on clinical time are required. These are spent in area hospitals under the watchful eyes of practicing respiratory therapists performing patient care and learning in a real-life environment. After passing all didactic and clinical areas and receiving an Associate in Science of Respiratory Therapy, the student must still pass national exams and be licensed in each state. As of 2015, a Bachelor Degree (4year degree) will be required before a student is eligible to take the national exams. Each state also requires various hours of continuing education for each licensing period in order to retain a license to practice.
After receiving a license, a respiratory therapist continues to learn new skills and may achieve specialty certifications both
within the respiratory therapy field as well as others available to them. For instance, the National Board of Respiratory Care (NBRC) offers specialty certifications in NeonatalPediatric Care, Acute Critical Care, and Sleep Studies. Also,
two different levels of Pulmonary Function Testing, certified and registered, are offered. The licensed Respiratory Therapist must pass further testing to achieve these certifications and prove continuing education in these areas every five years to retain them. Outside the NBRC, other areas of specialty such as Certified Tobacco Treatment Specialist and National Asthma Educator Certification are available to the
dedicated respiratory therapist. Many respiratory departments in various settings also require advance life support certifications. These include Advanced Cardiac Life Support for all therapists regardless of area of practice as well as the specialty areas of Pediatric Advance Life Support and Neonatal Resuscitation Provider. As respiratory therapists are not hired for specific areas of care generally, but are expected to provide care to all age groups, in various situations most therapists have all three advanced certifications. Those expected to work in the Neonatal Intensive Care Unit are also usually required or at least encouraged to obtain S.T.A.B.L.E. certification. This encompasses the special knowledge required to stabilize and care for newborns.
Respiratory therapists can continue their education achieving Master and Doctorate degrees and diversifying their practice into anesthesiology, heart-lung bypass procedures, and healthcare administration. The vast majority, however, remain devoted to their calling of quality patient care and safety, spending the years of their career in direct patient care. Respiratory Therapists (RRT) are not physicians nor are they nurses, instead, they are intensely trained specialists part of a medical team cooperating to manage patient illness of all types. The next time you are told “I’m from the respiratory department” thank that Respiratory Therapist for every breath you take.
OCTOBER ISSUE • 2012 7
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 Alvaro Betancur, D.D.S.
Scalloped tongue is a tongueshaped anomaly, referring to the tongue edge of the visible traces of the teeth, also known as Indian tongue. When the borders of the tongue has marks like indentations is called scalloped tongue. One of the first clinical skills learned by medical students is the importance of asking the patient to "put out your tongue, please," recognizing that observing the tongue may frequently
provide clues to a patient's overall well being. Even young children at play can be seen asking playmates to "say, aaah," mimicking their experiences of doctor visits where clearly much emphasis is placed on careful attention to this small organ.
The tongue, despite its small size, has been endowed with numerous powers throughout the centuries. As the primary tool of speech, the tongue has been blamed for dividing nations, yet also applauded for engendering great love, and for the ability to create and inspire. Torturers of old also appreciated the fundamental role of this organ and would frequently cut out the tongues of perceived offenders!
Physicians, too, have recognized the importance of the tongue in their practice of medicine. Scrutiny of the tongue may provide information about a patient's state of health or disease; hence, oral examination
ST. MARY’S MEDICAL CENTER WELCOMES NEUROSURGEON DR. BRETT A. OSBORN TO ITS MEDICAL STAFF
has assumed a central role in the clinical and dermatological examination.
The tongue has many relationships and connections in the body,; when scalloped could be signs of many medical conditions like spleen deficiency, blood deficiency, B12 deficiency, arthritis, sinus or digestive problems. Recent studies show that 89% of people with tongue scalloping suffer obstructive sleep apnea. Due to the high incidence, now is being considered as a marker for sleep apnea.
Scalloped tongue is also present in many patients with small dental arches or/and large tongue pressing on the teeth, which are typical conditions of patients that suffer from TMJ dysfunction and related craniofacial pain. Like teeth grinding and clenching, tongue scalloping use to be related to stress, but now we know that is just one way for the protective body's mechanism to move the jaw forward as an effort to open the airway so the person can breath.
Dr. Alvaro Betancur would like to offer you a free consultation at his Boca Raton or Pembroke Pines office.
WEST PALM BEACH, Fla.September, 2012- St. Mary’s Medical Center is proud to announce that Dr. Brett A. Osborn, D.O., has joined the hospital’s medical staff. Dr. Osborn specializes in neurosurgery. Dr. Osborn is trained to treat patients of all ages and brings a variety of interests within neurosurgery, from complex spine surgery to the treatment of adult hydrocephalus. He also provides services in surgical neuro-oncology and CyberKnife radio surgery. “At St. Mary’s Medical Center we’re convinced with Dr. Osborn’s growing passion and precision for some of the latest and most effective neurosurgical treatments we know he will be a tremendous asset at St. Mary’s Neuroscience Center.” says Chief Executive Officer Davide Carbone at St. Mary’s Medical Center. Dr. Osborn received his bachelor’s degree in General Science from Brandeis University. He attended medical school at the Chicago College of Osteopathic Medicine where he received his Doctor of Osteopathic Medicine degree in 1996. Afterwards, Dr.
