Orlando Medical News August 2022 by Orlando Medical News

AUGUST 2022

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New Clinic to Care for Patients with Long COVID Opens at AdventHealth Support for COVID-related research is a program component

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Mobile Check In

Kiosk Check In

Scan the QR Code to check in

Simple Kiosk to sign at the door

The QR code has brought forth ways to help with social

Our kiosk makes the check in process fast and easy. Place

distancing and contactless sign in. Customers can scan

the floor standing kiosk close to the entrance and patients

the QR code with their cell phone and sign in using the

will sign in quickly. Checking in at the door moves this

same questions as your kiosk. The QR automatically

procedure away from the reception window and reduces

checks your location to make sure the customer is close

casual conversations until the appropriate time. Gather

to the location. Post the QR code on parking signs, entry

information such as name, phone number, email and ask

ways and doors to expand your waiting area.

basic questions needed for the check in process.

HIPAA

Social Distancing

Organization

Reporting

Social DistancinFully HIPAA Compliant BAA Included

Patients can check in using cell phone from up to 1/4 mile away

Automatically sorts and organizes patients.

Data and Statistics provide valuable management reports

Schedule a 15 minute Live Demonstration Call Take a tour with a live person on the phone. We are happy to give you a personalized, online demonstration. We’ll show you all the features and answer any questions you may have. By the end of the short call, we can have you set up for a free, no obligation, 14 day trial of the complete system.

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CONTENTS PHYSICIAN SPOTLIGHT

Dr. Steven McCarus Reaches Milestone with 100th Gynecological Procedure Using Senhance

COVER New Clinic to Care for Patients with Long COVID Opens at AdventHealth

EOCC Business Expo: Your Reason Why

Navigating the Real Estate Rapids

TBI Traumatic Brain Injury TBI

Yes, Yes, we treat we treat that. that.

Pelvic Physical Therapy: Not Just for Women Anymore!

Traumatic Brain Injury ABI Anoxic Brain Injury ABI Anoxic Stroke Brain Injury Stroke Spinal Cord Injury

Spinal Cord Injury Multiple Trauma Multiple Trauma Neurological Disorders Neurological Disorders Complex Orthopedic Complex Orthopedic Joint Replacements Joint Replacements Amputations Amputations

SENIOR SECTION 10

Paying for Senior Care, Learn About Available Resources to Help You Cover the Costs

patients 15 & up for treatment We accept mostAccepting health insurance plans, workers’ compensation carriers and discount We accept most health insurance plans,networks. workers’ compensation carriers and discount networks. Call today to learn more 800.626.3876 • NeuLifeRehab.com

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Five Foods to Avoid if You Have IBS

Benefits of Aging Opens to Serve Seniors and Their Caregivers

The Ins & Outs of Downsizing

Diverse Identities and Death Care

GRAND ROUNDS

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New Clinic to Care for Patients with Long COVID Opens at AdventHealth Support for COVID-related research is a program component AdventHealth is investing in developing new ways to care for those affected by long COVID-19. At AdventHealth Orlando, the health care organization opened a comprehensive Post-COVID Clinic (PCC) designed for patients with a confirmed diagnosis of COVID-19 and coronavirus symptoms lasting 12 weeks or more. On Florida’s west coast, AdventHealth Tampa opened a long COVID clinic focusing on pulmonary issues. Led by AdventHealth Medical Group internal medicine physician Dwayne Gordon, MD, the PCC at AdventHealth Orlando is the first-of-its-kind within the hospital system and is composed of a multidisciplinary team, including primary care, behavioral health and physical therapy. The clinic can also refer long COVID patients to cardiologists, pulmonologists and clinicians specializing in substance abuse. “This is a new frontier for medicine; we don’t have as much information about long COVID, therefore there’s very little guidance to provide direction,” Gordon said. “This is a fresh approach to caring for patients and learning the best way to take care of the unique needs of long COVID patients.” Because long COVID can be difficult to diagnose, AdventHealth’s PCC established thorough screening processes for candidates, including an initial one-and-ahalf-hour evaluation with Gordon and the PCC mutli-disciplinary clinical team evaluating:

Dwayne Gordon, MD Dr. Dwayne Gordon evaluating a patient at the new Post-COVID Clinic.

• Medical history with co-morbidities

Richard E. Pratley, MD

• COVID history and experience, including date of positive test, symptoms (both previous and existing) and vaccination history

Dr. Richard E. Pratley conducting research at the AdventHealth Translational Research Institute.

• Complete physical therapy evaluation • GAD-7 screening for anxiety • PHQ9 screening for depression

“We developed a creative way to provide the physical therapy component of the clinic to all populations,” Gordon said. “Some patients receive traditional therapy in the office setting with a therapist and others use an app at home to access a specialized exercise program with photos, videos and written instructions to assist in their recovery.” To help the global medical community learn more about how this virus interacts with the body even after immunological clearance, the PCC partnered with the AdventHealth Transitional Research Institute to gather insights to support future research studies. One AdventHealth Transitional Research Institute study already underway examines how long COVID affects those with diabetes. Using advanced MRI imaging, researchers will observe changes to organs, such as the heart, lungs, liver, kidney, pancreas and spleen following a confirmed diagnosis of COVID-19 in people with and without diabetes to determine how COVID-19 and any related inflammation may impact organ function in diabetics and the overall damage to the body. “Throughout the pandemic, we’ve learned that COVID-19 can increase a person’s risk of diabetes, even months after infection, but we don’t really understand why,” Richard E. Pratley, MD, medical director of the AdventHealth Diabetes Institute and senior scientist in diabetes research at the AdventHealth Translational Research Institute said. According to research published in The Lancet Diabetes & Endocrinology, patients who have recovered from COVID-19 have a greater risk of developing diabetes up to a year later, even after a mild SARS-CoV-2 infection, compared with those who never had the disease. “There’s been a reported increase in new diagnoses of

During the initial consultation, clinicians from primary care, behavioral health and physical therapy disciplines collaborate to determine whether a COVID-19 infection truly caused a new condition or exacerbated a pre-existing condition. After evaluation, patients may be prescribed an initial 60-day plan, including referrals to subspecialities for additional treatments, with a follow-up scheduled to re-evaluate progress. “Since opening our doors on March 30, we are finding our initial patients are struggling with multiple issues, including insomnia, which affects other functions, including brain fog, anxiety and depression,” Gordon said. He added that he suspects a direct correlation and is interested to review the long-term results after treatment. Using the SLUMS Exam, a screening tool for dementia, several of AdventHealth’s initial PCC patients, whose ages range from 30 to 60 years old, have scored in the severe dementia range. “These are people who don’t have dementia, traditionally,” Gordon said. This echoes a recent study published in The Lancet. Researchers not affiliated with AdventHealth found COVID patients were 80 percent more likely to develop neurocognitive problems like brain fog and confusion, 41 percent more likely to be diagnosed with sleep disorders and 39 percent more likely to develop depression. In addition, the AdventHealth team is finding generalized weakness and deconditioning with long COVID patients, making the physical therapy support essential to returning patients to their baseline so they can resume work and daily activities, such as cooking, cleaning and bathing.

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AUGUST 2022

Do you have a candidate? If you are a physician and have patients that may be a candidate for the PCC, email CFD.PostCOVIDClinic@ adventhealth.com the patient’s name and contact information, as well as your name and contact information, and the PCC will follow-up to determine if the patient is qualified.

diabetes following a COVID-19 hospital admission, and this is true at our AdventHealth facilities in Central Florida too,” Pratley said. “But we don’t yet know if this is truly new diabetes cases or previously undiagnosed cases that were exacerbated by the virus or if a patient’s elevated blood sugars are due to some other unexpected cause, such as COVID treatments.” “During the past two years, we as a clinical community have learned a lot, improved and developed best practices in caring for those with COVID, but we recognize there is still much to learn,” Gordon said. “Ultimately, the PCC has broad implications for improving care across a wide spectrum of disciplines and everything we learn will play a critical role in establishing best practices for long term care.” The PCC currently has limited capacity, but a phased expansion is planned in the upcoming months.

