Community Newspapers Inspire Health 43 by Fox Print and Publishing

INSPIRE

PUBLISHED BY COMMUNITY NEWSPAPERS

SEPTEMBER | OCTOBER 2019

Complimentary

RECOGNIZING BREAST CANCER AWARENESS

Modern Salmon FINDING A BALANCE

BETWEEN SCHOOL AND ACTIVITIES

F U L F I L L I N G The Mission of Empowering Seniors to Live at Home

z e n i t r a Carlos M INSPIRE HEALTH

More for Your Heart Harry Aldrich, M.D. Cardiology South Miami, Coral Gables

Orlando Almanza, M.D. Cardiology South Miami

Phillip Erwin, M.D. Structural & Interventional Cardiology South Miami, Coral Gables

Jose Martel, M.D. Electrophysiology South Miami

coming together for your Cardiac Health ❤ Convenient Hours & Locations ❤ Full Range of Cardiology Services ❤ Next Day to Same Week Appointments ❤ Saturday Hours Available

Julio Barcena, M.D. Advanced Heart Failure Coral Gables, Doral

David Bejar, M.D. Cardiology Doral, Coral Gables

Lauren Frost, M.D. Cardiology South Miami, Coral Gables

Jaime Ghitelman, M.D. Interventional Cardiology South Miami, Doral

Joshua Harris, M.D. Cardiology South Miami

Luis Ortiz-Munoz, M.D. Cardiology Coral Gables, Kendall

Gerardo A. Polanco, M.D. Cardiology Kendall

Yasser Rodriguez, M.D. Electrophysiology Kendall, Doral

Matthew Snow, M.D. Cardiology South Miami

South Miami Location Medical Arts Building 6200 Sunset Drive, Suite#401 South Miami, FL 33143 305-666-4633

❤ Best Heart Specialists in South Florida

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Leonard Zwerling, M.D. Cardiology South Miami

Javier Jimenez, M.D. Advanced Heart Failure South Miami, Coral Gables

Abbe Rosenbaum, M.D. Cardiology South Miami

Raquel Bernal, ARNP South Miami

South Miami Location Coral Gables Location Medical Square Building 4675 Ponce De Leon Blvd, Suite#203 7330 SW 62nd Place, Suite#310 Coral Gables, FL 33146 305-666-4633 South Miami, FL 33143 305-663-1001

September § October

Nestor M. Demorizi, M.D. Cardiology Kendall

Jorge Cuello, M.D. Cardiology South Miami

www.mycardiologist.com

Dan Krauthamer, M.D. Interventional Cardiology South Miami

Yale Samole, M.D. Cardiology South Miami, Coral Gables

Jonathan Dunn, M.D. Cardiology Coral Gables, Kendall

Romeo Majano, M.D. Interventional Cardiology South Miami

Eric Schroeder, M.D. Interventional Cardiology South Miami

Patricia Chavarria, ARNP South Miami

Kendall Location 8500 SW 92nd Street Miami, FL 33156 305-666-4633

Doral Location 7725 NW 48 Street, Suite#200 Doral, FL 33166 305-666-4633

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*Other providers are available in our network. **We’re here from 8am to 8pm, Monday to Friday (from October 1 to March 31, 8am to 8pm, 7 days a week). Devoted Health is an HMO plan with a Medicare contract. Enrollment in Devoted Health depends on contract renewal. Devoted Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-338-6833 (TTY 711). ATANSYON: 3 Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-800-338-6833 (TTY 711). H1290_19L585_M INSPIRE HEALTH

contents S E P T E M B E R | O C TO B E R  2 0 1 9

26 United HomeCare:

FOCUSED ON FULFILLING THE NEEDS OF THE ELDERLY

8 CANCER PREVENTION

32 MIGHTY KIDS

62 VOLUNTEERISM

10 EXERCISE

34 BACK-TO-SCHOOL

64 IMMUNOLOGY

12 CANCER TREATMENT

38 PRIMARY CARE

14 BREAST CANCER

42 SUPER FOOD

Stay attuned to the risk factors for breast cancer Finding exercise when you’re traveling Common options for treating breast cancer

Prevention and what you need to know

20 INFORMED CONSENT Communications with your gynecologist is key

23 RECIPE

Giving peace of mind to patients in treatment

Fall season brings asthma and allergy kids Maintaining a relationship with your PCP The super power of almonds

48 EDUCATION

Nurses that care about their community

56 RECIPE

Providing South Florida's children with the best protection possible

Modelmronn

Acorn squash caesar salad

Almond crusted cauliflowr steaks with mango cabbage salsa

30 PET HEALTH

58 FIGHTING FOODS

Keeping our furry companions safe

Finding a balance between school and activities

INSPIRE HEALTH

Apples, broccoli, and berries battle cancer

September § October

72 HEALTHY MIND

The key to lasting happiness

74 ORTHOPEDIC CARE

The challenge of establishing a center of excellence

76 FIT FOOD

Garlic gives you something to smile about

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editor’s letter

Inspired by Autumn In literature, autumn is a common metaphor for the mellower season of life, signifying ripeness, change, and maturity – an idea expressed by English Poet John Donne when he wrote, “No spring nor summer beauty hath such grace, As I have seen in one autumnal face.” As such, our cover story highlights the challenges and joys of growing older – and to a certain extent, the business of getting older. At the helm of United Home Health, Carlos Martinez shares how he and his team expertly serve the everyday needs of our aging population, while ensuring a better tomorrow through political advocacy. But beyond simply noting the passing of summer, Inspire Health recognizes the many other faces of autumn. Because in a more traditional sense, this season also marks the return of rich and savory comfort foods into our diets! Yes! Flip through our pages to find sumptuous seasonal recipes for Acorn Squash Caesar Salad and Spicy Creamy Corn Soup – or how ‘bout a steaming bowl of Roasted Veggie Soup. To make sure you’re getting your fit on, in time for the upcoming holiday feasting season – we're helping you in Finding Exercise When You're Traveling. And because October is Breast Cancer Awareness Month, we recognize how Miami-based medical practices and organizations are raising awareness on this front. You might also want to check out our Wellness Department for features on taking proactive approaches to preventing breast cancer.

M A G A Z I N E PUBLISHED BY COMMUNITY NEWSPAPERS

publisher GRANT MILLER

executive editor MICHAEL MILLER

managing editor BILL KRESS

director of advertising AMY DONNER

marketing director KARINA HINTZ

contributing writers CHRISTOPHER PEARSON NANCY EAGLETON UNNI GREENE

account executives DIANE SCHILLER GEORGIA TAIT GLORIA BURNS

Peace, love, and pumpkins.

MILLER MYERS FARA SAX RICHARD NEIDORF

GRANT MILLER Publisher

MICHAEL MILLER Executive Editor

6 7 9 6 S W 6 2 N D AV E N U E S O U T H M I A M I , F L 3 314 3 PH 305- 662- 6863 I N S P I R E H E A LT H @ C N E W S . N E T

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A PROACTIVE APPROACH TO PREVENTING

BREAST CANCER

A TOTAL OF 1 IN 8 WOMEN ARE DIAGNOSED WITH BREAST CANCER DURING THEIR LIFETIME; UNDERSTANDING THE RISKS AND LIVING A PROACTIVE LIFESTYLE MAY HELP YOU FROM BEING ONE OF THEM.

ome of the known breast cancer risk factors such as age, sex, and family history, you are simply powerless to change. According to statistics, being a woman over the age of 65 is perhaps the greatest risk factor. However, despite your age, sex, and genetics, you can be a responsible prevention advocate by taking the necessary measures to protect and monitor your health on a regular basis. GET TESTED: Prevention methods can save your life! Breast cancer screenings

(mammograms) are still the primary tool used for early detection and is deemed the most important strategy in improving survival rates. Mammography is an X-ray examination of the breast. It can detect cancer in the breast when it is quite small, long before it may be felt by an at home breast examination. Approximately 85%-90% of all breast cancers are detectable by mammography. Early detection is the key to reducing mortality rates, reducing rates by 20%-30% in women over 50 years of age.

While mammography is the primary tool used, there still exist some 10%-15% of breast cancers that are not visible on mammography; however, they can be felt by performing a physical examination of the breast. Therefore, a normal mammogram does not always exclude the possibility of breast cancer. Three things are needed for a thorough examination by your health care provider, palpation, visual inspection, and a mammogram. Typically, during a routine physical checkup, your gynecologist will conduct an examination of the breast. You should also do a palpation exam yourself on a regular basis. The American Cancer Society (ACS) recommends a baseline mammogram for all women by age 40 and annual mammograms for women 40 and older for as long as they are in good health. A baseline mammogram at 35 years of age may be recommended by your doctor if you have “lumpy breasts” or breast symptoms, or are at high risk of developing breast cancer. Screenings are extremely important, but so is living a lifestyle that promotes health and wellness. MINIMIZE YOUR RISK: 1. Reduce saturated fats (red meats, egg yolks, dairy products, fast food) 2. Reduce alcohol consumption 3. Exercise regularly (At least 30 minutes 5 times per week) 4. Increase your intake of fresh fruits and vegetables (antioxidant powerhouses) Do your part to prevent the possibility of developing breast cancer, schedule regular breast exams, eat a healthy diet, and exercise regularly. If you are currently at high risk, switch to a healthy lifestyle today and call your doctor now to set up your next breast exam--it could save your life!

INSPIRE HEALTH

September § October

DR. MARIO ALMEIDA welcomes Doctors Health Plans, Inc. and Devoted Health to our office.

BILLINGUAL STAFF

INTERNAL MEDICINE, NEPHROLOGY, AND HYPERTENSION

MARIO ALMEIDA, MD AND ASSOCIATES

Dr. Almeida specializes in Internal Medicine, Nephrology, and Hypertension. He has been in private practice in Miami since 1988. Dr. Almeida has been an active speaker on the management of type 2 diabetes, hypertension, cholesterol management, and anemia associated with kidney disease. Previously he served as Chief of Medicine, a member of the Critical Care Committee, and as Vice-President of Medical Staff at Doctorâ&#x20AC;&#x2122;s Hospital.

NOW ACCEPTING:

CALL TO MAKE YOUR APPOINTMENT TODAY (305) 669-3360INSPIRE HEALTH 7000 SW 62ND AVE. STE 605 SOUTH MIAMI, FL 33143

exercise

FINDING EXERCISE

When You’r e Traveling Stay on Top of Your Fitness When You’re Away from Home By Juliane Morris

Vacation or business travel tends to lead to overindulging, treating yourself while away and coming home feeling off course. If your itinerary includes upcoming travel, think about following these ideas or modifications of them to help maintain some great exercise options toward your health and wellness.

SKIPPING HIGH KNEES Skipping High Knees challenge and work many muscle groups by activating hip flexors, strengthening legs and enhancing coordination. The movement of the exercise mimics jumping rope and counts on speed and large muscle motor control.

GRASSHOPPER PUSH-UP The Grasshopper Push-Up is a variation of the traditional push up. This exercise is challenging and may not be for everyone. They take some getting used to, so practice your form and do them slowly and carefully to get the hang of them. The different angles used with these train different sets of muscles. They enhance flexibility in your lower body and because the movements are intense, after just a

INSPIRE HEALTH

Step 1:: Skip in place by hopping on one leg while bringing the other knee up toward your chest. Lift your knee so it is a bit higher than perpendicular with your body. Swing your arms as you skip with the opposite arm. When your left arm is forward then your right knee is up.

few reps you’ll feel the burn. Step 1: Place the palms of your hands flat on the floor shoulder-width apart but in line with your shoulders. If your wrists are unable to bear much weight, modify with a closed fist floor placement. Steady your toes on the floor and squeeze your glute muscles to stabilize the body. Form your body into a strong, straight line from your shoulders to your toes. Your face should be downward toward the floor.

September § October

Step 2: 2: Repeat the skipping motion, alternating sides. Try two to three sets for 30 seconds.

Step 2: Tighten your core and bend your right leg under your body. Keep your leg under your body as you inhale and then bend at your elbows to lower your body until your chest is near the floor without allowing your right leg to touch the floor. You can turn your head as you move so as not to strain your neck. Inhaling when you move down to the floor relaxes your ribcage while expanding your abdomen.

Step 3: Exhale slowly, pressing your body back to the starting straightposition, returning and straight ening your right leg next to the straight left leg. Exhaling as you push yourself to the starting plank position releases air to help your ab muscles contract, making the push-up easier and safer. Step 4: Repeat the steps with the left leg.

MODIFICATION: These exercises are not for everyone. Only those who are used to a regular exercise program should attempt them.

BIRD DOG PLANK The Bird Dog Plank strengthens your lower back, works your glute, and targets the core abdominal muscles that line the front of your stomach wall. A staple for home or away, this will help you stay on top of your exercise

commitment, even when you’re dragging from jetlag. Step 1: Place your hands and knees on the floor–down on all fours–hips square, knees under hips and hands under shoulders and at shoulder-width, keeping your back straight and your core engaged.

Step 2: Lift up one arm parallel with the floor while lifting up the opposite leg parallel with the floor, forming a straight line from fingertips of raised arm to toes pointed of raised leg. Step 3: Hold the position for ten seconds with hips squared and core engaged and without

leaning forward or back but centered and balanced over hand and knee, hips level and not curved up sideways. Step 4: Repeat eight to ten times on each side, two to three sets.

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WOMEN SHOULD KNOW

MASTECTOMY IS NOT THE ONLY OPTION BREAST CANCER CONTINUES TO THREATEN WOMEN Breast cancer is the most diagnosed cancer among women in the US, second only to skin cancer. Statistics show that 1 out of 8 women will be diagnosed with breast cancer in their lifetime. The cure rate for breast cancer is exceptionally high, especially when detected early, reaching up to 95% success rate; however, it remains the second leading cause of cancer death among women. Why is this the case in today’s advanced technological world? Breast cancer is actually a complicated type of cancer - no two patients are the same, so every woman needs to be evaluated and treated individually. Several types of breast cancer can behave aggressively– spreading quickly to lymph nodes and from there throughout the body. Because of this there is a high recurrence rate, even if the entire breast is removed. WHAT ARE THE VARIOUS OPTIONS FOR TREATING BREAST CANCER? The most common treatment options provided by doctors and oncologists are surgery or chemotherapy, two quite traditional and invasive forms of treatment. Surgery, which is a localized approach, usually refers to either a lumpectomy, which removes just the tumor area or a mastectomy, which removes the entire breast. Chemotherapy is a broad approach, whereby chemicals treat the entire body in hopes of killing the cancer, but often with collateral damage, as is seen through the various and severe side effects.

INSPIRE HEALTH

September § October

However, there is a third approach which doctors often overlook – Radiation Therapy – a localized treatment option where high energy x-rays are directed to a certain part of the body. Radiation therapy is a completely safe and less invasive option that actually has far better rates at minimizing recurrence of cancer and has tremendous success with early-detected breast cancer patients. In this treatment form, women are able to keep their breasts, retain the sensation and minimize the chances of their cancer coming back. WHAT IS THE PREFERRED APPROACH FOR TREATING BREAST CANCER AT ICI? For early cancer, we favor radiation treatment via the prone position, with the patient lying face down using specialized treatment beds, separating the breasts from other body parts and critical organs and eliminating damage to the lungs or heart. Brachytherapy is another radiation modality that allows for part of the breast to be treated with radiation, as opposed to the entire breast. Both treatments have identical success rates when compared with other surgical treatments. In conclusion, if you are diagnosed with breast cancer, do your homework. We recommend consulting with a breast surgeon, a medical oncologist, and a radiation oncologist before starting any treatment. A one-size-fits-all approach does not exist and all patients should be aware of ALL of their options.

WHAT ARE THE BENEFITS OF RADIATION COMPARED TO MASTECTOMY?