Dr. Brett A. Osborn, D.O.
Osborn completed his seven-year internship and residency in the Department of Neurosurgery at the New York University (NYU) Medical Center. During his residency training, he focused on the diagnosis and treatment of brain tumors.
Dr. Osborn is licensed in both West Virginia and Florida and is a member of the American Medical Association and the American Osteopathic Association. He is a fellow of the American Association of Neurological Surgeons (boardcertified) and a Diplomate of the American Academy of AntiAging Medicine. He has also been named a HealthGrades Recognized Doctor.
Delray Medical Center celebrates 30 year anniversary
his photo was taken from the recent celebration Delray Medical Center had at its 30th Anniversary Cocktail reception. Employees, doctors, and volunteers who have been on staff for 30 years were on hand along with the current staff members celebrating the excellence and growth of the largest hospital in Delray Beach.
Boca Raton 3401 N.Federal Hwy., Suite 101 Boca Raton, Florida 33431 561-750-6790
Tongue scalloping (marks of teeth on the borders) is a useful clinical indicator of sleep pathology and its presence should prompt the physician to inquire about snoring history.
Pembroke Pines 18503 Pines Blvd., Suite 305 Pembroke Pines, Florida 33029 954-392-1851
Save your life… Peaceful Sleep without CPAP
PEACEFUL SLEEP WITHOUT CPAP 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 Covered by most Medical Insurance and Medicare
Member Alvaro Betancur, D.D.S.
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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.
Mark Bryan CEO Delray Medical Center, Dr. Lee Greene, Dr. Jonathan Wideroff, Dr. Bryan Wasserman, Dr. Robert Zann
Family Dental Care Comprehensive
Our Services Include:
Snoring ruins your sex life
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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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
Wisdom Teeth Removal * Oral Rehabilitation Gums Treatment: surgical and non-surgical Root canals * Fillings * Crowns * TMJ
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Starting as young as 2 years old, you may help your children to solve ear inflammation symptoms, develop a beautiful face and smile with a more attractive profile as well as prevent sleep apnea and avoid orthognathic surgery; all with Funtional Appliances and Facial focused Orthodontics.
We can straighten your teeth at any age, fast and comfortably using invisible technology with or without braces. Improve your facial appearance with a beautiful and healthy smile. 3401 N.Federal Hwy. Suite 101 18503 Pines Blvd. Suite 305 Boca Raton, FL 33431 Pembroke Pines, FL 33029
8 OCTOBER ISSUE
Breast cancer B
Kishore K. Dass, MD
Board-Certified Radiation Oncologist
reast cancer is the most prevalent non-dermatologic cancer among women in the United States and the second leading cause of cancer death among women. Fortunately, the breast cancer death rate has decreased over the past ten years. The treatment of breast cancer requires a multi-disciplinary team consisting of surgeons, radiologists, pathologists, medical oncologists and radiation oncologists. Radiation plays an integral role in the treatment of pre-cancerous lesions (ductal carcinoma in situ or DCIS), early stage breast cancer, and locally advanced breast cancer.
Albert Attia, MD
Radiation Oncologist – South Florida Radiation Oncology, LLC
In patients who undergo a lumpectomy, regardless of stage, adjuvant radiation is indicated. The options of radiation can potentially include fractionated external beam radiotherapy or partial breast radiotherapy. Partial breast radiotherapy can be done through external radiation or brachytherapy. Brachytherapy involves insertion of a radioactive source inside the breast for a period of time to treat the lumpectomy region. This source can be placed through a single channel or multiple channels into the breast cavity. Partial breast radiotherapy done through external beam involves the use of multiple
beams to treat the lumpectomy region only sparing the remainder of the breast. Results from partial breast radiation studies seem promising but are still maturing. The American Society for Radiation Oncology (ASTRO) has recommendations on which patients can be eligible for partial breast irradiation. Some of these guidelines include patients with small tumors less than 2-3 cm, patients who are older than 50 years of age, clear surgical margins and no lymph node involvement present. If the patient is eligible, then she undergoes treatment twice a day for five consecutive days. Standard fractionated external radiation consists of daily treatments Monday through Friday for approximately six weeks. Fractionated radiation covers the breast and possibly the lymph node regions if these were found to be involved after surgery. The first 25 or so treatments cover these regions followed by what is called a “boost” or “conedown” which treats the lumpectomy cavity for another 5-8 fractions. If a patient chooses to undergo a mastectomy, she will usually require adjuvant radiation if she has positive margins, four or more lymph nodes, or a large
tumor measuring five centimeters or more. This is currently an area of debate but thus far, patients who fit these criteria will usually undergo radiation after mastectomy. Other patients with 1-3 lymph nodes positive may benefit from adjuvant radiation but it is usually decided on a case-by-case basis as many other features have to be taken into account. With post-mastectomy radiation, the chest wall and regional lymph nodes are treated followed by a “boost” to the chest wall scar. The benefit of adjuvant radiation whether in the setting of after lumpectomy or mastectomy is the decreased likelihood of recurrence. For eligible patients,
radiation after mastectomy has been shown to prolong life. Some studies even suggest that patients who undergo radiation after lumpectomy versus those who do not also have a survival benefit. Many factors have to be taken into account when deciding if the patient requires radiation after surgery and which kind of radiation treatment use. The importance of a multi-disciplinary approach cannot be emphasized enough as each case is unique and requires the input from everyone in the treatment team. At SFRO, we pride ourselves in not only in providing all the various types of treatment for breast cancer but in also having a multi-disciplinary approach.