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Dr. Steven McCarus Reaches Milestone with 100th Gynecological Procedure Using Senhance Robotic system more economical and easy to use.

One hundred women have benefitted from a surgical system, unique in Florida at AdventHealth Winter Park, that is more precise, minimally invasive and helps lead to quicker patient recovery with little or no scarring.

cerned about scarring,” McCarus said. “Senhance can be used for hysterectomies and other benign female surgeries, general gynecology and soft tissue operations in the gut area.” Robots are not replacing surgeons, but they are certainly making modern medicine more efficient. with the latest in surgical options and advantages. McCarus with his wife and partner, Dr. Tamberly McCarus, a gynecological surgeon at AdventHealth Winter Park, have performed 100 procedures since 2019. Many of the scheduled procedures were put on hold during the COVID-19 global pandemic. “After 100 cases, I can say Senhance takes the best aspects of a surgical robot and infuses it into a unique

Recently, Dr. Steven McCarus, an internationally recognized obstetrics and gynecology surgeon performed his 100th gynecological procedure using the Senhance Surgical System. “We thought it would be a good system for minimally invasive women’s surgery for patients con-

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system,” McCarus said. “It’s very easy to use and creates a comfort zone for the surgeon. We’re able to make 5-millimeter and 3-millimeter incisions with Senhance, which are minimally invasive and help lead to quicker patient recovery with little or no scarring.” Patients are always made aware of the robotics used during surgery, said McCarus. They are briefed in advance so there are no surprises. “Patients don’t ask for robotic surgery, but it is a matter of physician preference,” said McCarus. “The device is more precise, which benefits the patient, but the robotic platform is easier on the surgeon. The big screen gives you better visualization.” Beyond the practical application during surgery, McCarus cited the economics involved with Senhance surgery as it relates to overall health care costs. The Senhance® Surgical System removes the economic limitations of current robotic systems with standard reusable instruments and an open-platform architecture strategy that enables hospitals to leverage existing technology investments. That keeps time and cost-per-procedure comparable to manual laparoscopy, so that the benefits of robotics can reach more patients, in more care settings, for a greater variety of procedures. “It utilizes already existing equipment in the operating room, so there are no additional costs that you find with other robotic devices,” he said. “We’ve had zero complications directly related to the system=no complications during laparoscopic hysterectomies, no hernias, no infections=and we’ve been able to complete all of the cases.” “This is the first generation of the product, and it’s a unique system that is growing to be a major player in surgery,” McCarus said. “An augmented intelligence platform (digital surgery) will be the next generation. We’re pretty early in the journey, but it’s worked well. This is far better than any other system I have used.”

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Business Expo: Your Reason Why

Testimonial Tuesday on Location TUESDAY, AUGUST 9 | 3:00-5:30PM LIVE of Facebook & On Location

Misters & Sisters Great After Hour Adventures

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TUESDAY, AUGUST 9 | 5:30-7:00PM Brix & Mortar Avalon Park

Picture if you will, a sea of businesses in rows of three throughout the restaurant, atrium, hall, and back conference entrance of one of Orlando’s most stunning hotels.

The Hybrid Member Academy: Roadmap to Member Success WEDNESDAY, AUGUST 10 | 8:30AM10:30AM Hybrid Event - East Orlando Chamber office

Healthcare Collaborative Meet & Greet Breakfast

More than one hundred businesses highlighting their products and services offering you a one-stop-shop for everything you need. Food, drinks, giveaway’s and more makes this the place to be on August 25. Where is this delightful event for adults to connect and peruse? It is the annual East Orlando Chamber (EOCC) Business Expo, August 25 from 5-8 PM at the DoubleTree Orlando Airport. With 100+ exhibitors, it is the best place to connect with EOCC Members and nonmember participants in one place, not to mention another 300-400 potential customers visiting your space during this three-hour event. For those participating in the event, it was an easy decision. Audrey & Ben Hochstetter, owners of Signarama Orlando North have been part of the Expo for years watching it grow in popularity. There was so much excitement for their products and services that they have secured a second table and scheduled more team members to meet the need. The leads from last year were so strong, that they anticipate 2022 to be even better. Last year was a first for Justin Walsh, Store Manager at TD Bank University Blvd. Given the uptick of the Covid variant, he was a little apprehensive, uncertain what to expect. After the event, the entire bank was talking about how engaged the businesses were. Businesses came to their table interested in how they could collaborate and connect them with others. He not only got business from the event but continues to expand his connections with those he met. In fact, he is even volunteering for an organization he met in 2021. Justin and the TD Bank team are ABSOLUTELY attending the event this year and encourage other to do the same. Membership sales is important to Sam’s Club Lake Nona. With a clear objective, goals for the day and a tray of cookies in hand, the Sam’s team had one of the most profitable days for the year. Secrets to their success included standing in front of their table, greeting everyone passing their table, an engaging smile and an offer attendees just could not refuse. James Groves with Hole in the Wall Drywall Repair was so excited for this year’s event, he signed up as soon as registration opened, purchased an extra table, and secured his spot on the Bingo Card. This is a man with a plan. Hungry for more? We have our restaurant partners featuring bites to delight. Host site, DoubleTree Orlando Airport will feature a spread of delectable delights in the restaurant’s breakfast nook. Relax and unwind with the tasty treats of ChebaHut. Enjoy the fresh, farm to table tastes from CHOP5 or the organic refreshment from Clean Juice Waterford Lakes. Guacamole Mexican Grill will spice up your evening, while Marlow’s Tavern tantalizes with Tavern treats. Looking for comfort food? Metro Diner has just what you are looking for. P1 Vodka will bring the pizazz to the evening while you eat like a rock star with Rock & Brews favorites and socialize big time with Keg Social. There

Hosted by UCF Lake Nona Hospital THURSDAY, AUGUST 11 | 7:30-9:00AM UCF Lake Nona Hospital

Ribbon Cutting: The Learning Experience O-Town West THURSDAY, AUGUST 11 | 11:00AM12:30PM The Learning Experience O-Town West

EOCC Advocacy Advisory Council FRIDAY, AUGUST 12 | 10:00-11:00AM Virtual Meeting. Register to participate

EOCC Real Estate Advisory Council Planning Meeting

TUESDAY, JULY 19 | 9:00-10:00AM East Orlando Chamber of Commerce

Financial Literacy 101 Lunch & Learn Presented by World Financial Group WEDNESDAY, AUGUST 17 11:30AM-12:30PM East Orlando Chamber office

Coffee Club Nona: Often imitated, never duplicated … the ORIGINAL Coffee Club (3rd Thursday of the month) THURSDAY, AUGUST 18 | 8:30-9:30AM Sam’s Club Lake Nona FREE to EOCC Members | $10 for Non-Members

EOCC Business Expo 2022 Exhibitor Registration THURSDAY, AUGUST 25 | 5:00-8:00PM DoubleTree Orlando Airport

EOCC #Buzz4Biz Discover the Value of Chamber Investment TUESDAY, AUGUST 30 | 8:30-9:30AM The 5th Floor Orlando

OPTIC Orlando: Top 10 Ways to Safeguard Your Personal Privacy Online FRIDAY, SEPTEMBER 16 | 9:00-10:00 AM Full Sail University. $10 per person includes light breakfast bites

Visit EOCC.org for a complete listing of August events 7

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“Incredible things in the business world are never made by a single person, but by a team.” Steve Jobs, Co-founder, Chairman & CEO of Apple

is so much to do, see and taste at this year’s Business Expo, make it a date night. If you want to continue the fun, join us for the After Party at Marlow’s Tavern Lee Vista at 8:00 PM. It is all about connecting, building relationships, and making new friends. Purchase your tickets to attend the 2022 EOCC Business Expo now. It is a real bargain at just $10 a piece for a chance to talk to vendors, sample delicious food, connect with others and win prizes. For those reading this article, use Promo Code OMN2022 to get in FREE. The East Orlando Chamber Business Expo 2022 is Thursday, August 25, 2022, from 5:00=8:00 PM at the DoubleTree Orlando Airport Hotel, 5555 Hazeltine National Drive, Orlando, FL 32812. Register today at eocc.org. For more information or to register for events call (407) 277-5951 or visit our website at eocc.org. The East Orlando Chamber of Commerce everywhere East of I-4.