• Faster and less invasive

•

– while surgery and chemotherapy options require several uncomfortable procedures with a high risk of complications taking between 6-12 months, radiation therapy treatment averages only four to six weeks, each session being only 15 minutes. No reconstructive surgery - mastectomies often come with the need for multiple surgeries; meaning a lengthy process and extended recovery times that can take up to one year. Excellent cosmetic results – women can keep their breasts and maintain sensation. Minimal recovery times – radiation therapy is performed on an outpatient basis without the need of anesthesia or hospital stay. High success rates and lower recurrence rates – up to 95% success rates when detected early.

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SCREENING MAMMOGRAMS KEY TO EARLY DETECTION OF BREAST CANCER WHILE BREAST CANCER SCREENING RECOMMENDATIONS ARE DIRECTED TO WOMEN AGE 40 AND OLDER, IT IS ALSO IMPORTANT FOR YOUNGER WOMEN TO BE AWARE OF THEIR OWN BREAST HEALTH. “Breast cancer in women under the age of 40 is relatively uncommon, affecting fewer than 7 percent of all new breast cancer diagnoses, but it still accounts for more than 13,000 new cases annually in the United States,” said Starr Mautner, M.D., a breast surgeon at Miami Cancer Institute. “I have diagnosed enough patients in their 20s and 30s to know that it’s important for teenagers, in addition to young adults, to have a general understanding of breast cancer, the signs and symptoms and what to do if they feel something abnormal.” Most women over the age of 40 have cancers that are detected via screening mammograms. The good news about early detection is that a significant number of women who are diagnosed with breast cancer are receiving their diagnosis early thanks to mammogram screenings, Dr. Mautner says. She refers to a recent study, published online in the October issue of the American Journal of Roentgenology (AJR), of nearly 33,000 women between 40 and 49 years old in the U.S. who had a mammogram to screen for breast cancer. Women aged 40 to 49 represented 18.8 percent of all the breast cancers detected among the women, translating into a screening-de-

tection cancer rate of 3.6 per 1,000. The incidence of breast cancer found by mammogram screening was slightly higher for the second group of women studied. Those women, aged 45 to 49 years, had a screening-detected breast cancer rate of 4.1 per 1,000, representing 9.8 percent of all the women who took part in the research. ANNUAL MAMMOGRAMS STARTING AT AGE 40 As a result of the study, the American Cancer Society (ACS) and U.S. Preventive Services Task Force (USPSTF) continue support the recommendations of the American College of Radiology (ACR) that women begin getting an annual screening mammogram at age 40. Baptist Health South Florida also supports annual mammograms for women at average risk starting at age 40. One in six breast cancers occur in women age 40-49. Mammograms save lives in all women, and specifically in women age 40-45. When breast cancer is found early and in a localized state, the five-year survival rate is near 100 percent, according to the National Breast Center Foundation. A patient’s ethnicity and personal and family history of cancer should

also go into the equation to determine when a woman should start having screening mammograms, Dr. Mautner adds and the ACS and USPSTF research found. BRCA GENE AND BREAST CANCER About 15 percent and 32 percent of women 40-44 years old and 45-49 years old, respectively, whose breast cancer was found through a screening mammogram, have a first-degree relative with breast cancer or the BRCA gene, according to the ACS and USPSTF research. However, more than 60 percent of the cancers found in the women of these two age groups was invasive, the research showed. “The role BRCA mutations play, especially in younger women, is important to note,” Dr. Mautner said. “Women who are genetic mutation carriers or who have first degree relatives diagnosed with premenopausal breast cancer are recommended to start screening mammograms before the age of 40.” For young women who do not meet criteria to start mammograms before the age of 40, Dr. Mautner stresses the importance of self-exam, familiarity with family history and general knowledge of breast cancer as steps they can take to start screening early. “If a mass is found either by the patient or by her physician, it should not be disregarded just because the patient is young. Every palpable mass should be taken seriously and worked up with appropriate imaging and biopsied when warranted.”

MAMMOGRAMS SAVE LIVES. SCHEDULE YOUR MAMMOGRAM TODAY. When breast cancer is detected early, at a localized stage, the survival rate is 98 percent. To schedule an appointment, call 786-573-6000 in Miami-Dade or Broward, 305-434-1588 in Monroe, 561-374-5300 in Palm Beach or visit BaptistHealth.net/BreastHealth.

INSPIRE HEALTH

September § October

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EXPERTS IN PINK EN ESPAÑOL LAUNCHES WITH SIGNING AT BOOKS AND BOOKS Authors Cindy Papale-Hammontree and Sabrina Hernandez Cano are launching Experts in Pink:Your Guide to Breast Health en Español on October 12 and hosting a book signing at Books and Books in Coral Gables at 5 p.m.The free event, hosted by Univision 23 news anchor Sandra Peebles, will feature a medical panel discussion with eight experts. Experts in Pink is the third book by the duo, who are committed to helping patients and their caregivers navigate their way through a breast cancer diagnosis and treatment armed with knowledge, hope and inspiration. Their first book, The Empty Cup Runneth Over, was released in 2007 followed by a second book, Miami Breast Cancer Experts: Your Indispensable Guide to Breast Health, in 2014. The third book covers important topics like cardiac effects after chemotherapy and radiation therapy, conveyed by cardiologist Javier Jimenez, M.D., and breast reconstruction, shared by plastic surgeons Roger Khouri, M.D., and Daniel Calva Cerqueira, M.D. Describing her passion projects, Cindy said, “Before we published the first edition, many books had been written about breast cancer, but never had experts in the field and throughout a community come together to share their knowledge of this specialty for the benefit of breast cancer patients and their caregivers.” Cindy has been a member of the Miami Breast Center team since 2010. Prior to joining the Center, she worked for the University of Miami Sylvester Comprehensive Cancer Center for 27 years. Her passion for helping other breast cancer survivors became more pronounced after she was diagnosed in 2000 with stage I, multi-focal, invasive breast cancer

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September § October

and underwent a bilateral mastectomy. She first started lecturing on the topic to high school and college students and then began writing to help educate women. Cindy is currently collaborating with Peabody Award-winning producer Derek Britt on a feature film and series inspired by her breast cancer journey. She has recently joined the Board of BRCAstrong, an organization that supports and educates survivors and previvors. Sabrina Hernandez Cano is a registered dietician, nutrition counselor and certified diabetes educator who specializes in bariatric and diabetic nutrition. She serves as CEO of Hummingwell, a wellness bar or meal replacement made with balanced nutrition designed to promote a healthy lifestyle. She graduated from Florida

International University with a degree in dietetics and nutrition and trained at Cleveland Clinic Hospital and Palm Springs Hospital. She has worked as a cardiovascular nutrition educator for Miami Cardiac & Vascular Institute at Baptist Hospital and as a clinical educator for Berkeley Heartlab. She served as president of the Miami Dietetic Association from 1999 to 2000 and was voted the Greater Miami Dietitian of 2000 by the association. She also is a member of the American Diabetics Association. Join Cindy and Sabrina and a medical panel for the release of Experts in Pink en Español on Saturday, October 12, 5 p.m., at Books and Books, 265 Aragon Avenue, in Coral Gables. For more information, visit Experts in Pink on Facebook.

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BREAST CANCER PREVENTION: WHAT YOU NEED TO KNOW WHEN IT COMES TO BREAST CANCER PREVENTION, AWARENESS AND LIVING HEALTHY ARE AT THE TOP OF THE LIST.

“While age – getting older – is one of the top risk factors for breast cancer, there are a multitude of risk factors that we can act on,” said Jane Mendez, M.D., chief of breast surgery at Miami Cancer Institute. American Cancer Society (ACS) research says about 42 percent of cancer cases and 45 percent of cancer deaths in the United States are linked to modifiable risk factors – making them preventable. Like other cancers, breast cancer prevention has a lot to do with living a healthy lifestyle. Adopting specific healthy habits can extend a man’s life expectancy by 14 years and add an average of 12 years to women’s lives, according to a study published earlier this year in the American Heart Association journal Circulation. They include: • Eating a healthy diet • Getting regular exercise • Not smoking • Maintaining a healthy weight • Limiting alcohol In addition to following these healthy habits, doctors recommend a few other preventive measures to help reduce a person’s risk of breast cancer. ANNUAL MAMMOGRAMS STARTING AT AGE 40 Despite controversy in recent years about the age at which screening for breast cancer should begin, Baptist Health South Florida, along with the U.S. Preventive Services Task Force (USPSTF), the American Society of Breast Surgeons and the American College of Radiology (ACR), continues to support annual mammograms for women at average risk starting at age 40.

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September § October

One in six breast cancers occur in women age 40-49, according to the ACS. Mammograms save lives in all women, and specifically in women ages 40-45. When breast cancer is found early and in a localized state, the fiveyear survival rate is near 100 percent, according to the National Breast Center Foundation. “Although each person has their own risk factors and family history, I educate patients to start having mammograms done at age 40 and annually thereafter,” said Dr. Mendez. “And there’s no limit by which a lady should have her last mammogram providing she’s healthy and can have treatment if something is detected. There’s no age limit for mammography.” FAMILY HISTORY A patient’s ethnicity and personal and family history of cancer should also go into the equation to determine when a woman should start having screening mammograms, said Starr Mautner, M.D., a breast surgeon at Miami Cancer Institute. Physicians may decide to screen a woman earlier if a family member was diagnosed with breast cancer at an early age. For young women who do not meet criteria to start mammograms before the age of 40, Dr. Mautner stresses the importance of self-exam, familiarity with family history and general knowledge of breast cancer as steps they can take to start screening early. “It’s important that women of all ages – from teenagers and young adults to older women – have a general understanding of breast cancer, the signs and symptoms and what to do

if they feel something abnormal,” Dr. Mautner adds. “If a mass is found either by the patient or by her physician, it should be taken seriously and worked up with appropriate imaging and biopsied when warranted.” SCREENING GUIDELINES Here are breast cancer screening guidelines from the American Society of Breast Surgeons: Women age 25 or older should undergo formal risk assessment for breast cancer. Women with an average risk of breast cancer should initiate yearly screening mammography at age 40. Women with a higher-than-average risk of breast cancer should undergo yearly screening mammography and be offered yearly supplemental imaging; this screening should be initiated at a risk-based age. Screening mammography should cease when life expectancy is less than 10 years. MAMMOGRAMS SAVE LIVES. SCHEDULE YOUR MAMMOGRAM TODAY. When breast cancer is detected early, at a localized stage, the survival rate is 98 percent. To schedule an appointment, call 786-573-6000 in Miami-Dade or Broward, 305-4341588 in Monroe, 561-374-5300 in Palm Beach or visit BaptistHealth.net/ BreastHealth.

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JAIME L. SEPULVEDA, MD ON THE PROCESS OF

Informed Consent FOR GYNECOLOGIC

COSMETIC PROCEDURES By Bill Kress

or years, reconstructive surgeons have been using cosmetic procedures in the effort to restore function and appearance. But as the U.S. population grows healthier, the desire to reshape and enhance our physical appearance has lead to an increased demand for minimally invasive and surgical procedures. In fact, data just released by the American Society of Plastic Surgeons shows an increase of more than 250,000 cosmetic procedures over the previous year. The increased trend for cosmetic procedures has been observed in the last five years with a total of 17.7 million surgical and minimally invasive cosmetic procedures in 2018. As the popularity and widespread acceptance of cosmetic procedures grow, it comes as no surprise that the feasibility of improving our appearance is now expanding to the area of female genital enhancement â&#x20AC;&#x201C; a set of procedures known as vaginal rejuvenation. In 2015, nearly 9,000 women underwent labioplasty procedures to enhance the appearance of their external genitalia. Other procedures such as vaginal laxity reduction procedures, cosmetic treatments of the vulva, and clitoral hood reduction have seen similar increases. Understanding the options and types of surgery available can be daunting. As in all medical procedures a clear understanding of the goals of the procedure, clear communication with your surgeon, and realistic expectations are instrumental in achieving the goals of confidence and satisfaction.

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September Â§ October

Knowledge of the anatomy and meticulous surgical technique are the medical hallmark of all female reconstructive and cosmetic genital procedures. Having an educated dialogue at the time of consultation with your gynecological cosmetic surgeon is paramount in achieving realistic and fulfilling results. Inspire Health magazine recently sat down with Dr. Jaime L. Sepulveda, a leader in the field of Female Pelvic Surgery. Dr. Sepulveda holds a board certification in Obstetrics and Gynecology with a subspecialty certification in Female Pelvic Medicine & Reconstructive Surgery. His South Miami practice has focused in female genital surgery for over 25 years. Q. What tips can you share for patients before coming in for a consultation about a cosmetic gynecologic procedure? A. As a patient, you must be able to confidently convey to the surgeon the specific cosmetic issues and perceived problems you are experiencing. Your doctor, in turn, should listen to you and explain the options to address the source of your concerns. It is essential to have a communication based on a shared perspective. This means going through the external anatomy with the use of a mirror and point out the areas to be addressed. So, be prepared to point out which area you would like to have repaired or remodeled. The field of cosmetic gynecology has evolved greatly

over the last 10 years. There are well described procedures and techniques that fit with what you want to achieve. Expect to build an effective partnership in planning your procedure with an optimal outcome in mind. Q. So is it safe to say that positive patient outcomes depend on successful communication with the physician? A. Developing effective patient–physician communication requires skill in conducting patient-centered interviews. Physicians should converse in a caring, communicative fashion; and actively engage in shared decision making with patients. This approach applies to all disciplines in medicine and is particularly crucial in cosmetic gynecologic surgery. The beginning of the informed consent process in cosmetic gynecology requires for both the patient and physician to share information, express treatment preferences, and agree on a treatment plan. The conversation may require more than one encounter. Specifically for cosmetic gynecology a good outcome is measured by how much the final results agree with the expectations. Q. How does the conversation about results compare when talking about a reconstructive procedure vs. a cosmetic surgery? A. Reconstructive procedures outcomes are based on how the function is restored. Simply stated, reconstructive procedures to correct such conditions as the involuntary loss of urine or feces are considered “successful” when control is restored. In the case of vaginal prolapse, it is measured by the resolution of the feeling of a bulge. The way cosmetic outcomes are measured, is based on how satisfied a woman is with the appearance after the reshaping of the genitalia – as planned during the evaluation before surgery. One area in which a reconstructive and a cosmetic procedures come together is with regard to vaginoplasty, a vaginal repair for looseness. Q. It is well established that an informed consent should convey the goals and expectations of a cosmetic surgical procedure, as well as the commonly known risks and benefits. Yet, don’t most people think of “informed consent as just another form to sign in advance of a medical procedure? A. Well, if you fast-forward to the end of the dialogue between a patient and doctor, yes, you sign an informed-consent form. But there’s so much more that leads up to that moment. It truly is the basis of everything we do in medicine. Informed consent is a dynamic process, not like a contract with every single possible complication, risk, and benefit are spelled out. Instead, it should include what is relevant.

The interaction of conveying complex information to a woman in a way that is relevant, listening to what she desires to enhance, and then allowing for a transfer of will through surgery forms the basis of surgical care. Cosmetic procedures in gynecology empower a woman through a personal choice of self image. Dr. Sepulveda’s office is located at 6200 Sunset Drive, Suite 504. For information, call 305-669-6267 or visit www.miamiurogynecologycenter.com.

VAGINAL PROCEDURES: • • • • • •

Vaginoplasty Labiaplasty of the Labia Minora with reduction of excess Labiaplasty of the Labia Majora Perineoplasty Revision of unacceptable gynecological repairs Repair of obstetric lacerations

UROGYNECOLOGY • • • •

Non-mesh urinary leakage surgery Mid-urethral sling for urinary leakage Paravaginal repair Vaginal mesh complications

INSPIRE HEALTH

healthy body

STRATEGIES TO STAY HEALTHY AFTER

e s u a p o Men

It can be hard watching your body change as you age and go through menopause. But with just a few adjustments, it is possible to stay healthy and continue to live an active and rich life.