Healthy Eating: Cherries are Delicious and Nutritious dried or juiced. It also does not matter when you decide you would like them! They are superb for snacking, meal time, or as a treat. Here are a few creative ways to include them in your meal time!
Cindy Collins, Ph.D., R.D.
Experimental Health Psychology / Nutrition
By Cindy Collins, Ph.D., R.D., Raquel Rivera, S.A.
herries are such a wonderful fruit, full of vitamin C, fiber and even potassium. They also contain anthocyanins, a bioactive compound which affords potential health advantages such as reduction of cancer risk, heart disease and inflammation. Cherries even contain melatonin which is hard to find in foods. Melatonin is beneficial for regulation of natural sleep cycles. In its simple elegance, the cherry provides such a tremendous nutritional advantage. The best part about this tiny wonder fruit is it does not matter how you choose to eat them; they come fresh/ frozen, canned,
Fun Ideas: • Add cherry juice to seltzer • Add a few cherries into your salad • Next time you make oatmeal cookies, try adding dried cranberries to them • Add them into your favorite grain to give it a nice savory flavor (oatmeal, rice)
Here is a suggested recipe from American Institute of Cancer Research: http://www.aicr.org/, (Issue # 395, April 10, 2012)
Fruit-Infused Pork Tenderloin Pork is a versatile meat that goes well with a variety of fruits and vegetables. This recipe features cherries and pomegranate juice that give the meat a tender, sweet taste. Cherries contain vitamins A and C, potassium and fiber. Tart cherries actually have nearly 20 times more vitamin A than strawberries and blueberries. Lab studies are also looking at the phytochemical anthocyanin, credited with giving cherries their notable red hue, for its powerful antioxidant properties. Pair with a light,
spring salad for even more phytochemicals.
Pork Tenderloin with Pomegranate Cherry Sauce 1/2 cup dried tart cherries 3/4 cup pomegranate juice, divided 1 lb. pork tenderloin 4 tsp. canola oil 1/2 cup fat-free reduced-sodium chicken broth 1/4 cup finely chopped shallots 1 tsp. dried thyme 1 Tbsp. coarse seed mustard 2 tsp. unsalted butter, optional Salt and ground black pepper Place cherries in small bowl. Add 1/2 cup pomegranate juice and let sit until cherries are
plump, about 20 minutes. Drain, setting fruit aside and reserving liquid. Cut tenderloin crosswise into 8 pieces. Using your palm, gently flatten each piece to an even thickness.
Heat oil in large skillet over medium-high heat. Add pork and cook until it is browned on both sides, turning meat once, about 6 minutes in all. When instant read thermometer reads 150 degrees F. or meat resists slightly when pressed with your finger, remove it to plate, cover loosely with foil, and set aside. Pour broth into the pan. As it
boils, use wooden spatula to scrape up all browned bits. When broth is reduced by half, 4-5 minutes, add cherries, shallots, pomegranate juice and reserved juice from soaking, thyme and mustard. Simmer vigorously until liquid is reduced by one-third, 4 to 5 minutes. Return meat and any juices that have collected to pan and cook until meat is barely pink in the center or instant read thermometer registers 160 degrees F. Season with salt and pepper to taste. Place 2 pieces of tenderloin on each of 4 dinner plates. If using, swirl butter into sauce until it melts. Spoon sauce over meat. Serve immediately.
Note: If the tenderloin has a silverskin membrane, remove it or at the meat counter, ask the butcher to do it for you.
Makes 4 servings.
Per serving: 238 calories, 5 g total fat (4 g saturated fat), 43 g carbohydrate, 7 g protein, 6 g dietary fiber, 155 mg sodium. For more information on cherries please refer to: 1. ADA Times, Volume 8, Issue #4, Summer 2011 2. http://lef.org/magazine/ mag2007/dec2007_sf_ cherries_01.htm
Now Let the Experts in Breast Cancer Treatment Take Care of You. The American Cancer Institute predicts that, despite a healthy lifestyle, more than 200,000 women in the U.S. will contract breast cancer this year. That’s why at South Florida Radiation Oncology, our team of radiation oncologists renders the most technically advanced treatments in the field, including protocol based, IMRT, TrueBeam™ and partial breast irradiation. Our medical staff — together with you, your specialist and primary care physician — will collaborate and select the best treatment option for your particular diagnosis as well as your personal requirements. At South Florida Radiation Oncology, we recognize that every patient is an individual, with unique treatment needs and a distinctive lifestyle. Call South Florida Radiation Oncology and let us take gentle, compassionate and effective care of you today so you can get back to taking care of yourself tomorrow.