Navigating the Real Estate Rapids BY GARY BALANOFF

Whether you are thinking about getting into the residential or commercial markets of real estate, you have no doubt seen the headlines: “Interest rate hikes quell interest in homes” “Orlando rated one of the metro areas with highest spike in rent and purchase price” That seems great if you are looking to sell and get out of the market completely, but what if you seek an investment? What to do if you want to buy an office condo or free-standing building for your medical practice? How do you make the right move? Are there steps to protect your investment? The answers depend, of course, on your particular situation, but there is value to be had in both residential and commercial buildings. First, let’s take a look at commercial. You might have noticed that despite the fact that more than 2 million people live in the Metro Orlando area; there are not that many commercial spots available. And the ones that are available, are asking for large rents, followed by large rent increases. Many practitioners have decided to purchase a building or office space rather than fight with out-of-state owners regarding rent hikes. The last time I moved office spaces, I had occupied the same space for 13 years, and thought the landlord might reward my on-time payments for that period of time with a flat or slightly reduced rent payment, or even split the space and charge less based on the space I occupied. They basically said if I was not willing to pay significantly more, they would put the space back on market and find someone else! To which I replied, “Go ahead!” Three years later, and $300,000 lighter in their collective wallets, they finally rented to our successor tenant. They could have recouped a lot of money if they did not get so

greedy, but they did not. I saved a significant amount and moved to a new space that was just opening, got a few months of free rent, followed by a much lower bill. And the space was one block away! It is an important lesson if you are looking to buy or rent space, or if you are looking to expand your horizons by buying and then leasing to commercial or residential tenants. Be a little flexible with ontime, full-pay tenants who treat the property and you with respect. So, what about the choices you have available to you now? Looking for commercial space is a little difficult if you want to buy. Often, there is space, but it is only for rent because the major centers are owned by conglomerates interested only in profits, and sometimes tax losses to offset their huge gains over the past 5 years of escalating rents. Cash does speak loudest, both in winning a bid for residential and commercial property. Most of my investors currently are all cash. That does not mean I do not encourage them to seek the alternative of getting a commercial loan. But if you have not done a commercial building loan previously, it is a little different

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than your traditional residential loan. In buying a home, you can put as little as 0 down payment for a VA loan, 3 percent for conventional and 3.5 percent for FHA. The loans typically run either 15 or 30 years and at time of this printing, run 5-6 percent depending on percentage down, credit rating, and strength of your employment. Lenders are VERY pleased to deal with doctors because you usually have access to a sound financial background, income, and resources. So, it is not usually a problem to get a prime rate loan. The same is not quite as easy with commercial, because they are likely to give you a loan with 20-25 percent down payment, at ¾ percent to 1 percent above the residential rate. With rates rising on every kind of loan, that can make the loan not only harder to get, especially without a track record of paying off previous commercial loans, but also make the total payment “nut” much harder to crack. If you have the cash, it is usually wiser to use that and you only have other business-related expenses to pay each month, with no big mortgage payment. It feels good not to have a large rent payment to go along with insurance costs, staff, equipment, and utilities payments. If your business outgrows the location, you can use extra resources to either expand to another location and build new patients there or find bigger space and rent this first building to another commercial tenant, where you can set the rules and payment schedule and have a nice profit coming in from your investment. Example: $1 million building paid all cash. Taxes might be $8000/year, and insurance might run $5000-6000/year. But those are all the costs included in your ownership. If you take a loan of $750,000 you are still paying $250,000 out of pocket and paying those same taxes and insurance. But your monthly Principal and Interest payment on a 6 percent rate over 20 years would be typically $5373. So, in a year, you would be paying $64,476, and at the end of 5 years when the lender re-negotiates the terms of the loan (because it has a 5-year cap), you have paid $322,380, and still need to pay off $638,926. And can you predict what the rate will be then? Even if the value of the building increases by 5 percent per year (a fairly normal and reasonable appreciation), the building should appraise at approximately $1.27 million. Which means you will be able to qualify to refinance. If the rates are lower in 5 years, you will have plenty of options. But if rates are higher, will you need to rent the space for the amount needed to make a profit? Perhaps, but if not, you are looking at an investment that continues to need upgrades to enable renting or selling, and not enough revenue stream to make that happen. So, if you can, my recommendation is to fund out of pocket, and you will have more long-term stability and resources and potential return than any other method.

AUGUST 2022

Pelvic Physical Therapy: Not Just for Women Anymore! BY CHARLES DUDLEY, MPT, COMT

wraps up business as quickly as possible and gets out of there! The only time I have seen men chatting in the men’s room was at Oktoberfest in Munich when everyone was drunk, and barriers were at an all time low! BTW, so was the partition between urinals. Actually, there were no urinals, it was a trough with a partial wall between you and the guy on the other side facing you. Very awkward, even when drunk. We are social creatures and if it is not being talked about then it must not be important. This is what has led to a 28-year gap between the binary sexes in pelvic health. Don’t believe me? June Allison was the spokesperson for Depends in 1984. She was perfect because she represented their target audience, older women with incontinence. Depends for Men did not come out until 2012. In an effort to normalize their product, they did not use older men for their commercials, no, they used younger men who were active, even having professional athletes try their product and be a spokesperson. Right question, wrong answer. U.S. sales of incontinence products were a $4.4b industry in 2020, while PDE5 inhibitors brought in $3.5b. That is a lot of people peeing themselves and getting hard! Pelvic physical therapy treats both of these conditions, and many more. Pelvic physical therapy is the culmination of orthopedics, neurology, psychology, endocrinology, urology, and G.I. just to name a few areas they are trained because of the uniqueness of the pelvic region and its relationship to all of these systems. Pelvic floor muscles are part of our core to give us trunk stability and can lead to back and/or hip pain when weak. The same muscle group gives bladder control, as well as bowel control. The very same muscles give us sexual function, whether penile, vaginal, metoidioplasty, or neovaginal. It has an elegant system of neurological control blending conscious and subconscious systems. When was the last time you consciously coordinated the muscles for an

Pelvic physical therapy has been around for quite a long time but unlike other areas of physical therapy, with equal access to all sexes and genders, pelvic physical therapy is largely skewed toward cis women, dominating the field of research as well as trained physical therapists. According to the National Library of Medicine, there are 12,443 articles for women’s pelvic health and 2,974 articles for women’s pelvic physical therapy, compared to 80 articles for men’s pelvic health and only 22 articles for men’s pelvic physical therapy. There is even less research data for the transgender community, bringing in only 55 research articles for transgender pelvic health and only six articles for transgender pelvic physical therapy and it only gets worse. Trans men have only ONE article for pelvic health and NONE for pelvic physical therapy. Ironically the disparity we see between cis women and cis men regarding pelvic research holds true in the trans community, albeit far fewer articles for trans pelvic than cis pelvic. Trans women have 37 articles for pelvic health (Compared to 12,443 for cis women) and a mere six articles for pelvic physical therapy, a quick afternoon of reading over tea for some of you. The problem is we all have a pelvic floor! I have heard of doctors telling their male patients they don’t have a pelvic floor and have nothing to worry about, but they do on both counts. I have also heard stories of doctors telling trans men they cannot get pregnant because of being on HRT, but if you have a vagina and sleep with someone spermy, then yes, while the chances are lower because of the HRT, you can still get pregnant. Is it any wonder that we are unintentionally putting our patients at risk? Not out of malice but out of a lack of knowledge. I mean, it is not like there is a lot of reading involved at this point from the research article standpoint, so why haven’t you read them yet? Simple. It is not talked about. There is a social factor when it comes to how each of these groups has conversations and the more marginalized the group the more selective they become in who they trust with certain information about themselves with not just medical providers, but also with each other. You are wondering why men are lumped into this category of marginalized groups? In this instance, they are. The social pressures to be strong, masculine and invulnerable is oppressive. Men do not talk to each other in the bathroom while women share make up and chat with their friends. It is not uncommon for women to go to the lady’s room in pairs but men one at a time. If a guy is at the urinal and another guy starts talking to him, he