By Shannon Brown

CONSIDER BIOIDENTICAL HORMONES. Bioidentical hormones have gotten a lot of attention recently. Instead of hormone medications, bioidentical hormones are an exact match to the hormones produced by a woman’s body. Although there aren’t many long-term studies examining this treatment yet, it has been praised within the medical community eliminating some unpleasant side effects of typical hormone therapy, such as brain fog and low energy. Short-term studies have found they can reduce hot flashes and vaginal dryness. There is a slightly increased risk of breast cancer with hormone use. However, some doctors believe that since bioidentical hormones are chemically different than hormone therapy drugs, they may not cause this same risk.

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MEASURE WAIST CIRCUMFERENCE. Most research has found that menopause doesn’t cause weight gain, but rather, a redistribution of weight from other parts of the body to the abdomen. A recent study in the American Journal of Obstetrics and Gynecology confirmed this. Ananthan Ambikairajah, the lead study author, thinks this finding is important. “Central fat has been linked with dementia risk, and central fat is [also] linked with cardiovascular disease risk,” he said. Measuring your waist is a simple way to check your health. In general, a waist size of above 31 inches greatly increases your risk of chronic disease, and above 34.5 inches means a greatly increased risk.

September § October

EAT NUTRITIONALLY DENSE FOODS. As you age, your metabolism slows down and you need fewer calories, but still need the same amount of nutrients. Older adults sometimes even have trouble absorbing nutrients, due to issues such as low stomach acid. Focus on foods that have a high concentration of nutrients, aiming for a mix of fruits and vegetables, grains, low-fat dairy, lean protein, and a small amount of healthy fats. STAY SOCIAL. While there are many advertisements for computer games to maintain your brain health, one of the best things you can do for your brain is to stay social. Social connections may help preserve your memory, and people who are isolated also tend to be more depressed, use more medications and are

hospitalized more. Socializing at mealtimes is also a great strategy to maintain your weight. One study published in Public Health Nutrition found that the act of cooking meals at home, including planning, shopping and socializing while eating, led to increased odds of survival in elderly adults. MAINTAIN MUSCLE MASS. One of the most important changes that occurs in aging is the loss of muscle mass. Without a maintenance strategy, adults lose 3-5 percent of their body’s muscle mass every year after age 30. Maintaining muscle is crucial to keep your metabolism moving and keep your waist within a healthy range. Aim for two to four workouts per week, including a mix of resistance training, aerobic exercise and walking. Older adults sometimes even have trouble absorbing nutrients, due to issues such as low stomach acid.

ACORN SQUASH CAESAR SALAD By Crissie Mergogey

Serves 2 Time: 25 minutes

 Ingredients Dressing  2 Tbsp tahini  1 Tbsp hummus  1-2 Tbsp water, depending on desired consistency  1Tbsp ground flaxseed  1 Tsp Dijon mustard  1 Tsp lemon juice  ½ Tsp apple cider vinegar Salad  2 cups chopped spinach  2 cups chopped dinosaur or Tuscan kale  ½ acorn squash, peeled and chopped into 1-inch pieces  1 Tbsp olive oil  ¼ Tsp onion powder  ¼ Tsp garlic powder  ¼ Tsp turmeric  Salt and pepper to taste  1 avocado, chopped  1 Tbsp hemp seeds

 Directions  Make the dressing by whisking all ingredients in a small bowl until well combined.  In a medium bowl, mix ½ the dressing with the spinach and kale. Mix until the greens are well coated. Set aside in the fridge for the greens to soften.  Steam the chopped squash for 5 minutes. Transfer squash to a pan with the olive oil and add the onion powder, garlic powder, and turmeric. Cook for 5-10 minutes, stirring frequently until the squash is tender.  Add the squash to the greens and top with avocado, hemp seeds, and the remaining dressing.

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ENJOY BETTER HEALTH,

Live a Healthier Life!

Kara Burnstine, MSRD, LD/N, CDE – Your GO-TO Dietitian Kara Burnstine, Registered Dietitian and Certified Diabetes Educator, is your trusted advisor on your journey toward optimal nutrition. The founder of Nutrition Your Weigh Inc. in Miami, FL, Kara, offers nearly 20 years of experience in providing nutrition education and counseling to promote health and wellness. Whether your goal includes weight management, healthy eating, disease prevention, or to obtain a healthier lifestyle, Kara focuses on the “why” to get you to the “how.” There is no “one size fits all” when it comes to nutrition. Kara provides personalized nutrition instruction, allowing you to achieve success with realistic life changes; however, there’s more! Need to boost company morale and engagement with your staff? In addition to individualized counseling, NYW provides a variety of programs and workshops for community centers, hospitals and small businesses. NYW offers fun, interactive lunch and learns on trending nutrition topics, and engages staff with on-site cooking demos. Your team will also learn about Kara’s 21-day Clean Eating Program for those who want a “reboot.” Weekly meal plans, daily motivation and Facebook Live classes are also included in the program. We always find excuses to hide behind, so be STRONGER THAN YOUR EXCUSES! Call NYW today to turn barriers into opportunities.

One-on-One Sessions | Corporate Wellness | Diabetes Prevention Programs Grocery Store Tours | Nutrition Lunch and Learns Community Nutrition Workshops 24

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September § October

NUTRITION YOUR WEIGH | 305-984-6220 | NUTRITIONYOURWEIGHINC.COM

Spicy Creamy Corn Soup SUPER NATURAL INGREDIENTS: • 1 cup hot water • 4 fresh corn cobs • 1 garlic clove • 1 lime • ½ avocado • ¼ red onion • 1 jalapeño • ½ tsp. of cumin • ½ tsp. of chilli powder Garnish 1 Tbsp. chopped red onion 2 Tbsp. corn kernels 1 Tbsp. fresh chopped cilantro 1 small tomato (chopped)

SOUP PREPARATION: 1. Remove husk and shuck corn. Wash thoroughly. Use a knife to cut kernels from the cob. 2. Squeeze the juice from one lime. Measure out water. 3. Chop the onion into quarter-size pieces. 4. Peel the garlic clove. 5. Cut avocado in half. Remove pit and scoop out half of the flesh. 6. Finely chop the tomato. WHIP IT UP: 1. In a high-powered blender, add corn kernels (set aside some for garnish), avocado, onion, garlic and jalapeño. 2. Next, add the water, lime juice, cumin and chilli powder.

O-Gee Paint - Inspire.qxp_Layout 1 8/27/18 2:20 PM Page 1

3. Pulse on high until texture becomes creamy. Add additional water as needed to derive desired texture. 4. Garnish, serve and enjoy!

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United HomeCare:

FOCUSED ON FULFILLING T H E N E E D S O F T H E E L D E R LY By Bill Kress

It should come as no surprise that one of Miami-Dade County’s largest and most respected not-for-profit agencies, United HomeCare, is leading the charge in how this city cares for its aging population. Now celebrating 45 years, this “gentle giant” in the community, with more than 800 employees and volunteers providing 22,000 hours of care every week to 3,500 clients, has a significant presence here. Their mission of allowing seniors to age with dignity and respect in the comfort of their own home, however, goes well beyond benefiting seniors, the disabled, and their family caregivers. Turns out, this big-name organization also has a big voice. United HomeCare is turning up the volume by advocating for sustainable improvements in programs and services that will not only help meet the current demands

INSPIRE HEALTH

September § October

of this important sub population of our community, but also help South Florida – and the entire state – be a more welcoming place for new retirees. Inspire Health recently caught up with Carlos Martinez, president and CEO of United HomeCare. He had much insight to share on this front, such as the fact that most of the half million people over age 60 in the Miami-Dade region are living on low and fixed incomes. Martinez says older adults generally prefer to live in the comfort of their own home as they age, and United HomeCare’s programs are succeeding helping individuals to prevent or delay institutional care. He adds that on average home care saves older adults thousands of dollars annually. There’s also significant cost savings to Florida taxpayers as well. The cost of placing these same

adults in nursing homes typically costs tax payers millions of more dollars annually. It’s concerning to Martinez, that sustaining home-care services presents an uphill battle, as rising business costs outpace reimbursements paid by funding sources. Fixing this problem entails not only identifying new and innovative funding sources, but also will require a paradigm shift in seeing seniors as worthy of the investment. In other words, there are no quick fixes – and a lot of work to do. With the continuation of what he terms, the “senior tsunami,” fed by 10,000 retiring baby-boomers each day flooding the U.S. market, Martinez says his agency is finding it necessary to go beyond the comfort of “home” – to take their case into the halls of government, corporate board rooms, and even into local classrooms.

TA L K I N G W I T H C A R L O S M A R T I N E Z N E V E R G E T S O L D – S O L E T ’ S S E E W H A T H E ’ S G O T T O S A Y, F I R S T H A N D : IH: If a persistent devaluation of seniors in our society is an obstacle in making positive change, then perhaps instead of a paradigm shift what we need is a good a paradigm shove? Well, that’s an interesting way to put it. But clearly, we do need to be more aggressive in order to realistically manage the growing issues of aging in our communities, and to properly fund the programs and services seniors so sorely need and deserve. So yes, people need to stop this persistent “out-of-sight, out-of-mind” mentality when it comes to the aging. And, I believe we can do that if we re-frame our approach to addressing their needs as an “economic development” imperative. IH: So, explain this notion that seniors present an economic development opportunity. Look at it this way: Gone are the days when everyone in the Northeast would head straight to Florida to retire. We are no longer the only “sunshine state” in the country. Many other sunbelt states are now competing with us for the baby-boomers – and the dollars that come with them. So clearly, if we are going to attract these active retirees, we have to do a few things better than other states. Such as provide better access to healthcare and offer more affordable housing options. Right now, in South Florida, the elderly are using up to 50 percent of their income for housing. This means they are being forced daily to make decisions between paying rent, paying for medication, or buying food. It’s an endless and unsustainable cycle. And honestly, it’s unconscionable that something like this is happening today in America. We need to do better for our senior population. So, in Florida, several communities are having conversations to develop a dedicated funding source for senior services. The need for increased funding persists

in communities such as Miami-Dade; Broward; Palm Beach; Tampa; Orlando; Jacksonville; and in the Florida Panhandle as well. IH: What exactly would the dedicated funding source provide for? Topping the list is funding for transportation for seniors, better access to healthcare, affordable housing, and also enhanced access to cultural amenities. I mean, just because someone is aging, doesn't mean they stop liking art or music. Problem is, how will they trek all the way to downtown Miami, pay for an expensive ticket, and enjoy a show? And how do we make that affordable and available? With technology. We can pipe in Broadway shows, operas, and symphonies – right into the community rooms of assisted-living facilities, nursing homes, and senior communities. But we could also get corporate donors to provide the technology and sponsor the programming. We are strategizing in all directions. Q. So, part of your advocacy plan is to outreach to local businesses, too? Absolutely. We’re being much more vocal with many of the different chambers of commerce around town. We are educating them to open their eyes to this important subset of the greater Miami population, especially when they plan for their goals conferences. IH: So this is a major goal of United HomeCare going into its 45th year? Yes, it's a goal of ours. But I’d even go so far as saying it’s a personal crusade for me. And sometimes when you’re so strongly driven by mission, you start considering all kinds of out-

side-the-box ideas. For instance, how about modeling a non-traditional funding stream for senior services to be funded through a “Hemp Tax?” This way, we do not increase property or sales taxes but rather place a tax to be borne by the nascent Hemp industry, which could eventually become a significant funding stream. IH: What other innovative ideas are in development? We are working to engage our youth to get involved in older-adult issues. Because realistically, it is difficult – if not impossible – to take a bus load of seniors out for an eight-hour drive to Tallahassee, to advocate for themselves at the state capital. So why not enlist young adults to do it for them – and do so very effectively. These young people could say they are representing their grandparents and their parents – and rather convincingly suggest that legislators listen to them because, as young voters, they are going to be around and politically active for another 60 years! We also need to engage heavily with the business community. Aging and older-adult issues are not just a government concern. They’re a community concern. We need to have the private sector working with the public sector. We are all responsible to save for retirement and to take care of our parents. But it’s a multi-pronged approach. As a society, we cannot continue to be of the mind-set where we wait until we’re seniors and then look solely to the government and community-based agencies to magically take care of it all for us. It’s a new day.

ABOUT UNITED HOMECARE In 1974, a United Way pilot program, United HomeCare, aimed to help families care for their elderly and disabled relatives in the comfort of their own home. Since then, United HomeCare has stayed true to that mission as an independent organization – and now a United Way impact partner – by serving more than 3,500 older adults and disabled adults annually. INSPIRE HEALTH

weight loss

TIPS TO HELP

POWER UP

YOUR FAT BURNING

FURNACE

GET INSPIRED! Lose fat naturally by turning up your fat burning furnace without the use of harmful diet pills. Eat thermogenic foods like lean meats, fiber filled veggies and whole grains. Regularly enjoy a refreshing glass of lemon water or lemon tea, and keep your body adequately hydrated so it can properly burn fat. Follow these tips, live a healthy life and losing fat will happen naturally.

1. EXERCISE BOOSTS ENERGY LEVELS

THE POWER OF C

WATER WORKS

Water does not burn fat; however, if the body is going to burn fat and calories adequately, it needs to be properly hydrated to do so. Dehydration can slow the fat-burning process. Why? Well, your liver plays a vital role in metabolizing food. Your liver is also a handy helper to your kidneys; if you are dehydrated, you can put a strain on your kidneys, which causes your liver to kick in and support the kidneys. If your liver is busy performing other duties, it will not be able to do its job of metabolizing fat. When fat misses the opportunity to be used as fuel, it is stored in the body. Do your body a tremendous favor; always stay properly hydrated so that your body can readily use fat.

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September § October

Drinking lemon water is an easy, effective way to flush fat from the body.The secret lies in the vitamin C that lemons contain.Vitamin C actually helps the body process fat at a faster rate and stimulates the amino acid carnitine, which speeds up metabolism. Whether you prefer grapefruit juice or lemon water, taking advantage of the vitamin C found in these fruits it is a fantastic way to get fat moving naturally.

REV IT UP SMOOTHIE In a blender add the following ingredients: ● Juice squeezed from one large navel orange ● 1/2 frozen banana ● 1 cup of plain Greek yogurt ● 2 tbs ground flaxseed ● 1 tbs chia seeds (I use ground) ● 1 tbs wheat germ ● 1 cup of ice ● ¼ cup of water ● 1 packet of Stevia Calories: 250

If grocery shopping, homework, laundry, cooking and cleaning are on your daily to-do list, exercise is a must-do to get it all done with gusto. Regular exercise can improve endurance, stamina and muscle strength making daily activities a breeze.

2. TIME TO UNWIND

Exercise can be fun; it gives you the chance to unwind, relieving daily stressors. It is something you can do for yourself. Since many are more inclined to stick to an exercise program they actually enjoy doing, pick something you have fun doing. Choose an activity that fits your personality; if it burns calories, it will be effective.

3. IMPROVES MOOD

Exercise releases feel good hormones known as endorphins. Endorphins can make you smile while minimizing feelings of anxiety, stress, and depression. Many women even report that regular exercise helps improve their PMS and menopause symptoms.