Get back to living your life.
877.930.SFRO ( 7376 ) www.sfrollc.com
C YBERKNIFE ®
BOCA RA AT TON
BO OY Y N T O N B E AC AC H
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Palm Beach Gastroenterology Consultants, LLC
Krishna Tripuraneni M.D., M.B.A.
Vikram Tarugu M.D
Call Us Today If You Suffer From Any Of The Following: Abdominal Pain Bleeding Chest Pain Cirrhosis of the Liver Colitis Constipation Diarrhea
Pancreatis Stomach and Duodenal Ulcer Ulcerative Colitis Reflux Disease Hemochromatosis Hemorrhoids Hepatitis
Digestive Diseases Stats Dysphagia Gallstones Gastroesophageal Jaundice Lactose Intolerance Liver Disease Nervous Stomach
Venra Clinical Studies, LLC Also offering
IRRITABLE BOWEL SYNDROME?
We are conducting a clinical research study of an investigational medicine. If you meet the following criteria, you may be interested in participating in this clinical trial.
• Age 18 – 79 inclusive • At least 28 stools over a 7-day period • Moderate to severe Pain in your abdomen associated with: • relief by defecation, • change in frequency of bowel movements, or • change in appearance of stool.
Participants receive study related care, diagnostic tests, and study medication at no cost. Payment for time and travel to the study center may be provided
For more information about the research study, please contact:
Two Convenient Locations: WELLINGTON
1157 South State Road 7 Wellington, Florida 33414
561.795.3330 Venra Clinical Studies, LLC 561-795-3330 ex. 249 firstname.lastname@example.org
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.
OCTOBER ISSUE • 2012 11
Is Genetic Testing for You? By Deborah Lynn
hile interviewing Dr. John Rimmer at his Jupiter office, I quickly realized just how passionate he is about every single patient that walks through his door. The women are not just a number or a face to him. As he is genuinely interested and concerned about every single person that comes through his door - he knows every single one of them by name. His sensitivity is one that is rarely felt, but I was drawn to it. If you didn’t know better, you would think that he himself experiences everything that his patients go through – one by one. As we sat and discussed many different issues that pertain to breast cancer, I noticed that one topic in particular hit home with him, genetic testing.
If women have a history of breast cancer in their family – they need to get genetically tested to see if they carry the mutation – period! There are no excuses with this one and why would there be? Is it the fear of finding out they are probably going to get breast cancer? I guess for some people, they would rather not know. However, what’s the alternative? Possibly getting breast cancer and having to go through radiation, chemotherapy and hormone
therapy. That IS the alternative and it’s not a pretty one and not a guarantee either.
Since breast cancer can result from changes in genes called “hereditary mutations” those genes can be passed down from mothers and fathers to their daughters and sons. Yes, men can also get breast cancer and they too can be predisposed to get the disease.
As the founder and director of the Kristin Hoke Breast Cancer Program at Jupiter Medical Center, Dr. Rimmer is a firm believer in genetic testing.
Genes that are associated with heredity cancer are called BRCA1 and BRCA2. If changes in these genes occurs, you can be at greater risk for not only breast cancer, but also ovarian and several other forms of cancer.
Kristin Hoke is a perfect example of why both men and women need genetic testing IF they have a family of breast cancer. If a patient tests positive for the gene, they will have an opportunity to make a choice. Unfortunately, if you choose to wait and see, you may have no choice.
Kristin had a history of breast cancer in her family – she had the mutation and she knew that she would probably get breast
cancer at some point in her life and yet, chose not to get tested. Although she found out at 40 that she had stage one breast cancer and went through all the right procedures to cure her, she eventually succumbed to her disease. If Kristin had undergone genetic testing, she may very well be alive today. She could have had her breasts removed – that fatty tissue that can be completely reconstructed and possibly look even better than before.
Times have changed and in the past women chose not to have a mastectomy as they often looked like patchwork or disfigured after having the surgery – that is just not the case today.
When you find out early that you carry the gene, you can have a double mastectomy (remove the fatty tissue), have reconstructive surgery and be cancer free! That’s right, when you have surgery to remove your breasts – you do not need to have chemotherapy, radiation or hormone therapy and are cancer free, those individuals are called “previvors.” Once you are diagnosed with cancer, you are known as a “survivor.” According to FORCE (Facing Our Risk Cancer Empowered):
• If you test positive for a mutation, each of your children and siblings have a 50% chance of carry thing the mutation themselves. Aunts, uncles, nieces, nephews and cousins may also carry the mutation.
• If you test positive for a mutation, you are at greater risk for a second breast cancer and other cancers.
• If you test negative for the mutations, your risk for other cancers depends on other factors.
FORCE is a wonderful nonprofit organization for women who have a family history or are at risk genetically for breast or ovarian cancer and for family members who also are at risk and are there to help support you through this difficult time.