orgasm? We don’t! We can tell if there is solid, liquid, or gas in our rectum and discriminately let out one but not the other, even though we sometimes get it wrong. We can pee without pooping, poop without peeing, and engage in sex without releasing the two sphincters when we engage the pelvic floor leading up to climax or relax it after climax. We all have a pelvic floor with muscles that control our most intimate of needs regardless of our gender identity and I encourage you to reach out to your local pelvic physical therapist closest to you as they help patients get to the core problem and truly fix them. Don’t ignore the canary in the cave. Charles Dudley, MPT, COMT, of Davenport Pelvic Therapy, has been a physical therapist for over 2 decades in the U.S. and London, UK. He is a certified orthopedic manual therapist specializing in men’s pelvic health as well as transgender health with training through Herman & Wallace Institute of Pelvic Rehab where he is also a teacher’s assistant. He is also the medic/physical therapist for the Orlando Otters, RFC. Visit www.davenportpelvic.com. Email him at charles@davenportpelvic.com

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SENIOR || HEALTHCARE & LIVING

Five Foods to Avoid if You Have IBS FROM DIGESTIVE AND LIVER CENTER OF FLORIDA

Irritable bowel syndrome (IBS) is an intestinal disorder that causes gas, diarrhea, pain in the belly area, and even constipation. Unfortunately, if you do have IBS, you’ll be dealing with this chronic disorder long term. Symptoms of IBS vary per individual, but the most common ones include abdominal pain (cramping or bloating), changes in your bowel movement’s appearance, and how often you’re having the bowel movement. These symptoms can actually be triggered by stress and the food you eat. With this in mind, the Digestive and Liver Center of Florida is here to help you manage this condition by information you on foods you should be avoiding if you have IBS. Check it out!

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Our Orlando GI Experts Suggest You Avoid the Following Foods

Delivering the BEST options for Assisted Living Facilities

1) Gluten It’s a group of seed storage proteins found in grains like rye, wheat, and barley. There are people who have a serious immune reaction to gluten (celiac disease), or even a gluten intolerance. These conditions have the same symptoms as diarrhea predominant IBS. Because of this, our Orlando GI experts at the Digestive and Liver Center suggest to avoid foods with gluten.

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Serving Central Florida

2) Dairy It’s reported that consuming dairy can trigger IBS symptoms; it may still be uncertain if people with IBS are more likely to be lactose intolerant. Our Orlando physicians at the Digestive and Liver Center suggest switching to plant-based milks if dairy or milk products are causing intolerable digestive issues. If you need to completely cut out dairy, you can consume other calcium-rich foods like beans, nuts, sardines, seeds, etc.

assistedlivinglocators.com/orlando-northeast

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3) Fried Foods The high fat content in fried foods can be harsh on the stomach. Also, did you know that frying the food can actually change the chemical makeup of the food? This makes it more difficult to digest, meaning you’ll have rough gastrointestinal symptoms. As a healthy alternative, grill or bake your favorite foods instead.

4) Caffeinated Drinks Caffeine has a stimulating power on the intestines than causes diarrhea. Therefore, anything like coffee, sodas, energy drinks, etc., should be avoided. In the event you’re in need of an energy boost, try eating a snack or taking a walk. 5) Processed Foods Foods like chips, processed meats (hot dogs, sausages), frozen meals, etc., all have an excess amount of salt, sugar, and fat. This is definitely a trigger for symptoms. We know that Orlando commutes aren’t easy, and that the last thing you’d want to do is cook after a long day of work. Nevertheless, it’s the best thing to do to maintain your health.

Visit the Digestive and Liver Center Keep in mind that while all of the above are suggested items to not have in your daily diet, each person has their own unique situation. Learn more about your body and which foods make you feel good and which ones make you feel uncomfortable. You can have a more detailed conversation with one of our gastroenterologists about your diet at the Digestive and Liver Center. Conveniently in 6 different locations in the Orlando area. Call to schedule your appointment at (407) 384-7388

Benefits of Aging Opens to Serve Seniors and Their Caregivers With age often comes the need for additional care, and Sara Rodriguez, MS, CMS, owner and founder of Benefits of Aging recognized, after 15 years of serving seniors, that her passion for delivering that care goes beyond seniors and applies to their adult children and caregivers, as well. Rodriguez formed Benefits of Aging to use her Medicaid expertise to apply and help get clients approved for Medicaid benefits to pay for needed care services. She holds a master's degree and Graduate Certificate in Aging. She and her team have a 100% approval rate for all their Medicaid applications. With Medicaid benefits in place, a daughter can

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focus on a loving and caring relationship with her elderly mother, rather than suffering from caregiver burnout. An elderly man can receive the equipment he needs to feel independent and keep his dignity. Moving into Assisted Living becomes a welcome relief rather than an unattainable goal due to cost. Senior care creates a financial burden and Benefits of Aging helps navigate the complexities of financial resources and the differences between Medicare, Medicaid and Long-term Care programs. Staff knows how each available benefit works efficiently, separately and in combination. If the time comes for placement in a Living Center, the experienced staff can help match loved one's needs and wants to the best facility in the area. For more information visit www.benefitsofaging.com

SENIOR || HEALTHCARE & LIVING

Paying for Senior Care, Learn About Available Resources to Help You Cover the Costs

• Insurance Policies. Life insurance, long-term

BY BEAU W. HERMAN

care insurance, long-term care annuities and hybrid policies can be used to provide a regular stipend that can go a long way toward covering expenses for everything from adult day care to skilled nursing. While the best time to take advantage of long-term care policies is when you are younger, there are still options available at almost any stage of life. In order to find out what options you might have, consult with a trusted financial planner, eldercare attorney or a Certified Senior Advisor.

“How do I pay for senior care?” It’s a question many aging Americans and their families struggle with now more than ever. While many people think that they have saved up enough in retirement for assisted living, when it comes time to start planning for that phase of life, many people find that what they thought was enough to cover assisted living costs, is not. Senior Advisors across the United States suggest learning about creative financial resources that are available. They can also answer a wide range of questions on long term care and can refer to you to appropriate state and federal resources for Medicare and Medicaid. Many people who need senior care services put it off because they are unsure of how they´ll pay for it. The median monthly rate for a one-bedroom unit in an assisted living community in Central Florida is $4,000 per month and in some regions it’s even higher. Many families are understandably concerned about how to pay for assisted living. Below are some financial resource options you may want to consider.

• Bridge Loans. These programs can help homeowners quicken their cash flow when they need it most, regardless of the real estate outlook of their local market or readiness to put a house up for sale. While bridge loans are relatively new, they are gaining in popularity and are geared toward families looking to place a loved one into an Assisted Living Facility, which may make them easier to obtain than going to a traditional bank or lending source, and the terms are fairly competitive.

• Reverse Mortgages. Another way to unlock home equity, reverse mortgages provide a way for seniors to remain in their homes while generating funds for their care. There are advantages and disadvantages to this. While at one time they were considered risky, new federal guidelines have ensured that there is more transparency in the marketplace and consumers have a better understanding of what they are signing up for. While many lending institutions offer some type of reverse mortgage product, there are some banks that specialize only in reverse mortgage. Do some research and consult with a trusted advisor to see who could offer you the best product in the marketplace.

• Veterans Aid & Attendance. If you or your spouse served in the military during active duty, you may qualify for this monthly benefit, which can help cover in-home, assisted living or nursing home care. While veterans or their loved ones can complete the application on their own, most find a benefit in using an Elder Care consultant to help them with the process. Like many government programs, the application and approval process can be complicated and overwhelming, which is why hiring a professional to help can be beneficial.