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pets

Safety

FOR PETS By Kai Bragg

Make sure you securely strap in pets when riding in a car or fast moving boat.

hen you’re out for a day of fun and recreation, safety is always an important thing to consider. If you take your pets along for the fun, be sure to think of them too. Whether taking a walk, going for a car ride or spending time on the water, it’s up to us to keep our furry companions safe. If you go out for a walk, be sure to keep your pets close. Pets can easily stray into traffic, and using a leash is a great way to prevent them from getting injured. Using a leash also helps prevent them from chasing potentially dangerous animals. If you use a retractable leash, pay extra attention to what’s going on around you and your pets. A retractable leash can allow excited pets to bolt into dangerous situations. When riding in a car, be sure to strap your pets in. We wear seatbelts for a reason, and our pets need

INSPIRE HEALTH

September § October

them too. Seatbelts can make a huge difference in an accident, and can also help prevent your traveling companions from jumping out of moving vehicles. If you bring your animals on car rides, and especially if they ride in the open bed of a truck, make sure they are securely fastened. If you spend time on the water, whether swimming or boating, make sure your pets are protected. For weak swimmers, a PFD can be a huge benefit. Keeping unsure pets afloat, PFDs are a great way to introduce pets to water. Preventing the worry of injury from fatigue, they can also help older pets continue to enjoy a nice swim. If boating is your recreation of choice, be sure to secure your pets as you would in a car. If an animal jumps out of a boat traveling at higher speeds, they can be severely injured from impacting the water. Always provide your pets with an easy way to get out of the water. There are many op-

tions for attachable boat steps, ramps and lifts that will allow your tired pets to climb safely out of the water. Keeping your pets safe takes little extra time. Consider these basic things when you bring your pets along for the fun. Keep them out of traffic and safe from wild animals by using a leash. Make sure you securely strap in pets when riding in a car or fast-moving boat. Make use of a PFD for weak swimmers and always provide an easy way to get out of the water for swimming pets.

Keeping your pets safe takes little extra time.

With a passion for supporting the physical and mental health of the community for more than 20 years, Gables Optimal Health helps clients and patients find the perfect way to reach their peak potential in a natural and balanced way. Meet the experienced and passionate practitioners at Gables Optimal Health, each focusing on a specific holistic modality: ACUPUNCTURE Lissa Nirenberg DOM, FABORM treats patients of all ages in the areas of fertility, emotional issues and physical pain. REIKI Joan Nordhagen, certified with Japan, is one of the few Jikiden Reiki teachers and practitioners in South Florida. This Japanese energy healing method helps with illness and restores physical, mental, and emotional health.

CLINICAL THERMOGRAPHY Jennifer Kaufman, CCT, offers thermography breast and full body screenings; radiation free, compression free, painless; no direct contact. MASSAGE THERAPY Oneida Barisuck, LMT, specializes in deep tissue and prenatal massage.

STRESS RELIEF COUNSELOR Paty ‘Mariposa’ Hernandez uses complementary therapies to help release stress naturally including counseling, coaching, Reiki, and other energy healing techniques. REFLEXOLOGY Mary Susan Heydemann RN, LMT, aids the body in healing using reflex points in the feet and hands to reduce pain, restore function and movement, decrease fluid accumulation, improve circulation, and promote relaxation.

For information or to schedule an appointment, call 305-567-1973 or email us at info@gablesoptimalhealth.com. Also visit www.gablesoptimalhealth.com.

Gables Optimal Health.qxp_Layout 1 6/3/19 4:33 PM Page 1

The art of

healing Raise your vibration & uncover your optimal health naturally

RestoRe the mind | Rejuvenate the body | Replenish the soul Acupuncture Lissa Nirenberg, DOM

Massage Therapy Oneida Borisuck, LMT

Reﬂexology Mary Heydemann, LMT

Stress Release Therapist Paty Mariposa, MSW

Thermography Jennifer Kaufman, CCT

Jikiden Reiki Joan Nordhagen

195 GIRALDA AVE. CORAL GABLES, FL 33134 | 305.567.1973 | WWW.GABLESOPTIMALHEALTH.COM INSPIRE HEALTH

mighty kids

FINDING A BALANCE BETWEEN SCHOOL AND ACTIVITIES

your children’s schedule and see if they have some time for unstructured play. Make sure that your family has time to By Elizabeth Madrie Hardin spend together. Family meals are also important, so ensure he average you have time to sit down A HEALTHY BALANCE American child’s for dinner together, at least a Children can become day doesn’t end overscheduled which can lead few times per week. Work in when school enough time for homework to stress. The key is finding lets out. About and plenty of sleep. a healthy balance between 42 percent of school-aged school and extracurricular children play sports, 28 perKNOWING WHEN TO activities. How do parents cent are active in clubs, and CUT BACK know how many activities 30 percent take lessons after their child should take part in? Watch your child for school. These extracurricular When it comes to sports, try cues. Joan Grayson-Cohen activities are beneficial. Learn- to limit it to one sport per of Jewish Family Services ing to work and play together season. Remember that most warned that children who with other children hones make excuses about not after school sports involve skills that school may not. A attending activities may be both practices and games 2015 study published in the overscheduled. If they can every week. The same goes American Journal of Public never find their shin guards for music lessons. Your child Health highlights the imporbefore soccer practice or if might only attend lessons tance of strong social and one afternoon per week, but they are happy when practice emotional skills. The study is canceled, they might be musicians need to practice. claimed that these skills are ready for a break. Also, watch There is no “magic number” better indicators of a child’s for a drop in grades, an inabilof activities that is best for future academic and career children though. Every family ity to entertain themselves success than cognitive skills. and fatigue. is different. Take a look at

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September § October

Watch for a drop in grades, an inability to entertain themselves and fatigue

LETTING CHILDREN CHOOSE There may be activities that you don’t want your children to quit. Psychiatrist Alvin Rosenfeld advised parents to categorize extracurriculars as required (like religious school) or optional. Let the child choose from the optional category. Another good rule is to require them to finish out the year or the season and then decide whether to take the activity up again next time.

Julio Martinez PT, DPT

Lucy Barnett PT/Co-Owner

William Gutierrez Owner, PT OCS,ATC,CSCS

Lauren Palmero PT, DPT

Vincent Ortiz PTA

SPORTS AND ORTHOPEDIC PHYSICAL THERAPY ESTABLISHED IN 2006 WHO WE ARE

WHAT WE DO

• Our Team can help you achieve your goals • 90+ years combined experience • Schools attended: University of Miami, Miami-Dade College, and Florida International University • Miami Natives • English, Spanish & French Spoken

• Individually focused attention to your needs - one on one - personalized • General Physical Therapy • Orthopedic Physical Therapy • Sports Physical Therapy • Sports Training/Strength & Conditioning • Sprains & Strains • Wellness Programs

8603 South Dixie Hwy Suite 308 Miami, FL 33156 305-661-1441 info@dadephysicaltherapy.com MONDAY - FRIDAY 8AM - 7PM | MOST INSURANCES ACCEPTED INSPIRE HEALTH

feature

FUN FALL AND HALLOWEEN PUNS to share wi th You r

Kids

By Emily Koelsch

all is one of the best times of year full of events, cooler days and vibrant colors of changing leaves. The season is particularly fun for kids visiting pumpkin patches, preparing Halloween costumes, picking apples and navigating corn mazes. It’s a great time to get outdoors and experience some special activities with your kids.

While you’re enjoying the season, have some extra fun with creative and seasonal word play. Here are a few of our favorite puns (some might argue a few of our worst) to get you started: • Make sure that you remind your kids how GOURDgeous this time of year is. • While you’re outside enjoying the foliage, let them know that you hope this time LEAVES them feeling inspired.

• It really is the perfect time to let kids know that you beLEAF in them and that you think they’re SPOOKtacular. • Are you having trouble convincing them to pick apples at the orchard? If so, encourage them to at least conCIDER it. • Perhaps they need help fixing a broken Jack-olantern? Easy, just use a

pumpkin patch. • It’s always good to incorporate some math into your activities, so see if they can calculate the ratio of a pumpkin’s circumference to its diameter. Obviously, the answer is Pumpkin Pi. • Do you need help coming up with a cosTOMB? How about being a mummy? • Speaking of mummies, do your kids know what kind of music they like? Mostly Wrap. • Or do they know why the ghost wouldn’t dance at the Halloween party? He had no BODY to dance with.

Despite some of our CORNy jokes, we hope you have an aMAIZEing season with your family. And in all seriousness, we hope you and your family enjoy these fall jokes and have fun trying to come up with a few of your own. Puns or no puns, take advantage of this wonderful season to enjoy some quality time together.

The season is kids particularly fun for g as they enjoy visitin ing ar ep pumpkin patches, pr Halloween costumes

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Back-to-School with Asthma & Allergy Associates of Florida By Bill Kress For kids, parents, and even teachers, “back to school” means adjusting to an entirely new routine. But for those who suffer food allergies or are more severely affected by the flu due to pre-existing respiratory issues, the fall season also brings with it some serious risks. “There’s lots of excitement in the air, seeing friends again and learning new things, but there are other big issues to consider this time of year,” says Rolando A. Nuñez, M.D. “Especially if there are food allergies present.” On staff with Asthma

and Allergy Associates of Florida since 2011, Dr. Nuñez focuses on the prevention, diagnosis, and treatment of immune system problems such as allergies, asthma, and certain immune deficiency disorders. He warns that, in the school setting, there is a potentially greater risk of exposure. For some kids, these accidental exposures to foods such as peanuts could lead to a serious – even life threatening – allergic reaction. The good news is, due to huge increase in such instances, people are now more aware of food allergies. More awareness means less risk of exposure. The thing about food allergies is no one ever has an anaphylactic reaction on

purpose. “Every single time it happens, it is an accident. You can tell someone you are allergic to a particular food, they forget, and accidentally give you something with that item in it,” says Dr. Nuñez. Sometimes, exposure to an allergen can lead to a life-threatening condition called anaphylaxis. This severe reaction happens when an over-release of chemicals puts the person into shock. “All that said, this is actually a good a time to be allergic to foods, because finally there’s possible treatment in the pipeline,” says Dr. Nuñez The doctor is referring to two products presently being reviewed by the Food and Drug Administration promising to desensitize people to foods

such as peanuts. The other common issue this time of year is related to influenza – the flu. When patients with respiratory conditions like asthma or COPD get sick with flu, its symptoms are typically much more severe. As a result, Dr. Nuñez is emphasizing the importance of the flu vaccine for his patients. “Although it does not provide 100 percent protection, a vaccine does reduce your risk of getting influenza, and if you get it, it will less severe,” he says. “It’s your choice but I strongly recommend anyone with a history of any asthma or respiratory illness consider this important tool that is available to you.”

Dr. Nuñez practices at Asthma and Allergy Associates of Florida, located at 7800 SW 87 Ave., C-340, Miami, FL 33173. For information or to make an appointment, call 305-595-0109 or visit www.allergyweb.com.

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REASONS GREEN DENTISTRY IS GAINING POPULARITY By Dr. Nammy Patel, DDS

For a growing number of patients, a trip to the dentist isn’t what it used to be– and that’s how they want it.

ather than just a routine “drill-andfill” for a cavity, they may receive a head massage, meditative advice and diet suggestions that would seem more befitting a gastroenterologist. What they won’t receive are traditional amalgam fillings– about 50 percent of which are composed of mercury, which has been associated with numerous health issues

and is considered an environmental hazard. This emerging branch of dentistry–which dental professionals say is largely patient-driven–is called “holistic” or “holistic biological.” Holistic dentists believe that poor oral health leads to poor physical health. They perform traditional procedures but consider the whole body–diet, lifestyle, emotional health–when treating teeth.

They also focus on using what they consider to be safer materials. “It’s the opposite of common dental culture, which is simply ‘drill and fill,’ ” says Dr. Nammy Patel, DDS (www. sfgreendentist.com), author of Age With Style:Your Guide To A Youthful Smile & Healthy Living. “Holistic dentistry is looking at and addressing the underlying causes for gum disease and cavities; for example, is it your diet, hormonal changes, or acid reflux? “For many years in the dental profession, it was assumed that your oral health had only a tangential effect on your overall health. We now know better.”

drawn-out procedures that can hurt overall well-being,” Dr. Patel says. “That doesn’t mean sacrificing high-tech treatments for disease. Laser treatments for gum disease and cleaning are one example of minimally-invasive. The latter does a great job of destroying bacteria that are the biggest danger to your oral health. Air abrasion and ozone therapy are other effective minimally-invasive procedures. Biocompatible and non-toxic materials. Holistic dentists will remove amalgam (mercury) fillings and favor dental appliances made from more natural substances. “A traditional approach to dentistry often uses mercury fillings or crowns and other Dr. Patel provides five harmful materials when treatreasons holistic dentistry is ing dental issues.” trending up as a treatment  Alternatives to root canals. approach by patients:  Focus on the whole body Dr. Patel says holistic dentists and root cause. Holistic den- are more likely to look at tistry looks beyond symptoms alternatives, such as herbs, laser to find root causes for dental therapy, or extractions.  Balances cosmetics and issues while expanding methfunction. “Missing, damaged, or ods of preventive care. crooked teeth can make you  Minimally-invasive feel self-conscious and affect treatments. “The focus is your quality of life. ” on helping patients avoid unnecessary, painful and

n and Air abrasio are py ozone thera allyim in effective m edures. oc invasive pr

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For example, Humana.com offers members a variety of tools, including: • Physician Finder Plus: Allows members to search for doctors by coverage and network • Humana MyChoice Tool: Allows you to search online and compare doctors, hospitals, and outpatient facilities so you can understand the costs surrounding many medical procedures

The Importance of Having a Primary Care Physician According to a national survey conducted by Esquire magazine in April 2011, about half of men ages 18 to 50 don’t have a primary care physician, and one third of men haven’t had a checkup in more than a year . It’s important for both men and women to develop and maintain a relationship with a primary care physician. A primary care physician cares for patients of any age. You may often hear people refer to them as a PCP or primary care doctor. He or she can assess and treat a wide range of conditions, and refers patients with more serious conditions to specialists or other healthcare facilities for more intensive care. One of the differentiating factors of a primary care physician from most other specialties is that they focus on relationships: the doctor knows the patient well enough to make informed decisions about care, and the patient feels comfortable enough to ask questions. Primary care physicians are still important – especially in this digital age. According to the Pew Internet and American Life Project, eight in 10 Americans turn to the Internet to look for health information. While looking online may not hurt, it’s important to see your primary care physician for a proper diagnosis and avoid unfounded anxiety about one’s wellness due to information found online.

The Importance of Regular Visits with Your PCP The old adage “an ounce of prevention is worth a pound of cure” holds true with your primary care physician. One of the most important things you can do for your health is to have a yearly physical. Under the Affordable Care Act, if you have health insurance or have Medicare, you are eligible for a free annual “wellness” visit. A thorough exam allows your primary care physician to pick up on a variety of illnesses and can catch potentially devastating diseases early on. Your doctor can also review your current health and helps set up a plan for improving it, by creating diet and exercise goals, as well as having scheduling preventive services like flu shots and cancer screenings.

How to Choose the Right Primary Care Physician for You Sometimes the best way to find a good primary care physician is to ask friends and families for recommendations. If you are new to an area and do not have a network of friends in the community, find a hospital with an excellent reputation and visit its website or call its physician referral line to get the names of some physicians who attend there. You can also visit your health plans website to see if they have any tools or resources to help you make your decision.

Check the physicians’ credentials and certifications on sites such as the American Board of Medical Specialties. If you want to meet the primary care physician to gauge your comfort level, it’s wise to set up an interview with the doctor to get a feel for their personality.

Who Qualifies as a Primary Care Physician? There are 24 specialties in medicine but typically only three specialties qualify as PCPs : • Family Practice or General Practice: A family practitioner is qualified to care for the entire family. A family practitioner can be board-certified and also have training in a variety of subjects, including Obstetrics and Gynecology, Pediatrics, Internal Medicine and Psychiatry. • Internal Medicine: An internist can diagnose and treat disease with medicine. An internist is not a surgeon. There are several sub-specialties an internist can have, including: specializing in a particular organ, like the lungs or the kidneys, a particular disease, like diabetes, or a particular age group, like the elderly. • Pediatrics: A pediatrician specializes in the overall well-being of children. Most pediatricians treat children from birth until adolescence or about 14 years old. Pediatricians can have subspecialties such as surgery or pediatric cardiology. Having a primary care physician and maintaining a relationship with them is key to your health.