So, let me ask you - given the choice, would YOU get tested or take a chance with your life?
Please give Dr. John Rimmer a call today to schedule your genetic tests. For additional information about the Kristin Hoke Breast Cancer Program, you can visit www.jupitermed.com/breasthealth. Or, for more information regarding FORCE, go to their website at www.facingourrisk.org.
Where breast health technology and compassion meet. Dr. John Rimmer is a Board-Certified General Surgeon whose practice focuses on diseases of the breast. Dr. Rimmer is the Founder and Medical Director of the Kristin Hoke Breast Health Program at Jupiter Medical Center. In addition to diseases of the breast, he also offers treatment options for gallbladders, hernias, and benign or malgiment skin lesions. Office procedures include: - Breast ultrasound - Ultrasound guided biopsy - Cyst aspirations - L-Dex (lymphedema testing) - Lesion removal - Incision and drainage of infected cysts or abscesses - Mamosite or Savi (Breast Brachytherapy device placement)
210 Jupiter Lakes Boulevard Building 5000 – Suite 202 Jupiter, Florida 33458
(561) 748-1242 Visit our website at www.johnrimmermd.com
12 OCTOBER ISSUE
Ask Dr. Sharma
Shekhar V. Sharma, M.D. Board Certified in Internal Medicine
Question #1 - Hi Doc! I have
been urinating a lot more than usual and also drinking water by the gallon and my vision is a little hazy at times, what’s going on?
Answer: You could be having
a condition called diabetes mellitus, which means your blood sugar levels are higher than normal and the above symptoms could be coming from high levels of sugar in your blood. By definition, diabetes mellitus is a condition when your blood sugar is above 125 mg/dL of your blood.
Question #2 – I have these
heartburns for a while and I am a diabetic. My neighbor told me to take some Zantac and it should be alright. But, I do not feel comfortable with that advice, please advise.
Answer: You could have acid reflux disease or worse, it could be a heart condition called angina that presents itself in this way. In such a scenario, I would seek immediate medical help because a lot of diabetics could have hidden heart disease which can present itself with a spectrum of symptoms. Although this could be misleading to the layman, but not to a wise doctor. A diabetic can have belching, heartburns or no symptoms at all and can still have underlying coronary heart disease.
Question #3 – Doctor, I am a
70 year-old male with severe low back pains and I was told that I have arthritis of my lower spine and to take Advil. What do you think?
Answer: If you have never
been checked for abdominal aortic aneurysm then you should have an ultrasound of the abdominal aorta because large aneurysms of the abdominal aorta can be present with low back pains. Although, I am not discounting the fact that you could be having severe arthritis of your lumbar spine, which also can cause low back pain. However, considering your age and especially if you were a smoker in the past, you could potentially have an aortic aneurysm, so seek medical attention soon.
ety with my heart beating fast in my chest at times and I am concerned.
Answer – I think you could
Question #4 – Dear Doctor, I really feel tired when I wake up in the morning and I’m sleepy during the daytime and fatigued. I also check my blood pressure at home and it’s high.
Answer: You could be having
a condition called sleep apnea syndrome. In layman’s terms, sleep apnea means stopping breathing for several seconds when you are asleep. This causes impaired oxygenation of one’s brain. It can also cause diabetes mellitus and people with this condition usually have fatigue and feel sleepy during the day. This condition is usually associated with obesity where obstruction to the airway can cause sleep apnea and we term it as obstructive sleep apnea.
Question #5 – Hello! Doctor, I am a 70 year-old female and have frequent episodes of anxi-
have a condition called palpitations, which means a feeling of the heart beating in the chest. You could also be having a condition called cardiac arrhythmia. Although, anxiety attacks can be associated with fast heartbeats and I am not discounting that as an issue. However, that would be the last issue on my mind, but as a physician, we have to rule out other potentially dangerous situations of the heart, which could be causing these symptoms. A fast heart rate can be caused by a hyperactive thyroid gland and some medications which are commonly taken like over-the-counter decongestants. Please get an EKG done through your primary care doctor and you definitely need to have a Holter monitor placed to check what is going on with you. You also need to have some laboratory studies on your blood as well.
Question #6 – I wake with a mild headache every morning and I have never seen a doctor regarding this.
Answer – This is commonly seen in uncontrolled hypertension that means your blood pressure may be high and you are unaware of the condition. Please
have your blood pressure checked as soon as possible. If your headaches do not go away after correction of your blood pressure, you will need to have a CAT scan or MRI of the brain.
Question #7 – Doctor, I am
75 years-old, my husband is 80 years-old and he bumped his head about a month ago. Lately, I have been noticing that he is not himself, a little confused at times and he does have Alzheimer’s disease.
Answer – Ma’am, if your hus-
band is on blood thinners of any type and bumped his head weeks ago, he could be having a subtle condition called subdural hematoma, which means bleeding outside the brain, which could be causing these symptoms. I would stop all blood thinners and go to the emergency room. I would strongly recommend anyone with questions like the above should seek immediate medical care and not wait for answers through a newspaper. An ounce of prevention is worth a pound of cure.