• Social Security. When you choose to begin drawing on these benefits can make a big difference in your financial plan. The longer you wait to begin withdrawing from Social Security, the more you will receive monthly. Unlike other monthly government entitlement payouts, 100you’re your monthly social security can be used to pay for assisted living expenses. Learn more about how to plan what’s best for your scenario by contacting the Social Security Administration or a trusted Elder Care Advisor.

Making the decision of how to pay for assisted living and choosing the right facility can be challenging for a family. If you have questions about a move to assisted living, a knowledgeable professional can assist you in reviewing your options. While this may be the only time you will be faced with this challenge, an experienced advisor can make recommendations based on years of experience and proven outcomes. Beau W. Herman, Certified Senior Advisor®, is the owner of Assisted Living Locators in Winter Park. He is a lifelong resident of Central Florida and provides a no-cost, placement and referral service that offers the best senior care options, information, and resources available. Visit assistedlivinglocators.com/care-advisor/orlando-northeast

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AUGUST 2022

Meet the new community bringing faith and expert support together. Providence Living at Maitland is unlike any memory support community you’ve seen - as exquisite as the people who will call us home.

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SENIOR || HEALTHCARE & LIVING

The Ins & Outs of Downsizing BY TERRI MISEK

The previous article in this series, When is it Time to Downsize? outlines the reasons to consider downsizing, and provides tips for making informed relocation decisions. This article covers what to consider once you’ve made the decision to downsize.

making process. If you don’t have a family lawyer, you may want to consider working with an elder law attorney.

Step 2: Decide Where to Move: 1. Locally 2. To a different city 3. To a different state

Step 1: Create your Downsizing Dream Team

Step 3: Decide what size and type of new home would best suit your needs:

Having a knowledgeable team will help you relocate with the minimum amount of stress. Consider including the following on your team:

• Smaller house • • • • •

Family Member(s) Senior Real Estate Specialist | Hire a SRES (Senior Real Estate Specialist) to help you list your home. An SRES is important because the can share their network of qualified resources such as elder law attorneys, financial advisors, move managers and other professionals who can be extremely helpful during your transition.

Sell | Once you’ve determined what you are keeping, gifting and donating, it’s time to figure out how to sell the rest. If you want to sell things yourself, options to consider include:

Apartment Condo Retirement community Assisted living facility RV & travel the world

• Garage Sale (Individual or Community)

Step 4: Decide what to take to your new home. It’s helpful to divide your possessions into four groups:

Senior Move Manager | Hire a Senior Move Manager who specializes in facilitating every aspect of the downsizing process. Visit the National Association of Move Senior Managers for a list of move managers near you: www.nasmm.org.

Keep | Decide what possessions mean the most to you (“Bring you joy” in Marie Kondo language!); these are the treasured keepsakes you want to take with you to your new home. It’s important to consider the layout of your new home. Don’t over pack!

Estate Sale Planner | Ask your realtor or move manager for recommendations, or check out the National Estate Sales Association for a list of members: www.nesa-usa.com/

Gift | After you’ve decided what you are taking to your new home, invite your children and grandchildren to come and pick out things that they find meaningful and would like to have. You may also want to invite close friends to choose mementos.

Trusted Advisors (Legal & Financial) | Be sure to include your attorney and financial planner in the decision-

Donate | Pick an organization that you like to support and could use your extra furniture, clothes, housewares and other items. If none of the organizations you currently support could benefit from what you want to donate, consider a reputable national charity such as Good Will, Habitat for Humanity, or the Salvation Army. You can check out charities on www.charitywatch.org or www.charitynavigator.org.

• • • • •

Consignment Shops Church Bazaars On-Line: Craig’s List, E-bay, Let it Go, etc. If you’d prefer to hire someone to help you, options to consider include: • Estate Sale Planner • Furniture Liquidator • Arts & Antique Dealer Stay tuned for the next article in this series: Making the Move! Terri Shayne Misek is a Senior Real Estate Specialist who specializes in helping seniors transition from their current home to a future home they’ll love. She’s active in her local community and co-leads a widows group in Longwood. For more information about Terri and her services, visit her website: www.SeniorRealEstateFL.com.

Advance Patient Care With Better Digital Health

Empowering digital healthcare by connecting caregivers and patients. Connectivity is at the core of the healthcare digital transformation helping to change, improve and save lives. Empowering digital healthcare by connecting caregivers and patients will help enhance the overall patient experience and your facilities reputation. You need advanced communication services from a provider like Smart City Metro who will take care of you as well as you take care of your patients. We deliver the most advanced communication services over a state-of-the-art fiber network, dedicated account management, professional technical support, and the most responsive locally based customer care you won’t find anywhere else. Highly flexible, scalable fiber Internet network to keep up with the pace of healthcare Digitally transform legacy systems with a secure SD-WAN solution Easily and securely connect care teams and patients with Hosted Voice and Unified Communications Connect locations site-to-site or site-to-multi site Ethernet solutions over a secure fiber network Whatever size of your facility, and if you staff is on-site or remote, let Smart City Metro’s network be the backbone of your infrastructure that enables you to provide the world class care your patients deserve.

Call today for free communications assessment at 407-828-6400 LEARN MORE

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AUGUST 2022

Diverse Identities & Death Care ■ Solutions & Resources

BY MATTHEW ROSENTHAL AND TEE ROGERS

When we talk to families about end-of-life planning, we should be reducing the uneasiness for them as much as possible.

Identity Directives There’s a new free resource for your patients: Identity Affirming Deathcare Directives © A complement to other planning documents, this fill-inthe-blank style workbook records identity preferences and how they will be honored during hospital/hospice care and by funeral and cemetery professionals. It lets loved ones know how we perceive our identity and how that identity informs our own decisions about our care at the end of our life. The workbook is for LGBTQ+ identities as well as all Religious, Secular, and Spiritual Identities (RSSI). It guides through identity choices for hospice and for final arrangements. Planning ahead for our care as death approaches and for our care after death has occurred, is essential. It reduces stress for our loved ones as well as ourselves, providing a roadmap that answers the financial, emotional, and logistical questions that will arise. Preplanning quells chaos at the time those decisions need to be made, but it also gives us peace of mind now; we no longer have to worry about what is going to happen or where we or our loved ones will turn for help when the time comes. DOWNLOAD THE WORKBOOK HERE Free download of the Identity-Affirming Deathcare Directives© workbook, workshop information, and identity affirming grief support resources.

We must be sensitive to individual circumstance, and it is essential that we know about resources in our community where patients of diverse identities can find affirming, safe professionals to support them. Facing mortality is difficult enough for all of us, but some have added concerns. When your diverse patients – specifically, LGBTQ+ or those of religious minorities or secular identities – think about deathcare planning, they may face anxiety about how their identity will affect their care – a stress point you can help mitigate using the tools in this article. DEI (Diversity, Equity, and Inclusion) fluency means being educated about diverse identities, aware of identity experiences, and knowledgeable about resources. Being Identity Affirming means serving as a safe and understanding professional space where diverse identity individuals are welcomed, honored for who they are, and do not have to feel uncomfortable or judged. End of life care professionals who are DEI fluent and identity affirming can ease concerns and make a difficult situation much less challenging. They can also connect clients to networks of other affirming providers and resources. Your clients may worry that hospice care workers won’t be affirming or possibly even accepting of an identity, that an estate planning attorney won’t help ensure that someone other than their next of kin can handle final arrangements, or that family or deathcare professionals will hold or perform services that are unwanted or dishonoring to their identity.

Workshops or Q&A sessions Interested in further discussion to enhance awareness for your staff regarding deathcare resources for all LGBTQ+ and minority Religious, Secular, and Spiritual Identities (RSSI)? Schedule a free on-site workshop or Q&A session

about identity affirming end-of-life planning or ask us about community workshop schedules. The first community workshop will be held on August 11. Details and RSVP: http://IADD-081122.eventbrite.com

■ Identity Affirming Grief Support Resources There are many resources for support when grieving a loss; unfortunately, grief support groups and even mental health providers may turn people of diverse identities away. Or if not turned away, the person seeking help may find themselves in a “support” relationship that is not at all supportive of their identity.