Editor’s Note: This article was submitted by Humana. To learn more about the Primary Care Physicians in Humana’s Medicare Advantage plan networks call 1-800-345-8017. Sources 1 http://yourlife.usatoday.com/health/medical/menshealth/story/2011/03/Study-Half-of-men-dont-go-to-the-doctor/45453184/1 2 http://www.ivillage.com/how-find-best-primary-care-provider-you/4-a-157016 3 http://www.ehealthinsurance.com/individual-health-insurance/resources/choosing-pcp/

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September § October

Humana’s affordable Medicare Advantage plans connect you with the care you deserve.

Our doctors use some of the most sophisticated tools. Their ears. You deserve a Medicare Advantage plan that helps you find great care. Care that’s delivered by a doctor who listens to your thoughts and understands your lifestyle. Humana’s Medicare Advantage plan networks give you access to doctors, nurses and care teams that treat you proactively and aim to not keep you waiting. Ponce MediClub is in the Humana network to help you move forward with confidence.

Treating you how you should be treated. Learn more at HealthThatCares.com/Florida or call to speak with a licensed Humana sales agent. 844-663-8083 (TTY: 711) 8 a.m. - 8 p.m., Monday - Friday Humana is a Medicare Advantage HMO, PPO and PFFS organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. Other providers are available in our network. Provider may also contract with other plan sponsors. Important! At Humana, it is important you are treated fairly. Humana Inc. and its subsidiaries comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. ATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Call 1-877-320-1235 (TTY: 711). Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-320-1235 (TTY: 711). 繁體中文 (Chinese): 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-877-320-1235 (TTY：711) 。 Y0040_GHHKFUJEN_C INSPIRE HEALTH

Can I Lower My Risk of Breast Cancer? Apart from skin cancers, breast cancer is the most common cancer in women. In fact, about 271,270 women are expected to be diagnosed with invasive breast cancer in 2019 in the US. Unfortunately, there is no sure way to prevent it. Many risk factors are beyond your control, such as being female and getting older. But, other risk factors can be changed and may lower your risk. Here are some: Get to and stay at a healthy weight: Both increased body weight and weight gain as an adult are linked with a higher risk of breast cancer after menopause. The American Cancer Society recommends you stay at a healthy weight throughout your life and avoid excess weight gain by balancing your food intake with physical activity. Be physically active: Moderate to vigorous physical activity is linked with lower breast cancer risk. The American Cancer Society recommends that adults get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week. Limit or avoid alcohol: Alcohol consumption also increases risk of breast cancer. Even low levels of alcohol intake have been linked with an increase in risk. The American Cancer Society recommends that women who drink have

no more than 1 alcoholic drink a day. A drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Other factors that might lower risk: Women who choose to breastfeed for at least several months may also get an added benefit of reducing their breast cancer risk. Using hormone therapy after menopause can increase your risk of breast cancer. To avoid this, talk to your health care provider about non-hormonal options to treat menopausal symptoms. For women who are known to be at increased risk for breast cancer, it’s recommended to have more frequent doctor visits and tests to look for breast cancer. While this approach doesn’t lower breast cancer risk, it might help find it early, when it’s likely to be easier to treat. The American Cancer Society is committed to educating the community on how to prevent and early detect cancer. Its Making Strides Against Breast Cancer walks raise awareness and funds to save lives from breast cancer. Each event brings people together to make a difference for everyone who has been touched by breast cancer. The walks raise money to fund innovative research, provide free information and support, and to help people reduce their breast cancer risk or find it early when it's most treatable.

By walking in an event, raising funds, volunteering or forming a team, you're helping the American Cancer Society save lives. You can join the Making Strides Against Breast Cancer walk in Miami on Saturday, October 26 at 8:00 a.m. at Marlins Park. For more information visit www.makingstrideswalk.org/miamifl

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If you or your loved ones suffer from anxiety or depression, we have the latest FDA approved treatment. Ask us about TMS today.

Our team of highly skilled professionals work individually and collectively to provide superior service in the ongoing commitment to fulďŹ ll the needs of our clients. We evaluate all types of neurological issues, specialize in Stroke, Parkinsonâ&#x20AC;&#x2122;s Disease, Radiculopathies, Dementia, Headache and Peripheral Nerve Damage. We also evaluate and treat severe major depression and anxiety with our state of the art technology of Neuro-star Transcranial Magnetic Stimulation (TMS), for patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode. We offer IV Vitamins and Mineral Therapy, Botox for Migraine headaches performed by our Neurologist.

7374 SW 93 Ave, Suite 201 Miami, FL 33173 (786) 753-7467 sunsetneurological.com sunsetneurologicalgroup@yahoo.com

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super food

s d n o m Al

trial. All of this only the tip of the iceberg of health benefits associated with eating almonds. Now that we know adding almonds to our diet is advantageous to our health, how can we incorporate this super food into our diets? Almonds make a great snack on their own and you can add chopped almonds in your salads or homemade pizza for extra crunch. Try using almond flour and milk in your baking recipes, too! Enjoy almonds roasted, raw, soaked, lightly salted or sweetened. Keep them in your pantry, purse, car and office for a quick and easily accessible super food snack. Almond milk is a creamy and delicious treat for regulation. According to vegans and dairy consumers a 2018 study published alike! Store-bought almond in the journal Nutrients, milk contains ingredients almonds reduce levels of your body doesn’t need. harmful LDL cholesterol Luckily, plant-based milks and help maintain healthy are easy to make at home. levels of good HDL choles- You’ll need a blender, water, terol. The fiber in almonds a nut milk bag, almonds not only helps suppress ap- and a jar. No nut milk bag? petite and regulate blood Use a sieve, a cheesecloth sugar levels, it also feeds or an old (clean!) T-shirt. your healthy gut flora! Soak your almonds in water This super food also overnight before blending helps manage type 2 them in four to five cups diabetes. A randomized of water and filter the pulp controlled study published from the milk. That’s it! The in the journal Metabolism milk will stay fresh for three had patients with type 2 to four days in the fridge. diabetes replace 20 perDon’t fret if you’ve made cent of their daily caloric extra, it will stay fresh in intake with almonds. The the freezer for up to one results show that parmonth. Drooling yet? Grab ticipants saw benefits to a handful of almonds and glycemic control and lipid know you’re doing someprofiles after the 12 week thing good for your body.

THE SUPER POWER OF

By Kristy Podruchny

ave you ever looked at an almond and wondered how nature packed so much potential into such a tiny food? Almonds are powerful seeds that contain vitamins, minerals, healthy fatty acids

and antioxidants. They’re a great source of polyphenols, magnesium, potassium, zinc and vitamin E just to name a few. Quite the super food! Almonds are allies in areas including cardiovascular health, maintaining healthy gut flora, and blood sugar

The fiber in almonds not on helps suppressly appetite and regulate blood sugar levels, also feeds youit healthy gut fl r ora!

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ENCOMPASS HEALTH REHABILITATION HOSPITAL OF MIAMI

Rich History Shapes a Bright Future

n October 2018, HealthSouth Rehabilitation Center of Miami changed its name to Encompass Health Rehabilitation Hospital of Miami. This name change is an important milestone in our journey to deliver connected care and superior outcomes. The transition to the Encompass Health name did not change the services or care that our patients experience—we remain committed to delivering high-quality, cost-effective care and superior outcomes. It does, however, reflect our expanding national footprint and strategy to provide high-quality, coordinated care through our inpatient rehabilitation hospitals and home health and hospice agencies. We are proud to offer patient experiences that reap the benefits of collaboration, including improved care protocols and communication. At the heart of the hospital are the Encompass Health team members, who take a comprehensive approach to providing the best therapy, nursing care and patient, family and community education. Encompass Health was formed in 1984 when HealthSouth Corporation bought Old Cutler Manor, a nursing home comprised of 60 long-termcare beds and 120 skilled nursing beds. Not unlike many businesses in Cutler Bay, Encompass Health has

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September § October

gone through many changes over the years—surviving hurricanes, economic upheavals and population growth as well as the ever-changing aspects of healthcare delivery. The changing face of South Florida makes our location easily accessible to clients from the Florida Keys to North Miami Beach. In 1989, renovations transformed our facility into a stand-alone acute rehabilitation hospital. In 1992, Hurricane Andrew damaged the buildings, prompting further renovations and rebuilding to meet the new and stricter Miami-Dade County building codes. From 1997 to 2000, HealthSouth Corporation partnered with the government of Puerto Rico to create a rehabilitation channel for catastrophic cases, such as brain injury, gunshot wounds, near drownings and motor vehicle accidents, and a framework for the development of a rehabilitation hospital in Puerto Rico.

During this time, HealthSouth grew and flourished as the facility housed many patients and their families from Puerto Rico. Over the years, our hospital has maintained a Certificate of Distinction by The Joint Commission as a Disease-Specific Stroke Rehabilitation Program and Disease-Specific Hip Fracture Rehabilitation Program. Our latest recertification occurred in September 2018. Our hospital also met the stringent criteria to be awarded the status of a Stroke Center of Excellence for 2018. We welcome new patients and their family members as well as the community to visit and tour the hospital, meet our therapists and discover why Encompass Health Rehabilitation Hospital of Miami is the best choice for rehabilitation. We thank the community for its unwavering support over the years.

Encompass Health Rehabilitation Center of Miami is located at 20601 Old Cutler Road. For more information, call 305-251-3800 or visit www.emcompasshealth.com.

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natural beauty

NATURAL

Dandruff Remedies By Crissie Mergogey

espite the negative social stigma about dandruff, at least 50 percent of people struggle with a flaky scalp. So, if you have dandruff, you are not alone. An itchy, flaky scalp is a widespread issue caused by a variety of factors ranging from diet and gut health to genetics. It may sound gross, but dandruff is usually caused by a type of fungus. No need to freak out! It is possible to get rid of it. Most dandruff shampoos contain harsh chemicals to kill the fungus. Luckily, there are plenty of natural remedies to fight dandruff!

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To use essential oils on the scalp, add a few drops to 2 tablespoons of a carrier oil (like coconut oil), massage it on to the scalp, let it sit for 10 minutes, then wash your hair normally.  RAW HONEY If you think putting honey in your hair is a bad idea, think again. Raw or Manuka honey is a great natural remedy for soothing the scalp and fighting dandruff-causing microbes. Plus, honey is full of nutrients that will condition your hair! Raw honey is pretty thick stuff, so it is best to dilute it with warm water first. Try a mixture of 2 tablespoons honey with 2/3 cups of warm water. To make it more effective, add essential oils to the mix!

September § October

 APPLE CIDER VINEGAR The malic and acetic acids in apple cider vinegar work together to shed off excess skin cells and fight microbes that cause dandruff. For best results, find a vinegar with “the mother.” Mix 1/4 cup apple cider vinegar with 1/4 cup water and coat your scalp with the mixture. Wash it off after an hour. Tea tree o il is so powerful, only a tin y amount is needed to see positiv e results f or dandruff .

PROBIOTICS & A HEALTHY DIET You’ve probably heard that eating probiotics can improve digestive health, but did you know they are good for skin health too? Skin is covered in microbes, and most of them are good to keep around. Dandruff occurs when a certain fungus takes over the good microbes. To keep the good microbes healthy, add more probiotics and prebiotics to your diet. Probiotics are good microbes that are found in kombucha, kimchi, and sauerkraut. Prebiotics are foods that feed the good bacteria, which include vegetables, fruits, whole grains, nuts and seeds.

YOUR SOUL

 ESSENTIAL OILS  Tea tree oil is a powerful anti-fungal. It is so powerful that only a tiny amount is needed to see positive results for dandruff.  Frankincense oil is another effective anti-fungal for dandruff. It has also been

shown to fight candida and staph microbes, which may also contribute to an irritated scalp.  Lavender oil can soothe an itchy scalp while also fighting bacteria and fungi.

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WEST COAST UNIVERSITY STUDENTS ARE INVOLVED IN THE

Well-Being

As leaders in patient care, nurses are primarily concerned with the well-being and health of those around them. They’re uniquely tasked with promoting a lifestyle of wellness - both at work and in their neighborhoods. Many choose to serve as health advocates by volunteering and fostering welfare in their local community, with more than 80 percent of nurses volunteering either formally or informally to promote a culture of health in their communities. (1) In the South Florida community, West Coast University (WCU) sets volunteering in motion so their students have opportunities to serve the neighborhoods their patients call home. Not only does WCU set up events for students to get first-hand experience, but the university itself is also dedicated to serving the community through healthcare education. The most critical factor of nursing education is mastering the business of caring. In addition to WCU’s dedication to providing students with hands-on training and advanced technology, the University understands that skills learned through volunteering will transfer directly to the workforce. By encouraging students to participate in service events throughout South Florida, WCU observes twofold benefits: crucial experience

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OF THE COMMUNITY

for their nursing students and continued improvement of community health. “Through volunteering, nursing students learn to become ambassadors for the nursing profession, advance the mission of caring, and expand their professional network for their future careers,” said Farrah Jerome, Career Services Specialist at WCU Miami. “Regardless of what role they play, WCU Miami nursing students provide community assistance with passion, dignity, and respect.” WCU nursing students proudly take on many roles in South Florida, from serving as ambassadors of the profession for high school students to providing expertise on specialized topics in the homeless community. For example, healthcare resources are desperately in demand for local veterans. WCU Miami students have combatted this by providing screenings for blood pressure, blood glucose levels and health teachings on different health issues in the annual “Community and Veteran Stand Down” event. “As nurses, there is an inherent trait within us to care for others,” said Kristina Bryant, WCU Miami alumna. “I was fortunate enough to participate in WCU’s Community and Veteran Stand Down event where we were able to provide basic assessments to veterans in need.”

September § October

In addition, WCU Miami partners with Camillus House, a local homeless shelter, to offer screening and basic health assessments that help stabilize diabetes and hypertension at their community health fair to hundreds of South Floridians. West Coast University Miami also gives back to the youth by organizing its “A Day in the Life of a Nurse” event to expose local high school students to nursing career possibilities. The students experience several different labs available at WCU Miami, including the newest technologically

advanced simulator in the skills lab, the birthing suite, and the BIOPAC science lab. Nursing students have the opportunity to make a meaningful impact by setting examples of successful healthcare professionals and fostering a passion for care in their community. “Volunteering through WCU Miami has furthered my ability to tailor education and advocacy for each individual and community,” said Bryant. “This experience has strengthened my desire to provide health care and education that any patient can understand and feel comfortable receiving.”

West Coast University is institutionally accredited by the WASC Senior College and University Commission (WSCUC) - 985 Atlantic Avenue, #100, Alameda, CA 94501, 510-748-9001,www.wascsenior.org. West Coast University's Nursing programs are programmatically accredited by the Commission on Collegiate Nursing Education (CCNE), 655 K Street, Suite 750, Washington DC 20001, (202) 887-6791, http://www.aacnnursing.org/CCNE. WCU does not guarantee employment. The opinion is the individual’s sole opinion and not necessarily representative of that of the school, any instructor, or any student. (1)- McCollum, Meriel, et al. “Nurses Improve Their Communities’ Health Where They Live, Learn, Work, and Play.” Policy, Politics, & Nursing Practice, vol. 18, no. 1, Feb. 2017, pp. 7–16, doi:10.1177/1527154417698142. https://journals.sagepub.com/doi/10.1177/1527154417698142

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westcoastuniversity.edu 1 Students that have been conditionally accepted will be required to meet all admission requirements in order to advance into Nursing core courses. All students must progress normally and successfully pass their courses in order to advance into Nursing core courses. Students should review their program specific requirements located in the University Catalog for more information. 2 West Coast University is institutionally accredited by WASC Senior College and University Commission (WSCUC), 985 Atlantic Avenue, #100, Alameda, California 94501, 510-748-9001, www.wascsenior.org 3 West Coast University’s Nursing programs are also programmatically accredited by the Commission on Collegiate Nursing Education (CCNE), 655 K Street, Suite 750, Washington DC 20001, (202) 887-6791, www.aacn.nche.edu/CCNE/reports/accprog.asp. WCU cannot guarantee employment.