Shekhar Sharma, M.D. is a board-certified Internist. His primary concern is your health and well-being. If you have any questions or concerns for the doctor, please forward them to email@example.com
PALM BEACH PRIMARY CARE ASSOCIATES, INC. State of the Art Office Building with Imaging Center,
Shekhar Sharma M.D. Ebonee Johnson A.R.N.P.
Accepting New Patients
MEDICARE, BLUE CROSS BLUE SHIELD, UNITED HEALTH CARE, AETNA, CIGNA, HEALTH CARE DISTRICT AND MOST MAJOR INSURANCES ACCEPTED On staff at Palms West Hospital and Wellington Regional Medical Center
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Tel: (561) 996-7742 • Fax: (561) 753-8730
OCTOBER ISSUE â€˘ 2012
Alan B. Miller Pavilion Grand Opening Event
The Alan B. Miller Pavilion Grand Opening Celebration and Dedication was held on Wednesday, October 3, 2012. Alan B. Miller, Chairman of the Board and CEO of Universal Health Services, Inc. and Jerel Humphrey, CEO of Wellington Regional Medical Center addressed the crowd. Local political leaders and other dignitaries participated in the ribbon-cutting ceremony. The Pavilion Dr. Jeffrey Bishop, Jerel Humphrey CEO of Wellington opened to the public on Regional Medical Center, Alan B. Miller, Jaene Miranda, and Bob Margolis. October 8, 2012.
8596 Wendy Lane East West Palm Beach
This beautiful custom home is waiting for you in Banyan Lakes. It offers 5 bedrooms, 3 1/2 baths and 3 CG.
The living room boasts soaring 20' coffered ceiling, double crown moulding and beautiful travertine marble flooring. The den has triple glass windows for privacy. An elegant dining room features an illuminated tray ceiling adjacent to a built-in wet bar with granite countertop.
Jerel Humphrey CEO, Dr. Matthew Smith, Dr. Ishan Gunawardene, and Robert Campton.
Dr. Todd Gersten, and Dr. Eric Grimm.
The incredible gourmet kitchen features Brazilian
"Golden Fire" granite, cherry wood cabinets and top-of-the-line appliances. It's charming breakfast nook, spacious family room and built-in wall units with marble inlays add to the beauty of this custom home.
The master suite has tripe crowned coffered ceilings, a luxury master bath with an over-sized jacuzzi tub / travertine marble / shower and surround sound.
In addition, there are professional window treatments; stem wall construction (which raises the property three feet), steel reinforced concrete at roof line with walk space in attic, pre-wiring for pool system, surround sound in the LR/FR/MBR/MBA.
Please contact Bill Tavernise at 561-209-8304 or BillTavernise@keyes.com to view this lovely property.
Francisco Gonzalez, Benjamin Shenkman and Jesse Seligman.
The Leading Brokerage Company in Florida since 1926
Dr. Kathleen Minnick, Dr. Arul Chidambaram, and Brian Grosso.
Anna Lee and Mike Salamone.
Bill Tavernise 561-209-8304
Bob Wolff 561-352-0620
14 OCTOBER ISSUE
Kirk Alexander and his wife, Dr. Veronica Pedro.
Palms West CEO, Eric & Jennifer Goldman, with Dr. Becker.
Dr. Edward and Maria Becker with Mary O’Connor, President and CEO of the Boys & Girls Clubs of Palm Beach County and Juan “Tony” Nelson.
Dr. Becker opens his home to the Boys & Girls Club of Palm Beach County
Maria Becker and Mary O’Connor.
Brighton Someone’s Day for Breast Cancer Awareness Month endy Bright was on hand to represent both Stylist 1 and SFRO’s new Survivorship Clinic as Brighton Collectibles unveiled their new Cancer Awareness Bracelet.
While there, Wendy offered free lessons on how to style wigs, gave make-overs to those in attendance, and added a lovely strand of pink hair to those that wanted a little boost. You can purchase a beautiful 2012 Breast Cancer Awareness Bracelet through October. Just call or visit the Brighton Collectibles Wellington location and tell them you are there to support SFRO. If you would additional information about Wendy and the services she offers, you can e-mail her at firstname.lastname@example.org or give her a call at 561-348-0399. Or, if you would like additional information on SFRO Survivorship Clinic, visit www.sfrollc.com.
Breast Cancer Awareness Bracelet
Wendy Bright brings SFRO to Brighton Collectibles
DEAR DEBORAH: I have been divorced for two years now and I feel that I am finally ready to start dating. With three children that range in age from six to ten, I am not expecting that to be an easy task. My question is this, if I meet someone, how long before I can introduce them to my children? - Ready to Date?
Dear Ready to Date: Divorce has a major impact on children. Sometimes you will not realize just how much until they get older. Since they are still young and impressionable, your job is to provide them with the stability, security and love that they need to thrive in their day-to-day life. They need to know that you will always be there for them. Therefore, when you do find someone of interest, I would prefer for you
to wait until it is an exclusive relationship and you know that he will be around for a long time – not just for the moment. Again, these are very important times for your children in terms of how they view relationships and as they develop into their teen years and adulthood. It is your job to make sure your lifestyle does not have a negative impact on their emotional growth.