LGBTQ+ Resources • The Center Orlando Resource Guide: https:// thecenterorlando.org/resourceguide • NAMI Resource Guide: https://namigo.org/resources/lgbtq-services • 26 Health, Mental Health Resources: https://26health.org/service/mental-health • National Resource Center on LGBTQ+ Aging: https://www.lgbtagingcenter.org • PRIDE Chamber (LGBTQ+/Ally owned businesses and organizations): https://ThePrideChamber.org

Secular Resources (Atheist, Humanist, and other non-religious identities) • Find Humanist Celebrants and Chaplains: http://TheHumanistSociety.org • Humanist Celebrants or Chaplains serve the non-religious community in the same role as religious clergy. • Contact The Humanist Society for referrals: endorsement@humanist-society.org • Humanist Celebrant Orlando: http://HumanistCelebrantOrlando.com • Recovering From Religion (local support groups): https://www.recoveringfromreligion.org • Grief Beyond Belief: http://griefbeyondbelief.org • Readings, Links, & Resources: http://griefbeyondbelief.org/resources

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• Death, Grief, and Belief: https://deathgriefandbelief.com • Secular Therapy Project: https://www.seculartherapy.org

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• Humanist Community in Central Florida: • Central Florida Freethought Community: http://CFLFreethought.org

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• Other groups & support https://americanhumanist.org/get-involved/ find-or-start-a-chapter/

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Find resource list here: https://humanistcelebrantorlando.com/identity-affirming-resources/

139 N Central Avenue, Oviedo, FL 32765 2900 South Orlando Drive, Sanford, FL 32773 (407) 365-5151 (407) 322-3000 Every Wednesday 2 – 5 pm Every 2nd Tuesday 9 am – 2 pm https://www.oviedotownhouse.com/Dine-In-Menu http://www.sanfordpatiogrill.com/menu/

■ Identity Affirming Final Arrangements Planning There are heartbreaking stories of how people of diverse identities experience the funeral industry and end-of-life planning: people denied service from funeral homes and grief support, experiencing fear of being dishonored in death and having identity ignored or even erased, and loved ones traumatized by family rifts and battles over final arrangements. There are tools available to help families plan ahead, mitigating these and other challenges.

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Matthew Rosenthal, Esq. of Rosenthal Meyer, PLLC provides comprehensive advanced estate planning that solves many of the issues that arise after a death occurs. Tee Rogers is a funeral and cemetery planning advisor with Dignity Memorial. Together, we created the Identity Affirming Deathcare Directives© workbook and we both serve in our Central Florida community providing identity affirming planning services. If you would like further information on identity affirming deathcare planning or any of these resources, contact Tee Rogers at tee.rogers@outlook.com or 407-608-9242. For information on identity-affirming estate planning and legal questions, contact Matthew Rosenthal, Esq., mrosenthal@rosenthalmeyer.com or 407-504-9725.

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//www.facebook.com/CFLDFD email: cfldfd01@gmail.com

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AUGUST 2022

ORLANDO || GRAND ROUNDS Obituary for Matthew David Auker

(CNO). In her role, Ms. Colorado will supervise the nursing department and coordinate its daily operations to ensure patients receive the highest level of care. Ms. Colorado has more than 25 years of experience in hospital operations and nursing leadership. For the past decade, she served as chief nurse executive/vice president of patient care services at Monmouth Medical Center in Lakewood, New Jersey, part of the RWJBarnabas Health System. “Throughout her career, Judy has driven improvement in nurse engagement and patient satisfaction,” said Thibaut van Marcke, president, Orlando Health Dr. P. Phillips and senior vice president Orlando Health southeast region. “She is a dynamic leader and has used a shared governance model to solve complex problems throughout her career.” Ms. Colorado earned a Bachelor of Science from the Mary Johnston College of Nursing at Philippine Christian University in Manila, Philippines. She has a Master of Arts in nursing administration from New York University.

Matthew David Auker, of Altamonte Springs passed away unexpectedly on July 14, 2022, at the age of 64. He was a Comfort Keepers franchisee. Comfort Keepers is a senior in-home care company that Matt had owned and operated very successfully since 2001. Matt was a good man and with a kind soul. He was the most thoughtful, loving, and likable person around. Matt was well known for his friendliness and never hesitated to let people know that he loved them. He will be missed deeply for his big heart, his laugh, his empathy & compassion, his faith and his loyalty.

Digestive and Liver Center Hires New Doctor

National Ovarian Cancer Coalition Affirming 30-Year Commitment to Health Equity

The Digestive and Liver Center welcomes a new Gastroenterologist to the team, Sedat Ekici, MD. Ekici earned his Medical Degree at the University of Istanbul, Cerrahpasa Faculty of Medicine. After earning his medical degree, he continued his studies at Long Island College Hospital in Brooklyn, New York, where he completed his internal medicine residency as well as his Gastroenterology Fellowship. Ekici specializes in colonoscopies for colon cancer detection and removal of polyps, routine endoscopies, therapeutic ERCP with cholangioscopy, and a full scope of gastroenterology office practices with a special interest in liver diseases. Ekici has also been a vital part of research publications. One of his most notable topics has been on predicting hepatic fibrosis and cirrhosis in hepatitis C patients in a community setting. He is fluent in English, French, Turkish, and is in intermediate level Spanish to communicate in a medical office setting. Digestive and Liver Center of Florida is a gastroenterologist and colorectal surgery practice with six locations and two surgery centers founded over 15-years ago with the mission to provide sophisticated, state-of-the-art medical care within a compassionate and Patient First experience.

As the National Ovarian Cancer Coalition (NOCC) celebrates its 30th year of supporting survivor quality of life and ovarian cancer research, the organization has launched two new programs to reaffirm its commitment to increasing health equity in the ovarian cancer community. You and Ovarian Cancer - Animated Patients Guide From the time of diagnosis, ovarian cancer patients, caregivers, and families face the daunting task of understanding this disease and making critical health decisions. NOCC’s You and Ovarian Cancer - Animated Patients Guide was developed in collaboration with Mechanisms in Medicine to provide credible, health literate, and evidence-based ovarian cancer education. This highly visual resource aims to provide the education, knowledge, and skills people need to make informed health decisions with their health care team. This program can be found at YouAndOvarianCancer.com. NOCC would like to thank its partners for their support of this education program, Alkermes plc, AstraZeneca Pharmaceuticals LP, Clovis Oncology, Inc., Eisai Inc., Genentech, GSK, Merck & Co, Inc., Novartis, Novocure Inc., Pfizer, Inc. NOCC Financial Assistance Program Understanding full well the financial burden that an ovarian cancer diagnosis can have on an individual and their families, the NOCC Financial Assistance Program was created with the Patent Advocate Foundation to support patients with non-medical expenses that will reduce the financial barriers associated with diagnosis and adherence to treatment. This program aims to support treatment

Orlando Health Dr. P. Phillips Hospital names new Chief Nursing Officer Judy Colorado, RN, BSN, MA, has joined Orlando Health Dr. P. Phillips Hospital as chief nursing officer

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adherence for a better quality of life and clinical trial participation, which will lead to advancement in ovarian cancer research. The program is divided into two funds; National Ovarian Cancer Coalition Treatment Fund provides $1,000 to offset the costs of non-medical expenses for those in active treatment or on maintenance therapy for ovarian cancer. National Ovarian Cancer Coalition Clinical Trial Fund provides $2,500 to offset the costs of non-medical expenses related to enrollment and participation in clinical trials.. As the organization looks to the next 30 years and beyond; both programs will serve to address critical health priorities in the ovarian cancer community. Reducing barriers to understanding ovarian cancer, treatment adherence, and clinical trial participation will lead to a world where no one will lose their life to this disease.