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eat fresh

Modemrnon Sal

HEALTHY FISH WITH A DARK SIDE By Kristy Podruchny

Fresh Salmon is a buttery pink meat that happens to be one of the best sources of omega-3 fatty acids like DHA and EPA. It is a high protein, low calorie food that is a great source of vitamin D, B12 and selenium to name a few. What’s not to love?

almon also contains a pigment called astaxanthin (ASX) that, according to a study from Nutrients, has “potent antiwrinkle and antioxidant effects” and “may prevent UV-induced immunosuppression.” Another study from Molecular Nutrition and Food Research found that ASX improves brain health and spatial memory! The high omega-3 fatty acid content in salmon is what gives this fish much of its reputation for being a healthy food. These are essential fatty acids that can’t be produced in our bodies and must be eaten. This high omega-3 content means that digging into salmon on a regular basis could also help manage symptoms of ADHD. Researchers who published a study in Journal of Lipids concluded “omega-3/6 fatty acids offer great promise as a suitable adjunctive therapy for ADHD.” According to the Washington State Department of Health (WSDH), DHA and EPA help reduce inflammation in our bodies and are import-

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September § October

ant for heart and brain health. The amount of omega-3 fatty acids present in salmon depends on what the fish has been eating. Farmed salmon are fed a specific diet meant to keep those amounts even with, or higher than wild salmon. If you’re trying to avoid soy or GMO’s, keep in mind that farmed salmon are often fed fishmeal, grains and oilseeds that are often soy-derived. The highly controversial genetically engineered salmon are also set to hit the market in 2020. Did you know that eating salmon may help prevent and treat certain types of cancer? According to the National Institutes of Health, “some studies have shown associations between higher intakes and/or blood levels of omega-3s and a decreased risk of certain cancers, including breast and colorectal cancers.” A study of women aged 50-76 cited by the NIH found that women who took fish oil supplements had “32 percent lower risk of breast cancer after a mean of six years than those who did not take fish oil.” Overfishing and environmental

The amou omega-3 nt of acids pres fatty salmon d ent in e what the fipends on s been eatinh has g. pollutants like PCB’s and POP’s have given the farmed version of this flavorful and nourishing fish a dark side. The pollutants come from industrial chemical waste, pesticides and pharmaceuticals and are stored and accumulate in fatty tissue. A study published in BMC fed mice POP’s sourced from farmed Atlantic salmon and discovered that POP’s can increase the risk of developing type 2 diabetes. A similar study published in the International Journal of Environmental Research and Public Health noted that “POPs via salmon oil consumption induced abdominal obesity, dyslipidemia, glucose intolerance, insulin resistance and hepatic steatosis.” This is something to keep in mind while you’re seeking out the perfect salmon fillet. Next time you’re out grocery shopping, take time to glance at the label to make sure you’re buying sustainably harvested wild salmon.

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Williamson Buick GMC is a J.D. Power 2019 Dealer of Excellence for the Customer Sales Experience.

J.D. Power 2019 Dealer of Excellence Program recognition is based on achievement of high scores from automotive manufacturer customer research and completion of an in-dealership best practices verification visit. For more information, visit jdpower.com/DOE

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September ยง October

Williamson Automotive 7815 SW 104TH St. Miami, FL WilliamsonAutomotiveGroup.com

Sales 1-877-228-6093 Mon.-Fri. 9am - 8pm Sat. 9am - 6pm Sun. 11am - 5pm

Service 1-866-597-6015 Mon.-Fri. 7:30am - 7pm Sat. 8am - 5pm Sun. Closed

The first couple weeks for her at Easterseals were a little difficult, but ultimately she adapted – which was nothing short of miraculous. Now, when we drop her off, my mother is so pleased to know there are people waiting for her there – and so happy to see her every day. They make her feel like a princess.

A Family’s Journey with Dementia Leads to Easterseals By Myriam De La Asuncion, Caregiver When my family and I learned of my mother’s Alzheimer’s diagnosis five years ago, we were devastated.The idea of our mom suffering from symptoms of dementia and memory loss was almost too much to bear. Even worse was fathoming the prospect of placing our mother into a facility that looked like so many we’ve seen tucked into shopping centers around the area, offering minimal staff supervision and much worse. I remember sitting in one of those parking lots in tears, with my sister on the phone, saying ‘I can’t imagine putting mom in a place like this.’ We felt an obligation out of love to give her the right environment with the right people to care for her because, after all, she raised us with so much love. Then we heard about Easterseals. Aside from their historic mission of taking care of children with special needs, we learned they also care for people with Alzheimer’s. Upon taking an onsite tour, the staff took my mom aside. And at one point, we noticed she was laughing with the Easterseals.qxp_Layout 1 4/18/19 10:51 AM Page 1 staff and actually opening up to them. What a relief.

Yes – this is a difficult and unfortunate disease, but I’m realizing that places like Easterseals South Florida impact the entire family in a positive and loving way. We feel as though we’ve gotten our lives back. And while we may never get our mother back entirely, we are able to once again find joy in so many little things. Easterseals has made a great impact in our lives. They not only have a beautiful facility, but their staff is very loving. I feel it. And if I feel it, I imagine many other families will as well. Easterseals South Florida is a 501(c) (3) nonprofit organization. For information, call 305-325-0470, or visit www. easterseals.com/southflorida/. To make a donation to the Center, please call 305-547-4765.

all abilities. limitless possibilities. Come see our newest specialized Alzheimer’s services day care! NEW LOCATION! 11025 SW 84TH STREET, COTTAGE 12 KENDALL, FL 33173 PHONE: (305)547-4750 OTHER EASTERSEALS ADULT DAY CARE LOCATIONS: MIAMI | HIALEAH | PEMBROKE PINES INSPIRE HEALTH

Villa Serena Live in an Enchanted Tropical Garden!

7480 SW 64 Street, South Miami, FL 33143

Welcome to Villa Serena! Centrally located in a South Miami acre estate neighborhood, insulated from city noise and bustle. A unique refuge from daily pressures, nestled in enchanted gardens of exotic plants and flowers, with winding walks and ponds stocked with koi and goldfish. Walk out of your master suite and greet the day on the couches and beds on the veranda. Listen to the sounds of the bird habitats or the songs of the many wild birds attracted to the feeders scattered throughout the property. Let your guests stay in their own apartment separated from the main house by tall coral walls and strategic plantings. Meet them for drinks by the pool and the expansive entertainment Tiki huts with couches and hammocks. Afterwards, serve dinner from the professional outdoor barbeque and ranges followed by a swim in the lighted, heated pool and feel the silky water sanitized by a salt-water system. Visitors often compare this property to Fairchild Gardens. It is certainly a rare find in todayâ&#x20AC;&#x2122;s Miami, initially designed and planted by an architect and groomed by expert hands for fifty years, the gardens surround a modern, convenient house with artistic touches and verdant vistas. Giant trees shelter rare plants at multiple levels, a striking vision at night when the gardens are bathed in architectural lighting. The true feeling of a Polynesian resort getaway! 3 Beds / 3 Baths + 1/1 Guest | 3,069 Adj. sf. | 39,422 sf. lot | â&#x2020;&#x201C;$1,349,000

Tere Shelton Bernace

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September Â§ October

Shelton and Stewart Realtors Broker-Owner 305.607.7212 tbernace@sheltonandstewart.com

Richard Machado

Shelton and Stewart Realtors Realtor-Associates 305.333.8870 richardrmachado@gmail.com

Your Tomorrow Starts

today We are the perfect mix of stress-free, wellness living and, an ideal location where living better is living well. East Ridge is the area’s only true continuing care retirement community (CCRC). We also offer lease options in all levels of care. Our Independent living residents enjoy our 76 acre park like community featuring a South Florida neighborhood setting with easy access to great outdoor amenities and terriﬁc dining.

To arrange a personal tour Call 305.256.3564 19301 S.W. 87th Avenue Cutler Bay, FL 33157 eastridgeatcutlerbay.com

ASSISTED LIVING MEMORY CARE SKILLED NURSING

Assisted Living Facility License #6091

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recipe  Ingredients Cauliflower Steaks  1 large cauliflower  1 cup almonds  1/2 cup panko breadcrumbs  1/4 cup flour  1/2 cup milk  1 tsp smoked paprika  1 tsp garlic powder  1 tsp onion powder  1/4 tsp salt Mango Cabbage Slaw  2 Tbsp milk  1 Tbsp maple syrup  2 Tsp apple cider vinegar  Salt and pepper to taste  1 cup shredded cabbage  1/2 cup thin sliced mango  1/3 cup diced spinach or kale  Directions  Trim the leaves and the bottom of the stem from the cauliflower. Make sure to keep the core intact.  Cut the cauliflower in half, from the top, down. Slice the halves into 1-inch slices. Save the excess florets for another meal.

ALMOND CRUSTED CAULIFLOWER STEAKS WITH MANGO CABBAGE SLAW

Makes 2-3 cauliflower steaks Time: 1 hour

By Crissie Mergogey

 Pulse the almonds in a blender or food processor until the texture is similar to breadcrumbs. Mix in the panko breadcrumbs and pour onto a plate.  In a bowl, combine the flour, milk, smoked paprika, garlic powder, onion powder, and salt. Dip the cauliflower slices into the batter and coat completely.  After dipping in the batter, coat the cauliflower with the almond and breadcrumb mixture.

 Place the cauliflower on a lined or oiled baking sheet. Bake at 375°F for 40 minutes, turning halfway through.  Prepare the Mango Cabbage Slaw. Mix the milk, maple syrup, apple cider vinegar, salt, and pepper in a bowl. Add the cabbage, mango and spinach to the bowl and mix until well coated.  Remove the cauliflower from the oven, let sit 5 minutes, then serve with the Mango Cabbage slaw.

NOTE:

You can use chicken or salmon instead of cauliflower, if desired.

INSPIRE HEALTH

September § October

Easy, natural looking beauty. Your best

kept beauty secret.

Frank J. Ferrin, MD A diplomat of the American Academy of Anti-Aging Medicine, Dr Ferrin has achieved board certification by the Academy and has been in the field of anti-aging and rejuvenation for over 10 years when his first med-spa opened in 2009.

P R O M O T I N G H E A LT H A N D W E L L N E S S The medical field of Anti-Aging and Functional Medicine is dedicated to preventing age related health issues while preserving as much mental and physical capacity as possible. Simply put, we should all have aspirations to live life to the fullest while enjoying a healthy body and mind. As our baby-boomers grow a bit older, this particular generation ( 50+) has demonstrated a joy for life that requires vitality, stamina, mental clarity and focus, physical fitness and agility. This particular generation has demonstrated a desire to maintain a youthful appearance and addresses health maintenance from a new perspective that focuses more on wellness and prevention in an effort to avoid causing factors that lead to degenerative diseases and illness. They typically will continue to be productive members of the community and engage in various intellectual endeavors like theater and book publishing as well as social activities including “mature dating”, traveling, golf, tennis and assorted other activities. It should be no wonder that rejuvenation treatments and cosmetic surgical enhancements have become quite popular ranging from: Hormone optimization treatments | Weight management Anti-wrinkle Botox and dermal fillers Lasers and radio-frequency treatments to improve skin-tone and facial conditioning Physical enhancements with fat reduction by CoolSculpting or liposuction

Frank J. Ferrin MD 2020 Ponce de Leon Blvd. Ste. 105 305-640-5602 ebsculpting.com

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APPLES, BROCCOLI and BERRIES Battle Cancer

Top Cancer

FIGHTING FOODS apples • blueberries • broccoli • cruciferous vegetables • berries • dark green leafy vegetables • coffee • cherries • cranberries • curry • dry beans, peas and lentils • Flaxseed • garlic • ginger • grapes and grape juice • grapefruit • green tea • onions • tomatoes • soy • squash • walnuts and other nuts • whole grains

By Tricia Danflous YOU’VE HEARD IT ONCE, YOU’VE HEARD IT TWICE AND PROBABLY MORE THAN THRICE – AN APPLE A DAY KEEPS THE DOCTOR AWAY. ADD IN GENEROUS SERVINGS OF BROCCOLI AND WHOLE GRAINS, WITH A GLASS OF GREEN TEA, AND YOU HAVE AMMUNITION FOR THE CANCER FIGHT.

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September § October

with a handful of broccoli sprouts on salads or sandwiches for extra carcinogen fighting power. If your sweet tooth is calling, try gingerbread cookies. Ginger root contains curcumin, currently under investigation as a source for minimizing the potential for ovarian cancer and brain tumors. No sweets in your diet? Sprinkle ginger on vegetables or combine with other spices for Asian-inspired dishes. Fighting cancer with super foods does not have to be challenging, tasteless or complicated. The American Cancer Society says use a color guide. Research indicates that colorful, freshly picked foods such as red raspberries, bright blueberries, red and orange peppers, purple eggplant and deep green spinach, for example, are excellent choices. Begin your cancer crusade today. Prepare a meal with one or two super foods and remember what your mother told you - an apple a day keeps the doctor away. You can celebrate a healthier you with a glass of red wine or grape juice – the resveratrol-filled choices are also weapons against cancer.

WHAT TO EAT IF YOU HAVE CANCER: HEALING FOODS THAT BOOST YOUR IMMUNE SYSTEM by Daniella Chace, MSc, CN

“When my husband was diagnosed with cancer this book had a lot to do with his recovery. I learned to cook with herbs that were helpful with working with chemo and other drugs he was on at the time. The key was cooking with antioxidants to rid the body of the poison pumped in every day during the chemo regimen. Ginger is amazing and kept the nausea at bay. I still use several of the recipes today even though my husband is cancer free.” -Suzanne F., Metairie, LA

YOUR SOUL

healthy diet, healthy weight and regular exercise are the foundation for minimizing the risk for contemporary disorders. Yes, even cancer. Although nutrition-enriched meals cannot cure or guarantee cancer prevention, increasing research indicates that a plant-based diet is significant ammunition to battle cancer. According to American Institute for Cancer Research (AICR) and other studies, flavonoids, phenolic acids, antioxidants, curcumin, phytochemicals, folate, sulforaphane, calcium, and reservatol are among substances that may inhibit cancer cell development. The flavonoids and phenolic acid in apples, for example, protect cells and may slow down cancer progression. Supplements are not the answer. AICR indicates the synergy of compounds working together in food is the best. Make room on your plate for superfoods ranging from broccoli and tomatoes, to berries and walnuts. Sulforphene, found in broccoli and other cruciferous vegetables, is connected to the prevention of colon and prostate cancers especially when chewed thoroughly. Entice your family

#drivepink

Driven to ďŹ nd a cure. On behalf of all those whose lives have been touched by breast cancer, we are proud to support the cause.

Mercedes-Benz of Coral Gables 300 Almeria Avenue | 305.445.8593 | MBCoralGables.com On the corner of Salzedo and Almeria, 3 blocks south of Miracle Mile

Mercedes-Benz of Cutler Bay 10701 SW 211th Street | 305.251.0345 | MBCutlerBay.com Where the Turnpike meets 211th Street, adjacent to Southland Mall

WILLIAMSON IS MIAMI Williamson Cadillac is a J.D. Power 2019 Dealer of Excellence for the Customer Sales Experience.