DEAR DEBORAH: I met the most incredible man and quickly found myself overwhelmed by what I was feeling. I had never been in love before although I am in my early forties. This experience has truly taken me to my knees and he feels the same way. How soon is too soon to know when you are in love? I just want to follow my heart and be true to myself. - In Love and Loving it!
Selection of Breast Cancer Collectibles
Dear In Love and Loving it: There is no rhyme or reason when you fall in love. Love can happen quickly or build over time. I am a firm believer in knowing when something feels right and following your heart. If you feel that strongly about him and he feels that way about you – there should be no question. Loving someone is the most incredible feeling in the world and there is no reason why you shouldn’t follow your heart. Just be sure that you are both giving equally to the relationship as they do tend to falter if one party gives more than the other.
DEAR DEBORAH: Having been married for ten years, I am now divorced and dating. At 40, I do not want children and most women my age that haven’t had them, want them. Another issue is when women find out what I do for a
Dear Deborah living, they are immediately interested. I want to find a woman that is not interested in what I do, but instead want to know the man behind the career. How and where do I find someone that wants to get to know me, is understanding and intelligent enough to hold a conversation. Any recommendations? - Newly Single
Dear Newly Single: Wow, that is a tall order. Unfortunately, I have no idea what you do for a living and perhaps my advice would change if I did. If women are drawn to you for what you do – stop telling them. If they ask, change the subject and say something along the lines of “that’s not important right now, however I would really like to know more
about you.” Through conversation, you will learn if there is any interest. If there is mutual interest, she has the ability to communicate on the level in which you prefer and has her own career, than by all means, when the time is right, tell her. See if she changes her attitude when you do tell her. If she was lukewarm to you prior to learning your occupation and once you tell her she suddenly becomes interested – take a pass. If you would like to find someone that understands what you do for a living and can add value to your life – start looking at industry functions.
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: email@example.com as we would love to help.
OCTOBER ISSUE • 2012 15
More Drugs Linked to Meningitis Outbreak: FDA
Upcoming Charity and Medical Fundraising Events October 15 – November 30, 2012 October 17
Susan G. Komen for the Cure. Pink Ribbon Luncheon. Woodfield Country Club, Boca Raton. Cost of the luncheon is $125.00. For additional information, contact 561-514-3020 or e-mail firstname.lastname@example.org. Or, visit their website at www.komensouthflorida.org.
he U.S. Food and Drug Administration issued warnings Monday about additional drugs produced by the specialty pharmacy at the center of the current meningitis outbreak. The FDA said it was investigating a report of a meningitis infection in a patient who got a different steroid than the type linked to the more than 230 such infections nationwide. The agency also said it was checking reports of fungal infection in a heart transplant patient given a cardiac solution made by the drug producer in question, the New England Compounding Center of Framingham, Mass. The solution is used to paralyze heart muscle to prevent injury to the heart. But it's possible the infection could have come from a source other than the solution, the agency said. The possible meningitis infection reported was associated with an epidural injection for back pain of a steroid called triamcinolone acetonide. All the previous steroid-related meningitis cases were linked to methylprednisolone acetate, a similar steroid injectable product, the FDA said in a news release.
Breast Cancer Awareness - Project Pink. Marriott Hotel in Palm Beach Gardens. 97.9 WRMF will be on hand. 6:00p.m. – 10:00 p.m.
October 19 The FDA said it was advising all health-care professionals to follow up with any patients who were given any injectable drug from or produced by the New England Compounding Center. These drugs include medications used in eye surgery, and the heart solution purchased from or produced by the company after May 21. On Tuesday, federal health officials said 19 more cases of fungal meningitis linked to the initial round of contaminated steroid injections have been reported, bringing the total number of cases to 231. The number of deaths held steady at 15, the U.S. Centers for Disease Control and Prevention said. The agency also listed two cases of joint infections linked to the injections. There also have been two cases of what the CDC calls "peripheral joint infection," meaning an infection in a knee, hip, shoulder or elbow. These peripheral joint infections -- caused by injections of pain-killing steroids -- aren't considered as dangerous as injections near the spine for back pain that have been tied to the potentially fatal meningitis infections.