COVID-19 Vaccines Available For Ages Six Months to Five Years at Community Health Centers Community Health Centers, Inc. is, currently, offering the COVID-19 Vaccine for ages six months to five years in Orange and Lake counties. New or established patients are eligible. Both the Pfizer and the Moderna COVID-19 Vaccines are available. To schedule an appointment, please call 407-905-8827 (Orange County) or 352-314-7400 (Lake County). Community Health Centers, Inc. continues to offer the Pfizer or Modera COVID-19 vaccines for all individuals. To schedule an appointment for the vaccine, please call 407-905-8827 (Orange County) or 352-3147400 (Lake County).

WeCare tlc Announces Dr. Thuc Huynh as Medical Director WeCare tlc, a leading provider of onsite and near-site workplace health centers, welcomes Dr. Thuc Huynh as its new Medical Director. Dr. Huynh is a board-certified family physician with nearly 15 years’ experience in clinical operations and leadership. WeCare tlc will be leveraging her experience in developing hybrid care models as well as her passion, skills and expertise in medical informatics to help expand the company’s capabilities. “We’re excited to bring Dr. Huynh to the team and are confident her expertise will help distinguish WeCare tlc above our competitors,” said Raegan Le Douaron, president and CEO of WeCare tlc. “Her experience will be vital as we work toward developing our hybrid care models and expanding our telehealth options, which will provide more access to quality care as well as save clients time and money.” Her expertise is in understanding the unique and complex challenges of inter-state virtual health practices. She has advised virtual practices on regulatory compliance, policies and procedures and product development as well as developed and delivered training for clinicians to deliver quality care as a virtual practitioner. Dr. Huynh’s experience and passion for using digital health to reduce wait times, expand access to quality care and track treatments will play an integral part as WeCare tlc works to develop a hybrid healthcare model for clients. “I look forward to working with WeCare tlc to provide patients with more healthcare access options, including virtual healthcare,” said Dr. Huynh. “I believe our clients and patients will find having more ways to access healthcare outside of traditional office visits will make receiving the quality care they deserve quicker, easier and much more convenient.” Dr. Huynh holds a bachelor’s degree in health science and M.D. from the Medical University of the Americas, and completed the RCRH Family Medicine Residency program, graduating as chief resident. She holds several certifications from Epic including Physician Builder, Epic Classicist and Smartforms. For more information on WeCare tlc, visit https://wecaretlc.com.

NORTH FLORIDA || GRAND ROUNDS Dr. Robert D. Karch appointed as Director of the Florida Department of Health in Orange County

received two Cardiology Fellowships, one in General Cardiology and Interventional/Structural Cardiology from New York Presbyterian and NYU Winthrop Hospitals. Dr. Chughtai is also board-certified in Interventional Cardiology. He performs procedures on the heart including stent placement, procedures to fix leg arteries, installs permanent pacemakers and implanted heart monitors, procedures on leg veins. He also performs non-invasive testing on the heart including CT of the Heart, stress testing, and vascular testing. Dr. Chughtai completed his Internal Medicine training at Mount Sinai School of Medicine at Jersey City in 2008. Dr. Chugtai completed his Fellowships at Wake Forest University of Health Sciences, St. Joseph Mercy Oakland Hospital and Wayne State University at St. John Hospital in General Cardiology and Interventional Cardiology. Dr. Hussain and Dr. Chughtai are now accepting new patients at HCA Florida Seminole Cardiology Specialists located at 305 N. Mangoustine Avenue, Suite 200 in Sanford. For more information, or to make an appointment online, visit HCAFloridaPhysicans.com,

The Florida Department of Health in Orange County (DOH-Orange) is proud to announce the recent appointment of Dr. Robert D. Karch, M.D., M.P.H., F.A.A.P. as the Health Officer and Director of DOH-Orange by Florida Surgeon General Joseph A. Ladapo, M.D., Ph.D. Dr. Karch brings over two decades of experience in the medical field and extensive public health and administrative experience. Before joining DOH-Orange, Dr. Karch served as the Deputy Secretary and Deputy State Health Officer for Children’s Medical Services at the Florida Department of Health, assuming that role in 2020. Prior to this position, he practiced ambulatory and inpatient pediatrics with the Nemours Foundation and had served as the president of the medical staff and chair of the medical executive committee at Nemours Children’s Hospital in Orlando, Florida. He is an Associate Professor of Pediatrics at the University of Central Florida (UCF) College of Medicine, where he directed the medical nutrition curriculum. He also served as the UCF College of Medicine pediatric clerkship site director for the Nemours Children’s Hospital inpatient teaching service from 2014-2019. He was inducted into the Gold Humanism Honor Society at UCF College of Medicine in 2017. He is board certified by the American Board of Pediatrics and is a fellow of the American Academy of Pediatrics (AAP). He is also a member of the Florida Chapter of the American Academy of Pediatrics (FCAAP), the American Public Health Association, the Florida Public Health Association, and the American Society for Nutrition. He is a Board Member of the Florida Healthy Kids Corporation, the Florida Developmental Disability Council and the Florida Genetic and Newborn Screening Advisory Committee. He serves on the Florida State Health Improvement Plan (SHIP) (2022-2026) Advisory Committee and is a Co-Chair of the SHIP Injury, Safety and Violence Priority Area Workgroup. Dr. Karch earned his Bachelor of Arts degree in Biology from the University of Delaware, a Master of Public Health degree with special emphasis in health promotion and disease prevention from the Columbia University Mailman School of Public Health in New York City and a Master of Science degree in Health Policy Research from the University of Pennsylvania in Philadelphia. He earned his Medical Degree (MD) from the Georgetown University School of Medicine in Washington, D.C.

NORTH FLORIDA AdventHealth Ocala Partners with Marion County Public Schools and the Community Foundation to Give Back to Students

In a first ever county-wide event, AdventHealth Ocala partnered with the Community Foundation and Marion County Public Schools to provide free services and more than 6,000 backpacks filled with supplies to families throughout Marion County. AdventHealth Ocala’s Auxiliary Center served as the main host location with satellite locations at:

and urology (48th). Beyond the ranked specialties, three UF Health Shands specialties were rated as “high performing,” which puts them in the top 10% of all hospitals nationally in their respective disciplines. Those are cardiology and heart surgery, gastroenterology and gastrointestinal surgery and neurology/neurosurgery. In the procedures and conditions ratings, UF Health Shands is distinguished as “high performing” in 15 categories. Those are abdominal aortic aneurysm repair, colon cancer surgery, chronic obstructive pulmonary disease, diabetes, heart attack, heart failure, hip fracture, hip replacement, kidney failure, knee replacement, lung cancer surgery, ovarian cancer surgery, pneumonia, prostate cancer surgery and stroke. The orthopaedics ranking is the highest ever for the department, which has now been either nationally ranked or high performing for nine consecutive years. Orthopaedics rose in the rankings partly due to significant improvements in discharging patients to their homes rather than a rehabilitation facility. That effort and others are now producing positive benefits for patients, said Mark T. Scarborough, M.D., a professor and chair of the College of Medicine’s department of orthopaedics and sports

Pediatrics Exam Table with Digital Weight Scale

• Belleview High School • Dunnellon Middle School • Ft. McCoy Middle School

HCA Florida Lake Monroe Hospital Announces Opening of HCA Florida Seminole Cardiology Specialists