LOCATION 7815 SW 104TH St. Miami, FL

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WilliamsonCadillac.com

SALES 1-877-579-0775 Mon.-Fri. 9am - 8pm Sat. 9am - 6pm Sun. 11am - 5pm

SERVICE 1-866-372-8217 Mon.-Fri. 7:30am - 7pm Sat. 8am - 5pm Sun. Closed

YOUR TRUSTED CHOICE SINCE 1954

IMPACT

WINDOWS AND DOORS

Finding which glass is the right glass for your home can be tricky. Luckily, the Companies of R&S is there to help. With all of the top brands at our disposal, we are certain to ямБnd just the right look for your home. 100% FINANCING AVAILABLE | NO MONEY DOWN

Free Quote, Call Now! (305) 256-6666 8715 SW 129 TERRACE MIAMI, FL 33176 | RSCOMPANIES.COM

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Give Peace of Mind TO CANCER PATIENTS BY BECOMING A VOLUNTEER DRIVER

ne of the biggest roadblocks to cancer treatment can be the lack of transportation. An estimated 3.5 million Americans delay or have difficulty getting needed medical care each year due to the lack of available and affordable transportation to treatment. In Florida, 131,470 residents will be diagnosed with cancer this year, and for many of them getting to treatments can be their biggest roadblock. Many patients have no vehicle or are simply too ill to drive. Family and friends

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may help, but over the course of several months, they may not always have the time or resources to provide every ride. A successful transportation assistance program can be a tremendous, potentially life-saving asset to the community. American Cancer Society’s Road to Recovery program provides cancer patients with free rides to and from treatment. The Road to Recovery program is at the very heart of the American Cancer Society’s work of removing barriers to quality health care. That’s why volunteering for this program is so important.

September § October

For those who cannot drive themselves or have no other means of getting to cancer-related medical appointments, volunteers donate their time to give these patients a muchneeded ride. ACS currently

has nearly 10,000 Road To Recovery drivers nationally, but the need for drivers is greater than the number of volunteers. In many communities, due to the lack of drivers, transportation needs can go unmet. ACS screens and trains all volunteer drivers directly and coordinates the rides for patients. Volunteer drivers donate their time and can provide as many rides as they want. All drivers must have: • A good driving record • A current, valid driver’s license • Proof of adequate automobile insurance • Access to a safe and reliable vehicle • Schedule availability • Regular desktop, laptop, or tablet computer access The American Cancer Society needs to recruit over 100 volunteer drivers in Southeast Florida. For more information on Road to Recovery or how to become a volunteer driver visit www.cancer.org/drive or call 1.800.227.2345.

“I wonder what Grandma is doing at The Palace tonight?” Grandkids can’t wait to see what will happen when they visit The Palace.

One thing they know for sure is that Grandma won’t be sitting alone in her room in front of the TV with nothing to do. The Palace has been honored as America’s #1 senior community for its social calendar and activities, and you’d be amazed how our entertainment program rivals a cruise ship. Every week there are live shows on stage, events to join in, classes to learn and songs to sing. We even have a free Happy Hour every day. Best of all, with so much to do, the whole family is invited to join us. And they do! Every week our dining room is filled with big family tables. They celebrate birthdays and holidays with us. For many of them, The Palace becomes the center of a new family life together. And sometimes, they even get to watch Grandma win a dance contest.

One Andalusia Avenue, Coral Gables

305.445.7444 • www.PalaceCoralGables.com

Luxury Living for Seniors INSPIRE HEALTH

Providing South Floridaâ&#x20AC;&#x2122;s Children with the Best Protection Possible School-age children, from preschoolers to college students, need vaccines. Making sure that your children receive all their vaccinations on time is one of the most important things you can do as a parent to ensure your children's long-term health as well as the health of friends, classmates, and others in your community. Getting every recommended dose of each vaccine provides children with the best protection possible. Keep in mind that there are many opportunities to catch-up on vaccines for your preteen or teen. Preteens and teens typically see their

doctors or other health care professionals for physicals before participation in sports, camping events, travel, and applying to college. Immunization is one of modern medicine's most significant public health achievements. Vaccines have eradicated smallpox, stopped wild poliovirus, measles, and rubella from being able to spread widely in the United States, and significantly reduced the number of cases of other diseases. Despite these efforts, tens of thousands of people in the United States still die from vaccine-preventable diseases every year.

LITTLE HAVANA PRIMARY CARE CENTER 1901 S.W. 1ST. STREET, MIAMI, FLORIDA 33135 INSPIRE HEALTH September Â§ October TEL: 305-203-5230

From July 1 to September 30, 2019, new pediatric patients without health insurance may receive a free comprehensive check-up and required vaccinations for school. Covered vaccinations include, but are not limited to the following: polio, Varivax (chicken-p ox), measles, mumps, rubella (MMR), DTap or Tdap (Diphtheria, Tetanus, Pertussis). New pediatric patients may also receive a back-to-school supply kit. To redeem this promotion, one MUST first make an appointment by calling 305-576-1234 EXT: 470 (English) and 471 (Spanish).

TRAINING

MINDS

TOUCHING HEARTS

FULLY ACCREDITED PRIVATE EVANGELICAL CHRISTIAN PRE-K THROUGH 12TH PREPARATORY SCHOOL.

Miami Christian School has an emphasis on individual nurturing, quality academics, critical & analytical thinking skills, technology, fine arts, practical arts, athletics, character development, community service, extracurricular activities and maintaining a small student/teacher ratio.

A 64 YEAR LEGACY OF SHAPING FUTURE LEADERS K-3 THROUGH 12 GRADE PREPARATORY SCHOOL INSPIRE HEALTH

Call Today to Schedule a Tour 305.221.7754 | 200 NW 109 Avenue, Miami, FL 33172 | miamichristian.org

healthy destinations

KETANGA FITNESS RETREATS

By Crissie Mergogey

etanga Fitness Retreats follow a “Travel Well” philosophy that combines fitness, adventure, and relaxation into one unforgettable vacation. Unlike many retreats, Ketanga does not have a single location. Instead, vacations are organized around the world. Their goal is to create accessible travel opportunities for a variety of fitness and wellness enthusiasts. Some examples of trips include “Pilates & Pinot,” “Boxing & the Beach,” and “Fitness, Food & Fun.”

Each unique vacation includes exercise classes for many fitness levels ranging from yoga to boxing to high intensity boot camp. The skilled coaches at Ketanga Fitness Retreats are knowledgeable and fun to be around so you will enjoy your workouts! Many fun and exciting local adventures are also scheduled during the trip. Depending on the location, adventures may include sunset sailboat excursions, zip-lining, horseback riding, biking, surfing and more. Since this is a vacation,

plenty of relaxation and free time is also provided on each retreat. Certain trips also feature food, cooking classes and wine-tastings. Ketanga Fitness Retreats for September 2019 to February 2020 can be booked right now by visiting their website. Each retreat is thoroughly planned with

The lineup fo r 2020 getawa ys includes som ething for everyone with retreats focu se on high inten d si interval train ty ing, yoga and box ing.

daily itineraries. Upcoming trips take place in Ireland, Italy, Costa Rica, the Bahamas and Columbia! To kick off each new year, Ketanga Fitness Retreats hosts Camp Ketanga, a 5-week annual wellness festival in Costa Rica. Each camp features 1-2 daily workouts, outdoor Costa Rican adventures, buffet breakfast, two group dinners, airport transportation and all the amenities offered by a four-star beach-front resort. The lineup for 2020 getaways includes something for everyone with retreats focused on high intensity interval training, yoga, and boxing. These retreats are a great way to start a new fitness journey for a new year! Retreats are offered year-round and are the perfect getaway for an active adventurer. Ketanga does all the planning for you, so you can enjoy your well-deserved vacation!

Contact Information Email: info@ketangafitness.com Phone: (800) 484-0726 Website: ketangafitness.com

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September § October

DISORDERS WE TREAT

Allergic Rhinitis (Hay Fever) Anaphylaxis Asthma Breathing Difficulties Chronic Cough Oral Allergy Syndrome Contact Dermatitis Pet Allergy Drug Allergy Pollen, Mold & Dust Mite Allergy Eczema Sinusitis Food Allergy Urticaria (Hives) Insect Allergy

OUR LOCATIONS AVENTURA

21150 Biscayne Blvd., Suite 408 Aventura, FL 33180 PH. 305-932-3252 F. 305-932-2798 E. aventura@florida-allergy.com

Jaime Landman, M.D.

Zevy Landman, M.D.

Ileana M. Rodicio, M.D.

BOCA RATON

7301 W. Palmetto Park Rd., Suite 105-C Boca Raton, FL 33433 PH. 561-392-8832 F. 561-392-3953 E. bocaraton@florida-allergy.com

CORAL GABLES

475 Biltmore Way, Suite 311 Coral Gables, FL 33134 PH. 305-445-9422 F. 305-444-4651 E. coralgables@florida-allergy.com

CORAL SPRINGS

Michael P. Pacin, M.D.

Frank J. Martell, M.D.

Philip C. Mirmelli, M.D.

1801 University Drive, Suite 101 Coral Springs, FL 33071 PH. 954-344-8100 F. 954-344-8086 E. coralsprings@florida-allergy.com

FT. LAUDERDALE

1960 N.E. 47th Street, Suite 101 Ft. Lauderdale, FL 33308 PH. 954-772-3366 F. 954-489-9820 E. ftlauderdale@florida-allergy.com

HIALEAH/MIAMI LAKES

7150 W 20 Avenue, Suite 106 Hialeah, FL 33016 PH. 305-362-7762 F. 305-362-0368 E. hml@florida-allergy.com

Sharlene J. Llanes, M.D.

Walter M. Ryan III, D.O.

Adriana M. Bonansea-Frances, M.D., PhD.

HOLLYWOOD/EMERALD HILLS

2699 Stirling Rd. Suite B-305 Hollywood, FL 33312 PH. 954-981-9180 F. 954-961-4752 E. hollywood@florida-allergy.com

HOMESTEAD

100 NE 15th St., Suite 104 Homestead, FL 33033 PH. 305-245-1100 F. 305-245-0852 E. homestead@florida-allergy.com

KENDALL

9035 Sunset Drive, Suite 202 Miami, FL 33173 PH. 305-279-3366 F. 305-271-3355 E. kendall@florida-allergy.com

Kfir Shamir, M.D.

Barry J. Mark, M.D.

KENDALL REGIONAL

11880 SW 40 Street, Suite 304-C Miami, FL 33175 PH. 305-223-8919 F. 305-223-8650 E. kendallregional@florida-allergy.com

MIAMI BEACH

400 Arthur Godfrey Road, Suite 504 Miami Beach, FL 33140 PH. 305-538-8339 F. 305-538-4907 E. miamibeach@florida-allergy.com

NORTH MIAMI BEACH

16401 NW 2 Avenue, Suite 204 Miami, FL 33169 PH. 305-945-4131 F. 305-945-0052 E. northmiamibeach@florida-allergy.com

PALMETTO BAY

14411 S. Dixie Highway, Suite 223 Palmetto Bay, FL 33176 PH. 305-255-4868 F. 305-255-4922 E. palmettobay@florida-allergy.com

PALM BEACH GARDENS

3365 Burns Rd., Suite 206 Palm Beach Gardens, FL 33410 PH. 561-227-1456 F. 561-775-7980 E. pbg@florida-allergy.com

PEMBROKE PINES

600 North Hiatus Road, Suite 215 Pembroke Pines, FL 33026 PH. 954-437-3600 F. 954-437-8251 E. pembrokepines@florida-allergy.com

PLANTATION

350 N.W. 84th Avenue, Suite 205 Plantation, FL 33324 PH. 954-472-4848 F. 954-472-8500 E. plantation@florida-allergy.com

WEST KENDALL

9000 SW 137th Avenue, Suite 213 Miami, FL 33186 PH. 305-388-0078 F. 305-388-2029 E. westkendall@florida-allergy.com

WESTON

1290 Weston Road, Suite 300 Weston, FL 33327 PH. 954-389-2599 F. 954-389-2590 E. weston@florida-allergy.com

Tamar N. Rubin, M.D.

Florida-Allergy.com 1.877.4.ALLERGY

INSPIRE HEALTH 67 #thefloridaallergygroup

e.qxp_Layout 1 8/13/19 1:29 PM Page 1

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are in poor health. If you are age 65 or older,

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your open enrollment period starts on Minnesota, the first prescription drug coverage you can purchase FILLING THE GAP setts, and Wisconsin, which You may also not need to buy a re you or someone you care for about to day of the month in which you're 65 or older a Medicare Part D Prescription Drug Plan). You may also not need to buy a Medigap have their own standardized plans). Medigap policy workpast past Are you or someone you care 65? Perhaps you are being bombarded and enrolled in Medicare Part B. If you don't policyififyou you work ageage 65 and have emcurrently are Plans and have employersponsored for about tocarturn 65? h mailed solicitations from insurance buy Perhaps a Medigapyou policy duringThe openplans enrollAre allsold Medigap policies created65 equal? ployer sponsored health insurance. If you s every month. A lot of ment,with you may not be able to buy policyF andGenerally, yes. Although policies find yourself this situation, A-D,thePlans G, and Plans K-N. 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The plans currently sold Plans A- care, help you compare age). you In thismay case,not yourneed employer's plan may ingarelong-term vision care,Medigap dental policies offered In addition, get lots questions about nce companies, Medigap policies are de- D, Plans F and G, and Plans K-N. Each in your area. cover costs that Medicare doesn't. care, orbeneprescription drugs (to obtain to buy a Medigap policy if you are but I’d like to focus ned to cover costs notMedicare, paid by original Medigap plan on offers a different set of The information has been obtained from sources considered to be reliable, but we prescription employersponsored not guarantee that the foregoing material is accurate or complete. Any inforMedicare won't cover all of dicare, helping you fillMedigap. the gaps in your fits. All cover certain out-of-pocket costs, in- drug Doescoverage everyone you needcan Medigap? covered bydoan mation is not a complete summary or statement of all available data necessary for dicare coverage. cluding Medicare amounts. No. In Part fact, it's for an insurance compurchase a Medicare Dillegal Prescriphealth planmaking after you decision retire (e.g., as part an investment and does not constitute a recommendation. Prior your health-care costs during re- coinsurance to making any investment decision, please consult with your financial advisor Some plansto alsobuy cover other costs, as all pany to sell you a Medigap policyofthat tionsuch Drug Plan). a subretirement about your severance individual situation. Anypackage). opinions are those of the author, and not nectirement, so you may want a en's the best time to buy a Medigap or part of Medicare Part A and Part B de- stantially duplicates any existing coverage essarily those of Raymond James. This article was written by Gus Vega, Certified Co-Founder, WealthEngage Branch Manager with RJFS. In thisYou case,Financial yourPlanner, employer's planandmay supplemental medical insurance policyemergency costs, and you have, including Medicare coverage. cy? ductibles, foreign travel He can be reached at 786.264.4954, 9155 S. Dadeland Blvd. # 1014, Miami, FL AREMedigap ALL MEDIGAP he best time to buy a known Medigapas policy is Medicare WealthEngage is not a registered broker dealer and is independent of Raycover that Medicare doesn't. excess charges. don't needPOLICIES a Medigap policy if you joincosts a 33156. Medigap. OfferedPart by Bprivate James Financial Services, Inc. Securities offered through Raymond James ng open enrollment, when you can't be policies do not cover certain health-care ex- EQUAL? Medicare Advantage plan or a private fee-for- mond CREATED Financial Services, Inc., member FINRA / SIPC. Investment advisory services insurance companies, Medigap policies ed down or charged more because you penses, including long-term care, vision care, service plan, or if you qualify for Medicaid or offered through Raymond James Financial Services Advisors, Inc. Generally, yes. Although Medigap The information has been obtained from are designed to cover costs not paid sources considered to be reliable, but we do not by original Medicare, helping you fill the policies are sold through private insurguarantee that the foregoing material is accurate ance companies, they're standardized gaps in your Medicare coverage. or complete. Any information is not a complete and regulated by state and federal law. summary or statement of all available data WHEN'S THE BEST TIME TO BUY However, even though the plans that necessary for making an investment decision and A MEDIGAP POLICY? insurance companies offer are identidoes not constitute a recommendation. Prior to making any investment decision, please consult cal, the quality of the companies that The best time to buy a Medigap with your financial advisor about your individual policy is during open enrollment, when offer the plans may be different. Look situation. Any opinions are those of the author, closely at each company's reputation, you can't be turned down or charged and not necessarily those of Raymond James. financial strength, and customer service more because you are in poor health. This article was written by Gus Vega, Certistandards. And check out what you'll fied Financial Planner, Co-Founder, WealthEngage If you are age 65 or older, your open and Branch Manager with RJFS. He can be pay for Medigap coverage. Medigap enrollment period starts on the first reached at 786.264.4954, 9155 S. Dadeland premiums vary widely, both from day of the month in which you're 65 Blvd. # 1014, Miami, FL 33156. WealthEngage is or older and enrolled in Medicare Part company to company and from state not a registered broker dealer and is indepento state. You can find a tool on the B. If you don't buy a Medigap policy dent of Raymond James Financial Services, Medicare website, medicare.gov, Inc. Securities offered through Raymond James during open enrollment, you may not Financial Services, Inc., member FINRA / SIPC. that will help you compare Medigap be able to buy the policy that you Investment advisory services offered through want later. You may find yourself having policies offered in your area. Raymond James Financial Services Advisors, Inc. to settle for whatever type of policy DOES EVERYONE NEED MEDIGAP? an insurance company is willing to No. In fact, it's illegal for an insursell you. That is because insurers have ance company to sell you a Medigap greater freedom to deny applications policy that substantially duplicates any or charge higher premiums for health existing coverage you have, including reasons once open enrollment closes. Medicare coverage. You don't need a WHAT'S COVERED IN A Medigap policy if you join a Medicare MEDIGAP POLICY? Advantage plan or a private fee-forservice plan, or if you qualify for MedicUnder federal law, only 10 stanaid or have group coverage through dardized plans can be offered as your spouse. Medigap plans (except in Massachu-