Avoid Scary Calorie Counts This Halloween
aiting until the last minute to buy Halloween candy is a good way to stick to a healthy diet and cut extra calories, an expert suggests, because if the candy isn't sitting around the house, you won't be tempted to eat it. And those little bags of candy add up to extra pounds. For example, a 0.75-ounce "fun-size" bag of M&M's contains 100 calories and 3.3 grams of fat, according to a news release from EmblemHealth. Dr. William Gillespie, a pediatrician and EmblemHealth's Chief Medical Officer, said taking the focus off candy altogether and concentrating on other Halloween activities -- such as telling spooky stories and making crafts or costumes -- is another way to encourage healthy choices. Gillespie offered several other tips to ensure people of all ages enjoy a healthy Halloween, including: Keep candy out of sight. Once kids enjoy a night of trick-ortreating, put their remaining
candy away so they will be less likely to think about it. Toss extra candy. Another way to limit the amount of candy kids eat is to allow them to choose a few of their favorites from their Halloween bag and get rid of the rest. Don't be too restrictive. If candy becomes a "forbidden" treat, it may be even more tempting. Eat before trick-or-treating. If kids fill up with a healthy meal or snack before they head out on Halloween, they may eat less candy. Don't buy tempting candy. Adults who buy Halloween candy for their home or office should buy treats they don't actually like so they are less tempted to eat it. Don't supersize. Buying miniature treats instead of candy that is snack size can help cut extra calories.
Starlight Children’s Foundation. 10th Annual Starlight Greater Open. The Polo Club of Boca Raton in Boca Raton. Cost is $250.00 for a single golfer. Fee includes green fees, cart, gift bag lunch, dinner and a tee sign. Contact Robert Peters for additional information at 954-318-2178 or Robert.email@example.com. Or, visit their website at www.starlight.org/florida.
Alliance for Eating Disorders Awareness. Inaugural Alliance Golf Classic. PGA National Resort & Spa - Squire Course, Palm Beach Gardens. Cost is $175.00 per golfer or a foursome for $675.00. This event is presented by Freeman Injury Law & Futures of Palm Beach. To reserve your spot, call 800-863-2819 and mention you are with The Alliance. Or, visit their website at www.allianceforeatingdisorders.com.
Cancer Alliance of Help and Hope's 2012 Charity Ball. Boots ‘n Bling Ball. Harriet Himmel Theater. Tickets are $175.00. Silent auction, dinner and dancing. For additional information, call 561-748-7227 or e-mail them at firstname.lastname@example.org. Or, you can visit their website at www.cahh.org. Alzheimer’s Association. Walk to End Alzheimer’s. Meyer Amphitheatre, West Palm Beach. For additional information, contact Duane Hamilton at 800-272-3900 or email@example.com.
Gold Coast Down Syndrome Organization. 18th Annual Buddy Walk. $15.00 - $20.00 to participate in the walk. John Prince Park, Lake Worth. For additional information, contact 561-912-1231 or e-mail firstname.lastname@example.org.
The Center for Creative Education. Ladies in their Little Black Dresses. Saks Fifth Avenue in the Gardens Mall, Palm Beach Gardens. Tickets are $150.00 per person. For additional information contact 561-805-9927 or visit their website at www.cceflorida.org.
Unicorn Children’s Foundation. 5th Annual Denim, Diamonds, and Dice Casino. Ritz-Carlton, Manalapan. Cost is $125.00 for general admission, $250.00 for V.I.P. and $250.00 for the Texas Hold’em tournament. For additional information, contact 561-620-9377 or visit their website at www.unicornchildrensfoundation.org/casino.
Caring Hearts Auxiliary. Keep Memories Alive Walk. Town Center at Boca Raton in Boca Raton. Cost is $30.00-$40.00. Proceeds benefit the Louis and Anne Green Memory and Wellness Center. For additional information, contact 561-297-4066 or email@example.com.
Arthritis Foundation. Arthritis Walk. John Prince Park, Lake Worth. For additional information, go to their website at http://2012awlakeworth.kintera.org.
Veterans Affairs Medical Center. 7th Annual Mayor’s Veteran’s Golf Classic. Palm Beach Gardens Golf Course, Palm Beach Gardens. Single player is $85.00 and a foursome is $300.00-$320.00. Visit their link at http://www.pbgfl.com/controls/NewsFeed.aspx?FeedID=160 to register. Or, go to the City of Palm Beach Gardens website.
Bethesda Hospital Foundation. Women of Grace Annual Luncheon. Ritz-Carlton, Palm Beach. Tickets are $100.00. For additional information, visit their website at www.bethesdahospitalfoundation.org.
5th Annual Margarita Ball. Community Friends (distributes toys to over 25 charities in WPB). The Lake Pavilion, West Palm Beach. For additional information, contact 561-807-6650.
St. Jude Children’s Research Hospital. Give Thanks Walk. John Prince Park, Lake Worth. For additional information, contact 305-265-1371.
New Hope Charities. Holiday Bizarre at The Beach Club, Palm Beach. For additional information, contact Jane Maestro at 561-366-5093 or firstname.lastname@example.org.
Brighton Collectibles – Wellington and SFRO. For the entire month of October, you can order the new breast cancer awareness bracelet from Brighton’s Wellington location in Wellington Green Mall. If you order a bracelet through that location, please mention South Florida Radiation Oncology (SFRO) as $10.00 from every bracelet will be donated for their new Survivorship Clinic SFRO. For additional information, you can visit their website at email@example.com, or give them a call at 561-333-3558. Please e-mail us at firstname.lastname@example.org if you would like to have your event listed in our Upcoming Events section.
WELLINGTON REGIONAL MEDICAL CENTER
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.
Published on Oct 27, 2012