• Lake Weir High School • Liberty Middle School • North Marion High School

HCA Florida Lake Monroe Hospital, an affiliate of HCA Florida Healthcare, announced the opening of HCA Florida Seminole Cardiology Specialists further expanding access to cardiovascular care for the residents of Central Florida. HCA Florida Lake Monroe Hospital is pleased to welcome Dr. Hafiz G. Hussain, M.D. and Dr. Haroon Chughtai, M.D. at HCA Florida Seminole Cardiology Specialists. “After a thorough and comprehensive search, we are excited to have found Dr. Hussain and Dr. Chughtai as both of these distinguished board-certified cardiologists have proven clinical experience that provide a great benefit to our health system, our community, and the patients we serve,” said Trey Abshier, Chief Executive Officer, HCA Florida Lake Monroe Hospital. “Dr.Hussain and Dr. Chughtai are both welcome additions to the dedicated team at HCA Florida Lake Monroe Hospital as we continue to enhance our ability to provide the highest level of care for our patients in Central Florida.” Dr. Hussain is a board-certified Interventional Cardiologist caring for patients in Sanford. He specializes in Interventional and Structural Cardiology. Dr. Hussain obtained his medical degree from King Edward Medical University and completed his residency training at NYU Lutheran Medical Center. Dr. Hussain

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UF Health Shands hospitals nationally ranked in 10 adult, Pediatric Medical Specialties University of Florida Health Shands Hospital once again has the most nationally recognized adult and pediatric specialties among Florida hospitals ranked by U.S. News & World Report. The 2022-23 Best Hospitals report released today solidifies UF Health’s position as the state’s premier destination for nationally ranked health care specialties. The analysis of more than 4,500 adult hospitals again puts UF Health in elite company with health systems nationwide that are ranked in medical specialties. The adult hospital rankings come six weeks after UF Health Shands Children’s Hospital tied for the No. 1 pediatric hospital in Florida and earned national rankings in five pediatric specialties from U.S. News & World Report. Overall, UF Health Shands Hospital is ranked in 10 adult and pediatric medical specialties. The five adult specialties ranked among the nation’s top 50 are orthopaedics (26th), ear, nose and throat (40th), geriatrics (45th), pulmonology and lung surgery (48th)

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VOLUSIA/BREVARD || GRAND ROUNDS at Vanderbilt University and the Biologic Response Modifiers Program (BRMP) at the National Cancer Institute, Dr. Oldham is a pioneer in the field of oncology. He holds a Clinical Professorship of Medicine in Hematology/Oncology at the University of Missouri-Columbia and has been a Clinical Professor in the Department of Biomedical Sciences at Florida State University College of Medicine. Additionally, he has served as a consultant in the US and overseas including Gen-Cell (Rhône-Poulenc), Jenner Technologies, Welcome Biotechnology Ltd. and Amersham Corporation in England. He also served as a senior consultant with the American Red Cross, Cell Genesys Inc., Xcyte Therapies and Maxim Pharmaceuticals.

medicine. The department has improved its outcomes for knee replacements, hip fractures, hip replacements, Scarborough said. It did so while also enhancing access to care, boosting patient satisfaction scores and seeing more patients, he noted. As a growing department, orthopaedics now has seven divisions with expertise in many specialties.

DOH-Marion Recognized for Efforts to Improve Older Adults’ Health The Florida Department of Health in Marion County has been designated an Age-Friendly Public Health System by a national group that advocates for policies to promote illness and injury prevention and health equity for older Americans. The Trust for America’s Health (TFAH) cited DOH-Marion’s commitment to the health and well-being of older adults in Marion County as the reason for the recognition. The group noted that it has worked with the Florida Department of Health since 2018 to make promoting healthy aging a top priority for all county health departments in the state. On its website, TFAH notes that the state of Florida is “deeply committed to improving the health and well-being of older Floridians.” DOH-Marion has exhibited that commitment, the group noted. “Trust for America’s Health’s Age-Friendly Public Health Systems Recognition Program is designed to encourage and support state and local health departments as they embrace their role in improving and supporting older adult health,” said TFAH Senior Policy Development Manager Megan Wolfe. “The Department of Health in Marion County is working to enhance the lives of its older residents through collaboration with community partners, expanded programs focused on older adult health, and using data to develop elder-focused public health interventions. TFAH is pleased to recognize DOH-Marion as an Age-Friendly Public Health System.” DOH-Marion works to promote healthy aging among older adults since people 65 or older make up 29% of the county’s population.

Parrish Medical Group Welcomes General Surgeon Alphonse Pecoraro Jr., MD, FACS TITUSVILLE — Parrish Medical Group is pleased to welcome Board-Certified General Surgeon Alphonse Pecoraro Jr., MD, FACS to the North Brevard community. Dr. Pecoraro completed his undergraduate degree in biochemistry and his medical degree at New Jersey Medical School in Newark, graduating as Valedictorian of both his college and medical school class. Subsequently, he completed both his internship and residency training in General Surgery at New York University/Bellevue Hospital, where he also served as Executive Chief Resident. His office is located at Parrish Healthcare Center at Titus Landing, 250 Harrison Street, Titusville, FL 32780. Dr. Pecoraro’s clinical interests encompass a broad spectrum of surgical specialties and diseases including disorders of the breast, colon, stomach, gallbladder, pancreas, hernia, complex wound care and skin related disorders. With a special interest in surgical oncology, Dr. Pecoraro held appointment as the Cancer Liaison Physician to the American College of Surgeons and received two consecutive national recognition awards for his work in this role. In addition, he has held numerous appointments including the Chief of Surgery and Chief of Medical Staff at Cape Canaveral Hospital, as well as Director of Residency Education and Chief of Surgery at Staten Island University Hospital in Staten Island, NY. More recently, he served as Chief of Surgery Chairman of Credentials Committee and a past member of the Board of Trustees at Rockledge Regional Medical Center. He is a Fellow of the American College of Surgeons and maintains membership in many medical organizations including the American Society of Breast Surgeons, Society of American Gastrointestinal and Endoscopic Surgery and Society of Surgery of the Alimentary Tract (SSAT). He has also been elected as a member of Alpha Omega Alpha Medical Honor Society.

VOLUSIA/BREVARD Prominent Oncology/Hematology Specialist Robert K. Oldham, MD, joins Parrish Healthcare TITUSVILLE, FLA. (July 25, 2022)— Parrish Healthcare and Parrish Medical Group are pleased to welcome Board-Certified Oncologist Robert K. Oldham, MD to the North Brevard community. Dr. Oldham is an internationally recognized oncology/hematology specialist and is regarded as a leading pioneer in the development and use of immunotherapy - the fourth modality in cancer treatment. His primary mission has been to improve the outcomes for his patients with cancer and blood disorders. Dr. Oldham attended the University of Missouri where his undergraduate studies were in chemical engineering and pre-medical sciences. He completed his internship and residency in Internal Medicine at Vanderbilt in Nashville. He continued his education with a Medical Oncology Fellowship and graduate studies in immunology at the National Cancer Institute (NCI) in Bethesda, Maryland where he served as Clinical Associate in the Radiation Branch and in the Cellular and Tumor Immunology Section of the Laboratory of Cell Biology. Dr. Oldham also completed a fellowship in Paris, France with Professor Georges Mathé, a distinguished bone marrow transplant hematologist. Extremely active in both research and leadership in cancer treatment, Dr. Oldham has served in multiple roles as a professor and research associate all around the globe. As a founder of multiple oncology divisions and organizations including the Biological Therapy Institute and Bio-therapeutics Incorporated, the Division of Oncology

Michael Yacoub, MD, Now Seeing Patients at the Halifax Health | UF Health – Medical Center of Deltona Board-certified vascular surgeon, Michael Yacoub, MD, is now seeing patients at the Halifax Health | UF Health – Medical Center of Deltona. This state of the art facility is located in the Medical Office Annex, 3300 Halifax Crossing Blvd., Deltona, FL 32725, and is ready to provide treatment for a variety of vascular needs. The team offers outpatient services and full surgical and procedural capabilities. Once you receive a referral from your primary care physician you can book an appointment with Dr. Yacoub by calling 386.457.6384. Michael Yacoub, MD, FACS attended Ross University School of Medicine and completed his residency at St. John Hospital and Medical Center in Detroit, MI. His professional interests include open and endovascular treatment of aortic aneurysms and aortic dissection, minimally invasive treatment of thoracoabdominal aneurysms using fenestrated-branched endografts and open treatment of mesenteric occlusive disease.

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