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OPTIMIZING PERFORMANCE AND PHYSICAL CAPACITY

• Physical Therapy • Sports Performance • Manual Therapy and Hands-on Treatment • Stretch Therapy • Pain Neuroscience Education (PNE) • Cupping • Personal Training

Dr. Rob Poliszuk PT, DPT, CSCS

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September ยง October

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healthy mind

THE KEY

TO LASTING HAPPINESS

By Caitlyn McKey looking intently into one ne of the many another’s eyes. One of the aspects of living participants should focus on life as a human being non-reactive, while is trying to find the other simply smiles. happiness. Most of us have In displays of this brief been advertised a promise that someone has discovered experiment, the person who is supposed to remain nonthe key to happiness. reactive eventually begins Unfortunately, what we to smile. Thus, providing are sold is temporary and evidence that what or who leaves us still starving for we surround ourselves with happiness. Shawn Achor, a will innately become the Harvard graduate in the field energy or “vibe” we carry of positive psychology and with us. Achor explains author of The Happiness Advantage, is trying to change that this happens because humans, through evolution, the way we quantify, define have come to work off an and experience happiness. invisible network where Achor’s studies have we are influenced by our discovered how humans are surroundings. This invisible intrinsically wired to connect network is also linked to our and feed off of each other’s behaviors or “vibes.” To prove survival instinct, helping us navigate the world around this, he provides an example us. So, what does all of this where he explains that two mean? people should sit directly across from one another

Investing in our friends, family and community helps increase happiness

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Achor has crafted his research into a list of seven principles that we can follow in order to attain and experience true happiness.  The first principle discusses meditation, or what I like to think of as brain breaks. These brain breaks allow for moments of contemplation, reflection and gratitude. Achor also lists buying an experience over an object, random acts of kindness, finding something to look forward to and exercising a signature strength as a means of gaining true happiness.  In the second principle, Achor discusses how shifting perspective to a more positive or optimistic outlook can drastically alter your experience into a happier one.  The third principle teaches us how to notice and identify patterns in our own behavior and how we can alter them to take advantage of every opportunity we face.  The fourth principle discusses the idea of “falling up” rather than failing. Achor explains that we can turn a failed experience into a positive one when we

have a take-away from the overall experience. Changing the failure into a lesson learned alters the experience into a positive one because we focus on what we’ve gained (the lesson) rather than the negatives or where we failed.  In the fifth principle, Achor discusses what he calls the “Zorro Circle.” This principle explains that in situations where we begin to lose our balance, there is a need to refocus on smaller steps in order to get back on track to the bigger goal. In a sense, this principle tells us to practice mindfulness by pulling our attention to what is present and what needs our attention in the now. The sixth principle titled “the 20-second rule,” teaches us how to replace bad habits with good ones by taking 20 seconds to pause and reflect on the action we are taking.  Finally, the last principle focuses on social investment. Achor explains that by investing in our friends, family and community we find a key to excellence. By supporting our own socia l support system, we gain ten-fold and build an infallible network that will invest in us equally. This practice also continues the wave of happiness; your happiness becomes contagious. Having this impenetrable force proves essential in our overall success. Achor provides evidence that we can change the neuro paths of our brain to not only seek out positivity, but to live as bright beacons of happiness and optimism for ourselves and the world around us.

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CORAL GABLES HOSPITAL’S DR. GILBERT BEAUPERTHUY-ROJAS ON BUILDING TEAMS WITH INNOVATIVE MINDS

Orthopedic Surgeon Gilbert Beauperthuy-Rojas, DO, knows Coral Gables Hospital. Not only because he serves as director of its Orthopedic Center of Excellence, but because he’s been supporting the hospital since becoming a volunteer there at just 17 years old. Upon graduating from Nova Southeastern University College of Osteopathic Medicine, Dr. Beauperthuy-Rojas dove into a career in private practice and affiliated with Coral Gables Hospital, where he established the Orthopedic Center of Excellence in 2015. In 2017, under his leadership, the 245-bed hospital became the first facility in Miami-Dade area to achieve certification for both total-hip and total-knee replacement from the Joint Commission. Here, Dr. Beauperthuy-Rojas talks about this achievement, as well as the biggest challenge facing the healthcare industry – and more: Q: Tell us about your proudest moment at Coral Gables Hospital. GB: I've been with this hospital since I went into private practice 23 years ago. My proudest moment was establishing the Orthopedic Center of Excellence within the hospital. I took on that challenge about three years ago and developed a program that delivers excellent orthopedic care to the community. We were already doing great things here, so I approached the administration with the idea that we could make it even better by establishing guidelines for physicians and by ensuring that all patients

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September § October

receive top-notch care. With the backing of our fearless CEO, Cristina Jimenez, we pursued the Joint Commission certification by establishing the center in 2015, presenting the updated guidelines to other physicians, and working with them to ensure they understood all the initiatives and goals. Our commitment to success resulted in securing the Joint Commission certification in 2017. In the process, we took a small community hospital and created a program that is now the envy of all orthopedic programs in the area. We suddenly started getting calls from other hospitals to learn how they might establish a similar program. I'm quite proud of that. Q: What goals do you have for the Orthopedic Center of Excellence? GB: I wish to obtain the advanced certification with the Joint Commission. We've applied for it and are working hard to achieve that goal by spring 2019. I also hope be recognized by Becker's Hospital Review as an Orthopedic Center of Excellence. To achieve these goals, we've established a stringent set of criteria, including reducing our readmission rate, limiting our surgical-site infection rates, and increasing our discharge-to-home vs. discharge-to-rehab rates. Q: What advice would you offer other orthopedic directors? GB: Make it a point to surround yourself with dedicated people with innovative minds – and then listen to them. My team consists of Chief Nursing Officer Jessica Miller, RN, who is brilliant, and with other great nurses – all of whom embody a spirit of true teamwork. They also believe that putting the patient first is paramount.

Q: What is the biggest challenge facing the healthcare industry? GB: Cost containment and delivering higher quality healthcare top the list. All areas in healthcare are strained, specifically hospitals and physicians. The cost of care is going up, but there is no increase in reimbursements. So, it's up to us to control rising costs, while also improving care delivery – which presents quite a challenge for us as leaders and physicians. Q: Outside of healthcare, what is your passion? GB: I have done about 20 triathlons in my lifetime, both the Olympic distance and the full Ironman – two, in fact. When training, I complete 15 hours of exercise per week. To fit in the training during my busy workweek, I mostly exercise first thing in the morning because later in the day, things pop up, emergencies happen. Q: Who inspires you? GB: My parents. They were immigrants into this country who came with nothing. They taught me that anything can be accomplished with hard work and persistence. Q: What impressive goals have you recently attained? GB: We earned the advanced certification with the Joint Commission, the only hospital in the area to achieve that certification, as well as the Blue Distinction Center of Excellence for Knee & Hip Replacement. To achieve these goals, we established a stringent set of criteria, including reducing our readmission rate, limiting our surgical-site infection rates, and increasing our discharge-tohome vs. discharge-to-rehab rates.

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FOOD THAT INSPIRES

Heart Healthy

& Happy

Do you want to boost your mood and improve heart health?

Crack open a clove of garlic and unleash the benefits that millions of people are already experiencing-- a healthy heart and a happy smile! Fresh crushed garlic is rich in hydrogen sulfide which relaxes blood vessels, allowing increased blood circulation. And that’s not all. A new study published in the Journal of Agricultural and Food Chemistry reports that garlic oil improves antioxidant enzyme expression, lowers heart inflammation and stops cell death, effectively maintaining the integrity of vital heart tissue. The study also highlighted that over 20 different substances in garlic oil provide therapeutic benefits. Adding a clove a day to your daily diet is an almost effortless way to nourish your hardworking heart. Something to Smile About While studying the effects of garlic on the cardiovascular system, scientists reported another wonderful benefit--patients experienced an elevated mood. This makes sense, since garlic is rich in selenium-- a known mood booster. In comparison, the opposite is true, individuals with a selenium deficiency tend to be more irritable, experience greater depression and are more hostile. On a happier note, garlic consumption may also help to regulate the number of fat cells that get formed in the body. It seems to normalize the metabolism and also detoxify the body’s systems by binding to heavy metals and other harmful pollutants and destroying them-- a toxin scavenger. Garlic has too many benefits to pass up, and if you have an aversion to its odor, garlic capsules are available. However, fresh is always best; a freshly cracked clove will ensure greater benefits. Chop it up and toss onto a garden salad, add it to cold dips and salsas, or throw a half to a whole clove in a smoothie--it adds a punch of flavor. A clove a day will have you smiling and feeling healthier in no time.

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September § October

Ridiculously Good Roasted Veggie Soup What you need:  1 large sweet potato chopped into one inch cubes  1 small purple onion quartered (remove skin)  6 cloves of garlic (cut tips, leave skin on)  1 eggplant cut length wise into one inch sticks (leave skin on)  1 red bell pepper cut in slices  2 sprigs of rosemary  Salt and Pepper  2 Tbsp. of olive oil  3 1/2 cups of vegetable broth What you do: Spray a large baking pan with non-stick spray. After prepping all vegetables as directed above, scatter them evenly on the pan. Drizzle olive oil and sprinkle with salt and pepper; cut rosemary sprigs with kitchen shears and spread evenly over veggies. Roast veggies for 20 minutes in a 350 degree oven then flip them over and toss to make sure they are coated with the olive oil. Continue roasting for another 20-25 minutes or just until the sweet potatoes have softened. Once veggies are cooked, remove the skin from the garlic. Add all veggies to a Dutch oven, add vegetable broth, bring to a boil, reduce heat and use a hand blender to puree the soup to a creamy texture. If you don’t have a hand held blender you can use a regular blender, just add veggies to the pitcher and pulse until well blended. Add salt and pepper to taste. How to enjoy: Feed a family of four with this amazing veggie soup and they will get their veggie intake for the day. Complete the meal by adding a protein and complex carbohydrate to your plate. It is perfect paired with a grilled chicken Panini. Makes 4 servings. 250 Calories per serving.

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WHAT YOU SHOULD KNOW ABOUT

NOSE SURGERY By Carlos Wolf, M.D.

Dear Dr. Wolf, Should I have an open rhinoplasty or a closed rhinoplasty? You may feel like you have a choice in this matter, but in most cases you do not! During the 30 years I have been practicing, I have seen the number of surgeons who can perform both types of rhinoplasty procedures plummet. Due to the complexity of nose surgery, it is easier for the surgeon to do an open rhinoplasty. The training in closed, or endonasal rhinoplasty, has been limited; therefore, the average plastic surgeon or facial plastic surgeon only performs the open approach. So, what is the difference between an open and closed approach? The closed approach is performed with no external incisions and is done through the nose. It limits the damage and/or change to the tip and can essentially be performed on most patients. The open approach involves making an incision underneath the nose, elevating the skin, dissecting through all the nasal structures and, most often, using multiple grafts throughout the nose tip and body. Grafting the nose

creates forces that, after surgery, often will make the nose appear crooked or feel unnaturally hard. In experienced hands, this is a good approach for patients who have thick tips, are having reconstruction or want a very well-defined tip. However, for the average nose surgery, it is not the approach I feel is appropriate. Unfortunately, many patients are having the wrong operation because of the surgeon’s lack of experience. I recently saw a patient who had two prior rhinoplasties. The first rhinoplasty lasted eight hours and the second rhinoplasty lasted three hours. After 11 hours of surgery, the patient had a nose with multiple grafts that was still large and did not meet her expectations. Because many doctors are now performing procedures in their offices and surgical centers and are not associated with a hospital, there is minimal to no oversight. So, what are the questions that you should ask your surgeon to determine if he or she is qualified to perform your surgery?

Dr. Carlos Wolf is a board-certified plastic surgeon. He is a partner in Miami Plastic Surgery and Clinical Assistant Professor in the Department of Surgery at FIU Herbert Wertheim School of Medicine. For more information, email cwolf@miamiplasticsurgery.com, call 305-595-2969, visit www.miamiplasticsurgery.com or follow Dr. Wolf on Instagram.

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How long does the surgery take? If this is your primary rhinoplasty, it should take no more than three to four hours. Usually, one to two hours is the average length of time for this surgery. Do you image patients to determine exactly what they want and if you can give them that option? By asking this question, you will know better if your doctor can meet your expectations. Will you be using rib graft and or other grafting material in my nose? In my opinion, rib graft should not be used in any primary rhinoplasty procedure unless there is a congenital deformity (birth defect). Rib graft often is very hard, tends to warp and should only be used by experts. Harvesting of a graft also can leave permanent scars on the chest. Doctors performing less than 50 rhinoplasty procedures a year should not be performing this procedure. Multiple cartilage grafting usually is not necessary and is being performed by surgeons who attend symposiums and then think it is the cat’s meow. Again, limited grafting may be done, but not excessive amounts. What is your revision rate? This is very important to know because you might be one of those people having a revision. Every surgeon will do revision operations because of results that do not meet the expectation of the patient or his or her own standards. However, revision rates should not exceed 10 percent, in my opinion. And finally, if you do need a revision, does the doctor charge for that revision and the operating room fee and anesthesia? These are questions that are important to ask prior to having your surgery. After all, a well-informed patient is a much happier patient.

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September ยง October

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